1.1 	A bill for an act
1.2 	relating to human services finance and policy; appropriating money for human 
1.3 	services and health-related programs; modifying various provisions governing 
1.4 	community supports, housing, continuing care, health care, managed care 
1.5 	organizations, health insurance, direct care and treatment, children and families, 
1.6 	chemical and mental health services, Department of Human Services operations, 
1.7 	Department of Health policy, and health licensing boards; establishing a license 
1.8 	for substance abuse disorder treatment; authorizing transfers; providing for 
1.9 	supplemental rates; modifying reimbursement rates and premium scales; making 
1.10 	forecast adjustments; providing for audits; establishing crumb rubber playground 
1.11 	moratorium; authorizing pilot projects and studies; requiring reports; establishing 
1.12 	a legislative commission; making technical and terminology changes;amending 
1.13 	Minnesota Statutes 2016, sections 3.972, by adding a subdivision; 13.32, by adding 
1.14 	a subdivision; 13.46, subdivisions 1, 2, 4; 13.69, subdivision 1; 13.84, subdivision 
1.15 	5; 62A.04, subdivision 1; 62A.21, subdivision 2a; 62A.3075; 62D.105, subdivisions 
1.16 	1, 2; 62E.04, subdivision 11; 62E.05, subdivision 1; 62E.06, by adding a 
1.17 	subdivision; 62M.07; 62U.02; 62V.05, subdivision 12; 103I.101, subdivisions 2, 
1.18 	5; 103I.111, subdivisions 6, 7, 8; 103I.205; 103I.301; 103I.501; 103I.505; 103I.515; 
1.19 	103I.535, subdivisions 3, 6, by adding a subdivision; 103I.541; 103I.545, 
1.20 	subdivisions 1, 2; 103I.711, subdivision 1; 103I.715, subdivision 2; 119B.011, by 
1.21 	adding subdivisions; 119B.02, subdivision 5; 119B.09, subdivision 9a; 119B.125, 
1.22 	subdivisions 4, 6; 119B.13, subdivisions 1, 6; 119B.16, subdivisions 1, 1a, 1b, by 
1.23 	adding subdivisions; 144.05, subdivision 6; 144.0724, subdivisions 4, 6; 144.122; 
1.24 	144.1501, subdivision 2; 144.551, subdivision 1; 144A.071, subdivision 4d; 
1.25 	144A.351; 144A.472, subdivision 7; 144A.474, subdivision 11; 144A.4799, 
1.26 	subdivision 3; 144A.70, subdivision 6, by adding a subdivision; 144D.04, 
1.27 	subdivision 2, by adding a subdivision; 144D.06; 145.4716, subdivision 2; 145.986, 
1.28 	subdivision 1a; 146B.02, subdivisions 2, 5, 8, by adding subdivisions; 146B.03, 
1.29 	subdivisions 6, 7; 146B.07, subdivision 4; 146B.10, subdivision 1; 147.01, 
1.30 	subdivision 7; 147.02, subdivision 1; 147.03, subdivision 1; 147B.08, by adding 
1.31 	a subdivision; 147C.40, by adding a subdivision; 148.5194, subdivision 7; 148.6402, 
1.32 	subdivision 4; 148.6405; 148.6408, subdivision 2; 148.6410, subdivision 2; 
1.33 	148.6412, subdivision 2; 148.6415; 148.6418, subdivisions 1, 2, 4, 5; 148.6420, 
1.34 	subdivisions 1, 3, 5; 148.6423; 148.6425, subdivisions 2, 3; 148.6428; 148.6443, 
1.35 	subdivisions 5, 6, 7, 8; 148.6445, subdivisions 1, 10; 148.6448; 157.16, subdivision 
1.36 	1; 214.01, subdivision 2; 245.4889, subdivision 1; 245.91, subdivisions 4, 6; 
1.37 	245.97, subdivision 6; 245A.02, subdivision 2b, by adding a subdivision; 245A.03, 
1.38 	subdivisions 2, 7; 245A.04, subdivision 14; 245A.06, subdivision 2; 245A.07, 
1.39 	subdivision 3; 245A.11, by adding subdivisions; 245A.191; 245A.50, subdivision 
2.1 	5; 245D.03, subdivision 1; 245D.04, subdivision 3; 245D.071, subdivision 3; 
2.2 	245D.11, subdivision 4; 245D.24, subdivision 3; 245E.01, by adding a subdivision; 
2.3 	245E.02, subdivisions 1, 3, 4; 245E.03, subdivisions 2, 4; 245E.04; 245E.05, 
2.4 	subdivision 1; 245E.06, subdivisions 1, 2, 3; 245E.07, subdivision 1; 252.27, 
2.5 	subdivision 2a; 252.41, subdivision 3; 253B.10, subdivision 1; 253B.22, subdivision 
2.6 	1; 254A.01; 254A.02, subdivisions 2, 3, 5, 6, 8, 10, by adding subdivisions; 
2.7 	254A.03; 254A.035, subdivision 1; 254A.04; 254A.08; 254A.09; 254A.19, 
2.8 	subdivision 3; 254B.01, subdivision 3, by adding a subdivision; 254B.03, 
2.9 	subdivision 2; 254B.04, subdivisions 1, 2b; 254B.05, subdivisions 1, 1a, 5; 
2.10 	254B.051; 254B.07; 254B.08; 254B.09; 254B.12, subdivision 2; 254B.13, 
2.11 	subdivision 2a; 256.01, subdivision 41, by adding a subdivision; 256.045, 
2.12 	subdivision 3; 256.969, subdivisions 2b, 4b, by adding a subdivision; 256.975, 
2.13 	subdivision 7, by adding a subdivision; 256.98, subdivision 8; 256B.04, 
2.14 	subdivisions 21, 22; 256B.056, subdivision 5c; 256B.0621, subdivision 10; 
2.15 	256B.0625, subdivisions 3b, 7, 20, 45a, 57, 64, by adding subdivisions; 256B.0659, 
2.16 	subdivisions 1, 2, 11, 21, by adding a subdivision; 256B.072; 256B.0755, 
2.17 	subdivisions 1, 3, 4, by adding a subdivision; 256B.0911, subdivisions 1a, 3a, 4d, 
2.18 	by adding subdivisions; 256B.0915, subdivisions 1, 1a, 3a, 3e, 3h, 5, by adding 
2.19 	subdivisions; 256B.092, subdivision 4; 256B.0922, subdivision 1; 256B.0924, by 
2.20 	adding a subdivision; 256B.0943, subdivision 13; 256B.0945, subdivisions 2, 4; 
2.21 	256B.196, subdivision 2; 256B.431, subdivisions 10, 16, 30; 256B.434, subdivisions 
2.22 	4, 4f; 256B.49, subdivisions 11, 15; 256B.4913, subdivision 4a, by adding a 
2.23 	subdivision; 256B.4914, subdivisions 2, 3, 5, 6, 7, 8, 9, 10, 16; 256B.493, 
2.24 	subdivisions 1, 2, by adding a subdivision; 256B.50, subdivision 1b; 256B.5012, 
2.25 	by adding a subdivision; 256B.69, subdivision 9e; 256B.76, subdivisions 1, 2; 
2.26 	256B.766; 256B.85, subdivisions 3, 5, 6; 256C.23, subdivision 2, by adding 
2.27 	subdivisions; 256C.233, subdivisions 1, 2; 256C.24, subdivisions 1, 2, by adding 
2.28 	a subdivision; 256C.261; 256D.44, subdivisions 4, 5; 256E.30, subdivision 2; 
2.29 	256I.03, subdivision 8; 256I.04, subdivisions 1, 2d, 2g, 3; 256I.05, subdivisions 
2.30 	1a, 1c, 1e, 1j, 1m, 8, by adding subdivisions; 256I.06, subdivisions 2, 8; 256J.24, 
2.31 	subdivision 5; 256J.45, subdivision 2; 256L.03, subdivisions 1, 1a, 5; 256L.15, 
2.32 	subdivision 2; 256P.06, subdivision 2; 256R.02, subdivisions 4, 18; 256R.07, by 
2.33 	adding a subdivision; 256R.10, by adding a subdivision; 256R.37; 256R.40, 
2.34 	subdivision 5; 256R.41; 256R.47; 256R.49, subdivision 1; 260C.451, subdivision 
2.35 	6; 317A.811, subdivision 1, by adding a subdivision; 327.15, subdivision 3; 
2.36 	609.5315, subdivision 5c; 626.556, subdivisions 2, 3, 3c, 10d, 10j; Laws 2009, 
2.37 	chapter 101, article 1, section 12; Laws 2012, chapter 247, article 6, section 2, 
2.38 	subdivision 2; Laws 2013, chapter 108, article 15, section 2, subdivision 2; Laws 
2.39 	2014, chapter 312, article 23, section 9, subdivision 8, by adding a subdivision; 
2.40 	Laws 2015, chapter 71, article 14, section 3, subdivision 2, as amended; Laws 
2.41 	2017, chapter 2, article 1, sections 1, subdivision 3; 2, subdivision 4, by adding a 
2.42 	subdivision; 3; 5; 7; article 2, section 13; proposing coding for new law in 
2.43 	Minnesota Statutes, chapters 62J; 62K; 62Q; 119B; 144; 144D; 145; 147A; 148; 
2.44 	245; 245A; 256; 256B; 256I; 256N; 256R; 317A; 448; proposing coding for new 
2.45 	law as Minnesota Statutes, chapters 144H; 245G; repealing Minnesota Statutes 
2.46 	2016, sections 13.468; 147A.21; 147B.08, subdivisions 1, 2, 3; 147C.40, 
2.47 	subdivisions 1, 2, 3, 4; 148.6402, subdivision 2; 148.6450; 245A.1915; 245A.192; 
2.48 	254A.02, subdivision 4; 256B.0659, subdivision 22; 256B.19, subdivision 1c; 
2.49 	256B.4914, subdivision 16; 256B.64; 256C.23, subdivision 3; 256C.233, 
2.50 	subdivision 4; 256C.25, subdivisions 1, 2; 256J.626, subdivision 5; Laws 2014, 
2.51 	chapter 312, article 23, section 9, subdivision 5; Minnesota Rules, parts 5600.2500; 
2.52 	9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 12, 13, 14, 14a, 15, 15a, 
2.53 	16, 17, 17a, 17b, 17c, 18, 20, 21; 9530.6410; 9530.6415; 9530.6420; 9530.6422; 
2.54 	9530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445; 9530.6450; 9530.6455; 
2.55 	9530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480; 9530.6485; 9530.6490; 
2.56 	9530.6495; 9530.6500; 9530.6505.
2.57 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.1 	ARTICLE 1
3.2 	COMMUNITY SUPPORTS

3.3 	Section 1. Minnesota Statutes 2016, section 144A.351, is amended to read:
3.4 	144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS: 
3.5 	REPORT AND STUDY REQUIRED.
3.6 		Subdivision 1.Report requirements. The commissioners of health and human services, 
3.7 	with the cooperation of counties and in consultation with stakeholders, including persons 
3.8 	who need or are using long-term care services and supports, lead agencies, regional entities, 
3.9 	senior, disability, and mental health organization representatives, service providers, and 
3.10 	community members shall prepare a report to the legislature by August 15, 2013, and 
3.11 	biennially thereafter, regarding the status of the full range of long-term care services and 
3.12 	supports for the elderly and children and adults with disabilities and mental illnesses in 
3.13 	Minnesota. Any amounts appropriated for this report are available in either year of the 
3.14 	biennium. The report shall address:
3.15 	(1) demographics and need for long-term care services and supports in Minnesota;
3.16 	(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances, 
3.17 	and corrective action plans;
3.18 	(3) status of long-term care services and related mental health services, housing options, 
3.19 	and supports by county and region including:
3.20 	(i) changes in availability of the range of long-term care services and housing options;
3.21 	(ii) access problems, including access to the least restrictive and most integrated services 
3.22 	and settings, regarding long-term care services; and
3.23 	(iii) comparative measures of long-term care services availability, including serving 
3.24 	people in their home areas near family, and changes over time; and
3.25 	(4) recommendations regarding goals for the future of long-term care services and 
3.26 	supports, policy and fiscal changes, and resource development and transition needs.
3.27 		Subd. 2.Critical access study. The commissioner of human services shall conduct a 
3.28 	onetime study to assess local capacity and availability of home and community-based 
3.29 	services for older adults, people with disabilities, and people with mental illnesses. The 
3.30 	study must assess critical access at the community level and identify potential strategies to 
3.31 	build home and community-based service capacity in critical access areas. The report shall 
3.32 	be submitted to the legislature no later than August 15, 2015.

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

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

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

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

7.10 	Sec. 4. [256.477] SELF-ADVOCACY GRANTS.
7.11 	(a) The commissioner shall make available a grant for the purposes of establishing and 
7.12 	maintaining a statewide self-advocacy network for persons with intellectual and 
7.13 	developmental disabilities. The self-advocacy network shall:
7.14 	(1) ensure that persons with intellectual and developmental disabilities are informed of 
7.15 	their rights in employment, housing, transportation, voting, government policy, and other 
7.16 	issues pertinent to the intellectual and developmental disability community;
7.17 	(2) provide public education and awareness of the civil and human rights issues persons 
7.18 	with intellectual and developmental disabilities face;
7.19 	(3) provide funds, technical assistance, and other resources for self-advocacy groups 
7.20 	across the state; and
7.21 	(4) organize systems of communications to facilitate an exchange of information between 
7.22 	self-advocacy groups.
7.23 	(b) An organization receiving a grant under paragraph (a) must be an organization 
7.24 	governed by people with intellectual and developmental disabilities that administers a 
7.25 	statewide network of disability groups in order to maintain and promote self-advocacy 
7.26 	services and supports for persons with intellectual and developmental disabilities throughout 
7.27 	the state.
7.28 	(c) An organization receiving a grant under paragraph (a) must use the funds for the 
7.29 	following purposes:
7.30 	(1) to maintain the infrastructure needed to train and support the activities of a statewide 
7.31 	network of peer-to-peer mentors for people with developmental disabilities, focused on 
7.32 	building awareness of service options and advocacy skills necessary to move toward full 
8.1 	inclusion in community life, including the development and delivery of the curriculum to 
8.2 	support the peer-to-peer network;
8.3 	(2) to provide outreach activities, including statewide conferences and disability 
8.4 	networking opportunities focused on self-advocacy, informed choice, and community 
8.5 	engagement skills;
8.6 	(3) to provide an annual leadership program for persons with intellectual and 
8.7 	developmental disabilities; and
8.8 	(4) to provide for administrative and general operating costs associated with managing 
8.9 	and maintaining facilities, program delivery, evaluation, staff, and technology.

8.10 	Sec. 5. Minnesota Statutes 2016, section 256B.0659, subdivision 1, is amended to read:
8.11 		Subdivision 1.Definitions. (a) For the purposes of this section, the terms defined in 
8.12 	paragraphs (b) to (r) (s) have the meanings given unless otherwise provided in text.
8.13 	(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility, 
8.14 	positioning, eating, and toileting.
8.15 	(c) "Behavior," effective January 1, 2010, means a category to determine the home care 
8.16 	rating and is based on the criteria found in this section. "Level I behavior" means physical 
8.17 	aggression towards self, others, or destruction of property that requires the immediate 
8.18 	response of another person.
8.19 	(d) "Complex health-related needs," effective January 1, 2010, means a category to 
8.20 	determine the home care rating and is based on the criteria found in this section.
8.21 	(e) "Complex personal care assistance services" means personal care assistance services:
8.22 	(1) for a person who qualifies for ten hours or more of personal care assistance services 
8.23 	per day; and
8.24 	(2) provided by a personal care assistant who is qualified to provide complex personal 
8.25 	assistance services under subdivision 11, paragraph (d).
8.26 	(e) (f) "Critical activities of daily living," effective January 1, 2010, means transferring, 
8.27 	mobility, eating, and toileting.
8.28 	(f) (g) "Dependency in activities of daily living" means a person requires assistance to 
8.29 	begin and complete one or more of the activities of daily living.
8.30 	(g) (h) "Extended personal care assistance service" means personal care assistance 
8.31 	services included in a service plan under one of the home and community-based services 
9.1 	waivers authorized under sections 256B.0915, 256B.092, subdivision 5, and 256B.49, which 
9.2 	exceed the amount, duration, and frequency of the state plan personal care assistance services 
9.3 	for participants who:
9.4 	(1) need assistance provided periodically during a week, but less than daily will not be 
9.5 	able to remain in their homes without the assistance, and other replacement services are 
9.6 	more expensive or are not available when personal care assistance services are to be reduced; 
9.7 	or
9.8 	(2) need additional personal care assistance services beyond the amount authorized by 
9.9 	the state plan personal care assistance assessment in order to ensure that their safety, health, 
9.10 	and welfare are provided for in their homes.
9.11 	(h) (i) "Health-related procedures and tasks" means procedures and tasks that can be 
9.12 	delegated or assigned by a licensed health care professional under state law to be performed 
9.13 	by a personal care assistant.
9.14 	(i) (j) "Instrumental activities of daily living" means activities to include meal planning 
9.15 	and preparation; basic assistance with paying bills; shopping for food, clothing, and other 
9.16 	essential items; performing household tasks integral to the personal care assistance services; 
9.17 	communication by telephone and other media; and traveling, including to medical 
9.18 	appointments and to participate in the community.
9.19 	(j) (k) "Managing employee" has the same definition as Code of Federal Regulations, 
9.20 	title 42, section 455.
9.21 	(k) (l) "Qualified professional" means a professional providing supervision of personal 
9.22 	care assistance services and staff as defined in section 256B.0625, subdivision 19c.
9.23 	(l) (m) "Personal care assistance provider agency" means a medical assistance enrolled 
9.24 	provider that provides or assists with providing personal care assistance services and includes 
9.25 	a personal care assistance provider organization, personal care assistance choice agency, 
9.26 	class A licensed nursing agency, and Medicare-certified home health agency.
9.27 	(m) (n) "Personal care assistant" or "PCA" means an individual employed by a personal 
9.28 	care assistance agency who provides personal care assistance services.
9.29 	(n) (o) "Personal care assistance care plan" means a written description of personal care 
9.30 	assistance services developed by the personal care assistance provider according to the 
9.31 	service plan.
9.32 	(o) (p) "Responsible party" means an individual who is capable of providing the support 
9.33 	necessary to assist the recipient to live in the community.
10.1 	(p) (q) "Self-administered medication" means medication taken orally, by injection, 
10.2 	nebulizer, or insertion, or applied topically without the need for assistance.
10.3 	(q) (r) "Service plan" means a written summary of the assessment and description of the 
10.4 	services needed by the recipient.
10.5 	(r) (s) "Wages and benefits" means wages and salaries, the employer's share of FICA 
10.6 	taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage 
10.7 	reimbursement, health and dental insurance, life insurance, disability insurance, long-term 
10.8 	care insurance, uniform allowance, and contributions to employee retirement accounts.

10.9 	EFFECTIVE DATE. This section is effective July 1, 2018.

10.10 	Sec. 6. Minnesota Statutes 2016, section 256B.0659, subdivision 2, is amended to read:
10.11 		Subd. 2.Personal care assistance services; covered services. (a) The personal care 
10.12 	assistance services eligible for payment include services and supports furnished to an 
10.13 	individual, as needed, to assist in:
10.14 	(1) activities of daily living;
10.15 	(2) health-related procedures and tasks;
10.16 	(3) observation and redirection of behaviors; and
10.17 	(4) instrumental activities of daily living.
10.18 	(b) Activities of daily living include the following covered services:
10.19 	(1) dressing, including assistance with choosing, application, and changing of clothing 
10.20 	and application of special appliances, wraps, or clothing;
10.21 	(2) grooming, including assistance with basic hair care, oral care, shaving, applying 
10.22 	cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included, 
10.23 	except for recipients who are diabetic or have poor circulation;
10.24 	(3) bathing, including assistance with basic personal hygiene and skin care;
10.25 	(4) eating, including assistance with hand washing and application of orthotics required 
10.26 	for eating, transfers, and feeding;
10.27 	(5) transfers, including assistance with transferring the recipient from one seating or 
10.28 	reclining area to another;
10.29 	(6) mobility, including assistance with ambulation, including use of a wheelchair. 
10.30 	Mobility does not include providing transportation for a recipient;
11.1 	(7) positioning, including assistance with positioning or turning a recipient for necessary 
11.2 	care and comfort; and
11.3 	(8) toileting, including assistance with helping recipient with bowel or bladder elimination 
11.4 	and care including transfers, mobility, positioning, feminine hygiene, use of toileting 
11.5 	equipment or supplies, cleansing the perineal area, inspection of the skin, and adjusting 
11.6 	clothing.
11.7 	(c) Health-related procedures and tasks include the following covered services:
11.8 	(1) range of motion and passive exercise to maintain a recipient's strength and muscle 
11.9 	functioning;
11.10 	(2) assistance with self-administered medication as defined by this section, including 
11.11 	reminders to take medication, bringing medication to the recipient, and assistance with 
11.12 	opening medication under the direction of the recipient or responsible party, including 
11.13 	medications given through a nebulizer;
11.14 	(3) interventions for seizure disorders, including monitoring and observation; and
11.15 	(4) other activities considered within the scope of the personal care service and meeting 
11.16 	the definition of health-related procedures and tasks under this section.
11.17 	(d) A personal care assistant may provide health-related procedures and tasks associated 
11.18 	with the complex health-related needs of a recipient if the procedures and tasks meet the 
11.19 	definition of health-related procedures and tasks under this section and the personal care 
11.20 	assistant is trained by a qualified professional and demonstrates competency to safely 
11.21 	complete the procedures and tasks. Delegation of health-related procedures and tasks and 
11.22 	all training must be documented in the personal care assistance care plan and the recipient's 
11.23 	and personal care assistant's files. A personal care assistant must not determine the medication 
11.24 	dose or time for medication.
11.25 	(e) Effective January 1, 2010, for a personal care assistant to provide the health-related 
11.26 	procedures and tasks of tracheostomy suctioning and services to recipients on ventilator 
11.27 	support there must be:
11.28 	(1) delegation and training by a registered nurse, certified or licensed respiratory therapist, 
11.29 	or a physician;
11.30 	(2) utilization of clean rather than sterile procedure;
11.31 	(3) specialized training about the health-related procedures and tasks and equipment, 
11.32 	including ventilator operation and maintenance;
12.1 	(4) individualized training regarding the needs of the recipient; and
12.2 	(5) supervision by a qualified professional who is a registered nurse.
12.3 	(f) Effective January 1, 2010, a personal care assistant may observe and redirect the 
12.4 	recipient for episodes where there is a need for redirection due to behaviors. Training of 
12.5 	the personal care assistant must occur based on the needs of the recipient, the personal care 
12.6 	assistance care plan, and any other support services provided.
12.7 	(g) Instrumental activities of daily living under subdivision 1, paragraph (i) (j).

12.8 	EFFECTIVE DATE. This section is effective July 1, 2018.

12.9 	Sec. 7. Minnesota Statutes 2016, section 256B.0659, subdivision 11, is amended to read:
12.10 		Subd. 11.Personal care assistant; requirements. (a) A personal care assistant must 
12.11 	meet the following requirements:
12.12 	(1) be at least 18 years of age with the exception of persons who are 16 or 17 years of 
12.13 	age with these additional requirements:
12.14 	(i) supervision by a qualified professional every 60 days; and
12.15 	(ii) employment by only one personal care assistance provider agency responsible for 
12.16 	compliance with current labor laws;
12.17 	(2) be employed by a personal care assistance provider agency;
12.18 	(3) enroll with the department as a personal care assistant after clearing a background 
12.19 	study. Except as provided in subdivision 11a, before a personal care assistant provides 
12.20 	services, the personal care assistance provider agency must initiate a background study on 
12.21 	the personal care assistant under chapter 245C, and the personal care assistance provider 
12.22 	agency must have received a notice from the commissioner that the personal care assistant 
12.23 	is:
12.24 	(i) not disqualified under section 245C.14; or
12.25 	(ii) is disqualified, but the personal care assistant has received a set aside of the 
12.26 	disqualification under section 245C.22;
12.27 	(4) be able to effectively communicate with the recipient and personal care assistance 
12.28 	provider agency;
12.29 	(5) be able to provide covered personal care assistance services according to the recipient's 
12.30 	personal care assistance care plan, respond appropriately to recipient needs, and report 
12.31 	changes in the recipient's condition to the supervising qualified professional or physician;
13.1 	(6) not be a consumer of personal care assistance services;
13.2 	(7) maintain daily written records including, but not limited to, time sheets under 
13.3 	subdivision 12;
13.4 	(8) effective January 1, 2010, complete standardized training as determined by the 
13.5 	commissioner before completing enrollment. The training must be available in languages 
13.6 	other than English and to those who need accommodations due to disabilities. Personal care 
13.7 	assistant training must include successful completion of the following training components: 
13.8 	basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic 
13.9 	roles and responsibilities of personal care assistants including information about assistance 
13.10 	with lifting and transfers for recipients, emergency preparedness, orientation to positive 
13.11 	behavioral practices, fraud issues, and completion of time sheets. Upon completion of the 
13.12 	training components, the personal care assistant must demonstrate the competency to provide 
13.13 	assistance to recipients;
13.14 	(9) complete training and orientation on the needs of the recipient; and
13.15 	(10) be limited to providing and being paid for up to 275 hours per month of personal 
13.16 	care assistance services regardless of the number of recipients being served or the number 
13.17 	of personal care assistance provider agencies enrolled with. The number of hours worked 
13.18 	per day shall not be disallowed by the department unless in violation of the law.
13.19 	(b) A legal guardian may be a personal care assistant if the guardian is not being paid 
13.20 	for the guardian services and meets the criteria for personal care assistants in paragraph (a).
13.21 	(c) Persons who do not qualify as a personal care assistant include parents, stepparents, 
13.22 	and legal guardians of minors; spouses; paid legal guardians of adults; family foster care 
13.23 	providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of 
13.24 	a residential setting.
13.25 	(d) A personal care assistant is qualified to provide complex personal care assistance 
13.26 	services defined in subdivision 1, paragraph (e), if the personal care assistant:
13.27 	(1) provides services according to the care plan in subdivision 7 to an individual described 
13.28 	in subdivision 1, paragraph (e), clause (1); and
13.29 	(2) beginning July 1, 2018, satisfies the current requirements of Medicare for training 
13.30 	and competency or competency evaluation of home health aides or nursing assistants, as 
13.31 	provided by Code of Federal Regulations, title 42, section 483.151 or 484.36, or alternative, 
13.32 	comparable, state-approved training and competency requirements.

13.33 	EFFECTIVE DATE. This section is effective July 1, 2018.

14.1 	Sec. 8. Minnesota Statutes 2016, section 256B.0659, is amended by adding a subdivision 
14.2 	to read:
14.3 		Subd. 17a.Rate for complex personal care assistance services. The rate paid to a 
14.4 	provider for complex personal care assistance services shall be 110 percent of the rate paid 
14.5 	for personal care assistance services.

14.6 	EFFECTIVE DATE. This section is effective July 1, 2018.

14.7 	Sec. 9. Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:
14.8 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
14.9 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
14.10 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
14.11 	a format determined by the commissioner, information and documentation that includes, 
14.12 	but is not limited to, the following:
14.13 	(1) the personal care assistance provider agency's current contact information including 
14.14 	address, telephone number, and e-mail address;
14.15 	(2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid 
14.16 	revenue in the previous calendar year is up to and including $300,000, the provider agency 
14.17 	must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is 
14.18 	over $300,000, the provider agency must purchase a surety bond of $100,000. The surety 
14.19 	bond must be in a form approved by the commissioner, must be renewed annually, and must 
14.20 	allow for recovery of costs and fees in pursuing a claim on the bond;
14.21 	(3) proof of fidelity bond coverage in the amount of $20,000;
14.22 	(4) proof of workers' compensation insurance coverage;
14.23 	(5) proof of liability insurance;
14.24 	(6) a description of the personal care assistance provider agency's organization identifying 
14.25 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
14.26 	of the directors, owners, or staff to other service providers;
14.27 	(7) a copy of the personal care assistance provider agency's written policies and 
14.28 	procedures including: hiring of employees; training requirements; service delivery; and 
14.29 	employee and consumer safety including process for notification and resolution of consumer 
14.30 	grievances, identification and prevention of communicable diseases, and employee 
14.31 	misconduct;
15.1 	(8) copies of all other forms the personal care assistance provider agency uses in the 
15.2 	course of daily business including, but not limited to:
15.3 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
15.4 	varies from the standard time sheet for personal care assistance services approved by the 
15.5 	commissioner, and a letter requesting approval of the personal care assistance provider 
15.6 	agency's nonstandard time sheet;
15.7 	(ii) the personal care assistance provider agency's template for the personal care assistance 
15.8 	care plan; and
15.9 	(iii) the personal care assistance provider agency's template for the written agreement 
15.10 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
15.11 	(9) a list of all training and classes that the personal care assistance provider agency 
15.12 	requires of its staff providing personal care assistance services;
15.13 	(10) documentation that the personal care assistance provider agency and staff have 
15.14 	successfully completed all the training required by this section, including the requirements 
15.15 	under subdivision 11, paragraph (d), if complex personal care assistance services are provided 
15.16 	and submitted for payment;
15.17 	(11) documentation of the agency's marketing practices;
15.18 	(12) disclosure of ownership, leasing, or management of all residential properties that 
15.19 	is used or could be used for providing home care services;
15.20 	(13) documentation that the agency will use the following percentages of revenue 
15.21 	generated from the medical assistance rate paid for personal care assistance services for 
15.22 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
15.23 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
15.24 	providers. The revenue generated by the qualified professional and the reasonable costs 
15.25 	associated with the qualified professional shall not be used in making this calculation; and
15.26 	(14) effective May 15, 2010, documentation that the agency does not burden recipients' 
15.27 	free exercise of their right to choose service providers by requiring personal care assistants 
15.28 	to sign an agreement not to work with any particular personal care assistance recipient or 
15.29 	for another personal care assistance provider agency after leaving the agency and that the 
15.30 	agency is not taking action on any such agreements or requirements regardless of the date 
15.31 	signed.
15.32 	(b) Personal care assistance provider agencies shall provide the information specified 
15.33 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
16.1 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
16.2 	the information specified in paragraph (a) from all personal care assistance providers 
16.3 	beginning July 1, 2009.
16.4 	(c) All personal care assistance provider agencies shall require all employees in 
16.5 	management and supervisory positions and owners of the agency who are active in the 
16.6 	day-to-day management and operations of the agency to complete mandatory training as 
16.7 	determined by the commissioner before enrollment of the agency as a provider. Employees 
16.8 	in management and supervisory positions and owners who are active in the day-to-day 
16.9 	operations of an agency who have completed the required training as an employee with a 
16.10 	personal care assistance provider agency do not need to repeat the required training if they 
16.11 	are hired by another agency, if they have completed the training within the past three years. 
16.12 	By September 1, 2010, the required training must be available with meaningful access 
16.13 	according to title VI of the Civil Rights Act and federal regulations adopted under that law 
16.14 	or any guidance from the United States Health and Human Services Department. The 
16.15 	required training must be available online or by electronic remote connection. The required 
16.16 	training must provide for competency testing. Personal care assistance provider agency 
16.17 	billing staff shall complete training about personal care assistance program financial 
16.18 	management. This training is effective July 1, 2009. Any personal care assistance provider 
16.19 	agency enrolled before that date shall, if it has not already, complete the provider training 
16.20 	within 18 months of July 1, 2009. Any new owners or employees in management and 
16.21 	supervisory positions involved in the day-to-day operations are required to complete 
16.22 	mandatory training as a requisite of working for the agency. Personal care assistance provider 
16.23 	agencies certified for participation in Medicare as home health agencies are exempt from 
16.24 	the training required in this subdivision. When available, Medicare-certified home health 
16.25 	agency owners, supervisors, or managers must successfully complete the competency test.

16.26 	Sec. 10. Minnesota Statutes 2016, section 256B.0911, subdivision 1a, is amended to read:
16.27 		Subd. 1a.Definitions. For purposes of this section, the following definitions apply:
16.28 	(a) Until additional requirements apply under paragraph (b), "long-term care consultation 
16.29 	services" means:
16.30 	(1) intake for and access to assistance in identifying services needed to maintain an 
16.31 	individual in the most inclusive environment;
16.32 	(2) providing recommendations for and referrals to cost-effective community services 
16.33 	that are available to the individual;
17.1 	(3) development of an individual's person-centered community support plan;
17.2 	(4) providing information regarding eligibility for Minnesota health care programs;
17.3 	(5) face-to-face long-term care consultation assessments, which may be completed in a 
17.4 	hospital, nursing facility, intermediate care facility for persons with developmental disabilities 
17.5 	(ICF/DDs), regional treatment centers, or the person's current or planned residence;
17.6 	(6) determination of home and community-based waiver and other service eligibility as 
17.7 	required under sections 256B.0913, 256B.0915, and 256B.49, including level of care 
17.8 	determination for individuals who need an institutional level of care as determined under 
17.9 	subdivision 4e, based on assessment and community support plan development, appropriate 
17.10 	referrals to obtain necessary diagnostic information, and including an eligibility determination 
17.11 	for consumer-directed community supports;
17.12 	(7) providing recommendations for institutional placement when there are no 
17.13 	cost-effective community services available;
17.14 	(8) providing access to assistance to transition people back to community settings after 
17.15 	institutional admission; and
17.16 	(9) providing information about competitive employment, with or without supports, for 
17.17 	school-age youth and working-age adults and referrals to the Disability Linkage Line and 
17.18 	Disability Benefits 101 to ensure that an informed choice about competitive employment 
17.19 	can be made. For the purposes of this subdivision, "competitive employment" means work 
17.20 	in the competitive labor market that is performed on a full-time or part-time basis in an 
17.21 	integrated setting, and for which an individual is compensated at or above the minimum 
17.22 	wage, but not less than the customary wage and level of benefits paid by the employer for 
17.23 	the same or similar work performed by individuals without disabilities.
17.24 	(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c, 
17.25 	and 3a, "long-term care consultation services" also means:
17.26 	(1) service eligibility determination for state plan home care services identified in:
17.27 	(i) section 256B.0625, subdivisions 7, 19a, and 19c;
17.28 	(ii) consumer support grants under section 256.476; or
17.29 	(iii) section 256B.85;
17.30 	(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024, 
17.31 	determination of eligibility for case management services available under sections 256B.0621, 
17.32 	subdivision 2, paragraph (4), and 256B.0924 and Minnesota Rules, part 9525.0016;
18.1 	(3) determination of institutional level of care, home and community-based service 
18.2 	waiver, and other service eligibility as required under section 256B.092, determination of 
18.3 	eligibility for family support grants under section 252.32, semi-independent living services 
18.4 	under section 252.275, and day training and habilitation services under section 256B.092; 
18.5 	and
18.6 	(4) obtaining necessary diagnostic information to determine eligibility under clauses (2) 
18.7 	and (3).
18.8 	(c) "Long-term care options counseling" means the services provided by the linkage 
18.9 	lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also 
18.10 	includes telephone assistance and follow up once a long-term care consultation assessment 
18.11 	has been completed.
18.12 	(d) "Minnesota health care programs" means the medical assistance program under this 
18.13 	chapter and the alternative care program under section 256B.0913.
18.14 	(e) "Lead agencies" means counties administering or tribes and health plans under 
18.15 	contract with the commissioner to administer long-term care consultation assessment and 
18.16 	support planning services.
18.17 	(f) "Person-centered planning" includes the active participation of a person with a 
18.18 	disability in the person's services and program, including in making meaningful and informed 
18.19 	choices about the person's own goals and objectives, as well as making meaningful and 
18.20 	informed choices about the services the person receives. For the purposes of this paragraph, 
18.21 	"informed choice" means the process of the person with a disability choosing from all 
18.22 	available service options based on accurate and complete information concerning all available 
18.23 	service options and concerning the person's own preferences, abilities, goals, and objectives. 
18.24 	In order for a person to make an informed choice, all available options must be developed 
18.25 	and presented to the person by a partnership consisting of the person and the individuals 
18.26 	that will empower the consumer to make decisions.

18.27 	Sec. 11. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
18.28 		Subd. 3a.Initial assessment and support planning. (a) Persons requesting initial 
18.29 	assessment, initial services planning, or other assistance intended to support community-based 
18.30 	living, including persons who need assessment in order to determine initial waiver or 
18.31 	alternative care program eligibility, must be visited by a long-term care consultation team 
18.32 	within 20 calendar days after the date on which an initial assessment was requested or 
18.33 	recommended. Upon statewide implementation of subdivisions 2b, 2c, and 5, This 
19.1 	requirement also applies to an initial assessment of a person requesting personal care 
19.2 	assistance services and home care nursing. The commissioner shall provide at least a 90-day 
19.3 	notice to lead agencies prior to the effective date of this requirement. Face-to-face initial 
19.4 	assessments must be conducted according to paragraphs (b) to (i).
19.5 	(b) Upon implementation of subdivisions 2b, 2c, and 5, Lead agencies shall use certified 
19.6 	assessors to conduct the initial assessment. For a person with complex health care needs, a 
19.7 	public health or registered nurse from the team must be consulted.
19.8 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
19.9 	be used to complete a an initial comprehensive, person-centered assessment. The initial 
19.10 	assessment must include the health, psychological, functional, environmental, and social 
19.11 	needs of the individual necessary to develop a community support plan that meets the 
19.12 	individual's needs and preferences.
19.13 	(d) The initial assessment must be conducted in a face-to-face interview with the person 
19.14 	being assessed and the person's legal representative. At the request of the person, other 
19.15 	individuals may participate in the assessment to provide information on the needs, strengths, 
19.16 	and preferences of the person necessary to develop a community support plan that ensures 
19.17 	the person's health and safety. Except for legal representatives or family members invited 
19.18 	by the person, persons participating in the assessment may not be a provider of service or 
19.19 	have any financial interest in the provision of services. For persons who are to be initially
19.20 	assessed for elderly waiver customized living services under section 256B.0915, with the 
19.21 	permission of the person being assessed or the person's designated or legal representative, 
19.22 	the client's current or proposed provider of services may submit a copy of the provider's 
19.23 	nursing assessment or written report outlining its recommendations regarding the client's 
19.24 	care needs. The person conducting the assessment must notify the provider of the date by 
19.25 	which this information is to be submitted. This information shall be provided to the person 
19.26 	conducting the assessment prior to the assessment. For a person who is to be initially assessed 
19.27 	for waiver services under section 256B.092 or 256B.49, with the permission of the person 
19.28 	being assessed or the person's designated legal representative, the person's current provider 
19.29 	of services may submit a written report outlining recommendations regarding the person's 
19.30 	care needs prepared by a direct service employee with at least 20 hours of service to that 
19.31 	client. The person conducting the assessment or reassessment must notify the provider of 
19.32 	the date by which this information is to be submitted. This information shall be provided 
19.33 	to the person conducting the assessment and the person or the person's legal representative, 
19.34 	and must be considered prior to the finalization of the assessment or reassessment.
20.1 	(e) The person or the person's legal representative must be provided with a written 
20.2 	community support plan within 40 calendar days of the initial assessment visit, regardless 
20.3 	of whether the individual is eligible for Minnesota health care programs. The written 
20.4 	community support plan must include:
20.5 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
20.6 	(2) the individual's options and choices to meet identified needs, including all available 
20.7 	options for case management services and providers;
20.8 	(3) identification of health and safety risks and how those risks will be addressed, 
20.9 	including practical personal risk management strategies;
20.10 	(4) referral information; and
20.11 	(5) informal caregiver supports, if applicable.
20.12 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
20.13 	(b), clause (1), the person or person's representative must also receive a copy of the home 
20.14 	care service plan developed by the certified assessor.
20.15 	(f) A person may request assistance in identifying community supports without 
20.16 	participating in a complete assessment. Upon a request for assistance identifying community 
20.17 	support, the person must be transferred or referred to long-term care options counseling 
20.18 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
20.19 	telephone assistance and follow up.
20.20 	(g) The person has the right to make the final decision between institutional placement 
20.21 	and community placement after the recommendations have been provided, except as provided 
20.22 	in section 256.975, subdivision 7a, paragraph (d).
20.23 	(h) The lead agency must give the person receiving initial assessment or support planning, 
20.24 	or the person's legal representative, materials, and forms supplied by the commissioner 
20.25 	containing the following information:
20.26 	(1) written recommendations for community-based services and consumer-directed 
20.27 	options;
20.28 	(2) documentation that the most cost-effective alternatives available, including 
20.29 	independent living, were offered to the individual. For purposes of this clause, 
20.30 	"cost-effective" means community services and living arrangements that cost the same as 
20.31 	or less than institutional care or corporate foster care. For an individual found to meet 
20.32 	eligibility criteria for home and community-based service programs under section 256B.0915
21.1 	or 256B.49, "cost-effectiveness" has the meaning found in the federally approved waiver 
21.2 	plan for each program;
21.3 	(3) the need for and purpose of preadmission screening conducted by long-term care 
21.4 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
21.5 	nursing facility placement. If the individual selects nursing facility placement, the lead 
21.6 	agency shall forward information needed to complete the level of care determinations and 
21.7 	screening for developmental disability and mental illness collected during the assessment 
21.8 	to the long-term care options counselor using forms provided by the commissioner;
21.9 	(4) the role of long-term care consultation assessment and support planning in eligibility 
21.10 	determination for waiver and alternative care programs, and state plan home care, case 
21.11 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
21.12 	and (b);
21.13 	(5) information about Minnesota health care programs;
21.14 	(6) the person's freedom to accept or reject the recommendations of the team;
21.15 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
21.16 	Act, chapter 13;
21.17 	(8) the certified assessor's decision regarding the person's need for institutional level of 
21.18 	care as determined under criteria established in subdivision 4e, the certified assessor's 
21.19 	decision regarding the person's need for corporate foster care, and the certified assessor's 
21.20 	decision regarding the person's eligibility for all services and programs as defined in 
21.21 	subdivision 1a, paragraphs (a), clause (6), and (b); and
21.22 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
21.23 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
21.24 	(8), and (b), and incorporating the certified assessor's decision regarding the need for 
21.25 	institutional level of care, the certified assessor's decision regarding the need for corporate 
21.26 	foster care, or the lead agency's final decisions regarding public programs eligibility according 
21.27 	to section 256.045, subdivision 3.
21.28 	(i) Face-to-face assessment completed as part of an initial eligibility determination for 
21.29 	the alternative care, elderly waiver, community access for disability inclusion, community 
21.30 	alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915, 
21.31 	and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after 
21.32 	the date of assessment.
22.1 	(j) The effective eligibility start date for programs in paragraph (i) can never be prior to 
22.2 	the date of initial assessment. If an initial assessment was completed more than 60 days 
22.3 	before the effective waiver or alternative care program eligibility start date, assessment and 
22.4 	support plan information must be updated and documented in the department's Medicaid 
22.5 	Management Information System (MMIS). Notwithstanding retroactive medical assistance 
22.6 	coverage of state plan services, the effective date of eligibility for programs included in 
22.7 	paragraph (i) cannot be prior to the date the most recent updated initial assessment is 
22.8 	completed.

22.9 	Sec. 12. Minnesota Statutes 2016, section 256B.0911, is amended by adding a subdivision 
22.10 	to read:
22.11 		Subd. 3f.Service updates and modifications. (a) A service update may substitute for 
22.12 	an annual reassessment under this section and Minnesota Rules, part 9525.0016, whenever 
22.13 	permitted by federal law and either there is not a significant change in a person's condition 
22.14 	or there is not a change in the person's needs for services. Service updates must be completed 
22.15 	face-to-face annually unless completed by phone. A service update may be completed by 
22.16 	telephone only if the person is able to participate in the update by telephone and no more 
22.17 	than two consecutive service updates are completed by phone.
22.18 	(b) A service update must include a review of the most recent written community support 
22.19 	plan and home care plan, as well as a review of the initial baseline data, evaluation of service 
22.20 	effectiveness, modification of service plan and appropriate referrals, update of initial 
22.21 	assessment or most recent reassessment forms, obtaining service authorizations, and ongoing 
22.22 	consumer education.
22.23 	(c) To the extent permitted by federal law, a service modification may substitute for a 
22.24 	reassessment otherwise required under this chapter following a change in condition or a 
22.25 	change in eligibility.
22.26 	(d) A service update or service modification must be documented in a manner determined 
22.27 	by the commissioner.
22.28 	(e) If the person receiving services or the person's legal representative requests a 
22.29 	reassessment under subdivision 3g, a service update or service modification must not be 
22.30 	substituted for a reassessment.

23.1 	Sec. 13. Minnesota Statutes 2016, section 256B.0911, is amended by adding a subdivision 
23.2 	to read:
23.3 		Subd. 3g.Annual reassessments and other reassessments. (a) All reassessments must 
23.4 	be conducted according to subdivision 3a.
23.5 	(b) Any person who received an initial assessment under subdivision 3a and whose 
23.6 	continued eligibility for medical assistance services under federal law requires an annual 
23.7 	reassessment must be reassessed annually.
23.8 	(c) If an annual reassessment is not required under federal law for a person who received 
23.9 	an initial assessment under subdivision 3a, lead agencies are not required to perform an 
23.10 	annual reassessment unless the person or the person's legal representative requests an annual 
23.11 	reassessment or the person has experienced a significant change in condition.

23.12 	Sec. 14. Minnesota Statutes 2016, section 256B.0911, subdivision 4d, is amended to read:
23.13 		Subd. 4d.Preadmission screening of individuals under 65 years of age. (a) It is the 
23.14 	policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness 
23.15 	are served in the most integrated setting appropriate to their needs and have the necessary 
23.16 	information to make informed choices about home and community-based service options.
23.17 	(b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing 
23.18 	facility must be screened prior to admission according to the requirements outlined in section 
23.19 	256.975, subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as 
23.20 	required under section 256.975, subdivision 7.
23.21 	(c) Individuals under 65 years of age who are admitted to nursing facilities with only a 
23.22 	telephone screening must receive a face-to-face initial assessment from the long-term care 
23.23 	consultation team member of the county in which the facility is located or from the recipient's 
23.24 	county case manager within 40 calendar days of admission.
23.25 	(d) At the face-to-face initial assessment, the long-term care consultation team member 
23.26 	or county case manager must perform the activities required under subdivision 3b.
23.27 	(e) For individuals under 21 years of age, a screening interview which recommends 
23.28 	nursing facility admission must be face-to-face and approved by the commissioner before 
23.29 	the individual is admitted to the nursing facility.
23.30 	(f) In the event that an individual under 65 years of age is admitted to a nursing facility 
23.31 	on an emergency basis, the Senior LinkAge Line must be notified of the admission on the 
24.1 	next working day, and a face-to-face initial assessment as described in paragraph (c) must 
24.2 	be conducted within 40 calendar days of admission.
24.3 	(g) At the face-to-face initial assessment, the long-term care consultation team member 
24.4 	or the case manager must present information about home and community-based options, 
24.5 	including consumer-directed options, so the individual can make informed choices. If the 
24.6 	individual chooses home and community-based services, the long-term care consultation 
24.7 	team member or case manager must complete a written relocation plan within 20 working 
24.8 	days of the visit. The plan shall describe the services needed to move out of the facility and 
24.9 	a time line for the move which is designed to ensure a smooth transition to the individual's 
24.10 	home and community.
24.11 	(h) An individual under 65 years of age residing in a nursing facility whose condition 
24.12 	is likely to change shall receive a face-to-face assessmentreassessment under subdivision 
24.13 	3g at least every 12 months to review the person's service choices and available alternatives 
24.14 	unless the individual indicates, in writing, that annual visits are not desired. In this case, the 
24.15 	individual must receive a face-to-face assessment reassessment at least once every 36 months 
24.16 	for the same purposes.
24.17 	(i) An individual under 65 years of age residing in a nursing facility whose condition is 
24.18 	unlikely to change may, upon request, receive a face-to-face reassessment under subdivision 
24.19 	3g. An individual who does not request a reassessment under this paragraph must receive 
24.20 	an annual service update under subdivision 3f.
24.21 	(j) Notwithstanding the provisions of subdivision 6, the commissioner may pay county 
24.22 	agencies directly for face-to-face initial assessments or reassessments for individuals under 
24.23 	65 years of age who are being considered for placement or residing in a nursing facility.
24.24 	(j) (k)  Funding for preadmission screening follow-up shall be provided to the Disability 
24.25 	Linkage Line for the under-60 population by the Department of Human Services to cover 
24.26 	options counseling salaries and expenses to provide the services described in subdivisions 
24.27 	7a to 7c. The Disability Linkage Line shall employ, or contract with other agencies to 
24.28 	employ, within the limits of available funding, sufficient personnel to provide preadmission 
24.29 	screening follow-up services and shall seek to maximize federal funding for the service as 
24.30 	provided under section 256.01, subdivision 2, paragraph (dd).

24.31 	Sec. 15. Minnesota Statutes 2016, section 256B.0915, subdivision 1a, is amended to read:
24.32 		Subd. 1a.Elderly waiver case management services. (a) Except as provided to 
24.33 	individuals under prepaid medical assistance programs as described in paragraph (h), case 
25.1 	management services under the home and community-based services waiver for elderly 
25.2 	individuals are available from providers meeting qualification requirements and the standards 
25.3 	specified in subdivision 1b. Eligible recipients may choose any qualified provider of case 
25.4 	management services.
25.5 	(b) Case management services assist individuals who receive waiver services in gaining 
25.6 	access to needed waiver and other state plan services and assist individuals in appeals under 
25.7 	section 256.045, as well as needed medical, social, educational, and other services regardless 
25.8 	of the funding source for the services to which access is gained. Case managers shall 
25.9 	collaborate with consumers, families, legal representatives, and relevant medical experts 
25.10 	and service providers in the development and periodic review of the coordinated service 
25.11 	and support plan.
25.12 	(c) A case aide shall provide assistance to the case manager in carrying out administrative 
25.13 	activities of the case management function. The case aide may not assume responsibilities 
25.14 	that require professional judgment including assessments, reassessments, and care plan 
25.15 	development. The case manager is responsible for providing oversight of the case aide.
25.16 	(d) Case managers shall be responsible for ongoing monitoring of the provision of 
25.17 	services included in the individual's plan of care. Case managers shall initiate the process 
25.18 	of reassessment of the individual's coordinated service and support plan and review the plan 
25.19 	at intervals specified in the federally approved waiver plan.
25.20 	(e) The county of service or tribe must provide access to and arrange for case management 
25.21 	services. County of service has the meaning given it in Minnesota Rules, part 9505.0015, 
25.22 	subpart 11.
25.23 	(f) Except as described in paragraph (h), case management services must be provided 
25.24 	by a public or private agency that is enrolled as a medical assistance provider determined 
25.25 	by the commissioner to meet all of the requirements in subdivision 1b. Case management 
25.26 	services must not be provided to a recipient by a private agency that has a financial interest 
25.27 	in the provision of any other services included in the recipient's coordinated service and 
25.28 	support plan. For purposes of this section, "private agency" means any agency that is not 
25.29 	identified as a lead agency under section 256B.0911, subdivision 1a, paragraph (e).
25.30 	(g) Case management service activities provided to or arranged for a person include:
25.31 	(1) development of the coordinated service and support plan under subdivision 6;
25.32 	(2) informing the individual or the individual's legal guardian or conservator of service 
25.33 	options, and options for case management services and providers;
26.1 	(3) consulting with relevant medical experts or service providers;
26.2 	(4) assisting the person in the identification of potential providers;
26.3 	(5) assisting the person to access services;
26.4 	(6) coordination of services; and
26.5 	(7) evaluation and monitoring of the services identified in the plan, which must 
26.6 	incorporate at least one annualinclude a face-to-face visit by the case manager with each 
26.7 	person at the request of the individual or the individual's legal guardian or conservator of 
26.8 	service options.
26.9 	(h) Notwithstanding any requirements in this section, for individuals enrolled in prepaid 
26.10 	medical assistance programs under section 256B.69, subdivisions 6b and 23, the health plan 
26.11 	shall provide or arrange to provide elderly waiver case management services in paragraph 
26.12 	(g), in accordance with contract requirements established by the commissioner.

26.13 	Sec. 16. Minnesota Statutes 2016, section 256B.0915, subdivision 5, is amended to read:
26.14 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client shall 
26.15 	receive an initial assessment of strengths, informal supports, and need for services in 
26.16 	accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a client 
26.17 	served under the elderly waiver must be conducted at least every 12 months and at other 
26.18 	timesaccording to section 256B.0911, subdivision 3g, when the case manager determines 
26.19 	that there has been significant change in the client's functioning or at the request of the client 
26.20 	or the client's legal guardian or conservator of service options. This may include instances 
26.21 	where the client is discharged from the hospital. There must be a determination that the 
26.22 	client requires nursing facility level of care as defined in section 256B.0911, subdivision 
26.23 	4e, at an initial assessment under section 256B.0911, subdivision 3a, and any subsequent 
26.24 	assessments reassessments under section 256B.0911, subdivision 3g, or annual service 
26.25 	updates under section 256B.0911, subdivision 3f, to initiate and maintain participation in 
26.26 	the waiver program.
26.27 	(b) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
26.28 	appropriate to determine nursing facility level of care for purposes of medical assistance 
26.29 	payment for nursing facility services, only face-to-face initial assessments conducted 
26.30 	according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility 
26.31 	level of care determination will be accepted for purposes of initial and ongoing access to 
26.32 	waiver service payment. Only reassessments conducted according to section 256B.0911, 
26.33 	subdivision 3g, that result in a nursing facility level of need determination or annual service 
27.1 	updates conducted according to section 256B.0911, subdivision 3f, that demonstrate no 
27.2 	improvement in the client's condition shall be accepted for the purposes of ongoing access 
27.3 	to waiver service payments.

27.4 	Sec. 17. Minnesota Statutes 2016, section 256B.49, subdivision 15, is amended to read:
27.5 		Subd. 15.Coordinated service and support plan; comprehensive transitional service 
27.6 	plan; maintenance service plan. (a) Each recipient of home and community-based waivered 
27.7 	services shall be provided a copy of the written coordinated service and support plan which 
27.8 	meets the requirements in section 256B.092, subdivision 1b.
27.9 	(b) In developing the comprehensive transitional service plan, the individual receiving 
27.10 	services, the case manager, and the guardian, if applicable, will identify the transitional 
27.11 	service plan fundamental service outcome and anticipated timeline to achieve this outcome. 
27.12 	Within the first 20 days following a recipient's request for an assessment or reassessment, 
27.13 	the transitional service planning team must be identified. A team leader must be identified 
27.14 	who will be responsible for assigning responsibility and communicating with team members 
27.15 	to ensure implementation of the transition plan and ongoing assessment and communication 
27.16 	process. The team leader should be an individual, such as the case manager or guardian, 
27.17 	who has the opportunity to follow the recipient to the next level of service.
27.18 	Within ten days following an assessment, a comprehensive transitional service plan must 
27.19 	be developed incorporating elements of a comprehensive functional assessment and including 
27.20 	short-term measurable outcomes and timelines for achievement of and reporting on these 
27.21 	outcomes. Functional milestones must also be identified and reported according to the 
27.22 	timelines agreed upon by the transitional service planning team. In addition, the 
27.23 	comprehensive transitional service plan must identify additional supports that may assist 
27.24 	in the achievement of the fundamental service outcome such as the development of greater 
27.25 	natural community support, increased collaboration among agencies, and technological 
27.26 	supports.
27.27 	The timelines for reporting on functional milestones will prompt a reassessment of 
27.28 	services provided, the units of services, rates, and appropriate service providers. It is the 
27.29 	responsibility of the transitional service planning team leader to review functional milestone 
27.30 	reporting to determine if the milestones are consistent with observable skills and that 
27.31 	milestone achievement prompts any needed changes to the comprehensive transitional 
27.32 	service plan.
27.33 	For those whose fundamental transitional service outcome involves the need to procure 
27.34 	housing, a plan for the recipient to seek the resources necessary to secure the least restrictive 
28.1 	housing possible should be incorporated into the plan, including employment and public 
28.2 	supports such as housing access and shelter needy funding.
28.3 	(c) Counties and other agencies responsible for funding community placement and 
28.4 	ongoing community supportive services are responsible for the implementation of the 
28.5 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
28.6 	effective transitional service delivery and efficient utilization of funding resources.
28.7 	(d) Following one year of transitional services, the transitional services planning team 
28.8 	will make a determination as to whether or not the individual receiving services requires 
28.9 	the current level of continuous and consistent support in order to maintain the recipient's 
28.10 	current level of functioning. Recipients who are determined to have not had a significant 
28.11 	change in functioning for 12 months must move from a transitional to a maintenance service 
28.12 	plan. Recipients on a maintenance service plan must be reassessed to determine if the 
28.13 	recipient would benefit from a transitional service plan at least every 12 months and at other 
28.14 	times when there has been a significant change in the recipient's functioning or at the request 
28.15 	of the recipient or the recipient's guardian. This assessment should consider any changes to 
28.16 	technological or natural community supports.
28.17 	(e) When a county is evaluating denials, reductions, or terminations of home and 
28.18 	community-based services under this section for an individual, the case manager shall offer 
28.19 	to meet with the individual or the individual's guardian in order to discuss the prioritization 
28.20 	of service needs within the coordinated service and support plan, comprehensive transitional 
28.21 	service plan, or maintenance service plan. The reduction in the authorized services for an 
28.22 	individual due to changes in funding for waivered services may not exceed the amount 
28.23 	needed to ensure medically necessary services to meet the individual's health, safety, and 
28.24 	welfare.
28.25 	(f) At the time of reassessment, local agency case managers shall assess each recipient 
28.26 	of community access for disability inclusion or brain injury waivered services currently 
28.27 	residing in a licensed adult foster home that is not the primary residence of the license 
28.28 	holder, or in which the license holder is not the primary caregiver, to determine if that 
28.29 	recipient could appropriately be served in a community-living setting. If appropriate for the 
28.30 	recipient, the case manager shall offer the recipient, through a person-centered planning 
28.31 	process, the option to receive alternative housing and service options. In the event that the 
28.32 	recipient chooses to transfer from the adult foster home, the vacated bed shall not be filled 
28.33 	with another recipient of waiver services and group residential housing and the licensed 
28.34 	capacity shall be reduced accordingly, unless the savings required by the licensed bed closure 
28.35 	reductions under Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, 
29.1 	paragraph (f), for foster care settings where the physical location is not the primary residence 
29.2 	of the license holder are met through voluntary changes described in section 245A.03, 
29.3 	subdivision 7, paragraph (e), or as provided under paragraph (a), clauses (3) and (4). If the 
29.4 	adult foster home becomes no longer viable due to these transfers, the county agency, with 
29.5 	the assistance of the department, shall facilitate a consolidation of settings or closure. This 
29.6 	reassessment process shall be completed by July 1, 2013.

29.7 	Sec. 18. Minnesota Statutes 2016, section 256B.4913, subdivision 4a, is amended to read:
29.8 		Subd. 4a.Rate stabilization adjustment. (a) For purposes of this subdivision, 
29.9 	"implementation period" means the period beginning January 1, 2014, and ending on the 
29.10 	last day of the month in which the rate management system is populated with the data 
29.11 	necessary to calculate rates for substantially all individuals receiving home and 
29.12 	community-based waiver services under sections 256B.092 and 256B.49. "Banding period" 
29.13 	means the time period beginning on January 1, 2014, and ending upon the expiration of the 
29.14 	12-month period defined in paragraph (c), clause (5).
29.15 	(b) For purposes of this subdivision, the historical rate for all service recipients means 
29.16 	the individual reimbursement rate for a recipient in effect on December 1, 2013, except 
29.17 	that:
29.18 	(1) for a day service recipient who was not authorized to receive these waiver services 
29.19 	prior to January 1, 2014; added a new service or services on or after January 1, 2014; or 
29.20 	changed providers on or after January 1, 2014, the historical rate must be the weighted 
29.21 	average authorized rate for the provider number in the county of service, effective December 
29.22 	1, 2013; or
29.23 	(2) for a unit-based service with programming or a unit-based service without 
29.24 	programming recipient who was not authorized to receive these waiver services prior to 
29.25 	January 1, 2014; added a new service or services on or after January 1, 2014; or changed 
29.26 	providers on or after January 1, 2014, the historical rate must be the weighted average 
29.27 	authorized rate for each provider number in the county of service, effective December 1, 
29.28 	2013; or
29.29 	(3) for residential service recipients who change providers on or after January 1, 2014, 
29.30 	the historical rate must be set by each lead agency within their county aggregate budget 
29.31 	using their respective methodology for residential services effective December 1, 2013, for 
29.32 	determining the provider rate for a similarly situated recipient being served by that provider.
30.1 	(c) The commissioner shall adjust individual reimbursement rates determined under this 
30.2 	section so that the unit rate is no higher or lower than:
30.3 	(1) 0.5 percent from the historical rate for the implementation period;
30.4 	(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately 
30.5 	following the time period of clause (1);
30.6 	(3) 0.5 percent from the rate in effect in clause (2), for the 12-month period immediately 
30.7 	following the time period of clause (2);
30.8 	(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately 
30.9 	following the time period of clause (3);
30.10 	(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately 
30.11 	following the time period of clause (4); and
30.12 	(6) no adjustment to the rate in effect in clause (5) for the 12-month period immediately 
30.13 	following the time period of clause (5). During this banding rate period, the commissioner 
30.14 	shall not enforce any rate decrease or increase that would otherwise result from the end of 
30.15 	the banding period. The commissioner shall, upon enactment, seek federal approval for the 
30.16 	addition of this banding period; and
30.17 	(7) one percent from the rate in effect in clause (6) for the 12-month period immediately 
30.18 	following the time period of clause (6).
30.19 	(d) The commissioner shall review all changes to rates that were in effect on December 
30.20 	1, 2013, to verify that the rates in effect produce the equivalent level of spending and service 
30.21 	unit utilization on an annual basis as those in effect on October 31, 2013.
30.22 	(e) By December 31, 2014, the commissioner shall complete the review in paragraph 
30.23 	(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
30.24 	(f) During the banding period, the Medicaid Management Information System (MMIS) 
30.25 	service agreement rate must be adjusted to account for change in an individual's need. The 
30.26 	commissioner shall adjust the Medicaid Management Information System (MMIS) service 
30.27 	agreement rate by:
30.28 	(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
30.29 	individual with variables reflecting the level of service in effect on December 1, 2013;
30.30 	(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the 
30.31 	individual with variables reflecting the updated level of service at the time of application; 
30.32 	and
31.1 	(3) adding to or subtracting from the Medicaid Management Information System (MMIS) 
31.2 	service agreement rate, the difference between the values in clauses (1) and (2).
31.3 	(g) This subdivision must not apply to rates for recipients served by providers new to a 
31.4 	given county after January 1, 2014. Providers of personal supports services who also acted 
31.5 	as fiscal support entities must be treated as new providers as of January 1, 2014.

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

31.10 	Sec. 19. Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision 
31.11 	to read:
31.12 		Subd. 7.New services. (a) A service added to section 256B.4914 after January 1, 2014, 
31.13 	is not subject to rate stabilization adjustment in this section.
31.14 	(b) Employment support services authorized after January 1, 2018, under the new 
31.15 	employment support services definition according to the home and community-based services 
31.16 	waivers for people with disabilities under sections 256B.092 and 256B.49 are not subject 
31.17 	to rate stabilization adjustment in this section.

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

31.19 	Sec. 20. Minnesota Statutes 2016, section 256B.4914, subdivision 2, is amended to read:
31.20 		Subd. 2.Definitions. (a) For purposes of this section, the following terms have the 
31.21 	meanings given them, unless the context clearly indicates otherwise.
31.22 	(b) "Commissioner" means the commissioner of human services.
31.23 	(c) "Component value" means underlying factors that are part of the cost of providing 
31.24 	services that are built into the waiver rates methodology to calculate service rates.
31.25 	(d) "Customized living tool" means a methodology for setting service rates that delineates 
31.26 	and documents the amount of each component service included in a recipient's customized 
31.27 	living service plan.
31.28 	(e) "Disability waiver rates system" means a statewide system that establishes rates that 
31.29 	are based on uniform processes and captures the individualized nature of waiver services 
31.30 	and recipient needs.
32.1 	(f) "Individual staffing" means the time spent as a one-to-one interaction specific to an 
32.2 	individual recipient by staff to provide direct support and assistance with activities of daily 
32.3 	living, instrumental activities of daily living, and training to participants, and is based on 
32.4 	the requirements in each individual's coordinated service and support plan under section 
32.5 	245D.02, subdivision 4b; any coordinated service and support plan addendum under section 
32.6 	245D.02, subdivision 4c; and an assessment tool. Provider observation of an individual's 
32.7 	needs must also be considered.
32.8 	(g) "Lead agency" means a county, partnership of counties, or tribal agency charged 
32.9 	with administering waivered services under sections 256B.092 and 256B.49.
32.10 	(h) "Median" means the amount that divides distribution into two equal groups, one-half 
32.11 	above the median and one-half below the median.
32.12 	(i) "Payment or rate" means reimbursement to an eligible provider for services provided 
32.13 	to a qualified individual based on an approved service authorization.
32.14 	(j) "Rates management system" means a Web-based software application that uses a 
32.15 	framework and component values, as determined by the commissioner, to establish service 
32.16 	rates.
32.17 	(k) "Recipient" means a person receiving home and community-based services funded 
32.18 	under any of the disability waivers.
32.19 	(l) "Shared staffing" means time spent by employees, not defined under paragraph (f), 
32.20 	providing or available to provide more than one individual with direct support and assistance 
32.21 	with activities of daily living as defined under section 256B.0659, subdivision 1, paragraph 
32.22 	(b); instrumental activities of daily living as defined under section 256B.0659, subdivision 
32.23 	1, paragraph (i); ancillary activities needed to support individual services; and training to 
32.24 	participants, and is based on the requirements in each individual's coordinated service and 
32.25 	support plan under section 245D.02, subdivision 4b; any coordinated service and support 
32.26 	plan addendum under section 245D.02, subdivision 4c; an assessment tool; and provider 
32.27 	observation of an individual's service need. Total shared staffing hours are divided 
32.28 	proportionally by the number of individuals who receive the shared service provisions.
32.29 	(m) "Staffing ratio" means the number of recipients a service provider employee supports 
32.30 	during a unit of service based on a uniform assessment tool, provider observation, case 
32.31 	history, and the recipient's services of choice, and not based on the staffing ratios under 
32.32 	section 245D.31.
32.33 	(n) "Unit of service" means the following:
33.1 	(1) for residential support services under subdivision 6, a unit of service is a day. Any 
33.2 	portion of any calendar day, within allowable Medicaid rules, where an individual spends 
33.3 	time in a residential setting is billable as a day;
33.4 	(2) for day services under subdivision 7:
33.5 	(i) for day training and habilitation services, a unit of service is either:
33.6 	(A) a day unit of service is defined as six or more hours of time spent providing direct 
33.7 	services and transportation; or
33.8 	(B) a partial day unit of service is defined as fewer than six hours of time spent providing 
33.9 	direct services and transportation; and
33.10 	(C) for new day service recipients after January 1, 2014, 15 minute units of service must 
33.11 	be used for fewer than six hours of time spent providing direct services and transportation;
33.12 	(ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A 
33.13 	day unit of service is six or more hours of time spent providing direct services;
33.14 	(iii) for prevocational services, a unit of service is a day or an hour. A day unit of service 
33.15 	is six or more hours of time spent providing direct service;
33.16 	(3) for unit-based services with programming under subdivision 8:
33.17 	(i) for supported living services, a unit of service is a day or 15 minutes. When a day 
33.18 	rate is authorized, any portion of a calendar day where an individual receives services is 
33.19 	billable as a day; and
33.20 	(ii) for all other services, a unit of service is 15 minutes; and
33.21 	(4) for unit-based services without programming under subdivision 9:
33.22 	(i) for respite services, a unit of service is a day or 15 minutes. When a day rate is 
33.23 	authorized, any portion of a calendar day when an individual receives services is billable 
33.24 	as a day; and
33.25 	(ii) for all other services, a unit of service is 15 minutes.

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

33.28 	Sec. 21. Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:
33.29 		Subd. 3.Applicable services. Applicable services are those authorized under the state's 
33.30 	home and community-based services waivers under sections 256B.092 and 256B.49, 
34.1 	including the following, as defined in the federally approved home and community-based 
34.2 	services plan:
34.3 	(1) 24-hour customized living;
34.4 	(2) adult day care;
34.5 	(3) adult day care bath;
34.6 	(4) behavioral programming;
34.7 	(5) companion services;
34.8 	(6) customized living;
34.9 	(7) day training and habilitation;
34.10 	(8) housing access coordination;
34.11 	(9) independent living skills;
34.12 	(10) in-home family support;
34.13 	(11) night supervision;
34.14 	(12) personal support;
34.15 	(13) prevocational services;
34.16 	(14) residential care services;
34.17 	(15) residential support services;
34.18 	(16) respite services;
34.19 	(17) structured day services;
34.20 	(18) supported employment services;
34.21 	(19) (18) supported living services;
34.22 	(20) (19) transportation services; and
34.23 	(20) individualized home supports;
34.24 	(21) independent living skills specialist services;
34.25 	(22) employment exploration services;
34.26 	(23) employment development services;
34.27 	(24) employment support services; and
35.1 	(21) (25) other services as approved by the federal government in the state home and 
35.2 	community-based services plan.

35.3 	EFFECTIVE DATE. (a) Clause (20) is effective the day following final enactment.
35.4 	(b) Clauses (21) to (24) are effective upon federal approval. The commissioner of human 
35.5 	services shall notify the revisor of statutes when federal approval is obtained.

35.6 	Sec. 22. Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:
35.7 		Subd. 5.Base wage index and standard component values. (a) The base wage index 
35.8 	is established to determine staffing costs associated with providing services to individuals 
35.9 	receiving home and community-based services. For purposes of developing and calculating 
35.10 	the proposed base wage, Minnesota-specific wages taken from job descriptions and standard 
35.11 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
35.12 	the most recent edition of the Occupational Handbook must be used. The base wage index 
35.13 	must be calculated as follows:
35.14 	(1) for residential direct care staff, the sum of:
35.15 	(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home 
35.16 	health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide assistant
35.17 	(SOC code 31-1012 31-1014); and 20 percent of the median wage for social and human 
35.18 	services aide (SOC code 21-1093); and
35.19 	(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide 
35.20 	(SOC code 31-1011); 20 percent of the median wage for personal and home health aide 
35.21 	(SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC code 
35.22 	31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
35.23 	29-2053); and 20 percent of the median wage for social and human services aide (SOC code 
35.24 	21-1093);
35.25 	(2) for day services, 20 percent of the median wage for nursing aide assistant (SOC code 
35.26 	31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code 
35.27 	29-2053); and 60 percent of the median wage for social and human services aide (SOC code 
35.28 	21-1093);
35.29 	(3) for residential asleep-overnight staff, the wage will be $7.66 per hour is the minimum 
35.30 	wage in Minnesota for large employers, except in a family foster care setting, the wage is 
35.31 	$2.80 per hour 36 percent of the minimum wage in Minnesota for large employers;
36.1 	(4) for behavior program analyst staff, 100 percent of the median wage for mental health 
36.2 	counselors (SOC code 21-1014);
36.3 	(5) for behavior program professional staff, 100 percent of the median wage for clinical 
36.4 	counseling and school psychologist (SOC code 19-3031);
36.5 	(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric 
36.6 	technicians (SOC code 29-2053);
36.7 	(7) for supportive living services staff, 20 percent of the median wage for nursing aide
36.8 	assistant (SOC code 31-1012 31-1014); 20 percent of the median wage for psychiatric 
36.9 	technician (SOC code 29-2053); and 60 percent of the median wage for social and human 
36.10 	services aide (SOC code 21-1093);
36.11 	(8) for housing access coordination staff, 50 100 percent of the median wage for 
36.12 	community and social services specialist (SOC code 21-1099); and 50 percent of the median 
36.13 	wage for social and human services aide (SOC code 21-1093);
36.14 	(9) for in-home family support staff, 20 percent of the median wage for nursing aide 
36.15 	(SOC code 31-1012); 30 percent of the median wage for community social service specialist 
36.16 	(SOC code 21-1099); 40 percent of the median wage for social and human services aide 
36.17 	(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC 
36.18 	code 29-2053);
36.19 	(10) for individualized home supports services staff, 40 percent of the median wage for 
36.20 	community social service specialist (SOC code 21-1099); 50 percent of the median wage 
36.21 	for social and human services aide (SOC code 21-1093); and ten percent of the median 
36.22 	wage for psychiatric technician (SOC code 29-2053);
36.23 	(11) for independent living skills staff, 40 percent of the median wage for community 
36.24 	social service specialist (SOC code 21-1099); 50 percent of the median wage for social and 
36.25 	human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric 
36.26 	technician (SOC code 29-2053);
36.27 	(12) for independent living skills specialist staff, 100 percent of mental health and 
36.28 	substance abuse social worker (SOC code 21-1023);
36.29 	(11) (13)  for supported employment support services staff, 20 50 percent of the median 
36.30 	wage for nursing aide rehabilitation counselor (SOC code 31-1012 21-1015); 20 percent of 
36.31 	the median wage for psychiatric technician (SOC code 29-2053); and 60 50 percent of the 
36.32 	median wage for community and social and human services aide specialist (SOC code 
36.33 	21-1093 21-1099);
37.1 	(14) for employment exploration services staff, 50 percent of the median wage for 
37.2 	rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for 
37.3 	community and social services specialist (SOC code 21-1099);
37.4 	(15) for employment development services staff, 50 percent of the median wage for 
37.5 	education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent 
37.6 	of the median wage for community and social services specialist (SOC code 21-1099);
37.7 	(12) (16) for adult companion staff, 50 percent of the median wage for personal and 
37.8 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
37.9 	orderlies, and attendants assistant (SOC code 31-1012 31-1014);
37.10 	(13) (17) for night supervision staff, 20 percent of the median wage for home health 
37.11 	aide (SOC code 31-1011); 20 percent of the median wage for personal and home health 
37.12 	aide (SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC 
37.13 	code 31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC 
37.14 	code 29-2053); and 20 percent of the median wage for social and human services aide (SOC 
37.15 	code 21-1093);
37.16 	(14) (18) for respite staff, 50 percent of the median wage for personal and home care 
37.17 	aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, 
37.18 	and attendants assistant (SOC code 31-1012 31-1014);
37.19 	(15) (19) for personal support staff, 50 percent of the median wage for personal and 
37.20 	home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, 
37.21 	orderlies, and attendants assistant (SOC code 31-1012 31-1014);
37.22 	(16) (20) for supervisory staff, the basic wage is $17.43 per hour, 100 percent of the 
37.23 	median wage for community and social services specialist (SOC code 21-1099), with the 
37.24 	exception of the supervisor of behavior professional, behavior analyst, and behavior 
37.25 	specialists, which must be $30.75 per hour is 100 percent of the median wage for clinical 
37.26 	counseling and school psychologist (SOC code 19-3031);
37.27 	(17) (21) for registered nurse staff, the basic wage is $30.82 per hour, 100 percent of 
37.28 	the median wage for registered nurses (SOC code 29-1141); and
37.29 	(18) (22) for licensed practical nurse staff, the basic wage is $18.64 per hour 100 percent 
37.30 	of the median wage for licensed practical nurses (SOC code 29-2061).
37.31 	(b) Component values for residential support services are:
37.32 	(1) supervisory span of control ratio: 11 percent;
38.1 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.2 	(3) employee-related cost ratio: 23.6 percent;
38.3 	(4) general administrative support ratio: 13.25 percent;
38.4 	(5) program-related expense ratio: 1.3 percent; and
38.5 	(6) absence and utilization factor ratio: 3.9 percent.
38.6 	(c) Component values for family foster care are:
38.7 	(1) supervisory span of control ratio: 11 percent;
38.8 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.9 	(3) employee-related cost ratio: 23.6 percent;
38.10 	(4) general administrative support ratio: 3.3 percent;
38.11 	(5) program-related expense ratio: 1.3 percent; and
38.12 	(6) absence factor: 1.7 percent.
38.13 	(d) Component values for day services for all services are:
38.14 	(1) supervisory span of control ratio: 11 percent;
38.15 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.16 	(3) employee-related cost ratio: 23.6 percent;
38.17 	(4) program plan support ratio: 5.6 percent;
38.18 	(5) client programming and support ratio: ten percent;
38.19 	(6) general administrative support ratio: 13.25 percent;
38.20 	(7) program-related expense ratio: 1.8 percent; and
38.21 	(8) absence and utilization factor ratio: 3.99.4 percent.
38.22 	(e) Component values for unit-based services with programming are:
38.23 	(1) supervisory span of control ratio: 11 percent;
38.24 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.25 	(3) employee-related cost ratio: 23.6 percent;
38.26 	(4) program plan supports ratio: 3.1 15.5 percent;
38.27 	(5) client programming and supports ratio: 8.6 4.7 percent;
39.1 	(6) general administrative support ratio: 13.25 percent;
39.2 	(7) program-related expense ratio: 6.1 percent; and
39.3 	(8) absence and utilization factor ratio: 3.9 percent.
39.4 	(f) Component values for unit-based services without programming except respite are:
39.5 	(1) supervisory span of control ratio: 11 percent;
39.6 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
39.7 	(3) employee-related cost ratio: 23.6 percent;
39.8 	(4) program plan support ratio: 3.1 7.0 percent;
39.9 	(5) client programming and support ratio: 8.6 2.3 percent;
39.10 	(6) general administrative support ratio: 13.25 percent;
39.11 	(7) program-related expense ratio: 6.1 2.9 percent; and
39.12 	(8) absence and utilization factor ratio: 3.9 percent.
39.13 	(g) Component values for unit-based services without programming for respite are:
39.14 	(1) supervisory span of control ratio: 11 percent;
39.15 	(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
39.16 	(3) employee-related cost ratio: 23.6 percent;
39.17 	(4) general administrative support ratio: 13.25 percent;
39.18 	(5) program-related expense ratio: 6.1 2.9 percent; and
39.19 	(6) absence and utilization factor ratio: 3.9 percent.
39.20 	(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph 
39.21 	(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor 
39.22 	Statistics available on December 31, 2016. The commissioner shall publish these updated 
39.23 	values and load them into the rate management system. This adjustment occurs every five 
39.24 	years. For adjustments in 2021 and beyond, the commissioner shall use the data available 
39.25 	on December 31 of the calendar year five years prior.On January 1, 2022, and every two 
39.26 	years thereafter, the commissioner shall update the base wage index in paragraph (a) based 
39.27 	on the most recently available wage data by SOC from the Bureau of Labor Statistics. The 
39.28 	commissioner shall publish these updated values and load them into the rate management 
39.29 	system.
40.1 	(i) On July 1, 2017, the commissioner shall update the framework components in 
40.2 	paragraphs (b) to (g) paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f), 
40.3 	clause (5); subdivision 6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17), 
40.4 	for changes in the Consumer Price Index. The commissioner will adjust these values higher 
40.5 	or lower by the percentage change in the Consumer Price Index-All Items, United States 
40.6 	city average (CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall 
40.7 	publish these updated values and load them into the rate management system. This adjustment 
40.8 	occurs every five years. For adjustments in 2021 and beyond, the commissioner shall use 
40.9 	the data available on January 1 of the calendar year four years prior and January 1 of the 
40.10 	current calendar year. On January 1, 2022, and every two years thereafter, the commissioner 
40.11 	shall update the framework components in paragraph (d), clause (5); paragraph (e), clause 
40.12 	(5); and paragraph (f), clause (5); subdivision 6, clauses (8) and (9); and subdivision 7, 
40.13 	clauses (10), (16), and (17), for changes in the Consumer Price Index. The commissioner 
40.14 	shall adjust these values higher or lower by the percentage change in the CPI-U from the 
40.15 	date of the previous update to the date of the data most recently available prior to the 
40.16 	scheduled update. The commissioner shall publish these updated values and load them into 
40.17 	the rate management system.
40.18 	(j) If Bureau of Labor Statistics SOC or Consumer Price Index items are unavailable in 
40.19 	the future, the commissioner shall recommend to the legislature codes or items to update 
40.20 	and replace missing component values.
40.21 	(k) The commissioner must ensure that wage values and component values in subdivisions 
40.22 	5 to 9 reflect the cost to provide the service. As determined by the commissioner, in 
40.23 	consultation with stakeholders identified in section 256B.4913, subdivision 5, a provider 
40.24 	enrolled to provide services with rates determined under this section must submit business 
40.25 	cost data to the commissioner to support research on the cost of providing services that have 
40.26 	rates determined by the disability waiver rates system. Required business cost data includes, 
40.27 	but is not limited to:
40.28 	(1) worker wage costs;
40.29 	(2) benefits paid;
40.30 	(3) supervisor wage costs;
40.31 	(4) executive wage costs;
40.32 	(5) vacation, sick, and training time paid;
40.33 	(6) taxes, workers' compensation, and unemployment insurance costs paid;
41.1 	(7) administrative costs paid;
41.2 	(8) program costs paid;
41.3 	(9) transportation costs paid;
41.4 	(10) vacancy rates; and
41.5 	(11) other data relating to costs required to provide services requested by the 
41.6 	commissioner.
41.7 	(l) A provider must submit cost component data at least once in any five-year period, 
41.8 	on a schedule determined by the commissioner, in consultation with stakeholders identified 
41.9 	in section 256B.4913, subdivision 5. If a provider fails to submit required reporting data, 
41.10 	the commissioner shall provide notice to providers that have not provided required data 30 
41.11 	days after the required submission date, and a second notice for providers who have not 
41.12 	provided required data 60 days after the required submission date. The commissioner shall 
41.13 	temporarily suspend payments to the provider if cost component data is not received 90 
41.14 	days after the required submission date. Withheld payments shall be made once data is 
41.15 	received by the commissioner.
41.16 	(m) The commissioner shall conduct a random audit of data submitted under paragraph 
41.17 	(k) to ensure data accuracy. The commissioner shall analyze cost documentation in paragraph 
41.18 	(k) and provide recommendations for adjustments to cost components.
41.19 	(n) The commissioner shall analyze cost documentation in paragraph (k) and, in 
41.20 	consultation with stakeholders identified in section 256B.4913, subdivision 5, may submit 
41.21 	recommendations on component values and inflationary factor adjustments to the chairs 
41.22 	and ranking minority members of the legislative committees with jurisdiction over human 
41.23 	services every four years beginning January 1, 2020. The commissioner shall make 
41.24 	recommendations in conjunction with reports submitted to the legislature according to 
41.25 	subdivision 10, paragraph (e). The commissioner shall release business cost data in an 
41.26 	aggregate form, and business cost data from individual providers shall not be released except 
41.27 	as provided for in current law.
41.28 	(o) The commissioner, in consultation with stakeholders identified in section 256B.4913, 
41.29 	subdivision 5, shall develop and implement a process for providing training and technical 
41.30 	assistance necessary to support provider submission of cost documentation required under 
41.31 	paragraph (k).

41.32 	EFFECTIVE DATE. (a) The amendments to paragraphs (a) to (g) are effective January 
41.33 	1, 2018, except the amendment to paragraph (d), clause (8), which is effective January 1, 
42.1 	2019, and the amendment to paragraph (a), clause (10), which is effective the day following 
42.2 	final enactment.
42.3 	(b) The amendments to paragraphs (h) to (o) are effective the day following final 
42.4 	enactment.

42.5 	Sec. 23. Minnesota Statutes 2016, section 256B.4914, subdivision 6, is amended to read:
42.6 		Subd. 6.Payments for residential support services. (a) Payments for residential support 
42.7 	services, as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22, 
42.8 	must be calculated as follows:
42.9 	(1) determine the number of shared staffing and individual direct staff hours to meet a 
42.10 	recipient's needs provided on site or through monitoring technology;
42.11 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
42.12 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
42.13 	5. This is defined as the direct-care rate;
42.14 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
42.15 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
42.16 	to the result of clause (2). This is defined as the customized direct-care rate;
42.17 	(4) multiply the number of shared and individual direct staff hours provided on site or 
42.18 	through monitoring technology and nursing hours by the appropriate staff wages in 
42.19 	subdivision 5, paragraph (a), or the customized direct-care rate;
42.20 	(5) multiply the number of shared and individual direct staff hours provided on site or 
42.21 	through monitoring technology and nursing hours by the product of the supervision span 
42.22 	of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision 
42.23 	wage in subdivision 5, paragraph (a), clause (16) (20);
42.24 	(6) combine the results of clauses (4) and (5), excluding any shared and individual direct 
42.25 	staff hours provided through monitoring technology, and multiply the result by one plus 
42.26 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b), 
42.27 	clause (2). This is defined as the direct staffing cost;
42.28 	(7) for employee-related expenses, multiply the direct staffing cost, excluding any shared 
42.29 	and individual direct staff hours provided through monitoring technology, by one plus the 
42.30 	employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
42.31 	(8) for client programming and supports, the commissioner shall add $2,179; and
43.1 	(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if 
43.2 	customized for adapted transport, based on the resident with the highest assessed need.
43.3 	(b) The total rate must be calculated using the following steps:
43.4 	(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any shared 
43.5 	and individual direct staff hours provided through monitoring technology that was excluded 
43.6 	in clause (7);
43.7 	(2) sum the standard general and administrative rate, the program-related expense ratio, 
43.8 	and the absence and utilization ratio;
43.9 	(3) divide the result of clause (1) by one minus the result of clause (2). This is the total 
43.10 	payment amount; and
43.11 	(4) adjust the result of clause (3) by a factor to be determined by the commissioner to 
43.12 	adjust for regional differences in the cost of providing services.
43.13 	(c) The payment methodology for customized living, 24-hour customized living, and 
43.14 	residential care services must be the customized living tool. Revisions to the customized 
43.15 	living tool must be made to reflect the services and activities unique to disability-related 
43.16 	recipient needs.
43.17 	(d) For individuals enrolled prior to January 1, 2014, the days of service authorized must 
43.18 	meet or exceed the days of service used to convert service agreements in effect on December 
43.19 	1, 2013, and must not result in a reduction in spending or service utilization due to conversion 
43.20 	during the implementation period under section 256B.4913, subdivision 4a. If during the 
43.21 	implementation period, an individual's historical rate, including adjustments required under 
43.22 	section 256B.4913, subdivision 4a, paragraph (c), is equal to or greater than the rate 
43.23 	determined in this subdivision, the number of days authorized for the individual is 365.
43.24 	(e) The number of days authorized for all individuals enrolling after January 1, 2014, 
43.25 	in residential services must include every day that services start and end.
43.26 	(f) Beginning January 1, 2018, for foster care and supportive living services provided 
43.27 	in a corporate setting with rates calculated under this section, the number of days authorized 
43.28 	must not exceed 350 days in an annual service span.

43.29 	Sec. 24. Minnesota Statutes 2016, section 256B.4914, subdivision 7, is amended to read:
43.30 		Subd. 7.Payments for day programs. Payments for services with day programs 
43.31 	including adult day care, day treatment and habilitation, prevocational services, and structured 
43.32 	day services must be calculated as follows:
44.1 	(1) determine the number of units of service and staffing ratio to meet a recipient's needs:
44.2 	(i) the staffing ratios for the units of service provided to a recipient in a typical week 
44.3 	must be averaged to determine an individual's staffing ratio; and
44.4 	(ii) the commissioner, in consultation with service providers, shall develop a uniform 
44.5 	staffing ratio worksheet to be used to determine staffing ratios under this subdivision;
44.6 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
44.7 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
44.8 	5;
44.9 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
44.10 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
44.11 	to the result of clause (2). This is defined as the customized direct-care rate;
44.12 	(4) multiply the number of day program direct staff hours and nursing hours by the 
44.13 	appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;
44.14 	(5) multiply the number of day direct staff hours by the product of the supervision span 
44.15 	of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate supervision 
44.16 	wage in subdivision 5, paragraph (a), clause (16) (20);
44.17 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
44.18 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d), clause 
44.19 	(2). This is defined as the direct staffing rate;
44.20 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
44.21 	plan support ratio in subdivision 5, paragraph (d), clause (4);
44.22 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
44.23 	employee-related cost ratio in subdivision 5, paragraph (d), clause (3);
44.24 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
44.25 	the client programming and support ratio in subdivision 5, paragraph (d), clause (5);
44.26 	(10) for program facility costs, add $19.30 per week with consideration of staffing ratios 
44.27 	to meet individual needs;
44.28 	(11) for adult day bath services, add $7.01 per 15 minute unit;
44.29 	(12) this is the subtotal rate;
44.30 	(13) sum the standard general and administrative rate, the program-related expense ratio, 
44.31 	and the absence and utilization factor ratio;
45.1 	(14) divide the result of clause (12) by one minus the result of clause (13). This is the 
45.2 	total payment amount;
45.3 	(15) adjust the result of clause (14) by a factor to be determined by the commissioner 
45.4 	to adjust for regional differences in the cost of providing services;
45.5 	(16) for transportation provided as part of day training and habilitation for an individual 
45.6 	who does not require a lift, add:
45.7 	(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without 
45.8 	a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a 
45.9 	vehicle with a lift;
45.10 	(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without 
45.11 	a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a 
45.12 	vehicle with a lift;
45.13 	(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without 
45.14 	a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a 
45.15 	vehicle with a lift; or
45.16 	(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift, 
45.17 	$16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle 
45.18 	with a lift;
45.19 	(17) for transportation provided as part of day training and habilitation for an individual 
45.20 	who does require a lift, add:
45.21 	(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a 
45.22 	lift, and $15.05 for a shared ride in a vehicle with a lift;
45.23 	(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a 
45.24 	lift, and $28.16 for a shared ride in a vehicle with a lift;
45.25 	(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a 
45.26 	lift, and $58.76 for a shared ride in a vehicle with a lift; or
45.27 	(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift, 
45.28 	and $80.93 for a shared ride in a vehicle with a lift.

45.29 	Sec. 25. Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:
45.30 		Subd. 8.Payments for unit-based services with programming. Payments for unit-based 
45.31 	services with programming, including behavior programming, housing access coordination, 
46.1 	in-home family support, independent living skills training, independent living skills specialist 
46.2 	services, individualized home supports, hourly supported living services, employment 
46.3 	exploration services, employment development services, and supported employment support 
46.4 	services provided to an individual outside of any day or residential service plan must be 
46.5 	calculated as follows, unless the services are authorized separately under subdivision 6 or 
46.6 	7:
46.7 	(1) determine the number of units of service to meet a recipient's needs;
46.8 	(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics 
46.9 	Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 
46.10 	5;
46.11 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
46.12 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
46.13 	to the result of clause (2). This is defined as the customized direct-care rate;
46.14 	(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
46.15 	5, paragraph (a), or the customized direct-care rate;
46.16 	(5) multiply the number of direct staff hours by the product of the supervision span of 
46.17 	control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision 
46.18 	wage in subdivision 5, paragraph (a), clause (16) (20);
46.19 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
46.20 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause 
46.21 	(2). This is defined as the direct staffing rate;
46.22 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
46.23 	plan supports ratio in subdivision 5, paragraph (e), clause (4);
46.24 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
46.25 	employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
46.26 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
46.27 	the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
46.28 	(10) this is the subtotal rate;
46.29 	(11) sum the standard general and administrative rate, the program-related expense ratio, 
46.30 	and the absence and utilization factor ratio;
46.31 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
46.32 	total payment amount;
47.1 	(13) for supported employment support services provided in a shared manner, divide 
47.2 	the total payment amount in clause (12) by the number of service recipients, not to exceed 
47.3 	three six. For independent living skills training and individualized home supports provided 
47.4 	in a shared manner, divide the total payment amount in clause (12) by the number of service 
47.5 	recipients, not to exceed two; and
47.6 	(14) adjust the result of clause (13) by a factor to be determined by the commissioner 
47.7 	to adjust for regional differences in the cost of providing services.

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

47.9 	Sec. 26. Minnesota Statutes 2016, section 256B.4914, subdivision 9, is amended to read:
47.10 		Subd. 9.Payments for unit-based services without programming. Payments for 
47.11 	unit-based services without programming, including night supervision, personal support, 
47.12 	respite, and companion care provided to an individual outside of any day or residential 
47.13 	service plan must be calculated as follows unless the services are authorized separately 
47.14 	under subdivision 6 or 7:
47.15 	(1) for all services except respite, determine the number of units of service to meet a 
47.16 	recipient's needs;
47.17 	(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
47.18 	Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
47.19 	(3) for a recipient requiring customization for deaf and hard-of-hearing language 
47.20 	accessibility under subdivision 12, add the customization rate provided in subdivision 12 
47.21 	to the result of clause (2). This is defined as the customized direct care rate;
47.22 	(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
47.23 	5 or the customized direct care rate;
47.24 	(5) multiply the number of direct staff hours by the product of the supervision span of 
47.25 	control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision 
47.26 	wage in subdivision 5, paragraph (a), clause (16) (20);
47.27 	(6) combine the results of clauses (4) and (5), and multiply the result by one plus the 
47.28 	employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (f), clause 
47.29 	(2). This is defined as the direct staffing rate;
47.30 	(7) for program plan support, multiply the result of clause (6) by one plus the program 
47.31 	plan support ratio in subdivision 5, paragraph (f), clause (4);
48.1 	(8) for employee-related expenses, multiply the result of clause (7) by one plus the 
48.2 	employee-related cost ratio in subdivision 5, paragraph (f), clause (3);
48.3 	(9) for client programming and supports, multiply the result of clause (8) by one plus 
48.4 	the client programming and support ratio in subdivision 5, paragraph (f), clause (5);
48.5 	(10) this is the subtotal rate;
48.6 	(11) sum the standard general and administrative rate, the program-related expense ratio, 
48.7 	and the absence and utilization factor ratio;
48.8 	(12) divide the result of clause (10) by one minus the result of clause (11). This is the 
48.9 	total payment amount;
48.10 	(13) for respite services, determine the number of day units of service to meet an 
48.11 	individual's needs;
48.12 	(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics 
48.13 	Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
48.14 	(15) for a recipient requiring deaf and hard-of-hearing customization under subdivision 
48.15 	12, add the customization rate provided in subdivision 12 to the result of clause (14). This 
48.16 	is defined as the customized direct care rate;
48.17 	(16) multiply the number of direct staff hours by the appropriate staff wage in subdivision 
48.18 	5, paragraph (a);
48.19 	(17) multiply the number of direct staff hours by the product of the supervisory span of 
48.20 	control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision 
48.21 	wage in subdivision 5, paragraph (a), clause (16) (20);
48.22 	(18) combine the results of clauses (16) and (17), and multiply the result by one plus 
48.23 	the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g), 
48.24 	clause (2). This is defined as the direct staffing rate;
48.25 	(19) for employee-related expenses, multiply the result of clause (18) by one plus the 
48.26 	employee-related cost ratio in subdivision 5, paragraph (g), clause (3);
48.27 	(20) this is the subtotal rate;
48.28 	(21) sum the standard general and administrative rate, the program-related expense ratio, 
48.29 	and the absence and utilization factor ratio;
48.30 	(22) divide the result of clause (20) by one minus the result of clause (21). This is the 
48.31 	total payment amount; and
49.1 	(23) adjust the result of clauses (12) and (22) by a factor to be determined by the 
49.2 	commissioner to adjust for regional differences in the cost of providing services.

49.3 	Sec. 27. Minnesota Statutes 2016, section 256B.4914, subdivision 10, is amended to read:
49.4 		Subd. 10.Updating payment values and additional information. (a) From January 
49.5 	1, 2014, through December 31, 2017, the commissioner shall develop and implement uniform 
49.6 	procedures to refine terms and adjust values used to calculate payment rates in this section.
49.7 	(b) No later than July 1, 2014, the commissioner shall, within available resources, begin 
49.8 	to conduct research and gather data and information from existing state systems or other 
49.9 	outside sources on the following items:
49.10 	(1) differences in the underlying cost to provide services and care across the state; and
49.11 	(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and 
49.12 	units of transportation for all day services, which must be collected from providers using 
49.13 	the rate management worksheet and entered into the rates management system; and
49.14 	(3) the distinct underlying costs for services provided by a license holder under sections 
49.15 	245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided 
49.16 	by a license holder certified under section 245D.33.
49.17 	(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid 
49.18 	set of rates management system data, the commissioner, in consultation with stakeholders, 
49.19 	shall analyze for each service the average difference in the rate on December 31, 2013, and 
49.20 	the framework rate at the individual, provider, lead agency, and state levels. The 
49.21 	commissioner shall issue semiannual reports to the stakeholders on the difference in rates 
49.22 	by service and by county during the banding period under section 256B.4913, subdivision 
49.23 	4a. The commissioner shall issue the first report by October 1, 2014, and the final report 
49.24 	shall be issued by December 31, 2018.
49.25 	(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall 
49.26 	begin the review and evaluation of the following values already in subdivisions 6 to 9, or 
49.27 	issues that impact all services, including, but not limited to:
49.28 	(1) values for transportation rates for day services;
49.29 	(2) values for transportation rates in residential services;
49.30 	(3) (2) values for services where monitoring technology replaces staff time;
49.31 	(4) (3) values for indirect services;
50.1 	(5) (4) values for nursing;
50.2 	(6) component values for independent living skills;
50.3 	(7) component values for family foster care that reflect licensing requirements;
50.4 	(8) adjustments to other components to replace the budget neutrality factor;
50.5 	(9) remote monitoring technology for nonresidential services;
50.6 	(10) values for basic and intensive services in residential services;
50.7 	(11) (5) values for the facility use rate in day services, and the weightings used in the 
50.8 	day service ratios and adjustments to those weightings;
50.9 	(12) (6) values for workers' compensation as part of employee-related expenses;
50.10 	(13) (7) values for unemployment insurance as part of employee-related expenses;
50.11 	(14) a component value to reflect costs for individuals with rates previously adjusted 
50.12 	for the inclusion of group residential housing rate 3 costs, only for any individual enrolled 
50.13 	as of December 31, 2013; and
50.14 	(15) (8) any changes in state or federal law with an a direct impact on the underlying 
50.15 	cost of providing home and community-based services.; and
50.16 	(9) outcome measures, determined by the commissioner, for home and community-based 
50.17 	services rates determined under this section.
50.18 	(e) The commissioner shall report to the chairs and the ranking minority members of 
50.19 	the legislative committees and divisions with jurisdiction over health and human services 
50.20 	policy and finance with the information and data gathered under paragraphs (b) to (d) on 
50.21 	the following dates:
50.22 	(1) January 15, 2015, with preliminary results and data;
50.23 	(2) January 15, 2016, with a status implementation update, and additional data and 
50.24 	summary information;
50.25 	(3) January 15, 2017, with the full report; and
50.26 	(4) January 15, 2019 2020, with another full report, and a full report once every four 
50.27 	years thereafter.
50.28 	(f) Based on the commissioner's evaluation of the information and data collected in 
50.29 	paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by 
50.30 	January 15, 2015, to address any issues identified during the first year of implementation. 
51.1 	After January 15, 2015, the commissioner may make recommendations to the legislature 
51.2 	to address potential issues.
51.3 	(g) (f) The commissioner shall implement a regional adjustment factor to all rate 
51.4 	calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Beginning July 
51.5 	1, 2017, the commissioner shall renew analysis and implement changes to the regional 
51.6 	adjustment factors when adjustments required under subdivision 5, paragraph (h), occur. 
51.7 	Prior to implementation, the commissioner shall consult with stakeholders on the 
51.8 	methodology to calculate the adjustment.
51.9 	(h) (g) The commissioner shall provide a public notice via LISTSERV in October of 
51.10 	each year beginning October 1, 2014, containing information detailing legislatively approved 
51.11 	changes in:
51.12 	(1) calculation values including derived wage rates and related employee and 
51.13 	administrative factors;
51.14 	(2) service utilization;
51.15 	(3) county and tribal allocation changes; and
51.16 	(4) information on adjustments made to calculation values and the timing of those 
51.17 	adjustments.
51.18 	The information in this notice must be effective January 1 of the following year.
51.19 	(i) No later than July 1, 2016, the commissioner shall develop and implement, in 
51.20 	consultation with stakeholders, a methodology sufficient to determine the shared staffing 
51.21 	levels necessary to meet, at a minimum, health and welfare needs of individuals who will 
51.22 	be living together in shared residential settings, and the required shared staffing activities 
51.23 	described in subdivision 2, paragraph (l). This determination methodology must ensure 
51.24 	staffing levels are adaptable to meet the needs and desired outcomes for current and 
51.25 	prospective residents in shared residential settings.
51.26 	(j) (h) When the available shared staffing hours in a residential setting are insufficient 
51.27 	to meet the needs of an individual who enrolled in residential services after January 1, 2014, 
51.28 	or insufficient to meet the needs of an individual with a service agreement adjustment 
51.29 	described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours 
51.30 	shall be used.
51.31 	(i) The commissioner shall study the underlying cost of absence and utilization for day 
51.32 	services. Based on the commissioner's evaluation of the data collected under this paragraph, 
52.1 	the commissioner shall make recommendations to the legislature by January 15, 2018, for 
52.2 	changes, if any, to the absence and utilization factor ratio component value for day services.
52.3 	(j) Beginning July 1, 2017, the commissioner shall collect transportation and trip 
52.4 	information for all day services through the rates management system.

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

52.6 	Sec. 28. Minnesota Statutes 2016, section 256B.4914, subdivision 16, is amended to read:
52.7 		Subd. 16.Budget neutrality adjustments. (a) The commissioner shall use the following 
52.8 	adjustments to the rate generated by the framework to assure budget neutrality until the rate 
52.9 	information is available to implement paragraph (b). The rate generated by the framework 
52.10 	shall be multiplied by the appropriate factor, as designated below:
52.11 	(1) for residential services: 1.003;
52.12 	(2) for day services: 1.000;
52.13 	(3) for unit-based services with programming: 0.941; and
52.14 	(4) for unit-based services without programming: 0.796.
52.15 	(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated 
52.16 	spending for all home and community-based waiver services under the new payment rates 
52.17 	defined in subdivisions 6 to 9 with estimated spending for the same recipients and services 
52.18 	under the rates in effect on July 1, 2013. This comparison must distinguish spending under 
52.19 	each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and 
52.20 	services for one or more service months after the new rates have gone into effect. The 
52.21 	commissioner shall consult with the commissioner of management and budget on this 
52.22 	analysis to ensure budget neutrality. If estimated spending under the new rates for services 
52.23 	under one or more subdivisions differs in this comparison by 0.3 percent or more, the 
52.24 	commissioner shall assure aggregate budget neutrality across all service areas by adjusting 
52.25 	the budget neutrality factor in paragraph (a) in each subdivision so that total estimated 
52.26 	spending for each subdivision under the new rates matches estimated spending under the 
52.27 	rates in effect on July 1, 2013.
52.28 	(c) A service rate developed using values in subdivision 5, paragraph (a), clause (10), 
52.29 	is not subject to budget neutrality adjustments.

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

53.1 	Sec. 29. Minnesota Statutes 2016, section 256B.85, subdivision 3, is amended to read:
53.2 		Subd. 3.Eligibility. (a) CFSS is available to a person who meets one of the following:
53.3 	(1) is an enrollee of medical assistance as determined under section 256B.055, 256B.056, 
53.4 	or 256B.057, subdivisions 5 and 9;
53.5 	(2) is a participant in the alternative care program under section 256B.0913;
53.6 	(3) is a waiver participant as defined under section 256B.0915, 256B.092, 256B.093, or 
53.7 	256B.49; or
53.8 	(4) has medical services identified in a person's individualized education program and 
53.9 	is eligible for services as determined in section 256B.0625, subdivision 26.
53.10 	(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also 
53.11 	meet all of the following:
53.12 	(1) require assistance and be determined dependent in one activity of daily living or 
53.13 	Level I behavior based on an initial assessment under section 256B.0911, subdivision 3a, 
53.14 	a reassessment under section 256B.0911, subdivision 3g, or an annual service update under 
53.15 	section 256B.0911, subdivision 3f; and
53.16 	(2) is not a participant under a family support grant under section 252.32.

53.17 	Sec. 30. Minnesota Statutes 2016, section 256B.85, subdivision 5, is amended to read:
53.18 		Subd. 5.Assessment requirements. (a) The initial assessment of functional need must:
53.19 	(1) be conducted by a certified assessor according to the criteria established in section 
53.20 	256B.0911, subdivision 3a;
53.21 	(2) be conducted face-to-face, initially and at least annually thereafter, or when there is 
53.22 	a significant change in the participant's condition or a change in the need for services and 
53.23 	supports, or at the request of the participant when the participant experiences a change in 
53.24 	condition or needs a change in the services or supports; and
53.25 	(3) be completed using the format established by the commissioner.
53.26 	(b) The results of the assessment and any recommendations and authorizations for CFSS 
53.27 	must be determined and communicated in writing by the lead agency's certified assessor as 
53.28 	defined in section 256B.0911 to the participant and the agency-provider or FMS provider 
53.29 	chosen by the participant within 40 calendar days and must include the participant's right 
53.30 	to appeal under section 256.045, subdivision 3.
54.1 	(c) The lead agency assessor may authorize a temporary authorization for CFSS services 
54.2 	to be provided under the agency-provider model. Authorization for a temporary level of 
54.3 	CFSS services under the agency-provider model is limited to the time specified by the 
54.4 	commissioner, but shall not exceed 45 days. The level of services authorized under this 
54.5 	paragraph shall have no bearing on a future authorization. Participants approved for a 
54.6 	temporary authorization shall access the consultation service to complete their orientation 
54.7 	and selection of a service model.

54.8 	Sec. 31. Minnesota Statutes 2016, section 256B.85, subdivision 6, is amended to read:
54.9 		Subd. 6.Community first services and supports service delivery plan. (a) The CFSS 
54.10 	service delivery plan must be developed and evaluated through a person-centered planning 
54.11 	process by the participant, or the participant's representative or legal representative who 
54.12 	may be assisted by a consultation services provider. The CFSS service delivery plan must 
54.13 	reflect the services and supports that are important to the participant and for the participant 
54.14 	to meet the needs assessed by the certified assessor and identified in the coordinated service 
54.15 	and support plan identified in section 256B.0915, subdivision 6. The CFSS service delivery 
54.16 	plan must be reviewed by the participant, the consultation services provider, and the 
54.17 	agency-provider or FMS provider prior to starting services and at least annually upon 
54.18 	reassessment, oras necessary when there is a significant change in the participant's condition, 
54.19 	or a change in the need for services and supports, or at the request of the participant or the 
54.20 	participant's representative.
54.21 	(b) The commissioner shall establish the format and criteria for the CFSS service delivery 
54.22 	plan.
54.23 	(c) The CFSS service delivery plan must be person-centered and:
54.24 	(1) specify the consultation services provider, agency-provider, or FMS provider selected 
54.25 	by the participant;
54.26 	(2) reflect the setting in which the participant resides that is chosen by the participant;
54.27 	(3) reflect the participant's strengths and preferences;
54.28 	(4) include the methods and supports used to address the needs as identified through an 
54.29 	assessment of functional needs;
54.30 	(5) include the participant's identified goals and desired outcomes;
55.1 	(6) reflect the services and supports, paid and unpaid, that will assist the participant to 
55.2 	achieve identified goals, including the costs of the services and supports, and the providers 
55.3 	of those services and supports, including natural supports;
55.4 	(7) identify the amount and frequency of face-to-face supports and amount and frequency 
55.5 	of remote supports and technology that will be used;
55.6 	(8) identify risk factors and measures in place to minimize them, including individualized 
55.7 	backup plans;
55.8 	(9) be understandable to the participant and the individuals providing support;
55.9 	(10) identify the individual or entity responsible for monitoring the plan;
55.10 	(11) be finalized and agreed to in writing by the participant and signed by all individuals 
55.11 	and providers responsible for its implementation;
55.12 	(12) be distributed to the participant and other people involved in the plan;
55.13 	(13) prevent the provision of unnecessary or inappropriate care;
55.14 	(14) include a detailed budget for expenditures for budget model participants or 
55.15 	participants under the agency-provider model if purchasing goods; and
55.16 	(15) include a plan for worker training and development provided according to 
55.17 	subdivision 18a detailing what service components will be used, when the service components 
55.18 	will be used, how they will be provided, and how these service components relate to the 
55.19 	participant's individual needs and CFSS support worker services.
55.20 	(d) The total units of agency-provider services or the service budget amount for the 
55.21 	budget model include both annual totals and a monthly average amount that cover the 
55.22 	number of months of the service agreement. The amount used each month may vary, but 
55.23 	additional funds must not be provided above the annual service authorization amount, 
55.24 	determined according to subdivision 8, unless a change in condition is assessed and 
55.25 	authorized by the certified assessor and documented in the coordinated service and support 
55.26 	plan and CFSS service delivery plan.
55.27 	(e) In assisting with the development or modification of the CFSS service delivery plan 
55.28 	during the authorization time period, the consultation services provider shall:
55.29 	(1) consult with the FMS provider on the spending budget when applicable; and
55.30 	(2) consult with the participant or participant's representative, agency-provider, and case 
55.31 	manager/care coordinator.
56.1 	(f) The CFSS service delivery plan must be approved by the consultation services provider 
56.2 	for participants without a case manager or care coordinator who is responsible for authorizing 
56.3 	services. A case manager or care coordinator must approve the plan for a waiver or alternative 
56.4 	care program participant.

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

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

56.15 	Sec. 34. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision 
56.16 	to read:
56.17 		Subd. 2c.Interpreting services. "Interpreting services" means services that include:
56.18 	(1) interpreting between a spoken language, such as English, and a visual language, such 
56.19 	as American Sign Language;
56.20 	(2) interpreting between a spoken language and a visual representation of a spoken 
56.21 	language, such as cued speech and signing systems in English;
56.22 	(3) interpreting within one language where the interpreter uses natural gestures and 
56.23 	silently repeats the spoken message, replacing some words or phrases to give higher visibility 
56.24 	on the lips;
56.25 	(4) interpreting using low vision or tactile methods for people who have a combined 
56.26 	hearing and vision loss or are deafblind; and
56.27 	(5) interpreting between one communication mode or language into another 
56.28 	communication mode or language that is linguistically and culturally appropriate for the 
56.29 	participants in the communication exchange.

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

57.6 	Sec. 36. Minnesota Statutes 2016, section 256C.233, subdivision 1, is amended to read:
57.7 		Subdivision 1.Deaf and Hard-of-Hearing Services Division. The commissioners of 
57.8 	human services, education, employment and economic development, and health shall create 
57.9 	a distinct and separate organizational unit to be known as advise the commissioner of human 
57.10 	services on the activities of the Deaf and Hard-of-Hearing Services Division to address. 
57.11 	This division  addresses the developmental, social, educational, and occupationaland 
57.12 	social-emotional needs of persons who are deaf, persons who are deafblind, and persons 
57.13 	who are hard-of-hearing persons through a statewide network of collaborative services and 
57.14 	by coordinating the promulgation of public policies, regulations, legislation, and programs 
57.15 	affecting advocates on behalf of and provides information and training about how to best 
57.16 	serve persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing 
57.17 	persons. An interdepartmental management team shall advise the activities of the Deaf and 
57.18 	Hard-of-Hearing Services Division. The commissioner of human services shall coordinate 
57.19 	the work of the interagency management team advisers and receive legislative appropriations 
57.20 	for the division.

57.21 	Sec. 37. Minnesota Statutes 2016, section 256C.233, subdivision 2, is amended to read:
57.22 		Subd. 2.Responsibilities. The Deaf and Hard-of-Hearing Services Division shall:
57.23 	(1) establish and maintain a statewide network of regional service centersculturally 
57.24 	affirmative services for Minnesotans who are deaf, Minnesotans who are deafblind, and
57.25 	Minnesotans who are hard-of-hearing Minnesotans;
57.26 	(2) assist work across divisions within  the Departments Department of Human Services, 
57.27 	Education, and Employment and Economic Development to coordinate the promulgation 
57.28 	and implementation of public policies, regulations, legislation, programs, and services 
57.29 	affecting as well as with other agencies and counties, to ensure that there is an understanding 
57.30 	of:
57.31 	(i) the communication challenges faced by persons who are deaf, persons who are
57.32 	deafblind, and persons who are hard-of-hearing persons;
58.1 	(ii) the best practices for accommodating and mitigating communication challenges; 
58.2 	and
58.3 	(iii) the legal requirements for providing access to and effective communication with 
58.4 	persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing; and
58.5 	(3) provide a coordinated system of assess the supply and demand  statewide interpreting 
58.6 	or for interpreter referral services. and real-time captioning services, implement strategies 
58.7 	to provide greater access to these services in areas without sufficient supply, and build the 
58.8 	base of service providers across the state;
58.9 	(4) maintain a statewide information resource that includes contact information and 
58.10 	professional certification credentials of interpreting service providers and real-time captioning 
58.11 	service providers;
58.12 	(5) provide culturally affirmative mental health services to persons who are deaf, persons 
58.13 	who are hard-of-hearing, and persons who are deafblind, who:
58.14 	(i) use a visual language such as American Sign Language or a tactile form of a language; 
58.15 	or
58.16 	(ii) otherwise need culturally affirmative therapeutic services;
58.17 	(6) research and develop best practices and recommendations for emerging issues;
58.18 	(7) provide as much information as practicable on the division's stand-alone Web site 
58.19 	in American Sign Language; and
58.20 	(8) report to the chairs and ranking minority members of the legislative committees with 
58.21 	jurisdiction over human services biennially, beginning on January 1, 2019, on the following:
58.22 	(i) the number of regional service center staff, the location of the office of each staff 
58.23 	person, other service providers with which they are colocated, the number of people served 
58.24 	by each staff person, and a breakdown of whether each person was served on-site or off-site, 
58.25 	and for those served off-site, a list of locations where services were delivered, and the 
58.26 	number who were served in-person and the number who were served via technology;
58.27 	(ii) the amount and percentage of the division budget spent on reasonable 
58.28 	accommodations for staff;
58.29 	(iii) the number of people who use demonstration equipment and consumer evaluations 
58.30 	of the experience;
59.1 	(iv) the number of training sessions provided by division staff, the topics covered, the 
59.2 	number of participants, and consumer evaluations, including a breakdown by delivery 
59.3 	method such as in-person or via technology;
59.4 	(v) the number of training sessions hosted at a division location provided by another 
59.5 	service provider, the topics covered, the number of participants, and consumer evaluations, 
59.6 	including a breakdown by delivery method such as in-person or via technology;
59.7 	(vi) for each grant awarded, the amount awarded to the grantee and a summary of the 
59.8 	grantee's results, including consumer evaluations of the services or products provided;
59.9 	(vii) the number of people on waiting lists for any services provided by division staff 
59.10 	or for services or equipment funded through grants awarded by the division;
59.11 	(viii) the amount of time staff spent driving to appointments to deliver direct one-to-one 
59.12 	client services in locations outside of the regional service centers;
59.13 	(ix) the amount spent on mileage reimbursement and the number of clients who received 
59.14 	mileage reimbursement for traveling to the regional service centers for services; and
59.15 	(x) the regional needs and feedback on addressing service gaps identified by the advisory 
59.16 	committee.

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

59.23 	Sec. 39. Minnesota Statutes 2016, section 256C.24, subdivision 2, is amended to read:
59.24 		Subd. 2.Responsibilities. Each regional service center shall:
59.25 	(1) serve as a central entry point for establish connections and collaborations colocating 
59.26 	with other public and private entities providing services to persons who are deaf, persons 
59.27 	who are deafblind, and persons who are hard-of-hearing persons in need of services and 
59.28 	make referrals to the services needed in the region;
59.29 	(2) for those in need of services, assist in coordinating services between service providers 
59.30 	and persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing, 
59.31 	and the persons' families, and make referrals to the services needed;
60.1 	(2) (3) employ staff trained to work with persons who are deaf, persons who are deafblind, 
60.2 	and persons who are hard-of-hearing persons;
60.3 	(3) (4) if adequate services are not available from another public or private service 
60.4 	provider in the region, provide to all individual assistance to persons who are  deaf, persons 
60.5 	who are deafblind, and persons who are hard-of-hearing persons access to interpreter services 
60.6 	which are necessary to help them obtain services, and the persons' families. Individual 
60.7 	culturally affirmative assistance may be provided using technology only in areas of the state 
60.8 	when a person has access to sufficient quality telecommunications or broadband services 
60.9 	to allow effective communication. When a person who is deaf, a person who is deafblind, 
60.10 	or a person who is hard-of-hearing does not have access to sufficient telecommunications 
60.11 	or broadband service, individual assistance shall be available in person;
60.12 	(5) identify regional training needs, work with deaf and hard-of-hearing services training 
60.13 	staff, and collaborate with others to deliver training for persons who are deaf, persons who 
60.14 	are deafblind, and persons who are hard-of-hearing, and the persons' families, and other 
60.15 	service providers about subjects including the persons' rights under the law, American Sign 
60.16 	Language, and the impact of hearing loss and options for accommodating it;
60.17 	(4) implement a plan to provide loaned equipment and resource materials to deaf, 
60.18 	deafblind, and hard-of-hearing(6) have a mobile or permanent lab where persons who are 
60.19 	deaf, persons who are deafblind, and persons who are hard-of-hearing can try a selection 
60.20 	of modern assistive technology and equipment to determine what would best meet the 
60.21 	persons' needs;
60.22 	(5) cooperate with responsible departments and administrative authorities to provide 
60.23 	access for deaf, deafblind, and hard-of-hearing persons to services provided by state, county, 
60.24 	and regional agencies;
60.25 	(6) (7) collaborate with the Resource Center for the Deaf and Hard-of-Hearing Persons, 
60.26 	other divisions of the Department of Education, and local school districts to develop and 
60.27 	deliver programs and services for families with children who are deaf, children who are 
60.28 	deafblind, or children who are hard-of-hearing children and to support school personnel 
60.29 	serving these children;
60.30 	(7) when possible, (8) provide training to the social service or income maintenance staff 
60.31 	employed by counties or by organizations with whom counties contract for services to 
60.32 	ensure that communication barriers which prevent persons who are deaf, persons who are 
60.33 	deafblind, and persons who are hard-of-hearing persons from using services are removed;
61.1 	(8) when possible, (9) provide training to state and regional human service agencies in 
61.2 	the region regarding program access for persons who are deaf, persons who are deafblind, 
61.3 	and persons who are hard-of-hearing persons; and
61.4 	(9) (10) assess the ongoing need and supply of services for persons who are deaf, persons 
61.5 	who are deafblind, and persons who are hard-of-hearing persons in all parts of the state, 
61.6 	annually consult with the division's advisory committees to identify regional needs and 
61.7 	solicit feedback on addressing service gaps, and cooperate with public and private service 
61.8 	providers to develop these services.;
61.9 	(11) provide culturally affirmative mental health services to persons who are deaf, 
61.10 	persons who are hard-of-hearing, and persons who are deafblind, who:
61.11 	(i) use a visual language such as American Sign Language or a tactile form of a language; 
61.12 	or
61.13 	(ii) otherwise need culturally affirmative therapeutic services; and
61.14 	(12) establish partnerships with state and regional entities statewide with the technological 
61.15 	capacity to provide Minnesotans with virtual access to the division's services and 
61.16 	division-sponsored training via technology.

61.17 	Sec. 40. Minnesota Statutes 2016, section 256C.24, is amended by adding a subdivision 
61.18 	to read:
61.19 		Subd. 4.Transportation cost reimbursement. Persons who are deaf, persons who are 
61.20 	deafblind, and persons who are hard-of-hearing, and the person's family members who 
61.21 	travel more than 50 miles round-trip from the person's home or work location to receive 
61.22 	services at the regional service center may be reimbursed by the Deaf and Hard-of-Hearing 
61.23 	Division for mileage at the reimbursement rate established by the Internal Revenue Service.

