SF 800

Conference Committee Report - 90th Legislature (2017 - 2018) Posted on 05/08/2017 10:17pm

1.1CONFERENCE COMMITTEE REPORT ON S.F. No. 800

1.2A bill for an act

1.3relating to human services finance and policy; appropriating money for human
1.4services and health-related programs; modifying various provisions governing
1.5community supports, housing, continuing care, health care, managed care
1.6organizations, health insurance, direct care and treatment, children and families,
1.7chemical and mental health services, Department of Human Services operations,
1.8Department of Health policy, and health licensing boards; establishing a license
1.9for substance abuse disorder treatment; authorizing transfers; providing for
1.10supplemental rates; modifying reimbursement rates and premium scales; making
1.11forecast adjustments; providing for audits; establishing crumb rubber playground
1.12moratorium; authorizing pilot projects and studies; requiring reports; establishing
1.13a legislative commission; making technical and terminology changes;amending
1.14Minnesota Statutes 2016, sections 3.972, by adding a subdivision; 13.32, by adding
1.15a subdivision; 13.46, subdivisions 1, 2, 4; 13.69, subdivision 1; 13.84, subdivision
1.165; 62A.04, subdivision 1; 62A.21, subdivision 2a; 62A.3075; 62D.105, subdivisions
1.171, 2; 62E.04, subdivision 11; 62E.05, subdivision 1; 62E.06, by adding a
1.18subdivision; 62M.07; 62U.02; 62V.05, subdivision 12; 103I.101, subdivisions 2,
1.195; 103I.111, subdivisions 6, 7, 8; 103I.205; 103I.301; 103I.501; 103I.505; 103I.515;
1.20103I.535, subdivisions 3, 6, by adding a subdivision; 103I.541; 103I.545,
1.21subdivisions 1, 2; 103I.711, subdivision 1; 103I.715, subdivision 2; 119B.011, by
1.22adding subdivisions; 119B.02, subdivision 5; 119B.09, subdivision 9a; 119B.125,
1.23subdivisions 4, 6; 119B.13, subdivisions 1, 6; 119B.16, subdivisions 1, 1a, 1b, by
1.24adding subdivisions; 144.05, subdivision 6; 144.0724, subdivisions 4, 6; 144.122;
1.25144.1501, subdivision 2; 144.551, subdivision 1; 144A.071, subdivision 4d;
1.26144A.351; 144A.472, subdivision 7; 144A.474, subdivision 11; 144A.4799,
1.27subdivision 3; 144A.70, subdivision 6, by adding a subdivision; 144D.04,
1.28subdivision 2, by adding a subdivision; 144D.06; 145.4716, subdivision 2; 145.986,
1.29subdivision 1a; 146B.02, subdivisions 2, 5, 8, by adding subdivisions; 146B.03,
1.30subdivisions 6, 7; 146B.07, subdivision 4; 146B.10, subdivision 1; 147.01,
1.31subdivision 7; 147.02, subdivision 1; 147.03, subdivision 1; 147B.08, by adding
1.32a subdivision; 147C.40, by adding a subdivision; 148.5194, subdivision 7; 148.6402,
1.33subdivision 4; 148.6405; 148.6408, subdivision 2; 148.6410, subdivision 2;
1.34148.6412, subdivision 2; 148.6415; 148.6418, subdivisions 1, 2, 4, 5; 148.6420,
1.35subdivisions 1, 3, 5; 148.6423; 148.6425, subdivisions 2, 3; 148.6428; 148.6443,
1.36subdivisions 5, 6, 7, 8; 148.6445, subdivisions 1, 10; 148.6448; 157.16, subdivision
1.371; 214.01, subdivision 2; 245.4889, subdivision 1; 245.91, subdivisions 4, 6;
1.38245.97, subdivision 6; 245A.02, subdivision 2b, by adding a subdivision; 245A.03,
1.39subdivisions 2, 7; 245A.04, subdivision 14; 245A.06, subdivision 2; 245A.07,
1.40subdivision 3; 245A.11, by adding subdivisions; 245A.191; 245A.50, subdivision
1.415; 245D.03, subdivision 1; 245D.04, subdivision 3; 245D.071, subdivision 3;
1.42245D.11, subdivision 4; 245D.24, subdivision 3; 245E.01, by adding a subdivision;
2.1245E.02, subdivisions 1, 3, 4; 245E.03, subdivisions 2, 4; 245E.04; 245E.05,
2.2subdivision 1; 245E.06, subdivisions 1, 2, 3; 245E.07, subdivision 1; 252.27,
2.3subdivision 2a; 252.41, subdivision 3; 253B.10, subdivision 1; 253B.22, subdivision
2.41; 254A.01; 254A.02, subdivisions 2, 3, 5, 6, 8, 10, by adding subdivisions;
2.5254A.03; 254A.035, subdivision 1; 254A.04; 254A.08; 254A.09; 254A.19,
2.6subdivision 3; 254B.01, subdivision 3, by adding a subdivision; 254B.03,
2.7subdivision 2; 254B.04, subdivisions 1, 2b; 254B.05, subdivisions 1, 1a, 5;
2.8254B.051; 254B.07; 254B.08; 254B.09; 254B.12, subdivision 2; 254B.13,
2.9subdivision 2a; 256.01, subdivision 41, by adding a subdivision; 256.045,
2.10subdivision 3; 256.969, subdivisions 2b, 4b, by adding a subdivision; 256.975,
2.11subdivision 7, by adding a subdivision; 256.98, subdivision 8; 256B.04,
2.12subdivisions 21, 22; 256B.056, subdivision 5c; 256B.0621, subdivision 10;
2.13256B.0625, subdivisions 3b, 7, 20, 45a, 57, 64, by adding subdivisions; 256B.0659,
2.14subdivisions 1, 2, 11, 21, by adding a subdivision; 256B.072; 256B.0755,
2.15subdivisions 1, 3, 4, by adding a subdivision; 256B.0911, subdivisions 1a, 3a, 4d,
2.16by adding subdivisions; 256B.0915, subdivisions 1, 1a, 3a, 3e, 3h, 5, by adding
2.17subdivisions; 256B.092, subdivision 4; 256B.0922, subdivision 1; 256B.0924, by
2.18adding a subdivision; 256B.0943, subdivision 13; 256B.0945, subdivisions 2, 4;
2.19256B.196, subdivision 2; 256B.431, subdivisions 10, 16, 30; 256B.434, subdivisions
2.204, 4f; 256B.49, subdivisions 11, 15; 256B.4913, subdivision 4a, by adding a
2.21subdivision; 256B.4914, subdivisions 2, 3, 5, 6, 7, 8, 9, 10, 16; 256B.493,
2.22subdivisions 1, 2, by adding a subdivision; 256B.50, subdivision 1b; 256B.5012,
2.23by adding a subdivision; 256B.69, subdivision 9e; 256B.76, subdivisions 1, 2;
2.24256B.766; 256B.85, subdivisions 3, 5, 6; 256C.23, subdivision 2, by adding
2.25subdivisions; 256C.233, subdivisions 1, 2; 256C.24, subdivisions 1, 2, by adding
2.26a subdivision; 256C.261; 256D.44, subdivisions 4, 5; 256E.30, subdivision 2;
2.27256I.03, subdivision 8; 256I.04, subdivisions 1, 2d, 2g, 3; 256I.05, subdivisions
2.281a, 1c, 1e, 1j, 1m, 8, by adding subdivisions; 256I.06, subdivisions 2, 8; 256J.24,
2.29subdivision 5; 256J.45, subdivision 2; 256L.03, subdivisions 1, 1a, 5; 256L.15,
2.30subdivision 2; 256P.06, subdivision 2; 256R.02, subdivisions 4, 18; 256R.07, by
2.31adding a subdivision; 256R.10, by adding a subdivision; 256R.37; 256R.40,
2.32subdivision 5; 256R.41; 256R.47; 256R.49, subdivision 1; 260C.451, subdivision
2.336; 317A.811, subdivision 1, by adding a subdivision; 327.15, subdivision 3;
2.34609.5315, subdivision 5c; 626.556, subdivisions 2, 3, 3c, 10d, 10j; Laws 2009,
2.35chapter 101, article 1, section 12; Laws 2012, chapter 247, article 6, section 2,
2.36subdivision 2; Laws 2013, chapter 108, article 15, section 2, subdivision 2; Laws
2.372014, chapter 312, article 23, section 9, subdivision 8, by adding a subdivision;
2.38Laws 2015, chapter 71, article 14, section 3, subdivision 2, as amended; Laws
2.392017, chapter 2, article 1, sections 1, subdivision 3; 2, subdivision 4, by adding a
2.40subdivision; 3; 5; 7; article 2, section 13; proposing coding for new law in
2.41Minnesota Statutes, chapters 62J; 62K; 62Q; 119B; 144; 144D; 145; 147A; 148;
2.42245; 245A; 256; 256B; 256I; 256N; 256R; 317A; 448; proposing coding for new
2.43law as Minnesota Statutes, chapters 144H; 245G; repealing Minnesota Statutes
2.442016, sections 13.468; 147A.21; 147B.08, subdivisions 1, 2, 3; 147C.40,
2.45subdivisions 1, 2, 3, 4; 148.6402, subdivision 2; 148.6450; 245A.1915; 245A.192;
2.46254A.02, subdivision 4; 256B.0659, subdivision 22; 256B.19, subdivision 1c;
2.47256B.4914, subdivision 16; 256B.64; 256C.23, subdivision 3; 256C.233,
2.48subdivision 4; 256C.25, subdivisions 1, 2; 256J.626, subdivision 5; Laws 2014,
2.49chapter 312, article 23, section 9, subdivision 5; Minnesota Rules, parts 5600.2500;
2.509530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 12, 13, 14, 14a, 15, 15a,
2.5116, 17, 17a, 17b, 17c, 18, 20, 21; 9530.6410; 9530.6415; 9530.6420; 9530.6422;
2.529530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445; 9530.6450; 9530.6455;
2.539530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480; 9530.6485; 9530.6490;
2.549530.6495; 9530.6500; 9530.6505.
3.1May 8, 2017
3.2The Honorable Michelle L. Fischbach
3.3President of the Senate
3.4The Honorable Kurt L. Daudt
3.5Speaker of the House of Representatives
3.6We, the undersigned conferees for S.F. No. 800 report that we have agreed upon the
3.7items in dispute and recommend as follows:
3.8That the House recede from its amendments and that S.F. No. 800 be further amended
3.9as follows:
3.10Delete everything after the enacting clause and insert:

3.11"ARTICLE 1

3.12COMMUNITY SUPPORTS

3.13    Section 1. Minnesota Statutes 2016, section 144A.351, subdivision 1, is amended to read:
3.14    Subdivision 1. Report requirements. The commissioners of health and human services,
3.15with the cooperation of counties and in consultation with stakeholders, including persons
3.16who need or are using long-term care services and supports, lead agencies, regional entities,
3.17senior, disability, and mental health organization representatives, service providers, and
3.18community members shall prepare a report to the legislature by August 15, 2013, and
3.19biennially thereafter, regarding the status of the full range of long-term care services and
3.20supports for the elderly and children and adults with disabilities and mental illnesses in
3.21Minnesota. Any amounts appropriated for this report are available in either year of the
3.22biennium. The report shall address:
3.23    (1) demographics and need for long-term care services and supports in Minnesota;
3.24    (2) summary of county and regional reports on long-term care gaps, surpluses, imbalances,
3.25and corrective action plans;
3.26    (3) status of long-term care services and related mental health services, housing options,
3.27and supports by county and region including:
3.28    (i) changes in availability of the range of long-term care services and housing options;
3.29    (ii) access problems, including access to the least restrictive and most integrated services
3.30and settings, regarding long-term care services; and
3.31    (iii) comparative measures of long-term care services availability, including serving
3.32people in their home areas near family, and changes over time; and
4.1    (4) recommendations regarding goals for the future of long-term care services and
4.2supports, policy and fiscal changes, and resource development and transition needs.

4.3    Sec. 2. Minnesota Statutes 2016, section 245D.03, subdivision 1, is amended to read:
4.4    Subdivision 1. Applicability. (a) The commissioner shall regulate the provision of home
4.5and community-based services to persons with disabilities and persons age 65 and older
4.6pursuant to this chapter. The licensing standards in this chapter govern the provision of
4.7basic support services and intensive support services.
4.8(b) Basic support services provide the level of assistance, supervision, and care that is
4.9necessary to ensure the health and welfare of the person and do not include services that
4.10are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
4.11person. Basic support services include:
4.12(1) in-home and out-of-home respite care services as defined in section 245A.02,
4.13subdivision 15, and under the brain injury, community alternative care, community access
4.14for disability inclusion, developmental disability, and elderly waiver plans, excluding
4.15out-of-home respite care provided to children in a family child foster care home licensed
4.16under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license
4.17holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,
4.18or successor provisions; and section 245D.061 or successor provisions, which must be
4.19stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,
4.20subpart 4;
4.21(2) adult companion services as defined under the brain injury, community access for
4.22disability inclusion, and elderly waiver plans, excluding adult companion services provided
4.23under the Corporation for National and Community Services Senior Companion Program
4.24established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
4.25(3) personal support as defined under the developmental disability waiver plan;
4.26(4) 24-hour emergency assistance, personal emergency response as defined under the
4.27community access for disability inclusion and developmental disability waiver plans;
4.28(5) night supervision services as defined under the brain injury waiver plan; and
4.29(6) homemaker services as defined under the community access for disability inclusion,
4.30brain injury, community alternative care, developmental disability, and elderly waiver plans,
4.31excluding providers licensed by the Department of Health under chapter 144A and those
4.32providers providing cleaning services only; and
5.1(7) individual community living support under section 256B.0915, subdivision 3j.
5.2(c) Intensive support services provide assistance, supervision, and care that is necessary
5.3to ensure the health and welfare of the person and services specifically directed toward the
5.4training, habilitation, or rehabilitation of the person. Intensive support services include:
5.5(1) intervention services, including:
5.6(i) behavioral support services as defined under the brain injury and community access
5.7for disability inclusion waiver plans;
5.8(ii) in-home or out-of-home crisis respite services as defined under the developmental
5.9disability waiver plan; and
5.10(iii) specialist services as defined under the current developmental disability waiver
5.11plan;
5.12(2) in-home support services, including:
5.13(i) in-home family support and supported living services as defined under the
5.14developmental disability waiver plan;
5.15(ii) independent living services training as defined under the brain injury and community
5.16access for disability inclusion waiver plans; and
5.17(iii) semi-independent living services; and
5.18(iv) individualized home supports services as defined under the brain injury, community
5.19alternative care, and community access for disability inclusion waiver plans;
5.20(3) residential supports and services, including:
5.21(i) supported living services as defined under the developmental disability waiver plan
5.22provided in a family or corporate child foster care residence, a family adult foster care
5.23residence, a community residential setting, or a supervised living facility;
5.24(ii) foster care services as defined in the brain injury, community alternative care, and
5.25community access for disability inclusion waiver plans provided in a family or corporate
5.26child foster care residence, a family adult foster care residence, or a community residential
5.27setting; and
5.28(iii) residential services provided to more than four persons with developmental
5.29disabilities in a supervised living facility, including ICFs/DD;
5.30(4) day services, including:
5.31(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
6.2under the developmental disability waiver plan; and
6.3(iii) prevocational services as defined under the brain injury and community access for
6.4disability inclusion waiver plans; and
6.5(5) supported employment as defined under the brain injury, developmental disability,
6.6and community access for disability inclusion waiver plans employment exploration services
6.7as defined under the brain injury, community alternative care, community access for disability
6.8inclusion, and developmental disability waiver plans;
6.9(6) employment development services as defined under the brain injury, community
6.10alternative care, community access for disability inclusion, and developmental disability
6.11waiver plans; and
6.12(7) employment support services as defined under the brain injury, community alternative
6.13care, community access for disability inclusion, and developmental disability waiver plans.
6.14EFFECTIVE DATE.(a) The amendment to paragraphs (b) and (c), clause (2), is
6.15effective the day following final enactment.
6.16(b) The amendments to paragraph (c), clauses (5) to (7), are effective upon federal
6.17approval. The commissioner of human services shall notify the revisor of statutes when
6.18federal 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
6.21disabilities. (a) "Day training and habilitation services for adults with developmental
6.22disabilities" means services that:
6.23(1) include supervision, training, assistance, and supported employment, center-based
6.24work-related activities, or other community-integrated activities designed and implemented
6.25in accordance with the individual service and individual habilitation plans required under
6.26Minnesota Rules, parts 9525.0004 to 9525.0036, to help an adult reach and maintain the
6.27highest possible level of independence, productivity, and integration into the community;
6.28and
6.29(2) are provided by a vendor licensed under sections 245A.01 to 245A.16 and 252.28,
6.30subdivision 2 , to provide day training and habilitation services.
6.31(b) Day training and habilitation services reimbursable under this section do not include
6.32special education and related services as defined in the Education of the Individuals with
7.1Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and (17),
7.2or vocational services funded under section 110 of the Rehabilitation Act of 1973, United
7.3States Code, title 29, section 720, as amended.
7.4(c) Day training and habilitation services do not include employment exploration,
7.5employment development, or employment support services as defined in the home and
7.6community-based services waivers for people with disabilities authorized under sections
7.7256B.092 and 256B.49.
7.8EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
7.9of 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
7.12maintaining a statewide self-advocacy network for persons with intellectual and
7.13developmental disabilities. The self-advocacy network shall:
7.14(1) ensure that persons with intellectual and developmental disabilities are informed of
7.15their rights in employment, housing, transportation, voting, government policy, and other
7.16issues pertinent to the intellectual and developmental disability community;
7.17(2) provide public education and awareness of the civil and human rights issues persons
7.18with intellectual and developmental disabilities face;
7.19(3) provide funds, technical assistance, and other resources for self-advocacy groups
7.20across the state; and
7.21(4) organize systems of communications to facilitate an exchange of information between
7.22self-advocacy groups.
7.23(b) An organization receiving a grant under paragraph (a) must be an organization
7.24governed by people with intellectual and developmental disabilities that administers a
7.25statewide network of disability groups in order to maintain and promote self-advocacy
7.26services and supports for persons with intellectual and developmental disabilities throughout
7.27the state.

7.28    Sec. 5. Minnesota Statutes 2016, section 256B.0625, subdivision 6a, is amended to read:
7.29    Subd. 6a. Home health services. Home health services are those services specified in
7.30Minnesota Rules, part 9505.0295 and sections 256B.0651 and 256B.0653. Medical assistance
7.31covers home health services at a recipient's home residence or in the community where
8.1normal life activities take the recipient. Medical assistance does not cover home health
8.2services for residents of a hospital, nursing facility, or intermediate care facility, unless the
8.3commissioner of human services has authorized skilled nurse visits for less than 90 days
8.4for a resident at an intermediate care facility for persons with developmental disabilities,
8.5to prevent an admission to a hospital or nursing facility or unless a resident who is otherwise
8.6eligible is on leave from the facility and the facility either pays for the home health services
8.7or forgoes the facility per diem for the leave days that home health services are used. Home
8.8health services must be provided by a Medicare certified home health agency. All nursing
8.9and home health aide services must be provided according to sections 256B.0651 to
8.10256B.0653 .

8.11    Sec. 6. Minnesota Statutes 2016, section 256B.0625, subdivision 31, is amended to read:
8.12    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
8.13supplies and equipment. Separate payment outside of the facility's payment rate shall be
8.14made for wheelchairs and wheelchair accessories for recipients who are residents of
8.15intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs
8.16and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions
8.17and limitations as coverage for recipients who do not reside in institutions. A wheelchair
8.18purchased outside of the facility's payment rate is the property of the recipient.
8.19(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
8.20must enroll as a Medicare provider.
8.21(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics,
8.22or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment
8.23requirement if:
8.24(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic,
8.25or medical supply;
8.26(2) the vendor serves ten or fewer medical assistance recipients per year;
8.27(3) the commissioner finds that other vendors are not available to provide same or similar
8.28durable medical equipment, prosthetics, orthotics, or medical supplies; and
8.29(4) the vendor complies with all screening requirements in this chapter and Code of
8.30Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
8.31the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
8.32and Medicaid Services approved national accreditation organization as complying with the
9.1Medicare program's supplier and quality standards and the vendor serves primarily pediatric
9.2patients.
9.3(d) Durable medical equipment means a device or equipment that:
9.4(1) can withstand repeated use;
9.5(2) is generally not useful in the absence of an illness, injury, or disability; and
9.6(3) is provided to correct or accommodate a physiological disorder or physical condition
9.7or is generally used primarily for a medical purpose.
9.8(e) Electronic tablets may be considered durable medical equipment if the electronic
9.9tablet will be used as an augmentative and alternative communication system as defined
9.10under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must
9.11be locked in order to prevent use not related to communication.
9.12(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
9.13locked to prevent use not as an augmentative communication device, a recipient of waiver
9.14services may use an electronic tablet for a use not related to communication when the
9.15recipient has been authorized under the waiver to receive one or more additional applications
9.16that can be loaded onto the electronic tablet, such that allowing the additional use prevents
9.17the purchase of a separate electronic tablet with waiver funds.
9.18(g) An order or prescription for medical supplies, equipment, or appliances must meet
9.19the requirements in Code of Federal Regulations, title 42, part 470.

9.20    Sec. 7. Minnesota Statutes 2016, section 256B.0653, subdivision 2, is amended to read:
9.21    Subd. 2. Definitions. For the purposes of this section, the following terms have the
9.22meanings given.
9.23(a) "Assessment" means an evaluation of the recipient's medical need for home health
9.24agency services by a registered nurse or appropriate therapist that is conducted within 30
9.25days of a request.
9.26(b) "Home care therapies" means occupational, physical, and respiratory therapy and
9.27speech-language pathology services provided in the home by a Medicare certified home
9.28health agency.
9.29(c) "Home health agency services" means services delivered in the recipient's home
9.30residence, except as specified in section 256B.0625, by a home health agency to a recipient
9.31with medical needs due to illness, disability, or physical conditions in settings permitted
9.32under section 256B.0625, subdivision 6a.
10.1(d) "Home health aide" means an employee of a home health agency who completes
10.2medically oriented tasks written in the plan of care for a recipient.
10.3(e) "Home health agency" means a home care provider agency that is Medicare-certified.
10.4(f) "Occupational therapy services" mean the services defined in Minnesota Rules, part
10.59505.0390.
10.6(g) "Physical therapy services" mean the services defined in Minnesota Rules, part
10.79505.0390.
10.8(h) "Respiratory therapy services" mean the services defined in chapter 147C.
10.9(i) "Speech-language pathology services" mean the services defined in Minnesota Rules,
10.10part 9505.0390.
10.11(j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks
10.12required due to a recipient's medical condition that can only be safely provided by a
10.13professional nurse to restore and maintain optimal health.
10.14(k) "Store-and-forward technology" means telehomecare services that do not occur in
10.15real time via synchronous transmissions such as diabetic and vital sign monitoring.
10.16(l) "Telehomecare" means the use of telecommunications technology via live, two-way
10.17interactive audiovisual technology which may be augmented by store-and-forward
10.18technology.
10.19(m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to deliver
10.20a skilled nurse visit to a recipient located at a site other than the site where the nurse is
10.21located and is used in combination with face-to-face skilled nurse visits to adequately meet
10.22the recipient's needs.

10.23    Sec. 8. Minnesota Statutes 2016, section 256B.0653, subdivision 3, is amended to read:
10.24    Subd. 3. Home health aide visits. (a) Home health aide visits must be provided by a
10.25certified home health aide using a written plan of care that is updated in compliance with
10.26Medicare regulations. A home health aide shall provide hands-on personal care, perform
10.27simple procedures as an extension of therapy or nursing services, and assist in instrumental
10.28activities of daily living as defined in section 256B.0659, including assuring that the person
10.29gets to medical appointments if identified in the written plan of care. Home health aide
10.30visits must may be provided in the recipient's home or in the community where normal life
10.31activities take the recipient.
11.1    (b) All home health aide visits must have authorization under section 256B.0652. The
11.2commissioner shall limit home health aide visits to no more than one visit per day per
11.3recipient.
11.4    (c) Home health aides must be supervised by a registered nurse or an appropriate therapist
11.5when providing services that are an extension of therapy.

11.6    Sec. 9. Minnesota Statutes 2016, section 256B.0653, subdivision 4, is amended to read:
11.7    Subd. 4. Skilled nurse visit services. (a) Skilled nurse visit services must be provided
11.8by a registered nurse or a licensed practical nurse under the supervision of a registered nurse,
11.9according to the written plan of care and accepted standards of medical and nursing practice
11.10according to chapter 148. Skilled nurse visit services must be ordered by a physician and
11.11documented in a plan of care that is reviewed and approved by the ordering physician at
11.12least once every 60 days. All skilled nurse visits must be medically necessary and provided
11.13in the recipient's home residence or in the community where normal life activities take the
11.14recipient, except as allowed under section 256B.0625, subdivision 6a.
11.15(b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of up
11.16to two visits per day per recipient. All visits must be based on assessed needs.
11.17(c) Telehomecare skilled nurse visits are allowed when the recipient's health status can
11.18be accurately measured and assessed without a need for a face-to-face, hands-on encounter.
11.19All telehomecare skilled nurse visits must have authorization and are paid at the same
11.20allowable rates as face-to-face skilled nurse visits.
11.21(d) The provision of telehomecare must be made via live, two-way interactive audiovisual
11.22technology and may be augmented by utilizing store-and-forward technologies. Individually
11.23identifiable patient data obtained through real-time or store-and-forward technology must
11.24be maintained as health records according to sections 144.291 to 144.298. If the video is
11.25used for research, training, or other purposes unrelated to the care of the patient, the identity
11.26of the patient must be concealed.
11.27(e) Authorization for skilled nurse visits must be completed under section 256B.0652.
11.28A total of nine face-to-face skilled nurse visits per calendar year do not require authorization.
11.29All telehomecare skilled nurse visits require authorization.

12.1    Sec. 10. Minnesota Statutes 2016, section 256B.0653, subdivision 5, is amended to read:
12.2    Subd. 5. Home care therapies. (a) Home care therapies include the following: physical
12.3therapy, occupational therapy, respiratory therapy, and speech and language pathology
12.4therapy services.
12.5(b) Home care therapies must be:
12.6(1) provided in the recipient's residence or in the community where normal life activities
12.7take the recipient after it has been determined the recipient is unable to access outpatient
12.8therapy;
12.9(2) prescribed, ordered, or referred by a physician and documented in a plan of care and
12.10reviewed, according to Minnesota Rules, part 9505.0390;
12.11(3) assessed by an appropriate therapist; and
12.12(4) provided by a Medicare-certified home health agency enrolled as a Medicaid provider
12.13agency.
12.14(c) Restorative and specialized maintenance therapies must be provided according to
12.15Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be used
12.16as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
12.17(d) For both physical and occupational therapies, the therapist and the therapist's assistant
12.18may not both bill for services provided to a recipient on the same day.

12.19    Sec. 11. Minnesota Statutes 2016, section 256B.0653, subdivision 6, is amended to read:
12.20    Subd. 6. Noncovered home health agency services. The following are not eligible for
12.21payment under medical assistance as a home health agency service:
12.22(1) telehomecare skilled nurses services that is communication between the home care
12.23nurse and recipient that consists solely of a telephone conversation, facsimile, electronic
12.24mail, or a consultation between two health care practitioners;
12.25(2) the following skilled nurse visits:
12.26(i) for the purpose of monitoring medication compliance with an established medication
12.27program for a recipient;
12.28(ii) administering or assisting with medication administration, including injections,
12.29prefilling syringes for injections, or oral medication setup of an adult recipient, when, as
12.30determined and documented by the registered nurse, the need can be met by an available
13.1pharmacy or the recipient or a family member is physically and mentally able to
13.2self-administer or prefill a medication;
13.3(iii) services done for the sole purpose of supervision of the home health aide or personal
13.4care assistant;
13.5(iv) services done for the sole purpose to train other home health agency workers;
13.6(v) services done for the sole purpose of blood samples or lab draw when the recipient
13.7is able to access these services outside the home; and
13.8(vi) Medicare evaluation or administrative nursing visits required by Medicare;
13.9(3) home health aide visits when the following activities are the sole purpose for the
13.10visit: companionship, socialization, household tasks, transportation, and education; and
13.11(4) home care therapies provided in other settings such as a clinic, day program, or as
13.12an inpatient or when the recipient can access therapy outside of the recipient's residence;
13.13and
13.14(5) home health agency services without qualifying documentation of a face-to-face
13.15encounter as specified in subdivision 7.

13.16    Sec. 12. Minnesota Statutes 2016, section 256B.0653, is amended by adding a subdivision
13.17to read:
13.18    Subd. 7. Face-to-face encounter. (a) A face-to-face encounter by a qualifying provider
13.19must be completed for all home health services regardless of the need for prior authorization,
13.20except when providing a onetime perinatal visit by skilled nursing. The face-to-face encounter
13.21may occur through telemedicine as defined in section 256B.0625, subdivision 3b. The
13.22encounter must be related to the primary reason the recipient requires home health services
13.23and must occur within the 90 days before or the 30 days after the start of services. The
13.24face-to-face encounter may be conducted by one of the following practitioners, licensed in
13.25Minnesota:
13.26(1) a physician;
13.27(2) a nurse practitioner or clinical nurse specialist;
13.28(3) a certified nurse midwife; or
13.29(4) a physician assistant.
13.30(b) The allowed nonphysician practitioner, as described in this subdivision, performing
13.31the face-to-face encounter must communicate the clinical findings of that face-to-face
14.1encounter to the ordering physician. Those clinical findings must be incorporated into a
14.2written or electronic document included in the recipient's medical record. To assure clinical
14.3correlation between the face-to-face encounter and the associated home health services, the
14.4physician responsible for ordering the services must:
14.5(1) document that the face-to-face encounter, which is related to the primary reason the
14.6recipient requires home health services, occurred within the required time period; and
14.7(2) indicate the practitioner who conducted the encounter and the date of the encounter.
14.8(c) For home health services requiring authorization, including prior authorization, home
14.9health agencies must retain the qualifying documentation of a face-to-face encounter as part
14.10of the recipient health service record, and submit the qualifying documentation to the
14.11commissioner or the commissioner's designee upon request.

14.12    Sec. 13. Minnesota Statutes 2016, section 256B.0659, subdivision 1, is amended to read:
14.13    Subdivision 1. Definitions. (a) For the purposes of this section, the terms defined in
14.14paragraphs (b) to (r) (s) have the meanings given unless otherwise provided in text.
14.15    (b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility,
14.16positioning, eating, and toileting.
14.17    (c) "Behavior," effective January 1, 2010, means a category to determine the home care
14.18rating and is based on the criteria found in this section. "Level I behavior" means physical
14.19aggression towards self, others, or destruction of property that requires the immediate
14.20response of another person.
14.21    (d) "Complex health-related needs," effective January 1, 2010, means a category to
14.22determine the home care rating and is based on the criteria found in this section.
14.23(e) "Complex personal care assistance services" means personal care assistance services:
14.24(1) for a person who qualifies for ten hours or more of personal care assistance services
14.25per day; and
14.26(2) provided by a personal care assistant who is qualified to provide complex personal
14.27assistance services under subdivision 11, paragraph (d).
14.28    (e) (f) "Critical activities of daily living," effective January 1, 2010, means transferring,
14.29mobility, eating, and toileting.
14.30    (f) (g) "Dependency in activities of daily living" means a person requires assistance to
14.31begin and complete one or more of the activities of daily living.
15.1    (g) (h) "Extended personal care assistance service" means personal care assistance
15.2services included in a service plan under one of the home and community-based services
15.3waivers authorized under sections 256B.0915, 256B.092, subdivision 5, and 256B.49, which
15.4exceed the amount, duration, and frequency of the state plan personal care assistance services
15.5for participants who:
15.6    (1) need assistance provided periodically during a week, but less than daily will not be
15.7able to remain in their homes without the assistance, and other replacement services are
15.8more expensive or are not available when personal care assistance services are to be reduced;
15.9or
15.10    (2) need additional personal care assistance services beyond the amount authorized by
15.11the state plan personal care assistance assessment in order to ensure that their safety, health,
15.12and welfare are provided for in their homes.
15.13    (h) (i) "Health-related procedures and tasks" means procedures and tasks that can be
15.14delegated or assigned by a licensed health care professional under state law to be performed
15.15by a personal care assistant.
15.16    (i) (j) "Instrumental activities of daily living" means activities to include meal planning
15.17and preparation; basic assistance with paying bills; shopping for food, clothing, and other
15.18essential items; performing household tasks integral to the personal care assistance services;
15.19communication by telephone and other media; and traveling, including to medical
15.20appointments and to participate in the community.
15.21    (j) (k) "Managing employee" has the same definition as Code of Federal Regulations,
15.22title 42, section 455.
15.23    (k) (l) "Qualified professional" means a professional providing supervision of personal
15.24care assistance services and staff as defined in section 256B.0625, subdivision 19c.
15.25    (l) (m) "Personal care assistance provider agency" means a medical assistance enrolled
15.26provider that provides or assists with providing personal care assistance services and includes
15.27a personal care assistance provider organization, personal care assistance choice agency,
15.28class A licensed nursing agency, and Medicare-certified home health agency.
15.29    (m) (n) "Personal care assistant" or "PCA" means an individual employed by a personal
15.30care assistance agency who provides personal care assistance services.
15.31    (n) (o) "Personal care assistance care plan" means a written description of personal care
15.32assistance services developed by the personal care assistance provider according to the
15.33service plan.
16.1    (o) (p) "Responsible party" means an individual who is capable of providing the support
16.2necessary to assist the recipient to live in the community.
16.3    (p) (q) "Self-administered medication" means medication taken orally, by injection,
16.4nebulizer, or insertion, or applied topically without the need for assistance.
16.5    (q) (r) "Service plan" means a written summary of the assessment and description of the
16.6services needed by the recipient.
16.7    (r) (s) "Wages and benefits" means wages and salaries, the employer's share of FICA
16.8taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage
16.9reimbursement, health and dental insurance, life insurance, disability insurance, long-term
16.10care insurance, uniform allowance, and contributions to employee retirement accounts.
16.11EFFECTIVE DATE.This section is effective July 1, 2018.

16.12    Sec. 14. Minnesota Statutes 2016, section 256B.0659, subdivision 2, is amended to read:
16.13    Subd. 2. Personal care assistance services; covered services. (a) The personal care
16.14assistance services eligible for payment include services and supports furnished to an
16.15individual, as needed, to assist in:
16.16(1) activities of daily living;
16.17(2) health-related procedures and tasks;
16.18(3) observation and redirection of behaviors; and
16.19(4) instrumental activities of daily living.
16.20(b) Activities of daily living include the following covered services:
16.21(1) dressing, including assistance with choosing, application, and changing of clothing
16.22and application of special appliances, wraps, or clothing;
16.23(2) grooming, including assistance with basic hair care, oral care, shaving, applying
16.24cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included,
16.25except for recipients who are diabetic or have poor circulation;
16.26(3) bathing, including assistance with basic personal hygiene and skin care;
16.27(4) eating, including assistance with hand washing and application of orthotics required
16.28for eating, transfers, and feeding;
16.29(5) transfers, including assistance with transferring the recipient from one seating or
16.30reclining area to another;
17.1(6) mobility, including assistance with ambulation, including use of a wheelchair.
17.2Mobility does not include providing transportation for a recipient;
17.3(7) positioning, including assistance with positioning or turning a recipient for necessary
17.4care and comfort; and
17.5(8) toileting, including assistance with helping recipient with bowel or bladder elimination
17.6and care including transfers, mobility, positioning, feminine hygiene, use of toileting
17.7equipment or supplies, cleansing the perineal area, inspection of the skin, and adjusting
17.8clothing.
17.9(c) Health-related procedures and tasks include the following covered services:
17.10(1) range of motion and passive exercise to maintain a recipient's strength and muscle
17.11functioning;
17.12(2) assistance with self-administered medication as defined by this section, including
17.13reminders to take medication, bringing medication to the recipient, and assistance with
17.14opening medication under the direction of the recipient or responsible party, including
17.15medications given through a nebulizer;
17.16(3) interventions for seizure disorders, including monitoring and observation; and
17.17(4) other activities considered within the scope of the personal care service and meeting
17.18the definition of health-related procedures and tasks under this section.
17.19(d) A personal care assistant may provide health-related procedures and tasks associated
17.20with the complex health-related needs of a recipient if the procedures and tasks meet the
17.21definition of health-related procedures and tasks under this section and the personal care
17.22assistant is trained by a qualified professional and demonstrates competency to safely
17.23complete the procedures and tasks. Delegation of health-related procedures and tasks and
17.24all training must be documented in the personal care assistance care plan and the recipient's
17.25and personal care assistant's files. A personal care assistant must not determine the medication
17.26dose or time for medication.
17.27(e) Effective January 1, 2010, for a personal care assistant to provide the health-related
17.28procedures and tasks of tracheostomy suctioning and services to recipients on ventilator
17.29support there must be:
17.30(1) delegation and training by a registered nurse, certified or licensed respiratory therapist,
17.31or a physician;
17.32(2) utilization of clean rather than sterile procedure;
18.1(3) specialized training about the health-related procedures and tasks and equipment,
18.2including ventilator operation and maintenance;
18.3(4) individualized training regarding the needs of the recipient; and
18.4(5) supervision by a qualified professional who is a registered nurse.
18.5(f) Effective January 1, 2010, a personal care assistant may observe and redirect the
18.6recipient for episodes where there is a need for redirection due to behaviors. Training of
18.7the personal care assistant must occur based on the needs of the recipient, the personal care
18.8assistance care plan, and any other support services provided.
18.9(g) Instrumental activities of daily living under subdivision 1, paragraph (i) (j).
18.10EFFECTIVE DATE.This section is effective July 1, 2018.

18.11    Sec. 15. Minnesota Statutes 2016, section 256B.0659, subdivision 11, is amended to read:
18.12    Subd. 11. Personal care assistant; requirements. (a) A personal care assistant must
18.13meet the following requirements:
18.14    (1) be at least 18 years of age with the exception of persons who are 16 or 17 years of
18.15age with these additional requirements:
18.16    (i) supervision by a qualified professional every 60 days; and
18.17    (ii) employment by only one personal care assistance provider agency responsible for
18.18compliance with current labor laws;
18.19    (2) be employed by a personal care assistance provider agency;
18.20    (3) enroll with the department as a personal care assistant after clearing a background
18.21study. Except as provided in subdivision 11a, before a personal care assistant provides
18.22services, the personal care assistance provider agency must initiate a background study on
18.23the personal care assistant under chapter 245C, and the personal care assistance provider
18.24agency must have received a notice from the commissioner that the personal care assistant
18.25is:
18.26    (i) not disqualified under section 245C.14; or
18.27    (ii) is disqualified, but the personal care assistant has received a set aside of the
18.28disqualification under section 245C.22;
18.29    (4) be able to effectively communicate with the recipient and personal care assistance
18.30provider agency;
19.1    (5) be able to provide covered personal care assistance services according to the recipient's
19.2personal care assistance care plan, respond appropriately to recipient needs, and report
19.3changes in the recipient's condition to the supervising qualified professional or physician;
19.4    (6) not be a consumer of personal care assistance services;
19.5    (7) maintain daily written records including, but not limited to, time sheets under
19.6subdivision 12;
19.7    (8) effective January 1, 2010, complete standardized training as determined by the
19.8commissioner before completing enrollment. The training must be available in languages
19.9other than English and to those who need accommodations due to disabilities. Personal care
19.10assistant training must include successful completion of the following training components:
19.11basic first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic
19.12roles and responsibilities of personal care assistants including information about assistance
19.13with lifting and transfers for recipients, emergency preparedness, orientation to positive
19.14behavioral practices, fraud issues, and completion of time sheets. Upon completion of the
19.15training components, the personal care assistant must demonstrate the competency to provide
19.16assistance to recipients;
19.17    (9) complete training and orientation on the needs of the recipient; and
19.18    (10) be limited to providing and being paid for up to 275 hours per month of personal
19.19care assistance services regardless of the number of recipients being served or the number
19.20of personal care assistance provider agencies enrolled with. The number of hours worked
19.21per day shall not be disallowed by the department unless in violation of the law.
19.22    (b) A legal guardian may be a personal care assistant if the guardian is not being paid
19.23for the guardian services and meets the criteria for personal care assistants in paragraph (a).
19.24    (c) Persons who do not qualify as a personal care assistant include parents, stepparents,
19.25and legal guardians of minors; spouses; paid legal guardians of adults; family foster care
19.26providers, except as otherwise allowed in section 256B.0625, subdivision 19a; and staff of
19.27a residential setting.
19.28(d) A personal care assistant is qualified to provide complex personal care assistance
19.29services as defined in subdivision 1, paragraph (e), if the personal care assistant:
19.30(1) provides services according to the care plan in subdivision 7 to an individual described
19.31in subdivision 1, paragraph (e), clause (1); and
19.32(2) satisfies the current requirements of Medicare for training and competency or
19.33competency evaluation of home health aides or nursing assistants, as provided by Code of
20.1Federal Regulations, title 42, section 483.151 or 484.36, or alternative, comparable,
20.2state-approved training and competency requirements.
20.3EFFECTIVE DATE.This section is effective July 1, 2018.

20.4    Sec. 16. Minnesota Statutes 2016, section 256B.0659, is amended by adding a subdivision
20.5to read:
20.6    Subd. 17a. Rate for complex personal care assistance services. The rate paid to a
20.7provider for complex personal care assistance services shall be 110 percent of the rate paid
20.8for personal care assistance services.
20.9EFFECTIVE DATE.This section is effective July 1, 2018.

20.10    Sec. 17. Minnesota Statutes 2016, section 256B.0659, subdivision 21, is amended to read:
20.11    Subd. 21. Requirements for provider enrollment of personal care assistance provider
20.12agencies. (a) All personal care assistance provider agencies must provide, at the time of
20.13enrollment, reenrollment, and revalidation as a personal care assistance provider agency in
20.14a format determined by the commissioner, information and documentation that includes,
20.15but is not limited to, the following:
20.16    (1) the personal care assistance provider agency's current contact information including
20.17address, telephone number, and e-mail address;
20.18    (2) proof of surety bond coverage. Upon new enrollment, or if the provider's Medicaid
20.19revenue in the previous calendar year is up to and including $300,000, the provider agency
20.20must purchase a surety bond of $50,000. If the Medicaid revenue in the previous year is
20.21over $300,000, the provider agency must purchase a surety bond of $100,000. The surety
20.22bond must be in a form approved by the commissioner, must be renewed annually, and must
20.23allow for recovery of costs and fees in pursuing a claim on the bond;
20.24    (3) proof of fidelity bond coverage in the amount of $20,000;
20.25    (4) proof of workers' compensation insurance coverage;
20.26    (5) proof of liability insurance;
20.27    (6) a description of the personal care assistance provider agency's organization identifying
20.28the names of all owners, managing employees, staff, board of directors, and the affiliations
20.29of the directors, owners, or staff to other service providers;
20.30    (7) a copy of the personal care assistance provider agency's written policies and
20.31procedures including: hiring of employees; training requirements; service delivery; and
21.1employee and consumer safety including process for notification and resolution of consumer
21.2grievances, identification and prevention of communicable diseases, and employee
21.3misconduct;
21.4    (8) copies of all other forms the personal care assistance provider agency uses in the
21.5course of daily business including, but not limited to:
21.6    (i) a copy of the personal care assistance provider agency's time sheet if the time sheet
21.7varies from the standard time sheet for personal care assistance services approved by the
21.8commissioner, and a letter requesting approval of the personal care assistance provider
21.9agency's nonstandard time sheet;
21.10    (ii) the personal care assistance provider agency's template for the personal care assistance
21.11care plan; and
21.12    (iii) the personal care assistance provider agency's template for the written agreement
21.13in subdivision 20 for recipients using the personal care assistance choice option, if applicable;
21.14    (9) a list of all training and classes that the personal care assistance provider agency
21.15requires of its staff providing personal care assistance services;
21.16    (10) documentation that the personal care assistance provider agency and staff have
21.17successfully completed all the training required by this section, including the requirements
21.18under subdivision 11, paragraph (d), if complex personal care assistance services are provided
21.19and submitted for payment;
21.20    (11) documentation of the agency's marketing practices;
21.21    (12) disclosure of ownership, leasing, or management of all residential properties that
21.22is used or could be used for providing home care services;
21.23    (13) documentation that the agency will use the following percentages of revenue
21.24generated from the medical assistance rate paid for personal care assistance services for
21.25employee personal care assistant wages and benefits: 72.5 percent of revenue in the personal
21.26care assistance choice option and 72.5 percent of revenue from other personal care assistance
21.27providers. The revenue generated by the qualified professional and the reasonable costs
21.28associated with the qualified professional shall not be used in making this calculation; and
21.29    (14) effective May 15, 2010, documentation that the agency does not burden recipients'
21.30free exercise of their right to choose service providers by requiring personal care assistants
21.31to sign an agreement not to work with any particular personal care assistance recipient or
21.32for another personal care assistance provider agency after leaving the agency and that the
22.1agency is not taking action on any such agreements or requirements regardless of the date
22.2signed.
22.3    (b) Personal care assistance provider agencies shall provide the information specified
22.4in paragraph (a) to the commissioner at the time the personal care assistance provider agency
22.5enrolls as a vendor or upon request from the commissioner. The commissioner shall collect
22.6the information specified in paragraph (a) from all personal care assistance providers
22.7beginning July 1, 2009.
22.8    (c) All personal care assistance provider agencies shall require all employees in
22.9management and supervisory positions and owners of the agency who are active in the
22.10day-to-day management and operations of the agency to complete mandatory training as
22.11determined by the commissioner before enrollment of the agency as a provider. Employees
22.12in management and supervisory positions and owners who are active in the day-to-day
22.13operations of an agency who have completed the required training as an employee with a
22.14personal care assistance provider agency do not need to repeat the required training if they
22.15are hired by another agency, if they have completed the training within the past three years.
22.16By September 1, 2010, the required training must be available with meaningful access
22.17according to title VI of the Civil Rights Act and federal regulations adopted under that law
22.18or any guidance from the United States Health and Human Services Department. The
22.19required training must be available online or by electronic remote connection. The required
22.20training must provide for competency testing. Personal care assistance provider agency
22.21billing staff shall complete training about personal care assistance program financial
22.22management. This training is effective July 1, 2009. Any personal care assistance provider
22.23agency enrolled before that date shall, if it has not already, complete the provider training
22.24within 18 months of July 1, 2009. Any new owners or employees in management and
22.25supervisory positions involved in the day-to-day operations are required to complete
22.26mandatory training as a requisite of working for the agency. Personal care assistance provider
22.27agencies certified for participation in Medicare as home health agencies are exempt from
22.28the training required in this subdivision. When available, Medicare-certified home health
22.29agency owners, supervisors, or managers must successfully complete the competency test.

22.30    Sec. 18. Minnesota Statutes 2016, section 256B.0911, subdivision 1a, is amended to read:
22.31    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
22.32    (a) Until additional requirements apply under paragraph (b), "long-term care consultation
22.33services" means:
23.1    (1) intake for and access to assistance in identifying services needed to maintain an
23.2individual in the most inclusive environment;
23.3    (2) providing recommendations for and referrals to cost-effective community services
23.4that are available to the individual;
23.5    (3) development of an individual's person-centered community support plan;
23.6    (4) providing information regarding eligibility for Minnesota health care programs;
23.7    (5) face-to-face long-term care consultation assessments, which may be completed in a
23.8hospital, nursing facility, intermediate care facility for persons with developmental disabilities
23.9(ICF/DDs), regional treatment centers, or the person's current or planned residence;
23.10    (6) determination of home and community-based waiver and other service eligibility as
23.11required under sections 256B.0913, 256B.0915, and 256B.49, including level of care
23.12determination for individuals who need an institutional level of care as determined under
23.13subdivision 4e, based on assessment and community support plan development, appropriate
23.14referrals to obtain necessary diagnostic information, and including an eligibility determination
23.15for consumer-directed community supports;
23.16    (7) providing recommendations for institutional placement when there are no
23.17cost-effective community services available;
23.18    (8) providing access to assistance to transition people back to community settings after
23.19institutional admission; and
23.20(9) providing information about competitive employment, with or without supports, for
23.21school-age youth and working-age adults and referrals to the Disability Linkage Line and
23.22Disability Benefits 101 to ensure that an informed choice about competitive employment
23.23can be made. For the purposes of this subdivision, "competitive employment" means work
23.24in the competitive labor market that is performed on a full-time or part-time basis in an
23.25integrated setting, and for which an individual is compensated at or above the minimum
23.26wage, but not less than the customary wage and level of benefits paid by the employer for
23.27the same or similar work performed by individuals without disabilities.
23.28(b) Upon statewide implementation of lead agency requirements in subdivisions 2b, 2c,
23.29and 3a, "long-term care consultation services" also means:
23.30(1) service eligibility determination for state plan home care services identified in:
23.31(i) section 256B.0625, subdivisions 7, 19a, and 19c;
23.32(ii) consumer support grants under section 256.476; or
24.1(iii) section 256B.85;
24.2(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
24.3determination of eligibility for case management services available under sections 256B.0621,
24.4subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part 9525.0016;
24.5(3) determination of institutional level of care, home and community-based service
24.6waiver, and other service eligibility as required under section 256B.092, determination of
24.7eligibility for family support grants under section 252.32, semi-independent living services
24.8under section 252.275, and day training and habilitation services under section 256B.092;
24.9and
24.10(4) obtaining necessary diagnostic information to determine eligibility under clauses (2)
24.11and (3).
24.12    (c) "Long-term care options counseling" means the services provided by the linkage
24.13lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and also
24.14includes telephone assistance and follow up once a long-term care consultation assessment
24.15has been completed.
24.16    (d) "Minnesota health care programs" means the medical assistance program under this
24.17chapter and the alternative care program under section 256B.0913.
24.18    (e) "Lead agencies" means counties administering or tribes and health plans under
24.19contract with the commissioner to administer long-term care consultation assessment and
24.20support planning services.
24.21(f) "Person-centered planning" is a process that includes the active participation of a
24.22person in the planning of the person's services, including in making meaningful and informed
24.23choices about the person's own goals, talents, and objectives, as well as making meaningful
24.24and informed choices about the services the person receives. For the purposes of this section,
24.25"informed choice" means a voluntary choice of services by a person from all available
24.26service options based on accurate and complete information concerning all available service
24.27options and concerning the person's own preferences, abilities, goals, and objectives. In
24.28order for a person to make an informed choice, all available options must be developed and
24.29presented to the person to empower the person to make decisions.

24.30    Sec. 19. Minnesota Statutes 2016, section 256B.0911, subdivision 2b, is amended to read:
24.31    Subd. 2b. MnCHOICES certified assessors. (a) Each lead agency shall use certified
24.32assessors who have completed MnCHOICES training and the certification processes
24.33determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate
25.1best practices in assessment and support planning including person-centered planning
25.2principals principles and have a common set of skills that must ensure consistency and
25.3equitable access to services statewide. A lead agency may choose, according to departmental
25.4policies, to contract with a qualified, certified assessor to conduct assessments and
25.5reassessments on behalf of the lead agency. Certified assessors must use person-centered
25.6planning principles to conduct an interview that identifies what is important to the person,
25.7the person's needs for supports, health and safety concerns, and the person's abilities, interests,
25.8and goals.
25.9    Certified assessors are responsible for:
25.10(1) ensuring persons are offered objective, unbiased access to resources;
25.11(2) ensuring persons have the needed information to support informed choice, including
25.12where and how they choose to live and the opportunity to pursue desired employment;
25.13(3) determining level of care and eligibility for long-term services and supports;
25.14(4) using the information gathered from the interview to develop a person-centered
25.15community support plan that reflects identified needs and support options within the context
25.16of values, interests, and goals important to the person; and
25.17(5) providing the person with a community support plan that summarizes the person's
25.18assessment findings, support options, and agreed-upon next steps.
25.19    (b) MnCHOICES certified assessors are persons with a minimum of a bachelor's degree
25.20in social work, nursing with a public health nursing certificate, or other closely related field
25.21with at least one year of home and community-based experience, or a registered nurse with
25.22at least two years of home and community-based experience who has received training and
25.23certification specific to assessment and consultation for long-term care services in the state.

25.24    Sec. 20. Minnesota Statutes 2016, section 256B.0911, is amended by adding a subdivision
25.25to read:
25.26    Subd. 3f. Long-term care reassessments and community support plan updates.
25.27Face-to-face reassessments must be conducted annually or as required by federal and state
25.28laws and rules. Reassessments build upon all previous assessments conducted and include
25.29a review of needs and services to identify any changes. Reassessments provide information
25.30to support the person's informed choice and opportunities to express choice regarding
25.31activities that contribute to quality of life, as well as information and opportunity to identify
25.32goals related to desired employment, community activities, and preferred living environment.
25.33Reassessments allow for a review of the current support plan's effectiveness, monitoring of
26.1services, and the development of an updated person-centered community support plan.
26.2Reassessments verify continued eligibility or offer alternatives as warranted and provide
26.3an opportunity for quality assurance of service delivery.

26.4    Sec. 21. Minnesota Statutes 2016, section 256B.0911, subdivision 4d, is amended to read:
26.5    Subd. 4d. Preadmission screening of individuals under 65 years of age. (a) It is the
26.6policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness
26.7are served in the most integrated setting appropriate to their needs and have the necessary
26.8information to make informed choices about home and community-based service options.
26.9    (b) Individuals under 65 years of age who are admitted to a Medicaid-certified nursing
26.10facility must be screened prior to admission according to the requirements outlined in section
26.11256.975 , subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as
26.12required under section 256.975, subdivision 7.
26.13    (c) Individuals under 65 years of age who are admitted to nursing facilities with only a
26.14telephone screening must receive a face-to-face assessment from the long-term care
26.15consultation team member of the county in which the facility is located or from the recipient's
26.16county case manager within 40 calendar days of admission the timeline established by the
26.17commissioner, based on review of data.
26.18    (d) At the face-to-face assessment, the long-term care consultation team member or
26.19county case manager must perform the activities required under subdivision 3b.
26.20    (e) For individuals under 21 years of age, a screening interview which recommends
26.21nursing facility admission must be face-to-face and approved by the commissioner before
26.22the individual is admitted to the nursing facility.
26.23    (f) In the event that an individual under 65 years of age is admitted to a nursing facility
26.24on an emergency basis, the Senior LinkAge Line must be notified of the admission on the
26.25next working day, and a face-to-face assessment as described in paragraph (c) must be
26.26conducted within 40 calendar days of admission the timeline established by the commissioner,
26.27based on review of data.
26.28    (g) At the face-to-face assessment, the long-term care consultation team member or the
26.29case manager must present information about home and community-based options, including
26.30consumer-directed options, so the individual can make informed choices. If the individual
26.31chooses home and community-based services, the long-term care consultation team member
26.32or case manager must complete a written relocation plan within 20 working days of the
26.33visit. The plan shall describe the services needed to move out of the facility and a time line
27.1for the move which is designed to ensure a smooth transition to the individual's home and
27.2community.
27.3    (h) An individual under 65 years of age residing in a nursing facility shall receive a
27.4face-to-face assessment at least every 12 months to review the person's service choices and
27.5available alternatives unless the individual indicates, in writing, that annual visits are not
27.6desired. In this case, the individual must receive a face-to-face assessment at least once
27.7every 36 months for the same purposes.
27.8    (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay county
27.9agencies directly for face-to-face assessments for individuals under 65 years of age who
27.10are being considered for placement or residing in a nursing facility.
27.11(j) Funding for preadmission screening follow-up shall be provided to the Disability
27.12Linkage Line for the under-60 population by the Department of Human Services to cover
27.13options counseling salaries and expenses to provide the services described in subdivisions
27.147a to 7c. The Disability Linkage Line shall employ, or contract with other agencies to
27.15employ, within the limits of available funding, sufficient personnel to provide preadmission
27.16screening follow-up services and shall seek to maximize federal funding for the service as
27.17provided under section 256.01, subdivision 2, paragraph (dd).

27.18    Sec. 22. Minnesota Statutes 2016, section 256B.0911, subdivision 5, is amended to read:
27.19    Subd. 5. Administrative activity. (a) The commissioner shall streamline the processes,
27.20including timelines for when assessments need to be completed, required to provide the
27.21services in this section and shall implement integrated solutions to automate the business
27.22processes to the extent necessary for community support plan approval, reimbursement,
27.23program planning, evaluation, and policy development.
27.24(b) The commissioner of human services shall work with lead agencies responsible for
27.25conducting long-term consultation services to modify the MnCHOICES application and
27.26assessment policies to create efficiencies while ensuring federal compliance with medical
27.27assistance and long-term services and supports eligibility criteria.

27.28    Sec. 23. Minnesota Statutes 2016, section 256B.0921, is amended to read:
27.29256B.0921 HOME AND COMMUNITY-BASED SERVICES INCENTIVE POOL.
27.30    The commissioner of human services shall develop an initiative to provide incentives
27.31for innovation in: (1) achieving integrated competitive employment,; (2) achieving integrated
27.32competitive employment for youth under age 25 upon their graduation from school; (3)
28.1living in the most integrated setting,; and (4) other outcomes determined by the commissioner.
28.2The commissioner shall seek requests for proposals and shall contract with one or more
28.3entities to provide incentive payments for meeting identified outcomes. The initial requests
28.4for proposals must be issued by October 1, 2016.