61.24 	Sec. 41. Minnesota Statutes 2016, section 256C.261, is amended to read:
61.25 	256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND PERSONS.
61.26 	(a) The commissioner of human services shall combine the existing biennial base level 
61.27 	funding for deafblind services into a single grant program. At least 35 percent of the total 
61.28 	funding is awarded for services and other supports to deafblind children and their families 
61.29 	and at least 25 percent is awarded for services and other supports todeafblindadultsuse at 
61.30 	least 35 percent of the deafblind services biennial base level grant funding for services and 
61.31 	other supports for a child who is deafblind and the child's family. The commissioner shall 
62.1 	use at least 25 percent of the deafblind services biennial base level grant funding for services 
62.2 	and other supports for an adult who is deafblind.
62.3 	The commissioner shall award grants for the purposes of:
62.4 	(1) providing services and supports to individuals persons who are deafblind; and
62.5 	(2) developing and providing training to counties and the network of senior citizen 
62.6 	service providers. The purpose of the training grants is to teach counties how to use existing 
62.7 	programs that capture federal financial participation to meet the needs of eligible persons 
62.8 	who are deafblind persons and to build capacity of senior service programs to meet the 
62.9 	needs of seniors with a dual sensory hearing and vision loss.
62.10 	(b) The commissioner may make grants:
62.11 	(1) for services and training provided by organizations; and
62.12 	(2) to develop and administer consumer-directed services.
62.13 	(c) Consumer-directed services shall be provided in whole by grant-funded providers. 
62.14 	The deaf and hard-of-hearing regional service centers shall not provide any aspect of a 
62.15 	grant-funded consumer-directed services program.
62.16 	(c) (d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant 
62.17 	under paragraph (a).
62.18 	(d) (e) Deafblind service providers may, but are not required to, provide intervenor 
62.19 	services as part of the service package provided with grant funds under this section.

62.20 	Sec. 42. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET 
62.21 	METHODOLOGY EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND 
62.22 	CRISIS RESIDENTIAL SETTINGS.
62.23 	(a) By September 30, 2017, the commissioner shall establish an institutional and crisis 
62.24 	bed consumer-directed community supports budget exception process in the home and 
62.25 	community-based services waivers under Minnesota Statutes, sections 256B.092 and 
62.26 	256B.49. This budget exception process shall be available for any individual who:
62.27 	(1) is not offered available and appropriate services within 60 days since approval for 
62.28 	discharge from the individual's current institutional setting; and
62.29 	(2) requires services that are more expensive than appropriate services provided in a 
62.30 	noninstitutional setting using the consumer-directed community supports option.
63.1 	(b) Institutional settings for purposes of this exception include intermediate care facilities 
63.2 	for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka 
63.3 	Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget 
63.4 	exception shall be limited to no more than the amount of appropriate services provided in 
63.5 	a noninstitutional setting as determined by the lead agency managing the individual's home 
63.6 	and community-based services waiver. The lead agency shall notify the Department of 
63.7 	Human Services of the budget exception.

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

63.9 	Sec. 43. FEDERAL WAIVER REQUESTS.
 63.10 	The commissioner of human services shall submit necessary waiver amendments to the 
63.11 	Centers for Medicare and Medicaid Services to add employment exploration services, 
63.12 	employment development services, and employment support services to the home and 
63.13 	community-based services waiver authorized under Minnesota Statutes, sections 256B.092 
63.14 	and 256B.49. The commissioner shall also submit necessary waiver amendments to remove 
63.15 	community-based employment from day training and habilitation and prevocational services. 
63.16 	The commissioner shall submit the necessary waiver amendments by October 1, 2017.

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

63.18 	Sec. 44. TRANSPORTATION STUDY.
 63.19 	The commissioner of human services, with cooperation from lead agencies and in 
63.20 	consultation with stakeholders, shall conduct a study to identify opportunities to increase 
63.21 	access to transportation services for an individual who receives home and community-based 
63.22 	services. The commissioner shall submit a report with recommendations to the chairs and 
63.23 	ranking minority members of the legislative committees with jurisdiction over human 
63.24 	services by January 15, 2019. The report shall:
63.25 	(1) study all aspects of the current transportation service network, including the fleet 
63.26 	available, the different rate-setting methods currently used, methods that an individual uses 
63.27 	to access transportation, and the diversity of available provider agencies;
63.28 	(2) identify current barriers for an individual accessing transportation and for a provider 
63.29 	providing waiver services transportation in the marketplace;
63.30 	(3) identify efficiencies and collaboration opportunities to increase available 
63.31 	transportation, including transportation funded by medical assistance, and available regional 
63.32 	transportation and transit options;
64.1 	(4) study transportation solutions in other states for delivering home and community-based 
64.2 	services;
64.3 	(5) study provider costs required to administer transportation services;
64.4 	(6) make recommendations for coordinating and increasing transportation accessibility 
64.5 	across the state; and
64.6 	(7) make recommendations for the rate setting of waivered transportation.

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

64.8 	Sec. 45. DIRECTION TO COMMISSIONER; TELECOMMUNICATION 
64.9 	EQUIPMENT PROGRAM.
 64.10 	(a) The commissioner of human services shall work in consultation with the Commission 
64.11 	of Deaf, Deafblind, and Hard-of-Hearing Minnesotans to provide recommendations by 
64.12 	January 15, 2018, to the chairs and ranking minority members of the house of representatives 
64.13 	and senate committees with jurisdiction over human services to modernize the 
64.14 	telecommunication equipment program. The recommendations must address:
64.15 	(1) types of equipment and supports the program should provide to ensure people with 
64.16 	communication difficulties have equitable access to telecommunications services;
64.17 	(2) additional services the program should provide such as education about technology 
64.18 	options that can improve a person's access to telecommunications service; and
64.19 	(3) how the current program's service delivery structure might be improved to better 
64.20 	meet the needs of people with communication disabilities.
64.21 	(b) The commissioner shall also provide draft legislative language to accomplish the 
64.22 	recommendations. Final recommendations, the final report, and draft legislative language 
64.23 	must be approved by both the commissioner and the chair of the commission.

64.24 	Sec. 46. DIRECTION TO COMMISSIONER; BILLING FOR MENTAL HEALTH 
64.25 	SERVICES.
 64.26 	By January 1, 2018, the commissioner of human services shall report to the chairs and 
64.27 	ranking minority members of the house of representatives and senate committees with 
64.28 	jurisdiction over deaf and hard-of-hearing services on the potential costs and benefits of the 
64.29 	Deaf and Hard-of-Hearing Services Division billing for the cost of providing mental health 
64.30 	services.

65.1 	Sec. 47. DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES.
 65.2 	The commissioner of human services shall work with lead agencies responsible for 
65.3 	conducting long-term consultation services under Minnesota Statutes, section 256B.0911, 
65.4 	to modify the MnCHOICES assessment tool and related policies to:
65.5 	(1) reduce assessment times;
65.6 	(2) create efficiencies within the tool and within practice and policy for conducting 
65.7 	assessments and support planning;
65.8 	(3) implement policy changes reducing the frequency and depth of assessment and 
65.9 	reassessment, while ensuring federal compliance with medical assistance and disability 
65.10 	waiver eligibility requirements; and
65.11 	(4) evaluate alternative payment methods.

65.12 	Sec. 48. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS 
65.13 	BUDGET METHODOLOGY EXCEPTION.
 65.14 	(a) No later than September 30, 2017, if necessary, the commissioner of human services 
65.15 	shall submit an amendment to the Centers for Medicare and Medicaid Services for the home 
65.16 	and community-based services waivers authorized under Minnesota Statutes, sections 
65.17 	256B.092 and 256B.49, to expand the exception to the consumer-directed community 
65.18 	supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to increase 
65.19 	consumer-directed community support budgets up to 30 percent for the following:
65.20 	(1) consumer-directed community support participants whose current consumer-directed 
65.21 	community support budget cannot accommodate increased services and supports identified 
65.22 	in the participant's coordinated service and support plan and that are required in order to:
65.23 	(i) increase the amount of time a participant works or otherwise improves employment 
65.24 	opportunity;
65.25 	(ii) plan a transition to, move to, or live in a setting described in Minnesota Statutes, 
65.26 	section 256D.44, subdivision 5, paragraph (f), clause (1), item (ii), or paragraph (g); or
65.27 	(iii) develop and implement a positive support plan; or
65.28 	(2) home and community-based waiver participants who are currently using licensed 
65.29 	providers for residential services that cost more annually than the participant would spend 
65.30 	under a consumer-directed community support plan for any and all of the services and 
65.31 	supports needed to meet the goals identified in clause (1).
66.1 	(b) The exception under paragraph (a), clause (1), is limited to those consumer-directed 
66.2 	community participants who can demonstrate that the participant shall discontinue 
66.3 	consumer-directed community supports and accept other nonself-directed waiver services 
66.4 	because the participant cannot meet the goals described in paragraph (a), clause (1), within 
66.5 	the participant's current consumer-directed community support budget limits.
66.6 	(c) The exception under paragraph (a), clause (2), is limited to those home and 
66.7 	community-based waiver participants who can demonstrate that, upon choosing to become 
66.8 	a consumer-directed community support participant, the total cost of services, including the 
66.9 	exception, would be less than the cost of the waiver services the participant would otherwise 
66.10 	receive.

66.11 	Sec. 49.  REPEALER.
 66.12 	(a) Minnesota Statutes 2016, sections 256C.23, subdivision 3; 256C.233, subdivision 
66.13 	4; and 256C.25, subdivisions 1 and 2, are repealed effective the day following final 
66.14 	enactment.
66.15 	(b) Minnesota Statutes 2016, section 256B.4914, subdivision 16, is repealed effective 
66.16 	January 1, 2018.

66.17 	ARTICLE 2
66.18 	HOUSING

66.19 	Section 1. Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:
66.20 		Subd. 2.Contents of contract.  A housing with services contract, which need not be 
66.21 	entitled as such to comply with this section, shall include at least the following elements in 
66.22 	itself or through supporting documents or attachments:
66.23 	(1) the name, street address, and mailing address of the establishment;
66.24 	(2) the name and mailing address of the owner or owners of the establishment and, if 
66.25 	the owner or owners is not a natural person, identification of the type of business entity of 
66.26 	the owner or owners;
66.27 	(3) the name and mailing address of the managing agent, through management agreement 
66.28 	or lease agreement, of the establishment, if different from the owner or owners;
66.29 	(4) the name and address of at least one natural person who is authorized to accept service 
66.30 	of process on behalf of the owner or owners and managing agent;
67.1 	(5) a statement describing the registration and licensure status of the establishment and 
67.2 	any provider providing health-related or supportive services under an arrangement with the 
67.3 	establishment;
67.4 	(6) the term of the contract;
67.5 	(7) a description of the services to be provided to the resident in the base rate to be paid 
67.6 	by resident, including a delineation of the portion of the base rate that constitutes rent and 
67.7 	a delineation of charges for each service included in the base rate;
67.8 	(8) a description of any additional services, including home care services, available for 
67.9 	an additional fee from the establishment directly or through arrangements with the 
67.10 	establishment, and a schedule of fees charged for these services;
67.11 	(9) a description of the process through which the contract may be modified, amended, 
67.12 	or terminated, including whether a move to a different room or sharing a room would be 
67.13 	required in the event that the tenant can no longer pay the current rent;
67.14 	(10) a description of the establishment's complaint resolution process available to residents 
67.15 	including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;
67.16 	(11) the resident's designated representative, if any;
67.17 	(12) the establishment's referral procedures if the contract is terminated;
67.18 	(13) requirements of residency used by the establishment to determine who may reside 
67.19 	or continue to reside in the housing with services establishment;
67.20 	(14) billing and payment procedures and requirements;
67.21 	(15) a statement regarding the ability of residents a resident to receive services from 
67.22 	service providers with whom the establishment does not have an arrangement;
67.23 	(16) a statement regarding the availability of public funds for payment for residence or 
67.24 	services in the establishment; and
67.25 	(17) a statement regarding the availability of and contact information for long-term care 
67.26 	consultation services under section 256B.0911 in the county in which the establishment is 
67.27 	located.

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

68.1 	Sec. 2. Minnesota Statutes 2016, section 144D.04, is amended by adding a subdivision to 
68.2 	read:
68.3 		Subd. 2a.Additional contract requirements. (a) For a resident receiving one or more 
68.4 	health-related services from the establishment's arranged home care provider, as defined in 
68.5 	section 144D.01, subdivision 6, the contract must include the requirements in paragraph 
68.6 	(b). A restriction of a resident's rights under this subdivision is allowed only if determined 
68.7 	necessary for health and safety reasons identified by the home care provider's registered 
68.8 	nurse in an initial assessment or reassessment, as defined under section 144A.4791, 
68.9 	subdivision 8, and documented in the written service plan under section 144A.4791, 
68.10 	subdivision 9. Any restrictions of those rights for people served under sections 256B.0915 
68.11 	and 256B.49 must be documented in the resident's coordinated service and support plan 
68.12 	(CSSP), as defined under sections 256B.0915, subdivision 6 and 256B.49, subdivision 15.
68.13 	(b) The contract must include a statement:
68.14 	(1) regarding the ability of a resident to furnish and decorate the resident's unit within 
68.15 	the terms of the lease;
68.16 	(2) regarding the resident's right to access food at any time;
68.17 	(3) regarding a resident's right to choose the resident's visitors and times of visits;
68.18 	(4) regarding the resident's right to choose a roommate if sharing a unit; and
68.19 	(5) notifying the resident of the resident's right to have and use a lockable door to the 
68.20 	resident's unit. The landlord shall provide the locks on the unit. Only a staff member with 
68.21 	a specific need to enter the unit shall have keys, and advance notice must be given to the 
68.22 	resident before entrance, when possible.

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

68.24 	Sec. 3. Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:
68.25 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial license 
68.26 	for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult 
68.27 	foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter 
68.28 	for a physical location that will not be the primary residence of the license holder for the 
68.29 	entire period of licensure. If a license is issued during this moratorium, and the license 
68.30 	holder changes the license holder's primary residence away from the physical location of 
68.31 	the foster care license, the commissioner shall revoke the license according to section 
69.1 	245A.07. The commissioner shall not issue an initial license for a community residential 
69.2 	setting licensed under chapter 245D. Exceptions to the moratorium include:
69.3 	(1) foster care settings that are required to be registered under chapter 144D;
69.4 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
69.5 	community residential setting licenses replacing adult foster care licenses in existence on 
69.6 	December 31, 2013, and determined to be needed by the commissioner under paragraph 
69.7 	(b);
69.8 	(3) new foster care licenses or community residential setting licenses determined to be 
69.9 	needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD, 
69.10 	or regional treatment center; restructuring of state-operated services that limits the capacity 
69.11 	of state-operated facilities; or allowing movement to the community for people who no 
69.12 	longer require the level of care provided in state-operated facilities as provided under section 
69.13 	256B.092, subdivision 13, or 256B.49, subdivision 24;
69.14 	(4) new foster care licenses or community residential setting licenses determined to be 
69.15 	needed by the commissioner under paragraph (b) for persons requiring hospital level care; 
69.16 	or
69.17 	(5) new foster care licenses or community residential setting licenses determined to be 
69.18 	needed by the commissioner for the transition of people from personal care assistance to 
69.19 	the home and community-based services. When approving an exception under this paragraph, 
69.20 	the commissioner shall consider the resource need determination process in paragraph (h), 
69.21 	the availability of foster care licensed beds in the geographic area in which the licensee 
69.22 	seeks to operate, the results of a person's choices during their annual assessment and service 
69.23 	plan review, and the recommendation of the local county board. The determination by the 
69.24 	commissioner is final and not subject to appeal;
69.25 	(6) new foster care licenses or community residential setting licenses determined to be 
69.26 	needed by the commissioner for the transition of people from the residential care waiver 
69.27 	services to foster care services. This exception applies only when:
69.28 	(i) the person's case manager provided the person with information about the choice of 
69.29 	service, service provider, and location of service to help the person make an informed choice; 
69.30 	and
69.31 	(ii) the person's foster care services are less than or equal to the cost of the person's 
69.32 	services delivered in the residential care waiver service setting as determined by the lead 
69.33 	agency; or
70.1 	(7) new foster care licenses or community residential setting licenses for people receiving 
70.2 	services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and 
70.3 	for which a license is required. This exception does not apply to people living in their own 
70.4 	home. For purposes of this clause, there is a presumption that a foster care or community 
70.5 	residential setting license is required for services provided to three or more people in a 
70.6 	dwelling unit when the setting is controlled by the provider. A license holder subject to this 
70.7 	exception may rebut the presumption that a license is required by seeking a reconsideration 
70.8 	of the commissioner's determination. The commissioner's disposition of a request for 
70.9 	reconsideration is final and not subject to appeal under chapter 14. The exception is available 
70.10 	until June 30, 2018. This exception is available when:
70.11 	(i) the person's case manager provided the person with information about the choice of 
70.12 	service, service provider, and location of service, including in the person's home, to help 
70.13 	the person make an informed choice; and
70.14 	(ii) the person's services provided in the licensed foster care or community residential 
70.15 	setting are less than or equal to the cost of the person's services delivered in the unlicensed 
70.16 	setting as determined by the lead agency.
70.17 	(b) The commissioner shall determine the need for newly licensed foster care homes or 
70.18 	community residential settings as defined under this subdivision. As part of the determination, 
70.19 	the commissioner shall consider the availability of foster care capacity in the area in which 
70.20 	the licensee seeks to operate, and the recommendation of the local county board. The 
70.21 	determination by the commissioner must be final. A determination of need is not required 
70.22 	for a change in ownership at the same address.
70.23 	(c) When an adult resident served by the program moves out of a foster home that is not 
70.24 	the primary residence of the license holder according to section 256B.49, subdivision 15, 
70.25 	paragraph (f), or the adult community residential setting, the county shall immediately 
70.26 	inform the Department of Human Services Licensing Division. The department shallmay 
70.27 	decrease the statewide licensed capacity for adult foster care settings where the physical 
70.28 	location is not the primary residence of the license holder, or for adult community residential 
70.29 	settings, if the voluntary changes described in paragraph (e) are not sufficient to meet the 
70.30 	savings required by reductions in licensed bed capacity under Laws 2011, First Special 
70.31 	Session chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term 
70.32 	care residential services capacity within budgetary limits. Implementation of the statewide 
70.33 	licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense 
70.34 	up to 128 beds by June 30, 2014, using the needs determination process. Prior to any 
70.35 	involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies 
71.1 	and license holders to determine which adult foster care settings, where the physical location 
71.2 	is not the primary residence of the license holder, or community residential settings, are 
71.3 	licensed for up to five beds, but have operated at less than full capacity for 12 or more 
71.4 	months as of March 1, 2014. The settings that meet these criteria must be the first to be 
71.5 	considered for an involuntary decrease in statewide licensed capacity, up to a maximum of 
71.6 	35 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall 
71.7 	prioritize the selection of those beds to be closed based on the length of time the beds have 
71.8 	been vacant. The longer a bed has been vacant, the higher priority it must be given for 
71.9 	closure. Under this paragraph, the commissioner has the authority to reduce unused licensed 
71.10 	capacity of a current foster care program, or the community residential settings, to accomplish 
71.11 	the consolidation or closure of settings. Under this paragraph, the commissioner has the 
71.12 	authority to manage statewide capacity, including adjusting the capacity available to each 
71.13 	county and adjusting statewide available capacity, to meet the statewide needs identified 
71.14 	through the process in paragraph (e). A decreased licensed capacity according to this 
71.15 	paragraph is not subject to appeal under this chapter.
71.16 	(d) Residential settings that would otherwise be subject to the decreased license capacity 
71.17 	established in paragraph (c) shall be exempt if the license holder's beds are occupied by 
71.18 	residents whose primary diagnosis is mental illness and the license holder is certified under 
71.19 	the requirements in subdivision 6a or section 245D.33.
71.20 	(e) A resource need determination process, managed at the state level, using the available 
71.21 	reports required by section 144A.351, and other data and information shall be used to 
71.22 	determine where the reduced capacity requireddetermined under paragraph (c) section 
71.23 	256B.493 will be implemented. The commissioner shall consult with the stakeholders 
71.24 	described in section 144A.351, and employ a variety of methods to improve the state's 
71.25 	capacity to meet the informed decisions of those people who want to move out of corporate 
71.26 	foster care or community residential settings, long-term care service needs within budgetary 
71.27 	limits, including seeking proposals from service providers or lead agencies to change service 
71.28 	type, capacity, or location to improve services, increase the independence of residents, and 
71.29 	better meet needs identified by the long-term care services and supports reports and statewide 
71.30 	data and information. By February 1, 2013, and August 1, 2014, and each following year, 
71.31 	the commissioner shall provide information and data and targets on the overall capacity of 
71.32 	licensed long-term care services and supports, actions taken under this subdivision to manage 
71.33 	statewide long-term care services and supports resources, and any recommendations for 
71.34 	change to the legislative committees with jurisdiction over health and human services budget.
72.1 	(f) At the time of application and reapplication for licensure, the applicant and the license 
72.2 	holder that are subject to the moratorium or an exclusion established in paragraph (a) are 
72.3 	required to inform the commissioner whether the physical location where the foster care 
72.4 	will be provided is or will be the primary residence of the license holder for the entire period 
72.5 	of licensure. If the primary residence of the applicant or license holder changes, the applicant 
72.6 	or license holder must notify the commissioner immediately. The commissioner shall print 
72.7 	on the foster care license certificate whether or not the physical location is the primary 
72.8 	residence of the license holder.
72.9 	(g) License holders of foster care homes identified under paragraph (f) that are not the 
72.10 	primary residence of the license holder and that also provide services in the foster care home 
72.11 	that are covered by a federally approved home and community-based services waiver, as 
72.12 	authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services 
72.13 	licensing division that the license holder provides or intends to provide these waiver-funded 
72.14 	services.
72.15 	(h) The commissioner may adjust capacity to address needs identified in section 
72.16 	144A.351. Under this authority, the commissioner may approve new licensed settings or 
72.17 	delicense exiting settings. Delicensing of settings will be accomplished through a process 
72.18 	identified in section 256B.493. Annually, by August 1, the commissioner shall provide 
72.19 	information and data on capacity of licensed long-term services and supports, actions taken 
72.20 	under the subdivision to manage statewide long-term services and supports resources, and 
72.21 	any recommendations for change to the legislative committees with jurisdiction over the 
72.22 	health and human services budget.
72.23 	(i) The commissioner must notify a license holder when its corporate foster care or 
72.24 	community residential setting licensed beds are reduced under this section. The notice of 
72.25 	reduction of licensed beds must be in writing and delivered to the license holder by certified 
72.26 	mail or personal service. The notice must state why the licensed beds are reduced and must 
72.27 	inform the license holder of its right to request reconsideration by the commissioner. The 
72.28 	license holder's request for reconsideration must be in writing. If mailed, the request for 
72.29 	reconsideration must be postmarked and sent to the commissioner within 20 calendar days 
72.30 	after the license holder's receipt of the notice of reduction of licensed beds. If a request for 
72.31 	reconsideration is made by personal service, it must be received by the commissioner within 
72.32 	20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
72.33 	(j) The commissioner shall not issue an initial license for children's residential treatment 
72.34 	services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter 
73.1 	for a program that Centers for Medicare and Medicaid Services would consider an institution 
73.2 	for mental diseases.

73.3 	Sec. 4. Minnesota Statutes 2016, section 245A.04, subdivision 14, is amended to read:
73.4 		Subd. 14.Policies and procedures for program administration required and 
73.5 	enforceable. (a) The license holder shall develop program policies and procedures necessary 
73.6 	to maintain compliance with licensing requirements under Minnesota Statutes and Minnesota 
73.7 	Rules.
73.8 	(b) The license holder shall:
73.9 	(1) provide training to program staff related to their duties in implementing the program's 
73.10 	policies and procedures developed under paragraph (a);
73.11 	(2) document the provision of this training; and
73.12 	(3) monitor implementation of policies and procedures by program staff.
73.13 	(c) The license holder shall keep program policies and procedures readily accessible to 
73.14 	staff and index the policies and procedures with a table of contents or another method 
73.15 	approved by the commissioner.
73.16 	(d) An adult foster care license holder that provides foster care services to a resident 
73.17 	under section 256B.0915 must annually provide a copy of the resident termination policy 
73.18 	under section 245A.11, subdivision 11, to a resident covered by the policy.

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

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

74.1 	Sec. 6. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
74.2 	read:
74.3 		Subd. 10.Adult foster care resident rights. (a) The license holder shall ensure that a 
74.4 	resident and a resident's legal representative are given, at admission:
74.5 	(1) an explanation and copy of the resident's rights specified in paragraph (b);
74.6 	(2) a written summary of the Vulnerable Adults Protection Act prepared by the 
74.7 	department; and
74.8 	(3) the name, address, and telephone number of the local agency to which a resident or 
74.9 	a resident's legal representative may submit an oral or written complaint.
74.10 	(b) Adult foster care resident rights include the right to:
74.11 	(1) have daily, private access to and use of a non-coin-operated telephone for local and 
74.12 	long-distance telephone calls made collect or paid for by the resident;
74.13 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
74.14 	correspondence or communication;
74.15 	(3) have use of and free access to common areas in the residence and the freedom to 
74.16 	come and go from the residence at will;
74.17 	(4) have privacy for visits with the resident's spouse, next of kin, legal counsel, religious 
74.18 	adviser, or others, according to section 363A.09 of the Human Rights Act, including privacy 
74.19 	in the resident's bedroom;
74.20 	(5) keep, use, and access the resident's personal clothing and possessions as space permits, 
74.21 	unless this right infringes on the health, safety, or rights of another resident or household 
74.22 	member, including the right to access the resident's personal possessions at any time;
74.23 	(6) choose the resident's visitors and time of visits and participate in activities of 
74.24 	commercial, religious, political, and community groups without interference if the activities 
74.25 	do not infringe on the rights of another resident or household member;
74.26 	(7) if married, privacy for visits by the resident's spouse, and, if both spouses are residents 
74.27 	of the adult foster home, the residents have the right to share a bedroom and bed;
74.28 	(8) privacy, including use of the lock on the resident's bedroom door or unit door. A 
74.29 	resident's privacy must be respected by license holders, caregivers, household members, 
74.30 	and volunteers by knocking on the door of a resident's bedroom or bathroom and seeking 
74.31 	consent before entering, except in an emergency;
75.1 	(9) furnish and decorate the resident's bedroom or living unit;
75.2 	(10) engage in chosen activities and have an individual schedule supported by the license 
75.3 	holder that meets the resident's preferences;
75.4 	(11) freedom and support to access food at any time;
75.5 	(12) have personal, financial, service, health, and medical information kept private, and 
75.6 	be advised of disclosure of this information by the license holder;
75.7 	(13) access records and recorded information about the resident according to applicable 
75.8 	state and federal law, regulation, or rule;
75.9 	(14) be free from maltreatment;
75.10 	(15) be treated with courtesy and respect and receive respectful treatment of the resident's 
75.11 	property;
75.12 	(16) reasonable observance of cultural and ethnic practice and religion;
75.13 	(17) be free from bias and harassment regarding race, gender, age, disability, spirituality, 
75.14 	and sexual orientation;
75.15 	(18) be informed of and use the license holder's grievance policy and procedures, 
75.16 	including how to contact the highest level of authority in the program;
75.17 	(19) assert the resident's rights personally, or have the rights asserted by the resident's 
75.18 	family, authorized representative, or legal representative, without retaliation; and
75.19 	(20) give or withhold written informed consent to participate in any research or 
75.20 	experimental treatment.
75.21 	(c) A restriction of a resident's rights under paragraph (b), clauses (1) to (4), (6), (8), 
75.22 	(10), and (11), is allowed only if determined necessary to ensure the health, safety, and 
75.23 	well-being of the resident. Any restriction of a resident's right must be documented and 
75.24 	justified in the resident's individual abuse prevention plan required by sections 245A.65, 
75.25 	subdivision 2, paragraph (b) and 626.557, subdivision 14. For a resident served under section 
75.26 	256B.0915, the case manager must be part of the interdisciplinary team under section 
75.27 	245A.65, subdivision 2, paragraph (b). The restriction must be implemented in the least 
75.28 	restrictive manner necessary to protect the resident and provide support to reduce or eliminate 
75.29 	the need for the restriction.

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

76.1 	Sec. 7. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to 
76.2 	read:
76.3 		Subd. 11.Adult foster care service termination for elderly waiver participants. (a) 
76.4 	This subdivision applies to foster care services for a resident served under section 256B.0915.
76.5 	(b) The foster care license holder must establish policies and procedures for service 
76.6 	termination that promote continuity of care and service coordination with the resident and 
76.7 	the case manager and with another licensed caregiver, if any, who also provides support to 
76.8 	the resident. The policy must include the requirements specified in paragraphs (c) to (h).
76.9 	(c) The license holder must allow a resident to remain in the program and cannot terminate 
76.10 	services unless:
76.11 	(1) the termination is necessary for the resident's health, safety, and well-being and the 
76.12 	resident's needs cannot be met in the facility;
76.13 	(2) the safety of the resident or another resident in the program is endangered and positive 
76.14 	support strategies were attempted and have not achieved and effectively maintained safety 
76.15 	for the resident or another resident in the program;
76.16 	(3) the health, safety, and well-being of the resident or another resident in the program 
76.17 	would otherwise be endangered;
76.18 	(4) the program was not paid for services;
76.19 	(5) the program ceases to operate; or
76.20 	(6) the resident was terminated by the lead agency from waiver eligibility.
76.21 	(d) Before giving notice of service termination, the license holder must document the 
76.22 	action taken to minimize or eliminate the need for termination. The action taken by the 
76.23 	license holder must include, at a minimum:
76.24 	(1) consultation with the resident's interdisciplinary team to identify and resolve issues 
76.25 	leading to a notice of service termination; and
76.26 	(2) a request to the case manager or other professional consultation or intervention 
76.27 	services to support the resident in the program. This requirement does not apply to a notice 
76.28 	of service termination issued under paragraph (c), clause (4) or (5).
76.29 	(e) If, based on the best interests of the resident, the circumstances at the time of notice 
76.30 	were such that the license holder was unable to take the action specified in paragraph (d), 
76.31 	the license holder must document the specific circumstances and the reason the license 
76.32 	holder was unable to take the action.
77.1 	(f) The license holder must notify the resident or the resident's legal representative and 
77.2 	the case manager in writing of the intended service termination. The notice must include:
77.3 	(1) the reason for the action;
77.4 	(2) except for service termination under paragraph (c), clause (4) or (5), a summary of 
77.5 	the action taken to minimize or eliminate the need for termination and the reason the action 
77.6 	failed to prevent the termination;
77.7 	(3) the resident's right to appeal the service termination under section 256.045, subdivision 
77.8 	3, paragraph (a); and
77.9 	(4) the resident's right to seek a temporary order staying the service termination according 
77.10 	to the procedures in section 256.045, subdivision 4a, or subdivision 6, paragraph (c).
77.11 	(g) Notice of the proposed service termination must be given at least 30 days before 
77.12 	terminating a resident's service.
77.13 	(h) After the resident receives the notice of service termination and before the services 
77.14 	are terminated, the license holder must:
77.15 	(1) work with the support team or expanded support team to develop reasonable 
77.16 	alternatives to support continuity of care and to protect the resident;
77.17 	(2) provide information requested by the resident or case manager; and
77.18 	(3) maintain information about the service termination, including the written notice of 
77.19 	service termination, in the resident's record.

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

77.21 	Sec. 8. Minnesota Statutes 2016, section 245D.04, subdivision 3, is amended to read:
77.22 		Subd. 3.Protection-related rights. (a) A person's protection-related rights include the 
77.23 	right to:
77.24 	(1) have personal, financial, service, health, and medical information kept private, and 
77.25 	be advised of disclosure of this information by the license holder;
77.26 	(2) access records and recorded information about the person in accordance with 
77.27 	applicable state and federal law, regulation, or rule;
77.28 	(3) be free from maltreatment;
77.29 	(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited 
77.30 	procedure identified in section 245D.06, subdivision 5, or successor provisions, except for: 
78.1 	(i) emergency use of manual restraint to protect the person from imminent danger to self 
78.2 	or others according to the requirements in section 245D.061 or successor provisions; or (ii) 
78.3 	the use of safety interventions as part of a positive support transition plan under section 
78.4 	245D.06, subdivision 8, or successor provisions;
78.5 	(5) receive services in a clean and safe environment when the license holder is the owner, 
78.6 	lessor, or tenant of the service site;
78.7 	(6) be treated with courtesy and respect and receive respectful treatment of the person's 
78.8 	property;
78.9 	(7) reasonable observance of cultural and ethnic practice and religion;
78.10 	(8) be free from bias and harassment regarding race, gender, age, disability, spirituality, 
78.11 	and sexual orientation;
78.12 	(9) be informed of and use the license holder's grievance policy and procedures, including 
78.13 	knowing how to contact persons responsible for addressing problems and to appeal under 
78.14 	section 256.045;
78.15 	(10) know the name, telephone number, and the Web site, e-mail, and street addresses 
78.16 	of protection and advocacy services, including the appropriate state-appointed ombudsman, 
78.17 	and a brief description of how to file a complaint with these offices;
78.18 	(11) assert these rights personally, or have them asserted by the person's family, 
78.19 	authorized representative, or legal representative, without retaliation;
78.20 	(12) give or withhold written informed consent to participate in any research or 
78.21 	experimental treatment;
78.22 	(13) associate with other persons of the person's choice;
78.23 	(14) personal privacy, including the right to use the lock on the person's bedroom or unit 
78.24 	door; and
78.25 	(15) engage in chosen activities; and
78.26 	(16) access to the person's personal possessions at any time, including financial resources.
78.27 	(b) For a person residing in a residential site licensed according to chapter 245A, or 
78.28 	where the license holder is the owner, lessor, or tenant of the residential service site, 
78.29 	protection-related rights also include the right to:
78.30 	(1) have daily, private access to and use of a non-coin-operated telephone for local calls 
78.31 	and long-distance calls made collect or paid for by the person;
79.1 	(2) receive and send, without interference, uncensored, unopened mail or electronic 
79.2 	correspondence or communication;
79.3 	(3) have use of and free access to common areas in the residence and the freedom to 
79.4 	come and go from the residence at will; and
79.5 	(4) choose the person's visitors and time of visits and have privacy for visits with the 
79.6 	person's spouse, next of kin, legal counsel, religious advisor adviser, or others, in accordance 
79.7 	with section 363A.09 of the Human Rights Act, including privacy in the person's bedroom.;
79.8 	(5) the freedom and support to access food at any time;
79.9 	(6) the freedom to furnish and decorate the person's bedroom or living unit;
79.10 	(7) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling 
79.11 	paint, mold, vermin, and insects;
79.12 	(8) a setting that is free from hazards that threaten the person's health or safety;
79.13 	(9) a setting that meets state and local building and zoning definitions of a dwelling unit 
79.14 	in a residential occupancy; and
79.15 	(10) have access to potable water and three nutritionally balanced meals and nutritious 
79.16 	snacks between meals each day.
79.17 	(c) Restriction of a person's rights under paragraph (a), clauses (13) to (15) (16), or 
79.18 	paragraph (b) is allowed only if determined necessary to ensure the health, safety, and 
79.19 	well-being of the person. Any restriction of those rights must be documented in the person's 
79.20 	coordinated service and support plan or coordinated service and support plan addendum. 
79.21 	The restriction must be implemented in the least restrictive alternative manner necessary 
79.22 	to protect the person and provide support to reduce or eliminate the need for the restriction 
79.23 	in the most integrated setting and inclusive manner. The documentation must include the 
79.24 	following information:
79.25 	(1) the justification for the restriction based on an assessment of the person's vulnerability 
79.26 	related to exercising the right without restriction;
79.27 	(2) the objective measures set as conditions for ending the restriction;
79.28 	(3) a schedule for reviewing the need for the restriction based on the conditions for 
79.29 	ending the restriction to occur semiannually from the date of initial approval, at a minimum, 
79.30 	or more frequently if requested by the person, the person's legal representative, if any, and 
79.31 	case manager; and
80.1 	(4) signed and dated approval for the restriction from the person, or the person's legal 
80.2 	representative, if any. A restriction may be implemented only when the required approval 
80.3 	has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the 
80.4 	right must be immediately and fully restored.

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

80.6 	Sec. 9. Minnesota Statutes 2016, section 245D.071, subdivision 3, is amended to read:
80.7 		Subd. 3.Assessment and initial service planning. (a) Within 15 days of service initiation 
80.8 	the license holder must complete a preliminary coordinated service and support plan 
80.9 	addendum based on the coordinated service and support plan.
80.10 	(b) Within the scope of services, the license holder must, at a minimum, complete 
80.11 	assessments in the following areas before the 45-day planning meeting:
80.12 	(1) the person's ability to self-manage health and medical needs to maintain or improve 
80.13 	physical, mental, and emotional well-being, including, when applicable, allergies, seizures, 
80.14 	choking, special dietary needs, chronic medical conditions, self-administration of medication 
80.15 	or treatment orders, preventative screening, and medical and dental appointments;
80.16 	(2) the person's ability to self-manage personal safety to avoid injury or accident in the 
80.17 	service setting, including, when applicable, risk of falling, mobility, regulating water 
80.18 	temperature, community survival skills, water safety skills, and sensory disabilities; and
80.19 	(3) the person's ability to self-manage symptoms or behavior that may otherwise result 
80.20 	in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension 
80.21 	or termination of services by the license holder, or other symptoms or behaviors that may 
80.22 	jeopardize the health and welfare of the person or others.
80.23 	Assessments must produce information about the person that describes the person's overall 
80.24 	strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be 
80.25 	based on the person's status within the last 12 months at the time of service initiation. 
80.26 	Assessments based on older information must be documented and justified. Assessments 
80.27 	must be conducted annually at a minimum or within 30 days of a written request from the 
80.28 	person or the person's legal representative or case manager. The results must be reviewed 
80.29 	by the support team or expanded support team as part of a service plan review.
80.30 	(c) Within 45 days of service initiation, the license holder must meet with the person, 
80.31 	the person's legal representative, the case manager, and other members of the support team 
80.32 	or expanded support team to determine the following based on information obtained from 
80.33 	the assessments identified in paragraph (b), the person's identified needs in the coordinated 
81.1 	service and support plan, and the requirements in subdivision 4 and section 245D.07, 
81.2 	subdivision 1a:
81.3 	(1) the scope of the services to be provided to support the person's daily needs and 
81.4 	activities;
81.5 	(2) the person's desired outcomes and the supports necessary to accomplish the person's 
81.6 	desired outcomes;
81.7 	(3) the person's preferences for how services and supports are provided, including how 
81.8 	the provider will support the person to have control of the person's schedule;
81.9 	(4) whether the current service setting is the most integrated setting available and 
81.10 	appropriate for the person; and
81.11 	(5) how services must be coordinated across other providers licensed under this chapter 
81.12 	serving the person and members of the support team or expanded support team to ensure 
81.13 	continuity of care and coordination of services for the person.

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

81.15 	Sec. 10. Minnesota Statutes 2016, section 245D.11, subdivision 4, is amended to read:
81.16 		Subd. 4.Admission criteria. The license holder must establish policies and procedures 
81.17 	that promote continuity of care by ensuring that admission or service initiation criteria:
81.18 	(1) is consistent with the service-related rights identified in section 245D.04, subdivisions 
81.19 	2, clauses (4) to (7), and 3, clause (8);
81.20 	(2) identifies the criteria to be applied in determining whether the license holder can 
81.21 	develop services to meet the needs specified in the person's coordinated service and support 
81.22 	plan;
81.23 	(3) requires a license holder providing services in a health care facility to comply with 
81.24 	the requirements in section 243.166, subdivision 4b, to provide notification to residents 
81.25 	when a registered predatory offender is admitted into the program or to a potential admission 
81.26 	when the facility was already serving a registered predatory offender. For purposes of this 
81.27 	clause, "health care facility" means a facility licensed by the commissioner as a residential 
81.28 	facility under chapter 245A to provide adult foster care or residential services to persons 
81.29 	with disabilities; and
81.30 	(4) requires that when a person or the person's legal representative requests services 
81.31 	from the license holder, a refusal to admit the person must be based on an evaluation of the 
81.32 	person's assessed needs and the license holder's lack of capacity to meet the needs of the 
82.1 	person. The license holder must not refuse to admit a person based solely on the type of 
82.2 	residential services the person is receiving, or solely on the person's severity of disability, 
82.3 	orthopedic or neurological handicaps, sight or hearing impairments, lack of communication 
82.4 	skills, physical disabilities, toilet habits, behavioral disorders, or past failure to make progress. 
82.5 	Documentation of the basis for refusal must be provided to the person or the person's legal 
82.6 	representative and case manager upon request.; and
82.7 	(5) requires the person or the person's legal representative and license holder to sign and 
82.8 	date the residency agreement when the license holder provides foster care or supported 
82.9 	living services under section 245D.03, subdivision 1, paragraph (c), clause (3), item (i) or 
82.10 	(ii), to a person living in a community residential setting defined in section 245D.02, 
82.11 	subdivision 4a; an adult foster home defined in Minnesota Rules, part 9555.5105, subpart 
82.12 	5; or a foster family home defined in Minnesota Rules, part 9560.0521, subpart 12. The 
82.13 	residency agreement must include service termination requirements specified in section 
82.14 	245D.10, subdivision 3a, paragraphs (b) to (f). The residency agreement must be reviewed 
82.15 	annually, dated, and signed by the person or the person's legal representative and license 
82.16 	holder.

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

82.18 	Sec. 11. Minnesota Statutes 2016, section 245D.24, subdivision 3, is amended to read:
82.19 		Subd. 3.Bedrooms. (a) People Each person receiving services must have a choice of 
82.20 	roommate and must mutually consent, in writing, to sharing a bedroom with one another. 
82.21 	No more than two people receiving services may share one bedroom.
82.22 	(b) A single occupancy bedroom must have at least 80 square feet of floor space with a 
82.23 	7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor 
82.24 	space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and other 
82.25 	habitable rooms by floor-to-ceiling walls containing no openings except doorways and must 
82.26 	not serve as a corridor to another room used in daily living.
82.27 	(c) A person's personal possessions and items for the person's own use are the only items 
82.28 	permitted to be stored in a person's bedroom.
82.29 	(d) Unless otherwise documented through assessment as a safety concern for the person, 
82.30 	each person must be provided with the following furnishings:
82.31 	(1) a separate bed of proper size and height for the convenience and comfort of the 
82.32 	person, with a clean mattress in good repair;
82.33 	(2) clean bedding appropriate for the season for each person;
83.1 	(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal 
83.2 	possessions and clothing; and
83.3 	(4) a mirror for grooming.
83.4 	(e) When possible, a person must be allowed to have items of furniture that the person 
83.5 	personally owns in the bedroom, unless doing so would interfere with safety precautions, 
83.6 	violate a building or fire code, or interfere with another person's use of the bedroom. A 
83.7 	person may choose not to have a cabinet, dresser, shelves, or a mirror in the bedroom, as 
83.8 	otherwise required under paragraph (d), clause (3) or (4). A person may choose to use a 
83.9 	mattress other than an innerspring mattress and may choose not to have the mattress on a 
83.10 	mattress frame or support. If a person chooses not to have a piece of required furniture, the 
83.11 	license holder must document this choice and is not required to provide the item. If a person 
83.12 	chooses to use a mattress other than an innerspring mattress or chooses not to have a mattress 
83.13 	frame or support, the license holder must document this choice and allow the alternative 
83.14 	desired by the person.
83.15 	(f) A person must be allowed to bring personal possessions into the bedroom and other 
83.16 	designated storage space, if such space is available, in the residence. The person must be 
83.17 	allowed to accumulate possessions to the extent the residence is able to accommodate them, 
83.18 	unless doing so is contraindicated for the person's physical or mental health, would interfere 
83.19 	with safety precautions or another person's use of the bedroom, or would violate a building 
83.20 	or fire code. The license holder must allow for locked storage of personal items. Any 
83.21 	restriction on the possession or locked storage of personal items, including requiring a 
83.22 	person to use a lock provided by the license holder, must comply with section 245D.04, 
83.23 	subdivision 3, paragraph (c), and allow the person to be present if and when the license 
83.24 	holder opens the lock.
83.25 	(g) A person must be allowed to lock the person's bedroom door. The license holder 
83.26 	must document and assess the physical plant and the environment, and the population served, 
83.27 	and identify the risk factors that require using locked doors, and the specific action taken 
83.28 	to minimize the safety risk to a person receiving services at the site.

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

83.30 	Sec. 12. Minnesota Statutes 2016, section 256.045, subdivision 3, is amended to read:
83.31 		Subd. 3.State agency hearings. (a) State agency hearings are available for the following:
83.32 	(1) any person applying for, receiving or having received public assistance, medical 
83.33 	care, or a program of social services granted by the state agency or a county agency or the 
84.1 	federal Food Stamp Act whose application for assistance is denied, not acted upon with 
84.2 	reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed 
84.3 	to have been incorrectly paid;
84.4 	(2) any patient or relative aggrieved by an order of the commissioner under section 
84.5 	252.27;
84.6 	(3) a party aggrieved by a ruling of a prepaid health plan;
84.7 	(4) except as provided under chapter 245C, any individual or facility determined by a 
84.8 	lead investigative agency to have maltreated a vulnerable adult under section 626.557 after 
84.9 	they have exercised their right to administrative reconsideration under section 626.557;
84.10 	(5) any person whose claim for foster care payment according to a placement of the 
84.11 	child resulting from a child protection assessment under section 626.556 is denied or not 
84.12 	acted upon with reasonable promptness, regardless of funding source;
84.13 	(6) any person to whom a right of appeal according to this section is given by other 
84.14 	provision of law;
84.15 	(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver 
84.16 	under section 256B.15;
84.17 	(8) an applicant aggrieved by an adverse decision to an application or redetermination 
84.18 	for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
84.19 	(9) except as provided under chapter 245A, an individual or facility determined to have 
84.20 	maltreated a minor under section 626.556, after the individual or facility has exercised the 
84.21 	right to administrative reconsideration under section 626.556;
84.22 	(10) except as provided under chapter 245C, an individual disqualified under sections 
84.23 	245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23, 
84.24 	on the basis of serious or recurring maltreatment; a preponderance of the evidence that the 
84.25 	individual has committed an act or acts that meet the definition of any of the crimes listed 
84.26 	in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section 
84.27 	626.556, subdivision 3, or 626.557, subdivision 3. Hearings regarding a maltreatment 
84.28 	determination under clause (4) or (9) and a disqualification under this clause in which the 
84.29 	basis for a disqualification is serious or recurring maltreatment, shall be consolidated into 
84.30 	a single fair hearing. In such cases, the scope of review by the human services judge shall 
84.31 	include both the maltreatment determination and the disqualification. The failure to exercise 
84.32 	the right to an administrative reconsideration shall not be a bar to a hearing under this section 
85.1 	if federal law provides an individual the right to a hearing to dispute a finding of 
85.2 	maltreatment;
85.3 	(11) any person with an outstanding debt resulting from receipt of public assistance, 
85.4 	medical care, or the federal Food Stamp Act who is contesting a setoff claim by the 
85.5 	Department of Human Services or a county agency. The scope of the appeal is the validity 
85.6 	of the claimant agency's intention to request a setoff of a refund under chapter 270A against 
85.7 	the debt;
85.8 	(12) a person issued a notice of service termination under section 245D.10, subdivision 
85.9 	3a, from residential supports and services as defined in section 245D.03, subdivision 1, 
85.10 	paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a; or
85.11 	(13) an individual disability waiver recipient based on a denial of a request for a rate 
85.12 	exception under section 256B.4914.; or
85.13 	(14) a person issued a notice of service termination under section 245A.11, subdivision 
85.14 	11, that is not otherwise subject to appeal under subdivision 4a.
85.15 	(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10), 
85.16 	is the only administrative appeal to the final agency determination specifically, including 
85.17 	a challenge to the accuracy and completeness of data under section 13.04. Hearings requested 
85.18 	under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or 
85.19 	after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged 
85.20 	to have maltreated a resident prior to October 1, 1995, shall be held as a contested case 
85.21 	proceeding under the provisions of chapter 14. Hearings requested under paragraph (a), 
85.22 	clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A 
85.23 	hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only 
85.24 	available when there is no district court action pending. If such action is filed in district 
85.25 	court while an administrative review is pending that arises out of some or all of the events 
85.26 	or circumstances on which the appeal is based, the administrative review must be suspended 
85.27 	until the judicial actions are completed. If the district court proceedings are completed, 
85.28 	dismissed, or overturned, the matter may be considered in an administrative hearing.
85.29 	(c) For purposes of this section, bargaining unit grievance procedures are not an 
85.30 	administrative appeal.
85.31 	(d) The scope of hearings involving claims to foster care payments under paragraph (a), 
85.32 	clause (5), shall be limited to the issue of whether the county is legally responsible for a 
85.33 	child's placement under court order or voluntary placement agreement and, if so, the correct 
86.1 	amount of foster care payment to be made on the child's behalf and shall not include review 
86.2 	of the propriety of the county's child protection determination or child placement decision.
86.3 	(e) The scope of hearings under paragraph (a), clause clauses (12) and (14), shall be 
86.4 	limited to whether the proposed termination of services is authorized under section 245D.10, 
86.5 	subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements 
86.6 	of section 245D.10, subdivision 3a, paragraph paragraphs (c) to (e), or 245A.11, subdivision 
86.7 	2a, paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of 
86.8 	termination of services, the scope of the hearing shall also include whether the case 
86.9 	management provider has finalized arrangements for a residential facility, a program, or 
86.10 	services that will meet the assessed needs of the recipient by the effective date of the service 
86.11 	termination.
86.12 	(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor 
86.13 	under contract with a county agency to provide social services is not a party and may not 
86.14 	request a hearing under this section, except if assisting a recipient as provided in subdivision 
86.15 	4.
86.16 	(g) An applicant or recipient is not entitled to receive social services beyond the services 
86.17 	prescribed under chapter 256M or other social services the person is eligible for under state 
86.18 	law.
86.19 	(h) The commissioner may summarily affirm the county or state agency's proposed 
86.20 	action without a hearing when the sole issue is an automatic change due to a change in state 
86.21 	or federal law.
86.22 	(i) Unless federal or Minnesota law specifies a different time frame in which to file an 
86.23 	appeal, an individual or organization specified in this section may contest the specified 
86.24 	action, decision, or final disposition before the state agency by submitting a written request 
86.25 	for a hearing to the state agency within 30 days after receiving written notice of the action, 
86.26 	decision, or final disposition, or within 90 days of such written notice if the applicant, 
86.27 	recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision 
86.28 	13, why the request was not submitted within the 30-day time limit. The individual filing 
86.29 	the appeal has the burden of proving good cause by a preponderance of the evidence.

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

86.31 	Sec. 13. [256B.051] HOUSING SUPPORT SERVICES.
86.32 		Subdivision 1.Purpose. Housing support services are established to provide housing 
86.33 	support services to an individual with a disability that limits the individual's ability to obtain 
87.1 	or maintain stable housing. The services support an individual's transition to housing in the 
87.2 	community and increase long-term stability in housing, to avoid future periods of being at 
87.3 	risk of homelessness or institutionalization.
87.4 		Subd. 2.Definitions. (a) For the purposes of this section, the terms defined in this 
87.5 	subdivision have the meanings given.
87.6 	(b) "At-risk of homelessness" means (1) an individual that is faced with a  set of 
87.7 	circumstances likely to cause the individual to become homeless, or (2) an individual 
87.8 	previously homeless, who will be discharged from a correctional, medical, mental health, 
87.9 	or treatment center, who lacks sufficient resources to pay for housing and does not have a 
87.10 	permanent place to live.
87.11 	(c) "Commissioner" means the commissioner of human services.
87.12 	(d) "Homeless" means an individual or family lacking a fixed, adequate nighttime 
87.13 	residence.
87.14 	(e) "Individual with a disability" means:
87.15 	(1) an individual who is aged, blind, or disabled as determined by the criteria used by 
87.16 	the title 11 program of the Social Security Act, United States Code, title 42, section 416, 
87.17 	paragraph (i), item (1); or
87.18 	(2) an individual who meets a category of eligibility under section 256D.05, subdivision 
87.19 	1, paragraph (a), clauses (1), (3), (5) to (9), or (14).
87.20 	(f) "Institution" means a setting as defined in section 256B.0621, subdivision 2, clause 
87.21 	(3), and the Minnesota Security Hospital as defined in section 253.20.
87.22 		Subd. 3.Eligibility. An individual with a disability is eligible for housing support services 
87.23 	if the individual:
87.24 	(1) is 18 years of age or older;
87.25 	(2) is enrolled in medical assistance;
87.26 	(3) has an assessment of functional need that determines a need for services due to 
87.27 	limitations caused by the individual's disability;
87.28 	(4) resides in or plans to transition to a community-based setting as defined in Code of 
87.29 	Federal Regulations, title 42, section 441.301(c); and
87.30 	(5) has housing instability evidenced by:
87.31 	(i) being homeless or at-risk of homelessness;
88.1 	(ii) being in the process of transitioning from, or having transitioned in the past six 
88.2 	months from, an institution or licensed or registered setting;
88.3 	(iii) being eligible for waiver services under section 256B.0915, 256B.092, or 256B.49; 
88.4 	or
88.5 	(iv) having been identified by a long-term care consultation under section 256B.0911 
88.6 	as at risk of institutionalization.
88.7 		Subd. 4.Assessment requirements. (a) An individual's assessment of functional need 
88.8 	must be conducted by one of the following methods:
88.9 	(1) an assessor according to the criteria established in section 256B.0911, subdivision 
88.10 	3a, using a format established by the commissioner;
88.11 	(2) documented need for services as verified by a professional statement of need as 
88.12 	defined in section 256I.03, subdivision 12; or
88.13 	(3) according to the continuum of care coordinated assessment system established in 
88.14 	Code of Federal Regulations, title 24, section 578.3, using a format established by the 
88.15 	commissioner.
88.16 	(b) An individual must be reassessed within one year of initial assessment, and annually 
88.17 	thereafter.
88.18 		Subd. 5.Housing support services. (a) Housing support services include housing 
88.19 	transition services and housing and tenancy sustaining services.
88.20 	(b) Housing transition services are defined as:
88.21 	(1) tenant screening and housing assessment;
88.22 	(2) assistance with the housing search and application process;
88.23 	(3) identifying resources to cover onetime moving expenses;
88.24 	(4) ensuring a new living arrangement is safe and ready for move-in;
88.25 	(5) assisting in arranging for and supporting details of a move; and
88.26 	(6) developing a housing support crisis plan.
88.27 	(c) Housing and tenancy sustaining services include:
88.28 	(1) prevention and early identification of behaviors that may jeopardize continued stable 
88.29 	housing;
89.1 	(2) education and training on roles, rights, and responsibilities of the tenant and the 
89.2 	property manager;
89.3 	(3) coaching to develop and maintain key relationships with property managers and 
89.4 	neighbors;
89.5 	(4) advocacy and referral to community resources to prevent eviction when housing is 
89.6 	at risk;
89.7 	(5) assistance with housing recertification process;
89.8 	(6) coordination with the tenant to regularly review, update, and modify housing support 
89.9 	and crisis plan; and
89.10 	(7) continuing training on being a good tenant, lease compliance, and household 
89.11 	management.
89.12 	(d) A housing support service may include person-centered planning for people who are 
89.13 	not eligible to receive person-centered planning through any other service, if the 
89.14 	person-centered planning is provided by a consultation service provider that is under contract 
89.15 	with the department and enrolled as a Minnesota health care program.
89.16 		Subd. 6.Provider qualifications and duties. A provider eligible for reimbursement 
89.17 	under this section shall:
89.18 	(1) enroll as a medical assistance Minnesota health care program provider and meet all 
89.19 	applicable provider standards and requirements;
89.20 	(2) demonstrate compliance with federal and state laws and policies for housing support 
89.21 	services as determined by the commissioner;
89.22 	(3) comply with background study requirements under chapter 245C and maintain 
89.23 	documentation of background study requests and results; and
89.24 	(4) directly provide housing support services and not use a subcontractor or reporting 
89.25 	agent.
89.26 		Subd. 7.Housing support supplemental service rates. Supplemental service rates for 
89.27 	individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph 
89.28 	(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year 
89.29 	period. This reduction only applies to supplemental service rates for individuals eligible for 
89.30 	housing support services under this section.

90.1 	EFFECTIVE DATE. (a) Subdivisions 1 to 6 are contingent upon federal approval. The 
90.2 	commissioner of human services shall notify the revisor of statutes when federal approval 
90.3 	is obtained.
90.4 	(b) Subdivision 7 is contingent upon federal approval of subdivisions 1 to 6. The 
90.5 	commissioner of human services shall notify the revisor of statutes when federal approval 
90.6 	is obtained.

90.7 	Sec. 14. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
90.8 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
90.9 	planning, or other assistance intended to support community-based living, including persons 
90.10 	who need assessment in order to determine waiver or alternative care program eligibility, 
90.11 	must be visited by a long-term care consultation team within 20 calendar days after the date 
90.12 	on which an assessment was requested or recommended. Upon statewide implementation 
90.13 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
90.14 	requesting personal care assistance services and home care nursing. The commissioner shall 
90.15 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
90.16 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
90.17 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
90.18 	assessors to conduct the assessment. For a person with complex health care needs, a public 
90.19 	health or registered nurse from the team must be consulted.
90.20 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
90.21 	be used to complete a comprehensive, person-centered assessment. The assessment must 
90.22 	include the health, psychological, functional, environmental, and social needs of the 
90.23 	individual necessary to develop a community support plan that meets the individual's needs 
90.24 	and preferences.
90.25 	(d) The assessment must be conducted in a face-to-face interview with the person being 
90.26 	assessed and the person's legal representative. At the request of the person, other individuals 
90.27 	may participate in the assessment to provide information on the needs, strengths, and 
90.28 	preferences of the person necessary to develop a community support plan that ensures the 
90.29 	person's health and safety. Except for legal representatives or family members invited by 
90.30 	the person, persons participating in the assessment may not be a provider of service or have 
90.31 	any financial interest in the provision of services. For persons who are to be assessed for 
90.32 	elderly waiver customized living services under section 256B.0915, with the permission of 
90.33 	the person being assessed or the person's designated or legal representative, the client's 
90.34 	current or proposed provider of services may submit a copy of the provider's nursing 
91.1 	assessment or written report outlining its recommendations regarding the client's care needs. 
91.2 	The person conducting the assessment must notify the provider of the date by which this 
91.3 	information is to be submitted. This information shall be provided to the person conducting 
91.4 	the assessment prior to the assessment. For a person who is to be assessed for waiver services 
91.5 	under section 256B.092 or 256B.49, with the permission of the person being assessed or 
91.6 	the person's designated legal representative, the person's current provider of services may 
91.7 	submit a written report outlining recommendations regarding the person's care needs prepared 
91.8 	by a direct service employee with at least 20 hours of service to that client. The person 
91.9 	conducting the assessment or reassessment must notify the provider of the date by which 
91.10 	this information is to be submitted. This information shall be provided to the person 
91.11 	conducting the assessment and the person or the person's legal representative, and must be 
91.12 	considered prior to the finalization of the assessment or reassessment.
91.13 	(e) The person or the person's legal representative must be provided with a written 
91.14 	community support plan within 40 calendar days of the assessment visit, regardless of 
91.15 	whether the individual is eligible for Minnesota health care programs. The written community 
91.16 	support plan must include:
91.17 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
91.18 	(2) the individual's options and choices to meet identified needs, including all available 
91.19 	options for case management services and providers;
91.20 	(3) identification of health and safety risks and how those risks will be addressed, 
91.21 	including personal risk management strategies;
91.22 	(4) referral information; and
91.23 	(5) informal caregiver supports, if applicable.
91.24 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
91.25 	(b), clause (1), the person or person's representative must also receive a copy of the home 
91.26 	care service plan developed by the certified assessor.
91.27 	(f) A person may request assistance in identifying community supports without 
91.28 	participating in a complete assessment. Upon a request for assistance identifying community 
91.29 	support, the person must be transferred or referred to long-term care options counseling 
91.30 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
91.31 	telephone assistance and follow up.
92.1 	(g) The person has the right to make the final decision between institutional placement 
92.2 	and community placement after the recommendations have been provided, except as provided 
92.3 	in section 256.975, subdivision 7a, paragraph (d).
92.4 	(h) The lead agency must give the person receiving assessment or support planning, or 
92.5 	the person's legal representative, materials, and forms supplied by the commissioner 
92.6 	containing the following information:
92.7 	(1) written recommendations for community-based services and consumer-directed 
92.8 	options;
92.9 	(2) documentation that the most cost-effective alternatives available were offered to the 
92.10 	individual. For purposes of this clause, "cost-effective" means community services and 
92.11 	living arrangements that cost the same as or less than institutional care. For an individual 
92.12 	found to meet eligibility criteria for home and community-based service programs under 
92.13 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
92.14 	approved waiver plan for each program;
92.15 	(3) the need for and purpose of preadmission screening conducted by long-term care 
92.16 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
92.17 	nursing facility placement. If the individual selects nursing facility placement, the lead 
92.18 	agency shall forward information needed to complete the level of care determinations and 
92.19 	screening for developmental disability and mental illness collected during the assessment 
92.20 	to the long-term care options counselor using forms provided by the commissioner;
92.21 	(4) the role of long-term care consultation assessment and support planning in eligibility 
92.22 	determination for waiver and alternative care programs, and state plan home care, case 
92.23 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
92.24 	and (b);
92.25 	(5) information about Minnesota health care programs;
92.26 	(6) the person's freedom to accept or reject the recommendations of the team;
92.27 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
92.28 	Act, chapter 13;
92.29 	(8) the certified assessor's decision regarding the person's need for institutional level of 
92.30 	care as determined under criteria established in subdivision 4e and the certified assessor's 
92.31 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
92.32 	paragraphs (a), clause (6), and (b); and
93.1 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
93.2 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
93.3 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
93.4 	or the lead agency's final decisions regarding public programs eligibility according to section 
93.5 	256.045, subdivision 3.
93.6 	(i) Face-to-face assessment completed as part of eligibility determination for the 
93.7 	alternative care, elderly waiver, community access for disability inclusion, community 
93.8 	alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915, 
93.9 	and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after 
93.10 	the date of assessment.
93.11 	(j) The effective eligibility start date for programs in paragraph (i) can never be prior to 
93.12 	the date of assessment. If an assessment was completed more than 60 days before the 
93.13 	effective waiver or alternative care program eligibility start date, assessment and support 
93.14 	plan information must be updated and documented in the department's Medicaid Management 
93.15 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
93.16 	state plan services, the effective date of eligibility for programs included in paragraph (i) 
93.17 	cannot be prior to the date the most recent updated assessment is completed.
93.18 	(k) At the time of reassessment, the certified assessor shall assess each person receiving 
93.19 	waiver services currently residing in a community residential setting, or licensed adult foster 
93.20 	care home that is not the primary residence of the license holder, or in which the license 
93.21 	holder is not the primary caregiver, to determine if that person would prefer to be served in 
93.22 	a community-living settings as defined in section 256B.49, subdivision 23. The certified 
93.23 	assessor shall offer the person, through a person-centered planning process, the option to 
93.24 	receive alternative housing and service options.

93.25 	Sec. 15. Minnesota Statutes 2016, section 256B.0915, subdivision 1, is amended to read:
93.26 		Subdivision 1.Authority. (a) The commissioner is authorized to apply for a home and 
93.27 	community-based services waiver for the elderly, authorized under section 1915(c) of the 
93.28 	Social Security Act, in order to obtain federal financial participation to expand the availability 
93.29 	of services for persons who are eligible for medical assistance. The commissioner may 
93.30 	apply for additional waivers or pursue other federal financial participation which is 
93.31 	advantageous to the state for funding home care services for the frail elderly who are eligible 
93.32 	for medical assistance. The provision of waivered services to elderly and disabled medical 
93.33 	assistance recipients must comply with the criteria for service definitions and provider 
93.34 	standards approved in the waiver.
94.1 	(b) The commissioner shall comply with the requirements in the federally approved 
94.2 	transition plan for the home and community-based services waivers authorized under this 
94.3 	section.

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

94.5 	Sec. 16. Minnesota Statutes 2016, section 256B.092, subdivision 4, is amended to read:
94.6 		Subd. 4.Home and community-based services for developmental disabilities. (a) 
94.7 	The commissioner shall make payments to approved vendors participating in the medical 
94.8 	assistance program to pay costs of providing home and community-based services, including 
94.9 	case management service activities provided as an approved home and community-based 
94.10 	service, to medical assistance eligible persons with developmental disabilities who have 
94.11 	been screened under subdivision 7 and according to federal requirements. Federal 
94.12 	requirements include those services and limitations included in the federally approved 
94.13 	application for home and community-based services for persons with developmental 
94.14 	disabilities and subsequent amendments.
94.15 	(b) Effective July 1, 1995, contingent upon federal approval and state appropriations 
94.16 	made available for this purpose, and in conjunction with Laws 1995, chapter 207, article 8, 
94.17 	section 40, the commissioner of human services shall allocate resources to county agencies 
94.18 	for home and community-based waivered services for persons with developmental disabilities 
94.19 	authorized but not receiving those services as of June 30, 1995, based upon the average 
94.20 	resource need of persons with similar functional characteristics. To ensure service continuity 
94.21 	for service recipients receiving home and community-based waivered services for persons 
94.22 	with developmental disabilities prior to July 1, 1995, the commissioner shall make available 
94.23 	to the county of financial responsibility home and community-based waivered services 
94.24 	resources based upon fiscal year 1995 authorized levels.
94.25 	(c) Home and community-based resources for all recipients shall be managed by the 
94.26 	county of financial responsibility within an allowable reimbursement average established 
94.27 	for each county. Payments for home and community-based services provided to individual 
94.28 	recipients shall not exceed amounts authorized by the county of financial responsibility. 
94.29 	For specifically identified former residents of nursing facilities, the commissioner shall be 
94.30 	responsible for authorizing payments and payment limits under the appropriate home and 
94.31 	community-based service program. Payment is available under this subdivision only for 
94.32 	persons who, if not provided these services, would require the level of care provided in an 
94.33 	intermediate care facility for persons with developmental disabilities.
95.1 	(d) The commissioner shall comply with the requirements in the federally approved 
95.2 	transition plan for the home and community-based services waivers for the elderly authorized 
95.3 	under this section.

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

95.5 	Sec. 17. Minnesota Statutes 2016, section 256B.49, subdivision 11, is amended to read:
95.6 		Subd. 11.Authority. (a) The commissioner is authorized to apply for home and 
95.7 	community-based service waivers, as authorized under section 1915(c) of the Social Security 
95.8 	Act to serve persons under the age of 65 who are determined to require the level of care 
95.9 	provided in a nursing home and persons who require the level of care provided in a hospital. 
95.10 	The commissioner shall apply for the home and community-based waivers in order to:
95.11 	(1) promote the support of persons with disabilities in the most integrated settings;
95.12 	(2) expand the availability of services for persons who are eligible for medical assistance;
95.13 	(3) promote cost-effective options to institutional care; and
95.14 	(4) obtain federal financial participation.
95.15 	(b) The provision of waivered services to medical assistance recipients with disabilities 
95.16 	shall comply with the requirements outlined in the federally approved applications for home 
95.17 	and community-based services and subsequent amendments, including provision of services 
95.18 	according to a service plan designed to meet the needs of the individual. For purposes of 
95.19 	this section, the approved home and community-based application is considered the necessary 
95.20 	federal requirement.
95.21 	(c) The commissioner shall provide interested persons serving on agency advisory 
95.22 	committees, task forces, the Centers for Independent Living, and others who request to be 
95.23 	on a list to receive, notice of, and an opportunity to comment on, at least 30 days before 
95.24 	any effective dates, (1) any substantive changes to the state's disability services program 
95.25 	manual, or (2) changes or amendments to the federally approved applications for home and 
95.26 	community-based waivers, prior to their submission to the federal Centers for Medicare 
95.27 	and Medicaid Services.
95.28 	(d) The commissioner shall seek approval, as authorized under section 1915(c) of the 
95.29 	Social Security Act, to allow medical assistance eligibility under this section for children 
95.30 	under age 21 without deeming of parental income or assets.
96.1 	(e) The commissioner shall seek approval, as authorized under section 1915(c) of the 
96.2 	Social Act, to allow medical assistance eligibility under this section for individuals under 
96.3 	age 65 without deeming the spouse's income or assets.
96.4 	(f) The commissioner shall comply with the requirements in the federally approved 
96.5 	transition plan for the home and community-based services waivers authorized under this 
96.6 	section.

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

96.8 	Sec. 18. Minnesota Statutes 2016, section 256B.49, subdivision 15, is amended to read:
96.9 		Subd. 15.Coordinated service and support plan; comprehensive transitional service 
96.10 	plan; maintenance service plan. (a) Each recipient of home and community-based waivered 
96.11 	services shall be provided a copy of the written coordinated service and support plan which 
96.12 	meets the requirements in section 256B.092, subdivision 1b.
96.13 	(b) In developing the comprehensive transitional service plan, the individual receiving 
96.14 	services, the case manager, and the guardian, if applicable, will identify the transitional 
96.15 	service plan fundamental service outcome and anticipated timeline to achieve this outcome. 
96.16 	Within the first 20 days following a recipient's request for an assessment or reassessment, 
96.17 	the transitional service planning team must be identified. A team leader must be identified 
96.18 	who will be responsible for assigning responsibility and communicating with team members 
96.19 	to ensure implementation of the transition plan and ongoing assessment and communication 
96.20 	process. The team leader should be an individual, such as the case manager or guardian, 
96.21 	who has the opportunity to follow the recipient to the next level of service.
96.22 	Within ten days following an assessment, a comprehensive transitional service plan must 
96.23 	be developed incorporating elements of a comprehensive functional assessment and including 
96.24 	short-term measurable outcomes and timelines for achievement of and reporting on these 
96.25 	outcomes. Functional milestones must also be identified and reported according to the 
96.26 	timelines agreed upon by the transitional service planning team. In addition, the 
96.27 	comprehensive transitional service plan must identify additional supports that may assist 
96.28 	in the achievement of the fundamental service outcome such as the development of greater 
96.29 	natural community support, increased collaboration among agencies, and technological 
96.30 	supports.
96.31 	The timelines for reporting on functional milestones will prompt a reassessment of 
96.32 	services provided, the units of services, rates, and appropriate service providers. It is the 
96.33 	responsibility of the transitional service planning team leader to review functional milestone 
97.1 	reporting to determine if the milestones are consistent with observable skills and that 
97.2 	milestone achievement prompts any needed changes to the comprehensive transitional 
97.3 	service plan.
97.4 	For those whose fundamental transitional service outcome involves the need to procure 
97.5 	housing, a plan for the recipient to seek the resources necessary to secure the least restrictive 
97.6 	housing possible should be incorporated into the plan, including employment and public 
97.7 	supports such as housing access and shelter needy funding.
97.8 	(c) Counties and other agencies responsible for funding community placement and 
97.9 	ongoing community supportive services are responsible for the implementation of the 
97.10 	comprehensive transitional service plans. Oversight responsibilities include both ensuring 
97.11 	effective transitional service delivery and efficient utilization of funding resources.
97.12 	(d) Following one year of transitional services, the transitional services planning team 
97.13 	will make a determination as to whether or not the individual receiving services requires 
97.14 	the current level of continuous and consistent support in order to maintain the recipient's 
97.15 	current level of functioning. Recipients who are determined to have not had a significant 
97.16 	change in functioning for 12 months must move from a transitional to a maintenance service 
97.17 	plan. Recipients on a maintenance service plan must be reassessed to determine if the 
97.18 	recipient would benefit from a transitional service plan at least every 12 months and at other 
97.19 	times when there has been a significant change in the recipient's functioning. This assessment 
97.20 	should consider any changes to technological or natural community supports.
97.21 	(e) When a county is evaluating denials, reductions, or terminations of home and 
97.22 	community-based services under this section for an individual, the case manager shall offer 
97.23 	to meet with the individual or the individual's guardian in order to discuss the prioritization 
97.24 	of service needs within the coordinated service and support plan, comprehensive transitional 
97.25 	service plan, or maintenance service plan. The reduction in the authorized services for an 
97.26 	individual due to changes in funding for waivered services may not exceed the amount 
97.27 	needed to ensure medically necessary services to meet the individual's health, safety, and 
97.28 	welfare.
97.29 	(f) At the time of reassessment, local agency case managers shall assess each recipient 
97.30 	of community access for disability inclusion or brain injury waivered services currently 
97.31 	residing in a licensed adult foster home that is not the primary residence of the license 
97.32 	holder, or in which the license holder is not the primary caregiver, to determine if that 
97.33 	recipient could appropriately be served in a community-living setting. If appropriate for the 
97.34 	recipient, the case manager shall offer the recipient, through a person-centered planning 
98.1 	process, the option to receive alternative housing and service options. In the event that the 
98.2 	recipient chooses to transfer from the adult foster home, the vacated bed shall not be filled 
98.3 	with another recipient of waiver services and group residential housing and the licensed 
98.4 	capacity shall be reduced accordingly, unless the savings required by the licensed bed closure 
98.5 	reductions under Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, 
98.6 	paragraph (f), for foster care settings where the physical location is not the primary residence 
98.7 	of the license holder are met through voluntary changes described in section 245A.03, 
98.8 	subdivision 7, paragraph (e), or as provided under paragraph (a), clauses (3) and (4). If the 
98.9 	adult foster home becomes no longer viable due to these transfers, the county agency, with 
98.10 	the assistance of the department, shall facilitate a consolidation of settings or closure. This 
98.11 	reassessment process shall be completed by July 1, 2013.

98.12 	Sec. 19. Minnesota Statutes 2016, section 256B.493, subdivision 1, is amended to read:
98.13 		Subdivision 1.Commissioner's duties; report. The commissioner of human services 
98.14 	shall solicit proposals for the conversion of services provided for persons with disabilities 
98.15 	in settings licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, or community 
98.16 	residential settings licensed under chapter 245D, to other types of community settings in 
98.17 	conjunction with the closure of identified licensed adult foster care settings has the authority 
98.18 	to manage statewide licensed corporate foster care or community residential settings capacity, 
98.19 	including the reduction and realignment of licensed capacity of a current foster care or 
98.20 	community residential settings to accomplish the consolidation or closure of settings. The 
98.21 	commissioner shall implement a program for planned closure of licensed corporate adult 
98.22 	foster care or community residential settings, necessary as a preferred method to: (1) respond 
98.23 	to the informed decisions of those individuals who want to move out of these settings into 
98.24 	other types of community settings; and (2) achieve necessary budgetary savings required 
98.25 	in section 245A.03, subdivision 7, paragraphs (c) and (d).

98.26 	Sec. 20. Minnesota Statutes 2016, section 256B.493, subdivision 2, is amended to read:
98.27 		Subd. 2.Planned closure process needs determination. The commissioner shall 
98.28 	announce and implement a program for planned closure of adult foster care homes. Planned 
98.29 	closure shall be the preferred method for achieving necessary budgetary savings required 
98.30 	by the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph 
98.31 	(c). If additional closures are required to achieve the necessary savings, the commissioner 
98.32 	shall use the process and priorities in section 245A.03, subdivision 7, paragraph (c) A 
98.33 	resource need determination process, managed at the state level, using available reports 
99.1 	required by section 144A.351 and other data and information shall be used by the 
99.2 	commissioner to align capacity where needed.

99.3 	Sec. 21. Minnesota Statutes 2016, section 256B.493, is amended by adding a subdivision 
99.4 	to read:
99.5 		Subd. 2a.Closure process. (a) The commissioner shall work with stakeholders to 
99.6 	establish a process for the application, review, approval, and implementation of setting 
99.7 	closures. Voluntary proposals from license holders for consolidation and closure of adult 
99.8 	foster care or community residential settings are encouraged. Whether voluntary or 
99.9 	involuntary, all closure plans must include:
99.10 	(1) a description of the proposed closure plan, identifying the home or homes and 
99.11 	occupied beds;
99.12 	(2) the proposed timetable for the proposed closure, including the proposed dates for 
99.13 	notification to people living there and the affected lead agencies, commencement of closure, 
99.14 	and completion of closure;
99.15 	(3) the proposed relocation plan jointly developed by the counties of financial 
99.16 	responsibility, the people living there and their legal representatives, if any, who wish to 
99.17 	continue to receive services from the provider, and the providers for current residents of 
99.18 	any adult foster care home designated for closure; and
99.19 	(4) documentation from the provider in a format approved by the commissioner that all 
99.20 	the adult foster care homes or community residential settings receiving a planned closure 
99.21 	rate adjustment under the plan have accepted joint and severable for recovery of 
99.22 	overpayments under section 256B.0641, subdivision 2, for the facilities designated for 
99.23 	closure under this plan.
99.24 	(b) The commissioner shall give first priority to closure plans which:
99.25 	(1) target counties and geographic areas which have:
99.26 	(i) need for other types of services;
99.27 	(ii) need for specialized services;
99.28 	(iii) higher than average per capita use of licensed corporate foster care or community 
99.29 	residential settings; or
99.30 	(iv) residents not living in the geographic area of their choice;
99.31 	(2) demonstrate savings of medical assistance expenditures; and
100.1 	(3) demonstrate that alternative services are based on the recipient's choice of provider 
100.2 	and are consistent with federal law, state law, and federally approved waiver plans.
100.3 	The commissioner shall also consider any information provided by people using services, 
100.4 	their legal representatives, family members, or the lead agency on the impact of the planned 
100.5 	closure on people and the services they need.
100.6 	(c) For each closure plan approved by the commissioner, a contract must be established 
100.7 	between the commissioner, the counties of financial responsibility, and the participating 
100.8 	license holder.

100.9 	Sec. 22. Minnesota Statutes 2016, section 256D.44, subdivision 4, is amended to read:
100.10 		Subd. 4.Temporary absence due to illness. For the purposes of this subdivision, "home" 
100.11 	means a residence owned or rented by a recipient or the recipient's spouse. Home does not 
100.12 	include a group residential housing facility. Assistance payments for recipients who are 
100.13 	temporarily absent from their home due to hospitalization for illness must continue at the 
100.14 	same level of payment during their absence if the following criteria are met:
100.15 	(1) a physician certifies that the absence is not expected to continue for more than three 
100.16 	months;
100.17 	(2) a physician certifies that the recipient will be able to return to independent living; 
100.18 	and
100.19 	(3) the recipient has expenses associated with maintaining a residence in the community.

100.20 	Sec. 23. Minnesota Statutes 2016, section 256D.44, subdivision 5, is amended to read:
100.21 		Subd. 5.Special needs. (a) In addition to the state standards of assistance established 
100.22 	in subdivisions 1 to 4, payments are allowed for the following special needs of recipients 
100.23 	of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment 
100.24 	center, or a group residential setting authorized to receive housing facility support payments 
100.25 	under chapter 256I.
100.26 	(a) (b) The county agency shall pay a monthly allowance for medically prescribed diets 
100.27 	if the cost of those additional dietary needs cannot be met through some other maintenance 
100.28 	benefit. The need for special diets or dietary items must be prescribed by a licensed physician. 
100.29 	Costs for special diets shall be determined as percentages of the allotment for a one-person 
100.30 	household under the thrifty food plan as defined by the United States Department of 
100.31 	Agriculture. The types of diets and the percentages of the thrifty food plan that are covered 
100.32 	are as follows:
101.1 	(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
101.2 	(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of 
101.3 	thrifty food plan;
101.4 	(3) controlled protein diet, less than 40 grams and requires special products, 125 percent 
101.5 	of thrifty food plan;
101.6 	(4) low cholesterol diet, 25 percent of thrifty food plan;
101.7 	(5) high residue diet, 20 percent of thrifty food plan;
101.8 	(6) pregnancy and lactation diet, 35 percent of thrifty food plan;
101.9 	(7) gluten-free diet, 25 percent of thrifty food plan;
101.10 	(8) lactose-free diet, 25 percent of thrifty food plan;
101.11 	(9) antidumping diet, 15 percent of thrifty food plan;
101.12 	(10) hypoglycemic diet, 15 percent of thrifty food plan; or
101.13 	(11) ketogenic diet, 25 percent of thrifty food plan.
101.14 	(b) (c) Payment for nonrecurring special needs must be allowed for necessary home 
101.15 	repairs or necessary repairs or replacement of household furniture and appliances using the 
101.16 	payment standard of the AFDC program in effect on July 16, 1996, for these expenses, as 
101.17 	long as other funding sources are not available.
101.18 	(c) (d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated 
101.19 	by the county or approved by the court. This rate shall not exceed five percent of the 
101.20 	assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian 
101.21 	or conservator is a member of the county agency staff, no fee is allowed.
101.22 	(d) (e) The county agency shall continue to pay a monthly allowance of $68 for restaurant 
101.23 	meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and 
101.24 	who eats two or more meals in a restaurant daily. The allowance must continue until the 
101.25 	person has not received Minnesota supplemental aid for one full calendar month or until 
101.26 	the person's living arrangement changes and the person no longer meets the criteria for the 
101.27 	restaurant meal allowance, whichever occurs first.
101.28 	(e) (f) A fee of ten percent of the recipient's gross income or $25, whichever is less, is 
101.29 	allowed for representative payee services provided by an agency that meets the requirements 
101.30 	under SSI regulations to charge a fee for representative payee services. This special need 
102.1 	is available to all recipients of Minnesota supplemental aid regardless of their living 
102.2 	arrangement.
102.3 	(f) (g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half 
102.4 	of the maximum allotment authorized by the federal Food Stamp Program for a federal 
102.5 	Supplemental Security Income payment amount for a single individual which is in effect 
102.6 	on the first day of July of each year will be added to the standards of assistance established 
102.7 	in subdivisions 1 to 4 for adults under the age of 65 who qualify as shelter needy in need 
102.8 	of housing assistance and are:
102.9 	(i) relocating from an institution, a setting authorized to receive housing support under 
102.10 	chapter 256I, or an adult mental health residential treatment program under section 
102.11 	256B.0622; or
102.12 	(ii) eligible for personal care assistance under section 256B.0659; or
102.13 	(iii) home and community-based waiver recipients living in their own home or rented 
102.14 	or leased apartment which is not owned, operated, or controlled by a provider of service 
102.15 	not related by blood or marriage, unless allowed under paragraph (g).
102.16 	(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter 
102.17 	needy benefit under this paragraph is considered a household of one. An eligible individual 
102.18 	who receives this benefit prior to age 65 may continue to receive the benefit after the age 
102.19 	of 65.
102.20 	(3) "Shelter needy Housing assistance" means that the assistance unit incurs monthly 
102.21 	shelter costs that exceed 40 percent of the assistance unit's gross income before the application 
102.22 	of this special needs standard. "Gross income" for the purposes of this section is the 
102.23 	applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the 
102.24 	standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient 
102.25 	of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income, 
102.26 	shall not be considered shelter needy in need of housing assistance for purposes of this 
102.27 	paragraph.
102.28 	(g) Notwithstanding this subdivision, to access housing and services as provided in 
102.29 	paragraph (f), the recipient may choose housing that may be owned, operated, or controlled 
102.30 	by the recipient's service provider. When housing is controlled by the service provider, the 
102.31 	individual may choose the individual's own service provider as provided in section 256B.49, 
102.32 	subdivision 23, clause (3). When the housing is controlled by the service provider, the 
102.33 	service provider shall implement a plan with the recipient to transition the lease to the 
102.34 	recipient's name. Within two years of signing the initial lease, the service provider shall 
103.1 	transfer the lease entered into under this subdivision to the recipient. In the event the landlord 
103.2 	denies this transfer, the commissioner may approve an exception within sufficient time to 
103.3 	ensure the continued occupancy by the recipient. This paragraph expires June 30, 2016.

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

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

103.13 	Sec. 25. Minnesota Statutes 2016, section 256I.04, subdivision 1, is amended to read:
103.14 		Subdivision 1.Individual eligibility requirements. An individual is eligible for and 
103.15 	entitled to a group residential housing support payment to be made on the individual's behalf 
103.16 	if the agency has approved the individual's residence in a group residentialsetting where 
103.17 	the individual will receive housing settingsupport and the individual meets the requirements 
103.18 	in paragraph (a) or, (b), or (c).
103.19 	(a) The individual is aged, blind, or is over 18 years of age and disabled as determined 
103.20 	under the criteria used by the title II program of the Social Security Act, and meets the 
103.21 	resource restrictions and standards of section 256P.02, and the individual's countable income 
103.22 	after deducting the (1) exclusions and disregards of the SSI program, (2) the medical 
103.23 	assistance personal needs allowance under section 256B.35, and (3) an amount equal to the 
103.24 	income actually made available to a community spouse by an elderly waiver participant 
103.25 	under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058, 
103.26 	subdivision 2, is less than the monthly rate specified in the agency's agreement with the 
103.27 	provider of group residential housing support in which the individual resides.
103.28 	(b) The individual meets a category of eligibility under section 256D.05, subdivision 1, 
103.29 	paragraph (a), clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable, and the 
103.30 	individual's resources are less than the standards specified by section 256P.02, and the 
103.31 	individual's countable income as determined under section 256P.06, less the medical 
103.32 	assistance personal needs allowance under section 256B.35 is less than the monthly rate 
104.1 	specified in the agency's agreement with the provider of group residential housing support 
104.2 	in which the individual resides.
104.3 	(c) The individual receives licensed residential crisis stabilization services under section 
104.4 	256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive 
104.5 	concurrent group residential housing payments if receiving licensed residential crisis 
104.6 	stabilization services under section 256B.0624, subdivision 7.

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

104.8 	Sec. 26. Minnesota Statutes 2016, section 256I.04, subdivision 2d, is amended to read:
104.9 		Subd. 2d.Conditions of payment; commissioner's right to suspend or terminate 
104.10 	agreement. (a) Group residential Housing or supplementary services support must be 
104.11 	provided to the satisfaction of the commissioner, as determined at the sole discretion of the 
104.12 	commissioner's authorized representative, and in accordance with all applicable federal, 
104.13 	state, and local laws, ordinances, rules, and regulations, including business registration 
104.14 	requirements of the Office of the Secretary of State. A provider shall not receive payment 
104.15 	for room and board or supplementary services or housing found by the commissioner to be 
104.16 	performed or provided in violation of federal, state, or local law, ordinance, rule, or 
104.17 	regulation.
104.18 	(b) The commissioner has the right to suspend or terminate the agreement immediately 
104.19 	when the commissioner determines the health or welfare of the housing or service recipients 
104.20 	is endangered, or when the commissioner has reasonable cause to believe that the provider 
104.21 	has breached a material term of the agreement under subdivision 2b.
104.22 	(c) Notwithstanding paragraph (b), if the commissioner learns of a curable material 
104.23 	breach of the agreement by the provider, the commissioner shall provide the provider with 
104.24 	a written notice of the breach and allow ten days to cure the breach. If the provider does 
104.25 	not cure the breach within the time allowed, the provider shall be in default of the agreement 
104.26 	and the commissioner may terminate the agreement immediately thereafter. If the provider 
104.27 	has breached a material term of the agreement and cure is not possible, the commissioner 
104.28 	may immediately terminate the agreement.

104.29 	Sec. 27. Minnesota Statutes 2016, section 256I.04, subdivision 2g, is amended to read:
104.30 		Subd. 2g.Crisis shelters. Secure crisis shelters for battered women and their children 
104.31 	designated by the Minnesota Department of Corrections are not group residences eligible 
104.32 	for housing support under this chapter.

105.1 	Sec. 28. Minnesota Statutes 2016, section 256I.04, subdivision 3, is amended to read:
105.2 		Subd. 3.Moratorium on development of group residential housing support beds.
 105.3 	(a) Agencies shall not enter into agreements for new group residential housing support beds 
105.4 	with total rates in excess of the MSA equivalent rate except:
105.5 	(1) for group residential housing establishments licensed under chapter 245D provided 
105.6 	the facility is needed to meet the census reduction targets for persons with developmental 
105.7 	disabilities at regional treatment centers;
105.8 	(2) up to 80 beds in a single, specialized facility located in Hennepin County that will 
105.9 	provide housing for chronic inebriates who are repetitive users of detoxification centers and 
105.10 	are refused placement in emergency shelters because of their state of intoxication, and 
105.11 	planning for the specialized facility must have been initiated before July 1, 1991, in 
105.12 	anticipation of receiving a grant from the Housing Finance Agency under section 462A.05, 
105.13 	subdivision 20a, paragraph (b);
105.14 	(3) notwithstanding the provisions of subdivision 2a, for up to 190226 supportive 
105.15 	housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a 
105.16 	mental illness, a history of substance abuse, or human immunodeficiency virus or acquired 
105.17 	immunodeficiency syndrome. For purposes of this section, "homeless adult" means a person 
105.18 	who is living on the street or in a shelter or discharged from a regional treatment center, 
105.19 	community hospital, or residential treatment program and has no appropriate housing 
105.20 	available and lacks the resources and support necessary to access appropriate housing. At 
105.21 	least 70 percent of the supportive housing units must serve homeless adults with mental 
105.22 	illness, substance abuse problems, or human immunodeficiency virus or acquired 
105.23 	immunodeficiency syndrome who are about to be or, within the previous six months, has 
105.24 	been discharged from a regional treatment center, or a state-contracted psychiatric bed in 
105.25 	a community hospital, or a residential mental health or chemical dependency treatment 
105.26 	program. If a person meets the requirements of subdivision 1, paragraph (a), and receives 
105.27 	a federal or state housing subsidy, the group residential housing support rate for that person 
105.28 	is limited to the supplementary rate under section 256I.05, subdivision 1a, and is determined 
105.29 	by subtracting the amount of the person's countable income that exceeds the MSA equivalent 
105.30 	rate from the group residential housing support supplementary service rate. A resident in a 
105.31 	demonstration project site who no longer participates in the demonstration program shall 
105.32 	retain eligibility for a group residential housing support payment in an amount determined 
105.33 	under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under 
105.34 	section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are 
105.35 	available and the services can be provided through a managed care entity. If federal matching 
106.1 	funds are not available, then service funding will continue under section 256I.05, subdivision 
106.2 	1a;
106.3 	(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in 
106.4 	Hennepin County providing services for recovering and chemically dependent men that has 
106.5 	had a group residential housing support contract with the county and has been licensed as 
106.6 	a board and lodge facility with special services since 1980;
106.7 	(5) for a group residential housing support provider located in the city of St. Cloud, or 
106.8 	a county contiguous to the city of St. Cloud, that operates a 40-bed facility, that received 
106.9 	financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness 
106.10 	Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
106.11 	(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent 
106.12 	persons, operated by a group residential housing support provider that currently operates a 
106.13 	304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
106.14 	(7) for a group residential housing support provider that operates two ten-bed facilities, 
106.15 	one located in Hennepin County and one located in Ramsey County, that provide community 
106.16 	support and 24-hour-a-day supervision to serve the mental health needs of individuals who 
106.17 	have chronically lived unsheltered; and
106.18 	(8) for a group residential facility authorized for recipients of housing support in Hennepin 
106.19 	County with a capacity of up to 48 beds that has been licensed since 1978 as a board and 
106.20 	lodging facility and that until August 1, 2007, operated as a licensed chemical dependency 
106.21 	treatment program.
106.22 	(b) An agency may enter into a group residential housing support agreement for beds 
106.23 	with rates in excess of the MSA equivalent rate in addition to those currently covered under 
106.24 	a group residential housing support agreement if the additional beds are only a replacement 
106.25 	of beds with rates in excess of the MSA equivalent rate which have been made available 
106.26 	due to closure of a setting, a change of licensure or certification which removes the beds 
106.27 	from group residential housing support payment, or as a result of the downsizing of a group 
106.28 	residential housing setting authorized for recipients of housing support. The transfer of 
106.29 	available beds from one agency to another can only occur by the agreement of both agencies.

106.30 	Sec. 29. Minnesota Statutes 2016, section 256I.05, subdivision 1a, is amended to read:
106.31 		Subd. 1a.Supplementary service rates. (a) Subject to the provisions of section 256I.04, 
106.32 	subdivision 3, the county agency may negotiate a payment not to exceed $426.37 for other 
106.33 	services necessary to provide room and board provided by the group residence if the residence 
107.1 	is licensed by or registered by the Department of Health, or licensed by the Department of 
107.2 	Human Services to provide services in addition to room and board, and if the provider of 
107.3 	services is not also concurrently receiving funding for services for a recipient under a home 
107.4 	and community-based waiver under title XIX of the Social Security Act; or funding from 
107.5 	the medical assistance program under section 256B.0659, for personal care services for 
107.6 	residents in the setting; or residing in a setting which receives funding under section 245.73. 
107.7 	If funding is available for other necessary services through a home and community-based 
107.8 	waiver, or personal care services under section 256B.0659, then the GRH housing support
107.9 	rate is limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case 
107.10 	may the supplementary service rate exceed $426.37. The registration and licensure 
107.11 	requirement does not apply to establishments which are exempt from state licensure because 
107.12 	they are located on Indian reservations and for which the tribe has prescribed health and 
107.13 	safety requirements. Service payments under this section may be prohibited under rules to 
107.14 	prevent the supplanting of federal funds with state funds. The commissioner shall pursue 
107.15 	the feasibility of obtaining the approval of the Secretary of Health and Human Services to 
107.16 	provide home and community-based waiver services under title XIX of the Social Security 
107.17 	Act for residents who are not eligible for an existing home and community-based waiver 
107.18 	due to a primary diagnosis of mental illness or chemical dependency and shall apply for a 
107.19 	waiver if it is determined to be cost-effective.
107.20 	(b) The commissioner is authorized to make cost-neutral transfers from the GRH housing 
107.21 	support fund for beds under this section to other funding programs administered by the 
107.22 	department after consultation with the county or counties in which the affected beds are 
107.23 	located. The commissioner may also make cost-neutral transfers from the GRH housing 
107.24 	support fund to county human service agencies for beds permanently removed from the 
107.25 	GRH housing support census under a plan submitted by the county agency and approved 
107.26 	by the commissioner. The commissioner shall report the amount of any transfers under this 
107.27 	provision annually to the legislature.
107.28 	(c) Counties must not negotiate supplementary service rates with providers of group 
107.29 	residential housing support that are licensed as board and lodging with special services and 
107.30 	that do not encourage a policy of sobriety on their premises and make referrals to available 
107.31 	community services for volunteer and employment opportunities for residents.

108.1 	Sec. 30. Minnesota Statutes 2016, section 256I.05, subdivision 1c, is amended to read:
108.2 		Subd. 1c.Rate increases. An agency may not increase the rates negotiated for group 
108.3 	residential housing support above those in effect on June 30, 1993, except as provided in 
108.4 	paragraphs (a) to (f).
108.5 	(a) An agency may increase the rates for group residential housing settings room and 
108.6 	board to the MSA equivalent rate for those settings whose current rate is below the MSA 
108.7 	equivalent rate.
108.8 	(b) An agency may increase the rates for residents in adult foster care whose difficulty 
108.9 	of care has increased. The total group residential housing support rate for these residents 
108.10 	must not exceed the maximum rate specified in subdivisions 1 and 1a. Agencies must not 
108.11 	include nor increase group residential housing difficulty of care rates for adults in foster 
108.12 	care whose difficulty of care is eligible for funding by home and community-based waiver 
108.13 	programs under title XIX of the Social Security Act.
108.14 	(c) The room and board rates will be increased each year when the MSA equivalent rate 
108.15 	is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less 
108.16 	the amount of the increase in the medical assistance personal needs allowance under section 
108.17 	256B.35.
108.18 	(d) When a group residential housing rate is used to pay support pays for an individual's 
108.19 	room and board, or other costs necessary to provide room and board, the rate payable to the 
108.20 	residence must continue for up to 18 calendar days per incident that the person is temporarily 
108.21 	absent from the residence, not to exceed 60 days in a calendar year, if the absence or absences 
108.22 	have received the prior approval of the county agency's social service staff. Prior approval 
108.23 	is not required for emergency absences due to crisis, illness, or injury.
108.24 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
108.25 	change criteria exists if the group residential housing establishment experiences a 25 percent 
108.26 	increase or decrease in the total number of its beds, if the net cost of capital additions or 
108.27 	improvements is in excess of 15 percent of the current market value of the residence, or if 
108.28 	the residence physically moves, or changes its licensure, and incurs a resulting increase in 
108.29 	operation and property costs.
108.30 	(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid 
108.31 	for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who 
108.32 	reside in residences that are licensed by the commissioner of health as a boarding care home, 
108.33 	but are not certified for the purposes of the medical assistance program. However, an increase 
108.34 	under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical 
109.1 	assistance reimbursement rate for nursing home resident class A, in the geographic grouping 
109.2 	in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to 
109.3 	9549.0058.

109.4 	Sec. 31. Minnesota Statutes 2016, section 256I.05, subdivision 1e, is amended to read:
109.5 		Subd. 1e.Supplementary rate for certain facilities. (a) Notwithstanding the provisions 
109.6 	of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall negotiate a 
109.7 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
109.8 	month, including any legislatively authorized inflationary adjustments, for a group residential
109.9 	housing support provider that:
109.10 	(1) is located in Hennepin County and has had a group residential housing support 
109.11 	contract with the county since June 1996;
109.12 	(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 26-bed 
109.13 	facility; and
109.14 	(3) serves a chemically dependent clientele, providing 24 hours per day supervision and 
109.15 	limiting a resident's maximum length of stay to 13 months out of a consecutive 24-month 
109.16 	period.
109.17 	(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a 
109.18 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
109.19 	month, including any legislatively authorized inflationary adjustments, of a group residential
109.20 	housing support provider that:
109.21 	(1) is located in St. Louis County and has had a group residential housing support contract 
109.22 	with the county since 2006;
109.23 	(2) operates a 62-bed facility; and
109.24 	(3) serves a chemically dependent adult male clientele, providing 24 hours per day 
109.25 	supervision and limiting a resident's maximum length of stay to 13 months out of a 
109.26 	consecutive 24-month period.
109.27 	(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency 
109.28 	shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not 
109.29 	to exceed $700 per month, including any legislatively authorized inflationary adjustments, 
109.30 	for the group residential provider described under paragraphs (a) and (b), not to exceed an 
109.31 	additional 115 beds.

110.1 	Sec. 32. Minnesota Statutes 2016, section 256I.05, subdivision 1j, is amended to read:
110.2 		Subd. 1j.Supplementary rate for certain facilities; Crow Wing County.
 110.3 	Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a county 
110.4 	agency shall negotiate a supplementary rate in addition to the rate specified in subdivision 
110.5 	1, not to exceed $700 per month, including any legislatively authorized inflationary 
110.6 	adjustments, for a new 65-bed facility in Crow Wing County that will serve chemically 
110.7 	dependent persons operated by a group residential housing support provider that currently 
110.8 	operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which opened in 
110.9 	January of 2006.

110.10 	Sec. 33. Minnesota Statutes 2016, section 256I.05, subdivision 1m, is amended to read:
110.11 		Subd. 1m.Supplemental rate for certain facilities; Hennepin and Ramsey Counties.
 110.12 	(a) Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency 
110.13 	shall negotiate a supplemental service rate in addition to the rate specified in subdivision 
110.14 	1, not to exceed $700 per month or the existing monthly rate, whichever is higher, including 
110.15 	any legislatively authorized inflationary adjustments, for a group residential housing support 
110.16 	provider that operates two ten-bed facilities, one located in Hennepin County and one located 
110.17 	in Ramsey County, which provide community support and serve the mental health needs 
110.18 	of individuals who have chronically lived unsheltered, providing 24-hour-per-day supervision.
110.19 	(b) An individual who has lived in one of the facilities under paragraph (a), who is being 
110.20 	transitioned to independent living as part of the program plan continues to be eligible for 
110.21 	group residential housing room and board and the supplemental service rate negotiated with 
110.22 	the county under paragraph (a).

110.23 	Sec. 34. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
110.24 	to read:
110.25 		Subd. 1p.Supplementary rate; St. Louis County. Notwithstanding the provisions of 
110.26 	subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a 
110.27 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per 
110.28 	month, including any legislatively authorized inflationary adjustments, for a housing support 
110.29 	provider that:
110.30 	(1) is located in St. Louis County and has had a group residential housing contract with 
110.31 	the county since July 2016;
110.32 	(2) operates a 35-bed facility;
111.1 	(3) serves women who are chemically dependent, mentally ill, or both;
111.2 	(4) provides 24-hour per day supervision;
111.3 	(5) provides onsite support with skilled professionals, including a licensed practical 
111.4 	nurse, registered nurses, peer specialists, and resident counselors; and
111.5 	(6) provides independent living skills training and assistance with family reunification.

111.6 	Sec. 35. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
111.7 	to read:
111.8 		Subd. 1q.Supplemental rate; Olmsted County. Notwithstanding the provisions of 
111.9 	subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a 
111.10 	supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per 
111.11 	month, including any legislatively authorized inflationary adjustments, for a housing support 
111.12 	provider located in Olmsted County that operates long-term residential facilities with a total 
111.13 	of 104 beds that serve chemically dependent men and women and provide 24-hour-a-day 
111.14 	supervision and other support services.

111.15 	Sec. 36. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
111.16 	to read:
111.17 		Subd. 1r.Supplemental rate; Anoka County. Notwithstanding the provisions in this 
111.18 	section, a county agency shall negotiate a supplemental rate for 42 beds in addition to the 
111.19 	rate specified in subdivision 1, not to exceed the maximum rate in subdivision 1a per month, 
111.20 	including any legislatively authorized inflationary adjustments, for a housing support provider 
111.21 	that is located in Anoka County and provides emergency housing on the former Anoka 
111.22 	Regional Treatment Center campus.

111.23 	Sec. 37. Minnesota Statutes 2016, section 256I.05, subdivision 8, is amended to read:
111.24 		Subd. 8.State participation. For a resident of a group residence person who is eligible 
111.25 	under section 256I.04, subdivision 1, paragraph (b), state participation in the group residential
111.26 	housing support payment is determined according to section 256D.03, subdivision 2. For 
111.27 	a resident of a group residence person who is eligible under section 256I.04, subdivision 1, 
111.28 	paragraph (a), state participation in the group residential housing support rate is determined 
111.29 	according to section 256D.36.

112.1 	Sec. 38. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
112.2 	to read:
112.3 		Subd. 11.Transfer of emergency shelter funds. (a) The commissioner shall make a 
112.4 	cost-neutral transfer of funding from the group residential housing fund to county human 
112.5 	service agencies for emergency shelter beds removed from the group residential housing 
112.6 	census under a biennial plan submitted by the county and approved by the commissioner. 
112.7 	The biennial plan is due August 1, beginning August 1, 2017. The plan must describe: (1) 
112.8 	anticipated and actual outcomes for persons experiencing homelessness in emergency 
112.9 	shelters; (2) improved efficiencies in administration; (3) requirements for individual 
112.10 	eligibility; and (4) plans for quality assurance monitoring and quality assurance outcomes. 
112.11 	The commissioner shall review the county plan to monitor implementation and outcomes 
112.12 	at least biennially, and more frequently if the commissioner deems necessary.
112.13 	(b) The funding under paragraph (a) may be used for the provision of room and board 
112.14 	or supplemental services according to section 256I.03, subdivisions 2 and 8. Providers must 
112.15 	meet the requirements of section 256I.04, subdivisions 2a to 2f. Funding will be allocated 
112.16 	annually, and the room and board portion of the allocation shall be adjusted according to 
112.17 	the percentage change in the group residential housing room and board rate. The room and 
112.18 	board portion of the allocation shall be determined at the time of transfer. The commissioner 
112.19 	or county may return beds to the group residential housing fund with 180 days' notice, 
112.20 	including financial reconciliation.

112.21 	Sec. 39. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision 
112.22 	to read:
112.23 		Subd. 12.Decrease in supplementary service rate. For every housing support provider 
112.24 	with a supplementary service rate of $300 or higher, the commissioner shall reduce by five 
112.25 	percent the difference between the total supplementary service rate in effect on July 1, 2017, 
112.26 	and $300, and shall reduce by ten percent the difference between the total supplementary 
112.27 	service rate in effect on July 1, 2019, and $300. This subdivision does not apply to a facility 
112.28 	with rates established under subdivision 2.

112.29 	Sec. 40. Minnesota Statutes 2016, section 256I.06, subdivision 2, is amended to read:
112.30 		Subd. 2.Time of payment. A county agency may make payments to a group residence
112.31 	in advance for an individual whose stay in the group residence is expected to last beyond 
112.32 	the calendar month for which the payment is made. Group residential Housing support
112.33 	payments made by a county agency on behalf of an individual who is not expected to remain 
113.1 	in the group residence beyond the month for which payment is made must be made 
113.2 	subsequent to the individual's departure from the group residence.

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

113.4 	Sec. 41. Minnesota Statutes 2016, section 256I.06, subdivision 8, is amended to read:
113.5 		Subd. 8.Amount of group residential housing support payment. (a) The amount of 
113.6 	a group residential housing room and board payment to be made on behalf of an eligible 
113.7 	individual is determined by subtracting the individual's countable income under section 
113.8 	256I.04, subdivision 1, for a whole calendar month from the group residential housing 
113.9 	charge room and board rate for that same month. The group residential housing charge
113.10 	support payment is determined by multiplying the group residential housing support rate 
113.11 	times the period of time the individual was a resident or temporarily absent under section 
113.12 	256I.05, subdivision 1c, paragraph (d).
113.13 	(b) For an individual with earned income under paragraph (a), prospective budgeting 
113.14 	must be used to determine the amount of the individual's payment for the following six-month 
113.15 	period. An increase in income shall not affect an individual's eligibility or payment amount 
113.16 	until the month following the reporting month. A decrease in income shall be effective the 
113.17 	first day of the month after the month in which the decrease is reported.
113.18 	(c) For an individual who receives licensed residential crisis stabilization services under 
113.19 	section 256B.0624, subdivision 7, the amount of group residential housing payment is 
113.20 	determined by multiplying the group residential housing rate times the period of time the 
113.21 	individual was a resident.

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

113.23 	Sec. 42. [256I.09] COMMUNITY LIVING INFRASTRUCTURE.
113.24 	The commissioner shall awards grants to agencies through an annual competitive process. 
113.25 	Grants awarded under this section may be used for: (1) outreach to locate and engage people 
113.26 	who are homeless or residing in segregated settings to screen for basic needs and assist with 
113.27 	referral to community living resources; (2) building capacity to provide technical assistance 
113.28 	and consultation on housing and related support service resources for persons with both 
113.29 	disabilities and low income; or (3) streamlining the administration and monitoring activities 
113.30 	related to housing support funds. Agencies may collaborate and submit a joint application 
113.31 	for funding under this section.

114.1 	Sec. 43. REVISOR'S INSTRUCTION.
 114.2 	In each section of Minnesota Statutes referred to in column A, the revisor of statutes 
114.3 	shall change the phrase in column B to the phrase in column C. The revisor may make 
114.4 	technical and other necessary changes to sentence structure to preserve the meaning of the 
114.5 	text. The revisor shall make other changes in chapter titles; section, subdivision, part, and 
114.6 	subpart headnotes; and in other terminology necessary as a result of the enactment of this 
114.7 	section.

114.8	Column A
	Column B
	Column C
	
114.9114.10
	144A.071, subdivision 4d
	group residential housing
	housing support under chapter 
256I
	
114.11114.12	201.061, subdivision 3
	group residential housing
	setting authorized to provide 
housing support
	
114.13114.14114.15	244.052, subdivision 4c
	group residential housing 
facility
	licensed setting authorized to 
provide housing support 
under section 256I.04
	
114.16114.17	245.466, subdivision 7
	under group residential 
housing
	by housing support under 
chapter 256I
	
114.18	245.466, subdivision 7
	from group residential housing
	from housing support
	
114.19114.20	245.4661, subdivision 6
	group residential housing
	housing support under chapter 
256I
	
114.21114.22	245C.10, subdivision 11
	group residential housing or 
supplementary services
	housing support
	
114.23114.24	256.01, subdivision 18
	group residential housing
	housing support under chapter 
256I
	
114.25	256.017, subdivision 1
	group residential housing
	housing support
	
114.26114.27	256.98, subdivision 8
	group residential housing
	housing support under chapter 
256I
	
114.28114.29	256B.49, subdivision 15
	group residential housing
	housing support under chapter 
256I
	
114.30114.31	256B.4914, subdivision 10
	group residential housing rate 
3 costs
	housing support rate 3 costs 
under chapter 256I
	
114.32	256B.501, subdivision 4b
	group residential housing
	housing support
	
114.33114.34
114.35	256B.77, subdivision 12
	residential services covered 
under the group residential 
housing program
	housing support services 
under chapter 256I
	
114.36114.37	256D.44, subdivision 2
	group residential housing 
facility
	setting authorized to provide 
housing support
	
114.38114.39	256G.01, subdivision 3
	group residential housing
	housing support under chapter 
256I
	
114.40	256I.01
	Group Residential Housing
	Housing Support
	
114.41	256I.02
	Group Residential Housing
	Housing Support
	
114.42	256I.03, subdivision 2
	"Group residential housing"
	"Room and board"
	
115.1	256I.03, subdivision 2
	Group residential housing
	The room and board
	
115.2	256I.03, subdivision 3
	"Group residential housing"
	"Housing support"
	
115.3	256I.03, subdivision 6
	group residential housing
	room and board
	
115.4	256I.03, subdivisions 7 and 9
	group residential housing
	housing support
	
115.5
115.6	256I.04, subdivisions 1a, 1b, 
1c, and 2
	group residential housing
	housing support
	
115.7115.8	256I.04, subdivision 2a
	provide group residential 
housing
	provide housing support
	
115.9115.10
	256I.04, subdivision 2a
	of group residential housing 
or supplementary services
	of housing support
	
115.11115.12	256I.04, subdivision 2a
	complete group residential 
housing
	complete housing support
	
115.13115.14	256I.04, subdivision 2b
	group residential housing or 
supplementary services
	housing support
	
115.15115.16	256I.04, subdivision 2b
	provision of group residential 
housing
	provision of housing support
	
115.17115.18	256I.04, subdivision 2c
	group residential housing or 
supplementary services
	housing support
	
115.19115.20	256I.04, subdivision 2e
	group residential housing or 
supplementary services
	housing support
	
115.21115.22	256I.04, subdivision 4
	group residential housing 
payment for room and board
	room and board rate
	
115.23115.24	256I.05, subdivision 1
	living in group residential 
housing
	receiving housing support
	
115.25
115.26	256I.05, subdivisions 1h, 1k, 
1l, 7b, and 7c
	group residential housing
	housing support
	
115.27	256I.05, subdivision 2
	group residential housing
	room and board
	
115.28	256I.05, subdivision 3
	group residential housing
	room and board
	
115.29115.30	256I.05, subdivision 6
	reside in group residential 
housing
	receive housing support
	
115.31
115.32	256I.06, subdivisions 1, 3, 4, 
and 6
	group residential housing
	housing support
	
115.33	256I.06, subdivision 7
	group residential housing
	the housing support
	
115.34	256I.08
	group residential housing
	housing support
	
115.35	256P.03, subdivision 1
	group residential housing
	housing support
	
115.36	256P.05, subdivision 1
	group residential housing
	housing support
	
115.37	256P.07, subdivision 1
	group residential housing
	housing support
	
115.38	256P.08, subdivision 1
	group residential housing
	housing support
	
115.39115.40	290A.03, subdivision 8
	accepts group residential 
housing
	accepts housing support
	
115.41115.42	290A.03, subdivision 8
	the group residential housing 
program
	the housing support program

116.1 	ARTICLE 3
116.2 	CONTINUING CARE

116.3 	Section 1. Minnesota Statutes 2016, section 144.0724, subdivision 4, is amended to read:
116.4 		Subd. 4.Resident assessment schedule. (a) A facility must conduct and electronically 
116.5 	submit to the commissioner of health MDS assessments that conform with the assessment 
116.6 	schedule defined by Code of Federal Regulations, title 42, section 483.20, and published 
116.7 	by the United States Department of Health and Human Services, Centers for Medicare and 
116.8 	Medicaid Services, in the Long Term Care Assessment Instrument User's Manual, version 
116.9 	3.0, and subsequent updates when issued by the Centers for Medicare and Medicaid Services. 
116.10 	The commissioner of health may substitute successor manuals or question and answer 
116.11 	documents published by the United States Department of Health and Human Services, 
116.12 	Centers for Medicare and Medicaid Services, to replace or supplement the current version 
116.13 	of the manual or document.
116.14 	(b) The assessments used to determine a case mix classification for reimbursement 
116.15 	include the following:
116.16 	(1) a new admission assessment;
116.17 	(2) an annual assessment which must have an assessment reference date (ARD) within 
116.18 	92 days of the previous assessment and the previous comprehensive assessment;
116.19 	(3) a significant change in status assessment must be completed within 14 days of the 
116.20 	identification of a significant change, whether improvement or decline, and regardless of 
116.21 	the amount of time since the last significant change in status assessment;
116.22 	(4) all quarterly assessments must have an assessment reference date (ARD) within 92 
116.23 	days of the ARD of the previous assessment;
116.24 	(5) any significant correction to a prior comprehensive assessment, if the assessment 
116.25 	being corrected is the current one being used for RUG classification; and
116.26 	(6) any significant correction to a prior quarterly assessment, if the assessment being 
116.27 	corrected is the current one being used for RUG classification.
116.28 	(c) In addition to the assessments listed in paragraph (b), the assessments used to 
116.29 	determine nursing facility level of care include the following:
116.30 	(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by 
116.31 	the Senior LinkAge Line or other organization under contract with the Minnesota Board on 
116.32 	Aging; and
117.1 	(2) a nursing facility level of care determination as provided for under section 256B.0911, 
117.2 	subdivision 4e, as part of a face-to-face long-term care consultation assessment completed 
117.3 	under section 256B.0911, by a county, tribe, or managed care organization under contract 
117.4 	with the Department of Human Services.

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

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

117.23 	Sec. 3. Minnesota Statutes 2016, section 144A.071, subdivision 4d, is amended to read:
117.24 		Subd. 4d.Consolidation of nursing facilities. (a) The commissioner of health, in 
117.25 	consultation with the commissioner of human services, may approve a request for 
117.26 	consolidation of nursing facilities which includes the closure of one or more facilities and 
117.27 	the upgrading of the physical plant of the remaining nursing facility or facilities, the costs 
117.28 	of which exceed the threshold project limit under subdivision 2, clause (a). The 
117.29 	commissioners shall consider the criteria in this section, section 144A.073, and section 
117.30 	256B.437 256R.40, in approving or rejecting a consolidation proposal. In the event the 
117.31 	commissioners approve the request, the commissioner of human services shall calculate an 
117.32 	external fixed costs rate adjustment according to clauses (1) to (3):
118.1 	(1) the closure of beds shall not be eligible for a planned closure rate adjustment under 
118.2 	section 256B.437, subdivision 6 256R.40, subdivision 5;
118.3 	(2) the construction project permitted in this clause shall not be eligible for a threshold 
118.4 	project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception 
118.5 	adjustment under section 144A.073; and
118.6 	(3) the payment rate for external fixed costs for a remaining facility or facilities shall 
118.7 	be increased by an amount equal to 65 percent of the projected net cost savings to the state 
118.8 	calculated in paragraph (b), divided by the state's medical assistance percentage of medical 
118.9 	assistance dollars, and then divided by estimated medical assistance resident days, as 
118.10 	determined in paragraph (c), of the remaining nursing facility or facilities in the request in 
118.11 	this paragraph. The rate adjustment is effective on the later of the first day of the month 
118.12 	followingfirst day of the month of January or July, whichever date occurs first following 
118.13 	both the completion of the construction upgrades in the consolidation plan or the first day 
118.14 	of the month following and the complete closure of a facility closure of the facility or 
118.15 	facilities designated for closure in the consolidation plan. If more than one facility is receiving 
118.16 	upgrades in the consolidation plan, each facility's date of construction completion must be 
118.17 	evaluated separately.
118.18 	(b) For purposes of calculating the net cost savings to the state, the commissioner shall 
118.19 	consider clauses (1) to (7):
118.20 	(1) the annual savings from estimated medical assistance payments from the net number 
118.21 	of beds closed taking into consideration only beds that are in active service on the date of 
118.22 	the request and that have been in active service for at least three years;
118.23 	(2) the estimated annual cost of increased case load of individuals receiving services 
118.24 	under the elderly waiver;
118.25 	(3) the estimated annual cost of elderly waiver recipients receiving support under group 
118.26 	residential housing;
118.27 	(4) the estimated annual cost of increased case load of individuals receiving services 
118.28 	under the alternative care program;
118.29 	(5) the annual loss of license surcharge payments on closed beds;
118.30 	(6) the savings from not paying planned closure rate adjustments that the facilities would 
118.31 	otherwise be eligible for under section 256B.437 256R.40; and
119.1 	(7) the savings from not paying external fixed costs payment rate adjustments from 
119.2 	submission of renovation costs that would otherwise be eligible as threshold projects under 
119.3 	section 256B.434, subdivision 4f.
119.4 	(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical 
119.5 	assistance resident days of the remaining facility or facilities shall be computed assuming 
119.6 	95 percent occupancy multiplied by the historical percentage of medical assistance resident 
119.7 	days of the remaining facility or facilities, as reported on the facility's or facilities' most 
119.8 	recent nursing facility statistical and cost report filed before the plan of closure is submitted, 
119.9 	multiplied by 365.
119.10 	(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy 
119.11 	percentages will be those reported on the facility's or facilities' most recent nursing facility 
119.12 	statistical and cost report filed before the plan of closure is submitted, and the average 
119.13 	payment rates shall be calculated based on the approved payment rates in effect at the time 
119.14 	the consolidation request is submitted.
119.15 	(e) To qualify for the external fixed costs payment rate adjustment under this subdivision, 
119.16 	the closing facilities shall:
119.17 	(1) submit an application for closure according to section 256B.437, subdivision 3
119.18 	256R.40, subdivision 2; and
119.19 	(2) follow the resident relocation provisions of section 144A.161.
119.20 	(f) The county or counties in which a facility or facilities are closed under this subdivision 
119.21 	shall not be eligible for designation as a hardship area under subdivision 3 for five years 
119.22 	from the date of the approval of the proposed consolidation. The applicant shall notify the 
119.23 	county of this limitation and the county shall acknowledge this in a letter of support.

119.24 	EFFECTIVE DATE. This section is effective for consolidations occurring after July 
119.25 	1, 2017.

119.26 	Sec. 4. Minnesota Statutes 2016, section 256.975, subdivision 7, is amended to read:
119.27 		Subd. 7.Consumer information and assistance and long-term care options 
119.28 	counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a 
119.29 	statewide service to aid older Minnesotans and their families in making informed choices 
119.30 	about long-term care options and health care benefits. Language services to persons with 
119.31 	limited English language skills may be made available. The service, known as Senior 
119.32 	LinkAge Line, shall serve older adults as the designated Aging and Disability Resource 
119.33 	Center under United States Code, title 42, section 3001, the Older Americans Act 
120.1 	Amendments of 2006 in partnership with the Disability Linkage Line under section 256.01, 
120.2 	subdivision 24, and must be available during business hours through a statewide toll-free 
120.3 	number and the Internet. The Minnesota Board on Aging shall consult with, and when 
120.4 	appropriate work through, the area agencies on aging counties, and other entities that serve 
120.5 	aging and disabled populations of all ages, to provide and maintain the telephone 
120.6 	infrastructure and related support for the Aging and Disability Resource Center partners 
120.7 	which agree by memorandum to access the infrastructure, including the designated providers 
120.8 	of the Senior LinkAge Line and the Disability Linkage Line.
120.9 	(b) The service must provide long-term care options counseling by assisting older adults, 
120.10 	caregivers, and providers in accessing information and options counseling about choices in 
120.11 	long-term care services that are purchased through private providers or available through 
120.12 	public options. The service must:
120.13 	(1) develop and provide for regular updating of a comprehensive database that includes 
120.14 	detailed listings in both consumer- and provider-oriented formats that can provide search 
120.15 	results down to the neighborhood level;
120.16 	(2) make the database accessible on the Internet and through other telecommunication 
120.17 	and media-related tools;
120.18 	(3) link callers to interactive long-term care screening tools and make these tools available 
120.19 	through the Internet by integrating the tools with the database;
120.20 	(4) develop community education materials with a focus on planning for long-term care 
120.21 	and evaluating independent living, housing, and service options;
120.22 	(5) conduct an outreach campaign to assist older adults and their caregivers in finding 
120.23 	information on the Internet and through other means of communication;
120.24 	(6) implement a messaging system for overflow callers and respond to these callers by 
120.25 	the next business day;
120.26 	(7) link callers with county human services and other providers to receive more in-depth 
120.27 	assistance and consultation related to long-term care options;
120.28 	(8) link callers with quality profiles for nursing facilities and other home and 
120.29 	community-based services providers developed by the commissioners of health and human 
120.30 	services;
120.31 	(9) develop an outreach plan to seniors and their caregivers with a particular focus on 
120.32 	establishing a clear presence in places that seniors recognize and:
121.1 	(i) place a significant emphasis on improved outreach and service to seniors and their 
121.2 	caregivers by establishing annual plans by neighborhood, city, and county, as necessary, to 
121.3 	address the unique needs of geographic areas in the state where there are dense populations 
121.4 	of seniors;
121.5 	(ii) establish an efficient workforce management approach and assign community living 
121.6 	specialist staff and volunteers to geographic areas as well as aging and disability resource 
121.7 	center sites so that seniors and their caregivers and professionals recognize the Senior 
121.8 	LinkAge Line as the place to call for aging services and information;
121.9 	(iii) recognize the size and complexity of the metropolitan area service system by working 
121.10 	with metropolitan counties to establish a clear partnership with them, including seeking 
121.11 	county advice on the establishment of local aging and disabilities resource center sites; and
121.12 	(iv) maintain dashboards with metrics that demonstrate how the service is expanding 
121.13 	and extending or enhancing its outreach efforts in dispersed or hard to reach locations in 
121.14 	varied population centers;
121.15 	(10) incorporate information about the availability of housing options, as well as 
121.16 	registered housing with services and consumer rights within the MinnesotaHelp.info network 
121.17 	long-term care database to facilitate consumer comparison of services and costs among 
121.18 	housing with services establishments and with other in-home services and to support financial 
121.19 	self-sufficiency as long as possible. Housing with services establishments and their arranged 
121.20 	home care providers shall provide information that will facilitate price comparisons, including 
121.21 	delineation of charges for rent and for services available. The commissioners of health and 
121.22 	human services shall align the data elements required by section 144G.06, the Uniform 
121.23 	Consumer Information Guide, and this section to provide consumers standardized information 
121.24 	and ease of comparison of long-term care options. The commissioner of human services 
121.25 	shall provide the data to the Minnesota Board on Aging for inclusion in the 
121.26 	MinnesotaHelp.info network long-term care database;
121.27 	(11) provide long-term care options counseling. Long-term care options counselors shall:
121.28 	(i) for individuals not eligible for case management under a public program or public 
121.29 	funding source, provide interactive decision support under which consumers, family 
121.30 	members, or other helpers are supported in their deliberations to determine appropriate 
121.31 	long-term care choices in the context of the consumer's needs, preferences, values, and 
121.32 	individual circumstances, including implementing a community support plan;
122.1 	(ii) provide Web-based educational information and collateral written materials to 
122.2 	familiarize consumers, family members, or other helpers with the long-term care basics, 
122.3 	issues to be considered, and the range of options available in the community;
122.4 	(iii) provide long-term care futures planning, which means providing assistance to 
122.5 	individuals who anticipate having long-term care needs to develop a plan for the more 
122.6 	distant future; and
122.7 	(iv) provide expertise in benefits and financing options for long-term care, including 
122.8 	Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages, 
122.9 	private pay options, and ways to access low or no-cost services or benefits through 
122.10 	volunteer-based or charitable programs;
122.11 	(12) using risk management and support planning protocols, provide long-term care 
122.12 	options counseling under clause (13) to current residents of nursing homes deemed 
122.13 	appropriate for discharge by the commissioner, former residents of nursing homes who 
122.14 	were discharged to community settings, and older adults who request service after 
122.15 	consultation with the Senior LinkAge Line under clause (13). The Senior LinkAge Line 
122.16 	shall also receive referrals from the residents or staff of nursing homes. who meet a profile 
122.17 	that demonstrates that the consumer is either at risk of readmission to a nursing home or 
122.18 	hospital, or would benefit from long-term care options counseling to age in place. The Senior 
122.19 	LinkAge Line shall identify and contact residents or patients deemed appropriate for 
122.20 	discharge by developing targeting criteria and creating a profile in consultation with the 
122.21 	commissioner who. The commissioner shall provide designated Senior LinkAge Line contact 
122.22 	centers with a list of current or former nursing home residents or people discharged from a 
122.23 	hospital or for whom Medicare home care has ended, that meet the criteria as being 
122.24 	appropriate for discharge planning long-term care options counseling through a referral via 
122.25 	a secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a 
122.26 	preference to receive long-term care options counseling, with initial assessment and, if 
122.27 	appropriate, a referral to:
122.28 	(i) long-term care consultation services under section 256B.0911;
122.29 	(ii) designated care coordinators of contracted entities under section 256B.035 for persons 
122.30 	who are enrolled in a managed care plan; or
122.31 	(iii) the long-term care consultation team for those who are eligible for relocation service 
122.32 	coordination due to high-risk factors or psychological or physical disability; and
122.33 	(13) develop referral protocols and processes that will assist certified health care homes, 
122.34 	Medicare home care, and hospitals to identify at-risk older adults and determine when to 
123.1 	refer these individuals to the Senior LinkAge Line for long-term care options counseling 
123.2 	under this section. The commissioner is directed to work with the commissioner of health 
123.3 	to develop protocols that would comply with the health care home designation criteria and 
123.4 	protocols available at the time of hospital discharge or the end of Medicare home care. The 
123.5 	commissioner shall keep a record of the number of people who choose long-term care 
123.6 	options counseling as a result of this section.
123.7 	(c) Nursing homes shall provide contact information to the Senior LinkAge Line for 
123.8 	residents identified in paragraph (b), clause (12), to provide long-term care options counseling 
123.9 	pursuant to paragraph (b), clause (11). The contact information for residents shall include 
123.10 	all information reasonably necessary to contact residents, including first and last names, 
123.11 	permanent and temporary addresses, telephone numbers, and e-mail addresses.
123.12 	(d) The Senior LinkAge Line shall determine when it is appropriate to refer a consumer 
123.13 	who receives long-term care options counseling under paragraph (b), clause (12) or (13), 
123.14 	and who uses an unpaid caregiver to the self-directed caregiver service under subdivision 
123.15 	12.

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

123.17 	Sec. 5. Minnesota Statutes 2016, section 256.975, is amended by adding a subdivision to 
123.18 	read:
123.19 		Subd. 12.Self-directed caregiver grants. Beginning on July 1, 2019, the Minnesota 
123.20 	Board on Aging shall administer self-directed caregiver grants to support at risk family 
123.21 	caregivers of older adults or others eligible under the Older Americans Act of 1965, United 
123.22 	States Code, title 42, chapter 35, sections 3001 to 3058ff, to sustain family caregivers in 
123.23 	the caregivers' roles so older adults can remain at home longer. The board shall give priority 
123.24 	to consumers referred under section 256.975, subdivision 7, paragraph (d).

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

123.26 	Sec. 6. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
123.27 		Subd. 3a.Assessment and support planning. (a) Persons requesting assessment, services 
123.28 	planning, or other assistance intended to support community-based living, including persons 
123.29 	who need assessment in order to determine waiver or alternative care program eligibility, 
123.30 	must be visited by a long-term care consultation team within 20 calendar days after the date 
123.31 	on which an assessment was requested or recommended. Upon statewide implementation 
123.32 	of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person 
124.1 	requesting personal care assistance services and home care nursing. The commissioner shall 
124.2 	provide at least a 90-day notice to lead agencies prior to the effective date of this requirement. 
124.3 	Face-to-face assessments must be conducted according to paragraphs (b) to (i).
124.4 	(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified 
124.5 	assessors to conduct the assessment. For a person with complex health care needs, a public 
124.6 	health or registered nurse from the team must be consulted.
124.7 	(c) The MnCHOICES assessment provided by the commissioner to lead agencies must 
124.8 	be used to complete a comprehensive, person-centered assessment. The assessment must 
124.9 	include the health, psychological, functional, environmental, and social needs of the 
124.10 	individual necessary to develop a community support plan that meets the individual's needs 
124.11 	and preferences.
124.12 	(d) The assessment must be conducted in a face-to-face interview with the person being 
124.13 	assessed and the person's legal representative. At the request of the person, other individuals 
124.14 	may participate in the assessment to provide information on the needs, strengths, and 
124.15 	preferences of the person necessary to develop a community support plan that ensures the 
124.16 	person's health and safety. Except for legal representatives or family members invited by 
124.17 	the person, persons participating in the assessment may not be a provider of service or have 
124.18 	any financial interest in the provision of services. For persons who are to be assessed for 
124.19 	elderly waiver customized living or adult day services under section 256B.0915, with the 
124.20 	permission of the person being assessed or the person's designated or legal representative, 
124.21 	the client's current or proposed provider of services may submit a copy of the provider's 
124.22 	nursing assessment or written report outlining its recommendations regarding the client's 
124.23 	care needs. The person conducting the assessment must notify the provider of the date by 
124.24 	which this information is to be submitted. This information shall be provided to the person 
124.25 	conducting the assessment prior to the assessment. For a person who is to be assessed for 
124.26 	waiver services under section 256B.092 or 256B.49, with the permission of the person being 
124.27 	assessed or the person's designated legal representative, the person's current provider of 
124.28 	services may submit a written report outlining recommendations regarding the person's care 
124.29 	needs prepared by a direct service employee with at least 20 hours of service to that client. 
124.30 	The person conducting the assessment or reassessment must notify the provider of the date 
124.31 	by which this information is to be submitted. This information shall be provided to the 
124.32 	person conducting the assessment and the person or the person's legal representative, and 
124.33 	must be considered prior to the finalization of the assessment or reassessment.
125.1 	(e) The person or the person's legal representative must be provided with a written 
125.2 	community support plan within 40 calendar days of the assessment visit, regardless of 
125.3 	whether the individual is eligible for Minnesota health care programs.
125.4 	(f) For a person being assessed for elderly waiver services under section 256B.0915, a 
125.5 	provider who submitted information under paragraph (d) shall receive a copy of the 
125.6 	assessment, the final written community support plan when available, the case mix level, 
125.7 	and the Residential Services Workbook.
125.8 	(g) The written community support plan must include:
125.9 	(1) a summary of assessed needs as defined in paragraphs (c) and (d);
125.10 	(2) the individual's options and choices to meet identified needs, including all available 
125.11 	options for case management services and providers;
125.12 	(3) identification of health and safety risks and how those risks will be addressed, 
125.13 	including personal risk management strategies;
125.14 	(4) referral information; and
125.15 	(5) informal caregiver supports, if applicable.
125.16 	For a person determined eligible for state plan home care under subdivision 1a, paragraph 
125.17 	(b), clause (1), the person or person's representative must also receive a copy of the home 
125.18 	care service plan developed by the certified assessor.
125.19 	(f) (h) A person may request assistance in identifying community supports without 
125.20 	participating in a complete assessment. Upon a request for assistance identifying community 
125.21 	support, the person must be transferred or referred to long-term care options counseling 
125.22 	services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for 
125.23 	telephone assistance and follow up.
125.24 	(g) (i) The person has the right to make the final decision between institutional placement 
125.25 	and community placement after the recommendations have been provided, except as provided 
125.26 	in section 256.975, subdivision 7a, paragraph (d).
125.27 	(h) (j) The lead agency must give the person receiving assessment or support planning, 
125.28 	or the person's legal representative, materials, and forms supplied by the commissioner 
125.29 	containing the following information:
125.30 	(1) written recommendations for community-based services and consumer-directed 
125.31 	options;
126.1 	(2) documentation that the most cost-effective alternatives available were offered to the 
126.2 	individual. For purposes of this clause, "cost-effective" means community services and 
126.3 	living arrangements that cost the same as or less than institutional care. For an individual 
126.4 	found to meet eligibility criteria for home and community-based service programs under 
126.5 	section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally 
126.6 	approved waiver plan for each program;
126.7 	(3) the need for and purpose of preadmission screening conducted by long-term care 
126.8 	options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects 
126.9 	nursing facility placement. If the individual selects nursing facility placement, the lead 
126.10 	agency shall forward information needed to complete the level of care determinations and 
126.11 	screening for developmental disability and mental illness collected during the assessment 
126.12 	to the long-term care options counselor using forms provided by the commissioner;
126.13 	(4) the role of long-term care consultation assessment and support planning in eligibility 
126.14 	determination for waiver and alternative care programs, and state plan home care, case 
126.15 	management, and other services as defined in subdivision 1a, paragraphs (a), clause (6), 
126.16 	and (b);
126.17 	(5) information about Minnesota health care programs;
126.18 	(6) the person's freedom to accept or reject the recommendations of the team;
126.19 	(7) the person's right to confidentiality under the Minnesota Government Data Practices 
126.20 	Act, chapter 13;
126.21 	(8) the certified assessor's decision regarding the person's need for institutional level of 
126.22 	care as determined under criteria established in subdivision 4e and the certified assessor's 
126.23 	decision regarding eligibility for all services and programs as defined in subdivision 1a, 
126.24 	paragraphs (a), clause (6), and (b); and
126.25 	(9) the person's right to appeal the certified assessor's decision regarding eligibility for 
126.26 	all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and 
126.27 	(8), and (b), and incorporating the decision regarding the need for institutional level of care 
126.28 	or the lead agency's final decisions regarding public programs eligibility according to section 
126.29 	256.045, subdivision 3.
126.30 	(i) (k) Face-to-face assessment completed as part of eligibility determination for the 
126.31 	alternative care, elderly waiver, community access for disability inclusion, community 
126.32 	alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915, 
127.1 	and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after 
127.2 	the date of assessment.
127.3 	(j) (l) The effective eligibility start date for programs in paragraph (i)(k) can never be 
127.4 	prior to the date of assessment. If an assessment was completed more than 60 days before 
127.5 	the effective waiver or alternative care program eligibility start date, assessment and support 
127.6 	plan information must be updated and documented in the department's Medicaid Management 
127.7 	Information System (MMIS). Notwithstanding retroactive medical assistance coverage of 
127.8 	state plan services, the effective date of eligibility for programs included in paragraph (i)
127.9 	(k) cannot be prior to the date the most recent updated assessment is completed.
127.10 	(m) If an eligibility update is completed within 90 days of the previous face-to-face 
127.11 	assessment and documented in the department's Medicaid Management Information System 
127.12 	(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date 
127.13 	of the previous face-to-face assessment when all other eligibility requirements are met.

127.14 	Sec. 7. Minnesota Statutes 2016, section 256B.0915, subdivision 3a, is amended to read:
127.15 		Subd. 3a.Elderly waiver cost limits. (a) Effective on the first day of the state fiscal 
127.16 	year in which the resident assessment system as described in section 256B.438 256R.17 for 
127.17 	nursing home rate determination is implemented and the first day of each subsequent state 
127.18 	fiscal year, the monthly limit for the cost of waivered services to an individual elderly waiver 
127.19 	client shall be the monthly limit of the case mix resident class to which the waiver client 
127.20 	would be assigned under Minnesota Rules, parts 9549.0051 to 9549.0059, in effect on the 
127.21 	last day of the previous state fiscal year, adjusted by any legislatively adopted home and 
127.22 	community-based services percentage rate adjustment. If a legislatively authorized increase 
127.23 	is service-specific, the monthly cost limit shall be adjusted based on the overall average 
127.24 	increase to the elderly waiver program.
127.25 	(b) The monthly limit for the cost of waivered services under paragraph (a) to an 
127.26 	individual elderly waiver client assigned to a case mix classification A with:
127.27 	(1) no dependencies in activities of daily living; or
127.28 	(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when 
127.29 	the dependency score in eating is three or greater as determined by an assessment performed 
127.30 	under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new 
127.31 	participants enrolled in the program on or after July 1, 2011. This monthly limit shall be 
127.32 	applied to all other participants who meet this criteria at reassessment. This monthly limit 
127.33 	shall be increased annually as described in paragraphs (a) and (e).
128.1 	(c) If extended medical supplies and equipment or environmental modifications are or 
128.2 	will be purchased for an elderly waiver client, the costs may be prorated for up to 12 
128.3 	consecutive months beginning with the month of purchase. If the monthly cost of a recipient's 
128.4 	waivered services exceeds the monthly limit established in paragraph (a), (b), (d), or (e), 
128.5 	the annual cost of all waivered services shall be determined. In this event, the annual cost 
128.6 	of all waivered services shall not exceed 12 times the monthly limit of waivered services 
128.7 	as described in paragraph (a), (b), (d), or (e).
128.8 	(d) Effective July 1, 2013, the monthly cost limit of waiver services, including any 
128.9 	necessary home care services described in section 256B.0651, subdivision 2, for individuals 
128.10 	who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1, 
128.11 	paragraph (g), shall be the average of the monthly medical assistance amount established 
128.12 	for home care services as described in section 256B.0652, subdivision 7, and the annual 
128.13 	average contracted amount established by the commissioner for nursing facility services 
128.14 	for ventilator-dependent individuals. This monthly limit shall be increased annually as 
128.15 	described in paragraphs (a) and (e).
128.16 	(e) Effective July 1, 2016 January 1, 2018, and each July January 1 thereafter, the monthly 
128.17 	cost limits for elderly waiver services in effect on the previous June 30 December 31 shall 
128.18 	be increased by the difference between any legislatively adopted home and community-based 
128.19 	provider rate increases effective on July January 1 or since the previous July January 1 and 
128.20 	the average statewide percentage increase in nursing facility operating payment rates under 
128.21 	sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective the previous January 
128.22 	1. This paragraph shall only apply if the average statewide percentage increase in nursing 
128.23 	facility operating payment rates is greater than any legislatively adopted home and 
128.24 	community-based provider rate increases effective on July January 1, or occurring since 
128.25 	the previous July January 1.

128.26 	Sec. 8. Minnesota Statutes 2016, section 256B.0915, subdivision 3e, is amended to read:
128.27 		Subd. 3e.Customized living service rate. (a) Payment for customized living services 
128.28 	shall be a monthly rate authorized by the lead agency within the parameters established by 
128.29 	the commissioner. The payment agreement must delineate the amount of each component 
128.30 	service included in the recipient's customized living service plan. The lead agency, with 
128.31 	input from the provider of customized living services, shall ensure that there is a documented 
128.32 	need within the parameters established by the commissioner for all component customized 
128.33 	living services authorized.
129.1 	(b) The payment rate must be based on the amount of component services to be provided 
129.2 	utilizing component rates established by the commissioner. Counties and tribes shall use 
129.3 	tools issued by the commissioner to develop and document customized living service plans 
129.4 	and rates.
129.5 	(c) Component service rates must not exceed payment rates for comparable elderly 
129.6 	waiver or medical assistance services and must reflect economies of scale. Customized 
129.7 	living services must not include rent or raw food costs.
129.8 	(d) With the exception of individuals described in subdivision 3a, paragraph (b), the 
129.9 	individualized monthly authorized payment for the customized living service plan shall not 
129.10 	exceed 50 percent of the greater of either the statewide or any of the geographic groups'
129.11 	weighted average monthly nursing facility rate of the case mix resident class to which the 
129.12 	elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0051
129.13 	to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph 
129.14 	(a). Effective On July 1 of the state fiscal each year in which the resident assessment system 
129.15 	as described in section 256B.438 for nursing home rate determination is implemented and 
129.16 	July 1 of each subsequent state fiscal year, the individualized monthly authorized payment 
129.17 	for the services described in this clause shall not exceed the limit which was in effect on 
129.18 	June 30 of the previous state fiscal year updated annually based on legislatively adopted 
129.19 	changes to all service rate maximums for home and community-based service providers.
129.20 	(e) For rates effective on or after January 1, 2022, the elderly waiver payment for 
129.21 	customized living services includes a cognitive and behavioral needs factor equal to an 
129.22 	additional 15 percent applied to the component service rates for a client:
129.23 	(1) for whom the total monthly hours for customized living services divided by 30.4 is 
129.24 	less than 3.62; and
129.25 	(2) is determined, based on responses to questions 45 and 51 of the Minnesota long-term 
129.26 	care consultation assessment form, to have either:
129.27 	(i) wandering or orientation issues; or
129.28 	(ii) anxiety, verbal aggression, physical aggression, repetitive behavior, agitation, 
129.29 	self-injurious behavior, or behavior related to property destruction.
129.30 	(e) Effective July 1, 2011, (f) The individualized monthly payment for the customized 
129.31 	living service plan for individuals described in subdivision 3a, paragraph (b), must be the 
129.32 	monthly authorized payment limit for customized living for individuals classified as case 
129.33 	mix A, reduced by 25 percent. This rate limit must be applied to all new participants enrolled 
130.1 	in the program on or after July 1, 2011, who meet the criteria described in subdivision 3a, 
130.2 	paragraph (b). This monthly limit also applies to all other participants who meet the criteria 
130.3 	described in subdivision 3a, paragraph (b), at reassessment.
130.4 	(f) (g) Customized living services are delivered by a provider licensed by the Department 
130.5 	of Health as a class A or class F home care provider and provided in a building that is 
130.6 	registered as a housing with services establishment under chapter 144D. Licensed home 
130.7 	care providers are subject to section 256B.0651, subdivision 14.
130.8 	(g) (h) A provider may not bill or otherwise charge an elderly waiver participant or their 
130.9 	family for additional units of any allowable component service beyond those available under 
130.10 	the service rate limits described in paragraph (d) (e), nor for additional units of any allowable 
130.11 	component service beyond those approved in the service plan by the lead agency.
130.12 	(h)(i) Effective July 1, 2016  January 1, 2018, and each July January 1 thereafter, 
130.13 	individualized service rate limits for customized living services under this subdivision shall 
130.14 	be increased by the difference between any legislatively adopted home and community-based 
130.15 	provider rate increases effective on July January 1 or since the previous July January 1 and 
130.16 	the average statewide percentage increase in nursing facility operating payment rates under 
130.17 	sections 256B.431, and256B.434, and 256B.441 chapter 256R, effective the previous 
130.18 	January 1. This paragraph shall only apply if the average statewide percentage increase in 
130.19 	nursing facility operating payment rates is greater than any legislatively adopted home and 
130.20 	community-based provider rate increases effective on July January 1, or occurring since 
130.21 	the previous July January 1.

130.22 	Sec. 9. Minnesota Statutes 2016, section 256B.0915, subdivision 3h, is amended to read:
130.23 		Subd. 3h.Service rate limits; 24-hour customized living services. (a) The payment 
130.24 	rate for 24-hour customized living services is a monthly rate authorized by the lead agency 
130.25 	within the parameters established by the commissioner of human services. The payment 
130.26 	agreement must delineate the amount of each component service included in each recipient's 
130.27 	customized living service plan. The lead agency, with input from the provider of customized 
130.28 	living services, shall ensure that there is a documented need within the parameters established 
130.29 	by the commissioner for all component customized living services authorized. The lead 
130.30 	agency shall not authorize 24-hour customized living services unless there is a documented 
130.31 	need for 24-hour supervision.
130.32 	(b) For purposes of this section, "24-hour supervision" means that the recipient requires 
130.33 	assistance due to needs related to one or more of the following:
131.1 	(1) intermittent assistance with toileting, positioning, or transferring;
131.2 	(2) cognitive or behavioral issues;
131.3 	(3) a medical condition that requires clinical monitoring; or
131.4 	(4) for all new participants enrolled in the program on or after July 1, 2011, and all other 
131.5 	participants at their first reassessment after July 1, 2011, dependency in at least three of the 
131.6 	following activities of daily living as determined by assessment under section 256B.0911: 
131.7 	bathing; dressing; grooming; walking; or eating when the dependency score in eating is 
131.8 	three or greater; and needs medication management and at least 50 hours of service per 
131.9 	month. The lead agency shall ensure that the frequency and mode of supervision of the 
131.10 	recipient and the qualifications of staff providing supervision are described and meet the 
131.11 	needs of the recipient.
131.12 	(c) The payment rate for 24-hour customized living services must be based on the amount 
131.13 	of component services to be provided utilizing component rates established by the 
131.14 	commissioner. Counties and tribes will use tools issued by the commissioner to develop 
131.15 	and document customized living plans and authorize rates.
131.16 	(d) Component service rates must not exceed payment rates for comparable elderly 
131.17 	waiver or medical assistance services and must reflect economies of scale.
131.18 	(e) The individually authorized 24-hour customized living payments, in combination 
131.19 	with the payment for other elderly waiver services, including case management, must not 
131.20 	exceed the recipient's community budget cap specified in subdivision 3a. Customized living 
131.21 	services must not include rent or raw food costs.
131.22 	(f) The individually authorized 24-hour customized living payment rates shall not exceed 
131.23 	the 95 percentile of statewide monthly authorizations for 24-hour customized living services 
131.24 	in effect and in the Medicaid management information systems on March 31, 2009, for each 
131.25 	case mix resident class under Minnesota Rules, parts 9549.0051 to 9549.0059, to which 
131.26 	elderly waiver service clients are assigned. When there are fewer than 50 authorizations in 
131.27 	effect in the case mix resident class, the commissioner shall multiply the calculated service 
131.28 	payment rate maximum for the A classification by the standard weight for that classification 
131.29 	under Minnesota Rules, parts 9549.0051 to 9549.0059, to determine the applicable payment 
131.30 	rate maximum. Service payment rate maximums shall be updated annually based on 
131.31 	legislatively adopted changes to all service rates for home and community-based service 
131.32 	providers.
132.1 	(g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner may 
132.2 	establish alternative payment rate systems for 24-hour customized living services in housing 
132.3 	with services establishments which are freestanding buildings with a capacity of 16 or fewer, 
132.4 	by applying a single hourly rate for covered component services provided in either:
132.5 	(1) licensed corporate adult foster homes; or
132.6 	(2) specialized dementia care units which meet the requirements of section 144D.065 
132.7 	and in which:
132.8 	(i) each resident is offered the option of having their own apartment; or
132.9 	(ii) the units are licensed as board and lodge establishments with maximum capacity of 
132.10 	eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205, 
132.11 	subparts 1, 2, 3, and 4, item A.
132.12 	(h) Twenty-four-hour customized living services are delivered by a provider licensed 
132.13 	by the Department of Health as a class A or class F home care provider and provided in a 
132.14 	building that is registered as a housing with services establishment under chapter 144D. 
132.15 	Licensed home care providers are subject to section 256B.0651, subdivision 14.
132.16 	(i) A provider may not bill or otherwise charge an elderly waiver participant or their 
132.17 	family for additional units of any allowable component service beyond those available under 
132.18 	the service rate limits described in paragraph (e), nor for additional units of any allowable 
132.19 	component service beyond those approved in the service plan by the lead agency.
132.20 	(j) Effective July 1, 2016 January 1, 2018, and each July January 1 thereafter, 
132.21 	individualized service rate limits for 24-hour customized living services under this 
132.22 	subdivision shall be increased by the difference between any legislatively adopted home 
132.23 	and community-based provider rate increases effective on July January 1 or since the previous 
132.24 	July January 1 and the average statewide percentage increase in nursing facility operating 
132.25 	payment rates under sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective 
132.26 	the previous January 1. This paragraph shall only apply if the average statewide percentage 
132.27 	increase in nursing facility operating payment rates is greater than any legislatively adopted 
132.28 	home and community-based provider rate increases effective on July January 1, or occurring 
132.29 	since the previous July January 1.

132.30 	Sec. 10. Minnesota Statutes 2016, section 256B.0915, subdivision 5, is amended to read:
132.31 		Subd. 5.Assessments and reassessments for waiver clients. (a) Each client shall 
132.32 	receive an initial assessment of strengths, informal supports, and need for services in 
132.33 	accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a client 
133.1 	served under the elderly waiver must be conducted at least every 12 months and at other 
133.2 	times when the case manager determines that there has been significant change in the client's 
133.3 	functioning. This may include instances where the client is discharged from the hospital. 
133.4 	There must be a determination that the client requires nursing facility level of care as defined 
133.5 	in section 256B.0911, subdivision 4e, at initial and subsequent assessments to initiate and 
133.6 	maintain participation in the waiver program.
133.7 	(b) Regardless of other assessments identified in section 144.0724, subdivision 4, as 
133.8 	appropriate to determine nursing facility level of care for purposes of medical assistance 
133.9 	payment for nursing facility services, only face-to-face assessments conducted according 
133.10 	to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility level of care 
133.11 	determination will be accepted for purposes of initial and ongoing access to waiver service 
133.12 	payment.
133.13 	(c) The lead agency shall conduct a change-in-condition reassessment before the annual 
133.14 	reassessment in cases where a client's condition changed due to a major health event, an 
133.15 	emerging need or risk, worsening health condition, or cases where the current services do 
133.16 	not meet the client's needs. A change-in-condition reassessment may be initiated by the lead 
133.17 	agency, or it may be requested by the client or requested on the client's behalf by another 
133.18 	party, such as a provider of services. The lead agency shall complete a change-in-condition 
133.19 	reassessment no later than 20 calendar days from the request. The lead agency shall conduct 
133.20 	these assessments in a timely manner and expedite urgent requests. The lead agency shall 
133.21 	evaluate urgent requests based on the client's needs and risk to the client if a reassessment 
133.22 	is not completed.

133.23 	Sec. 11. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
133.24 	to read:
133.25 		Subd. 11.Payment rates; application. The payment methodologies in subdivisions 12 
133.26 	to 16 apply to elderly waiver and elderly waiver customized living under this section, 
133.27 	alternative care under section 256B.0913, essential community supports under section 
133.28 	256B.0922, and community access for disability inclusion customized living, brain injury 
133.29 	customized living, and elderly waiver foster care and residential care.

133.30 	Sec. 12. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
133.31 	to read:
133.32 		Subd. 12.Payment rates; phase-in. (a) Effective January 1, 2019, through December 
133.33 	31, 2020, all rates and rate components for services under subdivision 11 shall be the sum 
134.1 	of 12 percent of the rates calculated under subdivisions 13 to 16 and 88 percent of the rates 
134.2 	calculated using the rate methodology in effect as of June 30, 2017.
134.3 	(b) Effective January 1, 2021, all rates and rate components for services under subdivision 
134.4 	11 shall be the sum of 20 percent of the rates calculated under subdivisions 13 to 16 and 80 
134.5 	percent of the rates calculated using the rate methodology in effect as of June 30, 2017.

134.6 	Sec. 13. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
134.7 	to read:
134.8 		Subd. 13.Payment rates; establishment. (a) The commissioner shall use standard 
134.9 	occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in 
134.10 	the most recent edition of the Occupational Handbook and data from the most recent and 
134.11 	available nursing facility cost report, to establish rates and component rates every January 
134.12 	1 using Minnesota-specific wages taken from job descriptions.
134.13 	(b) In creating the rates and component rates, the commissioner shall establish a base 
134.14 	wage calculation for each component service and value, and add the following factors:
134.15 	(1) payroll taxes and benefits;
134.16 	(2) general and administrative;
134.17 	(3) program plan support;
134.18 	(4) registered nurse management and supervision; and
134.19 	(5) social worker supervision.

134.20 	Sec. 14. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
134.21 	to read:
134.22 		Subd. 14.Payment rates; base wage index. (a) Base wages are calculated for customized 
134.23 	living, foster care, and residential care component services as follows:
134.24 	(1) the home management and support services base wage equals 33.33 percent of the 
134.25 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home 
134.26 	care aide (SOC code 39-9021); 33.33 percent of the Minneapolis-St. Paul-Bloomington, 
134.27 	MN-WI MetroSA average wage for food preparation workers (SOC code 35-2021); and 
134.28 	33.34 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage 
134.29 	for maids and housekeeping cleaners (SOC code 37-2012);
134.30 	(2) the home care aide base wage equals 50 percent of the Minneapolis-St. 
134.31 	Paul-Bloomington, MN-WI MetroSA average wage for home health aides (SOC code 
135.1 	31-1011); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
135.2 	average wage for nursing assistants (SOC code 31-1014);
135.3 	(3) the home health aide base wage equals 20 percent of the Minneapolis-St. 
135.4 	Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed 
135.5 	vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St. 
135.6 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
135.7 	31-1014); and
135.8 	(4) the medication setups by licensed practical nurse base wage equals ten percent of 
135.9 	the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical 
135.10 	and licensed vocational nurses (SOC code 29-2061); and 90 percent of the Minneapolis-St. 
135.11 	Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code 
135.12 	29-1141).
135.13 	(b) Base wages are calculated for the following services as follows:
135.14 	(1) the chore services base wage equals 100 percent of the Minneapolis-St. 
135.15 	Paul-Bloomington, MN-WI MetroSA average wage for landscaping and groundskeeping 
135.16 	workers (SOC code 37-3011);
135.17 	(2) the companion services base wage equals 50 percent of the Minneapolis-St. 
135.18 	Paul-Bloomington, MN-WI MetroSA average wage for personal and home care aides (SOC 
135.19 	code 39-9021); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
135.20 	average wage for maids and housekeeping cleaners (SOC code 37-2012);
135.21 	(3) the homemaker services and assistance with personal care base wage equals 60 
135.22 	percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for 
135.23 	personal and home care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. 
135.24 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
135.25 	31-1014); and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
135.26 	average wage for maids and housekeeping cleaners (SOC code 37-2012);
135.27 	(4) the homemaker services and cleaning base wage equals 60 percent of the 
135.28 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home 
135.29 	care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
135.30 	MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the 
135.31 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and 
135.32 	housekeeping cleaners (SOC code 37-2012);
136.1 	(5) the homemaker services and home management base wage equals 60 percent of the 
136.2 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home 
136.3 	care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI 
136.4 	MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the 
136.5 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and 
136.6 	housekeeping cleaners (SOC code 37-2012);
136.7 	(6) the in-home respite care services base wage equals five percent of the Minneapolis-St. 
136.8 	Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code 
136.9 	29-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average 
136.10 	wage for nursing assistants (SOC code 31-1014); and 20 percent of the Minneapolis-St. 
136.11 	Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed 
136.12 	vocational nurses (SOC code 29-2061);
136.13 	(7) the out-of-home respite care services base wage equals five percent of the 
136.14 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for registered nurses 
136.15 	(SOC code 29-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA 
136.16 	average wage for nursing assistants (SOC code 31-1014); and 20 percent of the 
136.17 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical 
136.18 	and licensed vocational nurses (SOC code 29-2061); and
136.19 	(8) the individual community living support base wage equals 20 percent of the 
136.20 	Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical 
136.21 	and licensed vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St. 
136.22 	Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code 
136.23 	31-1014).
136.24 	(c) Base wages are calculated for the following values as follows:
136.25 	(1) the registered nurse base wage equals 100 percent of the Minneapolis-St. 
136.26 	Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code 
136.27 	29-1141); and
136.28 	(2) the social worker base wage equals 100 percent of the Minneapolis-St. 
136.29 	Paul-Bloomington, MN-WI MetroSA average wage for medical and public health social 
136.30 	workers (SOC code 21-1022).
136.31 	(d) If any of the SOC codes and positions are no longer available, the commissioner 
136.32 	shall, in consultation with stakeholders, select a new SOC code and position that is the 
136.33 	closest match to the previously used SOC position.

137.1 	Sec. 15. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
137.2 	to read:
137.3 		Subd. 15.Payment rates; factors. The commissioner shall use the following factors:
137.4 	(1) the payroll taxes and benefits factor is the sum of net payroll taxes and benefits 
137.5 	divided by the sum of all salaries for all nursing facilities on the most recent and available 
137.6 	cost report;
137.7 	(2) the general and administrative factor is the sum of net general and administrative 
137.8 	expenses minus administrative salaries divided by total operating expenses for all nursing 
137.9 	facilities on the most recent and available cost report;
137.10 	(3) the program plan support factor is defined as the direct service staff needed to provide 
137.11 	support for the home and community-based service when not engaged in direct contact with 
137.12 	clients. Based on the 2016 Non-Wage Provider Costs in Home and Community-Based 
137.13 	Disability Waiver Services Report, this factor equals 12.8 percent;
137.14 	(4) the registered nurse management and supervision factor equals 15 percent of the 
137.15 	product of the position's base wage and the sum of the factors in clauses (1) to (3); and
137.16 	(5) the social worker supervision factor equals 15 percent of the product of the position's 
137.17 	base wage and the sum of the factors in clauses (1) to (3).

137.18 	Sec. 16. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
137.19 	to read:
137.20 		Subd. 16.Payment rates; component rates. (a) For the purposes of this subdivision, 
137.21 	the "adjusted base wage" for a position equals the position's base wage plus:
137.22 	(1) the position's base wage multiplied by the payroll taxes and benefits factor;
137.23 	(2) the position's base wage multiplied by the general and administrative factor; and
137.24 	(3) the position's base wage multiplied by the program plan support factor.
137.25 	(b) For medication setups by licensed nurse, registered nurse, and social worker services, 
137.26 	the component rate for each service equals the respective position's adjusted base wage.
137.27 	(c) For home management and support services, home care aide, and home health aide 
137.28 	services, the component rate for each service equals the respective position's adjusted base 
137.29 	wage plus the registered nurse management and supervision factor.
137.30 	(d) The home management and support services component rate shall be used for payment 
137.31 	for socialization and transportation component rates under elderly waiver customized living.
138.1 	(e) The 15-minute unit rates for chore services and companion services are calculated 
138.2 	as follows:
138.3 	(1) sum the adjusted base wage for the respective position and the social worker factor; 
138.4 	and
138.5 	(2) divide the result of clause (1) by four.
138.6 	(f) The 15-minute unit rates for homemaker services and assistance with personal care, 
138.7 	homemaker services and cleaning, and homemaker services and home management are 
138.8 	calculated as follows:
138.9 	(1) sum the adjusted base wage for the respective position and the registered nurse 
138.10 	management and supervision factor; and
138.11 	(2) divide the result of clause (1) by four.
138.12 	(g) The 15-minute unit rate for in-home respite care services is calculated as follows:
138.13 	(1) sum the adjusted base wage for in-home respite care services and the registered nurse 
138.14 	management and supervision factor; and
138.15 	(2) divide the result of clause (1) by four.
138.16 	(h) The in-home respite care services daily rate equals the in-home respite care services 
138.17 	15-minute unit rate multiplied by 18.
138.18 	(i) The 15-minute unit rate for out-of-home respite care is calculated as follows:
138.19 	(1) sum the out-of-home respite care services adjusted base wage and the registered 
138.20 	nurse management and supervision factor; and
138.21 	(2) divide the result of clause (1) by four.
138.22 	(j) The out-of-home respite care services daily rate equals the out-of-home respite care 
138.23 	services 15-minute unit rate multiplied by 18.
138.24 	(k) The individual community living support rate is calculated as follows:
138.25 	(1) sum the adjusted base wage for the home care aide rate in subdivision 14, paragraph 
138.26 	(a), clause (2), and the social worker factor; and
138.27 	(2) divide the result of clause (1) by four.
138.28 	(l) The home delivered meals rate equals $9.30. Beginning July 1, 2018, the commissioner 
138.29 	shall increase the home delivered meals rate every July 1 by the percent increase in the 
138.30 	nursing facility dietary per diem using the two most recent nursing facility cost reports.
139.1 	(m) The adult day services rate is based on the home care aide rate in subdivision 14, 
139.2 	paragraph (a), clause (2), plus the additional factors from subdivision 15, except that the 
139.3 	general and administrative factor used shall be 20 percent. The nonregistered nurse portion 
139.4 	of the rate shall be multiplied by 0.25, to reflect an assumed-ratio staffing of one caregiver 
139.5 	to four clients, and divided by four to determine the 15-minute unit rate. The registered 
139.6 	nurse portion is divided by four to determine the 15-minute unit rate and $0.63 per 15-minute 
139.7 	unit is added to cover the cost of meals.
139.8 	(n) The adult day services bath 15-minute unit rate is the same as the calculation of the 
139.9 	adult day services 15-minute unit rate without the adjustment for staffing ratio.
139.10 	(o) If a bath is authorized for an adult day services client, at least two 15-minute units 
139.11 	must be authorized to allow for adequate time to meet client needs. Adult day services may 
139.12 	be authorized for up to 48 units, or 12 hours, per day based on client and family caregiver 
139.13 	needs.

139.14 	Sec. 17. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision 
139.15 	to read:
139.16 		Subd. 17.Evaluation of rate methodology. The commissioner, in consultation with 
139.17 	stakeholders, shall conduct a study to evaluate the following:
139.18 	(1) base wages in subdivision 14, to determine if the standard occupational classification 
139.19 	codes for each rate and component rate are an appropriate representation of staff who deliver 
139.20 	the services; and
139.21 	(2) factors in subdivision 15, and adjusted base wage calculation in subdivision 16, to 
139.22 	determine if the factors and calculations appropriately address nonwage provider costs.
139.23 	By January 1, 2019, the commissioner shall submit a report to the legislature on the 
139.24 	changes to the rate methodology in this statute, based on the results of the evaluation. Where 
139.25 	feasible, the report shall address the impact of the new rates on the workforce situation and 
139.26 	client access to services. The report should include any changes to the rate calculations 
139.27 	methods that the commissioner recommends.

139.28 	Sec. 18. Minnesota Statutes 2016, section 256B.0922, subdivision 1, is amended to read:
139.29 		Subdivision 1.Essential community supports. (a) The purpose of the essential 
139.30 	community supports program is to provide targeted services to persons age 65 and older 
139.31 	who need essential community support, but whose needs do not meet the level of care 
139.32 	required for nursing facility placement under section 144.0724, subdivision 11.
140.1 	(b) Essential community supports are available not to exceed $400 $600 per person per 
140.2 	month. Essential community supports may be used as authorized within an authorization 
140.3 	period not to exceed 12 months. Services must be available to a person who:
140.4 	(1) is age 65 or older;
140.5 	(2) is not eligible for medical assistance;
140.6 	(3) has received a community assessment under section 256B.0911, subdivision 3a or 
140.7 	3b, and does not require the level of care provided in a nursing facility;
140.8 	(4) meets the financial eligibility criteria for the alternative care program under section 
140.9 	256B.0913, subdivision 4;
140.10 	(5) has a community support plan; and
140.11 	(6) has been determined by a community assessment under section 256B.0911, 
140.12 	subdivision 3a or 3b, to be a person who would require provision of at least one of the 
140.13 	following services, as defined in the approved elderly waiver plan, in order to maintain their 
140.14 	community residence:
140.15 	(i) adult day services;
140.16 	(ii) family caregiver support services;
140.17 	(iii) respite care;
140.18 	(iii) (iv) homemaker support;
140.19 	(v) companion services;
140.20 	(iv) (vi) chores;
140.21 	(v) (vii) a personal emergency response device or system;
140.22 	(vi) (viii) home-delivered meals; or
140.23 	(vii) (ix) community living assistance as defined by the commissioner.
140.24 	(c) The person receiving any of the essential community supports in this subdivision 
140.25 	must also receive service coordination, not to exceed $600 in a 12-month authorization 
140.26 	period, as part of their community support plan.
140.27 	(d) A person who has been determined to be eligible for essential community supports 
140.28 	must be reassessed at least annually and continue to meet the criteria in paragraph (b) to 
140.29 	remain eligible for essential community supports.
141.1 	(e) The commissioner is authorized to use federal matching funds for essential community 
141.2 	supports as necessary and to meet demand for essential community supports as outlined in 
141.3 	subdivision 2, and that amount of federal funds is appropriated to the commissioner for this 
141.4 	purpose.

141.5 	Sec. 19. Minnesota Statutes 2016, section 256B.431, subdivision 10, is amended to read:
141.6 		Subd. 10.Property rate adjustments and construction projects. A nursing facility 
141.7 	completing a construction project that is eligible for a rate adjustment under section 
141.8 	256B.434, subdivision 4f, and that was not approved through the moratorium exception 
141.9 	process in section 144A.073 must request from the commissioner a property-related payment 
141.10 	rate adjustment. If the request is made within 60 days after the construction project's 
141.11 	completion date, The effective date of the rate adjustment is the first of the month of January 
141.12 	or July, whichever occurs first following both the construction project's completion date
141.13 	and submission of the provider's rate adjustment request. If the request is made more than 
141.14 	60 days after the completion date, the rate adjustment is effective on the first of the month 
141.15 	following the request. The commissioner shall provide a rate notice reflecting the allowable 
141.16 	costs within 60 days after receiving all the necessary information to compute the rate 
141.17 	adjustment. No sooner than the effective date of the rate adjustment for the construction 
141.18 	project, a nursing facility may adjust its rates by the amount anticipated to be allowed. Any 
141.19 	amounts collected from private pay residents in excess of the allowable rate must be repaid 
141.20 	to private pay residents with interest at the rate used by the commissioner of revenue for 
141.21 	the late payment of taxes and in effect on the date the rate increase is effective. Construction 
141.22 	projects with completion dates within one year of the completion date associated with the 
141.23 	property rate adjustment request and phased projects with project completion dates within 
141.24 	three years of the last phase of the phased project must be aggregated for purposes of the 
141.25 	minimum thresholds in subdivisions 16 and 17, and the maximum threshold in section 
141.26 	144A.071, subdivision 2. "Construction project" and "project construction costs" have the 
141.27 	meanings given them in Minnesota Statutes, section 144A.071, subdivision 1a.

141.28 	EFFECTIVE DATE. This section is effective for projects completed after January 1, 
141.29 	2018.

141.30 	Sec. 20. Minnesota Statutes 2016, section 256B.431, subdivision 16, is amended to read:
141.31 		Subd. 16.Major additions and replacements; equity incentive. For rate years beginning 
141.32 	after June 30, 1993, if a nursing facility acquires capital assets in connection with a project 
141.33 	approved under the moratorium exception process in section 144A.073 or in connection 
142.1 	with an addition to or replacement of buildings, attached fixtures, or land improvements 
142.2 	for which the total historical cost of those capital asset additions exceeds the lesser of 
142.3 	$150,000 or ten percent of the most recent appraised value, the nursing facility shall be 
142.4 	eligible for an equity incentive payment rate as in paragraphs (a) to (d). This computation 
142.5 	is separate from the determination of the nursing facility's rental rate. An equity incentive 
142.6 	payment rate as computed under this subdivision is limited to one in a 12-month period.
142.7 	(a) An eligible nursing facility shall receive an equity incentive payment rate equal to 
142.8 	the allowable historical cost of the capital asset acquired, minus the allowable debt directly 
142.9 	identified to that capital asset, multiplied by the equity incentive factor as described in 
142.10 	paragraphs (b) and (c), and divided by the nursing facility's occupancy factor under 
142.11 	subdivision 3f, paragraph (c). This amount shall be added to the nursing facility's total 
142.12 	payment rate and shall be effective the same day as the incremental increase in paragraph 
142.13 	(d) or subdivision 17. The allowable historical cost of the capital assets and the allowable 
142.14 	debt shall be determined as provided in Minnesota Rules, parts 9549.0010 to 9549.0080, 
142.15 	and this section.
142.16 	(b) The equity incentive factor shall be determined under clauses (1) to (4):
142.17 	(1) divide the initial allowable debt in paragraph (a) by the initial historical cost of the 
142.18 	capital asset additions referred to in paragraph (a), then cube the quotient,
142.19 	(2) subtract the amount calculated in clause (1) from the number one,
142.20 	(3) determine the difference between the rental factor and the lesser of two percentage 
142.21 	points above the posted yield for standard conventional fixed rate mortgages of the Federal 
142.22 	Home Loan Mortgage Corporation as published in the Wall Street Journal and in effect on 
142.23 	the first day of the month the debt or cost is incurred, or 16 percent,
142.24 	(4) multiply the amount calculated in clause (2) by the amount calculated in clause (3).
142.25 	(c) The equity incentive payment rate shall be limited to the term of the allowable debt 
142.26 	in paragraph (a), not greater than 20 years nor less than ten years. If no debt is incurred in 
142.27 	acquiring the capital asset, the equity incentive payment rate shall be paid for ten years. The 
142.28 	sale of a nursing facility under subdivision 14 shall terminate application of the equity 
142.29 	incentive payment rate effective on the date provided in subdivision 14, paragraph (f), for 
142.30 	the sale.
142.31 	(d) A nursing facility with an addition to or a renovation of its buildings, attached fixtures, 
142.32 	or land improvements meeting the criteria in this subdivision and not receiving the 
142.33 	property-related payment rate adjustment in subdivision 17, shall receive the incremental 
143.1 	increase in the nursing facility's rental rate as determined under Minnesota Rules, parts 
143.2 	9549.0010 to 9549.0080, and this section. The incremental increase shall be added to the 
143.3 	nursing facility's property-related payment rate. The effective date of this incremental 
143.4 	increase shall be the first day of the month of January or July, whichever occurs first 
143.5 	following the month in date on which the addition or replacement is completed.

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

143.8 	Sec. 21. Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:
143.9 		Subd. 30.Bed layaway and delicensure. (a) For rate years beginning on or after July 
143.10 	1, 2000, a nursing facility reimbursed under this section which has placed beds on layaway 
143.11 	shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph 
143.12 	(c), and calculation of the rental per diem, have those beds given the same effect as if the 
143.13 	beds had been delicensed so long as the beds remain on layaway. At the time of a layaway, 
143.14 	a facility may change its single bed election for use in calculating capacity days under 
143.15 	Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be 
143.16 	effective the first day of the month of January or July, whichever occurs first following the 
143.17 	month indate on which the layaway of the beds becomes effective under section 144A.071, 
143.18 	subdivision 4b.
143.19 	(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to 
143.20 	the contrary under section 256B.434, a nursing facility reimbursed under that section which
143.21 	that has placed beds on layaway shall, for so long as the beds remain on layaway, be allowed 
143.22 	to:
143.23 	(1) aggregate the applicable investment per bed limits based on the number of beds 
143.24 	licensed immediately prior to entering the alternative payment system;
143.25 	(2) retain or change the facility's single bed election for use in calculating capacity days 
143.26 	under Minnesota Rules, part 9549.0060, subpart 11; and
143.27 	(3) establish capacity days based on the number of beds immediately prior to the layaway 
143.28 	and the number of beds after the layaway.
143.29 	The commissioner shall increase the facility's property payment rate by the incremental 
143.30 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
143.31 	diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and 
143.32 	(3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
143.33 	project after its base year, the base year property rate shall be the moratorium project property 
144.1 	rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4, 
144.2 	paragraph (c). The property payment rate increase shall be effective the first day of the 
144.3 	month of January or July, whichever occurs first following the month indate on which the 
144.4 	layaway of the beds becomes effective.
144.5 	(c) If a nursing facility removes a bed from layaway status in accordance with section 
144.6 	144A.071, subdivision 4b, the commissioner shall establish capacity days based on the 
144.7 	number of licensed and certified beds in the facility not on layaway and shall reduce the 
144.8 	nursing facility's property payment rate in accordance with paragraph (b).
144.9 	(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision 
144.10 	to the contrary under section 256B.434, a nursing facility reimbursed under that section, 
144.11 	which that has delicensed beds after July 1, 2000, by giving notice of the delicensure to the 
144.12 	commissioner of health according to the notice requirements in section 144A.071, subdivision 
144.13 	4b, shall be allowed to:
144.14 	(1) aggregate the applicable investment per bed limits based on the number of beds 
144.15 	licensed immediately prior to entering the alternative payment system;
144.16 	(2) retain or change the facility's single bed election for use in calculating capacity days 
144.17 	under Minnesota Rules, part 9549.0060, subpart 11; and
144.18 	(3) establish capacity days based on the number of beds immediately prior to the 
144.19 	delicensure and the number of beds after the delicensure.
144.20 	The commissioner shall increase the facility's property payment rate by the incremental 
144.21 	increase in the rental per diem resulting from the recalculation of the facility's rental per 
144.22 	diem applying only the changes resulting from the delicensure of beds and clauses (1), (2), 
144.23 	and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception 
144.24 	project after its base year, the base year property rate shall be the moratorium project property 
144.25 	rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4, 
144.26 	paragraph (c). The property payment rate increase shall be effective the first day of the 
144.27 	month of January or July, whichever occurs first following the month indate on which the 
144.28 	delicensure of the beds becomes effective.
144.29 	(e) For nursing facilities reimbursed under this section or section 256B.434, any beds 
144.30 	placed on layaway shall not be included in calculating facility occupancy as it pertains to 
144.31 	leave days defined in Minnesota Rules, part 9505.0415.
145.1 	(f) For nursing facilities reimbursed under this section or section 256B.434, the rental 
145.2 	rate calculated after placing beds on layaway may not be less than the rental rate prior to 
145.3 	placing beds on layaway.
145.4 	(g) A nursing facility receiving a rate adjustment as a result of this section shall comply 
145.5 	with section 256B.47, subdivision 2 256R.06, subdivision 5.
145.6 	(h) A facility that does not utilize the space made available as a result of bed layaway 
145.7 	or delicensure under this subdivision to reduce the number of beds per room or provide 
145.8 	more common space for nursing facility uses or perform other activities related to the 
145.9 	operation of the nursing facility shall have its property rate increase calculated under this 
145.10 	subdivision reduced by the ratio of the square footage made available that is not used for 
145.11 	these purposes to the total square footage made available as a result of bed layaway or 
145.12 	delicensure.

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

145.14 	Sec. 22. Minnesota Statutes 2016, section 256B.434, subdivision 4, is amended to read:
145.15 		Subd. 4.Alternate rates for nursing facilities. Effective for the rate years beginning 
145.16 	on and after January 1, 2019, a nursing facility's case mix property payment ratesrate for 
145.17 	the second and subsequent years of a facility's contract under this section are the previous 
145.18 	rate year's contractproperty payment ratesrate plus an inflation adjustment and, for facilities 
145.19 	reimbursed under this section or section 256B.431, an adjustment to include the cost of any 
145.20 	increase in Health Department licensing fees for the facility taking effect on or after July 
145.21 	1, 2001. The index for the inflation adjustment must be based on the change in the Consumer 
145.22 	Price Index-All Items (United States City average) (CPI-U) forecasted by the commissioner 
145.23 	of management and budget's national economic consultant Reports and Forecasts Division 
145.24 	of the Department of Human Services, as forecasted in the fourth quarter of the calendar 
145.25 	year preceding the rate year. The inflation adjustment must be based on the 12-month period 
145.26 	from the midpoint of the previous rate year to the midpoint of the rate year for which the 
145.27 	rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 
145.28 	2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July 
145.29 	1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the 
145.30 	property-related payment rate. For the rate years beginning on October 1, 2011, October 1, 
145.31 	2012, October 1, 2013, October 1, 2014, October 1, 2015, January 1, 2016, and January 1, 
145.32 	2017, the rate adjustment under this paragraph shall be suspended. Beginning in 2005, 
145.33 	adjustment to the property payment rate under this section and section 256B.431 shall be 
145.34 	effective on October 1. In determining the amount of the property-related payment rate 
146.1 	adjustment under this paragraph, the commissioner shall determine the proportion of the 
146.2 	facility's rates that are property-related based on the facility's most recent cost report.

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

146.4 	Sec. 23. Minnesota Statutes 2016, section 256B.434, subdivision 4f, is amended to read:
146.5 		Subd. 4f.Construction project rate adjustments effective October 1, 2006. (a) 
146.6 	Effective October 1, 2006, facilities reimbursed under this section may receive a property 
146.7 	rate adjustment for construction projects exceeding the threshold in section 256B.431, 
146.8 	subdivision 16, and below the threshold in section 144A.071, subdivision 2, clause (a). For 
146.9 	these projects, capital assets purchased shall be counted as construction project costs for a 
146.10 	rate adjustment request made by a facility if they are: (1) purchased within 24 months of 
146.11 	the completion of the construction project; (2) purchased after the completion date of any 
146.12 	prior construction project; and (3) are not purchased prior to July 14, 2005. Except as 
146.13 	otherwise provided in this subdivision, the definitions, rate calculation methods, and 
146.14 	principles in sections 144A.071 and 256B.431 and Minnesota Rules, parts 9549.0010 to 
146.15 	9549.0080, shall be used to calculate rate adjustments for allowable construction projects 
146.16 	under this subdivision and section 144A.073. Facilities completing construction projects 
146.17 	between October 1, 2005, and October 1, 2006, are eligible to have a property rate adjustment 
146.18 	effective October 1, 2006. Facilities completing projects after October 1, 2006, are eligible 
146.19 	for a property rate adjustment effective on the first day of the month following the completion 
146.20 	date. Facilities completing projects after January 1, 2018, are eligible for a property rate 
146.21 	adjustment effective on the first day of the month of January or July, whichever occurs 
146.22 	immediately following the completion date.
146.23 	(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under 
146.24 	section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a 
146.25 	construction project on or after October 1, 2004, and do not have a contract under subdivision 
146.26 	3 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431, 
146.27 	subdivision 10, through September 30, 2006. If the request results in the commissioner 
146.28 	determining a rate adjustment is allowable, the rate adjustment is effective on the first of 
146.29 	the month following project completion. These facilities shall be allowed to accumulate 
146.30 	construction project costs for the period October 1, 2004, to September 30, 2006.
146.31 	(c) Facilities shall be allowed construction project rate adjustments no sooner than 12 
146.32 	months after completing a previous construction project. Facilities must request the rate 
146.33 	adjustment according to section 256B.431, subdivision 10.
147.1 	(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060, 
147.2 	subpart 11. For rate calculations under this section, the number of licensed beds in the 
147.3 	nursing facility shall be the number existing after the construction project is completed and 
147.4 	the number of days in the nursing facility's reporting period shall be 365.
147.5 	(e) The value of assets to be recognized for a total replacement project as defined in 
147.6 	section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value 
147.7 	of assets to be recognized for all other projects shall be computed as described in clause 
147.8 	(2).
147.9 	(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the 
147.10 	number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the 
147.11 	maximum amount of assets allowable in a facility's property rate calculation. If a facility's 
147.12 	current request for a rate adjustment results from the completion of a construction project 
147.13 	that was previously approved under section 144A.073, the assets to be used in the rate 
147.14 	calculation cannot exceed the lesser of the amount determined under sections 144A.071, 
147.15 	subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction 
147.16 	project. A current request that is not the result of a project under section 144A.073 cannot 
147.17 	exceed the limit under section 144A.071, subdivision 2, paragraph (a). Applicable credits 
147.18 	must be deducted from the cost of the construction project.
147.19 	(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the 
147.20 	number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be 
147.21 	used to compute the maximum amount of assets allowable in a facility's property rate 
147.22 	calculation.
147.23 	(ii) The value of a facility's assets to be compared to the amount in item (i) begins with 
147.24 	the total appraised value from the last rate notice a facility received when its rates were set 
147.25 	under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value 
147.26 	shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each 
147.27 	rate year the facility received an inflation factor on its property-related rate when its rates 
147.28 	were set under this section. The value of assets listed as previous capital additions, capital 
147.29 	additions, and special projects on the facility's base year rate notice and the value of assets 
147.30 	related to a construction project for which the facility received a rate adjustment when its 
147.31 	rates were determined under this section shall be added to the indexed appraised value.
147.32 	(iii) The maximum amount of assets to be recognized in computing a facility's rate 
147.33 	adjustment after a project is completed is the lesser of the aggregate replacement-cost-new 
148.1 	limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the 
148.2 	construction project.
148.3 	(iv) If a facility's current request for a rate adjustment results from the completion of a 
148.4 	construction project that was previously approved under section 144A.073, the assets to be 
148.5 	added to the rate calculation cannot exceed the lesser of the amount determined under 
148.6 	sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable 
148.7 	costs of the construction project. A current request that is not the result of a project under 
148.8 	section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2, 
148.9 	paragraph (a). Assets disposed of as a result of a construction project and applicable credits 
148.10 	must be deducted from the cost of the construction project.
148.11 	(f) For construction projects approved under section 144A.073, allowable debt may 
148.12 	never exceed the lesser of the cost of the assets purchased, the threshold limit in section 
148.13 	144A.071, subdivision 2, or the replacement-cost-new limit less previously existing capital 
148.14 	debt.
148.15 	(g) For construction projects that were not approved under section 144A.073, allowable 
148.16 	debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such 
148.17 	construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously 
148.18 	existing capital debt. Amounts of debt taken out that exceed the costs of a construction 
148.19 	project shall not be allowed regardless of the use of the funds.
148.20 	For all construction projects being recognized, interest expense and average debt shall 
148.21 	be computed based on the first 12 months following project completion. "Previously existing 
148.22 	capital debt" means capital debt recognized on the last rate determined under section 
148.23 	256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt 
148.24 	recognized for a construction project for which the facility received a rate adjustment when 
148.25 	its rates were determined under this section.
148.26 	For a total replacement project as defined in section 256B.431, subdivision 17d, the 
148.27 	value of previously existing capital debt shall be zero.
148.28 	(h) In addition to the interest expense allowed from the application of paragraph (f), the 
148.29 	amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and 
148.30 	(3), will be added to interest expense.
148.31 	(i) The equity portion of the construction project shall be computed as the allowable 
148.32 	assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be 
148.33 	multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added. 
149.1 	This sum must be divided by 95 percent of capacity days to compute the construction project 
149.2 	rate adjustment.
149.3 	(j) For projects that are not a total replacement of a nursing facility, the amount in 
149.4 	paragraph (i) is adjusted for nonreimbursable areas and then added to the current property 
149.5 	payment rate of the facility.
149.6 	(k) For projects that are a total replacement of a nursing facility, the amount in paragraph 
149.7 	(i) becomes the new property payment rate after being adjusted for nonreimbursable areas. 
149.8 	Any amounts existing in a facility's rate before the effective date of the construction project 
149.9 	for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements 
149.10 	under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431, 
149.11 	subdivision 19, shall be removed from the facility's rates.
149.12 	(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060, 
149.13 	subpart 10, as the result of construction projects under this section. Allowable equipment 
149.14 	shall be included in the construction project costs.
149.15 	(m) Capital assets purchased after the completion date of a construction project shall be 
149.16 	counted as construction project costs for any future rate adjustment request made by a facility 
149.17 	under section 144A.071, subdivision 2, clause (a), if they are purchased within 24 months 
149.18 	of the completion of the future construction project.
149.19 	(n) In subsequent rate years, the property payment rate for a facility that results from 
149.20 	the application of this subdivision shall be the amount inflated in subdivision 4.
149.21 	(o) Construction projects are eligible for an equity incentive under section 256B.431, 
149.22 	subdivision 16. When computing the equity incentive for a construction project under this 
149.23 	subdivision, only the allowable costs and allowable debt related to the construction project 
149.24 	shall be used. The equity incentive shall not be a part of the property payment rate and not 
149.25 	inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing 
149.26 	facilities reimbursed under this section shall be allowed for a duration determined under 
149.27 	section 256B.431, subdivision 16, paragraph (c).

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

149.29 	Sec. 24. Minnesota Statutes 2016, section 256B.50, subdivision 1b, is amended to read:
149.30 		Subd. 1b.Filing an appeal. To appeal, the provider shall file with the commissioner a 
149.31 	written notice of appeal; the appeal must be postmarked or received by the commissioner 
149.32 	within 60 days of the publication date the determination of the payment rate was mailed or 
149.33 	personally received by a provider, whichever is earlier printed on the rate notice. The notice 
150.1 	of appeal must specify each disputed item; the reason for the dispute; the total dollar amount 
150.2 	in dispute for each separate disallowance, allocation, or adjustment of each cost item or part 
150.3 	of a cost item; the computation that the provider believes is correct; the authority in statute 
150.4 	or rule upon which the provider relies for each disputed item; the name and address of the 
150.5 	person or firm with whom contacts may be made regarding the appeal; and other information 
150.6 	required by the commissioner.

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

150.8 	Sec. 25. Minnesota Statutes 2016, section 256B.5012, is amended by adding a subdivision 
150.9 	to read:
150.10 		Subd. 3a.Therapeutic leave days. Notwithstanding Minnesota Rules, part 9505.0415, 
150.11 	subpart 7, a vacant bed in an intermediate care facility for persons with developmental 
150.12 	disabilities shall be counted as a reserved bed when determining occupancy rates and 
150.13 	eligibility for payment of a therapeutic leave day.

150.14 	Sec. 26. Minnesota Statutes 2016, section 256R.02, subdivision 4, is amended to read:
150.15 		Subd. 4.Administrative costs. "Administrative costs" means the identifiable costs for 
150.16 	administering the overall activities of the nursing home. These costs include salaries and 
150.17 	wages of the administrator, assistant administrator, business office employees, security 
150.18 	guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases related 
150.19 	to business office functions, licenses, and permits except as provided in the external fixed 
150.20 	costs category, employee recognition, travel including meals and lodging, all training except 
150.21 	as specified in subdivision 17, voice and data communication or transmission, office supplies, 
150.22 	property and liability insurance and other forms of insurance not designated to other areas
150.23 	except insurance that is a fringe benefit under subdivision 22, personnel recruitment, legal 
150.24 	services, accounting services, management or business consultants, data processing, 
150.25 	information technology, Web site, central or home office costs, business meetings and 
150.26 	seminars, postage, fees for professional organizations, subscriptions, security services, 
150.27 	advertising, board of directors fees, working capital interest expense, and bad debts, and 
150.28 	bad debt collection fees.

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

150.30 	Sec. 27. Minnesota Statutes 2016, section 256R.02, subdivision 18, is amended to read:
150.31 		Subd. 18.Employer health insurance costs. "Employer health insurance costs" means 
150.32 	premium expenses for group coverage and reinsurance,; actual expenses incurred for 
151.1 	self-insured plans, including reinsurance; and employer contributions to employee health 
151.2 	reimbursement and health savings accounts. Premium and expense costs and contributions 
151.3 	are allowable for (1) all employees and (2) the spouse and dependents of those employees 
151.4 	who meet the definition of full-time employees under the federal Affordable Care Act, 
151.5 	Public Law 111-148 are employed on average at least 30 hours per week.

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

151.7 	Sec. 28. Minnesota Statutes 2016, section 256R.07, is amended by adding a subdivision 
151.8 	to read:
151.9 		Subd. 6.Electronic signature. For documentation requiring a signature under this 
151.10 	chapter or section 256B.431 or 256B.434, use of an electronic signature as defined under 
151.11 	section 325L.02, paragraph (h), is allowed.

151.12 	Sec. 29. Minnesota Statutes 2016, section 256R.10, is amended by adding a subdivision 
151.13 	to read:
151.14 		Subd. 7.Not specified allowed costs. When the cost category for allowed cost items or 
151.15 	services is not specified in this chapter or the provider reimbursement manual, the 
151.16 	commissioner, in consultation with stakeholders, shall determine the cost category for the 
151.17 	allowed cost item or service.

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

151.19 	Sec. 30. [256R.18] REPORT BY COMMISSIONER OF HUMAN SERVICES.
151.20 	Beginning January 1, 2019, the commissioner shall provide to the house of representatives 
151.21 	and senate committees with jurisdiction over nursing facility payment rates a biennial report 
151.22 	on the effectiveness of the reimbursement system in improving quality, restraining costs, 
151.23 	and any other features of the system as determined by the commissioner.

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

151.25 	Sec. 31. Minnesota Statutes 2016, section 256R.37, is amended to read:
151.26 	256R.37 SCHOLARSHIPS.
151.27 	(a) For the 27-month period beginning October 1, 2015, through December 31, 2017, 
151.28 	the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing 
151.29 	facility with no scholarship per diem that is requesting a scholarship per diem to be added 
151.30 	to the external fixed payment rate to be used:
152.1 	(1) for employee scholarships that satisfy the following requirements:
152.2 	(i) scholarships are available to all employees who work an average of at least ten hours 
152.3 	per week at the facility except the administrator, and to reimburse student loan expenses 
152.4 	for newly hired and recently graduated registered nurses and licensed practical nurses, and 
152.5 	training expenses for nursing assistants as specified in section 144A.611, subdivisions 2
152.6 	and 4, who are newly hired and have graduated within the last 12 months; and
152.7 	(ii) the course of study is expected to lead to career advancement with the facility or in 
152.8 	long-term care, including medical care interpreter services and social work; and
152.9 	(2) to provide job-related training in English as a second language.
152.10 	(b) All facilities may annually request a rate adjustment under this section by submitting 
152.11 	information to the commissioner on a schedule and in a form supplied by the commissioner. 
152.12 	The commissioner shall allow a scholarship payment rate equal to the reported and allowable 
152.13 	costs divided by resident days.
152.14 	(c) In calculating the per diem under paragraph (b), the commissioner shall allow costs 
152.15 	related to tuition, direct educational expenses, and reasonable costs as defined by the 
152.16 	commissioner for child care costs and transportation expenses related to direct educational 
152.17 	expenses.
152.18 	(d) The rate increase under this section is an optional rate add-on that the facility must 
152.19 	request from the commissioner in a manner prescribed by the commissioner. The rate 
152.20 	increase must be used for scholarships as specified in this section.
152.21 	(e) For instances in which a rate adjustment will be 15 cents or greater, nursing facilities 
152.22 	that close beds during a rate year may request to have their scholarship adjustment under 
152.23 	paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect 
152.24 	the reduction in resident days compared to the cost report year.

152.25 	Sec. 32. Minnesota Statutes 2016, section 256R.40, subdivision 5, is amended to read:
152.26 		Subd. 5.Planned closure rate adjustment. (a) The commissioner shall calculate the 
152.27 	amount of the planned closure rate adjustment available under subdivision 6 according to 
152.28 	clauses (1) to (4):
152.29 	(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;
152.30 	(2) the total number of beds in the nursing facility or facilities receiving the planned 
152.31 	closure rate adjustment must be identified;
153.1 	(3) capacity days are determined by multiplying the number determined under clause 
153.2 	(2) by 365; and
153.3 	(4) the planned closure rate adjustment is the amount available in clause (1), divided by 
153.4 	capacity days determined under clause (3).
153.5 	(b) A planned closure rate adjustment under this section is effective on the first day of 
153.6 	the month of January or July, whichever occurs immediately following completion of closure 
153.7 	of the facility designated for closure in the application and becomes part of the nursing 
153.8 	facility's external fixed payment rate.
153.9 	(c) Upon the request of a closing facility, the commissioner must allow the facility a 
153.10 	closure rate adjustment as provided under section 144A.161, subdivision 10.
153.11 	(d) A facility that has received a planned closure rate adjustment may reassign it to 
153.12 	another facility that is under the same ownership at any time within three years of its effective 
153.13 	date. The amount of the adjustment is computed according to paragraph (a).
153.14 	(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the 
153.15 	commissioner shall recalculate planned closure rate adjustments for facilities that delicense 
153.16 	beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar 
153.17 	amount. The recalculated planned closure rate adjustment is effective from the date the per 
153.18 	bed dollar amount is increased.

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

153.20 	Sec. 33. Minnesota Statutes 2016, section 256R.41, is amended to read:
153.21 	256R.41 SINGLE-BED ROOM INCENTIVE.
153.22 	(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed 
153.23 	under this chapter shall be increased by 20 percent multiplied by the ratio of the number of 
153.24 	new single-bed rooms created divided by the number of active beds on July 1, 2005, for 
153.25 	each bed closure that results in the creation of a single-bed room after July 1, 2005. The 
153.26 	commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each 
153.27 	year. For eligible bed closures for which the commissioner receives a notice from a facility 
153.28 	during a calendar quarter that a bed has been delicensed and a new single-bed room has 
153.29 	been established, the rate adjustment in this paragraph shall be effective on either the first 
153.30 	day of the second month following that calendar quarter of January or July, whichever 
153.31 	occurs immediately following the date of the bed delicensure.
154.1 	(b) A nursing facility is prohibited from discharging residents for purposes of establishing 
154.2 	single-bed rooms. A nursing facility must submit documentation to the commissioner in a 
154.3 	form prescribed by the commissioner, certifying the occupancy status of beds closed to 
154.4 	create single-bed rooms. In the event that the commissioner determines that a facility has 
154.5 	discharged a resident for purposes of establishing a single-bed room, the commissioner shall 
154.6 	not provide a rate adjustment under paragraph (a).

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

154.8 	Sec. 34. Minnesota Statutes 2016, section 256R.47, is amended to read:
154.9 	256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING 
154.10 	FACILITIES.
154.11 	(a) The commissioner, in consultation with the commissioner of health, may designate 
154.12 	certain nursing facilities as critical access nursing facilities. The designation shall be granted 
154.13 	on a competitive basis, within the limits of funds appropriated for this purpose.
154.14 	(b) The commissioner shall request proposals from nursing facilities every two years. 
154.15 	Proposals must be submitted in the form and according to the timelines established by the 
154.16 	commissioner. In selecting applicants to designate, the commissioner, in consultation with 
154.17 	the commissioner of health, and with input from stakeholders, shall develop criteria designed 
154.18 	to preserve access to nursing facility services in isolated areas, rebalance long-term care, 
154.19 	and improve quality. To the extent practicable, the commissioner shall ensure an even 
154.20 	distribution of designations across the state.
154.21 	(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing facilities 
154.22 	designated as critical access nursing facilities:
154.23 	(1) partial rebasing, with the commissioner allowing a designated facility operating 
154.24 	payment rates being the sum of up to 60 percent of the operating payment rate determined 
154.25 	in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of 
154.26 	the two portions being equal to 100 percent, of the operating payment rate that would have 
154.27 	been allowed had the facility not been designated. The commissioner may adjust these 
154.28 	percentages by up to 20 percent and may approve a request for less than the amount allowed;
154.29 	(2) enhanced payments for leave days. Notwithstanding section 256R.43, upon 
154.30 	designation as a critical access nursing facility, the commissioner shall limit payment for 
154.31 	leave days to 60 percent of that nursing facility's total payment rate for the involved resident, 
154.32 	and shall allow this payment only when the occupancy of the nursing facility, inclusive of 
154.33 	bed hold days, is equal to or greater than 90 percent;
155.1 	(3) two designated critical access nursing facilities, with up to 100 beds in active service, 
155.2 	may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part 
155.3 	4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner 
155.4 	of health shall consider each waiver request independently based on the criteria under 
155.5 	Minnesota Rules, part 4658.0040;
155.6 	(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall 
155.7 	be 40 percent of the amount that would otherwise apply; and
155.8 	(5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to 
155.9 	designated critical access nursing facilities.
155.10 	(d) Designation of a critical access nursing facility is for a period of two years, after 
155.11 	which the benefits allowed under paragraph (c) shall be removed. Designated facilities may 
155.12 	apply for continued designation.
155.13 	(e) This section is suspended and no state or federal funding shall be appropriated or 
155.14 	allocated for the purposes of this section from January 1, 2016, to December 31, 2017 2019.

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

155.16 	Sec. 35. Minnesota Statutes 2016, section 256R.49, subdivision 1, is amended to read:
155.17 		Subdivision 1.Rate adjustments for compensation-related costs. (a) Operating payment 
155.18 	rates of all nursing facilities that are reimbursed under this chapter shall be increased effective 
155.19 	for rate years beginning on and after October 1, 2014, to address changes in compensation 
155.20 	costs for nursing facility employees paid less than $14 per hour in accordance with this 
155.21 	section. Rate increases provided under this section before October 1, 2016, expire effective 
155.22 	January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective 
155.23 	January 1, 2019.
155.24 	(b) Nursing facilities that receive approval of the applications in subdivision 2 must 
155.25 	receive rate adjustments according to subdivision 4. The rate adjustments must be used to 
155.26 	pay compensation costs for nursing facility employees paid less than $14 per hour.

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

155.28 	Sec. 36. DIRECTION TO COMMISSIONER; ADULT DAY SERVICES STAFFING 
155.29 	RATIOS.
 155.30 	The commissioner of human services shall study the staffing ratio for adult day services 
155.31 	clients and shall provide the chairs and ranking minority members of the house of 
156.1 	representatives and senate committees with jurisdiction over adult day services with 
156.2 	recommendations to adjust staffing ratios based on client needs by January 1, 2018.

156.3 	Sec. 37. DIRECTION TO THE COMMISSIONER; BORDER CITY NURSING 
156.4 	FACILITY RATE STUDY.
 156.5 	The commissioner of human services shall conduct a study using existing administrative 
156.6 	appropriations, to assess the rate disparity between the medical assistance rates paid to 
156.7 	nursing facilities located in Moorhead and those located in an adjacent city in another state 
156.8 	and in cities contiguous to the adjacent city. The study shall review past, current, and 
156.9 	projected disparities in rates and the impact of the disparities on workforce shortage issues 
156.10 	and continued access to medical assistance nursing facility services in Moorhead. The 
156.11 	commissioner shall submit the report to the legislature no later than January 15, 2018.

156.12 	Sec. 38. REVISOR'S INSTRUCTION.
 156.13 	The revisor of statutes, in consultation with the House Research Department, Office of 
156.14 	Senate Counsel, Research, and Fiscal Analysis, and Department of Human Services shall 
156.15 	prepare legislation for the 2018 legislative session to recodify laws governing the elderly 
156.16 	waiver program in Minnesota Statutes, chapter 256B.

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

156.18 	ARTICLE 4
156.19 	HEALTH CARE

156.20 	Section 1. Minnesota Statutes 2016, section 3.972, is amended by adding a subdivision 
156.21 	to read:
156.22 		Subd. 2b.Audits of managed care organizations. (a) The legislative auditor shall audit 
156.23 	each managed care organization that contracts with the commissioner of human services to 
156.24 	provide health care services under sections 256B.69, 256B.692, and 256L.12. The legislative 
156.25 	auditor shall design the audits to determine if a managed care organization used the public 
156.26 	money in compliance with federal and state laws, rules, and in accordance with provisions 
156.27 	in the managed care organization's contract with the commissioner of human services. The 
156.28 	legislative auditor shall determine the schedule and scope of the audit work and may contract 
156.29 	with vendors to assist with the audits. The managed care organization must cooperate with 
156.30 	the legislative auditor and must provide the legislative auditor with all data, documents, and 
156.31 	other information, regardless of classification, that the legislative auditor requests to conduct 
156.32 	an audit. The legislative auditor shall periodically report audit results and recommendations 
157.1 	to the Legislative Audit Commission and the chairs and ranking minority members of the 
157.2 	legislative committees with jurisdiction over health and human services policy and finance.
157.3 	(b) For purposes of this subdivision, a "managed care organization" means a 
157.4 	demonstration provider as defined under section 256B.69, subdivision 2.

157.5 	Sec. 2. Minnesota Statutes 2016, section 13.69, subdivision 1, is amended to read:
157.6 		Subdivision 1.Classifications. (a) The following government data of the Department 
157.7 	of Public Safety are private data:
157.8 	(1) medical data on driving instructors, licensed drivers, and applicants for parking 
157.9 	certificates and special license plates issued to physically disabled persons;
157.10 	(2) other data on holders of a disability certificate under section 169.345, except that (i) 
157.11 	data that are not medical data may be released to law enforcement agencies, and (ii) data 
157.12 	necessary for enforcement of sections 169.345 and 169.346 may be released to parking 
157.13 	enforcement employees or parking enforcement agents of statutory or home rule charter 
157.14 	cities and towns;
157.15 	(3) Social Security numbers in driver's license and motor vehicle registration records, 
157.16 	except that Social Security numbers must be provided to the Department of Revenue for 
157.17 	purposes of tax administration, the Department of Labor and Industry for purposes of 
157.18 	workers' compensation administration and enforcement, the Department of Human Services 
157.19 	for purposes of recovery of Minnesota health care program benefits paid, and the Department 
157.20 	of Natural Resources for purposes of license application administration; and
157.21 	(4) data on persons listed as standby or temporary custodians under section 171.07, 
157.22 	subdivision 11, except that the data must be released to:
157.23 	(i) law enforcement agencies for the purpose of verifying that an individual is a designated 
157.24 	caregiver; or
157.25 	(ii) law enforcement agencies who state that the license holder is unable to communicate 
157.26 	at that time and that the information is necessary for notifying the designated caregiver of 
157.27 	the need to care for a child of the license holder.
157.28 	The department may release the Social Security number only as provided in clause (3) 
157.29 	and must not sell or otherwise provide individual Social Security numbers or lists of Social 
157.30 	Security numbers for any other purpose.
158.1 	(b) The following government data of the Department of Public Safety are confidential 
158.2 	data: data concerning an individual's driving ability when that data is received from a member 
158.3 	of the individual's family.

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

158.5 	Sec. 3. [62J.815] HEALTH CARE PROVIDERS PRICE DISCLOSURES.
158.6 	(a) Each health care provider, as defined by section 62J.03, subdivision 8, except hospitals 
158.7 	and outpatient surgical centers subject to the requirements of section 62J.82, shall maintain 
158.8 	a list of the services or procedures that correspond with the 35 most frequent current 
158.9 	procedural terminology (CPT) codes, and a list of the ten most frequent CPT codes for 
158.10 	preventive services used by the provider for reimbursement purposes and the provider's 
158.11 	charge for each of these services or procedures that the provider would charge to patients 
158.12 	who are not covered by private or public health care coverage.
158.13 	(b) This list must be updated annually and be readily available on site at no cost to the 
158.14 	public. The provider must also post this information on the provider's Web site or the health 
158.15 	care clinic's Web site where the provider practices.

158.16 	Sec. 4. Minnesota Statutes 2016, section 62U.02, is amended to read:
158.17 	62U.02 PAYMENT RESTRUCTURING; QUALITY INCENTIVE PAYMENTS.
158.18 		Subdivision 1.Development. (a) The commissioner of health shall develop a standardized 
158.19 	set of measures for use by health plan companies as specified in subdivision 5. As part of 
158.20 	the standardized set of measures, the commissioner shall establish statewide measures by 
158.21 	which to assess the quality of health care services offered by health care providers, including 
158.22 	health care providers certified as health care homes under section 256B.0751. Quality 
158.23 	measures must be based on medical evidence and be developed through a process in which 
158.24 	providers participate. The statewide measures shall be used for the quality incentive payment 
158.25 	system developed in subdivision 2 and the quality transparency requirements in subdivision 
158.26 	3. The statewide measures must:
158.27 	(1) for purposes of assessing the quality of care provided at physician clinics, including 
158.28 	clinics certified as health care homes under section 256B.0751, be selected from the available 
158.29 	measures as defined in Code of Federal Regulations, title 42, part 414 or 495, as amended, 
158.30 	unless the stakeholders identified under paragraph (b) determine that a particular diagnosis, 
158.31 	condition, service, or procedure is not reflected in any of the available measures in a way 
158.32 	that meets identified needs;
159.1 	(2) be based on medical evidence;
159.2 	(3) be developed through a process in which providers participate and consumer and 
159.3 	community input and perspectives are obtained;
159.4 	(1) (4) include uniform definitions, measures, and forms for submission of data, to the 
159.5 	greatest extent possible;
159.6 	(2) (5) seek to avoid increasing the administrative burden on health care providers; and
159.7 	(3) be initially based on existing quality indicators for physician and hospital services, 
159.8 	which are measured and reported publicly by quality measurement organizations, including, 
159.9 	but not limited to, Minnesota Community Measurement and specialty societies;
159.10 	(4) (6) place a priority on measures of health care outcomes, rather than process measures, 
159.11 	wherever possible; and
159.12 	(5) incorporate measures for primary care, including preventive services, coronary artery 
159.13 	and heart disease, diabetes, asthma, depression, and other measures as determined by the 
159.14 	commissioner.
159.15 	The measures may also include measures of care infrastructure and patient satisfaction.
159.16 	(b) By June 30, 2018, the commissioner shall develop a measurement framework that 
159.17 	identifies the most important elements for assessing the quality of care, articulates statewide 
159.18 	quality improvement goals, ensures clinical relevance, fosters alignment with other 
159.19 	measurement efforts, and defines the roles of stakeholders. By December 15, 2018, the 
159.20 	commissioner shall use the framework to update the statewide measures used to assess the 
159.21 	quality of health care services offered by health care providers, including health care 
159.22 	providers certified as health care homes under section 256B.0751. No more than six statewide 
159.23 	measures shall be required for single-specialty physician practices and no more than ten 
159.24 	statewide measures shall be required for multispecialty physician practices. Measures in 
159.25 	addition to the six statewide measures for single-specialty practices and the ten statewide 
159.26 	measures for multispecialty practices may be included for a physician practice if derived 
159.27 	from administrative claims data. Care infrastructure measures collected according to section 
159.28 	62J.495 shall not be counted toward the maximum number of measures specified in this 
159.29 	paragraph. The commissioner shall develop the framework in consultation with stakeholders 
159.30 	that include consumer, community, and advocacy organizations representing diverse 
159.31 	communities and patients; health plan companies; health care providers whose quality is 
159.32 	assessed, including providers who serve primarily socioeconomically complex patient 
159.33 	populations; health care purchasers; community health boards; and quality improvement 
160.1 	and measurement organizations. The commissioner, in consultation with stakeholders, shall 
160.2 	review the framework at least once every three years. The commissioner shall also submit 
160.3 	a report to the chairs and ranking minority members of the legislative committees with 
160.4 	jurisdiction over health and human services policy and finance by September 30, 2018, 
160.5 	summarizing the development of the measurement framework and making recommendations 
160.6 	on the type and appropriate maximum number of measures in the statewide measures set 
160.7 	for implementation on January 1, 2020.
160.8 	(b) (c) Effective July 1, 2016, the commissioner shall stratify quality measures by race, 
160.9 	ethnicity, preferred language, and country of origin beginning with five measures, and 
160.10 	stratifying additional measures to the extent resources are available. On or after January 1, 
160.11 	2018, the commissioner may require measures to be stratified by other sociodemographic 
160.12 	factors or composite indices of multiple factors that according to reliable data are correlated 
160.13 	with health disparities and have an impact on performance on quality or cost indicators. 
160.14 	New methods of stratifying data under this paragraph must be tested and evaluated through 
160.15 	pilot projects prior to adding them to the statewide system. In determining whether to add 
160.16 	additional sociodemographic factors and developing the methodology to be used, the 
160.17 	commissioner shall consider the reporting burden on providers and determine whether there 
160.18 	are alternative sources of data that could be used. The commissioner shall ensure that 
160.19 	categories and data collection methods are developed in consultation with those communities 
160.20 	impacted by health disparities using culturally appropriate community engagement principles 
160.21 	and methods. The commissioner shall implement this paragraph in coordination with the 
160.22 	contracting entity retained under subdivision 4, in order to build upon the data stratification 
160.23 	methodology that has been developed and tested by the entity. Nothing in this paragraph 
160.24 	expands or changes the commissioner's authority to collect, analyze, or report health care 
160.25 	data. Any data collected to implement this paragraph must be data that is available or is 
160.26 	authorized to be collected under other laws. Nothing in this paragraph grants authority to 
160.27 	the commissioner to collect or analyze patient-level or patient-specific data of the patient 
160.28 	characteristics identified under this paragraph.
160.29 	(c) (d) The statewide measures shall be reviewed at least annually by the commissioner.
160.30 		Subd. 2.Quality incentive payments. (a) By July 1, 2009, the commissioner shall 
160.31 	develop a system of quality incentive payments under which providers are eligible for 
160.32 	quality-based payments that are in addition to existing payment levels, based upon a 
160.33 	comparison of provider performance against specified targets, and improvement over time. 
160.34 	The targets must be based upon and consistent with the quality measures established under 
160.35 	subdivision 1.
161.1 	(b) To the extent possible, the payment system must adjust for variations in patient 
161.2 	population in order to reduce incentives to health care providers to avoid high-risk patients 
161.3 	or populations, including those with risk factors related to race, ethnicity, language, country 
161.4 	of origin, and sociodemographic factors.
161.5 	(c) The requirements of section 62Q.101 do not apply under this incentive payment 
161.6 	system.
161.7 		Subd. 3.Quality transparency. (a) The commissioner shall establish standards for 
161.8 	measuring health outcomes, establish a system for risk adjusting quality measures, and issue 
161.9 	annual periodic public reports on trends in provider quality beginning July 1, 2010 at the 
161.10 	statewide, regional, or clinic levels.
161.11 	(b) Effective July 1, 2017, the risk adjustment system established under this subdivision 
161.12 	shall adjust for patient characteristics identified under subdivision 1, paragraph (b) (c), that 
161.13 	are correlated with health disparities and have an impact on performance on cost and quality 
161.14 	measures. The risk adjustment method may consist of reporting based on an 
161.15 	actual-to-expected comparison that reflects the characteristics of the patient population 
161.16 	served by the clinic or hospital. The commissioner shall implement this paragraph in 
161.17 	coordination with any contracting entity retained under subdivision 4.
161.18 	(c) By January 1, 2010, Physician clinics and hospitals shall submit standardized 
161.19 	electronic information on the outcomes and processes associated with patient care for the 
161.20 	identified statewide measures to the commissioner or the commissioner's designee in the 
161.21 	formats specified by the commissioner, which must include alternative formats for clinics 
161.22 	or hospitals experiencing technological or economic barriers to submission in standardized 
161.23 	electronic form. In addition to measures of care processes and outcomes, the report may 
161.24 	include other measures designated by the commissioner, including, but not limited to, care 
161.25 	infrastructure and patient satisfaction. The commissioner shall ensure that any quality data 
161.26 	reporting requirements established under this subdivision are not duplicative of publicly 
161.27 	reported, communitywide quality reporting activities currently under way in Minnesota. 
161.28 	The commissioner shall ensure that any quality data reporting requirements for physician 
161.29 	clinics are aligned with the specifications and timelines for the selected measures as defined 
161.30 	in subdivision 1, paragraph (a), clause (1). The commissioner may develop additional data 
161.31 	on race, ethnicity, preferred language, country of origin, or other sociodemographic factors 
161.32 	as identified under subdivision 1, paragraph (c), and as required for stratification or risk 
161.33 	adjustment. None of the statewide measures selected shall require providers to use an external 
161.34 	vendor to administer or collect data. Nothingin this subdivision is intended to replace or 
162.1 	duplicate current privately supported activities related to quality measurement and reporting 
162.2 	in Minnesota.
162.3 		Subd. 4.Contracting. The commissioner may contract with a private entity or consortium 
162.4 	of private entities to complete the tasks in subdivisions 1 to 3. The private entity or 
162.5 	consortium must be nonprofit and have governance that includes representatives from the 
162.6 	following stakeholder groups: health care providers, including providers serving high 
162.7 	concentrations of patients and communities impacted by health disparities; health plan 
162.8 	companies; consumers, including consumers representing groups who experience health 
162.9 	disparities; employers or other health care purchasers; and state government. No one 
162.10 	stakeholder group shall have a majority of the votes on any issue or hold extraordinary 
162.11 	powers not granted to any other governance stakeholder.
162.12 		Subd. 5.Implementation. (a) By January 1, 2010, Health plan companies shall use the 
162.13 	standardized quality set of measures established under this section and shall not require 
162.14 	providers to use and report health plan company-specific quality and outcome measures.
162.15 	(b) By July 1, 2010, the commissioner of management and budget shall implement this 
162.16 	incentive payment system for all participants in the state employee group insurance program.

162.17 	Sec. 5. Minnesota Statutes 2016, section 62V.05, subdivision 12, is amended to read:
162.18 		Subd. 12.Reports on interagency agreements and intra-agency transfers. The 
162.19 	MNsure Board shall provide quarterly reports to the chairs and ranking minority members 
162.20 	of the legislative committees with jurisdiction over health and human services policy and 
162.21 	finance on:
162.22 	(1) interagency agreements or service-level agreements and any renewals or extensions 
162.23 	of existing interagency or service-level agreements with a state department under section 
162.24 	15.01, state agency under section 15.012, or the Office of MN.IT Services, with a value of 
162.25 	more than $100,000, or related agreements with the same department or agency with a 
162.26 	cumulative value of more than $100,000; and
162.27 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
162.28 	agencies.
162.29 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
162.30 	amount, purpose, and effective date of the agreement, and the duration of the agreement, 
162.31 	and a copy of the agreement.

163.1 	Sec. 6. Minnesota Statutes 2016, section 256.01, is amended by adding a subdivision to 
163.2 	read:
163.3 		Subd. 18f.Asset verification system. The commissioner shall implement the Asset 
163.4 	Verification System (AVS) according to Public Law 110-252, title VII, section 7001(d), to 
163.5 	verify assets for an individual applying for or renewing health care benefits under section 
163.6 	256B.055, subdivision 7.

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

163.8 	Sec. 7. Minnesota Statutes 2016, section 256.01, subdivision 41, is amended to read:
163.9 		Subd. 41.Reports on interagency agreements and intra-agency transfers. The 
163.10 	commissioner of human services shall provide quarterly reports to the chairs and ranking 
163.11 	minority members of the legislative committees with jurisdiction over health and human 
163.12 	services policy and finance on:
163.13 	(1) interagency agreements or service-level agreements and any renewals or extensions 
163.14 	of existing interagency or service-level agreements with a state department under section 
163.15 	15.01, state agency under section 15.012, or the Office of MN.IT Services, with a value of 
163.16 	more than $100,000, or related agreements with the same department or agency with a 
163.17 	cumulative value of more than $100,000; and
163.18 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
163.19 	agencies.
163.20 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
163.21 	amount, purpose, and effective date of the agreement, and the duration of the agreement, 
163.22 	and a copy of the agreement.

163.23 	Sec. 8. Minnesota Statutes 2016, section 256.969, subdivision 2b, is amended to read:
163.24 		Subd. 2b.Hospital payment rates. (a) For discharges occurring on or after November 
163.25 	1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according 
163.26 	to the following:
163.27 	(1) critical access hospitals as defined by Medicare shall be paid using a cost-based 
163.28 	methodology;
163.29 	(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology 
163.30 	under subdivision 25;
164.1 	(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation 
164.2 	distinct parts as defined by Medicare shall be paid according to the methodology under 
164.3 	subdivision 12; and
164.4 	(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
164.5 	(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not 
164.6 	be rebased, except that a Minnesota long-term hospital shall be rebased effective January 
164.7 	1, 2011, based on its most recent Medicare cost report ending on or before September 1, 
164.8 	2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on 
164.9 	December 31, 2010. For rate setting periods after November 1, 2014, in which the base 
164.10 	years are updated, a Minnesota long-term hospital's base year shall remain within the same 
164.11 	period as other hospitals.
164.12 	(c) Effective for discharges occurring on and after November 1, 2014, payment rates 
164.13 	for hospital inpatient services provided by hospitals located in Minnesota or the local trade 
164.14 	area, except for the hospitals paid under the methodologies described in paragraph (a), 
164.15 	clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a 
164.16 	manner similar to Medicare. The base year for the rates effective November 1, 2014, shall 
164.17 	be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring 
164.18 	that the total aggregate payments under the rebased system are equal to the total aggregate 
164.19 	payments that were made for the same number and types of services in the base year. Separate 
164.20 	budget neutrality calculations shall be determined for payments made to critical access 
164.21 	hospitals and payments made to hospitals paid under the DRG system. Only the rate increases 
164.22 	or decreases under subdivision 3a or 3c that applied to the hospitals being rebased during 
164.23 	the entire base period shall be incorporated into the budget neutrality calculation.
164.24 	(d) For discharges occurring on or after November 1, 2014, through the next rebasing 
164.25 	that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph 
164.26 	(a), clause (4), shall include adjustments to the projected rates that result in no greater than 
164.27 	a five percent increase or decrease from the base year payments for any hospital. Any 
164.28 	adjustments to the rates made by the commissioner under this paragraph and paragraph (e) 
164.29 	shall maintain budget neutrality as described in paragraph (c).
164.30 	(e) For discharges occurring on or after November 1, 2014, through the next rebasing 
164.31 	that occurs the commissioner may make additional adjustments to the rebased rates, and 
164.32 	when evaluating whether additional adjustments should be made, the commissioner shall 
164.33 	consider the impact of the rates on the following:
164.34 	(1) pediatric services;
165.1 	(2) behavioral health services;
165.2 	(3) trauma services as defined by the National Uniform Billing Committee;
165.3 	(4) transplant services;
165.4 	(5) obstetric services, newborn services, and behavioral health services provided by 
165.5 	hospitals outside the seven-county metropolitan area;
165.6 	(6) outlier admissions;
165.7 	(7) low-volume providers; and
165.8 	(8) services provided by small rural hospitals that are not critical access hospitals.
165.9 	(f) Hospital payment rates established under paragraph (c) must incorporate the following:
165.10 	(1) for hospitals paid under the DRG methodology, the base year payment rate per 
165.11 	admission is standardized by the applicable Medicare wage index and adjusted by the 
165.12 	hospital's disproportionate population adjustment;
165.13 	(2) for critical access hospitals, payment rates for discharges between November 1, 2014, 
165.14 	and June 30, 2015, shall be set to the same rate of payment that applied for discharges on 
165.15 	October 31, 2014;
165.16 	(3) the cost and charge data used to establish hospital payment rates must only reflect 
165.17 	inpatient services covered by medical assistance; and
165.18 	(4) in determining hospital payment rates for discharges occurring on or after the rate 
165.19 	year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per 
165.20 	discharge shall be based on the cost-finding methods and allowable costs of the Medicare 
165.21 	program in effect during the base year or years.
165.22 	(g) The commissioner shall validate the rates effective November 1, 2014, by applying 
165.23 	the rates established under paragraph (c), and any adjustments made to the rates under 
165.24 	paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the 
165.25 	total aggregate payments for the same number and types of services under the rebased rates 
165.26 	are equal to the total aggregate payments made during calendar year 2013.
165.27 	(h) Effective for discharges occurring on or after July 1, 2017 2021, and every two years 
165.28 	thereafter, payment rates under this section shall be rebased to reflect only those changes 
165.29 	in hospital costs between the existing base year and the next base year. The commissioner 
165.30 	shall establish the base year for each rebasing period considering the most recent year for 
165.31 	which filed Medicare cost reports are available. The estimated change in the average payment 
165.32 	per hospital discharge resulting from a scheduled rebasing must be calculated and made 
166.1 	available to the legislature by January 15 of each year in which rebasing is scheduled to 
166.2 	occur, and must include by hospital the differential in payment rates compared to the 
166.3 	individual hospital's costs.
166.4 	(i) Effective for discharges occurring on or after July 1, 2015, payment rates for critical 
166.5 	access hospitals located in Minnesota or the local trade area shall be determined using a 
166.6 	new cost-based methodology. The commissioner shall establish within the methodology 
166.7 	tiers of payment designed to promote efficiency and cost-effectiveness. Payment rates for 
166.8 	hospitals under this paragraph shall be set at a level that does not exceed the total cost for 
166.9 	critical access hospitals as reflected in base year cost reports. Until the next rebasing that 
166.10 	occurs, the new methodology shall result in no greater than a five percent decrease from 
166.11 	the base year payments for any hospital, except a hospital that had payments that were 
166.12 	greater than 100 percent of the hospital's costs in the base year shall have their rate set equal 
166.13 	to 100 percent of costs in the base year. The rates paid for discharges on and after July 1, 
166.14 	2016, covered under this paragraph shall be increased by the inflation factor in subdivision 
166.15 	1, paragraph (a). The new cost-based rate shall be the final rate and shall not be settled to 
166.16 	actual incurred costs. Hospitals shall be assigned a payment tier based on the following 
166.17 	criteria:
166.18 	(1) hospitals that had payments at or below 80 percent of their costs in the base year 
166.19 	shall have a rate set that equals 85 percent of their base year costs;
166.20 	(2) hospitals that had payments that were above 80 percent, up to and including 90 
166.21 	percent of their costs in the base year shall have a rate set that equals 95 percent of their 
166.22 	base year costs; and
166.23 	(3) hospitals that had payments that were above 90 percent of their costs in the base year 
166.24 	shall have a rate set that equals 100 percent of their base year costs.
166.25 	(j) The commissioner may refine the payment tiers and criteria for critical access hospitals 
166.26 	to coincide with the next rebasing under paragraph (h). The factors used to develop the new 
166.27 	methodology may include, but are not limited to:
166.28 	(1) the ratio between the hospital's costs for treating medical assistance patients and the 
166.29 	hospital's charges to the medical assistance program;
166.30 	(2) the ratio between the hospital's costs for treating medical assistance patients and the 
166.31 	hospital's payments received from the medical assistance program for the care of medical 
166.32 	assistance patients;
167.1 	(3) the ratio between the hospital's charges to the medical assistance program and the 
167.2 	hospital's payments received from the medical assistance program for the care of medical 
167.3 	assistance patients;
167.4 	(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
167.5 	(5) the proportion of that hospital's costs that are administrative and trends in 
167.6 	administrative costs; and
167.7 	(6) geographic location.

167.8 	Sec. 9. Minnesota Statutes 2016, section 256.969, is amended by adding a subdivision to 
167.9 	read:
167.10 		Subd. 2e.Alternate inpatient payment rate. (a) If the days, costs, and revenues 
167.11 	associated with patients who are eligible for medical assistance and also have private health 
167.12 	insurance are required to be included in the calculation of the hospital-specific 
167.13 	disproportionate share hospital payment limit for a rate year, then the commissioner, effective 
167.14 	retroactively from rate years beginning on or after January 1, 2015, shall compute an alternate 
167.15 	inpatient payment rate for a Minnesota hospital that is designated as a children's hospital 
167.16 	and enumerated as such by Medicare. The commissioner shall reimburse the hospital for a 
167.17 	rate year at the higher of the amount calculated under the alternate payment rate or the 
167.18 	amount calculated under subdivision 9.
167.19 	(b) The alternate payment rate must meet the criteria in clauses (1) to (4):
167.20 	(1) the alternate payment rate shall be structured to target a total aggregate reimbursement 
167.21 	amount equal to two percent less than each children's hospital's cost coverage percentage 
167.22 	in the applicable base year for providing fee-for-service inpatient services under this section 
167.23 	to patients enrolled in medical assistance;
167.24 	(2) costs shall be determined using the most recently available medical assistance cost 
167.25 	report provided under subdivision 4b, paragraph (a), clause (3), for the applicable base year. 
167.26 	Costs shall be determined using standard Medicare cost finding and cost allocation methods 
167.27 	and applied in the same manner as the costs were in the rebasing for the applicable base 
167.28 	year. If the medical assistance cost report is not available, costs shall be determined in the 
167.29 	interim using the Medicare cost report;
167.30 	(3) in any rate year in which payment to a hospital is made using the alternate payment 
167.31 	rate, no payments shall be made to the hospital under subdivision 9; and
168.1 	(4) if the alternate payment amount increases payments at a rate that is higher than the 
168.2 	inflation factor applied over the rebasing period, the commissioner shall take this into 
168.3 	consideration when setting payment rates at the next rebasing.

168.4 	Sec. 10. Minnesota Statutes 2016, section 256.969, subdivision 4b, is amended to read:
168.5 		Subd. 4b.Medical assistance cost reports for services. (a) A hospital that meets one 
168.6 	of the following criteria must annually submit to the commissioner medical assistance cost 
168.7 	reports within six months of the end of the hospital's fiscal year:
168.8 	(1) a hospital designated as a critical access hospital that receives medical assistance 
168.9 	payments; or
168.10 	(2) a Minnesota hospital or out-of-state hospital located within a Minnesota local trade 
168.11 	area that receives a disproportionate population adjustment under subdivision 9; or
168.12 	(3) a Minnesota hospital that is designated as a children's hospital and enumerated as 
168.13 	such by Medicare.
168.14 	For purposes of this subdivision, local trade area has the meaning given in subdivision 
168.15 	17.
168.16 	(b) The commissioner shall suspend payments to any hospital that fails to submit a report 
168.17 	required under this subdivision. Payments must remain suspended until the report has been 
168.18 	filed with and accepted by the commissioner.

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

168.20 	Sec. 11. [256B.0371] ADMINISTRATION OF DENTAL SERVICES.
168.21 		Subdivision 1.Contract for dental administration services. (a) The commissioner 
168.22 	shall contract with up to two dental administrators to administer dental services for all 
168.23 	recipients of medical assistance and MinnesotaCare.
168.24 	(b) The dental administrator must provide administrative services, including, but not 
168.25 	limited to:
168.26 	(1) provider recruitment, contracting, and assistance;
168.27 	(2) recipient outreach and assistance;
168.28 	(3) utilization management and review for medical necessity of dental services;
168.29 	(4) dental claims processing, including submission of encounter claims to the department;
168.30 	(5) coordination with other services;
169.1 	(6) management of fraud and abuse;
169.2 	(7) monitoring of access to dental services;
169.3 	(8) performance measurement;
169.4 	(9) quality improvement and evaluation requirements; and
169.5 	(10) management of third party liability requirements.
169.6 	(c) A payment to a contracted dental provider shall be at the rates established under 
169.7 	section 256B.76.
169.8 		Subd. 2.Requirements. (a) Recipients shall be given a choice of dental provider, 
169.9 	including any provider who agrees to the provider participation requirements and payment 
169.10 	rates established under this section. The commissioner and dental services administrator 
169.11 	shall comply with the network adequacy, geographic access, and essential community 
169.12 	provider requirements that apply to managed care plans and county-based purchasing plans 
169.13 	for nondental services.
169.14 	(b) The commissioner shall implement this section in consultation with representatives 
169.15 	of providers who provide dental services to patients enrolled in medical assistance or 
169.16 	MinnesotaCare, including, but not limited to, providers who serve primarily low-income 
169.17 	and socioeconomically complex patient populations.
169.18 	(c) The commissioner shall consult with county-based purchasing plans on the 
169.19 	development and review of a request for proposals, and development of metrics to evaluate 
169.20 	the performance of a dental administrator. A contract between the commissioner and a 
169.21 	dental administrator must ensure that the administrator coordinates and works with 
169.22 	county-based purchasing plans to assist enrollees in accessing appropriate dental care within 
169.23 	their geographic areas.

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

169.25 	Sec. 12. Minnesota Statutes 2016, section 256B.04, subdivision 21, is amended to read:
169.26 		Subd. 21.Provider enrollment. (a) The commissioner shall enroll providers and conduct 
169.27 	screening activities as required by Code of Federal Regulations, title 42, section 455, subpart 
169.28 	E, including database checks, unannounced pre- and post-enrollment site visits, fingerprinting, 
169.29 	and criminal background studies. A provider providing services from multiple locations 
169.30 	must enroll each location separately. The commissioner may deny a provider's incomplete 
169.31 	application for enrollment if a provider fails to respond to the commissioner's request for 
169.32 	additional information within 60 days of the request.
170.1 	(b) The commissioner must revalidate each provider under this subdivision at least once 
170.2 	every five years. The commissioner may revalidate a personal care assistance agency under 
170.3 	this subdivision once every three years. The commissioner shall conduct revalidation as 
170.4 	follows:
170.5 	(1) provide 30-day notice of revalidation due date to include instructions for revalidation 
170.6 	and a list of materials the provider must submit to revalidate;
170.7 	(2) notify the provider that fails to completely respond within 30 days of any deficiencies 
170.8 	and allow an additional 30 days to comply; and
170.9 	(3) give 60-day notice of termination and immediately suspend a provider's ability to 
170.10 	bill for failure to remedy any deficiencies within the 30-day time period. The provider shall 
170.11 	have no right to appeal suspension of ability to bill.
170.12 	(c) The commissioner may suspend a provider's ability to bill for a failure to comply 
170.13 	with any individual provider requirements or conditions of participation until the provider 
170.14 	comes into compliance. The commissioner's decision to suspend the provider is not subject 
170.15 	to an administrative appeal.
170.16 	(d) Notwithstanding any other provision to the contrary, all correspondence and 
170.17 	notifications, including notifications of termination and other actions, shall be delivered 
170.18 	electronically to a provider's MN-ITS mailbox. For a provider that does not have a MN-ITS 
170.19 	account and mailbox, notice shall be sent by first class mail.
170.20 	(e) If the commissioner or the Centers for Medicare and Medicaid Services determines 
170.21 	that a provider is designated "high-risk," the commissioner may withhold payment from 
170.22 	providers within that category upon initial enrollment for a 90-day period. The withholding 
170.23 	for each provider must begin on the date of the first submission of a claim.
170.24 	(b) (f) An enrolled provider that is also licensed by the commissioner under chapter 
170.25 	245A, or is licensed as a home care provider by the Department of Health under chapter 
170.26 	144A and has a home and community-based services designation on the home care license 
170.27 	under section 144A.484, must designate an individual as the entity's compliance officer. 
170.28 	The compliance officer must:
170.29 	(1) develop policies and procedures to assure adherence to medical assistance laws and 
170.30 	regulations and to prevent inappropriate claims submissions;
170.31 	(2) train the employees of the provider entity, and any agents or subcontractors of the 
170.32 	provider entity including billers, on the policies and procedures under clause (1);
171.1 	(3) respond to allegations of improper conduct related to the provision or billing of 
171.2 	medical assistance services, and implement action to remediate any resulting problems;
171.3 	(4) use evaluation techniques to monitor compliance with medical assistance laws and 
171.4 	regulations;
171.5 	(5) promptly report to the commissioner any identified violations of medical assistance 
171.6 	laws or regulations; and
171.7 	(6) within 60 days of discovery by the provider of a medical assistance reimbursement 
171.8 	overpayment, report the overpayment to the commissioner and make arrangements with 
171.9 	the commissioner for the commissioner's recovery of the overpayment.
171.10 	The commissioner may require, as a condition of enrollment in medical assistance, that a 
171.11 	provider within a particular industry sector or category establish a compliance program that 
171.12 	contains the core elements established by the Centers for Medicare and Medicaid Services.
171.13 	(c) (g) The commissioner may revoke the enrollment of an ordering or rendering provider 
171.14 	for a period of not more than one year, if the provider fails to maintain and, upon request 
171.15 	from the commissioner, provide access to documentation relating to written orders or requests 
171.16 	for payment for durable medical equipment, certifications for home health services, or 
171.17 	referrals for other items or services written or ordered by such provider, when the 
171.18 	commissioner has identified a pattern of a lack of documentation. A pattern means a failure 
171.19 	to maintain documentation or provide access to documentation on more than one occasion. 
171.20 	Nothing in this paragraph limits the authority of the commissioner to sanction a provider 
171.21 	under the provisions of section 256B.064.
171.22 	(d) (h) The commissioner shall terminate or deny the enrollment of any individual or 
171.23 	entity if the individual or entity has been terminated from participation in Medicare or under 
171.24 	the Medicaid program or Children's Health Insurance Program of any other state.
171.25 	(e) (i) As a condition of enrollment in medical assistance, the commissioner shall require 
171.26 	that a provider designated "moderate" or "high-risk" by the Centers for Medicare and 
171.27 	Medicaid Services or the commissioner permit the Centers for Medicare and Medicaid 
171.28 	Services, its agents, or its designated contractors and the state agency, its agents, or its 
171.29 	designated contractors to conduct unannounced on-site inspections of any provider location. 
171.30 	The commissioner shall publish in the Minnesota Health Care Program Provider Manual a 
171.31 	list of provider types designated "limited," "moderate," or "high-risk," based on the criteria 
171.32 	and standards used to designate Medicare providers in Code of Federal Regulations, title 
171.33 	42, section 424.518. The list and criteria are not subject to the requirements of chapter 14. 
171.34 	The commissioner's designations are not subject to administrative appeal.
172.1 	(f) (j) As a condition of enrollment in medical assistance, the commissioner shall require 
172.2 	that a high-risk provider, or a person with a direct or indirect ownership interest in the 
172.3 	provider of five percent or higher, consent to criminal background checks, including 
172.4 	fingerprinting, when required to do so under state law or by a determination by the 
172.5 	commissioner or the Centers for Medicare and Medicaid Services that a provider is designated 
172.6 	high-risk for fraud, waste, or abuse.
172.7 	(g) (k)(1) Upon initial enrollment, reenrollment, and notification of revalidation, all 
172.8 	durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) medical suppliers 
172.9 	meeting the durable medical equipment provider and supplier definition in clause (3), 
172.10 	operating in Minnesota and receiving Medicaid funds must purchase a surety bond that is 
172.11 	annually renewed and designates the Minnesota Department of Human Services as the 
172.12 	obligee, and must be submitted in a form approved by the commissioner. For purposes of 
172.13 	this clause, the following medical suppliers are not required to obtain a surety bond: a 
172.14 	federally qualified health center, a home health agency, the Indian Health Service, a 
172.15 	pharmacy, and a rural health clinic.
172.16 	(2) At the time of initial enrollment or reenrollment, durable medical equipment providers 
172.17 	and suppliers defined in clause (3) must purchase a surety bond of $50,000. If a revalidating 
172.18 	provider's Medicaid revenue in the previous calendar year is up to and including $300,000, 
172.19 	the provider agency must purchase a surety bond of $50,000. If a revalidating provider's 
172.20 	Medicaid revenue in the previous calendar year is over $300,000, the provider agency must 
172.21 	purchase a surety bond of $100,000. The surety bond must allow for recovery of costs and 
172.22 	fees in pursuing a claim on the bond.
172.23 	(3) "Durable medical equipment provider or supplier" means a medical supplier that can 
172.24 	purchase medical equipment or supplies for sale or rental to the general public and is able 
172.25 	to perform or arrange for necessary repairs to and maintenance of equipment offered for 
172.26 	sale or rental.
172.27 	(h) (l) The Department of Human Services may require a provider to purchase a surety 
172.28 	bond as a condition of initial enrollment, reenrollment, reinstatement, or continued enrollment 
172.29 	if: (1) the provider fails to demonstrate financial viability, (2) the department determines 
172.30 	there is significant evidence of or potential for fraud and abuse by the provider, or (3) the 
172.31 	provider or category of providers is designated high-risk pursuant to paragraph (a) (e) and 
172.32 	as per Code of Federal Regulations, title 42, section 455.450. The surety bond must be in 
172.33 	an amount of $100,000 or ten percent of the provider's payments from Medicaid during the 
172.34 	immediately preceding 12 months, whichever is greater. The surety bond must name the 
172.35 	Department of Human Services as an obligee and must allow for recovery of costs and fees 
173.1 	in pursuing a claim on the bond. This paragraph does not apply if the provider currently 
173.2 	maintains a surety bond under the requirements in section 256B.0659 or 256B.85.

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

173.4 	Sec. 13. Minnesota Statutes 2016, section 256B.04, subdivision 22, is amended to read:
173.5 		Subd. 22.Application fee. (a) The commissioner must collect and retain federally 
173.6 	required nonrefundable application fees to pay for provider screening activities in accordance 
173.7 	with Code of Federal Regulations, title 42, section 455, subpart E. The enrollment application 
173.8 	must be made under the procedures specified by the commissioner, in the form specified 
173.9 	by the commissioner, and accompanied by an application fee described in paragraph (b), 
173.10 	or a request for a hardship exception as described in the specified procedures. Application 
173.11 	fees must be deposited in the provider screening account in the special revenue fund. 
173.12 	Amounts in the provider screening account are appropriated to the commissioner for costs 
173.13 	associated with the provider screening activities required in Code of Federal Regulations, 
173.14 	title 42, section 455, subpart E. The commissioner shall conduct screening activities as 
173.15 	required by Code of Federal Regulations, title 42, section 455, subpart E, and as otherwise 
173.16 	provided by law, to include database checks, unannounced pre- and postenrollment site 
173.17 	visits, fingerprinting, and criminal background studies. The commissioner must revalidate 
173.18 	all providers under this subdivision at least once every five years must revalidate all personal 
173.19 	care assistance agencies under this subdivision at least once every three years.
173.20 	(b) The application fee under this subdivision is $532 for the calendar year 2013. For 
173.21 	calendar year 2014 and subsequent years, the fee:
173.22 	(1) is adjusted by the percentage change to the Consumer Price Index for all urban 
173.23 	consumers, United States city average, for the 12-month period ending with June of the 
173.24 	previous year. The resulting fee must be announced in the Federal Register;
173.25 	(2) is effective from January 1 to December 31 of a calendar year;
173.26 	(3) is required on the submission of an initial application, an application to establish a 
173.27 	new practice location, an application for reenrollment when the provider is not enrolled at 
173.28 	the time of application of reenrollment, or at revalidation when required by federal regulation; 
173.29 	and
173.30 	(4) must be in the amount in effect for the calendar year during which the application 
173.31 	for enrollment, new practice location, or reenrollment is being submitted.
173.32 	(c) The application fee under this subdivision cannot be charged to:
174.1 	(1) providers who are enrolled in Medicare or who provide documentation of payment 
174.2 	of the fee to, and enrollment with, another state, unless the commissioner is required to 
174.3 	rescreen the provider;
174.4 	(2) providers who are enrolled but are required to submit new applications for purposes 
174.5 	of reenrollment;
174.6 	(3) a provider who enrolls as an individual; and
174.7 	(4) group practices and clinics that bill on behalf of individually enrolled providers 
174.8 	within the practice who have reassigned their billing privileges to the group practice or 
174.9 	clinic.

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

174.11 	Sec. 14. Minnesota Statutes 2016, section 256B.056, subdivision 5c, is amended to read:
174.12 		Subd. 5c.Excess income standard. (a) The excess income standard for parents and 
174.13 	caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard 
174.14 	specified in subdivision 4, paragraph (b).
174.15 	(b) The excess income standard for a person whose eligibility is based on blindness, 
174.16 	disability, or age of 65 or more years shall equal 80 81 percent of the federal poverty 
174.17 	guidelines.

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

174.19 	Sec. 15. Minnesota Statutes 2016, section 256B.0621, subdivision 10, is amended to read:
174.20 		Subd. 10.Payment rates. The commissioner shall set payment rates for targeted case 
174.21 	management under this subdivision. Case managers may bill according to the following 
174.22 	criteria:
174.23 	(1) for relocation targeted case management, case managers may bill for direct case 
174.24 	management activities, including face-to-face and contact, telephone contacts contact, and 
174.25 	interactive video contact according to section 256B.0924, subdivision 4a, in the lesser of:
174.26 	(i) 180 days preceding an eligible recipient's discharge from an institution; or
174.27 	(ii) the limits and conditions which apply to federal Medicaid funding for this service;
174.28 	(2) for home care targeted case management, case managers may bill for direct case 
174.29 	management activities, including face-to-face and telephone contacts; and
175.1 	(3) billings for targeted case management services under this subdivision shall not 
175.2 	duplicate payments made under other program authorities for the same purpose.