28.5    Sec. 24. Minnesota Statutes 2016, section 256B.4913, subdivision 4a, is amended to read:
28.6    Subd. 4a. Rate stabilization adjustment. (a) For purposes of this subdivision,
28.7"implementation period" means the period beginning January 1, 2014, and ending on the
28.8last day of the month in which the rate management system is populated with the data
28.9necessary to calculate rates for substantially all individuals receiving home and
28.10community-based waiver services under sections 256B.092 and 256B.49. "Banding period"
28.11means the time period beginning on January 1, 2014, and ending upon the expiration of the
28.1212-month period defined in paragraph (c), clause (5).
28.13(b) For purposes of this subdivision, the historical rate for all service recipients means
28.14the individual reimbursement rate for a recipient in effect on December 1, 2013, except
28.15that:
28.16(1) for a day service recipient who was not authorized to receive these waiver services
28.17prior to January 1, 2014; added a new service or services on or after January 1, 2014; or
28.18changed providers on or after January 1, 2014, the historical rate must be the weighted
28.19average authorized rate for the provider number in the county of service, effective December
28.201, 2013; or
28.21(2) for a unit-based service with programming or a unit-based service without
28.22programming recipient who was not authorized to receive these waiver services prior to
28.23January 1, 2014; added a new service or services on or after January 1, 2014; or changed
28.24providers on or after January 1, 2014, the historical rate must be the weighted average
28.25authorized rate for each provider number in the county of service, effective December 1,
28.262013; or
28.27(3) for residential service recipients who change providers on or after January 1, 2014,
28.28the historical rate must be set by each lead agency within their county aggregate budget
28.29using their respective methodology for residential services effective December 1, 2013, for
28.30determining the provider rate for a similarly situated recipient being served by that provider.
28.31(c) The commissioner shall adjust individual reimbursement rates determined under this
28.32section so that the unit rate is no higher or lower than:
28.33(1) 0.5 percent from the historical rate for the implementation period;
29.1(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period immediately
29.2following the time period of clause (1);
29.3(3) 0.5 percent from the rate in effect in clause (2), for the 12-month period immediately
29.4following the time period of clause (2);
29.5(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period immediately
29.6following the time period of clause (3);
29.7(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period immediately
29.8following the time period of clause (4); and
29.9(6) no adjustment to the rate in effect in clause (5) for the 12-month period immediately
29.10following the time period of clause (5). During this banding rate period, the commissioner
29.11shall not enforce any rate decrease or increase that would otherwise result from the end of
29.12the banding period. The commissioner shall, upon enactment, seek federal approval for the
29.13addition of this banding period; and
29.14(7) one percent from the rate in effect in clause (6) for the 12-month period immediately
29.15following the time period of clause (6).
29.16(d) The commissioner shall review all changes to rates that were in effect on December
29.171, 2013, to verify that the rates in effect produce the equivalent level of spending and service
29.18unit utilization on an annual basis as those in effect on October 31, 2013.
29.19(e) By December 31, 2014, the commissioner shall complete the review in paragraph
29.20(d), adjust rates to provide equivalent annual spending, and make appropriate adjustments.
29.21(f) During the banding period, the Medicaid Management Information System (MMIS)
29.22service agreement rate must be adjusted to account for change in an individual's need. The
29.23commissioner shall adjust the Medicaid Management Information System (MMIS) service
29.24agreement rate by:
29.25(1) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the
29.26individual with variables reflecting the level of service in effect on December 1, 2013;
29.27(2) calculating a service rate under section 256B.4914, subdivision 6, 7, 8, or 9, for the
29.28individual with variables reflecting the updated level of service at the time of application;
29.29and
29.30(3) adding to or subtracting from the Medicaid Management Information System (MMIS)
29.31service agreement rate, the difference between the values in clauses (1) and (2).
30.1(g) This subdivision must not apply to rates for recipients served by providers new to a
30.2given county after January 1, 2014. Providers of personal supports services who also acted
30.3as fiscal support entities must be treated as new providers as of January 1, 2014.
30.4EFFECTIVE DATE.(a) The amendment to paragraph (b) is effective the day following
30.5final enactment.
30.6(b) The amendment to paragraph (c) is effective upon federal approval. The commissioner
30.7of human services shall notify the revisor of statutes when federal approval is obtained.

30.8    Sec. 25. Minnesota Statutes 2016, section 256B.4913, is amended by adding a subdivision
30.9to read:
30.10    Subd. 7. New services. (a) A service added to section 256B.4914 after January 1, 2014,
30.11is not subject to rate stabilization adjustment in this section.
30.12(b) Employment support services authorized after January 1, 2018, under the new
30.13employment support services definition according to the home and community-based services
30.14waivers for people with disabilities under sections 256B.092 and 256B.49 are not subject
30.15to rate stabilization adjustment in this section.
30.16EFFECTIVE DATE.This section is effective the day following final enactment.

30.17    Sec. 26. Minnesota Statutes 2016, section 256B.4914, subdivision 2, is amended to read:
30.18    Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
30.19meanings given them, unless the context clearly indicates otherwise.
30.20(b) "Commissioner" means the commissioner of human services.
30.21(c) "Component value" means underlying factors that are part of the cost of providing
30.22services that are built into the waiver rates methodology to calculate service rates.
30.23(d) "Customized living tool" means a methodology for setting service rates that delineates
30.24and documents the amount of each component service included in a recipient's customized
30.25living service plan.
30.26(e) "Disability waiver rates system" means a statewide system that establishes rates that
30.27are based on uniform processes and captures the individualized nature of waiver services
30.28and recipient needs.
30.29(f) "Individual staffing" means the time spent as a one-to-one interaction specific to an
30.30individual recipient by staff to provide direct support and assistance with activities of daily
30.31living, instrumental activities of daily living, and training to participants, and is based on
31.1the requirements in each individual's coordinated service and support plan under section
31.2245D.02, subdivision 4b ; any coordinated service and support plan addendum under section
31.3245D.02, subdivision 4c ; and an assessment tool. Provider observation of an individual's
31.4needs must also be considered.
31.5(g) "Lead agency" means a county, partnership of counties, or tribal agency charged
31.6with administering waivered services under sections 256B.092 and 256B.49.
31.7(h) "Median" means the amount that divides distribution into two equal groups, one-half
31.8above the median and one-half below the median.
31.9(i) "Payment or rate" means reimbursement to an eligible provider for services provided
31.10to a qualified individual based on an approved service authorization.
31.11(j) "Rates management system" means a Web-based software application that uses a
31.12framework and component values, as determined by the commissioner, to establish service
31.13rates.
31.14(k) "Recipient" means a person receiving home and community-based services funded
31.15under any of the disability waivers.
31.16(l) "Shared staffing" means time spent by employees, not defined under paragraph (f),
31.17providing or available to provide more than one individual with direct support and assistance
31.18with activities of daily living as defined under section 256B.0659, subdivision 1, paragraph
31.19(b); instrumental activities of daily living as defined under section 256B.0659, subdivision
31.201, paragraph (i); ancillary activities needed to support individual services; and training to
31.21participants, and is based on the requirements in each individual's coordinated service and
31.22support plan under section 245D.02, subdivision 4b; any coordinated service and support
31.23plan addendum under section 245D.02, subdivision 4c; an assessment tool; and provider
31.24observation of an individual's service need. Total shared staffing hours are divided
31.25proportionally by the number of individuals who receive the shared service provisions.
31.26(m) "Staffing ratio" means the number of recipients a service provider employee supports
31.27during a unit of service based on a uniform assessment tool, provider observation, case
31.28history, and the recipient's services of choice, and not based on the staffing ratios under
31.29section 245D.31.
31.30    (n) "Unit of service" means the following:
31.31    (1) for residential support services under subdivision 6, a unit of service is a day. Any
31.32portion of any calendar day, within allowable Medicaid rules, where an individual spends
31.33time in a residential setting is billable as a day;
32.1    (2) for day services under subdivision 7:
32.2    (i) for day training and habilitation services, a unit of service is either:
32.3    (A) a day unit of service is defined as six or more hours of time spent providing direct
32.4services and transportation; or
32.5    (B) a partial day unit of service is defined as fewer than six hours of time spent providing
32.6direct services and transportation; and
32.7    (C) for new day service recipients after January 1, 2014, 15 minute units of service must
32.8be used for fewer than six hours of time spent providing direct services and transportation;
32.9    (ii) for adult day and structured day services, a unit of service is a day or 15 minutes. A
32.10day unit of service is six or more hours of time spent providing direct services;
32.11    (iii) for prevocational services, a unit of service is a day or an hour. A day unit of service
32.12is six or more hours of time spent providing direct service;
32.13    (3) for unit-based services with programming under subdivision 8:
32.14    (i) for supported living services, a unit of service is a day or 15 minutes. When a day
32.15rate is authorized, any portion of a calendar day where an individual receives services is
32.16billable as a day; and
32.17    (ii) for all other services, a unit of service is 15 minutes; and
32.18    (4) for unit-based services without programming under subdivision 9:
32.19    (i) for respite services, a unit of service is a day or 15 minutes. When a day rate is
32.20authorized, any portion of a calendar day when an individual receives services is billable
32.21as a day; and
32.22    (ii) for all other services, a unit of service is 15 minutes.
32.23EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
32.24of human services shall notify the revisor of statutes when federal approval is obtained.

32.25    Sec. 27. Minnesota Statutes 2016, section 256B.4914, subdivision 3, is amended to read:
32.26    Subd. 3. Applicable services. Applicable services are those authorized under the state's
32.27home and community-based services waivers under sections 256B.092 and 256B.49,
32.28including the following, as defined in the federally approved home and community-based
32.29services plan:
32.30(1) 24-hour customized living;
33.1(2) adult day care;
33.2(3) adult day care bath;
33.3(4) behavioral programming;
33.4(5) companion services;
33.5(6) customized living;
33.6(7) day training and habilitation;
33.7(8) housing access coordination;
33.8(9) independent living skills;
33.9(10) in-home family support;
33.10(11) night supervision;
33.11(12) personal support;
33.12(13) prevocational services;
33.13(14) residential care services;
33.14(15) residential support services;
33.15(16) respite services;
33.16(17) structured day services;
33.17(18) supported employment services;
33.18(19) (18) supported living services;
33.19(20) (19) transportation services; and
33.20(20) individualized home supports;
33.21(21) independent living skills specialist services;
33.22(22) employment exploration services;
33.23(23) employment development services;
33.24(24) employment support services; and
33.25(21) (25) other services as approved by the federal government in the state home and
33.26community-based services plan.
33.27EFFECTIVE DATE.(a) Clause (20) is effective the day following final enactment.
34.1(b) Clauses (21) to (24) are effective upon federal approval. The commissioner of human
34.2services shall notify the revisor of statutes when federal approval is obtained.

34.3    Sec. 28. Minnesota Statutes 2016, section 256B.4914, subdivision 5, is amended to read:
34.4    Subd. 5. Base wage index and standard component values. (a) The base wage index
34.5is established to determine staffing costs associated with providing services to individuals
34.6receiving home and community-based services. For purposes of developing and calculating
34.7the proposed base wage, Minnesota-specific wages taken from job descriptions and standard
34.8occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in
34.9the most recent edition of the Occupational Handbook must be used. The base wage index
34.10must be calculated as follows:
34.11(1) for residential direct care staff, the sum of:
34.12(i) 15 percent of the subtotal of 50 percent of the median wage for personal and home
34.13health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide assistant
34.14(SOC code 31-1012 31-1014); and 20 percent of the median wage for social and human
34.15services aide (SOC code 21-1093); and
34.16(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide
34.17(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
34.18(SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC code
34.1931-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
34.2029-2053); and 20 percent of the median wage for social and human services aide (SOC code
34.2121-1093);
34.22(2) for day services, 20 percent of the median wage for nursing aide assistant (SOC code
34.2331-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
34.2429-2053); and 60 percent of the median wage for social and human services aide (SOC code
34.2521-1093);
34.26(3) for residential asleep-overnight staff, the wage will be $7.66 per hour is the minimum
34.27wage in Minnesota for large employers, except in a family foster care setting, the wage is
34.28$2.80 per hour 36 percent of the minimum wage in Minnesota for large employers;
34.29(4) for behavior program analyst staff, 100 percent of the median wage for mental health
34.30counselors (SOC code 21-1014);
34.31(5) for behavior program professional staff, 100 percent of the median wage for clinical
34.32counseling and school psychologist (SOC code 19-3031);
35.1(6) for behavior program specialist staff, 100 percent of the median wage for psychiatric
35.2technicians (SOC code 29-2053);
35.3(7) for supportive living services staff, 20 percent of the median wage for nursing aide
35.4assistant (SOC code 31-1012 31-1014); 20 percent of the median wage for psychiatric
35.5technician (SOC code 29-2053); and 60 percent of the median wage for social and human
35.6services aide (SOC code 21-1093);
35.7(8) for housing access coordination staff, 50 100 percent of the median wage for
35.8community and social services specialist (SOC code 21-1099); and 50 percent of the median
35.9wage for social and human services aide (SOC code 21-1093);
35.10(9) for in-home family support staff, 20 percent of the median wage for nursing aide
35.11(SOC code 31-1012); 30 percent of the median wage for community social service specialist
35.12(SOC code 21-1099); 40 percent of the median wage for social and human services aide
35.13(SOC code 21-1093); and ten percent of the median wage for psychiatric technician (SOC
35.14code 29-2053);
35.15(10) for individualized home supports services staff, 40 percent of the median wage for
35.16community social service specialist (SOC code 21-1099); 50 percent of the median wage
35.17for social and human services aide (SOC code 21-1093); and ten percent of the median
35.18wage for psychiatric technician (SOC code 29-2053);
35.19(11) for independent living skills staff, 40 percent of the median wage for community
35.20social service specialist (SOC code 21-1099); 50 percent of the median wage for social and
35.21human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
35.22technician (SOC code 29-2053);
35.23(12) for independent living skills specialist staff, 100 percent of mental health and
35.24substance abuse social worker (SOC code 21-1023);
35.25(11) (13) for supported employment support services staff, 20 50 percent of the median
35.26wage for nursing aide rehabilitation counselor (SOC code 31-1012 21-1015); 20 percent of
35.27the median wage for psychiatric technician (SOC code 29-2053); and 60 50 percent of the
35.28median wage for community and social and human services aide specialist (SOC code
35.2921-1093 21-1099);
35.30(14) for employment exploration services staff, 50 percent of the median wage for
35.31rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
35.32community and social services specialist (SOC code 21-1099);
36.1(15) for employment development services staff, 50 percent of the median wage for
36.2education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
36.3of the median wage for community and social services specialist (SOC code 21-1099);
36.4(12) (16) for adult companion staff, 50 percent of the median wage for personal and
36.5home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
36.6orderlies, and attendants assistant (SOC code 31-1012 31-1014);
36.7(13) (17) for night supervision staff, 20 percent of the median wage for home health
36.8aide (SOC code 31-1011); 20 percent of the median wage for personal and home health
36.9aide (SOC code 39-9021); 20 percent of the median wage for nursing aide assistant (SOC
36.10code 31-1012 31-1014); 20 percent of the median wage for psychiatric technician (SOC
36.11code 29-2053); and 20 percent of the median wage for social and human services aide (SOC
36.12code 21-1093);
36.13(14) (18) for respite staff, 50 percent of the median wage for personal and home care
36.14aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies,
36.15and attendants assistant (SOC code 31-1012 31-1014);
36.16(15) (19) for personal support staff, 50 percent of the median wage for personal and
36.17home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
36.18orderlies, and attendants assistant (SOC code 31-1012 31-1014);
36.19(16) (20) for supervisory staff, the basic wage is $17.43 per hour, 100 percent of the
36.20median wage for community and social services specialist (SOC code 21-1099), with the
36.21exception of the supervisor of behavior professional, behavior analyst, and behavior
36.22specialists, which must be $30.75 per hour is 100 percent of the median wage for clinical
36.23counseling and school psychologist (SOC code 19-3031);
36.24(17) (21) for registered nurse staff, the basic wage is $30.82 per hour, 100 percent of
36.25the median wage for registered nurses (SOC code 29-1141); and
36.26(18) (22) for licensed practical nurse staff, the basic wage is $18.64 per hour 100 percent
36.27of the median wage for licensed practical nurses (SOC code 29-2061).
36.28(b) Component values for residential support services are:
36.29(1) supervisory span of control ratio: 11 percent;
36.30(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
36.31(3) employee-related cost ratio: 23.6 percent;
36.32(4) general administrative support ratio: 13.25 percent;
37.1(5) program-related expense ratio: 1.3 percent; and
37.2(6) absence and utilization factor ratio: 3.9 percent.
37.3(c) Component values for family foster care are:
37.4(1) supervisory span of control ratio: 11 percent;
37.5(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
37.6(3) employee-related cost ratio: 23.6 percent;
37.7(4) general administrative support ratio: 3.3 percent;
37.8(5) program-related expense ratio: 1.3 percent; and
37.9(6) absence factor: 1.7 percent.
37.10(d) Component values for day services for all services are:
37.11(1) supervisory span of control ratio: 11 percent;
37.12(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
37.13(3) employee-related cost ratio: 23.6 percent;
37.14(4) program plan support ratio: 5.6 percent;
37.15(5) client programming and support ratio: ten percent;
37.16(6) general administrative support ratio: 13.25 percent;
37.17(7) program-related expense ratio: 1.8 percent; and
37.18(8) absence and utilization factor ratio: 3.9 9.4 percent.
37.19(e) Component values for unit-based services with programming are:
37.20(1) supervisory span of control ratio: 11 percent;
37.21(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
37.22(3) employee-related cost ratio: 23.6 percent;
37.23(4) program plan supports ratio: 3.1 15.5 percent;
37.24(5) client programming and supports ratio: 8.6 4.7 percent;
37.25(6) general administrative support ratio: 13.25 percent;
37.26(7) program-related expense ratio: 6.1 percent; and
37.27(8) absence and utilization factor ratio: 3.9 percent.
38.1(f) Component values for unit-based services without programming except respite are:
38.2(1) supervisory span of control ratio: 11 percent;
38.3(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.4(3) employee-related cost ratio: 23.6 percent;
38.5(4) program plan support ratio: 3.1 7.0 percent;
38.6(5) client programming and support ratio: 8.6 2.3 percent;
38.7(6) general administrative support ratio: 13.25 percent;
38.8(7) program-related expense ratio: 6.1 2.9 percent; and
38.9(8) absence and utilization factor ratio: 3.9 percent.
38.10(g) Component values for unit-based services without programming for respite are:
38.11(1) supervisory span of control ratio: 11 percent;
38.12(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
38.13(3) employee-related cost ratio: 23.6 percent;
38.14(4) general administrative support ratio: 13.25 percent;
38.15(5) program-related expense ratio: 6.1 2.9 percent; and
38.16(6) absence and utilization factor ratio: 3.9 percent.
38.17(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
38.18(a) based on the wage data by standard occupational code (SOC) from the Bureau of Labor
38.19Statistics available on December 31, 2016. The commissioner shall publish these updated
38.20values and load them into the rate management system. This adjustment occurs every five
38.21years. For adjustments in 2021 and beyond, the commissioner shall use the data available
38.22on December 31 of the calendar year five years prior. On January 1, 2022, and every two
38.23years thereafter, the commissioner shall update the base wage index in paragraph (a) based
38.24on the most recently available wage data by SOC from the Bureau of Labor Statistics. The
38.25commissioner shall publish these updated values and load them into the rate management
38.26system.
38.27(i) On July 1, 2017, the commissioner shall update the framework components in
38.28paragraphs (b) to (g) paragraph (d), clause (5); paragraph (e), clause (5); and paragraph (f),
38.29clause (5); subdivision 6, clauses (8) and (9); and subdivision 7, clauses (10), (16), and (17),
38.30for changes in the Consumer Price Index. The commissioner will adjust these values higher
39.1or lower by the percentage change in the Consumer Price Index-All Items, United States
39.2city average (CPI-U) from January 1, 2014, to January 1, 2017. The commissioner shall
39.3publish these updated values and load them into the rate management system. This adjustment
39.4occurs every five years. For adjustments in 2021 and beyond, the commissioner shall use
39.5the data available on January 1 of the calendar year four years prior and January 1 of the
39.6current calendar year. On January 1, 2022, and every two years thereafter, the commissioner
39.7shall update the framework components in paragraph (d), clause (5); paragraph (e), clause
39.8(5); and paragraph (f), clause (5); subdivision 6, clauses (8) and (9); and subdivision 7,
39.9clauses (10), (16), and (17), for changes in the Consumer Price Index. The commissioner
39.10shall adjust these values higher or lower by the percentage change in the CPI-U from the
39.11date of the previous update to the date of the data most recently available prior to the
39.12scheduled update. The commissioner shall publish these updated values and load them into
39.13the rate management system.
39.14(j) In this subdivision, if Bureau of Labor Statistics occupational codes or Consumer
39.15Price Index items are unavailable in the future, the commissioner shall recommend to the
39.16legislature codes or items to update and replace missing component values.
39.17(k) The commissioner must ensure that wage values and component values in subdivisions
39.185 to 9 reflect the cost to provide the service. As determined by the commissioner, in
39.19consultation with stakeholders identified in section 256B.4913, subdivision 5, a provider
39.20enrolled to provide services with rates determined under this section must submit requested
39.21cost data to the commissioner to support research on the cost of providing services that have
39.22rates determined by the disability waiver rates system. Requested cost data may include,
39.23but is not limited to:
39.24(1) worker wage costs;
39.25(2) benefits paid;
39.26(3) supervisor wage costs;
39.27(4) executive wage costs;
39.28(5) vacation, sick, and training time paid;
39.29(6) taxes, workers' compensation, and unemployment insurance costs paid;
39.30(7) administrative costs paid;
39.31(8) program costs paid;
39.32(9) transportation costs paid;
40.1(10) vacancy rates; and
40.2(11) other data relating to costs required to provide services requested by the
40.3commissioner.
40.4(l) At least once in any five-year period, a provider must submit cost data for a fiscal
40.5year that ended not more than 18 months prior to the submission date. The commissioner
40.6shall provide each provider a 90-day notice prior to its submission due date. If a provider
40.7fails to submit required reporting data, the commissioner shall provide notice to providers
40.8that have not provided required data 30 days after the required submission date, and a second
40.9notice for providers who have not provided required data 60 days after the required
40.10submission date. The commissioner shall temporarily suspend payments to the provider if
40.11cost data is not received 90 days after the required submission date. Withheld payments
40.12shall be made once data is received by the commissioner.
40.13(m) The commissioner shall conduct a random validation of data submitted under
40.14paragraph (k) to ensure data accuracy. The commissioner shall analyze cost documentation
40.15in paragraph (k) and provide recommendations for adjustments to cost components.
40.16(n) The commissioner shall analyze cost documentation in paragraph (k) and, in
40.17consultation with stakeholders identified in section 256B.4913, subdivision 5, may submit
40.18recommendations on component values and inflationary factor adjustments to the chairs
40.19and ranking minority members of the legislative committees with jurisdiction over human
40.20services every four years beginning January 1, 2020. The commissioner shall make
40.21recommendations in conjunction with reports submitted to the legislature according to
40.22subdivision 10, paragraph (e). The commissioner shall release business cost data in an
40.23aggregate form, and business cost data from individual providers shall not be released except
40.24as provided for in current law.
40.25(o) The commissioner, in consultation with stakeholders identified in section 256B.4913,
40.26subdivision 5, shall develop and implement a process for providing training and technical
40.27assistance necessary to support provider submission of cost documentation required under
40.28paragraph (k).
40.29EFFECTIVE DATE.(a) The amendments to paragraphs (a) to (g) are effective January
40.301, 2018, except the amendment to paragraph (d), clause (8), which is effective January 1,
40.312019, and the amendment to paragraph (a), clause (10), which is effective the day following
40.32final enactment.
40.33(b) The amendments to paragraphs (h) to (o) are effective the day following final
40.34enactment.

41.1    Sec. 29. Minnesota Statutes 2016, section 256B.4914, subdivision 6, is amended to read:
41.2    Subd. 6. Payments for residential support services. (a) Payments for residential support
41.3services, as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22,
41.4must be calculated as follows:
41.5(1) determine the number of shared staffing and individual direct staff hours to meet a
41.6recipient's needs provided on site or through monitoring technology;
41.7(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
41.8Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
41.95. This is defined as the direct-care rate;
41.10(3) for a recipient requiring customization for deaf and hard-of-hearing language
41.11accessibility under subdivision 12, add the customization rate provided in subdivision 12
41.12to the result of clause (2). This is defined as the customized direct-care rate;
41.13(4) multiply the number of shared and individual direct staff hours provided on site or
41.14through monitoring technology and nursing hours by the appropriate staff wages in
41.15subdivision 5, paragraph (a), or the customized direct-care rate;
41.16(5) multiply the number of shared and individual direct staff hours provided on site or
41.17through monitoring technology and nursing hours by the product of the supervision span
41.18of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision
41.19wage in subdivision 5, paragraph (a), clause (16) (20);
41.20(6) combine the results of clauses (4) and (5), excluding any shared and individual direct
41.21staff hours provided through monitoring technology, and multiply the result by one plus
41.22the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b),
41.23clause (2). This is defined as the direct staffing cost;
41.24(7) for employee-related expenses, multiply the direct staffing cost, excluding any shared
41.25and individual direct staff hours provided through monitoring technology, by one plus the
41.26employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
41.27(8) for client programming and supports, the commissioner shall add $2,179; and
41.28(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
41.29customized for adapted transport, based on the resident with the highest assessed need.
41.30(b) The total rate must be calculated using the following steps:
42.1(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any shared
42.2and individual direct staff hours provided through monitoring technology that was excluded
42.3in clause (7);
42.4(2) sum the standard general and administrative rate, the program-related expense ratio,
42.5and the absence and utilization ratio;
42.6(3) divide the result of clause (1) by one minus the result of clause (2). This is the total
42.7payment amount; and
42.8(4) adjust the result of clause (3) by a factor to be determined by the commissioner to
42.9adjust for regional differences in the cost of providing services.
42.10(c) The payment methodology for customized living, 24-hour customized living, and
42.11residential care services must be the customized living tool. Revisions to the customized
42.12living tool must be made to reflect the services and activities unique to disability-related
42.13recipient needs.
42.14(d) For individuals enrolled prior to January 1, 2014, the days of service authorized must
42.15meet or exceed the days of service used to convert service agreements in effect on December
42.161, 2013, and must not result in a reduction in spending or service utilization due to conversion
42.17during the implementation period under section 256B.4913, subdivision 4a. If during the
42.18implementation period, an individual's historical rate, including adjustments required under
42.19section 256B.4913, subdivision 4a, paragraph (c), is equal to or greater than the rate
42.20determined in this subdivision, the number of days authorized for the individual is 365.
42.21(e) The number of days authorized for all individuals enrolling after January 1, 2014,
42.22in residential services must include every day that services start and end.

42.23    Sec. 30. Minnesota Statutes 2016, section 256B.4914, subdivision 7, is amended to read:
42.24    Subd. 7. Payments for day programs. Payments for services with day programs
42.25including adult day care, day treatment and habilitation, prevocational services, and structured
42.26day services must be calculated as follows:
42.27(1) determine the number of units of service and staffing ratio to meet a recipient's needs:
42.28(i) the staffing ratios for the units of service provided to a recipient in a typical week
42.29must be averaged to determine an individual's staffing ratio; and
42.30(ii) the commissioner, in consultation with service providers, shall develop a uniform
42.31staffing ratio worksheet to be used to determine staffing ratios under this subdivision;
43.1(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
43.2Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
43.35;
43.4(3) for a recipient requiring customization for deaf and hard-of-hearing language
43.5accessibility under subdivision 12, add the customization rate provided in subdivision 12
43.6to the result of clause (2). This is defined as the customized direct-care rate;
43.7(4) multiply the number of day program direct staff hours and nursing hours by the
43.8appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;
43.9(5) multiply the number of day direct staff hours by the product of the supervision span
43.10of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate supervision
43.11wage in subdivision 5, paragraph (a), clause (16) (20);
43.12(6) combine the results of clauses (4) and (5), and multiply the result by one plus the
43.13employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d), clause
43.14(2). This is defined as the direct staffing rate;
43.15(7) for program plan support, multiply the result of clause (6) by one plus the program
43.16plan support ratio in subdivision 5, paragraph (d), clause (4);
43.17(8) for employee-related expenses, multiply the result of clause (7) by one plus the
43.18employee-related cost ratio in subdivision 5, paragraph (d), clause (3);
43.19(9) for client programming and supports, multiply the result of clause (8) by one plus
43.20the client programming and support ratio in subdivision 5, paragraph (d), clause (5);
43.21(10) for program facility costs, add $19.30 per week with consideration of staffing ratios
43.22to meet individual needs;
43.23(11) for adult day bath services, add $7.01 per 15 minute unit;
43.24(12) this is the subtotal rate;
43.25(13) sum the standard general and administrative rate, the program-related expense ratio,
43.26and the absence and utilization factor ratio;
43.27(14) divide the result of clause (12) by one minus the result of clause (13). This is the
43.28total payment amount;
43.29(15) adjust the result of clause (14) by a factor to be determined by the commissioner
43.30to adjust for regional differences in the cost of providing services;
44.1(16) for transportation provided as part of day training and habilitation for an individual
44.2who does not require a lift, add:
44.3(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle without
44.4a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared ride in a
44.5vehicle with a lift;
44.6(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle without
44.7a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared ride in a
44.8vehicle with a lift;
44.9(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle without
44.10a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared ride in a
44.11vehicle with a lift; or
44.12(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a lift,
44.13$16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a vehicle
44.14with a lift;
44.15(17) for transportation provided as part of day training and habilitation for an individual
44.16who does require a lift, add:
44.17(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with a
44.18lift, and $15.05 for a shared ride in a vehicle with a lift;
44.19(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a
44.20lift, and $28.16 for a shared ride in a vehicle with a lift;
44.21(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with a
44.22lift, and $58.76 for a shared ride in a vehicle with a lift; or
44.23(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a lift,
44.24and $80.93 for a shared ride in a vehicle with a lift.

44.25    Sec. 31. Minnesota Statutes 2016, section 256B.4914, subdivision 8, is amended to read:
44.26    Subd. 8. Payments for unit-based services with programming. Payments for unit-based
44.27services with programming, including behavior programming, housing access coordination,
44.28in-home family support, independent living skills training, independent living skills specialist
44.29services, individualized home supports, hourly supported living services, employment
44.30exploration services, employment development services, and supported employment support
44.31services provided to an individual outside of any day or residential service plan must be
45.1calculated as follows, unless the services are authorized separately under subdivision 6 or
45.27:
45.3    (1) determine the number of units of service to meet a recipient's needs;
45.4    (2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
45.5Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
45.65;
45.7    (3) for a recipient requiring customization for deaf and hard-of-hearing language
45.8accessibility under subdivision 12, add the customization rate provided in subdivision 12
45.9to the result of clause (2). This is defined as the customized direct-care rate;
45.10    (4) multiply the number of direct staff hours by the appropriate staff wage in subdivision
45.115, paragraph (a), or the customized direct-care rate;
45.12    (5) multiply the number of direct staff hours by the product of the supervision span of
45.13control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
45.14wage in subdivision 5, paragraph (a), clause (16) (20);
45.15    (6) combine the results of clauses (4) and (5), and multiply the result by one plus the
45.16employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e), clause
45.17(2). This is defined as the direct staffing rate;
45.18    (7) for program plan support, multiply the result of clause (6) by one plus the program
45.19plan supports ratio in subdivision 5, paragraph (e), clause (4);
45.20    (8) for employee-related expenses, multiply the result of clause (7) by one plus the
45.21employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
45.22    (9) for client programming and supports, multiply the result of clause (8) by one plus
45.23the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
45.24    (10) this is the subtotal rate;
45.25    (11) sum the standard general and administrative rate, the program-related expense ratio,
45.26and the absence and utilization factor ratio;
45.27    (12) divide the result of clause (10) by one minus the result of clause (11). This is the
45.28total payment amount;
45.29    (13) for supported employment support services provided in a shared manner, divide
45.30the total payment amount in clause (12) by the number of service recipients, not to exceed
45.31three six. For independent living skills training and individualized home supports provided
46.1in a shared manner, divide the total payment amount in clause (12) by the number of service
46.2recipients, not to exceed two; and
46.3    (14) adjust the result of clause (13) by a factor to be determined by the commissioner
46.4to adjust for regional differences in the cost of providing services.
46.5EFFECTIVE DATE.This section is effective the day following final enactment.

46.6    Sec. 32. Minnesota Statutes 2016, section 256B.4914, subdivision 9, is amended to read:
46.7    Subd. 9. Payments for unit-based services without programming. Payments for
46.8unit-based services without programming, including night supervision, personal support,
46.9respite, and companion care provided to an individual outside of any day or residential
46.10service plan must be calculated as follows unless the services are authorized separately
46.11under subdivision 6 or 7:
46.12(1) for all services except respite, determine the number of units of service to meet a
46.13recipient's needs;
46.14(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
46.15Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
46.16(3) for a recipient requiring customization for deaf and hard-of-hearing language
46.17accessibility under subdivision 12, add the customization rate provided in subdivision 12
46.18to the result of clause (2). This is defined as the customized direct care rate;
46.19(4) multiply the number of direct staff hours by the appropriate staff wage in subdivision
46.205 or the customized direct care rate;
46.21(5) multiply the number of direct staff hours by the product of the supervision span of
46.22control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision
46.23wage in subdivision 5, paragraph (a), clause (16) (20);
46.24(6) combine the results of clauses (4) and (5), and multiply the result by one plus the
46.25employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (f), clause
46.26(2). This is defined as the direct staffing rate;
46.27(7) for program plan support, multiply the result of clause (6) by one plus the program
46.28plan support ratio in subdivision 5, paragraph (f), clause (4);
46.29(8) for employee-related expenses, multiply the result of clause (7) by one plus the
46.30employee-related cost ratio in subdivision 5, paragraph (f), clause (3);
47.1(9) for client programming and supports, multiply the result of clause (8) by one plus
47.2the client programming and support ratio in subdivision 5, paragraph (f), clause (5);
47.3(10) this is the subtotal rate;
47.4(11) sum the standard general and administrative rate, the program-related expense ratio,
47.5and the absence and utilization factor ratio;
47.6(12) divide the result of clause (10) by one minus the result of clause (11). This is the
47.7total payment amount;
47.8(13) for respite services, determine the number of day units of service to meet an
47.9individual's needs;
47.10(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
47.11Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
47.12(15) for a recipient requiring deaf and hard-of-hearing customization under subdivision
47.1312, add the customization rate provided in subdivision 12 to the result of clause (14). This
47.14is defined as the customized direct care rate;
47.15(16) multiply the number of direct staff hours by the appropriate staff wage in subdivision
47.165, paragraph (a);
47.17(17) multiply the number of direct staff hours by the product of the supervisory span of
47.18control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision
47.19wage in subdivision 5, paragraph (a), clause (16) (20);
47.20(18) combine the results of clauses (16) and (17), and multiply the result by one plus
47.21the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g),
47.22clause (2). This is defined as the direct staffing rate;
47.23(19) for employee-related expenses, multiply the result of clause (18) by one plus the
47.24employee-related cost ratio in subdivision 5, paragraph (g), clause (3);
47.25(20) this is the subtotal rate;
47.26(21) sum the standard general and administrative rate, the program-related expense ratio,
47.27and the absence and utilization factor ratio;
47.28(22) divide the result of clause (20) by one minus the result of clause (21). This is the
47.29total payment amount; and
47.30(23) adjust the result of clauses (12) and (22) by a factor to be determined by the
47.31commissioner to adjust for regional differences in the cost of providing services.

48.1    Sec. 33. Minnesota Statutes 2016, section 256B.4914, subdivision 10, is amended to read:
48.2    Subd. 10. Updating payment values and additional information. (a) From January
48.31, 2014, through December 31, 2017, the commissioner shall develop and implement uniform
48.4procedures to refine terms and adjust values used to calculate payment rates in this section.
48.5(b) No later than July 1, 2014, the commissioner shall, within available resources, begin
48.6to conduct research and gather data and information from existing state systems or other
48.7outside sources on the following items:
48.8(1) differences in the underlying cost to provide services and care across the state; and
48.9(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and
48.10units of transportation for all day services, which must be collected from providers using
48.11the rate management worksheet and entered into the rates management system; and
48.12(3) the distinct underlying costs for services provided by a license holder under sections
48.13245D.05 , 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided
48.14by a license holder certified under section 245D.33.
48.15(c) Beginning January 1, 2014, through December 31, 2018, using a statistically valid
48.16set of rates management system data, the commissioner, in consultation with stakeholders,
48.17shall analyze for each service the average difference in the rate on December 31, 2013, and
48.18the framework rate at the individual, provider, lead agency, and state levels. The
48.19commissioner shall issue semiannual reports to the stakeholders on the difference in rates
48.20by service and by county during the banding period under section 256B.4913, subdivision
48.214a . The commissioner shall issue the first report by October 1, 2014, and the final report
48.22shall be issued by December 31, 2018.
48.23(d) No later than July 1, 2014, the commissioner, in consultation with stakeholders, shall
48.24begin the review and evaluation of the following values already in subdivisions 6 to 9, or
48.25issues that impact all services, including, but not limited to:
48.26(1) values for transportation rates for day services;
48.27(2) values for transportation rates in residential services;
48.28(3) (2) values for services where monitoring technology replaces staff time;
48.29(4) (3) values for indirect services;
48.30(5) (4) values for nursing;
48.31(6) component values for independent living skills;
49.1(7) component values for family foster care that reflect licensing requirements;
49.2(8) adjustments to other components to replace the budget neutrality factor;
49.3(9) remote monitoring technology for nonresidential services;
49.4(10) values for basic and intensive services in residential services;
49.5(11) (5) values for the facility use rate in day services, and the weightings used in the
49.6day service ratios and adjustments to those weightings;
49.7(12) (6) values for workers' compensation as part of employee-related expenses;
49.8(13) (7) values for unemployment insurance as part of employee-related expenses;
49.9(14) a component value to reflect costs for individuals with rates previously adjusted
49.10for the inclusion of group residential housing rate 3 costs, only for any individual enrolled
49.11as of December 31, 2013; and
49.12(15) (8) any changes in state or federal law with an a direct impact on the underlying
49.13cost of providing home and community-based services.; and
49.14(9) outcome measures, determined by the commissioner, for home and community-based
49.15services rates determined under this section.
49.16(e) The commissioner shall report to the chairs and the ranking minority members of
49.17the legislative committees and divisions with jurisdiction over health and human services
49.18policy and finance with the information and data gathered under paragraphs (b) to (d) on
49.19the following dates:
49.20(1) January 15, 2015, with preliminary results and data;
49.21(2) January 15, 2016, with a status implementation update, and additional data and
49.22summary information;
49.23(3) January 15, 2017, with the full report; and
49.24(4) January 15, 2019 2020, with another full report, and a full report once every four
49.25years thereafter.
49.26(f) Based on the commissioner's evaluation of the information and data collected in
49.27paragraphs (b) to (d), the commissioner shall make recommendations to the legislature by
49.28January 15, 2015, to address any issues identified during the first year of implementation.
49.29After January 15, 2015, the commissioner may make recommendations to the legislature
49.30to address potential issues.
50.1(g) (f) The commissioner shall implement a regional adjustment factor to all rate
50.2calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Beginning July
50.31, 2017, the commissioner shall renew analysis and implement changes to the regional
50.4adjustment factors when adjustments required under subdivision 5, paragraph (h), occur.
50.5Prior to implementation, the commissioner shall consult with stakeholders on the
50.6methodology to calculate the adjustment.
50.7(h) (g) The commissioner shall provide a public notice via LISTSERV in October of
50.8each year beginning October 1, 2014, containing information detailing legislatively approved
50.9changes in:
50.10(1) calculation values including derived wage rates and related employee and
50.11administrative factors;
50.12(2) service utilization;
50.13(3) county and tribal allocation changes; and
50.14(4) information on adjustments made to calculation values and the timing of those
50.15adjustments.
50.16The information in this notice must be effective January 1 of the following year.
50.17(i) No later than July 1, 2016, the commissioner shall develop and implement, in
50.18consultation with stakeholders, a methodology sufficient to determine the shared staffing
50.19levels necessary to meet, at a minimum, health and welfare needs of individuals who will
50.20be living together in shared residential settings, and the required shared staffing activities
50.21described in subdivision 2, paragraph (l). This determination methodology must ensure
50.22staffing levels are adaptable to meet the needs and desired outcomes for current and
50.23prospective residents in shared residential settings.
50.24(j) (h) When the available shared staffing hours in a residential setting are insufficient
50.25to meet the needs of an individual who enrolled in residential services after January 1, 2014,
50.26or insufficient to meet the needs of an individual with a service agreement adjustment
50.27described in section 256B.4913, subdivision 4a, paragraph (f), then individual staffing hours
50.28shall be used.
50.29(i) The commissioner shall study the underlying cost of absence and utilization for day
50.30services. Based on the commissioner's evaluation of the data collected under this paragraph,
50.31the commissioner shall make recommendations to the legislature by January 15, 2018, for
50.32changes, if any, to the absence and utilization factor ratio component value for day services.
51.1(j) Beginning July 1, 2017, the commissioner shall collect transportation and trip
51.2information for all day services through the rates management system.
51.3EFFECTIVE DATE.This section is effective the day following final enactment.

51.4    Sec. 34. Minnesota Statutes 2016, section 256B.4914, subdivision 16, is amended to read:
51.5    Subd. 16. Budget neutrality adjustments. (a) The commissioner shall use the following
51.6adjustments to the rate generated by the framework to assure budget neutrality until the rate
51.7information is available to implement paragraph (b). The rate generated by the framework
51.8shall be multiplied by the appropriate factor, as designated below:
51.9(1) for residential services: 1.003;
51.10(2) for day services: 1.000;
51.11(3) for unit-based services with programming: 0.941; and
51.12(4) for unit-based services without programming: 0.796.
51.13(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated
51.14spending for all home and community-based waiver services under the new payment rates
51.15defined in subdivisions 6 to 9 with estimated spending for the same recipients and services
51.16under the rates in effect on July 1, 2013. This comparison must distinguish spending under
51.17each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients and
51.18services for one or more service months after the new rates have gone into effect. The
51.19commissioner shall consult with the commissioner of management and budget on this
51.20analysis to ensure budget neutrality. If estimated spending under the new rates for services
51.21under one or more subdivisions differs in this comparison by 0.3 percent or more, the
51.22commissioner shall assure aggregate budget neutrality across all service areas by adjusting
51.23the budget neutrality factor in paragraph (a) in each subdivision so that total estimated
51.24spending for each subdivision under the new rates matches estimated spending under the
51.25rates in effect on July 1, 2013.
51.26(c) A service rate developed using values in subdivision 5, paragraph (a), clause (10),
51.27is not subject to budget neutrality adjustments.
51.28EFFECTIVE DATE.This section is effective the day following final enactment.

52.1    Sec. 35. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision
52.2to read:
52.3    Subd. 1a. Culturally affirmative. "Culturally affirmative" describes services that are
52.4designed and delivered within the context of the culture, language, and life experiences of
52.5a person who is deaf, a person who is deafblind, and a person who is hard-of-hearing.

52.6    Sec. 36. Minnesota Statutes 2016, section 256C.23, subdivision 2, is amended to read:
52.7    Subd. 2. Deaf. "Deaf" means a hearing loss of such severity that the individual must
52.8depend primarily on visual communication such as American Sign Language or other signed
52.9language, visual and manual means of communication such as signing systems in English
52.10or Cued Speech, writing, lip speech reading, manual communication, and gestures.

52.11    Sec. 37. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision
52.12to read:
52.13    Subd. 2c. Interpreting services. "Interpreting services" means services that include:
52.14(1) interpreting between a spoken language, such as English, and a visual language, such
52.15as American Sign Language;
52.16(2) interpreting between a spoken language and a visual representation of a spoken
52.17language, such as Cued Speech and signing systems in English;
52.18(3) interpreting within one language where the interpreter uses natural gestures and
52.19silently repeats the spoken message, replacing some words or phrases to give higher visibility
52.20on the lips;
52.21(4) interpreting using low vision or tactile methods for persons who have a combined
52.22hearing and vision loss or are deafblind; and
52.23(5) interpreting from one communication mode or language into another communication
52.24mode or language that is linguistically and culturally appropriate for the participants in the
52.25communication exchange.

52.26    Sec. 38. Minnesota Statutes 2016, section 256C.23, is amended by adding a subdivision
52.27to read:
52.28    Subd. 6. Real-time captioning. "Real-time captioning" means a method of captioning
52.29in which a caption is simultaneously prepared and displayed or transmitted at the time of
52.30origination by specially trained real-time captioners.

53.1    Sec. 39. Minnesota Statutes 2016, section 256C.233, subdivision 1, is amended to read:
53.2    Subdivision 1. Deaf and Hard-of-Hearing Services Division. The commissioners of
53.3human services, education, employment and economic development, and health shall create
53.4a distinct and separate organizational unit to be known as advise the commissioner of human
53.5services on the activities of the Deaf and Hard-of-Hearing Services Division to address.
53.6This division addresses the developmental, social, educational, and occupational and
53.7social-emotional needs of persons who are deaf, persons who are deafblind, and persons
53.8who are hard-of-hearing persons through a statewide network of collaborative services and
53.9by coordinating the promulgation of public policies, regulations, legislation, and programs
53.10affecting advocates on behalf of and provides information and training about how to best
53.11serve persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing
53.12persons. An interdepartmental management team shall advise the activities of the Deaf and
53.13Hard-of-Hearing Services Division. The commissioner of human services shall coordinate
53.14the work of the interagency management team advisers and receive legislative appropriations
53.15for the division.

53.16    Sec. 40. Minnesota Statutes 2016, section 256C.233, subdivision 2, is amended to read:
53.17    Subd. 2. Responsibilities. The Deaf and Hard-of-Hearing Services Division shall:
53.18(1) establish and maintain a statewide network of regional service centers culturally
53.19affirmative services for Minnesotans who are deaf, Minnesotans who are deafblind, and
53.20Minnesotans who are hard-of-hearing Minnesotans;
53.21(2) assist work across divisions within the Departments Department of Human Services,
53.22Education, and Employment and Economic Development to coordinate the promulgation
53.23and implementation of public policies, regulations, legislation, programs, and services
53.24affecting as well as with other agencies and counties, to ensure that there is an understanding
53.25of:
53.26(i) the communication challenges faced by persons who are deaf, persons who are
53.27deafblind, and persons who are hard-of-hearing persons;
53.28(ii) the best practices for accommodating and mitigating communication challenges;
53.29and
53.30(iii) the legal requirements for providing access to and effective communication with
53.31persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing; and
53.32(3) provide a coordinated system of assess the supply and demand statewide interpreting
53.33or for interpreter referral services. and real-time captioning services, implement strategies
54.1to provide greater access to these services in areas without sufficient supply, and build the
54.2base of service providers across the state;
54.3(4) maintain a statewide information resource that includes contact information and
54.4professional certification credentials of interpreting service providers and real-time captioning
54.5service providers;
54.6(5) provide culturally affirmative mental health services to persons who are deaf, persons
54.7who are deafblind, and persons who are hard-of-hearing who:
54.8(i) use a visual language such as American Sign Language or a tactile form of a language;
54.9or
54.10(ii) otherwise need culturally affirmative therapeutic services;
54.11(6) research and develop best practices and recommendations for emerging issues;
54.12(7) provide as much information as practicable on the division's stand-alone Web site
54.13in American Sign Language; and
54.14(8) report to the chairs and ranking minority members of the legislative committees with
54.15jurisdiction over human services biennially, beginning on January 1, 2019, on the following:
54.16(i) the number of regional service center staff, the location of the office of each staff
54.17person, other service providers with which they are colocated, the number of people served
54.18by each staff person and a breakdown of whether each person was served on-site or off-site,
54.19and for those served off-site, a list of locations where services were delivered and the number
54.20who were served in-person and the number who were served via technology;
54.21(ii) the amount and percentage of the division budget spent on reasonable
54.22accommodations for staff;
54.23(iii) the number of people who use demonstration equipment and consumer evaluations
54.24of the experience;
54.25(iv) the number of training sessions provided by division staff, the topics covered, the
54.26number of participants, and consumer evaluations, including a breakdown by delivery
54.27method such as in-person or via technology;
54.28(v) the number of training sessions hosted at a division location provided by another
54.29service provider, the topics covered, the number of participants, and consumer evaluations,
54.30including a breakdown by delivery method such as in-person or via technology;
54.31(vi) for each grant awarded, the amount awarded to the grantee and a summary of the
54.32grantee's results, including consumer evaluations of the services or products provided;
55.1(vii) the number of people on waiting lists for any services provided by division staff
55.2or for services or equipment funded through grants awarded by the division;
55.3(viii) the amount of time staff spent driving to appointments to deliver direct one-to-one
55.4client services in locations outside of the regional service centers;
55.5(ix) the amount spent on mileage reimbursement and the number of clients who received
55.6mileage reimbursement for traveling to the regional service centers for services; and
55.7(x) the regional needs and feedback on addressing service gaps identified by the advisory
55.8committees.

55.9    Sec. 41. Minnesota Statutes 2016, section 256C.24, subdivision 1, is amended to read:
55.10    Subdivision 1. Location. The Deaf and Hard-of-Hearing Services Division shall establish
55.11up to eight at least six regional service centers for persons who are deaf and persons who
55.12are hard-of-hearing persons. The centers shall be distributed regionally to provide access
55.13for persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing
55.14persons in all parts of the state.

55.15    Sec. 42. Minnesota Statutes 2016, section 256C.24, subdivision 2, is amended to read:
55.16    Subd. 2. Responsibilities. Each regional service center shall:
55.17(1) serve as a central entry point for establish connections and collaborations and explore
55.18co-locating with other public and private entities providing services to persons who are
55.19deaf, persons who are deafblind, and persons who are hard-of-hearing persons in need of
55.20services and make referrals to the services needed in the region;
55.21(2) for those in need of services, assist in coordinating services between service providers
55.22and persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing,
55.23and the persons' families, and make referrals to the services needed;
55.24(2) (3) employ staff trained to work with persons who are deaf, persons who are deafblind,
55.25and persons who are hard-of-hearing persons;
55.26(3) (4) if adequate services are not available from another public or private service
55.27provider in the region, provide to all individual assistance to persons who are deaf, persons
55.28who are deafblind, and persons who are hard-of-hearing persons access to interpreter services
55.29which are necessary to help them obtain services, and the persons' families. Individual
55.30culturally affirmative assistance may be provided using technology only in areas of the state
55.31where a person has access to sufficient quality telecommunications or broadband services
56.1to allow effective communication. When a person who is deaf, a person who is deafblind,
56.2or a person who is hard-of-hearing does not have access to sufficient telecommunications
56.3or broadband service, individual assistance shall be available in person;
56.4(5) identify regional training needs, work with deaf and hard-of-hearing services training
56.5staff, and collaborate with others to deliver training for persons who are deaf, persons who
56.6are deafblind, and persons who are hard-of-hearing, and the persons' families, and other
56.7service providers about subjects including the persons' rights under the law, American Sign
56.8Language, and the impact of hearing loss and options for accommodating it;
56.9(4) implement a plan to provide loaned equipment and resource materials to deaf,
56.10deafblind, and hard-of-hearing (6) have a mobile or permanent lab where persons who are
56.11deaf, persons who are deafblind, and persons who are hard-of-hearing can try a selection
56.12of modern assistive technology and equipment to determine what would best meet the
56.13persons' needs;
56.14(5) cooperate with responsible departments and administrative authorities to provide
56.15access for deaf, deafblind, and hard-of-hearing persons to services provided by state, county,
56.16and regional agencies;
56.17(6) (7) collaborate with the Resource Center for the Deaf and Hard-of-Hearing Persons,
56.18other divisions of the Department of Education, and local school districts to develop and
56.19deliver programs and services for families with children who are deaf, children who are
56.20deafblind, or children who are hard-of-hearing children and to support school personnel
56.21serving these children;
56.22(7) when possible, (8) provide training to the social service or income maintenance staff
56.23employed by counties or by organizations with whom counties contract for services to
56.24ensure that communication barriers which prevent persons who are deaf, persons who are
56.25deafblind, and persons who are hard-of-hearing persons from using services are removed;
56.26(8) when possible, (9) provide training to state and regional human service agencies in
56.27the region regarding program access for persons who are deaf, persons who are deafblind,
56.28and persons who are hard-of-hearing persons; and
56.29(9) (10) assess the ongoing need and supply of services for persons who are deaf, persons
56.30who are deafblind, and persons who are hard-of-hearing persons in all parts of the state,
56.31annually consult with the division's advisory committees to identify regional needs and
56.32solicit feedback on addressing service gaps, and cooperate with public and private service
56.33providers to develop these services.;
57.1(11) provide culturally affirmative mental health services to persons who are deaf,
57.2persons who are deafblind, and persons who are hard-of-hearing who:
57.3(i) use a visual language such as American Sign Language or a tactile form of a language;
57.4or
57.5(ii) otherwise need culturally affirmative therapeutic services; and
57.6(12) establish partnerships with state and regional entities statewide that have the
57.7technological capacity to provide Minnesotans with virtual access to the division's services
57.8and division-sponsored training via technology.

57.9    Sec. 43. Minnesota Statutes 2016, section 256C.261, is amended to read:
57.10256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND PERSONS.
57.11    (a) The commissioner of human services shall combine the existing biennial base level
57.12funding for deafblind services into a single grant program. At least 35 percent of the total
57.13funding is awarded for services and other supports to deafblind children and their families
57.14and at least 25 percent is awarded for services and other supports to deafblind adults. use
57.15at least 35 percent of the deafblind services biennial base level grant funding for services
57.16and other supports for a child who is deafblind and the child's family. The commissioner
57.17shall use at least 25 percent of the deafblind services biennial base level grant funding for
57.18services and other supports for an adult who is deafblind.
57.19    The commissioner shall award grants for the purposes of:
57.20    (1) providing services and supports to individuals persons who are deafblind; and
57.21    (2) developing and providing training to counties and the network of senior citizen
57.22service providers. The purpose of the training grants is to teach counties how to use existing
57.23programs that capture federal financial participation to meet the needs of eligible persons
57.24who are deafblind persons and to build capacity of senior service programs to meet the
57.25needs of seniors with a dual sensory hearing and vision loss.
57.26    (b) The commissioner may make grants:
57.27    (1) for services and training provided by organizations; and
57.28    (2) to develop and administer consumer-directed services.
57.29(c) Consumer-directed services shall be provided in whole by grant-funded providers.
57.30The deaf and hard-of-hearing regional service centers shall not provide any aspect of a
57.31grant-funded consumer-directed services program.
58.1    (c) (d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant
58.2under paragraph (a).
58.3    (d) (e) Deafblind service providers may, but are not required to, provide intervenor
58.4services as part of the service package provided with grant funds under this section.

58.5    Sec. 44. EXPANSION OF CONSUMER-DIRECTED COMMUNITY SUPPORTS
58.6BUDGET METHODOLOGY EXCEPTION.
58.7(a) No later than September 30, 2017, if necessary, the commissioner of human services
58.8shall submit an amendment to the Centers for Medicare and Medicaid Services for the home
58.9and community-based services waivers authorized under Minnesota Statutes, sections
58.10256B.092 and 256B.49, to expand the exception to the consumer-directed community
58.11supports budget methodology under Laws 2015, chapter 71, article 7, section 54, to provide
58.12up to 30 percent more funds for either:
58.13(1) consumer-directed community supports participants who have a coordinated service
58.14and support plan which identifies the need for an increased amount of services or supports
58.15under consumer-directed community supports than the amount they are currently receiving
58.16under the consumer-directed community supports budget methodology:
58.17(i) to increase the amount of time a person works or otherwise improves employment
58.18opportunities;
58.19(ii) to plan a transition to, move to, or live in a setting described in Minnesota Statutes,
58.20section 256D.44, subdivision 5, paragraph (f), clause (1), item (ii), or paragraph (g); or
58.21(iii) to develop and implement a positive behavior support plan; or
58.22(2) home and community-based waiver participants who are currently using licensed
58.23providers for (i) employment supports or services during the day; or (ii) residential services,
58.24either of which cost more annually than the person would spend under a consumer-directed
58.25community supports plan for any or all of the supports needed to meet the goals identified
58.26in paragraph (a), clause (1), items (i), (ii), and (iii).
58.27(b) The exception under paragraph (a), clause (1), is limited to those persons who can
58.28demonstrate that they will have to discontinue using consumer-directed community supports
58.29and accept other non-self-directed waiver services because their supports needed for the
58.30goals described in paragraph (a), clause (1), items (i), (ii), and (iii), cannot be met within
58.31the consumer-directed community supports budget limits.
59.1(c) The exception under paragraph (a), clause (2), is limited to those persons who can
59.2demonstrate that, upon choosing to become a consumer-directed community supports
59.3participant, the total cost of services, including the exception, will be less than the cost of
59.4current waiver services.
59.5EFFECTIVE DATE.The exception under this section is effective October 1, 2017, or
59.6upon federal approval, whichever is later. Notwithstanding any other law to the contrary,
59.7the exception in Laws 2016, chapter 144, section 1, remains in effect until the exception
59.8under Laws 2015, chapter 71, article 7, section 54, or under this section becomes effective,
59.9whichever occurs first. The commissioner of human services shall notify the revisor of
59.10statutes when federal approval is obtained.

59.11    Sec. 45. CONSUMER-DIRECTED COMMUNITY SUPPORTS BUDGET
59.12METHODOLOGY EXCEPTION FOR PERSONS LEAVING INSTITUTIONS AND
59.13CRISIS RESIDENTIAL SETTINGS.
59.14(a) By September 30, 2017, the commissioner shall establish an institutional and crisis
59.15bed consumer-directed community supports budget exception process in the home and
59.16community-based services waivers under Minnesota Statutes, sections 256B.092 and
59.17256B.49. This budget exception process shall be available for any individual who:
59.18(1) is not offered available and appropriate services within 60 days since approval for
59.19discharge from the individual's current institutional setting; and
59.20(2) requires services that are more expensive than appropriate services provided in a
59.21noninstitutional setting using the consumer-directed community supports option.
59.22(b) Institutional settings for purposes of this exception include intermediate care facilities
59.23for persons with developmental disabilities; nursing facilities; acute care hospitals; Anoka
59.24Metro Regional Treatment Center; Minnesota Security Hospital; and crisis beds. The budget
59.25exception shall be limited to no more than the amount of appropriate services provided in
59.26a noninstitutional setting as determined by the lead agency managing the individual's home
59.27and community-based services waiver. The lead agency shall notify the Department of
59.28Human Services of the budget exception.
59.29EFFECTIVE DATE.This section is effective the day following final enactment.

60.1    Sec. 46. CONSUMER-DIRECTED COMMUNITY SUPPORTS REVISED BUDGET
60.2METHODOLOGY REPORT.
60.3(a) The commissioner of human services, in consultation with stakeholders and others
60.4including representatives of lead agencies, home and community-based services waiver
60.5participants using consumer-directed community supports, advocacy groups, state agencies,
60.6the Institute on Community Integration at the University of Minnesota, and service and
60.7financial management providers, shall develop a revised consumer-directed community
60.8supports budget methodology. The new methodology shall be based on (1) the costs of
60.9providing services as reflected by the wage and other relevant components incorporated in
60.10the disability waiver rate formulas under Minnesota Statutes, chapter 256B, and (2)
60.11state-to-county waiver-funding methodologies. The new methodology should develop
60.12individual consumer-directed community supports budgets comparable to those provided
60.13for similar needs individuals if paying for non-consumer-directed community supports
60.14waiver services.
60.15(b) By December 15, 2018, the commissioner shall report a revised consumer-directed
60.16community supports budget methodology, including proposed legislation and funding
60.17necessary to implement the new methodology, to the chairs and ranking minority members
60.18of the house of representatives and senate committees with jurisdiction over health and
60.19human services.
60.20EFFECTIVE DATE.This section is effective the day following final enactment.

60.21    Sec. 47. FEDERAL WAIVER AMENDMENTS.
60.22The commissioner of human services shall submit necessary waiver amendments to the
60.23Centers for Medicare and Medicaid Services to add employment exploration services,
60.24employment development services, and employment support services to the home and
60.25community-based services waivers authorized under Minnesota Statutes, sections 256B.092
60.26and 256B.49. The commissioner shall also submit necessary waiver amendments to remove
60.27community-based employment services from day training and habilitation and prevocational
60.28services. The commissioner shall submit all necessary waiver amendments by October 1,
60.292017.
60.30EFFECTIVE DATE.This section is effective the day following final enactment.

61.1    Sec. 48. TRANSPORTATION STUDY.
61.2The commissioner of human services, with cooperation from lead agencies and in
61.3consultation with stakeholders, shall conduct a study to identify opportunities to increase
61.4access to transportation services for an individual who receives home and community-based
61.5services. The commissioner shall submit a report with recommendations to the chairs and
61.6ranking minority members of the legislative committees with jurisdiction over human
61.7services by January 15, 2019. The report shall:
61.8(1) study all aspects of the current transportation service network, including the fleet
61.9available, the different rate-setting methods currently used, methods that an individual uses
61.10to access transportation, and the diversity of available provider agencies;
61.11(2) identify current barriers for an individual accessing transportation and for a provider
61.12providing waiver services transportation in the marketplace;
61.13(3) identify efficiencies and collaboration opportunities to increase available
61.14transportation, including transportation funded by medical assistance, and available regional
61.15transportation and transit options;
61.16(4) study transportation solutions in other states for delivering home and community-based
61.17services;
61.18(5) study provider costs required to administer transportation services;
61.19(6) make recommendations for coordinating and increasing transportation accessibility
61.20across the state; and
61.21(7) make recommendations for the rate setting of waivered transportation.
61.22EFFECTIVE DATE.This section is effective the day following final enactment.

61.23    Sec. 49. DIRECTION TO COMMISSIONER; TELECOMMUNICATION
61.24EQUIPMENT PROGRAM.
61.25The commissioner of human services shall work in consultation with the Commission
61.26of Deaf, Deafblind, and Hard-of-Hearing Minnesotans to provide recommendations by
61.27January 15, 2018, to the chairs and ranking minority members of the house of representatives
61.28and senate committees with jurisdiction over human services to modernize the
61.29telecommunication equipment program. The recommendations must address:
61.30(1) types of equipment and supports the program should provide to ensure people with
61.31communication difficulties have equitable access to telecommunications services;
62.1(2) additional services the program should provide, such as education about technology
62.2options that can improve a person's access to telecommunications services; and
62.3(3) how the current program's service delivery structure might be improved to better
62.4meet the needs of people with communication disabilities.
62.5The commissioner shall also provide draft legislative language to accomplish the
62.6recommendations. Final recommendations, the final report, and draft legislative language
62.7must be approved by both the commissioner and the chair of the Commission of Deaf,
62.8Deafblind, and Hard-of-Hearing Minnesotans.

62.9    Sec. 50. DIRECTION TO COMMISSIONER; BILLING FOR MENTAL HEALTH
62.10SERVICES.
62.11By January 1, 2018, the commissioner of human services shall report to the chairs and
62.12ranking minority members of the house of representatives and senate committees with
62.13jurisdiction over deaf and hard-of-hearing services on the potential costs and benefits of the
62.14Deaf and Hard-of-Hearing Services Division billing for the cost of providing mental health
62.15services.

62.16    Sec. 51. DIRECTION TO COMMISSIONER; MnCHOICES ASSESSMENT TOOL.
62.17The commissioner of human services shall work with lead agencies responsible for
62.18conducting long-term consultation services under Minnesota Statutes, section 256B.0911,
62.19to modify the MnCHOICES assessment tool and related policies to:
62.20(1) reduce assessment times;
62.21(2) create efficiencies within the tool and within practice and policy for conducting
62.22assessments and support planning;
62.23(3) implement policy changes reducing the frequency and depth of assessment and
62.24reassessment, while ensuring federal compliance with medical assistance and disability
62.25waiver eligibility requirements; and
62.26(4) evaluate alternative payment methods.

62.27    Sec. 52. RANDOM MOMENT TIME STUDY EVALUATION REQUIRED.
62.28The commissioner of human services shall evaluate the random moment time study
62.29methodology for reimbursement of costs associated with county duties required under
62.30Minnesota Statutes, section 256B.0911. The study must determine whether random moment
62.31is efficient and effective in supporting functions of assessment and support planning and
63.1the purpose under Minnesota Statutes, section 256B.0911, subdivision 1. The commissioner
63.2shall submit a report to the chairs and ranking minority members of the house of
63.3representatives and senate committees with jurisdiction over health and human services by
63.4January 15, 2019. The report must provide recommendations for changes to payment
63.5methodologies and functions related to assessment, eligibility determination, and support
63.6planning.

63.7    Sec. 53. REPEALER.
63.8(a) Minnesota Statutes 2016, sections 144A.351, subdivision 2; 256C.23, subdivision
63.93; 256C.233, subdivision 4; and 256C.25, subdivisions 1 and 2, are repealed.
63.10(b) Minnesota Statutes 2016, section 256B.4914, subdivision 16, is repealed effective
63.11January 1, 2018.
63.12(c) Laws 2012, chapter 247, article 4, section 47, as amended by Laws 2014, chapter
63.13312, article 27, section 72, Laws 2015, chapter 71, article 7, section 58, Laws 2016, chapter
63.14144, section 1; and Laws 2015, chapter 71, article 7, section 54, are repealed upon the
63.15effective date of section 44.

63.16ARTICLE 2

63.17HOUSING

63.18    Section 1. Minnesota Statutes 2016, section 144D.04, subdivision 2, is amended to read:
63.19    Subd. 2. Contents of contract. A housing with services contract, which need not be
63.20entitled as such to comply with this section, shall include at least the following elements in
63.21itself or through supporting documents or attachments:
63.22(1) the name, street address, and mailing address of the establishment;
63.23(2) the name and mailing address of the owner or owners of the establishment and, if
63.24the owner or owners is not a natural person, identification of the type of business entity of
63.25the owner or owners;
63.26(3) the name and mailing address of the managing agent, through management agreement
63.27or lease agreement, of the establishment, if different from the owner or owners;
63.28(4) the name and address of at least one natural person who is authorized to accept service
63.29of process on behalf of the owner or owners and managing agent;
64.1(5) a statement describing the registration and licensure status of the establishment and
64.2any provider providing health-related or supportive services under an arrangement with the
64.3establishment;
64.4(6) the term of the contract;
64.5(7) a description of the services to be provided to the resident in the base rate to be paid
64.6by resident, including a delineation of the portion of the base rate that constitutes rent and
64.7a delineation of charges for each service included in the base rate;
64.8(8) a description of any additional services, including home care services, available for
64.9an additional fee from the establishment directly or through arrangements with the
64.10establishment, and a schedule of fees charged for these services;
64.11(9) a description of the process through which the contract may be modified, amended,
64.12or terminated, including whether a move to a different room or sharing a room would be
64.13required in the event that the tenant can no longer pay the current rent;
64.14(10) a description of the establishment's complaint resolution process available to residents
64.15including the toll-free complaint line for the Office of Ombudsman for Long-Term Care;
64.16(11) the resident's designated representative, if any;
64.17(12) the establishment's referral procedures if the contract is terminated;
64.18(13) requirements of residency used by the establishment to determine who may reside
64.19or continue to reside in the housing with services establishment;
64.20(14) billing and payment procedures and requirements;
64.21(15) a statement regarding the ability of residents a resident to receive services from
64.22service providers with whom the establishment does not have an arrangement;
64.23(16) a statement regarding the availability of public funds for payment for residence or
64.24services in the establishment; and
64.25(17) a statement regarding the availability of and contact information for long-term care
64.26consultation services under section 256B.0911 in the county in which the establishment is
64.27located.
64.28EFFECTIVE DATE.This section is effective the day following final enactment.

65.1    Sec. 2. Minnesota Statutes 2016, section 144D.04, is amended by adding a subdivision to
65.2read:
65.3    Subd. 2a. Additional contract requirements. (a) For a resident receiving one or more
65.4health-related services from the establishment's arranged home care provider, as defined in
65.5section 144D.01, subdivision 6, the contract must include the requirements in paragraph
65.6(b). A restriction of a resident's rights under this subdivision is allowed only if determined
65.7necessary for health and safety reasons identified by the home care provider's registered
65.8nurse in an initial assessment or reassessment, as defined under section 144A.4791,
65.9subdivision 8, and documented in the written service plan under section 144A.4791,
65.10subdivision 9. Any restrictions of those rights for people served under sections 256B.0915
65.11and 256B.49 must be documented in the resident's coordinated service and support plan
65.12(CSSP), as defined under sections 256B.0915, subdivision 6 and 256B.49, subdivision 15.
65.13(b) The contract must include a statement:
65.14(1) regarding the ability of a resident to furnish and decorate the resident's unit within
65.15the terms of the lease;
65.16(2) regarding the resident's right to access food at any time;
65.17(3) regarding a resident's right to choose the resident's visitors and times of visits;
65.18(4) regarding the resident's right to choose a roommate if sharing a unit; and
65.19(5) notifying the resident of the resident's right to have and use a lockable door to the
65.20resident's unit. The landlord shall provide the locks on the unit. Only a staff member with
65.21a specific need to enter the unit shall have keys, and advance notice must be given to the
65.22resident before entrance, when possible.
65.23EFFECTIVE DATE.This section is effective the day following final enactment.

65.24    Sec. 3. Minnesota Statutes 2016, section 245A.03, subdivision 7, is amended to read:
65.25    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial license
65.26for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
65.27foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
65.28for a physical location that will not be the primary residence of the license holder for the
65.29entire period of licensure. If a license is issued during this moratorium, and the license
65.30holder changes the license holder's primary residence away from the physical location of
65.31the foster care license, the commissioner shall revoke the license according to section
66.1245A.07 . The commissioner shall not issue an initial license for a community residential
66.2setting licensed under chapter 245D. Exceptions to the moratorium include:
66.3(1) foster care settings that are required to be registered under chapter 144D;
66.4(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
66.5community residential setting licenses replacing adult foster care licenses in existence on
66.6December 31, 2013, and determined to be needed by the commissioner under paragraph
66.7(b);
66.8(3) new foster care licenses or community residential setting licenses determined to be
66.9needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
66.10or regional treatment center; restructuring of state-operated services that limits the capacity
66.11of state-operated facilities; or allowing movement to the community for people who no
66.12longer require the level of care provided in state-operated facilities as provided under section
66.13256B.092 , subdivision 13, or 256B.49, subdivision 24;
66.14(4) new foster care licenses or community residential setting licenses determined to be
66.15needed by the commissioner under paragraph (b) for persons requiring hospital level care;
66.16or
66.17(5) new foster care licenses or community residential setting licenses determined to be
66.18needed by the commissioner for the transition of people from personal care assistance to
66.19the home and community-based services. When approving an exception under this paragraph,
66.20the commissioner shall consider the resource need determination process in paragraph (h),
66.21the availability of foster care licensed beds in the geographic area in which the licensee
66.22seeks to operate, the results of a person's choices during their annual assessment and service
66.23plan review, and the recommendation of the local county board. The determination by the
66.24commissioner is final and not subject to appeal;
66.25(6) new foster care licenses or community residential setting licenses determined to be
66.26needed by the commissioner for the transition of people from the residential care waiver
66.27services to foster care services. This exception applies only when:
66.28(i) the person's case manager provided the person with information about the choice of
66.29service, service provider, and location of service to help the person make an informed choice;
66.30and
66.31(ii) the person's foster care services are less than or equal to the cost of the person's
66.32services delivered in the residential care waiver service setting as determined by the lead
66.33agency; or
67.1(7) new foster care licenses or community residential setting licenses for people receiving
67.2services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
67.3for which a license is required. This exception does not apply to people living in their own
67.4home. For purposes of this clause, there is a presumption that a foster care or community
67.5residential setting license is required for services provided to three or more people in a
67.6dwelling unit when the setting is controlled by the provider. A license holder subject to this
67.7exception may rebut the presumption that a license is required by seeking a reconsideration
67.8of the commissioner's determination. The commissioner's disposition of a request for
67.9reconsideration is final and not subject to appeal under chapter 14. The exception is available
67.10until June 30, 2018. This exception is available when:
67.11(i) the person's case manager provided the person with information about the choice of
67.12service, service provider, and location of service, including in the person's home, to help
67.13the person make an informed choice; and
67.14(ii) the person's services provided in the licensed foster care or community residential
67.15setting are less than or equal to the cost of the person's services delivered in the unlicensed
67.16setting as determined by the lead agency.
67.17(b) The commissioner shall determine the need for newly licensed foster care homes or
67.18community residential settings as defined under this subdivision. As part of the determination,
67.19the commissioner shall consider the availability of foster care capacity in the area in which
67.20the licensee seeks to operate, and the recommendation of the local county board. The
67.21determination by the commissioner must be final. A determination of need is not required
67.22for a change in ownership at the same address.
67.23(c) When an adult resident served by the program moves out of a foster home that is not
67.24the primary residence of the license holder according to section 256B.49, subdivision 15,
67.25paragraph (f), or the adult community residential setting, the county shall immediately
67.26inform the Department of Human Services Licensing Division. The department shall may
67.27decrease the statewide licensed capacity for adult foster care settings where the physical
67.28location is not the primary residence of the license holder, or for adult community residential
67.29settings, if the voluntary changes described in paragraph (e) are not sufficient to meet the
67.30savings required by reductions in licensed bed capacity under Laws 2011, First Special
67.31Session chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term
67.32care residential services capacity within budgetary limits. Implementation of the statewide
67.33licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense
67.34up to 128 beds by June 30, 2014, using the needs determination process. Prior to any
67.35involuntary reduction of licensed capacity, the commissioner shall consult with lead agencies
68.1and license holders to determine which adult foster care settings, where the physical location
68.2is not the primary residence of the license holder, or community residential settings, are
68.3licensed for up to five beds, but have operated at less than full capacity for 12 or more
68.4months as of March 1, 2014. The settings that meet these criteria must be the first to be
68.5considered for an involuntary decrease in statewide licensed capacity, up to a maximum of
68.635 beds. If more than 35 beds are identified that meet these criteria, the commissioner shall
68.7prioritize the selection of those beds to be closed based on the length of time the beds have
68.8been vacant. The longer a bed has been vacant, the higher priority it must be given for
68.9closure. Under this paragraph, the commissioner has the authority to reduce unused licensed
68.10capacity of a current foster care program, or the community residential settings, to accomplish
68.11the consolidation or closure of settings. Under this paragraph, the commissioner has the
68.12authority to manage statewide capacity, including adjusting the capacity available to each
68.13county and adjusting statewide available capacity, to meet the statewide needs identified
68.14through the process in paragraph (e). A decreased licensed capacity according to this
68.15paragraph is not subject to appeal under this chapter.
68.16(d) Residential settings that would otherwise be subject to the decreased license capacity
68.17established in paragraph (c) shall be exempt if the license holder's beds are occupied by
68.18residents whose primary diagnosis is mental illness and the license holder is certified under
68.19the requirements in subdivision 6a or section 245D.33.
68.20(e) A resource need determination process, managed at the state level, using the available
68.21reports required by section 144A.351, and other data and information shall be used to
68.22determine where the reduced capacity required determined under paragraph (c) section
68.23256B.493 will be implemented. The commissioner shall consult with the stakeholders
68.24described in section 144A.351, and employ a variety of methods to improve the state's
68.25capacity to meet the informed decisions of those people who want to move out of corporate
68.26foster care or community residential settings, long-term care service needs within budgetary
68.27limits, including seeking proposals from service providers or lead agencies to change service
68.28type, capacity, or location to improve services, increase the independence of residents, and
68.29better meet needs identified by the long-term care services and supports reports and statewide
68.30data and information. By February 1, 2013, and August 1, 2014, and each following year,
68.31the commissioner shall provide information and data and targets on the overall capacity of
68.32licensed long-term care services and supports, actions taken under this subdivision to manage
68.33statewide long-term care services and supports resources, and any recommendations for
68.34change to the legislative committees with jurisdiction over health and human services budget.
69.1    (f) At the time of application and reapplication for licensure, the applicant and the license
69.2holder that are subject to the moratorium or an exclusion established in paragraph (a) are
69.3required to inform the commissioner whether the physical location where the foster care
69.4will be provided is or will be the primary residence of the license holder for the entire period
69.5of licensure. If the primary residence of the applicant or license holder changes, the applicant
69.6or license holder must notify the commissioner immediately. The commissioner shall print
69.7on the foster care license certificate whether or not the physical location is the primary
69.8residence of the license holder.
69.9    (g) License holders of foster care homes identified under paragraph (f) that are not the
69.10primary residence of the license holder and that also provide services in the foster care home
69.11that are covered by a federally approved home and community-based services waiver, as
69.12authorized under section 256B.0915, 256B.092, or 256B.49, must inform the human services
69.13licensing division that the license holder provides or intends to provide these waiver-funded
69.14services.
69.15(h) The commissioner may adjust capacity to address needs identified in section
69.16144A.351. Under this authority, the commissioner may approve new licensed settings or
69.17delicense existing settings. Delicensing of settings will be accomplished through a process
69.18identified in section 256B.493. Annually, by August 1, the commissioner shall provide
69.19information and data on capacity of licensed long-term services and supports, actions taken
69.20under the subdivision to manage statewide long-term services and supports resources, and
69.21any recommendations for change to the legislative committees with jurisdiction over the
69.22health and human services budget.
69.23(i) The commissioner must notify a license holder when its corporate foster care or
69.24community residential setting licensed beds are reduced under this section. The notice of
69.25reduction of licensed beds must be in writing and delivered to the license holder by certified
69.26mail or personal service. The notice must state why the licensed beds are reduced and must
69.27inform the license holder of its right to request reconsideration by the commissioner. The
69.28license holder's request for reconsideration must be in writing. If mailed, the request for
69.29reconsideration must be postmarked and sent to the commissioner within 20 calendar days
69.30after the license holder's receipt of the notice of reduction of licensed beds. If a request for
69.31reconsideration is made by personal service, it must be received by the commissioner within
69.3220 calendar days after the license holder's receipt of the notice of reduction of licensed beds.
69.33    (j) The commissioner shall not issue an initial license for children's residential treatment
69.34services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
69.35for a program that Centers for Medicare and Medicaid Services would consider an institution
70.1for mental diseases. Facilities that serve only private pay clients are exempt from the
70.2moratorium described in this paragraph. The commissioner has the authority to manage
70.3existing statewide capacity for children's residential treatment services subject to the
70.4moratorium under this paragraph and may issue an initial license for such facilities if the
70.5initial license would not increase the statewide capacity for children's residential treatment
70.6services subject to the moratorium under this paragraph.

70.7    Sec. 4. Minnesota Statutes 2016, section 245A.04, subdivision 14, is amended to read:
70.8    Subd. 14. Policies and procedures for program administration required and
70.9enforceable. (a) The license holder shall develop program policies and procedures necessary
70.10to maintain compliance with licensing requirements under Minnesota Statutes and Minnesota
70.11Rules.
70.12    (b) The license holder shall:
70.13    (1) provide training to program staff related to their duties in implementing the program's
70.14policies and procedures developed under paragraph (a);
70.15    (2) document the provision of this training; and
70.16    (3) monitor implementation of policies and procedures by program staff.
70.17    (c) The license holder shall keep program policies and procedures readily accessible to
70.18staff and index the policies and procedures with a table of contents or another method
70.19approved by the commissioner.
70.20(d) An adult foster care license holder that provides foster care services to a resident
70.21under section 256B.0915 must annually provide a copy of the resident termination policy
70.22under section 245A.11, subdivision 11, to a resident covered by the policy.

70.23    Sec. 5. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
70.24read:
70.25    Subd. 9. Adult foster care bedrooms. (a) A resident receiving services must have a
70.26choice of roommate. Each roommate must consent in writing to sharing a bedroom with
70.27one another. The license holder is responsible for notifying a resident of the resident's right
70.28to request a change of roommate.
70.29(b) The license holder must provide a lock for each resident's bedroom door, unless
70.30otherwise indicated for the resident's health, safety, or well-being. A restriction on the use
70.31of the lock must be documented and justified in the resident's individual abuse prevention
71.1plan required by sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision
71.214.For a resident served under section 256B.0915, the case manager must be part of the
71.3interdisciplinary team under section 245A.65, subdivision 2, paragraph (b).
71.4EFFECTIVE DATE.This section is effective the day following final enactment.

71.5    Sec. 6. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
71.6read:
71.7    Subd. 10. Adult foster care resident rights. (a) The license holder shall ensure that a
71.8resident and a resident's legal representative are given, at admission:
71.9(1) an explanation and copy of the resident's rights specified in paragraph (b);
71.10(2) a written summary of the Vulnerable Adults Protection Act prepared by the
71.11department; and
71.12(3) the name, address, and telephone number of the local agency to which a resident or
71.13a resident's legal representative may submit an oral or written complaint.
71.14(b) Adult foster care resident rights include the right to:
71.15(1) have daily, private access to and use of a non-coin-operated telephone for local and
71.16long-distance telephone calls made collect or paid for by the resident;
71.17(2) receive and send, without interference, uncensored, unopened mail or electronic
71.18correspondence or communication;
71.19(3) have use of and free access to common areas in the residence and the freedom to
71.20come and go from the residence at will;
71.21(4) have privacy for visits with the resident's spouse, next of kin, legal counsel, religious
71.22adviser, or others, according to section 363A.09 of the Human Rights Act, including privacy
71.23in the resident's bedroom;
71.24(5) keep, use, and access the resident's personal clothing and possessions as space permits,
71.25unless this right infringes on the health, safety, or rights of another resident or household
71.26member, including the right to access the resident's personal possessions at any time;
71.27(6) choose the resident's visitors and time of visits and participate in activities of
71.28commercial, religious, political, and community groups without interference if the activities
71.29do not infringe on the rights of another resident or household member;
71.30(7) if married, privacy for visits by the resident's spouse, and, if both spouses are residents
71.31of the adult foster home, the residents have the right to share a bedroom and bed;
72.1(8) privacy, including use of the lock on the resident's bedroom door or unit door. A
72.2resident's privacy must be respected by license holders, caregivers, household members,
72.3and volunteers by knocking on the door of a resident's bedroom or bathroom and seeking
72.4consent before entering, except in an emergency;
72.5(9) furnish and decorate the resident's bedroom or living unit;
72.6(10) engage in chosen activities and have an individual schedule supported by the license
72.7holder that meets the resident's preferences;
72.8(11) freedom and support to access food at any time;
72.9(12) have personal, financial, service, health, and medical information kept private, and
72.10be advised of disclosure of this information by the license holder;
72.11(13) access records and recorded information about the resident according to applicable
72.12state and federal law, regulation, or rule;
72.13(14) be free from maltreatment;
72.14(15) be treated with courtesy and respect and receive respectful treatment of the resident's
72.15property;
72.16(16) reasonable observance of cultural and ethnic practice and religion;
72.17(17) be free from bias and harassment regarding race, gender, age, disability, spirituality,
72.18and sexual orientation;
72.19(18) be informed of and use the license holder's grievance policy and procedures,
72.20including how to contact the highest level of authority in the program;
72.21(19) assert the resident's rights personally, or have the rights asserted by the resident's
72.22family, authorized representative, or legal representative, without retaliation; and
72.23(20) give or withhold written informed consent to participate in any research or
72.24experimental treatment.
72.25(c) A restriction of a resident's rights under paragraph (b), clauses (1) to (4), (6), (8),
72.26(10), and (11), is allowed only if determined necessary to ensure the health, safety, and
72.27well-being of the resident. Any restriction of a resident's right must be documented and
72.28justified in the resident's individual abuse prevention plan required by sections 245A.65,
72.29subdivision 2, paragraph (b) and 626.557, subdivision 14. For a resident served under section
72.30256B.0915, the case manager must be part of the interdisciplinary team under section
72.31245A.65, subdivision 2, paragraph (b). The restriction must be implemented in the least
73.1restrictive manner necessary to protect the resident and provide support to reduce or eliminate
73.2the need for the restriction.
73.3EFFECTIVE DATE.This section is effective the day following final enactment.

73.4    Sec. 7. Minnesota Statutes 2016, section 245A.11, is amended by adding a subdivision to
73.5read:
73.6    Subd. 11. Adult foster care service termination for elderly waiver participants. (a)
73.7This subdivision applies to foster care services for a resident served under section 256B.0915.
73.8(b) The foster care license holder must establish policies and procedures for service
73.9termination that promote continuity of care and service coordination with the resident and
73.10the case manager and with another licensed caregiver, if any, who also provides support to
73.11the resident. The policy must include the requirements specified in paragraphs (c) to (h).
73.12(c) The license holder must allow a resident to remain in the program and cannot terminate
73.13services unless:
73.14(1) the termination is necessary for the resident's health, safety, and well-being and the
73.15resident's needs cannot be met in the facility;
73.16(2) the safety of the resident or another resident in the program is endangered and positive
73.17support strategies were attempted and have not achieved and effectively maintained safety
73.18for the resident or another resident in the program;
73.19(3) the health, safety, and well-being of the resident or another resident in the program
73.20would otherwise be endangered;
73.21(4) the program was not paid for services;
73.22(5) the program ceases to operate; or
73.23(6) the resident was terminated by the lead agency from waiver eligibility.
73.24(d) Before giving notice of service termination, the license holder must document the
73.25action taken to minimize or eliminate the need for termination. The action taken by the
73.26license holder must include, at a minimum:
73.27(1) consultation with the resident's interdisciplinary team to identify and resolve issues
73.28leading to a notice of service termination; and
73.29(2) a request to the case manager or other professional consultation or intervention
73.30services to support the resident in the program. This requirement does not apply to a notice
73.31of service termination issued under paragraph (c), clause (4) or (5).
74.1(e) If, based on the best interests of the resident, the circumstances at the time of notice
74.2were such that the license holder was unable to take the action specified in paragraph (d),
74.3the license holder must document the specific circumstances and the reason the license
74.4holder was unable to take the action.
74.5(f) The license holder must notify the resident or the resident's legal representative and
74.6the case manager in writing of the intended service termination. The notice must include:
74.7(1) the reason for the action;
74.8(2) except for service termination under paragraph (c), clause (4) or (5), a summary of
74.9the action taken to minimize or eliminate the need for termination and the reason the action
74.10failed to prevent the termination;
74.11(3) the resident's right to appeal the service termination under section 256.045, subdivision
74.123, paragraph (a); and
74.13(4) the resident's right to seek a temporary order staying the service termination according
74.14to the procedures in section 256.045, subdivision 4a, or subdivision 6, paragraph (c).
74.15(g) Notice of the proposed service termination must be given at least 30 days before
74.16terminating a resident's service.
74.17(h) After the resident receives the notice of service termination and before the services
74.18are terminated, the license holder must:
74.19(1) work with the support team or expanded support team to develop reasonable
74.20alternatives to support continuity of care and to protect the resident;
74.21(2) provide information requested by the resident or case manager; and
74.22(3) maintain information about the service termination, including the written notice of
74.23service termination, in the resident's record.
74.24EFFECTIVE DATE.This section is effective the day following final enactment.

74.25    Sec. 8. Minnesota Statutes 2016, section 245D.04, subdivision 3, is amended to read:
74.26    Subd. 3. Protection-related rights. (a) A person's protection-related rights include the
74.27right to:
74.28(1) have personal, financial, service, health, and medical information kept private, and
74.29be advised of disclosure of this information by the license holder;
74.30(2) access records and recorded information about the person in accordance with
74.31applicable state and federal law, regulation, or rule;
75.1(3) be free from maltreatment;
75.2(4) be free from restraint, time out, seclusion, restrictive intervention, or other prohibited
75.3procedure identified in section 245D.06, subdivision 5, or successor provisions, except for:
75.4(i) emergency use of manual restraint to protect the person from imminent danger to self
75.5or others according to the requirements in section 245D.061 or successor provisions; or (ii)
75.6the use of safety interventions as part of a positive support transition plan under section
75.7245D.06, subdivision 8 , or successor provisions;
75.8(5) receive services in a clean and safe environment when the license holder is the owner,
75.9lessor, or tenant of the service site;
75.10(6) be treated with courtesy and respect and receive respectful treatment of the person's
75.11property;
75.12(7) reasonable observance of cultural and ethnic practice and religion;
75.13(8) be free from bias and harassment regarding race, gender, age, disability, spirituality,
75.14and sexual orientation;
75.15(9) be informed of and use the license holder's grievance policy and procedures, including
75.16knowing how to contact persons responsible for addressing problems and to appeal under
75.17section 256.045;
75.18(10) know the name, telephone number, and the Web site, e-mail, and street addresses
75.19of protection and advocacy services, including the appropriate state-appointed ombudsman,
75.20and a brief description of how to file a complaint with these offices;
75.21(11) assert these rights personally, or have them asserted by the person's family,
75.22authorized representative, or legal representative, without retaliation;
75.23(12) give or withhold written informed consent to participate in any research or
75.24experimental treatment;
75.25(13) associate with other persons of the person's choice;
75.26(14) personal privacy, including the right to use the lock on the person's bedroom or unit
75.27door; and
75.28(15) engage in chosen activities; and
75.29(16) access to the person's personal possessions at any time, including financial resources.
76.1(b) For a person residing in a residential site licensed according to chapter 245A, or
76.2where the license holder is the owner, lessor, or tenant of the residential service site,
76.3protection-related rights also include the right to:
76.4(1) have daily, private access to and use of a non-coin-operated telephone for local calls
76.5and long-distance calls made collect or paid for by the person;
76.6(2) receive and send, without interference, uncensored, unopened mail or electronic
76.7correspondence or communication;
76.8(3) have use of and free access to common areas in the residence and the freedom to
76.9come and go from the residence at will; and
76.10(4) choose the person's visitors and time of visits and have privacy for visits with the
76.11person's spouse, next of kin, legal counsel, religious advisor adviser, or others, in accordance
76.12with section 363A.09 of the Human Rights Act, including privacy in the person's bedroom.;
76.13(5) the freedom and support to access food at any time;
76.14(6) the freedom to furnish and decorate the person's bedroom or living unit;
76.15(7) a setting that is clean and free from accumulation of dirt, grease, garbage, peeling
76.16paint, mold, vermin, and insects;
76.17(8) a setting that is free from hazards that threaten the person's health or safety;
76.18(9) a setting that meets state and local building and zoning definitions of a dwelling unit
76.19in a residential occupancy; and
76.20(10) have access to potable water and three nutritionally balanced meals and nutritious
76.21snacks between meals each day.
76.22(c) Restriction of a person's rights under paragraph (a), clauses (13) to (15) (16), or
76.23paragraph (b) is allowed only if determined necessary to ensure the health, safety, and
76.24well-being of the person. Any restriction of those rights must be documented in the person's
76.25coordinated service and support plan or coordinated service and support plan addendum.
76.26The restriction must be implemented in the least restrictive alternative manner necessary
76.27to protect the person and provide support to reduce or eliminate the need for the restriction
76.28in the most integrated setting and inclusive manner. The documentation must include the
76.29following information:
76.30(1) the justification for the restriction based on an assessment of the person's vulnerability
76.31related to exercising the right without restriction;
76.32(2) the objective measures set as conditions for ending the restriction;
77.1(3) a schedule for reviewing the need for the restriction based on the conditions for
77.2ending the restriction to occur semiannually from the date of initial approval, at a minimum,
77.3or more frequently if requested by the person, the person's legal representative, if any, and
77.4case manager; and
77.5(4) signed and dated approval for the restriction from the person, or the person's legal
77.6representative, if any. A restriction may be implemented only when the required approval
77.7has been obtained. Approval may be withdrawn at any time. If approval is withdrawn, the
77.8right must be immediately and fully restored.
77.9EFFECTIVE DATE.This section is effective the day following final enactment.

77.10    Sec. 9. Minnesota Statutes 2016, section 245D.071, subdivision 3, is amended to read:
77.11    Subd. 3. Assessment and initial service planning. (a) Within 15 days of service initiation
77.12the license holder must complete a preliminary coordinated service and support plan
77.13addendum based on the coordinated service and support plan.
77.14(b) Within the scope of services, the license holder must, at a minimum, complete
77.15assessments in the following areas before the 45-day planning meeting:
77.16(1) the person's ability to self-manage health and medical needs to maintain or improve
77.17physical, mental, and emotional well-being, including, when applicable, allergies, seizures,
77.18choking, special dietary needs, chronic medical conditions, self-administration of medication
77.19or treatment orders, preventative screening, and medical and dental appointments;
77.20(2) the person's ability to self-manage personal safety to avoid injury or accident in the
77.21service setting, including, when applicable, risk of falling, mobility, regulating water
77.22temperature, community survival skills, water safety skills, and sensory disabilities; and
77.23(3) the person's ability to self-manage symptoms or behavior that may otherwise result
77.24in an incident as defined in section 245D.02, subdivision 11, clauses (4) to (7), suspension
77.25or termination of services by the license holder, or other symptoms or behaviors that may
77.26jeopardize the health and welfare of the person or others.
77.27Assessments must produce information about the person that describes the person's overall
77.28strengths, functional skills and abilities, and behaviors or symptoms. Assessments must be
77.29based on the person's status within the last 12 months at the time of service initiation.
77.30Assessments based on older information must be documented and justified. Assessments
77.31must be conducted annually at a minimum or within 30 days of a written request from the
77.32person or the person's legal representative or case manager. The results must be reviewed
77.33by the support team or expanded support team as part of a service plan review.
78.1(c) Within 45 days of service initiation, the license holder must meet with the person,
78.2the person's legal representative, the case manager, and other members of the support team
78.3or expanded support team to determine the following based on information obtained from
78.4the assessments identified in paragraph (b), the person's identified needs in the coordinated
78.5service and support plan, and the requirements in subdivision 4 and section 245D.07,
78.6subdivision 1a :
78.7(1) the scope of the services to be provided to support the person's daily needs and
78.8activities;
78.9(2) the person's desired outcomes and the supports necessary to accomplish the person's
78.10desired outcomes;
78.11(3) the person's preferences for how services and supports are provided, including how
78.12the provider will support the person to have control of the person's schedule;
78.13(4) whether the current service setting is the most integrated setting available and
78.14appropriate for the person; and
78.15(5) how services must be coordinated across other providers licensed under this chapter
78.16serving the person and members of the support team or expanded support team to ensure
78.17continuity of care and coordination of services for the person.
78.18EFFECTIVE DATE.This section is effective the day following final enactment.

78.19    Sec. 10. Minnesota Statutes 2016, section 245D.11, subdivision 4, is amended to read:
78.20    Subd. 4. Admission criteria. The license holder must establish policies and procedures
78.21that promote continuity of care by ensuring that admission or service initiation criteria:
78.22(1) is consistent with the service-related rights identified in section 245D.04, subdivisions
78.232 , clauses (4) to (7), and 3, clause (8);
78.24(2) identifies the criteria to be applied in determining whether the license holder can
78.25develop services to meet the needs specified in the person's coordinated service and support
78.26plan;
78.27(3) requires a license holder providing services in a health care facility to comply with
78.28the requirements in section 243.166, subdivision 4b, to provide notification to residents
78.29when a registered predatory offender is admitted into the program or to a potential admission
78.30when the facility was already serving a registered predatory offender. For purposes of this
78.31clause, "health care facility" means a facility licensed by the commissioner as a residential
79.1facility under chapter 245A to provide adult foster care or residential services to persons
79.2with disabilities; and
79.3(4) requires that when a person or the person's legal representative requests services
79.4from the license holder, a refusal to admit the person must be based on an evaluation of the
79.5person's assessed needs and the license holder's lack of capacity to meet the needs of the
79.6person. The license holder must not refuse to admit a person based solely on the type of
79.7residential services the person is receiving, or solely on the person's severity of disability,
79.8orthopedic or neurological handicaps, sight or hearing impairments, lack of communication
79.9skills, physical disabilities, toilet habits, behavioral disorders, or past failure to make progress.
79.10Documentation of the basis for refusal must be provided to the person or the person's legal
79.11representative and case manager upon request.; and
79.12(5) requires the person or the person's legal representative and license holder to sign and
79.13date the residency agreement when the license holder provides foster care or supported
79.14living services under section 245D.03, subdivision 1, paragraph (c), clause (3), item (i) or
79.15(ii), to a person living in a community residential setting defined in section 245D.02,
79.16subdivision 4a; an adult foster home defined in Minnesota Rules, part 9555.5105, subpart
79.175; or a foster family home defined in Minnesota Rules, part 9560.0521, subpart 12. The
79.18residency agreement must include service termination requirements specified in section
79.19245D.10, subdivision 3a, paragraphs (b) to (f). The residency agreement must be reviewed
79.20annually, dated, and signed by the person or the person's legal representative and license
79.21holder.
79.22EFFECTIVE DATE.This section is effective the day following final enactment.

79.23    Sec. 11. Minnesota Statutes 2016, section 245D.24, subdivision 3, is amended to read:
79.24    Subd. 3. Bedrooms. (a) People Each person receiving services must have a choice of
79.25roommate and must mutually consent, in writing, to sharing a bedroom with one another.
79.26No more than two people receiving services may share one bedroom.
79.27(b) A single occupancy bedroom must have at least 80 square feet of floor space with a
79.287-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor
79.29space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and other
79.30habitable rooms by floor-to-ceiling walls containing no openings except doorways and must
79.31not serve as a corridor to another room used in daily living.
79.32(c) A person's personal possessions and items for the person's own use are the only items
79.33permitted to be stored in a person's bedroom.
80.1(d) Unless otherwise documented through assessment as a safety concern for the person,
80.2each person must be provided with the following furnishings:
80.3(1) a separate bed of proper size and height for the convenience and comfort of the
80.4person, with a clean mattress in good repair;
80.5(2) clean bedding appropriate for the season for each person;
80.6(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal
80.7possessions and clothing; and
80.8(4) a mirror for grooming.
80.9(e) When possible, a person must be allowed to have items of furniture that the person
80.10personally owns in the bedroom, unless doing so would interfere with safety precautions,
80.11violate a building or fire code, or interfere with another person's use of the bedroom. A
80.12person may choose not to have a cabinet, dresser, shelves, or a mirror in the bedroom, as
80.13otherwise required under paragraph (d), clause (3) or (4). A person may choose to use a
80.14mattress other than an innerspring mattress and may choose not to have the mattress on a
80.15mattress frame or support. If a person chooses not to have a piece of required furniture, the
80.16license holder must document this choice and is not required to provide the item. If a person
80.17chooses to use a mattress other than an innerspring mattress or chooses not to have a mattress
80.18frame or support, the license holder must document this choice and allow the alternative
80.19desired by the person.
80.20(f) A person must be allowed to bring personal possessions into the bedroom and other
80.21designated storage space, if such space is available, in the residence. The person must be
80.22allowed to accumulate possessions to the extent the residence is able to accommodate them,
80.23unless doing so is contraindicated for the person's physical or mental health, would interfere
80.24with safety precautions or another person's use of the bedroom, or would violate a building
80.25or fire code. The license holder must allow for locked storage of personal items. Any
80.26restriction on the possession or locked storage of personal items, including requiring a
80.27person to use a lock provided by the license holder, must comply with section 245D.04,
80.28subdivision 3 , paragraph (c), and allow the person to be present if and when the license
80.29holder opens the lock.
80.30(g) A person must be allowed to lock the person's bedroom door. The license holder
80.31must document and assess the physical plant and the environment, and the population served,
80.32and identify the risk factors that require using locked doors, and the specific action taken
80.33to minimize the safety risk to a person receiving services at the site.
81.1EFFECTIVE DATE.This section is effective the day following final enactment.

81.2    Sec. 12. Minnesota Statutes 2016, section 256.045, subdivision 3, is amended to read:
81.3    Subd. 3. State agency hearings. (a) State agency hearings are available for the following:
81.4    (1) any person applying for, receiving or having received public assistance, medical
81.5care, or a program of social services granted by the state agency or a county agency or the
81.6federal Food Stamp Act whose application for assistance is denied, not acted upon with
81.7reasonable promptness, or whose assistance is suspended, reduced, terminated, or claimed
81.8to have been incorrectly paid;
81.9    (2) any patient or relative aggrieved by an order of the commissioner under section
81.10252.27 ;
81.11    (3) a party aggrieved by a ruling of a prepaid health plan;
81.12    (4) except as provided under chapter 245C, any individual or facility determined by a
81.13lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
81.14they have exercised their right to administrative reconsideration under section 626.557;
81.15    (5) any person whose claim for foster care payment according to a placement of the
81.16child resulting from a child protection assessment under section 626.556 is denied or not
81.17acted upon with reasonable promptness, regardless of funding source;
81.18    (6) any person to whom a right of appeal according to this section is given by other
81.19provision of law;
81.20    (7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
81.21under section 256B.15;
81.22    (8) an applicant aggrieved by an adverse decision to an application or redetermination
81.23for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;
81.24    (9) except as provided under chapter 245A, an individual or facility determined to have
81.25maltreated a minor under section 626.556, after the individual or facility has exercised the
81.26right to administrative reconsideration under section 626.556;
81.27    (10) except as provided under chapter 245C, an individual disqualified under sections
81.28245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
81.29on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
81.30individual has committed an act or acts that meet the definition of any of the crimes listed
81.31in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
81.32626.556, subdivision 3 , or 626.557, subdivision 3. Hearings regarding a maltreatment
82.1determination under clause (4) or (9) and a disqualification under this clause in which the
82.2basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
82.3a single fair hearing. In such cases, the scope of review by the human services judge shall
82.4include both the maltreatment determination and the disqualification. The failure to exercise
82.5the right to an administrative reconsideration shall not be a bar to a hearing under this section
82.6if federal law provides an individual the right to a hearing to dispute a finding of
82.7maltreatment;
82.8    (11) any person with an outstanding debt resulting from receipt of public assistance,
82.9medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
82.10Department of Human Services or a county agency. The scope of the appeal is the validity
82.11of the claimant agency's intention to request a setoff of a refund under chapter 270A against
82.12the debt;
82.13    (12) a person issued a notice of service termination under section 245D.10, subdivision
82.143a, from residential supports and services as defined in section 245D.03, subdivision 1,
82.15paragraph (c), clause (3), that is not otherwise subject to appeal under subdivision 4a; or
82.16    (13) an individual disability waiver recipient based on a denial of a request for a rate
82.17exception under section 256B.4914.; or
82.18(14) a person issued a notice of service termination under section 245A.11, subdivision
82.1911, that is not otherwise subject to appeal under subdivision 4a.
82.20    (b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
82.21is the only administrative appeal to the final agency determination specifically, including
82.22a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
82.23under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
82.24after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
82.25to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
82.26proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
82.27clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
82.28hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
82.29available when there is no district court action pending. If such action is filed in district
82.30court while an administrative review is pending that arises out of some or all of the events
82.31or circumstances on which the appeal is based, the administrative review must be suspended
82.32until the judicial actions are completed. If the district court proceedings are completed,
82.33dismissed, or overturned, the matter may be considered in an administrative hearing.
83.1    (c) For purposes of this section, bargaining unit grievance procedures are not an
83.2administrative appeal.
83.3    (d) The scope of hearings involving claims to foster care payments under paragraph (a),
83.4clause (5), shall be limited to the issue of whether the county is legally responsible for a
83.5child's placement under court order or voluntary placement agreement and, if so, the correct
83.6amount of foster care payment to be made on the child's behalf and shall not include review
83.7of the propriety of the county's child protection determination or child placement decision.
83.8    (e) The scope of hearings under paragraph (a), clause clauses (12) and (14), shall be
83.9limited to whether the proposed termination of services is authorized under section 245D.10,
83.10subdivision 3a , paragraph (b), or 245A.11, subdivision 11, and whether the requirements
83.11of section 245D.10, subdivision 3a, paragraph paragraphs (c) to (e), or 245A.11, subdivision
83.122a, paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
83.13termination of services, the scope of the hearing shall also include whether the case
83.14management provider has finalized arrangements for a residential facility, a program, or
83.15services that will meet the assessed needs of the recipient by the effective date of the service
83.16termination.
83.17    (f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
83.18under contract with a county agency to provide social services is not a party and may not
83.19request a hearing under this section, except if assisting a recipient as provided in subdivision
83.204.
83.21    (g) An applicant or recipient is not entitled to receive social services beyond the services
83.22prescribed under chapter 256M or other social services the person is eligible for under state
83.23law.
83.24    (h) The commissioner may summarily affirm the county or state agency's proposed
83.25action without a hearing when the sole issue is an automatic change due to a change in state
83.26or federal law.
83.27    (i) Unless federal or Minnesota law specifies a different time frame in which to file an
83.28appeal, an individual or organization specified in this section may contest the specified
83.29action, decision, or final disposition before the state agency by submitting a written request
83.30for a hearing to the state agency within 30 days after receiving written notice of the action,
83.31decision, or final disposition, or within 90 days of such written notice if the applicant,
83.32recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
83.3313, why the request was not submitted within the 30-day time limit. The individual filing
83.34the appeal has the burden of proving good cause by a preponderance of the evidence.
84.1EFFECTIVE DATE.This section is effective the day following final enactment.

84.2    Sec. 13. [256B.051] HOUSING SUPPORT SERVICES.
84.3    Subdivision 1. Purpose. Housing support services are established to provide housing
84.4support services to an individual with a disability that limits the individual's ability to obtain
84.5or maintain stable housing. The services support an individual's transition to housing in the
84.6community and increase long-term stability in housing, to avoid future periods of being at
84.7risk of homelessness or institutionalization.
84.8    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in this
84.9subdivision have the meanings given.
84.10(b) "At-risk of homelessness" means (1) an individual that is faced with a set of
84.11circumstances likely to cause the individual to become homeless, or (2) an individual
84.12previously homeless, who will be discharged from a correctional, medical, mental health,
84.13or treatment center, who lacks sufficient resources to pay for housing and does not have a
84.14permanent place to live.
84.15(c) "Commissioner" means the commissioner of human services.
84.16(d) "Homeless" means an individual or family lacking a fixed, adequate nighttime
84.17residence.
84.18(e) "Individual with a disability" means:
84.19(1) an individual who is aged, blind, or disabled as determined by the criteria used by
84.20the title 11 program of the Social Security Act, United States Code, title 42, section 416,
84.21paragraph (i), item (1); or
84.22(2) an individual who meets a category of eligibility under section 256D.05, subdivision
84.231, paragraph (a), clauses (1), (3), (5) to (9), or (14).
84.24(f) "Institution" means a setting as defined in section 256B.0621, subdivision 2, clause
84.25(3), and the Minnesota Security Hospital as defined in section 253.20.
84.26    Subd. 3. Eligibility. An individual with a disability is eligible for housing support services
84.27if the individual:
84.28(1) is 18 years of age or older;
84.29(2) is enrolled in medical assistance;
84.30(3) has an assessment of functional need that determines a need for services due to
84.31limitations caused by the individual's disability;
85.1(4) resides in or plans to transition to a community-based setting as defined in Code of
85.2Federal Regulations, title 42, section 441.301(c); and
85.3(5) has housing instability evidenced by:
85.4(i) being homeless or at-risk of homelessness;
85.5(ii) being in the process of transitioning from, or having transitioned in the past six
85.6months from, an institution or licensed or registered setting;
85.7(iii) being eligible for waiver services under section 256B.0915, 256B.092, or 256B.49;
85.8or
85.9(iv) having been identified by a long-term care consultation under section 256B.0911
85.10as at risk of institutionalization.
85.11    Subd. 4. Assessment requirements. (a) An individual's assessment of functional need
85.12must be conducted by one of the following methods:
85.13(1) an assessor according to the criteria established in section 256B.0911, subdivision
85.143a, using a format established by the commissioner;
85.15(2) documented need for services as verified by a professional statement of need as
85.16defined in section 256I.03, subdivision 12; or
85.17(3) according to the continuum of care coordinated assessment system established in
85.18Code of Federal Regulations, title 24, section 578.3, using a format established by the
85.19commissioner.
85.20(b) An individual must be reassessed within one year of initial assessment, and annually
85.21thereafter.
85.22    Subd. 5. Housing support services. (a) Housing support services include housing
85.23transition services and housing and tenancy sustaining services.
85.24(b) Housing transition services are defined as:
85.25(1) tenant screening and housing assessment;
85.26(2) assistance with the housing search and application process;
85.27(3) identifying resources to cover onetime moving expenses;
85.28(4) ensuring a new living arrangement is safe and ready for move-in;
85.29(5) assisting in arranging for and supporting details of a move; and
85.30(6) developing a housing support crisis plan.
86.1(c) Housing and tenancy sustaining services include:
86.2(1) prevention and early identification of behaviors that may jeopardize continued stable
86.3housing;
86.4(2) education and training on roles, rights, and responsibilities of the tenant and the
86.5property manager;
86.6(3) coaching to develop and maintain key relationships with property managers and
86.7neighbors;
86.8(4) advocacy and referral to community resources to prevent eviction when housing is
86.9at risk;
86.10(5) assistance with housing recertification process;
86.11(6) coordination with the tenant to regularly review, update, and modify housing support
86.12and crisis plan; and
86.13(7) continuing training on being a good tenant, lease compliance, and household
86.14management.
86.15(d) A housing support service may include person-centered planning for people who are
86.16not eligible to receive person-centered planning through any other service, if the
86.17person-centered planning is provided by a consultation service provider that is under contract
86.18with the department and enrolled as a Minnesota health care program.
86.19    Subd. 6. Provider qualifications and duties. A provider eligible for reimbursement
86.20under this section shall:
86.21(1) enroll as a medical assistance Minnesota health care program provider and meet all
86.22applicable provider standards and requirements;
86.23(2) demonstrate compliance with federal and state laws and policies for housing support
86.24services as determined by the commissioner;
86.25(3) comply with background study requirements under chapter 245C and maintain
86.26documentation of background study requests and results; and
86.27(4) directly provide housing support services and not use a subcontractor or reporting
86.28agent.
86.29    Subd. 7. Housing support supplemental service rates. Supplemental service rates for
86.30individuals in settings according to sections 144D.025, 256I.04, subdivision 3, paragraph
86.31(a), clause (3), and 256I.05, subdivision 1g, shall be reduced by one-half over a two-year
87.1period. This reduction only applies to supplemental service rates for individuals eligible for
87.2housing support services under this section.
87.3EFFECTIVE DATE.(a) Subdivisions 1 to 6 are contingent upon federal approval. The
87.4commissioner of human services shall notify the revisor of statutes when federal approval
87.5is obtained.
87.6(b) Subdivision 7 is contingent upon federal approval of subdivisions 1 to 6. The
87.7commissioner of human services shall notify the revisor of statutes when federal approval
87.8is obtained.

87.9    Sec. 14. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
87.10    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, services
87.11planning, or other assistance intended to support community-based living, including persons
87.12who need assessment in order to determine waiver or alternative care program eligibility,
87.13must be visited by a long-term care consultation team within 20 calendar days after the date
87.14on which an assessment was requested or recommended. Upon statewide implementation
87.15of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
87.16requesting personal care assistance services and home care nursing. The commissioner shall
87.17provide at least a 90-day notice to lead agencies prior to the effective date of this requirement.
87.18Face-to-face assessments must be conducted according to paragraphs (b) to (i).
87.19    (b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
87.20assessors to conduct the assessment. For a person with complex health care needs, a public
87.21health or registered nurse from the team must be consulted.
87.22    (c) The MnCHOICES assessment provided by the commissioner to lead agencies must
87.23be used to complete a comprehensive, person-centered assessment. The assessment must
87.24include the health, psychological, functional, environmental, and social needs of the
87.25individual necessary to develop a community support plan that meets the individual's needs
87.26and preferences.
87.27    (d) The assessment must be conducted in a face-to-face interview with the person being
87.28assessed and the person's legal representative. At the request of the person, other individuals
87.29may participate in the assessment to provide information on the needs, strengths, and
87.30preferences of the person necessary to develop a community support plan that ensures the
87.31person's health and safety. Except for legal representatives or family members invited by
87.32the person, persons participating in the assessment may not be a provider of service or have
87.33any financial interest in the provision of services. For persons who are to be assessed for
88.1elderly waiver customized living services under section 256B.0915, with the permission of
88.2the person being assessed or the person's designated or legal representative, the client's
88.3current or proposed provider of services may submit a copy of the provider's nursing
88.4assessment or written report outlining its recommendations regarding the client's care needs.
88.5The person conducting the assessment must notify the provider of the date by which this
88.6information is to be submitted. This information shall be provided to the person conducting
88.7the assessment prior to the assessment. For a person who is to be assessed for waiver services
88.8under section 256B.092 or 256B.49, with the permission of the person being assessed or
88.9the person's designated legal representative, the person's current provider of services may
88.10submit a written report outlining recommendations regarding the person's care needs prepared
88.11by a direct service employee with at least 20 hours of service to that client. The person
88.12conducting the assessment or reassessment must notify the provider of the date by which
88.13this information is to be submitted. This information shall be provided to the person
88.14conducting the assessment and the person or the person's legal representative, and must be
88.15considered prior to the finalization of the assessment or reassessment.
88.16    (e) The person or the person's legal representative must be provided with a written
88.17community support plan within 40 calendar days of the assessment visit, regardless of
88.18whether the individual is eligible for Minnesota health care programs. The written community
88.19support plan must include:
88.20(1) a summary of assessed needs as defined in paragraphs (c) and (d);
88.21(2) the individual's options and choices to meet identified needs, including all available
88.22options for case management services and providers;
88.23(3) identification of health and safety risks and how those risks will be addressed,
88.24including personal risk management strategies;
88.25(4) referral information; and
88.26(5) informal caregiver supports, if applicable.
88.27For a person determined eligible for state plan home care under subdivision 1a, paragraph
88.28(b), clause (1), the person or person's representative must also receive a copy of the home
88.29care service plan developed by the certified assessor.
88.30(f) A person may request assistance in identifying community supports without
88.31participating in a complete assessment. Upon a request for assistance identifying community
88.32support, the person must be transferred or referred to long-term care options counseling
89.1services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
89.2telephone assistance and follow up.
89.3    (g) The person has the right to make the final decision between institutional placement
89.4and community placement after the recommendations have been provided, except as provided
89.5in section 256.975, subdivision 7a, paragraph (d).
89.6    (h) The lead agency must give the person receiving assessment or support planning, or
89.7the person's legal representative, materials, and forms supplied by the commissioner
89.8containing the following information:
89.9    (1) written recommendations for community-based services and consumer-directed
89.10options;
89.11(2) documentation that the most cost-effective alternatives available were offered to the
89.12individual. For purposes of this clause, "cost-effective" means community services and
89.13living arrangements that cost the same as or less than institutional care. For an individual
89.14found to meet eligibility criteria for home and community-based service programs under
89.15section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
89.16approved waiver plan for each program;
89.17(3) the need for and purpose of preadmission screening conducted by long-term care
89.18options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
89.19nursing facility placement. If the individual selects nursing facility placement, the lead
89.20agency shall forward information needed to complete the level of care determinations and
89.21screening for developmental disability and mental illness collected during the assessment
89.22to the long-term care options counselor using forms provided by the commissioner;
89.23    (4) the role of long-term care consultation assessment and support planning in eligibility
89.24determination for waiver and alternative care programs, and state plan home care, case
89.25management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
89.26and (b);
89.27    (5) information about Minnesota health care programs;
89.28    (6) the person's freedom to accept or reject the recommendations of the team;
89.29    (7) the person's right to confidentiality under the Minnesota Government Data Practices
89.30Act, chapter 13;
89.31    (8) the certified assessor's decision regarding the person's need for institutional level of
89.32care as determined under criteria established in subdivision 4e and the certified assessor's
90.1decision regarding eligibility for all services and programs as defined in subdivision 1a,
90.2paragraphs (a), clause (6), and (b); and
90.3    (9) the person's right to appeal the certified assessor's decision regarding eligibility for
90.4all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
90.5(8), and (b), and incorporating the decision regarding the need for institutional level of care
90.6or the lead agency's final decisions regarding public programs eligibility according to section
90.7256.045, subdivision 3 .
90.8    (i) Face-to-face assessment completed as part of eligibility determination for the
90.9alternative care, elderly waiver, community access for disability inclusion, community
90.10alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915,
90.11and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after
90.12the date of assessment.
90.13(j) The effective eligibility start date for programs in paragraph (i) can never be prior to
90.14the date of assessment. If an assessment was completed more than 60 days before the
90.15effective waiver or alternative care program eligibility start date, assessment and support
90.16plan information must be updated and documented in the department's Medicaid Management
90.17Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
90.18state plan services, the effective date of eligibility for programs included in paragraph (i)
90.19cannot be prior to the date the most recent updated assessment is completed.
90.20(k) At the time of reassessment, the certified assessor shall assess each person receiving
90.21waiver services currently residing in a community residential setting, or licensed adult foster
90.22care home that is not the primary residence of the license holder, or in which the license
90.23holder is not the primary caregiver, to determine if that person would prefer to be served in
90.24a community-living settings as defined in section 256B.49, subdivision 23. The certified
90.25assessor shall offer the person, through a person-centered planning process, the option to
90.26receive alternative housing and service options.