175.3 	EFFECTIVE DATE. This section is effective three months after federal approval.

175.4 	Sec. 16. Minnesota Statutes 2016, section 256B.0625, subdivision 3b, is amended to read:
175.5 		Subd. 3b.Telemedicine services. (a) Medical assistance covers medically necessary 
175.6 	services and consultations delivered by a licensed health care provider via telemedicine in 
175.7 	the same manner as if the service or consultation was delivered in person. Coverage is 
175.8 	limited to three telemedicine services per enrollee per calendar week. Telemedicine services 
175.9 	shall be paid at the full allowable rate.
175.10 	(b) The commissioner shall establish criteria that a health care provider must attest to 
175.11 	in order to demonstrate the safety or efficacy of delivering a particular service via 
175.12 	telemedicine. The attestation may include that the health care provider:
175.13 	(1) has identified the categories or types of services the health care provider will provide 
175.14 	via telemedicine;
175.15 	(2) has written policies and procedures specific to telemedicine services that are regularly 
175.16 	reviewed and updated;
175.17 	(3) has policies and procedures that adequately address patient safety before, during, 
175.18 	and after the telemedicine service is rendered;
175.19 	(4) has established protocols addressing how and when to discontinue telemedicine 
175.20 	services; and
175.21 	(5) has an established quality assurance process related to telemedicine services.
175.22 	(c) As a condition of payment, a licensed health care provider must document each 
175.23 	occurrence of a health service provided by telemedicine to a medical assistance enrollee. 
175.24 	Health care service records for services provided by telemedicine must meet the requirements 
175.25 	set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:
175.26 	(1) the type of service provided by telemedicine;
175.27 	(2) the time the service began and the time the service ended, including an a.m. and p.m. 
175.28 	designation;
175.29 	(3) the licensed health care provider's basis for determining that telemedicine is an 
175.30 	appropriate and effective means for delivering the service to the enrollee;
176.1 	(4) the mode of transmission of the telemedicine service and records evidencing that a 
176.2 	particular mode of transmission was utilized;
176.3 	(5) the location of the originating site and the distant site;
176.4 	(6) if the claim for payment is based on a physician's telemedicine consultation with 
176.5 	another physician, the written opinion from the consulting physician providing the 
176.6 	telemedicine consultation; and
176.7 	(7) compliance with the criteria attested to by the health care provider in accordance 
176.8 	with paragraph (b).
176.9 	(d) For purposes of this subdivision, unless otherwise covered under this chapter, 
176.10 	"telemedicine" is defined as the delivery of health care services or consultations while the 
176.11 	patient is at an originating site and the licensed health care provider is at a distant site. A 
176.12 	communication between licensed health care providers, or a licensed health care provider 
176.13 	and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission 
176.14 	does not constitute telemedicine consultations or services. Telemedicine may be provided 
176.15 	by means of real-time two-way, interactive audio and visual communications, including the 
176.16 	application of secure video conferencing or store-and-forward technology to provide or 
176.17 	support health care delivery, which facilitate the assessment, diagnosis, consultation, 
176.18 	treatment, education, and care management of a patient's health care.
176.19 	(e) For purposes of this section, "licensed health care provider" is defined under section 
176.20 	62A.671, subdivision 6, and includes a mental health practitioner as defined under section 
176.21 	245.462, subdivision 17, or 245.4871, subdivision 26, working under the general supervision 
176.22 	of a mental health professional; "health care provider" is defined under section 62A.671, 
176.23 	subdivision 3; and "originating site" is defined under section 62A.671, subdivision 7.

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

176.25 	Sec. 17. Minnesota Statutes 2016, section 256B.0625, subdivision 7, is amended to read:
176.26 		Subd. 7.Home care nursing. Medical assistance covers home care nursing services in 
176.27 	a recipient's home. Recipients who are authorized to receive home care nursing services in 
176.28 	their home may use approved hours outside of the home during hours when normal life 
176.29 	activities take them outside of their home. To use home care nursing services at school, the 
176.30 	recipient or responsible party must provide written authorization in the care plan identifying 
176.31 	the chosen provider and the daily amount of services to be used at school. Medical assistance 
176.32 	does not cover home care nursing services for residents of a hospital, nursing facility, 
176.33 	intermediate care facility, or a health care facility licensed by the commissioner of health, 
177.1 	except as authorized in section 256B.64 for ventilator-dependent recipients in hospitals or
177.2 	unless a resident who is otherwise eligible is on leave from the facility and the facility either 
177.3 	pays for the home care nursing services or forgoes the facility per diem for the leave days 
177.4 	that home care nursing services are used. Total hours of service and payment allowed for 
177.5 	services outside the home cannot exceed that which is otherwise allowed in an in-home 
177.6 	setting according to sections 256B.0651 and 256B.0654 . All home care nursing services 
177.7 	must be provided according to the limits established under sections 256B.0651, 256B.0653, 
177.8 	and 256B.0654. Home care nursing services may not be reimbursed if the nurse is the family 
177.9 	foster care provider of a recipient who is under age 18, unless allowed under section 
177.10 	256B.0654, subdivision 4.

177.11 	Sec. 18. Minnesota Statutes 2016, section 256B.0625, subdivision 20, is amended to read:
177.12 		Subd. 20.Mental health case management. (a) To the extent authorized by rule of the 
177.13 	state agency, medical assistance covers case management services to persons with serious 
177.14 	and persistent mental illness and children with severe emotional disturbance. Services 
177.15 	provided under this section must meet the relevant standards in sections 245.461 to 245.4887, 
177.16 	the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts 
177.17 	9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
177.18 	(b) Entities meeting program standards set out in rules governing family community 
177.19 	support services as defined in section 245.4871, subdivision 17, are eligible for medical 
177.20 	assistance reimbursement for case management services for children with severe emotional 
177.21 	disturbance when these services meet the program standards in Minnesota Rules, parts 
177.22 	9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
177.23 	(c) Medical assistance and MinnesotaCare payment for mental health case management 
177.24 	shall be made on a monthly basis. In order to receive payment for an eligible child, the 
177.25 	provider must document at least a face-to-face contact with the child, the child's parents, or 
177.26 	the child's legal representative. To receive payment for an eligible adult, the provider must 
177.27 	document:
177.28 	(1) at least a face-to-face contact with the adult or the adult's legal representative or a 
177.29 	contact by interactive video that meets the requirements of subdivision 20b; or
177.30 	(2) at least a telephone contact with the adult or the adult's legal representative and 
177.31 	document a face-to-face contact or a contact by interactive video that meets the requirements 
177.32 	of subdivision 20b with the adult or the adult's legal representative within the preceding 
177.33 	two months.
178.1 	(d) Payment for mental health case management provided by county or state staff shall 
178.2 	be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph 
178.3 	(b), with separate rates calculated for child welfare and mental health, and within mental 
178.4 	health, separate rates for children and adults.
178.5 	(e) Payment for mental health case management provided by Indian health services or 
178.6 	by agencies operated by Indian tribes may be made according to this section or other relevant 
178.7 	federally approved rate setting methodology.
178.8 	(f) Payment for mental health case management provided by vendors who contract with 
178.9 	a county or Indian tribe shall be based on a monthly rate negotiated by the host county or 
178.10 	tribe. The negotiated rate must not exceed the rate charged by the vendor for the same 
178.11 	service to other payers. If the service is provided by a team of contracted vendors, the county 
178.12 	or tribe may negotiate a team rate with a vendor who is a member of the team. The team 
178.13 	shall determine how to distribute the rate among its members. No reimbursement received 
178.14 	by contracted vendors shall be returned to the county or tribe, except to reimburse the county 
178.15 	or tribe for advance funding provided by the county or tribe to the vendor.
178.16 	(g) If the service is provided by a team which includes contracted vendors, tribal staff, 
178.17 	and county or state staff, the costs for county or state staff participation in the team shall be 
178.18 	included in the rate for county-provided services. In this case, the contracted vendor, the 
178.19 	tribal agency, and the county may each receive separate payment for services provided by 
178.20 	each entity in the same month. In order to prevent duplication of services, each entity must 
178.21 	document, in the recipient's file, the need for team case management and a description of 
178.22 	the roles of the team members.
178.23 	(h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for 
178.24 	mental health case management shall be provided by the recipient's county of responsibility, 
178.25 	as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds 
178.26 	used to match other federal funds. If the service is provided by a tribal agency, the nonfederal 
178.27 	share, if any, shall be provided by the recipient's tribe. When this service is paid by the state 
178.28 	without a federal share through fee-for-service, 50 percent of the cost shall be provided by 
178.29 	the recipient's county of responsibility.
178.30 	(i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance 
178.31 	and MinnesotaCare include mental health case management. When the service is provided 
178.32 	through prepaid capitation, the nonfederal share is paid by the state and the county pays no 
178.33 	share.
179.1 	(j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider 
179.2 	that does not meet the reporting or other requirements of this section. The county of 
179.3 	responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency, 
179.4 	is responsible for any federal disallowances. The county or tribe may share this responsibility 
179.5 	with its contracted vendors.
179.6 	(k) The commissioner shall set aside a portion of the federal funds earned for county 
179.7 	expenditures under this section to repay the special revenue maximization account under 
179.8 	section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
179.9 	(1) the costs of developing and implementing this section; and
179.10 	(2) programming the information systems.
179.11 	(l) Payments to counties and tribal agencies for case management expenditures under 
179.12 	this section shall only be made from federal earnings from services provided under this 
179.13 	section. When this service is paid by the state without a federal share through fee-for-service, 
179.14 	50 percent of the cost shall be provided by the state. Payments to county-contracted vendors 
179.15 	shall include the federal earnings, the state share, and the county share.
179.16 	(m) Case management services under this subdivision do not include therapy, treatment, 
179.17 	legal, or outreach services.
179.18 	(n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital, 
179.19 	and the recipient's institutional care is paid by medical assistance, payment for case 
179.20 	management services under this subdivision is limited to the lesser of:
179.21 	(1) the last 180 days of the recipient's residency in that facility and may not exceed more 
179.22 	than six months in a calendar year; or
179.23 	(2) the limits and conditions which apply to federal Medicaid funding for this service.
179.24 	(o) Payment for case management services under this subdivision shall not duplicate 
179.25 	payments made under other program authorities for the same purpose.
179.26 	(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting 
179.27 	licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week, 
179.28 	mental health targeted case management services must actively support identification of 
179.29 	community alternatives for the recipient and discharge planning.

179.30 	EFFECTIVE DATE. This section is effective three months after federal approval.

180.1 	Sec. 19. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
180.2 	to read:
180.3 		Subd. 20b.Mental health targeted case management through interactive video. (a) 
180.4 	Subject to federal approval, contact made for targeted case management by interactive video 
180.5 	shall be eligible for payment if:
180.6 	(1) the person receiving targeted case management services is residing in:
180.7 	(i) a hospital;
180.8 	(ii) a nursing facility; or
180.9 	(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging 
180.10 	establishment or lodging establishment that provides supportive services or health supervision 
180.11 	services according to section 157.17 that is staffed 24 hours a day, seven days a week;
180.12 	(2) interactive video is in the best interests of the person and is deemed appropriate by 
180.13 	the person receiving targeted case management or the person's legal guardian, the case 
180.14 	management provider, and the provider operating the setting where the person is residing;
180.15 	(3) the use of interactive video is approved as part of the person's written personal service 
180.16 	or case plan, taking into consideration the person's vulnerability and active personal 
180.17 	relationships; and
180.18 	(4) interactive video is used for up to, but not more than, 50 percent of the minimum 
180.19 	required face-to-face contact.
180.20 	(b) The person receiving targeted case management or the person's legal guardian has 
180.21 	the right to choose and consent to the use of interactive video under this subdivision and 
180.22 	has the right to refuse the use of interactive video at any time.
180.23 	(c) The commissioner shall establish criteria that a targeted case management provider 
180.24 	must attest to in order to demonstrate the safety or efficacy of delivering the service via 
180.25 	interactive video. The attestation may include that the case management provider has:
180.26 	(1) written policies and procedures specific to interactive video services that are regularly 
180.27 	reviewed and updated;
180.28 	(2) policies and procedures that adequately address client safety before, during, and after 
180.29 	the interactive video services are rendered;
180.30 	(3) established protocols addressing how and when to discontinue interactive video 
180.31 	services; and
181.1 	(4) established a quality assurance process related to interactive video services.
181.2 	(d) As a condition of payment, the targeted case management provider must document 
181.3 	the following for each occurrence of targeted case management provided by interactive 
181.4 	video:
181.5 	(1) the time the service began and the time the service ended, including an a.m. and p.m. 
181.6 	designation;
181.7 	(2) the basis for determining that interactive video is an appropriate and effective means 
181.8 	for delivering the service to the person receiving case management services;
181.9 	(3) the mode of transmission of the interactive video services and records evidencing 
181.10 	that a particular mode of transmission was utilized;
181.11 	(4) the location of the originating site and the distant site; and
181.12 	(5) compliance with the criteria attested to by the targeted case management provider 
181.13 	as provided in paragraph (c).

181.14 	EFFECTIVE DATE. This section is effective three months after federal approval.

181.15 	Sec. 20. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision 
181.16 	to read:
181.17 		Subd. 56a.Post-arrest community-based service coordination. (a) Medical assistance 
181.18 	covers post-arrest community-based service coordination for an individual who:
181.19 	(1) has been identified as having a mental illness or substance use disorder using a 
181.20 	screening tool approved by the commissioner;
181.21 	(2) does not require the security of a public detention facility and is not considered an 
181.22 	inmate of a public institution as defined in Code of Federal Regulations, title 42, section 
181.23 	435.1010;
181.24 	(3) meets the eligibility requirements in section 256B.056; and
181.25 	(4) has agreed to participate in post-arrest community-based service coordination through 
181.26 	a diversion contract in lieu of incarceration.
181.27 	(b) Post-arrest community-based service coordination means navigating services to 
181.28 	address a client's mental health, chemical health, social, economic, and housing needs, or 
181.29 	any other activity targeted at reducing the incidence of jail utilization and connecting 
181.30 	individuals with existing covered services available to them, including, but not limited to, 
181.31 	targeted case management, waiver case management, or care coordination.
182.1 	(c) Post-arrest community-based service coordination must be provided by individuals 
182.2 	who are qualified under one of the following criteria:
182.3 	(1) a licensed mental health professional as defined in section 245.462, subdivision 18, 
182.4 	clauses (1) to (6);
182.5 	(2) a mental health practitioner as defined in section 245.462, subdivision 17, working 
182.6 	under the clinical supervision of a mental health professional; or
182.7 	(3) a certified peer specialist under section 256B.0615, working under the clinical 
182.8 	supervision of a mental health professional.
182.9 	(d) Reimbursement must be made in 15-minute increments and allowed for up to 60 
182.10 	days following the initial determination of eligibility.
182.11 	(e) Providers of post-arrest community-based service coordination shall annually report 
182.12 	to the commissioner on the number of individuals served, and number of the 
182.13 	community-based services that were accessed by recipients. The commissioner shall ensure 
182.14 	that services and payments provided under post-arrest community-based service coordination 
182.15 	do not duplicate services or payments provided under section 256B.0625, subdivision 20, 
182.16 	256B.0753, 256B.0755, or 256B.0757.
182.17 	(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for 
182.18 	post-arrest community-based service coordination services shall be provided by the recipient's 
182.19 	county of residence, from sources other than federal funds or funds used to match other 
182.20 	federal funds.

182.21 	EFFECTIVE DATE. This section is effective three months after federal approval.

182.22 	Sec. 21. Minnesota Statutes 2016, section 256B.0625, subdivision 57, is amended to read:
182.23 		Subd. 57.Payment for Part B Medicare crossover claims. (a) Effective for services 
182.24 	provided on or after January 1, 2012, medical assistance payment for an enrollee's 
182.25 	cost-sharing associated with Medicare Part B is limited to an amount up to the medical 
182.26 	assistance total allowed, when the medical assistance rate exceeds the amount paid by 
182.27 	Medicare.
182.28 	(b) Excluded from this limitation are payments for mental health services and payments 
182.29 	for dialysis services provided to end-stage renal disease patients. The exclusion for mental 
182.30 	health services does not apply to payments for physician services provided by psychiatrists 
182.31 	and advanced practice nurses with a specialty in mental health.
183.1 	(c) Excluded from this limitation are payments to federally qualified health centers, 
183.2 	Indian Health Services, and rural health clinics.

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

183.4 	Sec. 22. Minnesota Statutes 2016, section 256B.0625, subdivision 64, is amended to read:
183.5 		Subd. 64.Investigational drugs, biological products, and devices. (a) Medical 
183.6 	assistance and the early periodic screening, diagnosis, and treatment (EPSDT) program do 
183.7 	not cover costs incidental to, associated with, or resulting from the use of investigational 
183.8 	drugs, biological products, or devices as defined in section 151.375.
183.9 	(b) Notwithstanding paragraph (a), stiripentol may be covered by the EPSDT program 
183.10 	if all the following conditions are met:
183.11 	(1) the use of stiripentol is determined to be medically necessary;
183.12 	(2) the enrollee has a documented diagnosis of Dravet syndrome, regardless of whether 
183.13 	an SCN1A genetic mutation is found, or the enrollee is a child with malignant migrating 
183.14 	partial epilepsy in infancy due to an SCN2A genetic mutation;
183.15 	(3) all other available covered prescription medications that are medically necessary for 
183.16 	the enrollee have been tried without successful outcomes; and
183.17 	(4) the United States Food and Drug Administration has approved the treating physician's 
183.18 	individual patient investigational new drug application (IND) for the use of stiripentol for 
183.19 	treatment.
183.20 	This paragraph does not apply to MinnesotaCare coverage under chapter 256L.

183.21 	Sec. 23. Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:
183.22 		Subd. 21.Requirements for provider enrollment of personal care assistance provider 
183.23 	agencies. (a) All personal care assistance provider agencies must provide, at the time of 
183.24 	enrollment, reenrollment, and revalidation as a personal care assistance provider agency in 
183.25 	a format determined by the commissioner, information and documentation that includes, 
183.26 	but is not limited to, the following:
183.27 	(1) the personal care assistance provider agency's current contact information including 
183.28 	address, telephone number, and e-mail address;
183.29 	(2) proof of surety bond coverage for each location providing services. Upon new 
183.30 	enrollment, or if the provider's Medicaid revenue in the previous calendar year is up to and 
183.31 	including $300,000, the provider agency must purchase a surety bond of $50,000. If the 
184.1 	Medicaid revenue in the previous year is over $300,000, the provider agency must purchase 
184.2 	a surety bond of $100,000. The surety bond must be in a form approved by the commissioner, 
184.3 	must be renewed annually, and must allow for recovery of costs and fees in pursuing a claim 
184.4 	on the bond;
184.5 	(3) proof of fidelity bond coverage in the amount of $20,000 for each business location 
184.6 	providing service;
184.7 	(4) proof of workers' compensation insurance coverage identifying the business address 
184.8 	where PCA services are provided from;
184.9 	(5) proof of liability insurance coverage identifying the business address where PCA 
184.10 	services are provided from and naming the department as a certificate holder;
184.11 	(6) a description of the personal care assistance provider agency's organization identifying 
184.12 	the names of all owners, managing employees, staff, board of directors, and the affiliations 
184.13 	of the directors, owners, or staff to other service providers;
184.14 	(7) (6) a copy of the personal care assistance provider agency's written policies and 
184.15 	procedures including: hiring of employees; training requirements; service delivery; and 
184.16 	employee and consumer safety including process for notification and resolution of consumer 
184.17 	grievances, identification and prevention of communicable diseases, and employee 
184.18 	misconduct;
184.19 	(8) (7) copies of all other forms the personal care assistance provider agency uses in the 
184.20 	course of daily business including, but not limited to:
184.21 	(i) a copy of the personal care assistance provider agency's time sheet if the time sheet 
184.22 	varies from the standard time sheet for personal care assistance services approved by the 
184.23 	commissioner, and a letter requesting approval of the personal care assistance provider 
184.24 	agency's nonstandard time sheet;
184.25 	(ii) the personal care assistance provider agency's template for the personal care assistance 
184.26 	care plan; and
184.27 	(iii) the personal care assistance provider agency's template for the written agreement 
184.28 	in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
184.29 	(9) (8) a list of all training and classes that the personal care assistance provider agency 
184.30 	requires of its staff providing personal care assistance services;
184.31 	(10) (9) documentation that the personal care assistance provider agency and staff have 
184.32 	successfully completed all the training required by this section;
185.1 	(11) (10) documentation of the agency's marketing practices;
185.2 	(12) (11) disclosure of ownership, leasing, or management of all residential properties 
185.3 	that is used or could be used for providing home care services;
185.4 	(13) (12) documentation that the agency will use the following percentages of revenue 
185.5 	generated from the medical assistance rate paid for personal care assistance services for 
185.6 	employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal 
185.7 	care assistance choice option and 72.5 percent of revenue from other personal care assistance 
185.8 	providers. The revenue generated by the qualified professional and the reasonable costs 
185.9 	associated with the qualified professional shall not be used in making this calculation; and
185.10 	(14) (13) effective May 15, 2010, documentation that the agency does not burden 
185.11 	recipients' free exercise of their right to choose service providers by requiring personal care 
185.12 	assistants to sign an agreement not to work with any particular personal care assistance 
185.13 	recipient or for another personal care assistance provider agency after leaving the agency 
185.14 	and that the agency is not taking action on any such agreements or requirements regardless 
185.15 	of the date signed.
185.16 	(b) Personal care assistance provider agencies shall provide the information specified 
185.17 	in paragraph (a) to the commissioner at the time the personal care assistance provider agency 
185.18 	enrolls as a vendor or upon request from the commissioner. The commissioner shall collect 
185.19 	the information specified in paragraph (a) from all personal care assistance providers 
185.20 	beginning July 1, 2009.
185.21 	(c) All personal care assistance provider agencies shall require all employees in 
185.22 	management and supervisory positions and owners of the agency who are active in the 
185.23 	day-to-day management and operations of the agency to complete mandatory training as 
185.24 	determined by the commissioner before submitting an application for enrollment of the 
185.25 	agency as a provider. All personal care assistance provider agencies shall also require 
185.26 	qualified professionals to complete the training required by subdivision 13 before submitting 
185.27 	an application for enrollment of the agency as a provider. Employees in management and 
185.28 	supervisory positions and owners who are active in the day-to-day operations of an agency 
185.29 	who have completed the required training as an employee with a personal care assistance 
185.30 	provider agency do not need to repeat the required training if they are hired by another 
185.31 	agency, if they have completed the training within the past three years. By September 1, 
185.32 	2010, the required training must be available with meaningful access according to title VI 
185.33 	of the Civil Rights Act and federal regulations adopted under that law or any guidance from 
185.34 	the United States Health and Human Services Department. The required training must be 
186.1 	available online or by electronic remote connection. The required training must provide for 
186.2 	competency testing. Personal care assistance provider agency billing staff shall complete 
186.3 	training about personal care assistance program financial management. This training is 
186.4 	effective July 1, 2009. Any personal care assistance provider agency enrolled before that 
186.5 	date shall, if it has not already, complete the provider training within 18 months of July 1, 
186.6 	2009. Any new owners or employees in management and supervisory positions involved 
186.7 	in the day-to-day operations are required to complete mandatory training as a requisite of 
186.8 	working for the agency. Personal care assistance provider agencies certified for participation 
186.9 	in Medicare as home health agencies are exempt from the training required in this 
186.10 	subdivision. When available, Medicare-certified home health agency owners, supervisors, 
186.11 	or managers must successfully complete the competency test.
186.12 	(d) All surety bonds, fidelity bonds, workers' compensation insurance, and liability 
186.13 	insurance required by this subdivision must be maintained continuously. After initial 
186.14 	enrollment, a provider must submit proof of bonds and required coverages at any time at 
186.15 	the request of the commissioner. Services provided while there are lapses in coverage are 
186.16 	not eligible for payment. Lapses in coverage may result in sanctions, including termination. 
186.17 	The commissioner shall send instructions and a due date to submit the requested information 
186.18 	to the personal care assistance provider agency.

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

186.20 	Sec. 24. Minnesota Statutes 2016, section 256B.072, is amended to read:
186.21 	256B.072 PERFORMANCE REPORTING AND QUALITY IMPROVEMENT 
186.22 	SYSTEM.
186.23 	(a) The commissioner of human services shall establish a performance reporting system 
186.24 	for health care providers who provide health care services to public program recipients 
186.25 	covered under chapters 256B, 256D, and 256L, reporting separately for managed care and 
186.26 	fee-for-service recipients.
186.27 	(b) The measures used for the performance reporting system for medical groups shall
186.28 	may include measures of care for asthma, diabetes, hypertension, and coronary artery disease 
186.29 	and measures of preventive care services. The measures used for the performance reporting 
186.30 	system for inpatient hospitals shall include measures of care for acute myocardial infarction, 
186.31 	heart failure, and pneumonia, and measures of care and prevention of surgical infections. 
186.32 	In the case of a medical group, the measures used shall be consistent with measures published 
186.33 	by nonprofit Minnesota or national organizations that produce and disseminate health care 
186.34 	quality measures or evidence-based health care guidelines section 62U.02, subdivision 1, 
187.1 	paragraph (a), clause (1). In the case of inpatient hospital measures, the commissioner shall 
187.2 	appoint the Minnesota Hospital Association and Stratis Health to advise on the development 
187.3 	of the performance measures to be used for hospital reporting. To enable a consistent 
187.4 	measurement process across the community, the commissioner may use measures of care 
187.5 	provided for patients in addition to those identified in paragraph (a). The commissioner 
187.6 	shall ensure collaboration with other health care reporting organizations so that the measures 
187.7 	described in this section are consistent with those reported by those organizations and used 
187.8 	by other purchasers in Minnesota.
187.9 	(c) The commissioner may require providers to submit information in a required format 
187.10 	to a health care reporting organization or to cooperate with the information collection 
187.11 	procedures of that organization. The commissioner may collaborate with a reporting 
187.12 	organization to collect information reported and to prevent duplication of reporting.
187.13 	(d) By October 1, 2007, and annually thereafter, the commissioner shall report through 
187.14 	a public Web site the results by medical groups and hospitals, where possible, of the measures 
187.15 	under this section, and shall compare the results by medical groups and hospitals for patients 
187.16 	enrolled in public programs to patients enrolled in private health plans. To achieve this 
187.17 	reporting, the commissioner may collaborate with a health care reporting organization that 
187.18 	operates a Web site suitable for this purpose.
187.19 	(e) Performance measures must be stratified as provided under section 62U.02, 
187.20 	subdivision 1, paragraph (b) (c), and risk-adjusted as specified in section 62U.02, subdivision 
187.21 	3, paragraph (b).
187.22 	(f) Notwithstanding paragraph (b), by January 1, 2019, the commissioner shall consider 
187.23 	and appropriately adjust quality metrics and benchmarks for providers who primarily serve 
187.24 	socioeconomically complex patient populations and request to be scored on additional 
187.25 	measures in this subdivision. This applies to all Minnesota health care programs, including 
187.26 	for patient populations enrolled in health plans, county-based purchasing plans, or managed 
187.27 	care organizations and for value-based purchasing arrangements, including, but not limited 
187.28 	to, initiatives operating under sections 256B.0751, 256B.0753, 256B.0755, 256B.0756, and 
187.29 	256B.0757.

187.30 	Sec. 25. Minnesota Statutes 2016, section 256B.0755, subdivision 1, is amended to read:
187.31 		Subdivision 1.Implementation. (a) The commissioner shall develop and authorize
187.32 	continue and expand a demonstration project established under this section to test alternative 
187.33 	and innovative integrated health care delivery systems partnerships, including accountable 
187.34 	care organizations that provide services to a specified patient population for an agreed-upon 
188.1 	total cost of care or risk/gain sharing payment arrangement. The commissioner shall develop 
188.2 	a request for proposals for participation in the demonstration project in consultation with 
188.3 	hospitals, primary care providers, health plans, and other key stakeholders.
188.4 	(b) In developing the request for proposals, the commissioner shall:
188.5 	(1) establish uniform statewide methods of forecasting utilization and cost of care for 
188.6 	the appropriate Minnesota public program populations, to be used by the commissioner for 
188.7 	the health care delivery system integrated health partnership projects;
188.8 	(2) identify key indicators of quality, access, patient satisfaction, and other performance 
188.9 	indicators that will be measured, in addition to indicators for measuring cost savings;
188.10 	(3) allow maximum flexibility to encourage innovation and variation so that a variety 
188.11 	of provider collaborations are able to become health care delivery systems integrated health 
188.12 	partnerships, and may be customized for the special needs and barriers of patient populations 
188.13 	experiencing health disparities due to social, economic, racial, or ethnic factors,;
188.14 	(4) encourage and authorize different levels and types of financial risk;
188.15 	(5) encourage and authorize projects representing a wide variety of geographic locations, 
188.16 	patient populations, provider relationships, and care coordination models;
188.17 	(6) encourage projects that involve close partnerships between the health care delivery 
188.18 	system integrated health partnership and counties and nonprofit agencies that provide services 
188.19 	to patients enrolled with the health care delivery system integrated health partnership, 
188.20 	including social services, public health, mental health, community-based services, and 
188.21 	continuing care;
188.22 	(7) encourage projects established by community hospitals, clinics, and other providers 
188.23 	in rural communities;
188.24 	(8) identify required covered services for a total cost of care model or services considered 
188.25 	in whole or partially in an analysis of utilization for a risk/gain sharing model;
188.26 	(9) establish a mechanism to monitor enrollment;
188.27 	(10) establish quality standards for the delivery system integrated health partnership
188.28 	demonstrations that are appropriate for the particular patient population to be served; and
188.29 	(11) encourage participation of privately insured population so as to create sufficient 
188.30 	alignment in demonstration systems.
188.31 	(c) To be eligible to participate in the demonstration project an integrated health 
188.32 	partnership, a health care delivery system must:
189.1 	(1) provide required covered services and care coordination to recipients enrolled in the 
189.2 	health care delivery system integrated health partnership;
189.3 	(2) establish a process to monitor enrollment and ensure the quality of care provided;
189.4 	(3) in cooperation with counties and community social service agencies, coordinate the 
189.5 	delivery of health care services with existing social services programs;
189.6 	(4) provide a system for advocacy and consumer protection; and
189.7 	(5) adopt innovative and cost-effective methods of care delivery and coordination, which 
189.8 	may include the use of allied health professionals, telemedicine, patient educators, care 
189.9 	coordinators, and community health workers.
189.10 	(d) A health care delivery system An integrated health partnership demonstration may 
189.11 	be formed by the following groups of providers of services and suppliers if they have 
189.12 	established a mechanism for shared governance:
189.13 	(1) professionals in group practice arrangements;
189.14 	(2) networks of individual practices of professionals;
189.15 	(3) partnerships or joint venture arrangements between hospitals and health care 
189.16 	professionals;
189.17 	(4) hospitals employing professionals; and
189.18 	(5) other groups of providers of services and suppliers as the commissioner determines 
189.19 	appropriate.
189.20 	A managed care plan or county-based purchasing plan may participate in this 
189.21 	demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).
189.22 	A health care delivery system An integrated health partnership may contract with a 
189.23 	managed care plan or a county-based purchasing plan to provide administrative services, 
189.24 	including the administration of a payment system using the payment methods established 
189.25 	by the commissioner for health care delivery systems integrated health partnerships.
189.26 	(e) The commissioner may require a health care delivery system an integrated health 
189.27 	partnership to enter into additional third-party contractual relationships for the assessment 
189.28 	of risk and purchase of stop loss insurance or another form of insurance risk management 
189.29 	related to the delivery of care described in paragraph (c).

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

190.1 	Sec. 26. Minnesota Statutes 2016, section 256B.0755, subdivision 3, is amended to read:
190.2 		Subd. 3.Accountability. (a) Health care delivery systems Integrated health partnerships
190.3 	must accept responsibility for the quality of care based on standards established under 
190.4 	subdivision 1, paragraph (b), clause (10), and the cost of care or utilization of services 
190.5 	provided to its enrollees under subdivision 1, paragraph (b), clause (1). Accountability 
190.6 	standards must be appropriate to the particular population served.
190.7 	(b) A health care delivery system An integrated health partnership may contract and 
190.8 	coordinate with providers and clinics for the delivery of services and shall contract with 
190.9 	community health clinics, federally qualified health centers, community mental health 
190.10 	centers or programs, county agencies, and rural clinics to the extent practicable.
190.11 	(c) A health care delivery system An integrated health partnership must indicate how it 
190.12 	will coordinate with other services affecting its patients' health, quality of care, and cost of 
190.13 	care that are provided by other providers, county agencies, and other organizations in the 
190.14 	local service area. The health care delivery system integrated health partnership must indicate 
190.15 	how it will engage other providers, counties, and organizations, including county-based 
190.16 	purchasing plans, that provide services to patients of the health care delivery system
190.17 	integrated health partnership on issues related to local population health, including applicable 
190.18 	local needs, priorities, and public health goals. The health care delivery system integrated 
190.19 	health partnership must describe how local providers, counties, organizations, including 
190.20 	county-based purchasing plans, and other relevant purchasers were consulted in developing 
190.21 	the application to participate in the demonstration project.

190.22 	Sec. 27. Minnesota Statutes 2016, section 256B.0755, subdivision 4, is amended to read:
190.23 		Subd. 4.Payment system. (a) In developing a payment system for health care delivery 
190.24 	systems integrated health partnerships, the commissioner shall establish a total cost of care 
190.25 	benchmark or a risk/gain sharing payment model to be paid for services provided to the 
190.26 	recipients enrolled in a health care delivery system an integrated health partnership.
190.27 	(b) The payment system may include incentive payments to health care delivery systems
190.28 	integrated health partnerships that meet or exceed annual quality and performance targets 
190.29 	realized through the coordination of care.
190.30 	(c) An amount equal to the savings realized to the general fund as a result of the 
190.31 	demonstration project shall be transferred each fiscal year to the health care access fund.
190.32 	(d) The payment system shall include a population-based payment that supports care 
190.33 	coordination services for all enrollees served by the integrated health partnerships, and is 
191.1 	risk-adjusted to reflect varying levels of care coordination intensiveness for enrollees with 
191.2 	chronic conditions, limited English skills, cultural differences, or other barriers to health 
191.3 	care. The population-based payment shall be a per member, per month payment paid at least 
191.4 	on a quarterly basis. Integrated health partnerships receiving this payment must continue 
191.5 	to meet cost and quality metrics under the program to maintain eligibility for the 
191.6 	population-based payment. An integrated health partnership is eligible to receive a payment 
191.7 	under this paragraph even if the partnership is not participating in a risk-based or gain-sharing 
191.8 	payment model and regardless of the size of the patient population served by the integrated 
191.9 	health partnership. Any integrated health partnership participant certified as a health care 
191.10 	home under section 256B.0751 that agrees to a payment method that includes 
191.11 	population-based payments for care coordination is not eligible to receive health care home 
191.12 	payment or care coordination fee authorized under section 62U.03 or 256B.0753, subdivision 
191.13 	1, or in-reach care coordination under section 256B.0625, subdivision 56, for any medical 
191.14 	assistance or MinnesotaCare recipients enrolled or attributed to the integrated health 
191.15 	partnership under this demonstration.

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

191.17 	Sec. 28. Minnesota Statutes 2016, section 256B.0755, is amended by adding a subdivision 
191.18 	to read:
191.19 		Subd. 9.Patient incentives. The commissioner may authorize an integrated health 
191.20 	partnership to provide financial incentives for patients to:
191.21 	(1) see a primary care provider for an initial health assessment;
191.22 	(2) maintain a continuous relationship with the primary care provider; and
191.23 	(3) participate in ongoing health improvement and coordination of care activities.

191.24 	Sec. 29. Minnesota Statutes 2016, section 256B.0924, is amended by adding a subdivision 
191.25 	to read:
191.26 		Subd. 4a.Targeted case management through interactive video. (a) Subject to federal 
191.27 	approval, contact made for targeted case management by interactive video shall be eligible 
191.28 	for payment under subdivision 6 if:
191.29 	(1) the person receiving targeted case management services is residing in:
191.30 	(i) a hospital;
191.31 	(ii) a nursing facility; or
192.1 	(iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging 
192.2 	establishment or lodging establishment that provides supportive services or health supervision 
192.3 	services according to section 157.17 that is staffed 24 hours a day, seven days a week;
192.4 	(2) interactive video is in the best interests of the person and is deemed appropriate by 
192.5 	the person receiving targeted case management or the person's legal guardian, the case 
192.6 	management provider, and the provider operating the setting where the person is residing;
192.7 	(3) the use of interactive video is approved as part of the person's written personal service 
192.8 	or case plan; and
192.9 	(4) interactive video is used for up to, but not more than, 50 percent of the minimum 
192.10 	required face-to-face contact.
192.11 	(b) The person receiving targeted case management or the person's legal guardian has 
192.12 	the right to choose and consent to the use of interactive video under this subdivision and 
192.13 	has the right to refuse the use of interactive video at any time.
192.14 	(c) The commissioner shall establish criteria that a targeted case management provider 
192.15 	must attest to in order to demonstrate the safety or efficacy of delivering the service via 
192.16 	interactive video. The attestation may include that the case management provider has:
192.17 	(1) written policies and procedures specific to interactive video services that are regularly 
192.18 	reviewed and updated;
192.19 	(2) policies and procedures that adequately address client safety before, during, and after 
192.20 	the interactive video services are rendered;
192.21 	(3) established protocols addressing how and when to discontinue interactive video 
192.22 	services; and
192.23 	(4) established a quality assurance process related to interactive video services.
192.24 	(d) As a condition of payment, the targeted case management provider must document 
192.25 	the following for each occurrence of targeted case management provided by interactive 
192.26 	video:
192.27 	(1) the time the service began and the time the service ended, including an a.m. and p.m. 
192.28 	designation;
192.29 	(2) the basis for determining that interactive video is an appropriate and effective means 
192.30 	for delivering the service to the person receiving case management services;
192.31 	(3) the mode of transmission of the interactive video services and records evidencing 
192.32 	that a particular mode of transmission was utilized;
193.1 	(4) the location of the originating site and the distant site; and
193.2 	(5) compliance with the criteria attested to by the targeted case management provider 
193.3 	as provided in paragraph (c).

193.4 	EFFECTIVE DATE. This section is effective three months after federal approval.

193.5 	Sec. 30. Minnesota Statutes 2016, section 256B.196, subdivision 2, is amended to read:
193.6 		Subd. 2.Commissioner's duties. (a) For the purposes of this subdivision and subdivision 
193.7 	3, the commissioner shall determine the fee-for-service outpatient hospital services upper 
193.8 	payment limit for nonstate government hospitals. The commissioner shall then determine 
193.9 	the amount of a supplemental payment to Hennepin County Medical Center and Regions 
193.10 	Hospital for these services that would increase medical assistance spending in this category 
193.11 	to the aggregate upper payment limit for all nonstate government hospitals in Minnesota. 
193.12 	In making this determination, the commissioner shall allot the available increases between 
193.13 	Hennepin County Medical Center and Regions Hospital based on the ratio of medical 
193.14 	assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner 
193.15 	shall adjust this allotment as necessary based on federal approvals, the amount of 
193.16 	intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors, 
193.17 	in order to maximize the additional total payments. The commissioner shall inform Hennepin 
193.18 	County and Ramsey County of the periodic intergovernmental transfers necessary to match 
193.19 	federal Medicaid payments available under this subdivision in order to make supplementary 
193.20 	medical assistance payments to Hennepin County Medical Center and Regions Hospital 
193.21 	equal to an amount that when combined with existing medical assistance payments to 
193.22 	nonstate governmental hospitals would increase total payments to hospitals in this category 
193.23 	for outpatient services to the aggregate upper payment limit for all hospitals in this category 
193.24 	in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make 
193.25 	supplementary payments to Hennepin County Medical Center and Regions Hospital.
193.26 	(b) For the purposes of this subdivision and subdivision 3, the commissioner shall 
193.27 	determine an upper payment limit for physicians and other billing professionals affiliated 
193.28 	with Hennepin County Medical Center and with Regions Hospital. The upper payment limit 
193.29 	shall be based on the average commercial rate or be determined using another method 
193.30 	acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall 
193.31 	inform Hennepin County and Ramsey County of the periodic intergovernmental transfers 
193.32 	necessary to match the federal Medicaid payments available under this subdivision in order 
193.33 	to make supplementary payments to physicians and other billing professionals affiliated 
193.34 	with Hennepin County Medical Center and to make supplementary payments to physicians 
194.1 	and other billing professionals affiliated with Regions Hospital through HealthPartners 
194.2 	Medical Group equal to the difference between the established medical assistance payment 
194.3 	for physician and other billing professional services and the upper payment limit. Upon 
194.4 	receipt of these periodic transfers, the commissioner shall make supplementary payments 
194.5 	to physicians and other billing professionals affiliated with Hennepin County Medical Center 
194.6 	and shall make supplementary payments to physicians and other billing professionals 
194.7 	affiliated with Regions Hospital through HealthPartners Medical Group.
194.8 	(c) Beginning January 1, 2010, Hennepin County and Ramsey County may make monthly 
194.9 	voluntary intergovernmental transfers to the commissioner in amounts not to exceed 
194.10 	$12,000,000 per year from Hennepin County and $6,000,000 per year from Ramsey County. 
194.11 	The commissioner shall increase the medical assistance capitation payments to any licensed 
194.12 	health plan under contract with the medical assistance program that agrees to make enhanced 
194.13 	payments to Hennepin County Medical Center or Regions Hospital. The increase shall be 
194.14 	in an amount equal to the annual value of the monthly transfers plus federal financial 
194.15 	participation, with each health plan receiving its pro rata share of the increase based on the 
194.16 	pro rata share of medical assistance admissions to Hennepin County Medical Center and 
194.17 	Regions Hospital by those plans. For the purposes of this paragraph, "the base amount" 
194.18 	means the total annual value of increased medical assistance capitation payments under this 
194.19 	paragraph in state fiscal year 2018. For managed care contracts beginning on or after July 
194.20 	1, 2018, the commissioner shall reduce the total annual value of increased medical assistance 
194.21 	capitation payments under this paragraph by an amount equal to ten percent of the base 
194.22 	amount, and by an additional ten percent of the base amount for each subsequent contract 
194.23 	year until June 30, 2025. Upon the request of the commissioner, health plans shall submit 
194.24 	individual-level cost data for verification purposes. The commissioner may ratably reduce 
194.25 	these payments on a pro rata basis in order to satisfy federal requirements for actuarial 
194.26 	soundness. If payments are reduced, transfers shall be reduced accordingly. Any licensed 
194.27 	health plan that receives increased medical assistance capitation payments under the 
194.28 	intergovernmental transfer described in this paragraph shall increase its medical assistance 
194.29 	payments to Hennepin County Medical Center and Regions Hospital by the same amount 
194.30 	as the increased payments received in the capitation payment described in this paragraph.
194.31 	This paragraph expires on July 1, 2025.
194.32 	(d) For the purposes of this subdivision and subdivision 3, the commissioner shall 
194.33 	determine an upper payment limit for ambulance services affiliated with Hennepin County 
194.34 	Medical Center and the city of St. Paul. The upper payment limit shall be based on the 
194.35 	average commercial rate or be determined using another method acceptable to the Centers 
195.1 	for Medicare and Medicaid Services. The commissioner shall inform Hennepin County and 
195.2 	the city of St. Paul of the periodic intergovernmental transfers necessary to match the federal 
195.3 	Medicaid payments available under this subdivision in order to make supplementary 
195.4 	payments to Hennepin County Medical Center and the city of St. Paul equal to the difference 
195.5 	between the established medical assistance payment for ambulance services and the upper 
195.6 	payment limit. Upon receipt of these periodic transfers, the commissioner shall make 
195.7 	supplementary payments to Hennepin County Medical Center and the city of St. Paul.
195.8 	(e) The commissioner shall inform the transferring governmental entities on an ongoing 
195.9 	basis of the need for any changes needed in the intergovernmental transfers in order to 
195.10 	continue the payments under paragraphs (a) to (d), at their maximum level, including 
195.11 	increases in upper payment limits, changes in the federal Medicaid match, and other factors.
195.12 	(f) The payments in paragraphs (a) to (d) shall be implemented independently of each 
195.13 	other, subject to federal approval and to the receipt of transfers under subdivision 3.

195.14 	Sec. 31. Minnesota Statutes 2016, section 256B.69, subdivision 9e, is amended to read:
195.15 		Subd. 9e.Financial audits. (a) The legislative auditor shall conduct or contract with 
195.16 	vendors to conduct independent third-party financial audits of the information required to 
195.17 	be provided by audit managed care plans and county-based purchasing plans under 
195.18 	subdivision 9c, paragraph (b). The audits by the vendors shall be conducted as vendor 
195.19 	resources permit and in accordance with generally accepted government auditing standards 
195.20 	issued by the United States Government Accountability Office. The contract with the vendors 
195.21 	shall be designed and administered so as to render the independent third-party audits eligible 
195.22 	for a federal subsidy, if available. The contract shall require the audits to include a 
195.23 	determination of compliance with the federal Medicaid rate certification process to determine 
195.24 	if a managed care plan or county-based purchasing plan used public money in compliance 
195.25 	with federal and state laws, rules, and in accordance with provisions in the plan's contract 
195.26 	with the commissioner. The legislative auditor shall conduct the audits in accordance with 
195.27 	section 3.972, subdivision 2b.
195.28 	(b) For purposes of this subdivision, "independent third-party" means a vendor that is 
195.29 	independent in accordance with government auditing standards issued by the United States 
195.30 	Government Accountability Office.

195.31 	Sec. 32. Minnesota Statutes 2016, section 256B.76, subdivision 1, is amended to read:
195.32 		Subdivision 1.Physician reimbursement.  (a) Effective for services rendered on or after 
195.33 	October 1, 1992, the commissioner shall make payments for physician services as follows:
196.1 	(1) payment for level one Centers for Medicare and Medicaid Services' common 
196.2 	procedural coding system codes titled "office and other outpatient services," "preventive 
196.3 	medicine new and established patient," "delivery, antepartum, and postpartum care," "critical 
196.4 	care," cesarean delivery and pharmacologic management provided to psychiatric patients, 
196.5 	and level three codes for enhanced services for prenatal high risk, shall be paid at the lower 
196.6 	of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992. If the 
196.7 	rate on any procedure code within these categories is different than the rate that would have 
196.8 	been paid under the methodology in section 256B.74, subdivision 2, then the larger rate 
196.9 	shall be paid;
196.10 	(2) payments for all other services shall be paid at the lower of (i) submitted charges, 
196.11 	or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
196.12 	(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th 
196.13 	percentile of 1989, less the percent in aggregate necessary to equal the above increases 
196.14 	except that payment rates for home health agency services shall be the rates in effect on 
196.15 	September 30, 1992.
196.16 	(b) Effective for services rendered on or after January 1, 2000, payment rates for physician 
196.17 	and professional services shall be increased by three percent over the rates in effect on 
196.18 	December 31, 1999, except for home health agency and family planning agency services. 
196.19 	The increases in this paragraph shall be implemented January 1, 2000, for managed care.
196.20 	(c) Effective for services rendered on or after July 1, 2009, payment rates for physician 
196.21 	and professional services shall be reduced by five percent, except that for the period July 
196.22 	1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical 
196.23 	assistance and general assistance medical care programs, over the rates in effect on June 
196.24 	30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other 
196.25 	outpatient visits, preventive medicine visits and family planning visits billed by physicians, 
196.26 	advanced practice nurses, or physician assistants in a family planning agency or in one of 
196.27 	the following primary care practices: general practice, general internal medicine, general 
196.28 	pediatrics, general geriatrics, and family medicine. This reduction and the reductions in 
196.29 	paragraph (d) do not apply to federally qualified health centers, rural health centers, and 
196.30 	Indian health services. Effective October 1, 2009, payments made to managed care plans 
196.31 	and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall 
196.32 	reflect the payment reduction described in this paragraph.
196.33 	(d) Effective for services rendered on or after July 1, 2010, payment rates for physician 
196.34 	and professional services shall be reduced an additional seven percent over the five percent 
197.1 	reduction in rates described in paragraph (c). This additional reduction does not apply to 
197.2 	physical therapy services, occupational therapy services, and speech pathology and related 
197.3 	services provided on or after July 1, 2010. This additional reduction does not apply to 
197.4 	physician services billed by a psychiatrist or an advanced practice nurse with a specialty in 
197.5 	mental health. Effective October 1, 2010, payments made to managed care plans and 
197.6 	county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect 
197.7 	the payment reduction described in this paragraph.
197.8 	(e) Effective for services rendered on or after September 1, 2011, through June 30, 2013, 
197.9 	payment rates for physician and professional services shall be reduced three percent from 
197.10 	the rates in effect on August 31, 2011. This reduction does not apply to physical therapy 
197.11 	services, occupational therapy services, and speech pathology and related services.
197.12 	(f) Effective for services rendered on or after September 1, 2014, payment rates for 
197.13 	physician and professional services, including physical therapy, occupational therapy, speech 
197.14 	pathology, and mental health services shall be increased by five percent from the rates in 
197.15 	effect on August 31, 2014. In calculating this rate increase, the commissioner shall not 
197.16 	include in the base rate for August 31, 2014, the rate increase provided under section 
197.17 	256B.76, subdivision 7. This increase does not apply to federally qualified health centers, 
197.18 	rural health centers, and Indian health services. Payments made to managed care plans and 
197.19 	county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.
197.20 	(g) Effective for services rendered on or after July 1, 2015, payment rates for physical 
197.21 	therapy, occupational therapy, and speech pathology and related services provided by a 
197.22 	hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause 
197.23 	(4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments 
197.24 	made to managed care plans and county-based purchasing plans shall not be adjusted to 
197.25 	reflect payments under this paragraph.
197.26 	(h) Effective for services provided on or after July 1, 2017, through June 30, 2019, 
197.27 	payment rates for physician and professional services, shall be reduced by 2.3 percent, and 
197.28 	effective for services provided on or after July 1, 2019, payments shall be reduced by three 
197.29 	percent. Payments made to managed care plans and county-based purchasing plans shall 
197.30 	be adjusted to reflect the rate reductions in this paragraph effective January 1, 2018. The 
197.31 	services identified in paragraph (g) are not included in the rate reduction described in this 
197.32 	paragraph.

198.1 	Sec. 33. Minnesota Statutes 2016, section 256B.76, subdivision 2, is amended to read:
198.2 		Subd. 2.Dental reimbursement.  (a) Effective for services rendered on or after October 
198.3 	1, 1992, the commissioner shall make payments for dental services as follows:
198.4 	(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent 
198.5 	above the rate in effect on June 30, 1992; and
198.6 	(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile 
198.7 	of 1989, less the percent in aggregate necessary to equal the above increases.
198.8 	(b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments 
198.9 	shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
198.10 	(c) Effective for services rendered on or after January 1, 2000, payment rates for dental 
198.11 	services shall be increased by three percent over the rates in effect on December 31, 1999.
198.12 	(d) Effective for services provided on or after January 1, 2002, payment for diagnostic 
198.13 	examinations and dental x-rays provided to children under age 21 shall be the lower of (1) 
198.14 	the submitted charge, or (2) 85 percent of median 1999 charges.
198.15 	(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000, 
198.16 	for managed care.
198.17 	(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated 
198.18 	dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare 
198.19 	principles of reimbursement. This payment shall be effective for services rendered on or 
198.20 	after January 1, 2011, to recipients enrolled in managed care plans or county-based 
198.21 	purchasing plans.
198.22 	(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in 
198.23 	paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a 
198.24 	supplemental state payment equal to the difference between the total payments in paragraph 
198.25 	(f) and $1,850,000 shall be paid from the general fund to state-operated services for the 
198.26 	operation of the dental clinics.
198.27 	(h) If the cost-based payment system for state-operated dental clinics described in 
198.28 	paragraph (f) does not receive federal approval, then state-operated dental clinics shall be 
198.29 	designated as critical access dental providers under subdivision 4, paragraph (b), and shall 
198.30 	receive the critical access dental reimbursement rate as described under subdivision 4, 
198.31 	paragraph (a).
199.1 	(i) Effective for services rendered on or after September 1, 2011, through June 30, 2013, 
199.2 	payment rates for dental services shall be reduced by three percent. This reduction does not 
199.3 	apply to state-operated dental clinics in paragraph (f).
199.4 	(j) (h) Effective for services rendered on or after January 1, 2014, payment rates for 
199.5 	dental services shall be increased by five percent from the rates in effect on December 31, 
199.6 	2013. This increase does not apply to state-operated dental clinics in paragraph (f), federally 
199.7 	qualified health centers, rural health centers, and Indian health services. Effective January 
199.8 	1, 2014, payments made to managed care plans and county-based purchasing plans under 
199.9 	sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase described in 
199.10 	this paragraph.
199.11 	(k) Effective for services rendered on or after July 1, 2015, through December 31, 2016, 
199.12 	the commissioner shall increase payment rates for services furnished by dental providers 
199.13 	located outside of the seven-county metropolitan area by the maximum percentage possible 
199.14 	above the rates in effect on June 30, 2015, while remaining within the limits of funding 
199.15 	appropriated for this purpose. This increase does not apply to state-operated dental clinics 
199.16 	in paragraph (f), federally qualified health centers, rural health centers, and Indian health 
199.17 	services. Effective January 1, 2016, through December 31, 2016, payments to managed care 
199.18 	plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect 
199.19 	the payment increase described in this paragraph. The commissioner shall require managed 
199.20 	care and county-based purchasing plans to pass on the full amount of the increase, in the 
199.21 	form of higher payment rates to dental providers located outside of the seven-county 
199.22 	metropolitan area.
199.23 	(l) (i) Effective for services provided on or after January 1, 2017, through June 30, 2017,
199.24 	the commissioner shall increase payment rates by 9.65 percent for dental services provided 
199.25 	outside of the seven-county metropolitan area. This increase does not apply to state-operated 
199.26 	dental clinics in paragraph (f), federally qualified health centers, rural health centers, or 
199.27 	Indian health services. Effective January 1, 2017, through June 30, 2017, payments to 
199.28 	managed care plans and county-based purchasing plans under sections 256B.69 and 256B.692
199.29 	shall reflect the payment increase described in this paragraph.
199.30 	(j) Effective for services rendered on or after July 1, 2017, payment rates for dental 
199.31 	services shall be increased by 25 percent. This increase does not apply to state-operated 
199.32 	dental clinics in paragraph (f), federally qualified health centers, rural health centers, and 
199.33 	Indian health services when an encounter rate is paid. Payments made to managed care 
199.34 	plans and county-based purchasing plans shall not be adjusted to reflect the payment increase 
199.35 	described in this paragraph.

200.1 	Sec. 34. [256B.7635] REIMBURSEMENT FOR EVIDENCE-BASED PUBLIC 
200.2 	HEALTH NURSE HOME VISITS.
200.3 	Effective for services provided on or after January 1, 2018, prenatal and postpartum 
200.4 	follow-up home visits provided by public health nurses or registered nurses supervised by 
200.5 	a public health nurse using evidence-based models shall be paid a minimum of $140 per 
200.6 	visit. Evidence-based postpartum follow-up home visits must be administered by home 
200.7 	visiting programs that meet the United States Department of Health and Human Services 
200.8 	criteria for evidence-based models and are identified by the commissioner of health as 
200.9 	eligible to be implemented under the Maternal, Infant, and Early Childhood Home Visiting 
200.10 	program. Home visits must target mothers and their children beginning with prenatal visits 
200.11 	through age three for the child.

200.12 	Sec. 35. Minnesota Statutes 2016, section 256B.766, is amended to read:
200.13 	256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
200.14 	(a) Effective for services provided on or after July 1, 2009, total payments for basic care 
200.15 	services, shall be reduced by three percent, except that for the period July 1, 2009, through 
200.16 	June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance 
200.17 	and general assistance medical care programs, prior to third-party liability and spenddown 
200.18 	calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services, 
200.19 	occupational therapy services, and speech-language pathology and related services as basic 
200.20 	care services. The reduction in this paragraph shall apply to physical therapy services, 
200.21 	occupational therapy services, and speech-language pathology and related services provided 
200.22 	on or after July 1, 2010.
200.23 	(b) Payments made to managed care plans and county-based purchasing plans shall be 
200.24 	reduced for services provided on or after October 1, 2009, to reflect the reduction effective 
200.25 	July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010, 
200.26 	to reflect the reduction effective July 1, 2010.
200.27 	(c) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
200.28 	total payments for outpatient hospital facility fees shall be reduced by five percent from the 
200.29 	rates in effect on August 31, 2011.
200.30 	(d) Effective for services provided on or after September 1, 2011, through June 30, 2013, 
200.31 	total payments for ambulatory surgery centers facility fees, medical supplies and durable 
200.32 	medical equipment not subject to a volume purchase contract, prosthetics and orthotics, 
200.33 	renal dialysis services, laboratory services, public health nursing services, physical therapy 
201.1 	services, occupational therapy services, speech therapy services, eyeglasses not subject to 
201.2 	a volume purchase contract, hearing aids not subject to a volume purchase contract, and 
201.3 	anesthesia services shall be reduced by three percent from the rates in effect on August 31, 
201.4 	2011.
201.5 	(e) Effective for services provided on or after September 1, 2014, payments for 
201.6 	ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory 
201.7 	services, public health nursing services, eyeglasses not subject to a volume purchase contract, 
201.8 	and hearing aids not subject to a volume purchase contract shall be increased by three percent 
201.9 	and payments for outpatient hospital facility fees shall be increased by three percent. 
201.10 	Payments made to managed care plans and county-based purchasing plans shall not be 
201.11 	adjusted to reflect payments under this paragraph.
201.12 	(f) Payments for medical supplies and durable medical equipment not subject to a volume 
201.13 	purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through 
201.14 	June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable 
201.15 	medical equipment not subject to a volume purchase contract, and prosthetics and orthotics, 
201.16 	provided on or after July 1, 2015, shall be increased by three percent from the rates as 
201.17 	determined under paragraphs (i) and (j).
201.18 	(g) Effective for services provided on or after July 1, 2015, payments for outpatient 
201.19 	hospital facility fees, medical supplies and durable medical equipment not subject to a 
201.20 	volume purchase contract, prosthetics, and orthotics, and laboratory services to a hospital 
201.21 	meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4), 
201.22 	shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made 
201.23 	to managed care plans and county-based purchasing plans shall not be adjusted to reflect 
201.24 	payments under this paragraph.
201.25 	(h) This section does not apply to physician and professional services, inpatient hospital 
201.26 	services, family planning services, mental health services, dental services, prescription 
201.27 	drugs, medical transportation, federally qualified health centers, rural health centers, Indian 
201.28 	health services, and Medicare cost-sharing.
201.29 	(i) Effective for services provided on or after July 1, 2015, the following categories of 
201.30 	durable medical equipment shall be individually priced items: enteral nutrition and supplies, 
201.31 	customized and other specialized tracheostomy tubes and supplies, electric patient lifts, and 
201.32 	durable medical equipment repair and service. This paragraph does not apply to medical 
201.33 	supplies and durable medical equipment subject to a volume purchase contract, products 
201.34 	subject to the preferred diabetic testing supply program, and items provided to dually eligible 
202.1 	recipients when Medicare is the primary payer for the item. The commissioner shall not 
202.2 	apply any medical assistance rate reductions to durable medical equipment as a result of 
202.3 	Medicare competitive bidding.
202.4 	(j) Effective for services provided on or after July 1, 2015, medical assistance payment 
202.5 	rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased 
202.6 	as follows:
202.7 	(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that 
202.8 	were subject to the Medicare competitive bid that took effect in January of 2009 shall be 
202.9 	increased by 9.5 percent; and
202.10 	(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on 
202.11 	the medical assistance fee schedule, whether or not subject to the Medicare competitive bid 
202.12 	that took effect in January of 2009, shall be increased by 2.94 percent, with this increase 
202.13 	being applied after calculation of any increased payment rate under clause (1).
202.14 	This paragraph does not apply to medical supplies and durable medical equipment subject 
202.15 	to a volume purchase contract, products subject to the preferred diabetic testing supply 
202.16 	program, items provided to dually eligible recipients when Medicare is the primary payer 
202.17 	for the item, and individually priced items identified in paragraph (i). Payments made to 
202.18 	managed care plans and county-based purchasing plans shall not be adjusted to reflect the 
202.19 	rate increases in this paragraph.
202.20 	(k) Effective for services provided on or after July 1, 2017, through June 30, 2019, 
202.21 	payments for basic care services, including physical therapy services; occupational therapy 
202.22 	services; speech language pathology and related services; ambulatory surgical center facility 
202.23 	fees; medical supplies and durable medical equipment, not subject to a volume purchase 
202.24 	contract; prosthetics; orthotics; renal dialysis services; laboratory services; public health 
202.25 	nursing services; eyeglasses, not subject to a volume purchase contract; hearing aids, not 
202.26 	subject to a volume purchase contract; and anesthesia services shall be reduced by 2.3 
202.27 	percent and effective for services provided on or after July 1, 2019, payments shall be 
202.28 	reduced by three percent. Payments made to managed care plans and county-based purchasing 
202.29 	plans shall be adjusted to reflect the rate reduction in this paragraph effective January 1, 
202.30 	2018. The services identified in paragraph (g) are not included in the rate reduction described 
202.31 	in this paragraph. The services described under section 256B.0625, subdivision 58, are 
202.32 	included in the rate reduction described in this paragraph.

202.33 	EFFECTIVE DATE. The amendment in paragraph (g) is effective the day following 
202.34 	final enactment.

203.1 	Sec. 36. Minnesota Statutes 2016, section 256L.03, subdivision 1, is amended to read:
203.2 		Subdivision 1.Covered health services. (a) "Covered health services" means the health 
203.3 	services reimbursed under chapter 256B, with the exception of special education services, 
203.4 	home care nursing services, adult dental care services other than services covered under 
203.5 	section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation 
203.6 	services, personal care assistance and case management services, and nursing home or 
203.7 	intermediate care facilities services.
203.8 	(b) No public funds shall be used for coverage of abortion under MinnesotaCare except 
203.9 	where the life of the female would be endangered or substantial and irreversible impairment 
203.10 	of a major bodily function would result if the fetus were carried to term; or where the 
203.11 	pregnancy is the result of rape or incest.
203.12 	(c) Covered health services shall be expanded as provided in this section.
203.13 	(d) For the purposes of covered health services under this section, "child" means an 
203.14 	individual younger than 19 years of age.

203.15 	Sec. 37. Minnesota Statutes 2016, section 256L.03, subdivision 1a, is amended to read:
203.16 		Subd. 1a. Children; MinnesotaCare health care reform waiver.  Children are eligible 
203.17 	for coverage of all services that are eligible for reimbursement under the medical assistance 
203.18 	program according to chapter 256B, except special education services and that abortion 
203.19 	services under MinnesotaCare shall be limited as provided under subdivision 1. Children 
203.20 	are exempt from the provisions of subdivision 5, regarding co-payments. Children who are 
203.21 	lawfully residing in the United States but who are not "qualified noncitizens" under title IV 
203.22 	of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public 
203.23 	Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage of all 
203.24 	services provided under the medical assistance program according to chapter 256B.

203.25 	Sec. 38. Minnesota Statutes 2016, section 256L.03, subdivision 5, is amended to read:
203.26 		Subd. 5.Cost-sharing. (a) Except as otherwise provided in this subdivision, the 
203.27 	MinnesotaCare benefit plan shall include the following cost-sharing requirements for all 
203.28 	enrollees:
203.29 	(1) $3 per prescription for adult enrollees;
203.30 	(2) $25 for eyeglasses for adult enrollees;
204.1 	(3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an 
204.2 	episode of service which is required because of a recipient's symptoms, diagnosis, or 
204.3 	established illness, and which is delivered in an ambulatory setting by a physician or 
204.4 	physician assistant, chiropractor, podiatrist, nurse midwife, advanced practice nurse, 
204.5 	audiologist, optician, or optometrist;
204.6 	(4) $6 for nonemergency visits to a hospital-based emergency room for services provided 
204.7 	through December 31, 2010, and $3.50 effective January 1, 2011; and
204.8 	(5) a family deductible equal to $2.75 per month per family and adjusted annually by 
204.9 	the percentage increase in the medical care component of the CPI-U for the period of 
204.10 	September to September of the preceding calendar year, rounded to the next-higher five 
204.11 	cent increment.
204.12 	(b) Paragraph (a) does (a) Co-payments, coinsurance, and deductibles do not apply to 
204.13 	children under the age of 21 and to American Indians as defined in Code of Federal 
204.14 	Regulations, title 42, section 447.51 600.5.
204.15 	(c) Paragraph (a), clause (3), does not apply to mental health services.
204.16 	(d) MinnesotaCare reimbursements to fee-for-service providers and payments to managed 
204.17 	care plans or county-based purchasing plans shall not be increased as a result of the reduction 
204.18 	of the co-payments in paragraph (a), clause (4), effective January 1, 2011.
204.19 	(e) The commissioner, through the contracting process under section 256L.12, may 
204.20 	allow managed care plans and county-based purchasing plans to waive the family deductible 
204.21 	under paragraph (a), clause (5). The value of the family deductible shall not be included in 
204.22 	the capitation payment to managed care plans and county-based purchasing plans. Managed 
204.23 	care plans and county-based purchasing plans shall certify annually to the commissioner 
204.24 	the dollar value of the family deductible.
204.25 	(f) (b) The commissioner shall increase adjust co-payments, coinsurance, and deductibles
204.26 	for covered services in a manner sufficient to reduce maintain the actuarial value of the 
204.27 	benefit to 94 percent. The cost-sharing changes described in this paragraph do not apply to 
204.28 	eligible recipients or services exempt from cost-sharing under state law. The cost-sharing 
204.29 	changes described in this paragraph shall not be implemented prior to January 1, 2016.
204.30 	(g) (c) The cost-sharing changes authorized under paragraph (f) (b) must satisfy the 
204.31 	requirements for cost-sharing under the Basic Health Program as set forth in Code of Federal 
204.32 	Regulations, title 42, sections 600.510 and 600.520.

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

205.1 	Sec. 39. Minnesota Statutes 2016, section 256L.15, subdivision 2, is amended to read:
205.2 		Subd. 2.Sliding fee scale; monthly individual or family income. (a) The commissioner 
205.3 	shall establish a sliding fee scale to determine the percentage of monthly individual or family 
205.4 	income that households at different income levels must pay to obtain coverage through the 
205.5 	MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly 
205.6 	individual or family income.
205.7 	(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according 
205.8 	to the premium scale specified in paragraph (d).
205.9 	(c) Paragraph (b) does not apply to:
205.10 	(1) children 20 years of age or younger; and
205.11 	(2) individuals with household incomes below 35 percent of the federal poverty 
205.12 	guidelines.
205.13 	(d) The following premium scale is established for each individual in the household who 
205.14 	is 21 years of age or older and enrolled in MinnesotaCare:

205.15
205.16	Federal Poverty Guideline 
Greater than or Equal to
	Less than
	Individual Premium 
Amount
	
205.17	35%
	55%
	$4
	
205.18	55%
	80%
	$6
	
205.19	80%
	90%
	$8
	
205.20	90%
	100%
	$10
	
205.21	100%
	110%
	$12
	
205.22	110%
	120%
	$14
	
205.23	120%
	130%
	$15
	
205.24	130%
	140%
	$16
	
205.25	140%
	150%
	$25
	
205.26	150%
	160%
	$29 $37
	
205.27	160%
	170%
	$33 $44
	
205.28	170%
	180%
	$38 $52
	
205.29	180%
	190%
	$43 $61
	
205.30	190%
	200%
	$50 $71
	
205.31	200%
		$80

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

206.1 	Sec. 40. CAPITATION PAYMENT DELAY.
 206.2 	(a) The commissioner of human services shall delay $54,654,000 of the medical assistance 
206.3 	capitation payment to managed care plans and county-based purchasing plans due in April 
206.4 	2019 and all of the payment due in May 2019 and the payment due in April 2019 for special 
206.5 	needs basic care until July 1, 2019. The payment shall be made no earlier than July 1, 2019, 
206.6 	and no later than July 31, 2019.
206.7 	(b) The commissioner of human services shall delay the medical assistance capitation 
206.8 	payment to managed care plans and county-based purchasing plans due in April 2021 and 
206.9 	May 2021 and the payment due in April 2021 for special needs basic care until July 1, 2021. 
206.10 	The payment shall be made no earlier than July 1, 2021, and no later than July 31, 2021.

206.11 	Sec. 41. COMMISSIONER DUTY TO SEEK FEDERAL APPROVAL.
 206.12 	The commissioner of human services shall seek federal approval that is necessary to 
206.13 	implement Minnesota Statutes, sections 256B.0621, subdivision 10; 256B.0924, subdivision 
206.14 	4a; and 256B.0625, subdivision 20b, for interactive video contact.

206.15 	Sec. 42. LEGISLATIVE COMMISSION ON MANAGED CARE.
 206.16 		Subdivision 1.Establishment. (a) A legislative commission is created to study and 
206.17 	make recommendations to the legislature on issues relating to the competitive bidding 
206.18 	program and procurement process for the medical assistance and MinnesotaCare contracts 
206.19 	with managed care organizations for nonelderly, nondisabled adults and children enrollees.
206.20 	(b) For purposes of this section, "managed care organization" means a demonstration 
206.21 	provider as defined under Minnesota Statutes, section 256B.69, subdivision 2.
206.22 		Subd. 2.Membership. (a) The commission consists of:
206.23 	(1) four members of the senate, two members appointed by the senate majority leader 
206.24 	and two members appointed by the senate minority leader;
206.25 	(2) four members of the house of representatives, two members appointed by the speaker 
206.26 	of the house and two members appointed by the minority leader; and
206.27 	(3) the commissioner of human services or the commissioner's designee.
206.28 	(b) The appointing authorities must make their appointments by July 1, 2017.
206.29 	(c) The ranking senator from the majority party appointed to the commission shall 
206.30 	convene the first meeting no later than September 1, 2017.
207.1 	(d) The commission shall elect a chair among its members at the first meeting.
207.2 	(e) Members serve without compensation or reimbursement for expenses, except that 
207.3 	legislative members may receive per diem and be reimbursed for expenses as provided in 
207.4 	the rules governing their respective bodies.
207.5 		Subd. 3.Staff. The commissioner of human services shall provide staff and administrative 
207.6 	and research services, as needed, to the commission.
207.7 		Subd. 4.Duties. (a) The commission shall study, review, and make recommendations 
207.8 	on the competitive bidding process for the managed care contracts that provide services to 
207.9 	the nonelderly, nondisabled adults and children enrolled in medical assistance and 
207.10 	MinnesotaCare. When reviewing the competitive bidding process, the commission shall 
207.11 	consider and make recommendations on the following:
207.12 	(1) the number of geographic regions to be established for competitive bidding and each 
207.13 	procurement cycle and the criteria to be used in determining the minimum number of 
207.14 	managed care organizations to serve each region or statistical area;
207.15 	(2) the specifications of the request for proposals, including whether managed care 
207.16 	organizations must address in their proposals priority areas identified by counties;
207.17 	(3) the criteria to be used to determine whether managed care organizations will be 
207.18 	requested to provide a best and final offer;
207.19 	(4) the evaluation process that the commissioner must consider when evaluating each 
207.20 	proposal, including the scoring weight to be given when there is a county board resolution 
207.21 	identifying a managed care organization preference, and whether consideration shall be 
207.22 	given to network adequacy for such services as dental, mental health, and primary care;
207.23 	(5) the notification process to inform managed care organizations about the award 
207.24 	determinations, but before the contracts are signed;
207.25 	(6) process for appealing the commissioner's decision on the selection of a managed 
207.26 	care plan or county-based purchasing plan in a county or counties; and
207.27 	(7) whether an independent evaluation of the competitive bidding process is necessary, 
207.28 	and if so, what the evaluation should entail.
207.29 	(b) The commissioner shall consider the frequency of the procurement process in terms 
207.30 	of how often the commissioner should conduct the procurement of managed care contracts 
207.31 	and whether procurement should be conducted on a statewide basis or at staggered times 
207.32 	for a limited number of counties within a specified region.
208.1 	(c) The commission shall review proposed legislation that incorporates new federal 
208.2 	regulations into managed care statutes, including the recodification of the managed care 
208.3 	requirements in Minnesota Statutes, sections 256B.69 and 256B.692.
208.4 	(d) The commission shall study, review, and make recommendations on a process that 
208.5 	meets federal regulations for ensuring that provider rate increases passed by the legislature 
208.6 	and incorporated into the capitated rates paid to managed care organizations are recognized 
208.7 	in the rates paid by the managed care organizations to the providers while still providing 
208.8 	managed care organizations the flexibility in negotiating rates paid to their provider networks.
208.9 	(e) The commission shall consult with interested stakeholders and may solicit public 
208.10 	testimony, as deemed necessary.
208.11 		Subd. 5.Report. (a) The commission shall report its recommendations to the chairs and 
208.12 	ranking minority members of the legislative committees with jurisdiction over health and 
208.13 	human services policy and finance by February 15, 2018. The report shall include any draft 
208.14 	legislation necessary to implement the recommendations.
208.15 	(b) The commission shall provide preliminary recommendations to the commissioner 
208.16 	of human services to be used by the commissioner if the commissioner decides to conduct 
208.17 	a procurement for managed care contracts for the 2019 contract year.
208.18 		Subd. 6.Open meetings. The commission is subject to Minnesota Statutes, section 
208.19 	3.055.
208.20 		Subd. 7.Expiration. This section expires June 30, 2018.

208.21 	Sec. 43. HEALTH CARE ACCESS FUND ASSESSMENT.
 208.22 	(a) The commissioner of human services, in consultation with the commissioner of 
208.23 	management and budget, shall assess any federal health care reform legislation passed at 
208.24 	the federal level on its effect on the MinnesotaCare program and the need for the health 
208.25 	care access fund as its continued source of funding.
208.26 	(b) The commissioner shall report to the chairs and ranking minority members of the 
208.27 	legislative committees with jurisdiction over health care policy and finance within 90 days 
208.28 	of the passage of any federal health care reform legislation.

208.29 	Sec. 44. OPIOID USE AND ACUPUNCTURE STUDY.
 208.30 	(a) Within existing appropriations, the Human Services Policy Committee, established 
208.31 	under Minnesota Statutes, section 256B.0625, subdivision 3c, in consultation with the opioid 
209.1 	prescribing work group, shall study and compare the use of opiates for the treatment of 
209.2 	chronic pain conditions when acupuncture services are also part of the treatment for chronic 
209.3 	pain.
209.4 	(b) The committee shall identify a sample of medical assistance recipients who are 
209.5 	utilizing opiate prescriptions for the treatment of chronic pain, and a sample of recipients 
209.6 	who are utilizing opiate prescriptions as well as receiving or have received acupuncture 
209.7 	services as part of their treatment of chronic pain. The two sample groups must be similar 
209.8 	in pain diagnosis, co-morbidities, and demographic characteristics.
209.9 	(c) In comparing the sample groups, the committee shall look at each group's number 
209.10 	of opiate prescriptions filled, the number of refills, utilization of other health care services, 
209.11 	and the number of emergency room visits.
209.12 	(d) The committee shall report the aggregate findings of the study to the chairs and 
209.13 	ranking minority members of the senate and house of representatives legislative committees 
209.14 	with jurisdiction over health and human services policy and finance by February 15, 2018. 
209.15 	The report shall not contain or disclose any patient identifying data.

209.16 	Sec. 45. REVISOR'S INSTRUCTION.
 209.17 	The revisor of statutes, in the next edition of Minnesota Statutes, shall change the term 
209.18 	"health care delivery system" and similar terms to "integrated health partnership" and similar 
209.19 	terms, wherever it appears in Minnesota Statutes, section 256B.0755.

209.20 	Sec. 46.  REPEALER.
 209.21 	Minnesota Statutes 2016, sections 256B.0659, subdivision 22; 256B.19, subdivision 1c; 
209.22 	and 256B.64, are repealed.

209.23 	ARTICLE 5
209.24 	HEALTH INSURANCE

209.25 	Section 1. Minnesota Statutes 2016, section 62A.04, subdivision 1, is amended to read:
209.26 		Subdivision 1.Reference. Any reference to "standard provisions" which may appear in 
209.27 	other sections and which refer to accident and sickness or accident and health insurance 
209.28 	shall hereinafter be construed as referring to accident and sickness policy provisions. The 
209.29 	provisions of subdivision 2, clauses (4), (5), (6), (7), (8), (9), (10), and (12); subdivision 3, 
209.30 	clauses (1), (3), (4), (5), (6), and (7); subdivision 6; and subdivision 10 do not apply to 
210.1 	accident and sickness or accident and health insurance that are health plans defined in section 
210.2 	62A.011, subdivision 3.

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

210.5 	Sec. 2. Minnesota Statutes 2016, section 62A.21, subdivision 2a, is amended to read:
210.6 		Subd. 2a.Continuation privilege. Every policy described in subdivision 1 shall contain 
210.7 	a provision which permits continuation of coverage under the policy for the insured's former 
210.8 	spouse and dependent children upon as defined in section 62Q.01, subdivision 2a, and 
210.9 	former spouse, who was covered on the day before entry of a valid decree of dissolution of 
210.10 	marriage. The coverage shall be continued until the earlier of the following dates:
210.11 	(a) the date the insured's former spouse becomes covered under any other group health 
210.12 	plan; or
210.13 	(b) the date coverage would otherwise terminate under the policy.
210.14 	If the coverage is provided under a group policy, any required premium contributions 
210.15 	for the coverage shall be paid by the insured on a monthly basis to the group policyholder 
210.16 	for remittance to the insurer. The policy must require the group policyholder to, upon request, 
210.17 	provide the insured with written verification from the insurer of the cost of this coverage 
210.18 	promptly at the time of eligibility for this coverage and at any time during the continuation 
210.19 	period. In no event shall the amount of premium charged exceed 102 percent of the cost to 
210.20 	the plan for such period of coverage for other similarly situated spouses and dependent 
210.21 	children with respect to whom the marital relationship has not dissolved, without regard to 
210.22 	whether such cost is paid by the employer or employee.
210.23 	Upon request by the insured's former spouse or dependent child children and former 
210.24 	spouse, who was covered on the day before entry of a valid decree of dissolution, a health 
210.25 	carrier must provide the instructions necessary to enable the child or former spouse to elect 
210.26 	continuation of coverage.

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

210.29 	Sec. 3. Minnesota Statutes 2016, section 62A.3075, is amended to read:
210.30 	62A.3075 CANCER CHEMOTHERAPY TREATMENT COVERAGE.
211.1 	(a) A health plan company that provides coverage under a health plan for cancer 
211.2 	chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance 
211.3 	amount for a prescribed, orally administered anticancer medication that is used to kill or 
211.4 	slow the growth of cancerous cells than what the health plan requires for an intravenously 
211.5 	administered or injected cancer medication that is provided, regardless of formulation or 
211.6 	benefit category determination by the health plan company.
211.7 	(b) A health plan company must not achieve compliance with this section by imposing 
211.8 	an increase in co-payment, deductible, or coinsurance amount for an intravenously 
211.9 	administered or injected cancer chemotherapy agent covered under the health plan.
211.10 	(c) Nothing in this section shall be interpreted to prohibit a health plan company from 
211.11 	requiring prior authorization or imposing other appropriate utilization controls in approving 
211.12 	coverage for any chemotherapy.
211.13 	(d) A plan offered by the commissioner of management and budget under section 43A.23
211.14 	is deemed to be at parity and in compliance with this section.
211.15 	(e) A health plan company is in compliance with this section if it does not include orally 
211.16 	administered anticancer medication in the fourth tier of its pharmacy benefit.
211.17 	(f) A health plan company that provides coverage under a health plan for cancer 
211.18 	chemotherapy treatment must indicate the level of coverage for orally administered anticancer 
211.19 	medication within its pharmacy benefit filing with the commissioner.

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

211.22 	Sec. 4. Minnesota Statutes 2016, section 62D.105, subdivision 1, is amended to read:
211.23 		Subdivision 1.Requirement. Every health maintenance contract, which in addition to 
211.24 	covering the enrollee also provides coverage to the spouse and dependent children to the 
211.25 	limiting age as defined in section 62Q.01, subdivision 2a, of the enrollee and spouse who 
211.26 	was covered on the day before entry of a valid decree of dissolution shall: (1) permit the 
211.27 	spouse and dependent children to the limiting age as defined in section 62Q.01, subdivision 
211.28 	2a, to elect to continue coverage when the enrollee becomes enrolled for benefits under title 
211.29 	XVIII of the Social Security Act (Medicare); and (2) permit the dependent children to 
211.30 	continue coverage when they cease to be dependent children to the limiting age as defined 
211.31 	in section 62Q.01, subdivision 2a, under the generally applicable requirement of the plan.

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

212.1 	Sec. 5. Minnesota Statutes 2016, section 62D.105, subdivision 2, is amended to read:
212.2 		Subd. 2.Continuation privilege. The coverage described in subdivision 1 may be 
212.3 	continued until the earlier of the following dates:
212.4 	(1) the date coverage would otherwise terminate under the contract;
212.5 	(2) 36 months after continuation by the spouse or dependent was elected; or
212.6 	(3) the date the spouse or dependent children become covered under another group health 
212.7 	plan or Medicare.
212.8 	If coverage is provided under a group policy, any required fees for the coverage shall 
212.9 	be paid by the enrollee on a monthly basis to the group contract holder for remittance to the 
212.10 	health maintenance organization. In no event shall the fee charged exceed 102 percent of 
212.11 	the cost to the plan for such coverage for other similarly situated spouse and dependent 
212.12 	children to the limiting age as defined in section 62Q.01, subdivision 2a, to whom subdivision 
212.13 	1 is not applicable, without regard to whether such cost is paid by the employer or employee.

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

212.16 	Sec. 6. Minnesota Statutes 2016, section 62E.04, subdivision 11, is amended to read:
212.17 		Subd. 11.Essential health benefits package Affordable Care Act compliant plans.
 212.18 	For individual or small group health plans that include the essential health benefits package 
212.19 	and are any policy of accident and health insurance subject to the requirements of the 
212.20 	Affordable Care Act, as defined under section 62A.011, subdivision 1a, that is offered, sold, 
212.21 	issued, or renewed on or after January 1, 2014 2018, the requirements of this section do not 
212.22 	apply.

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

212.25 	Sec. 7. Minnesota Statutes 2016, section 62E.05, subdivision 1, is amended to read:
212.26 		Subdivision 1.Certification. Upon application by an insurer, fraternal, or employer for 
212.27 	certification of a plan of health coverage as a qualified plan or a qualified Medicare 
212.28 	supplement plan for the purposes of sections 62E.01 to 62E.19, the commissioner shall 
212.29 	make a determination within 90 days as to whether the plan is qualified. All plans of health 
212.30 	coverage, except Medicare supplement policies, shall be labeled as "qualified" or 
212.31 	"nonqualified" on the front of the policy or contract, or on the schedule page. All qualified 
213.1 	plans shall indicate whether they are number one, two, or three coverage plans. For any 
213.2 	policy of accident and health insurance subject to the requirements of the Affordable Care 
213.3 	Act, as defined under section 62A.011, subdivision 1a, that is offered, sold, issued, or 
213.4 	renewed on or after January 1, 2018, the requirements of this section do not apply.

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

213.7 	Sec. 8. Minnesota Statutes 2016, section 62E.06, is amended by adding a subdivision to 
213.8 	read:
213.9 		Subd. 5.Affordable Care Act compliant plans. For any policy of accident and health 
213.10 	insurance subject to the requirements of the Affordable Care Act, as defined under section 
213.11 	62A.011, subdivision 1a, that is offered, sold, issued, or renewed on or after January 1, 
213.12 	2018, the requirements of this section do not apply.

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

213.15 	Sec. 9. [62K.16] COVERAGE TERMINATION NOTIFICATION.
213.16 	(a) All individual health carriers issuing individual health plans must permit enrollees 
213.17 	to terminate their individual health plan coverage by directly contacting either the health 
213.18 	carrier or MNsure, if the enrollee purchased the coverage through MNsure. If an enrollee 
213.19 	terminates coverage by contacting the health carrier directly, the health carrier must inform 
213.20 	MNsure of the termination request.
213.21 	(b) Health plan companies and MNsure shall develop a form that can be accessed by an 
213.22 	enrollee through either the health plan company's Web site or MNsure's Web site for the 
213.23 	purpose of terminating coverage online.
213.24 	(c) Termination of coverage shall be effective the first day of the month following the 
213.25 	month in which the enrollee notified either the health carrier or MNsure.

213.26 	Sec. 10. Minnesota Statutes 2016, section 62M.07, is amended to read:
213.27 	62M.07 PRIOR AUTHORIZATION OF SERVICES.
213.28 	(a) Utilization review organizations conducting prior authorization of services must have 
213.29 	written standards that meet at a minimum the following requirements:
213.30 	(1) written procedures and criteria used to determine whether care is appropriate, 
213.31 	reasonable, or medically necessary;
214.1 	(2) a system for providing prompt notification of its determinations to enrollees and 
214.2 	providers and for notifying the provider, enrollee, or enrollee's designee of appeal procedures 
214.3 	under clause (4);
214.4 	(3) compliance with section 62M.05, subdivisions 3a and 3b, regarding time frames for 
214.5 	approving and disapproving prior authorization requests;
214.6 	(4) written procedures for appeals of denials of prior authorization which specify the 
214.7 	responsibilities of the enrollee and provider, and which meet the requirements of sections 
214.8 	62M.06 and 72A.285, regarding release of summary review findings; and
214.9 	(5) procedures to ensure confidentiality of patient-specific information, consistent with 
214.10 	applicable law.
214.11 	(b) No utilization review organization, health plan company, or claims administrator 
214.12 	may conduct or require prior authorization of emergency confinement or emergency 
214.13 	treatment. The enrollee or the enrollee's authorized representative may be required to notify 
214.14 	the health plan company, claims administrator, or utilization review organization as soon 
214.15 	after the beginning of the emergency confinement or emergency treatment as reasonably 
214.16 	possible.
214.17 	(c) If prior authorization for a health care service is required, the utilization review 
214.18 	organization, health plan company, or claim administrator must allow providers to submit 
214.19 	requests for prior authorization of the health care services without unreasonable delay by 
214.20 	telephone, facsimile, or voice mail or through an electronic mechanism 24 hours a day, 
214.21 	seven days a week. This paragraph does not apply to dental service covered under 
214.22 	MinnesotaCare or medical assistance.
214.23 	(d) Any prior authorization for a prescription drug must remain valid for the duration 
214.24 	of an enrollee's contract term. These requirements related to the validity of prior authorization 
214.25 	apply only if:
214.26 	(1) the drug continues to be prescribed for a patient with a condition that requires ongoing 
214.27 	medication therapy;
214.28 	(2) the drug has not otherwise been deemed unsafe by the Food and Drug Administration;
214.29 	(3) the drug has not been withdrawn by the manufacturer or the Food and Drug 
214.30 	Administration;
214.31 	(4) there is no evidence of the enrollee's abuse or misuse of the prescription drug; and
215.1 	(5) no independent source of research, clinical guidelines, or evidence-based standards 
215.2 	has issued drug-specific warnings or recommended changes in drug usage.
215.3 	This paragraph does not apply to individuals enrolled in a public health care program under 
215.4 	chapter 256B or 256L; or assigned to the restricted recipient program under Minnesota 
215.5 	Rules, parts 9505.2160 to 9505.2245.

215.6 	Sec. 11. [62Q.575] ACCESS TO PRIMARY CARE PROVIDERS.
215.7 		Subdivision 1.Provider network. (a) No health plan company offering an individual 
215.8 	health plan that is not a grandfathered plan shall deny a primary care provider the right to 
215.9 	contract with the health plan company as an in-network provider if the primary care provider 
215.10 	meets one of the following criteria:
215.11 	(1) is certified as a health care home by the commissioner of health under section 
215.12 	256B.0751. To remain eligible for in-network status under this section, the primary care 
215.13 	provider must maintain certification as a health care home; or
215.14 	(2) is in the process of becoming certified as a health care home under section 256B.0751. 
215.15 	To remain eligible for in-network status under this subdivision, the primary care provider 
215.16 	must complete the certification process within six months to remain an in-network provider.
215.17 	(b) A health plan company may require the primary care provider to meet reasonable 
215.18 	data, utilization review, and quality assurance requirements on the same basis as other 
215.19 	in-network providers.
215.20 	(c) The primary care provider must agree to serve all enrollees of the health care company 
215.21 	who select or designate the primary care provider, if designation is required.
215.22 	(d) The primary care provider and health plan company may negotiate the payment rate 
215.23 	for covered services provided by the primary care provider. The rate must not be less than 
215.24 	the rate paid by the health plan company to the provider under a different category of 
215.25 	coverage or health product, or other arrangement within a category of coverage.
215.26 		Subd. 2.Cost-sharing or other conditions. No health plan company shall impose a 
215.27 	co-payment, fee, or other cost-sharing requirement for selecting or designating a primary 
215.28 	care provider of the enrollee's choosing or impose other conditions that limit the enrollee's 
215.29 	ability to utilize a primary care provider of the enrollee's choosing, unless the health plan 
215.30 	company imposes the same cost-sharing requirements, fees, conditions, or limits upon an 
215.31 	enrollee's selection or designation of any of the health plan company's in-network primary 
215.32 	care providers.
216.1 		Subd. 3.Care coordination. (a) As part of the provider contract with primary care 
216.2 	providers that are certified health care homes, the contract must include a care coordination 
216.3 	payment for providing care coordination services. The care coordination payment under 
216.4 	this subdivision must be a per enrollee, per month payment and must be in addition to the 
216.5 	payment rate for the covered services provided by the primary care provider.
216.6 	(b) The care coordination payment may vary based on care complexity, but must at least 
216.7 	be equal to the payment amounts established under section 256B.0753.
216.8 	(c) The health plan company shall not impose a co-payment, fee, or other cost-sharing 
216.9 	requirement for care coordination services.
216.10 		Subd. 4.Notice. The health plan company shall provide notice to enrollees of the 
216.11 	provisions of this section.
216.12 		Subd. 5.Definition. For purposes of this section, "primary care provider" means a 
216.13 	physician licensed under chapter 147 or an advanced practice registered nurse licensed 
216.14 	under chapter 148 who specializes in the practice of family medicine, general internal 
216.15 	medicine, obstetrics and gynecology, or general pediatrics; or a health care clinic that 
216.16 	specializes in the above-mentioned areas and utilizes a primary care team that includes 
216.17 	physicians, physician assistants, or advanced practice registered nurses.
216.18 		Subd. 6.Limitations. (a) This section does not apply to enrollees who are enrolled in 
216.19 	a public health care program under chapter 256B or 256L, or the Minnesota restricted 
216.20 	recipient program pursuant to Minnesota Rules, part 9505.2238.
216.21 	(b) This section does not waive any exclusions of coverage under the terms and conditions 
216.22 	of the enrollee's health plan.
216.23 	(c) This section only applies to individual health plans.
216.24 		Subd. 7.Enforcement. The commissioner of health shall enforce this section.

216.25 	EFFECTIVE DATE. This section is effective January 1, 2018, and applies to any 
216.26 	individual health plan offered, sold, issued, or renewed on or after that date.

216.27 	Sec. 12. [62Q.678] NETWORK OFFERINGS.
216.28 	(a) In counties where a health plan company actively markets an individual health plan, 
216.29 	the health plan company must offer, in those counties, at least one individual health plan 
216.30 	with a provider network that includes in-network access to more than a single health care 
216.31 	provider system or a health plan that includes more than one primary care location in a 
217.1 	county. This section is applicable only for the plan year in which the health plan company 
217.2 	actively markets an individual health plan.
217.3 	(b) The commissioner of health shall enforce this section.

217.4 	EFFECTIVE DATE. This section is effective January 1, 2018, and applies to any health 
217.5 	plan offered, sold, issued, or renewed on or after that date.

217.6 	Sec. 13. [62Q.83] PRESCRIPTION DRUG BENEFIT TRANSPARENCY AND 
217.7 	MANAGEMENT.
217.8 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
217.9 	the meanings given them.
217.10 	(b) "Drug" has the meaning given in section 151.01, subdivision 5.
217.11 	(c) "Enrollee contract year" means the 12-month term during which benefits associated 
217.12 	with health plan company products are in effect.
217.13 	(d) "Formulary" means a list of prescription drugs that have been developed by clinical 
217.14 	and pharmacy experts and represents the health plan company's medically appropriate and 
217.15 	cost-effective prescription drugs approved for use.
217.16 	(e) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, and 
217.17 	includes an entity that performs pharmacy benefits management for the health plan company. 
217.18 	For purposes of this definition, "pharmacy benefits management" means the administration 
217.19 	or management of prescription drug benefits provided by the health plan company for the 
217.20 	benefit of its enrollees and may include, but is not limited to, procurement of prescription 
217.21 	drugs, clinical formulary development and management services, claims processing, and 
217.22 	rebate contracting and administration.
217.23 	(f) "Prescription" has the meaning given in section 151.01, subdivision 16a.
217.24 		Subd. 2.Prescription drug benefit disclosure. (a) A health plan company that provides 
217.25 	prescription drug benefit coverage and uses a formulary must make its formulary and related 
217.26 	benefit information available by electronic means and, upon request, in writing, at least 30 
217.27 	days prior to annual renewal dates.
217.28 	(b) Formularies must be organized and disclosed consistent with the most recent version 
217.29 	of the United States Pharmacopeia's (USP) Model Guidelines.
217.30 	(c) For each item or category of items on the formulary, the specific enrollee benefit 
217.31 	terms must be identified, including enrollee cost-sharing and expected out-of-pocket costs.
218.1 		Subd. 3.Formulary changes. (a) Once a formulary has been established, a health plan 
218.2 	company may, at any time during the enrollee's contract year:
218.3 	(1) expand its formulary by adding drugs to the formulary;
218.4 	(2) reduce co-payments or coinsurance; or
218.5 	(3) move a drug to a benefit category that reduces an enrollee's cost.
218.6 	(b) A health plan company may remove a brand name drug from its formulary or place 
218.7 	a brand name drug in a benefit category that increases an enrollee's cost only upon the 
218.8 	addition to the formulary of a generic or multisource brand name drug rated as therapeutically 
218.9 	equivalent according to the FDA Orange Book or a biologic drug rated as interchangeable 
218.10 	according to the FDA Purple Book at a lower cost to the enrollee, and upon at least a 60-day 
218.11 	notice to prescribers, pharmacists, and affected enrollees.
218.12 	(c) A health plan company may change utilization review requirements or move drugs 
218.13 	to a benefit category that increases an enrollee's cost during the enrollee's contract year upon 
218.14 	at least a 60-day notice to prescribers, pharmacists, and affected enrollees, provided that 
218.15 	these changes do not apply to enrollees who are currently taking the drugs affected by these 
218.16 	changes for the duration of the enrollee's contract year.
218.17 	(d) A health plan company may remove any drugs from its formulary that have been 
218.18 	deemed unsafe by the Food and Drug Administration, that have been withdrawn by either 
218.19 	the Food and Drug Administration or the product manufacturer, or when an independent 
218.20 	source of research, clinical guidelines, or evidence-based standards has issued drug-specific 
218.21 	warnings or recommended changes in drug usage.
218.22 		Subd. 4.Exclusions. This section does not apply to individuals enrolled in a public 
218.23 	health care program under chapter 256B or 256L, or assigned to the restricted recipient 
218.24 	program under Minnesota Rules, parts 9505.2160 to 9505.2245.

218.25 	Sec. 14. Minnesota Statutes 2016, section 317A.811, subdivision 1, is amended to read:
218.26 		Subdivision 1.When required. (a) Except as provided in subdivision 6, the following 
218.27 	corporations shall notify the attorney general of their intent to dissolve, merge, or consolidate, 
218.28 	or to transfer all or substantially all of their assets:
218.29 	(1) a corporation that holds assets for a charitable purpose as defined in section 501B.35, 
218.30 	subdivision 2; or
218.31 	(2) a health maintenance organization operating under chapter 62D;
218.32 	(3) a service plan corporation operating under chapter 62C; or
219.1 	(2) (4) a corporation that is exempt under section 501(c)(3) of the Internal Revenue Code 
219.2 	of 1986, or any successor section.
219.3 	(b) The notice must include:
219.4 	(1) the purpose of the corporation that is giving the notice;
219.5 	(2) a list of assets owned or held by the corporation for charitable purposes;
219.6 	(3) a description of restricted assets and purposes for which the assets were received;
219.7 	(4) a description of debts, obligations, and liabilities of the corporation;
219.8 	(5) a description of tangible assets being converted to cash and the manner in which 
219.9 	they will be sold;
219.10 	(6) anticipated expenses of the transaction, including attorney fees;
219.11 	(7) a list of persons to whom assets will be transferred, if known;
219.12 	(8) the purposes of persons receiving the assets; and
219.13 	(9) the terms, conditions, or restrictions, if any, to be imposed on the transferred assets.
219.14 	The notice must be signed on behalf of the corporation by an authorized person.

219.15 	Sec. 15. Minnesota Statutes 2016, section 317A.811, is amended by adding a subdivision 
219.16 	to read:
219.17 		Subd. 1a.Nonprofit health care entity; notice and approval required. A corporation 
219.18 	that is a health maintenance organization or a service plan corporation is subject to notice 
219.19 	and approval requirements for certain transactions under section 317A.814.

219.20 	Sec. 16. [317A.814] NONPROFIT HEALTH CARE ENTITY CONVERSIONS.
219.21 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
219.22 	(b) "Commissioner" means the commissioner of commerce if the nonprofit health care 
219.23 	entity at issue is a service plan corporation operating under chapter 62C, and the 
219.24 	commissioner of health if the nonprofit health care entity at issue is a health maintenance 
219.25 	organization operating under chapter 62D.
219.26 	(c) "Conversion benefit entity" means a foundation, corporation, limited liability 
219.27 	company, trust, partnership, or other entity that receives public benefit assets, or their value, 
219.28 	in connection with a conversion transaction.
220.1 	(d) "Conversion transaction" or "transaction" means a transaction in which a nonprofit 
220.2 	health care entity merges, consolidates, converts, or transfers all or a substantial portion of 
220.3 	its assets to an entity that is not a nonprofit corporation organized under this chapter that is 
220.4 	also exempt under United States Code, title 26, section 501(c)(3). The substitution of a new 
220.5 	corporate member that transfers the control, responsibility for, or governance of a nonprofit 
220.6 	health care entity is also considered a transaction for purposes of this section.
220.7 	(e) "Family member" means a spouse, parent, or child or other legal dependent.
220.8 	(f) "Nonprofit health care entity" means a service plan corporation operating under 
220.9 	chapter 62C and a health maintenance organization operating under chapter 62D.
220.10 	(g) "Public benefit assets" means the entirety of a nonprofit health care entity's assets, 
220.11 	whether tangible or intangible.
220.12 	(h) "Related organization" has the meaning given in section 317A.011.
220.13 		Subd. 2.Private inurement. A nonprofit health care entity must not enter into a 
220.14 	conversion transaction if a person who has been an officer, director, or other executive of 
220.15 	the nonprofit health care entity, or of a related organization, or a family member of that 
220.16 	person:
220.17 	(1) has or will receive any compensation or other financial benefit, directly or indirectly, 
220.18 	in connection with the conversion transaction;
220.19 	(2) has held or will hold, regardless of whether guaranteed or contingent, an ownership 
220.20 	stake, stock, securities, investment, or other financial interest in, or receive any type of 
220.21 	compensation or other financial benefit from, any entity to which the nonprofit health care 
220.22 	entity transfers public benefit assets in connection with a conversion transaction; or
220.23 	(3) has held or will hold, regardless of whether guaranteed or contingent, an ownership 
220.24 	stake, stock, securities, investment, or other financial interest in, or receive any type of 
220.25 	compensation or other financial benefit from, any entity that has or will have a business 
220.26 	relationship with any entity to which the nonprofit health care entity transfers public benefit 
220.27 	assets in connection with a conversion transaction.
220.28 		Subd. 3.Attorney general notice and approval required. (a) Before entering into a 
220.29 	conversion transaction, the nonprofit health care entity must notify the attorney general as 
220.30 	specified under section 317A.811, subdivision 1. The notice required by this subdivision 
220.31 	also must include an itemization of the nonprofit health care entity's public benefit assets 
220.32 	and the valuation that the entity  attributes to those assets, a proposed plan for distribution 
220.33 	of the value of those assets to a conversion benefit entity that meets the requirements of 
221.1 	subdivision 5, and other information from the health maintenance organization or the 
221.2 	proposed conversion benefit entity that the attorney general reasonably considers necessary 
221.3 	for review of the proposed transaction.
221.4 	(b) A copy of the notice and other information required under this subdivision must be 
221.5 	given to the commissioner.
221.6 		Subd. 4.Review elements. (a) The attorney general may approve, conditionally approve, 
221.7 	or not approve a conversion transaction under this section. In making a decision whether 
221.8 	to approve, conditionally approve, or not approve a proposed transaction, the attorney 
221.9 	general, in consultation with the commissioner, shall consider any factors the attorney 
221.10 	general considers relevant, including whether:
221.11 	(1) the proposed transaction complies with this chapter and chapter 501B and other 
221.12 	applicable laws;
221.13 	(2) the proposed transaction involves or constitutes a breach of charitable trust;
221.14 	(3) the nonprofit health care entity will receive full and fair value for its public benefit 
221.15 	assets;
221.16 	(4) the full and fair value of the public benefit assets to be transferred has been 
221.17 	manipulated in a manner that causes or has caused the value of the assets to decrease;
221.18 	(5) the proceeds of the proposed transaction will be used consistent with the public 
221.19 	benefit for which the assets are held by the nonprofit health care entity;
221.20 	(6) the proposed transaction will result in a breach of fiduciary duty, as determined by 
221.21 	the attorney general, including whether:
221.22 	(i) conflicts of interest exist related to payments to or benefits conferred upon officers, 
221.23 	directors, board members, and executives of the nonprofit health care entity or a related 
221.24 	organization;
221.25 	(ii) the nonprofit health care entity's board of directors exercised reasonable care and 
221.26 	due diligence in deciding to pursue the transaction, in selecting the entity with which to 
221.27 	pursue the transaction, and in negotiating the terms and conditions of the transaction; and
221.28 	(iii) the nonprofit health care entity's board of directors considered all reasonably viable 
221.29 	alternatives, including any competing offers for its public benefit assets, or alternative 
221.30 	transactions;
222.1 	(7) the transaction will result in private inurement to any person, including owners, 
222.2 	stakeholders, or directors, officers, or key staff of the nonprofit health care entity or entity 
222.3 	to which the nonprofit health care entity proposes to transfer public benefit assets;
222.4 	(8) the conversion benefit entity meets the requirements of subdivision 5; and
222.5 	(9) the attorney general and the commissioner have been provided with sufficient 
222.6 	information by the nonprofit health care entity to adequately evaluate the proposed transaction 
222.7 	and the effects on the public, provided the attorney general or the commissioner has notified 
222.8 	the nonprofit health care entity or the proposed conversion benefit entity of any inadequacy 
222.9 	of the information and has provided a reasonable opportunity to remedy that inadequacy.
222.10 	In addition, the attorney general shall consider the public comments received regarding 
222.11 	the proposed conversion transaction and the proposed transaction's likely effect on the 
222.12 	availability, accessibility, and affordability of health care services to the public.
222.13 	(b) The attorney general must consult with the commissioner in making a decision 
222.14 	whether to approve or disapprove a transaction.
222.15 		Subd. 5.Conversion benefit entity requirements. (a) A conversion benefit entity must 
222.16 	be an existing or new domestic nonprofit corporation organized under this chapter and also 
222.17 	be exempt under United States Code, title 26, section 501(c)(3).
222.18 	(b) The conversion benefit entity must be completely independent of any influence or 
222.19 	control by the nonprofit health care entity and related organizations, all entities to which 
222.20 	the nonprofit health care entity transfers any public benefit assets in connection with a 
222.21 	conversion transaction, and the directors, officers, and other executives of those organizations 
222.22 	or entities.
222.23 	(c) The conversion benefit entity must have in place procedures and policies to prohibit 
222.24 	conflicts of interest, including but not limited to prohibiting conflicts of interests relating 
222.25 	to any grant-making activities that may benefit:
222.26 	(1) the directors, officers, or other executives of the conversion benefit entity;
222.27 	(2) any entity to which the nonprofit health care entity transfers any public benefit assets 
222.28 	in connection with a conversion transaction; or
222.29 	(3) any directors, officers, or other executives of any entity to which the nonprofit health 
222.30 	care entity transfers any public benefit assets in connection with a conversion transaction.
222.31 	(d) The charitable purpose and grant-making functions of the conversion benefit entity 
222.32 	must be dedicated to meeting the health care needs of the people of this state.
223.1 		Subd. 6.Public comment. Before issuing a decision under subdivision 7, the attorney 
223.2 	general may solicit public comment regarding the proposed conversion transaction. The 
223.3 	attorney general may hold one or more public meetings or solicit written or electronic 
223.4 	correspondence. If a meeting is held, notice of the meeting must be published in a qualified 
223.5 	newspaper of general circulation in this state at least seven days before the meeting.
223.6 		Subd. 7.Period for approval or disapproval; extension. (a) Within 150 days of 
223.7 	receiving notice of a proposed transaction, the attorney general shall notify the nonprofit 
223.8 	health care entity in writing of its decision to approve, conditionally approve, or disapprove 
223.9 	the transaction. If the transaction is not approved, the notice must include the reason for the 
223.10 	decision. If the transaction is conditionally approved, the notice must specify the conditions 
223.11 	that must be met. The attorney general may extend this period for an additional 90 days if 
223.12 	necessary to obtain additional information.
223.13 	(b) The time periods under this subdivision are suspended during the time when a request 
223.14 	from the attorney general for additional information is outstanding.
223.15 		Subd. 8.Transfer of value of assets required. If a proposed conversion transaction is 
223.16 	approved or conditionally approved by the attorney general, the nonprofit health care entity 
223.17 	shall transfer the entirety of the full and fair value of its public benefit assets to one or more 
223.18 	conversion benefit entities as part of the transaction.
223.19 		Subd. 9.Assessment of costs. The nonprofit health care entity or the conversion benefit 
223.20 	entity must reimburse the attorney general or a state agency for all reasonable and actual 
223.21 	costs incurred by the attorney general or a state agency in reviewing a proposed conversion 
223.22 	transaction, including attorney fees at the billing rate used by the attorney general for state 
223.23 	agencies and the costs for retention of actuarial, valuation, or other experts or consultants, 
223.24 	and administrative costs.
223.25 		Subd. 10.Annual report by conversion benefit entity. A conversion benefit entity 
223.26 	must submit an annual report to the attorney general that contains a detailed description of 
223.27 	its charitable activities related to the use of the public benefit assets received under a 
223.28 	transaction that is approved under this section.
223.29 		Subd. 11.Penalties; remedies. A conversion transaction entered into in violation of 
223.30 	this section is null and void. The attorney general is authorized to bring an action to unwind 
223.31 	a conversion transaction entered into in violation of this section and to recover the amount 
223.32 	of any private inurement received or held in violation of subdivision 2. In addition to this 
223.33 	recovery, the officers, directors, and other executives of each entity that is a party to and 
223.34 	materially participated in a conversion transaction entered into in violation of this section 
224.1 	may be subject to a civil penalty of up to the greater of either the entirety of any financial 
224.2 	benefit each one derived from the transaction, or $1,000,000, as determined by the court. 
224.3 	The attorney general is authorized to enforce this section pursuant to section 8.31.
224.4 		Subd. 12.Relation to other law. (a) This section is in addition to, and does not affect 
224.5 	or limit any power, remedy, or responsibility of a health maintenance organization, service 
224.6 	plan corporation, a conversion benefit entity, the attorney general, or the commissioner 
224.7 	under this chapter, chapter 62C, 62D, 501B, or other law.
224.8 	(b) Nothing in this section authorizes a nonprofit health care entity to enter into a 
224.9 	conversion transaction not otherwise permitted under this chapter.

224.10 	Sec. 17. Laws 2017, chapter 2, article 1, section 1, subdivision 3, is amended to read:
224.11 		Subd. 3.Eligible individual. "Eligible individual" means a Minnesota resident who:
224.12 	(1) is not receiving a an advanced premium tax credit under Code of Federal Regulations, 
224.13 	title 26, section 1.36B-2, as of the date their coverage is effectuated in a month in which 
224.14 	their coverage is effective;
224.15 	(2) is not enrolled in public program coverage under Minnesota Statutes, section 
224.16 	256B.055, or 256L.04; and
224.17 	(3) purchased an individual health plan from a health carrier in the individual market.

224.18 	Sec. 18. Laws 2017, chapter 2, article 1, section 2, subdivision 4, is amended to read:
224.19 		Subd. 4.Data practices. (a) The definitions in Minnesota Statutes, section 13.02, apply 
224.20 	to this subdivision.
224.21 	(b) Government data on an enrollee or health carrier under this section are private data 
224.22 	on individuals or nonpublic data, except that the total reimbursement requested by a health 
224.23 	carrier and the total state payment to the health carrier are public data.
224.24 	(c) Notwithstanding Minnesota Statutes, section 138.17, not public government data on 
224.25 	an enrollee or health carrier collected under this section must be destroyed by June 30, 2018, 
224.26 	or upon completion by the legislative auditor of the audits required by section 3, whichever 
224.27 	is later, except to the extent the legislative auditor maintains data for a longer period of time 
224.28 	in order to comply with generally accepted government auditing standards.

225.1 	Sec. 19. Laws 2017, chapter 2, article 1, section 2, is amended by adding a subdivision to 
225.2 	read:
225.3 		Subd. 5.Data sharing. (a) Notwithstanding any law to the contrary, the commissioner 
225.4 	of human services and the executive director of MNsure must disclose to the commissioner 
225.5 	of management and budget data on public program coverage enrollment under Minnesota 
225.6 	Statutes, sections 256B.055 and 256L.04, data on an enrollee's receipt of an advanced 
225.7 	premium tax credit under Code of Federal Regulations, title 26, section 1.36B-2.
225.8 	(b) Notwithstanding any law to the contrary, the commissioner of management and 
225.9 	budget must disclose data to health carriers on enrollees' enrollment in public program 
225.10 	coverage under Minnesota Statutes, section 256B.055 or 256L.04, to the extent that the 
225.11 	commissioner determines the disclosure is necessary for purposes of determining eligibility 
225.12 	for the premium subsidy program authorized by this act.
225.13 	(c) Data disclosed under this subdivision may be used only for the purpose of 
225.14 	administration of the premium subsidy program under this act and may not be further 
225.15 	disclosed to any other person, except as otherwise provided by law.

225.16 	Sec. 20. Laws 2017, chapter 2, article 1, section 3, is amended to read:
225.17 	Sec. 3. AUDITS.
 225.18 	(a) The legislative auditor shall conduct audits of the health carriers' supporting data, as 
225.19 	prescribed by the commissioner, to determine whether payments align with criteria 
225.20 	established in sections 1 and 2. The commissioner of human services shall provide data as 
225.21 	necessary to the legislative auditor to complete the audit. The commissioner shall withhold 
225.22 	or charge back payments to the health carriers to the extent they do not align with the criteria 
225.23 	established in sections 1 and 2, as determined by the audit.
225.24 	(b) The legislative auditor shall audit the extent to which health carriers provided premium 
225.25 	subsidies to persons meeting the residency and other eligibility requirements specified in 
225.26 	section 1, subdivision 3. The legislative auditor shall report to the commissioner the amount 
225.27 	of premium subsidies provided by each health carrier to persons not eligible for a premium 
225.28 	subsidy. The commissioner, in consultation with the commissioners of commerce and,
225.29 	health, and human services shall develop and implement a process to recover from health 
225.30 	carriers the amount of premium subsidies received for enrollees determined to be ineligible 
225.31 	for premium subsidies by the legislative auditor. The legislative auditor, when conducting 
225.32 	the required audit, and the commissioner, when determining the amount of premium subsidy 
225.33 	to be recovered, may take into account the extent to which a health carrier makes use of the 
226.1 	Minnesota eligibility system, as defined in Minnesota Statutes, section 62V.055, subdivision 
226.2 	1.

226.3 	Sec. 21. Laws 2017, chapter 2, article 1, section 5, is amended to read:
226.4 	Sec. 5. SUNSET.
 226.5 	This article sunsets June 30, other than section 2, subdivision 5, and section 3, sunsets 
226.6 	August 31, 2018.

226.7 	Sec. 22. Laws 2017, chapter 2, article 1, section 7, is amended to read:
226.8 	Sec. 7. APPROPRIATIONS.
 226.9 	(a) $311,788,000 in fiscal year 2017 is appropriated from the general fund to the 
226.10 	commissioner of management and budget for premium assistance under section 2. This 
226.11 	appropriation is onetime and is available through June 30 August 31, 2018.
226.12 	(b) $157,000 in fiscal year 2017 is appropriated from the general fund to the legislative 
226.13 	auditor for purposes of section 3. This appropriation is onetime.
226.14 	(c) Any unexpended amount from the appropriation in paragraph (a) after June 30, 2018, 
226.15 	shall be transferred on July 1 no later than August 31, 2018, from the general fund to the 
226.16 	budget reserve account under Minnesota Statutes, section 16A.152, subdivision 1a.

226.17 	Sec. 23. Laws 2017, chapter 2, article 2, section 13, is amended to read:
226.18 	Sec. 13. 62Q.556 UNAUTHORIZED PROVIDER SERVICES.
226.19 		Subdivision 1.Unauthorized provider services. (a) Except as provided in paragraph 
226.20 	(c), unauthorized provider services occur when an enrollee receives services:
226.21 	(1) from a nonparticipating provider at a participating hospital or ambulatory surgical 
226.22 	center, when the services are rendered:
226.23 	(i) due to the unavailability of a participating provider;
226.24 	(ii) by a nonparticipating provider without the enrollee's knowledge; or
226.25 	(iii) due to the need for unforeseen services arising at the time the services are being 
226.26 	rendered; or
226.27 	(2) from a participating provider that sends a specimen taken from the enrollee in the 
226.28 	participating provider's practice setting to a nonparticipating laboratory, pathologist, or other 
226.29 	medical testing facility.
227.1 	(b) Unauthorized provider services do not include emergency services as defined in 
227.2 	section 62Q.55, subdivision 3.
227.3 	(c) The services described in paragraph (a), clause (2), are not unauthorized provider 
227.4 	services if the enrollee gives advance written consent to the provider acknowledging that 
227.5 	the use of a provider, or the services to be rendered, may result in costs not covered by the 
227.6 	health plan.
227.7 		Subd. 2.Prohibition. (a) An enrollee's financial responsibility for the unauthorized 
227.8 	provider services shall be the same cost-sharing requirements, including co-payments, 
227.9 	deductibles, coinsurance, coverage restrictions, and coverage limitations, as those applicable 
227.10 	to services received by the enrollee from a participating provider. A health plan company 
227.11 	must apply any enrollee cost sharing requirements, including co-payments, deductibles, and 
227.12 	coinsurance, for unauthorized provider services to the enrollee's annual out-of-pocket limit 
227.13 	to the same extent payments to a participating provider would be applied.
227.14 	(b) A health plan company must attempt to negotiate the reimbursement, less any 
227.15 	applicable enrollee cost sharing under paragraph (a), for the unauthorized provider services 
227.16 	with the nonparticipating provider. If a health plan company's and nonparticipating provider's 
227.17 	attempts to negotiate reimbursement for the health care services do not result in a resolution, 
227.18 	the health plan company or provider may elect to refer the matter for binding arbitration, 
227.19 	chosen in accordance with paragraph (c). A nondisclosure agreement must be executed by 
227.20 	both parties prior to engaging an arbitrator in accordance with this section. The cost of 
227.21 	arbitration must be shared equally between the parties.
227.22 	(c) The commissioner of health, in consultation with the commissioner of the Bureau 
227.23 	of Mediation Services, must develop a list of professionals qualified in arbitration, for the 
227.24 	purpose of resolving disputes between a health plan company and nonparticipating provider 
227.25 	arising from the payment for unauthorized provider services. The commissioner of health 
227.26 	shall publish the list on the department of health's Web Site, and update the list as appropriate.
227.27 	(d) The arbitrator must consider relevant information, including the health plan company's 
227.28 	payments to other nonparticipating providers for the same services, the circumstances and 
227.29 	complexity of the particular case, and the usual and customary rate for the service based on 
227.30 	information available in a database in a national, independent, not-for-profit corporation, 
227.31 	and similar fees received by the provider for the same services from other health plans in 
227.32 	which the provider is nonparticipating, in reaching a decision.
227.33 		Subd. 3.Scope. This section does not apply to services provided under chapter 256B or 
227.34 	256L.

228.1 	Sec. 24. Laws 2017, chapter 2, article 2, section 13, the effective date, is amended to read:

228.2 	EFFECTIVE DATE. This section is effective 90 days following final enactment January 
228.3 	1, 2019, and applies to provider services provided on or after that date.

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

228.5 	Sec. 25. WAIVER.
 228.6 	MNsure shall seek any federal waivers necessary to permit enrollees to contact health 
228.7 	carriers directly to terminate individual health plan coverage according to Minnesota Statutes, 
228.8 	section 62K.16, when the individual purchased the coverage through MNsure.

228.9 	EFFECTIVE DATE. This section is effective January 1, 2018, or upon federal approval 
228.10 	if required, whichever is later.

228.11 	ARTICLE 6
228.12 	DIRECT CARE AND TREATMENT

228.13 	Section 1. Minnesota Statutes 2016, section 253B.10, subdivision 1, is amended to read:
228.14 		Subdivision 1.Administrative requirements. (a) When a person is committed, the 
228.15 	court shall issue a warrant or an order committing the patient to the custody of the head of 
228.16 	the treatment facility. The warrant or order shall state that the patient meets the statutory 
228.17 	criteria for civil commitment.
228.18 	(b) The commissioner shall prioritize patients being admitted from jail or a correctional 
228.19 	institution who are:
228.20 	(1) ordered confined in a state hospital for an examination under Minnesota Rules of 
228.21 	Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
228.22 	(2) under civil commitment for competency treatment and continuing supervision under 
228.23 	Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
228.24 	(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal 
228.25 	Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be 
228.26 	detained in a state hospital or other facility pending completion of the civil commitment 
228.27 	proceedings; or
228.28 	(4) committed under this chapter to the commissioner after dismissal of the patient's 
228.29 	criminal charges.
229.1 	Patients described in this paragraph must be admitted to a service operated by the 
229.2 	commissioner within 48 hours. Regardless of when the 48-hour time period expires, a 
229.3 	regional treatment center is not required to admit a patient after 12:00 p.m. on Friday and 
229.4 	before 8:00 a.m. on Monday. The commitment must be ordered by the court as provided in 
229.5 	section 253B.09, subdivision 1, paragraph (c).
229.6 	(c) Upon the arrival of a patient at the designated treatment facility, the head of the 
229.7 	facility shall retain the duplicate of the warrant and endorse receipt upon the original warrant 
229.8 	or acknowledge receipt of the order. The endorsed receipt or acknowledgment must be filed 
229.9 	in the court of commitment. After arrival, the patient shall be under the control and custody 
229.10 	of the head of the treatment facility.
229.11 	(d) Copies of the petition for commitment, the court's findings of fact and conclusions 
229.12 	of law, the court order committing the patient, the report of the examiners, and the prepetition 
229.13 	report shall be provided promptly to the treatment facility.

229.14 	Sec. 2. Minnesota Statutes 2016, section 253B.22, subdivision 1, is amended to read:
229.15 		Subdivision 1.Establishment. The commissioner shall establish a review board of three 
229.16 	or more persons for each regional center to review the admission and retention of its patients 
229.17 	receiving services under this chapter. The review board shall be comprised of two members 
229.18 	and one chair. Each board member shall be selected and appointed by the commissioner. 
229.19 	The appointed members shall be limited to one term of no more than three years and no 
229.20 	board member can serve more than three consecutive three-year terms. One member shall 
229.21 	be qualified in the diagnosis of mental illness, developmental disability, or chemical 
229.22 	dependency, and one member shall be an attorney. The commissioner may, upon written 
229.23 	request from the appropriate federal authority, establish a review panel for any federal 
229.24 	treatment facility within the state to review the admission and retention of patients 
229.25 	hospitalized under this chapter. For any review board established for a federal treatment 
229.26 	facility, one of the persons appointed by the commissioner shall be the commissioner of 
229.27 	veterans affairs or the commissioner's designee.

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

230.7 	ARTICLE 7
230.8 	CHILDREN AND FAMILIES

230.9 	Section 1. Minnesota Statutes 2016, section 13.32, is amended by adding a subdivision 
230.10 	to read:
230.11 		Subd. 12.Access by welfare system. County personnel in the welfare system may 
230.12 	request access to education data in order to coordinate services for a student or family. The 
230.13 	request must be submitted to the chief administrative officer of the school and must include 
230.14 	the basis for the request and a description of the information that is requested. The chief 
230.15 	administrative officer must provide a copy of the request to the parent or legal guardian of 
230.16 	the student who is the subject of the request, along with a form the parent or legal guardian 
230.17 	may execute to consent to the release of specified information to the requester. Education 
230.18 	data may be released under this subdivision only if the parent or legal guardian gives 
230.19 	informed consent to the release.