90.27    Sec. 15. Minnesota Statutes 2016, section 256B.0915, subdivision 1, is amended to read:
90.28    Subdivision 1. Authority. (a) The commissioner is authorized to apply for a home and
90.29community-based services waiver for the elderly, authorized under section 1915(c) of the
90.30Social Security Act, in order to obtain federal financial participation to expand the availability
90.31of services for persons who are eligible for medical assistance. The commissioner may
90.32apply for additional waivers or pursue other federal financial participation which is
90.33advantageous to the state for funding home care services for the frail elderly who are eligible
90.34for medical assistance. The provision of waivered services to elderly and disabled medical
91.1assistance recipients must comply with the criteria for service definitions and provider
91.2standards approved in the waiver.
91.3(b) The commissioner shall comply with the requirements in the federally approved
91.4transition plan for the home and community-based services waivers authorized under this
91.5section.
91.6EFFECTIVE DATE.This section is effective the day following final enactment.

91.7    Sec. 16. Minnesota Statutes 2016, section 256B.092, subdivision 4, is amended to read:
91.8    Subd. 4. Home and community-based services for developmental disabilities. (a)
91.9The commissioner shall make payments to approved vendors participating in the medical
91.10assistance program to pay costs of providing home and community-based services, including
91.11case management service activities provided as an approved home and community-based
91.12service, to medical assistance eligible persons with developmental disabilities who have
91.13been screened under subdivision 7 and according to federal requirements. Federal
91.14requirements include those services and limitations included in the federally approved
91.15application for home and community-based services for persons with developmental
91.16disabilities and subsequent amendments.
91.17(b) Effective July 1, 1995, contingent upon federal approval and state appropriations
91.18made available for this purpose, and in conjunction with Laws 1995, chapter 207, article 8,
91.19section 40, the commissioner of human services shall allocate resources to county agencies
91.20for home and community-based waivered services for persons with developmental disabilities
91.21authorized but not receiving those services as of June 30, 1995, based upon the average
91.22resource need of persons with similar functional characteristics. To ensure service continuity
91.23for service recipients receiving home and community-based waivered services for persons
91.24with developmental disabilities prior to July 1, 1995, the commissioner shall make available
91.25to the county of financial responsibility home and community-based waivered services
91.26resources based upon fiscal year 1995 authorized levels.
91.27(c) Home and community-based resources for all recipients shall be managed by the
91.28county of financial responsibility within an allowable reimbursement average established
91.29for each county. Payments for home and community-based services provided to individual
91.30recipients shall not exceed amounts authorized by the county of financial responsibility.
91.31For specifically identified former residents of nursing facilities, the commissioner shall be
91.32responsible for authorizing payments and payment limits under the appropriate home and
91.33community-based service program. Payment is available under this subdivision only for
92.1persons who, if not provided these services, would require the level of care provided in an
92.2intermediate care facility for persons with developmental disabilities.
92.3(d) The commissioner shall comply with the requirements in the federally approved
92.4transition plan for the home and community-based services waivers for the elderly authorized
92.5under this section.
92.6EFFECTIVE DATE.This section is effective the day following final enactment.

92.7    Sec. 17. Minnesota Statutes 2016, section 256B.49, subdivision 11, is amended to read:
92.8    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and
92.9community-based service waivers, as authorized under section 1915(c) of the Social Security
92.10Act to serve persons under the age of 65 who are determined to require the level of care
92.11provided in a nursing home and persons who require the level of care provided in a hospital.
92.12The commissioner shall apply for the home and community-based waivers in order to:
92.13    (1) promote the support of persons with disabilities in the most integrated settings;
92.14    (2) expand the availability of services for persons who are eligible for medical assistance;
92.15    (3) promote cost-effective options to institutional care; and
92.16    (4) obtain federal financial participation.
92.17    (b) The provision of waivered services to medical assistance recipients with disabilities
92.18shall comply with the requirements outlined in the federally approved applications for home
92.19and community-based services and subsequent amendments, including provision of services
92.20according to a service plan designed to meet the needs of the individual. For purposes of
92.21this section, the approved home and community-based application is considered the necessary
92.22federal requirement.
92.23    (c) The commissioner shall provide interested persons serving on agency advisory
92.24committees, task forces, the Centers for Independent Living, and others who request to be
92.25on a list to receive, notice of, and an opportunity to comment on, at least 30 days before
92.26any effective dates, (1) any substantive changes to the state's disability services program
92.27manual, or (2) changes or amendments to the federally approved applications for home and
92.28community-based waivers, prior to their submission to the federal Centers for Medicare
92.29and Medicaid Services.
92.30    (d) The commissioner shall seek approval, as authorized under section 1915(c) of the
92.31Social Security Act, to allow medical assistance eligibility under this section for children
92.32under age 21 without deeming of parental income or assets.
93.1    (e) The commissioner shall seek approval, as authorized under section 1915(c) of the
93.2Social Act, to allow medical assistance eligibility under this section for individuals under
93.3age 65 without deeming the spouse's income or assets.
93.4(f) The commissioner shall comply with the requirements in the federally approved
93.5transition plan for the home and community-based services waivers authorized under this
93.6section.
93.7EFFECTIVE DATE.This section is effective the day following final enactment.

93.8    Sec. 18. Minnesota Statutes 2016, section 256B.49, subdivision 15, is amended to read:
93.9    Subd. 15. Coordinated service and support plan; comprehensive transitional service
93.10plan; maintenance service plan. (a) Each recipient of home and community-based waivered
93.11services shall be provided a copy of the written coordinated service and support plan which
93.12meets the requirements in section 256B.092, subdivision 1b.
93.13(b) In developing the comprehensive transitional service plan, the individual receiving
93.14services, the case manager, and the guardian, if applicable, will identify the transitional
93.15service plan fundamental service outcome and anticipated timeline to achieve this outcome.
93.16Within the first 20 days following a recipient's request for an assessment or reassessment,
93.17the transitional service planning team must be identified. A team leader must be identified
93.18who will be responsible for assigning responsibility and communicating with team members
93.19to ensure implementation of the transition plan and ongoing assessment and communication
93.20process. The team leader should be an individual, such as the case manager or guardian,
93.21who has the opportunity to follow the recipient to the next level of service.
93.22Within ten days following an assessment, a comprehensive transitional service plan must
93.23be developed incorporating elements of a comprehensive functional assessment and including
93.24short-term measurable outcomes and timelines for achievement of and reporting on these
93.25outcomes. Functional milestones must also be identified and reported according to the
93.26timelines agreed upon by the transitional service planning team. In addition, the
93.27comprehensive transitional service plan must identify additional supports that may assist
93.28in the achievement of the fundamental service outcome such as the development of greater
93.29natural community support, increased collaboration among agencies, and technological
93.30supports.
93.31The timelines for reporting on functional milestones will prompt a reassessment of
93.32services provided, the units of services, rates, and appropriate service providers. It is the
93.33responsibility of the transitional service planning team leader to review functional milestone
94.1reporting to determine if the milestones are consistent with observable skills and that
94.2milestone achievement prompts any needed changes to the comprehensive transitional
94.3service plan.
94.4For those whose fundamental transitional service outcome involves the need to procure
94.5housing, a plan for the recipient to seek the resources necessary to secure the least restrictive
94.6housing possible should be incorporated into the plan, including employment and public
94.7supports such as housing access and shelter needy funding.
94.8(c) Counties and other agencies responsible for funding community placement and
94.9ongoing community supportive services are responsible for the implementation of the
94.10comprehensive transitional service plans. Oversight responsibilities include both ensuring
94.11effective transitional service delivery and efficient utilization of funding resources.
94.12(d) Following one year of transitional services, the transitional services planning team
94.13will make a determination as to whether or not the individual receiving services requires
94.14the current level of continuous and consistent support in order to maintain the recipient's
94.15current level of functioning. Recipients who are determined to have not had a significant
94.16change in functioning for 12 months must move from a transitional to a maintenance service
94.17plan. Recipients on a maintenance service plan must be reassessed to determine if the
94.18recipient would benefit from a transitional service plan at least every 12 months and at other
94.19times when there has been a significant change in the recipient's functioning. This assessment
94.20should consider any changes to technological or natural community supports.
94.21(e) When a county is evaluating denials, reductions, or terminations of home and
94.22community-based services under this section for an individual, the case manager shall offer
94.23to meet with the individual or the individual's guardian in order to discuss the prioritization
94.24of service needs within the coordinated service and support plan, comprehensive transitional
94.25service plan, or maintenance service plan. The reduction in the authorized services for an
94.26individual due to changes in funding for waivered services may not exceed the amount
94.27needed to ensure medically necessary services to meet the individual's health, safety, and
94.28welfare.
94.29(f) At the time of reassessment, local agency case managers shall assess each recipient
94.30of community access for disability inclusion or brain injury waivered services currently
94.31residing in a licensed adult foster home that is not the primary residence of the license
94.32holder, or in which the license holder is not the primary caregiver, to determine if that
94.33recipient could appropriately be served in a community-living setting. If appropriate for the
94.34recipient, the case manager shall offer the recipient, through a person-centered planning
95.1process, the option to receive alternative housing and service options. In the event that the
95.2recipient chooses to transfer from the adult foster home, the vacated bed shall not be filled
95.3with another recipient of waiver services and group residential housing and the licensed
95.4capacity shall be reduced accordingly, unless the savings required by the licensed bed closure
95.5reductions under Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40,
95.6paragraph (f), for foster care settings where the physical location is not the primary residence
95.7of the license holder are met through voluntary changes described in section 245A.03,
95.8subdivision 7 , paragraph (e), or as provided under paragraph (a), clauses (3) and (4). If the
95.9adult foster home becomes no longer viable due to these transfers, the county agency, with
95.10the assistance of the department, shall facilitate a consolidation of settings or closure. This
95.11reassessment process shall be completed by July 1, 2013.

95.12    Sec. 19. Minnesota Statutes 2016, section 256B.493, subdivision 1, is amended to read:
95.13    Subdivision 1. Commissioner's duties; report. The commissioner of human services
95.14shall solicit proposals for the conversion of services provided for persons with disabilities
95.15in settings licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, or community
95.16residential settings licensed under chapter 245D, to other types of community settings in
95.17conjunction with the closure of identified licensed adult foster care settings has the authority
95.18to manage statewide licensed corporate foster care or community residential settings capacity,
95.19including the reduction and realignment of licensed capacity of a current foster care or
95.20community residential settings to accomplish the consolidation or closure of settings. The
95.21commissioner shall implement a program for planned closure of licensed corporate adult
95.22foster care or community residential settings, necessary as a preferred method to: (1) respond
95.23to the informed decisions of those individuals who want to move out of these settings into
95.24other types of community settings; and (2) achieve necessary budgetary savings required
95.25in section 245A.03, subdivision 7, paragraphs (c) and (d).

95.26    Sec. 20. Minnesota Statutes 2016, section 256B.493, subdivision 2, is amended to read:
95.27    Subd. 2. Planned closure process needs determination. The commissioner shall
95.28announce and implement a program for planned closure of adult foster care homes. Planned
95.29closure shall be the preferred method for achieving necessary budgetary savings required
95.30by the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph
95.31(c). If additional closures are required to achieve the necessary savings, the commissioner
95.32shall use the process and priorities in section 245A.03, subdivision 7, paragraph (c) A
95.33resource need determination process, managed at the state level, using available reports
96.1required by section 144A.351 and other data and information shall be used by the
96.2commissioner to align capacity where needed.

96.3    Sec. 21. Minnesota Statutes 2016, section 256B.493, is amended by adding a subdivision
96.4to read:
96.5    Subd. 2a. Closure process. (a) The commissioner shall work with stakeholders to
96.6establish a process for the application, review, approval, and implementation of setting
96.7closures. Voluntary proposals from license holders for consolidation and closure of adult
96.8foster care or community residential settings are encouraged. Whether voluntary or
96.9involuntary, all closure plans must include:
96.10(1) a description of the proposed closure plan, identifying the home or homes and
96.11occupied beds;
96.12(2) the proposed timetable for the proposed closure, including the proposed dates for
96.13notification to people living there and the affected lead agencies, commencement of closure,
96.14and completion of closure;
96.15(3) the proposed relocation plan jointly developed by the counties of financial
96.16responsibility, the people living there and their legal representatives, if any, who wish to
96.17continue to receive services from the provider, and the providers for current residents of
96.18any adult foster care home designated for closure; and
96.19(4) documentation from the provider in a format approved by the commissioner that all
96.20the adult foster care homes or community residential settings receiving a planned closure
96.21rate adjustment under the plan have accepted joint and severable for recovery of
96.22overpayments under section 256B.0641, subdivision 2, for the facilities designated for
96.23closure under this plan.
96.24(b) The commissioner shall give first priority to closure plans which:
96.25(1) target counties and geographic areas which have:
96.26(i) need for other types of services;
96.27(ii) need for specialized services;
96.28(iii) higher than average per capita use of licensed corporate foster care or community
96.29residential settings; or
96.30(iv) residents not living in the geographic area of their choice;
96.31(2) demonstrate savings of medical assistance expenditures; and
97.1(3) demonstrate that alternative services are based on the recipient's choice of provider
97.2and are consistent with federal law, state law, and federally approved waiver plans.
97.3The commissioner shall also consider any information provided by people using services,
97.4their legal representatives, family members, or the lead agency on the impact of the planned
97.5closure on people and the services they need.
97.6    (c) For each closure plan approved by the commissioner, a contract must be established
97.7between the commissioner, the counties of financial responsibility, and the participating
97.8license holder.

97.9    Sec. 22. Minnesota Statutes 2016, section 256D.44, subdivision 4, is amended to read:
97.10    Subd. 4. Temporary absence due to illness. For the purposes of this subdivision, "home"
97.11means a residence owned or rented by a recipient or the recipient's spouse. Home does not
97.12include a group residential housing facility. Assistance payments for recipients who are
97.13temporarily absent from their home due to hospitalization for illness must continue at the
97.14same level of payment during their absence if the following criteria are met:
97.15(1) a physician certifies that the absence is not expected to continue for more than three
97.16months;
97.17(2) a physician certifies that the recipient will be able to return to independent living;
97.18and
97.19(3) the recipient has expenses associated with maintaining a residence in the community.

97.20    Sec. 23. Minnesota Statutes 2016, section 256D.44, subdivision 5, is amended to read:
97.21    Subd. 5. Special needs. (a) In addition to the state standards of assistance established
97.22in subdivisions 1 to 4, payments are allowed for the following special needs of recipients
97.23of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
97.24center, or a group residential setting authorized to receive housing facility support payments
97.25under chapter 256I.
97.26    (a) (b) The county agency shall pay a monthly allowance for medically prescribed diets
97.27if the cost of those additional dietary needs cannot be met through some other maintenance
97.28benefit. The need for special diets or dietary items must be prescribed by a licensed physician.
97.29Costs for special diets shall be determined as percentages of the allotment for a one-person
97.30household under the thrifty food plan as defined by the United States Department of
97.31Agriculture. The types of diets and the percentages of the thrifty food plan that are covered
97.32are as follows:
98.1    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
98.2    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of
98.3thrifty food plan;
98.4    (3) controlled protein diet, less than 40 grams and requires special products, 125 percent
98.5of thrifty food plan;
98.6    (4) low cholesterol diet, 25 percent of thrifty food plan;
98.7    (5) high residue diet, 20 percent of thrifty food plan;
98.8    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
98.9    (7) gluten-free diet, 25 percent of thrifty food plan;
98.10    (8) lactose-free diet, 25 percent of thrifty food plan;
98.11    (9) antidumping diet, 15 percent of thrifty food plan;
98.12    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
98.13    (11) ketogenic diet, 25 percent of thrifty food plan.
98.14    (b) (c) Payment for nonrecurring special needs must be allowed for necessary home
98.15repairs or necessary repairs or replacement of household furniture and appliances using the
98.16payment standard of the AFDC program in effect on July 16, 1996, for these expenses, as
98.17long as other funding sources are not available.
98.18    (c) (d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated
98.19by the county or approved by the court. This rate shall not exceed five percent of the
98.20assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian
98.21or conservator is a member of the county agency staff, no fee is allowed.
98.22    (d) (e) The county agency shall continue to pay a monthly allowance of $68 for restaurant
98.23meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and
98.24who eats two or more meals in a restaurant daily. The allowance must continue until the
98.25person has not received Minnesota supplemental aid for one full calendar month or until
98.26the person's living arrangement changes and the person no longer meets the criteria for the
98.27restaurant meal allowance, whichever occurs first.
98.28    (e) (f) A fee of ten percent of the recipient's gross income or $25, whichever is less, is
98.29allowed for representative payee services provided by an agency that meets the requirements
98.30under SSI regulations to charge a fee for representative payee services. This special need
99.1is available to all recipients of Minnesota supplemental aid regardless of their living
99.2arrangement.
99.3    (f) (g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half
99.4of the maximum allotment authorized by the federal Food Stamp Program for a federal
99.5Supplemental Security Income payment amount for a single individual which is in effect
99.6on the first day of July of each year will be added to the standards of assistance established
99.7in subdivisions 1 to 4 for adults under the age of 65 who qualify as shelter needy in need
99.8of housing assistance and are:
99.9    (i) relocating from an institution, a setting authorized to receive housing support under
99.10chapter 256I, or an adult mental health residential treatment program under section
99.11256B.0622 ; or
99.12    (ii) eligible for personal care assistance under section 256B.0659; or
99.13    (iii) home and community-based waiver recipients living in their own home or rented
99.14or leased apartment which is not owned, operated, or controlled by a provider of service
99.15not related by blood or marriage, unless allowed under paragraph (g).
99.16    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter
99.17needy benefit under this paragraph is considered a household of one. An eligible individual
99.18who receives this benefit prior to age 65 may continue to receive the benefit after the age
99.19of 65.
99.20    (3) "Shelter needy Housing assistance" means that the assistance unit incurs monthly
99.21shelter costs that exceed 40 percent of the assistance unit's gross income before the application
99.22of this special needs standard. "Gross income" for the purposes of this section is the
99.23applicant's or recipient's income as defined in section 256D.35, subdivision 10, or the
99.24standard specified in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient
99.25of a federal or state housing subsidy, that limits shelter costs to a percentage of gross income,
99.26shall not be considered shelter needy in need of housing assistance for purposes of this
99.27paragraph.
99.28(g) Notwithstanding this subdivision, to access housing and services as provided in
99.29paragraph (f), the recipient may choose housing that may be owned, operated, or controlled
99.30by the recipient's service provider. When housing is controlled by the service provider, the
99.31individual may choose the individual's own service provider as provided in section 256B.49,
99.32subdivision 23 , clause (3). When the housing is controlled by the service provider, the
99.33service provider shall implement a plan with the recipient to transition the lease to the
99.34recipient's name. Within two years of signing the initial lease, the service provider shall
100.1transfer the lease entered into under this subdivision to the recipient. In the event the landlord
100.2denies this transfer, the commissioner may approve an exception within sufficient time to
100.3ensure the continued occupancy by the recipient. This paragraph expires June 30, 2016.
100.4EFFECTIVE DATE.Paragraphs (a) to (f) are effective July 1, 2017. Paragraph (g),
100.5clause (1), is effective July 1, 2020, except paragraph (g), clause (1), items (ii) and (iii), are
100.6effective July 1, 2017.

100.7    Sec. 24. Minnesota Statutes 2016, section 256I.03, subdivision 8, is amended to read:
100.8    Subd. 8. Supplementary services. "Supplementary services" means housing support
100.9services provided to residents of group residential housing providers individuals in addition
100.10to room and board including, but not limited to, oversight and up to 24-hour supervision,
100.11medication reminders, assistance with transportation, arranging for meetings and
100.12appointments, and arranging for medical and social services.

100.13    Sec. 25. Minnesota Statutes 2016, section 256I.04, subdivision 1, is amended to read:
100.14    Subdivision 1. Individual eligibility requirements. An individual is eligible for and
100.15entitled to a group residential housing support payment to be made on the individual's behalf
100.16if the agency has approved the individual's residence in a group residential setting where
100.17the individual will receive housing setting support and the individual meets the requirements
100.18in paragraph (a) or, (b), or (c).
100.19(a) The individual is aged, blind, or is over 18 years of age and disabled as determined
100.20under the criteria used by the title II program of the Social Security Act, and meets the
100.21resource restrictions and standards of section 256P.02, and the individual's countable income
100.22after deducting the (1) exclusions and disregards of the SSI program, (2) the medical
100.23assistance personal needs allowance under section 256B.35, and (3) an amount equal to the
100.24income actually made available to a community spouse by an elderly waiver participant
100.25under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058,
100.26subdivision 2 , is less than the monthly rate specified in the agency's agreement with the
100.27provider of group residential housing support in which the individual resides.
100.28(b) The individual meets a category of eligibility under section 256D.05, subdivision 1,
100.29paragraph (a), clauses (1), (3), (5) to (9), and (14), and paragraph (b), if applicable, and the
100.30individual's resources are less than the standards specified by section 256P.02, and the
100.31individual's countable income as determined under section 256P.06, less the medical
100.32assistance personal needs allowance under section 256B.35 is less than the monthly rate
101.1specified in the agency's agreement with the provider of group residential housing support
101.2in which the individual resides.
101.3(c) The individual receives licensed residential crisis stabilization services under section
101.4256B.0624, subdivision 7, and is receiving medical assistance. The individual may receive
101.5concurrent housing support payments if receiving licensed residential crisis stabilization
101.6services under section 256B.0624, subdivision 7.
101.7EFFECTIVE DATE.Paragraph (c) is effective October 1, 2017.

101.8    Sec. 26. Minnesota Statutes 2016, section 256I.04, subdivision 2d, is amended to read:
101.9    Subd. 2d. Conditions of payment; commissioner's right to suspend or terminate
101.10agreement. (a) Group residential Housing or supplementary services support must be
101.11provided to the satisfaction of the commissioner, as determined at the sole discretion of the
101.12commissioner's authorized representative, and in accordance with all applicable federal,
101.13state, and local laws, ordinances, rules, and regulations, including business registration
101.14requirements of the Office of the Secretary of State. A provider shall not receive payment
101.15for room and board or supplementary services or housing found by the commissioner to be
101.16performed or provided in violation of federal, state, or local law, ordinance, rule, or
101.17regulation.
101.18(b) The commissioner has the right to suspend or terminate the agreement immediately
101.19when the commissioner determines the health or welfare of the housing or service recipients
101.20is endangered, or when the commissioner has reasonable cause to believe that the provider
101.21has breached a material term of the agreement under subdivision 2b.
101.22(c) Notwithstanding paragraph (b), if the commissioner learns of a curable material
101.23breach of the agreement by the provider, the commissioner shall provide the provider with
101.24a written notice of the breach and allow ten days to cure the breach. If the provider does
101.25not cure the breach within the time allowed, the provider shall be in default of the agreement
101.26and the commissioner may terminate the agreement immediately thereafter. If the provider
101.27has breached a material term of the agreement and cure is not possible, the commissioner
101.28may immediately terminate the agreement.

101.29    Sec. 27. Minnesota Statutes 2016, section 256I.04, subdivision 2g, is amended to read:
101.30    Subd. 2g. Crisis shelters. Secure crisis shelters for battered women and their children
101.31designated by the Minnesota Department of Corrections are not group residences eligible
101.32for housing support under this chapter.

102.1    Sec. 28. Minnesota Statutes 2016, section 256I.04, subdivision 3, is amended to read:
102.2    Subd. 3. Moratorium on development of group residential housing support beds.
102.3    (a) Agencies shall not enter into agreements for new group residential housing support beds
102.4with total rates in excess of the MSA equivalent rate except:
102.5(1) for group residential housing establishments licensed under chapter 245D provided
102.6the facility is needed to meet the census reduction targets for persons with developmental
102.7disabilities at regional treatment centers;
102.8(2) up to 80 beds in a single, specialized facility located in Hennepin County that will
102.9provide housing for chronic inebriates who are repetitive users of detoxification centers and
102.10are refused placement in emergency shelters because of their state of intoxication, and
102.11planning for the specialized facility must have been initiated before July 1, 1991, in
102.12anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
102.13subdivision 20a , paragraph (b);
102.14(3) notwithstanding the provisions of subdivision 2a, for up to 190 226 supportive
102.15housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a
102.16mental illness, a history of substance abuse, or human immunodeficiency virus or acquired
102.17immunodeficiency syndrome. For purposes of this section, "homeless adult" means a person
102.18who is living on the street or in a shelter or discharged from a regional treatment center,
102.19community hospital, or residential treatment program and has no appropriate housing
102.20available and lacks the resources and support necessary to access appropriate housing. At
102.21least 70 percent of the supportive housing units must serve homeless adults with mental
102.22illness, substance abuse problems, or human immunodeficiency virus or acquired
102.23immunodeficiency syndrome who are about to be or, within the previous six months, has
102.24been discharged from a regional treatment center, or a state-contracted psychiatric bed in
102.25a community hospital, or a residential mental health or chemical dependency treatment
102.26program. If a person meets the requirements of subdivision 1, paragraph (a), and receives
102.27a federal or state housing subsidy, the group residential housing support rate for that person
102.28is limited to the supplementary rate under section 256I.05, subdivision 1a, and is determined
102.29by subtracting the amount of the person's countable income that exceeds the MSA equivalent
102.30rate from the group residential housing support supplementary service rate. A resident in a
102.31demonstration project site who no longer participates in the demonstration program shall
102.32retain eligibility for a group residential housing support payment in an amount determined
102.33under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under
102.34section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are
102.35available and the services can be provided through a managed care entity. If federal matching
103.1funds are not available, then service funding will continue under section 256I.05, subdivision
103.21a ;
103.3(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in
103.4Hennepin County providing services for recovering and chemically dependent men that has
103.5had a group residential housing support contract with the county and has been licensed as
103.6a board and lodge facility with special services since 1980;
103.7(5) for a group residential housing support provider located in the city of St. Cloud, or
103.8a county contiguous to the city of St. Cloud, that operates a 40-bed facility, that received
103.9financing through the Minnesota Housing Finance Agency Ending Long-Term Homelessness
103.10Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
103.11(6) for a new 65-bed facility in Crow Wing County that will serve chemically dependent
103.12persons, operated by a group residential housing support provider that currently operates a
103.13304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
103.14(7) for a group residential housing support provider that operates two ten-bed facilities,
103.15one located in Hennepin County and one located in Ramsey County, that provide community
103.16support and 24-hour-a-day supervision to serve the mental health needs of individuals who
103.17have chronically lived unsheltered; and
103.18(8) for a group residential facility authorized for recipients of housing support in Hennepin
103.19County with a capacity of up to 48 beds that has been licensed since 1978 as a board and
103.20lodging facility and that until August 1, 2007, operated as a licensed chemical dependency
103.21treatment program.
103.22    (b) An agency may enter into a group residential housing support agreement for beds
103.23with rates in excess of the MSA equivalent rate in addition to those currently covered under
103.24a group residential housing support agreement if the additional beds are only a replacement
103.25of beds with rates in excess of the MSA equivalent rate which have been made available
103.26due to closure of a setting, a change of licensure or certification which removes the beds
103.27from group residential housing support payment, or as a result of the downsizing of a group
103.28residential housing setting authorized for recipients of housing support. The transfer of
103.29available beds from one agency to another can only occur by the agreement of both agencies.

103.30    Sec. 29. Minnesota Statutes 2016, section 256I.05, subdivision 1a, is amended to read:
103.31    Subd. 1a. Supplementary service rates. (a) Subject to the provisions of section 256I.04,
103.32subdivision 3 , the county agency may negotiate a payment not to exceed $426.37 for other
103.33services necessary to provide room and board provided by the group residence if the residence
104.1is licensed by or registered by the Department of Health, or licensed by the Department of
104.2Human Services to provide services in addition to room and board, and if the provider of
104.3services is not also concurrently receiving funding for services for a recipient under a home
104.4and community-based waiver under title XIX of the Social Security Act; or funding from
104.5the medical assistance program under section 256B.0659, for personal care services for
104.6residents in the setting; or residing in a setting which receives funding under section 245.73.
104.7If funding is available for other necessary services through a home and community-based
104.8waiver, or personal care services under section 256B.0659, then the GRH housing support
104.9rate is limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case
104.10may the supplementary service rate exceed $426.37. The registration and licensure
104.11requirement does not apply to establishments which are exempt from state licensure because
104.12they are located on Indian reservations and for which the tribe has prescribed health and
104.13safety requirements. Service payments under this section may be prohibited under rules to
104.14prevent the supplanting of federal funds with state funds. The commissioner shall pursue
104.15the feasibility of obtaining the approval of the Secretary of Health and Human Services to
104.16provide home and community-based waiver services under title XIX of the Social Security
104.17Act for residents who are not eligible for an existing home and community-based waiver
104.18due to a primary diagnosis of mental illness or chemical dependency and shall apply for a
104.19waiver if it is determined to be cost-effective.
104.20(b) The commissioner is authorized to make cost-neutral transfers from the GRH housing
104.21support fund for beds under this section to other funding programs administered by the
104.22department after consultation with the county or counties in which the affected beds are
104.23located. The commissioner may also make cost-neutral transfers from the GRH housing
104.24support fund to county human service agencies for beds permanently removed from the
104.25GRH housing support census under a plan submitted by the county agency and approved
104.26by the commissioner. The commissioner shall report the amount of any transfers under this
104.27provision annually to the legislature.
104.28    (c) Counties must not negotiate supplementary service rates with providers of group
104.29residential housing support that are licensed as board and lodging with special services and
104.30that do not encourage a policy of sobriety on their premises and make referrals to available
104.31community services for volunteer and employment opportunities for residents.

105.1    Sec. 30. Minnesota Statutes 2016, section 256I.05, subdivision 1c, is amended to read:
105.2    Subd. 1c. Rate increases. An agency may not increase the rates negotiated for group
105.3residential housing support above those in effect on June 30, 1993, except as provided in
105.4paragraphs (a) to (f).
105.5(a) An agency may increase the rates for group residential housing settings room and
105.6board to the MSA equivalent rate for those settings whose current rate is below the MSA
105.7equivalent rate.
105.8(b) An agency may increase the rates for residents in adult foster care whose difficulty
105.9of care has increased. The total group residential housing support rate for these residents
105.10must not exceed the maximum rate specified in subdivisions 1 and 1a. Agencies must not
105.11include nor increase group residential housing difficulty of care rates for adults in foster
105.12care whose difficulty of care is eligible for funding by home and community-based waiver
105.13programs under title XIX of the Social Security Act.
105.14(c) The room and board rates will be increased each year when the MSA equivalent rate
105.15is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, less
105.16the amount of the increase in the medical assistance personal needs allowance under section
105.17256B.35 .
105.18(d) When a group residential housing rate is used to pay support pays for an individual's
105.19room and board, or other costs necessary to provide room and board, the rate payable to the
105.20residence must continue for up to 18 calendar days per incident that the person is temporarily
105.21absent from the residence, not to exceed 60 days in a calendar year, if the absence or absences
105.22have received the prior approval of the county agency's social service staff. Prior approval
105.23is not required for emergency absences due to crisis, illness, or injury.
105.24(e) For facilities meeting substantial change criteria within the prior year. Substantial
105.25change criteria exists if the group residential housing establishment experiences a 25 percent
105.26increase or decrease in the total number of its beds, if the net cost of capital additions or
105.27improvements is in excess of 15 percent of the current market value of the residence, or if
105.28the residence physically moves, or changes its licensure, and incurs a resulting increase in
105.29operation and property costs.
105.30(f) Until June 30, 1994, an agency may increase by up to five percent the total rate paid
105.31for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 256D.54 who
105.32reside in residences that are licensed by the commissioner of health as a boarding care home,
105.33but are not certified for the purposes of the medical assistance program. However, an increase
105.34under this clause must not exceed an amount equivalent to 65 percent of the 1991 medical
106.1assistance reimbursement rate for nursing home resident class A, in the geographic grouping
106.2in which the facility is located, as established under Minnesota Rules, parts 9549.0051 to
106.39549.0058.

106.4    Sec. 31. Minnesota Statutes 2016, section 256I.05, subdivision 1e, is amended to read:
106.5    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the provisions
106.6of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall negotiate a
106.7supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per
106.8month, including any legislatively authorized inflationary adjustments, for a group residential
106.9housing support provider that:
106.10(1) is located in Hennepin County and has had a group residential housing support
106.11contract with the county since June 1996;
106.12(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a 26-bed
106.13facility; and
106.14(3) serves a chemically dependent clientele, providing 24 hours per day supervision and
106.15limiting a resident's maximum length of stay to 13 months out of a consecutive 24-month
106.16period.
106.17(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
106.18supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per
106.19month, including any legislatively authorized inflationary adjustments, of a group residential
106.20housing support provider that:
106.21(1) is located in St. Louis County and has had a group residential housing support contract
106.22with the county since 2006;
106.23(2) operates a 62-bed facility; and
106.24(3) serves a chemically dependent adult male clientele, providing 24 hours per day
106.25supervision and limiting a resident's maximum length of stay to 13 months out of a
106.26consecutive 24-month period.
106.27(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
106.28shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
106.29to exceed $700 per month, including any legislatively authorized inflationary adjustments,
106.30for the group residential provider described under paragraphs (a) and (b), not to exceed an
106.31additional 115 beds.

107.1    Sec. 32. Minnesota Statutes 2016, section 256I.05, subdivision 1j, is amended to read:
107.2    Subd. 1j. Supplementary rate for certain facilities; Crow Wing County.
107.3    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a county
107.4agency shall negotiate a supplementary rate in addition to the rate specified in subdivision
107.51, not to exceed $700 per month, including any legislatively authorized inflationary
107.6adjustments, for a new 65-bed facility in Crow Wing County that will serve chemically
107.7dependent persons operated by a group residential housing support provider that currently
107.8operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which opened in
107.9January of 2006.

107.10    Sec. 33. Minnesota Statutes 2016, section 256I.05, subdivision 1m, is amended to read:
107.11    Subd. 1m. Supplemental rate for certain facilities; Hennepin and Ramsey Counties.
107.12    (a) Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
107.13shall negotiate a supplemental service rate in addition to the rate specified in subdivision
107.141, not to exceed $700 per month or the existing monthly rate, whichever is higher, including
107.15any legislatively authorized inflationary adjustments, for a group residential housing support
107.16provider that operates two ten-bed facilities, one located in Hennepin County and one located
107.17in Ramsey County, which provide community support and serve the mental health needs
107.18of individuals who have chronically lived unsheltered, providing 24-hour-per-day supervision.
107.19    (b) An individual who has lived in one of the facilities under paragraph (a), who is being
107.20transitioned to independent living as part of the program plan continues to be eligible for
107.21group residential housing room and board and the supplemental service rate negotiated with
107.22the county under paragraph (a).

107.23    Sec. 34. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
107.24to read:
107.25    Subd. 1p. Supplementary rate; St. Louis County. Notwithstanding the provisions of
107.26subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a
107.27supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700 per
107.28month, including any legislatively authorized inflationary adjustments, for a housing support
107.29provider that:
107.30(1) is located in St. Louis County and has had a housing support contract with the county
107.31since July 2016;
107.32(2) operates a 35-bed facility;
108.1(3) serves women who are chemically dependent, mentally ill, or both;
108.2(4) provides 24-hour per day supervision;
108.3(5) provides on-site support with skilled professionals, including a licensed practical
108.4nurse, registered nurses, peer specialists, and resident counselors; and
108.5(6) provides independent living skills training and assistance with family reunification.

108.6    Sec. 35. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
108.7to read:
108.8    Subd. 1q. Supplemental rate; Olmsted County. Notwithstanding the provisions of
108.9subdivisions 1a and 1c, beginning July 1, 2017, a county agency shall negotiate a
108.10supplementary rate in addition to the rate specified in subdivision 1, not to exceed $750 per
108.11month, including any legislatively authorized inflationary adjustments, for a housing support
108.12provider located in Olmsted County that operates long-term residential facilities with a total
108.13of 104 beds that serve chemically dependent men and women and provide 24-hour-a-day
108.14supervision and other support services.

108.15    Sec. 36. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
108.16to read:
108.17    Subd. 1r. Supplemental rate; Anoka County. Notwithstanding the provisions in this
108.18section, a county agency shall negotiate a supplemental rate for 42 beds in addition to the
108.19rate specified in subdivision 1, not to exceed the maximum rate allowed under subdivision
108.201a, including any legislatively authorized inflationary adjustments, for a housing support
108.21provider that is located in Anoka County and provides emergency housing on the former
108.22Anoka Regional Treatment Center campus.

108.23    Sec. 37. Minnesota Statutes 2016, section 256I.05, is amended by adding a subdivision
108.24to read:
108.25    Subd. 11. Transfer of emergency shelter funds. (a) The commissioner shall make a
108.26cost-neutral transfer of funding from the housing support fund to county human service
108.27agencies for emergency shelter beds removed from the housing support census under a
108.28biennial plan submitted by the county and approved by the commissioner. The plan must
108.29describe: (1) anticipated and actual outcomes for persons experiencing homelessness in
108.30emergency shelters; (2) improved efficiencies in administration; (3) requirements for
108.31individual eligibility; and (4) plans for quality assurance monitoring and quality assurance
109.1outcomes. The commissioner shall review the county plan to monitor implementation and
109.2outcomes at least biennially, and more frequently if the commissioner deems necessary.
109.3(b) The funding under paragraph (a) may be used for the provision of room and board
109.4or supplemental services according to section 256I.03, subdivisions 2 and 8. Providers must
109.5meet the requirements of section 256I.04, subdivisions 2a to 2f. Funding must be allocated
109.6annually, and the room and board portion of the allocation shall be adjusted according to
109.7the percentage change in the housing support room and board rate. The room and board
109.8portion of the allocation shall be determined at the time of transfer. The commissioner or
109.9county may return beds to the housing support fund with 180 days' notice, including financial
109.10reconciliation.
109.11EFFECTIVE DATE.This section is effective July 1, 2017.

109.12    Sec. 38. Minnesota Statutes 2016, section 256I.06, subdivision 2, is amended to read:
109.13    Subd. 2. Time of payment. A county agency may make payments to a group residence
109.14in advance for an individual whose stay in the group residence is expected to last beyond
109.15the calendar month for which the payment is made. Group residential Housing support
109.16payments made by a county agency on behalf of an individual who is not expected to remain
109.17in the group residence beyond the month for which payment is made must be made
109.18subsequent to the individual's departure from the group residence.
109.19EFFECTIVE DATE.This section is effective July 1, 2017.

109.20    Sec. 39. Minnesota Statutes 2016, section 256I.06, subdivision 8, is amended to read:
109.21    Subd. 8. Amount of group residential housing support payment. (a) The amount of
109.22a group residential housing room and board payment to be made on behalf of an eligible
109.23individual is determined by subtracting the individual's countable income under section
109.24256I.04, subdivision 1 , for a whole calendar month from the group residential housing
109.25charge room and board rate for that same month. The group residential housing charge
109.26support payment is determined by multiplying the group residential housing support rate
109.27times the period of time the individual was a resident or temporarily absent under section
109.28256I.05, subdivision 1c , paragraph (d).
109.29(b) For an individual with earned income under paragraph (a), prospective budgeting
109.30must be used to determine the amount of the individual's payment for the following six-month
109.31period. An increase in income shall not affect an individual's eligibility or payment amount
110.1until the month following the reporting month. A decrease in income shall be effective the
110.2first day of the month after the month in which the decrease is reported.
110.3(c) For an individual who receives licensed residential crisis stabilization services under
110.4section 256B.0624, subdivision 7, the amount of housing support payment is determined
110.5by multiplying the housing support rate times the period of time the individual was a resident.
110.6EFFECTIVE DATE.Paragraph (c) is effective October 1, 2017.

110.7    Sec. 40. [256I.09] COMMUNITY LIVING INFRASTRUCTURE.
110.8The commissioner shall awards grants to agencies through an annual competitive process.
110.9Grants awarded under this section may be used for: (1) outreach to locate and engage people
110.10who are homeless or residing in segregated settings to screen for basic needs and assist with
110.11referral to community living resources; (2) building capacity to provide technical assistance
110.12and consultation on housing and related support service resources for persons with both
110.13disabilities and low income; or (3) streamlining the administration and monitoring activities
110.14related to housing support funds. Agencies may collaborate and submit a joint application
110.15for funding under this section.

110.16    Sec. 41. DIRECTION TO COMMISSIONER; HOUSING SUPPORT STUDY.
110.17Within available appropriations, the commissioner of human services shall study the
110.18housing support supplementary service rates under Minnesota Statutes, section 256I.05,
110.19and make recommendations on the supplementary service rate structure to the chairs and
110.20ranking minority members of the legislative committees with jurisdiction over human
110.21services policy and finance by January 15, 2018.

110.22    Sec. 42. REVISOR'S INSTRUCTION.
110.23In each section of Minnesota Statutes referred to in column A, the revisor of statutes
110.24shall change the phrase in column B to the phrase in column C. The revisor may make
110.25technical and other necessary changes to sentence structure to preserve the meaning of the
110.26text. The revisor shall make other changes in chapter titles; section, subdivision, part, and
110.27subpart headnotes; and in other terminology necessary as a result of the enactment of this
110.28section.

110.29	Column A	Column B	Column C
110.30 110.31	144A.071, subdivision 4d	group residential housing	housing support under chapter 256I
110.32 110.33	201.061, subdivision 3	group residential housing	setting authorized to provide housing support
111.1 111.2 111.3	244.052, subdivision 4c	group residential housing facility	licensed setting authorized to provide housing support under section 256I.04
111.4 111.5	245.466, subdivision 7	under group residential housing	by housing support under chapter 256I
111.6	245.466, subdivision 7	from group residential housing	from housing support
111.7 111.8	245.4661, subdivision 6	group residential housing	housing support under chapter 256I
111.9 111.10	245C.10, subdivision 11	group residential housing or supplementary services	housing support
111.11 111.12	256.01, subdivision 18	group residential housing	housing support under chapter 256I
111.13	256.017, subdivision 1	group residential housing	housing support
111.14 111.15	256.98, subdivision 8	group residential housing	housing support under chapter 256I
111.16 111.17	256B.49, subdivision 15	group residential housing	housing support under chapter 256I
111.18 111.19	256B.4914, subdivision 10	group residential housing rate 3 costs	housing support rate 3 costs under chapter 256I
111.20	256B.501, subdivision 4b	group residential housing	housing support
111.21 111.22 111.23	256B.77, subdivision 12	residential services covered under the group residential housing program	housing support services under chapter 256I
111.24 111.25	256D.44, subdivision 2	group residential housing facility	setting authorized to provide housing support
111.26 111.27	256G.01, subdivision 3	group residential housing	housing support under chapter 256I
111.28	256I.01	Group Residential Housing	Housing Support
111.29	256I.02	Group Residential Housing	Housing Support
111.30	256I.03, subdivision 2	"Group residential housing"	"Room and board"
111.31	256I.03, subdivision 2	Group residential housing	The room and board
111.32	256I.03, subdivision 3	"Group residential housing"	"Housing support"
111.33	256I.03, subdivision 6	group residential housing	room and board
111.34	256I.03, subdivisions 7 and 9	group residential housing	housing support
111.35 111.36	256I.04, subdivisions 1a, 1b, 1c, and 2	group residential housing	housing support
111.37 111.38	256I.04, subdivision 2a	provide group residential housing	provide housing support
111.39 111.40	256I.04, subdivision 2a	of group residential housing or supplementary services	of housing support
111.41 111.42	256I.04, subdivision 2a	complete group residential housing	complete housing support
111.43 111.44	256I.04, subdivision 2b	group residential housing or supplementary services	housing support
112.1 112.2	256I.04, subdivision 2b	provision of group residential housing	provision of housing support
112.3 112.4	256I.04, subdivision 2c	group residential housing or supplementary services	housing support
112.5 112.6	256I.04, subdivision 2e	group residential housing or supplementary services	housing support
112.7 112.8	256I.04, subdivision 4	group residential housing payment for room and board	room and board rate
112.9 112.10	256I.05, subdivision 1	living in group residential housing	receiving housing support
112.11 112.12	256I.05, subdivisions 1h, 1k, 1l, 7b, and 7c	group residential housing	housing support
112.13	256I.05, subdivision 2	group residential housing	room and board
112.14	256I.05, subdivision 3	group residential housing	room and board
112.15 112.16	256I.05, subdivision 6	reside in group residential housing	receive housing support
112.17 112.18	256I.06, subdivisions 1, 3, 4, and 6	group residential housing	housing support
112.19	256I.06, subdivision 7	group residential housing	the housing support
112.20	256I.08	group residential housing	housing support
112.21	256P.03, subdivision 1	group residential housing	housing support
112.22	256P.05, subdivision 1	group residential housing	housing support
112.23	256P.07, subdivision 1	group residential housing	housing support
112.24	256P.08, subdivision 1	group residential housing	housing support
112.25 112.26	290A.03, subdivision 8	accepts group residential housing	accepts housing support
112.27 112.28	290A.03, subdivision 8	the group residential housing program	the housing support program

112.29ARTICLE 3

112.30CONTINUING CARE

112.31    Section 1. Minnesota Statutes 2016, section 144.0724, subdivision 4, is amended to read:
112.32    Subd. 4. Resident assessment schedule. (a) A facility must conduct and electronically
112.33submit to the commissioner of health MDS assessments that conform with the assessment
112.34schedule defined by Code of Federal Regulations, title 42, section 483.20, and published
112.35by the United States Department of Health and Human Services, Centers for Medicare and
112.36Medicaid Services, in the Long Term Care Assessment Instrument User's Manual, version
112.373.0, and subsequent updates when issued by the Centers for Medicare and Medicaid Services.
112.38The commissioner of health may substitute successor manuals or question and answer
112.39documents published by the United States Department of Health and Human Services,
113.1Centers for Medicare and Medicaid Services, to replace or supplement the current version
113.2of the manual or document.
113.3(b) The assessments used to determine a case mix classification for reimbursement
113.4include the following:
113.5(1) a new admission assessment;
113.6(2) an annual assessment which must have an assessment reference date (ARD) within
113.792 days of the previous assessment and the previous comprehensive assessment;
113.8(3) a significant change in status assessment must be completed within 14 days of the
113.9identification of a significant change, whether improvement or decline, and regardless of
113.10the amount of time since the last significant change in status assessment;
113.11(4) all quarterly assessments must have an assessment reference date (ARD) within 92
113.12days of the ARD of the previous assessment;
113.13(5) any significant correction to a prior comprehensive assessment, if the assessment
113.14being corrected is the current one being used for RUG classification; and
113.15(6) any significant correction to a prior quarterly assessment, if the assessment being
113.16corrected is the current one being used for RUG classification.
113.17(c) In addition to the assessments listed in paragraph (b), the assessments used to
113.18determine nursing facility level of care include the following:
113.19(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
113.20the Senior LinkAge Line or other organization under contract with the Minnesota Board on
113.21Aging; and
113.22(2) a nursing facility level of care determination as provided for under section 256B.0911,
113.23subdivision 4e , as part of a face-to-face long-term care consultation assessment completed
113.24under section 256B.0911, by a county, tribe, or managed care organization under contract
113.25with the Department of Human Services.

113.26    Sec. 2. Minnesota Statutes 2016, section 144.0724, subdivision 6, is amended to read:
113.27    Subd. 6. Penalties for late or nonsubmission. (a) A facility that fails to complete or
113.28submit an assessment according to subdivisions 4 and 5 for a RUG-IV classification within
113.29seven days of the time requirements listed in the Long-Term Care Facility Resident
113.30Assessment Instrument User's Manual is subject to a reduced rate for that resident. The
113.31reduced rate shall be the lowest rate for that facility. The reduced rate is effective on the
113.32day of admission for new admission assessments, on the ARD for significant change in
114.1status assessments, or on the day that the assessment was due for all other assessments and
114.2continues in effect until the first day of the month following the date of submission and
114.3acceptance of the resident's assessment.
114.4    (b) If loss of revenue due to penalties incurred by a facility for any period of 92 days
114.5are equal to or greater than 1.0 0.1 percent of the total operating costs on the facility's most
114.6recent annual statistical and cost report, a facility may apply to the commissioner of human
114.7services for a reduction in the total penalty amount. The commissioner of human services,
114.8in consultation with the commissioner of health, may, at the sole discretion of the
114.9commissioner of human services, limit the penalty for residents covered by medical assistance
114.10to 15 ten days.
114.11EFFECTIVE DATE.This section is effective the day following final enactment.

114.12    Sec. 3. Minnesota Statutes 2016, section 144.562, subdivision 2, is amended to read:
114.13    Subd. 2. Eligibility for license condition. (a) A hospital is not eligible to receive a
114.14license condition for swing beds unless (1) it either has a licensed bed capacity of less than
114.1550 beds defined in the federal Medicare regulations, Code of Federal Regulations, title 42,
114.16section 482.66, or it has a licensed bed capacity of 50 beds or more and has swing beds that
114.17were approved for Medicare reimbursement before May 1, 1985, or it has a licensed bed
114.18capacity of less than 65 beds and the available nursing homes within 50 miles have had, in
114.19the aggregate, an average occupancy rate of 96 percent or higher in the most recent two
114.20years as documented on the statistical reports to the Department of Health; and (2) it is
114.21located in a rural area as defined in the federal Medicare regulations, Code of Federal
114.22Regulations, title 42, section 482.66.
114.23(b) Except for those critical access hospitals established under section 144.1483, clause
114.24(9), and section 1820 of the federal Social Security Act, United States Code, title 42, section
114.251395i-4, that have an attached nursing home or that owned a nursing home located in the
114.26same municipality as of May 1, 2005, eligible hospitals are allowed a total of 2,000 days
114.27of swing bed use per year. Critical access hospitals that have an attached nursing home or
114.28that owned a nursing home located in the same municipality as of May 1, 2005, are allowed
114.29swing bed use as provided in federal law.
114.30(c) Except for critical access hospitals that have an attached nursing home or that owned
114.31a nursing home located in the same municipality as of May 1, 2005, the commissioner of
114.32health may approve swing bed use beyond 2,000 days as long as there are no Medicare
114.33certified skilled nursing facility beds available within 25 miles of that hospital that are
114.34willing to admit the patient and the patient agrees to the referral being sent to the skilled
115.1nursing facility. Critical access hospitals exceeding 2,000 swing bed days must maintain
115.2documentation that they have contacted skilled nursing facilities within 25 miles to determine
115.3if any skilled nursing facility beds are available that are willing to admit the patient and the
115.4patient agrees to the referral being sent to the skilled nursing facility.
115.5(d) After reaching 2,000 days of swing bed use in a year, an eligible hospital to which
115.6this limit applies may admit six additional patients to swing beds each year without seeking
115.7approval from the commissioner or being in violation of this subdivision. These six swing
115.8bed admissions are exempt from the limit of 2,000 annual swing bed days for hospitals
115.9subject to this limit.
115.10(e) A health care system that is in full compliance with this subdivision may allocate its
115.11total limit of swing bed days among the hospitals within the system, provided that no hospital
115.12in the system without an attached nursing home may exceed 2,000 swing bed days per year.

115.13    Sec. 4. Minnesota Statutes 2016, section 144A.071, subdivision 4d, is amended to read:
115.14    Subd. 4d. Consolidation of nursing facilities. (a) The commissioner of health, in
115.15consultation with the commissioner of human services, may approve a request for
115.16consolidation of nursing facilities which includes the closure of one or more facilities and
115.17the upgrading of the physical plant of the remaining nursing facility or facilities, the costs
115.18of which exceed the threshold project limit under subdivision 2, clause (a). The
115.19commissioners shall consider the criteria in this section, section 144A.073, and section
115.20256B.437 256R.40, in approving or rejecting a consolidation proposal. In the event the
115.21commissioners approve the request, the commissioner of human services shall calculate an
115.22external fixed costs rate adjustment according to clauses (1) to (3):
115.23(1) the closure of beds shall not be eligible for a planned closure rate adjustment under
115.24section 256B.437, subdivision 6 256R.40, subdivision 5;
115.25(2) the construction project permitted in this clause shall not be eligible for a threshold
115.26project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception
115.27adjustment under section 144A.073; and
115.28(3) the payment rate for external fixed costs for a remaining facility or facilities shall
115.29be increased by an amount equal to 65 percent of the projected net cost savings to the state
115.30calculated in paragraph (b), divided by the state's medical assistance percentage of medical
115.31assistance dollars, and then divided by estimated medical assistance resident days, as
115.32determined in paragraph (c), of the remaining nursing facility or facilities in the request in
115.33this paragraph. The rate adjustment is effective on the later of the first day of the month
116.1following first day of the month of January or July, whichever date occurs first following
116.2both the completion of the construction upgrades in the consolidation plan or the first day
116.3of the month following and the complete closure of a facility closure of the facility or
116.4facilities designated for closure in the consolidation plan. If more than one facility is receiving
116.5upgrades in the consolidation plan, each facility's date of construction completion must be
116.6evaluated separately.
116.7(b) For purposes of calculating the net cost savings to the state, the commissioner shall
116.8consider clauses (1) to (7):
116.9(1) the annual savings from estimated medical assistance payments from the net number
116.10of beds closed taking into consideration only beds that are in active service on the date of
116.11the request and that have been in active service for at least three years;
116.12(2) the estimated annual cost of increased case load of individuals receiving services
116.13under the elderly waiver;
116.14(3) the estimated annual cost of elderly waiver recipients receiving support under group
116.15residential housing;
116.16(4) the estimated annual cost of increased case load of individuals receiving services
116.17under the alternative care program;
116.18(5) the annual loss of license surcharge payments on closed beds;
116.19(6) the savings from not paying planned closure rate adjustments that the facilities would
116.20otherwise be eligible for under section 256B.437 256R.40; and
116.21(7) the savings from not paying external fixed costs payment rate adjustments from
116.22submission of renovation costs that would otherwise be eligible as threshold projects under
116.23section 256B.434, subdivision 4f.
116.24(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical
116.25assistance resident days of the remaining facility or facilities shall be computed assuming
116.2695 percent occupancy multiplied by the historical percentage of medical assistance resident
116.27days of the remaining facility or facilities, as reported on the facility's or facilities' most
116.28recent nursing facility statistical and cost report filed before the plan of closure is submitted,
116.29multiplied by 365.
116.30(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy
116.31percentages will be those reported on the facility's or facilities' most recent nursing facility
116.32statistical and cost report filed before the plan of closure is submitted, and the average
117.1payment rates shall be calculated based on the approved payment rates in effect at the time
117.2the consolidation request is submitted.
117.3(e) To qualify for the external fixed costs payment rate adjustment under this subdivision,
117.4the closing facilities shall:
117.5(1) submit an application for closure according to section 256B.437, subdivision 3
117.6256R.40, subdivision 2; and
117.7(2) follow the resident relocation provisions of section 144A.161.
117.8(f) The county or counties in which a facility or facilities are closed under this subdivision
117.9shall not be eligible for designation as a hardship area under subdivision 3 for five years
117.10from the date of the approval of the proposed consolidation. The applicant shall notify the
117.11county of this limitation and the county shall acknowledge this in a letter of support.
117.12EFFECTIVE DATE.This section is effective for consolidations occurring after July
117.131, 2017.

117.14    Sec. 5. Minnesota Statutes 2016, section 144A.74, is amended to read:
117.15144A.74 MAXIMUM CHARGES.
117.16A supplemental nursing services agency must not bill or receive payments from a nursing
117.17home licensed under this chapter at a rate higher than 150 percent of the sum of the weighted
117.18average wage rate, plus a factor determined by the commissioner to incorporate payroll
117.19taxes as defined in Minnesota Rules, part 9549.0020, subpart 33 section 256R.02, subdivision
117.2037, for the applicable employee classification for the geographic group to which the nursing
117.21home is assigned under Minnesota Rules, part 9549.0052 specified in section 256R.23,
117.22subdivision 4. The weighted average wage rates must be determined by the commissioner
117.23of human services and reported to the commissioner of health on an annual basis. Wages
117.24are defined as hourly rate of pay and shift differential, including weekend shift differential
117.25and overtime. Facilities shall provide information necessary to determine weighted average
117.26wage rates to the commissioner of human services in a format requested by the commissioner.
117.27The maximum rate must include all charges for administrative fees, contract fees, or other
117.28special charges in addition to the hourly rates for the temporary nursing pool personnel
117.29supplied to a nursing home. A nursing home that pays for the actual travel and housing costs
117.30for supplemental nursing services agency staff working at the facility and that pays these
117.31costs to the employee, the agency, or another vendor, is not violating the limitation on
117.32charges described in this section.
117.33EFFECTIVE DATE.This section is effective the day following final enactment.

118.1    Sec. 6. Minnesota Statutes 2016, section 256.975, subdivision 7, is amended to read:
118.2    Subd. 7. Consumer information and assistance and long-term care options
118.3counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
118.4statewide service to aid older Minnesotans and their families in making informed choices
118.5about long-term care options and health care benefits. Language services to persons with
118.6limited English language skills may be made available. The service, known as Senior
118.7LinkAge Line, shall serve older adults as the designated Aging and Disability Resource
118.8Center under United States Code, title 42, section 3001, the Older Americans Act
118.9Amendments of 2006 in partnership with the Disability Linkage Line under section 256.01,
118.10subdivision 24 , and must be available during business hours through a statewide toll-free
118.11number and the Internet. The Minnesota Board on Aging shall consult with, and when
118.12appropriate work through, the area agencies on aging counties, and other entities that serve
118.13aging and disabled populations of all ages, to provide and maintain the telephone
118.14infrastructure and related support for the Aging and Disability Resource Center partners
118.15which agree by memorandum to access the infrastructure, including the designated providers
118.16of the Senior LinkAge Line and the Disability Linkage Line.
118.17    (b) The service must provide long-term care options counseling by assisting older adults,
118.18caregivers, and providers in accessing information and options counseling about choices in
118.19long-term care services that are purchased through private providers or available through
118.20public options. The service must:
118.21    (1) develop and provide for regular updating of a comprehensive database that includes
118.22detailed listings in both consumer- and provider-oriented formats that can provide search
118.23results down to the neighborhood level;
118.24    (2) make the database accessible on the Internet and through other telecommunication
118.25and media-related tools;
118.26    (3) link callers to interactive long-term care screening tools and make these tools available
118.27through the Internet by integrating the tools with the database;
118.28    (4) develop community education materials with a focus on planning for long-term care
118.29and evaluating independent living, housing, and service options;
118.30    (5) conduct an outreach campaign to assist older adults and their caregivers in finding
118.31information on the Internet and through other means of communication;
118.32    (6) implement a messaging system for overflow callers and respond to these callers by
118.33the next business day;
119.1    (7) link callers with county human services and other providers to receive more in-depth
119.2assistance and consultation related to long-term care options;
119.3    (8) link callers with quality profiles for nursing facilities and other home and
119.4community-based services providers developed by the commissioners of health and human
119.5services;
119.6(9) develop an outreach plan to seniors and their caregivers with a particular focus on
119.7establishing a clear presence in places that seniors recognize and:
119.8(i) place a significant emphasis on improved outreach and service to seniors and their
119.9caregivers by establishing annual plans by neighborhood, city, and county, as necessary, to
119.10address the unique needs of geographic areas in the state where there are dense populations
119.11of seniors;
119.12(ii) establish an efficient workforce management approach and assign community living
119.13specialist staff and volunteers to geographic areas as well as aging and disability resource
119.14center sites so that seniors and their caregivers and professionals recognize the Senior
119.15LinkAge Line as the place to call for aging services and information;
119.16(iii) recognize the size and complexity of the metropolitan area service system by working
119.17with metropolitan counties to establish a clear partnership with them, including seeking
119.18county advice on the establishment of local aging and disabilities resource center sites; and
119.19(iv) maintain dashboards with metrics that demonstrate how the service is expanding
119.20and extending or enhancing its outreach efforts in dispersed or hard to reach locations in
119.21varied population centers;
119.22    (10) incorporate information about the availability of housing options, as well as
119.23registered housing with services and consumer rights within the MinnesotaHelp.info network
119.24long-term care database to facilitate consumer comparison of services and costs among
119.25housing with services establishments and with other in-home services and to support financial
119.26self-sufficiency as long as possible. Housing with services establishments and their arranged
119.27home care providers shall provide information that will facilitate price comparisons, including
119.28delineation of charges for rent and for services available. The commissioners of health and
119.29human services shall align the data elements required by section 144G.06, the Uniform
119.30Consumer Information Guide, and this section to provide consumers standardized information
119.31and ease of comparison of long-term care options. The commissioner of human services
119.32shall provide the data to the Minnesota Board on Aging for inclusion in the
119.33MinnesotaHelp.info network long-term care database;
120.1(11) provide long-term care options counseling. Long-term care options counselors shall:
120.2(i) for individuals not eligible for case management under a public program or public
120.3funding source, provide interactive decision support under which consumers, family
120.4members, or other helpers are supported in their deliberations to determine appropriate
120.5long-term care choices in the context of the consumer's needs, preferences, values, and
120.6individual circumstances, including implementing a community support plan;
120.7(ii) provide Web-based educational information and collateral written materials to
120.8familiarize consumers, family members, or other helpers with the long-term care basics,
120.9issues to be considered, and the range of options available in the community;
120.10(iii) provide long-term care futures planning, which means providing assistance to
120.11individuals who anticipate having long-term care needs to develop a plan for the more
120.12distant future; and
120.13(iv) provide expertise in benefits and financing options for long-term care, including
120.14Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
120.15private pay options, and ways to access low or no-cost services or benefits through
120.16volunteer-based or charitable programs;
120.17(12) using risk management and support planning protocols, provide long-term care
120.18options counseling under clause (13) to current residents of nursing homes deemed
120.19appropriate for discharge by the commissioner, former residents of nursing homes who
120.20were discharged to community settings, and older adults who request service after
120.21consultation with the Senior LinkAge Line under clause (13). The Senior LinkAge Line
120.22shall also receive referrals from the residents or staff of nursing homes. who meet a profile
120.23that demonstrates that the consumer is either at risk of readmission to a nursing home or
120.24hospital, or would benefit from long-term care options counseling to age in place. The Senior
120.25LinkAge Line shall identify and contact residents or patients deemed appropriate for
120.26discharge by developing targeting criteria and creating a profile in consultation with the
120.27commissioner who. The commissioner shall provide designated Senior LinkAge Line contact
120.28centers with a list of current or former nursing home residents or people discharged from a
120.29hospital or for whom Medicare home care has ended, that meet the criteria as being
120.30appropriate for discharge planning long-term care options counseling through a referral via
120.31a secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a
120.32preference to receive long-term care options counseling, with initial assessment and, if
120.33appropriate, a referral to:
120.34(i) long-term care consultation services under section 256B.0911;
121.1(ii) designated care coordinators of contracted entities under section 256B.035 for persons
121.2who are enrolled in a managed care plan; or
121.3(iii) the long-term care consultation team for those who are eligible for relocation service
121.4coordination due to high-risk factors or psychological or physical disability; and
121.5(13) develop referral protocols and processes that will assist certified health care homes,
121.6Medicare home care, and hospitals to identify at-risk older adults and determine when to
121.7refer these individuals to the Senior LinkAge Line for long-term care options counseling
121.8under this section. The commissioner is directed to work with the commissioner of health
121.9to develop protocols that would comply with the health care home designation criteria and
121.10protocols available at the time of hospital discharge or the end of Medicare home care. The
121.11commissioner shall keep a record of the number of people who choose long-term care
121.12options counseling as a result of this section.
121.13(c) Nursing homes shall provide contact information to the Senior LinkAge Line for
121.14residents identified in paragraph (b), clause (12), to provide long-term care options counseling
121.15pursuant to paragraph (b), clause (11). The contact information for residents shall include
121.16all information reasonably necessary to contact residents, including first and last names,
121.17permanent and temporary addresses, telephone numbers, and e-mail addresses.
121.18(d) The Senior LinkAge Line shall determine when it is appropriate to refer a consumer
121.19who receives long-term care options counseling under paragraph (b), clause (12) or (13),
121.20and who uses an unpaid caregiver to the self-directed caregiver service under subdivision
121.2112.
121.22EFFECTIVE DATE.This section is effective July 1, 2017.

121.23    Sec. 7. Minnesota Statutes 2016, section 256.975, is amended by adding a subdivision to
121.24read:
121.25    Subd. 12. Self-directed caregiver grants. Beginning on July 1, 2019, the Minnesota
121.26Board on Aging shall administer self-directed caregiver grants to support at risk family
121.27caregivers of older adults or others eligible under the Older Americans Act of 1965, United
121.28States Code, title 42, chapter 35, sections 3001 to 3058ff, to sustain family caregivers in
121.29the caregivers' roles so older adults can remain at home longer. The board shall give priority
121.30to consumers referred under section 256.975, subdivision 7, paragraph (d).
121.31EFFECTIVE DATE.This section is effective July 1, 2017.

122.1    Sec. 8. [256.9755] CAREGIVER SUPPORT PROGRAMS.
122.2    Subdivision 1. Program goals. It is the goal of all area agencies on aging and caregiver
122.3support programs to support family caregivers of persons with Alzheimer's disease or other
122.4related dementias who are living in the community by:
122.5(1) promoting caregiver support programs that serve Minnesotans in their homes and
122.6communities; and
122.7(2) providing, within the limits of available funds, the caregiver support services that
122.8will enable the family caregiver to access caregiver support programs in the most
122.9cost-effective and efficient manner.
122.10    Subd. 2. Authority. The Minnesota Board on Aging shall allocate to area agencies on
122.11aging the state and federal funds which are received for the caregiver support program in a
122.12manner consistent with federal requirements.
122.13    Subd. 3. Caregiver support services. Funds allocated to an area agency on aging for
122.14caregiver support services must be used in a manner consistent with the National Family
122.15Caregiver Support Program to reach family caregivers of persons with Alzheimer's disease
122.16or related dementias. The funds must be used to provide social, nonmedical,
122.17community-based services and activities that provide respite for caregivers and social
122.18interaction for participants.

122.19    Sec. 9. Minnesota Statutes 2016, section 256B.0911, subdivision 3a, is amended to read:
122.20    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment, services
122.21planning, or other assistance intended to support community-based living, including persons
122.22who need assessment in order to determine waiver or alternative care program eligibility,
122.23must be visited by a long-term care consultation team within 20 calendar days after the date
122.24on which an assessment was requested or recommended. Upon statewide implementation
122.25of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
122.26requesting personal care assistance services and home care nursing. The commissioner shall
122.27provide at least a 90-day notice to lead agencies prior to the effective date of this requirement.
122.28Face-to-face assessments must be conducted according to paragraphs (b) to (i).
122.29    (b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
122.30assessors to conduct the assessment. For a person with complex health care needs, a public
122.31health or registered nurse from the team must be consulted.
122.32    (c) The MnCHOICES assessment provided by the commissioner to lead agencies must
122.33be used to complete a comprehensive, person-centered assessment. The assessment must
123.1include the health, psychological, functional, environmental, and social needs of the
123.2individual necessary to develop a community support plan that meets the individual's needs
123.3and preferences.
123.4    (d) The assessment must be conducted in a face-to-face interview with the person being
123.5assessed and the person's legal representative. At the request of the person, other individuals
123.6may participate in the assessment to provide information on the needs, strengths, and
123.7preferences of the person necessary to develop a community support plan that ensures the
123.8person's health and safety. Except for legal representatives or family members invited by
123.9the person, persons participating in the assessment may not be a provider of service or have
123.10any financial interest in the provision of services. For persons who are to be assessed for
123.11elderly waiver customized living or adult day services under section 256B.0915, with the
123.12permission of the person being assessed or the person's designated or legal representative,
123.13the client's current or proposed provider of services may submit a copy of the provider's
123.14nursing assessment or written report outlining its recommendations regarding the client's
123.15care needs. The person conducting the assessment must notify the provider of the date by
123.16which this information is to be submitted. This information shall be provided to the person
123.17conducting the assessment prior to the assessment. For a person who is to be assessed for
123.18waiver services under section 256B.092 or 256B.49, with the permission of the person being
123.19assessed or the person's designated legal representative, the person's current provider of
123.20services may submit a written report outlining recommendations regarding the person's care
123.21needs prepared by a direct service employee with at least 20 hours of service to that client.
123.22The person conducting the assessment or reassessment must notify the provider of the date
123.23by which this information is to be submitted. This information shall be provided to the
123.24person conducting the assessment and the person or the person's legal representative, and
123.25must be considered prior to the finalization of the assessment or reassessment.
123.26    (e) The person or the person's legal representative must be provided with a written
123.27community support plan within 40 calendar days of the assessment visit, regardless of
123.28whether the individual is eligible for Minnesota health care programs.
123.29    (f) For a person being assessed for elderly waiver services under section 256B.0915, a
123.30provider who submitted information under paragraph (d) shall receive a copy of the
123.31assessment, the final written community support plan when available, the case mix level,
123.32and the Residential Services Workbook.
123.33    (g) The written community support plan must include:
123.34(1) a summary of assessed needs as defined in paragraphs (c) and (d);
124.1(2) the individual's options and choices to meet identified needs, including all available
124.2options for case management services and providers;
124.3(3) identification of health and safety risks and how those risks will be addressed,
124.4including personal risk management strategies;
124.5(4) referral information; and
124.6(5) informal caregiver supports, if applicable.
124.7For a person determined eligible for state plan home care under subdivision 1a, paragraph
124.8(b), clause (1), the person or person's representative must also receive a copy of the home
124.9care service plan developed by the certified assessor.
124.10(f) (h) A person may request assistance in identifying community supports without
124.11participating in a complete assessment. Upon a request for assistance identifying community
124.12support, the person must be transferred or referred to long-term care options counseling
124.13services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
124.14telephone assistance and follow up.
124.15    (g) (i) The person has the right to make the final decision between institutional placement
124.16and community placement after the recommendations have been provided, except as provided
124.17in section 256.975, subdivision 7a, paragraph (d).
124.18    (h) (j) The lead agency must give the person receiving assessment or support planning,
124.19or the person's legal representative, materials, and forms supplied by the commissioner
124.20containing the following information:
124.21    (1) written recommendations for community-based services and consumer-directed
124.22options;
124.23(2) documentation that the most cost-effective alternatives available were offered to the
124.24individual. For purposes of this clause, "cost-effective" means community services and
124.25living arrangements that cost the same as or less than institutional care. For an individual
124.26found to meet eligibility criteria for home and community-based service programs under
124.27section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
124.28approved waiver plan for each program;
124.29(3) the need for and purpose of preadmission screening conducted by long-term care
124.30options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
124.31nursing facility placement. If the individual selects nursing facility placement, the lead
124.32agency shall forward information needed to complete the level of care determinations and
125.1screening for developmental disability and mental illness collected during the assessment
125.2to the long-term care options counselor using forms provided by the commissioner;
125.3    (4) the role of long-term care consultation assessment and support planning in eligibility
125.4determination for waiver and alternative care programs, and state plan home care, case
125.5management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
125.6and (b);
125.7    (5) information about Minnesota health care programs;
125.8    (6) the person's freedom to accept or reject the recommendations of the team;
125.9    (7) the person's right to confidentiality under the Minnesota Government Data Practices
125.10Act, chapter 13;
125.11    (8) the certified assessor's decision regarding the person's need for institutional level of
125.12care as determined under criteria established in subdivision 4e and the certified assessor's
125.13decision regarding eligibility for all services and programs as defined in subdivision 1a,
125.14paragraphs (a), clause (6), and (b); and
125.15    (9) the person's right to appeal the certified assessor's decision regarding eligibility for
125.16all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
125.17(8), and (b), and incorporating the decision regarding the need for institutional level of care
125.18or the lead agency's final decisions regarding public programs eligibility according to section
125.19256.045, subdivision 3 .
125.20    (i) (k) Face-to-face assessment completed as part of eligibility determination for the
125.21alternative care, elderly waiver, community access for disability inclusion, community
125.22alternative care, and brain injury waiver programs under sections 256B.0913, 256B.0915,
125.23and 256B.49 is valid to establish service eligibility for no more than 60 calendar days after
125.24the date of assessment.
125.25(j) (l) The effective eligibility start date for programs in paragraph (i)(k) can never be
125.26prior to the date of assessment. If an assessment was completed more than 60 days before
125.27the effective waiver or alternative care program eligibility start date, assessment and support
125.28plan information must be updated and documented in the department's Medicaid Management
125.29Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
125.30state plan services, the effective date of eligibility for programs included in paragraph (i)
125.31(k) cannot be prior to the date the most recent updated assessment is completed.
125.32(m) If an eligibility update is completed within 90 days of the previous face-to-face
125.33assessment and documented in the department's Medicaid Management Information System
126.1(MMIS), the effective date of eligibility for programs included in paragraph (k) is the date
126.2of the previous face-to-face assessment when all other eligibility requirements are met.

126.3    Sec. 10. Minnesota Statutes 2016, section 256B.0915, subdivision 3a, is amended to read:
126.4    Subd. 3a. Elderly waiver cost limits. (a) Effective on the first day of the state fiscal
126.5year in which the resident assessment system as described in section 256B.438 256R.17 for
126.6nursing home rate determination is implemented and the first day of each subsequent state
126.7fiscal year, the monthly limit for the cost of waivered services to an individual elderly waiver
126.8client shall be the monthly limit of the case mix resident class to which the waiver client
126.9would be assigned under Minnesota Rules, parts 9549.0051 to 9549.0059, in effect on the
126.10last day of the previous state fiscal year, adjusted by any legislatively adopted home and
126.11community-based services percentage rate adjustment. If a legislatively authorized increase
126.12is service-specific, the monthly cost limit shall be adjusted based on the overall average
126.13increase to the elderly waiver program.
126.14    (b) The monthly limit for the cost of waivered services under paragraph (a) to an
126.15individual elderly waiver client assigned to a case mix classification A with:
126.16(1) no dependencies in activities of daily living; or
126.17(2) up to two dependencies in bathing, dressing, grooming, walking, and eating when
126.18the dependency score in eating is three or greater as determined by an assessment performed
126.19under section 256B.0911 shall be $1,750 per month effective on July 1, 2011, for all new
126.20participants enrolled in the program on or after July 1, 2011. This monthly limit shall be
126.21applied to all other participants who meet this criteria at reassessment. This monthly limit
126.22shall be increased annually as described in paragraphs (a) and (e).
126.23(c) If extended medical supplies and equipment or environmental modifications are or
126.24will be purchased for an elderly waiver client, the costs may be prorated for up to 12
126.25consecutive months beginning with the month of purchase. If the monthly cost of a recipient's
126.26waivered services exceeds the monthly limit established in paragraph (a), (b), (d), or (e),
126.27the annual cost of all waivered services shall be determined. In this event, the annual cost
126.28of all waivered services shall not exceed 12 times the monthly limit of waivered services
126.29as described in paragraph (a), (b), (d), or (e).
126.30(d) Effective July 1, 2013, the monthly cost limit of waiver services, including any
126.31necessary home care services described in section 256B.0651, subdivision 2, for individuals
126.32who meet the criteria as ventilator-dependent given in section 256B.0651, subdivision 1,
126.33paragraph (g), shall be the average of the monthly medical assistance amount established
127.1for home care services as described in section 256B.0652, subdivision 7, and the annual
127.2average contracted amount established by the commissioner for nursing facility services
127.3for ventilator-dependent individuals. This monthly limit shall be increased annually as
127.4described in paragraphs (a) and (e).
127.5(e) Effective July 1, 2016 January 1, 2018, and each July January 1 thereafter, the monthly
127.6cost limits for elderly waiver services in effect on the previous June 30 December 31 shall
127.7be increased by the difference between any legislatively adopted home and community-based
127.8provider rate increases effective on July January 1 or since the previous July January 1 and
127.9the average statewide percentage increase in nursing facility operating payment rates under
127.10sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective the previous January
127.111. This paragraph shall only apply if the average statewide percentage increase in nursing
127.12facility operating payment rates is greater than any legislatively adopted home and
127.13community-based provider rate increases effective on July January 1, or occurring since
127.14the previous July January 1.

127.15    Sec. 11. Minnesota Statutes 2016, section 256B.0915, subdivision 3e, is amended to read:
127.16    Subd. 3e. Customized living service rate. (a) Payment for customized living services
127.17shall be a monthly rate authorized by the lead agency within the parameters established by
127.18the commissioner. The payment agreement must delineate the amount of each component
127.19service included in the recipient's customized living service plan. The lead agency, with
127.20input from the provider of customized living services, shall ensure that there is a documented
127.21need within the parameters established by the commissioner for all component customized
127.22living services authorized.
127.23(b) The payment rate must be based on the amount of component services to be provided
127.24utilizing component rates established by the commissioner. Counties and tribes shall use
127.25tools issued by the commissioner to develop and document customized living service plans
127.26and rates.
127.27(c) Component service rates must not exceed payment rates for comparable elderly
127.28waiver or medical assistance services and must reflect economies of scale. Customized
127.29living services must not include rent or raw food costs.
127.30    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
127.31individualized monthly authorized payment for the customized living service plan shall not
127.32exceed 50 percent of the greater of either the statewide or any of the geographic groups'
127.33weighted average monthly nursing facility rate of the case mix resident class to which the
127.34elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0051
128.1to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph
128.2(a). Effective On July 1 of the state fiscal each year in which the resident assessment system
128.3as described in section 256B.438 for nursing home rate determination is implemented and
128.4July 1 of each subsequent state fiscal year, the individualized monthly authorized payment
128.5for the services described in this clause shall not exceed the limit which was in effect on
128.6June 30 of the previous state fiscal year updated annually based on legislatively adopted
128.7changes to all service rate maximums for home and community-based service providers.
128.8(e) For rates effective on or after January 1, 2022, the elderly waiver payment for
128.9customized living services includes a cognitive and behavioral needs factor equal to an
128.10additional 15 percent applied to the component service rates for a client:
128.11(1) for whom the total monthly hours for customized living services divided by 30.4 is
128.12less than 3.62; and
128.13(2) who is determined, based on responses to questions 45 and 51 of the Minnesota
128.14long-term care consultation assessment form, to have either:
128.15(i) wandering or orientation issues; or
128.16(ii) anxiety, verbal aggression, physical aggression, repetitive behavior, agitation,
128.17self-injurious behavior, or behavior related to property destruction.
128.18(e) Effective July 1, 2011, (f) The individualized monthly payment for the customized
128.19living service plan for individuals described in subdivision 3a, paragraph (b), must be the
128.20monthly authorized payment limit for customized living for individuals classified as case
128.21mix A, reduced by 25 percent. This rate limit must be applied to all new participants enrolled
128.22in the program on or after July 1, 2011, who meet the criteria described in subdivision 3a,
128.23paragraph (b). This monthly limit also applies to all other participants who meet the criteria
128.24described in subdivision 3a, paragraph (b), at reassessment.
128.25    (f) (g) Customized living services are delivered by a provider licensed by the Department
128.26of Health as a class A or class F home care provider and provided in a building that is
128.27registered as a housing with services establishment under chapter 144D. Licensed home
128.28care providers are subject to section 256B.0651, subdivision 14.
128.29(g) (h) A provider may not bill or otherwise charge an elderly waiver participant or their
128.30family for additional units of any allowable component service beyond those available under
128.31the service rate limits described in paragraph (d) (e), nor for additional units of any allowable
128.32component service beyond those approved in the service plan by the lead agency.
129.1(h) (i) Effective July 1, 2016 January 1, 2018, and each July January 1 thereafter,
129.2individualized service rate limits for customized living services under this subdivision shall
129.3be increased by the difference between any legislatively adopted home and community-based
129.4provider rate increases effective on July January 1 or since the previous July January 1 and
129.5the average statewide percentage increase in nursing facility operating payment rates under
129.6sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective the previous January
129.71. This paragraph shall only apply if the average statewide percentage increase in nursing
129.8facility operating payment rates is greater than any legislatively adopted home and
129.9community-based provider rate increases effective on July January 1, or occurring since
129.10the previous July January 1.
129.11EFFECTIVE DATE.This section prevails over any conflicting amendment regardless
129.12of the order of enactment.

129.13    Sec. 12. Minnesota Statutes 2016, section 256B.0915, subdivision 3h, is amended to read:
129.14    Subd. 3h. Service rate limits; 24-hour customized living services. (a) The payment
129.15rate for 24-hour customized living services is a monthly rate authorized by the lead agency
129.16within the parameters established by the commissioner of human services. The payment
129.17agreement must delineate the amount of each component service included in each recipient's
129.18customized living service plan. The lead agency, with input from the provider of customized
129.19living services, shall ensure that there is a documented need within the parameters established
129.20by the commissioner for all component customized living services authorized. The lead
129.21agency shall not authorize 24-hour customized living services unless there is a documented
129.22need for 24-hour supervision.
129.23(b) For purposes of this section, "24-hour supervision" means that the recipient requires
129.24assistance due to needs related to one or more of the following:
129.25    (1) intermittent assistance with toileting, positioning, or transferring;
129.26    (2) cognitive or behavioral issues;
129.27    (3) a medical condition that requires clinical monitoring; or
129.28    (4) for all new participants enrolled in the program on or after July 1, 2011, and all other
129.29participants at their first reassessment after July 1, 2011, dependency in at least three of the
129.30following activities of daily living as determined by assessment under section 256B.0911:
129.31bathing; dressing; grooming; walking; or eating when the dependency score in eating is
129.32three or greater; and needs medication management and at least 50 hours of service per
129.33month. The lead agency shall ensure that the frequency and mode of supervision of the
130.1recipient and the qualifications of staff providing supervision are described and meet the
130.2needs of the recipient.
130.3(c) The payment rate for 24-hour customized living services must be based on the amount
130.4of component services to be provided utilizing component rates established by the
130.5commissioner. Counties and tribes will use tools issued by the commissioner to develop
130.6and document customized living plans and authorize rates.
130.7(d) Component service rates must not exceed payment rates for comparable elderly
130.8waiver or medical assistance services and must reflect economies of scale.
130.9(e) The individually authorized 24-hour customized living payments, in combination
130.10with the payment for other elderly waiver services, including case management, must not
130.11exceed the recipient's community budget cap specified in subdivision 3a. Customized living
130.12services must not include rent or raw food costs.
130.13(f) The individually authorized 24-hour customized living payment rates shall not exceed
130.14the 95 percentile of statewide monthly authorizations for 24-hour customized living services
130.15in effect and in the Medicaid management information systems on March 31, 2009, for each
130.16case mix resident class under Minnesota Rules, parts 9549.0051 to 9549.0059, to which
130.17elderly waiver service clients are assigned. When there are fewer than 50 authorizations in
130.18effect in the case mix resident class, the commissioner shall multiply the calculated service
130.19payment rate maximum for the A classification by the standard weight for that classification
130.20under Minnesota Rules, parts 9549.0051 to 9549.0059, to determine the applicable payment
130.21rate maximum. Service payment rate maximums shall be updated annually based on
130.22legislatively adopted changes to all service rates for home and community-based service
130.23providers.
130.24    (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner may
130.25establish alternative payment rate systems for 24-hour customized living services in housing
130.26with services establishments which are freestanding buildings with a capacity of 16 or fewer,
130.27by applying a single hourly rate for covered component services provided in either:
130.28    (1) licensed corporate adult foster homes; or
130.29    (2) specialized dementia care units which meet the requirements of section 144D.065
130.30and in which:
130.31    (i) each resident is offered the option of having their own apartment; or
131.1    (ii) the units are licensed as board and lodge establishments with maximum capacity of
131.2eight residents, and which meet the requirements of Minnesota Rules, part 9555.6205,
131.3subparts 1, 2, 3, and 4, item A.
131.4(h) Twenty-four-hour customized living services are delivered by a provider licensed
131.5by the Department of Health as a class A or class F home care provider and provided in a
131.6building that is registered as a housing with services establishment under chapter 144D.
131.7Licensed home care providers are subject to section 256B.0651, subdivision 14.
131.8(i) A provider may not bill or otherwise charge an elderly waiver participant or their
131.9family for additional units of any allowable component service beyond those available under
131.10the service rate limits described in paragraph (e), nor for additional units of any allowable
131.11component service beyond those approved in the service plan by the lead agency.
131.12(j) Effective July 1, 2016 January 1, 2018, and each July January 1 thereafter,
131.13individualized service rate limits for 24-hour customized living services under this
131.14subdivision shall be increased by the difference between any legislatively adopted home
131.15and community-based provider rate increases effective on July January 1 or since the previous
131.16July January 1 and the average statewide percentage increase in nursing facility operating
131.17payment rates under sections 256B.431, 256B.434, and 256B.441 chapter 256R, effective
131.18the previous January 1. This paragraph shall only apply if the average statewide percentage
131.19increase in nursing facility operating payment rates is greater than any legislatively adopted
131.20home and community-based provider rate increases effective on July January 1, or occurring
131.21since the previous July January 1.

131.22    Sec. 13. Minnesota Statutes 2016, section 256B.0915, subdivision 5, is amended to read:
131.23    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client shall
131.24receive an initial assessment of strengths, informal supports, and need for services in
131.25accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a client
131.26served under the elderly waiver must be conducted at least every 12 months and at other
131.27times when the case manager determines that there has been significant change in the client's
131.28functioning. This may include instances where the client is discharged from the hospital.
131.29There must be a determination that the client requires nursing facility level of care as defined
131.30in section 256B.0911, subdivision 4e, at initial and subsequent assessments to initiate and
131.31maintain participation in the waiver program.
131.32(b) Regardless of other assessments identified in section 144.0724, subdivision 4, as
131.33appropriate to determine nursing facility level of care for purposes of medical assistance
131.34payment for nursing facility services, only face-to-face assessments conducted according
132.1to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility level of care
132.2determination will be accepted for purposes of initial and ongoing access to waiver service
132.3payment.
132.4(c) The lead agency shall conduct a change-in-condition reassessment before the annual
132.5reassessment in cases where a client's condition changed due to a major health event, an
132.6emerging need or risk, worsening health condition, or cases where the current services do
132.7not meet the client's needs. A change-in-condition reassessment may be initiated by the lead
132.8agency, or it may be requested by the client or requested on the client's behalf by another
132.9party, such as a provider of services. The lead agency shall complete a change-in-condition
132.10reassessment no later than 20 calendar days from the request. The lead agency shall conduct
132.11these assessments in a timely manner and expedite urgent requests. The lead agency shall
132.12evaluate urgent requests based on the client's needs and risk to the client if a reassessment
132.13is not completed.

132.14    Sec. 14. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
132.15to read:
132.16    Subd. 11. Payment rates; application. The payment methodologies in subdivisions 12
132.17to 16 apply to elderly waiver and elderly waiver customized living under this section,
132.18alternative care under section 256B.0913, essential community supports under section
132.19256B.0922, and community access for disability inclusion customized living, brain injury
132.20customized living, and elderly waiver foster care and residential care.

132.21    Sec. 15. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
132.22to read:
132.23    Subd. 12. Payment rates; phase-in. (a) Effective January 1, 2019, through December
132.2431, 2020, all rates and rate components for services under subdivision 11 shall be the sum
132.25of 12 percent of the rates calculated under subdivisions 13 to 16 and 88 percent of the rates
132.26calculated using the rate methodology in effect as of June 30, 2017.
132.27(b) Effective January 1, 2021, all rates and rate components for services under subdivision
132.2811 shall be the sum of 20 percent of the rates calculated under subdivisions 13 to 16 and 80
132.29percent of the rates calculated using the rate methodology in effect as of June 30, 2017.

133.1    Sec. 16. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
133.2to read:
133.3    Subd. 13. Payment rates; establishment. (a) The commissioner shall use standard
133.4occupational classification (SOC) codes from the Bureau of Labor Statistics as defined in
133.5the most recent edition of the Occupational Handbook and data from the most recent and
133.6available nursing facility cost report, to establish rates and component rates every January
133.71 using Minnesota-specific wages taken from job descriptions.
133.8(b) In creating the rates and component rates, the commissioner shall establish a base
133.9wage calculation for each component service and value, and add the following factors:
133.10(1) payroll taxes and benefits;
133.11(2) general and administrative;
133.12(3) program plan support;
133.13(4) registered nurse management and supervision; and
133.14(5) social worker supervision.

133.15    Sec. 17. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
133.16to read:
133.17    Subd. 14. Payment rates; base wage index. (a) Base wages are calculated for customized
133.18living, foster care, and residential care component services as follows:
133.19(1) the home management and support services base wage equals 33.33 percent of the
133.20Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home
133.21care aide (SOC code 39-9021); 33.33 percent of the Minneapolis-St. Paul-Bloomington,
133.22MN-WI MetroSA average wage for food preparation workers (SOC code 35-2021); and
133.2333.34 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
133.24for maids and housekeeping cleaners (SOC code 37-2012);
133.25(2) the home care aide base wage equals 50 percent of the Minneapolis-St.
133.26Paul-Bloomington, MN-WI MetroSA average wage for home health aides (SOC code
133.2731-1011); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
133.28average wage for nursing assistants (SOC code 31-1014);
133.29(3) the home health aide base wage equals 20 percent of the Minneapolis-St.
133.30Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
133.31vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St.
134.1Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
134.231-1014); and
134.3(4) the medication setups by licensed practical nurse base wage equals ten percent of
134.4the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
134.5and licensed vocational nurses (SOC code 29-2061); and 90 percent of the Minneapolis-St.
134.6Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code
134.729-1141).
134.8(b) Base wages are calculated for the following services as follows:
134.9(1) the chore services base wage equals 100 percent of the Minneapolis-St.
134.10Paul-Bloomington, MN-WI MetroSA average wage for landscaping and groundskeeping
134.11workers (SOC code 37-3011);
134.12(2) the companion services base wage equals 50 percent of the Minneapolis-St.
134.13Paul-Bloomington, MN-WI MetroSA average wage for personal and home care aides (SOC
134.14code 39-9021); and 50 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
134.15average wage for maids and housekeeping cleaners (SOC code 37-2012);
134.16(3) the homemaker services and assistance with personal care base wage equals 60
134.17percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
134.18personal and home care aide (SOC code 39-9021); 20 percent of the Minneapolis-St.
134.19Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
134.2031-1014); and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
134.21average wage for maids and housekeeping cleaners (SOC code 37-2012);
134.22(4) the homemaker services and cleaning base wage equals 60 percent of the
134.23Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home
134.24care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
134.25MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the
134.26Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
134.27housekeeping cleaners (SOC code 37-2012);
134.28(5) the homemaker services and home management base wage equals 60 percent of the
134.29Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for personal and home
134.30care aide (SOC code 39-9021); 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
134.31MetroSA average wage for nursing assistants (SOC code 31-1014); and 20 percent of the
134.32Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
134.33housekeeping cleaners (SOC code 37-2012);
135.1(6) the in-home respite care services base wage equals five percent of the Minneapolis-St.
135.2Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code
135.329-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
135.4wage for nursing assistants (SOC code 31-1014); and 20 percent of the Minneapolis-St.
135.5Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
135.6vocational nurses (SOC code 29-2061);
135.7(7) the out-of-home respite care services base wage equals five percent of the
135.8Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for registered nurses
135.9(SOC code 29-1141); 75 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
135.10average wage for nursing assistants (SOC code 31-1014); and 20 percent of the
135.11Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
135.12and licensed vocational nurses (SOC code 29-2061); and
135.13(8) the individual community living support base wage equals 20 percent of the
135.14Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
135.15and licensed vocational nurses (SOC code 29-2061); and 80 percent of the Minneapolis-St.
135.16Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
135.1731-1014).
135.18(c) Base wages are calculated for the following values as follows:
135.19(1) the registered nurse base wage equals 100 percent of the Minneapolis-St.
135.20Paul-Bloomington, MN-WI MetroSA average wage for registered nurses (SOC code
135.2129-1141); and
135.22(2) the social worker base wage equals 100 percent of the Minneapolis-St.
135.23Paul-Bloomington, MN-WI MetroSA average wage for medical and public health social
135.24workers (SOC code 21-1022).
135.25(d) If any of the SOC codes and positions are no longer available, the commissioner
135.26shall, in consultation with stakeholders, select a new SOC code and position that is the
135.27closest match to the previously used SOC position.

135.28    Sec. 18. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
135.29to read:
135.30    Subd. 15. Payment rates; factors. The commissioner shall use the following factors:
135.31(1) the payroll taxes and benefits factor is the sum of net payroll taxes and benefits
135.32divided by the sum of all salaries for all nursing facilities on the most recent and available
135.33cost report;
136.1(2) the general and administrative factor is the sum of net general and administrative
136.2expenses minus administrative salaries divided by total operating expenses for all nursing
136.3facilities on the most recent and available cost report;
136.4(3) the program plan support factor is defined as the direct service staff needed to provide
136.5support for the home and community-based service when not engaged in direct contact with
136.6clients. Based on the 2016 Non-Wage Provider Costs in Home and Community-Based
136.7Disability Waiver Services Report, this factor equals 12.8 percent;
136.8(4) the registered nurse management and supervision factor equals 15 percent of the
136.9product of the position's base wage and the sum of the factors in clauses (1) to (3); and
136.10(5) the social worker supervision factor equals 15 percent of the product of the position's
136.11base wage and the sum of the factors in clauses (1) to (3).

136.12    Sec. 19. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
136.13to read:
136.14    Subd. 16. Payment rates; component rates. (a) For the purposes of this subdivision,
136.15the "adjusted base wage" for a position equals the position's base wage plus:
136.16(1) the position's base wage multiplied by the payroll taxes and benefits factor;
136.17(2) the position's base wage multiplied by the general and administrative factor; and
136.18(3) the position's base wage multiplied by the program plan support factor.
136.19(b) For medication setups by licensed nurse, registered nurse, and social worker services,
136.20the component rate for each service equals the respective position's adjusted base wage.
136.21(c) For home management and support services, home care aide, and home health aide
136.22services, the component rate for each service equals the respective position's adjusted base
136.23wage plus the registered nurse management and supervision factor.
136.24(d) The home management and support services component rate shall be used for payment
136.25for socialization and transportation component rates under elderly waiver customized living.
136.26(e) The 15-minute unit rates for chore services and companion services are calculated
136.27as follows:
136.28(1) sum the adjusted base wage for the respective position and the social worker factor;
136.29and
136.30(2) divide the result of clause (1) by four.
137.1(f) The 15-minute unit rates for homemaker services and assistance with personal care,
137.2homemaker services and cleaning, and homemaker services and home management are
137.3calculated as follows:
137.4(1) sum the adjusted base wage for the respective position and the registered nurse
137.5management and supervision factor; and
137.6(2) divide the result of clause (1) by four.
137.7(g) The 15-minute unit rate for in-home respite care services is calculated as follows:
137.8(1) sum the adjusted base wage for in-home respite care services and the registered nurse
137.9management and supervision factor; and
137.10(2) divide the result of clause (1) by four.
137.11(h) The in-home respite care services daily rate equals the in-home respite care services
137.1215-minute unit rate multiplied by 18.
137.13(i) The 15-minute unit rate for out-of-home respite care is calculated as follows:
137.14(1) sum the out-of-home respite care services adjusted base wage and the registered
137.15nurse management and supervision factor; and
137.16(2) divide the result of clause (1) by four.
137.17(j) The out-of-home respite care services daily rate equals the out-of-home respite care
137.18services 15-minute unit rate multiplied by 18.
137.19(k) The individual community living support rate is calculated as follows:
137.20(1) sum the adjusted base wage for the home care aide rate in subdivision 14, paragraph
137.21(a), clause (2), and the social worker factor; and
137.22(2) divide the result of clause (1) by four.
137.23(l) The home delivered meals rate equals $9.30. Beginning July 1, 2018, the commissioner
137.24shall increase the home delivered meals rate every July 1 by the percent increase in the
137.25nursing facility dietary per diem using the two most recent nursing facility cost reports.
137.26(m) The adult day services rate is based on the home care aide rate in subdivision 14,
137.27paragraph (a), clause (2), plus the additional factors from subdivision 15, except that the
137.28general and administrative factor used shall be 20 percent. The nonregistered nurse portion
137.29of the rate shall be multiplied by 0.25, to reflect an assumed-ratio staffing of one caregiver
137.30to four clients, and divided by four to determine the 15-minute unit rate. The registered
138.1nurse portion is divided by four to determine the 15-minute unit rate and $0.63 per 15-minute
138.2unit is added to cover the cost of meals.
138.3(n) The adult day services bath 15-minute unit rate is the same as the calculation of the
138.4adult day services 15-minute unit rate without the adjustment for staffing ratio.
138.5(o) If a bath is authorized for an adult day services client, at least two 15-minute units
138.6must be authorized to allow for adequate time to meet client needs. Adult day services may
138.7be authorized for up to 48 units, or 12 hours, per day based on client and family caregiver
138.8needs.

138.9    Sec. 20. Minnesota Statutes 2016, section 256B.0915, is amended by adding a subdivision
138.10to read:
138.11    Subd. 17. Evaluation of rate methodology. The commissioner, in consultation with
138.12stakeholders, shall conduct a study to evaluate the following:
138.13(1) base wages in subdivision 14, to determine if the standard occupational classification
138.14codes for each rate and component rate are an appropriate representation of staff who deliver
138.15the services; and
138.16(2) factors in subdivision 15, and adjusted base wage calculation in subdivision 16, to
138.17determine if the factors and calculations appropriately address nonwage provider costs.
138.18By January 1, 2019, the commissioner shall submit a report to the legislature on the
138.19changes to the rate methodology in this statute, based on the results of the evaluation. Where
138.20feasible, the report shall address the impact of the new rates on the workforce situation and
138.21client access to services. The report should include any changes to the rate calculations
138.22methods that the commissioner recommends.

138.23    Sec. 21. Minnesota Statutes 2016, section 256B.0922, subdivision 1, is amended to read:
138.24    Subdivision 1. Essential community supports. (a) The purpose of the essential
138.25community supports program is to provide targeted services to persons age 65 and older
138.26who need essential community support, but whose needs do not meet the level of care
138.27required for nursing facility placement under section 144.0724, subdivision 11.
138.28(b) Essential community supports are available not to exceed $400 $600 per person per
138.29month. Essential community supports may be used as authorized within an authorization
138.30period not to exceed 12 months. Services must be available to a person who:
138.31(1) is age 65 or older;
139.1(2) is not eligible for medical assistance;
139.2(3) has received a community assessment under section 256B.0911, subdivision 3a or
139.33b, and does not require the level of care provided in a nursing facility;
139.4(4) meets the financial eligibility criteria for the alternative care program under section
139.5256B.0913, subdivision 4 ;
139.6(5) has a community support plan; and
139.7(6) has been determined by a community assessment under section 256B.0911,
139.8subdivision 3a or 3b, to be a person who would require provision of at least one of the
139.9following services, as defined in the approved elderly waiver plan, in order to maintain their
139.10community residence:
139.11(i) adult day services;
139.12(ii) family caregiver support services;
139.13(iii) respite care;
139.14(iii) (iv) homemaker support;
139.15(v) companion services;
139.16(iv) (vi) chores;
139.17(v) (vii) a personal emergency response device or system;
139.18(vi) (viii) home-delivered meals; or
139.19(vii) (ix) community living assistance as defined by the commissioner.
139.20(c) The person receiving any of the essential community supports in this subdivision
139.21must also receive service coordination, not to exceed $600 in a 12-month authorization
139.22period, as part of their community support plan.
139.23(d) A person who has been determined to be eligible for essential community supports
139.24must be reassessed at least annually and continue to meet the criteria in paragraph (b) to
139.25remain eligible for essential community supports.
139.26(e) The commissioner is authorized to use federal matching funds for essential community
139.27supports as necessary and to meet demand for essential community supports as outlined in
139.28subdivision 2, and that amount of federal funds is appropriated to the commissioner for this
139.29purpose.

140.1    Sec. 22. Minnesota Statutes 2016, section 256B.431, subdivision 10, is amended to read:
140.2    Subd. 10. Property rate adjustments and construction projects. A nursing facility
140.3completing a construction project that is eligible for a rate adjustment under section
140.4256B.434, subdivision 4f , and that was not approved through the moratorium exception
140.5process in section 144A.073 must request from the commissioner a property-related payment
140.6rate adjustment. If the request is made within 60 days after the construction project's
140.7completion date, The effective date of the rate adjustment is the first of the month of January
140.8or July, whichever occurs first following both the construction project's completion date
140.9and submission of the provider's rate adjustment request. If the request is made more than
140.1060 days after the completion date, the rate adjustment is effective on the first of the month
140.11following the request. The commissioner shall provide a rate notice reflecting the allowable
140.12costs within 60 days after receiving all the necessary information to compute the rate
140.13adjustment. No sooner than the effective date of the rate adjustment for the construction
140.14project, a nursing facility may adjust its rates by the amount anticipated to be allowed. Any
140.15amounts collected from private pay residents in excess of the allowable rate must be repaid
140.16to private pay residents with interest at the rate used by the commissioner of revenue for
140.17the late payment of taxes and in effect on the date the rate increase is effective. Construction
140.18projects with completion dates within one year of the completion date associated with the
140.19property rate adjustment request and phased projects with project completion dates within
140.20three years of the last phase of the phased project must be aggregated for purposes of the
140.21minimum thresholds in subdivisions 16 and 17, and the maximum threshold in section
140.22144A.071, subdivision 2 . "Construction project" and "project construction costs" have the
140.23meanings given them in Minnesota Statutes, section 144A.071, subdivision 1a.
140.24EFFECTIVE DATE.This section is effective for projects completed after January 1,
140.252018.

140.26    Sec. 23. Minnesota Statutes 2016, section 256B.431, subdivision 16, is amended to read:
140.27    Subd. 16. Major additions and replacements; equity incentive. For rate years beginning
140.28after June 30, 1993, if a nursing facility acquires capital assets in connection with a project
140.29approved under the moratorium exception process in section 144A.073 or in connection
140.30with an addition to or replacement of buildings, attached fixtures, or land improvements
140.31for which the total historical cost of those capital asset additions exceeds the lesser of
140.32$150,000 or ten percent of the most recent appraised value, the nursing facility shall be
140.33eligible for an equity incentive payment rate as in paragraphs (a) to (d). This computation
141.1is separate from the determination of the nursing facility's rental rate. An equity incentive
141.2payment rate as computed under this subdivision is limited to one in a 12-month period.
141.3(a) An eligible nursing facility shall receive an equity incentive payment rate equal to
141.4the allowable historical cost of the capital asset acquired, minus the allowable debt directly
141.5identified to that capital asset, multiplied by the equity incentive factor as described in
141.6paragraphs (b) and (c), and divided by the nursing facility's occupancy factor under
141.7subdivision 3f, paragraph (c). This amount shall be added to the nursing facility's total
141.8payment rate and shall be effective the same day as the incremental increase in paragraph
141.9(d) or subdivision 17. The allowable historical cost of the capital assets and the allowable
141.10debt shall be determined as provided in Minnesota Rules, parts 9549.0010 to 9549.0080,
141.11and this section.
141.12(b) The equity incentive factor shall be determined under clauses (1) to (4):
141.13(1) divide the initial allowable debt in paragraph (a) by the initial historical cost of the
141.14capital asset additions referred to in paragraph (a), then cube the quotient,
141.15(2) subtract the amount calculated in clause (1) from the number one,
141.16(3) determine the difference between the rental factor and the lesser of two percentage
141.17points above the posted yield for standard conventional fixed rate mortgages of the Federal
141.18Home Loan Mortgage Corporation as published in the Wall Street Journal and in effect on
141.19the first day of the month the debt or cost is incurred, or 16 percent,
141.20(4) multiply the amount calculated in clause (2) by the amount calculated in clause (3).
141.21(c) The equity incentive payment rate shall be limited to the term of the allowable debt
141.22in paragraph (a), not greater than 20 years nor less than ten years. If no debt is incurred in
141.23acquiring the capital asset, the equity incentive payment rate shall be paid for ten years. The
141.24sale of a nursing facility under subdivision 14 shall terminate application of the equity
141.25incentive payment rate effective on the date provided in subdivision 14, paragraph (f), for
141.26the sale.
141.27(d) A nursing facility with an addition to or a renovation of its buildings, attached fixtures,
141.28or land improvements meeting the criteria in this subdivision and not receiving the
141.29property-related payment rate adjustment in subdivision 17, shall receive the incremental
141.30increase in the nursing facility's rental rate as determined under Minnesota Rules, parts
141.319549.0010 to 9549.0080, and this section. The incremental increase shall be added to the
141.32nursing facility's property-related payment rate. The effective date of this incremental
142.1increase shall be the first day of the month of January or July, whichever occurs first
142.2following the month in date on which the addition or replacement is completed.
142.3EFFECTIVE DATE.This section is effective for additions or replacements completed
142.4after January 1, 2018.

142.5    Sec. 24. Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:
142.6    Subd. 30. Bed layaway and delicensure. (a) For rate years beginning on or after July
142.71, 2000, a nursing facility reimbursed under this section which has placed beds on layaway
142.8shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph
142.9(c), and calculation of the rental per diem, have those beds given the same effect as if the
142.10beds had been delicensed so long as the beds remain on layaway. At the time of a layaway,
142.11a facility may change its single bed election for use in calculating capacity days under
142.12Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be
142.13effective the first day of the month of January or July, whichever occurs first following the
142.14month in date on which the layaway of the beds becomes effective under section 144A.071,
142.15subdivision 4b .
142.16(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to
142.17the contrary under section 256B.434, a nursing facility reimbursed under that section which
142.18that has placed beds on layaway shall, for so long as the beds remain on layaway, be allowed
142.19to:
142.20(1) aggregate the applicable investment per bed limits based on the number of beds
142.21licensed immediately prior to entering the alternative payment system;
142.22(2) retain or change the facility's single bed election for use in calculating capacity days
142.23under Minnesota Rules, part 9549.0060, subpart 11; and
142.24(3) establish capacity days based on the number of beds immediately prior to the layaway
142.25and the number of beds after the layaway.
142.26    The commissioner shall increase the facility's property payment rate by the incremental
142.27increase in the rental per diem resulting from the recalculation of the facility's rental per
142.28diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and
142.29(3). If a facility reimbursed under section 256B.434 completes a moratorium exception
142.30project after its base year, the base year property rate shall be the moratorium project property
142.31rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
142.32paragraph (c). The property payment rate increase shall be effective the first day of the
143.1month of January or July, whichever occurs first following the month in date on which the
143.2layaway of the beds becomes effective.
143.3(c) If a nursing facility removes a bed from layaway status in accordance with section
143.4144A.071, subdivision 4b , the commissioner shall establish capacity days based on the
143.5number of licensed and certified beds in the facility not on layaway and shall reduce the
143.6nursing facility's property payment rate in accordance with paragraph (b).
143.7(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision
143.8to the contrary under section 256B.434, a nursing facility reimbursed under that section,
143.9which that has delicensed beds after July 1, 2000, by giving notice of the delicensure to the
143.10commissioner of health according to the notice requirements in section 144A.071, subdivision
143.114b , shall be allowed to:
143.12(1) aggregate the applicable investment per bed limits based on the number of beds
143.13licensed immediately prior to entering the alternative payment system;
143.14(2) retain or change the facility's single bed election for use in calculating capacity days
143.15under Minnesota Rules, part 9549.0060, subpart 11; and
143.16(3) establish capacity days based on the number of beds immediately prior to the
143.17delicensure and the number of beds after the delicensure.
143.18    The commissioner shall increase the facility's property payment rate by the incremental
143.19increase in the rental per diem resulting from the recalculation of the facility's rental per
143.20diem applying only the changes resulting from the delicensure of beds and clauses (1), (2),
143.21and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception
143.22project after its base year, the base year property rate shall be the moratorium project property
143.23rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
143.24paragraph (c). The property payment rate increase shall be effective the first day of the
143.25month of January or July, whichever occurs first following the month in date on which the
143.26delicensure of the beds becomes effective.
143.27(e) For nursing facilities reimbursed under this section or section 256B.434, any beds
143.28placed on layaway shall not be included in calculating facility occupancy as it pertains to
143.29leave days defined in Minnesota Rules, part 9505.0415.
143.30(f) For nursing facilities reimbursed under this section or section 256B.434, the rental
143.31rate calculated after placing beds on layaway may not be less than the rental rate prior to
143.32placing beds on layaway.
144.1(g) A nursing facility receiving a rate adjustment as a result of this section shall comply
144.2with section 256B.47, subdivision 2 256R.06, subdivision 5.
144.3(h) A facility that does not utilize the space made available as a result of bed layaway
144.4or delicensure under this subdivision to reduce the number of beds per room or provide
144.5more common space for nursing facility uses or perform other activities related to the
144.6operation of the nursing facility shall have its property rate increase calculated under this
144.7subdivision reduced by the ratio of the square footage made available that is not used for
144.8these purposes to the total square footage made available as a result of bed layaway or
144.9delicensure.
144.10EFFECTIVE DATE.This section is effective for layaways occurring after July 1, 2017.

144.11    Sec. 25. Minnesota Statutes 2016, section 256B.434, subdivision 4, is amended to read:
144.12    Subd. 4. Alternate rates for nursing facilities. Effective for the rate years beginning
144.13on and after January 1, 2019, a nursing facility's case mix property payment rates rate for
144.14the second and subsequent years of a facility's contract under this section are the previous
144.15rate year's contract property payment rates rate plus an inflation adjustment and, for facilities
144.16reimbursed under this section or section 256B.431, an adjustment to include the cost of any
144.17increase in Health Department licensing fees for the facility taking effect on or after July
144.181, 2001. The index for the inflation adjustment must be based on the change in the Consumer
144.19Price Index-All Items (United States City average) (CPI-U) forecasted by the commissioner
144.20of management and budget's national economic consultant Reports and Forecasts Division
144.21of the Department of Human Services, as forecasted in the fourth quarter of the calendar
144.22year preceding the rate year. The inflation adjustment must be based on the 12-month period
144.23from the midpoint of the previous rate year to the midpoint of the rate year for which the
144.24rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1,
144.252001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1, 2007, July
144.261, 2008, October 1, 2009, and October 1, 2010, this paragraph shall apply only to the
144.27property-related payment rate. For the rate years beginning on October 1, 2011, October 1,
144.282012, October 1, 2013, October 1, 2014, October 1, 2015, January 1, 2016, and January 1,
144.292017, the rate adjustment under this paragraph shall be suspended. Beginning in 2005,
144.30adjustment to the property payment rate under this section and section 256B.431 shall be
144.31effective on October 1. In determining the amount of the property-related payment rate
144.32adjustment under this paragraph, the commissioner shall determine the proportion of the
144.33facility's rates that are property-related based on the facility's most recent cost report.
144.34EFFECTIVE DATE.This section is effective the day following final enactment.