230.20 	Sec. 2. Minnesota Statutes 2016, section 13.46, subdivision 1, is amended to read:
230.21 		Subdivision 1.Definitions. As used in this section:
230.22 	(a) "Individual" means an individual according to section 13.02, subdivision 8, but does 
230.23 	not include a vendor of services.
230.24 	(b) "Program" includes all programs for which authority is vested in a component of the 
230.25 	welfare system according to statute or federal law, including, but not limited to, Native 
230.26 	American tribe programs that provide a service component of the welfare system, the aid 
230.27 	to families with dependent children program formerly codified in sections 256.72 to 256.87, 
230.28 	Minnesota family investment program, temporary assistance for needy families program, 
230.29 	medical assistance, general assistance, general assistance medical care formerly codified in 
230.30 	chapter 256D, child care assistance program, and child support collections.
230.31 	(c) "Welfare system" includes the Department of Human Services, local social services 
230.32 	agencies, county welfare agencies, county public health agencies, county veteran services 
231.1 	agencies, county housing agencies, private licensing agencies, the public authority responsible 
231.2 	for child support enforcement, human services boards, community mental health center 
231.3 	boards, state hospitals, state nursing homes, the ombudsman for mental health and 
231.4 	developmental disabilities, Native American tribes to the extent a tribe provides a service 
231.5 	component of the welfare system, and persons, agencies, institutions, organizations, and 
231.6 	other entities under contract to any of the above agencies to the extent specified in the 
231.7 	contract.
231.8 	(d) "Mental health data" means data on individual clients and patients of community 
231.9 	mental health centers, established under section 245.62, mental health divisions of counties 
231.10 	and other providers under contract to deliver mental health services, or the ombudsman for 
231.11 	mental health and developmental disabilities.
231.12 	(e) "Fugitive felon" means a person who has been convicted of a felony and who has 
231.13 	escaped from confinement or violated the terms of probation or parole for that offense.
231.14 	(f) "Private licensing agency" means an agency licensed by the commissioner of human 
231.15 	services under chapter 245A to perform the duties under section 245A.16.

231.16 	Sec. 3. Minnesota Statutes 2016, section 13.46, subdivision 2, is amended to read:
231.17 		Subd. 2.General. (a) Data on individuals collected, maintained, used, or disseminated 
231.18 	by the welfare system are private data on individuals, and shall not be disclosed except:
231.19 	(1) according to section 13.05;
231.20 	(2) according to court order;
231.21 	(3) according to a statute specifically authorizing access to the private data;
231.22 	(4) to an agent of the welfare system and an investigator acting on behalf of a county, 
231.23 	the state, or the federal government, including a law enforcement person or attorney in the 
231.24 	investigation or prosecution of a criminal, civil, or administrative proceeding relating to the 
231.25 	administration of a program;
231.26 	(5) to personnel of the welfare system who require the data to verify an individual's 
231.27 	identity; determine eligibility, amount of assistance, and the need to provide services to an 
231.28 	individual or family across programs; coordinate services for an individual or family; 
231.29 	evaluate the effectiveness of programs; assess parental contribution amounts; and investigate 
231.30 	suspected fraud;
231.31 	(6) to administer federal funds or programs;
231.32 	(7) between personnel of the welfare system working in the same program;
232.1 	(8) to the Department of Revenue to assess parental contribution amounts for purposes 
232.2 	of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit programs 
232.3 	and to identify individuals who may benefit from these programs. The following information 
232.4 	may be disclosed under this paragraph: an individual's and their dependent's names, dates 
232.5 	of birth, Social Security numbers, income, addresses, and other data as required, upon 
232.6 	request by the Department of Revenue. Disclosures by the commissioner of revenue to the 
232.7 	commissioner of human services for the purposes described in this clause are governed by 
232.8 	section 270B.14, subdivision 1. Tax refund or tax credit programs include, but are not limited 
232.9 	to, the dependent care credit under section 290.067, the Minnesota working family credit 
232.10 	under section 290.0671, the property tax refund and rental credit under section 290A.04, 
232.11 	and the Minnesota education credit under section 290.0674;
232.12 	(9) between the Department of Human Services, the Department of Employment and 
232.13 	Economic Development, and when applicable, the Department of Education, for the following 
232.14 	purposes:
232.15 	(i) to monitor the eligibility of the data subject for unemployment benefits, for any 
232.16 	employment or training program administered, supervised, or certified by that agency;
232.17 	(ii) to administer any rehabilitation program or child care assistance program, whether 
232.18 	alone or in conjunction with the welfare system;
232.19 	(iii) to monitor and evaluate the Minnesota family investment program or the child care 
232.20 	assistance program by exchanging data on recipients and former recipients of food support, 
232.21 	cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance under chapter 
232.22 	119B, medical programs under chapter 256B or 256L, or a medical program formerly 
232.23 	codified under chapter 256D; and
232.24 	(iv) to analyze public assistance employment services and program utilization, cost, 
232.25 	effectiveness, and outcomes as implemented under the authority established in Title II, 
232.26 	Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of 1999. 
232.27 	Health records governed by sections 144.291 to 144.298 and "protected health information" 
232.28 	as defined in Code of Federal Regulations, title 45, section 160.103, and governed by Code 
232.29 	of Federal Regulations, title 45, parts 160-164, including health care claims utilization 
232.30 	information, must not be exchanged under this clause;
232.31 	(10) to appropriate parties in connection with an emergency if knowledge of the 
232.32 	information is necessary to protect the health or safety of the individual or other individuals 
232.33 	or persons;
233.1 	(11) data maintained by residential programs as defined in section 245A.02 may be 
233.2 	disclosed to the protection and advocacy system established in this state according to Part 
233.3 	C of Public Law 98-527 to protect the legal and human rights of persons with developmental 
233.4 	disabilities or other related conditions who live in residential facilities for these persons if 
233.5 	the protection and advocacy system receives a complaint by or on behalf of that person and 
233.6 	the person does not have a legal guardian or the state or a designee of the state is the legal 
233.7 	guardian of the person;
233.8 	(12) to the county medical examiner or the county coroner for identifying or locating 
233.9 	relatives or friends of a deceased person;
233.10 	(13) data on a child support obligor who makes payments to the public agency may be 
233.11 	disclosed to the Minnesota Office of Higher Education to the extent necessary to determine 
233.12 	eligibility under section 136A.121, subdivision 2, clause (5);
233.13 	(14) participant Social Security numbers and names collected by the telephone assistance 
233.14 	program may be disclosed to the Department of Revenue to conduct an electronic data 
233.15 	match with the property tax refund database to determine eligibility under section 237.70, 
233.16 	subdivision 4a;
233.17 	(15) the current address of a Minnesota family investment program participant may be 
233.18 	disclosed to law enforcement officers who provide the name of the participant and notify 
233.19 	the agency that:
233.20 	(i) the participant:
233.21 	(A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after 
233.22 	conviction, for a crime or attempt to commit a crime that is a felony under the laws of the 
233.23 	jurisdiction from which the individual is fleeing; or
233.24 	(B) is violating a condition of probation or parole imposed under state or federal law;
233.25 	(ii) the location or apprehension of the felon is within the law enforcement officer's 
233.26 	official duties; and
233.27 	(iii) the request is made in writing and in the proper exercise of those duties;
233.28 	(16) the current address of a recipient of general assistance may be disclosed to probation 
233.29 	officers and corrections agents who are supervising the recipient and to law enforcement 
233.30 	officers who are investigating the recipient in connection with a felony level offense;
233.31 	(17) information obtained from food support applicant or recipient households may be 
233.32 	disclosed to local, state, or federal law enforcement officials, upon their written request, for 
234.1 	the purpose of investigating an alleged violation of the Food Stamp Act, according to Code 
234.2 	of Federal Regulations, title 7, section 272.1(c);
234.3 	(18) the address, Social Security number, and, if available, photograph of any member 
234.4 	of a household receiving food support shall be made available, on request, to a local, state, 
234.5 	or federal law enforcement officer if the officer furnishes the agency with the name of the 
234.6 	member and notifies the agency that:
234.7 	(i) the member:
234.8 	(A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a 
234.9 	crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
234.10 	(B) is violating a condition of probation or parole imposed under state or federal law; 
234.11 	or
234.12 	(C) has information that is necessary for the officer to conduct an official duty related 
234.13 	to conduct described in subitem (A) or (B);
234.14 	(ii) locating or apprehending the member is within the officer's official duties; and
234.15 	(iii) the request is made in writing and in the proper exercise of the officer's official duty;
234.16 	(19) the current address of a recipient of Minnesota family investment program, general 
234.17 	assistance, or food support may be disclosed to law enforcement officers who, in writing, 
234.18 	provide the name of the recipient and notify the agency that the recipient is a person required 
234.19 	to register under section 243.166, but is not residing at the address at which the recipient is 
234.20 	registered under section 243.166;
234.21 	(20) certain information regarding child support obligors who are in arrears may be 
234.22 	made public according to section 518A.74;
234.23 	(21) data on child support payments made by a child support obligor and data on the 
234.24 	distribution of those payments excluding identifying information on obligees may be 
234.25 	disclosed to all obligees to whom the obligor owes support, and data on the enforcement 
234.26 	actions undertaken by the public authority, the status of those actions, and data on the income 
234.27 	of the obligor or obligee may be disclosed to the other party;
234.28 	(22) data in the work reporting system may be disclosed under section 256.998, 
234.29 	subdivision 7;
234.30 	(23) to the Department of Education for the purpose of matching Department of Education 
234.31 	student data with public assistance data to determine students eligible for free and 
234.32 	reduced-price meals, meal supplements, and free milk according to United States Code, 
235.1 	title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and state 
235.2 	funds that are distributed based on income of the student's family; and to verify receipt of 
235.3 	energy assistance for the telephone assistance plan;
235.4 	(24) the current address and telephone number of program recipients and emergency 
235.5 	contacts may be released to the commissioner of health or a community health board as 
235.6 	defined in section 145A.02, subdivision 5, when the commissioner or community health 
235.7 	board has reason to believe that a program recipient is a disease case, carrier, suspect case, 
235.8 	or at risk of illness, and the data are necessary to locate the person;
235.9 	(25) to other state agencies, statewide systems, and political subdivisions of this state, 
235.10 	including the attorney general, and agencies of other states, interstate information networks, 
235.11 	federal agencies, and other entities as required by federal regulation or law for the 
235.12 	administration of the child support enforcement program;
235.13 	(26) to personnel of public assistance programs as defined in section 256.741, for access 
235.14 	to the child support system database for the purpose of administration, including monitoring 
235.15 	and evaluation of those public assistance programs;
235.16 	(27) to monitor and evaluate the Minnesota family investment program by exchanging 
235.17 	data between the Departments of Human Services and Education, on recipients and former 
235.18 	recipients of food support, cash assistance under chapter 256, 256D, 256J, or 256K, child 
235.19 	care assistance under chapter 119B, medical programs under chapter 256B or 256L, or a 
235.20 	medical program formerly codified under chapter 256D;
235.21 	(28) to evaluate child support program performance and to identify and prevent fraud 
235.22 	in the child support program by exchanging data between the Department of Human Services, 
235.23 	Department of Revenue under section 270B.14, subdivision 1, paragraphs (a) and (b), 
235.24 	without regard to the limitation of use in paragraph (c), Department of Health, Department 
235.25 	of Employment and Economic Development, and other state agencies as is reasonably 
235.26 	necessary to perform these functions;
235.27 	(29) counties operating child care assistance programs under chapter 119B may 
235.28 	disseminate data on program participants, applicants, and providers to the commissioner of 
235.29 	education;
235.30 	(30) child support data on the child, the parents, and relatives of the child may be 
235.31 	disclosed to agencies administering programs under titles IV-B and IV-E of the Social 
235.32 	Security Act, as authorized by federal law; or
236.1 	(31) to a health care provider governed by sections 144.291 to 144.298, to the extent 
236.2 	necessary to coordinate services;
236.3 	(32) to the chief administrative officer of a school to coordinate services for a student 
236.4 	and family; data that may be disclosed under this clause are limited to name, date of birth, 
236.5 	gender, and address; or
236.6 	(33) to county correctional agencies to the extent necessary to coordinate services and 
236.7 	diversion programs; data that may be disclosed under this clause are limited to name, client 
236.8 	demographics, program, case status, and county worker information.
236.9 	(b) Information on persons who have been treated for drug or alcohol abuse may only 
236.10 	be disclosed according to the requirements of Code of Federal Regulations, title 42, sections 
236.11 	2.1 to 2.67.
236.12 	(c) Data provided to law enforcement agencies under paragraph (a), clause (15), (16), 
236.13 	(17), or (18), or paragraph (b), are investigative data and are confidential or protected 
236.14 	nonpublic while the investigation is active. The data are private after the investigation 
236.15 	becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
236.16 	(d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are 
236.17 	not subject to the access provisions of subdivision 10, paragraph (b).
236.18 	For the purposes of this subdivision, a request will be deemed to be made in writing if 
236.19 	made through a computer interface system.

236.20 	Sec. 4. Minnesota Statutes 2016, section 13.84, subdivision 5, is amended to read:
236.21 		Subd. 5.Disclosure. Private or confidential court services data shall not be disclosed 
236.22 	except:
236.23 	(a) pursuant to section 13.05;
236.24 	(b) pursuant to a statute specifically authorizing disclosure of court services data;
236.25 	(c) with the written permission of the source of confidential data;
236.26 	(d) to the court services department, parole or probation authority or state or local 
236.27 	correctional agency or facility having statutorily granted supervision over the individual 
236.28 	subject of the data, or to county personnel within the welfare system;
236.29 	(e) pursuant to subdivision 6;
236.30 	(f) pursuant to a valid court order; or
236.31 	(g) pursuant to section 611A.06, subdivision 3a.

237.1 	Sec. 5. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
237.2 	to read:
237.3 		Subd. 15b.Law enforcement authority. "Law enforcement authority" means a 
237.4 	government agency or department within or outside Minnesota with jurisdiction to investigate 
237.5 	or bring a civil or criminal action against a child care provider, including a county, city, or 
237.6 	district attorney's office, the Attorney General's Office, a human services agency, a United 
237.7 	States attorney's office, or a law enforcement agency.

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

237.9 	Sec. 6. Minnesota Statutes 2016, section 119B.011, is amended by adding a subdivision 
237.10 	to read:
237.11 		Subd. 19c.Stop payment. "Stop payment" means canceling a payment that was already 
237.12 	issued to a provider.

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

237.14 	Sec. 7. Minnesota Statutes 2016, section 119B.02, subdivision 5, is amended to read:
237.15 		Subd. 5.Program integrity. For child care assistance programs under this chapter, the 
237.16 	commissioner shall enforce the requirements for program integrity and fraud prevention 
237.17 	investigations under sections 256.046, 256.98, and 256.983 and chapter 245E.

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

237.19 	Sec. 8. Minnesota Statutes 2016, section 119B.09, subdivision 9a, is amended to read:
237.20 		Subd. 9a.Child care centers; assistance. (a) For the purposes of this subdivision, 
237.21 	"qualifying child" means a child who is not a child or dependent of an employee of the child 
237.22 	care provider. A child care center may receive authorizations for 25 or fewer children who 
237.23 	are dependents of the center's employees. If a child care center is authorized for more than 
237.24 	25 children who are dependents of center employees, the county cannot authorize additional 
237.25 	dependents of an employee until the number of children falls below 25.
237.26 	(b) Funds distributed under this chapter must not be paid for child care services that are 
237.27 	provided for a child or dependent of an employee under paragraph (a) unless at all times at 
237.28 	least 50 percent of the children for whom the child care provider is providing care are 
237.29 	qualifying children under paragraph (a).
237.30 	(c) If a child care provider satisfies the requirements for payment under paragraph (b), 
237.31 	but the percentage of qualifying children under paragraph (a) for whom the provider is 
238.1 	providing care falls below 50 percent, the provider shall have four weeks to raise the 
238.2 	percentage of qualifying children for whom the provider is providing care to at least 50 
238.3 	percent before payments to the provider are discontinued for child care services provided 
238.4 	for a child who is not a qualifying child.
238.5 	(d) This subdivision shall be implemented as follows:
238.6 	(1) no later than August 1, 2014, the commissioner shall issue a notice to providers who 
238.7 	have been identified as ineligible for funds distributed under this chapter as described in 
238.8 	paragraph (b); and
238.9 	(2) no later than January 5, 2015, payments to providers who do not comply with 
238.10 	paragraph (c) will be discontinued for child care services provided for children who are not 
238.11 	qualifying children.
238.12 	(e) If a child's authorization for child care assistance is terminated under this subdivision, 
238.13 	the county shall send a notice of adverse action to the provider and to the child's parent or 
238.14 	guardian, including information on the right to appeal, under Minnesota Rules, part 
238.15 	3400.0185.
238.16 	(f) (b) Funds paid to providers during the period of time between the issuance of a notice 
238.17 	under paragraph (d), clause (1), and discontinuation of payments under paragraph (d), clause 
238.18 	(2), when a center is authorized for more than 25 children who are dependents of center 
238.19 	employees must not be treated as overpayments under section 119B.11, subdivision 2a, due 
238.20 	to noncompliance with this subdivision.
238.21 	(g) (c) Nothing in this subdivision precludes the commissioner from conducting fraud 
238.22 	investigations relating to child care assistance, imposing sanctions, and obtaining monetary 
238.23 	recovery as otherwise provided by law.

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

238.25 	Sec. 9. [119B.097] AUTHORIZATION WITH A SECONDARY PROVIDER.
238.26 	(a) If a child uses any combination of the following providers paid by child care 
238.27 	assistance, a parent must choose one primary provider and one secondary provider per child 
238.28 	that can be paid by child care assistance:
238.29 	(1) an individual or child care center licensed under chapter 245A;
238.30 	(2) an individual or child care center or facility holding a valid child care license issued 
238.31 	by another state or tribe; or
238.32 	(3) a child care center exempt from licensing under section 245A.03.
239.1 	(b) The amount of child care authorized with the secondary provider cannot exceed 20 
239.2 	hours per two-week service period, per child, and the amount of care paid to a child's 
239.3 	secondary provider is limited under section 119B.13, subdivision 1. The total amount of 
239.4 	child care authorized with both the primary and secondary provider cannot exceed the 
239.5 	amount of child care allowed based on the parents' eligible activity schedule, the child's 
239.6 	school schedule, and any other factors relevant to the family's child care needs.

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

239.8 	Sec. 10. Minnesota Statutes 2016, section 119B.125, subdivision 4, is amended to read:
239.9 		Subd. 4.Unsafe care. A county may deny authorization as a child care provider to any 
239.10 	applicant or rescind revoke the authorization of any provider when the county knows or has 
239.11 	reason to believe that the provider is unsafe or that the circumstances of the chosen child 
239.12 	care arrangement are unsafe. The county must include the conditions under which a provider 
239.13 	or care arrangement will be determined to be unsafe in the county's child care fund plan 
239.14 	under section 119B.08, subdivision 3.

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

239.16 	Sec. 11. Minnesota Statutes 2016, section 119B.125, subdivision 6, is amended to read:
239.17 		Subd. 6.Record-keeping requirement. (a) As a condition of payment, all providers 
239.18 	receiving child care assistance payments must keep accurate and legible daily attendance 
239.19 	records at the site where services are delivered for children receiving child care assistance 
239.20 	and must make those records available immediately to the county or the commissioner upon 
239.21 	request. The attendance records must be completed daily and include the date, the first and 
239.22 	last name of each child in attendance, and the times when each child is dropped off and 
239.23 	picked up. To the extent possible, the times that the child was dropped off to and picked up 
239.24 	from the child care provider must be entered by the person dropping off or picking up the 
239.25 	child. The daily attendance records must be retained at the site where services are delivered 
239.26 	for six years after the date of service.
239.27 	(b) A county or the commissioner may deny or revoke a provider's authorization as a 
239.28 	child care provider to any applicant, rescind authorization of any provider, to receive child 
239.29 	care assistance payments under section 119B.13, subdivision 6, paragraph (d), pursue a 
239.30 	fraud disqualification under section 256.98, take an action against the provider under chapter 
239.31 	245E, or establish an attendance record overpayment claim in the systemunder paragraph 
239.32 	(c) against a current or former provider, when the county or the commissioner knows or 
239.33 	has reason to believe that the provider has not complied with the record-keeping requirement 
240.1 	in this subdivision. A provider's failure to produce attendance records as requested on more 
240.2 	than one occasion constitutes grounds for disqualification as a provider.
240.3 	(c) To calculate an attendance record overpayment under this subdivision, the 
240.4 	commissioner or county agency subtracts the maximum daily rate from the total amount 
240.5 	paid to a provider for each day that a child's attendance record is missing, unavailable, 
240.6 	incomplete, illegible, inaccurate, or otherwise inadequate.
240.7 	(d) The commissioner shall develop criteria to direct a county when the county must 
240.8 	establish an attendance overpayment under this subdivision.

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

240.10 	Sec. 12. Minnesota Statutes 2016, section 119B.13, subdivision 1, is amended to read:
240.11 		Subdivision 1.Subsidy restrictions. (a) Beginning February 3, 2014, the maximum 
240.12 	rate paid for child care assistance in any county or county price cluster under the child care 
240.13 	fund shall be the greater of the 25th percentile of the 2011 child care provider rate survey 
240.14 	or the maximum rate effective November 28, 2011. The commissioner may: (1) assign a 
240.15 	county with no reported provider prices to a similar price cluster; and (2) consider county 
240.16 	level access when determining final price clusters.
240.17 	(b) A rate which includes a special needs rate paid under subdivision 3 may be in excess 
240.18 	of the maximum rate allowed under this subdivision.
240.19 	(c) The department shall monitor the effect of this paragraph on provider rates. The 
240.20 	county shall pay the provider's full charges for every child in care up to the maximum 
240.21 	established. The commissioner shall determine the maximum rate for each type of care on 
240.22 	an hourly, full-day, and weekly basis, including special needs and disability care.
240.23 	(d) If a child uses one provider, the maximum payment to a provider for one day of care 
240.24 	must not exceed the daily rate. The maximum payment to a provider for one week of care 
240.25 	must not exceed the weekly rate.
240.26 	(d) (e) If a child uses two providers under section 119B.097, the maximum payment 
240.27 	must not exceed:
240.28 	(1) the daily rate for one day of care;
240.29 	(2) the weekly rate for one week of care by a child's primary provider; and
240.30 	(3) two daily rates during two weeks of care by a child's secondary provider.
241.1 	(f) Child care providers receiving reimbursement under this chapter must not be paid 
241.2 	activity fees or an additional amount above the maximum rates for care provided during 
241.3 	nonstandard hours for families receiving assistance.
241.4 	(e) When (g) If the provider charge is greater than the maximum provider rate allowed, 
241.5 	the parent is responsible for payment of the difference in the rates in addition to any family 
241.6 	co-payment fee.
241.7 	(f) (h) All maximum provider rates changes shall be implemented on the Monday 
241.8 	following the effective date of the maximum provider rate.
241.9 	(g) (i) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum 
241.10 	registration fees in effect on January 1, 2013, shall remain in effect.

241.11 	EFFECTIVE DATE. Paragraphs (d) to (i) are effective April 23, 2018.

241.12 	Sec. 13. Minnesota Statutes 2016, section 119B.13, subdivision 6, is amended to read:
241.13 		Subd. 6.Provider payments. (a) A provider must bill only for services documented 
241.14 	according to section 119B.125, subdivision 6. The provider shall bill for services provided 
241.15 	within ten days of the end of the service period. If bills are submitted within ten days of the 
241.16 	end of the service period, Payments under the child care fund shall be made within 3021 
241.17 	days of receiving a complete bill from the provider. Counties or the state may establish 
241.18 	policies that make payments on a more frequent basis.
241.19 	(b) If a provider has received an authorization of care and been issued a billing form for 
241.20 	an eligible family, the bill must be submitted within 60 days of the last date of service on 
241.21 	the bill. A bill submitted more than 60 days after the last date of service must be paid if the 
241.22 	county determines that the provider has shown good cause why the bill was not submitted 
241.23 	within 60 days. Good cause must be defined in the county's child care fund plan under 
241.24 	section 119B.08, subdivision 3, and the definition of good cause must include county error. 
241.25 	Any bill submitted more than a year after the last date of service on the bill must not be 
241.26 	paid.
241.27 	(c) If a provider provided care for a time period without receiving an authorization of 
241.28 	care and a billing form for an eligible family, payment of child care assistance may only be 
241.29 	made retroactively for a maximum of six months from the date the provider is issued an 
241.30 	authorization of care and billing form.
241.31 	(d) A county or the commissioner may refuse to issue a child care authorization to a 
241.32 	licensed or legal nonlicensed provider, revoke an existing child care authorization to a 
242.1 	licensed or legal nonlicensed provider, stop payment issued to a licensed or legal nonlicensed 
242.2 	provider, or refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
242.3 	(1) the provider admits to intentionally giving the county materially false information 
242.4 	on the provider's billing forms;
242.5 	(2) a county or the commissioner finds by a preponderance of the evidence that the 
242.6 	provider intentionally gave the county materially false information on the provider's billing 
242.7 	forms, or provided false attendance records to a county or the commissioner;
242.8 	(3) the provider is in violation of child care assistance program rules, until the agency 
242.9 	determines those violations have been corrected;
242.10 	(4) the provider is operating after:
242.11 	(i) an order of suspension of the provider's license issued by the commissioner; or
242.12 	(ii) an order of revocation of the provider's license; or
242.13 	(iii) a final order of conditional license issued by the commissioner for as long as the 
242.14 	conditional license is in effect;
242.15 	(5) the provider submits false an inaccurate attendance reports or refuses to provide 
242.16 	documentation of the child's attendance upon request; or record;
242.17 	(6) the provider gives false child care price information.; or
242.18 	(7) the provider fails to grant access to a county or the commissioner during regular 
242.19 	business hours to examine all records necessary to determine the extent of services provided 
242.20 	to a child care assistance recipient and the appropriateness of a claim for payment.
242.21 	(e) If a county or the commissioner finds that a provider violated paragraph (d), clause 
242.22 	(1) or (2), a county or the commissioner must deny or revoke the provider's authorization 
242.23 	and either pursue a fraud disqualification under section 256.98, subdivision 8, paragraph 
242.24 	(c), or refer the case to a law enforcement authority. A provider's rights related to an 
242.25 	authorization denial or revocation under this paragraph are established in section 119B.161. 
242.26 	If a provider's authorization is revoked or denied under this paragraph, the denial or 
242.27 	revocation lasts until either:
242.28 	(1) all criminal, civil, and administrative proceedings related to the provider's alleged 
242.29 	misconduct conclude and any appeal rights are exhausted; or
242.30 	(2) the commissioner decides, based on written evidence or argument submitted under 
242.31 	section 119B.161, to authorize the provider.
243.1 	(f) If a county or the commissioner denies or revokes a provider's authorization under 
243.2 	paragraph (d), clause (4), the provider shall not be authorized until the order of suspension 
243.3 	or order of revocation against the provider is lifted.
243.4 	(e) For purposes of (g) If a county or the commissioner finds that a provider violated
243.5 	paragraph (d), clauses (3), (5), and or (6), the county or the commissioner may withhold
243.6 	revoke or deny the provider's authorization or payment for a period of time not to exceed 
243.7 	three months beyond the time the condition has been corrected. If a provider's authorization 
243.8 	is revoked or denied under this paragraph, the denial or revocation may last up to 90 days 
243.9 	from the date a county or the commissioner denies or revokes the provider's authorization.
243.10 	(h) If a county or the commissioner determines a provider violated paragraph (d), clause 
243.11 	(7), a county or the commissioner must deny or revoke the provider's authorization until a 
243.12 	county or the commissioner determines whether the records sought comply with this chapter 
243.13 	and chapter 245E. The provider's rights related to an authorization denial or revocation 
243.14 	under this paragraph are established in section 119B.161.
243.15 	(f) (i) A county's payment policies must be included in the county's child care plan under 
243.16 	section 119B.08, subdivision 3. If payments are made by the state, in addition to being in 
243.17 	compliance with this subdivision, the payments must be made in compliance with section 
243.18 	16A.124.

243.19 	EFFECTIVE DATE. Paragraph (a) is effective September 25, 2017. Paragraphs (d) to 
243.20 	(i) are effective April 23, 2018.

243.21 	Sec. 14. Minnesota Statutes 2016, section 119B.16, subdivision 1, is amended to read:
243.22 		Subdivision 1.Fair hearing allowed for applicants and recipients. (a) An applicant 
243.23 	or recipient adversely affected by an action of a county agency action or the commissioner
243.24 	may request and receive a fair hearing in accordance with this subdivision and section 
243.25 	256.045.
243.26 	(b) A county agency must offer an informal conference to an applicant or recipient who 
243.27 	is entitled to a fair hearing under this section. A county agency shall advise an adversely 
243.28 	affected applicant or recipient that a request for a conference is optional and does not delay 
243.29 	or replace the right to a fair hearing.
243.30 	(c) An applicant or recipient does not have a right to a fair hearing if a county agency 
243.31 	or the commissioner takes action against a provider.
244.1 	(d) If a provider's authorization is suspended, denied, or revoked, a county agency or 
244.2 	the commissioner must mail notice to a child care assistance program recipient receiving 
244.3 	care from the provider.

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

244.5 	Sec. 15. Minnesota Statutes 2016, section 119B.16, subdivision 1a, is amended to read:
244.6 		Subd. 1a.Fair hearing allowed for providers. (a) This subdivision applies to providers 
244.7 	caring for children receiving child care assistance.
244.8 	(b) A provider to whom a county agency has assigned responsibility for an overpayment 
244.9 	may request a fair hearing in accordance with section 256.045 for the limited purpose of 
244.10 	challenging the assignment of responsibility for the overpayment and the amount of the 
244.11 	overpayment. The scope of the fair hearing does not include the issues of whether the 
244.12 	provider wrongfully obtained public assistance in violation of section 256.98 or was properly 
244.13 	disqualified under section 256.98, subdivision 8, paragraph (c), unless the fair hearing has 
244.14 	been combined with an administrative disqualification hearing brought against the provider 
244.15 	under section 256.046.
244.16 	(b) A provider may request a fair hearing only as specified in this subdivision.
244.17 	(c) A provider may request a fair hearing according to sections 256.045 and 256.046 if 
244.18 	a county agency or the commissioner:
244.19 	(1) denies or revokes a provider's authorization, unless the action entitles the provider 
244.20 	to a consolidated contested case hearing under section 119B.16, subdivision 3, or an 
244.21 	administrative review under section 119B.161;
244.22 	(2) assigns responsibility for an overpayment to a provider under section 119B.11, 
244.23 	subdivision 2a;
244.24 	(3) establishes an overpayment for failure to comply with section 119B.125, subdivision 
244.25 	6;
244.26 	(4) seeks monetary recovery or recoupment under section 245E.02, subdivision 4, 
244.27 	paragraph (c), clause (2);
244.28 	(5) initiates an administrative fraud disqualification hearing; or
244.29 	(6) issues a payment and the provider disagrees with the amount of the payment.
244.30 	(d) A provider may request a fair hearing by submitting a written request to the 
244.31 	Department of Human Services, Appeals Division. A provider's request must be received 
245.1 	by the appeals division no later than 30 days after the date a county or the commissioner 
245.2 	mails the notice. The provider's appeal request must contain the following:
245.3 	(1) each disputed item, the reason for the dispute, and, if appropriate, an estimate of the 
245.4 	dollar amount involved for each disputed item;
245.5 	(2) the computation the provider believes to be correct, if appropriate;
245.6 	(3) the statute or rule relied on for each disputed item; and
245.7 	(4) the name, address, and telephone number of the person at the provider's place of 
245.8 	business with whom contact may be made regarding the appeal.

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

245.10 	Sec. 16. Minnesota Statutes 2016, section 119B.16, subdivision 1b, is amended to read:
245.11 		Subd. 1b.Joint fair hearings. When a provider requests a fair hearing under subdivision 
245.12 	1a, the family in whose case the overpayment was created must be made a party to the fair 
245.13 	hearing. All other issues raised by the family must be resolved in the same proceeding. 
245.14 	When a family requests a fair hearing and claims that the county should have assigned 
245.15 	responsibility for an overpayment to a provider, the provider must be made a party to the 
245.16 	fair hearing. The human services judge assigned to a fair hearing may join a family or a 
245.17 	provider as a party to the fair hearing whenever joinder of that party is necessary to fully 
245.18 	and fairly resolve overpayment issues raised in the appeal.

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

245.20 	Sec. 17. Minnesota Statutes 2016, section 119B.16, is amended by adding a subdivision 
245.21 	to read:
245.22 		Subd. 1c.Notice to providers. (a) Before taking an action appealable under subdivision 
245.23 	1a, paragraph (c), a county agency or the commissioner must mail written notice to the 
245.24 	provider against whom the action is being taken.
245.25 	(b) The notice shall state:
245.26 	(1) the factual basis for the department's determination;
245.27 	(2) the action the department intends to take;
245.28 	(3) the dollar amount of the monetary recovery or recoupment, if known; and
245.29 	(4) the right to appeal the department's proposed action.
246.1 	(c) A county agency or the commissioner must mail the written notice at least 15 calendar 
246.2 	days before the adverse action's effective date.

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

246.4 	Sec. 18. Minnesota Statutes 2016, section 119B.16, is amended by adding a subdivision 
246.5 	to read:
246.6 		Subd. 3.Consolidated contested case hearing. If a county agency or the commissioner 
246.7 	denies or revokes a provider's authorization based on a licensing action, the provider may 
246.8 	only appeal the denial or revocation in the same contested case proceeding that the provider 
246.9 	appeals the licensing action.

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

246.11 	Sec. 19. Minnesota Statutes 2016, section 119B.16, is amended by adding a subdivision 
246.12 	to read:
246.13 		Subd. 4.Final department action. Unless the commissioner receives a timely and 
246.14 	proper request for an appeal, a county agency's or the commissioner's action shall be 
246.15 	considered a final department action.

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

246.17 	Sec. 20. [119B.161] ADMINISTRATIVE REVIEW.
246.18 		Subdivision 1.Temporary denial or revocation of authorization. (a) A provider has 
246.19 	the rights listed under this section if:
246.20 	(1) the provider's authorization was denied or revoked under section 119B.13, subdivision 
246.21 	6, paragraph (d), clause (1), (2), or (7);
246.22 	(2) the provider's authorization was temporarily suspended under paragraph (b); or
246.23 	(3) a payment was suspended under chapter 245E.
246.24 	(b) Unless the commissioner receives a timely and proper request for an appeal, a county's 
246.25 	or the commissioner's action is a final department action.
246.26 	(c) The commissioner may temporarily suspend a provider's authorization without prior 
246.27 	notice and opportunity for hearing if the commissioner determines either that there is a 
246.28 	credible allegation of fraud for which an investigation is pending under the child care 
246.29 	assistance program, or that the suspension is necessary for public safety and the best interests 
246.30 	of the child care assistance program. An allegation is considered credible if the allegation 
247.1 	has indications of reliability. The commissioner may determine that an allegation is credible, 
247.2 	if the commissioner reviewed all allegations, facts, and evidence carefully and acts judiciously 
247.3 	on a case-by-case basis.
247.4 		Subd. 2.Notice. (a) A county or the commissioner must mail a provider notice within 
247.5 	five days of suspending, revoking, or denying a provider's authorization under subdivision 
247.6 	1.
247.7 	(b) The notice must:
247.8 	(1) state the provision under which a county or the commissioner is denying, revoking, 
247.9 	or suspending a provider's authorization or suspending payment to the provider;
247.10 	(2) set forth the general allegations leading to the revocation, denial, or suspension of a 
247.11 	provider's authorization. The notice need not disclose any specific information concerning 
247.12 	an ongoing investigation;
247.13 	(3) state that the suspension, revocation, or denial of a provider's authorization is for a 
247.14 	temporary period and explain the circumstances under which the action expires; and
247.15 	(4) inform the provider of the right to submit written evidence and argument for 
247.16 	consideration by the commissioner.
247.17 	(c) Notwithstanding Minnesota Rules, part 3400.0185, if a county or the commissioner 
247.18 	denies or revokes a provider's authorization under section 119B.13, subdivision 6, paragraph 
247.19 	(d), clause (1), (2), or (7); suspends a payment to a provider under chapter 245E; or 
247.20 	temporarily suspends a payment to a provider under section 119B.161, subdivision 1, a 
247.21 	county or the commissioner must send notice of termination to an affected family. The 
247.22 	termination sent to an affected family is effective on the date the notice is created.
247.23 		Subd. 3.Duration. If a provider's authorization is denied or revoked under section 
247.24 	119B.13, subdivision 6, paragraph (d), clause (1), (2), or (7); authorization is temporarily 
247.25 	suspended under section 119B.161; or payment is suspended under chapter 245E, the 
247.26 	provider's denial, revocation, temporary suspension, or payment suspension remains in 
247.27 	effect until:
247.28 	(1) the commissioner or a law enforcement authority determines that there is insufficient 
247.29 	evidence warranting the action and a county or the commissioner does not pursue an 
247.30 	additional administrative remedy under chapter 245E or section 256.98; or
247.31 	(2) all criminal, civil, and administrative proceedings related to the provider's alleged 
247.32 	misconduct conclude and any appeal rights are exhausted.
248.1 		Subd. 4.Good cause exception. A county or the commissioner may find that good cause 
248.2 	exists not to deny, revoke, or suspend a provider's authorization, or not to continue a denial, 
248.3 	revocation, or suspension of a provider's authorization if any of the following are applicable:
248.4 	(1) a law enforcement authority specifically requested that a provider's authorization 
248.5 	not be denied, revoked, or suspended because it may compromise an ongoing investigation;
248.6 	(2) a county or the commissioner determines that the denial, revocation, or suspension 
248.7 	should be removed based on the provider's written submission; or
248.8 	(3) the commissioner determines that the denial, revocation, or suspension is not in the 
248.9 	best interests of the program.

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

248.11 	Sec. 21. Minnesota Statutes 2016, section 245A.50, subdivision 5, is amended to read:
248.12 		Subd. 5.Sudden unexpected infant death and abusive head trauma training. (a) 
248.13 	License holders must document that before staff persons, caregivers, and helpers assist in 
248.14 	the care of infants, they are instructed on the standards in section 245A.1435 and receive 
248.15 	training on reducing the risk of sudden unexpected infant death. In addition, license holders 
248.16 	must document that before staff persons, caregivers, and helpers assist in the care of infants 
248.17 	and children under school age, they receive training on reducing the risk of abusive head 
248.18 	trauma from shaking infants and young children. The training in this subdivision may be 
248.19 	provided as initial training under subdivision 1 or ongoing annual training under subdivision 
248.20 	7.
248.21 	(b) Sudden unexpected infant death reduction training required under this subdivision 
248.22 	must, at a minimum, address the risk factors related to sudden unexpected infant death, 
248.23 	means of reducing the risk of sudden unexpected infant death in child care, and license 
248.24 	holder communication with parents regarding reducing the risk of sudden unexpected infant 
248.25 	death.
248.26 	(c) Abusive head trauma training required under this subdivision must, at a minimum, 
248.27 	address the risk factors related to shaking infants and young children, means of reducing 
248.28 	the risk of abusive head trauma in child care, and license holder communication with parents 
248.29 	regarding reducing the risk of abusive head trauma.
248.30 	(d) Training for family and group family child care providers must be developed by the 
248.31 	commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved 
248.32 	by the Minnesota Center for Professional Development. Sudden unexpected infant death 
249.1 	reduction training and abusive head trauma training may be provided in a single course of 
249.2 	no more than two hours in length.
249.3 	(e) Sudden unexpected infant death reduction training and abusive head trauma training 
249.4 	required under this subdivision must be completed in person or as allowed under subdivision 
249.5 	10, clause (1) or (2), at least once every two years. On the years when the license holder is 
249.6 	not receiving training in person or as allowed under subdivision 10, clause (1) or (2), the 
249.7 	license holder must receive sudden unexpected infant death reduction training and abusive 
249.8 	head trauma training through a video of no more than one hour in length. The video must 
249.9 	be developed or approved by the commissioner.
249.10 	(f) An individual who is related to the license holder as defined in section 245A.02, 
249.11 	subdivision 13, and who is involved only in the care of the license holder's own infant or 
249.12 	child under school age and who is not designated to be a caregiver, helper, or substitute, as 
249.13 	defined in Minnesota Rules, part 9502.0315, for the licensed program, is exempt from the 
249.14 	sudden unexpected infant death and abusive head trauma training.

249.15 	Sec. 22. Minnesota Statutes 2016, section 245E.01, is amended by adding a subdivision 
249.16 	to read:
249.17 		Subd. 6a.Credible allegation of fraud. "Credible allegation of fraud" has the meaning 
249.18 	given in section 256B.064, subdivision 2, paragraph (b), clause (2).

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

249.20 	Sec. 23. Minnesota Statutes 2016, section 245E.02, subdivision 1, is amended to read:
249.21 		Subdivision 1.Investigating provider or recipient financial misconduct. The 
249.22 	department shall investigate alleged or suspected financial misconduct by providers and 
249.23 	errors related to payments issued by the child care assistance program under this chapter. 
249.24 	Recipients, employees, agents and consultants, and staff may be investigated when the 
249.25 	evidence shows that their conduct is related to the financial misconduct of a provider, license 
249.26 	holder, or controlling individual. When the alleged or suspected financial misconduct relates 
249.27 	to acting as a recruiter offering conditional employment on behalf of a provider that has 
249.28 	received funds from the child care assistance program, the department may investigate the 
249.29 	provider, center owner, director, manager, license holder, or other controlling individual or 
249.30 	agent, who is alleged to have acted as a recruiter offering conditional employment.

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

250.1 	Sec. 24. Minnesota Statutes 2016, section 245E.02, subdivision 3, is amended to read:
250.2 		Subd. 3.Determination of investigation. After completing its investigation, the 
250.3 	department shall issue one of the following determinations determine that:
250.4 	(1) no violation of child care assistance requirements occurred;
250.5 	(2) there is insufficient evidence to show that a violation of child care assistance 
250.6 	requirements occurred;
250.7 	(3) a preponderance of evidence shows a violation of child care assistance program law, 
250.8 	rule, or policy; or
250.9 	(4) there exists a credible allegation of fraud involving the child care assistance program.

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

250.11 	Sec. 25. Minnesota Statutes 2016, section 245E.02, subdivision 4, is amended to read:
250.12 		Subd. 4.Actions Referrals or administrative sanctions actions. (a) After completing 
250.13 	the determination under subdivision 3, the department may take one or more of the actions 
250.14 	or sanctions specified in this subdivision.
250.15 	(b) The department may take any of the following actions:
250.16 	(1) refer the investigation to law enforcement or a county attorney for possible criminal 
250.17 	prosecution;
250.18 	(2) refer relevant information to the department's licensing division, the background 
250.19 	studies division, the child care assistance program, the Department of Education, the federal 
250.20 	child and adult care food program, or appropriate child or adult protection agency;
250.21 	(3) enter into a settlement agreement with a provider, license holder, owner, agent, 
250.22 	controlling individual, or recipient; or
250.23 	(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction 
250.24 	for possible civil action under the Minnesota False Claims Act, chapter 15C.
250.25 	(c) In addition to section 256.98, the department may impose sanctions by:
250.26 	(1) pursuing administrative disqualification through hearings or waivers;
250.27 	(2) establishing and seeking monetary recovery or recoupment;
250.28 	(3) issuing an order of corrective action that states the practices that are violations of 
250.29 	child care assistance program policies, laws, or regulations, and that they must be corrected; 
250.30 	or
251.1 	(4) suspending, denying, or terminating payments to a provider.; or
251.2 	(5) taking an action under section 119B.13, subdivision 6, paragraph (d).
251.3 	(d) Upon a finding by If the commissioner determines that any child care provider, center 
251.4 	owner, director, manager, license holder, or other controlling individual of a child care 
251.5 	center has employed, used, or acted as a recruiter offering conditional employment for a 
251.6 	child care center that has received child care assistance program funding, the commissioner 
251.7 	shall:
251.8 	(1) immediately suspend all program payments to all child care centers in which the 
251.9 	person employing, using, or acting as a recruiter offering conditional employment is an 
251.10 	owner, director, manager, license holder, or other controlling individual. The commissioner 
251.11 	shall suspend program payments under this clause even if services have already been 
251.12 	provided; and
251.13 	(2) immediately and permanently revoke the licenses of all child care centers of which 
251.14 	the person employing, using, or acting as a recruiter offering conditional employment is an 
251.15 	owner, director, manager, license holder, or other controlling individual.

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

251.17 	Sec. 26. Minnesota Statutes 2016, section 245E.03, subdivision 2, is amended to read:
251.18 		Subd. 2.Failure to provide access. Failure to provide access may result in denial or 
251.19 	termination of authorizations for or payments to a recipient, provider, license holder, or 
251.20 	controlling individual in the child care assistance program. If a provider fails to grant the 
251.21 	department immediate access to records, the department may immediately suspend payments 
251.22 	under section 119B.161, or the department may deny or revoke the provider's authorization. 
251.23 	A provider, license holder, controlling individual, employee, or staff member must grant 
251.24 	the department access during any hours that the program is open to examine the provider's 
251.25 	program or the records listed in section 245E.05. A provider shall make records immediately 
251.26 	available at the provider's place of business at the time the department requests access, 
251.27 	unless the provider and the department both agree otherwise.

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

251.29 	Sec. 27. Minnesota Statutes 2016, section 245E.03, subdivision 4, is amended to read:
251.30 		Subd. 4.Continued or repeated failure to provide access. If the provider continues 
251.31 	to fail to provide access at the expiration of the 15-day notice period, child care assistance 
251.32 	program payments to the provider must be denied suspended beginning the 16th day 
252.1 	following notice of the initial failure or refusal to provide access. The department may 
252.2 	rescind the denial based upon good cause if the provider submits in writing a good cause 
252.3 	basis for having failed or refused to provide access. The writing must be postmarked no 
252.4 	later than the 15th day following the provider's notice of initial failure to provide access. A 
252.5 	provider's, license holder's, controlling individual's, employee's, staff member's, or recipient's 
252.6 	duty to provide access in this section continues after the provider's authorization is denied, 
252.7 	revoked, or suspended. Additionally, the provider, license holder, or controlling individual 
252.8 	must immediately provide complete, ongoing access to the department. Repeated failures 
252.9 	to provide access must, after the initial failure or for any subsequent failure, result in 
252.10 	termination from participation in the child care assistance program.

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

252.12 	Sec. 28. Minnesota Statutes 2016, section 245E.04, is amended to read:
252.13 	245E.04 HONEST AND TRUTHFUL STATEMENTS.
252.14 	It shall be unlawful for a provider, license holder, controlling individual, or recipient to:
252.15 	(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact means;
252.16 	(2) make any materially false, fictitious, or fraudulent statement or representation; or
252.17 	(3) make or use any false writing or document knowing the same to contain any materially 
252.18 	false, fictitious, or fraudulent statement or entry related to any child care assistance program 
252.19 	services that the provider, license holder, or controlling individual supplies or in relation to 
252.20 	any child care assistance payments received by a provider, license holder, or controlling 
252.21 	individual or to any fraud investigator or law enforcement officer conducting a financial 
252.22 	misconduct investigation.

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

252.24 	Sec. 29. Minnesota Statutes 2016, section 245E.05, subdivision 1, is amended to read:
252.25 		Subdivision 1.Records required to be retained. The following records must be 
252.26 	maintained, controlled, and made immediately accessible to license holders, providers, and 
252.27 	controlling individuals. The records must be organized and labeled to correspond to categories 
252.28 	that make them easy to identify so that they can be made available immediately upon request 
252.29 	to an investigator acting on behalf of the commissioner at the provider's place of business:
252.30 	(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting records;
253.1 	(2) daily attendance records required by and that comply with section 119B.125, 
253.2 	subdivision 6;
253.3 	(3) billing transmittal forms requesting payments from the child care assistance program 
253.4 	and billing adjustments related to child care assistance program payments;
253.5 	(4) records identifying all persons, corporations, partnerships, and entities with an 
253.6 	ownership or controlling interest in the provider's child care business;
253.7 	(5) employee or contractor records identifying those persons currently employed by the 
253.8 	provider's child care business or who have been employed by the business at any time within 
253.9 	the previous five years. The records must include each employee's name, hourly and annual 
253.10 	salary, qualifications, position description, job title, and dates of employment. In addition, 
253.11 	employee records that must be made available include the employee's time sheets, current 
253.12 	home address of the employee or last known address of any former employee, and 
253.13 	documentation of background studies required under chapter 119B or 245C;
253.14 	(6) records related to transportation of children in care, including but not limited to:
253.15 	(i) the dates and times that transportation is provided to children for transportation to 
253.16 	and from the provider's business location for any purpose. For transportation related to field 
253.17 	trips or locations away from the provider's business location, the names and addresses of 
253.18 	those field trips and locations must also be provided;
253.19 	(ii) the name, business address, phone number, and Web site address, if any, of the 
253.20 	transportation service utilized; and
253.21 	(iii) all billing or transportation records related to the transportation.

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

253.23 	Sec. 30. Minnesota Statutes 2016, section 245E.06, subdivision 1, is amended to read:
253.24 		Subdivision 1.Factors regarding imposition of administrative sanctions actions. (a) 
253.25 	The department shall consider the following factors in determining the administrative 
253.26 	sanctions actions to be imposed:
253.27 	(1) nature and extent of financial misconduct;
253.28 	(2) history of financial misconduct;
253.29 	(3) actions taken or recommended by other state agencies, other divisions of the 
253.30 	department, and court and administrative decisions;
253.31 	(4) prior imposition of sanctions actions;
254.1 	(5) size and type of provider;
254.2 	(6) information obtained through an investigation from any source;
254.3 	(7) convictions or pending criminal charges; and
254.4 	(8) any other information relevant to the acts or omissions related to the financial 
254.5 	misconduct.
254.6 	(b) Any single factor under paragraph (a) may be determinative of the department's 
254.7 	decision of whether and what sanctions are imposed actions to take.

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

254.9 	Sec. 31. Minnesota Statutes 2016, section 245E.06, subdivision 2, is amended to read:
254.10 		Subd. 2.Written notice of department sanction action; sanction action effective 
254.11 	date; informal meeting. (a) The department shall give notice in writing to a person of an 
254.12 	administrative sanction that is to be imposed. The notice shall be sent by mail as defined in 
254.13 	section 245E.01, subdivision 11.
254.14 	(b) The notice shall state:
254.15 	(1) the factual basis for the department's determination;
254.16 	(2) the sanction the department intends to take;
254.17 	(3) the dollar amount of the monetary recovery or recoupment, if any;
254.18 	(4) how the dollar amount was computed;
254.19 	(5) the right to dispute the department's determination and to provide evidence;
254.20 	(6) the right to appeal the department's proposed sanction; and
254.21 	(7) the option to meet informally with department staff, and to bring additional 
254.22 	documentation or information, to resolve the issues.
254.23 	(c) In cases of determinations resulting in denial or termination of payments, in addition 
254.24 	to the requirements of paragraph (b), the notice must state:
254.25 	(1) the length of the denial or termination;
254.26 	(2) the requirements and procedures for reinstatement; and
254.27 	(3) the provider's right to submit documents and written arguments against the denial 
254.28 	or termination of payments for review by the department before the effective date of denial 
254.29 	or termination.
255.1 	(d) The submission of documents and written argument for review by the department 
255.2 	under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the deadline 
255.3 	for filing an appeal.
255.4 	(a) When taking an action against a provider, the department must give notice to:
255.5 	(1) the provider as specified in section 119B.16 or 119B.161; and
255.6 	(2) a family as specified under Minnesota Rules, part 3400.0185, or section 119B.161.
255.7 	(e) (b) Notwithstanding section 245E.03, subdivision 4, and except for a payment 
255.8 	suspension or action under section 119B.161, subdivision 1, the effective date of the proposed 
255.9 	sanction action under this chapter shall be 30 days after the license holder's, provider's, 
255.10 	controlling individual's, or recipient's receipt of the notice, unless timely appealed. If a 
255.11 	timely appeal is made, the proposed sanction action shall be delayed pending the final 
255.12 	outcome of the appeal. Implementation of a proposed sanction action following the resolution 
255.13 	of a timely appeal may be postponed if, in the opinion of the department, the delay of 
255.14 	sanction action is necessary to protect the health or safety of children in care. The department 
255.15 	may consider the economic hardship of a person in implementing the proposed sanction, 
255.16 	but economic hardship shall not be a determinative factor in implementing the proposed 
255.17 	sanction.
255.18 	(f) Requests for an informal meeting to attempt to resolve issues and requests for appeals 
255.19 	must be sent or delivered to the department's Office of Inspector General, Financial Fraud 
255.20 	and Abuse Division.

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

255.22 	Sec. 32. Minnesota Statutes 2016, section 245E.06, subdivision 3, is amended to read:
255.23 		Subd. 3.Appeal of department sanction action. (a) If the department does not pursue 
255.24 	a criminal action against a provider, license holder, controlling individual, or recipient for 
255.25 	financial misconduct, but the department imposes an administrative sanction under section 
255.26 	245E.02, subdivision 4, paragraph (c), any individual or entity against whom the sanction 
255.27 	was imposed may appeal the department's administrative sanction under this section pursuant 
255.28 	to section 119B.16 or 256.045 with the additional requirements in clauses (1) to (4). An 
255.29 	appeal must specify:
255.30 	(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount 
255.31 	involved for each disputed item, if appropriate;
255.32 	(2) the computation that is believed to be correct, if appropriate;
256.1 	(3) the authority in the statute or rule relied upon for each disputed item; and
256.2 	(4) the name, address, and phone number of the person at the provider's place of business 
256.3 	with whom contact may be made regarding the appeal.
256.4 	(b) Notwithstanding section 245E.03, subdivision 4, an appeal is considered timely only 
256.5 	if postmarked or received by the department's Appeals Division within 30 days after receiving 
256.6 	a notice of department sanction.
256.7 	(c) Before the appeal hearing, the department may deny or terminate authorizations or 
256.8 	payment to the entity or individual if the department determines that the action is necessary 
256.9 	to protect the public welfare or the interests of the child care assistance program.
256.10 	A provider's rights related to an action taken under this chapter are established in sections 
256.11 	119B.16 and 119B.161.

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

256.13 	Sec. 33. Minnesota Statutes 2016, section 245E.07, subdivision 1, is amended to read:
256.14 		Subdivision 1.Grounds for and methods of monetary recovery. (a) The department 
256.15 	may obtain monetary recovery from a provider who has been improperly paid by the child 
256.16 	care assistance program, regardless of whether the error was on the part of the provider, the 
256.17 	department, or the county and regardless of whether the error was intentional or county 
256.18 	error. The department does not need to establish a pattern as a precondition of monetary 
256.19 	recovery of erroneous or false billing claims, duplicate billing claims, or billing claims 
256.20 	based on false statements or financial misconduct.
256.21 	(b) The department shall obtain monetary recovery from providers by the following 
256.22 	means:
256.23 	(1) permitting voluntary repayment of money, either in lump-sum payment or installment 
256.24 	payments;
256.25 	(2) using any legal collection process;
256.26 	(3) deducting or withholding program payments; or
256.27 	(4) utilizing the means set forth in chapter 16D.

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

257.1 	Sec. 34. Minnesota Statutes 2016, section 252.27, subdivision 2a, is amended to read:
257.2 		Subd. 2a.Contribution amount. (a) The natural or adoptive parents of a minor child, 
257.3 	including a child determined eligible for medical assistance without consideration of parental 
257.4 	income, must contribute to the cost of services used by making monthly payments on a 
257.5 	sliding scale based on income, unless the child is married or has been married, parental 
257.6 	rights have been terminated, or the child's adoption is subsidized according to chapter 259A 
257.7 	or through title IV-E of the Social Security Act. The parental contribution is a partial or full 
257.8 	payment for medical services provided for diagnostic, therapeutic, curing, treating, mitigating, 
257.9 	rehabilitation, maintenance, and personal care services as defined in United States Code, 
257.10 	title 26, section 213, needed by the child with a chronic illness or disability.
257.11 	(b) For households with adjusted gross income equal to or greater than 275 percent of 
257.12 	federal poverty guidelines, the parental contribution shall be computed by applying the 
257.13 	following schedule of rates to the adjusted gross income of the natural or adoptive parents:
257.14 	(1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty 
257.15 	guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental 
257.16 	contribution shall be determined using a sliding fee scale established by the commissioner 
257.17 	of human services which begins at 2.231.94 percent of adjusted gross income at 275 percent 
257.18 	of federal poverty guidelines and increases to 6.08 5.29 percent of adjusted gross income 
257.19 	for those with adjusted gross income up to 545 percent of federal poverty guidelines;
257.20 	(2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines 
257.21 	and less than 675 percent of federal poverty guidelines, the parental contribution shall be 
257.22 	6.085.29 percent of adjusted gross income;
257.23 	(3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty 
257.24 	guidelines and less than 975 percent of federal poverty guidelines, the parental contribution 
257.25 	shall be determined using a sliding fee scale established by the commissioner of human 
257.26 	services which begins at 6.085.29 percent of adjusted gross income at 675 percent of federal 
257.27 	poverty guidelines and increases to 8.17.05 percent of adjusted gross income for those with 
257.28 	adjusted gross income up to 975 percent of federal poverty guidelines; and
257.29 	(4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty 
257.30 	guidelines, the parental contribution shall be 10.138.81 percent of adjusted gross income.
257.31 	If the child lives with the parent, the annual adjusted gross income is reduced by $2,400 
257.32 	prior to calculating the parental contribution. If the child resides in an institution specified 
257.33 	in section 256B.35, the parent is responsible for the personal needs allowance specified 
257.34 	under that section in addition to the parental contribution determined under this section. 
258.1 	The parental contribution is reduced by any amount required to be paid directly to the child 
258.2 	pursuant to a court order, but only if actually paid.
258.3 	(c) The household size to be used in determining the amount of contribution under 
258.4 	paragraph (b) includes natural and adoptive parents and their dependents, including the 
258.5 	child receiving services. Adjustments in the contribution amount due to annual changes in 
258.6 	the federal poverty guidelines shall be implemented on the first day of July following 
258.7 	publication of the changes.
258.8 	(d) For purposes of paragraph (b), "income" means the adjusted gross income of the 
258.9 	natural or adoptive parents determined according to the previous year's federal tax form, 
258.10 	except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds 
258.11 	have been used to purchase a home shall not be counted as income.
258.12 	(e) The contribution shall be explained in writing to the parents at the time eligibility 
258.13 	for services is being determined. The contribution shall be made on a monthly basis effective 
258.14 	with the first month in which the child receives services. Annually upon redetermination 
258.15 	or at termination of eligibility, if the contribution exceeded the cost of services provided, 
258.16 	the local agency or the state shall reimburse that excess amount to the parents, either by 
258.17 	direct reimbursement if the parent is no longer required to pay a contribution, or by a 
258.18 	reduction in or waiver of parental fees until the excess amount is exhausted. All 
258.19 	reimbursements must include a notice that the amount reimbursed may be taxable income 
258.20 	if the parent paid for the parent's fees through an employer's health care flexible spending 
258.21 	account under the Internal Revenue Code, section 125, and that the parent is responsible 
258.22 	for paying the taxes owed on the amount reimbursed.
258.23 	(f) The monthly contribution amount must be reviewed at least every 12 months; when 
258.24 	there is a change in household size; and when there is a loss of or gain in income from one 
258.25 	month to another in excess of ten percent. The local agency shall mail a written notice 30 
258.26 	days in advance of the effective date of a change in the contribution amount. A decrease in 
258.27 	the contribution amount is effective in the month that the parent verifies a reduction in 
258.28 	income or change in household size.
258.29 	(g) Parents of a minor child who do not live with each other shall each pay the 
258.30 	contribution required under paragraph (a). An amount equal to the annual court-ordered 
258.31 	child support payment actually paid on behalf of the child receiving services shall be deducted 
258.32 	from the adjusted gross income of the parent making the payment prior to calculating the 
258.33 	parental contribution under paragraph (b).
259.1 	(h) The contribution under paragraph (b) shall be increased by an additional five percent 
259.2 	if the local agency determines that insurance coverage is available but not obtained for the 
259.3 	child. For purposes of this section, "available" means the insurance is a benefit of employment 
259.4 	for a family member at an annual cost of no more than five percent of the family's annual 
259.5 	income. For purposes of this section, "insurance" means health and accident insurance 
259.6 	coverage, enrollment in a nonprofit health service plan, health maintenance organization, 
259.7 	self-insured plan, or preferred provider organization.
259.8 	Parents who have more than one child receiving services shall not be required to pay 
259.9 	more than the amount for the child with the highest expenditures. There shall be no resource 
259.10 	contribution from the parents. The parent shall not be required to pay a contribution in 
259.11 	excess of the cost of the services provided to the child, not counting payments made to 
259.12 	school districts for education-related services. Notice of an increase in fee payment must 
259.13 	be given at least 30 days before the increased fee is due.
259.14 	(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in 
259.15 	the 12 months prior to July 1:
259.16 	(1) the parent applied for insurance for the child;
259.17 	(2) the insurer denied insurance;
259.18 	(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a 
259.19 	complaint or appeal, in writing, to the commissioner of health or the commissioner of 
259.20 	commerce, or litigated the complaint or appeal; and
259.21 	(4) as a result of the dispute, the insurer reversed its decision and granted insurance.
259.22 	For purposes of this section, "insurance" has the meaning given in paragraph (h).
259.23 	A parent who has requested a reduction in the contribution amount under this paragraph 
259.24 	shall submit proof in the form and manner prescribed by the commissioner or county agency, 
259.25 	including, but not limited to, the insurer's denial of insurance, the written letter or complaint 
259.26 	of the parents, court documents, and the written response of the insurer approving insurance. 
259.27 	The determinations of the commissioner or county agency under this paragraph are not rules 
259.28 	subject to chapter 14.

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

259.30 	Sec. 35. Minnesota Statutes 2016, section 256.98, subdivision 8, is amended to read:
259.31 		Subd. 8.Disqualification from program. (a) Any person found to be guilty of 
259.32 	wrongfully obtaining assistance by a federal or state court or by an administrative hearing 
260.1 	determination, or waiver thereof, through a disqualification consent agreement, or as part 
260.2 	of any approved diversion plan under section 401.065, or any court-ordered stay which 
260.3 	carries with it any probationary or other conditions, in the Minnesota family investment 
260.4 	program and any affiliated program to include the diversionary work program and the work 
260.5 	participation cash benefit program, the food stamp or food support program, the general 
260.6 	assistance program, the group residential housing program, or the Minnesota supplemental 
260.7 	aid program shall be disqualified from that program. In addition, any person disqualified 
260.8 	from the Minnesota family investment program shall also be disqualified from the food 
260.9 	stamp or food support program. The needs of that individual shall not be taken into 
260.10 	consideration in determining the grant level for that assistance unit:
260.11 	(1) for one year after the first offense;
260.12 	(2) for two years after the second offense; and
260.13 	(3) permanently after the third or subsequent offense.
260.14 	The period of program disqualification shall begin on the date stipulated on the advance 
260.15 	notice of disqualification without possibility of postponement for administrative stay or 
260.16 	administrative hearing and shall continue through completion unless and until the findings 
260.17 	upon which the sanctions were imposed are reversed by a court of competent jurisdiction. 
260.18 	The period for which sanctions are imposed is not subject to review. The sanctions provided 
260.19 	under this subdivision are in addition to, and not in substitution for, any other sanctions that 
260.20 	may be provided for by law for the offense involved. A disqualification established through 
260.21 	hearing or waiver shall result in the disqualification period beginning immediately unless 
260.22 	the person has become otherwise ineligible for assistance. If the person is ineligible for 
260.23 	assistance, the disqualification period begins when the person again meets the eligibility 
260.24 	criteria of the program from which they were disqualified and makes application for that 
260.25 	program.
260.26 	(b) A family receiving assistance through child care assistance programs under chapter 
260.27 	119B with a family member who is found to be guilty of wrongfully obtaining child care 
260.28 	assistance by a federal court, state court, or an administrative hearing determination or 
260.29 	waiver, through a disqualification consent agreement, as part of an approved diversion plan 
260.30 	under section 401.065, or a court-ordered stay with probationary or other conditions, is 
260.31 	disqualified from child care assistance programs. The disqualifications must be for periods 
260.32 	of one year and two years for the first and second offenses, respectively. Subsequent 
260.33 	violations must result in permanent disqualification. During the disqualification period, 
261.1 	disqualification from any child care program must extend to all child care programs and 
261.2 	must be immediately applied.
261.3 	(c) A provider caring for children receiving assistance through child care assistance 
261.4 	programs under chapter 119B is disqualified from receiving payment for child care services 
261.5 	from the child care assistance program under chapter 119B when the provider is found to 
261.6 	have wrongfully obtained child care assistance by a federal court, state court, or an 
261.7 	administrative hearing determination or waiver under section 256.046, through a 
261.8 	disqualification consent agreement, as part of an approved diversion plan under section 
261.9 	401.065, or a court-ordered stay with probationary or other conditions. The disqualification 
261.10 	must be for a period of one year two years for the first offense and two years for the second 
261.11 	offense. Any subsequent violation must result in permanent disqualification. The 
261.12 	disqualification period must be imposed immediately after a determination is made under 
261.13 	this paragraph. During the disqualification period, the provider is disqualified from receiving 
261.14 	payment from any child care program under chapter 119B.
261.15 	(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults 
261.16 	without children and upon federal approval, all categories of medical assistance and 
261.17 	remaining categories of MinnesotaCare, except for children through age 18, by a federal or 
261.18 	state court or by an administrative hearing determination, or waiver thereof, through a 
261.19 	disqualification consent agreement, or as part of any approved diversion plan under section 
261.20 	401.065, or any court-ordered stay which carries with it any probationary or other conditions, 
261.21 	is disqualified from that program. The period of disqualification is one year after the first 
261.22 	offense, two years after the second offense, and permanently after the third or subsequent 
261.23 	offense. The period of program disqualification shall begin on the date stipulated on the 
261.24 	advance notice of disqualification without possibility of postponement for administrative 
261.25 	stay or administrative hearing and shall continue through completion unless and until the 
261.26 	findings upon which the sanctions were imposed are reversed by a court of competent 
261.27 	jurisdiction. The period for which sanctions are imposed is not subject to review. The 
261.28 	sanctions provided under this subdivision are in addition to, and not in substitution for, any 
261.29 	other sanctions that may be provided for by law for the offense involved.

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

261.31 	Sec. 36. Minnesota Statutes 2016, section 256E.30, subdivision 2, is amended to read:
261.32 		Subd. 2.Allocation of money. (a) State money appropriated and community service 
261.33 	block grant money allotted to the state and all money transferred to the community service 
261.34 	block grant from other block grants shall be allocated annually to community action agencies 
262.1 	and Indian reservation governments under clauses (b) and (c), and to migrant and seasonal 
262.2 	farmworker organizations under clause (d).
262.3 	(b) The available annual money will provide base funding to all community action 
262.4 	agencies and the Indian reservations. Base funding amounts per agency are as follows: for 
262.5 	agencies with low income populations up to 3,999 1,999, $25,000; 4,000 2,000 to 23,999, 
262.6 	$50,000; and 24,000 or more, $100,000.
262.7 	(c) All remaining money of the annual money available after the base funding has been 
262.8 	determined must be allocated to each agency and reservation in proportion to the size of 
262.9 	the poverty level population in the agency's service area compared to the size of the poverty 
262.10 	level population in the state.
262.11 	(d) Allocation of money to migrant and seasonal farmworker organizations must not 
262.12 	exceed three percent of the total annual money available. Base funding allocations must be 
262.13 	made for all community action agencies and Indian reservations that received money under 
262.14 	this subdivision, in fiscal year 1984, and for community action agencies designated under 
262.15 	this section with a service area population of 35,000 or greater.

262.16 	Sec. 37. Minnesota Statutes 2016, section 256J.24, subdivision 5, is amended to read:
262.17 		Subd. 5.MFIP transitional standard. The MFIP transitional standard is based on the 
262.18 	number of persons in the assistance unit eligible for both food and cash assistance. The 
262.19 	amount of the transitional standard is published annually by the Department of Human 
262.20 	Services. The following table represents the cash portion of the transitional standard effective 
262.21 	March 1, 2018.

262.22	Number of eligible people
	Cash portion
	
262.23	1
	$263
	
262.24	2
	$450
	
262.25	3
	$545
	
262.26	4
	$634
	
262.27	5
	$710
	
262.28	6
	$786
	
262.29	7
	$863
	
262.30	8
	$929
	
262.31	9
	$993
	
262.32	10
	$1,048
	
262.33	Over 10
	add $56 for each additional eligible person

263.1 	Sec. 38. Minnesota Statutes 2016, section 256J.45, subdivision 2, is amended to read:
263.2 		Subd. 2.General information. The MFIP orientation must consist of a presentation 
263.3 	that informs caregivers of:
263.4 	(1) the necessity to obtain immediate employment;
263.5 	(2) the work incentives under MFIP, including the availability of the federal earned 
263.6 	income tax credit and the Minnesota working family tax credit;
263.7 	(3) the requirement to comply with the employment plan and other requirements of the 
263.8 	employment and training services component of MFIP, including a description of the range 
263.9 	of work and training activities that are allowable under MFIP to meet the individual needs 
263.10 	of participants;
263.11 	(4) the consequences for failing to comply with the employment plan and other program 
263.12 	requirements, and that the county agency may not impose a sanction when failure to comply 
263.13 	is due to the unavailability of child care or other circumstances where the participant has 
263.14 	good cause under subdivision 3;
263.15 	(5) the rights, responsibilities, and obligations of participants;
263.16 	(6) the types and locations of child care services available through the county agency;
263.17 	(7) the availability and the benefits of the early childhood health and developmental 
263.18 	screening under sections 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10;
263.19 	(8) the caregiver's eligibility for transition year child care assistance under section 
263.20 	119B.05;
263.21 	(9) the availability of all health care programs, including transitional medical assistance;
263.22 	(10) the caregiver's option to choose an employment and training provider and information 
263.23 	about each provider, including but not limited to, services offered, program components, 
263.24 	job placement rates, job placement wages, and job retention rates;
263.25 	(11) the caregiver's option to request approval of an education and training plan according 
263.26 	to section 256J.53;
263.27 	(12) the work study programs available under the higher education system; and
263.28 	(13) information about the 60-month time limit exemptions under the family violence 
263.29 	waiver and referral information about shelters and programs for victims of family violence; 
263.30 	and
263.31 	(14) information about the income exclusions in section 256P.06, subdivision 2b.

264.1 	EFFECTIVE DATE. This section is effective July 1, 2018.

264.2 	Sec. 39. [256N.261] SUPPORT FOR ADOPTIVE, FOSTER, AND KINSHIP 
264.3 	FAMILIES.
264.4 		Subdivision 1.Program established. The commissioner shall design and implement a 
264.5 	coordinated program to reduce the need for placement changes or out-of-home placements 
264.6 	of children and youth in foster care, adoptive placements, and permanent physical and legal 
264.7 	custody kinship placements, and to improve the functioning and stability of these families. 
264.8 	To the extent federal funds are available, the commissioner shall provide the following 
264.9 	adoption and foster care-competent services and ensure that placements are trauma-informed 
264.10 	and child and family-centered:
264.11 	(1) a program providing information, referrals, a parent-to-parent support network, peer 
264.12 	support for youth, family activities, respite care, crisis services, educational support, and 
264.13 	mental health services for children and youth in adoption, foster care, and kinship placements 
264.14 	and adoptive, foster, and kinship families in Minnesota;
264.15 	(2) training offered statewide in Minnesota for adoptive and kinship families, and training 
264.16 	for foster families, and the professionals who serve the families, on the effects of trauma, 
264.17 	common disabilities of adopted children and children in foster care, and kinship placements, 
264.18 	and challenges in adoption, foster care, and kinship placements; and
264.19 	(3) periodic evaluation of these services to ensure program effectiveness in preserving 
264.20 	and improving the success of adoptive, foster, and kinship placements.
264.21 		Subd. 2.Definitions. (a) The definitions in this subdivision apply to this section.
264.22 	(b) "Child and family-centered" means individualized services that respond to a child's 
264.23 	or youth's strengths, interests, and current developmental stage, including social, cognitive, 
264.24 	emotional, physical, cultural, racial, and spiritual needs, and offer support to the entire 
264.25 	adoptive, foster, or kinship family.
264.26 	(c) "Trauma-informed" means care that acknowledges the effect trauma has on children 
264.27 	and the children's families; modifies services to respond to the effects of trauma; emphasizes 
264.28 	skill and strength-building rather than symptom management; and focuses on the physical 
264.29 	and psychological safety of the child and family.

265.1 	Sec. 40. Minnesota Statutes 2016, section 256P.06, subdivision 2, is amended to read:
265.2 		Subd. 2.Exempted individuals. (a) The following members of an assistance unit under 
265.3 	chapters 119B and 256J are exempt from having their earned income count towards the 
265.4 	income of an assistance unit:
265.5 	(1) children under six years old;
265.6 	(2) caregivers under 20 years of age enrolled at least half-time in school; and
265.7 	(3) minors enrolled in school full time.
265.8 	(b) The following members of an assistance unit are exempt from having their earned 
265.9 	and unearned income count towards the income of an assistance unit for 12 consecutive 
265.10 	calendar months, beginning the month following the marriage date, for benefits under chapter 
265.11 	256J if the household income does not exceed 275 percent of the federal poverty guideline:
265.12 	(1) a new spouse to a caretaker in an existing assistance unit; and
265.13 	(2) the spouse designated by a newly married couple, both of whom were already 
265.14 	members of an assistance unit under chapter 256J.
265.15 	(c) If members identified in paragraph (b) also receive assistance under section 119B.05, 
265.16 	they are exempt from having their earned and unearned income count towards the income 
265.17 	of the assistance unit if the household income prior to the exemption does not exceed 67 
265.18 	percent of the state median income for recipients for 26 consecutive biweekly periods 
265.19 	beginning the second biweekly period after the marriage date.

265.20 	EFFECTIVE DATE. This section is effective July 1, 2018.

265.21 	Sec. 41. Minnesota Statutes 2016, section 260C.451, subdivision 6, is amended to read:
265.22 		Subd. 6.Reentering foster care and accessing services after 18 years of age and up 
265.23 	to 21 years of age. (a) Upon request of an individual who had been under the guardianship 
265.24 	of the commissioner and who has left foster care without being adopted, the responsible 
265.25 	social services agency which had been the commissioner's agent for purposes of the 
265.26 	guardianship shall develop with the individual a plan to increase the individual's ability to 
265.27 	live safely and independently using the plan requirements of section 260C.212, subdivision 
265.28 	1, paragraph (c), clause (12), and to assist the individual to meet one or more of the eligibility 
265.29 	criteria in subdivision 4 if the individual wants to reenter foster care. The responsible social 
265.30 	services agency shall provide foster care as required to implement the plan. The responsible 
265.31 	social services agency shall enter into a voluntary placement agreement under section 
265.32 	260C.229 with the individual if the plan includes foster care.
266.1 	(b) Individuals who had not been under the guardianship of the commissioner of human 
266.2 	services prior to 18 years of age may ask to reenter foster care after age 18 and, to the extent 
266.3 	funds are available, the responsible social services agency that had responsibility for planning 
266.4 	for the individual before discharge from foster care may shall provide foster care or other 
266.5 	services to the individual for the purpose of increasing the individual's ability to live safely 
266.6 	and independently and to meet the eligibility criteria in subdivision 3a, if the individual:
266.7 	(1) was in foster care for the six consecutive months prior to the person's 18th birthday, 
266.8 	or left foster care within six months prior to the person's 18th birthday, and was not 
266.9 	discharged home, adopted, or received into a relative's home under a transfer of permanent 
266.10 	legal and physical custody under section 260C.515, subdivision 4; or
266.11 	(2) was discharged from foster care while on runaway status after age 15.
266.12 	(c) In conjunction with a qualifying and eligible individual under paragraph (b) and 
266.13 	other appropriate persons, the responsible social services agency shall develop a specific 
266.14 	plan related to that individual's vocational, educational, social, or maturational needs and,
266.15 	to the extent funds are available, provide foster care as required to implement the plan. The 
266.16 	responsible social services agency shall enter into a voluntary placement agreement with 
266.17 	the individual if the plan includes foster care.
266.18 	(d) A child who left foster care while under guardianship of the commissioner of human 
266.19 	services retains eligibility for foster care for placement at any time prior to 21 years of age.

266.20 	Sec. 42. Minnesota Statutes 2016, section 626.556, subdivision 10j, is amended to read:
266.21 		Subd. 10j.Release of data to mandated reporters. (a) A local social services or child 
266.22 	protection agency, or the agency responsible for assessing or investigating the report of 
266.23 	maltreatment or for providing child protective services, shall provide relevant private data 
266.24 	on individuals obtained under this section to a mandated reporter who made the report and 
266.25 	who has an ongoing responsibility for the health, education, or welfare of a child affected 
266.26 	by the data, unless the agency determines that providing the data would not be in the best 
266.27 	interests of the child. The agency may provide the data to other mandated reporters with 
266.28 	ongoing responsibility for the health, education, or welfare of the child. Mandated reporters 
266.29 	with ongoing responsibility for the health, education, or welfare of a child affected by the 
266.30 	data include the child's teachers or other appropriate school personnel, foster parents, health 
266.31 	care providers, respite care workers, therapists, social workers, child care providers, 
266.32 	residential care staff, crisis nursery staff, probation officers, and court services personnel. 
266.33 	Under this section, a mandated reporter need not have made the report to be considered a 
266.34 	person with ongoing responsibility for the health, education, or welfare of a child affected 
267.1 	by the data. Data provided under this section must be limited to data pertinent to the 
267.2 	individual's responsibility for caring for the child.
267.3 	(b) A reporter who receives private data on individuals under this subdivision must treat 
267.4 	the data according to that classification, regardless of whether the reporter is an employee 
267.5 	of a government entity. The remedies and penalties under sections 13.08 and 13.09 apply 
267.6 	if a reporter releases data in violation of this section or other law.

267.7 	Sec. 43. MINNESOTA BIRTH TO EIGHT PILOT PROJECT.
 267.8 		Subdivision 1.Authorization. The commissioner of human services shall award a grant 
267.9 	to Dakota County to develop and implement pilots that will evaluate the impact of a 
267.10 	coordinated systems and service delivery approach on key developmental milestones and 
267.11 	outcomes that ultimately lead to reading proficiency by age eight within the target population. 
267.12 	The pilot program is from July 1, 2017, to June 30, 2021.
267.13 		Subd. 2.Pilot design and goals. The pilot will establish five key developmental milestone 
267.14 	markers from birth to age eight. Enrollees in the pilot will be developmentally assessed and 
267.15 	tracked by a technology solution that tracks developmental milestones along the established 
267.16 	developmental continuum. If a child's progress falls below established milestones and the 
267.17 	weighted scoring, the coordinated service system will focus on identified areas of concern, 
267.18 	mobilize appropriate supportive services, and offer services to identified children and their 
267.19 	families.
267.20 		Subd. 3.Program participants in phase 1 target population. Pilot program participants 
267.21 	must:
267.22 	(1) be enrolled in a Women's Infant & Children (WIC) program;
267.23 	(2) be participating in a family home visiting program, or nurse family practice, or 
267.24 	Healthy Families America (HFA);
267.25 	(3) be children and families qualifying for and participating in early language learners 
267.26 	(ELL) in the school district in which they reside; and
267.27 	(4) be voluntarily willing to participate in the pilot.
267.28 		Subd. 4.Evaluation and report. The county or counties shall work with a third-party 
267.29 	evaluator to evaluate the effectiveness of the pilot and report back to the legislature each 
267.30 	year by February 1 with an update on the progress of the pilot. The final report on the pilot 
267.31 	is due January 1, 2022.

268.1 	Sec. 44. MINNESOTA PATHWAYS TO PROSPERITY PILOT PROJECT.
 268.2 		Subdivision 1.Authorization. The commissioner of human services may develop a 
268.3 	pilot that will test an alternative financing model for the distribution of publicly funded 
268.4 	benefits. The commissioner may work with interested counties to develop the pilot and 
268.5 	determine the waivers that are necessary to implement the pilot program based on the pilot 
268.6 	design in subdivisions 2 and 3, and outcome measures in subdivision 4.
268.7 		Subd. 2.Pilot program design and goals. The pilot program must reduce the historical 
268.8 	separation between the state funds and systems affecting families who are receiving public 
268.9 	assistance. The pilot program shall eliminate, where possible, funding restrictions to allow 
268.10 	a more comprehensive approach to the needs of the families in the pilot program, and focus 
268.11 	on upstream, prevention-oriented supports and interventions.
268.12 		Subd. 3.Program participants. Pilot program participants must:
268.13 	(1) be 26 years of age or younger with a minimum of one child;
268.14 	(2) voluntarily agree to participate in the pilot program;
268.15 	(3) be eligible for, applying for, or receiving public benefits including but not limited 
268.16 	to housing assistance, education supports, employment supports, child care, transportation 
268.17 	supports, medical assistance, earned income tax credit, or the child care tax credit; and
268.18 	(4) be enrolled in an education program that is focused on obtaining a career that will 
268.19 	likely result in a livable wage.
268.20 		Subd. 4.Outcomes. The outcomes measures for the pathways to prosperity include:
268.21 	(1) improvement in the affordability, safety, and permanence of suitable housing;
268.22 	(2) improvement in family functioning and stability, including in the areas of behavioral 
268.23 	health, incarceration, involvement with the child welfare system, or equivalent indicators;
268.24 	(3) secure educational gains for parent and specifically for children from early childhood 
268.25 	through high school, including absentee reduction, preschool readiness scores, third grade 
268.26 	reading competency, graduation, GPA, and standardized test improvement;
268.27 	(4) improvement in attachment to the workforce of one or both adults, including enhanced 
268.28 	job stability; wage gains; career advancement; progress in career preparation; or an equivalent 
268.29 	combination of these or related measures; and
268.30 	(5) improvement in health access and health outcomes for parents and children.

269.1 	Sec. 45. INDIAN CHILD WELFARE ACT COMPLIANCE SYSTEM REVIEW.
 269.2 	By February 1, 2018, the commissioner of human services shall report back to the 
269.3 	legislature on a system for the review of cases reported by counties for aid payments under 
269.4 	Minnesota Statutes, section 477A.0126, for compliance with the Indian Child Welfare Act 
269.5 	and the Minnesota Indian Family Preservation Act. The proposed case review system may 
269.6 	include, but is not limited to, the cases to be reviewed, the criteria to be reviewed to 
269.7 	demonstrate compliance with the Indian Child Welfare Act and the Minnesota Indian Family 
269.8 	Preservation Act, the rate of noncompliance, and training.

269.9 	Sec. 46.  REPEALER.
 269.10 	Minnesota Statutes 2016, sections 13.468; and 256J.626, subdivision 5, are repealed.

269.11 	ARTICLE 8
269.12 	CHEMICAL AND MENTAL HEALTH SERVICES

269.13 	Section 1. [245.4662] GRANT PROGRAM; MENTAL HEALTH INNOVATION.
269.14 		Subdivision 1.Definitions. (a) For the purposes of this section, the following terms have 
269.15 	the meaning given them:
269.16 	(b) "Community partnership" means a project involving the collaboration of two or more 
269.17 	eligible applicants.
269.18 	(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service 
269.19 	provider, hospital, or community partnership. Eligible applicant does not include a 
269.20 	state-operated direct care and treatment facility or program under chapter 246.
269.21 	(d) "Intensive residential treatment services" has the meaning given in section 256B.0622, 
269.22 	subdivision 2.
269.23 	(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section 
269.24 	473.121, subdivision 2.
269.25 		Subd. 2.Grants authorized. The commissioner of human services shall award grants 
269.26 	to eligible applicants to plan, establish, or operate programs to improve accessibility and 
269.27 	quality of community-based, outpatient mental health services and reduce the number of 
269.28 	clients admitted to regional treatment centers and community behavioral health hospitals. 
269.29 	The commissioner shall award half of all grant funds to eligible applicants in the metropolitan 
269.30 	area and half of all grant funds to eligible applicants outside the metropolitan area. The 
269.31 	commissioner shall publish criteria for grant awards no later than September 1, 2017.
270.1 		Subd. 3.Allocation of grants. (a) To receive a grant under this section, an applicant 
270.2 	must submit an application to the commissioner of human services by October 31, 2017, 
270.3 	and by October 31 each year thereafter. A grant may be awarded upon the signing of a grant 
270.4 	contract. An applicant may apply for and the commissioner may award grants for one-year 
270.5 	or two-year periods.
270.6 	(b) An application must be on a form and contain information as specified by the 
270.7 	commissioner but at a minimum must contain:
270.8 	(1) a description of the purpose or project for which grant funds will be used;
270.9 	(2) a description of the specific problem the grant funds will address;
270.10 	(3) a description of achievable objectives, a work plan, and a timeline for implementation 
270.11 	and completion of processes or projects enabled by the grant; and
270.12 	(4) a process for documenting and evaluating results of the grant.
270.13 	(c) The commissioner shall review each application to determine whether the application 
270.14 	is complete and whether the applicant and the project are eligible for a grant. In evaluating 
270.15 	applications according to paragraph (d), the commissioner shall establish criteria including, 
270.16 	but not limited to: the eligibility of the project; the applicant's thoroughness and clarity in 
270.17 	describing the problem grant funds are intended to address; a description of the applicant's 
270.18 	proposed project; a description of the population demographics and service area of the 
270.19 	proposed project; the manner in which the applicant will demonstrate the effectiveness of 
270.20 	any projects undertaken; and evidence of efficiencies and effectiveness gained through 
270.21 	collaborative efforts. The commissioner may also consider other relevant factors, including, 
270.22 	but not limited to, the proposed project's longevity and financial sustainability. In evaluating 
270.23 	applications, the commissioner may request additional information regarding a proposed 
270.24 	project, including information on project cost. An applicant's failure to provide the 
270.25 	information requested disqualifies an applicant. The commissioner shall determine the 
270.26 	number of grants awarded.
270.27 	(d) In determining whether eligible applicants receive grants under this section, the 
270.28 	commissioner shall give preference to the following:
270.29 	(1) intensive residential treatment services, providing time-limited mental health services 
270.30 	in a residential setting;
270.31 	(2) the creation of stand-alone urgent care centers for mental health and psychiatric 
270.32 	consultation services, crisis residential services or collaboration between crisis teams and 
270.33 	critical access hospitals;
271.1 	(3) establishing new community mental health services or expanding the capacity of 
271.2 	existing services; and
271.3 	(4) other innovative projects that improve options for mental health services in community 
271.4 	settings and reduce the number of clients who remain in regional treatment centers and 
271.5 	community behavioral health hospitals beyond when discharge is determined to be clinically 
271.6 	appropriate.
271.7 		Subd. 4.Awarding of grants. The commissioner must notify grantees of awards by 
271.8 	December 15, 2017, and grant funds must be disbursed by January 1, 2018, and by December 
271.9 	15 and January 1, respectively, each year thereafter.

271.10 	Sec. 2. Minnesota Statutes 2016, section 245.4889, subdivision 1, is amended to read:
271.11 		Subdivision 1.Establishment and authority. (a) The commissioner is authorized to 
271.12 	make grants from available appropriations to assist:
271.13 	(1) counties;
271.14 	(2) Indian tribes;
271.15 	(3) children's collaboratives under section 124D.23 or 245.493; or
271.16 	(4) mental health service providers.
271.17 	(b) The following services are eligible for grants under this section:
271.18 	(1) services to children with emotional disturbances as defined in section 245.4871, 
271.19 	subdivision 15, and their families;
271.20 	(2) transition services under section 245.4875, subdivision 8, for young adults under 
271.21 	age 21 and their families;
271.22 	(3) respite care services for children with severe emotional disturbances who are at risk 
271.23 	of out-of-home placement;
271.24 	(4) children's mental health crisis services;
271.25 	(5) mental health services for people from cultural and ethnic minorities;
271.26 	(6) children's mental health screening and follow-up diagnostic assessment and treatment;
271.27 	(7) services to promote and develop the capacity of providers to use evidence-based 
271.28 	practices in providing children's mental health services;
271.29 	(8) school-linked mental health services;
272.1 	(9) building evidence-based mental health intervention capacity for children birth to age 
272.2 	five;
272.3 	(10) suicide prevention and counseling services that use text messaging statewide;
272.4 	(11) mental health first aid training;
272.5 	(12) training for parents, collaborative partners, and mental health providers on the 
272.6 	impact of adverse childhood experiences and trauma and development of an interactive 
272.7 	Web site to share information and strategies to promote resilience and prevent trauma;
272.8 	(13) transition age services to develop or expand mental health treatment and supports 
272.9 	for adolescents and young adults 26 years of age or younger;
272.10 	(14) early childhood mental health consultation;
272.11 	(15) evidence-based interventions for youth at risk of developing or experiencing a first 
272.12 	episode of psychosis, and a public awareness campaign on the signs and symptoms of 
272.13 	psychosis; and
272.14 	(16) psychiatric consultation for primary care practitioners.;
272.15 	(17) providers to begin operations and meet program requirements when establishing a 
272.16 	new children's mental health program. These may be start-up grants; and
272.17 	(18) transportation for children to school-linked mental health services.
272.18 	(c) Services under paragraph (b) must be designed to help each child to function and 
272.19 	remain with the child's family in the community and delivered consistent with the child's 
272.20 	treatment plan. Transition services to eligible young adults under this paragraph (b) must 
272.21 	be designed to foster independent living in the community.

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

272.23 	Sec. 3. Minnesota Statutes 2016, section 245.91, subdivision 4, is amended to read:
272.24 		Subd. 4.Facility or program. "Facility" or "program" means a nonresidential or 
272.25 	residential program as defined in section 245A.02, subdivisions 10 and 14, that is required 
272.26 	to be licensed by the commissioner of human services, and any agency, facility, or program 
272.27 	that provides services or treatment for mental illness, developmental disabilities, chemical 
272.28 	dependency, or emotional disturbance that is required to be licensed, certified, or registered 
272.29 	by the commissioner of human services, health, or education; and an acute care inpatient 
272.30 	facility that provides services or treatment for mental illness, developmental disabilities, 
272.31 	chemical dependency, or emotional disturbance.

273.1 	Sec. 4. Minnesota Statutes 2016, section 245.91, subdivision 6, is amended to read:
273.2 		Subd. 6.Serious injury. "Serious injury" means:
273.3 	(1) fractures;
273.4 	(2) dislocations;
273.5 	(3) evidence of internal injuries;
273.6 	(4) head injuries with loss of consciousness or potential for a closed head injury or 
273.7 	concussion without loss of consciousness requiring a medical assessment by a health care 
273.8 	professional, whether or not further medical attention was sought;
273.9 	(5) lacerations involving injuries to tendons or organs, and those for which complications 
273.10 	are present;
273.11 	(6) extensive second-degree or third-degree burns, and other burns for which 
273.12 	complications are present;
273.13 	(7) extensive second-degree or third-degree frostbite, and others for which complications 
273.14 	are present;
273.15 	(8) irreversible mobility or avulsion of teeth;
273.16 	(9) injuries to the eyeball;
273.17 	(10) ingestion of foreign substances and objects that are harmful;
273.18 	(11) near drowning;
273.19 	(12) heat exhaustion or sunstroke; and
273.20 	(13) attempted suicide; and
273.21 	(13) (14) all other injuries and incidents considered serious after an assessment by a 
273.22 	physician. health care professional, including but not limited to self-injurious behavior, a 
273.23 	medication error requiring medical treatment, a suspected delay of medical treatment, a 
273.24 	complication of a previous injury, or a complication of medical treatment for an injury.

273.25 	Sec. 5. Minnesota Statutes 2016, section 245.97, subdivision 6, is amended to read:
273.26 		Subd. 6.Terms, compensation, and removal. The membership terms, compensation, 
273.27 	and removal of members of the committee and the filling of membership vacancies are 
273.28 	governed by section 15.0575 15.0597.

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

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

277.8 	Sec. 7. Minnesota Statutes 2016, section 245A.191, is amended to read:
277.9 	245A.191 PROVIDER ELIGIBILITY FOR PAYMENTS FROM THE CHEMICAL 
277.10 	DEPENDENCY CONSOLIDATED TREATMENT FUND.
277.11 	(a) When a chemical dependency substance use disorder treatment provider licensed 
277.12 	under chapter 245G or Minnesota Rules, parts 2960.0430 to 2960.0490or 9530.6405 to 
277.13 	9530.6505, agrees to meet the applicable requirements under section 254B.05, subdivision 
277.14 	5, paragraphs (b), clauses (1) to (4) and (6), (c), and (e), to be eligible for enhanced funding 
277.15 	from the chemical dependency consolidated treatment fund, the applicable requirements 
277.16 	under section 254B.05 are also licensing requirements that may be monitored for compliance 
277.17 	through licensing investigations and licensing inspections.
277.18 	(b) Noncompliance with the requirements identified under paragraph (a) may result in:
277.19 	(1) a correction order or a conditional license under section 245A.06, or sanctions under 
277.20 	section 245A.07;
277.21 	(2) nonpayment of claims submitted by the license holder for public program 
277.22 	reimbursement;
277.23 	(3) recovery of payments made for the service;
277.24 	(4) disenrollment in the public payment program; or
277.25 	(5) other administrative, civil, or criminal penalties as provided by law.

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

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

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

280.28 	Sec. 9. [245G.02] APPLICABILITY.
280.29 		Subdivision 1.Applicability. Except as provided in subdivisions 2 and 3, no person, 
280.30 	corporation, partnership, voluntary association, controlling individual, or other organization 
280.31 	may provide a substance use disorder treatment service to an individual with a substance 
280.32 	use disorder unless licensed by the commissioner.
281.1 		Subd. 2.Exemption from license requirement. This chapter does not apply to a county 
281.2 	or recovery community organization that is providing a service for which the county or 
281.3 	recovery community organization is an eligible vendor under section 254B.05. This chapter 
281.4 	does not apply to an organization whose primary functions are information, referral, 
281.5 	diagnosis, case management, and assessment for the purposes of client placement, education, 
281.6 	support group services, or self-help programs.  This chapter does not apply to the activities 
281.7 	of a licensed professional in private practice.
281.8 		Subd. 3.Excluded hospitals. This chapter does not apply to substance use disorder 
281.9 	treatment provided by a hospital licensed under chapter 62J, or under sections 144.50 to 
281.10 	144.56, unless the hospital accepts funds for substance use disorder treatment from the 
281.11 	consolidated chemical dependency treatment fund under chapter 254B, medical assistance 
281.12 	under chapter 256B, or MinnesotaCare or health care cost containment under chapter 256L, 
281.13 	or general assistance medical care formerly codified in chapter 256D.
281.14 		Subd. 4.Applicability of Minnesota Rules, chapter 2960. A residential adolescent 
281.15 	substance use disorder treatment program serving an individual younger than 16 years of 
281.16 	age must be licensed according to Minnesota Rules, chapter 2960.

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

281.18 	Sec. 10. [245G.03] LICENSING REQUIREMENTS.
281.19 		Subdivision 1.License requirements. (a) An applicant for a license to provide substance 
281.20 	use disorder treatment must comply with the general requirements in chapters 245A and 
281.21 	245C, sections 626.556 and 626.557, and Minnesota Rules, chapter 9544.
281.22 	(b) The commissioner may grant variances to the requirements in this chapter that do 
281.23 	not affect the client's health or safety if the conditions in section 245A.04, subdivision 9, 
281.24 	are met.
281.25 		Subd. 2.Application. Before the commissioner issues a license, an applicant must 
281.26 	submit, on forms provided by the commissioner, any documents the commissioner requires 
281.27 	to demonstrate the following:
281.28 	(1) compliance with this chapter;
281.29 	(2) compliance with applicable building, fire and safety codes, health rules, zoning 
281.30 	ordinances, and other applicable rules and regulations or documentation that a waiver was 
281.31 	granted. An applicant's receipt of a waiver does not constitute modification of any 
281.32 	requirement in this chapter; and
282.1 	(3) insurance coverage, including bonding, sufficient to cover all client funds, property, 
282.2 	and interests.
282.3 		Subd. 3.Change in license terms. (a) The commissioner must determine whether a 
282.4 	new license is needed when a change in clauses (1) to (4) occurs. A license holder must 
282.5 	notify the commissioner before a change in one of the following occurs:
282.6 	(1) the Department of Health's licensure of the program;
282.7 	(2) whether the license holder provides services specified in sections 245G.18 to 245G.22;
282.8 	(3) location; or
282.9 	(4) capacity if the license holder meets the requirements of section 245G.21.
282.10 	(b) A license holder must notify the commissioner and must apply for a new license if 
282.11 	there is a change in program ownership.

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

282.13 	Sec. 11. [245G.04] INITIAL SERVICES PLAN.
282.14 	(a) The license holder must complete an initial services plan on the day of service 
282.15 	initiation. The plan must address the client's immediate health and safety concerns, identify 
282.16 	the needs to be addressed in the first treatment session, and make treatment suggestions for 
282.17 	the client during the time between intake and completion of the individual treatment plan.
282.18 	(b) The initial services plan must include a determination of whether a client is a 
282.19 	vulnerable adult as defined in section 626.5572, subdivision 21. An adult client of a 
282.20 	residential program is a vulnerable adult. An individual abuse prevention plan, according 
282.21 	to sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph 
282.22 	(b), is required for a client who meets the definition of vulnerable adult.

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

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

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

286.7 	Sec. 13. [245G.06] INDIVIDUAL TREATMENT PLAN.
286.8 		Subdivision 1.General. Each client must have an individual treatment plan developed 
286.9 	by an alcohol and drug counselor within seven days of service initiation for a residential 
286.10 	program and within three sessions for all other programs. The client must have active, direct 
286.11 	involvement in selecting the anticipated outcomes of the treatment process and developing 
286.12 	the treatment plan. The individual treatment plan must be signed by the client and the alcohol 
286.13 	and drug counselor and document the client's involvement in the development of the plan. 
286.14 	The plan may be a continuation of the initial services plan required in section 245G.04. 
286.15 	Treatment planning must include ongoing assessment of client needs. An individual treatment 
286.16 	plan must be updated based on new information gathered about the client's condition and 
286.17 	on whether methods identified have the intended effect. A change to the plan must be signed 
286.18 	by the client and the alcohol and drug counselor. The plan must provide for the involvement 
286.19 	of the client's family and people selected by the client as important to the success of treatment 
286.20 	at the earliest opportunity, consistent with the client's treatment needs and written consent.
286.21 		Subd. 2.Plan contents. An individual treatment plan must be recorded in the six 
286.22 	dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue 
286.23 	identified in the assessment summary, prioritized according to the client's needs and focus, 
286.24 	and must include:
286.25 	(1) specific methods to address each identified need, including amount, frequency, and 
286.26 	anticipated duration of treatment service. The methods must be appropriate to the client's 
286.27 	language, reading skills, cultural background, and strengths;
286.28 	(2) resources to refer the client to when the client's needs are to be addressed concurrently 
286.29 	by another provider; and
286.30 	(3) goals the client must reach to complete treatment and terminate services.
286.31 		Subd. 3.Documentation of treatment services; treatment plan review. (a) A review 
286.32 	of all treatment services must be documented weekly and include a review of:
287.1 	(1) care coordination activities;
287.2 	(2) medical and other appointments the client attended;
287.3 	(3) issues related to medications that are not documented in the medication administration 
287.4 	record; and
287.5 	(4) issues related to attendance for treatment services, including the reason for any client 
287.6 	absence from a treatment service.
287.7 	(b) A note must be entered immediately following any significant event. A significant 
287.8 	event is an event that impacts the client's relationship with other clients, staff, the client's 
287.9 	family, or the client's treatment plan.
287.10 	(c) A treatment plan review must be entered in a client's file weekly or after each treatment 
287.11 	service, whichever is less frequent, by the staff member providing the service. The review 
287.12 	must indicate the span of time covered by the review and each of the six dimensions listed 
287.13 	in section 245G.05, subdivision 2, paragraph (c). The review must:
287.14 	(1) indicate the date, type, and amount of each treatment service provided and the client's 
287.15 	response to each service;
287.16 	(2) address each goal in the treatment plan and whether the methods to address the goals 
287.17 	are effective;
287.18 	(3) include monitoring of any physical and mental health problems;
287.19 	(4) document the participation of others;
287.20 	(5) document staff recommendations for changes in the methods identified in the treatment 
287.21 	plan and whether the client agrees with the change; and
287.22 	(6) include a review and evaluation of the individual abuse prevention plan according 
287.23 	to section 245A.65.
287.24 	(d) Each entry in a client's record must be accurate, legible, signed, and dated. A late 
287.25 	entry must be clearly labeled "late entry." A correction to an entry must be made in a way 
287.26 	in which the original entry can still be read.
287.27 		Subd. 4.Service discharge summary. (a) An alcohol and drug counselor must write a  
287.28 	discharge summary for each client. The summary must be completed within five days of 
287.29 	the client's service termination or within five days from the client's or program's decision 
287.30 	to terminate services, whichever is earlier.
288.1 	(b) The service discharge summary must be recorded in the six dimensions listed in 
288.2 	section 245G.05, subdivision 2, paragraph (c), and include the following information:
288.3 	(1) the client's issues, strengths, and needs while participating in treatment, including 
288.4 	services provided;
288.5 	(2) the client's progress toward achieving each goal identified in the individual treatment 
288.6 	plan;
288.7 	(3) a risk description according to section 245G.05; and
288.8 	(4) the reasons for and circumstances of service termination. If a program discharges a 
288.9 	client at staff request, the reason for discharge and the procedure followed for the decision 
288.10 	to discharge must be documented and comply with the program's policies on staff-initiated 
288.11 	client discharge. If a client is discharged at staff request, the program must give the client 
288.12 	crisis and other referrals appropriate for the client's needs and offer assistance to the client 
288.13 	to access the services.
288.14 	(c) For a client who successfully completes treatment, the summary must also include:
288.15 	(1) the client's living arrangements at service termination;
288.16 	(2) continuing care recommendations, including transitions between more or less intense 
288.17 	services, or more frequent to less frequent services, and referrals made with specific attention 
288.18 	to continuity of care for mental health, as needed;
288.19 	(3) service termination diagnosis; and
288.20 	(4) the client's prognosis.

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

288.22 	Sec. 14. [245G.07] TREATMENT SERVICE.
288.23 		Subdivision 1.Treatment service. (a) A license holder must offer the following treatment 
288.24 	services, unless clinically inappropriate and the justifying clinical rationale is documented:
288.25 	(1) individual and group counseling to help the client identify and address needs related 
288.26 	to substance use and develop strategies to avoid harmful substance use after discharge and 
288.27 	to help the client obtain the services necessary to establish a lifestyle free of the harmful 
288.28 	effects of substance use disorder;
288.29 	(2) client education strategies to avoid inappropriate substance use and health problems 
288.30 	related to substance use and the necessary lifestyle changes to regain and maintain health. 
288.31 	Client education must include information on tuberculosis education on a form approved 
289.1 	by the commissioner, the human immunodeficiency virus according to section 245A.19, 
289.2 	other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis. 
289.3 	A licensed alcohol and drug counselor must be present during an educational group;
289.4 	(3) a service to help the client integrate gains made during treatment into daily living 
289.5 	and to reduce the client's reliance on a staff member for support;
289.6 	(4) a service to address issues related to co-occurring disorders, including client education 
289.7 	on symptoms of mental illness, the possibility of comorbidity, and the need for continued 
289.8 	medication compliance while recovering from substance use disorder. A group must address 
289.9 	co-occurring disorders, as needed. When treatment for mental health problems is indicated, 
289.10 	the treatment must be integrated into the client's individual treatment plan;
289.11 	(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support 
289.12 	services provided one-to-one by an individual in recovery. Peer support services include 
289.13 	education, advocacy, mentoring through self-disclosure of personal recovery experiences, 
289.14 	attending recovery and other support groups with a client, accompanying the client to 
289.15 	appointments that support recovery, assistance accessing resources to obtain housing, 
289.16 	employment, education, and advocacy services, and nonclinical recovery support to assist 
289.17 	the transition from treatment into the recovery community; and
289.18 	(6) on July 1, 2018, or upon federal approval, whichever is later, care coordination 
289.19 	provided by an individual who meets the staff qualifications in section 245G.11, subdivision 
289.20 	7. Care coordination services include:
289.21 	(i) assistance in coordination with significant others to help in the treatment planning 
289.22 	process whenever possible;
289.23 	(ii) assistance in coordination with and follow up for medical services as identified in 
289.24 	the treatment plan;
289.25 	(iii) facilitation of referrals to substance use disorder services as indicated by a client's 
289.26 	medical provider, comprehensive assessment, or treatment plan;
289.27 	(iv) facilitation of referrals to mental health services as identified by a client's 
289.28 	comprehensive assessment or treatment plan;
289.29 	(v) assistance with referrals to economic assistance, social services, housing resources, 
289.30 	and prenatal care according to the client's needs;
289.31 	(vi) life skills advocacy and support accessing treatment follow-up, disease management, 
289.32 	and education services, including referral and linkages to long-term services and supports 
289.33 	as needed; and
290.1 	(vii) documentation of the provision of care coordination services in the client's file.
290.2 	(b) A treatment service provided to a client must be provided according to the individual 
290.3 	treatment plan and must consider cultural differences and special needs of a client.
290.4 		Subd. 2.Additional treatment service. A license holder may provide or arrange the 
290.5 	following additional treatment service as a part of the client's individual treatment plan:
290.6 	(1) relationship counseling provided by a qualified professional to help the client identify 
290.7 	the impact of the client's substance use disorder on others and to help the client and persons 
290.8 	in the client's support structure identify and change behaviors that contribute to the client's 
290.9 	substance use disorder;
290.10 	(2) therapeutic recreation to allow the client to participate in recreational activities 
290.11 	without the use of mood-altering chemicals and to plan and select leisure activities that do 
290.12 	not involve the inappropriate use of chemicals;
290.13 	(3) stress management and physical well-being to help the client reach and maintain an 
290.14 	appropriate level of health, physical fitness, and well-being;
290.15 	(4) living skills development to help the client learn basic skills necessary for independent 
290.16 	living;
290.17 	(5) employment or educational services to help the client become financially independent;
290.18 	(6) socialization skills development to help the client live and interact with others in a 
290.19 	positive and productive manner; and
290.20 	(7) room, board, and supervision at the treatment site to provide the client with a safe 
290.21 	and appropriate environment to gain and practice new skills.
290.22 		Subd. 3.Counselors. A treatment service, including therapeutic recreation, must be 
290.23 	provided by an alcohol and drug counselor according to section 245G.11, unless the 
290.24 	individual providing the service is specifically qualified according to the accepted credential 
290.25 	required to provide the service. Therapeutic recreation does not include planned leisure 
290.26 	activities.
290.27 		Subd. 4.Location of service provision. The license holder may provide services at any 
290.28 	of the license holder's licensed locations or at another suitable location including a school, 
290.29 	government building, medical or behavioral health facility, or social service organization. 
290.30 	If services are provided off site from the licensed site, the reason for the provision of services 
290.31 	remotely must be documented.

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

291.1 	Sec. 15. [245G.08] MEDICAL SERVICES.
291.2 		Subdivision 1.Health care services. An applicant or license holder must maintain a 
291.3 	complete description of the health care services, nursing services, dietary services, and 
291.4 	emergency physician services offered by the applicant or license holder.
291.5 		Subd. 2.Procedures. The applicant or license holder must have written procedures for 
291.6 	obtaining a medical intervention for a client, that are approved in writing by a physician 
291.7 	who is licensed under chapter 147, unless:
291.8 	(1) the license holder does not provide a service under section 245G.21; and
291.9 	(2) a medical intervention is referred to 911, the emergency telephone number, or the 
291.10 	client's physician.
291.11 		Subd. 3.Standing order protocol. A license holder that maintains a supply of naloxone 
291.12 	available for emergency treatment of opioid overdose must have a written standing order 
291.13 	protocol by a physician who is licensed under chapter 147, that permits the license holder 
291.14 	to maintain a supply of naloxone on site, and must require staff to undergo specific training 
291.15 	in administration of naloxone.
291.16 		Subd. 4.Consultation services. The license holder must have access to and document 
291.17 	the availability of a licensed mental health professional to provide diagnostic assessment 
291.18 	and treatment planning assistance.
291.19 		Subd. 5.Administration of medication and assistance with self-medication. (a) A 
291.20 	license holder must meet the requirements in this subdivision if a service provided includes 
291.21 	the administration of medication.
291.22 	(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a 
291.23 	licensed practitioner or a registered nurse the task of administration of medication or assisting 
291.24 	with self-medication, must:
291.25 	(1) successfully complete a medication administration training program for unlicensed 
291.26 	personnel through an accredited Minnesota postsecondary educational institution. A staff 
291.27 	member's completion of the course must be documented in writing and placed in the staff 
291.28 	member's personnel file;
291.29 	(2) be trained according to a formalized training program that is taught by a registered 
291.30 	nurse and offered by the license holder. The training must include the process for 
291.31 	administration of naloxone, if naloxone is kept on site. A staff member's completion of the 
291.32 	training must be documented in writing and placed in the staff member's personnel records; 
291.33 	or
292.1 	(3) demonstrate to a registered nurse competency to perform the delegated activity. A 
292.2 	registered nurse must be employed or contracted to develop the policies and procedures for 
292.3 	administration of medication or assisting with self-administration of medication, or both.
292.4 	(c) A registered nurse must provide supervision as defined in section 148.171, subdivision 
292.5 	23. The registered nurse's supervision must include, at a minimum, monthly on-site 
292.6 	supervision or more often if warranted by a client's health needs. The policies and procedures 
292.7 	must include:
292.8 	(1) a provision that a delegation of administration of medication is limited to the 
292.9 	administration of a medication that is administered orally, topically, or as a suppository, an 
292.10 	eye drop, an ear drop, or an inhalant;
292.11 	(2) a provision that each client's file must include documentation indicating whether 
292.12 	staff must conduct the administration of medication or the client must self-administer 
292.13 	medication, or both;
292.14 	(3) a provision that a client may carry emergency medication such as nitroglycerin as 
292.15 	instructed by the client's physician;
292.16 	(4) a provision for the client to self-administer medication when a client is scheduled to 
292.17 	be away from the facility;
292.18 	(5) a provision that if a client self-administers medication when the client is present in 
292.19 	the facility, the client must self-administer medication under the observation of a trained 
292.20 	staff member;
292.21 	(6) a provision that when a license holder serves a client who is a parent with a child, 
292.22 	the parent may only administer medication to the child under a staff member's supervision;
292.23 	(7) requirements for recording the client's use of medication, including staff signatures 
292.24 	with date and time;
292.25 	(8) guidelines for when to inform a nurse of problems with self-administration of 
292.26 	medication, including a client's failure to administer, refusal of a medication, adverse 
292.27 	reaction, or error; and
292.28 	(9) procedures for acceptance, documentation, and implementation of a prescription, 
292.29 	whether written, verbal, telephonic, or electronic.
292.30 		Subd. 6.Control of drugs. A license holder must have and implement written policies 
292.31 	and procedures developed by a registered nurse that contain:
293.1 	(1) a requirement that each drug must be stored in a locked compartment. A Schedule 
293.2 	II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked 
293.3 	compartment, permanently affixed to the physical plant or medication cart;
293.4 	(2) a system which accounts for all scheduled drugs each shift;
293.5 	(3) a procedure for recording the client's use of medication, including the signature of 
293.6 	the staff member who completed the administration of the medication with the time and 
293.7 	date;
293.8 	(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
293.9 	(5) a statement that only authorized personnel are permitted access to the keys to a locked 
293.10 	compartment;
293.11 	(6) a statement that no legend drug supply for one client shall be given to another client; 
293.12 	and
293.13 	(7) a procedure for monitoring the available supply of naloxone on site, replenishing 
293.14 	the naloxone supply when needed, and destroying naloxone according to clause (4).

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

293.16 	Sec. 16. [245G.09] CLIENT RECORDS.
293.17 		Subdivision 1.Client records required. (a) A license holder must maintain a file of 
293.18 	current and accurate client records on the premises where the treatment service is provided 
293.19 	or coordinated. For services provided off site, client records must be available at the program 
293.20 	and adhere to the same clinical and administrative policies and procedures as services 
293.21 	provided on site. A program using an electronic health record must maintain virtual access 
293.22 	to client records on the premises where the treatment service is delivered. The content and 
293.23 	format of client records must be uniform and entries in each record must be signed and 
293.24 	dated by the staff member making the entry. Client records must be protected against loss, 
293.25 	tampering, or unauthorized disclosure according to section 254A.09, chapter 13, and Code 
293.26 	of Federal Regulations, title 42, chapter 1, part 2, subpart B, sections 2.1 to 2.67, and title 
293.27 	45, parts 160 to 164.
293.28 	(b) The program must have a policy and procedure that identifies how the program will 
293.29 	track and record client attendance at treatment activities, including the date, duration, and 
293.30 	nature of each treatment service provided to the client.
293.31 		Subd. 2.Record retention. The client records of a discharged client must be retained 
293.32 	by a license holder for seven years. A license holder that ceases to provide treatment service 
294.1 	must retain client records for seven years from the date of facility closure and must notify 
294.2 	the commissioner of the location of the client records and the name of the individual 
294.3 	responsible for maintaining the client's records.
294.4 		Subd. 3.Contents. Client records must contain the following:
294.5 	(1) documentation that the client was given information on client rights and 
294.6 	responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided 
294.7 	an orientation to the program abuse prevention plan required under section 245A.65, 
294.8 	subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record 
294.9 	must contain documentation that the client was provided educational information according 
294.10 	to section 245G.05, subdivision 1, paragraph (b);
294.11 	(2) an initial services plan completed according to section 245G.04;
294.12 	(3) a comprehensive assessment completed according to section 245G.05;
294.13 	(4) an assessment summary completed according to section 245G.05, subdivision 2;
294.14 	(5) an individual abuse prevention plan according to sections 245A.65, subdivision 2, 
294.15 	and 626.557, subdivision 14, when applicable;
294.16 	(6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;
294.17 	(7) documentation of treatment services and treatment plan review according to section 
294.18 	245G.06, subdivision 3; and
294.19 	(8) a summary at the time of service termination according to section 245G.06, 
294.20 	subdivision 4.

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

294.22 	Sec. 17. [245G.10] STAFF REQUIREMENTS.
294.23 		Subdivision 1.Treatment director. A license holder must have a treatment director.
294.24 		Subd. 2.Alcohol and drug counselor supervisor. A license holder must employ an 
294.25 	alcohol and drug counselor supervisor who meets the requirements of section 245G.11, 
294.26 	subdivision 4. An individual may be simultaneously employed as a treatment director, 
294.27 	alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual 
294.28 	meets the qualifications for each position. If an alcohol and drug counselor is simultaneously 
294.29 	employed as an alcohol and drug counselor supervisor or treatment director, that individual 
294.30 	must be considered a 0.5 full-time equivalent alcohol and drug counselor for staff 
294.31 	requirements under subdivision 4.
295.1 		Subd. 3.Responsible staff member. A treatment director must designate a staff member 
295.2 	who, when present in the facility, is responsible for the delivery of treatment service. A 
295.3 	license holder must have a designated staff member during all hours of operation. A license 
295.4 	holder providing room and board and treatment at the same site must have a responsible 
295.5 	staff member on duty 24 hours a day. The designated staff member must know and understand 
295.6 	the implications of this chapter and sections 245A.65, 626.556, 626.557, and 626.5572.
295.7 		Subd. 4.Staff requirement.  It is the responsibility of the license holder to determine 
295.8 	an acceptable group size based on each client's needs except that treatment services provided 
295.9 	in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not 
295.10 	supervise more than 50 clients. The license holder must maintain a record that documents 
295.11 	compliance with this subdivision.
295.12 		Subd. 5.Medical emergency. When a client is present, a license holder must have at 
295.13 	least one staff member on the premises who has a current American Red Cross standard 
295.14 	first aid certificate or an equivalent certificate and at least one staff member on the premises 
295.15 	who has a current American Red Cross community, American Heart Association, or 
295.16 	equivalent CPR certificate. A single staff member with both certifications satisfies this 
295.17 	requirement.