145.1    Sec. 26. Minnesota Statutes 2016, section 256B.434, subdivision 4f, is amended to read:
145.2    Subd. 4f. Construction project rate adjustments effective October 1, 2006. (a)
145.3Effective October 1, 2006, facilities reimbursed under this section may receive a property
145.4rate adjustment for construction projects exceeding the threshold in section 256B.431,
145.5subdivision 16, and below the threshold in section 144A.071, subdivision 2, clause (a). For
145.6these projects, capital assets purchased shall be counted as construction project costs for a
145.7rate adjustment request made by a facility if they are: (1) purchased within 24 months of
145.8the completion of the construction project; (2) purchased after the completion date of any
145.9prior construction project; and (3) are not purchased prior to July 14, 2005. Except as
145.10otherwise provided in this subdivision, the definitions, rate calculation methods, and
145.11principles in sections 144A.071 and 256B.431 and Minnesota Rules, parts 9549.0010 to
145.129549.0080, shall be used to calculate rate adjustments for allowable construction projects
145.13under this subdivision and section 144A.073. Facilities completing construction projects
145.14between October 1, 2005, and October 1, 2006, are eligible to have a property rate adjustment
145.15effective October 1, 2006. Facilities completing projects after October 1, 2006, are eligible
145.16for a property rate adjustment effective on the first day of the month following the completion
145.17date. Facilities completing projects after January 1, 2018, are eligible for a property rate
145.18adjustment effective on the first day of the month of January or July, whichever occurs
145.19immediately following the completion date.
145.20(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under
145.21section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a
145.22construction project on or after October 1, 2004, and do not have a contract under subdivision
145.233 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431,
145.24subdivision 10, through September 30, 2006. If the request results in the commissioner
145.25determining a rate adjustment is allowable, the rate adjustment is effective on the first of
145.26the month following project completion. These facilities shall be allowed to accumulate
145.27construction project costs for the period October 1, 2004, to September 30, 2006.
145.28(c) Facilities shall be allowed construction project rate adjustments no sooner than 12
145.29months after completing a previous construction project. Facilities must request the rate
145.30adjustment according to section 256B.431, subdivision 10.
145.31(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060,
145.32subpart 11. For rate calculations under this section, the number of licensed beds in the
145.33nursing facility shall be the number existing after the construction project is completed and
145.34the number of days in the nursing facility's reporting period shall be 365.
146.1(e) The value of assets to be recognized for a total replacement project as defined in
146.2section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value
146.3of assets to be recognized for all other projects shall be computed as described in clause
146.4(2).
146.5(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
146.6number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the
146.7maximum amount of assets allowable in a facility's property rate calculation. If a facility's
146.8current request for a rate adjustment results from the completion of a construction project
146.9that was previously approved under section 144A.073, the assets to be used in the rate
146.10calculation cannot exceed the lesser of the amount determined under sections 144A.071,
146.11subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction
146.12project. A current request that is not the result of a project under section 144A.073 cannot
146.13exceed the limit under section 144A.071, subdivision 2, paragraph (a). Applicable credits
146.14must be deducted from the cost of the construction project.
146.15(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
146.16number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be
146.17used to compute the maximum amount of assets allowable in a facility's property rate
146.18calculation.
146.19(ii) The value of a facility's assets to be compared to the amount in item (i) begins with
146.20the total appraised value from the last rate notice a facility received when its rates were set
146.21under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value
146.22shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each
146.23rate year the facility received an inflation factor on its property-related rate when its rates
146.24were set under this section. The value of assets listed as previous capital additions, capital
146.25additions, and special projects on the facility's base year rate notice and the value of assets
146.26related to a construction project for which the facility received a rate adjustment when its
146.27rates were determined under this section shall be added to the indexed appraised value.
146.28(iii) The maximum amount of assets to be recognized in computing a facility's rate
146.29adjustment after a project is completed is the lesser of the aggregate replacement-cost-new
146.30limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the
146.31construction project.
146.32(iv) If a facility's current request for a rate adjustment results from the completion of a
146.33construction project that was previously approved under section 144A.073, the assets to be
146.34added to the rate calculation cannot exceed the lesser of the amount determined under
147.1sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable
147.2costs of the construction project. A current request that is not the result of a project under
147.3section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2,
147.4paragraph (a). Assets disposed of as a result of a construction project and applicable credits
147.5must be deducted from the cost of the construction project.
147.6(f) For construction projects approved under section 144A.073, allowable debt may
147.7never exceed the lesser of the cost of the assets purchased, the threshold limit in section
147.8144A.071 , subdivision 2, or the replacement-cost-new limit less previously existing capital
147.9debt.
147.10(g) For construction projects that were not approved under section 144A.073, allowable
147.11debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such
147.12construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously
147.13existing capital debt. Amounts of debt taken out that exceed the costs of a construction
147.14project shall not be allowed regardless of the use of the funds.
147.15For all construction projects being recognized, interest expense and average debt shall
147.16be computed based on the first 12 months following project completion. "Previously existing
147.17capital debt" means capital debt recognized on the last rate determined under section
147.18256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt
147.19recognized for a construction project for which the facility received a rate adjustment when
147.20its rates were determined under this section.
147.21For a total replacement project as defined in section 256B.431, subdivision 17d, the
147.22value of previously existing capital debt shall be zero.
147.23(h) In addition to the interest expense allowed from the application of paragraph (f), the
147.24amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and
147.25(3), will be added to interest expense.
147.26(i) The equity portion of the construction project shall be computed as the allowable
147.27assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be
147.28multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added.
147.29This sum must be divided by 95 percent of capacity days to compute the construction project
147.30rate adjustment.
147.31(j) For projects that are not a total replacement of a nursing facility, the amount in
147.32paragraph (i) is adjusted for nonreimbursable areas and then added to the current property
147.33payment rate of the facility.
148.1(k) For projects that are a total replacement of a nursing facility, the amount in paragraph
148.2(i) becomes the new property payment rate after being adjusted for nonreimbursable areas.
148.3Any amounts existing in a facility's rate before the effective date of the construction project
148.4for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements
148.5under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431,
148.6subdivision 19, shall be removed from the facility's rates.
148.7(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060,
148.8subpart 10, as the result of construction projects under this section. Allowable equipment
148.9shall be included in the construction project costs.
148.10(m) Capital assets purchased after the completion date of a construction project shall be
148.11counted as construction project costs for any future rate adjustment request made by a facility
148.12under section 144A.071, subdivision 2, clause (a), if they are purchased within 24 months
148.13of the completion of the future construction project.
148.14(n) In subsequent rate years, the property payment rate for a facility that results from
148.15the application of this subdivision shall be the amount inflated in subdivision 4.
148.16(o) Construction projects are eligible for an equity incentive under section 256B.431,
148.17subdivision 16. When computing the equity incentive for a construction project under this
148.18subdivision, only the allowable costs and allowable debt related to the construction project
148.19shall be used. The equity incentive shall not be a part of the property payment rate and not
148.20inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing
148.21facilities reimbursed under this section shall be allowed for a duration determined under
148.22section 256B.431, subdivision 16, paragraph (c).
148.23EFFECTIVE DATE.This section is effective January 1, 2018.

148.24    Sec. 27. Minnesota Statutes 2016, section 256B.50, subdivision 1b, is amended to read:
148.25    Subd. 1b. Filing an appeal. To appeal, the provider shall file with the commissioner a
148.26written notice of appeal; the appeal must be postmarked or received by the commissioner
148.27within 60 days of the publication date the determination of the payment rate was mailed or
148.28personally received by a provider, whichever is earlier printed on the rate notice. The notice
148.29of appeal must specify each disputed item; the reason for the dispute; the total dollar amount
148.30in dispute for each separate disallowance, allocation, or adjustment of each cost item or part
148.31of a cost item; the computation that the provider believes is correct; the authority in statute
148.32or rule upon which the provider relies for each disputed item; the name and address of the
149.1person or firm with whom contacts may be made regarding the appeal; and other information
149.2required by the commissioner.
149.3EFFECTIVE DATE.This section is effective the day following final enactment.

149.4    Sec. 28. Minnesota Statutes 2016, section 256B.5012, is amended by adding a subdivision
149.5to read:
149.6    Subd. 3a. Therapeutic leave days. Notwithstanding Minnesota Rules, part 9505.0415,
149.7subpart 7, a vacant bed in an intermediate care facility for persons with developmental
149.8disabilities shall be counted as a reserved bed when determining occupancy rates and
149.9eligibility for payment of a therapeutic leave day.

149.10    Sec. 29. Minnesota Statutes 2016, section 256B.5012, is amended by adding a subdivision
149.11to read:
149.12    Subd. 17. ICF/DD rate increase effective July 1, 2017; Murray County. Effective
149.13July 1, 2017, the daily rate for an intermediate care facility for persons with developmental
149.14disabilities located in Murray County that is classified as a class B facility and licensed for
149.1514 beds is $400. This increase is in addition to any other increase that is effective on July
149.161, 2017.

149.17    Sec. 30. Minnesota Statutes 2016, section 256R.02, subdivision 4, is amended to read:
149.18    Subd. 4. Administrative costs. "Administrative costs" means the identifiable costs for
149.19administering the overall activities of the nursing home. These costs include salaries and
149.20wages of the administrator, assistant administrator, business office employees, security
149.21guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases related
149.22to business office functions, licenses, and permits except as provided in the external fixed
149.23costs category, employee recognition, travel including meals and lodging, all training except
149.24as specified in subdivision 17, voice and data communication or transmission, office supplies,
149.25property and liability insurance and other forms of insurance not designated to other areas
149.26except insurance that is a fringe benefit under subdivision 22, personnel recruitment, legal
149.27services, accounting services, management or business consultants, data processing,
149.28information technology, Web site, central or home office costs, business meetings and
149.29seminars, postage, fees for professional organizations, subscriptions, security services,
149.30advertising, board of directors fees, working capital interest expense, and bad debts, and
149.31bad debt collection fees, and costs incurred for travel and housing for persons employed by
149.32a supplemental nursing services agency as defined in section 144A.70, subdivision 6.
150.1EFFECTIVE DATE.This section is effective October 1, 2017.

150.2    Sec. 31. Minnesota Statutes 2016, section 256R.02, subdivision 17, is amended to read:
150.3    Subd. 17. Direct care costs. "Direct care costs" means costs for the wages of nursing
150.4administration, direct care registered nurses, licensed practical nurses, certified nursing
150.5assistants, trained medication aides, employees conducting training in resident care topics
150.6and associated fringe benefits and payroll taxes; services from a supplemental nursing
150.7services agency; supplies that are stocked at nursing stations or on the floor and distributed
150.8or used individually, including, but not limited to: alcohol, applicators, cotton balls,
150.9incontinence pads, disposable ice bags, dressings, bandages, water pitchers, tongue
150.10depressors, disposable gloves, enemas, enema equipment, soap, medication cups, diapers,
150.11plastic waste bags, sanitary products, thermometers, hypodermic needles and syringes,
150.12clinical reagents or similar diagnostic agents, drugs that are not paid on a separate fee
150.13schedule by the medical assistance program or any other payer, and technology related to
150.14the provision of nursing care to residents, such as electronic charting systems; costs of
150.15materials used for resident care training, and training courses outside of the facility attended
150.16by direct care staff on resident care topics; and costs for nurse consultants, pharmacy
150.17consultants, and medical directors. Salaries and payroll taxes for nurse consultants who
150.18work out of a central office must be allocated proportionately by total resident days or by
150.19direct identification to the nursing facilities served by those consultants.

150.20    Sec. 32. Minnesota Statutes 2016, section 256R.02, subdivision 18, is amended to read:
150.21    Subd. 18. Employer health insurance costs. "Employer health insurance costs" means
150.22premium expenses for group coverage and reinsurance,; actual expenses incurred for
150.23self-insured plans, including reinsurance; and employer contributions to employee health
150.24reimbursement and health savings accounts. Premium and expense costs and contributions
150.25are allowable for (1) all employees and (2) the spouse and dependents of those employees
150.26who meet the definition of full-time employees under the federal Affordable Care Act,
150.27Public Law 111-148 are employed on average at least 30 hours per week.
150.28EFFECTIVE DATE.This section is effective the day following final enactment.

150.29    Sec. 33. Minnesota Statutes 2016, section 256R.02, subdivision 19, is amended to read:
150.30    Subd. 19. External fixed costs. "External fixed costs" means costs related to the nursing
150.31home surcharge under section 256.9657, subdivision 1; licensure fees under section 144.122;
150.32family advisory council fee under section 144A.33; scholarships under section 256R.37;
151.1planned closure rate adjustments under section 256R.40; consolidation rate adjustments
151.2under section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d;
151.3single-bed room incentives under section 256R.41; property taxes, assessments, and payments
151.4in lieu of taxes; employer health insurance costs; quality improvement incentive payment
151.5rate adjustments under section 256R.39; performance-based incentive payments under
151.6section 256R.38; special dietary needs under section 256R.51; rate adjustments for
151.7compensation-related costs for minimum wage changes under section 256R.49 provided
151.8on or after January 1, 2018; and Public Employees Retirement Association employer costs.

151.9    Sec. 34. Minnesota Statutes 2016, section 256R.02, subdivision 22, is amended to read:
151.10    Subd. 22. Fringe benefit costs. "Fringe benefit costs" means the costs for group life,
151.11dental, workers' compensation, and other employee insurances and short- and long-term
151.12disability, long-term care insurance, accident insurance, supplemental insurance, legal
151.13assistance insurance, profit sharing, health insurance costs not covered under subdivision
151.1418, including costs associated with part-time employee family members or retirees, and
151.15pension and retirement plan contributions, except for the Public Employees Retirement
151.16Association and employer health insurance costs; profit sharing; and retirement plans for
151.17which the employer pays all or a portion of the costs.

151.18    Sec. 35. Minnesota Statutes 2016, section 256R.02, subdivision 42, is amended to read:
151.19    Subd. 42. Raw food costs. "Raw food costs" means the cost of food provided to nursing
151.20facility residents and the allocation of dietary credits. Also included are special dietary
151.21supplements used for tube feeding or oral feeding, such as elemental high nitrogen diet.

151.22    Sec. 36. Minnesota Statutes 2016, section 256R.02, is amended by adding a subdivision
151.23to read:
151.24    Subd. 42a. Real estate taxes. "Real estate taxes" means the real estate tax liability shown
151.25on the annual property tax statement of the nursing facility for the reporting period. The
151.26term does not include personnel costs or fees for late payment.

151.27    Sec. 37. Minnesota Statutes 2016, section 256R.02, is amended by adding a subdivision
151.28to read:
151.29    Subd. 48a. Special assessments. "Special assessments" means the actual special
151.30assessments and related interest paid during the reporting period. The term does not include
151.31personnel costs or fees for late payment.

152.1    Sec. 38. Minnesota Statutes 2016, section 256R.02, subdivision 52, is amended to read:
152.2    Subd. 52. Therapy costs. "Therapy costs" means any costs related to medical assistance
152.3therapy services provided to residents that are not billed separately billable from the daily
152.4operating rate.

152.5    Sec. 39. Minnesota Statutes 2016, section 256R.06, subdivision 5, is amended to read:
152.6    Subd. 5. Notice to residents. (a) No increase in nursing facility rates for private paying
152.7residents shall be effective unless the nursing facility notifies the resident or person
152.8responsible for payment of the increase in writing 30 days before the increase takes effect.
152.9The notice must include the amount of the rate increase, the new payment rate, and the date
152.10the rate increase takes effect.
152.11A nursing facility may adjust its rates without giving the notice required by this
152.12subdivision when the purpose of the rate adjustment is to reflect a change in the case mix
152.13classification of the resident. The nursing facility shall notify private pay residents of any
152.14rate increase related to a change in case mix classifications in a timely manner after
152.15confirmation of the case mix classification change is received from the Department of
152.16Health.
152.17If the state fails to set rates as required by section 256R.09, subdivision 1, the time
152.18required for giving notice is decreased by the number of days by which the state was late
152.19in setting the rates.
152.20(b) If the state does not set rates by the date required in section 256R.09, subdivision 1,
152.21or otherwise provides nursing facilities with retroactive notification of the amount of a rate
152.22increase, nursing facilities shall meet the requirement for advance notice by informing the
152.23resident or person responsible for payments, on or before the effective date of the increase,
152.24that a rate increase will be effective on that date. The requirements of paragraph (a) do not
152.25apply to situations described in this paragraph.
152.26If the exact amount has not yet been determined, the nursing facility may raise the rates
152.27by the amount anticipated to be allowed. Any amounts collected from private pay residents
152.28in excess of the allowable rate must be repaid to private pay residents with interest at the
152.29rate used by the commissioner of revenue for the late payment of taxes and in effect on the
152.30date the rate increase is effective.

153.1    Sec. 40. Minnesota Statutes 2016, section 256R.07, is amended by adding a subdivision
153.2to read:
153.3    Subd. 6. Electronic signature. For documentation requiring a signature under this
153.4chapter or section 256B.431 or 256B.434, use of an electronic signature as defined under
153.5section 325L.02, paragraph (h), is allowed.

153.6    Sec. 41. Minnesota Statutes 2016, section 256R.10, is amended by adding a subdivision
153.7to read:
153.8    Subd. 7. Not specified allowed costs. When the cost category for allowed cost items or
153.9services is not specified in this chapter or the provider reimbursement manual, the
153.10commissioner, in consultation with stakeholders, shall determine the cost category for the
153.11allowed cost item or service.
153.12EFFECTIVE DATE.This section is effective the day following final enactment.

153.13    Sec. 42. [256R.18] REPORT BY COMMISSIONER OF HUMAN SERVICES.
153.14Beginning January 1, 2019, the commissioner shall provide to the house of representatives
153.15and senate committees with jurisdiction over nursing facility payment rates a biennial report
153.16on the effectiveness of the reimbursement system in improving quality, restraining costs,
153.17and any other features of the system as determined by the commissioner.
153.18EFFECTIVE DATE.This section is effective the day following final enactment.

153.19    Sec. 43. Minnesota Statutes 2016, section 256R.37, is amended to read:
153.20256R.37 SCHOLARSHIPS.
153.21(a) For the 27-month period beginning October 1, 2015, through December 31, 2017,
153.22the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing
153.23facility with no scholarship per diem that is requesting a scholarship per diem to be added
153.24to the external fixed payment rate to be used:
153.25(1) for employee scholarships that satisfy the following requirements:
153.26(i) scholarships are available to all employees who work an average of at least ten hours
153.27per week at the facility except the administrator, and to reimburse student loan expenses
153.28for newly hired and recently graduated registered nurses and licensed practical nurses, and
153.29training expenses for nursing assistants as specified in section 144A.611, subdivisions 2
153.30and 4, who are newly hired and have graduated within the last 12 months; and
154.1(ii) the course of study is expected to lead to career advancement with the facility or in
154.2long-term care, including medical care interpreter services and social work; and
154.3(2) to provide job-related training in English as a second language.
154.4(b) All facilities may annually request a rate adjustment under this section by submitting
154.5information to the commissioner on a schedule and in a form supplied by the commissioner.
154.6The commissioner shall allow a scholarship payment rate equal to the reported and allowable
154.7costs divided by resident days.
154.8(c) In calculating the per diem under paragraph (b), the commissioner shall allow costs
154.9related to tuition, direct educational expenses, and reasonable costs as defined by the
154.10commissioner for child care costs and transportation expenses related to direct educational
154.11expenses.
154.12(d) The rate increase under this section is an optional rate add-on that the facility must
154.13request from the commissioner in a manner prescribed by the commissioner. The rate
154.14increase must be used for scholarships as specified in this section.
154.15(e) For instances in which a rate adjustment will be 15 cents or greater, nursing facilities
154.16that close beds during a rate year may request to have their scholarship adjustment under
154.17paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect
154.18the reduction in resident days compared to the cost report year.

154.19    Sec. 44. Minnesota Statutes 2016, section 256R.40, subdivision 1, is amended to read:
154.20    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
154.21(b) "Closure" means the cessation of operations of a nursing facility and delicensure and
154.22decertification of all beds within the facility.
154.23(c) "Closure plan" means a plan to close a nursing facility and reallocate a portion of
154.24the resulting savings to provide planned closure rate adjustments at other facilities.
154.25(d) "Commencement of closure" means the date on which residents and designated
154.26representatives are notified of a planned closure as provided in section 144A.161, subdivision
154.275a, as part of an approved closure plan.
154.28(e) "Completion of closure" means the date on which the final resident of the nursing
154.29facility designated for closure in an approved closure plan is discharged from the facility
154.30or the date that beds from a partial closure are delicensed and decertified.
154.31(f) "Partial closure" means the delicensure and decertification of a portion of the beds
154.32within the facility.
155.1(g) "Planned closure rate adjustment" means an increase in a nursing facility's operating
155.2rates resulting from a planned closure or a planned partial closure of another facility.

155.3    Sec. 45. Minnesota Statutes 2016, section 256R.40, subdivision 5, is amended to read:
155.4    Subd. 5. Planned closure rate adjustment. (a) The commissioner shall calculate the
155.5amount of the planned closure rate adjustment available under subdivision 6 according to
155.6clauses (1) to (4):
155.7(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;
155.8(2) the total number of beds in the nursing facility or facilities receiving the planned
155.9closure rate adjustment must be identified;
155.10(3) capacity days are determined by multiplying the number determined under clause
155.11(2) by 365; and
155.12(4) the planned closure rate adjustment is the amount available in clause (1), divided by
155.13capacity days determined under clause (3).
155.14(b) A planned closure rate adjustment under this section is effective on the first day of
155.15the month of January or July, whichever occurs immediately following completion of closure
155.16of the facility designated for closure in the application and becomes part of the nursing
155.17facility's external fixed payment rate.
155.18(c) Upon the request of a closing facility, the commissioner must allow the facility a
155.19closure rate adjustment as provided under section 144A.161, subdivision 10.
155.20(d) A facility that has received a planned closure rate adjustment may reassign it to
155.21another facility that is under the same ownership at any time within three years of its effective
155.22date. The amount of the adjustment is computed according to paragraph (a).
155.23(e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the
155.24commissioner shall recalculate planned closure rate adjustments for facilities that delicense
155.25beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar
155.26amount. The recalculated planned closure rate adjustment is effective from the date the per
155.27bed dollar amount is increased.
155.28EFFECTIVE DATE.This section is effective for closures occurring after July 1, 2017.

155.29    Sec. 46. Minnesota Statutes 2016, section 256R.41, is amended to read:
155.30256R.41 SINGLE-BED ROOM INCENTIVE.
156.1(a) Beginning July 1, 2005, the operating payment rate for nursing facilities reimbursed
156.2under this chapter shall be increased by 20 percent multiplied by the ratio of the number of
156.3new single-bed rooms created divided by the number of active beds on July 1, 2005, for
156.4each bed closure that results in the creation of a single-bed room after July 1, 2005. The
156.5commissioner may implement rate adjustments for up to 3,000 new single-bed rooms each
156.6year. For eligible bed closures for which the commissioner receives a notice from a facility
156.7during a calendar quarter that a bed has been delicensed and a new single-bed room has
156.8been established, the rate adjustment in this paragraph shall be effective on either the first
156.9day of the second month of January or July, whichever occurs first following that calendar
156.10quarter the date of the bed delicensure.
156.11(b) A nursing facility is prohibited from discharging residents for purposes of establishing
156.12single-bed rooms. A nursing facility must submit documentation to the commissioner in a
156.13form prescribed by the commissioner, certifying the occupancy status of beds closed to
156.14create single-bed rooms. In the event that the commissioner determines that a facility has
156.15discharged a resident for purposes of establishing a single-bed room, the commissioner shall
156.16not provide a rate adjustment under paragraph (a).
156.17EFFECTIVE DATE.This section is effective for closures occurring after July 1, 2017.

156.18    Sec. 47. Minnesota Statutes 2016, section 256R.47, is amended to read:
156.19256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING
156.20FACILITIES.
156.21(a) The commissioner, in consultation with the commissioner of health, may designate
156.22certain nursing facilities as critical access nursing facilities. The designation shall be granted
156.23on a competitive basis, within the limits of funds appropriated for this purpose.
156.24(b) The commissioner shall request proposals from nursing facilities every two years.
156.25Proposals must be submitted in the form and according to the timelines established by the
156.26commissioner. In selecting applicants to designate, the commissioner, in consultation with
156.27the commissioner of health, and with input from stakeholders, shall develop criteria designed
156.28to preserve access to nursing facility services in isolated areas, rebalance long-term care,
156.29and improve quality. To the extent practicable, the commissioner shall ensure an even
156.30distribution of designations across the state.
156.31(c) The commissioner shall allow the benefits in clauses (1) to (5) for nursing facilities
156.32designated as critical access nursing facilities:
157.1(1) partial rebasing, with the commissioner allowing a designated facility operating
157.2payment rates being the sum of up to 60 percent of the operating payment rate determined
157.3in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of
157.4the two portions being equal to 100 percent, of the operating payment rate that would have
157.5been allowed had the facility not been designated. The commissioner may adjust these
157.6percentages by up to 20 percent and may approve a request for less than the amount allowed;
157.7(2) enhanced payments for leave days. Notwithstanding section 256R.43, upon
157.8designation as a critical access nursing facility, the commissioner shall limit payment for
157.9leave days to 60 percent of that nursing facility's total payment rate for the involved resident,
157.10and shall allow this payment only when the occupancy of the nursing facility, inclusive of
157.11bed hold days, is equal to or greater than 90 percent;
157.12(3) two designated critical access nursing facilities, with up to 100 beds in active service,
157.13may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part
157.144658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner
157.15of health shall consider each waiver request independently based on the criteria under
157.16Minnesota Rules, part 4658.0040;
157.17(4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall
157.18be 40 percent of the amount that would otherwise apply; and
157.19(5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to
157.20designated critical access nursing facilities.
157.21(d) Designation of a critical access nursing facility is for a period of two years, after
157.22which the benefits allowed under paragraph (c) shall be removed. Designated facilities may
157.23apply for continued designation.
157.24(e) This section is suspended and no state or federal funding shall be appropriated or
157.25allocated for the purposes of this section from January 1, 2016, to December 31, 2017 2019.
157.26EFFECTIVE DATE.This section is effective the day following final enactment.

157.27    Sec. 48. Minnesota Statutes 2016, section 256R.49, subdivision 1, is amended to read:
157.28    Subdivision 1. Rate adjustments for compensation-related costs. (a) Operating payment
157.29rates of all nursing facilities that are reimbursed under this chapter shall be increased effective
157.30for rate years beginning on and after October 1, 2014, to address changes in compensation
157.31costs for nursing facility employees paid less than $14 per hour in accordance with this
157.32section. Rate increases provided under this section before October 1, 2016, expire effective
158.1January 1, 2018, and rate increases provided on or after October 1, 2016, expire effective
158.2January 1, 2019.
158.3(b) Nursing facilities that receive approval of the applications in subdivision 2 must
158.4receive rate adjustments according to subdivision 4. The rate adjustments must be used to
158.5pay compensation costs for nursing facility employees paid less than $14 per hour.
158.6EFFECTIVE DATE.This section is effective the day following final enactment.

158.7    Sec. 49. Minnesota Statutes 2016, section 256R.53, subdivision 2, is amended to read:
158.8    Subd. 2. Nursing facility facilities in Breckenridge border cities. The operating
158.9payment rate of a nonprofit nursing facility that exists on January 1, 2015, is located within
158.10the boundaries of the city cities of Breckenridge or Moorhead, and is reimbursed under this
158.11chapter, is equal to the greater of:
158.12(1) the operating payment rate determined under section 256R.21, subdivision 3; or
158.13(2) the median case mix adjusted rates, including comparable rate components as
158.14determined by the median case mix adjusted rates, including comparable rate components
158.15as determined by the commissioner, for the equivalent case mix indices of the nonprofit
158.16nursing facility or facilities located in an adjacent city in another state and in cities contiguous
158.17to the adjacent city. The commissioner shall make the comparison required in this subdivision
158.18on November 1 of each year and shall apply it to the rates to be effective on the following
158.19January 1. The Minnesota facility's operating payment rate with a case mix index of 1.0 is
158.20computed by dividing the adjacent city's nursing facility or facilities' median operating
158.21payment rate with an index of 1.02 by 1.02. If the adjustments under this subdivision result
158.22in a rate that exceeds the limits in section 256R.23, subdivision 5, and whose costs exceed
158.23the rate in section 256R.24, subdivision 3, in a given rate year, the facility's rate shall not
158.24be subject to the limits in section 256R.23, subdivision 5, and shall not be limited to the
158.25rate established in section 256R.24, subdivision 3, for that rate year.
158.26EFFECTIVE DATE.The rate increases for a facility located in Moorhead are effective
158.27for the rate year beginning January 1, 2020, and annually thereafter.

158.28    Sec. 50. DIRECTION TO COMMISSIONER; ADULT DAY SERVICES STAFFING
158.29RATIOS.
158.30The commissioner of human services shall study the staffing ratio for adult day services
158.31clients and shall provide the chairs and ranking minority members of the house of
159.1representatives and senate committees with jurisdiction over adult day services with
159.2recommendations to adjust staffing ratios based on client needs by January 1, 2018.

159.3    Sec. 51. ALZHEIMER'S DISEASE WORKING GROUP.
159.4    Subdivision 1. Members. (a) The Minnesota Board on Aging must appoint 16 members
159.5to an Alzheimer's disease working group, as follows:
159.6(1) a caregiver of a person who has been diagnosed with Alzheimer's disease;
159.7(2) a person who has been diagnosed with Alzheimer's disease;
159.8(3) two representatives from the nursing facility or senior housing profession;
159.9(4) a representative of the home care or adult day services profession;
159.10(5) two geriatricians, one of whom serves a diverse or underserved community;
159.11(6) a psychologist who specializes in dementia care;
159.12(7) an Alzheimer's researcher;
159.13(8) a representative of the Alzheimer's Association;
159.14(9) two members from community-based organizations serving one or more diverse or
159.15underserved communities;
159.16(10) the commissioner of human services or a designee;
159.17(11) the commissioner of health or a designee;
159.18(12) the ombudsman for long-term care or a designee; and
159.19(13) one member of the Minnesota Board on Aging, selected by the board.
159.20(b) The executive director of the Minnesota Board on Aging serves on the working group
159.21as a nonvoting member.
159.22(c) The appointing authorities under this subdivision must complete their appointments
159.23no later than December 15, 2017.
159.24(d) To the extent practicable, the membership of the working group must reflect the
159.25diversity in Minnesota, and must include representatives from rural and metropolitan areas
159.26and representatives of different ethnicities, races, genders, ages, cultural groups, and abilities.
159.27    Subd. 2. Duties; recommendations. The Alzheimer's disease working group must
159.28review and revise the 2011 report, Preparing Minnesota for Alzheimer's: the Budgetary,
160.1Social and Personal Impacts. The working group shall consider and make recommendations
160.2and findings on the following issues as related to Alzheimer's disease or other dementias:
160.3(1) analysis and assessment of public health and health care data to accurately determine
160.4trends and disparities in cognitive decline;
160.5(2) public awareness, knowledge, and attitudes, including knowledge gaps, stigma,
160.6availability of information, and supportive community environments;
160.7(3) risk reduction, including health education and health promotion on risk factors,
160.8safety, and potentially avoidable hospitalizations;
160.9(4) diagnosis and treatment, including early detection, access to diagnosis, quality of
160.10dementia care, and cost of treatment;
160.11(5) professional education and training, including geriatric education for licensed health
160.12care professionals and dementia-specific training for direct care workers, first responders,
160.13and other professionals in communities;
160.14(6) residential services, including cost to families as well as regulation and licensing
160.15gaps; and
160.16(7) cultural competence and responsiveness to reduce health disparities and improve
160.17access to high-quality dementia care.
160.18    Subd. 3. Meetings. The Board on Aging must convene the first meeting of the working
160.19group no later than January 15, 2018. Before the first meeting, the Board on Aging must
160.20designate one member to serve as chair. Meetings of the working group must be open to
160.21the public, and to the extent practicable, technological means, such as Web casts, shall be
160.22used to reach the greatest number of people throughout the state. The working group may
160.23not meet more than five times.
160.24    Subd. 4. Compensation. Members of the working group serve without compensation,
160.25but may be reimbursed for allowed actual and necessary expenses incurred in the performance
160.26of the member's duties for the working group in the same manner and amount as authorized
160.27by the commissioner's plan adopted under Minnesota Statutes, section 43A.18, subdivision
160.282.
160.29    Subd. 5. Administrative support. The Minnesota Board on Aging shall provide
160.30administrative support and arrange meeting space for the working group.
160.31    Subd. 6. Report. The Board on Aging must submit a report providing the findings and
160.32recommendations of the working group, including any draft legislation necessary to
161.1implement the recommendations, to the governor and chairs and ranking minority members
161.2of the legislative committees with jurisdiction over health care by January 15, 2019.
161.3    Subd. 7. Expiration. The working group expires June 30, 2019, or the day after the
161.4working group submits the report required in subdivision 6, whichever is earlier.

161.5    Sec. 52. ELECTRONIC SERVICE DELIVERY DOCUMENTATION SYSTEM.
161.6    Subdivision 1. Documentation; establishment. The commissioner of human services
161.7shall establish implementation requirements and standards for an electronic service delivery
161.8documentation system to comply with the 21st Century Cures Act, Public Law 114-255.
161.9    Subd. 2. Definitions. (a) For purposes of this section, the terms in this subdivision have
161.10the meanings given them.
161.11(b) "Electronic service delivery documentation" means the electronic documentation of
161.12the:
161.13(1) type of service performed;
161.14(2) individual receiving the service;
161.15(3) date of the service;
161.16(4) location of the service delivery;
161.17(5) individual providing the service; and
161.18(6) time the service begins and ends.
161.19(c) "Electronic service delivery documentation system" means a system that provides
161.20electronic service delivery documentation that complies with the 21st Century Cures Act,
161.21Public Law 114-255, and the requirements of subdivision 3.
161.22(d) "Service" means one of the following:
161.23(1) personal care assistance services as defined in Minnesota Statutes, section 256B.0625,
161.24subdivision 19a, and provided according to Minnesota Statutes, section 256B.0659; or
161.25(2) community first services and supports under Minnesota Statutes, section 256B.85.
161.26    Subd. 3. Requirements. (a) In developing implementation requirements for an electronic
161.27service delivery documentation system, the commissioner shall consider electronic visit
161.28verification systems and other electronic service delivery documentation methods. The
161.29commissioner shall convene stakeholders that will be impacted by an electronic service
161.30delivery system, including service providers and their representatives, service recipients
162.1and their representatives, and, as appropriate, those with expertise in the development and
162.2operation of an electronic service delivery documentation system, to ensure that the
162.3requirements:
162.4(1) are minimally administratively and financially burdensome to a provider;
162.5(2) are minimally burdensome to the service recipient and the least disruptive to the
162.6service recipient in receiving and maintaining allowed services;
162.7(3) consider existing best practices and use of electronic service delivery documentation;
162.8(4) are conducted according to all state and federal laws;
162.9(5) are effective methods for preventing fraud when balanced against the requirements
162.10of clauses (1) and (2); and
162.11(6) are consistent with the Department of Human Services' policies related to covered
162.12services, flexibility of service use, and quality assurance.
162.13(b) The commissioner shall make training available to providers on the electronic service
162.14delivery documentation system requirements.
162.15(c) The commissioner shall establish baseline measurements related to preventing fraud
162.16and establish measures to determine the effect of electronic service delivery documentation
162.17requirements on program integrity.
162.18    Subd. 4. Legislative report. (a) The commissioner shall submit a report by January 15,
162.192018, to the chairs and ranking minority members of the legislative committees with
162.20jurisdiction over human services with recommendations, based on the requirements of
162.21subdivision 3, to establish electronic service delivery documentation system requirements
162.22and standards. The report shall identify:
162.23(1) the essential elements necessary to operationalize a base-level electronic service
162.24delivery documentation system to be implemented by January 1, 2019; and
162.25(2) enhancements to the base-level electronic service delivery documentation system to
162.26be implemented by January 1, 2019, or after, with projected operational costs and the costs
162.27and benefits for system enhancements.
162.28(b) The report must also identify current regulations on service providers that are either
162.29inefficient, minimally effective, or will be unnecessary with the implementation of an
162.30electronic service delivery documentation system.
162.31EFFECTIVE DATE.This section is effective the day following final enactment.

163.1    Sec. 53. DIRECTION TO COMMISSIONER; ICF/DD PAYMENT RATE STUDY.
163.2Within available appropriations, the commissioner of human services shall study the
163.3intermediate care facility for persons with developmental disabilities payment rates under
163.4Minnesota Statutes, sections 256B.5011 to 256B.5013, and make recommendations on the
163.5rate structure to the chairs and ranking minority members of the legislative committees with
163.6jurisdiction over human services policy and finance by January 15, 2018.

163.7    Sec. 54. REVISOR'S INSTRUCTION.
163.8The revisor of statutes, in consultation with the House Research Department, Office of
163.9Senate Counsel, Research, and Fiscal Analysis, and Department of Human Services shall
163.10prepare legislation for the 2018 legislative session to recodify laws governing the elderly
163.11waiver program in Minnesota Statutes, chapter 256B.
163.12EFFECTIVE DATE.This section is effective the day following final enactment.

163.13ARTICLE 4

163.14HEALTH CARE

163.15    Section 1. Minnesota Statutes 2016, section 3.972, is amended by adding a subdivision
163.16to read:
163.17    Subd. 2a. Audits of Department of Human Services. (a) To ensure continuous
163.18legislative oversight and accountability, the legislative auditor shall give high priority to
163.19auditing the programs, services, and benefits administered by the Department of Human
163.20Services. The audits shall determine whether the department offered programs and provided
163.21services and benefits only to eligible persons and organizations, and complied with applicable
163.22legal requirements.
163.23(b) The legislative auditor shall, based on an assessment of risk and using professional
163.24standards to provide a statistically significant sample, no less than three times each year,
163.25test a representative sample of persons enrolled in a medical assistance program or
163.26MinnesotaCare to determine whether they are eligible to receive benefits under those
163.27programs. The legislative auditor shall report the results to the commissioner of human
163.28services and recommend corrective actions. The commissioner shall provide a response to
163.29the legislative auditor within 20 business days, including corrective actions to be taken to
163.30address any problems identified by the legislative auditor and anticipated completion dates.
163.31The legislative auditor shall monitor the commissioner's implementation of corrective actions
163.32and periodically report the results to the Legislative Audit Commission and the chairs and
164.1ranking minority members of the legislative committees with jurisdiction over health and
164.2human services policy and finance. The legislative auditor's reports to the commission and
164.3the chairs and ranking minority members must include recommendations for any legislative
164.4actions needed to ensure that medical assistance and MinnesotaCare benefits are provided
164.5only to eligible persons.

164.6    Sec. 2. Minnesota Statutes 2016, section 3.972, is amended by adding a subdivision to
164.7read:
164.8    Subd. 2b. Audits of managed care organizations. (a) The legislative auditor shall audit
164.9each managed care organization that contracts with the commissioner of human services to
164.10provide health care services under sections 256B.69, 256B.692, and 256L.12. The legislative
164.11auditor shall design the audits to determine if a managed care organization used the public
164.12money in compliance with federal and state laws, rules, and in accordance with provisions
164.13in the managed care organization's contract with the commissioner of human services. The
164.14legislative auditor shall determine the schedule and scope of the audit work and may contract
164.15with vendors to assist with the audits. The managed care organization must cooperate with
164.16the legislative auditor and must provide the legislative auditor with all data, documents, and
164.17other information, regardless of classification, that the legislative auditor requests to conduct
164.18an audit. The legislative auditor shall periodically report audit results and recommendations
164.19to the Legislative Audit Commission and the chairs and ranking minority members of the
164.20legislative committees with jurisdiction over health and human services policy and finance.
164.21(b) For purposes of this subdivision, a "managed care organization" means a
164.22demonstration provider as defined under section 256B.69, subdivision 2.

164.23    Sec. 3. Minnesota Statutes 2016, section 13.69, subdivision 1, is amended to read:
164.24    Subdivision 1. Classifications. (a) The following government data of the Department
164.25of Public Safety are private data:
164.26    (1) medical data on driving instructors, licensed drivers, and applicants for parking
164.27certificates and special license plates issued to physically disabled persons;
164.28    (2) other data on holders of a disability certificate under section 169.345, except that (i)
164.29data that are not medical data may be released to law enforcement agencies, and (ii) data
164.30necessary for enforcement of sections 169.345 and 169.346 may be released to parking
164.31enforcement employees or parking enforcement agents of statutory or home rule charter
164.32cities and towns;
165.1    (3) Social Security numbers in driver's license and motor vehicle registration records,
165.2except that Social Security numbers must be provided to the Department of Revenue for
165.3purposes of tax administration, the Department of Labor and Industry for purposes of
165.4workers' compensation administration and enforcement, and the Department of Natural
165.5Resources for purposes of license application administration, and except that the last four
165.6digits of the Social Security number must be provided to the Department of Human Services
165.7for purposes of recovery of Minnesota health care program benefits paid; and
165.8    (4) data on persons listed as standby or temporary custodians under section 171.07,
165.9subdivision 11 , except that the data must be released to:
165.10    (i) law enforcement agencies for the purpose of verifying that an individual is a designated
165.11caregiver; or
165.12    (ii) law enforcement agencies who state that the license holder is unable to communicate
165.13at that time and that the information is necessary for notifying the designated caregiver of
165.14the need to care for a child of the license holder.
165.15    The department may release the Social Security number only as provided in clause (3)
165.16and must not sell or otherwise provide individual Social Security numbers or lists of Social
165.17Security numbers for any other purpose.
165.18    (b) The following government data of the Department of Public Safety are confidential
165.19data: data concerning an individual's driving ability when that data is received from a member
165.20of the individual's family.
165.21EFFECTIVE DATE.This section is effective July 1, 2017.

165.22    Sec. 4. [62J.815] HEALTH CARE PROVIDERS PRICE DISCLOSURES.
165.23(a) Each health care provider, as defined by section 62J.03, subdivision 8, except hospitals
165.24and outpatient surgical centers subject to the requirements of section 62J.82, shall maintain
165.25a list of the services or procedures that correspond with the 35 most frequent current
165.26procedural terminology (CPT) codes, and a list of the ten most frequent CPT codes for
165.27preventive services used by the provider for reimbursement purposes and the provider's
165.28charge for each of these services or procedures that the provider would charge to patients
165.29who are not covered by private or public health care coverage.
165.30(b) This list must be updated annually and be readily available on site at no cost to the
165.31public. The provider must also post this information on the provider's Web site or the health
165.32care clinic's Web site where the provider practices.

166.1    Sec. 5. Minnesota Statutes 2016, section 256.9686, subdivision 8, is amended to read:
166.2    Subd. 8. Rate year. "Rate year" means a calendar year from January 1 to December 31.
166.3Effective with the 2012 base year, rate year means a state fiscal year from July 1 to June
166.430.
166.5EFFECTIVE DATE.This section is effective the day following final enactment.

166.6    Sec. 6. Minnesota Statutes 2016, section 256.969, subdivision 1, is amended to read:
166.7    Subdivision 1. Hospital cost index. (a) The hospital cost index shall be the change in
166.8the Centers for Medicare and Medicaid Services Inpatient Hospital Market Basket. The
166.9commissioner shall use the indices as forecasted for the midpoint of the prior rate year to
166.10the midpoint of the current rate year.
166.11(b) Except as authorized under this section, for fiscal years beginning on or after July
166.121, 1993, the commissioner of human services shall not provide automatic annual inflation
166.13adjustments for hospital payment rates under medical assistance.
166.14EFFECTIVE DATE.This section is effective July 1, 2017.

166.15    Sec. 7. Minnesota Statutes 2016, section 256.969, subdivision 2b, is amended to read:
166.16    Subd. 2b. Hospital payment rates. (a) For discharges occurring on or after November
166.171, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
166.18to the following:
166.19(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
166.20methodology;
166.21(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
166.22under subdivision 25;
166.23(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
166.24distinct parts as defined by Medicare shall be paid according to the methodology under
166.25subdivision 12; and
166.26(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.
166.27    (b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
166.28be rebased, except that a Minnesota long-term hospital shall be rebased effective January
166.291, 2011, based on its most recent Medicare cost report ending on or before September 1,
166.302008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
166.31December 31, 2010. For rate setting periods after November 1, 2014, in which the base
167.1years are updated, a Minnesota long-term hospital's base year shall remain within the same
167.2period as other hospitals.
167.3(c) Effective for discharges occurring on and after November 1, 2014, payment rates
167.4for hospital inpatient services provided by hospitals located in Minnesota or the local trade
167.5area, except for the hospitals paid under the methodologies described in paragraph (a),
167.6clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
167.7manner similar to Medicare. The base year for the rates effective November 1, 2014, shall
167.8be calendar year 2012. The rebasing under this paragraph shall be budget neutral, ensuring
167.9that the total aggregate payments under the rebased system are equal to the total aggregate
167.10payments that were made for the same number and types of services in the base year. Separate
167.11budget neutrality calculations shall be determined for payments made to critical access
167.12hospitals and payments made to hospitals paid under the DRG system. Only the rate increases
167.13or decreases under subdivision 3a or 3c that applied to the hospitals being rebased during
167.14the entire base period shall be incorporated into the budget neutrality calculation.
167.15(d) For discharges occurring on or after November 1, 2014, through the next rebasing
167.16that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
167.17(a), clause (4), shall include adjustments to the projected rates that result in no greater than
167.18a five percent increase or decrease from the base year payments for any hospital. Any
167.19adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
167.20shall maintain budget neutrality as described in paragraph (c).
167.21(e) For discharges occurring on or after November 1, 2014, through the next two rebasing
167.22that occurs periods the commissioner may make additional adjustments to the rebased rates,
167.23and when evaluating whether additional adjustments should be made, the commissioner
167.24shall consider the impact of the rates on the following:
167.25(1) pediatric services;
167.26(2) behavioral health services;
167.27(3) trauma services as defined by the National Uniform Billing Committee;
167.28(4) transplant services;
167.29(5) obstetric services, newborn services, and behavioral health services provided by
167.30hospitals outside the seven-county metropolitan area;
167.31(6) outlier admissions;
167.32(7) low-volume providers; and
168.1(8) services provided by small rural hospitals that are not critical access hospitals.
168.2(f) Hospital payment rates established under paragraph (c) must incorporate the following:
168.3    (1) for hospitals paid under the DRG methodology, the base year payment rate per
168.4admission is standardized by the applicable Medicare wage index and adjusted by the
168.5hospital's disproportionate population adjustment;
168.6    (2) for critical access hospitals, payment rates for discharges between November 1, 2014,
168.7and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
168.8October 31, 2014;
168.9    (3) the cost and charge data used to establish hospital payment rates must only reflect
168.10inpatient services covered by medical assistance; and
168.11    (4) in determining hospital payment rates for discharges occurring on or after the rate
168.12year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
168.13discharge shall be based on the cost-finding methods and allowable costs of the Medicare
168.14program in effect during the base year or years. In determining hospital payment rates for
168.15discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
168.16methods and allowable costs of the Medicare program in effect during the base year or
168.17years.
168.18(g) The commissioner shall validate the rates effective November 1, 2014, by applying
168.19the rates established under paragraph (c), and any adjustments made to the rates under
168.20paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
168.21total aggregate payments for the same number and types of services under the rebased rates
168.22are equal to the total aggregate payments made during calendar year 2013.
168.23(h) Effective for discharges occurring on or after July 1, 2017, and every two years
168.24thereafter, payment rates under this section shall be rebased to reflect only those changes
168.25in hospital costs between the existing base year and the next base year. Changes in costs
168.26between base years shall be measured using the lower of the hospital cost index defined in
168.27subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
168.28claim. The commissioner shall establish the base year for each rebasing period considering
168.29the most recent year for which filed Medicare cost reports are available. The estimated
168.30change in the average payment per hospital discharge resulting from a scheduled rebasing
168.31must be calculated and made available to the legislature by January 15 of each year in which
168.32rebasing is scheduled to occur, and must include by hospital the differential in payment
168.33rates compared to the individual hospital's costs.
169.1(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
169.2for critical access hospitals located in Minnesota or the local trade area shall be determined
169.3using a new cost-based methodology. The commissioner shall establish within the
169.4methodology tiers of payment designed to promote efficiency and cost-effectiveness.
169.5Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
169.6the total cost for critical access hospitals as reflected in base year cost reports. Until the
169.7next rebasing that occurs, the new methodology shall result in no greater than a five percent
169.8decrease from the base year payments for any hospital, except a hospital that had payments
169.9that were greater than 100 percent of the hospital's costs in the base year shall have their
169.10rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
169.11after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
169.12in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
169.13be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
169.14following criteria:
169.15(1) hospitals that had payments at or below 80 percent of their costs in the base year
169.16shall have a rate set that equals 85 percent of their base year costs;
169.17(2) hospitals that had payments that were above 80 percent, up to and including 90
169.18percent of their costs in the base year shall have a rate set that equals 95 percent of their
169.19base year costs; and
169.20(3) hospitals that had payments that were above 90 percent of their costs in the base year
169.21shall have a rate set that equals 100 percent of their base year costs.
169.22(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
169.23to coincide with the next rebasing under paragraph (h). The factors used to develop the new
169.24methodology may include, but are not limited to:
169.25(1) the ratio between the hospital's costs for treating medical assistance patients and the
169.26hospital's charges to the medical assistance program;
169.27(2) the ratio between the hospital's costs for treating medical assistance patients and the
169.28hospital's payments received from the medical assistance program for the care of medical
169.29assistance patients;
169.30(3) the ratio between the hospital's charges to the medical assistance program and the
169.31hospital's payments received from the medical assistance program for the care of medical
169.32assistance patients;
169.33(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);
170.1(5) the proportion of that hospital's costs that are administrative and trends in
170.2administrative costs; and
170.3(6) geographic location.
170.4EFFECTIVE DATE.This section is effective July 1, 2017.

170.5    Sec. 8. Minnesota Statutes 2016, section 256.969, subdivision 3a, is amended to read:
170.6    Subd. 3a. Payments. (a) Acute care hospital billings under the medical assistance program
170.7must not be submitted until the recipient is discharged. However, the commissioner shall
170.8establish monthly interim payments for inpatient hospitals that have individual patient
170.9lengths of stay over 30 days regardless of diagnostic category. Except as provided in section
170.10256.9693 , medical assistance reimbursement for treatment of mental illness shall be
170.11reimbursed based on diagnostic classifications. Individual hospital payments established
170.12under this section and sections 256.9685, 256.9686, and 256.9695, in addition to third-party
170.13and recipient liability, for discharges occurring during the rate year shall not exceed, in
170.14aggregate, the charges for the medical assistance covered inpatient services paid for the
170.15same period of time to the hospital. Services that have rates established under subdivision
170.1611 or 12, must be limited separately from other services. After consulting with the affected
170.17hospitals, the commissioner may consider related hospitals one entity and may merge the
170.18payment rates while maintaining separate provider numbers. The operating and property
170.19base rates per admission or per day shall be derived from the best Medicare and claims data
170.20available when rates are established. The commissioner shall determine the best Medicare
170.21and claims data, taking into consideration variables of recency of the data, audit disposition,
170.22settlement status, and the ability to set rates in a timely manner. The commissioner shall
170.23notify hospitals of payment rates 30 days prior to implementation. The rate setting data
170.24must reflect the admissions data used to establish relative values. The commissioner may
170.25adjust base year cost, relative value, and case mix index data to exclude the costs of services
170.26that have been discontinued by the October 1 of the year preceding the rate year or that are
170.27paid separately from inpatient services. Inpatient stays that encompass portions of two or
170.28more rate years shall have payments established based on payment rates in effect at the time
170.29of admission unless the date of admission preceded the rate year in effect by six months or
170.30more. In this case, operating payment rates for services rendered during the rate year in
170.31effect and established based on the date of admission shall be adjusted to the rate year in
170.32effect by the hospital cost index.
171.1    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total payment,
171.2before third-party liability and spenddown, made to hospitals for inpatient services is reduced
171.3by .5 percent from the current statutory rates.
171.4    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
171.5admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before
171.6third-party liability and spenddown, is reduced five percent from the current statutory rates.
171.7Mental health services within diagnosis related groups 424 to 432 or corresponding
171.8APR-DRGs, and facilities defined under subdivision 16 are excluded from this paragraph.
171.9    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
171.10fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
171.11inpatient services before third-party liability and spenddown, is reduced 6.0 percent from
171.12the current statutory rates. Mental health services within diagnosis related groups 424 to
171.13432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded
171.14from this paragraph. Payments made to managed care plans shall be reduced for services
171.15provided on or after January 1, 2006, to reflect this reduction.
171.16    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
171.17fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
171.18to hospitals for inpatient services before third-party liability and spenddown, is reduced
171.193.46 percent from the current statutory rates. Mental health services with diagnosis related
171.20groups 424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision
171.2116 are excluded from this paragraph. Payments made to managed care plans shall be reduced
171.22for services provided on or after January 1, 2009, through June 30, 2009, to reflect this
171.23reduction.
171.24    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
171.25fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made
171.26to hospitals for inpatient services before third-party liability and spenddown, is reduced 1.9
171.27percent from the current statutory rates. Mental health services with diagnosis related groups
171.28424 to 432 or corresponding APR-DRGs, and facilities defined under subdivision 16 are
171.29excluded from this paragraph. Payments made to managed care plans shall be reduced for
171.30services provided on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
171.31    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
171.32fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for inpatient
171.33services before third-party liability and spenddown, is reduced 1.79 percent from the current
171.34statutory rates. Mental health services with diagnosis related groups 424 to 432 or
172.1corresponding APR-DRGs, and facilities defined under subdivision 16 are excluded from
172.2this paragraph. Payments made to managed care plans shall be reduced for services provided
172.3on or after July 1, 2011, to reflect this reduction.
172.4(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total payment
172.5for fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for
172.6inpatient services before third-party liability and spenddown, is reduced one percent from
172.7the current statutory rates. Facilities defined under subdivision 16 are excluded from this
172.8paragraph. Payments made to managed care plans shall be reduced for services provided
172.9on or after October 1, 2009, to reflect this reduction.
172.10(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total payment
172.11for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
172.12inpatient services before third-party liability and spenddown, is reduced 1.96 percent from
172.13the current statutory rates. Facilities defined under subdivision 16 are excluded from this
172.14paragraph. Payments made to managed care plans shall be reduced for services provided
172.15on or after January 1, 2011, to reflect this reduction.
172.16(j) Effective for discharges on and after November 1, 2014, from hospitals paid under
172.17subdivision 2b, paragraph (a), clauses (1) and (4), the rate adjustments in this subdivision
172.18must be incorporated into the rebased rates established under subdivision 2b, paragraph (c),
172.19and must not be applied to each claim.
172.20(k) Effective for discharges on and after July 1, 2015, from hospitals paid under
172.21subdivision 2b, paragraph (a), clauses (2) and (3), the rate adjustments in this subdivision
172.22must be incorporated into the rates and must not be applied to each claim.
172.23(l) Effective for discharges on and after July 1, 2017, from hospitals paid under
172.24subdivision 2b, paragraph (a), clause (2), the rate adjustments in this subdivision must be
172.25incorporated into the rates and must not be applied to each claim.
172.26EFFECTIVE DATE.This section is effective July 1, 2017.

172.27    Sec. 9. Minnesota Statutes 2016, section 256.969, subdivision 8, is amended to read:
172.28    Subd. 8. Unusual length of stay experience. (a) The commissioner shall establish day
172.29outlier thresholds for each diagnostic category established under subdivision 2 at two standard
172.30deviations beyond the mean length of stay. Payment for the days beyond the outlier threshold
172.31shall be in addition to the operating and property payment rates per admission established
172.32under subdivisions 2 and 2b. Payment for outliers shall be at 70 percent of the allowable
172.33operating cost, after adjustment by the case mix index, hospital cost index, relative values
173.1and the disproportionate population adjustment. The outlier threshold for neonatal and burn
173.2diagnostic categories shall be established at one standard deviation beyond the mean length
173.3of stay, and payment shall be at 90 percent of allowable operating cost calculated in the
173.4same manner as other outliers. A hospital may choose an alternative to the 70 percent outlier
173.5payment that is at a minimum of 60 percent and a maximum of 80 percent if the
173.6commissioner is notified in writing of the request by October 1 of the year preceding the
173.7rate year. The chosen percentage applies to all diagnostic categories except burns and
173.8neonates. The percentage of allowable cost that is unrecognized by the outlier payment shall
173.9be added back to the base year operating payment rate per admission.
173.10(b) Effective for admissions and transfers occurring on and after November 1, 2014, the
173.11commissioner shall establish payment rates for outlier payments that are based on Medicare
173.12methodologies.
173.13EFFECTIVE DATE.This section is effective July 1, 2017.

173.14    Sec. 10. Minnesota Statutes 2016, section 256.969, subdivision 8c, is amended to read:
173.15    Subd. 8c. Hospital residents. (a) For discharges occurring on or after November 1,
173.162014, payments for hospital residents shall be made as follows:
173.17(1) payments for the first 180 days of inpatient care shall be the APR-DRG system plus
173.18any outliers; and
173.19(2) payment for all medically necessary patient care subsequent to the first 180 days
173.20shall be reimbursed at a rate computed by multiplying the statewide average cost-to-charge
173.21ratio by the usual and customary charges.
173.22(b) For discharges occurring on or after July 1, 2017, payment for hospital residents
173.23shall be equal to the payments under subdivision 8, paragraph (b).
173.24EFFECTIVE DATE.This section is effective July 1, 2017.

173.25    Sec. 11. Minnesota Statutes 2016, section 256.969, subdivision 9, is amended to read:
173.26    Subd. 9. Disproportionate numbers of low-income patients served. (a) For admissions
173.27occurring on or after July 1, 1993, the medical assistance disproportionate population
173.28adjustment shall comply with federal law and shall be paid to a hospital, excluding regional
173.29treatment centers and facilities of the federal Indian Health Service, with a medical assistance
173.30inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined
173.31as follows:
174.1    (1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic
174.2mean for all hospitals excluding regional treatment centers and facilities of the federal Indian
174.3Health Service but less than or equal to one standard deviation above the mean, the
174.4adjustment must be determined by multiplying the total of the operating and property
174.5payment rates by the difference between the hospital's actual medical assistance inpatient
174.6utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers
174.7and facilities of the federal Indian Health Service; and
174.8    (2) for a hospital with a medical assistance inpatient utilization rate above one standard
174.9deviation above the mean, the adjustment must be determined by multiplying the adjustment
174.10that would be determined under clause (1) for that hospital by 1.1. The commissioner shall
174.11report annually on the number of hospitals likely to receive the adjustment authorized by
174.12this paragraph. The commissioner shall specifically report on the adjustments received by
174.13public hospitals and public hospital corporations located in cities of the first class.
174.14    (b) Certified public expenditures made by Hennepin County Medical Center shall be
174.15considered Medicaid disproportionate share hospital payments. Hennepin County and
174.16Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning
174.17July 1, 2005, or another date specified by the commissioner, that may qualify for
174.18reimbursement under federal law. Based on these reports, the commissioner shall apply for
174.19federal matching funds.
174.20    (c) Upon federal approval of the related state plan amendment, paragraph (b) is effective
174.21retroactively from July 1, 2005, or the earliest effective date approved by the Centers for
174.22Medicare and Medicaid Services.
174.23    (d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid
174.24in accordance with a new methodology using 2012 as the base year. Annual payments made
174.25under this paragraph shall equal the total amount of payments made for 2012. A licensed
174.26children's hospital shall receive only a single DSH factor for children's hospitals. Other
174.27DSH factors may be combined to arrive at a single factor for each hospital that is eligible
174.28for DSH payments. The new methodology shall make payments only to hospitals located
174.29in Minnesota and include the following factors:
174.30    (1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the
174.31base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000
174.32fee-for-service discharges in the base year shall receive a factor of 0.7880;
175.1    (2) a hospital that has in effect for the initial rate year a contract with the commissioner
175.2to provide extended psychiatric inpatient services under section 256.9693 shall receive a
175.3factor of 0.0160;
175.4    (3) a hospital that has received payment from the fee-for-service program for at least 20
175.5transplant services in the base year shall receive a factor of 0.0435;
175.6    (4) a hospital that has a medical assistance utilization rate in the base year between 20
175.7percent up to one standard deviation above the statewide mean utilization rate shall receive
175.8a factor of 0.0468;
175.9    (5) a hospital that has a medical assistance utilization rate in the base year that is at least
175.10one standard deviation above the statewide mean utilization rate but is less than three standard
175.11deviations above the mean shall receive a factor of 0.2300; and
175.12(6) a hospital that has a medical assistance utilization rate in the base year that is at least
175.13three standard deviations above the statewide mean utilization rate shall receive a factor of
175.140.3711.
175.15    (e) Any payments or portion of payments made to a hospital under this subdivision that
175.16are subsequently returned to the commissioner because the payments are found to exceed
175.17the hospital-specific DSH limit for that hospital shall be redistributed, proportionate to the
175.18number of fee-for-service discharges, to other DSH-eligible nonchildren's non-children's
175.19hospitals that have a medical assistance utilization rate that is at least one standard deviation
175.20above the mean.
175.21EFFECTIVE DATE.This section is effective July 1, 2017.