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

295.19 	Sec. 18. [245G.11] STAFF QUALIFICATIONS.
295.20 		Subdivision 1.General qualifications. (a) All staff members who have direct contact 
295.21 	must be 18 years of age or older. At the time of employment, each staff member must meet 
295.22 	the qualifications in this subdivision. For purposes of this subdivision, "problematic substance 
295.23 	use" means a behavior or incident listed by the license holder in the personnel policies and 
295.24 	procedures according to section 245G.13, subdivision 1, clause (5).
295.25 	(b) A treatment director, supervisor, nurse, counselor, student intern, or other professional 
295.26 	must be free of problematic substance use for at least the two years immediately preceding 
295.27 	employment and must sign a statement attesting to that fact.
295.28 	(c) A paraprofessional, recovery peer, or any other staff member with direct contact 
295.29 	must be free of problematic substance use for at least one year immediately preceding 
295.30 	employment and must sign a statement attesting to that fact.
295.31 		Subd. 2.Employment; prohibition on problematic substance use. A staff member 
295.32 	with direct contact must be free from problematic substance use as a condition of 
295.33 	employment, but is not required to sign additional statements. A staff member with direct 
296.1 	contact who is not free from problematic substance use must be removed from any 
296.2 	responsibilities that include direct contact for the time period specified in subdivision 1. 
296.3 	The time period begins to run on the date of the last incident of problematic substance use 
296.4 	as described in the facility's policies and procedures according to section 245G.13, 
296.5 	subdivision 1, clause (5).
296.6 		Subd. 3.Treatment directors. A treatment director must:
296.7 	(1) have at least one year of work experience in direct service to an individual with 
296.8 	substance use disorder or one year of work experience in the management or administration 
296.9 	of direct service to an individual with substance use disorder;
296.10 	(2) have a baccalaureate degree or three years of work experience in administration or 
296.11 	personnel supervision in human services; and
296.12 	(3) know and understand the implications of this chapter, chapter 245A, and sections 
296.13 	626.556, 626.557, and 626.5572. Demonstration of the treatment director's knowledge must 
296.14 	be documented in the personnel record.
296.15 		Subd. 4.Alcohol and drug counselor supervisors. An alcohol and drug counselor 
296.16 	supervisor must:
296.17 	(1) meet the qualification requirements in subdivision 5;
296.18 	(2) have three or more years of experience providing individual and group counseling 
296.19 	to individuals with substance use disorder; and
296.20 	(3) know and understand the implications of this chapter and sections 245A.65, 626.556, 
296.21 	626.557, and 626.5572.
296.22 		Subd. 5.Alcohol and drug counselor qualifications. (a) An alcohol and drug counselor 
296.23 	must either be licensed or exempt from licensure under chapter 148F.
296.24 	(b) An individual who is exempt from licensure under chapter 148F, must meet one of 
296.25 	the following additional requirements:
296.26 	(1) completion of at least a baccalaureate degree with a major or concentration in social 
296.27 	work, nursing, sociology, human services, or psychology, or licensure as a registered nurse; 
296.28 	successful completion of a minimum of 120 hours of classroom instruction in which each 
296.29 	of the core functions listed in chapter 148F is covered; and successful completion of 440 
296.30 	hours of supervised experience as an alcohol and drug counselor, either as a student or a 
296.31 	staff member;
297.1 	(2) completion of at least 270 hours of drug counselor training in which each of the core 
297.2 	functions listed in chapter 148F is covered, and successful completion of 880 hours of 
297.3 	supervised experience as an alcohol and drug counselor, either as a student or as a staff 
297.4 	member;
297.5 	(3) current certification as an alcohol and drug counselor or alcohol and drug counselor 
297.6 	reciprocal, through the evaluation process established by the International Certification and 
297.7 	Reciprocity Consortium Alcohol and Other Drug Abuse, Inc.;
297.8 	(4) completion of a bachelor's degree including 480 hours of alcohol and drug counseling 
297.9 	education from an accredited school or educational program and 880 hours of alcohol and 
297.10 	drug counseling practicum; or
297.11 	(5) employment in a program formerly licensed under Minnesota Rules, parts 9530.5000 
297.12 	to 9530.6400, and successful completion of 6,000 hours of supervised work experience in 
297.13 	a licensed program as an alcohol and drug counselor prior to January 1, 2005.
297.14 	(c) An alcohol and drug counselor may not provide a treatment service that requires 
297.15 	professional licensure unless the individual possesses the necessary license.  For the purposes 
297.16 	of enforcing this section, the commissioner has the authority to monitor a service provider's 
297.17 	compliance with the relevant standards of the service provider's profession and may issue 
297.18 	licensing actions against the license holder according to sections 245A.05, 245A.06, and 
297.19 	245A.07, based on the commissioner's determination of noncompliance.
297.20 		Subd. 6.Paraprofessionals. A paraprofessional must have knowledge of client rights, 
297.21 	according to section 148F.165, and staff member responsibilities. A paraprofessional may 
297.22 	not admit, transfer, or discharge a client but may be responsible for the delivery of treatment 
297.23 	service according to section 245G.10, subdivision 3.
297.24 		Subd. 7.Care coordination provider qualifications. (a) Care coordination must be 
297.25 	provided by qualified staff. An individual is qualified to provide care coordination if the 
297.26 	individual:
297.27 	(1) is skilled in the process of identifying and assessing a wide range of client needs;
297.28 	(2) is knowledgeable about local community resources and how to use those resources 
297.29 	for the benefit of the client;
297.30 	(3) has successfully completed 30 hours of classroom instruction on care coordination 
297.31 	for an individual with substance use disorder;
297.32 	(4) has either:
298.1 	(i) a bachelor's degree in one of the behavioral sciences or related fields; or
298.2 	(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest 
298.3 	Indian Council on Addictive Disorders; and
298.4 	(5) has at least 2,000 hours of supervised experience working with individuals with 
298.5 	substance use disorder.
298.6 	(b) A care coordinator must receive at least one hour of supervision regarding individual 
298.7 	service delivery from an alcohol and drug counselor weekly.
298.8 		Subd. 8.Recovery peer qualifications. A recovery peer must:
298.9 	(1) be at least 21 years of age and have a high school diploma or its equivalent;
298.10 	(2) have a minimum of one year in recovery from substance use disorder;
298.11 	(3) hold a current credential from a certification body approved by the commissioner 
298.12 	that demonstrates skills and training in the domains of ethics and boundaries, advocacy, 
298.13 	mentoring and education, and recovery and wellness support; and
298.14 	(4) receive ongoing supervision in areas specific to the domains of the recovery peer's 
298.15 	role by an alcohol and drug counselor or an individual with a certification approved by the 
298.16 	commissioner.
298.17 		Subd. 9.Volunteers. A volunteer may provide treatment service when the volunteer is 
298.18 	supervised and can be seen or heard by a staff member meeting the criteria in subdivision 
298.19 	4 or 5, but may not practice alcohol and drug counseling unless qualified under subdivision 
298.20 	5.
298.21 		Subd. 10.Student interns. A qualified staff member must supervise and be responsible 
298.22 	for a treatment service performed by a student intern and must review and sign each 
298.23 	assessment, progress note, and individual treatment plan prepared by a student intern. A 
298.24 	student intern must receive the orientation and training required in section 245G.13, 
298.25 	subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment staff may be 
298.26 	students or licensing candidates with time documented to be directly related to the provision 
298.27 	of treatment services for which the staff are authorized.
298.28 		Subd. 11.Individuals with temporary permit. (a) An individual with a temporary 
298.29 	permit from the Board of Behavioral Health and Therapy may provide chemical dependency 
298.30 	treatment service according to this subdivision.
298.31 	(b) An individual with a temporary permit must be supervised by a licensed alcohol and 
298.32 	drug counselor assigned by the license holder. The supervising licensed alcohol and drug 
299.1 	counselor must document the amount and type of supervision provided at least on a weekly 
299.2 	basis. The supervision must relate to the clinical practice.
299.3 	(c) An individual with a temporary permit must be supervised by a clinical supervisor 
299.4 	approved by the Board of Behavioral Health and Therapy. The supervision must be 
299.5 	documented and meet the requirements of section 148F.04, subdivision 4.

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

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

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

300.3 	Sec. 20. [245G.13] PROVIDER PERSONNEL POLICIES.
300.4 		Subdivision 1.Personnel policy requirements. A license holder must have written 
300.5 	personnel policies that are available to each staff member. The personnel policies must:
300.6 	(1) ensure that staff member retention, promotion, job assignment, or pay are not affected 
300.7 	by a good faith communication between a staff member and the department, the Department 
300.8 	of Health, the ombudsman for mental health and developmental disabilities, law enforcement, 
300.9 	or a local agency for the investigation of a complaint regarding a client's rights, health, or 
300.10 	safety;
300.11 	(2) contain a job description for each staff member position specifying responsibilities, 
300.12 	degree of authority to execute job responsibilities, and qualification requirements;
300.13 	(3) provide for a job performance evaluation based on standards of job performance 
300.14 	conducted on a regular and continuing basis, including a written annual review;
300.15 	(4) describe behavior that constitutes grounds for disciplinary action, suspension, or 
300.16 	dismissal, including policies that address staff member problematic substance use and the 
300.17 	requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement 
300.18 	with a client in violation of chapter 604, and policies prohibiting client abuse described in 
300.19 	sections 245A.65, 626.556, 626.557, and 626.5572;
300.20 	(5) identify how the program will identify whether behaviors or incidents are problematic 
300.21 	substance use, including a description of how the facility must address:
300.22 	(i) receiving treatment for substance use within the period specified for the position in 
300.23 	the staff qualification requirements, including medication-assisted treatment;
300.24 	(ii) substance use that negatively impacts the staff member's job performance;
300.25 	(iii) chemical use that affects the credibility of treatment services with a client, referral 
300.26 	source, or other member of the community;
300.27 	(iv) symptoms of intoxication or withdrawal on the job; and
300.28 	(v) the circumstances under which an individual who participates in monitoring by the 
300.29 	health professional services program for a substance use or mental health disorder is able 
300.30 	to provide services to the program's clients;
301.1 	(6) include a chart or description of the organizational structure indicating lines of 
301.2 	authority and responsibilities;
301.3 	(7) include orientation within 24 working hours of starting for each new staff member 
301.4 	based on a written plan that, at a minimum, must provide training related to the staff member's 
301.5 	specific job responsibilities, policies and procedures, client confidentiality, HIV minimum 
301.6 	standards, and client needs; and
301.7 	(8) include policies outlining the license holder's response to a staff member with a 
301.8 	behavior problem that interferes with the provision of treatment service.
301.9 		Subd. 2.Staff development. (a) A license holder must ensure that each staff member 
301.10 	has the training described in this subdivision.
301.11 	(b) Each staff member must be trained every two years in:
301.12 	(1) client confidentiality rules and regulations and client ethical boundaries; and
301.13 	(2) emergency procedures and client rights as specified in sections 144.651, 148F.165, 
301.14 	and 253B.03.
301.15 	(c) Annually each staff member with direct contact must be trained on mandatory 
301.16 	reporting as specified in sections 245A.65, 626.556, 626.5561, 626.557, and 626.5572, 
301.17 	including specific training covering the license holder's policies for obtaining a release of 
301.18 	client information.
301.19 	(d) Upon employment and annually thereafter, each staff member with direct contact 
301.20 	must receive training on HIV minimum standards according to section 245A.19.
301.21 	(e) A treatment director, supervisor, nurse, or counselor must have a minimum of 12 
301.22 	hours of training in co-occurring disorders that includes competencies related to philosophy, 
301.23 	trauma-informed care, screening, assessment, diagnosis and person-centered treatment 
301.24 	planning, documentation, programming, medication, collaboration, mental health 
301.25 	consultation, and discharge planning. A new staff member who has not obtained the training 
301.26 	must complete the training within six months of employment. A staff member may request, 
301.27 	and the license holder may grant, credit for relevant training obtained before employment, 
301.28 	which must be documented in the staff member's personnel file.
301.29 		Subd. 3.Personnel files. The license holder must maintain a separate personnel file for 
301.30 	each staff member. At a minimum, the personnel file must conform to the requirements of 
301.31 	this chapter. A personnel file must contain the following:
302.1 	(1) a completed application for employment signed by the staff member and containing 
302.2 	the staff member's qualifications for employment;
302.3 	(2) documentation related to the staff member's background study data, according to 
302.4 	chapter 245C;
302.5 	(3) for a staff member who provides psychotherapy services, employer names and 
302.6 	addresses for the past five years for which the staff member provided psychotherapy services, 
302.7 	and documentation of an inquiry required by sections 604.20 to 604.205 made to the staff 
302.8 	member's former employer regarding substantiated sexual contact with a client;
302.9 	(4) documentation that the staff member completed orientation and training;
302.10 	(5) documentation that the staff member meets the requirements in section 245G.11;
302.11 	(6) documentation demonstrating the staff member's compliance with section 245G.08, 
302.12 	subdivision 3, for a staff member who conducts administration of medication; and
302.13 	(7) documentation demonstrating the staff member's compliance with section 245G.18, 
302.14 	subdivision 2, for a staff member that treats an adolescent client.

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

302.16 	Sec. 21. [245G.14] SERVICE INITIATION AND TERMINATION POLICIES.
302.17 		Subdivision 1.Service initiation policy. A license holder must have a written service 
302.18 	initiation policy containing service initiation preferences that comply with this section and 
302.19 	Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria. 
302.20 	The license holder must not initiate services for an individual who does not meet the service 
302.21 	initiation criteria. The service initiation criteria must be either posted in the area of the 
302.22 	facility where services for a client are initiated, or given to each interested person upon 
302.23 	request. Titles of each staff member authorized to initiate services for a client must be listed 
302.24 	in the services initiation and termination policies.
302.25 		Subd. 2.License holder responsibilities. (a) The license holder must have and comply 
302.26 	with a written protocol for (1) assisting a client in need of care not provided by the license 
302.27 	holder, and (2) a client who poses a substantial likelihood of harm to the client or others, if 
302.28 	the behavior is beyond the behavior management capabilities of the staff members.
302.29 	(b) A service termination and denial of service initiation that poses an immediate threat 
302.30 	to the health of any individual or requires immediate medical intervention must be referred 
302.31 	to a medical facility capable of admitting the client.
303.1 	(c) A service termination policy and a denial of service initiation that involves the 
303.2 	commission of a crime against a license holder's staff member or on a license holder's 
303.3 	premises, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and 
303.4 	title 45, parts 160 to 164, must be reported to a law enforcement agency with jurisdiction.
303.5 		Subd. 3.Service termination policies. A license holder must have a written policy 
303.6 	specifying the conditions when a client must be terminated from service. The service 
303.7 	termination policy must include:
303.8 	(1) procedures for a client whose services were terminated under subdivision 2;
303.9 	(2) a description of client behavior that constitutes reason for a staff-requested service 
303.10 	termination and a process for providing this information to a client;
303.11 	(3) a requirement that before discharging a client from a residential setting, for not 
303.12 	reaching treatment plan goals, the license holder must confer with other interested persons 
303.13 	to review the issues involved in the decision. The documentation requirements for a 
303.14 	staff-requested service termination must describe why the decision to discharge is warranted, 
303.15 	the reasons for the discharge, and the alternatives considered or attempted before discharging 
303.16 	the client;
303.17 	(4) procedures consistent with section 253B.16, subdivision 2, that staff members must 
303.18 	follow when a client admitted under chapter 253B is to have services terminated;
303.19 	(5) procedures a staff member must follow when a client leaves against staff or medical 
303.20 	advice and when the client may be dangerous to the client or others, including a policy that 
303.21 	requires a staff member to assist the client with assessing needs of care or other resources;
303.22 	(6) procedures for communicating staff-approved service termination criteria to a client, 
303.23 	including the expectations in the client's individual treatment plan according to section 
303.24 	245G.06; and
303.25 	(7) titles of each staff member authorized to terminate a client's service must be listed 
303.26 	in the service initiation and service termination policies.

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

303.28 	Sec. 22. [245G.15] CLIENT RIGHTS PROTECTION.
303.29 		Subdivision 1.Explanation. A client has the rights identified in sections 144.651, 
303.30 	148F.165, 253B.03, and 254B.02, subdivision 2, as applicable. The license holder must 
303.31 	give each client at service initiation a written statement of the client's rights and 
303.32 	responsibilities. A staff member must review the statement with a client at that time.
304.1 		Subd. 2.Grievance procedure. At service initiation, the license holder must explain 
304.2 	the grievance procedure to the client or the client's representative. The grievance procedure 
304.3 	must be posted in a place visible to clients, and made available upon a client's or former 
304.4 	client's request. The grievance procedure must require that:
304.5 	(1) a staff member helps the client develop and process a grievance;
304.6 	(2) current telephone numbers and addresses of the Department of Human Services, 
304.7 	Licensing Division; the Office of Ombudsman for Mental Health and Developmental 
304.8 	Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board 
304.9 	of Behavioral Health and Therapy, when applicable, be made available to a client; and
304.10 	(3) a license holder responds to the client's grievance within three days of a staff member's 
304.11 	receipt of the grievance, and the client may bring the grievance to the highest level of 
304.12 	authority in the program if not resolved by another staff member.
304.13 		Subd. 3.Photographs of client. (a) A photograph, video, or motion picture of a client 
304.14 	taken in the provision of treatment service is considered client records. A photograph for 
304.15 	identification and a recording by video or audio technology to enhance either therapy or 
304.16 	staff member supervision may be required of a client, but may only be available for use as 
304.17 	communications within a program. A client must be informed when the client's actions are 
304.18 	being recorded by camera or other technology, and the client must have the right to refuse 
304.19 	any recording or photography, except as authorized by this subdivision.
304.20 	(b) A license holder must have a written policy regarding the use of any personal 
304.21 	electronic device that can record, transmit, or make images of another client. A license 
304.22 	holder must inform each client of this policy and the client's right to refuse being 
304.23 	photographed or recorded.

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

304.25 	Sec. 23. [245G.16] BEHAVIORAL EMERGENCY PROCEDURES.
304.26 	(a) A license holder or applicant must have written behavioral emergency procedures 
304.27 	that staff must follow when responding to a client who exhibits behavior that is threatening 
304.28 	to the safety of the client or others. Programs must incorporate person-centered planning 
304.29 	and trauma-informed care in the program's behavioral emergency procedure policies. The 
304.30 	procedures must include:
304.31 	(1) a plan designed to prevent a client from hurting themselves or others;
305.1 	(2) contact information for emergency resources that staff must consult when a client's 
305.2 	behavior cannot be controlled by the behavioral emergency procedures;
305.3 	(3) types of procedures that may be used;
305.4 	(4) circumstances under which behavioral emergency procedures may be used; and
305.5 	(5) staff members authorized to implement behavioral emergency procedures.
305.6 	(b) Behavioral emergency procedures must not be used to enforce facility rules or for 
305.7 	the convenience of staff. Behavioral emergency procedures must not be part of any client's 
305.8 	treatment plan, or used at any time for any reason except in response to specific current 
305.9 	behavior that threatens the safety of the client or others. Behavioral emergency procedures 
305.10 	may not include the use of seclusion or restraint.

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

305.12 	Sec. 24. [245G.17] EVALUATION.
305.13 	A license holder must participate in the drug and alcohol abuse normative evaluation 
305.14 	system by submitting information about each client to the commissioner in a manner 
305.15 	prescribed by the commissioner. A license holder must submit additional information 
305.16 	requested by the commissioner that is necessary to meet statutory or federal funding 
305.17 	requirements.

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

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

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

306.16 	Sec. 26. [245G.19] LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.
306.17 		Subdivision 1.Health license requirements. In addition to the requirements of sections 
306.18 	245G.01 to 245G.17, a license holder that offers supervision of a child of a client is subject 
306.19 	to the requirements of this section. A license holder providing room and board for a client 
306.20 	and the client's child must have an appropriate facility license from the Department of 
306.21 	Health.
306.22 		Subd. 2.Supervision of a child. "Supervision of a child" means a caregiver is within 
306.23 	sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can 
306.24 	intervene to protect the child's health and safety. For a school-age child it means a caregiver 
306.25 	is available to help and care for the child to protect the child's health and safety.
306.26 		Subd. 3.Policy and schedule required. A license holder must meet the following 
306.27 	requirements:
306.28 	(1) have a policy and schedule delineating the times and circumstances when the license 
306.29 	holder is responsible for supervision of a child in the program and when the child's parents 
306.30 	are responsible for supervision of a child. The policy must explain how the program will 
306.31 	communicate its policy about supervision of a child responsibility to the parent; and
307.1 	(2) have written procedures addressing the actions a staff member must take if a child 
307.2 	is neglected or abused, including while the child is under the supervision of the child's 
307.3 	parent.
307.4 		Subd. 4.Additional licensing requirements. During the times the license holder is 
307.5 	responsible for the supervision of a child, the license holder must meet the following 
307.6 	standards:
307.7 	(1) child and adult ratios in Minnesota Rules, part 9502.0367;
307.8 	(2) day care training in section 245A.50;
307.9 	(3) behavior guidance in Minnesota Rules, part 9502.0395;
307.10 	(4) activities and equipment in Minnesota Rules, part 9502.0415;
307.11 	(5) physical environment in Minnesota Rules, part 9502.0425; and
307.12 	(6) water, food, and nutrition in Minnesota Rules, part 9502.0445, unless the license 
307.13 	holder has a license from the Department of Health.

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

307.15 	Sec. 27. [245G.20] LICENSE HOLDERS SERVING PERSONS WITH 
307.16 	CO-OCCURRING DISORDERS.
307.17 	A license holder specializing in the treatment of a person with co-occurring disorders 
307.18 	must:
307.19 	(1) demonstrate that staff levels are appropriate for treating a client with a co-occurring 
307.20 	disorder, and that there are adequate staff members with mental health training;
307.21 	(2) have continuing access to a medical provider with appropriate expertise in prescribing 
307.22 	psychotropic medication;
307.23 	(3) have a mental health professional available for staff member supervision and 
307.24 	consultation;
307.25 	(4) determine group size, structure, and content considering the special needs of a client 
307.26 	with a co-occurring disorder;
307.27 	(5) have documentation of active interventions to stabilize mental health symptoms 
307.28 	present in the individual treatment plans and progress notes;
307.29 	(6) have continuing documentation of collaboration with continuing care mental health 
307.30 	providers, and involvement of the providers in treatment planning meetings;
308.1 	(7) have available program materials adapted to a client with a mental health problem;
308.2 	(8) have policies that provide flexibility for a client who may lapse in treatment or may 
308.3 	have difficulty adhering to established treatment rules as a result of a mental illness, with 
308.4 	the goal of helping a client successfully complete treatment; and
308.5 	(9) have individual psychotherapy and case management available during treatment 
308.6 	service.

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

308.8 	Sec. 28. [245G.21] REQUIREMENTS FOR LICENSED RESIDENTIAL 
308.9 	TREATMENT.
308.10 		Subdivision 1.Applicability. A license holder who provides supervised room and board 
308.11 	at the licensed program site as a treatment component is defined as a residential program 
308.12 	according to section 245A.02, subdivision 14, and is subject to this section.
308.13 		Subd. 2.Visitors. A client must be allowed to receive visitors at times prescribed by 
308.14 	the license holder. The license holder must set and post a notice of visiting rules and hours, 
308.15 	including both day and evening times. A client's right to receive visitors other than a personal 
308.16 	physician, religious adviser, county case manager, parole or probation officer, or attorney 
308.17 	may be subject to visiting hours established by the license holder for all clients. The treatment 
308.18 	director or designee may impose limitations as necessary for the welfare of a client provided 
308.19 	the limitation and the reasons for the limitation are documented in the client's file. A client 
308.20 	must be allowed to receive visits at all reasonable times from the client's personal physician, 
308.21 	religious adviser, county case manager, parole or probation officer, and attorney.
308.22 		Subd. 3.Client property management. A license holder who provides room and board 
308.23 	and treatment services to a client in the same facility, and any license holder that accepts 
308.24 	client property must meet the requirements for handling client funds and property in section 
308.25 	245A.04, subdivision 13. License holders:
308.26 	(1) may establish policies regarding the use of personal property to ensure that treatment 
308.27 	activities and the rights of other clients are not infringed upon;
308.28 	(2) may take temporary custody of a client's property for violation of a facility policy;
308.29 	(3) must retain the client's property for a minimum of seven days after the client's service 
308.30 	termination if the client does not reclaim property upon service termination, or for a minimum 
308.31 	of 30 days if the client does not reclaim property upon service termination and has received 
308.32 	room and board services from the license holder; and
309.1 	(4) must return all property held in trust to the client at service termination regardless 
309.2 	of the client's service termination status, except that:
309.3 	(i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section 
309.4 	609.5316, must be given to the custody of a local law enforcement agency. If giving the 
309.5 	property to the custody of a local law enforcement agency violates Code of Federal 
309.6 	Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug 
309.7 	paraphernalia, or drug container must be destroyed by a staff member designated by the 
309.8 	program director; and
309.9 	(ii) a weapon, explosive, and other property that can cause serious harm to the client or 
309.10 	others must be given to the custody of a local law enforcement agency, and the client must 
309.11 	be notified of the transfer and of the client's right to reclaim any lawful property transferred; 
309.12 	and
309.13 	(iii) a medication that was determined by a physician to be harmful after examining the 
309.14 	client must be destroyed, except when the client's personal physician approves the medication 
309.15 	for continued use.
309.16 		Subd. 4.Health facility license. A license holder who provides room and board and 
309.17 	treatment services in the same facility must have the appropriate license from the Department 
309.18 	of Health.
309.19 		Subd. 5.Facility abuse prevention plan. A license holder must establish and enforce 
309.20 	an ongoing facility abuse prevention plan consistent with sections 245A.65 and 626.557, 
309.21 	subdivision 14.
309.22 		Subd. 6.Individual abuse prevention plan. A license holder must prepare an individual 
309.23 	abuse prevention plan for each client as specified under sections 245A.65, subdivision 2, 
309.24 	and 626.557, subdivision 14.
309.25 		Subd. 7.Health services. A license holder must have written procedures for assessing 
309.26 	and monitoring a client's health, including a standardized data collection tool for collecting 
309.27 	health-related information about each client. The policies and procedures must be approved 
309.28 	and signed by a registered nurse.
309.29 		Subd. 8.Administration of medication. A license holder must meet the administration 
309.30 	of medications requirements of section 245G.08, subdivision 5, if services include medication 
309.31 	administration.

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

310.1 	Sec. 29. [245G.22] OPIOID TREATMENT PROGRAMS.
310.2 		Subdivision 1.Additional requirements. (a) An opioid treatment program licensed 
310.3 	under this chapter must also comply with the requirements of this section and Code of 
310.4 	Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on 
310.5 	federal standards or requirements also required under this section, the federal guidance or 
310.6 	interpretations shall apply.
310.7 	(b) Where a standard in this section differs from a standard in an otherwise applicable 
310.8 	administrative rule or statute, the standard of this section applies.
310.9 		Subd. 2.Definitions. (a) For purposes of this section, the terms defined in this subdivision 
310.10 	have the meanings given them.
310.11 	(b) "Diversion" means the use of a medication for the treatment of opioid addiction being 
310.12 	diverted from intended use of the medication.
310.13 	(c) "Guest dose" means administration of a medication used for the treatment of opioid 
310.14 	addiction to a person who is not a client of the program that is administering or dispensing 
310.15 	the medication.
310.16 	(d) "Medical director" means a physician licensed to practice medicine in the jurisdiction 
310.17 	that the opioid treatment program is located who assumes responsibility for administering 
310.18 	all medical services performed by the program, either by performing the services directly 
310.19 	or by delegating specific responsibility to authorized program physicians and health care 
310.20 	professionals functioning under the medical director's direct supervision.
310.21 	(e) "Medication used for the treatment of opioid use disorder" means a medication 
310.22 	approved by the Food and Drug Administration for the treatment of opioid use disorder.
310.23 	(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
310.24 	(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations, 
310.25 	title 42, section 8.12, and includes programs licensed under this chapter.
310.26 	(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605, 
310.27 	subpart 21a.
310.28 	(i) "Unsupervised use" means the use of a medication for the treatment of opioid use 
310.29 	disorder dispensed for use by a client outside of the program setting.
310.30 		Subd. 3.Medication orders. Before the program may administer or dispense a medication 
310.31 	used for the treatment of opioid use disorder:
311.1 	(1) a client-specific order must be received from an appropriately credentialed physician 
311.2 	who is enrolled as a Minnesota health care programs provider and meets all applicable 
311.3 	provider standards;
311.4 	(2) the signed order must be documented in the client's record; and
311.5 	(3) if the physician that issued the order is not able to sign the order when issued, the 
311.6 	unsigned order must be entered in the client record at the time it was received, and the 
311.7 	physician must review the documentation and sign the order in the client's record within 72 
311.8 	hours of the medication being ordered. The license holder must report to the commissioner 
311.9 	any medication error that endangers a client's health, as determined by the medical director.
311.10 		Subd. 4.High dose requirements. A client being administered or dispensed a dose 
311.11 	beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams 
311.12 	of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase, 
311.13 	must meet face-to-face with a prescribing physician. The meeting must occur before the 
311.14 	administration or dispensing of the increased medication dose.
311.15 		Subd. 5.Drug testing. Each client enrolled in the program must receive a minimum of 
311.16 	eight random drug abuse tests per 12 months of treatment. Drug abuse tests must be 
311.17 	reasonably disbursed over the 12-month period. A license holder may elect to conduct more 
311.18 	drug abuse tests.
311.19 		Subd. 6.Criteria for unsupervised use. (a) To limit the potential for diversion of 
311.20 	medication used for the treatment of opioid use disorder to the illicit market, medication 
311.21 	dispensed to a client for unsupervised use shall be subject to the following requirements:
311.22 	(1) any client in an opioid treatment program may receive a single unsupervised use 
311.23 	dose for a day that the clinic is closed for business, including Sundays and state and federal 
311.24 	holidays; and
311.25 	(2) other treatment program decisions on dispensing medications used for the treatment 
311.26 	of opioid use disorder to a client for unsupervised use shall be determined by the medical 
311.27 	director.
311.28 	(b) In determining whether a client may be permitted unsupervised use of medications, 
311.29 	a physician with authority to prescribe must consider the criteria in this paragraph. The 
311.30 	criteria in this paragraph must also be considered when determining whether dispensing 
311.31 	medication for a client's unsupervised use is appropriate to increase or to extend the amount 
311.32 	of time between visits to the program. The criteria are:
312.1 	(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics, 
312.2 	and alcohol;
312.3 	(2) regularity of program attendance;
312.4 	(3) absence of serious behavioral problems at the program;
312.5 	(4) absence of known recent criminal activity such as drug dealing;
312.6 	(5) stability of the client's home environment and social relationships;
312.7 	(6) length of time in comprehensive maintenance treatment;
312.8 	(7) reasonable assurance that unsupervised use medication will be safely stored within 
312.9 	the client's home; and
312.10 	(8) whether the rehabilitative benefit the client derived from decreasing the frequency 
312.11 	of program attendance outweighs the potential risks of diversion or unsupervised use.
312.12 	(c) The determination, including the basis of the determination must be documented in 
312.13 	the client's medical record.
312.14 		Subd. 7.Restrictions for unsupervised use of methadone hydrochloride. (a) If a 
312.15 	physician with authority to prescribe determines that a client meets the criteria in subdivision 
312.16 	6 and may be dispensed a medication used for the treatment of opioid addiction, the 
312.17 	restrictions in this subdivision must be followed when the medication to be dispensed is 
312.18 	methadone hydrochloride.
312.19 	(b) During the first 90 days of treatment, the unsupervised use medication supply must 
312.20 	be limited to a maximum of a single dose each week and the client shall ingest all other 
312.21 	doses under direct supervision.
312.22 	(c) In the second 90 days of treatment, the unsupervised use medication supply must be 
312.23 	limited to two doses per week.
312.24 	(d) In the third 90 days of treatment, the unsupervised use medication supply must not 
312.25 	exceed three doses per week.
312.26 	(e) In the remaining months of the first year, a client may be given a maximum six-day 
312.27 	unsupervised use medication supply.
312.28 	(f) After one year of continuous treatment, a client may be given a maximum two-week 
312.29 	unsupervised use medication supply.
312.30 	(g) After two years of continuous treatment, a client may be given a maximum one-month 
312.31 	unsupervised use medication supply, but must make monthly visits to the program.
313.1 		Subd. 8.Restriction exceptions. When a license holder has reason to accelerate the 
313.2 	number of unsupervised use doses of methadone hydrochloride, the license holder must 
313.3 	comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the 
313.4 	criteria for unsupervised use and must use the exception process provided by the federal 
313.5 	Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the 
313.6 	purposes of enforcement of this subdivision, the commissioner has the authority to monitor 
313.7 	a program for compliance with federal regulations and may issue licensing actions according 
313.8 	to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of 
313.9 	noncompliance.
313.10 		Subd. 9.Guest dose. To receive a guest dose, the client must be enrolled in an opioid 
313.11 	treatment program elsewhere in the state or country and be receiving the medication on a 
313.12 	temporary basis because the client is not able to receive the medication at the program in 
313.13 	which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any 
313.14 	one program and must not be for the convenience or benefit of either program. A guest dose 
313.15 	may also occur when the client's primary clinic is not open and the client is not receiving 
313.16 	unsupervised use doses.
313.17 		Subd. 10.Capacity management and waiting list system compliance. An opioid 
313.18 	treatment program must notify the department within seven days of the program reaching 
313.19 	both 90 and 100 percent of the program's capacity to care for clients. Each week, the program 
313.20 	must report its capacity, currently enrolled dosing clients, and any waiting list. A program 
313.21 	reporting 90 percent of capacity must also notify the department when the program's census 
313.22 	increases or decreases from the 90 percent level.
313.23 		Subd. 11.Waiting list. An opioid treatment program must have a waiting list system. 
313.24 	If the person seeking admission cannot be admitted within 14 days of the date of application, 
313.25 	each person seeking admission must be placed on the waiting list, unless the person seeking 
313.26 	admission is assessed by the program and found ineligible for admission according to this 
313.27 	chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and 
313.28 	title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each 
313.29 	person seeking treatment while awaiting admission. A person seeking admission on a waiting 
313.30 	list who receives no services under section 245G.07, subdivision 1, must not be considered 
313.31 	a client as defined in section 245G.01, subdivision 9.
313.32 		Subd. 12.Client referral. An opioid treatment program must consult the capacity 
313.33 	management system to ensure that a person on a waiting list is admitted at the earliest time 
313.34 	to a program providing appropriate treatment within a reasonable geographic area. If the 
313.35 	client was referred through a public payment system and if the program is not able to serve 
314.1 	the client within 14 days of the date of application for admission, the program must contact 
314.2 	and inform the referring agency of any available treatment capacity listed in the state capacity 
314.3 	management system.
314.4 		Subd. 13.Outreach. An opioid treatment program must carry out activities to encourage 
314.5 	an individual in need of treatment to undergo treatment. The program's outreach model 
314.6 	must:
314.7 	(1) select, train, and supervise outreach workers;
314.8 	(2) contact, communicate, and follow up with individuals with high-risk substance 
314.9 	misuse, individuals with high-risk substance misuse associates, and neighborhood residents 
314.10 	within the constraints of federal and state confidentiality requirements;
314.11 	(3) promote awareness among individuals who engage in substance misuse by injection 
314.12 	about the relationship between injecting substances and communicable diseases such as 
314.13 	HIV; and
314.14 	(4) recommend steps to prevent HIV transmission.
314.15 		Subd. 14.Central registry. (a) A license holder must comply with requirements to 
314.16 	submit information and necessary consents to the state central registry for each client 
314.17 	admitted, as specified by the commissioner. The license holder must submit data concerning 
314.18 	medication used for the treatment of opioid use disorder. The data must be submitted in a 
314.19 	method determined by the commissioner and the original information must be kept in the 
314.20 	client's record. The information must be submitted for each client at admission and discharge. 
314.21 	The program must document the date the information was submitted. The client's failure to 
314.22 	provide the information shall prohibit participation in an opioid treatment program. The 
314.23 	information submitted must include the client's:
314.24 	(1) full name and all aliases;
314.25 	(2) date of admission;
314.26 	(3) date of birth;
314.27 	(4) Social Security number or Alien Registration Number, if any;
314.28 	(5) current or previous enrollment status in another opioid treatment program;
314.29 	(6) government-issued photo identification card number; and
314.30 	(7) driver's license number, if any.
315.1 	(b) The requirements in paragraph (a) are effective upon the commissioner's 
315.2 	implementation of changes to the drug and alcohol abuse normative evaluation system or 
315.3 	development of an electronic system by which to submit the data.
315.4 		Subd. 15.Nonmedication treatment services; documentation. (a) The program must 
315.5 	offer at least 50 consecutive minutes of individual or group therapy treatment services as 
315.6 	defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first 
315.7 	ten weeks following admission, and at least 50 consecutive minutes per month thereafter. 
315.8 	As clinically appropriate, the program may offer these services cumulatively and not 
315.9 	consecutively in increments of no less than 15 minutes over the required time period, and 
315.10 	for a total of 60 minutes of treatment services over the time period, and must document the 
315.11 	reason for providing services cumulatively in the client's record. The program may offer 
315.12 	additional levels of service when deemed clinically necessary.
315.13 	(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05, 
315.14 	the assessment must be completed within 21 days of service initiation.
315.15 	(c) Notwithstanding the requirements of individual treatment plans set forth in section 
315.16 	245G.06:
315.17 	(1) treatment plan contents for a maintenance client are not required to include goals 
315.18 	the client must reach to complete treatment and have services terminated;
315.19 	(2) treatment plans for a client in a taper or detox status must include goals the client 
315.20 	must reach to complete treatment and have services terminated;
315.21 	(3) for the initial ten weeks after admission for all new admissions, readmissions, and 
315.22 	transfers, progress notes must be entered in a client's file at least weekly and be recorded 
315.23 	in each of the six dimensions upon the development of the treatment plan and thereafter. 
315.24 	Subsequently, the counselor must document progress in the six dimensions at least once 
315.25 	monthly or, when clinical need warrants, more frequently; and
315.26 	(4) upon the development of the treatment plan and thereafter, treatment plan reviews 
315.27 	must occur weekly, or after each treatment service, whichever is less frequent, for the first 
315.28 	ten weeks after the treatment plan is developed. Following the first ten weeks of treatment 
315.29 	plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent 
315.30 	revisions or documentation.
315.31 		Subd. 16.Prescription monitoring program. (a) The program must develop and 
315.32 	maintain a policy and procedure that requires the ongoing monitoring of the data from the 
316.1 	prescription monitoring program (PMP) for each client. The policy and procedure must 
316.2 	include how the program meets the requirements in paragraph (b).
316.3 	(b) If a medication used for the treatment of substance use disorder is administered or 
316.4 	dispensed to a client, the license holder shall be subject to the following requirements:
316.5 	(1) upon admission to a methadone clinic outpatient treatment program, a client must 
316.6 	be notified in writing that the commissioner of human services and the medical director 
316.7 	must monitor the PMP to review the prescribed controlled drugs a client received;
316.8 	(2) the medical director or the medical director's delegate must review the data from the 
316.9 	PMP described in section 152.126 before the client is ordered any controlled substance, as 
316.10 	defined under section 152.126, subdivision 1, paragraph (c), including medications used 
316.11 	for the treatment of opioid addiction, and the medical director's or the medical director's 
316.12 	delegate's subsequent reviews of the PMP data must occur at least every 90 days;
316.13 	(3) a copy of the PMP data reviewed must be maintained in the client's file;
316.14 	(4) when the PMP data contains a recent history of multiple prescribers or multiple 
316.15 	prescriptions for controlled substances, the physician's review of the data and subsequent 
316.16 	actions must be documented in the client's file within 72 hours and must contain the medical 
316.17 	director's determination of whether or not the prescriptions place the client at risk of harm 
316.18 	and the actions to be taken in response to the PMP findings. The provider must conduct 
316.19 	subsequent reviews of the PMP on a monthly basis; and
316.20 	(5) if at any time the medical director believes the use of the controlled substances places 
316.21 	the client at risk of harm, the program must seek the client's consent to discuss the client's 
316.22 	opioid treatment with other prescribers and must seek the client's consent for the other 
316.23 	prescriber to disclose to the opioid treatment program's medical director the client's condition 
316.24 	that formed the basis of the other prescriptions. If the information is not obtained within 
316.25 	seven days, the medical director must document whether or not changes to the client's 
316.26 	medication dose or number of unsupervised use doses are necessary until the information 
316.27 	is obtained.
316.28 	(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop 
316.29 	and implement an electronic system for the commissioner to routinely access the PMP data 
316.30 	to determine whether any client enrolled in an opioid addiction treatment program licensed 
316.31 	according to this section was prescribed or dispensed a controlled substance in addition to 
316.32 	that administered or dispensed by the opioid addiction treatment program. When the 
316.33 	commissioner determines there have been multiple prescribers or multiple prescriptions of 
316.34 	controlled substances for a client, the commissioner shall:
317.1 	(1) inform the medical director of the opioid treatment program only that the 
317.2 	commissioner determined the existence of multiple prescribers or multiple prescriptions of 
317.3 	controlled substances; and
317.4 	(2) direct the medical director of the opioid treatment program to access the data directly, 
317.5 	review the effect of the multiple prescribers or multiple prescriptions, and document the 
317.6 	review.
317.7 	(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception 
317.8 	to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), before 
317.9 	implementing this subdivision.
317.10 		Subd. 17.Policies and procedures. (a) A license holder must develop and maintain the 
317.11 	policies and procedures required in this subdivision.
317.12 	(b) For a program that is not open every day of the year, the license holder must maintain 
317.13 	a policy and procedure that permits a client to receive a single unsupervised use of medication 
317.14 	used for the treatment of opioid use disorder for days that the program is closed for business, 
317.15 	including, but not limited to, Sundays and state and federal holidays as required under 
317.16 	subdivision 6, paragraph (a), clause (1).
317.17 	(c) The license holder must maintain a policy and procedure that includes specific 
317.18 	measures to reduce the possibility of diversion. The policy and procedure must:
317.19 	(1) specifically identify and define the responsibilities of the medical and administrative 
317.20 	staff for performing diversion control measures; and
317.21 	(2) include a process for contacting no less than five percent of clients who have 
317.22 	unsupervised use of medication, excluding clients approved solely under subdivision 6, 
317.23 	paragraph (a), clause (1), to require clients to physically return to the program each month. 
317.24 	The system must require clients to return to the program within a stipulated time frame and 
317.25 	turn in all unused medication containers related to opioid use disorder treatment. The license 
317.26 	holder must document all related contacts on a central log and the outcome of the contact 
317.27 	for each client in the client's record.
317.28 	(d) Medication used for the treatment of opioid use disorder must be ordered, 
317.29 	administered, and dispensed according to applicable state and federal regulations and the 
317.30 	standards set by applicable accreditation entities. If a medication order requires assessment 
317.31 	by the person administering or dispensing the medication to determine the amount to be 
317.32 	administered or dispensed, the assessment must be completed by an individual whose 
317.33 	professional scope of practice permits an assessment. For the purposes of enforcement of 
318.1 	this paragraph, the commissioner has the authority to monitor the person administering or 
318.2 	dispensing the medication for compliance with state and federal regulations and the relevant 
318.3 	standards of the license holder's accreditation agency and may issue licensing actions 
318.4 	according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's 
318.5 	determination of noncompliance.
318.6 		Subd. 18.Quality improvement plan. The license holder must develop and maintain 
318.7 	a quality improvement plan that:
318.8 	(1) includes evaluation of the services provided to clients to identify issues that may 
318.9 	improve service delivery and client outcomes;
318.10 	(2) includes goals for the program to accomplish based on the evaluation;
318.11 	(3) is reviewed annually by the management of the program to determine whether the 
318.12 	goals were met and, if not, whether additional action is required;
318.13 	(4) is updated at least annually to include new or continued goals based on an updated 
318.14 	evaluation of services; and
318.15 	(5) identifies two specific goal areas, in addition to others identified by the program, 
318.16 	including:
318.17 	(i) a goal concerning oversight and monitoring of the premises around and near the 
318.18 	exterior of the program to reduce the possibility of medication used for the treatment of 
318.19 	opioid use disorder being inappropriately used by a client, including but not limited to the 
318.20 	sale or transfer of the medication to others; and
318.21 	(ii) a goal concerning community outreach, including but not limited to communications 
318.22 	with local law enforcement and county human services agencies, to increase coordination 
318.23 	of services and identification of areas of concern to be addressed in the plan.
318.24 		Subd. 19.Placing authorities. A program must provide certain notification and 
318.25 	client-specific updates to placing authorities for a client who is enrolled in Minnesota health 
318.26 	care programs. At the request of the placing authority, the program must provide 
318.27 	client-specific updates, including but not limited to informing the placing authority of 
318.28 	positive drug screenings and changes in medications used for the treatment of opioid use 
318.29 	disorder ordered for the client.
318.30 		Subd. 20.Duty to report suspected drug diversion. (a) To the fullest extent permitted 
318.31 	under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to 
318.32 	law enforcement any credible evidence that the program or its personnel knows, or reasonably 
319.1 	should know, that is directly related to a diversion crime on the premises of the program, 
319.2 	or a threat to commit a diversion crime.
319.3 	(b) "Diversion crime," for the purposes of this section, means diverting, attempting to 
319.4 	divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02, 
319.5 	on the program's premises.
319.6 	(c) The program must document the program's compliance with the requirement in 
319.7 	paragraph (a) in either a client's record or an incident report. A program's failure to comply 
319.8 	with paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.

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

319.10 	Sec. 30. Minnesota Statutes 2016, section 254A.01, is amended to read:
319.11 	254A.01 PUBLIC POLICY.
319.12 	It is hereby declared to be the public policy of this state that scientific evidence shows 
319.13 	that addiction to alcohol or other drugs is a chronic brain disorder with potential for 
319.14 	recurrence, and as with many other chronic conditions, people with substance use disorders 
319.15 	can be effectively treated and can enter recovery. The interests of society are best served 
319.16 	by reducing the stigma of substance use disorder and providing persons who are dependent 
319.17 	upon alcohol or other drugs with a comprehensive range of rehabilitative and social services
319.18 	that span intensity levels and are not restricted to a particular point in time. Further, it is 
319.19 	declared that treatment under these services shall be voluntary when possible: treatment 
319.20 	shall not be denied on the basis of prior treatment; treatment shall be based on an individual 
319.21 	treatment plan for each person undergoing treatment; treatment shall include a continuum 
319.22 	of services available for a person leaving a program of treatment; treatment shall include 
319.23 	all family members at the earliest possible phase of the treatment process.

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

319.25 	Sec. 31. Minnesota Statutes 2016, section 254A.02, subdivision 2, is amended to read:
319.26 		Subd. 2.Approved treatment program. "Approved treatment program" means care 
319.27 	and treatment services provided by any individual, organization or association to drug 
319.28 	dependent persons with a substance use disorder, which meets the standards established by 
319.29 	the commissioner of human services.

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

320.1 	Sec. 32. 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. 33. 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. 34. 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. 35. 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. 36. 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. 37. 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. 38. 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. 39. 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. 40. 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. 41. 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. 42. 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 Minnesota Rules, parts 9530.6510 to 9530.6590, and established for the 
325.15 	purpose of facilitating access into care and treatment by detoxifying and evaluating the 
325.16 	person and providing entrance into a comprehensive program. Evaluation of the person 
325.17 	shall include verification by a professional, after preliminary examination, that the person 
325.18 	is intoxicated or has symptoms of chemical dependency substance misuse or substance use 
325.19 	disorder and appears to be in imminent danger of harming self or others. A detoxification 
325.20 	program shall have available the services of a licensed physician for medical emergencies 
325.21 	and routine medical surveillance. A detoxification program licensed by the Department of 
325.22 	Human Services to serve both adults and minors at the same site must provide for separate 
325.23 	sleeping areas for adults and minors.

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

325.25 	Sec. 43. 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. 44. 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 	an assessor conducting a chemical use assessment under Minnesota Rules, parts 9530.6600
326.25 	to 9530.6655, may not have any direct or shared financial interest or referral relationship 
326.26 	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. 45. 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. 46. 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. 47. 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. 48. 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. 49. 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. 50. 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. 51. 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. 52. 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, 2018, 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.22 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. 53. 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. 54. 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. 55. 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 July 1, 2017.

337.12 	Sec. 56. 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. 57. 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. 58. Minnesota Statutes 2016, section 254B.13, subdivision 2a, is amended to read:
338.22 		Subd. 2a.Eligibility for navigator pilot program. (a) To be considered for participation 
338.23 	in a navigator pilot program, an individual must:
338.24 	(1) be a resident of a county with an approved navigator program;
338.25 	(2) be eligible for consolidated chemical dependency treatment fund services;
338.26 	(3) be a voluntary participant in the navigator program;
338.27 	(4) satisfy one of the following items:
338.28 	(i) have at least one severity rating of three or above in dimension four, five, or six in a 
338.29 	comprehensive assessment under Minnesota Rules, part 9530.6422 section 245G.05, 
338.30 	paragraph (c), clauses (4) to (6); or
339.1 	(ii) have at least one severity rating of two or above in dimension four, five, or six in a 
339.2 	comprehensive assessment under Minnesota Rules, part 9530.6422, section 245G.05, 
339.3 	paragraph (c), clauses (4) to (6), and be currently participating in a Rule 31 treatment program 
339.4 	under Minnesota Rules, parts 9530.6405 to 9530.6505, chapter 245G or be within 60 days 
339.5 	following discharge after participation in a Rule 31 treatment program; and
339.6 	(5) have had at least two treatment episodes in the past two years, not limited to episodes 
339.7 	reimbursed by the consolidated chemical dependency treatment funds. An admission to an 
339.8 	emergency room, a detoxification program, or a hospital may be substituted for one treatment 
339.9 	episode if it resulted from the individual's substance use disorder.
339.10 	(b) New eligibility criteria may be added as mutually agreed upon by the commissioner 
339.11 	and participating navigator programs.

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

339.13 	Sec. 59. Minnesota Statutes 2016, section 256B.0625, subdivision 45a, is amended to 
339.14 	read:
339.15 		Subd. 45a.Psychiatric residential treatment facility services for persons under 21 
339.16 	years of age. (a) Medical assistance covers psychiatric residential treatment facility services, 
339.17 	according to section 256B.0941, for persons under younger than 21 years of age. Individuals 
339.18 	who reach age 21 at the time they are receiving services are eligible to continue receiving 
339.19 	services until they no longer require services or until they reach age 22, whichever occurs 
339.20 	first.
339.21 	(b) For purposes of this subdivision, "psychiatric residential treatment facility" means 
339.22 	a facility other than a hospital that provides psychiatric services, as described in Code of 
339.23 	Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under age 21 in 
339.24 	an inpatient setting.
339.25 	(c) The commissioner shall develop admissions and discharge procedures and establish 
339.26 	rates consistent with guidelines from the federal Centers for Medicare and Medicaid Services.
339.27 	(d) The commissioner shall enroll up to 150 certified psychiatric residential treatment 
339.28 	facility services beds at up to six sites. The commissioner shall select psychiatric residential 
339.29 	treatment facility services providers through a request for proposals process. Providers of 
339.30 	state-operated services may respond to the request for proposals.

340.1 	Sec. 60. [256B.0941] PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY 
340.2 	FOR PERSONS UNDER 21 YEARS OF AGE.
340.3 		Subdivision 1.Eligibility. (a) An individual who is eligible for mental health treatment 
340.4 	services in a psychiatric residential treatment facility must meet all of the following criteria:
340.5 	(1) before admission, services are determined to be medically necessary by the state's 
340.6 	medical review agent according to Code of Federal Regulations, title 42, section 441.152;
340.7 	(2) is younger than 21 years of age at the time of admission. Services may continue until 
340.8 	the individual meets criteria for discharge or reaches 22 years of age, whichever occurs 
340.9 	first;
340.10 	(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic 
340.11 	and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression, 
340.12 	or a finding that the individual is a risk to self or others;
340.13 	(4) has functional impairment and a history of difficulty in functioning safely and 
340.14 	successfully in the community, school, home, or job; an inability to adequately care for 
340.15 	one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill 
340.16 	the individual's needs;
340.17 	(5) requires psychiatric residential treatment under the direction of a physician to improve 
340.18 	the individual's condition or prevent further regression so that services will no longer be 
340.19 	needed;
340.20 	(6) utilized and exhausted other community-based mental health services, or clinical 
340.21 	evidence indicates that such services cannot provide the level of care needed; and
340.22 	(7) was referred for treatment in a psychiatric residential treatment facility by a qualified 
340.23 	mental health professional licensed as defined in section 245.4871, subdivision 27, clauses 
340.24 	(1) to (6).
340.25 	(b) A mental health professional making a referral shall submit documentation to the 
340.26 	state's medical review agent containing all information necessary to determine medical 
340.27 	necessity, including a standard diagnostic assessment completed within 180 days of the 
340.28 	individual's admission. Documentation shall include evidence of family participation in the 
340.29 	individual's treatment planning and signed consent for services.
340.30 		Subd. 2.Services. Psychiatric residential treatment facility service providers must offer 
340.31 	and have the capacity to provide the following services:
341.1 	(1) development of the individual plan of care, review of the individual plan of care 
341.2 	every 30 days, and discharge planning by required members of the treatment team according 
341.3 	to Code of Federal Regulations, title 42, sections 441.155 to 441.156;
341.4 	(2) any services provided by a psychiatrist or physician for development of an individual 
341.5 	plan of care, conducting a review of the individual plan of care every 30 days, and discharge 
341.6 	planning by required members of the treatment team according to Code of Federal 
341.7 	Regulations, title 42, sections 441.155 to 441.156;
341.8 	(3) active treatment seven days per week that may include individual, family, or group 
341.9 	therapy as determined by the individual care plan;
341.10 	(4) individual therapy, provided a minimum of twice per week;
341.11 	(5) family engagement activities, provided a minimum of once per week;
341.12 	(6) consultation with other professionals, including case managers, primary care 
341.13 	professionals, community-based mental health providers, school staff, or other support 
341.14 	planners;
341.15 	(7) coordination of educational services between local and resident school districts and 
341.16 	the facility;
341.17 	(8) 24-hour nursing; and
341.18 	(9) direct care and supervision, supportive services for daily living and safety, and 
341.19 	positive behavior management.
341.20 		Subd. 3.Per diem rate. (a) The commissioner shall establish a statewide per diem rate 
341.21 	for psychiatric residential treatment facility services for individuals 21 years of age or 
341.22 	younger. The rate for a provider must not exceed the rate charged by that provider for the 
341.23 	same service to other payers. Payment must not be made to more than one entity for each 
341.24 	individual for services provided under this section on a given day. The commissioner shall 
341.25 	set rates prospectively for the annual rate period. The commissioner shall require providers 
341.26 	to submit annual cost reports on a uniform cost reporting form and shall use submitted cost 
341.27 	reports to inform the rate-setting process. The cost reporting shall be done according to 
341.28 	federal requirements for Medicare cost reports.
341.29 	(b) The following are included in the rate:
341.30 	(1) costs necessary for licensure and accreditation, meeting all staffing standards for 
341.31 	participation, meeting all service standards for participation, meeting all requirements for 
341.32 	active treatment, maintaining medical records, conducting utilization review, meeting 
342.1 	inspection of care, and discharge planning. The direct services costs must be determined 
342.2 	using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff 
342.3 	and service-related transportation; and
342.4 	(2) payment for room and board provided by facilities meeting all accreditation and 
342.5 	licensing requirements for participation.
342.6 	(c) A facility may submit a claim for payment outside of the per diem for professional 
342.7 	services arranged by and provided at the facility by an appropriately licensed professional 
342.8 	who is enrolled as a provider with Minnesota health care programs. Arranged services must 
342.9 	be billed by the facility on a separate claim, and the facility shall be responsible for payment 
342.10 	to the provider. These services must be included in the individual plan of care and are subject 
342.11 	to prior authorization by the state's medical review agent.
342.12 	(d) Medicaid shall reimburse for concurrent services as approved by the commissioner 
342.13 	to support continuity of care and successful discharge from the facility. "Concurrent services" 
342.14 	means services provided by another entity or provider while the individual is admitted to a 
342.15 	psychiatric residential treatment facility. Payment for concurrent services may be limited 
342.16 	and these services are subject to prior authorization by the state's medical review agent. 
342.17 	Concurrent services may include targeted case management, assertive community treatment, 
342.18 	clinical care consultation, team consultation, and treatment planning.
342.19 	(e) Payment rates under this subdivision shall not include the costs of providing the 
342.20 	following services:
342.21 	(1) educational services;
342.22 	(2) acute medical care or specialty services for other medical conditions;
342.23 	(3) dental services; and
342.24 	(4) pharmacy drug costs.
342.25 	(f) For purposes of this section, "actual cost" means costs that are allowable, allocable, 
342.26 	reasonable, and consistent with federal reimbursement requirements in Code of Federal 
342.27 	Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of 
342.28 	Management and Budget Circular Number A-122, relating to nonprofit entities.
342.29 		Subd. 4.Leave days. (a) Medical assistance covers therapeutic and hospital leave days, 
342.30 	provided the recipient was not discharged from the psychiatric residential treatment facility 
342.31 	and is expected to return to the psychiatric residential treatment facility. A reserved bed 
342.32 	must be held for a recipient on hospital leave or therapeutic leave.
343.1 	(b) A therapeutic leave day to home shall be used to prepare for discharge and 
343.2 	reintegration and shall be included in the individual plan of care. The state shall reimburse 
343.3 	75 percent of the per diem rate for a reserve bed day while the recipient is on therapeutic 
343.4 	leave. A therapeutic leave visit may not exceed three days without prior authorization.
343.5 	(c) A hospital leave day shall be a day for which a recipient has been admitted to a 
343.6 	hospital for medical or acute psychiatric care and is temporarily absent from the psychiatric 
343.7 	residential treatment facility. The state shall reimburse 50 percent of the per diem rate for 
343.8 	a reserve bed day while the recipient is receiving medical or psychiatric care in a hospital.

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

343.10 	Sec. 61. Minnesota Statutes 2016, section 256B.0943, subdivision 13, is amended to read:
343.11 		Subd. 13.Exception to excluded services. Notwithstanding subdivision 12, up to 15 
343.12 	hours of children's therapeutic services and supports provided within a six-month period to 
343.13 	a child with severe emotional disturbance who is residing in a hospital; a group home as 
343.14 	defined in Minnesota Rules, parts 2960.0130 to 2960.0220; a residential treatment facility 
343.15 	licensed under Minnesota Rules, parts 2960.0580 to 2960.0690; a psychiatric residential 
343.16 	treatment facility under section 256B.0625, subdivision 45a; a regional treatment center; 
343.17 	or other institutional group setting or who is participating in a program of partial 
343.18 	hospitalization are eligible for medical assistance payment if part of the discharge plan.

343.19 	Sec. 62. Minnesota Statutes 2016, section 256B.0945, subdivision 2, is amended to read:
343.20 		Subd. 2.Covered services. All services must be included in a child's individualized 
343.21 	treatment or multiagency plan of care as defined in chapter 245.
343.22 	For facilities that are not institutions for mental diseases according to federal statute and 
343.23 	regulation, medical assistance covers mental health-related services that are required to be 
343.24 	provided by a residential facility under section 245.4882 and administrative rules promulgated 
343.25 	thereunder, except for room and board. For residential facilities determined by the federal 
343.26 	Centers for Medicare and Medicaid Services to be an institution for mental diseases, medical 
343.27 	assistance covers medically necessary mental health services provided by the facility 
343.28 	according to section 256B.055, subdivision 13, except for room and board.

343.29 	Sec. 63. Minnesota Statutes 2016, section 256B.0945, subdivision 4, is amended to read:
343.30 		Subd. 4.Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, payments 
343.31 	to counties for residential services provided under this section by a residential facility shall:
344.1 	(1) for services provided by a residential facility that is not an institution for mental 
344.2 	diseases, only be made of federal earnings for services provided under this section, and the 
344.3 	nonfederal share of costs for services provided under this section shall be paid by the county 
344.4 	from sources other than federal funds or funds used to match other federal funds. Payment 
344.5 	to counties for services provided according to this section shall be a proportion of the per 
344.6 	day contract rate that relates to rehabilitative mental health services and shall not include 
344.7 	payment for costs or services that are billed to the IV-E program as room and board.; and
344.8 	(2) for services provided by a residential facility that is determined to be an institution 
344.9 	for mental diseases, be equivalent to the federal share of the payment that would have been 
344.10 	made if the residential facility were not an institution for mental diseases. The portion of 
344.11 	the payment representing what would be the nonfederal shares shall be paid by the county. 
344.12 	Payment to counties for services provided according to this section shall be a proportion of 
344.13 	the per day contract rate that relates to rehabilitative mental health services and shall not 
344.14 	include payment for costs or services that are billed to the IV-E program as room and board.
344.15 	(b) Per diem rates paid to providers under this section by prepaid plans shall be the 
344.16 	proportion of the per-day contract rate that relates to rehabilitative mental health services 
344.17 	and shall not include payment for group foster care costs or services that are billed to the 
344.18 	county of financial responsibility. Services provided in facilities located in bordering states 
344.19 	are eligible for reimbursement on a fee-for-service basis only as described in paragraph (a) 
344.20 	and are not covered under prepaid health plans.
344.21 	(c) Payment for mental health rehabilitative services provided under this section by or 
344.22 	under contract with an American Indian tribe or tribal organization or by agencies operated 
344.23 	by or under contract with an American Indian tribe or tribal organization must be made 
344.24 	according to section 256B.0625, subdivision 34, or other relevant federally approved 
344.25 	rate-setting methodology.
344.26 	(d) The commissioner shall set aside a portion not to exceed five percent of the federal 
344.27 	funds earned for county expenditures under this section to cover the state costs of 
344.28 	administering this section. Any unexpended funds from the set-aside shall be distributed to 
344.29 	the counties in proportion to their earnings under this section.

344.30 	Sec. 64. CHILDREN'S MENTAL HEALTH REPORT AND RECOMMENDATIONS.
 344.31 	The commissioner of human services shall conduct a comprehensive analysis of 
344.32 	Minnesota's continuum of intensive mental health services and shall develop 
344.33 	recommendations for a sustainable and community-driven continuum of care for children 
345.1 	with serious mental health needs, including children currently being served in residential 
345.2 	treatment. The commissioner's analysis shall include, but not be limited to:
345.3 	(1) data related to access, utilization, efficacy, and outcomes for Minnesota's current 
345.4 	system of residential mental health treatment for a child with a severe emotional disturbance;
345.5 	(2) potential expansion of the state's psychiatric residential treatment facility (PRTF) 
345.6 	capacity, including increasing the number of PRTF beds and conversion of existing children's 
345.7 	mental health residential treatment programs into PRTFs;
345.8 	(3) the capacity need for PRTF and other group settings within the state if adequate 
345.9 	community-based alternatives are accessible, equitable, and effective statewide;
345.10 	(4) recommendations for expanding alternative community-based service models to 
345.11 	meet the needs of a child with a serious mental health disorder who would otherwise require 
345.12 	residential treatment and potential service models that could be utilized, including data 
345.13 	related to access, utilization, efficacy, and outcomes;
345.14 	(5) models of care used in other states; and
345.15 	(6) analysis and specific recommendations for the design and implementation of new 
345.16 	service models, including analysis to inform rate setting as necessary.
345.17 	The analysis shall be supported and informed by extensive stakeholder engagement. 
345.18 	Stakeholders include individuals who receive services, family members of individuals who 
345.19 	receive services, providers, counties, health plans, advocates, and others. Stakeholder 
345.20 	engagement shall include interviews with key stakeholders, intentional outreach to individuals 
345.21 	who receive services and the individual's family members, and regional listening sessions.
345.22 	The commissioner shall provide a report with specific recommendations and timelines 
345.23 	for implementation to the legislative committees with jurisdiction over children's mental 
345.24 	health policy and finance by November 15, 2018.

345.25 	Sec. 65. RESIDENTIAL TREATMENT AND PAYMENT RATE REFORM.
 345.26 	The commissioner shall contract with an outside expert to identify recommendations 
345.27 	for the development of a substance use disorder residential treatment program model and 
345.28 	payment structure that is not subject to the federal institutions for mental diseases exclusion 
345.29 	and that is financially sustainable for providers, while incentivizing best practices and 
345.30 	improved treatment outcomes. The analysis and report must include recommendations and 
345.31 	a timeline for supporting providers to transition to the new models of care delivery. No later 
345.32 	than December 15, 2018, a report with recommendations must be delivered to members of 
346.1 	the legislative committees in the house of representatives and senate with jurisdiction over 
346.2 	health and human services policy and finance.

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

346.4 	Sec. 66. REVISOR'S INSTRUCTION.
 346.5 	In Minnesota Statutes and Minnesota Rules, the revisor of statutes, in consultation with 
346.6 	the with the Department of Human Services, shall make necessary cross-reference changes 
346.7 	that are needed as a result of the enactment of sections 6 to 27 and 65. The revisor shall 
346.8 	make any necessary technical and grammatical changes to preserve the meaning of the text.

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

346.10 	Sec. 67.  REPEALER.
 346.11 	(a) Minnesota Statutes 2016, sections 245A.1915; 245A.192; and 254A.02, subdivision 
346.12 	4, are repealed.
346.13 	(b) Minnesota Rules, parts 9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 
346.14 	12, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 20, and 21; 9530.6410; 9530.6415; 
346.15 	9530.6420; 9530.6422; 9530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445; 
346.16 	9530.6450; 9530.6455; 9530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480; 
346.17 	9530.6485; 9530.6490; 9530.6495; 9530.6500; and 9530.6505, are repealed.

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

346.19 	ARTICLE 9
346.20 	OPERATIONS

346.21 	Section 1. Minnesota Statutes 2016, section 13.46, subdivision 4, is amended to read:
346.22 		Subd. 4.Licensing data. (a) As used in this subdivision:
346.23 	(1) "licensing data" are all data collected, maintained, used, or disseminated by the 
346.24 	welfare system pertaining to persons licensed or registered or who apply for licensure or 
346.25 	registration or who formerly were licensed or registered under the authority of the 
346.26 	commissioner of human services;
346.27 	(2) "client" means a person who is receiving services from a licensee or from an applicant 
346.28 	for licensure; and
347.1 	(3) "personal and personal financial data" are Social Security numbers, identity of and 
347.2 	letters of reference, insurance information, reports from the Bureau of Criminal 
347.3 	Apprehension, health examination reports, and social/home studies.
347.4 	(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, license 
347.5 	holders, and former licensees are public: name, address, telephone number of licensees, 
347.6 	date of receipt of a completed application, dates of licensure, licensed capacity, type of 
347.7 	client preferred, variances granted, record of training and education in child care and child 
347.8 	development, type of dwelling, name and relationship of other family members, previous 
347.9 	license history, class of license, the existence and status of complaints, and the number of 
347.10 	serious injuries to or deaths of individuals in the licensed program as reported to the 
347.11 	commissioner of human services, the local social services agency, or any other county 
347.12 	welfare agency. For purposes of this clause, a serious injury is one that is treated requires 
347.13 	treatment by a physician.
347.14 	(ii) when a correction order, an order to forfeit a fine, an order of license suspension, an 
347.15 	order of temporary immediate suspension, an order of license revocation, an order of license 
347.16 	denial, or an order of conditional license has been issued, or a complaint is resolved, the 
347.17 	following data on current and former licensees and applicants are public: the general nature 
347.18 	of the complaint or allegations leading to the temporary immediate suspension; the substance 
347.19 	and investigative findings of the licensing or maltreatment complaint, licensing violation, 
347.20 	or substantiated maltreatment; the existence of settlement negotiations; the record of informal 
347.21 	resolution of a licensing violation; orders of hearing; findings of fact; conclusions of law; 
347.22 	specifications of the final correction order, fine, suspension, temporary immediate suspension, 
347.23 	revocation, denial, or conditional license contained in the record of licensing action; whether 
347.24 	a fine has been paid; and the status of any appeal of these actions.
347.25 	(iii) When a license denial under section 245A.05 or a sanction under section 245A.07
347.26 	is based on a determination that a license holder, applicant, or controlling individual is 
347.27 	responsible for maltreatment under section 626.556 or 626.557, the identity of the applicant, 
347.28 	license holder, or controlling individual as the individual responsible for maltreatment is 
347.29 	public data at the time of the issuance of the license denial or sanction.
347.30 	(iv) When a license denial under section 245A.05 or a sanction under section 245A.07
347.31 	is based on a determination that a license holder, applicant, or controlling individual is 
347.32 	disqualified under chapter 245C, the identity of the license holder, applicant, or controlling 
347.33 	individual as the disqualified individual and the reason for the disqualification are public 
347.34 	data at the time of the issuance of the licensing sanction or denial. If the applicant, license 
347.35 	holder, or controlling individual requests reconsideration of the disqualification and the 
348.1 	disqualification is affirmed, the reason for the disqualification and the reason to not set aside 
348.2 	the disqualification are public data.
348.3 	(2) For applicants who withdraw their application prior to licensure or denial of a license, 
348.4 	the following data are public: the name of the applicant, the city and county in which the 
348.5 	applicant was seeking licensure, the dates of the commissioner's receipt of the initial 
348.6 	application and completed application, the type of license sought, and the date of withdrawal 
348.7 	of the application.
348.8 	(3) for applicants who are denied a license, the following data are public: the name and 
348.9 	address of the applicant, the city and county in which the applicant was seeking licensure, 
348.10 	the dates of the commissioner's receipt of the initial application and completed application, 
348.11 	the type of license sought, the date of denial of the application, the nature of the basis for 
348.12 	the denial, the existence of settlement negotiations, the record of informal resolution of a 
348.13 	denial, orders of hearings, findings of fact, conclusions of law, specifications of the final 
348.14 	order of denial, and the status of any appeal of the denial.
348.15 	(4) When maltreatment is substantiated under section 626.556 or 626.557 and the victim 
348.16 	and the substantiated perpetrator are affiliated with a program licensed under chapter 245A, 
348.17 	the commissioner of human services, local social services agency, or county welfare agency 
348.18 	may inform the license holder where the maltreatment occurred of the identity of the 
348.19 	substantiated perpetrator and the victim.
348.20 	(5) Notwithstanding clause (1), for child foster care, only the name of the license holder 
348.21 	and the status of the license are public if the county attorney has requested that data otherwise 
348.22 	classified as public data under clause (1) be considered private data based on the best interests 
348.23 	of a child in placement in a licensed program.
348.24 	(c) The following are private data on individuals under section 13.02, subdivision 12, 
348.25 	or nonpublic data under section 13.02, subdivision 9: personal and personal financial data 
348.26 	on family day care program and family foster care program applicants and licensees and 
348.27 	their family members who provide services under the license.
348.28 	(d) The following are private data on individuals: the identity of persons who have made 
348.29 	reports concerning licensees or applicants that appear in inactive investigative data, and the 
348.30 	records of clients or employees of the licensee or applicant for licensure whose records are 
348.31 	received by the licensing agency for purposes of review or in anticipation of a contested 
348.32 	matter. The names of reporters of complaints or alleged violations of licensing standards 
348.33 	under chapters 245A, 245B, 245C, and 245D, and applicable rules and alleged maltreatment 
349.1 	under sections 626.556 and 626.557, are confidential data and may be disclosed only as 
349.2 	provided in section 626.556, subdivision 11, or 626.557, subdivision 12b.
349.3 	(e) Data classified as private, confidential, nonpublic, or protected nonpublic under this 
349.4 	subdivision become public data if submitted to a court or administrative law judge as part 
349.5 	of a disciplinary proceeding in which there is a public hearing concerning a license which 
349.6 	has been suspended, immediately suspended, revoked, or denied.
349.7 	(f) Data generated in the course of licensing investigations that relate to an alleged 
349.8 	violation of law are investigative data under subdivision 3.
349.9 	(g) Data that are not public data collected, maintained, used, or disseminated under this 
349.10 	subdivision that relate to or are derived from a report as defined in section 626.556, 
349.11 	subdivision 2, or 626.5572, subdivision 18, are subject to the destruction provisions of 
349.12 	sections 626.556, subdivision 11c, and 626.557, subdivision 12b.
349.13 	(h) Upon request, not public data collected, maintained, used, or disseminated under 
349.14 	this subdivision that relate to or are derived from a report of substantiated maltreatment as 
349.15 	defined in section 626.556 or 626.557 may be exchanged with the Department of Health 
349.16 	for purposes of completing background studies pursuant to section 144.057 and with the 
349.17 	Department of Corrections for purposes of completing background studies pursuant to 
349.18 	section 241.021.
349.19 	(i) Data on individuals collected according to licensing activities under chapters 245A 
349.20 	and 245C, data on individuals collected by the commissioner of human services according 
349.21 	to investigations under chapters 245A, 245B, 245C, and 245D, and sections 626.556 and 
349.22 	626.557 may be shared with the Department of Human Rights, the Department of Health, 
349.23 	the Department of Corrections, the ombudsman for mental health and developmental 
349.24 	disabilities, and the individual's professional regulatory board when there is reason to believe 
349.25 	that laws or standards under the jurisdiction of those agencies may have been violated or 
349.26 	the information may otherwise be relevant to the board's regulatory jurisdiction. Background 
349.27 	study data on an individual who is the subject of a background study under chapter 245C 
349.28 	for a licensed service for which the commissioner of human services is the license holder 
349.29 	may be shared with the commissioner and the commissioner's delegate by the licensing 
349.30 	division. Unless otherwise specified in this chapter, the identity of a reporter of alleged 
349.31 	maltreatment or licensing violations may not be disclosed.
349.32 	(j) In addition to the notice of determinations required under section 626.556, subdivision 
349.33 	10f, if the commissioner or the local social services agency has determined that an individual 
349.34 	is a substantiated perpetrator of maltreatment of a child based on sexual abuse, as defined 
350.1 	in section 626.556, subdivision 2, and the commissioner or local social services agency 
350.2 	knows that the individual is a person responsible for a child's care in another facility, the 
350.3 	commissioner or local social services agency shall notify the head of that facility of this 
350.4 	determination. The notification must include an explanation of the individual's available 
350.5 	appeal rights and the status of any appeal. If a notice is given under this paragraph, the 
350.6 	government entity making the notification shall provide a copy of the notice to the individual 
350.7 	who is the subject of the notice.
350.8 	(k) All not public data collected, maintained, used, or disseminated under this subdivision 
350.9 	and subdivision 3 may be exchanged between the Department of Human Services, Licensing 
350.10 	Division, and the Department of Corrections for purposes of regulating services for which 
350.11 	the Department of Human Services and the Department of Corrections have regulatory 
350.12 	authority.

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

350.16 	Sec. 3. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to 
350.17 	read:
350.18 		Subd. 2c.Annual or annually; family child care training requirements. For the 
350.19 	purposes of section 245A.50, subdivisions 1 to 9, "annual" or "annually" means the 12-month 
350.20 	period beginning on the license effective date or the annual anniversary of the effective date 
350.21 	and ending on the day prior to the annual anniversary of the license effective date.

350.22 	Sec. 4. [245A.055] NOTIFICATION TO PROVIDER.
350.23 	(a) When the county agency responsible for family child care and group family child 
350.24 	care licensing conducts an annual or biennial licensing inspection, the agency must provide, 
350.25 	before departure from the residence or facility, a written or electronic notification to the 
350.26 	licensee of potential licensing violations noted during the inspection and the condition that 
350.27 	constitutes the violation.
350.28 	(b) Providing this notification to the licensee does not relieve the county agency from 
350.29 	notifying the license holder and the commissioner of the violation as required by statute or 
350.30 	rule.

351.1 	Sec. 5. Minnesota Statutes 2016, section 245A.06, subdivision 2, is amended to read:
351.2 		Subd. 2.Reconsideration of correction orders. (a) If the applicant or license holder 
351.3 	believes that the contents of the commissioner's correction order are in error, the applicant 
351.4 	or license holder may ask the Department of Human Services to reconsider the parts of the 
351.5 	correction order that are alleged to be in error. The request for reconsideration must be made 
351.6 	in writing and must be postmarked and sent to the commissioner within 20 calendar days 
351.7 	after receipt of the correction order by the applicant or license holder, and:
351.8 	(1) specify the parts of the correction order that are alleged to be in error;
351.9 	(2) explain why they are in error; and
351.10 	(3) include documentation to support the allegation of error.
351.11 	A request for reconsideration does not stay any provisions or requirements of the 
351.12 	correction order. The commissioner's disposition of a request for reconsideration is final 
351.13 	and not subject to appeal under chapter 14.
351.14 	(b) This paragraph applies only to licensed family child care providers. A licensed family 
351.15 	child care provider who requests reconsideration of a correction order under paragraph (a) 
351.16 	may also request, on a form and in the manner prescribed by the commissioner, that the 
351.17 	commissioner expedite the review if:
351.18 	(1) the provider is challenging a violation and provides a description of how complying 
351.19 	with the corrective action for that violation would require the substantial expenditure of 
351.20 	funds or a significant change to their program; and
351.21 	(2) describes what actions the provider will take in lieu of the corrective action ordered 
351.22 	to ensure the health and safety of children in care pending the commissioner's review of the 
351.23 	correction order.
351.24 	(c) By January 1, 2018, and each year thereafter, the Department of Human Services 
351.25 	must report data to the chairs and ranking minority members of the legislative committees 
351.26 	with jurisdiction over human services policy from the previous year that includes:
351.27 	(1) the number of licensed family child care provider appeals of correction orders to the 
351.28 	Department of Human Services;
351.29 	(2) the number of correction order appeals by family child care providers that the 
351.30 	Department of Human Services grants; and
351.31 	(3) the number of correction order appeals that the Department of Human Services 
351.32 	denies.

352.1 	Sec. 6. Minnesota Statutes 2016, section 245A.07, subdivision 3, is amended to read:
352.2 		Subd. 3.License suspension, revocation, or fine. (a) The commissioner may suspend 
352.3 	or revoke a license, or impose a fine if:
352.4 	(1) a license holder fails to comply fully with applicable laws or rules;
352.5 	(2) a license holder, a controlling individual, or an individual living in the household 
352.6 	where the licensed services are provided or is otherwise subject to a background study has 
352.7 	a disqualification which has not been set aside under section 245C.22;
352.8 	(3) a license holder knowingly withholds relevant information from or gives false or 
352.9 	misleading information to the commissioner in connection with an application for a license, 
352.10 	in connection with the background study status of an individual, during an investigation, 
352.11 	or regarding compliance with applicable laws or rules; or
352.12 	(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to 
352.13 	submit the information required of an applicant under section 245A.04, subdivision 1, 
352.14 	paragraph (f) or (g).
352.15 	A license holder who has had a license suspended, revoked, or has been ordered to pay 
352.16 	a fine must be given notice of the action by certified mail or personal service. If mailed, the 
352.17 	notice must be mailed to the address shown on the application or the last known address of 
352.18 	the license holder. The notice must state the reasons the license was suspended, revoked, 
352.19 	or a fine was ordered.
352.20 	(b) If the license was suspended or revoked, the notice must inform the license holder 
352.21 	of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts 
352.22 	1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking 
352.23 	a license. The appeal of an order suspending or revoking a license must be made in writing 
352.24 	by certified mail or personal service. If mailed, the appeal must be postmarked and sent to 
352.25 	the commissioner within ten calendar days after the license holder receives notice that the 
352.26 	license has been suspended or revoked. If a request is made by personal service, it must be 
352.27 	received by the commissioner within ten calendar days after the license holder received the 
352.28 	order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a 
352.29 	timely appeal of an order suspending or revoking a license, the license holder may continue 
352.30 	to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and 
352.31 	(h), until the commissioner issues a final order on the suspension or revocation.
352.32 	(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license 
352.33 	holder of the responsibility for payment of fines and the right to a contested case hearing 
353.1 	under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an 
353.2 	order to pay a fine must be made in writing by certified mail or personal service. If mailed, 
353.3 	the appeal must be postmarked and sent to the commissioner within ten calendar days after 
353.4 	the license holder receives notice that the fine has been ordered. If a request is made by 
353.5 	personal service, it must be received by the commissioner within ten calendar days after 
353.6 	the license holder received the order.
353.7 	(2) The license holder shall pay the fines assessed on or before the payment date specified. 
353.8 	If the license holder fails to fully comply with the order, the commissioner may issue a 
353.9 	second fine or suspend the license until the license holder complies. If the license holder 
353.10 	receives state funds, the state, county, or municipal agencies or departments responsible for 
353.11 	administering the funds shall withhold payments and recover any payments made while the 
353.12 	license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine 
353.13 	until the commissioner issues a final order.
353.14 	(3) A license holder shall promptly notify the commissioner of human services, in writing, 
353.15 	when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the 
353.16 	commissioner determines that a violation has not been corrected as indicated by the order 
353.17 	to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify 
353.18 	the license holder by certified mail or personal service that a second fine has been assessed. 
353.19 	The license holder may appeal the second fine as provided under this subdivision.
353.20 	(4) Fines shall be assessed as follows:
353.21 	(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a 
353.22 	child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
353.23 	for which the license holder is determined responsible for the maltreatment under section 
353.24 	626.556, subdivision 10e, paragraph (i), or 626.557, subdivision 9c, paragraph (c);
353.25 	(ii) if the commissioner determines that a determination of maltreatment for which the 
353.26 	license holder is responsible is the result of maltreatment that meets the definition of serious 
353.27 	maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit 
353.28 	$5,000;
353.29 	(iii) for a program that operates out of the license holder's home and a program licensed 
353.30 	under Minnesota Rules, parts 9502.0300 to 9502.0495, the fine assessed against the license 
353.31 	holder shall not exceed $1,000 for each determination of maltreatment;
353.32 	(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule 
353.33 	governing matters of health, safety, or supervision, including but not limited to the provision 
354.1 	of adequate staff-to-child or adult ratios, and failure to comply with background study 
354.2 	requirements under chapter 245C; and
354.3 	(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule 
354.4 	other than those subject to a $5,000, $1,000, or $200 fine above in items (i) to (iv).
354.5 	For purposes of this section, "occurrence" means each violation identified in the 
354.6 	commissioner's fine order. Fines assessed against a license holder that holds a license to 
354.7 	provide home and community-based services, as identified in section 245D.03, subdivision 
354.8 	1, and a community residential setting or day services facility license under chapter 245D 
354.9 	where the services are provided, may be assessed against both licenses for the same 
354.10 	occurrence, but the combined amount of the fines shall not exceed the amount specified in 
354.11 	this clause for that occurrence.
354.12 	(5) When a fine has been assessed, the license holder may not avoid payment by closing, 
354.13 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
354.14 	license holder will be personally liable for payment. In the case of a corporation, each 
354.15 	controlling individual is personally and jointly liable for payment.
354.16 	(d) Except for background study violations involving the failure to comply with an order 
354.17 	to immediately remove an individual or an order to provide continuous, direct supervision, 
354.18 	the commissioner shall not issue a fine under paragraph (c) relating to a background study 
354.19 	violation to a license holder who self-corrects a background study violation before the 
354.20 	commissioner discovers the violation. A license holder who has previously exercised the 
354.21 	provisions of this paragraph to avoid a fine for a background study violation may not avoid 
354.22 	a fine for a subsequent background study violation unless at least 365 days have passed 
354.23 	since the license holder self-corrected the earlier background study violation.

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

354.25 	Sec. 7. [245A.1434] INFORMATION FOR CHILD CARE LICENSE HOLDERS.
354.26 	The commissioner shall inform family child care and child care center license holders 
354.27 	on a timely basis of changes to state and federal statute, rule, regulation, and policy relating 
354.28 	to the provision of licensed child care, the child care assistance program under chapter 119B, 
354.29 	the quality rating and improvement system under section 124D.142, and child care licensing 
354.30 	functions delegated to counties. Communications under this section shall include information 
354.31 	to promote license holder compliance with identified changes. Communications under this 
354.32 	section may be accomplished by electronic means and shall be made available to the public 
354.33 	online.

355.1 	Sec. 8. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
355.2 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
355.3 	Health responsible for assessing or investigating reports of maltreatment. (a) The county
355.4 	local welfare agency is the agency responsible for assessing or investigating allegations of 
355.5 	maltreatment in child foster care, family child care, legally unlicensed nonlicensed child 
355.6 	care, juvenile correctional facilities licensed under section 241.021 located in the local 
355.7 	welfare agency's county, and reports involving children served by an unlicensed personal 
355.8 	care provider organization under section 256B.0659. Copies of findings related to personal 
355.9 	care provider organizations under section 256B.0659 must be forwarded to the Department 
355.10 	of Human Services provider enrollment.
355.11 	(b) The Department of Human Services is the agency responsible for assessing or 
355.12 	investigating allegations of maltreatment in juvenile correctional facilities listed under 
355.13 	section 241.021 located in the local welfare agency's county and in facilities licensed or 
355.14 	certified under chapters 245A and 245D, except for child foster care and family child care.
355.15 	(c) The Department of Health is the agency responsible for assessing or investigating 
355.16 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
355.17 	144A.43 to 144A.482.

355.18 	ARTICLE 10
355.19 	HEALTH DEPARTMENT

355.20 	Section 1. Minnesota Statutes 2016, section 103I.101, subdivision 2, is amended to read:
355.21 		Subd. 2.Duties. The commissioner shall:
355.22 	(1) regulate the drilling, construction, modification, repair, and sealing of wells and 
355.23 	borings;
355.24 	(2) examine and license:
355.25 	(i) well contractors;
355.26 	(ii) persons constructing, repairing, and sealing bored geothermal heat exchangers;
355.27 	(iii) persons modifying or repairing well casings, well screens, or well diameters;
355.28 	(iv) persons constructing, repairing, and sealing drive point wells or dug wells;
355.29 	(v) persons installing well pumps or pumping equipment;
355.30 	(vi) persons constructing, repairing, and sealing dewatering wells;
356.1 	(vii) persons sealing wells; persons installing well pumps or pumping equipment or 
356.2 	borings; and
356.3 	(viii) persons excavating or drilling holes for the installation of elevator borings or 
356.4 	hydraulic cylinders;
356.5 	(3) register license and examine monitoring well contractors;
356.6 	(4) license explorers engaged in exploratory boring and examine individuals who 
356.7 	supervise or oversee exploratory boring;
356.8 	(5) after consultation with the commissioner of natural resources and the Pollution 
356.9 	Control Agency, establish standards for the design, location, construction, repair, and sealing 
356.10 	of wells and borings within the state; and
356.11 	(6) issue permits for wells, groundwater thermal devices, bored geothermal heat 
356.12 	exchangers, and elevator borings.

356.13 	Sec. 2. Minnesota Statutes 2016, section 103I.101, subdivision 5, is amended to read:
356.14 		Subd. 5.Commissioner to adopt rules. The commissioner shall adopt rules including:
356.15 	(1) issuance of licenses for:
356.16 	(i) qualified well contractors,;
356.17 	(ii) persons modifying or repairing well casings, well screens, or well diameters;
356.18 	(ii) (iii) persons constructing, repairing, and sealing drive point wells or dug wells;
356.19 	(iii) (iv) persons constructing, repairing, and sealing dewatering wells;
356.20 	(iv) (v) persons sealing wells or borings;
356.21 	(v) (vi) persons installing well pumps or pumping equipment;
356.22 	(vi) (vii) persons constructing, repairing, and sealing bored geothermal heat exchangers; 
356.23 	and
356.24 	(vii) (viii) persons constructing, repairing, and sealing elevator borings;
356.25 	(2) issuance of registration licenses for monitoring well contractors;
356.26 	(3) establishment of conditions for examination and review of applications for license 
356.27 	and registration certification;
356.28 	(4) establishment of conditions for revocation and suspension of license and registration
356.29 	certification;
357.1 	(5) establishment of minimum standards for design, location, construction, repair, and 
357.2 	sealing of wells and borings to implement the purpose and intent of this chapter;
357.3 	(6) establishment of a system for reporting on wells and borings drilled and sealed;
357.4 	(7) establishment of standards for the construction, maintenance, sealing, and water 
357.5 	quality monitoring of wells in areas of known or suspected contamination;
357.6 	(8) establishment of wellhead protection measures for wells serving public water supplies;
357.7 	(9) establishment of procedures to coordinate collection of well and boring data with 
357.8 	other state and local governmental agencies;
357.9 	(10) establishment of criteria and procedures for submission of well and boring logs, 
357.10 	formation samples or well or boring cuttings, water samples, or other special information 
357.11 	required for and water resource mapping; and
357.12 	(11) establishment of minimum standards for design, location, construction, maintenance, 
357.13 	repair, sealing, safety, and resource conservation related to borings, including exploratory 
357.14 	borings as defined in section 103I.005, subdivision 9.

357.15 	Sec. 3. Minnesota Statutes 2016, section 103I.111, subdivision 6, is amended to read:
357.16 		Subd. 6.Unsealed wells and borings are public health nuisances. A well or boring 
357.17 	that is required to be sealed under section 103I.301 but is not sealed is a public health 
357.18 	nuisance. A county may abate the unsealed well or boring with the same authority of a 
357.19 	community health board to abate a public health nuisance under section 145A.04, subdivision 
357.20 	8.

357.21 	Sec. 4. Minnesota Statutes 2016, section 103I.111, subdivision 7, is amended to read:
357.22 		Subd. 7.Local license or registration fees prohibited. (a) A political subdivision may 
357.23 	not require a licensed well contractor to pay a license or registration fee.
357.24 	(b) The commissioner of health must provide a political subdivision with a list of licensed 
357.25 	well contractors upon request.

357.26 	Sec. 5. Minnesota Statutes 2016, section 103I.111, subdivision 8, is amended to read:
357.27 		Subd. 8.Municipal regulation of drilling. A municipality may regulate all drilling, 
357.28 	except well, elevator shaft boring, and exploratory drilling that is subject to the provisions 
357.29 	of this chapter, above, in, through, and adjacent to subsurface areas designated for mined 
358.1 	underground space development and existing mined underground space. The regulations 
358.2 	may prohibit, restrict, control, and require permits for the drilling.

358.3 	Sec. 6. Minnesota Statutes 2016, section 103I.205, is amended to read:
358.4 	103I.205 WELL AND BORING CONSTRUCTION.
358.5 		Subdivision 1.Notification required. (a) Except as provided in paragraphs (d) and (e), 
358.6 	a person may not construct a well until a notification of the proposed well on a form 
358.7 	prescribed by the commissioner is filed with the commissioner with the filing fee in section 
358.8 	103I.208, and, when applicable, the person has met the requirements of paragraph (f). If 
358.9 	after filing the well notification an attempt to construct a well is unsuccessful, a new 
358.10 	notification is not required unless the information relating to the successful well has 
358.11 	substantially changed.
358.12 	(b) The property owner, the property owner's agent, or the well licensed contractor where 
358.13 	a well is to be located must file the well notification with the commissioner.
358.14 	(c) The well notification under this subdivision preempts local permits and notifications, 
358.15 	and counties or home rule charter or statutory cities may not require a permit or notification 
358.16 	for wells unless the commissioner has delegated the permitting or notification authority 
358.17 	under section 103I.111.
358.18 	(d) A person who is an individual that constructs a drive point water-supply well on 
358.19 	property owned or leased by the individual for farming or agricultural purposes or as the 
358.20 	individual's place of abode must notify the commissioner of the installation and location of 
358.21 	the well. The person must complete the notification form prescribed by the commissioner 
358.22 	and mail it to the commissioner by ten days after the well is completed. A fee may not be 
358.23 	charged for the notification. A person who sells drive point wells at retail must provide 
358.24 	buyers with notification forms and informational materials including requirements regarding 
358.25 	wells, their location, construction, and disclosure. The commissioner must provide the 
358.26 	notification forms and informational materials to the sellers.
358.27 	(e) A person may not construct a monitoring well until a permit is issued by the 
358.28 	commissioner for the construction. If after obtaining a permit an attempt to construct a well 
358.29 	is unsuccessful, a new permit is not required as long as the initial permit is modified to 
358.30 	indicate the location of the successful well.
358.31 	(f) When the operation of a well will require an appropriation permit from the 
358.32 	commissioner of natural resources, a person may not begin construction of the well until 
358.33 	the person submits the following information to the commissioner of natural resources:
359.1 	(1) the location of the well;
359.2 	(2) the formation or aquifer that will serve as the water source;
359.3 	(3) the maximum daily, seasonal, and annual pumpage rates and volumes that will be 
359.4 	requested in the appropriation permit; and
359.5 	(4) other information requested by the commissioner of natural resources that is necessary 
359.6 	to conduct the preliminary assessment required under section 103G.287, subdivision 1, 
359.7 	paragraph (c).
359.8 	The person may begin construction after receiving preliminary approval from the 
359.9 	commissioner of natural resources.
359.10 		Subd. 2.Emergency permit and notification exemptions. The commissioner may 
359.11 	adopt rules that modify the procedures for filing a well or boring notification or well or 
359.12 	boring permit if conditions occur that:
359.13 	(1) endanger the public health and welfare or cause a need to protect the groundwater; 
359.14 	or
359.15 	(2) require the monitoring well contractor, limited well/boring contractor, or well 
359.16 	contractor to begin constructing a well before obtaining a permit or notification.
359.17 		Subd. 3.Maintenance permit. (a) Except as provided under paragraph (b), a well that 
359.18 	is not in use must be sealed or have a maintenance permit.
359.19 	(b) If a monitoring well or a dewatering well is not sealed by 14 months after completion 
359.20 	of construction, the owner of the property on which the well is located must obtain and 
359.21 	annually renew a maintenance permit from the commissioner.
359.22 		Subd. 4.License required. (a) Except as provided in paragraph (b), (c), (d), or (e), 
359.23 	section 103I.401, subdivision 2, or 103I.601, subdivision 2, a person may not drill, construct, 
359.24 	repair, or seal a well or boring unless the person has a well contractor's license in possession.
359.25 	(b) A person may construct, repair, and seal a monitoring well if the person:
359.26 	(1) is a professional engineer licensed under sections 326.02 to 326.15 in the branches 
359.27 	of civil or geological engineering;
359.28 	(2) is a hydrologist or hydrogeologist certified by the American Institute of Hydrology;
359.29 	(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
359.30 	(4) is a geologist certified by the American Institute of Professional Geologists; or
359.31 	(5) meets the qualifications established by the commissioner in rule.
360.1 	A person must register with be licensed by the commissioner as a monitoring well 
360.2 	contractor on forms provided by the commissioner.
360.3 	(c) A person may do the following work with a limited well/boring contractor's license 
360.4 	in possession. A separate license is required for each of the six activities:
360.5 	(1) installing or repairing well screens or pitless units or pitless adaptors and well casings 
360.6 	from the pitless adaptor or pitless unit to the upper termination of the well casing;
360.7 	(2) constructing, repairing, and sealing drive point wells or dug wells;
360.8 	(3) installing well pumps or pumping equipment;
360.9 	(4) sealing wells or borings;
360.10 	(5) constructing, repairing, or sealing dewatering wells; or
360.11 	(6) constructing, repairing, or sealing bored geothermal heat exchangers.
360.12 	(d) A person may construct, repair, and seal an elevator boring with an elevator boring 
360.13 	contractor's license.
360.14 	(e) Notwithstanding other provisions of this chapter requiring a license or registration, 
360.15 	a license or registration is not required for a person who complies with the other provisions 
360.16 	of this chapter if the person is:
360.17 	(1) an individual who constructs a well on land that is owned or leased by the individual 
360.18 	and is used by the individual for farming or agricultural purposes or as the individual's place 
360.19 	of abode;
360.20 	(2) an individual who performs labor or services for a contractor licensed or registered
360.21 	under the provisions of this chapter in connection with the construction, sealing, or repair 
360.22 	of a well or boring at the direction and under the personal supervision of a contractor licensed 
360.23 	or registered under the provisions of this chapter; or
360.24 	(3) a licensed plumber who is repairing submersible pumps or water pipes associated 
360.25 	with well water systems if: (i) the repair location is within an area where there is no licensed 
360.26 	or registered well contractor within 50 miles, and (ii) the licensed plumber complies with 
360.27 	all relevant sections of the plumbing code.
360.28 		Subd. 5.At-grade monitoring wells. At-grade monitoring wells are authorized without 
360.29 	variance and may be installed for the purpose of evaluating groundwater conditions or for 
360.30 	use as a leak detection device. An at-grade monitoring well must be installed in accordance 
360.31 	with the rules of the commissioner. The at-grade monitoring wells must be installed with 
361.1 	an impermeable double locking cap approved by the commissioner and must be labeled 
361.2 	monitoring wells.
361.3 		Subd. 6.Distance requirements for sources of contamination, buildings, gas pipes, 
361.4 	liquid propane tanks, and electric lines. (a) A person may not place, construct, or install 
361.5 	an actual or potential source of contamination, building, gas pipe, liquid propane tank, or 
361.6 	electric line any closer to a well or boring than the isolation distances prescribed by the 
361.7 	commissioner by rule unless a variance has been prescribed by rule.
361.8 	(b) The commissioner shall establish by rule reduced isolation distances for facilities 
361.9 	which have safeguards in accordance with sections 18B.01, subdivision 26, and 18C.005, 
361.10 	subdivision 29.
361.11 		Subd. 7.Well identification label required. After a well has been constructed, the 
361.12 	person constructing the well must attach a label to the well showing the unique well number.
361.13 		Subd. 8.Wells on property of another. A person may not construct or have constructed 
361.14 	a well for the person's own use on the property of another until the owner of the property 
361.15 	on which the well is to be located and the intended well user sign a written agreement that 
361.16 	identifies which party will be responsible for obtaining all permits or filing notification, 
361.17 	paying applicable fees and for sealing the well. If the property owner refuses to sign the 
361.18 	agreement, the intended well user may, in lieu of a written agreement, state in writing to 
361.19 	the commissioner that the well user will be responsible for obtaining permits, filing 
361.20 	notification, paying applicable fees, and sealing the well. Nothing in this subdivision 
361.21 	eliminates the responsibilities of the property owner under this chapter, or allows a person 
361.22 	to construct a well on the property of another without consent or other legal authority.
361.23 		Subd. 9.Report of work. Within 30 days after completion or sealing of a well or boring, 
361.24 	the person doing the work must submit a verified report to the commissioner containing the 
361.25 	information specified by rules adopted under this chapter.
361.26 	Within 30 days after receiving the report, the commissioner shall send or otherwise 
361.27 	provide access to a copy of the report to the commissioner of natural resources, to the local 
361.28 	soil and water conservation district where the well is located, and to the director of the 
361.29 	Minnesota Geological Survey.

361.30 	Sec. 7. Minnesota Statutes 2016, section 103I.301, is amended to read:
361.31 	103I.301 WELL AND BORING SEALING REQUIREMENTS.
361.32 		Subdivision 1.Wells and borings. (a) A property owner must have a well or boring 
361.33 	sealed if:
362.1 	(1) the well or boring is contaminated or may contribute to the spread of contamination;
362.2 	(2) the well or boring was attempted to be sealed but was not sealed according to the 
362.3 	provisions of this chapter; or
362.4 	(3) the well or boring is located, constructed, or maintained in a manner that its continued 
362.5 	use or existence endangers groundwater quality or is a safety or health hazard.
362.6 	(b) A well or boring that is not in use must be sealed unless the property owner has a 
362.7 	maintenance permit for the well.
362.8 	(c) The property owner must have a well or boring sealed by a registered or licensed 
362.9 	person authorized to seal the well or boring, consistent with provisions of this chapter.
362.10 		Subd. 2.Monitoring wells. The owner of the property where a monitoring well is located 
362.11 	must have the monitoring well sealed when the well is no longer in use. The owner must 
362.12 	have a well contractor, limited well/boring sealing contractor, or a monitoring well contractor 
362.13 	seal the monitoring well.
362.14 		Subd. 3.Dewatering wells. (a) The owner of the property where a dewatering well is 
362.15 	located must have the dewatering well sealed when the dewatering well is no longer in use.
362.16 	(b) A well contractor, limited well/boring sealing contractor, or limited dewatering well 
362.17 	contractor shall seal the dewatering well.
362.18 		Subd. 4.Sealing procedures. Wells and borings must be sealed according to rules 
362.19 	adopted by the commissioner.
362.20 		Subd. 6.Notification required. A person may not seal a well until a notification of the 
362.21 	proposed sealing is filed as prescribed by the commissioner.

362.22 	Sec. 8. Minnesota Statutes 2016, section 103I.501, is amended to read:
362.23 	103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.
362.24 	(a) The commissioner shall regulate and license:
362.25 	(1) drilling, constructing, and repair of wells;
362.26 	(2) sealing of wells;
362.27 	(3) installing of well pumps and pumping equipment;
362.28 	(4) excavating, drilling, repairing, and sealing of elevator borings;
362.29 	(5) construction, repair, and sealing of environmental bore holes; and
362.30 	(6) construction, repair, and sealing of bored geothermal heat exchangers.
363.1 	(b) The commissioner shall examine and license well contractors, limited well/boring 
363.2 	contractors, and elevator boring contractors, and examine and register monitoring well 
363.3 	contractors.
363.4 	(c) The commissioner shall license explorers engaged in exploratory boring and shall 
363.5 	examine persons who supervise or oversee exploratory boring.

363.6 	Sec. 9. Minnesota Statutes 2016, section 103I.505, is amended to read:
363.7 	103I.505 RECIPROCITY OF LICENSES AND REGISTRATIONS
363.8 	CERTIFICATIONS.
363.9 		Subdivision 1.Reciprocity authorized. The commissioner may issue a license or register
363.10 	certify a person under this chapter, without giving an examination, if the person is licensed 
363.11 	or registered certified in another state and:
363.12 	(1) the requirements for licensing or registration certification under which the well or 
363.13 	boring contractor was licensed or registered person was certified do not conflict with this 
363.14 	chapter;
363.15 	(2) the requirements are of a standard not lower than that specified by the rules adopted 
363.16 	under this chapter; and
363.17 	(3) equal reciprocal privileges are granted to licensees or registrants certified persons
363.18 	of this state.
363.19 		Subd. 2.Fees required. A well or boring contractor or certified person must apply for 
363.20 	the license or registration certification and pay the fees under the provisions of this chapter 
363.21 	to receive a license or registration certification under this section.

363.22 	Sec. 10. Minnesota Statutes 2016, section 103I.515, is amended to read:
363.23 	103I.515 LICENSES NOT TRANSFERABLE.
363.24 	A license or registration certification issued under this chapter is not transferable.

363.25 	Sec. 11. Minnesota Statutes 2016, section 103I.535, subdivision 3, is amended to read:
363.26 		Subd. 3.Certification examination. After the commissioner has approved the 
363.27 	application, the applicant must take an examination given by the commissioner.

364.1 	Sec. 12. Minnesota Statutes 2016, section 103I.535, is amended by adding a subdivision 
364.2 	to read:
364.3 		Subd. 3b.Certification renewal. (a) A representative must file an application and a 
364.4 	renewal application fee to renew the certification by the date stated in the certification.
364.5 	(b) The renewal application must include information that the certified representative 
364.6 	has met continuing education requirements established by the commissioner by rule.

364.7 	Sec. 13. Minnesota Statutes 2016, section 103I.535, subdivision 6, is amended to read:
364.8 		Subd. 6.License fee. The fee for an elevator shaft boring contractor's license is $75.

364.9 	Sec. 14. Minnesota Statutes 2016, section 103I.541, is amended to read:
364.10 	103I.541 MONITORING WELL CONTRACTOR'S REGISTRATION LICENSE; 
364.11 	REPRESENTATIVE'S CERTIFICATION.
364.12 		Subdivision 1.Registration Certification. A person seeking registration as certification 
364.13 	to represent a monitoring well contractor must meet examination and experience requirements 
364.14 	adopted by the commissioner by rule.
364.15 		Subd. 2.Validity. A monitoring well contractor's registration certification is valid until 
364.16 	the date prescribed in the registration certification by the commissioner.
364.17 		Subd. 2a.Certification application. (a) An individual must submit an application and 
364.18 	application fee to the commissioner to apply for certification as a representative of a 
364.19 	monitoring well contractor.
364.20 	(b) The application must be on forms prescribed by the commissioner. The application 
364.21 	must state the applicant's qualifications for the certification, and other information required 
364.22 	by the commissioner.
364.23 		Subd. 2b.Issuance of registration. If a person employs a certified representative, 
364.24 	submits the bond under subdivision 3, and pays the registration fee of $75 for a monitoring 
364.25 	well contractor registration, the commissioner shall issue a monitoring well contractor 
364.26 	registration to the applicant. The fee for an individual registration is $75. The commissioner 
364.27 	may not act on an application until the application fee is paid.
364.28 		Subd. 2c.Certification fee. (a) The application fee for certification as a representative 
364.29 	of a monitoring well contractor is $75. The commissioner may not act on an application 
364.30 	until the application fee is paid.
365.1 	(b) The renewal fee for certification as a representative of a monitoring well contractor 
365.2 	is $75. The commissioner may not renew a certification until the renewal fee is paid.
365.3 		Subd. 2d.Examination. After the commissioner has approved an application, the 
365.4 	applicant must take an examination given by the commissioner.
365.5 		Subd. 2e.Issuance of certification. If the applicant meets the experience requirements 
365.6 	established by rule and passes the examination as determined by the commissioner, the 
365.7 	commissioner shall issue the applicant a certification to represent a monitoring well 
365.8 	contractor.
365.9 		Subd. 2f.Certification renewal. (a) A representative must file an application and a 
365.10 	renewal application fee to renew the certification by the date stated in the certification.
365.11 	(b) The renewal application must include information that the certified representative 
365.12 	has met continuing education requirements established by the commissioner by rule.
365.13 		Subd. 2g.Issuance of license. (a) If a person employs a certified representative, submits 
365.14 	the bond under subdivision 3, and pays the license fee of $75 for a monitoring well contractor 
365.15 	license, the commissioner shall issue a monitoring well contractor license to the applicant.
365.16 	(b) The commissioner may not act on an application until the application fee is paid.
365.17 		Subd. 3.Bond. (a) As a condition of being issued a monitoring well contractor's 
365.18 	registration license, the applicant must submit a corporate surety bond for $10,000 approved 
365.19 	by the commissioner. The bond must be conditioned to pay the state on performance of 
365.20 	work in this state that is not in compliance with this chapter or rules adopted under this 
365.21 	chapter. The bond is in lieu of other license bonds required by a political subdivision of the 
365.22 	state.
365.23 	(b) From proceeds of the bond, the commissioner may compensate persons injured or 
365.24 	suffering financial loss because of a failure of the applicant to perform work or duties in 
365.25 	compliance with this chapter or rules adopted under this chapter.
365.26 		Subd. 4.License renewal. (a) A person must file an application and a renewal application 
365.27 	fee to renew the registration license by the date stated in the registration license.
365.28 	(b) The renewal application fee for a monitoring well contractor's registration license is 
365.29 	$75.
365.30 	(c) The renewal application must include information that the certified representative 
365.31 	of the applicant has met continuing education requirements established by the commissioner 
365.32 	by rule.
366.1 	(d) At the time of the renewal, the commissioner must have on file all well and boring 
366.2 	construction reports, well and boring sealing reports, well permits, and notifications for 
366.3 	work conducted by the registered licensed person since the last registration license renewal.
366.4 		Subd. 5.Incomplete or late renewal. If a registered licensed person submits a renewal 
366.5 	application after the required renewal date:
366.6 	(1) the registered licensed person must include a late fee of $75; and
366.7 	(2) the registered licensed person may not conduct activities authorized by the monitoring 
366.8 	well contractor's registration license until the renewal application, renewal application fee, 
366.9 	late fee, and all other information required in subdivision 4 are submitted.

366.10 	Sec. 15. Minnesota Statutes 2016, section 103I.545, subdivision 1, is amended to read:
366.11 		Subdivision 1.Drilling machine. (a) A person may not use a drilling machine such as 
366.12 	a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license 
366.13 	or registration under this chapter unless the drilling machine is registered with the 
366.14 	commissioner.
366.15 	(b) A person must apply for the registration on forms prescribed by the commissioner 
366.16 	and submit a $75 registration fee.
366.17 	(c) A registration is valid for one year.

366.18 	Sec. 16. Minnesota Statutes 2016, section 103I.545, subdivision 2, is amended to read:
366.19 		Subd. 2.Hoist. (a) A person may not use a machine such as a hoist for an activity 
366.20 	requiring a license or registration under this chapter to repair wells or borings, seal wells 
366.21 	or borings, or install pumps unless the machine is registered with the commissioner.
366.22 	(b) A person must apply for the registration on forms prescribed by the commissioner 
366.23 	and submit a $75 registration fee.
366.24 	(c) A registration is valid for one year.

366.25 	Sec. 17. Minnesota Statutes 2016, section 103I.711, subdivision 1, is amended to read:
366.26 		Subdivision 1.Impoundment. The commissioner may apply to district court for a 
366.27 	warrant authorizing seizure and impoundment of all drilling machines or hoists owned or 
366.28 	used by a person. The court shall issue an impoundment order upon the commissioner's 
366.29 	showing that a person is constructing, repairing, or sealing wells or borings or installing 
366.30 	pumps or pumping equipment or excavating holes for installing elevator shafts borings
367.1 	without a license or registration as required under this chapter. A sheriff on receipt of the 
367.2 	warrant must seize and impound all drilling machines and hoists owned or used by the 
367.3 	person. A person from whom equipment is seized under this subdivision may file an action 
367.4 	in district court for the purpose of establishing that the equipment was wrongfully seized.

367.5 	Sec. 18. Minnesota Statutes 2016, section 103I.715, subdivision 2, is amended to read:
367.6 		Subd. 2.Gross misdemeanors. A person is guilty of a gross misdemeanor who:
367.7 	(1) willfully violates a provision of this chapter or order of the commissioner;
367.8 	(2) engages in the business of drilling or making wells, sealing wells, installing pumps 
367.9 	or pumping equipment, or constructing elevator shafts borings without a license required 
367.10 	by this chapter; or
367.11 	(3) engages in the business of exploratory boring without an exploratory borer's license 
367.12 	under this chapter.

367.13 	Sec. 19. Minnesota Statutes 2016, section 144.05, subdivision 6, is amended to read:
367.14 		Subd. 6.Reports on interagency agreements and intra-agency transfers. The 
367.15 	commissioner of health shall provide quarterly reports to the chairs and ranking minority 
367.16 	members of the legislative committees with jurisdiction over health and human services 
367.17 	policy and finance on:
367.18 	(1) interagency agreements or service-level agreements and any renewals or extensions 
367.19 	of existing interagency or service-level agreements with a state department under section 
367.20 	15.01, state agency under section 15.012, or the Office of MN.IT Services, with a value of 
367.21 	more than $100,000, or related agreements with the same department or agency with a 
367.22 	cumulative value of more than $100,000; and
367.23 	(2) transfers of appropriations of more than $100,000 between accounts within or between 
367.24 	agencies.
367.25 	The report must include the statutory citation authorizing the agreement, transfer or dollar 
367.26 	amount, purpose, and effective date of the agreement, and the duration of the agreement, 
367.27 	and a copy of the agreement.

367.28 	Sec. 20. [144.059] PALLIATIVE CARE ADVISORY COUNCIL.
367.29 		Subdivision 1.Membership. The Palliative Care Advisory Council shall consist of 18 
367.30 	public members.
368.1 		Subd. 2.Public members. (a) The commissioner shall appoint, in the manner provided 
368.2 	in section 15.0597, 18 public members, including the following:
368.3 	(1) two physicians, of which one is certified by the American Board of Hospice and 
368.4 	Palliative Medicine;
368.5 	(2) two registered nurses or advanced practice registered nurses, of which one is certified 
368.6 	by the National Board for Certification of Hospice and Palliative Nurses;
368.7 	(3) one care coordinator experienced in working with people with serious or chronic 
368.8 	illness and their families;
368.9 	(4) one spiritual counselor experienced in working with people with serious or chronic 
368.10 	illness and their families;
368.11 	(5) three licensed health professionals, such as complementary and alternative health 
368.12 	care practitioners, dieticians or nutritionists, pharmacists, or physical therapists, who are 
368.13 	neither physicians nor nurses, but who have experience  as members of a palliative care 
368.14 	interdisciplinary team working with people with serious or chronic illness and their families;
368.15 	(6) one licensed social worker experienced in working with people with serious or chronic 
368.16 	illness and their families;
368.17 	(7) four patients or personal caregivers experienced with serious or chronic illness;
368.18 	(8) one representative of a health plan company;
368.19 	(9) one physician assistant that is a member of the American Academy of Hospice and 
368.20 	Palliative Medicine; and
368.21 	(10) two members from any of the categories described in clauses (1) to (9).
368.22 	(b) The commissioner must include, where possible, representation that is racially, 
368.23 	culturally, linguistically, geographically, and economically diverse.
368.24 	(c) The council must include at least six members who reside outside Anoka, Carver, 
368.25 	Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Ramsey, Scott, Sherburne, Sibley, Stearns, 
368.26 	Washington, or Wright Counties.
368.27 	(d) To the extent possible, council membership must include persons who have experience 
368.28 	in palliative care research, palliative care instruction in a medical or nursing school setting, 
368.29 	palliative care services for veterans as a provider or recipient, or pediatric care.
368.30 	(e) Council membership must include health professionals who have palliative care work 
368.31 	experience or expertise in palliative care delivery models in a variety of inpatient, outpatient, 
369.1 	and community settings, including acute care, long-term care, or hospice, with a variety of 
369.2 	populations, including pediatric, youth, and adult patients.
369.3 		Subd. 3.Term. Members of the council shall serve for a term of three years and may 
369.4 	be reappointed. Members shall serve until their successors have been appointed.
369.5 		Subd. 4.Administration. The commissioner or the commissioner's designee shall 
369.6 	provide meeting space and administrative services for the council.
369.7 		Subd. 5.Chairs. At the council's first meeting, and biannually thereafter, the members 
369.8 	shall elect a chair and a vice-chair whose duties shall be established by the council.
369.9 		Subd. 6.Meeting. The council shall meet at least twice yearly.
369.10 		Subd. 7.No compensation. Public members of the council serve without compensation.
369.11 		Subd. 8.Duties. (a) The council shall consult with and advise the commissioner on 
369.12 	matters related to the establishment, maintenance, operation, and outcomes evaluation of 
369.13 	palliative care initiatives in the state.
369.14 	(b) By February 15 of each year, the council shall submit to the chairs and ranking 
369.15 	minority members of the committees of the senate and the house of representatives with 
369.16 	primary jurisdiction over health care a report containing:
369.17 	(1) the advisory council's assessment of the availability of palliative care in the state;
369.18 	(2) the advisory council's analysis of barriers to greater access to palliative care; and
369.19 	(3) recommendations for legislative action, with draft legislation to implement the 
369.20 	recommendations.
369.21 	(c) The Department of Health shall publish the report each year on the department's Web 
369.22 	site.
369.23 		Subd. 9.Open meetings. The council is subject to the requirements of chapter 13D.
369.24 		Subd. 10.Sunset. The council shall sunset January 1, 2025.

369.25 	Sec. 21. Minnesota Statutes 2016, section 144.122, is amended to read:
369.26 	144.122 LICENSE, PERMIT, AND SURVEY FEES.
369.27 	(a) The state commissioner of health, by rule, may prescribe procedures and fees for 
369.28 	filing with the commissioner as prescribed by statute and for the issuance of original and 
369.29 	renewal permits, licenses, registrations, and certifications issued under authority of the 
369.30 	commissioner. The expiration dates of the various licenses, permits, registrations, and 
370.1 	certifications as prescribed by the rules shall be plainly marked thereon. Fees may include 
370.2 	application and examination fees and a penalty fee for renewal applications submitted after 
370.3 	the expiration date of the previously issued permit, license, registration, and certification. 
370.4 	The commissioner may also prescribe, by rule, reduced fees for permits, licenses, 
370.5 	registrations, and certifications when the application therefor is submitted during the last 
370.6 	three months of the permit, license, registration, or certification period. Fees proposed to 
370.7 	be prescribed in the rules shall be first approved by the Department of Management and 
370.8 	Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be 
370.9 	in an amount so that the total fees collected by the commissioner will, where practical, 
370.10 	approximate the cost to the commissioner in administering the program. All fees collected 
370.11 	shall be deposited in the state treasury and credited to the state government special revenue 
370.12 	fund unless otherwise specifically appropriated by law for specific purposes.
370.13 	(b) The commissioner may charge a fee for voluntary certification of medical laboratories 
370.14 	and environmental laboratories, and for environmental and medical laboratory services 
370.15 	provided by the department, without complying with paragraph (a) or chapter 14. Fees 
370.16 	charged for environment and medical laboratory services provided by the department must 
370.17 	be approximately equal to the costs of providing the services.
370.18 	(c) The commissioner may develop a schedule of fees for diagnostic evaluations 
370.19 	conducted at clinics held by the services for children with disabilities program. All receipts 
370.20 	generated by the program are annually appropriated to the commissioner for use in the 
370.21 	maternal and child health program.
370.22 	(d) The commissioner shall set license fees for hospitals and nursing homes that are not 
370.23 	boarding care homes at the following levels:

370.24
370.25
370.26
370.27	Joint Commission on Accreditation of 
Healthcare Organizations (JCAHO) and 
American Osteopathic Association (AOA) 
hospitals
	$7,655 plus $16 per bed
	
370.28	Non-JCAHO and non-AOA hospitals
	$5,280 plus $250 per bed
	
370.29	Nursing home
	$183 plus $91 per bed
	
370.30 	The commissioner shall set license fees for outpatient surgical centers, boarding care 
370.31 	homes, and supervised living facilities at the following levels:

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

371.7	Prospective payment surveys for hospitals
	$
	900
	
371.8	Swing bed surveys for nursing homes
	$
	1,200
	
371.9	Psychiatric hospitals
	$
	1,400
	
371.10	Rural health facilities
	$
	1,100
	
371.11	Portable x-ray providers
	$
	500
	
371.12	Home health agencies
	$
	1,800
	
371.13	Outpatient therapy agencies
	$
	800
	
371.14	End stage renal dialysis providers
	$
	2,100
	
371.15	Independent therapists
	$
	800
	
371.16	Comprehensive rehabilitation outpatient facilities
	$
	1,200
	
371.17	Hospice providers
	$
	1,700
	
371.18	Ambulatory surgical providers
	$
	1,800
	
371.19	Hospitals
	$
	4,200
	
371.20
371.21
371.22	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.
	
371.23 	These fees shall be submitted at the time of the application for federal certification and 
371.24 	shall not be refunded. All fees collected after the date that the imposition of fees is not 
371.25 	prohibited by federal law shall be deposited in the state treasury and credited to the state 
371.26 	government special revenue fund.

371.27 	Sec. 22. Minnesota Statutes 2016, section 144.1501, subdivision 2, is amended to read:
371.28 		Subd. 2.Creation of account. (a) A health professional education loan forgiveness 
371.29 	program account is established. The commissioner of health shall use money from the 
371.30 	account to establish a loan forgiveness program:
371.31 	(1) for medical residents and mental health professionals agreeing to practice in designated 
371.32 	rural areas or underserved urban communities or specializing in the area of pediatric 
371.33 	psychiatry;
372.1 	(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach 
372.2 	at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program 
372.3 	at the undergraduate level or the equivalent at the graduate level;
372.4 	(3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care 
372.5 	facility for persons with developmental disability; or a hospital if the hospital owns and 
372.6 	operates a Minnesota nursing home and a minimum of 50 percent of the hours worked by 
372.7 	the nurse is in the nursing home; a housing with services establishment as defined in section 
372.8 	144D.01, subdivision 4; or for a home care provider as defined in section 144A.43, 
372.9 	subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing 
372.10 	field in a postsecondary program at the undergraduate level or the equivalent at the graduate 
372.11 	level;
372.12 	(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720 
372.13 	hours per year in their designated field in a postsecondary program at the undergraduate 
372.14 	level or the equivalent at the graduate level. The commissioner, in consultation with the 
372.15 	Healthcare Education-Industry Partnership, shall determine the health care fields where the 
372.16 	need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory 
372.17 	technology, radiologic technology, and surgical technology;
372.18 	(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses 
372.19 	who agree to practice in designated rural areas; and
372.20 	(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient 
372.21 	encounters to state public program enrollees or patients receiving sliding fee schedule 
372.22 	discounts through a formal sliding fee schedule meeting the standards established by the 
372.23 	United States Department of Health and Human Services under Code of Federal Regulations, 
372.24 	title 42, section 51, chapter 303.
372.25 	(b) Appropriations made to the account do not cancel and are available until expended, 
372.26 	except that at the end of each biennium, any remaining balance in the account that is not 
372.27 	committed by contract and not needed to fulfill existing commitments shall cancel to the 
372.28 	fund.

372.29 	Sec. 23. [144.1505] PRIMARY CARE CLINICAL TRAINING EXPANSION GRANT 
372.30 	PROGRAM.
372.31 		Subdivision 1.Definitions. For purposes of this section, the following definitions apply:
372.32 	(1) "eligible advanced practice registered nurse program" means a program that is located 
372.33 	in Minnesota and is currently accredited as a master's, doctoral, or postgraduate level 
373.1 	advanced practice registered nurse program by the Commission on Collegiate Nursing 
373.2 	Education or by the Accreditation Commission for Education in Nursing, or is a candidate 
373.3 	for accreditation;
373.4 	(2) "eligible mental health professional program" means a program that is located in 
373.5 	Minnesota and is listed as a mental health professional program by the appropriate accrediting 
373.6 	body for clinical social work, psychology, marriage and family therapy, or licensed 
373.7 	professional clinical counseling, or is a candidate for accreditation;
373.8 	(3) "eligible physician assistant program" means a program that is located in Minnesota 
373.9 	and is currently accredited as a physician assistant program by the Accreditation Review 
373.10 	Commission on Education for the Physician Assistant, or is a candidate for accreditation;
373.11 	(4) "project" means a project to establish or expand clinical training for physician 
373.12 	assistants, advanced practice registered nurses, or mental health professionals in Minnesota; 
373.13 	and
373.14 	(5) "mental health professional" means an individual providing clinical services in the 
373.15 	treatment of mental illness who meets one of the qualifications under section 245.462, 
373.16 	subdivision 18.
373.17 		Subd. 2.Program. (a) The commissioner of health shall award health professional 
373.18 	training site grants to eligible physician assistant, advanced practice registered nurse, and 
373.19 	mental health professional programs to plan and implement expanded clinical training. A 
373.20 	planning grant shall not exceed $75,000, and a training grant shall not exceed $150,000 for 
373.21 	the first year, $100,000 for the second year, and $50,000 for the third year per program.
373.22 	(b) Funds may be used for:
373.23 	(1) establishing or expanding clinical training for physician assistants, advanced practice 
373.24 	registered nurses, and mental health professionals in Minnesota;
373.25 	(2) recruitment, training, and retention of students and faculty;
373.26 	(3) connecting students with appropriate clinical training sites, internships, practicums, 
373.27 	or externship activities;
373.28 	(4) travel and lodging for students;
373.29 	(5) faculty, student, and preceptor salaries, incentives, or other financial support;
373.30 	(6) development and implementation of cultural competency training;
373.31 	(7) evaluations;
374.1 	(8) training site improvements, fees, equipment, and supplies required to establish, 
374.2 	maintain, or expand a physician assistant, advanced practice registered nurse, or mental 
374.3 	health professional training program; and
374.4 	(9) supporting clinical education in which trainees are part of a primary care team model.
374.5 		Subd. 3.Applications. Eligible physician assistant, advanced practice registered nurse, 
374.6 	and mental health professional programs seeking a grant shall apply to the commissioner. 
374.7 	Applications must include a description of the number of additional students who will be 
374.8 	trained using grant funds; attestation that funding will be used to support an increase in the 
374.9 	number of clinical training slots; a description of the problem that the proposed project will 
374.10 	address; a description of the project, including all costs associated with the project, sources 
374.11 	of funds for the project, detailed uses of all funds for the project, and the results expected; 
374.12 	and a plan to maintain or operate any component included in the project after the grant 
374.13 	period. The applicant must describe achievable objectives, a timetable, and roles and 
374.14 	capabilities of responsible individuals in the organization.
374.15 		Subd. 4.Consideration of applications. The commissioner shall review each application 
374.16 	to determine whether or not the application is complete and whether the program and the 
374.17 	project are eligible for a grant. In evaluating applications, the commissioner shall score each 
374.18 	application based on factors including, but not limited to, the applicant's clarity and 
374.19 	thoroughness in describing the project and the problems to be addressed, the extent to which 
374.20 	the applicant has demonstrated that the applicant has made adequate provisions to ensure 
374.21 	proper and efficient operation of the training program once the grant project is completed, 
374.22 	the extent to which the proposed project is consistent with the goal of increasing access to 
374.23 	primary care and mental health services for rural and underserved urban communities, the 
374.24 	extent to which the proposed project incorporates team-based primary care, and project 
374.25 	costs and use of funds.
374.26 		Subd. 5.Program oversight. The commissioner shall determine the amount of a grant 
374.27 	to be given to an eligible program based on the relative score of each eligible program's 
374.28 	application, other relevant factors discussed during the review, and the funds available to 
374.29 	the commissioner. Appropriations made to the program do not cancel and are available until 
374.30 	expended.  During the grant period, the commissioner may require and collect from programs 
374.31 	receiving grants any information necessary to evaluate the program.