175.22    Sec. 12. Minnesota Statutes 2016, section 256.969, subdivision 12, is amended to read:
175.23    Subd. 12. Rehabilitation hospitals and distinct parts. (a) Units of hospitals that are
175.24recognized as rehabilitation distinct parts by the Medicare program shall have separate
175.25provider numbers under the medical assistance program for rate establishment and billing
175.26purposes only. These units shall also have operating payment rates and the disproportionate
175.27population adjustment, if allowed by federal law, established separately from other inpatient
175.28hospital services.
175.29(b) The commissioner shall establish separate relative values under subdivision 2 for
175.30rehabilitation hospitals and distinct parts as defined by the Medicare program. Effective for
175.31discharges occurring on and after November 1, 2014, the commissioner, to the extent
175.32possible, shall replicate the existing payment rate methodology under the new diagnostic
175.33classification system. The result must be budget neutral, ensuring that the total aggregate
176.1payments under the new system are equal to the total aggregate payments made for the same
176.2number and types of services in the base year, calendar year 2012.
176.3(c) For individual hospitals that did not have separate medical assistance rehabilitation
176.4provider numbers or rehabilitation distinct parts in the base year, hospitals shall provide the
176.5information needed to separate rehabilitation distinct part cost and claims data from other
176.6inpatient service data.
176.7(d) Effective with discharges on or after July 1, 2017, payment to rehabilitation hospitals
176.8shall be established under subdivision 2b, paragraph (a), clause (4).
176.9EFFECTIVE DATE.This section is effective July 1, 2017.

176.10    Sec. 13. Minnesota Statutes 2016, section 256B.04, subdivision 12, is amended to read:
176.11    Subd. 12. Limitation on services. (a) Place limits on the types of services covered by
176.12medical assistance, the frequency with which the same or similar services may be covered
176.13by medical assistance for an individual recipient, and the amount paid for each covered
176.14service. The state agency shall promulgate rules establishing maximum reimbursement rates
176.15for emergency and nonemergency transportation.
176.16The rules shall provide:
176.17(1) an opportunity for all recognized transportation providers to be reimbursed for
176.18nonemergency transportation consistent with the maximum rates established by the agency;
176.19and
176.20(2) reimbursement of public and private nonprofit providers serving the disabled
176.21population generally at reasonable maximum rates that reflect the cost of providing the
176.22service regardless of the fare that might be charged by the provider for similar services to
176.23individuals other than those receiving medical assistance or medical care under this chapter;
176.24and.
176.25(3) reimbursement for each additional passenger carried on a single trip at a substantially
176.26lower rate than the first passenger carried on that trip.
176.27(b) The commissioner shall encourage providers reimbursed under this chapter to
176.28coordinate their operation with similar services that are operating in the same community.
176.29To the extent practicable, the commissioner shall encourage eligible individuals to utilize
176.30less expensive providers capable of serving their needs.
176.31(c) For the purpose of this subdivision and section 256B.02, subdivision 8, and effective
176.32on January 1, 1981, "recognized provider of transportation services" means an operator of
177.1special transportation service as defined in section 174.29 that has been issued a current
177.2certificate of compliance with operating standards of the commissioner of transportation
177.3or, if those standards do not apply to the operator, that the agency finds is able to provide
177.4the required transportation in a safe and reliable manner. Until January 1, 1981, "recognized
177.5transportation provider" includes an operator of special transportation service that the agency
177.6finds is able to provide the required transportation in a safe and reliable manner.

177.7    Sec. 14. Minnesota Statutes 2016, section 256B.056, subdivision 5c, is amended to read:
177.8    Subd. 5c. Excess income standard. (a) The excess income standard for parents and
177.9caretaker relatives, pregnant women, infants, and children ages two through 20 is the standard
177.10specified in subdivision 4, paragraph (b).
177.11    (b) The excess income standard for a person whose eligibility is based on blindness,
177.12disability, or age of 65 or more years shall equal 80 81 percent of the federal poverty
177.13guidelines.
177.14EFFECTIVE DATE.This section is effective June 1, 2019.

177.15    Sec. 15. Minnesota Statutes 2016, section 256B.0621, subdivision 10, is amended to read:
177.16    Subd. 10. Payment rates. The commissioner shall set payment rates for targeted case
177.17management under this subdivision. Case managers may bill according to the following
177.18criteria:
177.19    (1) for relocation targeted case management, case managers may bill for direct case
177.20management activities, including face-to-face and contact, telephone contacts contact, and
177.21interactive video contact according to section 256B.0924, subdivision 4a, in the lesser of:
177.22    (i) 180 days preceding an eligible recipient's discharge from an institution; or
177.23    (ii) the limits and conditions which apply to federal Medicaid funding for this service;
177.24    (2) for home care targeted case management, case managers may bill for direct case
177.25management activities, including face-to-face and telephone contacts; and
177.26    (3) billings for targeted case management services under this subdivision shall not
177.27duplicate payments made under other program authorities for the same purpose.
177.28EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
177.29of human services shall notify the revisor of statutes when federal approval is obtained.

178.1    Sec. 16. Minnesota Statutes 2016, section 256B.0625, subdivision 3b, is amended to read:
178.2    Subd. 3b. Telemedicine services. (a) Medical assistance covers medically necessary
178.3services and consultations delivered by a licensed health care provider via telemedicine in
178.4the same manner as if the service or consultation was delivered in person. Coverage is
178.5limited to three telemedicine services per enrollee per calendar week. Telemedicine services
178.6shall be paid at the full allowable rate.
178.7(b) The commissioner shall establish criteria that a health care provider must attest to
178.8in order to demonstrate the safety or efficacy of delivering a particular service via
178.9telemedicine. The attestation may include that the health care provider:
178.10(1) has identified the categories or types of services the health care provider will provide
178.11via telemedicine;
178.12(2) has written policies and procedures specific to telemedicine services that are regularly
178.13reviewed and updated;
178.14(3) has policies and procedures that adequately address patient safety before, during,
178.15and after the telemedicine service is rendered;
178.16(4) has established protocols addressing how and when to discontinue telemedicine
178.17services; and
178.18(5) has an established quality assurance process related to telemedicine services.
178.19(c) As a condition of payment, a licensed health care provider must document each
178.20occurrence of a health service provided by telemedicine to a medical assistance enrollee.
178.21Health care service records for services provided by telemedicine must meet the requirements
178.22set forth in Minnesota Rules, part 9505.2175, subparts 1 and 2, and must document:
178.23(1) the type of service provided by telemedicine;
178.24(2) the time the service began and the time the service ended, including an a.m. and p.m.
178.25designation;
178.26(3) the licensed health care provider's basis for determining that telemedicine is an
178.27appropriate and effective means for delivering the service to the enrollee;
178.28(4) the mode of transmission of the telemedicine service and records evidencing that a
178.29particular mode of transmission was utilized;
178.30(5) the location of the originating site and the distant site;
179.1(6) if the claim for payment is based on a physician's telemedicine consultation with
179.2another physician, the written opinion from the consulting physician providing the
179.3telemedicine consultation; and
179.4(7) compliance with the criteria attested to by the health care provider in accordance
179.5with paragraph (b).
179.6(d) For purposes of this subdivision, unless otherwise covered under this chapter,
179.7"telemedicine" is defined as the delivery of health care services or consultations while the
179.8patient is at an originating site and the licensed health care provider is at a distant site. A
179.9communication between licensed health care providers, or a licensed health care provider
179.10and a patient that consists solely of a telephone conversation, e-mail, or facsimile transmission
179.11does not constitute telemedicine consultations or services. Telemedicine may be provided
179.12by means of real-time two-way, interactive audio and visual communications, including the
179.13application of secure video conferencing or store-and-forward technology to provide or
179.14support health care delivery, which facilitate the assessment, diagnosis, consultation,
179.15treatment, education, and care management of a patient's health care.
179.16(e) For purposes of this section, "licensed health care provider" is defined means a
179.17licensed health care provider under section 62A.671, subdivision 6, and a mental health
179.18practitioner defined under section 245.462, subdivision 17, or 245.4871, subdivision 26,
179.19working under the general supervision of a mental health professional ; "health care provider"
179.20is defined under section 62A.671, subdivision 3; and "originating site" is defined under
179.21section 62A.671, subdivision 7.
179.22EFFECTIVE DATE.This section is effective the day following final enactment.

179.23    Sec. 17. Minnesota Statutes 2016, section 256B.0625, subdivision 7, is amended to read:
179.24    Subd. 7. Home care nursing. Medical assistance covers home care nursing services in
179.25a recipient's home. Recipients who are authorized to receive home care nursing services in
179.26their home may use approved hours outside of the home during hours when normal life
179.27activities take them outside of their home. To use home care nursing services at school, the
179.28recipient or responsible party must provide written authorization in the care plan identifying
179.29the chosen provider and the daily amount of services to be used at school. Medical assistance
179.30does not cover home care nursing services for residents of a hospital, nursing facility,
179.31intermediate care facility, or a health care facility licensed by the commissioner of health,
179.32except as authorized in section 256B.64 for ventilator-dependent recipients in hospitals or
179.33unless a resident who is otherwise eligible is on leave from the facility and the facility either
179.34pays for the home care nursing services or forgoes the facility per diem for the leave days
180.1that home care nursing services are used. Total hours of service and payment allowed for
180.2services outside the home cannot exceed that which is otherwise allowed in an in-home
180.3setting according to sections 256B.0651 and 256B.0654 . All home care nursing services
180.4must be provided according to the limits established under sections 256B.0651, 256B.0653,
180.5and 256B.0654. Home care nursing services may not be reimbursed if the nurse is the family
180.6foster care provider of a recipient who is under age 18, unless allowed under section
180.7256B.0654, subdivision 4 .

180.8    Sec. 18. Minnesota Statutes 2016, section 256B.0625, subdivision 13, is amended to read:
180.9    Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs when
180.10specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
180.11by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
180.12dispensing physician, or by a physician, physician assistant, or a nurse practitioner employed
180.13by or under contract with a community health board as defined in section 145A.02,
180.14subdivision 5 , for the purposes of communicable disease control.
180.15(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
180.16unless authorized by the commissioner.
180.17(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
180.18ingredient" is defined as a substance that is represented for use in a drug and when used in
180.19the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
180.20drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
180.21for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
180.22excipients which are included in the medical assistance formulary. Medical assistance covers
180.23selected active pharmaceutical ingredients and excipients used in compounded prescriptions
180.24when the compounded combination is specifically approved by the commissioner or when
180.25a commercially available product:
180.26(1) is not a therapeutic option for the patient;
180.27(2) does not exist in the same combination of active ingredients in the same strengths
180.28as the compounded prescription; and
180.29(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
180.30prescription.
180.31(d) Medical assistance covers the following over-the-counter drugs when prescribed by
180.32a licensed practitioner or by a licensed pharmacist who meets standards established by the
180.33commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
181.1planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
181.2with documented vitamin deficiencies, vitamins for children under the age of seven and
181.3pregnant or nursing women, and any other over-the-counter drug identified by the
181.4commissioner, in consultation with the formulary committee, as necessary, appropriate, and
181.5cost-effective for the treatment of certain specified chronic diseases, conditions, or disorders,
181.6and this determination shall not be subject to the requirements of chapter 14. A pharmacist
181.7may prescribe over-the-counter medications as provided under this paragraph for purposes
181.8of receiving reimbursement under Medicaid. When prescribing over-the-counter drugs under
181.9this paragraph, licensed pharmacists must consult with the recipient to determine necessity,
181.10provide drug counseling, review drug therapy for potential adverse interactions, and make
181.11referrals as needed to other health care professionals. Over-the-counter medications must
181.12be dispensed in a quantity that is the lowest of: (1) the number of dosage units contained in
181.13the manufacturer's original package; (2) the number of dosage units required to complete
181.14the patient's course of therapy; or (3) if applicable, the number of dosage units dispensed
181.15from a system using retrospective billing, as provided under subdivision 13e, paragraph
181.16(b).
181.17(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
181.18under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
181.19Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
181.20for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
181.21Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
181.22individuals, medical assistance may cover drugs from the drug classes listed in United States
181.23Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
181.2413g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
181.25not be covered.
181.26(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
181.27Program and dispensed by 340B covered entities and ambulatory pharmacies under common
181.28ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
181.29through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

181.30    Sec. 19. Minnesota Statutes 2016, section 256B.0625, subdivision 13e, is amended to
181.31read:
181.32    Subd. 13e. Payment rates. (a) Effective April 1, 2017, or upon federal approval,
181.33whichever is later, the basis for determining the amount of payment shall be the lower of
181.34the actual acquisition costs ingredient cost of the drugs or the maximum allowable cost by
182.1the commissioner plus the fixed professional dispensing fee; or the usual and customary
182.2price charged to the public. The usual and customary price is defined as the lowest price
182.3charged by the provider to a patient who pays for the prescription by cash, check, or charge
182.4account and includes those prices the pharmacy charges to customers enrolled in a
182.5prescription savings club or prescription discount club administered by the pharmacy or
182.6pharmacy chain. The amount of payment basis must be reduced to reflect all discount
182.7amounts applied to the charge by any third-party provider/insurer agreement or contract for
182.8submitted charges to medical assistance programs. The net submitted charge may not be
182.9greater than the patient liability for the service. The pharmacy professional dispensing fee
182.10shall be $3.65 $11.35 for legend prescription drugs prescriptions filled with legend drugs
182.11meeting the definition of "covered outpatient drugs" according to United States Code, title
182.1242, section 1396r-8(k)(2), except that the dispensing fee for intravenous solutions which
182.13must be compounded by the pharmacist shall be $8 $11.35 per bag, $14 per bag for cancer
182.14chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed
182.15in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in
182.16quantities greater than one liter. The professional dispensing fee for prescriptions filled with
182.17over-the-counter drugs meeting the definition of covered outpatient drugs shall be $11.35
182.18for dispensed quantities equal to or greater than the number of units contained in the
182.19manufacturer's original package. The professional dispensing fee shall be prorated based
182.20on the percentage of the package dispensed when the pharmacy dispenses a quantity less
182.21than the number of units contained in the manufacturer's original package. The pharmacy
182.22dispensing fee for prescribed over-the-counter drugs not meeting the definition of covered
182.23outpatient drugs shall be $3.65, except that the fee shall be $1.31 for retrospectively billing
182.24pharmacies when billing for quantities less than the number of units contained in the
182.25manufacturer's original package. Actual acquisition cost includes quantity and other special
182.26discounts except time and cash discounts. The actual acquisition for quantities equal to or
182.27greater than the number of units contained in the manufacturer's original package and shall
182.28be prorated based on the percentage of the package dispensed when the pharmacy dispenses
182.29a quantity less than the number of units contained in the manufacturer's original package.
182.30The National Average Drug Acquisition Cost (NADAC) shall be used to determine the
182.31ingredient cost of a drug shall be estimated by the commissioner at wholesale acquisition
182.32cost plus four percent for independently owned pharmacies located in a designated rural
182.33area within Minnesota, and at wholesale acquisition cost plus two percent for all other
182.34pharmacies. A pharmacy is "independently owned" if it is one of four or fewer pharmacies
182.35under the same ownership nationally. A "designated rural area" means an area defined as
182.36a small rural area or isolated rural area according to the four-category classification of the
183.1Rural Urban Commuting Area system developed for the United States Health Resources
183.2and Services Administration. Effective January 1, 2014, the actual acquisition. For drugs
183.3for which a NADAC is not reported, the commissioner shall estimate the ingredient cost at
183.4wholesale acquisition cost minus two percent. The commissioner shall establish the ingredient
183.5cost of a drug acquired through the federal 340B Drug Pricing Program shall be estimated
183.6by the commissioner at wholesale acquisition cost minus 40 percent at a 340B Drug Pricing
183.7Program maximum allowable cost. The 340B Drug Pricing Program maximum allowable
183.8cost shall be comparable to, but no higher than, the 340B Drug Pricing Program ceiling
183.9price established by the Health Resources and Services Administration. Wholesale acquisition
183.10cost is defined as the manufacturer's list price for a drug or biological to wholesalers or
183.11direct purchasers in the United States, not including prompt pay or other discounts, rebates,
183.12or reductions in price, for the most recent month for which information is available, as
183.13reported in wholesale price guides or other publications of drug or biological pricing data.
183.14The maximum allowable cost of a multisource drug may be set by the commissioner and it
183.15shall be comparable to, but the actual acquisition cost of the drug product and no higher
183.16than, the maximum amount paid by other third-party payors in this state who have maximum
183.17allowable cost programs and no higher than the NADAC of the generic product.
183.18Establishment of the amount of payment for drugs shall not be subject to the requirements
183.19of the Administrative Procedure Act.
183.20    (b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
183.21an automated drug distribution system meeting the requirements of section 151.58, or a
183.22packaging system meeting the packaging standards set forth in Minnesota Rules, part
183.236800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
183.24retrospective billing for prescription drugs dispensed to long-term care facility residents. A
183.25retrospectively billing pharmacy must submit a claim only for the quantity of medication
183.26used by the enrolled recipient during the defined billing period. A retrospectively billing
183.27pharmacy must use a billing period not less than one calendar month or 30 days.
183.28    (c) An additional dispensing fee of $.30 may be added to the dispensing fee paid to
183.29pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities
183.30when a unit dose blister card system, approved by the department, is used. Under this type
183.31of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National
183.32Drug Code (NDC) from the drug container used to fill the blister card must be identified
183.33on the claim to the department. The unit dose blister card containing the drug must meet
183.34the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return
183.35of unused drugs to the pharmacy for reuse. A pharmacy provider using packaging that meets
184.1the standards set forth in Minnesota Rules, part 6800.2700, is required to credit the
184.2department for the actual acquisition cost of all unused drugs that are eligible for reuse,
184.3unless the pharmacy is using retrospective billing. The commissioner may permit the drug
184.4clozapine to be dispensed in a quantity that is less than a 30-day supply.
184.5    (d) Whenever a maximum allowable cost has been set for If a pharmacy dispenses a
184.6multisource drug, payment shall be the lower of the usual and customary price charged to
184.7the public or the ingredient cost shall be the NADAC of the generic product or the maximum
184.8allowable cost established by the commissioner unless prior authorization for the brand
184.9name product has been granted according to the criteria established by the Drug Formulary
184.10Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated
184.11"dispense as written" on the prescription in a manner consistent with section 151.21,
184.12subdivision 2 .
184.13    (e) The basis for determining the amount of payment for drugs administered in an
184.14outpatient setting shall be the lower of the usual and customary cost submitted by the
184.15provider, 106 percent of the average sales price as determined by the United States
184.16Department of Health and Human Services pursuant to title XVIII, section 1847a of the
184.17federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
184.18set by the commissioner. If average sales price is unavailable, the amount of payment must
184.19be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
184.20cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
184.21Effective January 1, 2014, the commissioner shall discount the payment rate for drugs
184.22obtained through the federal 340B Drug Pricing Program by 20 percent. The payment for
184.23drugs administered in an outpatient setting shall be made to the administering facility or
184.24practitioner. A retail or specialty pharmacy dispensing a drug for administration in an
184.25outpatient setting is not eligible for direct reimbursement.
184.26    (f) The commissioner may negotiate lower reimbursement rates establish maximum
184.27allowable cost rates for specialty pharmacy products than the rates that are lower than the
184.28ingredient cost formulas specified in paragraph (a). The commissioner may require
184.29individuals enrolled in the health care programs administered by the department to obtain
184.30specialty pharmacy products from providers with whom the commissioner has negotiated
184.31lower reimbursement rates able to provide enhanced clinical services and willing to accept
184.32the specialty pharmacy reimbursement. Specialty pharmacy products are defined as those
184.33used by a small number of recipients or recipients with complex and chronic diseases that
184.34require expensive and challenging drug regimens. Examples of these conditions include,
184.35but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth
185.1hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of cancer.
185.2Specialty pharmaceutical products include injectable and infusion therapies, biotechnology
185.3drugs, antihemophilic factor products, high-cost therapies, and therapies that require complex
185.4care. The commissioner shall consult with the formulary committee to develop a list of
185.5specialty pharmacy products subject to this paragraph maximum allowable cost
185.6reimbursement. In consulting with the formulary committee in developing this list, the
185.7commissioner shall take into consideration the population served by specialty pharmacy
185.8products, the current delivery system and standard of care in the state, and access to care
185.9issues. The commissioner shall have the discretion to adjust the reimbursement rate maximum
185.10allowable cost to prevent access to care issues.
185.11(g) Home infusion therapy services provided by home infusion therapy pharmacies must
185.12be paid at rates according to subdivision 8d.
185.13(h) Effective for prescriptions filled on or after April 1, 2017, or upon federal approval,
185.14whichever is later, the commissioner shall increase the ingredient cost reimbursement
185.15calculated in paragraphs (a) and (f) by two percent for prescription and nonprescription
185.16drugs subject to the wholesale drug distributor tax under section 295.52.
185.17EFFECTIVE DATE.This section is effective retroactively from April 1, 2017, or from
185.18the effective date of federal approval, whichever is later. The commissioner of human
185.19services shall notify the revisor of statutes when federal approval is obtained.

185.20    Sec. 20. Minnesota Statutes 2016, section 256B.0625, subdivision 17, is amended to read:
185.21    Subd. 17. Transportation costs. (a) "Nonemergency medical transportation service"
185.22means motor vehicle transportation provided by a public or private person that serves
185.23Minnesota health care program beneficiaries who do not require emergency ambulance
185.24service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.
185.25(b) Medical assistance covers medical transportation costs incurred solely for obtaining
185.26emergency medical care or transportation costs incurred by eligible persons in obtaining
185.27emergency or nonemergency medical care when paid directly to an ambulance company,
185.28common carrier nonemergency medical transportation company, or other recognized
185.29providers of transportation services. Medical transportation must be provided by:
185.30(1) nonemergency medical transportation providers who meet the requirements of this
185.31subdivision;
185.32(2) ambulances, as defined in section 144E.001, subdivision 2;
185.33(3) taxicabs that meet the requirements of this subdivision;
186.1(4) public transit, as defined in section 174.22, subdivision 7; or
186.2(5) not-for-hire vehicles, including volunteer drivers.
186.3(c) Medical assistance covers nonemergency medical transportation provided by
186.4nonemergency medical transportation providers enrolled in the Minnesota health care
186.5programs. All nonemergency medical transportation providers must comply with the
186.6operating standards for special transportation service as defined in sections 174.29 to 174.30
186.7and Minnesota Rules, chapter 8840, and in consultation with the Minnesota Department of
186.8Transportation. All nonemergency medical transportation providers shall bill for
186.9nonemergency medical transportation services in accordance with Minnesota health care
186.10programs criteria. Publicly operated transit systems, volunteers, and not-for-hire vehicles
186.11are exempt from the requirements outlined in this paragraph.
186.12(d) An organization may be terminated, denied, or suspended from enrollment if:
186.13(1) the provider has not initiated background studies on the individuals specified in
186.14section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or
186.15(2) the provider has initiated background studies on the individuals specified in section
186.16174.30, subdivision 10 , paragraph (a), clauses (1) to (3), and:
186.17(i) the commissioner has sent the provider a notice that the individual has been
186.18disqualified under section 245C.14; and
186.19(ii) the individual has not received a disqualification set-aside specific to the special
186.20transportation services provider under sections 245C.22 and 245C.23.
186.21(e) The administrative agency of nonemergency medical transportation must:
186.22(1) adhere to the policies defined by the commissioner in consultation with the
186.23Nonemergency Medical Transportation Advisory Committee;
186.24(2) pay nonemergency medical transportation providers for services provided to
186.25Minnesota health care programs beneficiaries to obtain covered medical services;
186.26(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
186.27trips, and number of trips by mode; and
186.28(4) by July 1, 2016, in accordance with subdivision 18e, utilize a Web-based single
186.29administrative structure assessment tool that meets the technical requirements established
186.30by the commissioner, reconciles trip information with claims being submitted by providers,
186.31and ensures prompt payment for nonemergency medical transportation services.
187.1    (f) Until the commissioner implements the single administrative structure and delivery
187.2system under subdivision 18e, clients shall obtain their level-of-service certificate from the
187.3commissioner or an entity approved by the commissioner that does not dispatch rides for
187.4clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).
187.5    (g) The commissioner may use an order by the recipient's attending physician or a medical
187.6or mental health professional to certify that the recipient requires nonemergency medical
187.7transportation services. Nonemergency medical transportation providers shall perform
187.8driver-assisted services for eligible individuals, when appropriate. Driver-assisted service
187.9includes passenger pickup at and return to the individual's residence or place of business,
187.10assistance with admittance of the individual to the medical facility, and assistance in
187.11passenger securement or in securing of wheelchairs, child seats, or stretchers in the vehicle.
187.12Nonemergency medical transportation providers must take clients to the health care
187.13provider using the most direct route, and must not exceed 30 miles for a trip to a primary
187.14care provider or 60 miles for a trip to a specialty care provider, unless the client receives
187.15authorization from the local agency.
187.16Nonemergency medical transportation providers may not bill for separate base rates for
187.17the continuation of a trip beyond the original destination. Nonemergency medical
187.18transportation providers must maintain trip logs, which include pickup and drop-off times,
187.19signed by the medical provider or client, whichever is deemed most appropriate, attesting
187.20to mileage traveled to obtain covered medical services. Clients requesting client mileage
187.21reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
187.22services.
187.23(h) The administrative agency shall use the level of service process established by the
187.24commissioner in consultation with the Nonemergency Medical Transportation Advisory
187.25Committee to determine the client's most appropriate mode of transportation. If public transit
187.26or a certified transportation provider is not available to provide the appropriate service mode
187.27for the client, the client may receive a onetime service upgrade.
187.28(i) The covered modes of transportation, which may not be implemented without a new
187.29rate structure, are:
187.30(1) client reimbursement, which includes client mileage reimbursement provided to
187.31clients who have their own transportation, or to family or an acquaintance who provides
187.32transportation to the client;
187.33(2) volunteer transport, which includes transportation by volunteers using their own
187.34vehicle;
188.1(3) unassisted transport, which includes transportation provided to a client by a taxicab
188.2or public transit. If a taxicab or public transit is not available, the client can receive
188.3transportation from another nonemergency medical transportation provider;
188.4(4) assisted transport, which includes transport provided to clients who require assistance
188.5by a nonemergency medical transportation provider;
188.6(5) lift-equipped/ramp transport, which includes transport provided to a client who is
188.7dependent on a device and requires a nonemergency medical transportation provider with
188.8a vehicle containing a lift or ramp;
188.9(6) protected transport, which includes transport provided to a client who has received
188.10a prescreening that has deemed other forms of transportation inappropriate and who requires
188.11a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
188.12locks, a video recorder, and a transparent thermoplastic partition between the passenger and
188.13the vehicle driver; and (ii) who is certified as a protected transport provider; and
188.14(7) stretcher transport, which includes transport for a client in a prone or supine position
188.15and requires a nonemergency medical transportation provider with a vehicle that can transport
188.16a client in a prone or supine position.
188.17(j) The local agency shall be the single administrative agency and shall administer and
188.18reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
188.19commissioner has developed, made available, and funded the Web-based single
188.20administrative structure, assessment tool, and level of need assessment under subdivision
188.2118e. The local agency's financial obligation is limited to funds provided by the state or
188.22federal government.
188.23(k) The commissioner shall:
188.24(1) in consultation with the Nonemergency Medical Transportation Advisory Committee,
188.25verify that the mode and use of nonemergency medical transportation is appropriate;
188.26(2) verify that the client is going to an approved medical appointment; and
188.27(3) investigate all complaints and appeals.
188.28(l) The administrative agency shall pay for the services provided in this subdivision and
188.29seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
188.30local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
188.31recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.
189.1(m) Payments for nonemergency medical transportation must be paid based on the client's
189.2assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
189.3medical assistance reimbursement rates for nonemergency medical transportation services
189.4that are payable by or on behalf of the commissioner for nonemergency medical
189.5transportation services are:
189.6(1) $0.22 per mile for client reimbursement;
189.7(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
189.8transport;
189.9(3) equivalent to the standard fare for unassisted transport when provided by public
189.10transit, and $11 for the base rate and $1.30 per mile when provided by a nonemergency
189.11medical transportation provider;
189.12(4) $13 for the base rate and $1.30 per mile for assisted transport;
189.13(5) $18 for the base rate and $1.55 per mile for lift-equipped/ramp transport;
189.14(6) $75 for the base rate and $2.40 per mile for protected transport; and
189.15(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
189.16an additional attendant if deemed medically necessary.
189.17(n) The base rate for nonemergency medical transportation services in areas defined
189.18under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
189.19paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
189.20services in areas defined under RUCA to be rural or super rural areas is:
189.21(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
189.22rate in paragraph (m), clauses (1) to (7); and
189.23(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
189.24rate in paragraph (m), clauses (1) to (7).
189.25(o) For purposes of reimbursement rates for nonemergency medical transportation
189.26services under paragraphs (m) and (n), the zip code of the recipient's place of residence
189.27shall determine whether the urban, rural, or super rural reimbursement rate applies.
189.28(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
189.29a census-tract based classification system under which a geographical area is determined
189.30to be urban, rural, or super rural.
190.1(q) The commissioner, when determining reimbursement rates for nonemergency medical
190.2transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
190.3under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

190.4    Sec. 21. Minnesota Statutes 2016, section 256B.0625, subdivision 17b, is amended to
190.5read:
190.6    Subd. 17b. Documentation required. (a) As a condition for payment, nonemergency
190.7medical transportation providers must document each occurrence of a service provided to
190.8a recipient according to this subdivision. Providers must maintain odometer and other records
190.9sufficient to distinguish individual trips with specific vehicles and drivers. The documentation
190.10may be collected and maintained using electronic systems or software or in paper form but
190.11must be made available and produced upon request. Program funds paid for transportation
190.12that is not documented according to this subdivision shall be recovered by the department.
190.13(b) A nonemergency medical transportation provider must compile transportation records
190.14that meet the following requirements:
190.15(1) the record must be in English and must be legible according to the standard of a
190.16reasonable person;
190.17(2) the recipient's name must be on each page of the record; and
190.18(3) each entry in the record must document:
190.19(i) the date on which the entry is made;
190.20(ii) the date or dates the service is provided;
190.21(iii) the printed last name, first name, and middle initial of the driver;
190.22(iv) the signature of the driver attesting to the following: "I certify that I have accurately
190.23reported in this record the trip miles I actually drove and the dates and times I actually drove
190.24them. I understand that misreporting the miles driven and hours worked is fraud for which
190.25I could face criminal prosecution or civil proceedings.";
190.26(v) the signature of the recipient or authorized party attesting to the following: "I certify
190.27that I received the reported transportation service.", or the signature of the provider of
190.28medical services certifying that the recipient was delivered to the provider;
190.29(vi) the address, or the description if the address is not available, of both the origin and
190.30destination, and the mileage for the most direct route from the origin to the destination;
190.31(vii) the mode of transportation in which the service is provided;
191.1(viii) the license plate number of the vehicle used to transport the recipient;
191.2(ix) whether the service was ambulatory or nonambulatory until the modes under
191.3subdivision 17 are implemented;
191.4(x) the time of the pickup and the time of the drop-off with "a.m." and "p.m."
191.5designations;
191.6(xi) the name of the extra attendant when an extra attendant is used to provide special
191.7transportation service; and
191.8(xii) the electronic source documentation used to calculate driving directions and mileage.

191.9    Sec. 22. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
191.10to read:
191.11    Subd. 17c. Nursing facility transports. A Minnesota health care program enrollee
191.12residing in, or being discharged from, a licensed nursing facility is exempt from a level of
191.13need determination and is eligible for nonemergency medical transportation services until
191.14the enrollee no longer resides in a licensed nursing facility, as provided in section 256B.04,
191.15subdivision 14a.

191.16    Sec. 23. Minnesota Statutes 2016, section 256B.0625, subdivision 18h, is amended to
191.17read:
191.18    Subd. 18h. Managed care. (a) The following subdivisions do not apply to managed
191.19care plans and county-based purchasing plans:
191.20    (1) subdivision 17, paragraphs (d) to (k) (a), (b), (i), and (n);
191.21    (2) subdivision 18e 18; and
191.22    (3) subdivision 18g 18a.
191.23(b) A nonemergency medical transportation provider must comply with the operating
191.24standards for special transportation service specified in sections 174.29 to 174.30 and
191.25Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
191.26vehicles are exempt from the requirements in this paragraph.

191.27    Sec. 24. Minnesota Statutes 2016, section 256B.0625, subdivision 20, is amended to read:
191.28    Subd. 20. Mental health case management. (a) To the extent authorized by rule of the
191.29state agency, medical assistance covers case management services to persons with serious
191.30and persistent mental illness and children with severe emotional disturbance. Services
192.1provided under this section must meet the relevant standards in sections 245.461 to 245.4887,
192.2the Comprehensive Adult and Children's Mental Health Acts, Minnesota Rules, parts
192.39520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
192.4    (b) Entities meeting program standards set out in rules governing family community
192.5support services as defined in section 245.4871, subdivision 17, are eligible for medical
192.6assistance reimbursement for case management services for children with severe emotional
192.7disturbance when these services meet the program standards in Minnesota Rules, parts
192.89520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
192.9    (c) Medical assistance and MinnesotaCare payment for mental health case management
192.10shall be made on a monthly basis. In order to receive payment for an eligible child, the
192.11provider must document at least a face-to-face contact with the child, the child's parents, or
192.12the child's legal representative. To receive payment for an eligible adult, the provider must
192.13document:
192.14    (1) at least a face-to-face contact with the adult or the adult's legal representative or a
192.15contact by interactive video that meets the requirements of subdivision 20b; or
192.16    (2) at least a telephone contact with the adult or the adult's legal representative and
192.17document a face-to-face contact or a contact by interactive video that meets the requirements
192.18of subdivision 20b with the adult or the adult's legal representative within the preceding
192.19two months.
192.20    (d) Payment for mental health case management provided by county or state staff shall
192.21be based on the monthly rate methodology under section 256B.094, subdivision 6, paragraph
192.22(b), with separate rates calculated for child welfare and mental health, and within mental
192.23health, separate rates for children and adults.
192.24    (e) Payment for mental health case management provided by Indian health services or
192.25by agencies operated by Indian tribes may be made according to this section or other relevant
192.26federally approved rate setting methodology.
192.27    (f) Payment for mental health case management provided by vendors who contract with
192.28a county or Indian tribe shall be based on a monthly rate negotiated by the host county or
192.29tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
192.30service to other payers. If the service is provided by a team of contracted vendors, the county
192.31or tribe may negotiate a team rate with a vendor who is a member of the team. The team
192.32shall determine how to distribute the rate among its members. No reimbursement received
192.33by contracted vendors shall be returned to the county or tribe, except to reimburse the county
192.34or tribe for advance funding provided by the county or tribe to the vendor.
193.1    (g) If the service is provided by a team which includes contracted vendors, tribal staff,
193.2and county or state staff, the costs for county or state staff participation in the team shall be
193.3included in the rate for county-provided services. In this case, the contracted vendor, the
193.4tribal agency, and the county may each receive separate payment for services provided by
193.5each entity in the same month. In order to prevent duplication of services, each entity must
193.6document, in the recipient's file, the need for team case management and a description of
193.7the roles of the team members.
193.8    (h) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs for
193.9mental health case management shall be provided by the recipient's county of responsibility,
193.10as defined in sections 256G.01 to 256G.12, from sources other than federal funds or funds
193.11used to match other federal funds. If the service is provided by a tribal agency, the nonfederal
193.12share, if any, shall be provided by the recipient's tribe. When this service is paid by the state
193.13without a federal share through fee-for-service, 50 percent of the cost shall be provided by
193.14the recipient's county of responsibility.
193.15    (i) Notwithstanding any administrative rule to the contrary, prepaid medical assistance
193.16and MinnesotaCare include mental health case management. When the service is provided
193.17through prepaid capitation, the nonfederal share is paid by the state and the county pays no
193.18share.
193.19    (j) The commissioner may suspend, reduce, or terminate the reimbursement to a provider
193.20that does not meet the reporting or other requirements of this section. The county of
193.21responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal agency,
193.22is responsible for any federal disallowances. The county or tribe may share this responsibility
193.23with its contracted vendors.
193.24    (k) The commissioner shall set aside a portion of the federal funds earned for county
193.25expenditures under this section to repay the special revenue maximization account under
193.26section 256.01, subdivision 2, paragraph (o). The repayment is limited to:
193.27    (1) the costs of developing and implementing this section; and
193.28    (2) programming the information systems.
193.29    (l) Payments to counties and tribal agencies for case management expenditures under
193.30this section shall only be made from federal earnings from services provided under this
193.31section. When this service is paid by the state without a federal share through fee-for-service,
193.3250 percent of the cost shall be provided by the state. Payments to county-contracted vendors
193.33shall include the federal earnings, the state share, and the county share.
194.1    (m) Case management services under this subdivision do not include therapy, treatment,
194.2legal, or outreach services.
194.3    (n) If the recipient is a resident of a nursing facility, intermediate care facility, or hospital,
194.4and the recipient's institutional care is paid by medical assistance, payment for case
194.5management services under this subdivision is limited to the lesser of:
194.6    (1) the last 180 days of the recipient's residency in that facility and may not exceed more
194.7than six months in a calendar year; or
194.8    (2) the limits and conditions which apply to federal Medicaid funding for this service.
194.9    (o) Payment for case management services under this subdivision shall not duplicate
194.10payments made under other program authorities for the same purpose.
194.11(p) If the recipient is receiving care in a hospital, nursing facility, or residential setting
194.12licensed under chapter 245A or 245D that is staffed 24 hours a day, seven days a week,
194.13mental health targeted case management services must actively support identification of
194.14community alternatives for the recipient and discharge planning.
194.15EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
194.16of human services shall notify the revisor of statutes when federal approval is obtained.

194.17    Sec. 25. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
194.18to read:
194.19    Subd. 20b. Mental health targeted case management through interactive video. (a)
194.20Subject to federal approval, contact made for targeted case management by interactive video
194.21shall be eligible for payment if:
194.22    (1) the person receiving targeted case management services is residing in:
194.23    (i) a hospital;
194.24    (ii) a nursing facility; or
194.25    (iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
194.26establishment or lodging establishment that provides supportive services or health supervision
194.27services according to section 157.17 that is staffed 24 hours a day, seven days a week;
194.28    (2) interactive video is in the best interests of the person and is deemed appropriate by
194.29the person receiving targeted case management or the person's legal guardian, the case
194.30management provider, and the provider operating the setting where the person is residing;
195.1    (3) the use of interactive video is approved as part of the person's written personal service
195.2or case plan, taking into consideration the person's vulnerability and active personal
195.3relationships; and
195.4    (4) interactive video is used for up to, but not more than, 50 percent of the minimum
195.5required face-to-face contact.
195.6    (b) The person receiving targeted case management or the person's legal guardian has
195.7the right to choose and consent to the use of interactive video under this subdivision and
195.8has the right to refuse the use of interactive video at any time.
195.9    (c) The commissioner shall establish criteria that a targeted case management provider
195.10must attest to in order to demonstrate the safety or efficacy of delivering the service via
195.11interactive video. The attestation may include that the case management provider has:
195.12    (1) written policies and procedures specific to interactive video services that are regularly
195.13reviewed and updated;
195.14    (2) policies and procedures that adequately address client safety before, during, and after
195.15the interactive video services are rendered;
195.16    (3) established protocols addressing how and when to discontinue interactive video
195.17services; and
195.18    (4) established a quality assurance process related to interactive video services.
195.19    (d) As a condition of payment, the targeted case management provider must document
195.20the following for each occurrence of targeted case management provided by interactive
195.21video:
195.22    (1) the time the service began and the time the service ended, including an a.m. and p.m.
195.23designation;
195.24    (2) the basis for determining that interactive video is an appropriate and effective means
195.25for delivering the service to the person receiving case management services;
195.26    (3) the mode of transmission of the interactive video services and records evidencing
195.27that a particular mode of transmission was utilized;
195.28    (4) the location of the originating site and the distant site; and
195.29    (5) compliance with the criteria attested to by the targeted case management provider
195.30as provided in paragraph (c).
196.1EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
196.2of human services shall notify the revisor of statutes when federal approval is obtained.

196.3    Sec. 26. Minnesota Statutes 2016, section 256B.0625, subdivision 30, is amended to read:
196.4    Subd. 30. Other clinic services. (a) Medical assistance covers rural health clinic services,
196.5federally qualified health center services, nonprofit community health clinic services, and
196.6public health clinic services. Rural health clinic services and federally qualified health center
196.7services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and
196.8(C). Payment for rural health clinic and federally qualified health center services shall be
196.9made according to applicable federal law and regulation.
196.10    (b) A federally qualified health center (FQHC) that is beginning initial operation shall
196.11submit an estimate of budgeted costs and visits for the initial reporting period in the form
196.12and detail required by the commissioner. A federally qualified health center An FQHC that
196.13is already in operation shall submit an initial report using actual costs and visits for the
196.14initial reporting period. Within 90 days of the end of its reporting period, a federally qualified
196.15health center an FQHC shall submit, in the form and detail required by the commissioner,
196.16a report of its operations, including allowable costs actually incurred for the period and the
196.17actual number of visits for services furnished during the period, and other information
196.18required by the commissioner. Federally qualified health centers FQHCs that file Medicare
196.19cost reports shall provide the commissioner with a copy of the most recent Medicare cost
196.20report filed with the Medicare program intermediary for the reporting year which support
196.21the costs claimed on their cost report to the state.
196.22    (c) In order to continue cost-based payment under the medical assistance program
196.23according to paragraphs (a) and (b), a federally qualified health center an FQHC or rural
196.24health clinic must apply for designation as an essential community provider within six
196.25months of final adoption of rules by the Department of Health according to section 62Q.19,
196.26subdivision 7 . For those federally qualified health centers FQHCs and rural health clinics
196.27that have applied for essential community provider status within the six-month time
196.28prescribed, medical assistance payments will continue to be made according to paragraphs
196.29(a) and (b) for the first three years after application. For federally qualified health centers
196.30FQHCs and rural health clinics that either do not apply within the time specified above or
196.31who have had essential community provider status for three years, medical assistance
196.32payments for health services provided by these entities shall be according to the same rates
196.33and conditions applicable to the same service provided by health care providers that are not
196.34federally qualified health centers FQHCs or rural health clinics.
197.1    (d) Effective July 1, 1999, the provisions of paragraph (c) requiring a federally qualified
197.2health center an FQHC or a rural health clinic to make application for an essential community
197.3provider designation in order to have cost-based payments made according to paragraphs
197.4(a) and (b) no longer apply.
197.5    (e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall
197.6be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.
197.7    (f) Effective January 1, 2001, through December 31, 2018, each federally qualified
197.8health center FQHC and rural health clinic may elect to be paid either under the prospective
197.9payment system established in United States Code, title 42, section 1396a(aa), or under an
197.10alternative payment methodology consistent with the requirements of United States Code,
197.11title 42, section 1396a(aa), and approved by the Centers for Medicare and Medicaid Services.
197.12The alternative payment methodology shall be 100 percent of cost as determined according
197.13to Medicare cost principles.
197.14    (g) Effective for services provided on or after January 1, 2019, all claims for payment
197.15of clinic services provided by FQHCs and rural health clinics shall be paid by the
197.16commissioner, according to an annual election by the FQHC or rural health clinic, under
197.17the current prospective payment system described in paragraph (f), the alternative payment
197.18methodology described in paragraph (f), or the alternative payment methodology described
197.19in paragraph (l).
197.20    (g) (h) For purposes of this section, "nonprofit community clinic" is a clinic that:
197.21    (1) has nonprofit status as specified in chapter 317A;
197.22    (2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);
197.23    (3) is established to provide health services to low-income population groups, uninsured,
197.24high-risk and special needs populations, underserved and other special needs populations;
197.25    (4) employs professional staff at least one-half of which are familiar with the cultural
197.26background of their clients;
197.27    (5) charges for services on a sliding fee scale designed to provide assistance to
197.28low-income clients based on current poverty income guidelines and family size; and
197.29    (6) does not restrict access or services because of a client's financial limitations or public
197.30assistance status and provides no-cost care as needed.
197.31    (h) (i) Effective for services provided on or after January 1, 2015, all claims for payment
197.32of clinic services provided by federally qualified health centers FQHCs and rural health
198.1clinics shall be paid by the commissioner. Effective for services provided on or after January
198.21, 2015, through July 1, 2017, the commissioner shall determine the most feasible method
198.3for paying claims from the following options:
198.4    (1) federally qualified health centers FQHCs and rural health clinics submit claims
198.5directly to the commissioner for payment, and the commissioner provides claims information
198.6for recipients enrolled in a managed care or county-based purchasing plan to the plan, on
198.7a regular basis; or
198.8    (2) federally qualified health centers FQHCs and rural health clinics submit claims for
198.9recipients enrolled in a managed care or county-based purchasing plan to the plan, and those
198.10claims are submitted by the plan to the commissioner for payment to the clinic.
198.11Effective for services provided on or after January 1, 2019, FQHCs and rural health clinics
198.12shall submit claims directly to the commissioner for payment and the commissioner shall
198.13provide claims information for recipients enrolled in a managed care plan or county-based
198.14purchasing plan to the plan on a regular basis to be determined by the commissioner.
198.15    (i) (j) For clinic services provided prior to January 1, 2015, the commissioner shall
198.16calculate and pay monthly the proposed managed care supplemental payments to clinics,
198.17and clinics shall conduct a timely review of the payment calculation data in order to finalize
198.18all supplemental payments in accordance with federal law. Any issues arising from a clinic's
198.19review must be reported to the commissioner by January 1, 2017. Upon final agreement
198.20between the commissioner and a clinic on issues identified under this subdivision, and in
198.21accordance with United States Code, title 42, section 1396a(bb), no supplemental payments
198.22for managed care plan or county-based purchasing plan claims for services provided prior
198.23to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are
198.24unable to resolve issues under this subdivision, the parties shall submit the dispute to the
198.25arbitration process under section 14.57.
198.26    (j) (k) The commissioner shall seek a federal waiver, authorized under section 1115 of
198.27the Social Security Act, to obtain federal financial participation at the 100 percent federal
198.28matching percentage available to facilities of the Indian Health Service or tribal organization
198.29in accordance with section 1905(b) of the Social Security Act for expenditures made to
198.30organizations dually certified under Title V of the Indian Health Care Improvement Act,
198.31Public Law 94-437, and as a federally qualified health center FQHC under paragraph (a)
198.32that provides services to American Indian and Alaskan Native individuals eligible for
198.33services under this subdivision.
199.1    (l) Effective for services provided on or after January 1, 2019, all claims for payment
199.2of clinic services provided by FQHCs and rural health clinics shall be paid by the
199.3commissioner according to the current prospective payment system described in paragraph
199.4(f), or an alternative payment methodology with the following requirements:
199.5    (1) each FQHC and rural health clinic must receive a single medical and a single dental
199.6organization rate;
199.7    (2) the commissioner shall reimburse FQHCs and rural health clinics for allowable costs,
199.8including direct patient care costs and patient-related support services, based upon Medicare
199.9cost principles that apply at the time the alternative payment methodology is calculated;
199.10    (3) the 2019 payment rates for FQHCs and rural health clinics:
199.11    (i) must be determined using each FQHC's and rural health clinic's Medicare cost reports
199.12from 2015 and 2016. A provider must submit the required cost reports to the commissioner
199.13within six months of the second base year calendar or fiscal year end. Cost reports must be
199.14submitted six months before the quarter in which the base rate will take effect;
199.15    (ii) must be according to current Medicare cost principles applicable to FQHCs and rural
199.16health clinics at the time of the alternative payment rate calculation without the application
199.17of productivity screens and upper payment limits or the Medicare prospective payment
199.18system FQHC aggregate mean upper payment limit; and
199.19    (iii) must provide for a 60-day appeals process;
199.20    (4) the commissioner shall inflate the base year payment rate for FQHCs and rural health
199.21clinics to the effective date by using the Bureau of Economic Analysis's personal consumption
199.22expenditures medical care inflator;
199.23    (5) the commissioner shall establish a statewide trend inflator using 2015-2020 costs
199.24replacing the use of the personal consumption expenditures medical care inflator with the
199.252023 rate calculation forward;
199.26    (6) FQHC and rural health clinic payment rates shall be rebased by the commissioner
199.27every two years using the methodology described in clause (3), using the provider's Medicare
199.28cost reports from the previous third and fourth years. In nonrebasing years, the commissioner
199.29shall adjust using the Medicare economic index until 2023 when the statewide trend inflator
199.30is available;
199.31    (7) the commissioner shall increase payments by two percent according to Laws 2003,
199.32First Special Session chapter 14, article 13C, section 2, subdivision 6. This is an add-on to
199.33the rate and must not be included in the base rate calculation;
200.1    (8) for FQHCs and rural health clinics seeking a change of scope of services:
200.2    (i) the commissioner shall require FQHCs and rural health clinics to submit requests to
200.3the commissioner, if the change of scope would result in the medical or dental payment rate
200.4currently received by the FQHC or rural health clinic increasing or decreasing by at least
200.52-1/2 percent;
200.6    (ii) FQHCs and rural health clinics shall submit the request to the commissioner within
200.7seven business days of submission of the scope change to the federal Health Resources
200.8Services Administration;
200.9    (iii) the effective date of the payment change is the date the Health Resources Services
200.10Administration approves the FQHC's or rural health clinic's change of scope request;
200.11    (iv) for change of scope requests that do not require Health Resources Services
200.12Administration approval, FQHCs and rural health clinics shall submit the request to the
200.13commissioner before implementing the change, and the effective date of the change is the
200.14date the commissioner receives the request from the FQHC or rural health clinic; and
200.15    (v) the commissioner shall provide a response to the FQHC's or rural health clinic's
200.16change of scope request within 45 days of submission and provide a final decision regarding
200.17approval or disapproval within 120 days of submission. If more information is needed to
200.18evaluate the request, this timeline may be waived by mutual agreement of the commissioner
200.19and the FQHC or rural health clinic; and
200.20    (9) the commissioner shall establish a payment rate for new FQHC and rural health
200.21clinic organizations, considering the following factors:
200.22    (i) a comparison of patient caseload of FQHCs and rural health clinics within a 60-mile
200.23radius for organizations established outside the seven-county metropolitan area and within
200.24a 30-mile radius for organizations within the seven-county metropolitan area; and
200.25    (ii) if a comparison is not feasible under item (i), the commissioner may use Medicare
200.26cost reports or audited financial statements to establish the base rate.

200.27    Sec. 27. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
200.28to read:
200.29    Subd. 56a. Post-arrest community-based service coordination. (a) Medical assistance
200.30covers post-arrest community-based service coordination for an individual who:
200.31(1) has been identified as having a mental illness or substance use disorder using a
200.32screening tool approved by the commissioner;
201.1(2) does not require the security of a public detention facility and is not considered an
201.2inmate of a public institution as defined in Code of Federal Regulations, title 42, section
201.3435.1010;
201.4(3) meets the eligibility requirements in section 256B.056; and
201.5(4) has agreed to participate in post-arrest community-based service coordination through
201.6a diversion contract in lieu of incarceration.
201.7(b) Post-arrest community-based service coordination means navigating services to
201.8address a client's mental health, chemical health, social, economic, and housing needs, or
201.9any other activity targeted at reducing the incidence of jail utilization and connecting
201.10individuals with existing covered services available to them, including, but not limited to,
201.11targeted case management, waiver case management, or care coordination.
201.12(c) Post-arrest community-based service coordination must be provided by individuals
201.13who are qualified under one of the following criteria:
201.14(1) a licensed mental health professional as defined in section 245.462, subdivision 18,
201.15clauses (1) to (6);
201.16(2) a mental health practitioner as defined in section 245.462, subdivision 17, working
201.17under the clinical supervision of a mental health professional; or
201.18(3) a certified peer specialist under section 256B.0615, working under the clinical
201.19supervision of a mental health professional.
201.20(d) Reimbursement must be made in 15-minute increments and allowed for up to 60
201.21days following the initial determination of eligibility.
201.22(e) Providers of post-arrest community-based service coordination shall annually report
201.23to the commissioner on the number of individuals served, and number of the
201.24community-based services that were accessed by recipients. The commissioner shall ensure
201.25that services and payments provided under post-arrest community-based service coordination
201.26do not duplicate services or payments provided under section 256B.0625, subdivision 20,
201.27256B.0753, 256B.0755, or 256B.0757.
201.28(f) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of cost for
201.29post-arrest community-based service coordination services shall be provided by the recipient's
201.30county of residence, from sources other than federal funds or funds used to match other
201.31federal funds.
202.1EFFECTIVE DATE.This section is effective upon federal approval for services
202.2provided on or after July 1, 2017. The commissioner of human services shall notify the
202.3revisor of statutes when federal approval is obtained.

202.4    Sec. 28. Minnesota Statutes 2016, section 256B.0625, subdivision 64, is amended to read:
202.5    Subd. 64. Investigational drugs, biological products, and devices. (a) Medical
202.6assistance and the early periodic screening, diagnosis, and treatment (EPSDT) program do
202.7not cover costs incidental to, associated with, or resulting from the use of investigational
202.8drugs, biological products, or devices as defined in section 151.375.
202.9(b) Notwithstanding paragraph (a), stiripentol may be covered by the EPSDT program
202.10if all the following conditions are met:
202.11(1) the use of stiripentol is determined to be medically necessary;
202.12(2) the enrollee has a documented diagnosis of Dravet syndrome, regardless of whether
202.13an SCN1A genetic mutation is found, or the enrollee is a child with malignant migrating
202.14partial epilepsy in infancy due to an SCN2A genetic mutation;
202.15(3) all other available covered prescription medications that are medically necessary for
202.16the enrollee have been tried without successful outcomes; and
202.17(4) the United States Food and Drug Administration has approved the treating physician's
202.18individual patient investigational new drug application (IND) for the use of stiripentol for
202.19treatment.
202.20This paragraph does not apply to MinnesotaCare coverage under chapter 256L.

202.21    Sec. 29. Minnesota Statutes 2016, section 256B.072, is amended to read:
202.22256B.072 PERFORMANCE REPORTING AND QUALITY IMPROVEMENT
202.23SYSTEM.
202.24    Subdivision 1. Performance measures. (a) The commissioner of human services shall
202.25establish a performance reporting system for health care providers who provide health care
202.26services to public program recipients covered under chapters 256B, 256D, and 256L,
202.27reporting separately for managed care and fee-for-service recipients.
202.28(b) The measures used for the performance reporting system for medical groups shall
202.29include measures of care for asthma, diabetes, hypertension, and coronary artery disease
202.30and measures of preventive care services. The measures used for the performance reporting
202.31system for inpatient hospitals shall include measures of care for acute myocardial infarction,
203.1heart failure, and pneumonia, and measures of care and prevention of surgical infections.
203.2In the case of a medical group, the measures used shall be consistent with measures published
203.3by nonprofit Minnesota or national organizations that produce and disseminate health care
203.4quality measures or evidence-based health care guidelines. In the case of inpatient hospital
203.5measures, the commissioner shall appoint the Minnesota Hospital Association and Stratis
203.6Health to advise on the development of the performance measures to be used for hospital
203.7reporting. To enable a consistent measurement process across the community, the
203.8commissioner may use measures of care provided for patients in addition to those identified
203.9in paragraph (a). The commissioner shall ensure collaboration with other health care reporting
203.10organizations so that the measures described in this section are consistent with those reported
203.11by those organizations and used by other purchasers in Minnesota.
203.12(c) The commissioner may require providers to submit information in a required format
203.13to a health care reporting organization or to cooperate with the information collection
203.14procedures of that organization. The commissioner may collaborate with a reporting
203.15organization to collect information reported and to prevent duplication of reporting.
203.16(d) By October 1, 2007, and annually thereafter, the commissioner shall report through
203.17a public Web site the results by medical groups and hospitals, where possible, of the measures
203.18under this section, and shall compare the results by medical groups and hospitals for patients
203.19enrolled in public programs to patients enrolled in private health plans. To achieve this
203.20reporting, the commissioner may collaborate with a health care reporting organization that
203.21operates a Web site suitable for this purpose.
203.22(e) Performance measures must be stratified as provided under section 62U.02,
203.23subdivision 1, paragraph (b), and risk-adjusted as specified in section 62U.02, subdivision
203.243, paragraph (b).
203.25(f) Assessment of patient satisfaction with chronic pain management for the purpose of
203.26determining compensation or quality incentive payments is prohibited. The commissioner
203.27shall require managed care plans, county-based purchasing plans, and integrated health
203.28partnerships to comply with this requirement as a condition of contract. This prohibition
203.29does not apply to:
203.30(1) assessing patient satisfaction with chronic pain management for the purpose of quality
203.31improvement; and
203.32(2) pain management as a part of a palliative care treatment plan to treat patients with
203.33cancer or patients receiving hospice care.
204.1    Subd. 2. Adjustment of quality metrics for special populations. Notwithstanding
204.2subdivision 1, paragraph (b), by January 1, 2019, the commissioner shall consider and
204.3appropriately adjust quality metrics and benchmarks for providers who primarily serve
204.4socio-economically complex patient populations and request to be scored on additional
204.5measures in this subdivision. This requirement applies to all medical assistance and
204.6MinnesotaCare programs and enrollees, including persons enrolled in managed care and
204.7county-based purchasing plans or other managed care organizations, persons receiving care
204.8under fee-for-service, and persons receiving care under value-based purchasing arrangements,
204.9including but not limited to initiatives operating under sections 256B.0751, 256B.0753,
204.10256B.0755, 256B.0756, and 256B.0757.