374.32 	Sec. 24. Minnesota Statutes 2016, section 144.551, subdivision 1, is amended to read:
374.33 		Subdivision 1.Restricted construction or modification. (a) The following construction 
374.34 	or modification may not be commenced:
375.1 	(1) any erection, building, alteration, reconstruction, modernization, improvement, 
375.2 	extension, lease, or other acquisition by or on behalf of a hospital that increases the bed 
375.3 	capacity of a hospital, relocates hospital beds from one physical facility, complex, or site 
375.4 	to another, or otherwise results in an increase or redistribution of hospital beds within the 
375.5 	state; and
375.6 	(2) the establishment of a new hospital.
375.7 	(b) This section does not apply to:
375.8 	(1) construction or relocation within a county by a hospital, clinic, or other health care 
375.9 	facility that is a national referral center engaged in substantial programs of patient care, 
375.10 	medical research, and medical education meeting state and national needs that receives more 
375.11 	than 40 percent of its patients from outside the state of Minnesota;
375.12 	(2) a project for construction or modification for which a health care facility held an 
375.13 	approved certificate of need on May 1, 1984, regardless of the date of expiration of the 
375.14 	certificate;
375.15 	(3) a project for which a certificate of need was denied before July 1, 1990, if a timely 
375.16 	appeal results in an order reversing the denial;
375.17 	(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, 
375.18 	section 2;
375.19 	(5) a project involving consolidation of pediatric specialty hospital services within the 
375.20 	Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number 
375.21 	of pediatric specialty hospital beds among the hospitals being consolidated;
375.22 	(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to 
375.23 	an existing licensed hospital that will allow for the reconstruction of a new philanthropic, 
375.24 	pediatric-orthopedic hospital on an existing site and that will not result in a net increase in 
375.25 	the number of hospital beds. Upon completion of the reconstruction, the licenses of both 
375.26 	hospitals must be reinstated at the capacity that existed on each site before the relocation;
375.27 	(7) the relocation or redistribution of hospital beds within a hospital building or 
375.28 	identifiable complex of buildings provided the relocation or redistribution does not result 
375.29 	in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from 
375.30 	one physical site or complex to another; or (iii) redistribution of hospital beds within the 
375.31 	state or a region of the state;
375.32 	(8) relocation or redistribution of hospital beds within a hospital corporate system that 
375.33 	involves the transfer of beds from a closed facility site or complex to an existing site or 
376.1 	complex provided that: (i) no more than 50 percent of the capacity of the closed facility is 
376.2 	transferred; (ii) the capacity of the site or complex to which the beds are transferred does 
376.3 	not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal 
376.4 	health systems agency boundary in place on July 1, 1983; and (iv) the relocation or 
376.5 	redistribution does not involve the construction of a new hospital building;
376.6 	(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice 
376.7 	County that primarily serves adolescents and that receives more than 70 percent of its 
376.8 	patients from outside the state of Minnesota;
376.9 	(10) a project to replace a hospital or hospitals with a combined licensed capacity of 
376.10 	130 beds or less if: (i) the new hospital site is located within five miles of the current site; 
376.11 	and (ii) the total licensed capacity of the replacement hospital, either at the time of 
376.12 	construction of the initial building or as the result of future expansion, will not exceed 70 
376.13 	licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
376.14 	(11) the relocation of licensed hospital beds from an existing state facility operated by 
376.15 	the commissioner of human services to a new or existing facility, building, or complex 
376.16 	operated by the commissioner of human services; from one regional treatment center site 
376.17 	to another; or from one building or site to a new or existing building or site on the same 
376.18 	campus;
376.19 	(12) the construction or relocation of hospital beds operated by a hospital having a 
376.20 	statutory obligation to provide hospital and medical services for the indigent that does not 
376.21 	result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27 
376.22 	beds, of which 12 serve mental health needs, may be transferred from Hennepin County 
376.23 	Medical Center to Regions Hospital under this clause;
376.24 	(13) a construction project involving the addition of up to 31 new beds in an existing 
376.25 	nonfederal hospital in Beltrami County;
376.26 	(14) a construction project involving the addition of up to eight new beds in an existing 
376.27 	nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
376.28 	(15) a construction project involving the addition of 20 new hospital beds used for 
376.29 	rehabilitation services in an existing hospital in Carver County serving the southwest 
376.30 	suburban metropolitan area. Beds constructed under this clause shall not be eligible for 
376.31 	reimbursement under medical assistance or MinnesotaCare;
377.1 	(16) a project for the construction or relocation of up to 20 hospital beds for the operation 
377.2 	of up to two psychiatric facilities or units for children provided that the operation of the 
377.3 	facilities or units have received the approval of the commissioner of human services;
377.4 	(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation 
377.5 	services in an existing hospital in Itasca County;
377.6 	(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County 
377.7 	that closed 20 rehabilitation beds in 2002, provided that the beds are used only for 
377.8 	rehabilitation in the hospital's current rehabilitation building. If the beds are used for another 
377.9 	purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
377.10 	(19) a critical access hospital established under section 144.1483, clause (9), and section 
377.11 	1820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that 
377.12 	delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33, 
377.13 	to the extent that the critical access hospital does not seek to exceed the maximum number 
377.14 	of beds permitted such hospital under federal law;
377.15 	(20) notwithstanding section 144.552, a project for the construction of a new hospital 
377.16 	in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
377.17 	(i) the project, including each hospital or health system that will own or control the entity 
377.18 	that will hold the new hospital license, is approved by a resolution of the Maple Grove City 
377.19 	Council as of March 1, 2006;
377.20 	(ii) the entity that will hold the new hospital license will be owned or controlled by one 
377.21 	or more not-for-profit hospitals or health systems that have previously submitted a plan or 
377.22 	plans for a project in Maple Grove as required under section 144.552, and the plan or plans 
377.23 	have been found to be in the public interest by the commissioner of health as of April 1, 
377.24 	2005;
377.25 	(iii) the new hospital's initial inpatient services must include, but are not limited to, 
377.26 	medical and surgical services, obstetrical and gynecological services, intensive care services, 
377.27 	orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health 
377.28 	services, and emergency room services;
377.29 	(iv) the new hospital:
377.30 	(A) will have the ability to provide and staff sufficient new beds to meet the growing 
377.31 	needs of the Maple Grove service area and the surrounding communities currently being 
377.32 	served by the hospital or health system that will own or control the entity that will hold the 
377.33 	new hospital license;
378.1 	(B) will provide uncompensated care;
378.2 	(C) will provide mental health services, including inpatient beds;
378.3 	(D) will be a site for workforce development for a broad spectrum of health-care-related 
378.4 	occupations and have a commitment to providing clinical training programs for physicians 
378.5 	and other health care providers;
378.6 	(E) will demonstrate a commitment to quality care and patient safety;
378.7 	(F) will have an electronic medical records system, including physician order entry;
378.8 	(G) will provide a broad range of senior services;
378.9 	(H) will provide emergency medical services that will coordinate care with regional 
378.10 	providers of trauma services and licensed emergency ambulance services in order to enhance 
378.11 	the continuity of care for emergency medical patients; and
378.12 	(I) will be completed by December 31, 2009, unless delayed by circumstances beyond 
378.13 	the control of the entity holding the new hospital license; and
378.14 	(v) as of 30 days following submission of a written plan, the commissioner of health 
378.15 	has not determined that the hospitals or health systems that will own or control the entity 
378.16 	that will hold the new hospital license are unable to meet the criteria of this clause;
378.17 	(21) a project approved under section 144.553;
378.18 	(22) a project for the construction of a hospital with up to 25 beds in Cass County within 
378.19 	a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder 
378.20 	is approved by the Cass County Board;
378.21 	(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity 
378.22 	from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing 
378.23 	a separately licensed 13-bed skilled nursing facility;
378.24 	(24) notwithstanding section 144.552, a project for the construction and expansion of a 
378.25 	specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients 
378.26 	who are under 21 years of age on the date of admission. The commissioner conducted a 
378.27 	public interest review of the mental health needs of Minnesota and the Twin Cities 
378.28 	metropolitan area in 2008. No further public interest review shall be conducted for the 
378.29 	construction or expansion project under this clause;
378.30 	(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the 
378.31 	commissioner finds the project is in the public interest after the public interest review 
378.32 	conducted under section 144.552 is complete; or
379.1 	(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city 
379.2 	of Maple Grove, exclusively for patients who are under 21 years of age on the date of 
379.3 	admission, if the commissioner finds the project is in the public interest after the public 
379.4 	interest review conducted under section 144.552 is complete;
379.5 	(ii) this project shall serve patients in the continuing care benefit program under section 
379.6 	256.9693. The project may also serve patients not in the continuing care benefit program; 
379.7 	and
379.8 	(iii) if the project ceases to participate in the continuing care benefit program, the 
379.9 	commissioner must complete a subsequent public interest review under section 144.552. If 
379.10 	the project is found not to be in the public interest, the license must be terminated six months 
379.11 	from the date of that finding. If the commissioner of human services terminates the contract 
379.12 	without cause or reduces per diem payment rates for patients under the continuing care 
379.13 	benefit program below the rates in effect for services provided on December 31, 2015, the 
379.14 	project may cease to participate in the continuing care benefit program and continue to 
379.15 	operate without a subsequent public interest review; or
379.16 	(27) a project involving the addition of 21 new beds in an existing psychiatric hospital 
379.17 	in Hennepin County that is exclusively for patients who are under 21 years of age on the 
379.18 	date of admission.

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

379.20 	Sec. 25. Minnesota Statutes 2016, section 144A.472, subdivision 7, is amended to read:
379.21 		Subd. 7.Fees; application, change of ownership, and renewal. (a) An initial applicant 
379.22 	seeking temporary home care licensure must submit the following application fee to the 
379.23 	commissioner along with a completed application:
379.24 	(1) for a basic home care provider, $2,100; or
379.25 	(2) for a comprehensive home care provider, $4,200.
379.26 	(b) A home care provider who is filing a change of ownership as required under 
379.27 	subdivision 5 must submit the following application fee to the commissioner, along with 
379.28 	the documentation required for the change of ownership:
379.29 	(1) for a basic home care provider, $2,100; or
379.30 	(2) for a comprehensive home care provider, $4,200.
379.31 	(c) A home care provider who is seeking to renew the provider's license shall pay a fee 
379.32 	to the commissioner based on revenues derived from the provision of home care services 
380.1 	during the calendar year prior to the year in which the application is submitted, according 
380.2 	to the following schedule:
380.3 	License Renewal Fee

380.4	Provider Annual Revenue
	Fee
		
380.5	greater than $1,500,000
	$6,625
		
380.6
380.7	greater than $1,275,000 and no more than 
$1,500,000
	$5,797
		
380.8
380.9	greater than $1,100,000 and no more than 
$1,275,000
	$4,969
		
380.10
380.11	greater than $950,000 and no more than 
$1,100,000
	$4,141
		
380.12	greater than $850,000 and no more than $950,000
	$3,727
		
380.13	greater than $750,000 and no more than $850,000
	$3,313
		
380.14	greater than $650,000 and no more than $750,000
	$2,898
		
380.15	greater than $550,000 and no more than $650,000
	$2,485
		
380.16	greater than $450,000 and no more than $550,000
	$2,070
		
380.17	greater than $350,000 and no more than $450,000
	$1,656
		
380.18	greater than $250,000 and no more than $350,000
	$1,242
		
380.19	greater than $100,000 and no more than $250,000
	$828
		
380.20	greater than $50,000 and no more than $100,000
	$500
		
380.21	greater than $25,000 and no more than $50,000
	$400
		
380.22	no more than $25,000
	$200
		
380.23 	(d) If requested, the home care provider shall provide the commissioner information to 
380.24 	verify the provider's annual revenues or other information as needed, including copies of 
380.25 	documents submitted to the Department of Revenue.
380.26 	(e) At each annual renewal, a home care provider may elect to pay the highest renewal 
380.27 	fee for its license category, and not provide annual revenue information to the commissioner.
380.28 	(f) A temporary license or license applicant, or temporary licensee or licensee that 
380.29 	knowingly provides the commissioner incorrect revenue amounts for the purpose of paying 
380.30 	a lower license fee, shall be subject to a civil penalty in the amount of double the fee the 
380.31 	provider should have paid.
380.32 	(g) Fees and penalties collected under this section shall be deposited in the state treasury 
380.33 	and credited to the state government special revenue fund. All fees are nonrefundable. Fees 
380.34 	collected under paragraph (c) are nonrefundable even if received before July 1, 2017, for 
380.35 	temporary licenses or licenses being issued effective July 1, 2017, or later.
380.36 	(h) The license renewal fee schedule in this subdivision is effective July 1, 2016.

381.1 	Sec. 26. Minnesota Statutes 2016, section 144A.474, subdivision 11, is amended to read:
381.2 		Subd. 11.Fines. (a) Fines and enforcement actions under this subdivision may be assessed 
381.3 	based on the level and scope of the violations described in paragraph (c) as follows:
381.4 	(1) Level 1, no fines or enforcement;
381.5 	(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement 
381.6 	mechanisms authorized in section 144A.475 for widespread violations;
381.7 	(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement 
381.8 	mechanisms authorized in section 144A.475; and
381.9 	(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the enforcement 
381.10 	mechanisms authorized in section 144A.475.
381.11 	(b) Correction orders for violations are categorized by both level and scope and fines 
381.12 	shall be assessed as follows:
381.13 	(1) level of violation:
381.14 	(i) Level 1 is a violation that has no potential to cause more than a minimal impact on 
381.15 	the client and does not affect health or safety;
381.16 	(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential 
381.17 	to have harmed a client's health or safety, but was not likely to cause serious injury, 
381.18 	impairment, or death;
381.19 	(iii) Level 3 is a violation that harmed a client's health or safety, not including serious 
381.20 	injury, impairment, or death, or a violation that has the potential to lead to serious injury, 
381.21 	impairment, or death; and
381.22 	(iv) Level 4 is a violation that results in serious injury, impairment, or death.
381.23 	(2) scope of violation:
381.24 	(i) isolated, when one or a limited number of clients are affected or one or a limited 
381.25 	number of staff are involved or the situation has occurred only occasionally;
381.26 	(ii) pattern, when more than a limited number of clients are affected, more than a limited 
381.27 	number of staff are involved, or the situation has occurred repeatedly but is not found to be 
381.28 	pervasive; and
381.29 	(iii) widespread, when problems are pervasive or represent a systemic failure that has 
381.30 	affected or has the potential to affect a large portion or all of the clients.
382.1 	(c) If the commissioner finds that the applicant or a home care provider required to be 
382.2 	licensed under sections 144A.43 to 144A.482 has not corrected violations by the date 
382.3 	specified in the correction order or conditional license resulting from a survey or complaint 
382.4 	investigation, the commissioner may impose a fine. A notice of noncompliance with a 
382.5 	correction order must be mailed to the applicant's or provider's last known address. The 
382.6 	noncompliance notice must list the violations not corrected.
382.7 	(d) The license holder must pay the fines assessed on or before the payment date specified. 
382.8 	If the license holder fails to fully comply with the order, the commissioner may issue a 
382.9 	second fine or suspend the license until the license holder complies by paying the fine. A 
382.10 	timely appeal shall stay payment of the fine until the commissioner issues a final order.
382.11 	(e) A license holder shall promptly notify the commissioner in writing when a violation 
382.12 	specified in the order is corrected. If upon reinspection the commissioner determines that 
382.13 	a violation has not been corrected as indicated by the order, the commissioner may issue a 
382.14 	second fine. The commissioner shall notify the license holder by mail to the last known 
382.15 	address in the licensing record that a second fine has been assessed. The license holder may 
382.16 	appeal the second fine as provided under this subdivision.
382.17 	(f) A home care provider that has been assessed a fine under this subdivision has a right 
382.18 	to a reconsideration or a hearing under this section and chapter 14.
382.19 	(g) When a fine has been assessed, the license holder may not avoid payment by closing, 
382.20 	selling, or otherwise transferring the licensed program to a third party. In such an event, the 
382.21 	license holder shall be liable for payment of the fine.
382.22 	(h) In addition to any fine imposed under this section, the commissioner may assess 
382.23 	costs related to an investigation that results in a final order assessing a fine or other 
382.24 	enforcement action authorized by this chapter.
382.25 	(i) Fines collected under this subdivision shall be deposited in the state government 
382.26 	special revenue fund and credited to an account separate from the revenue collected under 
382.27 	section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines 
382.28 	collected may must be used by the commissioner for special projects to improve home care 
382.29 	in Minnesota as recommended by the advisory council established in section 144A.4799.

382.30 	Sec. 27. Minnesota Statutes 2016, section 144A.4799, subdivision 3, is amended to read:
382.31 		Subd. 3.Duties. (a) At the commissioner's request, the advisory council shall provide 
382.32 	advice regarding regulations of Department of Health licensed home care providers in this 
382.33 	chapter, including advice on the following:
383.1 	(1) community standards for home care practices;
383.2 	(2) enforcement of licensing standards and whether certain disciplinary actions are 
383.3 	appropriate;
383.4 	(3) ways of distributing information to licensees and consumers of home care;
383.5 	(4) training standards;
383.6 	(5) identifying emerging issues and opportunities in the home care field, including the 
383.7 	use of technology in home and telehealth capabilities;
383.8 	(6) allowable home care licensing modifications and exemptions, including a method 
383.9 	for an integrated license with an existing license for rural licensed nursing homes to provide 
383.10 	limited home care services in an adjacent independent living apartment building owned by 
383.11 	the licensed nursing home; and
383.12 	(7) recommendations for studies using the data in section 62U.04, subdivision 4, including 
383.13 	but not limited to studies concerning costs related to dementia and chronic disease among 
383.14 	an elderly population over 60 and additional long-term care costs, as described in section 
383.15 	62U.10, subdivision 6.
383.16 	(b) The advisory council shall perform other duties as directed by the commissioner.
383.17 	(c) The advisory council shall annually review the balance of the account in the state 
383.18 	government special revenue fund described in section 144A.474, subdivision 11, paragraph 
383.19 	(i), and make annual recommendations by January 15 directly to the chairs and ranking 
383.20 	minority members of the legislative committees with jurisdiction over health and human 
383.21 	services regarding appropriations to the commissioner for the purposes in section 144A.474, 
383.22 	subdivision 11, paragraph (i).

383.23 	Sec. 28. Minnesota Statutes 2016, section 144A.70, is amended by adding a subdivision 
383.24 	to read:
383.25 		Subd. 4a.Nurse. "Nurse" means a licensed practical nurse as defined in section 148.171, 
383.26 	subdivision 8, or a registered nurse as defined in section 148.171, subdivision 20.

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

383.28 	Sec. 29. Minnesota Statutes 2016, section 144A.70, subdivision 6, is amended to read:
383.29 		Subd. 6.Supplemental nursing services agency. "Supplemental nursing services 
383.30 	agency" means a person, firm, corporation, partnership, or association engaged for hire in 
383.31 	the business of providing or procuring temporary employment in health care facilities for 
384.1 	nurses, nursing assistants, nurse aides, and orderlies, and other licensed health professionals. 
384.2 	Supplemental nursing services agency does not include an individual who only engages in 
384.3 	providing the individual's services on a temporary basis to health care facilities. Supplemental 
384.4 	nursing services agency does not include a professional home care agency licensed under 
384.5 	section 144A.471 that only provides staff to other home care providers.

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

384.7 	Sec. 30. Minnesota Statutes 2016, section 144D.06, is amended to read:
384.8 	144D.06 OTHER LAWS.
384.9 	In addition to registration under this chapter, a housing with services establishment must 
384.10 	comply with chapter 504B and the provisions of section 325F.72, and shall obtain and 
384.11 	maintain all other licenses, permits, registrations, or other governmental approvals required 
384.12 	of it in addition to registration under this chapter. A housing with services establishment is 
384.13 	subject to the provisions of section 325F.72 and chapter 504B not required to obtain a 
384.14 	lodging license under chapter 157 and related rules.

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

384.16 	Sec. 31. [144D.071] CHANGE OF LIVING UNIT.
384.17 	Housing with services establishments must not require a resident to move from the 
384.18 	resident's living unit to another living unit, to share a unit, or to move out of the building 
384.19 	after a resident begins receiving services under section 256B.0915.

384.20 	Sec. 32. [144H.01] DEFINITIONS.
384.21 		Subdivision 1.Application. The terms defined in this section apply to this chapter.
384.22 		Subd. 2.Basic services. "Basic services" includes but is not limited to:
384.23 	(1) the development, implementation, and monitoring of a comprehensive protocol of 
384.24 	care that is developed in conjunction with the parent or guardian of a medically complex 
384.25 	or technologically dependent child and that specifies the medical, nursing, psychosocial, 
384.26 	and developmental therapies required by the medically complex or technologically dependent 
384.27 	child; and
384.28 	(2) the caregiver training needs of the child's parent or guardian.
384.29 		Subd. 3.Commissioner. "Commissioner" means the commissioner of health.
385.1 		Subd. 4.Licensee. "Licensee" means an owner of a prescribed pediatric extended care 
385.2 	(PPEC) center licensed under this chapter.
385.3 		Subd. 5.Medically complex or technologically dependent child. "Medically complex 
385.4 	or technologically dependent child" means a child who, because of a medical condition, 
385.5 	requires continuous therapeutic interventions or skilled nursing supervision which must be 
385.6 	prescribed by a licensed physician and administered by, or under the direct supervision of, 
385.7 	a licensed registered nurse.
385.8 		Subd. 6.Owner. "Owner" means an individual whose ownership interest provides 
385.9 	sufficient authority or control to affect or change decisions regarding the operation of the 
385.10 	PPEC center. An owner includes a sole proprietor, a general partner, or any other individual 
385.11 	whose ownership interest has the ability to affect the management and direction of the PPEC 
385.12 	center's policies.
385.13 		Subd. 7.Prescribed pediatric extended care center, PPEC center, or center.
 385.14 	"Prescribed pediatric extended care center," "PPEC center," or "center" means any facility 
385.15 	operated on a for-profit or nonprofit basis to provide nonresidential basic services to three 
385.16 	or more medically complex or technologically dependent children who require such services 
385.17 	and who are not related to the owner by blood, marriage, or adoption.
385.18 		Subd. 8.Supportive services or contracted services. "Supportive services or contracted 
385.19 	services" include but are not limited to speech therapy, occupational therapy, physical 
385.20 	therapy, social work services, developmental services, child life services, and psychology 
385.21 	services.

385.22 	Sec. 33. [144H.02] LICENSURE REQUIRED.
385.23 	A person may not own or operate a prescribed pediatric extended care center in this state 
385.24 	unless the person holds a temporary or current license issued under this chapter. A separate 
385.25 	license must be obtained for each PPEC center maintained on separate premises, even if 
385.26 	the same management operates the PPEC centers. Separate licenses are not required for 
385.27 	separate buildings on the same grounds. A center shall not be operated on the same grounds 
385.28 	as a child care center licensed under Minnesota Rules, chapter 9503.

385.29 	Sec. 34. [144H.03] EXEMPTIONS.
385.30 	This chapter does not apply to:
385.31 	(1) a facility operated by the United States government or a federal agency; or
385.32 	(2) a health care facility licensed under chapter 144 or 144A.

386.1 	Sec. 35. [144H.04] LICENSE APPLICATION AND RENEWAL.
386.2 		Subdivision 1.Licenses. A person seeking licensure for a PPEC center must submit a 
386.3 	completed application for licensure to the commissioner, in a form and manner determined 
386.4 	by the commissioner. The applicant must also submit the application fee, in the amount 
386.5 	specified in section 144H.05, subdivision 1. Effective February 1, 2019, the commissioner 
386.6 	shall issue a license for a PPEC center if the commissioner determines that the applicant 
386.7 	and center meet the requirements of this chapter and rules adopted under this chapter. A 
386.8 	license issued under this subdivision is valid for two years.
386.9 		Subd. 2.License renewal. A license issued under subdivision 1 may be renewed for a 
386.10 	period of two years if the licensee:
386.11 	(1) submits an application for renewal in a form and manner determined by the 
386.12 	commissioner, at least 30 days before the license expires. An application for renewal 
386.13 	submitted after the renewal deadline date must be accompanied by a late fee in the amount 
386.14 	specified in section 144H.05, subdivision 3;
386.15 	(2) submits the renewal fee in the amount specified in section 144H.05, subdivision 2;
386.16 	(3) demonstrates that the licensee has provided basic services at the PPEC center within 
386.17 	the past two years;
386.18 	(4) provides evidence that the applicant meets the requirements for licensure; and
386.19 	(5) provides other information required by the commissioner.
386.20 		Subd. 3.License not transferable. A PPEC center license issued under this section is 
386.21 	not transferable to another party. Before acquiring ownership of a PPEC center, a prospective 
386.22 	applicant must apply to the commissioner for a new license.

386.23 	Sec. 36. [144H.05] FEES.
386.24 		Subdivision 1.Initial application fee. The initial application fee for PPEC center 
386.25 	licensure is $11,000.
386.26 		Subd. 2.License renewal. The fee for renewal of a PPEC center license is $4,720.
386.27 		Subd. 3.Late fee. The fee for late submission of an application to renew a PPEC center 
386.28 	license is $25.
386.29 		Subd. 4.Nonrefundable; state government special revenue fund. All fees collected 
386.30 	under this chapter are nonrefundable and must be deposited in the state treasury and credited 
386.31 	to the state government special revenue fund.

387.1 	Sec. 37. [144H.06] RULEMAKING.
387.2 	The commissioner shall adopt rules necessary to implement the technical implementation 
387.3 	for sections 144H.01, 144H.02, 144H.03, 144H.04, and 144H.05. Rules adopted under this 
387.4 	section shall include requirements for:
387.5 	(1) applying for, issuing, and renewing PPEC center licenses;
387.6 	(2) a center's physical plant, including standards for plumbing, electrical, ventilation, 
387.7 	heating and cooling, adequate space, accessibility, and fire protection. These standards must 
387.8 	be based on the size of the building and the number of children to be served in the building; 
387.9 	and
387.10 	(3) limits to fines imposed by the commissioner for violations of this chapter or rules 
387.11 	adopted under this chapter.

387.12 	Sec. 38. [144H.07] SERVICES; LIMITATIONS.
387.13 		Subdivision 1.Services. A PPEC center must provide basic services to medically complex 
387.14 	or technologically dependent children, based on a protocol of care established for each child. 
387.15 	A PPEC center may provide services up to 24 hours a day and up to seven days a week.
387.16 		Subd. 2.Limitations. A PPEC center must comply with the following standards related 
387.17 	to services:
387.18 	(1) a child is prohibited from attending a PPEC center for more than 14 hours within a 
387.19 	24-hour period;
387.20 	(2) a PPEC center is prohibited from providing services other than those provided to 
387.21 	medically complex or technologically dependent children; and
387.22 	(3) the maximum capacity for medically complex or technologically dependent children 
387.23 	at a center shall not exceed 45 children.

387.24 	Sec. 39. [144H.08] ADMINISTRATION AND MANAGEMENT.
387.25 		Subdivision 1.Duties of owner. (a) The owner of a PPEC center shall have full legal 
387.26 	authority and responsibility for the operation of the center. A PPEC center must be organized 
387.27 	according to a written table of organization, describing the lines of authority and 
387.28 	communication to the child care level. The organizational structure must be designed to 
387.29 	ensure an integrated continuum of services for the children served.
387.30 	(b) The owner must designate one person as a center administrator, who is responsible 
387.31 	and accountable for overall management of the center.
388.1 		Subd. 2.Duties of administrator. The center administrator is responsible and accountable 
388.2 	for overall management of the center. The administrator must:
388.3 	(1) designate in writing a person to be responsible for the center when the administrator 
388.4 	is absent from the center for more than 24 hours;
388.5 	(2) maintain the following written records, in a place and form and using a system that 
388.6 	allows for inspection of the records by the commissioner during normal business hours:
388.7 	(i) a daily census record, which indicates the number of children currently receiving 
388.8 	services at the center;
388.9 	(ii) a record of all accidents or unusual incidents involving any child or staff member 
388.10 	that caused, or had the potential to cause, injury or harm to a person at the center or to center 
388.11 	property;
388.12 	(iii) copies of all current agreements with providers of supportive services or contracted 
388.13 	services;
388.14 	(iv) copies of all current agreements with consultants employed by the center, 
388.15 	documentation of each consultant's visits, and written, dated reports; and
388.16 	(v) a personnel record for each employee, which must include an application for 
388.17 	employment, references, employment history for the preceding five years, and copies of all 
388.18 	performance evaluations;
388.19 	(3) develop and maintain a current job description for each employee;
388.20 	(4) provide necessary qualified personnel and ancillary services to ensure the health, 
388.21 	safety, and proper care for each child; and
388.22 	(5) develop and implement infection control policies that comply with rules adopted by 
388.23 	the commissioner regarding infection control.

388.24 	Sec. 40. [144H.09] ADMISSION, TRANSFER, AND DISCHARGE POLICIES; 
388.25 	CONSENT FORM.
388.26 		Subdivision 1.Written policies. A PPEC center must have written policies and 
388.27 	procedures governing the admission, transfer, and discharge of children.
388.28 		Subd. 2.Consent form. A parent or guardian must sign a consent form outlining the 
388.29 	purpose of a PPEC center, specifying family responsibilities, authorizing treatment and 
388.30 	services, providing appropriate liability releases, and specifying emergency disposition 
388.31 	plans, before the child's admission to the center. The center must provide the child's parents 
389.1 	or guardians with a copy of the consent form and must maintain the consent form in the 
389.2 	child's medical record.

389.3 	Sec. 41. [144H.10] MEDICAL DIRECTOR.
389.4 	A PPEC center must have a medical director who is a physician licensed in Minnesota 
389.5 	and certified by the American Board of Pediatrics.

389.6 	Sec. 42. [144H.11] NURSING SERVICES.
389.7 		Subdivision 1.Nursing director. A PPEC center must have a nursing director who is 
389.8 	a registered nurse licensed in Minnesota, holds a current certification in cardiopulmonary 
389.9 	resuscitation, and has at least four years of general pediatric nursing experience, at least 
389.10 	one year of which must have been spent caring for medically fragile infants or children in 
389.11 	a pediatric intensive care, neonatal intensive care, PPEC center, or home care setting during 
389.12 	the previous five years. The nursing director is responsible for the daily operation of the 
389.13 	PPEC center.
389.14 		Subd. 2.Registered nurses. A registered nurse employed by a PPEC center must be a 
389.15 	registered nurse licensed in Minnesota, hold a current certification in cardiopulmonary 
389.16 	resuscitation, and have experience in the previous 24 months in being responsible for the 
389.17 	care of acutely ill or chronically ill children.
389.18 		Subd. 3.Licensed practical nurses. A licensed practical nurse employed by a PPEC 
389.19 	center must be supervised by a registered nurse and must be a licensed practical nurse 
389.20 	licensed in Minnesota, have at least two years of experience in pediatrics, and hold a current 
389.21 	certification in cardiopulmonary resuscitation.
389.22 		Subd. 4.Other direct care personnel. (a) Direct care personnel governed by this 
389.23 	subdivision include nursing assistants and individuals with training and experience in the 
389.24 	field of education, social services, or child care.
389.25 	(b) All direct care personnel employed by a PPEC center must work under the supervision 
389.26 	of a registered nurse and are responsible for providing direct care to children at the center. 
389.27 	Direct care personnel must have extensive, documented education and skills training in 
389.28 	providing care to infants and toddlers, provide employment references documenting skill 
389.29 	in the care of infants and children, and hold a current certification in cardiopulmonary 
389.30 	resuscitation.

390.1 	Sec. 43. [144H.12] TOTAL STAFFING FOR NURSING SERVICES AND DIRECT 
390.2 	CARE PERSONNEL.
390.3 	A PPEC center must provide total staffing for nursing services and direct care personnel 
390.4 	at a ratio of one staff person for every three children at the center. The staffing ratio required 
390.5 	in this section is the minimum staffing permitted.

390.6 	Sec. 44. [144H.13] MEDICAL RECORD; PROTOCOL OF CARE.
390.7 	A medical record and an individualized nursing protocol of care must be developed for 
390.8 	each child admitted to a PPEC center, must be maintained for each child, and must be signed 
390.9 	by authorized personnel.

390.10 	Sec. 45. [144H.14] QUALITY ASSURANCE PROGRAM.
390.11 	A PPEC center must have a quality assurance program, in which quarterly reviews are 
390.12 	conducted of the PPEC center's medical records and protocols of care for at least half of 
390.13 	the children served by the PPEC center. The quarterly review sample must be randomly 
390.14 	selected so each child at the center has an equal opportunity to be included in the review. 
390.15 	The committee conducting quality assurance reviews must include the medical director, 
390.16 	administrator, nursing director, and three other committee members determined by the PPEC 
390.17 	center.

390.18 	Sec. 46. [144H.15] INSPECTIONS.
390.19 	(a) The commissioner may inspect a PPEC center, including records held at the center, 
390.20 	at reasonable times as necessary to ensure compliance with this chapter and the rules adopted 
390.21 	under this chapter. During an inspection, a center must provide the commissioner with 
390.22 	access to all center records.
390.23 	(b) The commissioner must inspect a PPEC center before issuing or renewing a license 
390.24 	under this chapter.

390.25 	Sec. 47. [144H.16] COMPLIANCE WITH OTHER LAWS.
390.26 		Subdivision 1.Reporting of maltreatment of minors. A PPEC center must develop 
390.27 	policies and procedures for reporting suspected child maltreatment that fulfill the 
390.28 	requirements of section 626.556. The policies and procedures must include the telephone 
390.29 	numbers of the local county child protection agency for reporting suspected maltreatment. 
390.30 	The policies and procedures specified in this subdivision must be provided to the parents 
391.1 	or guardians of all children at the time of admission to the PPEC center and must be available 
391.2 	upon request.
391.3 		Subd. 2.Crib safety requirements. A PPEC center must comply with the crib safety 
391.4 	requirements in section 245A.146, to the extent they are applicable.

391.5 	Sec. 48. [144H.17] DENIAL, SUSPENSION, REVOCATION, REFUSAL TO RENEW 
391.6 	A LICENSE.
391.7 	(a) The commissioner may deny, suspend, revoke, or refuse to renew a license issued 
391.8 	under this chapter for:
391.9 	(1) a violation of this chapter or rules adopted under this chapter; or
391.10 	(2) an intentional or negligent act by an employee or contractor at the center that 
391.11 	materially affects the health or safety of children at the PPEC center.
391.12 	(b) Prior to any suspension, revocation, or refusal to renew a license, a licensee shall be 
391.13 	entitled to a hearing and review as provided in sections 14.57 to 14.69.

391.14 	Sec. 49. [144H.18] FINES; CORRECTIVE ACTION PLANS.
391.15 		Subdivision 1.Corrective action plans. If the commissioner determines that a PPEC 
391.16 	center is not in compliance with this chapter or rules adopted under this chapter, the 
391.17 	commissioner may require the center to submit a corrective action plan that demonstrates 
391.18 	a good-faith effort to remedy each violation by a specific date, subject to approval by the 
391.19 	commissioner.
391.20 		Subd. 2.Fines. The commissioner may issue a fine to a PPEC center, employee, or 
391.21 	contractor if the commissioner determines the center, employee, or contractor violated this 
391.22 	chapter or rules adopted under this chapter. The fine amount shall not exceed an amount 
391.23 	for each violation and an aggregate amount established by the commissioner in rule. The 
391.24 	failure to correct a violation by the date set by the commissioner, or a failure to comply 
391.25 	with an approved corrective action plan, constitutes a separate violation for each day the 
391.26 	failure continues, unless the commissioner approves an extension to a specific date. In 
391.27 	determining if a fine is to be imposed and establishing the amount of the fine, the 
391.28 	commissioner shall consider:
391.29 	(1) the gravity of the violation, including the probability that death or serious physical 
391.30 	or emotional harm to a child will result or has resulted, the severity of the actual or potential 
391.31 	harm, and the extent to which the applicable laws were violated;
392.1 	(2) actions taken by the owner or administrator to correct violations;
392.2 	(3) any previous violations; and
392.3 	(4) the financial benefit to the PPEC center of committing or continuing the violation.

392.4 	Sec. 50. [144H.19] CLOSING A PPEC CENTER.
392.5 	When a PPEC center voluntarily closes, it must, at least 30 days before closure, inform 
392.6 	each child's parents or guardians of the closure and when the closure will occur.

392.7 	Sec. 51. Minnesota Statutes 2016, section 145.4716, subdivision 2, is amended to read:
392.8 		Subd. 2.Duties of director. The director of child sex trafficking prevention is responsible 
392.9 	for the following:
392.10 	(1) developing and providing comprehensive training on sexual exploitation of youth 
392.11 	for social service professionals, medical professionals, public health workers, and criminal 
392.12 	justice professionals;
392.13 	(2) collecting, organizing, maintaining, and disseminating information on sexual 
392.14 	exploitation and services across the state, including maintaining a list of resources on the 
392.15 	Department of Health Web site;
392.16 	(3) monitoring and applying for federal funding for antitrafficking efforts that may 
392.17 	benefit victims in the state;
392.18 	(4) managing grant programs established under sections 145.4716 to 145.4718, and;
392.19 	609.3241, paragraph (c), clause (3); and 609.5315, subdivision 5c, clause (3);
392.20 	(5) managing the request for proposals for grants for comprehensive services, including 
392.21 	trauma-informed, culturally specific services;
392.22 	(6) identifying best practices in serving sexually exploited youth, as defined in section 
392.23 	260C.007, subdivision 31;
392.24 	(7) providing oversight of and technical support to regional navigators pursuant to section 
392.25 	145.4717;
392.26 	(8) conducting a comprehensive evaluation of the statewide program for safe harbor of 
392.27 	sexually exploited youth; and
392.28 	(9) developing a policy consistent with the requirements of chapter 13 for sharing data 
392.29 	related to sexually exploited youth, as defined in section 260C.007, subdivision 31, among 
392.30 	regional navigators and community-based advocates.

393.1 	Sec. 52. [145.9263] OPIOID PRESCRIBER EDUCATION AND PUBLIC 
393.2 	AWARENESS GRANTS.
393.3 	The commissioner of health, in coordination with the commissioner of human services, 
393.4 	shall award grants to nonprofit organizations for the purpose of expanding prescriber 
393.5 	education, public awareness and outreach on the opioid epidemic and overdose prevention 
393.6 	programs. The grantees must coordinate with health care systems, professional associations, 
393.7 	and emergency medical services providers. Each grantee receiving funds under this section 
393.8 	shall report to the commissioner on how the funds were spent and the outcomes achieved.

393.9 	Sec. 53. Minnesota Statutes 2016, section 145.986, subdivision 1a, is amended to read:
393.10 		Subd. 1a.Grants to local communities. (a) Beginning July 1, 2009, the commissioner 
393.11 	of health shall award competitive grants to community health boards and tribal governments 
393.12 	to convene, coordinate, and implement evidence-based strategies targeted at reducing the 
393.13 	percentage of Minnesotans who are obese or overweight and to reduce the use of tobacco. 
393.14 	Grants shall be awarded to all community health boards and tribal governments whose 
393.15 	proposals demonstrate the ability to implement programs designed to achieve the purposes 
393.16 	in subdivision 1 and other requirements of this section.
393.17 	(b) Grantee activities shall:
393.18 	(1) be based on scientific evidence;
393.19 	(2) be based on community input;
393.20 	(3) address behavior change at the individual, community, and systems levels;
393.21 	(4) occur in community, school, work site, and health care settings;
393.22 	(5) be focused on policy, systems, and environmental changes that support healthy 
393.23 	behaviors; and
393.24 	(6) address the health disparities and inequities that exist in the grantee's community.
393.25 	(c) To receive a grant under this section, community health boards and tribal governments 
393.26 	must submit proposals to the commissioner. A local match of ten percent of the total funding 
393.27 	allocation is required. This local match may include funds donated by community partners.
393.28 	(d) In order to receive a grant, community health boards and tribal governments must 
393.29 	submit a health improvement plan to the commissioner of health for approval. The 
393.30 	commissioner may require the plan to identify a community leadership team, community 
393.31 	partners, and a community action plan that includes an assessment of area strengths and 
393.32 	needs, proposed action strategies, technical assistance needs, and a staffing plan.
394.1 	(e) The grant recipient must implement the health improvement plan, evaluate the 
394.2 	effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.
394.3 	(f) Grant recipients shall report their activities and their progress toward the outcomes 
394.4 	established under subdivision 2 to the commissioner in a format and at a time specified by 
394.5 	the commissioner.
394.6 	(g) All grant recipients shall be held accountable for making progress toward the 
394.7 	measurable outcomes established in subdivision 2. The commissioner shall require a 
394.8 	corrective action plan and may reduce the funding level of grant recipients that do not make 
394.9 	adequate progress toward the measurable outcomes.
394.10 	(h) Beginning November 1, 2015, the commissioner shall offer grant recipients the 
394.11 	option of using a grant awarded under this subdivision to implement health improvement 
394.12 	strategies that improve the health status, delay the expression of dementia, or slow the 
394.13 	progression of dementia, for a targeted population at risk for dementia and shall award at 
394.14 	least two of the grants awarded on November 1, 2015, for these purposes. The grants must 
394.15 	meet all other requirements of this section. The commissioner shall coordinate grant planning 
394.16 	activities with the commissioner of human services, the Minnesota Board on Aging, and 
394.17 	community-based organizations with a focus on dementia. Each grant must include selected 
394.18 	outcomes and evaluation measures related to the incidence or progression of dementia 
394.19 	among the targeted population using the procedure described in subdivision 2.
394.20 	(i) Beginning July 1, 2017, the commissioner shall offer grant recipients the option of 
394.21 	using a grant awarded under this subdivision to confront the opioid addiction and overdose 
394.22 	epidemic, and shall award at least two of the grants awarded on or after July 1, 2017, for 
394.23 	these purposes. The grants awarded under this paragraph must meet all other requirements 
394.24 	of this section. The commissioner shall coordinate grant planning activities with the 
394.25 	commissioner of human services. Each grant shall include selected outcomes and evaluation 
394.26 	measures related to addressing the opioid epidemic.

394.27 	Sec. 54. Minnesota Statutes 2016, section 146B.02, subdivision 2, is amended to read:
394.28 		Subd. 2.Requirements and term of license. (a) Each application for an initial mobile 
394.29 	or fixed-site establishment license and for renewal must be submitted to the commissioner 
394.30 	on a form provided by the commissioner accompanied with the applicable fee required 
394.31 	under section 146B.10. The application must contain:
394.32 	(1) the name(s) of the owner(s) and operator(s) of the establishment;
394.33 	(2) the location of the establishment;
395.1 	(3) verification of compliance with all applicable local and state codes;
395.2 	(4) a description of the general nature of the business; and
395.3 	(5) any other relevant information deemed necessary by the commissioner.
395.4 	(b) If the information submitted is complete and complies with the requirements of this 
395.5 	chapter, the commissioner shall issue a provisional establishment license. The provisional 
395.6 	license is effective until the commissioner determines, after inspection, that the applicant 
395.7 	has met the requirements of this chapter. Upon approval, the commissioner shall issue a 
395.8 	body art establishment license effective for three years.
395.9 	(c) An establishment license must be renewed every two years.

395.10 	Sec. 55. Minnesota Statutes 2016, section 146B.02, subdivision 5, is amended to read:
395.11 		Subd. 5.Transfer of ownership, relocation, and display of license. (a) A body art 
395.12 	establishment license must be issued to a specific person and location and is not transferable. 
395.13 	A license must be prominently displayed in a public area of the establishment.
395.14 	(b) An owner who has purchased a body art establishment licensed under the previous 
395.15 	owner must submit an application to license the establishment within two weeks of the date 
395.16 	of sale. Notwithstanding subdivision 1, the new owner may continue to operate for 60 days 
395.17 	after the sale while waiting for a new license to be issued.
395.18 	(c) An owner of a licensed body art establishment who is relocating the establishment 
395.19 	must submit an application for the new location. The owner may request that the new 
395.20 	application become effective at a specified date in the future. If the relocation is not 
395.21 	accomplished by the date expected, and the license at the existing location expires, the 
395.22 	owner may apply for a temporary event permit to continue to operate at the old location. 
395.23 	The owner may apply for no more than four temporary event permits to continue operating 
395.24 	at the old location.

395.25 	Sec. 56. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
395.26 	to read:
395.27 		Subd. 7a.Supervisors. (a) Only a technician who has been licensed as a body artist for 
395.28 	at least two years in Minnesota or in a jurisdiction with which Minnesota has reciprocity 
395.29 	may supervise a temporary technician.
395.30 	(b) Any technician who agrees to supervise more than two temporary technicians during 
395.31 	the same time period must explain, to the satisfaction of the commissioner, how the technician 
396.1 	will provide supervision to each temporary technician in accordance with section 146B.01, 
396.2 	subdivision 28.
396.3 	(c) The commissioner may refuse to approve as a supervisor a technician who has been 
396.4 	disciplined in Minnesota or in another jurisdiction.

396.5 	Sec. 57. Minnesota Statutes 2016, section 146B.02, subdivision 8, is amended to read:
396.6 		Subd. 8.Temporary events event permit. (a) An owner or operator of a applicant for 
396.7 	a permit to hold a temporary body art establishment event shall submit an application for a 
396.8 	temporary events permit to the commissioner. The application must be received at least 14 
396.9 	days before the start of the event. The application must include the specific days and hours 
396.10 	of operation. The owner or operator An applicant issued a temporary event permit shall 
396.11 	comply with the requirements of this chapter.
396.12 	(b) Applications received less than 14 days prior to the start of the event may be processed 
396.13 	if the commissioner determines it is possible to conduct the all required work, including an 
396.14 	inspection.
396.15 	(c) The temporary events event permit must be prominently displayed in a public area 
396.16 	at the location.
396.17 	(d) The temporary events event permit, if approved, is valid for the specified dates and 
396.18 	hours listed on the application. No temporary events permit shall be issued for longer than 
396.19 	a 21-day period, and may not be extended.
396.20 	(e) No individual who does not hold a current body art establishment license may be 
396.21 	issued a temporary event permit more than four times within the same calendar year.
396.22 	(f) No individual who has been disciplined for a serious violation of this chapter within 
396.23 	three years preceding the intended start date of a temporary event may be issued a license 
396.24 	for a temporary event. Violations that preclude issuance of a temporary event permit include 
396.25 	unlicensed practice; practice in an unlicensed location; any of the conditions listed in section 
396.26 	146B.05, clauses (1) to (8), (12), or (13), 146B.08, subdivision 3, clauses (4), (5), and (10) 
396.27 	to (12), or any other violation that places the health or safety of a client at risk.

396.28 	Sec. 58. Minnesota Statutes 2016, section 146B.02, is amended by adding a subdivision 
396.29 	to read:
396.30 		Subd. 10.Licensure precluded. (a) The commissioner may choose to deny a body art 
396.31 	establishment license to an applicant who has been disciplined for a serious violation under 
396.32 	this chapter. Violations that constitute grounds for denial of license are any of the conditions 
397.1 	listed in section 146B.05, subdivision 1, clauses (1) to (8), (12), or (13), 146B.08, subdivision 
397.2 	3, clauses (4), (5), or (10) to (12), or any other violation that places the health or safety of 
397.3 	a client at risk.
397.4 	(b) In considering whether to grant a license to an applicant who has been disciplined 
397.5 	for a violation described in this subdivision, the commissioner shall consider evidence of 
397.6 	rehabilitation, including the nature and seriousness of the violation, circumstances relative 
397.7 	to the violation, the length of time elapsed since the violation, and evidence that demonstrates 
397.8 	that the applicant has maintained safe, ethical, and responsible body art practice since the 
397.9 	time of the most recent violation.

397.10 	Sec. 59. Minnesota Statutes 2016, section 146B.03, subdivision 6, is amended to read:
397.11 		Subd. 6.Licensure term; renewal. (a) A technician's license is valid for two years from 
397.12 	the date of issuance and may be renewed upon payment of the renewal fee established under 
397.13 	section 146B.10.
397.14 	(b) At renewal, a licensee must submit proof of continuing education approved by the 
397.15 	commissioner in the areas identified in subdivision 4.
397.16 	(c) The commissioner shall notify the technician of the pending expiration of a technician 
397.17 	license at least 60 days prior to license expiration.
397.18 	(d) A technician previously licensed in Minnesota whose license has lapsed for less than 
397.19 	six years may apply to renew. A technician previously licensed in Minnesota whose license 
397.20 	has lapsed for less than ten years and who was licensed in another jurisdiction or jurisdictions 
397.21 	during the entire time of lapse may apply to renew, but must submit proof of licensure in 
397.22 	good standing in all other jurisdictions in which the technician was licensed as a body artist 
397.23 	during the time of lapse. A technician previously licensed in Minnesota whose license has 
397.24 	lapsed for more than six years and who was not continuously licensed in another jurisdiction 
397.25 	during the period of Minnesota lapse must reapply for licensure under subdivision 4.

397.26 	Sec. 60. Minnesota Statutes 2016, section 146B.03, subdivision 7, is amended to read:
397.27 		Subd. 7.Temporary licensure. (a) The commissioner may issue a temporary license 
397.28 	to an applicant who submits to the commissioner on a form provided by the commissioner:
397.29 	(1) proof that the applicant is over the age of 18;
397.30 	(2) all fees required under section 148B.10; and
398.1 	(3) a letter from a licensed technician who has agreed to provide the supervision to meet 
398.2 	the supervised experience requirement under subdivision 4.
398.3 	(b) Upon completion of the required supervised experience, the temporary licensee shall 
398.4 	submit documentation of satisfactorily completing the requirements under subdivision 4, 
398.5 	and the applicable fee under section 146B.10. The commissioner shall issue a new license 
398.6 	in accordance with subdivision 4.
398.7 	(c) A temporary license issued under this subdivision is valid for one year and may be 
398.8 	renewed for one additional year twice.

398.9 	Sec. 61. Minnesota Statutes 2016, section 146B.07, subdivision 4, is amended to read:
398.10 		Subd. 4.Client record maintenance. (a) For each client, the body art establishment 
398.11 	operator shall maintain proper records of each procedure. The records of the procedure must 
398.12 	be kept for three years and must be available for inspection by the commissioner upon 
398.13 	request. The record must include the following:
398.14 	(1) the date of the procedure;
398.15 	(2) the information on the required picture identification showing the name, age, and 
398.16 	current address of the client;
398.17 	(3) a copy of the authorization form signed and dated by the client required under 
398.18 	subdivision 1, paragraph (b);
398.19 	(4) a description of the body art procedure performed;
398.20 	(5) the name and license number of the technician performing the procedure;
398.21 	(6) a copy of the consent form required under subdivision 3; and
398.22 	(7) if the client is under the age of 18 years, a copy of the consent form signed by the 
398.23 	parent or legal guardian as required under subdivision 2.
398.24 	(b) Each body artist shall maintain a copy of the informed consent required under 
398.25 	subdivision 3 for three years.

398.26 	Sec. 62. Minnesota Statutes 2016, section 146B.10, subdivision 1, is amended to read:
398.27 		Subdivision 1. Licensing fees. (a) The fee for the initial technician licensure and biennial 
398.28 	licensure renewal is $100.
398.29 	(b) The fee for temporary technician licensure is $100.
398.30 	(c) The fee for the temporary guest artist license is $50.
399.1 	(d) The fee for a dual body art technician license is $100.
399.2 	(e) The fee for a provisional establishment license is $1,000.
399.3 	(f) The fee for an initial establishment license and the three-year license renewal period 
399.4 	required in section 146B.02, subdivision 2, paragraph (b), is $1,000.
399.5 	(g) The fee for a temporary body art establishment permit is $75.
399.6 	(h) The commissioner shall prorate the initial two-year technician license fee and the 
399.7 	initial three-year body art establishment license fee based on the number of months in the 
399.8 	initial licensure period. The commissioner shall prorate the first renewal fee for the 
399.9 	establishment license based on the number of months from issuance of the provisional 
399.10 	license to the first renewal.

399.11 	Sec. 63. Minnesota Statutes 2016, section 148.5194, subdivision 7, is amended to read:
399.12 		Subd. 7.Audiologist biennial licensure fee. (a) The licensure fee for initial applicants 
399.13 	is $435. The biennial licensure fee for audiologists for clinical fellowship, doctoral externship, 
399.14 	temporary, initial applicants, and renewal licensees licenses is $435.
399.15 	(b) The audiologist fee is for practical examination costs greater than audiologist exam 
399.16 	fee receipts and for complaint investigation, enforcement action, and consumer information 
399.17 	and assistance expenditures related to hearing instrument dispensing.

399.18 	Sec. 64. Minnesota Statutes 2016, section 157.16, subdivision 1, is amended to read:
399.19 		Subdivision 1.License required annually. A license is required annually for every 
399.20 	person, firm, or corporation engaged in the business of conducting a food and beverage 
399.21 	service establishment, youth camp, hotel, motel, lodging establishment, public pool, or 
399.22 	resort. Any person wishing to operate a place of business licensed in this section shall first 
399.23 	make application, pay the required fee specified in this section, and receive approval for 
399.24 	operation, including plan review approval. Special event food stands are not required to 
399.25 	submit plans. Nonprofit organizations operating a special event food stand with multiple 
399.26 	locations at an annual one-day event shall be issued only one license. Application shall be 
399.27 	made on forms provided by the commissioner and shall require the applicant to state the 
399.28 	full name and address of the owner of the building, structure, or enclosure, the lessee and 
399.29 	manager of the food and beverage service establishment, hotel, motel, lodging establishment, 
399.30 	public pool, or resort; the name under which the business is to be conducted; and any other 
399.31 	information as may be required by the commissioner to complete the application for license.
400.1 	All fees collected under this section shall be deposited in the state government special 
400.2 	revenue fund.

400.3 	Sec. 65. Minnesota Statutes 2016, section 327.15, subdivision 3, is amended to read:
400.4 		Subd. 3.Fees, manufactured home parks and recreational camping areas. (a) The 
400.5 	following fees are required for manufactured home parks and recreational camping areas 
400.6 	licensed under this chapter. Fees collected under this section shall be deposited in the state 
400.7 	government special revenue fund. Recreational camping areas and manufactured home 
400.8 	parks shall pay the highest applicable base fee under paragraph (b). The license fee for new 
400.9 	operators of a manufactured home park or recreational camping area previously licensed 
400.10 	under this chapter for the same calendar year is one-half of the appropriate annual license 
400.11 	fee, plus any penalty that may be required. The license fee for operators opening on or after 
400.12 	October 1 is one-half of the appropriate annual license fee, plus any penalty that may be 
400.13 	required.
400.14 	(b) All manufactured home parks and recreational camping areas shall pay the following 
400.15 	annual base fee:
400.16 	(1) a manufactured home park, $150; and
400.17 	(2) a recreational camping area with:
400.18 	(i) 24 or less sites, $50;
400.19 	(ii) 25 to 99 sites, $212; and
400.20 	(iii) 100 or more sites, $300.
400.21 	In addition to the base fee, manufactured home parks and recreational camping areas shall 
400.22 	pay $4 for each licensed site. This paragraph does not apply to special event recreational 
400.23 	camping areas. Operators of a manufactured home park or a recreational camping area also 
400.24 	licensed under section 157.16 for the same location shall pay only one base fee, whichever 
400.25 	is the highest of the base fees found in this section or section 157.16.
400.26 	(c) In addition to the fee in paragraph (b), each manufactured home park or recreational 
400.27 	camping area shall pay an additional annual fee for each fee category specified in this 
400.28 	paragraph:
400.29 	(1) Manufactured home parks and recreational camping areas with public swimming 
400.30 	pools and spas shall pay the appropriate fees specified in section 157.16.
400.31 	(2) Individual private sewer or water, $60. "Individual private water" means a fee category 
400.32 	with a water supply other than a community public water supply as defined in Minnesota 
401.1 	Rules, chapter 4720. "Individual private sewer" means a fee category with a subsurface 
401.2 	sewage treatment system which uses subsurface treatment and disposal.
401.3 	(d) The following fees must accompany a plan review application for initial construction 
401.4 	of a manufactured home park or recreational camping area:
401.5 	(1) for initial construction of less than 25 sites, $375;
401.6 	(2) for initial construction of 25 to 99 sites, $400; and
401.7 	(3) for initial construction of 100 or more sites, $500.
401.8 	(e) The following fees must accompany a plan review application when an existing 
401.9 	manufactured home park or recreational camping area is expanded:
401.10 	(1) for expansion of less than 25 sites, $250;
401.11 	(2) for expansion of 25 to 99 sites, $300; and
401.12 	(3) for expansion of 100 or more sites, $450.

401.13 	Sec. 66. [448.58] ATHLETIC FIELDS AND PLAYGROUNDS; MORATORIUM; 
401.14 	DEFINITIONS.
401.15 		Subdivision 1.Definitions. (a) The definitions in this subdivision apply to this section.
401.16 	(b) "Crumb rubber" means rubber processed from a waste tire into granules or larger 
401.17 	pieces that are loosely combined to form a nonuniform surface.
401.18 	(c) "Municipality" has the meaning given in section 471.345.
401.19 	(d) "Waste tire" has the meaning given in section 115A.90.
401.20 		Subd. 2.Moratorium. (a) No municipality may construct an athletic field or playground 
401.21 	containing crumb rubber until July 1, 2020.
401.22 	(b) No athletic field or playground containing crumb rubber may be constructed on land 
401.23 	leased or owned by a municipality until July 1, 2020.

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

401.25 	Sec. 67. Minnesota Statutes 2016, section 609.5315, subdivision 5c, is amended to read:
401.26 		Subd. 5c.Disposition of money; prostitution. Money forfeited under section 609.5312, 
401.27 	subdivision 1, paragraph (b), must be distributed as follows:
401.28 	(1) 40 percent must be forwarded to the appropriate agency for deposit as a supplement 
401.29 	to the agency's operating fund or similar fund for use in law enforcement;
402.1 	(2) 20 percent must be forwarded to the prosecuting authority that handled the forfeiture 
402.2 	for deposit as a supplement to its operating fund or similar fund for prosecutorial purposes; 
402.3 	and
402.4 	(3) the remaining 40 percent must be forwarded to the commissioner of public safety
402.5 	health to be deposited in the safe harbor for youth account in the special revenue fund and 
402.6 	is appropriated to the commissioner for distribution to crime victims services organizations 
402.7 	that provide services to sexually exploited youth, as defined in section 260C.007, subdivision 
402.8 	31.

402.9 	Sec. 68. Minnesota Statutes 2016, section 626.556, subdivision 2, is amended to read:
402.10 		Subd. 2.Definitions. As used in this section, the following terms have the meanings 
402.11 	given them unless the specific content indicates otherwise:
402.12 	(a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence 
402.13 	or event which:
402.14 	(1) is not likely to occur and could not have been prevented by exercise of due care; and
402.15 	(2) if occurring while a child is receiving services from a facility, happens when the 
402.16 	facility and the employee or person providing services in the facility are in compliance with 
402.17 	the laws and rules relevant to the occurrence or event.
402.18 	(b) "Commissioner" means the commissioner of human services.
402.19 	(c) "Facility" means:
402.20 	(1) a licensed or unlicensed day care facility, residential facility, agency, hospital, 
402.21 	sanitarium, or other facility or institution required to be licensed under sections 144.50 to 
402.22 	144.58, 241.021, or 245A.01 to 245A.16, or chapter 144H or 245D;
402.23 	(2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; 
402.24 	or
402.25 	(3) a nonlicensed personal care provider organization as defined in section 256B.0625, 
402.26 	subdivision 19a.
402.27 	(d) "Family assessment" means a comprehensive assessment of child safety, risk of 
402.28 	subsequent child maltreatment, and family strengths and needs that is applied to a child 
402.29 	maltreatment report that does not allege sexual abuse or substantial child endangerment. 
402.30 	Family assessment does not include a determination as to whether child maltreatment 
402.31 	occurred but does determine the need for services to address the safety of family members 
402.32 	and the risk of subsequent maltreatment.
403.1 	(e) "Investigation" means fact gathering related to the current safety of a child and the 
403.2 	risk of subsequent maltreatment that determines whether child maltreatment occurred and 
403.3 	whether child protective services are needed. An investigation must be used when reports 
403.4 	involve sexual abuse or substantial child endangerment, and for reports of maltreatment in 
403.5 	facilities required to be licensed under chapter 245A or 245D; under sections 144.50 to 
403.6 	144.58 and 241.021; in a school as defined in section 120A.05, subdivisions 9, 11, and 13, 
403.7 	and chapter 124E; or in a nonlicensed personal care provider association as defined in section 
403.8 	256B.0625, subdivision 19a.
403.9 	(f) "Mental injury" means an injury to the psychological capacity or emotional stability 
403.10 	of a child as evidenced by an observable or substantial impairment in the child's ability to 
403.11 	function within a normal range of performance and behavior with due regard to the child's 
403.12 	culture.
403.13 	(g) "Neglect" means the commission or omission of any of the acts specified under 
403.14 	clauses (1) to (9), other than by accidental means:
403.15 	(1) failure by a person responsible for a child's care to supply a child with necessary 
403.16 	food, clothing, shelter, health, medical, or other care required for the child's physical or 
403.17 	mental health when reasonably able to do so;
403.18 	(2) failure to protect a child from conditions or actions that seriously endanger the child's 
403.19 	physical or mental health when reasonably able to do so, including a growth delay, which 
403.20 	may be referred to as a failure to thrive, that has been diagnosed by a physician and is due 
403.21 	to parental neglect;
403.22 	(3) failure to provide for necessary supervision or child care arrangements appropriate 
403.23 	for a child after considering factors as the child's age, mental ability, physical condition, 
403.24 	length of absence, or environment, when the child is unable to care for the child's own basic 
403.25 	needs or safety, or the basic needs or safety of another child in their care;
403.26 	(4) failure to ensure that the child is educated as defined in sections 120A.22 and 
403.27 	260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's 
403.28 	child with sympathomimetic medications, consistent with section 125A.091, subdivision 
403.29 	5;
403.30 	(5) nothing in this section shall be construed to mean that a child is neglected solely 
403.31 	because the child's parent, guardian, or other person responsible for the child's care in good 
403.32 	faith selects and depends upon spiritual means or prayer for treatment or care of disease or 
403.33 	remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker, 
403.34 	or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of 
404.1 	medical care may cause serious danger to the child's health. This section does not impose 
404.2 	upon persons, not otherwise legally responsible for providing a child with necessary food, 
404.3 	clothing, shelter, education, or medical care, a duty to provide that care;
404.4 	(6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision 
404.5 	2, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in 
404.6 	the child at birth, results of a toxicology test performed on the mother at delivery or the 
404.7 	child at birth, medical effects or developmental delays during the child's first year of life 
404.8 	that medically indicate prenatal exposure to a controlled substance, or the presence of a 
404.9 	fetal alcohol spectrum disorder;
404.10 	(7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
404.11 	(8) chronic and severe use of alcohol or a controlled substance by a parent or person 
404.12 	responsible for the care of the child that adversely affects the child's basic needs and safety; 
404.13 	or
404.14 	(9) emotional harm from a pattern of behavior which contributes to impaired emotional 
404.15 	functioning of the child which may be demonstrated by a substantial and observable effect 
404.16 	in the child's behavior, emotional response, or cognition that is not within the normal range 
404.17 	for the child's age and stage of development, with due regard to the child's culture.
404.18 	(h) "Nonmaltreatment mistake" means:
404.19 	(1) at the time of the incident, the individual was performing duties identified in the 
404.20 	center's child care program plan required under Minnesota Rules, part 9503.0045;
404.21 	(2) the individual has not been determined responsible for a similar incident that resulted 
404.22 	in a finding of maltreatment for at least seven years;
404.23 	(3) the individual has not been determined to have committed a similar nonmaltreatment 
404.24 	mistake under this paragraph for at least four years;
404.25 	(4) any injury to a child resulting from the incident, if treated, is treated only with 
404.26 	remedies that are available over the counter, whether ordered by a medical professional or 
404.27 	not; and
404.28 	(5) except for the period when the incident occurred, the facility and the individual 
404.29 	providing services were both in compliance with all licensing requirements relevant to the 
404.30 	incident.
404.31 	This definition only applies to child care centers licensed under Minnesota Rules, chapter 
404.32 	9503. If clauses (1) to (5) apply, rather than making a determination of substantiated 
405.1 	maltreatment by the individual, the commissioner of human services shall determine that a 
405.2 	nonmaltreatment mistake was made by the individual.
405.3 	(i) "Operator" means an operator or agency as defined in section 245A.02.
405.4 	(j) "Person responsible for the child's care" means (1) an individual functioning within 
405.5 	the family unit and having responsibilities for the care of the child such as a parent, guardian, 
405.6 	or other person having similar care responsibilities, or (2) an individual functioning outside 
405.7 	the family unit and having responsibilities for the care of the child such as a teacher, school 
405.8 	administrator, other school employees or agents, or other lawful custodian of a child having 
405.9 	either full-time or short-term care responsibilities including, but not limited to, day care, 
405.10 	babysitting whether paid or unpaid, counseling, teaching, and coaching.
405.11 	(k) "Physical abuse" means any physical injury, mental injury, or threatened injury, 
405.12 	inflicted by a person responsible for the child's care on a child other than by accidental 
405.13 	means, or any physical or mental injury that cannot reasonably be explained by the child's 
405.14 	history of injuries, or any aversive or deprivation procedures, or regulated interventions, 
405.15 	that have not been authorized under section 125A.0942 or 245.825.
405.16 	Abuse does not include reasonable and moderate physical discipline of a child 
405.17 	administered by a parent or legal guardian which does not result in an injury. Abuse does 
405.18 	not include the use of reasonable force by a teacher, principal, or school employee as allowed 
405.19 	by section 121A.582. Actions which are not reasonable and moderate include, but are not 
405.20 	limited to, any of the following:
405.21 	(1) throwing, kicking, burning, biting, or cutting a child;
405.22 	(2) striking a child with a closed fist;
405.23 	(3) shaking a child under age three;
405.24 	(4) striking or other actions which result in any nonaccidental injury to a child under 18 
405.25 	months of age;
405.26 	(5) unreasonable interference with a child's breathing;
405.27 	(6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
405.28 	(7) striking a child under age one on the face or head;
405.29 	(8) striking a child who is at least age one but under age four on the face or head, which 
405.30 	results in an injury;
405.31 	(9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled 
405.32 	substances which were not prescribed for the child by a practitioner, in order to control or 
406.1 	punish the child; or other substances that substantially affect the child's behavior, motor 
406.2 	coordination, or judgment or that results in sickness or internal injury, or subjects the child 
406.3 	to medical procedures that would be unnecessary if the child were not exposed to the 
406.4 	substances;
406.5 	(10) unreasonable physical confinement or restraint not permitted under section 609.379, 
406.6 	including but not limited to tying, caging, or chaining; or
406.7 	(11) in a school facility or school zone, an act by a person responsible for the child's 
406.8 	care that is a violation under section 121A.58.
406.9 	(l) "Practice of social services," for the purposes of subdivision 3, includes but is not 
406.10 	limited to employee assistance counseling and the provision of guardian ad litem and 
406.11 	parenting time expeditor services.
406.12 	(m) "Report" means any communication received by the local welfare agency, police 
406.13 	department, county sheriff, or agency responsible for child protection pursuant to this section 
406.14 	that describes neglect or physical or sexual abuse of a child and contains sufficient content 
406.15 	to identify the child and any person believed to be responsible for the neglect or abuse, if 
406.16 	known.
406.17 	(n) "Sexual abuse" means the subjection of a child by a person responsible for the child's 
406.18 	care, by a person who has a significant relationship to the child, as defined in section 609.341, 
406.19 	or by a person in a position of authority, as defined in section 609.341, subdivision 10, to 
406.20 	any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first 
406.21 	degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual 
406.22 	conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or 
406.23 	609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act 
406.24 	which involves a minor which constitutes a violation of prostitution offenses under sections 
406.25 	609.321 to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports 
406.26 	of known or suspected child sex trafficking involving a child who is identified as a victim 
406.27 	of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321, 
406.28 	subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the 
406.29 	status of a parent or household member who has committed a violation which requires 
406.30 	registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or 
406.31 	required registration under section 243.166, subdivision 1b, paragraph (a) or (b).
406.32 	(o) "Substantial child endangerment" means a person responsible for a child's care, by 
406.33 	act or omission, commits or attempts to commit an act against a child under their care that 
406.34 	constitutes any of the following:
407.1 	(1) egregious harm as defined in section 260C.007, subdivision 14;
407.2 	(2) abandonment under section 260C.301, subdivision 2;
407.3 	(3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's 
407.4 	physical or mental health, including a growth delay, which may be referred to as failure to 
407.5 	thrive, that has been diagnosed by a physician and is due to parental neglect;
407.6 	(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
407.7 	(5) manslaughter in the first or second degree under section 609.20 or 609.205;
407.8 	(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
407.9 	(7) solicitation, inducement, and promotion of prostitution under section 609.322;
407.10 	(8) criminal sexual conduct under sections 609.342 to 609.3451;
407.11 	(9) solicitation of children to engage in sexual conduct under section 609.352;
407.12 	(10) malicious punishment or neglect or endangerment of a child under section 609.377
407.13 	or 609.378;
407.14 	(11) use of a minor in sexual performance under section 617.246; or
407.15 	(12) parental behavior, status, or condition which mandates that the county attorney file 
407.16 	a termination of parental rights petition under section 260C.503, subdivision 2.
407.17 	(p) "Threatened injury" means a statement, overt act, condition, or status that represents 
407.18 	a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes, 
407.19 	but is not limited to, exposing a child to a person responsible for the child's care, as defined 
407.20 	in paragraph (j), clause (1), who has:
407.21 	(1) subjected a child to, or failed to protect a child from, an overt act or condition that 
407.22 	constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law 
407.23 	of another jurisdiction;
407.24 	(2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph 
407.25 	(b), clause (4), or a similar law of another jurisdiction;
407.26 	(3) committed an act that has resulted in an involuntary termination of parental rights 
407.27 	under section 260C.301, or a similar law of another jurisdiction; or
407.28 	(4) committed an act that has resulted in the involuntary transfer of permanent legal and 
407.29 	physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201, 
407.30 	subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law 
407.31 	of another jurisdiction.
408.1 	A child is the subject of a report of threatened injury when the responsible social services 
408.2 	agency receives birth match data under paragraph (q) from the Department of Human 
408.3 	Services.
408.4 	(q) Upon receiving data under section 144.225, subdivision 2b, contained in a birth 
408.5 	record or recognition of parentage identifying a child who is subject to threatened injury 
408.6 	under paragraph (p), the Department of Human Services shall send the data to the responsible 
408.7 	social services agency. The data is known as "birth match" data. Unless the responsible 
408.8 	social services agency has already begun an investigation or assessment of the report due 
408.9 	to the birth of the child or execution of the recognition of parentage and the parent's previous 
408.10 	history with child protection, the agency shall accept the birth match data as a report under 
408.11 	this section. The agency may use either a family assessment or investigation to determine 
408.12 	whether the child is safe. All of the provisions of this section apply. If the child is determined 
408.13 	to be safe, the agency shall consult with the county attorney to determine the appropriateness 
408.14 	of filing a petition alleging the child is in need of protection or services under section 
408.15 	260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is 
408.16 	determined not to be safe, the agency and the county attorney shall take appropriate action 
408.17 	as required under section 260C.503, subdivision 2.
408.18 	(r) Persons who conduct assessments or investigations under this section shall take into 
408.19 	account accepted child-rearing practices of the culture in which a child participates and 
408.20 	accepted teacher discipline practices, which are not injurious to the child's health, welfare, 
408.21 	and safety.

408.22 	Sec. 69. Minnesota Statutes 2016, section 626.556, subdivision 3, is amended to read:
408.23 		Subd. 3.Persons mandated to report; persons voluntarily reporting. (a) A person 
408.24 	who knows or has reason to believe a child is being neglected or physically or sexually 
408.25 	abused, as defined in subdivision 2, or has been neglected or physically or sexually abused 
408.26 	within the preceding three years, shall immediately report the information to the local welfare 
408.27 	agency, agency responsible for assessing or investigating the report, police department, 
408.28 	county sheriff, tribal social services agency, or tribal police department if the person is:
408.29 	(1) a professional or professional's delegate who is engaged in the practice of the healing 
408.30 	arts, social services, hospital administration, psychological or psychiatric treatment, child 
408.31 	care, education, correctional supervision, probation and correctional services, or law 
408.32 	enforcement; or
408.33 	(2) employed as a member of the clergy and received the information while engaged in 
408.34 	ministerial duties, provided that a member of the clergy is not required by this subdivision 
409.1 	to report information that is otherwise privileged under section 595.02, subdivision 1, 
409.2 	paragraph (c).
409.3 	(b) Any person may voluntarily report to the local welfare agency, agency responsible 
409.4 	for assessing or investigating the report, police department, county sheriff, tribal social 
409.5 	services agency, or tribal police department if the person knows, has reason to believe, or 
409.6 	suspects a child is being or has been neglected or subjected to physical or sexual abuse.
409.7 	(c) A person mandated to report physical or sexual child abuse or neglect occurring 
409.8 	within a licensed facility shall report the information to the agency responsible for licensing 
409.9 	the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 144H 
409.10 	or 245D; or a nonlicensed personal care provider organization as defined in section 
409.11 	256B.0625, subdivision 19 19a. A health or corrections agency receiving a report may 
409.12 	request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and 
409.13 	10b. A board or other entity whose licensees perform work within a school facility, upon 
409.14 	receiving a complaint of alleged maltreatment, shall provide information about the 
409.15 	circumstances of the alleged maltreatment to the commissioner of education. Section 13.03, 
409.16 	subdivision 4, applies to data received by the commissioner of education from a licensing 
409.17 	entity.
409.18 	(d) Notification requirements under subdivision 10 apply to all reports received under 
409.19 	this section.
409.20 	(e) For purposes of this section, "immediately" means as soon as possible but in no event 
409.21 	longer than 24 hours.

409.22 	Sec. 70. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
409.23 		Subd. 3c.Local welfare agency, Department of Human Services or Department of 
409.24 	Health responsible for assessing or investigating reports of maltreatment. (a) The county 
409.25 	local welfare agency is the agency responsible for assessing or investigating allegations of 
409.26 	maltreatment in child foster care, family child care, legally unlicensed child care, juvenile 
409.27 	correctional facilities licensed under section 241.021 located in the local welfare agency's 
409.28 	county, and reports involving children served by an unlicensed personal care provider 
409.29 	organization under section 256B.0659. Copies of findings related to personal care provider 
409.30 	organizations under section 256B.0659 must be forwarded to the Department of Human 
409.31 	Services provider enrollment.
410.1 	(b) The Department of Human Services is the agency responsible for assessing or 
410.2 	investigating allegations of maltreatment in facilities licensed under chapters 245A and 
410.3 	245D, except for child foster care and family child care.
410.4 	(c) The Department of Health is the agency responsible for assessing or investigating 
410.5 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and 
410.6 	144A.43 to 144A.482 or chapter 144H.

410.7 	Sec. 71. Minnesota Statutes 2016, section 626.556, subdivision 10d, is amended to read:
410.8 		Subd. 10d.Notification of neglect or abuse in facility. (a) When a report is received 
410.9 	that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the 
410.10 	care of a licensed or unlicensed day care facility, residential facility, agency, hospital, 
410.11 	sanitarium, or other facility or institution required to be licensed according to sections 144.50
410.12 	to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 144H or 245D, or a school as defined 
410.13 	in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed personal 
410.14 	care provider organization as defined in section 256B.0625, subdivision 19a, the 
410.15 	commissioner of the agency responsible for assessing or investigating the report or local 
410.16 	welfare agency investigating the report shall provide the following information to the parent, 
410.17 	guardian, or legal custodian of a child alleged to have been neglected, physically abused, 
410.18 	sexually abused, or the victim of maltreatment of a child in the facility: the name of the 
410.19 	facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or maltreatment 
410.20 	of a child in the facility has been received; the nature of the alleged neglect, physical abuse, 
410.21 	sexual abuse, or maltreatment of a child in the facility; that the agency is conducting an 
410.22 	assessment or investigation; any protective or corrective measures being taken pending the 
410.23 	outcome of the investigation; and that a written memorandum will be provided when the 
410.24 	investigation is completed.
410.25 	(b) The commissioner of the agency responsible for assessing or investigating the report 
410.26 	or local welfare agency may also provide the information in paragraph (a) to the parent, 
410.27 	guardian, or legal custodian of any other child in the facility if the investigative agency 
410.28 	knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or 
410.29 	maltreatment of a child in the facility has occurred. In determining whether to exercise this 
410.30 	authority, the commissioner of the agency responsible for assessing or investigating the 
410.31 	report or local welfare agency shall consider the seriousness of the alleged neglect, physical 
410.32 	abuse, sexual abuse, or maltreatment of a child in the facility; the number of children 
410.33 	allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a 
411.1 	child in the facility; the number of alleged perpetrators; and the length of the investigation. 
411.2 	The facility shall be notified whenever this discretion is exercised.
411.3 	(c) When the commissioner of the agency responsible for assessing or investigating the 
411.4 	report or local welfare agency has completed its investigation, every parent, guardian, or 
411.5 	legal custodian previously notified of the investigation by the commissioner or local welfare 
411.6 	agency shall be provided with the following information in a written memorandum: the 
411.7 	name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual 
411.8 	abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the 
411.9 	investigation findings; a statement whether maltreatment was found; and the protective or 
411.10 	corrective measures that are being or will be taken. The memorandum shall be written in a 
411.11 	manner that protects the identity of the reporter and the child and shall not contain the name, 
411.12 	or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed 
411.13 	during the investigation. If maltreatment is determined to exist, the commissioner or local 
411.14 	welfare agency shall also provide the written memorandum to the parent, guardian, or legal 
411.15 	custodian of each child in the facility who had contact with the individual responsible for 
411.16 	the maltreatment. When the facility is the responsible party for maltreatment, the 
411.17 	commissioner or local welfare agency shall also provide the written memorandum to the 
411.18 	parent, guardian, or legal custodian of each child who received services in the population 
411.19 	of the facility where the maltreatment occurred. This notification must be provided to the 
411.20 	parent, guardian, or legal custodian of each child receiving services from the time the 
411.21 	maltreatment occurred until either the individual responsible for maltreatment is no longer 
411.22 	in contact with a child or children in the facility or the conclusion of the investigation. In 
411.23 	the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions 
411.24 	9, 11, and 13, and chapter 124E, the commissioner of education need not provide notification 
411.25 	to parents, guardians, or legal custodians of each child in the facility, but shall, within ten 
411.26 	days after the investigation is completed, provide written notification to the parent, guardian, 
411.27 	or legal custodian of any student alleged to have been maltreated. The commissioner of 
411.28 	education may notify the parent, guardian, or legal custodian of any student involved as a 
411.29 	witness to alleged maltreatment.

411.30 	Sec. 72. Laws 2014, chapter 312, article 23, section 9, is amended by adding a subdivision 
411.31 	to read:
411.32 		Subd. 5a.Report to legislature. (a) The Legislative Health Care Workforce Commission 
411.33 	must provide a preliminary report to the legislature by December 31, 2018. The report must 
411.34 	include the following:
412.1 	(1) baseline data on the current supply and distribution of health care providers in the 
412.2 	state;
412.3 	(2) current projections of the demand for health professionals;
412.4 	(3) other data and analysis the commission is able to complete; and
412.5 	(4) recommendations on actions needed.
412.6 	(b) The commission must provide a final report to the legislature by December 31, 2020. 
412.7 	The final report must include a comprehensive five-year workforce plan that:
412.8 	(1) identifies current and anticipated health care workforce shortages by both provider 
412.9 	type and geography;
412.10 	(2) evaluates the effectiveness of incentives currently available to develop, attract, and 
412.11 	retain a highly skilled and diverse health care workforce;
412.12 	(3) evaluates alternative incentives to develop, attract, and retain a highly skilled and 
412.13 	diverse health care workforce;
412.14 	(4) identifies current causes and potential solutions to barriers related to the primary 
412.15 	care workforce including, but not limited to, training and residency shortages, disparities 
412.16 	in income between primary care and other providers, and negative perceptions of primary 
412.17 	care among students;
412.18 	(5) assesses the current supply and distribution of health care providers in the state, 
412.19 	trends in health care delivery, access, reform, and the effects of these trends on workforce 
412.20 	needs;
412.21 	(6) analyzes the effects of changing models of health care delivery, including team 
412.22 	models of care and emerging professions, on the demand for health professionals;
412.23 	(7) projects the five-year demand and supply of health professionals necessary to meet 
412.24 	the needs of health care within the state;
412.25 	(8) identifies all funding sources for which the state has administrative control that are 
412.26 	available for health professions training;
412.27 	(9) recommends how to improve data evaluation and analysis;
412.28 	(10) recommends how to improve oral health, mental health, and primary care training 
412.29 	and practice;
412.30 	(11) recommends how to improve the long-term care workforce; and
413.1 	(12) recommends actions needed to meet the projected demand for health professionals 
413.2 	over the five years of the plan.

413.3 	Sec. 73. Laws 2014, chapter 312, article 23, section 9, subdivision 8, is amended to read:
413.4 		Subd. 8.Expiration. The Legislative Health Care Workforce Commission expires on 
413.5 	January 1, 2017 2021.

413.6 	Sec. 74. Laws 2015, chapter 71, article 14, section 3, subdivision 2, as amended by Laws 
413.7 	2015, First Special Session chapter 6, section 2, is amended to read:

413.8	Subd. 2.Health Improvement

413.9	Appropriations by Fund
	
413.10	General
	68,653,000
	68,984,000
	
413.11
413.12	State Government 
Special Revenue
	6,264,000
	6,182,000
	
413.13	Health Care Access
	33,987,000
	33,421,000
	
413.14	Federal TANF
	11,713,000
	11,713,000
	
413.15 	Violence Against Asian Women Working 
413.16 	Group. $200,000 in fiscal year 2016 from the 
413.17 	general fund is for the working group on 
413.18 	violence against Asian women and children.
413.19 	MERC Program. $1,000,000 in fiscal year 
413.20 	2016 and $1,000,000 in fiscal year 2017 are 
413.21 	from the general fund for the MERC program 
413.22 	under Minnesota Statutes, section 62J.692, 
413.23 	subdivision 4.
413.24 	Poison Information Center Grants. 
413.25 	$750,000 in fiscal year 2016 and $750,000 in 
413.26 	fiscal year 2017 are from the general fund for 
413.27 	regional poison information center grants 
413.28 	under Minnesota Statutes, section 145.93.
413.29 	Advanced Care Planning. $250,000 in fiscal 
413.30 	year 2016 is from the general fund to award 
413.31 	a grant to a statewide advance care planning 
413.32 	resource organization that has expertise in 
413.33 	convening and coordinating community-based 
414.1 	strategies to encourage individuals, families, 
414.2 	caregivers, and health care providers to begin 
414.3 	conversations regarding end-of-life care 
414.4 	choices that express an individual's health care 
414.5 	values and preferences and are based on 
414.6 	informed health care decisions. This is a 
414.7 	onetime appropriation.
414.8 	Early Dental Prevention Initiatives. 
414.9 	$172,000 in fiscal year 2016 and $140,000 in 
414.10 	fiscal year 2017 are for the development and 
414.11 	distribution of the early dental prevention 
414.12 	initiative under Minnesota Statutes, section 
414.13 	144.3875.
414.14 	International Medical Graduate Assistance 
414.15 	Program. (a) $500,000 in fiscal year 2016 
414.16 	and $500,000 in fiscal year 2017 are from the 
414.17 	health care access fund for the grant programs 
414.18 	and necessary contracts under Minnesota 
414.19 	Statutes, section 144.1911, subdivisions 3, 
414.20 	paragraph (a), clause (4), and 4 and 5. The 
414.21 	commissioner may use up to $133,000 per 
414.22 	year of the appropriation for international 
414.23 	medical graduate assistance program 
414.24 	administration duties in Minnesota Statutes, 
414.25 	section 144.1911, subdivisions 3, 9, and 10, 
414.26 	and for administering the grant programs 
414.27 	under Minnesota Statutes, section 144.1911, 
414.28 	subdivisions 4, 5, and 6. The commissioner 
414.29 	shall develop recommendations for any 
414.30 	additional funding required for initiatives 
414.31 	needed to achieve the objectives of Minnesota 
414.32 	Statutes, section 144.1911. The commissioner 
414.33 	shall report the funding recommendations to 
414.34 	the legislature by January 15, 2016, in the 
414.35 	report required under Minnesota Statutes, 
415.1 	section 144.1911, subdivision 10. The base 
415.2 	for this purpose is $1,000,000 in fiscal years 
415.3 	2018 and 2019.
415.4 	(b) $500,000 in fiscal year 2016 and $500,000 
415.5 	in fiscal year 2017 are from the health care 
415.6 	access fund for transfer to the revolving 
415.7 	international medical graduate residency 
415.8 	account established in Minnesota Statutes, 
415.9 	section 144.1911, subdivision 6. This is a 
415.10 	onetime appropriation.
415.11 	Federally Qualified Health Centers. 
415.12 	$1,000,000 in fiscal year 2016 and $1,000,000 
415.13 	in fiscal year 2017 are from the general fund 
415.14 	to provide subsidies to federally qualified 
415.15 	health centers under Minnesota Statutes, 
415.16 	section 145.9269. This is a onetime 
415.17 	appropriation.
415.18 	Organ Donation. $200,000 in fiscal year 2016 
415.19 	is from the general fund to establish a grant 
415.20 	program to develop and create culturally 
415.21 	appropriate outreach programs that provide 
415.22 	education about the importance of organ 
415.23 	donation. Grants shall be awarded to a 
415.24 	federally designated organ procurement 
415.25 	organization and hospital system that performs 
415.26 	transplants. This is a onetime appropriation.
415.27 	Primary Care Residency. $1,500,000 in 
415.28 	fiscal year 2016 and $1,500,000 in fiscal year 
415.29 	2017 are from the general fund for the 
415.30 	purposes of the primary care residency 
415.31 	expansion grant program under Minnesota 
415.32 	Statutes, section 144.1506.
415.33 	Somali Women's Health Pilot Autism
415.34 	Program. (a) The commissioner of health 
416.1 	shall establish a pilot program between one or 
416.2 	more federally qualified health centers, as 
416.3 	defined under Minnesota Statutes, section 
416.4 	145.9269, a nonprofit organization that helps 
416.5 	Somali women, and the Minnesota Evaluation 
416.6 	Studies Institute, to develop a promising 
416.7 	strategy to address the preventative and 
416.8 	primary health care needs of, and address 
416.9 	health inequities experienced by, first 
416.10 	generation Somali women. The pilot program 
416.11 	must collaboratively develop a patient flow 
416.12 	process for first generation Somali women by:
416.13 	(1) addressing and identifying clinical and 
416.14 	cultural barriers to Somali women accessing 
416.15 	preventative and primary care, including, but 
416.16 	not limited to, cervical and breast cancer 
416.17 	screenings;
416.18 	(2) developing a culturally appropriate health 
416.19 	curriculum for Somali women based on the 
416.20 	outcomes from the community-based 
416.21 	participatory research report "Cultural 
416.22 	Traditions and the Reproductive Health of 
416.23 	Somali Refugees and Immigrants" to increase 
416.24 	the health literacy of Somali women and 
416.25 	develop culturally specific health care 
416.26 	information; and
416.27 	(3) training the federally qualified health 
416.28 	center's providers and staff to enhance 
416.29 	provider and staff cultural competence 
416.30 	regarding the cultural barriers, including 
416.31 	female genital cutting.
416.32 	(b) The pilot program must develop a process 
416.33 	that results in increased screening rates for 
416.34 	cervical and breast cancer and can be 
416.35 	replicated by other providers serving ethnic 
417.1 	minorities. The pilot program must conduct 
417.2 	an evaluation of the new patient flow process 
417.3 	used by Somali women to access federally 
417.4 	qualified health centers services award a grant 
417.5 	to Dakota County to partner with a 
417.6 	community-based organization with expertise 
417.7 	in serving Somali children with autism. The 
417.8 	grant must address barriers to accessing health 
417.9 	care and other resources by providing outreach 
417.10 	to Somali families on available support and 
417.11 	training to providers on Somali culture.
417.12 	(c) The pilot program must report the 
417.13 	outcomes to the commissioner by June 30, 
417.14 	2017. The grantee shall report to the 
417.15 	commissioner and the chairs and ranking 
417.16 	minority members of the legislative 
417.17 	committees with jurisdiction over health care 
417.18 	policy and finance on the grant funds used and 
417.19 	any notable outcomes achieved by January 15, 
417.20 	2019.
417.21 	(d) $110,000 in fiscal year 2016 is for the 
417.22 	Somali women's health pilot program grant to 
417.23 	Dakota County. Of this appropriation, the 
417.24 	commissioner may use up to $10,000 to 
417.25 	administer the program grant to Dakota 
417.26 	County. This appropriation is available until 
417.27 	June 30, 2017. This is a onetime appropriation.
417.28 	Menthol Cigarette Usage in 
417.29 	African-American Community Intervention 
417.30 	Grants. Of the health care access fund 
417.31 	appropriation for the statewide health 
417.32 	improvement program, $200,000 in fiscal year 
417.33 	2016 is for at least one grant that must be 
417.34 	awarded by the commissioner to implement 
417.35 	strategies and interventions to reduce the 
418.1 	disproportionately high usage of cigarettes by 
418.2 	African-Americans, especially the use of 
418.3 	menthol-flavored cigarettes, as well as the 
418.4 	disproportionate harm tobacco causes in that 
418.5 	community. The grantee shall engage 
418.6 	members of the African-American community 
418.7 	and community-based organizations. This 
418.8 	grant shall be awarded as part of the statewide 
418.9 	health improvement program grants awarded 
418.10 	on November 1, 2015, and must meet the 
418.11 	requirements of Minnesota Statutes, section 
418.12 	145.986.
418.13 	Targeted Home Visiting System. (a) $75,000 
418.14 	in fiscal year 2016 is for the commissioner of 
418.15 	health, in consultation with the commissioners 
418.16 	of human services and education, community 
418.17 	health boards, tribal nations, and other home 
418.18 	visiting stakeholders, to design baseline 
418.19 	training for new home visitors to ensure 
418.20 	statewide coordination across home visiting 
418.21 	programs.
418.22 	(b) $575,000 in fiscal year 2016 and 
418.23 	$2,000,000 fiscal year 2017 are to provide 
418.24 	grants to community health boards and tribal 
418.25 	nations for start-up grants for new 
418.26 	nurse-family partnership programs and for 
418.27 	grants to expand existing programs to serve 
418.28 	first-time mothers, prenatally by 28 weeks 
418.29 	gestation until the child is two years of age, 
418.30 	who are eligible for medical assistance under 
418.31 	Minnesota Statutes, chapter 256B, or the 
418.32 	federal Special Supplemental Nutrition 
418.33 	Program for Women, Infants, and Children. 
418.34 	The commissioner shall award grants to 
418.35 	community health boards or tribal nations in 
419.1 	metropolitan and rural areas of the state. 
419.2 	Priority for all grants shall be given to 
419.3 	nurse-family partnership programs that 
419.4 	provide services through a Minnesota health 
419.5 	care program-enrolled provider that accepts 
419.6 	medical assistance. Additionally, priority for 
419.7 	grants to rural areas shall be given to 
419.8 	community health boards and tribal nations 
419.9 	that expand services within regional 
419.10 	partnerships that provide the nurse-family 
419.11 	partnership program. Funding available under 
419.12 	this paragraph may only be used to 
419.13 	supplement, not to replace, funds being used 
419.14 	for nurse-family partnership home visiting 
419.15 	services as of June 30, 2015.
419.16 	Opiate Antagonists. $270,000 in fiscal year 
419.17 	2016 and $20,000 in fiscal year 2017 are from 
419.18 	the general fund for grants to the eight regional 
419.19 	emergency medical services programs to 
419.20 	purchase opiate antagonists and educate and 
419.21 	train emergency medical services persons, as 
419.22 	defined in Minnesota Statutes, section 
419.23 	144.7401, subdivision 4, clauses (1) and (2), 
419.24 	in the use of these antagonists in the event of 
419.25 	an opioid or heroin overdose. For the purposes 
419.26 	of this paragraph, "opiate antagonist" means 
419.27 	naloxone hydrochloride or any similarly acting 
419.28 	drug approved by the federal Food and Drug 
419.29 	Administration for the treatment of drug 
419.30 	overdose. Grants under this paragraph must 
419.31 	be distributed to all eight regional emergency 
419.32 	medical services programs. This is a onetime 
419.33 	appropriation and is available until June 30, 
419.34 	2017. The commissioner may use up to 
419.35 	$20,000 of the amount for opiate antagonists 
419.36 	for administration.
420.1 	Local and Tribal Public Health Grants. (a) 
420.2 	$894,000 in fiscal year 2016 and $894,000 in 
420.3 	fiscal year 2017 are for an increase in local 
420.4 	public health grants for community health 
420.5 	boards under Minnesota Statutes, section 
420.6 	145A.131, subdivision 1, paragraph (e).
420.7 	(b) $106,000 in fiscal year 2016 and $106,000 
420.8 	in fiscal year 2017 are for an increase in 
420.9 	special grants to tribal governments under 
420.10 	Minnesota Statutes, section 145A.14, 
420.11 	subdivision 2a.
420.12 	HCBS Employee Scholarships. $1,000,000 
420.13 	in fiscal year 2016 and $1,000,000 in fiscal 
420.14 	year 2017 are from the general fund for the 
420.15 	home and community-based services 
420.16 	employee scholarship program under 
420.17 	Minnesota Statutes, section 144.1503. The 
420.18 	commissioner may use up to $50,000 of the 
420.19 	amount for the HCBS employee scholarships 
420.20 	for administration.
420.21 	Family Planning Special Projects. 
420.22 	$1,000,000 in fiscal year 2016 and $1,000,000 
420.23 	in fiscal year 2017 are from the general fund 
420.24 	for family planning special project grants 
420.25 	under Minnesota Statutes, section 145.925.
420.26 	Positive Alternatives. $1,000,000 in fiscal 
420.27 	year 2016 and $1,000,000 in fiscal year 2017 
420.28 	are from the general fund for positive abortion 
420.29 	alternatives under Minnesota Statutes, section 
420.30 	145.4235.
420.31 	Safe Harbor for Sexually Exploited Youth. 
420.32 	$700,000 in fiscal year 2016 and $700,000 in 
420.33 	fiscal year 2017 are from the general fund for 
420.34 	the safe harbor program under Minnesota 
421.1 	Statutes, sections 145.4716 to 145.4718. Funds 
421.2 	shall be used for grants to increase the number 
421.3 	of regional navigators; training for 
421.4 	professionals who engage with exploited or 
421.5 	at-risk youth; implementing statewide 
421.6 	protocols and best practices for effectively 
421.7 	identifying, interacting with, and referring 
421.8 	sexually exploited youth to appropriate 
421.9 	resources; and program operating costs.
421.10 	Health Care Grants for Uninsured 
421.11 	Individuals. (a) $62,500 in fiscal year 2016 
421.12 	and $62,500 in fiscal year 2017 are from the 
421.13 	health care access fund for dental provider 
421.14 	grants in Minnesota Statutes, section 145.929, 
421.15 	subdivision 1.
421.16 	(b) $218,750 in fiscal year 2016 and $218,750 
421.17 	in fiscal year 2017 are from the health care 
421.18 	access fund for community mental health 
421.19 	program grants in Minnesota Statutes, section 
421.20 	145.929, subdivision 2.
421.21 	(c) $750,000 in fiscal year 2016 and $750,000 
421.22 	in fiscal year 2017 are from the health care 
421.23 	access fund for the emergency medical 
421.24 	assistance outlier grant program in Minnesota 
421.25 	Statutes, section 145.929, subdivision 3.
421.26 	(d) $218,750 of the health care access fund 
421.27 	appropriation in fiscal year 2016 and $218,750 
421.28 	in fiscal year 2017 are for community health 
421.29 	center grants under Minnesota Statutes, section 
421.30 	145.9269. A community health center that 
421.31 	receives a grant from this appropriation is not 
421.32 	eligible for a grant under paragraph (b).
421.33 	(e) The commissioner may use up to $25,000 
421.34 	of the appropriations for health care grants for 
422.1 	uninsured individuals in fiscal years 2016 and 
422.2 	2017 for grant administration.
422.3 	TANF Appropriations. (a) $1,156,000 of the 
422.4 	TANF funds is appropriated each year of the 
422.5 	biennium to the commissioner for family 
422.6 	planning grants under Minnesota Statutes, 
422.7 	section 145.925.
422.8 	(b) $3,579,000 of the TANF funds is 
422.9 	appropriated each year of the biennium to the 
422.10 	commissioner for home visiting and nutritional 
422.11 	services listed under Minnesota Statutes, 
422.12 	section 145.882, subdivision 7, clauses (6) and 
422.13 	(7). Funds must be distributed to community 
422.14 	health boards according to Minnesota Statutes, 
422.15 	section 145A.131, subdivision 1.
422.16 	(c) $2,000,000 of the TANF funds is 
422.17 	appropriated each year of the biennium to the 
422.18 	commissioner for decreasing racial and ethnic 
422.19 	disparities in infant mortality rates under 
422.20 	Minnesota Statutes, section 145.928, 
422.21 	subdivision 7.
422.22 	(d) $4,978,000 of the TANF funds is 
422.23 	appropriated each year of the biennium to the 
422.24 	commissioner for the family home visiting 
422.25 	grant program according to Minnesota 
422.26 	Statutes, section 145A.17. $4,000,000 of the 
422.27 	funding must be distributed to community 
422.28 	health boards according to Minnesota Statutes, 
422.29 	section 145A.131, subdivision 1. $978,000 of 
422.30 	the funding must be distributed to tribal 
422.31 	governments as provided in Minnesota 
422.32 	Statutes, section 145A.14, subdivision 2a.
422.33 	(e) The commissioner may use up to 6.23 
422.34 	percent of the funds appropriated each fiscal 
423.1 	year to conduct the ongoing evaluations 
423.2 	required under Minnesota Statutes, section 
423.3 	145A.17, subdivision 7, and training and 
423.4 	technical assistance as required under 
423.5 	Minnesota Statutes, section 145A.17, 
423.6 	subdivisions 4 and 5.
423.7 	TANF Carryforward. Any unexpended 
423.8 	balance of the TANF appropriation in the first 
423.9 	year of the biennium does not cancel but is 
423.10 	available for the second year.
423.11 	Health Professional Loan Forgiveness. 
423.12 	$2,631,000 in fiscal year 2016 and $2,631,000 
423.13 	in fiscal year 2017 are from the health care 
423.14 	access fund for the purposes of Minnesota 
423.15 	Statutes, section 144.1501. Of this 
423.16 	appropriation, the commissioner may use up 
423.17 	to $131,000 each year to administer the 
423.18 	program.
423.19 	Minnesota Stroke System. $350,000 in fiscal 
423.20 	year 2016 and $350,000 in fiscal year 2017 
423.21 	are from the general fund for the Minnesota 
423.22 	stroke system.
423.23 	Prevention of Violence in Health Care. 
423.24 	$50,000 in fiscal year 2016 is to continue the 
423.25 	prevention of violence in health care program 
423.26 	and creating violence prevention resources for 
423.27 	hospitals and other health care providers to 
423.28 	use in training their staff on violence 
423.29 	prevention. This is a onetime appropriation 
423.30 	and is available until June 30, 2017.
423.31 	Health Care Savings Determinations. (a) 
423.32 	The health care access fund base for the state 
423.33 	health improvement program is decreased by 
424.1 	$261,000 in fiscal year 2016 and decreased 
424.2 	by $110,000 in fiscal year 2017.
424.3 	(b) $261,000 in fiscal year 2016 and $110,000 
424.4 	in fiscal year 2017 are from the health care 
424.5 	access fund for the forecasting, cost reporting, 
424.6 	and analysis required by Minnesota Statutes, 
424.7 	section 62U.10, subdivisions 6 and 7.
424.8 	Base Level Adjustments. The general fund 
424.9 	base is decreased by $1,070,000 in fiscal year 
424.10 	2018 and by $1,020,000 in fiscal year 2019. 
424.11 	The state government special revenue fund 
424.12 	base is increased by $33,000 in fiscal year 
424.13 	2018. The health care access fund base is 
424.14 	increased by $610,000 in fiscal year 2018 and 
424.15 	by $23,000 in fiscal year 2019.

424.16 	Sec. 75. STUDY AND REPORT ON HOME CARE NURSING WORKFORCE 
424.17 	SHORTAGE.
 424.18 	(a) The chair and ranking minority member of the senate Human Services Reform 
424.19 	Finance and Policy Committee and the chair and ranking minority member of the house of 
424.20 	representatives Health and Human Services Finance Committee shall convene a working 
424.21 	group to study and report on the shortage of registered nurses and licensed practical nurses 
424.22 	available to provide low-complexity regular home care services to clients in need of such 
424.23 	services, especially clients covered by medical assistance, and to provide recommendations 
424.24 	for ways to address the workforce shortage. The working group shall consist of 12 members 
424.25 	appointed as follows:
424.26 	(1) the chair of the senate Human Services Reform Finance and Policy Committee or a 
424.27 	designee;
424.28 	(2) the ranking minority member of the senate Human Services Reform Finance and 
424.29 	Policy Committee or a designee;
424.30 	(3) the chair of the house of representatives Health and Human Services Finance 
424.31 	Committee or a designee;
424.32 	(4) the ranking minority member of the house of representatives Health and Human 
424.33 	Services Finance Committee or a designee;
425.1 	(5) the commissioner of human services or a designee;
425.2 	(6) the commissioner of health or a designee;
425.3 	(7) one representative appointed by the Professional Home Care Coalition;
425.4 	(8) one representative appointed by the Minnesota Home Care Association;
425.5 	(9) one representative appointed by the Minnesota Board of Nursing;
425.6 	(10) one representative appointed by the Minnesota Nurses Association;
425.7 	(11) one representative appointed by the Minnesota Licensed Practical Nurses 
425.8 	Association;
425.9 	(12) one representative appointed by the Minnesota Society of Medical Assistants;
425.10 	(13) one client who receives regular home care nursing services and is covered by medical 
425.11 	assistance appointed by the commissioner of human services after consulting with the 
425.12 	appointing authorities identified in clauses (7) to (12); and
425.13 	(14) one county public health nurse who is a certified assessor appointed by the 
425.14 	commissioner of health after consulting with the Minnesota Home Care Association.
425.15 	(b) The appointing authorities must appoint members by August 1, 2017.
425.16 	(c) The convening authorities shall convene the first meeting of the working group no 
425.17 	later than August 15, 2017, and caucus staff shall provide support and meeting space for 
425.18 	the working group. The Department of Health and the Department of Human Services shall 
425.19 	provide technical assistance to the working group by providing existing data and analysis 
425.20 	documenting the current and projected workforce shortages in the area of regular home care 
425.21 	nursing. The home care and assisted living program advisory council established under 
425.22 	Minnesota Statutes, section 144A.4799, shall provide advice and recommendations to the 
425.23 	working group. Working group members shall serve without compensation and shall not 
425.24 	be reimbursed for expenses.
425.25 	(d) The working group shall:
425.26 	(1) quantify the number of low-complexity regular home care nursing hours that are 
425.27 	authorized but not provided to clients covered by medical assistance, due to the shortage 
425.28 	of registered nurses and licensed practical nurses available to provide these home care 
425.29 	services;
426.1 	(2) quantify the current and projected workforce shortages of registered nurses and 
426.2 	licensed practical nurses available to provide low-complexity regular home care nursing 
426.3 	services to clients, especially clients covered by medical assistance;
426.4 	(3) develop recommendations for actions to take in the next two years to address the 
426.5 	regular home care nursing workforce shortage, including identifying other health care 
426.6 	professionals who may be able to provide low-complexity regular home care nursing services 
426.7 	with additional training; what additional training may be necessary for these health care 
426.8 	professionals; and how to address scope of practice and licensing issues;
426.9 	(4) compile reimbursement rates for regular home care nursing from other states and 
426.10 	determine Minnesota's national ranking with respect to reimbursement for regular home 
426.11 	care nursing;
426.12 	(5) determine whether reimbursement rates for regular home care nursing fully reimburse 
426.13 	providers for the cost of providing the service and whether the discrepancy, if any, between 
426.14 	rates and costs contributes to lack of access to regular home care nursing; and
426.15 	(6) by January 15, 2018, report on the findings and recommendations of the working 
426.16 	group to the chairs and ranking minority members of the legislative committees with 
426.17 	jurisdiction over health and human services policy and finance. The working group's report 
426.18 	shall include draft legislation.
426.19 	(e) The working group shall elect a chair from among its members at its first meeting.
426.20 	(f) The meetings of the working group shall be open to the public.
426.21 	(g) This section expires January 16, 2018, or the day after submitting the report required 
426.22 	by this section, whichever is earlier.

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

426.24 	Sec. 76. ACCOUNTABLE COMMUNITY FOR HEALTH OPIOID ABUSE 
426.25 	PREVENTION PILOT PROJECTS.
 426.26 	(a) The commissioner of health shall establish up to 12 opioid abuse prevention pilot 
426.27 	projects that provide innovative and collaborative solutions to confront opioid abuse. Each 
426.28 	pilot project must:
426.29 	(1) be designed to reduce emergency room and other health care provider visits resulting 
426.30 	from opioid use or abuse, and reduce rates of opioid addiction in the community;
427.1 	(2) establish multidisciplinary controlled substance care teams that may consist of 
427.2 	physicians, pharmacists, social workers, nurse care coordinators, and mental health 
427.3 	professionals;
427.4 	(3) deliver health care services and care coordination, through controlled substance care 
427.5 	teams, to reduce the inappropriate use of opioids by patients and rates of opioid addiction;
427.6 	(4) address any unmet social service needs that create barriers to managing pain 
427.7 	effectively and obtaining optimal health outcomes;
427.8 	(5) provide prescriber and dispenser education and assistance to reduce the inappropriate 
427.9 	prescribing and dispensing of opioids;
427.10 	(6) promote the adoption of best practices related to opioid disposal and reducing 
427.11 	opportunities for illegal access to opioids; and
427.12 	(7) engage partners outside of the health care system, including schools, law enforcement, 
427.13 	and social services, to address root causes of opioid abuse and addiction at the community 
427.14 	level.
427.15 	(b) The commissioner shall contract with an accountable community for health that 
427.16 	operates an opioid abuse prevention project and can document success in reducing opioid 
427.17 	use through the use of controlled substance care teams, to assist the commissioner in 
427.18 	administering this section and to provide technical assistance to the commissioner and to 
427.19 	entities selected to operate a pilot project.
427.20 	(c) The contract under paragraph (b) shall require the accountable community for health 
427.21 	to evaluate the extent to which the pilot projects were successful in reducing the inappropriate 
427.22 	use of opioids. The evaluation must analyze changes in the number of opioid prescriptions, 
427.23 	the number of emergency room visits related to opioid use, and other relevant measures. 
427.24 	The accountable community for health shall report evaluation results to the chairs and 
427.25 	ranking minority members of the legislative committees with jurisdiction over health and 
427.26 	human services policy and finance and public safety by December 15, 2019.

427.27 	Sec. 77. COMPREHENSIVE PLAN TO END HIV/AIDS.
 427.28 	(a) The commissioner of health, in coordination with the commissioner of human services, 
427.29 	and in consultation with community stakeholders, shall develop a strategic statewide 
427.30 	comprehensive plan that establishes a set of priorities and actions to address the state's HIV 
427.31 	epidemic by reducing the number of newly infected individuals; ensuring that individuals 
427.32 	living with HIV have access to quality, life-extending care regardless of race, gender, sexual 
428.1 	orientation, or socioeconomic circumstances; and ensuring the coordination of a statewide 
428.2 	response to reach the ultimate goal of the elimination of HIV in Minnesota.
428.3 	(b) The plan must identify strategies that are consistent with the National HIV/AIDS 
428.4 	Strategy plan, that reflect the scientific developments in HIV medical care and prevention 
428.5 	that have occurred, and that work toward the elimination of HIV. The plan must:
428.6 	(1) determine the appropriate level of testing, care, and services necessary to achieve 
428.7 	the goal of the elimination of HIV, beginning with meeting the following outcomes:
428.8 	(i) reduce the number of new diagnoses by at least 75 percent;
428.9 	(ii) increase the percentage of individuals living with HIV who know their serostatus to 
428.10 	at least 90 percent;
428.11 	(iii) increase the percentage of individuals living with HIV who are receiving HIV 
428.12 	treatment to at least 90 percent; and
428.13 	(iv) increase the percentage of individuals living with HIV who are virally suppressed 
428.14 	to at least 90 percent;
428.15 	(2) provide recommendations for the optimal allocation and alignment of existing state 
428.16 	and federal funding in order to achieve the greatest impact and ensure a coordinated statewide 
428.17 	effort; and
428.18 	(3) provide recommendations for evaluating new and enhanced interventions and an 
428.19 	estimate of additional  resources needed to provide these interventions.
428.20 	(c) The commissioner shall submit the comprehensive plan and recommendations to the 
428.21 	chairs and ranking minority members of the legislative committees with jurisdiction over 
428.22 	health and human services policy and finance by February 1, 2018.
428.23 	(d) The commissioner, after consulting with stakeholders, may implement this section 
428.24 	utilizing existing efforts being carried out for similar purposes in order to reduce the resources 
428.25 	required to implement this section.

428.26 	Sec. 78. SAFE HARBOR FOR ALL; STATEWIDE SEX TRAFFICKING VICTIMS 
428.27 	STRATEGIC PLAN.
 428.28 	(a) By October 1, 2018, the commissioner of health, in consultation with the 
428.29 	commissioners of public safety and human services, shall develop a comprehensive strategic 
428.30 	plan to address the needs of sex trafficking victims statewide.
429.1 	(b) In developing the plan, the commissioner of health shall seek recommendations from 
429.2 	professionals, community members, and stakeholders from across the state, with an emphasis 
429.3 	on the communities most impacted by sex trafficking. At a minimum, the commissioner 
429.4 	must seek input from the following groups: sex trafficking survivors and their family 
429.5 	members, statewide crime victim services coalitions, victim services providers, nonprofit 
429.6 	organizations, task forces, prosecutors, public defenders, tribal governments, public safety 
429.7 	and corrections professionals, public health professionals, human services professionals, 
429.8 	and impacted community members.
429.9 	(c) By January 15, 2019, the commissioner of health shall report to the chairs and ranking 
429.10 	minority members of the legislative committees with jurisdiction over health and human 
429.11 	services and criminal justice finance and policy on developing the statewide strategic plan, 
429.12 	including recommendations for additional legislation and funding. The report must contain 
429.13 	policy considerations regarding decriminalization of Minnesota Statutes, section 609.324, 
429.14 	subdivisions 6 and 7.
429.15 	(d) As used in this section, "sex trafficking victim" has the meaning given in Minnesota 
429.16 	Statutes, section 609.321, subdivision 7b.

429.17 	Sec. 79. DIRECTION TO THE COMMISSIONER OF HEALTH.
 429.18 	The commissioner of health shall work with interested stakeholders to evaluate whether 
429.19 	existing laws, including laws governing housing with services establishments, board and 
429.20 	lodging establishments with special services, assisted living designations, and home care 
429.21 	providers, as well as building code requirements and landlord tenancy laws, sufficiently 
429.22 	protect the health and safety of persons diagnosed with Alzheimer's disease or a related 
429.23 	dementia.

429.24 	Sec. 80. PALLIATIVE CARE ADVISORY COUNCIL.
 429.25 	The appointing authorities shall appoint the first members of the Palliative Care Advisory 
429.26 	Council under Minnesota Statutes, section 144.059, by October 1, 2017. The commissioner 
429.27 	of health shall convene the first meeting by November 15, 2017, and the commissioner or 
429.28 	the commissioner's designee shall act as chair until the council elects a chair at its first 
429.29 	meeting.

430.1 	Sec. 81. COUNTY-BASED PURCHASING PLANS.
 430.2 	The commissioner of health shall explore ways to allow county-based purchasing plans 
430.3 	meeting the requirements under Minnesota Statutes, section 256B.692, to sell health insurance 
430.4 	coverage in the individual and group health insurance markets.

430.5 	Sec. 82. REPEALER.
 430.6 	Laws 2014, chapter 312, article 23, section 9, subdivision 5, is repealed.

430.7 	ARTICLE 11
430.8 	HEALTH LICENSING BOARDS

430.9 	Section 1. Minnesota Statutes 2016, section 147.01, subdivision 7, is amended to read:
430.10 		Subd. 7.Physician application fee and license fees. (a) The board may charge a the 
430.11 	following nonrefundable application and license fees processed pursuant to sections 147.02, 
430.12 	147.03, 147.037, 147.0375, and 147.38:
430.13 	(1) physician application fee of, $200.;
430.14 	(2) physician annual registration renewal fee, $192;
430.15 	(3) physician endorsement to other states, $40;
430.16 	(4) physician emeritus license, $50;
430.17 	(5) physician temporary licenses, $60;
430.18 	(6) physician late fee, $60;
430.19 	(7) duplicate license fee, $20;
430.20 	(8) certification letter fee, $25;
430.21 	(9) education or training program approval fee, $100;
430.22 	(10) report creation and generation fee, $60;
430.23 	(11) examination administration fee (half day), $50;
430.24 	(12) examination administration fee (full day), $80; and
430.25 	(13) fees developed by the Interstate Commission for determining physician qualification 
430.26 	to register and participate in the interstate medical licensure compact, as established in rules 
430.27 	authorized in and pursuant to section 147.38, not to exceed $1,000.
431.1 	(b) The board may prorate the initial annual license fee. All licensees are required to 
431.2 	pay the full fee upon license renewal. The revenue generated from the fee must be deposited 
431.3 	in an account in the state government special revenue fund.

431.4 	Sec. 2. Minnesota Statutes 2016, section 147.02, subdivision 1, is amended to read:
431.5 		Subdivision 1.United States or Canadian medical school graduates. The board shall 
431.6 	issue a license to practice medicine to a person not currently licensed in another state or 
431.7 	Canada and who meets the requirements in paragraphs (a) to (i).
431.8 	(a) An applicant for a license shall file a written application on forms provided by the 
431.9 	board, showing to the board's satisfaction that the applicant is of good moral character and 
431.10 	satisfies the requirements of this section.
431.11 	(b) The applicant shall present evidence satisfactory to the board of being a graduate of 
431.12 	a medical or osteopathic medical school located in the United States, its territories or Canada, 
431.13 	and approved by the board based upon its faculty, curriculum, facilities, accreditation by a 
431.14 	recognized national accrediting organization approved by the board, and other relevant data, 
431.15 	or is currently enrolled in the final year of study at the school.
431.16 	(c) The applicant must have passed an examination as described in clause (1) or (2).
431.17 	(1) The applicant must have passed a comprehensive examination for initial licensure 
431.18 	prepared and graded by the National Board of Medical Examiners, the Federation of State 
431.19 	Medical Boards, the Medical Council of Canada, the National Board of Osteopathic 
431.20 	Examiners, or the appropriate state board that the board determines acceptable. The board 
431.21 	shall by rule determine what constitutes a passing score in the examination.
431.22 	(2) The applicant taking the United States Medical Licensing Examination (USMLE) 
431.23 	or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) must 
431.24 	have passed steps or levels one, two, and three. Step or level three must be passed within 
431.25 	five years of passing step or level two, or before the end of residency training. The applicant 
431.26 	must pass each of steps or levels one, two, and three with passing scores as recommended 
431.27 	by the USMLE program or National Board of Osteopathic Medical Examiners within three 
431.28 	attempts. The applicant taking combinations of Federation of State Medical Boards, National 
431.29 	Board of Medical Examiners, and USMLE may be accepted only if the combination is 
431.30 	approved by the board as comparable to existing comparable examination sequences and 
431.31 	all examinations are completed prior to the year 2000.
431.32 	(d) The applicant shall present evidence satisfactory to the board of the completion of 
431.33 	one year of graduate, clinical medical training in a program accredited by a national 
432.1 	accrediting organization approved by the board or other graduate training approved in 
432.2 	advance by the board as meeting standards similar to those of a national accrediting 
432.3 	organization.
432.4 	(e) The applicant may make arrangements with the executive director to appear in person 
432.5 	before the board or its designated representative to show that the applicant satisfies the 
432.6 	requirements of this section. The board may establish as internal operating procedures the 
432.7 	procedures or requirements for the applicant's personal presentation.
432.8 	(f) The applicant shall pay a nonrefundable fee established by the board by rule. The 
432.9 	fee may not be refunded. Upon application or notice of license renewal, the board must 
432.10 	provide notice to the applicant and to the person whose license is scheduled to be issued or 
432.11 	renewed of any additional fees, surcharges, or other costs which the person is obligated to 
432.12 	pay as a condition of licensure. The notice must:
432.13 	(1) state the dollar amount of the additional costs; and
432.14 	(2) clearly identify to the applicant the payment schedule of additional costs.
432.15 	(g) The applicant must not be under license suspension or revocation by the licensing 
432.16 	board of the state or jurisdiction in which the conduct that caused the suspension or revocation 
432.17 	occurred.
432.18 	(h) The applicant must not have engaged in conduct warranting disciplinary action 
432.19 	against a licensee, or have been subject to disciplinary action other than as specified in 
432.20 	paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph, 
432.21 	the board may issue a license only on the applicant's showing that the public will be protected 
432.22 	through issuance of a license with conditions and limitations the board considers appropriate.
432.23 	(i) If the examination in paragraph (c) was passed more than ten years ago, the applicant 
432.24 	must either:
432.25 	(1) pass the special purpose examination of the Federation of State Medical Boards with 
432.26 	a score of 75 or better within three attempts; or
432.27 	(2) have a current certification by a specialty board of the American Board of Medical 
432.28 	Specialties, of the American Osteopathic Association, the Royal College of Physicians and 
432.29 	Surgeons of Canada, or of the College of Family Physicians of Canada.

432.30 	Sec. 3. Minnesota Statutes 2016, section 147.03, subdivision 1, is amended to read:
432.31 		Subdivision 1.Endorsement; reciprocity. (a) The board may issue a license to practice 
432.32 	medicine to any person who satisfies the requirements in paragraphs (b) to (f)(e).
433.1 	(b) The applicant shall satisfy all the requirements established in section 147.02, 
433.2 	subdivision 1, paragraphs (a), (b), (d), (e), and (f).
433.3 	(c) The applicant shall:
433.4 	(1) have passed an examination prepared and graded by the Federation of State Medical 
433.5 	Boards, the National Board of Medical Examiners, or the United States Medical Licensing 
433.6 	Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph 
433.7 	(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council 
433.8 	of Canada; and
433.9 	(2) have a current license from the equivalent licensing agency in another state or Canada 
433.10 	and, if the examination in clause (1) was passed more than ten years ago, either:
433.11 	(i) pass the Special Purpose Examination of the Federation of State Medical Boards with 
433.12 	a score of 75 or better within three attempts; or
433.13 	(ii) have a current certification by a specialty board of the American Board of Medical 
433.14 	Specialties, of the American Osteopathic Association, the Royal College of Physicians and 
433.15 	Surgeons of Canada, or of the College of Family Physicians of Canada; or
433.16 	(3) if the applicant fails to meet the requirement established in section 147.02, subdivision 
433.17 	1, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and 
433.18 	three of the USMLE within the required three attempts, the applicant may be granted a 
433.19 	license provided the applicant:
433.20 	(i) has passed each of steps one, two, and three with passing scores as recommended by 
433.21 	the USMLE program within no more than four attempts for any of the three steps;
433.22 	(ii) is currently licensed in another state; and
433.23 	(iii) has current certification by a specialty board of the American Board of Medical 
433.24 	Specialties, the American Osteopathic Association Bureau of Professional Education, the 
433.25 	Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians 
433.26 	of Canada.
433.27 	(d) The applicant shall pay a fee established by the board by rule. The fee may not be 
433.28 	refunded.
433.29 	(e) (d) The applicant must not be under license suspension or revocation by the licensing 
433.30 	board of the state or jurisdiction in which the conduct that caused the suspension or revocation 
433.31 	occurred.
434.1 	(f) (e) The applicant must not have engaged in conduct warranting disciplinary action 
434.2 	against a licensee, or have been subject to disciplinary action other than as specified in 
434.3 	paragraph (e)(d). If an applicant does not satisfy the requirements stated in this paragraph, 
434.4 	the board may issue a license only on the applicant's showing that the public will be protected 
434.5 	through issuance of a license with conditions or limitations the board considers appropriate.
434.6 	(g) (f) Upon the request of an applicant, the board may conduct the final interview of 
434.7 	the applicant by teleconference.

434.8 	Sec. 4. [147A.28] PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.
434.9 	(a) The board may charge the following nonrefundable fees:
434.10 	(1) physician assistant application fee, $120;
434.11 	(2) physician assistant annual registration renewal fee (prescribing authority), $135;
434.12 	(3) physician assistant annual registration renewal fee (no prescribing authority), $115;
434.13 	(4) physician assistant temporary registration, $115;
434.14 	(5) physician assistant temporary permit, $60;
434.15 	(6) physician assistant locum tenens permit, $25;
434.16 	(7) physician assistant late fee, $50;
434.17 	(8) duplicate license fee, $20;
434.18 	(9) certification letter fee, $25;
434.19 	(10) education or training program approval fee, $100; and
434.20 	(11) report creation and generation fee, $60.
434.21 	(b) The board may prorate the initial annual license fee. All licensees are required to 
434.22 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
434.23 	in an account in the state government special revenue fund.

434.24 	Sec. 5. Minnesota Statutes 2016, section 147B.08, is amended by adding a subdivision to 
434.25 	read:
434.26 		Subd. 4.Acupuncturist application and license fees. (a) The board may charge the 
434.27 	following nonrefundable fees:
434.28 	(1) acupuncturist application fee, $150;
434.29 	(2) acupuncturist annual registration renewal fee, $150;
435.1 	(3) acupuncturist temporary registration fee, $60;
435.2 	(4) acupuncturist inactive status fee, $50;
435.3 	(5) acupuncturist late fee, $50;
435.4 	(6) duplicate license fee, $20;
435.5 	(7) certification letter fee, $25;
435.6 	(8) education or training program approval fee, $100; and
435.7 	(9) report creation and generation fee, $60.
435.8 	(b) The board may prorate the initial annual license fee. All licensees are required to 
435.9 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
435.10 	in an account in the state government special revenue fund.

435.11 	Sec. 6. Minnesota Statutes 2016, section 147C.40, is amended by adding a subdivision to 
435.12 	read:
435.13 		Subd. 5.Respiratory therapist application and license fees. (a) The board may charge 
435.14 	the following nonrefundable fees:
435.15 	(1) respiratory therapist application fee, $100;
435.16 	(2) respiratory therapist annual registration renewal fee, $90;
435.17 	(3) respiratory therapist inactive status fee, $50;
435.18 	(4) respiratory therapist temporary registration fee, $90;
435.19 	(5) respiratory therapist temporary permit, $60;
435.20 	(6) respiratory therapist late fee, $50;
435.21 	(7) duplicate license fee, $20;
435.22 	(8) certification letter fee, $25;
435.23 	(9) education or training program approval fee, $100; and
435.24 	(10) report creation and generation fee, $60.
435.25 	(b) The board may prorate the initial annual license fee. All licensees are required to 
435.26 	pay the full fee upon license renewal. The revenue generated from the fees must be deposited 
435.27 	in an account in the state government special revenue fund.

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

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

436.5 	Sec. 8. Minnesota Statutes 2016, section 148.6405, is amended to read:
436.6 	148.6405 LICENSURE APPLICATION REQUIREMENTS: PROCEDURES AND 
436.7 	QUALIFICATIONS.
436.8 	(a) An applicant for licensure must comply with the application requirements in section 
436.9 	148.6420. To qualify for licensure, an applicant must satisfy one of the requirements in 
436.10 	paragraphs (b) to (f) and not be subject to denial of licensure under section 148.6448.
436.11 	(b) A person who applies for licensure as an occupational therapist and who has not 
436.12 	been credentialed by the National Board for Certification in Occupational Therapy or another 
436.13 	jurisdiction must meet the requirements in section 148.6408.
436.14 	(c) A person who applies for licensure as an occupational therapy assistant and who has 
436.15 	not been credentialed by the National Board for Certification in Occupational Therapy or 
436.16 	another jurisdiction must meet the requirements in section 148.6410.
436.17 	(d) A person who is certified by the National Board for Certification in Occupational 
436.18 	Therapy may apply for licensure by equivalency and must meet the requirements in section 
436.19 	148.6412.
436.20 	(e) A person who is credentialed in another jurisdiction may apply for licensure by 
436.21 	reciprocity and must meet the requirements in section 148.6415.
436.22 	(f) A person who applies for temporary licensure must meet the requirements in section 
436.23 	148.6418.
436.24 	(g) A person who applies for licensure under paragraph (b), (c), or (f) more than two 
436.25 	and less than four years after meeting the requirements in section 148.6408 or 148.6410 
436.26 	must submit the following:
436.27 	(1) a completed and signed application for licensure on forms provided by the 
436.28 	commissioner board;
436.29 	(2) the license application fee required under section 148.6445;
436.30 	(3) if applying for occupational therapist licensure, proof of having met a minimum of 
436.31 	24 contact hours of continuing education in the two years preceding licensure application, 
437.1 	or if applying for occupational therapy assistant licensure, proof of having met a minimum 
437.2 	of 18 contact hours of continuing education in the two years preceding licensure application;
437.3 	(4) verified documentation of successful completion of 160 hours of supervised practice 
437.4 	approved by the commissioner board under a limited license specified in section 148.6425, 
437.5 	subdivision 3, paragraph (c); and
437.6 	(5) additional information as requested by the commissioner board to clarify information 
437.7 	in the application, including information to determine whether the individual has engaged 
437.8 	in conduct warranting disciplinary action under section 148.6448. The information must be 
437.9 	submitted within 30 days after the commissioner's board's request.
437.10 	(h) A person who applied for licensure under paragraph (b), (c), or (f) four years or more 
437.11 	after meeting the requirements in section 148.6408 or 148.6410 must meet all the 
437.12 	requirements in paragraph (g) except clauses (3) and (4), submit documentation of having 
437.13 	retaken and passed the credentialing examination for occupational therapist or occupational 
437.14 	therapy assistant, or of having completed an occupational therapy refresher program that 
437.15 	contains both a theoretical and clinical component approved by the commissioner board, 
437.16 	and verified documentation of successful completion of 480 hours of supervised practice 
437.17 	approved by the commissioner board under a limited license specified in section 148.6425, 
437.18 	subdivision 3, paragraph (c). The 480 hours of supervised practice must be completed in 
437.19 	six months and may be completed at the applicant's place of work. Only refresher courses 
437.20 	completed within one year prior to the date of application qualify for approval.

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

437.22 	Sec. 9. Minnesota Statutes 2016, section 148.6408, subdivision 2, is amended to read:
437.23 		Subd. 2.Qualifying examination score required. (a) An applicant must achieve a 
437.24 	qualifying score on the credentialing examination for occupational therapist.
437.25 	(b) The commissioner board shall determine the qualifying score for the credentialing 
437.26 	examination for occupational therapist. In determining the qualifying score, the commissioner
437.27 	board shall consider the cut score recommended by the National Board for Certification in 
437.28 	Occupational Therapy, or other national credentialing organization approved by the 
437.29 	commissioner board, using the modified Angoff method for determining cut score or another 
437.30 	method for determining cut score that is recognized as appropriate and acceptable by industry 
437.31 	standards.
437.32 	(c) The applicant is responsible for:
437.33 	(1) making arrangements to take the credentialing examination for occupational therapist;
438.1 	(2) bearing all expenses associated with taking the examination; and
438.2 	(3) having the examination scores sent directly to the commissioner board from the 
438.3 	testing service that administers the examination.

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

438.5 	Sec. 10. Minnesota Statutes 2016, section 148.6410, subdivision 2, is amended to read:
438.6 		Subd. 2.Qualifying examination score required. (a) An applicant for licensure must 
438.7 	achieve a qualifying score on the credentialing examination for occupational therapy 
438.8 	assistants.
438.9 	(b) The commissioner board shall determine the qualifying score for the credentialing 
438.10 	examination for occupational therapy assistants. In determining the qualifying score, the 
438.11 	commissioner board shall consider the cut score recommended by the National Board for 
438.12 	Certification in Occupational Therapy, or other national credentialing organization approved 
438.13 	by the commissioner board, using the modified Angoff method for determining cut score 
438.14 	or another method for determining cut score that is recognized as appropriate and acceptable 
438.15 	by industry standards.
438.16 	(c) The applicant is responsible for:
438.17 	(1) making all arrangements to take the credentialing examination for occupational 
438.18 	therapy assistants;
438.19 	(2) bearing all expense associated with taking the examination; and
438.20 	(3) having the examination scores sent directly to the commissioner board from the 
438.21 	testing service that administers the examination.

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

438.23 	Sec. 11. Minnesota Statutes 2016, section 148.6412, subdivision 2, is amended to read:
438.24 		Subd. 2.Persons certified by National Board for Certification in Occupational 
438.25 	Therapy after June 17, 1996. The commissioner board may license any person certified 
438.26 	by the National Board for Certification in Occupational Therapy as an occupational therapist 
438.27 	after June 17, 1996, if the commissioner board determines the requirements for certification 
438.28 	are equivalent to or exceed the requirements for licensure as an occupational therapist under 
438.29 	section 148.6408. The commissioner board may license any person certified by the National 
438.30 	Board for Certification in Occupational Therapy as an occupational therapy assistant after 
438.31 	June 17, 1996, if the commissioner board determines the requirements for certification are 
439.1 	equivalent to or exceed the requirements for licensure as an occupational therapy assistant 
439.2 	under section 148.6410. Nothing in this section limits the commissioner's board's authority 
439.3 	to deny licensure based upon the grounds for discipline in sections 148.6401 to 148.6450.

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

439.5 	Sec. 12. Minnesota Statutes 2016, section 148.6415, is amended to read:
439.6 	148.6415 LICENSURE BY RECIPROCITY.
439.7 	A person who holds a current credential as an occupational therapist in the District of 
439.8 	Columbia or a state or territory of the United States whose standards for credentialing are 
439.9 	determined by the commissioner board to be equivalent to or exceed the requirements for 
439.10 	licensure under section 148.6408 may be eligible for licensure by reciprocity as an 
439.11 	occupational therapist. A person who holds a current credential as an occupational therapy 
439.12 	assistant in the District of Columbia or a state or territory of the United States whose 
439.13 	standards for credentialing are determined by the commissioner board to be equivalent to 
439.14 	or exceed the requirements for licensure under section 148.6410 may be eligible for licensure 
439.15 	by reciprocity as an occupational therapy assistant. Nothing in this section limits the 
439.16 	commissioner's board's authority to deny licensure based upon the grounds for discipline 
439.17 	in sections 148.6401 to 148.6450. An applicant must provide:
439.18 	(1) the application materials as required by section 148.6420, subdivisions 1, 3, and 4;
439.19 	(2) the fees required by section 148.6445;
439.20 	(3) a copy of a current and unrestricted credential for the practice of occupational therapy 
439.21 	as either an occupational therapist or occupational therapy assistant;
439.22 	(4) a letter from the jurisdiction that issued the credential describing the applicant's 
439.23 	qualifications that entitled the applicant to receive the credential; and
439.24 	(5) other information necessary to determine whether the credentialing standards of the 
439.25 	jurisdiction that issued the credential are equivalent to or exceed the requirements for 
439.26 	licensure under sections 148.6401 to 148.6450.

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

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

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

440.4 	Sec. 14. Minnesota Statutes 2016, section 148.6418, subdivision 2, is amended to read:
440.5 		Subd. 2.Procedures. To be eligible for temporary licensure, an applicant must submit 
440.6 	a completed application for temporary licensure on forms provided by the commissioner
440.7 	board, the fees required by section 148.6445, and one of the following:
440.8 	(1) evidence of successful completion of the requirements in section 148.6408, 
440.9 	subdivision 1, or 148.6410, subdivision 1;
440.10 	(2) a copy of a current and unrestricted credential for the practice of occupational therapy 
440.11 	as either an occupational therapist or occupational therapy assistant in another jurisdiction; 
440.12 	or
440.13 	(3) a copy of a current and unrestricted certificate from the National Board for 
440.14 	Certification in Occupational Therapy stating that the applicant is certified as an occupational 
440.15 	therapist or occupational therapy assistant.

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

440.17 	Sec. 15. Minnesota Statutes 2016, section 148.6418, subdivision 4, is amended to read:
440.18 		Subd. 4.Supervision required. An applicant who has graduated from an accredited 
440.19 	occupational therapy program, as required by section 148.6408, subdivision 1, or 148.6410, 
440.20 	subdivision 1, and who has not passed the examination required by section 148.6408, 
440.21 	subdivision 2, or 148.6410, subdivision 2, must practice under the supervision of a licensed 
440.22 	occupational therapist. The supervising therapist must, at a minimum, supervise the person 
440.23 	working under temporary licensure in the performance of the initial evaluation, determination 
440.24 	of the appropriate treatment plan, and periodic review and modification of the treatment 
440.25 	plan. The supervising therapist must observe the person working under temporary licensure 
440.26 	in order to assure service competency in carrying out evaluation, treatment planning, and 
440.27 	treatment implementation. The frequency of face-to-face collaboration between the person 
440.28 	working under temporary licensure and the supervising therapist must be based on the 
440.29 	condition of each patient or client, the complexity of treatment and evaluation procedures, 
440.30 	and the proficiencies of the person practicing under temporary licensure. The occupational 
440.31 	therapist or occupational therapy assistant working under temporary licensure must provide 
440.32 	verification of supervision on the application form provided by the commissioner board.

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

441.2 	Sec. 16. Minnesota Statutes 2016, section 148.6418, subdivision 5, is amended to read:
441.3 		Subd. 5.Expiration of temporary licensure. A temporary license issued to a person 
441.4 	pursuant to subdivision 2, clause (1), expires six months from the date of issuance for 
441.5 	occupational therapists and occupational therapy assistants or on the date the commissioner
441.6 	board grants or denies licensure, whichever occurs first. A temporary license issued to a 
441.7 	person pursuant to subdivision 2, clause (2) or (3), expires 90 days after it is issued. Upon 
441.8 	application for renewal, a temporary license shall be renewed once to persons who have 
441.9 	not met the examination requirement under section 148.6408, subdivision 2, or 148.6410, 
441.10 	subdivision 2, within the initial temporary licensure period and who are not the subject of 
441.11 	a disciplinary action nor disqualified on the basis of items in section 148.6448, subdivision 
441.12 	1. Upon application for renewal, a temporary license shall be renewed once to persons who 
441.13 	are able to demonstrate good cause for failure to meet the requirements for licensure under 
441.14 	section 148.6412 or 148.6415 within the initial temporary licensure period and who are not 
441.15 	the subject of a disciplinary action nor disqualified on the basis of items in section 148.6448, 
441.16 	subdivision 1.

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

441.18 	Sec. 17. Minnesota Statutes 2016, section 148.6420, subdivision 1, is amended to read:
441.19 		Subdivision 1.Applications for licensure. An applicant for licensure must:
441.20 	(1) submit a completed application for licensure on forms provided by the commissioner
441.21 	board and must supply the information requested on the application, including:
441.22 	(i) the applicant's name, business address and business telephone number, business 
441.23 	setting, and daytime telephone number;
441.24 	(ii) the name and location of the occupational therapy program the applicant completed;
441.25 	(iii) a description of the applicant's education and training, including a list of degrees 
441.26 	received from educational institutions;
441.27 	(iv) the applicant's work history for the six years preceding the application, including 
441.28 	the number of hours worked;
441.29 	(v) a list of all credentials currently and previously held in Minnesota and other 
441.30 	jurisdictions;
441.31 	(vi) a description of any jurisdiction's refusal to credential the applicant;
442.1 	(vii) a description of all professional disciplinary actions initiated against the applicant 
442.2 	in any jurisdiction;
442.3 	(viii) information on any physical or mental condition or chemical dependency that 
442.4 	impairs the person's ability to engage in the practice of occupational therapy with reasonable 
442.5 	judgment or safety;
442.6 	(ix) a description of any misdemeanor or felony conviction that relates to honesty or to 
442.7 	the practice of occupational therapy;
442.8 	(x) a description of any state or federal court order, including a conciliation court 
442.9 	judgment or a disciplinary order, related to the individual's occupational therapy practice; 
442.10 	and
442.11 	(xi) a statement indicating the physical agent modalities the applicant will use and 
442.12 	whether the applicant will use the modalities as an occupational therapist or an occupational 
442.13 	therapy assistant under direct supervision;
442.14 	(2) submit with the application all fees required by section 148.6445;
442.15 	(3) sign a statement that the information in the application is true and correct to the best 
442.16 	of the applicant's knowledge and belief;
442.17 	(4) sign a waiver authorizing the commissioner board to obtain access to the applicant's 
442.18 	records in this or any other state in which the applicant holds or previously held a credential 
442.19 	for the practice of an occupation, has completed an accredited occupational therapy education 
442.20 	program, or engaged in the practice of occupational therapy;
442.21 	(5) submit additional information as requested by the commissioner board; and
442.22 	(6) submit the additional information required for licensure by equivalency, licensure 
442.23 	by reciprocity, and temporary licensure as specified in sections 148.6408 to 148.6418.

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

442.25 	Sec. 18. Minnesota Statutes 2016, section 148.6420, subdivision 3, is amended to read:
442.26 		Subd. 3.Applicants certified by National Board for Certification in Occupational 
442.27 	Therapy. An applicant who is certified by the National Board for Certification in 
442.28 	Occupational Therapy must provide the materials required in subdivision 1 and the following:
442.29 	(1) verified documentation from the National Board for Certification in Occupational 
442.30 	Therapy stating that the applicant is certified as an occupational therapist, registered or 
442.31 	certified occupational therapy assistant, the date certification was granted, and the applicant's 
443.1 	certification number. The document must also include a statement regarding disciplinary 
443.2 	actions. The applicant is responsible for obtaining this documentation by sending a form 
443.3 	provided by the commissioner board to the National Board for Certification in Occupational 
443.4 	Therapy; and
443.5 	(2) a waiver authorizing the commissioner board to obtain access to the applicant's 
443.6 	records maintained by the National Board for Certification in Occupational Therapy.

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

443.8 	Sec. 19. Minnesota Statutes 2016, section 148.6420, subdivision 5, is amended to read:
443.9 		Subd. 5.Action on applications for licensure. (a) The commissioner board shall 
443.10 	approve, approve with conditions, or deny licensure. The commissioner board shall act on 
443.11 	an application for licensure according to paragraphs (b) to (d).
443.12 	(b) The commissioner board shall determine if the applicant meets the requirements for 
443.13 	licensure. The commissioner board, or the advisory council at the commissioner's board's
443.14 	request, may investigate information provided by an applicant to determine whether the 
443.15 	information is accurate and complete.
443.16 	(c) The commissioner board shall notify an applicant of action taken on the application 
443.17 	and, if licensure is denied or approved with conditions, the grounds for the commissioner's
443.18 	board's determination.
443.19 	(d) An applicant denied licensure or granted licensure with conditions may make a 
443.20 	written request to the commissioner board, within 30 days of the date of the commissioner's
443.21 	board's determination, for reconsideration of the commissioner's board's determination. 
443.22 	Individuals requesting reconsideration may submit information which the applicant wants 
443.23 	considered in the reconsideration. After reconsideration of the commissioner's board's
443.24 	determination to deny licensure or grant licensure with conditions, the commissioner board
443.25 	shall determine whether the original determination should be affirmed or modified. An 
443.26 	applicant is allowed no more than one request in any one biennial licensure period for 
443.27 	reconsideration of the commissioner's board's determination to deny licensure or approve 
443.28 	licensure with conditions.

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

443.30 	Sec. 20. Minnesota Statutes 2016, section 148.6423, is amended to read:
443.31 	148.6423 LICENSURE RENEWAL.
444.1 		Subdivision 1.Renewal requirements. To be eligible for licensure renewal, a licensee 
444.2 	must:
444.3 	(1) submit a completed and signed application for licensure renewal on forms provided 
444.4 	by the commissioner board;
444.5 	(2) submit the renewal fee required under section 148.6445;
444.6 	(3) submit proof of having met the continuing education requirement of section 148.6443
444.7 	on forms provided by the commissioner board; and
444.8 	(4) submit additional information as requested by the commissioner board to clarify 
444.9 	information presented in the renewal application. The information must be submitted within 
444.10 	30 days after the commissioner's board's request.
444.11 		Subd. 2.Renewal deadline. (a) Except as provided in paragraph (c), licenses must be 
444.12 	renewed every two years. Licensees must comply with the following procedures in paragraphs 
444.13 	(b) to (e):
444.14 	(b) Each license must state an expiration date. An application for licensure renewal must 
444.15 	be received by the Department of Health board or postmarked at least 30 calendar days 
444.16 	before the expiration date. If the postmark is illegible, the application shall be considered 
444.17 	timely if received at least 21 calendar days before the expiration date.
444.18 	(c) If the commissioner board changes the renewal schedule and the expiration date is 
444.19 	less than two years, the fee and the continuing education contact hours to be reported at the 
444.20 	next renewal must be prorated.
444.21 	(d) An application for licensure renewal not received within the time required under 
444.22 	paragraph (b), but received on or before the expiration date, must be accompanied by a late 
444.23 	fee in addition to the renewal fee specified by section 148.6445.
444.24 	(e) Licensure renewals received after the expiration date shall not be accepted and persons 
444.25 	seeking licensed status must comply with the requirements of section 148.6425.
444.26 		Subd. 3.Licensure renewal notice. At least 60 calendar days before the expiration date 
444.27 	in subdivision 2, the commissioner board shall mail a renewal notice to the licensee's last 
444.28 	known address on file with the commissioner board. The notice must include an application 
444.29 	for licensure renewal and notice of fees required for renewal. The licensee's failure to receive 
444.30 	notice does not relieve the licensee of the obligation to meet the renewal deadline and other 
444.31 	requirements for licensure renewal.

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

445.1 	Sec. 21. Minnesota Statutes 2016, section 148.6425, subdivision 2, is amended to read:
445.2 		Subd. 2.Licensure renewal after licensure expiration date. An individual whose 
445.3 	application for licensure renewal is received after the licensure expiration date must submit 
445.4 	the following:
445.5 	(1) a completed and signed application for licensure following lapse in licensed status 
445.6 	on forms provided by the commissioner board;
445.7 	(2) the renewal fee and the late fee required under section 148.6445;
445.8 	(3) proof of having met the continuing education requirements in section 148.6443, 
445.9 	subdivision 1; and
445.10 	(4) additional information as requested by the commissioner board to clarify information 
445.11 	in the application, including information to determine whether the individual has engaged 
445.12 	in conduct warranting disciplinary action as set forth in section 148.6448. The information 
445.13 	must be submitted within 30 days after the commissioner's board's request.

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

445.15 	Sec. 22. Minnesota Statutes 2016, section 148.6425, subdivision 3, is amended to read:
445.16 		Subd. 3.Licensure renewal four years or more after licensure expiration date. (a) 
445.17 	An individual who requests licensure renewal four years or more after the licensure expiration 
445.18 	date must submit the following:
445.19 	(1) a completed and signed application for licensure on forms provided by the 
445.20 	commissioner board;
445.21 	(2) the renewal fee and the late fee required under section 148.6445 if renewal application 
445.22 	is based on paragraph (b), clause (1), (2), or (3), or the renewal fee required under section 
445.23 	148.6445 if renewal application is based on paragraph (b), clause (4);
445.24 	(3) proof of having met the continuing education requirement in section 148.6443, 
445.25 	subdivision 1, except the continuing education must be obtained in the two years immediately 
445.26 	preceding application renewal; and
445.27 	(4) at the time of the next licensure renewal, proof of having met the continuing education 
445.28 	requirement, which shall be prorated based on the number of months licensed during the 
445.29 	two-year licensure period.
445.30 	(b) In addition to the requirements in paragraph (a), the applicant must submit proof of 
445.31 	one of the following:
446.1 	(1) verified documentation of successful completion of 160 hours of supervised practice 
446.2 	approved by the commissioner board as described in paragraph (c);
446.3 	(2) verified documentation of having achieved a qualifying score on the credentialing 
446.4 	examination for occupational therapists or the credentialing examination for occupational 
446.5 	therapy assistants administered within the past year;
446.6 	(3) documentation of having completed a combination of occupational therapy courses 
446.7 	or an occupational therapy refresher program that contains both a theoretical and clinical 
446.8 	component approved by the commissioner board. Only courses completed within one year 
446.9 	preceding the date of the application or one year after the date of the application qualify for 
446.10 	approval; or
446.11 	(4) evidence that the applicant holds a current and unrestricted credential for the practice 
446.12 	of occupational therapy in another jurisdiction and that the applicant's credential from that 
446.13 	jurisdiction has been held in good standing during the period of lapse.
446.14 	(c) To participate in a supervised practice as described in paragraph (b), clause (1), the 
446.15 	applicant shall obtain limited licensure. To apply for limited licensure, the applicant shall 
446.16 	submit the completed limited licensure application, fees, and agreement for supervision of 
446.17 	an occupational therapist or occupational therapy assistant practicing under limited licensure 
446.18 	signed by the supervising therapist and the applicant. The supervising occupational therapist 
446.19 	shall state the proposed level of supervision on the supervision agreement form provided 
446.20 	by the commissioner board. The supervising therapist shall determine the frequency and 
446.21 	manner of supervision based on the condition of the patient or client, the complexity of the 
446.22 	procedure, and the proficiencies of the supervised occupational therapist. At a minimum, a 
446.23 	supervising occupational therapist shall be on the premises at all times that the person 
446.24 	practicing under limited licensure is working; be in the room ten percent of the hours worked 
446.25 	each week by the person practicing under limited licensure; and provide daily face-to-face 
446.26 	collaboration for the purpose of observing service competency of the occupational therapist 
446.27 	or occupational therapy assistant, discussing treatment procedures and each client's response 
446.28 	to treatment, and reviewing and modifying, as necessary, each treatment plan. The supervising 
446.29 	therapist shall document the supervision provided. The occupational therapist participating 
446.30 	in a supervised practice is responsible for obtaining the supervision required under this 
446.31 	paragraph and must comply with the commissioner's board's requirements for supervision 
446.32 	during the entire 160 hours of supervised practice. The supervised practice must be completed 
446.33 	in two months and may be completed at the applicant's place of work.
447.1 	(d) In addition to the requirements in paragraphs (a) and (b), the applicant must submit 
447.2 	additional information as requested by the commissioner board to clarify information in the 
447.3 	application, including information to determine whether the applicant has engaged in conduct 
447.4 	warranting disciplinary action as set forth in section 148.6448. The information must be 
447.5 	submitted within 30 days after the commissioner's board's request.

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

447.7 	Sec. 23. Minnesota Statutes 2016, section 148.6428, is amended to read:
447.8 	148.6428 CHANGE OF NAME, ADDRESS, OR EMPLOYMENT.
447.9 	A licensee who changes a name, address, or employment must inform the commissioner
447.10 	board, in writing, of the change of name, address, employment, business address, or business 
447.11 	telephone number within 30 days. A change in name must be accompanied by a copy of a 
447.12 	marriage certificate or court order. All notices or other correspondence mailed to or served 
447.13 	on a licensee by the commissioner board at the licensee's address on file with the 
447.14 	commissioner board shall be considered as having been received by the licensee.

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

447.16 	Sec. 24. Minnesota Statutes 2016, section 148.6443, subdivision 5, is amended to read:
447.17 		Subd. 5.Reporting continuing education contact hours. Within one month following 
447.18 	licensure expiration, each licensee shall submit verification that the licensee has met the 
447.19 	continuing education requirements of this section on the continuing education report form 
447.20 	provided by the commissioner board. The continuing education report form may require 
447.21 	the following information:
447.22 	(1) title of continuing education activity;
447.23 	(2) brief description of the continuing education activity;
447.24 	(3) sponsor, presenter, or author;
447.25 	(4) location and attendance dates;
447.26 	(5) number of contact hours; and
447.27 	(6) licensee's notarized affirmation that the information is true and correct.

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

448.1 	Sec. 25. Minnesota Statutes 2016, section 148.6443, subdivision 6, is amended to read:
448.2 		Subd. 6.Auditing continuing education reports. (a) The commissioner board may 
448.3 	audit a percentage of the continuing education reports based on random selection. A licensee 
448.4 	shall maintain all documentation required by this section for two years after the last day of 
448.5 	the biennial licensure period in which the contact hours were earned.
448.6 	(b) All renewal applications that are received after the expiration date may be subject 
448.7 	to a continuing education report audit.
448.8 	(c) Any licensee against whom a complaint is filed may be subject to a continuing 
448.9 	education report audit.
448.10 	(d) The licensee shall make the following information available to the commissioner
448.11 	board for auditing purposes:
448.12 	(1) a copy of the completed continuing education report form for the continuing education 
448.13 	reporting period that is the subject of the audit including all supporting documentation 
448.14 	required by subdivision 5;
448.15 	(2) a description of the continuing education activity prepared by the presenter or sponsor 
448.16 	that includes the course title or subject matter, date, place, number of program contact hours, 
448.17 	presenters, and sponsors;
448.18 	(3) documentation of self-study programs by materials prepared by the presenter or 
448.19 	sponsor that includes the course title, course description, name of sponsor or author, and 
448.20 	the number of hours required to complete the program;
448.21 	(4) documentation of university, college, or vocational school courses by a course 
448.22 	syllabus, listing in a course bulletin, or equivalent documentation that includes the course 
448.23 	title, instructor's name, course dates, number of contact hours, and course content, objectives, 
448.24 	or goals; and
448.25 	(5) verification of attendance by:
448.26 	(i) a signature of the presenter or a designee at the continuing education activity on the 
448.27 	continuing education report form or a certificate of attendance with the course name, course 
448.28 	date, and licensee's name;
448.29 	(ii) a summary or outline of the educational content of an audio or video educational 
448.30 	activity to verify the licensee's participation in the activity if a designee is not available to 
448.31 	sign the continuing education report form;
449.1 	(iii) verification of self-study programs by a certificate of completion or other 
449.2 	documentation indicating that the individual has demonstrated knowledge and has 
449.3 	successfully completed the program; or
449.4 	(iv) verification of attendance at a university, college, or vocational course by an official 
449.5 	transcript.

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

449.7 	Sec. 26. Minnesota Statutes 2016, section 148.6443, subdivision 7, is amended to read:
449.8 		Subd. 7.Waiver of continuing education requirements. The commissioner board may 
449.9 	grant a waiver of the requirements of this section in cases where the requirements would 
449.10 	impose an extreme hardship on the licensee. The request for a waiver must be in writing, 
449.11 	state the circumstances that constitute extreme hardship, state the period of time the licensee 
449.12 	wishes to have the continuing education requirement waived, and state the alternative 
449.13 	measures that will be taken if a waiver is granted. The commissioner board shall set forth, 
449.14 	in writing, the reasons for granting or denying the waiver. Waivers granted by the 
449.15 	commissioner board shall specify, in writing, the time limitation and required alternative 
449.16 	measures to be taken by the licensee. A request for waiver shall be denied if the commissioner
449.17 	board finds that the circumstances stated by the licensee do not support a claim of extreme 
449.18 	hardship, the requested time period for waiver is unreasonable, the alternative measures 
449.19 	proposed by the licensee are not equivalent to the continuing education activity being waived, 
449.20 	or the request for waiver is not submitted to the commissioner board within 60 days after 
449.21 	the expiration date.

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

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

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

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

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

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

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

450.14 	Sec. 30. Minnesota Statutes 2016, section 148.6448, is amended to read:
450.15 	148.6448 GROUNDS FOR DENIAL OF LICENSURE OR DISCIPLINE; 
450.16 	INVESTIGATION PROCEDURES; DISCIPLINARY ACTIONS.
450.17 		Subdivision 1.Grounds for denial of licensure or discipline. The commissioner board
450.18 	may deny an application for licensure, may approve licensure with conditions, or may 
450.19 	discipline a licensee using any disciplinary actions listed in subdivision 3 on proof that the 
450.20 	individual has:
450.21 	(1) intentionally submitted false or misleading information to the commissioner board
450.22 	or the advisory council;
450.23 	(2) failed, within 30 days, to provide information in response to a written request by the 
450.24 	commissioner board or advisory council;
450.25 	(3) performed services of an occupational therapist or occupational therapy assistant in 
450.26 	an incompetent manner or in a manner that falls below the community standard of care;
450.27 	(4) failed to satisfactorily perform occupational therapy services during a period of 
450.28 	temporary licensure;
450.29 	(5) violated sections 148.6401 to 148.6450;
451.1 	(6) failed to perform services with reasonable judgment, skill, or safety due to the use 
451.2 	of alcohol or drugs, or other physical or mental impairment;
451.3 	(7) been convicted of violating any state or federal law, rule, or regulation which directly 
451.4 	relates to the practice of occupational therapy;
451.5 	(8) aided or abetted another person in violating any provision of sections 148.6401 to 
451.6 	148.6450;
451.7 	(9) been disciplined for conduct in the practice of an occupation by the state of Minnesota, 
451.8 	another jurisdiction, or a national professional association, if any of the grounds for discipline 
451.9 	are the same or substantially equivalent to those in sections 148.6401 to 148.6450;
451.10 	(10) not cooperated with the commissioner or advisory council board in an investigation 
451.11 	conducted according to subdivision 2;
451.12 	(11) advertised in a manner that is false or misleading;
451.13 	(12) engaged in dishonest, unethical, or unprofessional conduct in connection with the 
451.14 	practice of occupational therapy that is likely to deceive, defraud, or harm the public;
451.15 	(13) demonstrated a willful or careless disregard for the health, welfare, or safety of a 
451.16 	client;
451.17 	(14) performed medical diagnosis or provided treatment, other than occupational therapy, 
451.18 	without being licensed to do so under the laws of this state;
451.19 	(15) paid or promised to pay a commission or part of a fee to any person who contacts 
451.20 	the occupational therapist for consultation or sends patients to the occupational therapist 
451.21 	for treatment;
451.22 	(16) engaged in an incentive payment arrangement, other than that prohibited by clause 
451.23 	(15), that promotes occupational therapy overutilization, whereby the referring person or 
451.24 	person who controls the availability of occupational therapy services to a client profits 
451.25 	unreasonably as a result of client treatment;
451.26 	(17) engaged in abusive or fraudulent billing practices, including violations of federal 
451.27 	Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical 
451.28 	assistance laws;
451.29 	(18) obtained money, property, or services from a consumer through the use of undue 
451.30 	influence, high pressure sales tactics, harassment, duress, deception, or fraud;
451.31 	(19) performed services for a client who had no possibility of benefiting from the services;
452.1 	(20) failed to refer a client for medical evaluation when appropriate or when a client 
452.2 	indicated symptoms associated with diseases that could be medically or surgically treated;
452.3 	(21) engaged in conduct with a client that is sexual or may reasonably be interpreted by 
452.4 	the client as sexual, or in any verbal behavior that is seductive or sexually demeaning to a 
452.5 	patient;
452.6 	(22) violated a federal or state court order, including a conciliation court judgment, or 
452.7 	a disciplinary order issued by the commissioner board, related to the person's occupational 
452.8 	therapy practice; or
452.9 	(23) any other just cause related to the practice of occupational therapy.
452.10 		Subd. 2.Investigation of complaints. The commissioner, or the advisory council when 
452.11 	authorized by the commissioner, board may initiate an investigation upon receiving a 
452.12 	complaint or other oral or written communication that alleges or implies that a person has 
452.13 	violated sections 148.6401 to 148.6450. In the receipt, investigation, and hearing of a 
452.14 	complaint that alleges or implies a person has violated sections 148.6401 to 148.6450, the 
452.15 	commissioner board shall follow the procedures in section 214.10.
452.16 		Subd. 3.Disciplinary actions. If the commissioner board finds that an occupational 
452.17 	therapist or occupational therapy assistant should be disciplined according to subdivision 
452.18 	1, the commissioner board may take any one or more of the following actions:
452.19 	(1) refuse to grant or renew licensure;
452.20 	(2) approve licensure with conditions;
452.21 	(3) revoke licensure;
452.22 	(4) suspend licensure;
452.23 	(5) any reasonable lesser action including, but not limited to, reprimand or restriction 
452.24 	on licensure; or
452.25 	(6) any action authorized by statute.
452.26 		Subd. 4.Effect of specific disciplinary action on use of title. Upon notice from the 
452.27 	commissioner board denying licensure renewal or upon notice that disciplinary actions have 
452.28 	been imposed and the person is no longer entitled to practice occupational therapy and use 
452.29 	the occupational therapy and licensed titles, the person shall cease to practice occupational 
452.30 	therapy, to use titles protected by sections 148.6401 to 148.6450, and to represent to the 
452.31 	public that the person is licensed by the commissioner board.
453.1 		Subd. 5.Reinstatement requirements after disciplinary action. A person who has 
453.2 	had licensure suspended may request and provide justification for reinstatement following 
453.3 	the period of suspension specified by the commissioner board. The requirements of sections 
453.4 	148.6423 and 148.6425 for renewing licensure and any other conditions imposed with the 
453.5 	suspension must be met before licensure may be reinstated.
453.6 		Subd. 6.Authority to contract.  The commissioner board shall contract with the health 
453.7 	professionals services program as authorized by sections 214.31 to 214.37 to provide these 
453.8 	services to practitioners under this chapter. The health professionals services program does 
453.9 	not affect the commissioner's board's authority to discipline violations of sections 148.6401
453.10 	to 148.6450.

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

453.12 	Sec. 31. [148.6449] BOARD OF OCCUPATIONAL THERAPY PRACTICE.
453.13 		Subdivision 1.Creation. The Board of Occupational Therapy Practice consists of 11 
453.14 	members appointed by the governor. The members are:
453.15 	(1) five occupational therapists licensed under sections 148.6401 to 148.6449;
453.16 	(2) three occupational therapy assistants licensed under sections 148.6401 to 148.6449; 
453.17 	and
453.18 	(3) three public members, including two members who have received occupational 
453.19 	therapy services or have a family member who has received occupational therapy services, 
453.20 	and one member who is a health care professional or health care provider licensed in 
453.21 	Minnesota.
453.22 		Subd. 2.Qualifications of board members. (a) The occupational therapy practitioners 
453.23 	appointed to the board must represent a variety of practice areas and settings.
453.24 	(b) At least two occupational therapy practitioners must be employed outside the 
453.25 	seven-county metropolitan area.
453.26 	(c) Board members shall serve for not more than two consecutive terms.
453.27 		Subd. 3.Recommendations for appointment. Prior to the end of the term of a member 
453.28 	of the board, or within 60 days after a position on the board becomes vacant, the Minnesota 
453.29 	Occupational Therapy Association and other interested persons and organizations may 
453.30 	recommend to the governor members qualified to serve on the board. The governor may 
453.31 	appoint members to the board from the list of persons recommended or from among other 
453.32 	qualified candidates.
454.1 		Subd. 4.Officers. The board shall biennially elect from its membership a chair, vice-chair, 
454.2 	and secretary-treasurer. Each officer shall serve until a successor is elected.
454.3 		Subd. 5.Executive director. The board shall appoint and employ an executive director 
454.4 	who is not a member of the board. The employment of the executive director shall be subject 
454.5 	to the terms described in section 214.04, subdivision 2a.
454.6 		Subd. 6.Terms; compensation; removal of members. Membership terms, compensation 
454.7 	of members, removal of members, the filling of membership vacancies, and fiscal year and 
454.8 	reporting requirements shall be as provided in chapter 214. The provision of staff, 
454.9 	administrative services, and office space; the review and processing of complaints; the 
454.10 	setting of board fees; and other activities relating to board operations shall be conducted 
454.11 	according to chapter 214.
454.12 		Subd. 7.Duties of the Board of Occupational Therapy Practice. (a) The board shall:
454.13 	(1) adopt and enforce rules and laws necessary for licensing occupational therapy 
454.14 	practitioners;
454.15 	(2) adopt and enforce rules for regulating the professional conduct of the practice of 
454.16 	occupational therapy;
454.17 	(3) issue licenses to qualified individuals in accordance with sections 148.6401 to 
454.18 	148.6449;
454.19 	(4) assess and collect fees for the issuance and renewal of licenses;
454.20 	(5) educate the public about the requirements for licensing occupational therapy 
454.21 	practitioners, educate occupational therapy practitioners about the rules of conduct, and 
454.22 	enable the public to file complaints against applicants and licensees who may have violated 
454.23 	sections 148.6401 to 148.6449; and
454.24 	(6) investigate individuals engaging in practices that violate sections 148.6401 to 
454.25 	148.6449 and take necessary disciplinary, corrective, or other action according to section 
454.26 	148.6448.
454.27 	(b) The board may adopt rules necessary to define standards or carry out the provisions 
454.28 	of sections 148.6401 to 148.6449. Rules shall be adopted according to chapter 14.

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

455.1 	Sec. 32. Minnesota Statutes 2016, section 214.01, subdivision 2, is amended to read:
455.2 		Subd. 2.Health-related licensing board. "Health-related licensing board" means the 
455.3 	Board of Examiners of Nursing Home Administrators established pursuant to section 
455.4 	144A.19, the Office of Unlicensed Complementary and Alternative Health Care Practice 
455.5 	established pursuant to section 146A.02, the Board of Medical Practice created pursuant to 
455.6 	section 147.01, the Board of Nursing created pursuant to section 148.181, the Board of 
455.7 	Chiropractic Examiners established pursuant to section 148.02, the Board of Optometry 
455.8 	established pursuant to section 148.52, the Board of Occupational Therapy Practice 
455.9 	established pursuant to section 148.6449, the Board of Physical Therapy established pursuant 
455.10 	to section 148.67, the Board of Psychology established pursuant to section 148.90, the Board 
455.11 	of Social Work pursuant to section 148E.025, the Board of Marriage and Family Therapy 
455.12 	pursuant to section 148B.30, the Board of Behavioral Health and Therapy established by 
455.13 	section 148B.51, the Board of Dietetics and Nutrition Practice established under section 
455.14 	148.622, the Board of Dentistry established pursuant to section 150A.02, the Board of 
455.15 	Pharmacy established pursuant to section 151.02, the Board of Podiatric Medicine established 
455.16 	pursuant to section 153.02, and the Board of Veterinary Medicine established pursuant to 
455.17 	section 156.01.

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

455.19 	Sec. 33. BOARD OF OCCUPATIONAL THERAPY PRACTICE.
 455.20 	The governor shall appoint all members to the Board of Occupational Therapy Practice 
455.21 	under Minnesota Statutes, section 148.6449, by October 1, 2017. The governor shall designate 
455.22 	one member of the board to convene the first meeting of the board by November 1, 2017. 
455.23 	The board shall elect officers at its first meeting.

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

455.25 	Sec. 34. REVISOR'S INSTRUCTION.
 455.26 	In Minnesota Statutes, the revisor of statutes shall replace references to Minnesota 
455.27 	Statutes, section 148.6450, with Minnesota Statutes, section 148.6449.

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

455.29 	Sec. 35.  REPEALER.
 455.30 	(a) Minnesota Statutes 2016, sections 147A.21; 147B.08, subdivisions 1, 2, and 3; 
455.31 	147C.40, subdivisions 1, 2, 3, and 4; 148.6402, subdivision 2; and 148.6450, are repealed.
456.1 	(b) Minnesota Rules, part 5600.2500, is repealed.

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

456.3 	ARTICLE 12
456.4 	HUMAN SERVICES FORECAST ADJUSTMENTS

456.5	Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
 	
456.6 	The dollar amounts shown are added to or, if shown in parentheses, are subtracted from 
456.7 	the appropriations in Laws 2015, chapter 71, article 14, as amended by Laws 2016, chapter 
456.8 	189, articles 22 and 23, from the general fund, or any other fund named, to the Department 
456.9 	of Human Services for the purposes specified in this article, to be available for the fiscal 
456.10 	years indicated for each purpose. The figure "2017" used in this article means that the 
456.11 	appropriations listed are available for the fiscal year ending June 30, 2017.

456.12				APPROPRIATIONS
	
456.13				Available for the Year
	
456.14				Ending June 30
	
456.15					2017

456.16
456.17	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

456.18	Subdivision 1.Total Appropriation
 	$
	(342,045,000)

456.19	Appropriations by Fund
	
456.20		2017
		
456.21	General Fund
	(198,450,000)
		
456.22	Health Care Access
	(146,590,000)
		
456.23	TANF
	2,995,000

456.24	Subd. 2.Forecasted Programs
 					
456.25	(a) MFIP/DWP Grants

456.26	Appropriations by Fund
	
456.27	General Fund
	(2,111,000)
		
456.28	TANF
	2,579,000

456.29	(b) MFIP Child Care Assistance Grants
		(6,513,000)

456.30	(c) General Assistance Grants
		(4,219,000)

456.31	(d) Minnesota Supplemental Aid Grants
		(581,000)

456.32	(e) Group Residential Housing Grants
		(533,000)

457.1	(f) Northstar Care for Children
		2,613,000

457.2	(g) MinnesotaCare Grants
		(145,883,000)
			
457.3 	This appropriation is from the health care 
457.4 	access fund.

457.5	(h) Medical Assistance Grants

457.6	Appropriations by Fund
	
457.7	General Fund
	(192,744,000)
		
457.8	Health Care Access
	(707,000)

457.9	(i) Alternative Care Grants
		-0-

457.10	(j) CD Entitlement Grants
		5,638,000

457.11	Subd. 3.Technical Activities
 		416,000
			
457.12 	This appropriation is from the TANF fund.

457.13 	Sec. 3. EFFECTIVE DATE.
 457.14 	Sections 1 and 2 are effective the day following final enactment.

457.15 	ARTICLE 13
457.16 	APPROPRIATIONS

457.17	Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.
 	
457.18 	The sums shown in the columns marked "Appropriations" are appropriated to the agencies 
457.19 	and for the purposes specified in this article. The appropriations are from the general fund, 
457.20 	or another named fund, and are available for the fiscal years indicated for each purpose. 
457.21 	The figures "2018" and "2019" used in this article mean that the appropriations listed under 
457.22 	them are available for the fiscal year ending June 30, 2018, or June 30, 2019, respectively. 
457.23 	"The first year" is fiscal year 2018. "The second year" is fiscal year 2019. "The biennium" 
457.24 	is fiscal years 2018 and 2019.

457.25				APPROPRIATIONS
	
457.26				Available for the Year
	
457.27				Ending June 30
	
457.28					2018
		2019

458.1
458.2	Sec. 2. COMMISSIONER OF HUMAN 
SERVICES

458.3	Subdivision 1.Total Appropriation
 	$
	7,446,117,000
	$
	7,512,091,000

458.4	Appropriations by Fund
	
458.5		2018
	2019
	
458.6	General
	6,892,691,000
	6,948,938,000
	
458.7
458.8	State Government 
Special Revenue
	4,274,000
	4,274,000
	
458.9	Health Care Access
	270,320,000
	286,281,000
	
458.10	Federal TANF
	276,936,000
	270,702,000
	
458.11	Lottery Prize
	1,896,000
	1,896,000
	
458.12 	The amounts that may be spent for each 
458.13 	purpose are specified in the following 
458.14 	subdivisions.

458.15	Subd. 2.TANF Maintenance of Effort
 					
458.16 	(a) The commissioner shall ensure that 
458.17 	sufficient qualified nonfederal expenditures 
458.18 	are made each year to meet the state's 
458.19 	maintenance of effort (MOE) requirements of 
458.20 	the TANF block grant specified under Code 
458.21 	of Federal Regulations, title 45, section 263.1. 
458.22 	In order to meet these basic TANF/MOE 
458.23 	requirements, the commissioner may report 
458.24 	as TANF/MOE expenditures only nonfederal 
458.25 	money expended for allowable activities listed 
458.26 	in the following clauses:
458.27 	(1) MFIP cash, diversionary work program, 
458.28 	and food assistance benefits under Minnesota 
458.29 	Statutes, chapter 256J;
458.30 	(2) the child care assistance programs under 
458.31 	Minnesota Statutes, sections 119B.03 and 
458.32 	119B.05, and county child care administrative 
458.33 	costs under Minnesota Statutes, section 
458.34 	119B.15;
459.1 	(3) state and county MFIP administrative costs 
459.2 	under Minnesota Statutes, chapters 256J and 
459.3 	256K;
459.4 	(4) state, county, and tribal MFIP employment 
459.5 	services under Minnesota Statutes, chapters 
459.6 	256J and 256K;
459.7 	(5) expenditures made on behalf of legal 
459.8 	noncitizen MFIP recipients who qualify for 
459.9 	the MinnesotaCare program under Minnesota 
459.10 	Statutes, chapter 256L;
459.11 	(6) qualifying working family credit 
459.12 	expenditures under Minnesota Statutes, section 
459.13 	290.0671;
459.14 	(7) qualifying Minnesota education credit 
459.15 	expenditures under Minnesota Statutes, section 
459.16 	290.0674; and
459.17 	(8) qualifying Head Start expenditures under 
459.18 	Minnesota Statutes, section 119A.50.
459.19 	(b) For the activities listed in paragraph (a), 
459.20 	clauses (2) to (8), the commissioner may 
459.21 	report only expenditures that are excluded 
459.22 	from the definition of assistance under Code 
459.23 	of Federal Regulations, title 45, section 
459.24 	260.31.
459.25 	(c) The commissioner shall ensure that the 
459.26 	MOE used by the commissioner of 
459.27 	management and budget for the February and 
459.28 	November forecasts required under Minnesota 
459.29 	Statutes, section 16A.103, contains 
459.30 	expenditures under paragraph (a), clause (1), 
459.31 	equal to at least 16 percent of the total required 
459.32 	under Code of Federal Regulations, title 45, 
459.33 	section 263.1.
460.1 	(d) The commissioner may not claim an 
460.2 	amount of TANF/MOE in excess of the 75 
460.3 	percent standard in Code of Federal 
460.4 	Regulations, title 45, section 263.1(a)(2), 
460.5 	except:
460.6 	(1) to the extent necessary to meet the 80 
460.7 	percent standard under Code of Federal 
460.8 	Regulations, title 45, section 263.1(a)(1), if it 
460.9 	is determined by the commissioner that the 
460.10 	state will not meet the TANF work 
460.11 	participation target rate for the current year;
460.12 	(2) to provide any additional amounts under 
460.13 	Code of Federal Regulations, title 45, section 
460.14 	264.5, that relate to replacement of TANF 
460.15 	funds due to the operation of TANF penalties; 
460.16 	and
460.17 	(3) to provide any additional amounts that may 
460.18 	contribute to avoiding or reducing TANF work 
460.19 	participation penalties through the operation 
460.20 	of the excess MOE provisions of Code of 
460.21 	Federal Regulations, title 45, section 261.43 
460.22 	(a)(2).
460.23 	(e) For the purposes of paragraph (d), the 
460.24 	commissioner may supplement the MOE claim 
460.25 	with working family credit expenditures or 
460.26 	other qualified expenditures to the extent such 
460.27 	expenditures are otherwise available after 
460.28 	considering the expenditures allowed in this 
460.29 	subdivision.
460.30 	(f) The requirement in Minnesota Statutes, 
460.31 	section 256.011, subdivision 3, that federal 
460.32 	grants or aids secured or obtained under that 
460.33 	subdivision be used to reduce any direct 
461.1 	appropriations provided by law, does not apply 
461.2 	if the grants or aids are federal TANF funds.
461.3 	(g) IT Appropriations Generally. This 
461.4 	appropriation includes funds for information 
461.5 	technology projects, services, and support. 
461.6 	Notwithstanding Minnesota Statutes, section 
461.7 	16E.0466, funding for information technology 
461.8 	project costs shall be incorporated into the 
461.9 	service level agreement and paid to the Office 
461.10 	of MN.IT Services by the Department of 
461.11 	Human Services under the rates and 
461.12 	mechanism specified in that agreement.
461.13 	(h) Receipts for Systems Project.
461.14 	Appropriations and federal receipts for 
461.15 	information systems projects for MAXIS, 
461.16 	PRISM, MMIS, ISDS, METS, and SSIS must 
461.17 	be deposited in the state systems account 
461.18 	authorized in Minnesota Statutes, section 
461.19 	256.014. Money appropriated for computer 
461.20 	projects approved by the commissioner of the 
461.21 	Office of MN.IT Services, funded by the 
461.22 	legislature, and approved by the commissioner 
461.23 	of management and budget may be transferred 
461.24 	from one project to another and from 
461.25 	development to operations as the 
461.26 	commissioner of human services considers 
461.27 	necessary. Any unexpended balance in the 
461.28 	appropriation for these projects does not 
461.29 	cancel and is available for ongoing 
461.30 	development and operations.

461.31	Subd. 3.Central Office; Operations

461.32	Appropriations by Fund
	
461.33	General
	108,954,000
	107,626,000
	
461.34
461.35	State Government 
Special Revenue
	4,149,000
	4,149,000
	
461.36	Health Care Access
	20,025,000
	20,025,000
	
462.1	Federal TANF
	100,000
	100,000
	
462.2 	(a) Administrative Recovery; Set-Aside. The 
462.3 	commissioner may invoice local entities 
462.4 	through the SWIFT accounting system as an 
462.5 	alternative means to recover the actual cost of 
462.6 	administering the following provisions:
462.7 	(1) Minnesota Statutes, section 125A.744, 
462.8 	subdivision 3;
462.9 	(2) Minnesota Statutes, section 245.495, 
462.10 	paragraph (b);
462.11 	(3) Minnesota Statutes, section 256B.0625, 
462.12 	subdivision 20, paragraph (k);
462.13 	(4) Minnesota Statutes, section 256B.0924, 
462.14 	subdivision 6, paragraph (g);
462.15 	(5) Minnesota Statutes, section 256B.0945, 
462.16 	subdivision 4, paragraph (d); and
462.17 	(6) Minnesota Statutes, section 256F.10, 
462.18 	subdivision 6, paragraph (b).
462.19 	(b) Vulnerable Adults Complaints Case 
462.20 	Management System. $258,000 in fiscal year 
462.21 	2018 is from the general fund for the Office 
462.22 	of Inspector General to implement a case 
462.23 	management system for tracking and 
462.24 	managing complaints and investigations 
462.25 	involving vulnerable adults. In consultation 
462.26 	with the Department of Health, Office of 
462.27 	Health Facility Complaints, the Office of 
462.28 	Inspector General shall ensure that the case 
462.29 	management system is capable of:
462.30 	(1) uniquely tracking each complaint received 
462.31 	by the Office of Inspector General and the 
462.32 	Office of Health Facility Complaints, whether 
462.33 	the complaint is received through the 
463.1 	Minnesota Adult Abuse Reporting Center, by 
463.2 	telephone, by referral from another agency or 
463.3 	division, or by any other means;
463.4 	(2) linking each complaint to any and all 
463.5 	investigations related to that complaint;
463.6 	(3) tracking and coordinating referrals and 
463.7 	communication between state agencies, 
463.8 	including the Office of Ombudsman for 
463.9 	Long-Term Care and the Office of 
463.10 	Ombudsman for Mental Health and 
463.11 	Developmental Disabilities; and
463.12 	(4) securing data as required under the 
463.13 	Vulnerable Adults Act and the Government 
463.14 	Data Practices Act.
463.15 	Products and services for the case management 
463.16 	system design, implementation, and 
463.17 	application hosting must be acquired using a 
463.18 	request for proposals.  This is a onetime 
463.19 	appropriation and is available until June 30, 
463.20 	2019.
463.21 	(c) Transfer to Office of Legislative Auditor.
463.22 	$600,000 in fiscal year 2018 and $600,000 in 
463.23 	fiscal year 2019 are for transfer to the Office 
463.24 	of the Legislative Auditor for audit activities 
463.25 	under Minnesota Statutes, section 3.972, 
463.26 	subdivision 2b.
463.27 	(d) Base Level Adjustment. The general fund 
463.28 	base is $104,288,000 in fiscal year 2020 and 
463.29 	$104,219,000 in fiscal year 2021.

463.30	Subd. 4.Central Office; Children and Families

463.31	Appropriations by Fund
	
463.32	General
	8,892,000
	8,648,000
	
463.33	Federal TANF
	2,582,000
	2,582,000
	
464.1 	(a) Financial Institution Data Match and 
464.2 	Payment of Fees. The commissioner is 
464.3 	authorized to allocate up to $310,000 each 
464.4 	year in fiscal year 2018 and fiscal year 2019 
464.5 	from the systems special revenue account to 
464.6 	make payments to financial institutions in 
464.7 	exchange for performing data matches 
464.8 	between account information held by financial 
464.9 	institutions and the public authority's database 
464.10 	of child support obligors as authorized by 
464.11 	Minnesota Statutes, section 13B.06, 
464.12 	subdivision 7.
464.13 	(b) Base Level Adjustment. The general fund 
464.14 	base is $8,588,000 in fiscal year 2020 and 
464.15 	$8,588,000 in fiscal year 2021.

464.16	Subd. 5.Central Office; Health Care

464.17	Appropriations by Fund
	
464.18	General
	16,998,000
	22,340,000
	
464.19	Health Care Access
	23,697,000
	23,804,000
	
464.20 	(a) Trust Guide. $200,000 in fiscal year 2018 
464.21 	and $150,000 in fiscal year 2019 are for the 
464.22 	development of a special needs trust guide that 
464.23 	directs the state medical assistance program's 
464.24 	trust recovery process and establishes 
464.25 	guidelines for the public. This is a onetime 
464.26 	appropriation.
464.27 	(b) Integrated Health Partnership Health 
464.28 	Information Exchange. $125,000 in fiscal 
464.29 	year 2018 and $250,000 in fiscal year 2019 
464.30 	are from the general fund to contract with 
464.31 	state-certified health information exchange 
464.32 	vendors to support providers participating in 
464.33 	an integrated health partnership under 
464.34 	Minnesota Statutes, section 256B.0755, to 
464.35 	connect enrollees with community supports 
465.1 	and social services and improve collaboration 
465.2 	among participating and authorized providers.
465.3 	(c) Base Level Adjustment. The general fund 
465.4 	base is $27,444,000 in fiscal year 2020 and 
465.5 	$27,677,000 in fiscal year 2021.

465.6
465.7	Subd. 6.Central Office; Continuing Care for 
Older Adults

465.8	Appropriations by Fund
	
465.9	General
	14,180,000
	13,951,000
	
465.10
465.11	State Government 
Special Revenue
	125,000
	125,000
	
465.12 	Base Level Adjustment. The general fund 
465.13 	base is$13,909,000 in fiscal year 2020 and 
465.14 	$13,909,000 in fiscal year 2021.

465.15	Subd. 7.Central Office; Community Supports

465.16	Appropriations by Fund
	
465.17	General
	25,251,000
	25,273,000
	
465.18	Lottery Prize
	163,000
	163,000
	
465.19 	(a) Transportation Study. $250,000 in fiscal 
465.20 	year 2018 and $250,000 in fiscal year 2019 
465.21 	are for the transportation study required under 
465.22 	article 1, section 43. This is a onetime 
465.23 	appropriation.
465.24 	(b) Deaf and Hard-of-Hearing Services. (a) 
465.25 	$850,000 in fiscal year 2018 and $700,000 in 
465.26 	fiscal year 2019 are from the general fund for 
465.27 	the Deaf and Hard-of-Hearing Division under 
465.28 	Minnesota Statutes, section 256C.233. 
465.29 	$150,000 of this appropriation must be used 
465.30 	for technology improvements, technology 
465.31 	support, and training for staff on the use of 
465.32 	technology for external facing services to 
465.33 	implement Minnesota Statutes, section 
465.34 	256C.24, subdivision 2, clause (12).
466.1 	(c) Substance Use Disorder System Study. 
466.2 	$150,000 in fiscal year 2018 and $150,000 in 
466.3 	fiscal year 2019 are for a substance use 
466.4 	disorder system study. This is a onetime 
466.5 	appropriation.
466.6 	(d) Base Level Adjustment. The general fund 
466.7 	base is $24,650,000 in fiscal year 2020 and 
466.8 	$24,533,000 in fiscal year 2021.

466.9	Subd. 8.Forecasted Programs; MFIP/DWP

466.10	Appropriations by Fund
	
466.11	General
	88,530,000
	97,912,000
	
466.12	Federal TANF
	94,617,000
	88,230,000

466.13
466.14	Subd. 9.Forecasted Programs; MFIP Child Care 
Assistance
 		107,385,000
		103,760,000

466.15
466.16	Subd. 10.Forecasted Programs; General 
Assistance
 		55,536,000
		57,221,000
	
466.17 	(a) General Assistance Standard. The 
466.18 	commissioner shall set the monthly standard 
466.19 	of assistance for general assistance units 
466.20 	consisting of an adult recipient who is 
466.21 	childless and unmarried or living apart from 
466.22 	parents or a legal guardian at $203. The 
466.23 	commissioner may reduce this amount 
466.24 	according to Laws 1997, chapter 85, article 3, 
466.25 	section 54.
466.26 	(b) Emergency General Assistance Limit.
466.27 	The amount appropriated for emergency 
466.28 	general assistance is limited to no more than 
466.29 	$6,729,812 in fiscal year 2018 and $6,729,812 
466.30 	in fiscal year 2019. Funds to counties shall be 
466.31 	allocated by the commissioner using the 
466.32 	allocation method under Minnesota Statutes, 
466.33 	section 256D.06.

466.34
466.35	Subd. 11.Forecasted Programs; Minnesota 
Supplemental Aid
 		40,484,000
		41,634,000

467.1
467.2	Subd. 12.Forecasted Programs; Group 
Residential Housing
 		170,337,000
		180,668,000

467.3
467.4	Subd. 13.Forecasted Programs; Northstar Care 
for Children
 		80,542,000
		96,433,000

467.5	Subd. 14.Forecasted Programs; MinnesotaCare
 		12,224,000
		13,308,000
	
467.6 	This appropriation is from the health care 
467.7 	access fund.

467.8
467.9	Subd. 15.Forecasted Programs; Medical 
Assistance

467.10	Appropriations by Fund
	
467.11	General
	5,307,745,000
	5,307,287,000
	
467.12	Health Care Access
	210,159,000
	224,929,000
	
467.13 	(a) Behavioral Health Services. $1,000,000 
467.14 	in fiscal year 2018 and $1,000,000 in fiscal 
467.15 	year 2019 are for behavioral health services 
467.16 	provided by hospitals identified under 
467.17 	Minnesota Statutes, section 256.969, 
467.18 	subdivision 2b, paragraph (a), clause (4). The 
467.19 	increase in payments shall be made by 
467.20 	increasing the adjustment under Minnesota 
467.21 	Statutes, section 256.969, subdivision 2b, 
467.22 	paragraph (e), clause (2).
467.23 	(b) Reform of MnCHOICES 
467.24 	Administration.The commissioner of human 
467.25 	services shall reduce expenditures for 
467.26 	MnCHOICES by $30,753,000 in fiscal year 
467.27 	2018 and $30,753,000 in fiscal year 2019. To 
467.28 	accomplish this reduction in expenditures, the 
467.29 	commissioner shall permit lead agencies as 
467.30 	defined in Minnesota Statutes, section 
467.31 	256B.0911, subdivision 1a, paragraph (e), to 
467.32 	substitute to the greatest extent permitted 
467.33 	under federal law, service updates under 
467.34 	Minnesota Statutes, section 256B.0911, 
467.35 	subdivision 3f, for reassessments required 
467.36 	under Minnesota Statutes, sections 256B.0659, 
468.1 	256B.0911, 256B.0915, 256B.092, 256B.49, 
468.2 	and 256B.85, when there is not a significant 
468.3 	change in the recipient's condition or need.

468.4
468.5	Subd. 16.Forecasted Programs; Alternative 
Care
 		44,587,000
		45,477,000
	
468.6 	Alternative Care Transfer. Any money 
468.7 	allocated to the alternative care program that 
468.8 	is not spent for the purposes indicated does 
468.9 	not cancel but must be transferred to the 
468.10 	medical assistance account.

468.11
468.12	Subd. 17.Forecasted Programs; Chemical 
Dependency Treatment Fund
 		116,213,000
		135,079,000

468.13
468.14	Subd. 18.Grant Programs; Support Services 
Grants

468.15	Appropriations by Fund
	
468.16	General
	8,715,000
	8,715,000
	
468.17	Federal TANF
	93,311,000
	93,311,000

468.18
468.19	Subd. 19.Grant Programs; Basic Sliding Fee 
Child Care Assistance Grants
 		51,945,000
		48,635,000
	
468.20 	Base Level Adjustment. The general fund 
468.21 	base is $48,708,000 in fiscal year 2020 and 
468.22 	$48,780,000 in fiscal year 2021.

468.23
468.24	Subd. 20.Grant Programs; Child Care 
Development Grants
 		1,737,000
		1,737,000

468.25
468.26	Subd. 21.Grant Programs; Child Support 
Enforcement Grants
 		50,000
		50,000

468.27
468.28	Subd. 22.Grant Programs; Children's Services 
Grants

468.29	Appropriations by Fund
	
468.30	General
	40,340,000
	39,465,000
	
468.31	Federal TANF
	140,000
	140,000
	
468.32 	(a) Title IV-E Adoption Assistance. (1) The 
468.33 	commissioner shall allocate funds from the 
468.34 	Title IV-E reimbursement to the state from 
468.35 	the Fostering Connections to Success and 
468.36 	Increasing Adoptions Act for adoptive, foster, 
469.1 	and kinship families as required in Minnesota 
469.2 	Statutes, section 256N.621.
469.3 	(2) Additional federal reimbursement to the 
469.4 	state as a result of the Fostering Connections 
469.5 	to Success and Increasing Adoptions Act's 
469.6 	expanded eligibility for title IV-E adoption 
469.7 	assistance is appropriated to the commissioner 
469.8 	for foster care, adoption, and kinship services, 
469.9 	including a parent-to-parent support network.
469.10 	(b) Adoption Assistance Incentive Grants.
469.11 	(1) The commissioner shall allocate federal 
469.12 	funds available for adoption and guardianship 
469.13 	assistance incentive grants for postadoption 
469.14 	services to support adoptive, foster, and 
469.15 	kinship families as required in Minnesota 
469.16 	Statutes, section 256N.621.
469.17 	(2) Federal funds available during fiscal years 
469.18 	2018 and 2019 for adoption incentive grants 
469.19 	must be used for foster care, adoption, and 
469.20 	kinship services, including a parent-to-parent 
469.21 	support network.
469.22 	(c) Adoption Support Services. The 
469.23 	commissioner shall allocate 20 percent of 
469.24 	federal funds from Title IV-B, subpart 2, of 
469.25 	the Social Security Act, Promoting Safe and 
469.26 	Stable Families, for adoption support services 
469.27 	under Minnesota Statutes, section 256N.261.
469.28 	(d) American Indian Child Welfare 
469.29 	Initiative. $800,000 in fiscal year 2018 is for 
469.30 	planning efforts to expand the American 
469.31 	Indian Child Welfare Initiative under 
469.32 	Minnesota Statutes, section 256.01, 
469.33 	subdivision 14b. Of this amount, $400,000 is 
469.34 	for a grant to the Mille Lacs Band of Ojibwe 
470.1 	and $400,000 is for a grant to the Red Lake 
470.2 	Nation. This is a onetime appropriation.
470.3 	(e) Anoka County Family Foster Care.
470.4 	$75,000 in fiscal year 2018 is from the general 
470.5 	fund for a grant to Anoka County to establish 
470.6 	and promote family foster care recruitment 
470.7 	models.  The county shall use the grant funds 
470.8 	for the purpose of increasing foster care 
470.9 	providers through administrative 
470.10 	simplification, nontraditional recruitment 
470.11 	models, and family incentive options, and 
470.12 	develop a strategic planning model to recruit 
470.13 	family foster care providers. This is a onetime 
470.14 	appropriation.
470.15 	(f) White Earth Band of Ojibwe Child 
470.16 	Welfare Services. $800,000 in fiscal year 
470.17 	2018 and $800,000 in fiscal year 2019 are 
470.18 	from the general fund for a grant to the White 
470.19 	Earth Band of Ojibwe to deliver child welfare 
470.20 	services.

470.21
470.22	Subd. 23.Grant Programs; Children and 
Community Service Grants
 		58,201,000
		58,201,000

470.23
470.24	Subd. 24.Grant Programs; Children and 
Economic Support Grants
 		31,280,000
		31,290,000
	
470.25 	(a) Minnesota Food Assistance Program. 
470.26 	Unexpended funds for the Minnesota food 
470.27 	assistance program for fiscal year 2018 do not 
470.28 	cancel but are available for this purpose in 
470.29 	fiscal year 2019.
470.30 	(b) At-Home Infant Child Care. $1,000,000 
470.31 	in fiscal year 2018 and $1,000,000 in fiscal 
470.32 	year 2019 are from the general fund for the 
470.33 	at-home infant child care program under 
470.34 	Minnesota Statutes, section 119B.035.
471.1 	(c) Community Action Grants. $750,000 in 
471.2 	fiscal year 2018 and $750,000 in fiscal year 
471.3 	2019 are for community action grants under 
471.4 	Minnesota Statutes, sections 256E.30 to 
471.5 	256E.32.
471.6 	(d) Family Assets for Independence.
471.7 	$250,000 in fiscal year 2018 and $250,000 in 
471.8 	fiscal year 2019 are for the family assets for 
471.9 	independence program under Minnesota 
471.10 	Statutes, section 256E.35.
471.11 	(e) Safe Harbor for Sexually Exploited 
471.12 	Youth. (1) $500,000 in fiscal year 2018 and 
471.13 	$500,000 in fiscal year 2019 are for 
471.14 	emergency shelter and transitional and 
471.15 	long-term housing beds for sexually exploited 
471.16 	youth and youth at risk of sexual exploitation.
471.17 	(2) $100,000 in fiscal year 2018 and $100,000 
471.18 	in fiscal year 2019 are for statewide youth 
471.19 	outreach workers connecting sexually 
471.20 	exploited youth and youth at risk of sexual 
471.21 	exploitation with shelter and services.
471.22 	(3) Youth 24 years of age or younger are 
471.23 	eligible for shelter, housing beds, and services 
471.24 	under this paragraph. In funding shelter, 
471.25 	housing beds, and outreach workers under this 
471.26 	paragraph, the commissioner shall emphasize 
471.27 	activities that promote capacity-building and 
471.28 	development of resources in greater 
471.29 	Minnesota.
471.30 	(f) Dakota County Child Data Tracking.
471.31 	$200,000 in fiscal year 2018 is for the 
471.32 	Minnesota Birth to Eight pilot project for the 
471.33 	development of the information technology 
471.34 	solution that will track the established 
472.1 	developmental milestone progress of each 
472.2 	child participating in the pilot up to age eight.
472.3 	(g) Housing Benefit Web Site. $130,000 in 
472.4 	fiscal year 2018 and $130,000 in fiscal year 
472.5 	2019 are to operate the housing benefit 101 
472.6 	Web site to help people who need affordable 
472.7 	housing, and supports to maintain that 
472.8 	housing, understand the range of housing 
472.9 	options and support services available.
472.10 	(h) Base Level Adjustments. The general 
472.11 	fund base is $31,743,000 in fiscal year 2020 
472.12 	and $31,743,000 in fiscal year 2021. The 
472.13 	general fund base includes $453,000 in fiscal 
472.14 	year 2020 and $453,000 in fiscal year 2021 
472.15 	for community living infrastructure grant 
472.16 	allocations under Minnesota Statutes, section 
472.17 	256I.09.

472.18	Subd. 25.Grant Programs; Health Care Grants

472.19	Appropriations by Fund
	
472.20	General
	4,119,000
	4,531,000
	
472.21	Health Care Access
	3,465,000
	3,465,000
	
472.22 	(a)  Dental Services Grants.   $820,000 in 
472.23 	fiscal year 2018 is from the general fund to 
472.24 	award dental services grants. The 
472.25 	commissioner may award grants under this 
472.26 	section to:
472.27 	(1) nonprofit community clinics;
472.28 	(2) federally qualified health centers, rural 
472.29 	health clinics, and public health clinics;
472.30 	(3) hospital-based dental clinics owned and 
472.31 	operated by a city, county, or former state 
472.32 	hospital as defined in Minnesota Statutes, 
472.33 	section 62Q.19, subdivision 1, paragraph (a), 
472.34 	clause (4); and
473.1 	(4) a dental clinic owned and operated by the 
473.2 	University of Minnesota or the Minnesota 
473.3 	State Colleges and Universities system.
473.4 	Grants may be used to fund costs related to 
473.5 	maintaining, coordinating, and improving 
473.6 	access for medical assistance and 
473.7 	MinnesotaCare enrollees to dental care in rural 
473.8 	Minnesota.
473.9 	In awarding grants, the commissioner shall 
473.10 	consider a grant applicant's experience in 
473.11 	delivering dental services to medical assistance 
473.12 	and MinnesotaCare enrollees in rural 
473.13 	communities, and the applicant's potential to 
473.14 	successfully maintain or expand access to 
473.15 	dental services for medical assistance and 
473.16 	MinnesotaCare enrollees.
473.17 	(b) Base Level Adjustment. The general fund 
473.18 	base is $3,711,000 in fiscal year 2020 and 
473.19 	$3,711,000 in fiscal year 2021.

473.20
473.21	Subd. 26.Grant Programs; Other Long-Term 
Care Grants
 		3,053,000
		3,478,000
	
473.22 	(a) Home and Community-Based Incentive 
473.23 	Pool. $1,553,000 in fiscal year 2018 and 
473.24 	$1,533,000 in fiscal year 2019 are for 
473.25 	incentive payments under Minnesota Statutes, 
473.26 	section 256B.0921. Of this amount, $500,000 
473.27 	in fiscal year 2020 and $500,000 in fiscal year 
473.28 	2021 are for the purposes described in 
473.29 	Minnesota Statutes, section 256B.0921, clause 
473.30 	(2). The base for these grants is $1,059,000 in 
473.31 	fiscal year 2020 and $1,059,000 in fiscal year 
473.32 	2021.
473.33 	(b) Base Level Adjustment. The general fund 
473.34 	base is $2,984,000 in fiscal year 2020 and 
473.35 	$2,984,000 in fiscal year 2021.

474.1
474.2	Subd. 27.Grant Programs; Aging and Adult 
Services Grants
 		30,746,000
		32,437,000
	
474.3 	Base Level Adjustments. The general fund 
474.4 	base is $32,811,000 in fiscal year 2020 and 
474.5 	$32,995,000 in fiscal year 2021. The general 
474.6 	fund base includes $334,000 in fiscal year 
474.7 	2020 and $477,000 in fiscal year 2021 for the 
474.8 	Minnesota Board on Aging for self-directed 
474.9 	caregiver grants under Minnesota Statutes, 
474.10 	section 256.975, subdivision 12.

474.11
474.12	Subd. 28.Grant Programs; Deaf and 
Hard-of-Hearing Grants
 		2,625,000
		2,775,000
	
474.13 	Expanded Services Grants. $750,000 in 
474.14 	fiscal year 2018 and $900,000 in fiscal year 
474.15 	2019 are for deaf and hard-of-hearing grants. 
474.16 	The funds must be used to provide services to 
474.17 	Minnesotans who are deafblind under 
474.18 	Minnesota Statutes, section 256C.261, to 
474.19 	provide culturally affirmative psychiatric 
474.20 	services, and to provide linguistically and 
474.21 	culturally appropriate mental health services 
474.22 	to children who are deaf, children who are 
474.23 	deafblind, and children who are 
474.24 	hard-of-hearing. Of this amount, $103,000 in 
474.25 	each year is to increase the grant to provide 
474.26 	mentors who have hearing loss to parents of 
474.27 	infants and children with newly identified 
474.28 	hearing loss. Each year the division must 
474.29 	provide funds for training in ProTactile 
474.30 	American Sign Language or other 
474.31 	communication systems used by people who 
474.32 	are deafblind. Training shall be provided to 
474.33 	persons who are deafblind and to interpreters, 
474.34 	support service providers, and interveners who 
474.35 	work with persons who are deafblind.

474.36	Subd. 29.Grant Programs; Disabilities Grants
 		20,852,000
		20,853,000
	
475.1 	(a) Disability Waiver Rate System 
475.2 	Transition Grants. $30,000 in fiscal year 
475.3 	2018 and $31,000 in fiscal year 2019 are for 
475.4 	grants to home and community-based 
475.5 	disability waiver services providers that are 
475.6 	projected to receive at least a ten percent 
475.7 	decrease in revenues due to transition to rates 
475.8 	calculated under Minnesota Statutes, section 
475.9 	256B.4914.The commissioner shall award 
475.10 	grants to ensure ongoing access for individuals 
475.11 	currently receiving these services and provide 
475.12 	stability to providers as they transition to new 
475.13 	service delivery models. The general fund base 
475.14 	for the grants under this paragraph is $287,000 
475.15 	in fiscal year 2020 and $288,000 in fiscal year 
475.16 	2021.
475.17 	(b) Self-Advocacy Grants. $183,000 in fiscal 
475.18 	year 2018 and $183,000 in fiscal year 2019 
475.19 	are for Minnesota Statutes, section 256.477.
475.20 	(c) Individual Community Living Grants.
475.21 	To the extent funding is available, the 
475.22 	commissioner may transfer funds from the 
475.23 	semi-independent living services grant to new 
475.24 	individual community living grants to pay for 
475.25 	transitional costs and facilitate the transition 
475.26 	of individuals from corporate foster care to 
475.27 	community living.
475.28 	(d) Gap Analysis. $217,000 in fiscal year 
475.29 	2018 and $218,000 in fiscal year 2019 are for 
475.30 	analysis of gaps in long-term care services 
475.31 	under Minnesota Statutes, section 144A.351.
475.32 	(e) Base Level Adjustment. The general fund 
475.33 	base is $21,109,000 in fiscal year 2020 and 
475.34 	$21,110,000 in fiscal year 2021.

476.1
476.2	Subd. 30.Grant Programs; Adult Mental Health 
Grants

476.3	Appropriations by Fund
	
476.4	General
	81,902,000
	81,802,000
	
476.5	Health Care Access
	750,000
	750,000
	
476.6 	(a) Mental Health Innovation Grants.
476.7 	$2,000,000 in fiscal year 2018 and$2,000,000 
476.8 	in fiscal year 2019 are from the general fund 
476.9 	for the mental health innovation grant program 
476.10 	under Minnesota Statutes, section 245.4662. 
476.11 	The general fund base for these grants is 
476.12 	$2,500,000 in fiscal year 2020 and $2,500,000 
476.13 	in fiscal year 2021.
476.14 	(b) Peer-Run Respite Services in Wadena 
476.15 	County. $100,000 in fiscal year 2018 is from 
476.16 	the general fund for a grant to Wadena County 
476.17 	for the planning and development of a peer-run 
476.18 	respite center for individuals experiencing 
476.19 	mental health conditions or co-occurring 
476.20 	substance abuse disorder. This is a onetime 
476.21 	appropriation and is available until June 30, 
476.22 	2021. The grant is contingent on Wadena 
476.23 	County providing to the commissioner of 
476.24 	human services a plan to fund, operate, and 
476.25 	sustain the program and services after the 
476.26 	onetime state grant is expended. Wadena 
476.27 	County must outline the proposed funding 
476.28 	stream or mechanism, and any necessary local 
476.29 	funding commitment, which will ensure the 
476.30 	program will result in a sustainable program 
476.31 	without future state funding. The funding 
476.32 	stream may include state funding for programs 
476.33 	and services for which the individuals served 
476.34 	under this paragraph may be eligible. The 
476.35 	commissioner of human services, in 
476.36 	collaboration with Wadena County, may 
477.1 	explore a plan for continued funding using 
477.2 	existing appropriations through eligibility for 
477.3 	group residential housing under Minnesota 
477.4 	Statutes, chapter 256I.
477.5 	The peer-run respite center must:
477.6 	(1) admit individuals who are in need of peer 
477.7 	support and supportive services while 
477.8 	addressing an increase in symptoms or 
477.9 	stressors or exacerbation of their mental health 
477.10 	or substance abuse;
477.11 	(2) admit individuals to reside at the center on 
477.12 	a short-term basis, no longer than five days;
477.13 	(3) be operated by a nonprofit organization;
477.14 	(4) employ individuals who have personal 
477.15 	experience with mental health or co-occurring 
477.16 	substance abuse conditions who meet the 
477.17 	qualifications of a mental health certified peer 
477.18 	specialist under Minnesota Statutes, section 
477.19 	256B.0615, or a recovery peer;
477.20 	(5) provide at least three but no more than six 
477.21 	beds in private rooms; and
477.22 	(6) not provide clinical services.
477.23 	By November 1, 2018, the commissioner of 
477.24 	human services, in consultation with Wadena 
477.25 	County, shall report to the committees in the 
477.26 	senate and house of representatives with 
477.27 	jurisdiction over mental health issues, the 
477.28 	status of planning and development of the 
477.29 	peer-run respite center, and the plan to 
477.30 	financially support the program and services 
477.31 	after the state grant is expended.
478.1 	(c) Base Level Adjustment. The general fund 
478.2 	base is $82,302,000 in fiscal year 2020 and 
478.3 	$82,302,000 in fiscal year 2021.

478.4
478.5	Subd. 31.Grant Programs; Child Mental Health 
Grants
 		21,361,000
		21,426,000
	
478.6 	(a) Children's Mental Health Collaborative 
478.7 	Grants. $600,000 in fiscal year 2018 and 
478.8 	$600,000 in fiscal year 2019 are for a grant 
478.9 	for a rural multicounty demonstration project 
478.10 	to assist transition-aged youth and young 
478.11 	adults with emotional behavioral disturbance 
478.12 	(EBD) or mental illnesses in making a 
478.13 	successful transition into adulthood. This is a 
478.14 	onetime appropriation.
478.15 	Children's mental health collaboratives under 
478.16 	Minnesota Statutes, section 245.493, are 
478.17 	eligible to apply for the grant under this 
478.18 	paragraph. The commissioner shall solicit 
478.19 	proposals and award the grant to one proposal 
478.20 	that best meets the requirement that a 
478.21 	demonstration project must:
478.22 	(1) build on and streamline transition services 
478.23 	by identifying rural youth 15 to 25 years of 
478.24 	age currently in the mental health system or 
478.25 	with emerging mental health conditions;
478.26 	(2) support youth to achieve, within the youth's 
478.27 	potential, personal goals in employment, 
478.28 	education, housing, and community life 
478.29 	functioning;
478.30 	(3) provide individualized motivational 
478.31 	coaching;
478.32 	(4) build on needed social supports;
478.33 	(5) demonstrate how services can be enhanced 
478.34 	for youth to successfully navigate the 
479.1 	complexities associated with their unique 
479.2 	needs;
479.3 	(6) use all available funding streams;
479.4 	(7) demonstrate collaboration with the local 
479.5 	children's mental health collaborative in 
479.6 	designing and implementing the demonstration 
479.7 	project;
479.8 	(8) evaluate the effectiveness of the project 
479.9 	by specifying and measuring outcomes 
479.10 	showing the level of progress for involved 
479.11 	youth; and
479.12 	(9) compare differences in outcomes and costs 
479.13 	to youth without previous access to this 
479.14 	project.
479.15 	By January 15, 2019, the commissioner shall 
479.16 	report to the legislative committees with 
479.17 	jurisdiction over mental health issues on the 
479.18 	status and outcomes of the demonstration 
479.19 	project. The children's mental health 
479.20 	collaborative administering the demonstration 
479.21 	project shall collect and report outcome data, 
479.22 	as requested by the commissioner, to support 
479.23 	the development of the report.
479.24 	(b) Base Level Adjustment. The general fund 
479.25 	base is $20,826,000 in fiscal year 2020 and 
479.26 	$20,826,000 in fiscal year 2021.

479.27
479.28	Subd. 32.Grant Programs; Chemical 
Dependency Treatment Support Grants

479.29	Appropriations by Fund
	
479.30	General
	2,136,000
	2,136,000
	
479.31	Lottery Prize
	1,733,000
	1,733,000
	
479.32 	(a) Minnesota Transitions Charter School.
479.33 	Notwithstanding any other law to the contrary, 
479.34 	Minnesota Transitions Charter School is 
480.1 	eligible to receive grants under Minnesota 
480.2 	Statutes, section 254A.03, subdivision 1.
480.3 	(b) Problem Gambling. $225,000 in fiscal 
480.4 	year 2018 and $225,000 in fiscal year 2019 
480.5 	are from the lottery prize fund for a grant to 
480.6 	the state affiliate recognized by the National 
480.7 	Council on Problem Gambling. The affiliate 
480.8 	must provide services to increase public 
480.9 	awareness of problem gambling, education, 
480.10 	and training for individuals and organizations 
480.11 	providing effective treatment services to 
480.12 	problem gamblers and their families, and 
480.13 	research related to problem gambling.

480.14	Subd. 33.Direct Care and Treatment - Generally
 					
480.15 	(a) Transfer Authority. Money appropriated 
480.16 	to budget activities under subdivisions 34, 35, 
480.17 	36, 37, and 38 may be transferred between 
480.18 	budget activities and between years of the 
480.19 	biennium with the approval of the 
480.20 	commissioner of management and budget.
480.21 	(b) Dedicated Receipts Available. Of the 
480.22 	revenue received under Minnesota Statutes, 
480.23 	section 246.18, subdivision 8, paragraph (a), 
480.24 	up to $1,000,000 each year is available for the 
480.25 	purposes of Minnesota Statutes, section 
480.26 	246.18, subdivision 8, paragraph (b), clause 
480.27 	(1); and up to $2,713,000 each year is 
480.28 	available for the purposes of Minnesota 
480.29 	Statutes, section 246.18, subdivision 8, 
480.30 	paragraph (b), clause (2).

480.31
480.32	Subd. 34.Direct Care and Treatment - Mental 
Health and Substance Abuse
 		114,521,000
		114,607,000
	
480.33 	(a)  Child and Adolescent Behavioral Health 
480.34 	Services. $405,000 in fiscal year 2018 and 
480.35 	$491,000 in fiscal year 2019 are to continue 
481.1 	to operate the child and adolescent behavioral 
481.2 	health services program under Minnesota 
481.3 	Statutes, section 246.014.
481.4 	(b) Base Level Adjustment. The general fund 
481.5 	base is $114,116,000 in fiscal year 2020 and 
481.6 	$114,116,000 in fiscal year 2021.

481.7
481.8	Subd. 35.Direct Care and Treatment - 
Community-Based Services
 		15,298,000
		15,298,000

481.9481.10
	Subd. 36.Direct Care and Treatment - Forensic 
Services
 		91,658,000
		91,675,000

481.11
481.12	Subd. 37.Direct Care and Treatment - Sex 
Offender Program
 		86,731,000
		86,731,000
	
481.13 	Transfer Authority. Money appropriated for 
481.14 	the Minnesota sex offender program may be 
481.15 	transferred between fiscal years of the 
481.16 	biennium with the approval of the 
481.17 	commissioner of management and budget.

481.18
481.19	Subd. 38.Direct Care and Treatment - 
Operations
 		39,787,000
		39,787,000

481.20	Subd. 39.Technical Activities
 		86,186,000
		86,339,000
	
481.21 	This appropriation is from the federal TANF 
481.22 	fund.
481.23 	Base Level Adjustment. The TANF fund 
481.24 	base is $86,346,000 in fiscal year 2020 and 
481.25 	$86,355,000 in fiscal year 2021.

481.26	Sec. 3. COMMISSIONER OF HEALTH

481.27	Subdivision 1.Total Appropriation
 	$
	195,996,000
	$
	185,274,000

481.28	Appropriations by Fund
	
481.29		2018
	2019
	
481.30	General
	96,670,000
	86,809,000
	
481.31
481.32	State Government 
Special Revenue
	52,703,000
	52,429,000
	
481.33	Health Care Access
	36,066,000
	35,479,000
	
481.34	Federal TANF
	10,557,000
	10,557,000
	
482.1 	The amounts that may be spent for each 
482.2 	purpose are specified in the following 
482.3 	subdivisions.

482.4	Subd. 2.Health Improvement

482.5	Appropriations by Fund
	
482.6	General
	74,543,000
	64,756,000
	
482.7
482.8	State Government 
Special Revenue
	6,215,000
	6,182,000
	
482.9	Health Care Access
	36,066,000
	35,479,000
	
482.10	Federal TANF
	10,557,000
	10,557,000
	
482.11 	(a) TANF Appropriations. (1) $3,579,000 
482.12 	of the TANF fund each year is for home 
482.13 	visiting and nutritional services listed under 
482.14 	Minnesota Statutes, section 145.882, 
482.15 	subdivision 7, clauses (6) and (7). Funds must 
482.16 	be distributed to community health boards 
482.17 	according to Minnesota Statutes, section 
482.18 	145A.131, subdivision 1.
482.19 	(2) $2,000,000 of the TANF fund each year 
482.20 	is for decreasing racial and ethnic disparities 
482.21 	in infant mortality rates under Minnesota 
482.22 	Statutes, section 145.928, subdivision 7.
482.23 	(3) $4,978,000 of the TANF fund  each year 
482.24 	is for the family home visiting grant program 
482.25 	according to Minnesota Statutes, section 
482.26 	145A.17. $4,000,000 of the funding must be 
482.27 	distributed to community health boards 
482.28 	according to Minnesota Statutes, section 
482.29 	145A.131, subdivision 1. $978,000 of the 
482.30 	funding must be distributed to tribal 
482.31 	governments according to Minnesota Statutes, 
482.32 	section 145A.14, subdivision 2a.
482.33 	(4) The commissioner may use up to 6.23 
482.34 	percent of the funds appropriated each year to 
482.35 	conduct the ongoing evaluations required 
483.1 	under Minnesota Statutes, section 145A.17, 
483.2 	subdivision 7, and training and technical 
483.3 	assistance as required under Minnesota 
483.4 	Statutes, section 145A.17, subdivisions 4 and 
483.5 	5.
483.6 	(b) TANF Carryforward. Any unexpended 
483.7 	balance of the TANF appropriation in the first 
483.8 	year of the biennium does not cancel but is 
483.9 	available for the second year.
483.10 	(c) Evidence-Based Home Visiting.
483.11 	$1,500,000 in fiscal year 2018 and $1,500,000 
483.12 	in fiscal year 2019 are from the general fund 
483.13 	to provide start-up and expansion grants to 
483.14 	community health boards, nonprofit 
483.15 	organizations, and tribal nations to start up or 
483.16 	expand evidence-based home visiting 
483.17 	programs. Grant funds must be used to start 
483.18 	up or expand evidence-based home visiting 
483.19 	programs in the county, reservation, or region 
483.20 	to serve families, such as parents with high 
483.21 	risk or high needs, parents with a history of 
483.22 	mental illness, domestic abuse, or substance 
483.23 	abuse, or first-time mothers prenatally until 
483.24 	the child is four years of age, who are eligible 
483.25 	for medical assistance under Minnesota 
483.26 	Statutes, chapter 256B, or the federal Special 
483.27 	Supplemental Nutrition Program for Women, 
483.28 	Infants, and Children. The commissioner shall 
483.29 	award grants to community health boards, 
483.30 	nonprofits, or tribal nations in metropolitan 
483.31 	and rural areas of the state. Priority for grants 
483.32 	to rural areas shall be given to community 
483.33 	health boards, nonprofits, and tribal nations 
483.34 	that expand services within regional 
483.35 	partnerships that provide the evidence-based 
484.1 	home visiting programs. This funding shall 
484.2 	only be used to supplement, not to replace, 
484.3 	funds being used for evidence-based home 
484.4 	visiting services as of June 30, 2017. The 
484.5 	general fund base for these grants is $750,000 
484.6 	in fiscal year 2020 and $750,000 in fiscal year 
484.7 	2021.
484.8 	(d) Safe Harbor for Sexually Exploited 
484.9 	Youth Services. $325,000 in fiscal year 2018 
484.10 	and $325,000 in fiscal year 2019 are from the 
484.11 	general fund for trauma-informed, culturally 
484.12 	specific services for sexually exploited youth. 
484.13 	Youth 24 years of age or younger are eligible 
484.14 	for services under this paragraph.
484.15 	(e) Safe Harbor Program. $225,000 in fiscal 
484.16 	year 2018 and $225,000 in fiscal year 2019 
484.17 	are from the general fund for training, 
484.18 	technical assistance, protocol implementation, 
484.19 	and evaluation activities related to the safe 
484.20 	harbor program. Of these amounts:
484.21 	(1) $100,000 each fiscal year is for providing 
484.22 	training and technical assistance to individuals 
484.23 	and organizations that provide safe harbor 
484.24 	services and receive funds for that purpose 
484.25 	from the commissioner of human services or 
484.26 	commissioner of health;
484.27 	(2) $100,000 each fiscal year is for protocol 
484.28 	implementation, which includes providing 
484.29 	technical assistance in establishing best 
484.30 	practices-based systems for effectively 
484.31 	identifying, interacting with, and referring 
484.32 	sexually exploited youth to appropriate 
484.33 	resources; and
485.1 	(3) $25,000 each fiscal year is for program 
485.2 	evaluation activities in compliance with 
485.3 	Minnesota Statutes, section 145.4718.
485.4 	(f) Administration of Safe Harbor Program.
485.5 	$60,000 in fiscal year 2018 and $60,000 in 
485.6 	fiscal year 2019 are for administration of the 
485.7 	safe harbor for sexually exploited youth 
485.8 	program.
485.9 	(g) Promoting Safe Harbor Capacity. In 
485.10 	funding services and activities under 
485.11 	paragraphs (d) and (e), the commissioner shall 
485.12 	emphasize activities that promote 
485.13 	capacity-building and development of 
485.14 	resources in greater Minnesota.
485.15 	(h) Statewide Strategic Plan for Victims of 
485.16 	Sex Trafficking. $73,000 in fiscal year 2018 
485.17 	is from the general fund for the development 
485.18 	of a comprehensive statewide strategic plan 
485.19 	and report to address the needs of sex 
485.20 	trafficking victims statewide. This is a onetime 
485.21 	appropriation.
485.22 	(i) Comprehensive Advanced Life Support 
485.23 	Educational Program. $100,000 in fiscal 
485.24 	year 2018 and $100,000 in fiscal year 2019 
485.25 	are from the general fund for the 
485.26 	comprehensive advanced life support 
485.27 	educational program under Minnesota Statutes, 
485.28 	section 144.6062.
485.29 	(j) Legislative Health Care Workforce 
485.30 	Commission. $130,000 in fiscal year 2018 
485.31 	and $130,000 in fiscal year 2019 are from the 
485.32 	general fund for the Legislative Health Care 
485.33 	Workforce Commission in Laws 2014, chapter 
485.34 	312, article 23, section 9. The commissioner 
486.1 	may transfer part of this appropriation to the 
486.2 	Legislative Coordinating Commission to 
486.3 	provide per diem and expense reimbursements 
486.4 	to the Legislative Health Care Workforce 
486.5 	Commission members.
486.6 	(k) Local Public Health Grants Payment 
486.7 	Delay. The commissioner shall pay 
486.8 	$7,736,000 of local public health grants for 
486.9 	fiscal year 2019 on July 1, 2019.
486.10 	(l) Opioid Abuse Prevention. $2,028,000 in 
486.11 	fiscal year 2018 is to establish up to 12 
486.12 	accountable community for health opioid 
486.13 	abuse prevention pilot projects. $28,000 of 
486.14 	this amount is for administration. This is a 
486.15 	onetime appropriation.
486.16 	(m) Opioid Prescriber Education. $535,000 
486.17 	in fiscal year 2018 and $535,000 in fiscal year 
486.18 	2019 are for opioid prescriber education and 
486.19 	public awareness grants under Minnesota 
486.20 	Statutes, section 145.9263. $35,000 in fiscal 
486.21 	year 2018 and $35,000 in fiscal year 2019 are 
486.22 	for administration.
486.23 	(n) Primary Care Clinical Training 
486.24 	Expansion Grant Program. $526,000 in 
486.25 	fiscal year 2018 and $526,000 in fiscal year 
486.26 	2019 are for the primary care clinical training 
486.27 	expansion grant program under Minnesota 
486.28 	Statutes, section 144.1505. $26,000 in fiscal 
486.29 	year 2018 and $26,000 in fiscal year 2019 are 
486.30 	for administration.
486.31 	(o) Base Level Adjustments. The general 
486.32 	fund base is $79,428,000 in fiscal year 2020 
486.33 	and $71,742,000 in fiscal year 2021. The 
486.34 	health care access fund base is $36,079,000 
487.1 	in fiscal year 2020 and $35,479,000 in fiscal 
487.2 	year 2021.

487.3	Subd. 3.Health Protection

487.4	Appropriations by Fund
	
487.5	General
	14,552,000
	14,478,000
	
487.6
487.7	State Government 
Special Revenue
	46,488,000
	46,247,000
	
487.8 	(a) Vulnerable Adults in Health Care 
487.9 	Settings. $633,000 in fiscal year 2018 and 
487.10 	$559,000 in fiscal year 2019 are added to the 
487.11 	appropriation from the general fund for 
487.12 	regulating health care and home care settings.
487.13 	(b) Base Level Adjustments. The general 
487.14 	fund base is $14,867,000 in fiscal year 2020 
487.15 	and $14,777,000 in fiscal year 2021. The state 
487.16 	government special revenue fund base is 
487.17 	$46,188,000 in fiscal year 2020 and 
487.18 	$46,180,000 in fiscal year 2021.

487.19	Subd. 4.Health Operations
 		7,575,000
		7,575,000

487.20	Sec. 4. HEALTH-RELATED BOARDS

487.21	Subdivision 1.Total Appropriation
 	$
	21,543,000
	$
	21,073,000
	
487.22 	This appropriation is from the state 
487.23 	government special revenue fund. The 
487.24 	amounts that may be spent for each purpose 
487.25 	are specified in the following subdivisions.

487.26	Subd. 2.Board of Chiropractic Examiners
 		542,000
		542,000
	
487.27 	Base Level Adjustment. The base is $547,000 
487.28 	in fiscal year 2020 and $547,000 in fiscal year 
487.29 	2021.

487.30	Subd. 3.Board of Dentistry
 		1,366,000
		1,366,000

487.31
487.32	Subd. 4.Board of Dietetics and Nutrition 
Practice
 		122,000
		122,000

487.33	Subd. 5.Board of Marriage and Family Therapy
 		296,000
		296,000
	
488.1 	Base Level Adjustment. The base is $297,000 
488.2 	in fiscal year 2020 and $297,000 in fiscal year 
488.3 	2021.

488.4	Subd. 6.Board of Medical Practice
 		4,890,000
		4,999,000
	
488.5 	This appropriation includes $955,000 in fiscal 
488.6 	year 2018 and $964,000 in fiscal year 2019 
488.7 	for the health professional services program. 
488.8 	The base for this program is $924,000 in fiscal 
488.9 	year 2020 and $924,000 in fiscal year 2021.
488.10 	Base Level Adjustment. The base is 
488.11 	$4,961,000 in fiscal year 2020 and $4,961,000 
488.12 	in fiscal year 2021.

488.13	Subd. 7.Board of Nursing
 		4,790,000
		4,190,000

488.14	Subd. 8.Board of Nursing Home Administrators
 		2,731,000
		2,752,000
	
488.15 	(a) Administrative Services Unit - Operating 
488.16 	Costs. Of this appropriation, $2,166,000 in 
488.17 	fiscal year 2018 and $2,187,000 in fiscal year 
488.18 	2019 are for operating costs of the 
488.19 	administrative services unit. The 
488.20 	administrative services unit may receive and 
488.21 	expend reimbursements for services it 
488.22 	performs for other agencies.
488.23 	(b) Administrative Services Unit - Volunteer 
488.24 	Health Care Provider Program. Of this 
488.25 	appropriation, $150,000 in fiscal year 2018 
488.26 	and $150,000 in fiscal year 2019 are to pay 
488.27 	for medical professional liability coverage 
488.28 	required under Minnesota Statutes, section 
488.29 	214.40.
488.30 	(c) Administrative Services Unit - Contested 
488.31 	Cases and Other Legal Proceedings. Of this 
488.32 	appropriation, $200,000 in fiscal year 2018 
488.33 	and $200,000 in fiscal year 2019 are for costs 
488.34 	of contested case hearings and other 
489.1 	unanticipated costs of legal proceedings 
489.2 	involving health-related boards funded under 
489.3 	this section. Upon certification by a 
489.4 	health-related board to the administrative 
489.5 	services unit that costs will be incurred and 
489.6 	that there is insufficient money available to 
489.7 	pay for the costs out of money currently 
489.8 	available to that board, the administrative 
489.9 	services unit is authorized to transfer money 
489.10 	from this appropriation to the board for 
489.11 	payment of those costs with the approval of 
489.12 	the commissioner of management and budget. 
489.13 	The commissioner of management and budget 
489.14 	must require any board that has an unexpended 
489.15 	balance for an amount transferred under this 
489.16 	paragraph to transfer the unexpended amount 
489.17 	to the administrative services unit to be 
489.18 	deposited in the state government special 
489.19 	revenue fund.

489.20	Subd. 9.Board of Optometry
 		167,000
		167,000

489.21	Subd. 10.Board of Pharmacy
 		3,069,000
		3,069,000

489.22	Subd. 11.Board of Physical Therapy
 		456,000
		456,000
	
489.23 	Base Level Adjustment. The base is $457,000 
489.24 	in fiscal year 2020 and $458,000 in fiscal year 
489.25 	2021.

489.26	Subd. 12.Board of Podiatric Medicine
 		204,000
		204,000

489.27	Subd. 13.Board of Psychology
 		999,000
		999,000

489.28	Subd. 14.Board of Social Work
 		1,122,000
		1,122,000

489.29	Subd. 15.Board of Veterinary Medicine
 		275,000
		275,000

489.30
489.31	Subd. 16.Board of Behavioral Health and 
Therapy
 		514,000
		514,000

490.1
490.2	Subd. 17.Board of Occupational Therapy 
Practice
 		374,000
		328,000

490.3
490.4	Sec. 5. EMERGENCY MEDICAL SERVICES 
REGULATORY BOARD
 	$
	3,702,000
	$
	3,702,000
	
490.5 	(a) Cooper/Sams Volunteer Ambulance 
490.6 	Program.$950,000 in fiscal year 2018 and 
490.7 	$950,000 in fiscal year 2019 are for the 
490.8 	Cooper/Sams volunteer ambulance program 
490.9 	under Minnesota Statutes, section 144E.40. 
490.10 	Of these amounts:
490.11 	(1)$861,000 in fiscal year 2018 and $861,000 
490.12 	in fiscal year 2019 are for the ambulance 
490.13 	service personnel longevity award and 
490.14 	incentive program under Minnesota Statutes, 
490.15 	section 144E.40; and
490.16 	(2) $89,000 in fiscal year 2018 and $89,000 
490.17 	in fiscal year 2019 are for the operation of the 
490.18 	ambulance service personnel longevity award 
490.19 	and incentive program under Minnesota 
490.20 	Statutes, section 144E.40.
490.21 	(b) EMSRB Board Operations. $1,391,000 
490.22 	in fiscal year 2018 and $1,391,000 in fiscal 
490.23 	year 2019 are for board operations.
490.24 	(c) Regional Grants. $785,000 in fiscal year 
490.25 	2018 and $785,000 in fiscal year 2019 are for 
490.26 	regional emergency medical services 
490.27 	programs, to be distributed equally to the eight 
490.28 	emergency medical service regions under 
490.29 	Minnesota Statutes, section 144E.50.
490.30 	(d) Ambulance Training Grant. $470,000 
490.31 	in fiscal year 2018 and $470,000 in fiscal year 
490.32 	2019 are for training grants under Minnesota 
490.33 	Statutes, section 144E.35.
491.1 	(e) Base Level Adjustment. The base is 
491.2 	$3,704,000 in fiscal year 2020 and $3,704,000 
491.3 	in fiscal year 2021.

491.4	Sec. 6. COUNCIL ON DISABILITY
 	$
	651,000
	$
	651,000
	
491.5 	Digital Accessibility Staffing. $22,000 in 
491.6 	fiscal year 2018 and $22,000 in fiscal year 
491.7 	2019 are for permanently retaining a digital 
491.8 	accessibility staff person.

491.9491.10
491.11
	Sec. 7. OMBUDSMAN FOR MENTAL 
HEALTH AND DEVELOPMENTAL 
DISABILITIES
 	$
	2,407,000
	$
	2,427,000

491.12	Sec. 8. OMBUDSPERSONS FOR FAMILIES
 	$
	543,000
	$
	551,000

491.13 	Sec. 9. Laws 2009, chapter 101, article 1, section 12, is amended to read:

491.14	Sec. 12. ADMINISTRATION

491.15	Subdivision 1.Total Appropriation
 	$
	19,973,000
	$
	19,617,000

491.16	Appropriations by Fund
	
491.17		2010
	2011
	
491.18	General
	19,723,000
	19,617,000
	
491.19
491.20	Special Revenue 
Fund
	250,000
	0
	
491.21 	The amounts that may be spent for each 
491.22 	purpose are specified in the following 
491.23 	subdivisions.

491.24	Subd. 2.Government and Citizen Services
 		18,097,000
		17,766,000

491.25	Appropriations by Fund
	
491.26	General
	17,847,000
	17,766,000
	
491.27
491.28	Special Revenue 
Fund
	250,000
	0
	
491.29 	(a) $802,000 the first year and $802,000 the 
491.30 	second year are for the Minnesota Geospatial 
491.31 	Information Office. Of the total appropriation, 
491.32 	$10,000 per year is intended for preparation 
491.33 	of township acreage data in Laws 2008, 
492.1 	chapter 366, article 17, section 7, subdivision 
492.2 	3.
492.3 	(b) $74,000 the first year and $74,000 the 
492.4 	second year are for the Council on 
492.5 	Developmental Disabilities.
492.6 	(c) $127,000 the first year and $127,000 the 
492.7 	second year are for transfer to the 
492.8 	commissioner of human services for a grant 
492.9 	to the Council on Developmental Disabilities 
492.10 	for the purpose of establishing a statewide 
492.11 	self-advocacy network for persons with 
492.12 	intellectual and developmental disabilities 
492.13 	(ID/DD). The self-advocacy network shall: 
492.14 	(1) ensure that persons with ID/DD are 
492.15 	informed of their rights in employment, 
492.16 	housing, transportation, voting, government 
492.17 	policy, and other issues pertinent to the ID/DD 
492.18 	community; (2) provide public education and 
492.19 	awareness of the civil and human rights issues 
492.20 	persons with ID/DD face; (3) provide funds, 
492.21 	technical assistance, and other resources for 
492.22 	self-advocacy groups across the state; and (4) 
492.23 	organize systems of communications to 
492.24 	facilitate an exchange of information between 
492.25 	self-advocacy groups. This appropriation must 
492.26 	be included in the base budget for the 
492.27 	commissioner of human services for the 
492.28 	biennium beginning July 1, 2011.
492.29 	(d) $250,000 the first year and $170,000 the 
492.30 	second year are to fund activities to prepare 
492.31 	for and promote the 2010 census.
492.32 	(e) $206,000 the first year and $206,000 the 
492.33 	second year are for the Office of the State 
492.34 	Archaeologist.
493.1 	(f) $8,388,000 the first year and $8,388,000 
493.2 	the second year are for office space costs of 
493.3 	the legislature and veterans organizations, for 
493.4 	ceremonial space, and for statutorily free 
493.5 	space.
493.6 	(g) $3,500,000 of the balance in the facilities 
493.7 	repair and replacement account in the special 
493.8 	revenue fund is canceled to the general fund 
493.9 	on July 1, 2009. This is a onetime cancellation.
493.10 	(h) The requirements imposed on the 
493.11 	commissioner of finance and the commissioner 
493.12 	of administration under Laws 2007, chapter 
493.13 	148, article 1, section 12, subdivision 2, 
493.14 	paragraph (b), relating to the savings 
493.15 	attributable to the real property portfolio 
493.16 	management system are inoperative.
493.17 	(i) $250,000 is appropriated to the 
493.18 	commissioner of administration from the 
493.19 	information and telecommunications account 
493.20 	in the special revenue fund to continue 
493.21 	planning for data center consolidation, 
493.22 	including beginning a predesign study and 
493.23 	lifecycle cost analysis, and exploring 
493.24 	technologies to reduce energy consumption 
493.25 	and operating costs.

493.26	Subd. 3.Administrative Management Support
 		1,876,000
		1,851,000
	
493.27 	$125,000 each year is for the Office of Grant 
493.28 	Management. During the biennium ending 
493.29 	June 30, 2011, the commissioner must recover 
493.30 	this amount through deductions in state grants 
493.31 	subject to the jurisdiction of the office. The 
493.32 	commissioner may not deduct more than 2.5 
493.33 	percent from the amount of any grant. The 
493.34 	amount deducted from appropriations for these 
493.35 	grants must be deposited in the general fund.
494.1 	$25,000 the first year is for the Office of 
494.2 	Grants Management to study and make 
494.3 	recommendations on improving collaborative 
494.4 	activities between the state, nonprofit entities, 
494.5 	and the private sector, including: (1) 
494.6 	recommendations for expanding successful 
494.7 	initiatives involving not-for-profit 
494.8 	organizations that have demonstrated 
494.9 	measurable, positive results in addressing 
494.10 	high-priority community issues; and (2) 
494.11 	recommendations on grant requirements and 
494.12 	design to encourage programs receiving grants 
494.13 	to become self-sufficient. The office may 
494.14 	appoint an advisory group to assist in the study 
494.15 	and recommendations. The office must report 
494.16 	its recommendations to the legislature by 
494.17 	January 15, 2010.

494.18 	Sec. 10. Laws 2012, chapter 247, article 6, section 2, subdivision 2, is amended to read:

494.19	Subd. 2.Central Office Operations

494.20	(a) Operations
		118,000
		356,000
	
494.21 	Base Level Adjustment. The general fund 
494.22 	base is increased by $91,000 in fiscal year 
494.23 	2014 and $44,000 in fiscal year 2015.

494.24	(b) Health Care
		24,000
		346,000
	
494.25 	This is a onetime appropriation.
494.26 	Managed Care Audit Activities. In fiscal 
494.27 	year 2014, and in each even-numbered year 
494.28 	thereafter, the commissioner shall transfer 
494.29 	from the health care access fund $1,740,000 
494.30 	to the legislative auditor for managed care 
494.31 	audit services under Minnesota Statutes, 
494.32 	section 256B.69, subdivision 9d. This is a 
494.33 	biennial appropriation. The health care access 
494.34 	fund base is increased by $1,842,000 in fiscal 
495.1 	year 2014. Notwithstanding any contrary 
495.2 	provision in this article, this paragraph does 
495.3 	not expire.

495.4	(c) Continuing Care
		19,000
		375,000
	
495.5 	Base Level Adjustment. The general fund 
495.6 	base is decreased by $159,000 in fiscal years 
495.7 	2014 and 2015.

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

495.9 	Sec. 11. Laws 2013, chapter 108, article 15, section 2, subdivision 2, is amended to read:

495.10	Subd. 2.Central Office
 					
495.11 	The amounts that may be spent from this 
495.12 	appropriation for each purpose are as follows:

495.13	(a) Operations
		2,909,000
		8,957,000
	
495.14 	Base Adjustment. The general fund base is 
495.15 	decreased by $8,916,000 in fiscal year 2016 
495.16 	and $8,916,000 in fiscal year 2017.

495.17	(b) Children and Families
		109,000
		206,000

495.18	(c) Continuing Care
		2,849,000
		3,574,000
	
495.19 	Base Adjustment. The general fund base is 
495.20 	decreased by $2,000 in fiscal year 2016 and 
495.21 	by $27,000 in fiscal year 2017.

495.22	(d) Group Residential Housing
		(1,166,000)
		(8,602,000)

495.23	(e) Medical Assistance
		(3,950,000)
		(6,420,000)

495.24	(f) Alternative Care
		(7,386,000)
		(6,851,000)

495.25	(g) Child and Community Service Grants
		3,000,000
		3,000,000

495.26	(h) Aging and Adult Services Grants
		5,365,000
		5,936,000
	
495.27 	Gaps Analysis. In fiscal year 2014, and in 
495.28 	each even-numbered year thereafter, $435,000 
495.29 	is appropriated to conduct an analysis of gaps 
495.30 	in long-term care services under Minnesota 
495.31 	Statutes, section 144A.351. This is a biennial 
495.32 	appropriation. The base is increased by 
496.1 	$435,000 in fiscal year 2016. Notwithstanding 
496.2 	any contrary provisions in this article, this 
496.3 	provision does not expire.
496.4 	Base Adjustment. The general fund base is 
496.5 	increased by $498,000 in fiscal year 2016, and 
496.6 	decreased by $124,000 in fiscal year 2017.

496.7	(i) Disabilities Grants
		414,000
		414,000

496.8 	Sec. 12. TRANSFERS.
 496.9 		Subdivision 1.Grants. The commissioner of human services, with the approval of the 
496.10 	commissioner of management and budget, may transfer unencumbered appropriation balances 
496.11 	for the biennium ending June 30, 2019, within fiscal years among the MFIP, general 
496.12 	assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota 
496.13 	Statutes, section 119B.05, Minnesota supplemental aid, and group residential housing 
496.14 	programs, the entitlement portion of Northstar Care for Children under Minnesota Statutes, 
496.15 	chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment 
496.16 	fund, and between fiscal years of the biennium. The commissioner shall inform the chairs 
496.17 	and ranking minority members of the senate Health and Human Services Finance Division 
496.18 	and the house of representatives Health and Human Services Finance Committee quarterly 
496.19 	about transfers made under this subdivision.
496.20 		Subd. 2.Administration. Positions, salary money, and nonsalary administrative money 
496.21 	may be transferred within the Departments of Health and Human Services as the 
496.22 	commissioners consider necessary, with the advance approval of the commissioner of 
496.23 	management and budget. The commissioner shall inform the chairs and ranking minority 
496.24 	members of the senate Health and Human Services Finance Division and the house of 
496.25 	representatives Health and Human Services Finance Committee quarterly about transfers 
496.26 	made under this subdivision.

496.27 	Sec. 13. INDIRECT COSTS NOT TO FUND PROGRAMS.
 496.28 	The commissioners of health and human services shall not use indirect cost allocations 
496.29 	to pay for the operational costs of any program for which they are responsible.

496.30 	Sec. 14. EXPIRATION OF UNCODIFIED LANGUAGE.
 496.31 	All uncodified language contained in this article expires on June 30, 2019, unless a 
496.32 	different expiration date is explicit.

497.1 	Sec. 15. EFFECTIVE DATE.
 497.2 	This article is effective July 1, 2017, unless a different effective date is specified.

APPENDIX 

Repealed Minnesota Statutes: S0800-3 

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. 

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. 

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.0659 PERSONAL CARE ASSISTANCE PROGRAM.Subd. 22.Annual review for personal care providers. 
(a) All personal care assistance provider agencies shall resubmit, on an annual basis, the information specified in subdivision 21, in a format determined by the commissioner, and provide a copy of the personal care assistance provider agency's most current version of its grievance policies and procedures along with a written record of grievances and resolutions of the grievances that the personal care assistance provider agency has received in the previous year and any other information requested by the commissioner. 

(b) The commissioner shall send annual review notification to personal care assistance provider agencies 30 days prior to renewal. The notification must: 

(1) list the materials and information the personal care assistance provider agency is required to submit; 

(2) provide instructions on submitting information to the commissioner; and 

(3) provide a due date by which the commissioner must receive the requested information. 

Personal care assistance provider agencies shall submit required documentation for annual review within 30 days of notification from the commissioner. If no documentation is submitted, the personal care assistance provider agency enrollment number must be terminated or suspended. 

(c) Personal care assistance provider agencies also currently licensed under section 144A.471, subdivision 6 or 7, or currently certified for participation in Medicare as a home health agency are deemed in compliance with the personal care assistance requirements for enrollment, annual review process, and documentation. 

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. 

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. 

256J.626 MFIP CONSOLIDATED FUND.Subd. 5.Innovation projects. 
Beginning January 1, 2005, no more than $3,000,000 of the funds annually appropriated to the commissioner for use in the consolidated fund shall be available to the commissioner to reward high-performing counties and tribes, support promising practices, and test innovative approaches to improving outcomes for MFIP participants, family stabilization services participants, and persons at risk of receiving MFIP as detailed in subdivision 3. Project funds may be targeted to geographic areas with poor outcomes as specified in section 256J.751, subdivision 5, or to subgroups within the MFIP case load who are experiencing poor outcomes. 

Repealed Minnesota Session Laws: S0800-3 

Laws 2014, chapter 312, article 23, section 9, subdivision 5
Sec. 9. LEGISLATIVE HEALTH CARE WORKFORCE COMMISSION. Subd. 5.Report to the legislature. 
The Legislative Health Care Workforce Commission must provide a preliminary report making recommendations to the legislature by December 31, 2014. The commission must provide a final report to the legislature by December 31, 2016. The final report must: 

(1) identify current and anticipated health care workforce shortages, by both provider type and geography; 

(2) evaluate the effectiveness of incentives currently available to develop, attract, and retain a highly skilled health care workforce; 

(3) study alternative incentives to develop, attract, and retain a highly skilled and diverse health care workforce; and 

(4) identify current causes and potential solutions to barriers related to the primary care workforce, including, but not limited to: 

(i) training and residency shortages; 

(ii) disparities in income between primary care and other providers; and 

(iii) negative perceptions of primary care among students. 

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. 

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.