204.11    Sec. 30. Minnesota Statutes 2016, section 256B.0755, subdivision 1, is amended to read:
204.12    Subdivision 1. Implementation. (a) The commissioner shall develop and authorize
204.13continue a demonstration project established under this section to test alternative and
204.14innovative integrated health care delivery systems partnerships, including accountable care
204.15organizations that provide services to a specified patient population for an agreed-upon total
204.16cost of care or risk/gain sharing payment arrangement. The commissioner shall develop a
204.17request for proposals for participation in the demonstration project in consultation with
204.18hospitals, primary care providers, health plans, and other key stakeholders.
204.19(b) In developing the request for proposals, the commissioner shall:
204.20(1) establish uniform statewide methods of forecasting utilization and cost of care for
204.21the appropriate Minnesota public program populations, to be used by the commissioner for
204.22the health care delivery system integrated health partnership projects;
204.23(2) identify key indicators of quality, access, patient satisfaction, and other performance
204.24indicators that will be measured, in addition to indicators for measuring cost savings;
204.25(3) allow maximum flexibility to encourage innovation and variation so that a variety
204.26of provider collaborations are able to become health care delivery systems integrated health
204.27partnerships, and may be customized for the special needs and barriers of patient populations
204.28experiencing health disparities due to social, economic, racial, or ethnic factors,;
204.29(4) encourage and authorize different levels and types of financial risk;
204.30(5) encourage and authorize projects representing a wide variety of geographic locations,
204.31patient populations, provider relationships, and care coordination models;
204.32(6) encourage projects that involve close partnerships between the health care delivery
204.33system integrated health partnership and counties and nonprofit agencies that provide services
205.1to patients enrolled with the health care delivery system integrated health partnership,
205.2including social services, public health, mental health, community-based services, and
205.3continuing care;
205.4(7) encourage projects established by community hospitals, clinics, and other providers
205.5in rural communities;
205.6(8) identify required covered services for a total cost of care model or services considered
205.7in whole or partially in an analysis of utilization for a risk/gain sharing model;
205.8(9) establish a mechanism to monitor enrollment;
205.9(10) establish quality standards for the delivery system integrated health partnership
205.10demonstrations that are appropriate for the particular patient population to be served; and
205.11(11) encourage participation of privately insured population so as to create sufficient
205.12alignment in demonstration systems.
205.13(c) To be eligible to participate in the demonstration project an integrated health
205.14partnership, a health care delivery system must:
205.15(1) provide required covered services and care coordination to recipients enrolled in the
205.16health care delivery system integrated health partnership;
205.17(2) establish a process to monitor enrollment and ensure the quality of care provided;
205.18(3) in cooperation with counties and community social service agencies, coordinate the
205.19delivery of health care services with existing social services programs;
205.20(4) provide a system for advocacy and consumer protection; and
205.21(5) adopt innovative and cost-effective methods of care delivery and coordination, which
205.22may include the use of allied health professionals, telemedicine, patient educators, care
205.23coordinators, and community health workers.
205.24(d) A health care delivery system An integrated health partnership demonstration may
205.25be formed by the following groups of providers of services and suppliers if they have
205.26established a mechanism for shared governance:
205.27(1) professionals in group practice arrangements;
205.28(2) networks of individual practices of professionals;
205.29(3) partnerships or joint venture arrangements between hospitals and health care
205.30professionals;
205.31(4) hospitals employing professionals; and
206.1(5) other groups of providers of services and suppliers as the commissioner determines
206.2appropriate.
206.3A managed care plan or county-based purchasing plan may participate in this
206.4demonstration in collaboration with one or more of the entities listed in clauses (1) to (5).
206.5A health care delivery system An integrated health partnership may contract with a
206.6managed care plan or a county-based purchasing plan to provide administrative services,
206.7including the administration of a payment system using the payment methods established
206.8by the commissioner for health care delivery systems integrated health partnerships.
206.9(e) The commissioner may require a health care delivery system an integrated health
206.10partnership to enter into additional third-party contractual relationships for the assessment
206.11of risk and purchase of stop loss insurance or another form of insurance risk management
206.12related to the delivery of care described in paragraph (c).
206.13EFFECTIVE DATE.This section is effective January 1, 2018.

206.14    Sec. 31. Minnesota Statutes 2016, section 256B.0755, subdivision 3, is amended to read:
206.15    Subd. 3. Accountability. (a) Health care delivery systems Integrated health partnerships
206.16must accept responsibility for the quality of care based on standards established under
206.17subdivision 1, paragraph (b), clause (10), and the cost of care or utilization of services
206.18provided to its enrollees under subdivision 1, paragraph (b), clause (1). Accountability
206.19standards must be appropriate to the particular population served.
206.20(b) A health care delivery system An integrated health partnership may contract and
206.21coordinate with providers and clinics for the delivery of services and shall contract with
206.22community health clinics, federally qualified health centers, community mental health
206.23centers or programs, county agencies, and rural clinics to the extent practicable.
206.24(c) A health care delivery system An integrated health partnership must indicate how it
206.25will coordinate with other services affecting its patients' health, quality of care, and cost of
206.26care that are provided by other providers, county agencies, and other organizations in the
206.27local service area. The health care delivery system integrated health partnership must indicate
206.28how it will engage other providers, counties, and organizations, including county-based
206.29purchasing plans, that provide services to patients of the health care delivery system
206.30integrated health partnership on issues related to local population health, including applicable
206.31local needs, priorities, and public health goals. The health care delivery system integrated
206.32health partnership must describe how local providers, counties, organizations, including
207.1county-based purchasing plans, and other relevant purchasers were consulted in developing
207.2the application to participate in the demonstration project.

207.3    Sec. 32. Minnesota Statutes 2016, section 256B.0755, subdivision 4, is amended to read:
207.4    Subd. 4. Payment system. (a) In developing a payment system for health care delivery
207.5systems integrated health partnerships, the commissioner shall establish a total cost of care
207.6benchmark or a risk/gain sharing payment model to be paid for services provided to the
207.7recipients enrolled in a health care delivery system an integrated health partnership.
207.8(b) The payment system may include incentive payments to health care delivery systems
207.9integrated health partnerships that meet or exceed annual quality and performance targets
207.10realized through the coordination of care.
207.11(c) An amount equal to the savings realized to the general fund as a result of the
207.12demonstration project shall be transferred each fiscal year to the health care access fund.
207.13(d) The payment system shall include a population-based payment that supports care
207.14coordination services for all enrollees served by the integrated health partnerships, and is
207.15risk-adjusted to reflect varying levels of care coordination intensiveness for enrollees with
207.16chronic conditions, limited English skills, cultural differences, are homeless, or experience
207.17health disparities or other barriers to health care. The population-based payment shall be a
207.18per member, per month payment paid at least on a quarterly basis. Integrated health
207.19partnerships receiving this payment must continue to meet cost and quality metrics under
207.20the program to maintain eligibility for the population-based payment. An integrated health
207.21partnership is eligible to receive a payment under this paragraph even if the partnership is
207.22not participating in a risk-based or gain-sharing payment model and regardless of the size
207.23of the patient population served by the integrated health partnership. Any integrated health
207.24partnership participant certified as a health care home under section 256B.0751 that agrees
207.25to a payment method that includes population-based payments for care coordination is not
207.26eligible to receive health care home payment or care coordination fee authorized under
207.27section 62U.03 or 256B.0753, subdivision 1, or in-reach care coordination under section
207.28256B.0625, subdivision 56, for any medical assistance or MinnesotaCare recipients enrolled
207.29or attributed to the integrated health partnership under this demonstration.
207.30EFFECTIVE DATE.This section is effective January 1, 2018.

208.1    Sec. 33. Minnesota Statutes 2016, section 256B.0755, is amended by adding a subdivision
208.2to read:
208.3    Subd. 9. Patient incentives. The commissioner may authorize an integrated health
208.4partnership to provide incentives for patients to:
208.5(1) see a primary care provider for an initial health assessment;
208.6(2) maintain a continuous relationship with the primary care provider; and
208.7(3) participate in ongoing health improvement and coordination of care activities.

208.8    Sec. 34. [256B.0759] HEALTH CARE DELIVERY SYSTEMS DEMONSTRATION
208.9PROJECT.
208.10    Subdivision 1. Implementation. (a) The commissioner shall develop and implement a
208.11demonstration project to test alternative and innovative health care delivery system payment
208.12and care models that provide services to medical assistance and MinnesotaCare enrollees
208.13for an agreed-upon, prospective per capita or total cost of care payment. The commissioner
208.14shall implement this demonstration project in coordination with, and as an expansion of,
208.15the demonstration project authorized under section 256B.0755.
208.16(b) In developing the demonstration project, the commissioner shall:
208.17(1) establish uniform statewide methods of forecasting utilization and cost of care for
208.18the medical assistance and MinnesotaCare populations to be served under the health care
208.19delivery system project;
208.20(2) identify key indicators of quality, access, and patient satisfaction, and identify methods
208.21to measure cost savings;
208.22(3) allow maximum flexibility to encourage innovation and variation so that a variety
208.23of provider collaborations are able to participate as health care delivery systems, and health
208.24care delivery systems can be customized to address the special needs and barriers of patient
208.25populations;
208.26(4) authorize participation by health care delivery systems representing a variety of
208.27geographic locations, patient populations, provider relationships, and care coordination
208.28models;
208.29(5) recognize the close partnerships between health care delivery systems and the counties
208.30and nonprofit agencies that also provide services to patients enrolled in the health care
208.31delivery system, including social services, public health, mental health, community-based
208.32services, and continuing care;
209.1(6) identify services to be included under a prospective per capita payment model, and
209.2project utilization and cost of these services under a total cost of care risk/gain sharing
209.3model;
209.4(7) establish a mechanism to monitor enrollment in each health care delivery system;
209.5and
209.6(8) establish quality standards for delivery systems that are appropriate for the specific
209.7patient populations served.
209.8    Subd. 2. Requirements for health care delivery systems. (a) To be eligible to participate
209.9in the demonstration project, a health care delivery system must:
209.10(1) provide required services and care coordination to individuals enrolled in the health
209.11care delivery system;
209.12(2) establish a process to monitor enrollment and ensure the quality of care provided;
209.13(3) in cooperation with counties and community social service agencies, coordinate the
209.14delivery of health care services with existing social services programs;
209.15(4) provide a system for advocacy and consumer protection; and
209.16(5) adopt innovative and cost-effective methods of care delivery and coordination, which
209.17may include the use of allied health professionals, telemedicine and patient educators, care
209.18coordinators, community paramedics, and community health workers.
209.19(b) A health care delivery system may be formed by the following types of health care
209.20providers, if they have established, as applicable, a mechanism for shared governance:
209.21(1) health care providers in group practice arrangements;
209.22(2) networks of health care providers in individual practice;
209.23(3) partnerships or joint venture arrangements between hospitals and health care providers;
209.24(4) hospitals employing or contracting with the necessary range of health care providers;
209.25and
209.26(5) other entities, as the commissioner determines appropriate.
209.27(c) A health care delivery system must contract with a third-party administrator to provide
209.28administrative services, including the administration of the payment system established
209.29under the demonstration project. The third-party administrator must conduct an assessment
209.30of risk, and must purchase stop-loss insurance or another form of insurance risk management
209.31related to the delivery of care. The commissioner may waive the requirement for contracting
210.1with a third-party administrator if the health care delivery system can demonstrate to the
210.2commissioner that it can satisfactorily perform all of the duties assigned to the third-party
210.3administrator.
210.4    Subd. 3. Enrollment. (a) Individuals eligible for medical assistance or MinnesotaCare
210.5shall be eligible for enrollment in a health care delivery system. Individuals required to
210.6enroll in the prepaid medical assistance program or prepaid MinnesotaCare may opt out of
210.7receiving care from a managed care or county-based purchasing plan, and elect to receive
210.8care through a health care delivery system established under this section.
210.9(b) Eligible applicants and recipients may enroll in a health care delivery system if the
210.10system serves the county in which the applicant or recipient resides. If more than one health
210.11care delivery system serves a county, the applicant or recipient may choose among the
210.12delivery systems. Enrollment in a specific health care delivery system shall be for a 12-month
210.13period, except that enrollees who do not maintain eligibility for medical assistance or
210.14MinnesotaCare shall be disenrolled, and enrollees experiencing a qualifying life event, as
210.15specified by the commissioner, may change health care delivery systems, or opt out of
210.16receiving coverage through a health care delivery system, within 60 days of the date of the
210.17qualifying life event.
210.18(c) The commissioner shall assign an applicant or recipient to a health care delivery
210.19system if:
210.20(1) the applicant or recipient is currently or has recently been attributed to the health
210.21care delivery system as part of an integrated health partnership under section 256B.0755;
210.22or
210.23(2) no choice has been made by the applicant or recipient. In this case, the commissioner
210.24shall enroll an applicant or recipient based on geographic criteria or based on the health
210.25care providers from whom the applicant or recipient has received prior care.
210.26    Subd. 4. Accountability. (a) Health care delivery systems are responsible for the quality
210.27of care based on standards established by the commissioner, and for enrollee cost of care
210.28and utilization of services. The commissioner shall adjust accountability standards including
210.29the quality, cost, and utilization of care to take into account the social, economic, or cultural
210.30barriers experienced by the health care delivery system's patient population.
210.31(b) A health care delivery system must contract with community health clinics, federally
210.32qualified health centers, community mental health centers or programs, county agencies,
210.33and rural health clinics to the extent practicable.
211.1(c) A health care delivery system must indicate to the commissioner how it will coordinate
211.2its services with those delivered by other providers, county agencies, and other organizations
211.3in the local service area. The health care delivery system must indicate how it will engage
211.4other providers, counties, and organizations that provide services to patients of the health
211.5care delivery system on issues related to local population health, including applicable local
211.6needs, priorities, and public health goals. The health care delivery system must describe
211.7how local providers, counties, and organizations were consulted in developing the application
211.8submitted to the commissioner requiring participation in the demonstration project.
211.9    Subd. 5. Payment system. The commissioner shall develop a payment system for the
211.10health care delivery system project that includes prospective per capita payments, total cost
211.11of care benchmarks, and risk/gain sharing payment options. The payment system may
211.12include incentive payments to health care delivery systems that meet or exceed annual
211.13quality and performance targets through the coordination of care.
211.14    Subd. 6. Federal waiver or approval. The commissioner shall seek all federal waivers
211.15or approval necessary to implement the health care delivery system demonstration project.
211.16The commissioner shall notify the chairs and ranking minority members of the legislative
211.17committees with jurisdiction over health and human services policy and finance of any
211.18federal action related to the request for waivers and approval.
211.19EFFECTIVE DATE.This section is effective January 1, 2018, or upon receipt of
211.20federal waivers or approval, whichever is later. The commissioner of human services shall
211.21notify the revisor of statutes when federal approval is obtained.

211.22    Sec. 35. Minnesota Statutes 2016, section 256B.0924, is amended by adding a subdivision
211.23to read:
211.24    Subd. 4a. Targeted case management through interactive video. (a) Subject to federal
211.25approval, contact made for targeted case management by interactive video shall be eligible
211.26for payment under subdivision 6 if:
211.27    (1) the person receiving targeted case management services is residing in:
211.28    (i) a hospital;
211.29    (ii) a nursing facility; or
211.30    (iii) a residential setting licensed under chapter 245A or 245D or a boarding and lodging
211.31establishment or lodging establishment that provides supportive services or health supervision
211.32services according to section 157.17 that is staffed 24 hours a day, seven days a week;
212.1    (2) interactive video is in the best interests of the person and is deemed appropriate by
212.2the person receiving targeted case management or the person's legal guardian, the case
212.3management provider, and the provider operating the setting where the person is residing;
212.4    (3) the use of interactive video is approved as part of the person's written personal service
212.5or case plan; and
212.6    (4) interactive video is used for up to, but not more than, 50 percent of the minimum
212.7required face-to-face contact.
212.8    (b) The person receiving targeted case management or the person's legal guardian has
212.9the right to choose and consent to the use of interactive video under this subdivision and
212.10has the right to refuse the use of interactive video at any time.
212.11    (c) The commissioner shall establish criteria that a targeted case management provider
212.12must attest to in order to demonstrate the safety or efficacy of delivering the service via
212.13interactive video. The attestation may include that the case management provider has:
212.14    (1) written policies and procedures specific to interactive video services that are regularly
212.15reviewed and updated;
212.16    (2) policies and procedures that adequately address client safety before, during, and after
212.17the interactive video services are rendered;
212.18    (3) established protocols addressing how and when to discontinue interactive video
212.19services; and
212.20    (4) established a quality assurance process related to interactive video services.
212.21    (d) As a condition of payment, the targeted case management provider must document
212.22the following for each occurrence of targeted case management provided by interactive
212.23video:
212.24    (1) the time the service began and the time the service ended, including an a.m. and p.m.
212.25designation;
212.26    (2) the basis for determining that interactive video is an appropriate and effective means
212.27for delivering the service to the person receiving case management services;
212.28    (3) the mode of transmission of the interactive video services and records evidencing
212.29that a particular mode of transmission was utilized;
212.30    (4) the location of the originating site and the distant site; and
213.1    (5) compliance with the criteria attested to by the targeted case management provider
213.2as provided in paragraph (c).
213.3EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
213.4of human services shall notify the revisor of statutes when federal approval is obtained.

213.5    Sec. 36. Minnesota Statutes 2016, section 256B.196, subdivision 2, is amended to read:
213.6    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and subdivision
213.73, the commissioner shall determine the fee-for-service outpatient hospital services upper
213.8payment limit for nonstate government hospitals. The commissioner shall then determine
213.9the amount of a supplemental payment to Hennepin County Medical Center and Regions
213.10Hospital for these services that would increase medical assistance spending in this category
213.11to the aggregate upper payment limit for all nonstate government hospitals in Minnesota.
213.12In making this determination, the commissioner shall allot the available increases between
213.13Hennepin County Medical Center and Regions Hospital based on the ratio of medical
213.14assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner
213.15shall adjust this allotment as necessary based on federal approvals, the amount of
213.16intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors,
213.17in order to maximize the additional total payments. The commissioner shall inform Hennepin
213.18County and Ramsey County of the periodic intergovernmental transfers necessary to match
213.19federal Medicaid payments available under this subdivision in order to make supplementary
213.20medical assistance payments to Hennepin County Medical Center and Regions Hospital
213.21equal to an amount that when combined with existing medical assistance payments to
213.22nonstate governmental hospitals would increase total payments to hospitals in this category
213.23for outpatient services to the aggregate upper payment limit for all hospitals in this category
213.24in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make
213.25supplementary payments to Hennepin County Medical Center and Regions Hospital.
213.26    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall
213.27determine an upper payment limit for physicians and other billing professionals affiliated
213.28with Hennepin County Medical Center and with Regions Hospital. The upper payment limit
213.29shall be based on the average commercial rate or be determined using another method
213.30acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
213.31inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
213.32necessary to match the federal Medicaid payments available under this subdivision in order
213.33to make supplementary payments to physicians and other billing professionals affiliated
213.34with Hennepin County Medical Center and to make supplementary payments to physicians
214.1and other billing professionals affiliated with Regions Hospital through HealthPartners
214.2Medical Group equal to the difference between the established medical assistance payment
214.3for physician and other billing professional services and the upper payment limit. Upon
214.4receipt of these periodic transfers, the commissioner shall make supplementary payments
214.5to physicians and other billing professionals affiliated with Hennepin County Medical Center
214.6and shall make supplementary payments to physicians and other billing professionals
214.7affiliated with Regions Hospital through HealthPartners Medical Group.
214.8    (c) Beginning January 1, 2010, Hennepin County and Ramsey County may make monthly
214.9voluntary intergovernmental transfers to the commissioner in amounts not to exceed
214.10$12,000,000 per year from Hennepin County and $6,000,000 per year from Ramsey County.
214.11The commissioner shall increase the medical assistance capitation payments to any licensed
214.12health plan under contract with the medical assistance program that agrees to make enhanced
214.13payments to Hennepin County Medical Center or Regions Hospital. The increase shall be
214.14in an amount equal to the annual value of the monthly transfers plus federal financial
214.15participation, with each health plan receiving its pro rata share of the increase based on the
214.16pro rata share of medical assistance admissions to Hennepin County Medical Center and
214.17Regions Hospital by those plans. Upon the request of the commissioner, health plans shall
214.18submit individual-level cost data for verification purposes. The commissioner may ratably
214.19reduce these payments on a pro rata basis in order to satisfy federal requirements for actuarial
214.20soundness. If payments are reduced, transfers shall be reduced accordingly. Any licensed
214.21health plan that receives increased medical assistance capitation payments under the
214.22intergovernmental transfer described in this paragraph shall increase its medical assistance
214.23payments to Hennepin County Medical Center and Regions Hospital by the same amount
214.24as the increased payments received in the capitation payment described in this paragraph.
214.25    (d) For the purposes of this subdivision and subdivision 3, the commissioner shall
214.26determine an upper payment limit for ambulance services affiliated with Hennepin County
214.27Medical Center and the city of St. Paul, and ambulance services owned and operated by
214.28another governmental entity that chooses to participate by requesting the commissioner to
214.29determine an upper payment limit. The upper payment limit shall be based on the average
214.30commercial rate or be determined using another method acceptable to the Centers for
214.31Medicare and Medicaid Services. The commissioner shall inform Hennepin County and,
214.32the city of St. Paul, and other participating governmental entities of the periodic
214.33intergovernmental transfers necessary to match the federal Medicaid payments available
214.34under this subdivision in order to make supplementary payments to Hennepin County
214.35Medical Center and, the city of St. Paul, and other participating governmental entities equal
215.1to the difference between the established medical assistance payment for ambulance services
215.2and the upper payment limit. Upon receipt of these periodic transfers, the commissioner
215.3shall make supplementary payments to Hennepin County Medical Center and, the city of
215.4St. Paul., and other participating governmental entities. A tribal government that owns and
215.5operates an ambulance service is not eligible to participate under this subdivision.
215.6    (e) For the purposes of this subdivision and subdivision 3, the commissioner shall
215.7determine an upper payment limit for physicians, dentists, and other billing professionals
215.8affiliated with the University of Minnesota and University of Minnesota Physicians. The
215.9upper payment limit shall be based on the average commercial rate or be determined using
215.10another method acceptable to the Centers for Medicare and Medicaid Services. The
215.11commissioner shall inform the University of Minnesota Medical School and University of
215.12Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to
215.13match the federal Medicaid payments available under this subdivision in order to make
215.14supplementary payments to physicians, dentists, and other billing professionals affiliated
215.15with the University of Minnesota and the University of Minnesota Physicians equal to the
215.16difference between the established medical assistance payment for physician, dentist, and
215.17other billing professional services and the upper payment limit. Upon receipt of these periodic
215.18transfers, the commissioner shall make supplementary payments to physicians, dentists,
215.19and other billing professionals affiliated with the University of Minnesota and the University
215.20of Minnesota Physicians.
215.21    (f) The commissioner shall inform the transferring governmental entities on an ongoing
215.22basis of the need for any changes needed in the intergovernmental transfers in order to
215.23continue the payments under paragraphs (a) to (d) (e), at their maximum level, including
215.24increases in upper payment limits, changes in the federal Medicaid match, and other factors.
215.25    (f) (g) The payments in paragraphs (a) to (d) (e) shall be implemented independently of
215.26each other, subject to federal approval and to the receipt of transfers under subdivision 3.
215.27(h) All of the data and funding transactions related to the payments in paragraphs (a) to
215.28(e) shall be between the commissioner and the governmental entities.
215.29(i) For purposes of this subdivision, billing professionals are limited to physicians, nurse
215.30practitioners, nurse midwives, clinical nurse specialists, physician assistants,
215.31anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and
215.32dental therapists.
216.1EFFECTIVE DATE.Paragraph (d) is effective July 1, 2017, or upon federal approval,
216.2whichever is later. The commissioner of human services shall notify the revisor of statutes
216.3when federal approval is received.

216.4    Sec. 37. Minnesota Statutes 2016, section 256B.196, subdivision 3, is amended to read:
216.5    Subd. 3. Intergovernmental transfers. Based on the determination by the commissioner
216.6under subdivision 2, Hennepin County and Ramsey County shall make periodic
216.7intergovernmental transfers to the commissioner for the purposes of subdivision 2, paragraphs
216.8(a) and (b). All of the intergovernmental transfers made by Hennepin County shall be used
216.9to match federal payments to Hennepin County Medical Center under subdivision 2,
216.10paragraph (a), and to physicians and other billing professionals affiliated with Hennepin
216.11County Medical Center under subdivision 2, paragraph (b). All of the intergovernmental
216.12transfers made by Ramsey County shall be used to match federal payments to Regions
216.13Hospital under subdivision 2, paragraph (a), and to physicians and other billing professionals
216.14affiliated with Regions Hospital through HealthPartners Medical Group under subdivision
216.152, paragraph (b). All of the intergovernmental transfer payments made by the University of
216.16Minnesota Medical School and the University of Minnesota School of Dentistry shall be
216.17used to match federal payments to the University of Minnesota and the University of
216.18Minnesota Physicians under subdivision 2, paragraph (e).

216.19    Sec. 38. Minnesota Statutes 2016, section 256B.196, subdivision 4, is amended to read:
216.20    Subd. 4. Adjustments permitted. (a) The commissioner may adjust the
216.21intergovernmental transfers under subdivision 3 and the payments under subdivision 2,
216.22based on the commissioner's determination of Medicare upper payment limits,
216.23hospital-specific charge limits, hospital-specific limitations on disproportionate share
216.24payments, medical inflation, actuarial certification, average commercial rates for physician
216.25and other professional services as defined in this section, and cost-effectiveness for purposes
216.26of federal waivers. Any adjustments must be made on a proportional basis. The commissioner
216.27may make adjustments under this subdivision only after consultation with the affected
216.28counties, university schools, and hospitals. All payments under subdivision 2 and all
216.29intergovernmental transfers under subdivision 3 are limited to amounts available after all
216.30other base rates, adjustments, and supplemental payments in chapter 256B are calculated.
216.31(b) The ratio of medical assistance payments specified in subdivision 2 to the voluntary
216.32intergovernmental transfers specified in subdivision 3 shall not be reduced except as provided
216.33under paragraph (a).

217.1    Sec. 39. Minnesota Statutes 2016, section 256B.69, subdivision 5a, is amended to read:
217.2    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section and
217.3section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
217.4may issue separate contracts with requirements specific to services to medical assistance
217.5recipients age 65 and older.
217.6    (b) A prepaid health plan providing covered health services for eligible persons pursuant
217.7to chapters 256B and 256L is responsible for complying with the terms of its contract with
217.8the commissioner. Requirements applicable to managed care programs under chapters 256B
217.9and 256L established after the effective date of a contract with the commissioner take effect
217.10when the contract is next issued or renewed.
217.11    (c) The commissioner shall withhold five percent of managed care plan payments under
217.12this section and county-based purchasing plan payments under section 256B.692 for the
217.13prepaid medical assistance program pending completion of performance targets. Each
217.14performance target must be quantifiable, objective, measurable, and reasonably attainable,
217.15except in the case of a performance target based on a federal or state law or rule. Criteria
217.16for assessment of each performance target must be outlined in writing prior to the contract
217.17effective date. Clinical or utilization performance targets and their related criteria must
217.18consider evidence-based research and reasonable interventions when available or applicable
217.19to the populations served, and must be developed with input from external clinical experts
217.20and stakeholders, including managed care plans, county-based purchasing plans, and
217.21providers. The managed care or county-based purchasing plan must demonstrate, to the
217.22commissioner's satisfaction, that the data submitted regarding attainment of the performance
217.23target is accurate. The commissioner shall periodically change the administrative measures
217.24used as performance targets in order to improve plan performance across a broader range
217.25of administrative services. The performance targets must include measurement of plan
217.26efforts to contain spending on health care services and administrative activities. The
217.27commissioner may adopt plan-specific performance targets that take into account factors
217.28affecting only one plan, including characteristics of the plan's enrollee population. The
217.29withheld funds must be returned no sooner than July of the following year if performance
217.30targets in the contract are achieved. The commissioner may exclude special demonstration
217.31projects under subdivision 23.
217.32(d) The commissioner shall require that managed care plans use the assessment and
217.33authorization processes, forms, timelines, standards, documentation, and data reporting
217.34requirements, protocols, billing processes, and policies consistent with medical assistance
217.35fee-for-service or the Department of Human Services contract requirements consistent with
218.1medical assistance fee-for-service or the Department of Human Services contract
218.2requirements for all personal care assistance services under section 256B.0659.
218.3(e) Effective for services rendered on or after January 1, 2012, the commissioner shall
218.4include as part of the performance targets described in paragraph (c) a reduction in the health
218.5plan's emergency department utilization rate for medical assistance and MinnesotaCare
218.6enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
218.7the health plan's utilization in 2009. To earn the return of the withhold each subsequent
218.8year, the managed care plan or county-based purchasing plan must achieve a qualifying
218.9reduction of no less than ten percent of the plan's emergency department utilization rate for
218.10medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
218.11in subdivisions 23 and 28, compared to the previous measurement year until the final
218.12performance target is reached. When measuring performance, the commissioner must
218.13consider the difference in health risk in a managed care or county-based purchasing plan's
218.14membership in the baseline year compared to the measurement year, and work with the
218.15managed care or county-based purchasing plan to account for differences that they agree
218.16are significant.
218.17The withheld funds must be returned no sooner than July 1 and no later than July 31 of
218.18the following calendar year if the managed care plan or county-based purchasing plan
218.19demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
218.20was achieved. The commissioner shall structure the withhold so that the commissioner
218.21returns a portion of the withheld funds in amounts commensurate with achieved reductions
218.22in utilization less than the targeted amount.
218.23The withhold described in this paragraph shall continue for each consecutive contract
218.24period until the plan's emergency room utilization rate for state health care program enrollees
218.25is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
218.26and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
218.27health plans in meeting this performance target and shall accept payment withholds that
218.28may be returned to the hospitals if the performance target is achieved.
218.29(f) Effective for services rendered on or after January 1, 2012, the commissioner shall
218.30include as part of the performance targets described in paragraph (c) a reduction in the plan's
218.31hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
218.32determined by the commissioner. To earn the return of the withhold each year, the managed
218.33care plan or county-based purchasing plan must achieve a qualifying reduction of no less
218.34than five percent of the plan's hospital admission rate for medical assistance and
218.35MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
219.128, compared to the previous calendar year until the final performance target is reached.
219.2When measuring performance, the commissioner must consider the difference in health risk
219.3in a managed care or county-based purchasing plan's membership in the baseline year
219.4compared to the measurement year, and work with the managed care or county-based
219.5purchasing plan to account for differences that they agree are significant.
219.6The withheld funds must be returned no sooner than July 1 and no later than July 31 of
219.7the following calendar year if the managed care plan or county-based purchasing plan
219.8demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
219.9rate was achieved. The commissioner shall structure the withhold so that the commissioner
219.10returns a portion of the withheld funds in amounts commensurate with achieved reductions
219.11in utilization less than the targeted amount.
219.12The withhold described in this paragraph shall continue until there is a 25 percent
219.13reduction in the hospital admission rate compared to the hospital admission rates in calendar
219.14year 2011, as determined by the commissioner. The hospital admissions in this performance
219.15target do not include the admissions applicable to the subsequent hospital admission
219.16performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
219.17this performance target and shall accept payment withholds that may be returned to the
219.18hospitals if the performance target is achieved.
219.19(g) Effective for services rendered on or after January 1, 2012, the commissioner shall
219.20include as part of the performance targets described in paragraph (c) a reduction in the plan's
219.21hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
219.22hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
219.23enrollees, as determined by the commissioner. To earn the return of the withhold each year,
219.24the managed care plan or county-based purchasing plan must achieve a qualifying reduction
219.25of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
219.26excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
219.27percent compared to the previous calendar year until the final performance target is reached.
219.28The withheld funds must be returned no sooner than July 1 and no later than July 31 of
219.29the following calendar year if the managed care plan or county-based purchasing plan
219.30demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
219.31subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
219.32so that the commissioner returns a portion of the withheld funds in amounts commensurate
219.33with achieved reductions in utilization less than the targeted amount.
220.1The withhold described in this paragraph must continue for each consecutive contract
220.2period until the plan's subsequent hospitalization rate for medical assistance and
220.3MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
220.428, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
220.52011. Hospitals shall cooperate with the plans in meeting this performance target and shall
220.6accept payment withholds that must be returned to the hospitals if the performance target
220.7is achieved.
220.8(h) Effective for services rendered on or after January 1, 2013, through December 31,
220.92013, the commissioner shall withhold 4.5 percent of managed care plan payments under
220.10this section and county-based purchasing plan payments under section 256B.692 for the
220.11prepaid medical assistance program. The withheld funds must be returned no sooner than
220.12July 1 and no later than July 31 of the following year. The commissioner may exclude
220.13special demonstration projects under subdivision 23.
220.14(i) Effective for services rendered on or after January 1, 2014, the commissioner shall
220.15withhold three percent of managed care plan payments under this section and county-based
220.16purchasing plan payments under section 256B.692 for the prepaid medical assistance
220.17program. The withheld funds must be returned no sooner than July 1 and no later than July
220.1831 of the following year. The commissioner may exclude special demonstration projects
220.19under subdivision 23.
220.20(j) A managed care plan or a county-based purchasing plan under section 256B.692 may
220.21include as admitted assets under section 62D.044 any amount withheld under this section
220.22that is reasonably expected to be returned.
220.23(k) Contracts between the commissioner and a prepaid health plan are exempt from the
220.24set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a), and
220.257.
220.26(l) The return of the withhold under paragraphs (h) and (i) is not subject to the
220.27requirements of paragraph (c).
220.28(m) Managed care plans and county-based purchasing plans shall maintain current and
220.29fully executed agreements for all subcontractors, including bargaining groups, for
220.30administrative services that are expensed to the state's public health care programs.
220.31Subcontractor agreements determined to be material, as defined by the commissioner after
220.32taking into account state contracting and relevant statutory requirements, must be in the
220.33form of a written instrument or electronic document containing the elements of offer,
220.34acceptance, consideration, payment terms, scope, duration of the contract, and how the
221.1subcontractor services relate to state public health care programs. Upon request, the
221.2commissioner shall have access to all subcontractor documentation under this paragraph.
221.3Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
221.4to section 13.02.
221.5(n) Effective for services provided on or after January 1, 2018, through December 31,
221.62018, the commissioner shall withhold two percent of the capitation payment provided to
221.7managed care plans under this section, and county-based purchasing plans under section
221.8256B.692, for each medical assistance enrollee. The withheld funds must be returned no
221.9sooner than July 1 and no later than July 31 of the following year, for capitation payments
221.10for enrollees for whom the plan has submitted to the commissioner a verification of coverage
221.11form completed and signed by the enrollee. The verification of coverage form must be
221.12developed by the commissioner and made available to managed care and county-based
221.13purchasing plans. The form must require the enrollee to provide the enrollee's name, street
221.14address, and the name of the managed care or county-based purchasing plan selected by or
221.15assigned to the enrollee, and must include a signature block that allows the enrollee to attest
221.16that the information provided is accurate. A plan shall request that all enrollees complete
221.17the verification of coverage form, and shall submit all completed forms to the commissioner
221.18by February 28, 2018. If a completed form for an enrollee is not received by the commissioner
221.19by that date:
221.20(1) the commissioner shall not return to the plan funds withheld for that enrollee;
221.21(2) the commissioner shall cease making capitation payments to the plan for that enrollee,
221.22effective with the April 2018 coverage month; and
221.23(3) the commissioner shall disenroll the enrollee from medical assistance, subject to any
221.24enrollee appeal.

221.25    Sec. 40. Minnesota Statutes 2016, section 256B.69, subdivision 9e, is amended to read:
221.26    Subd. 9e. Financial audits. (a) The legislative auditor shall conduct or contract with
221.27vendors to conduct independent third-party financial audits of the information required to
221.28be provided by audit managed care plans and county-based purchasing plans under
221.29subdivision 9c, paragraph (b). The audits by the vendors shall be conducted as vendor
221.30resources permit and in accordance with generally accepted government auditing standards
221.31issued by the United States Government Accountability Office. The contract with the vendors
221.32shall be designed and administered so as to render the independent third-party audits eligible
221.33for a federal subsidy, if available. The contract shall require the audits to include a
221.34determination of compliance with the federal Medicaid rate certification process to determine
222.1if a managed care plan or county-based purchasing plan used public money in compliance
222.2with federal and state laws, rules, and in accordance with provisions in the plan's contract
222.3with the commissioner. The legislative auditor shall conduct the audits in accordance with
222.4section 3.972, subdivision 2b.
222.5(b) For purposes of this subdivision, "independent third-party" means a vendor that is
222.6independent in accordance with government auditing standards issued by the United States
222.7Government Accountability Office.

222.8    Sec. 41. Minnesota Statutes 2016, section 256B.69, is amended by adding a subdivision
222.9to read:
222.10    Subd. 36. Competitive bidding and procurement. (a) For managed care organization
222.11contracts effective on or after January 1, 2019, the commissioner shall utilize a competitive
222.12price and technical bidding program on a regional basis for nonelderly adults and children
222.13who are not eligible on the basis of a disability and are enrolled in medical assistance and
222.14MinnesotaCare. The commissioner shall establish geographic regions for the purposes of
222.15competitive price bidding. The commissioner shall not implement a competitive price
222.16bidding program in a single procurement that exceeds 40 percent of the total enrollment to
222.17which this paragraph applies except in cases when a managed care organization withdraws
222.18from their contract with the state, managed care organizations merge, other significant
222.19market changes occur within the purchasing or health care delivery system, or counties
222.20agree to a larger procurement. The commissioner shall ensure that there is an adequate
222.21choice of managed care organizations based on the potential enrollment, in a manner that
222.22is consistent with the requirements of section 256B.694. The commissioner shall operate
222.23the competitive bidding program by region, but shall award contracts by county and shall
222.24allow managed care organizations with a service area consisting of only a portion of a region
222.25to bid on those counties within their licensed service area only. For purposes of this
222.26subdivision, "managed care organization" means a demonstration provider as defined in
222.27subdivision 2, paragraph (b).
222.28(b) The commissioner shall provide the scoring weight of selection criteria to be assigned
222.29in the procurement process and include the scoring weight in the request for proposals.
222.30Substantial weight shall be given to county board resolutions and priority areas identified
222.31by counties, when that input meets federal requirements under Code of Federal Regulations,
222.32title 42, part 338.58.
222.33(c) If a best and final offer is requested, each responding managed care organization
222.34must be offered the opportunity to submit a best and final offer.
223.1(d) The commissioner, when evaluating proposals, shall consider network adequacy for
223.2dental and other services.
223.3(e) After the managed care organizations are notified about the award determination,
223.4but before contracts are signed, the commissioner shall meet with any responder upon
223.5request to discuss their individual results in detail. No evaluation materials will be provided
223.6in writing until final contracts are signed.
223.7(f) The commissioner shall provide information to potential responders that outlines the
223.8goals and objectives of the procurement, in advance of any publication of a request for
223.9proposals under this section.
223.10(g) A managed care organization that is aggrieved by the commissioner's decision related
223.11to the selection of managed care organizations to deliver services in a county or counties
223.12may appeal the commissioner's decision using the process outlined in section 256B.69,
223.13subdivision 3a, paragraph (d), except that the recommendation of the three-person mediation
223.14panel shall be binding on the commissioner.
223.15(h) The commissioner shall contract for an independent evaluation of the competitive
223.16price bidding process. The contractor must solicit recommendations from all parties
223.17participating in the competitive price bidding process for service delivery in calendar year
223.182019 on how the competitive price bidding process may be improved for service delivery
223.19in calendar year 2020 and annually thereafter. The commissioner shall make evaluation
223.20results available to the public on the department's Web site.

223.21    Sec. 42. Minnesota Statutes 2016, section 256B.75, is amended to read:
223.22256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
223.23    (a) For outpatient hospital facility fee payments for services rendered on or after October
223.241, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
223.25or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
223.26which there is a federal maximum allowable payment. Effective for services rendered on
223.27or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
223.28emergency room facility fees shall be increased by eight percent over the rates in effect on
223.29December 31, 1999, except for those services for which there is a federal maximum allowable
223.30payment. Services for which there is a federal maximum allowable payment shall be paid
223.31at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
223.32aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
223.33upper limit. If it is determined that a provision of this section conflicts with existing or
224.1future requirements of the United States government with respect to federal financial
224.2participation in medical assistance, the federal requirements prevail. The commissioner
224.3may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
224.4participation resulting from rates that are in excess of the Medicare upper limitations.
224.5    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
224.6surgery hospital facility fee services for critical access hospitals designated under section
224.7144.1483 , clause (9), shall be paid on a cost-based payment system that is based on the
224.8cost-finding methods and allowable costs of the Medicare program. Effective for services
224.9provided on or after July 1, 2015, rates established for critical access hospitals under this
224.10paragraph for the applicable payment year shall be the final payment and shall not be settled
224.11to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
224.12year ending in 2016, the rate for outpatient hospital services shall be computed using
224.13information from each hospital's Medicare cost report as filed with Medicare for the year
224.14that is two years before the year that the rate is being computed. Rates shall be computed
224.15using information from Worksheet C series until the department finalizes the medical
224.16assistance cost reporting process for critical access hospitals. After the cost reporting process
224.17is finalized, rates shall be computed using information from Title XIX Worksheet D series.
224.18The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
224.19related to rural health clinics and federally qualified health clinics, divided by ancillary
224.20charges plus outpatient charges, excluding charges related to rural health clinics and federally
224.21qualified health clinics.
224.22    (c) Effective for services provided on or after July 1, 2003, rates that are based on the
224.23Medicare outpatient prospective payment system shall be replaced by a budget neutral
224.24prospective payment system that is derived using medical assistance data. The commissioner
224.25shall provide a proposal to the 2003 legislature to define and implement this provision.
224.26    (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
224.27before third-party liability and spenddown, made to hospitals for outpatient hospital facility
224.28services is reduced by .5 percent from the current statutory rate.
224.29    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
224.30services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
224.31services before third-party liability and spenddown, is reduced five percent from the current
224.32statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
224.33this paragraph.
225.1    (f) In addition to the reductions in paragraphs (d) and (e), the total payment for
225.2fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
225.3hospital facility services before third-party liability and spenddown, is reduced three percent
225.4from the current statutory rates. Mental health services and facilities defined under section
225.5256.969, subdivision 16 , are excluded from this paragraph.
225.6EFFECTIVE DATE.This section is effective July 1, 2017.

225.7    Sec. 43. [256B.7635] REIMBURSEMENT FOR EVIDENCE-BASED PUBLIC
225.8HEALTH NURSE HOME VISITS.
225.9Effective for services provided on or after January 1, 2018, prenatal and postpartum
225.10follow-up home visits provided by public health nurses or registered nurses supervised by
225.11a public health nurse using evidence-based models shall be paid $140 per visit.
225.12Evidence-based postpartum follow-up home visits must be administered by home visiting
225.13programs that meet the United States Department of Health and Human Services criteria
225.14for evidence-based models and are identified by the commissioner of health as eligible to
225.15be implemented under the Maternal, Infant, and Early Childhood Home Visiting program.
225.16Home visits must target mothers and their children beginning with prenatal visits through
225.17age three for the child.

225.18    Sec. 44. Minnesota Statutes 2016, section 256B.766, is amended to read:
225.19256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
225.20(a) Effective for services provided on or after July 1, 2009, total payments for basic care
225.21services, shall be reduced by three percent, except that for the period July 1, 2009, through
225.22June 30, 2011, total payments shall be reduced by 4.5 percent for the medical assistance
225.23and general assistance medical care programs, prior to third-party liability and spenddown
225.24calculation. Effective July 1, 2010, the commissioner shall classify physical therapy services,
225.25occupational therapy services, and speech-language pathology and related services as basic
225.26care services. The reduction in this paragraph shall apply to physical therapy services,
225.27occupational therapy services, and speech-language pathology and related services provided
225.28on or after July 1, 2010.
225.29(b) Payments made to managed care plans and county-based purchasing plans shall be
225.30reduced for services provided on or after October 1, 2009, to reflect the reduction effective
225.31July 1, 2009, and payments made to the plans shall be reduced effective October 1, 2010,
225.32to reflect the reduction effective July 1, 2010.
226.1(c) Effective for services provided on or after September 1, 2011, through June 30, 2013,
226.2total payments for outpatient hospital facility fees shall be reduced by five percent from the
226.3rates in effect on August 31, 2011.
226.4(d) Effective for services provided on or after September 1, 2011, through June 30, 2013,
226.5total payments for ambulatory surgery centers facility fees, medical supplies and durable
226.6medical equipment not subject to a volume purchase contract, prosthetics and orthotics,
226.7renal dialysis services, laboratory services, public health nursing services, physical therapy
226.8services, occupational therapy services, speech therapy services, eyeglasses not subject to
226.9a volume purchase contract, hearing aids not subject to a volume purchase contract, and
226.10anesthesia services shall be reduced by three percent from the rates in effect on August 31,
226.112011.
226.12(e) Effective for services provided on or after September 1, 2014, payments for
226.13ambulatory surgery centers facility fees, hospice services, renal dialysis services, laboratory
226.14services, public health nursing services, eyeglasses not subject to a volume purchase contract,
226.15and hearing aids not subject to a volume purchase contract shall be increased by three percent
226.16and payments for outpatient hospital facility fees shall be increased by three percent.
226.17Payments made to managed care plans and county-based purchasing plans shall not be
226.18adjusted to reflect payments under this paragraph.
226.19(f) Payments for medical supplies and durable medical equipment not subject to a volume
226.20purchase contract, and prosthetics and orthotics, provided on or after July 1, 2014, through
226.21June 30, 2015, shall be decreased by .33 percent. Payments for medical supplies and durable
226.22medical equipment not subject to a volume purchase contract, and prosthetics and orthotics,
226.23provided on or after July 1, 2015, shall be increased by three percent from the rates as
226.24determined under paragraphs (i) and (j).
226.25(g) Effective for services provided on or after July 1, 2015, payments for outpatient
226.26hospital facility fees, medical supplies and durable medical equipment not subject to a
226.27volume purchase contract, prosthetics and orthotics, and laboratory services to a hospital
226.28meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause (4),
226.29shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments made
226.30to managed care plans and county-based purchasing plans shall not be adjusted to reflect
226.31payments under this paragraph.
226.32(h) This section does not apply to physician and professional services, inpatient hospital
226.33services, family planning services, mental health services, dental services, prescription
227.1drugs, medical transportation, federally qualified health centers, rural health centers, Indian
227.2health services, and Medicare cost-sharing.
227.3(i) Effective for services provided on or after July 1, 2015, the following categories of
227.4medical supplies and durable medical equipment shall be individually priced items: enteral
227.5nutrition and supplies, customized and other specialized tracheostomy tubes and supplies,
227.6electric patient lifts, and durable medical equipment repair and service. This paragraph does
227.7not apply to medical supplies and durable medical equipment subject to a volume purchase
227.8contract, products subject to the preferred diabetic testing supply program, and items provided
227.9to dually eligible recipients when Medicare is the primary payer for the item. The
227.10commissioner shall not apply any medical assistance rate reductions to durable medical
227.11equipment as a result of Medicare competitive bidding.
227.12(j) Effective for services provided on or after July 1, 2015, medical assistance payment
227.13rates for durable medical equipment, prosthetics, orthotics, or supplies shall be increased
227.14as follows:
227.15(1) payment rates for durable medical equipment, prosthetics, orthotics, or supplies that
227.16were subject to the Medicare competitive bid that took effect in January of 2009 shall be
227.17increased by 9.5 percent; and
227.18(2) payment rates for durable medical equipment, prosthetics, orthotics, or supplies on
227.19the medical assistance fee schedule, whether or not subject to the Medicare competitive bid
227.20that took effect in January of 2009, shall be increased by 2.94 percent, with this increase
227.21being applied after calculation of any increased payment rate under clause (1).
227.22This paragraph does not apply to medical supplies and durable medical equipment subject
227.23to a volume purchase contract, products subject to the preferred diabetic testing supply
227.24program, items provided to dually eligible recipients when Medicare is the primary payer
227.25for the item, and individually priced items identified in paragraph (i). Payments made to
227.26managed care plans and county-based purchasing plans shall not be adjusted to reflect the
227.27rate increases in this paragraph.
227.28(k) Effective for nonpressure support ventilators provided on or after January 1, 2016,
227.29the rate shall be the lower of the submitted charge or the Medicare fee schedule rate. Effective
227.30for pressure support ventilators provided on or after January 1, 2016, the rate shall be the
227.31lower of the submitted charge or 47 percent above the Medicare fee schedule rate.
227.32EFFECTIVE DATE.This section is effective retroactively from January 1, 2016.

228.1    Sec. 45. [256B.90] DEFINITIONS.
228.2    Subdivision 1. Generally. For the purposes of sections 256B.90 to 256B.92, the following
228.3terms have the meanings given.
228.4    Subd. 2. Commissioner. "Commissioner" means the commissioner of human services.
228.5    Subd. 3. Department. "Department" means the Department of Human Services.
228.6    Subd. 4. Hospital. "Hospital" means a public or private institution licensed as a hospital
228.7under section 144.50 that participates in medical assistance.
228.8    Subd. 5. Medical assistance. "Medical assistance" means the state's Medicaid program
228.9under title XIX of the Social Security Act and administered according to this chapter.
228.10    Subd. 6. Potentially avoidable complication. "Potentially avoidable complication"
228.11means a harmful event or negative outcome with respect to an individual, including an
228.12infection or surgical complication, that: (1) occurs during the individual's transportation to
228.13a hospital or long-term care facility or after the individual's admission to a hospital or
228.14long-term care facility; and (2) may have resulted from the care caused by insufficient
228.15staffing due to nurses' union strikes in the hospital or long-term care facility by licensed
228.16practical nurses or registered nurses, lack of care, or treatment provided during the hospital
228.17or long-term care facility stay or during the individual's transportation to the hospital or
228.18long-term care facility rather than from a natural progression of an underlying disease.
228.19    Subd. 7. Potentially avoidable event. "Potentially avoidable event" means a potentially
228.20avoidable complication, potentially avoidable readmission, or a combination of those events.
228.21    Subd. 8. Potentially avoidable readmission. "Potentially avoidable readmission" means
228.22a return hospitalization of an individual within a period specified by the commissioner that
228.23may have resulted from deficiencies in the care or treatment provided to the individual
228.24during a previous hospital stay or from deficiencies in posthospital discharge follow-up.
228.25Potentially avoidable readmission does not include a hospital readmission necessitated by
228.26the occurrence of unrelated events after the discharge. Potentially avoidable readmission
228.27includes the readmission of an individual to a hospital for: (1) the same condition or
228.28procedure for which the individual was previously admitted; (2) an infection or other
228.29complication resulting from care previously provided; or (3) a condition or procedure that
228.30indicates that a surgical intervention performed during a previous admission was unsuccessful
228.31in achieving the anticipated outcome.

229.1    Sec. 46. [256B.91] MEDICAL ASSISTANCE OUTCOMES-BASED PAYMENT
229.2PROGRAM.
229.3    Subdivision 1. Generally. The commissioner must establish and implement a medical
229.4assistance outcomes-based payment program as a hospital outcomes program under section
229.5256B.92 to provide hospitals with information and incentives to reduce potentially avoidable
229.6events.
229.7    Subd. 2. Potentially avoidable event methodology. (a) The commissioner shall issue
229.8a request for proposals to select a methodology for identifying potentially avoidable events
229.9and for the costs associated with these events, and for measuring hospital performance with
229.10respect to these events.
229.11(b) The commissioner shall develop definitions for each potentially avoidable event
229.12according to the selected methodology.
229.13(c) To the extent possible, the methodology shall be one that has been used by other title
229.14XIX programs under the Social Security Act or by commercial payers in health care outcomes
229.15performance measurement and in outcome-based payment programs. The methodology
229.16shall be open, transparent, and available for review by the public.
229.17    Subd. 3. Medical assistance system waste. (a) The commissioner must conduct a
229.18comprehensive analysis of relevant state databases to identify waste in the medical assistance
229.19system.
229.20(b) The analysis must identify instances of potentially avoidable events in medical
229.21assistance, and the costs associated with these events. The overall estimate of waste must
229.22be broken down into actionable categories including but not limited to regions, hospitals,
229.23MCOs, physicians, licensed practical nurses and registered nurses, other unlicensed health
229.24care personnel, service lines, diagnosis-related groups, medical conditions and procedures,
229.25patient characteristics, provider characteristics, and medical assistance program type.
229.26(c) Information collected from this analysis must be utilized in hospital outcomes
229.27programs described in this section.

229.28    Sec. 47. [256B.92] HOSPITAL OUTCOMES PROGRAM.
229.29    Subdivision 1. Generally. The hospital outcomes program shall:
229.30(1) target reduction of potentially avoidable readmissions and complications;
229.31(2) apply to all state acute care hospitals participating in medical assistance. Program
229.32adjustments may be made for certain types of hospitals; and
230.1(3) be implemented in two phases: performance reporting and outcomes-based financial
230.2incentives.
230.3    Subd. 2. Phase 1; performance reporting. (a) The commissioner shall develop and
230.4maintain a reporting system to provide each hospital in Minnesota with regular confidential
230.5reports regarding the hospital's performance for potentially avoidable readmissions and
230.6potentially avoidable complications.
230.7(b) The commissioner shall:
230.8(1) conduct ongoing analyses of relevant state claims databases to identify instances of
230.9potentially avoidable readmissions and potentially avoidable complications, and the
230.10expenditures associated with these events;
230.11(2) create or locate state readmission and complications norms;
230.12(3) measure actual-to-expected hospital performance compared to state norms;
230.13(4) compare hospitals with peers using risk adjustment procedures that account for the
230.14severity of illness of each hospital's patients;
230.15(5) distribute reports to hospitals to provide actionable information to create policies,
230.16contracts, or programs designed to improve target outcomes; and
230.17(6) foster collaboration among hospitals to share best practices.
230.18(c) A hospital may share the information contained in the outcome performance reports
230.19with physicians and other health care providers providing services at the hospital to foster
230.20coordination and cooperation in the hospital's outcome improvement and waste reduction
230.21initiatives.
230.22    Subd. 3. Phase 2; outcomes-based financial incentives. Twelve months after
230.23implementation of performance reporting under subdivision 2, the commissioner must
230.24establish financial incentives for a hospital to reduce potentially avoidable readmissions
230.25and potentially avoidable complications.
230.26    Subd. 4. Rate adjustment methodology. (a) The commissioner must adjust the
230.27reimbursement that a hospital receives under the All Patients Refined Diagnosis-Related
230.28Group inpatient prospective payment system based on the hospital's performance exceeding,
230.29or failing to achieve, outcome results based on the rates of potentially avoidable readmissions
230.30and potentially avoidable complications.
230.31(b) The rate adjustment methodology must:
230.32(1) apply to each hospital discharge;
231.1(2) determine a hospital-specific potentially avoidable outcome adjustment factor based
231.2on the hospital's actual versus expected risk-adjusted performance compared to the state
231.3norm;
231.4(3) be based on a retrospective analysis of performance prospectively applied;
231.5(4) include both rewards and penalties; and
231.6(5) be communicated to a hospital in a clear and transparent manner.
231.7    Subd. 5. Amendment of contracts. The commissioner must amend contracts with
231.8participating hospitals as necessary to incorporate the financial incentives established under
231.9this section.
231.10    Subd. 6. Budget neutrality. The hospital outcomes program shall be implemented in a
231.11budget-neutral manner with respect to aggregate Medicaid hospital expenditures.

231.12    Sec. 48. CAPITATION PAYMENT DELAY.
231.13(a) The commissioner of human services shall delay the medical assistance capitation
231.14payment to managed care plans and county-based purchasing plans due in May 2019 and
231.15the payment due in April 2019 for special needs basic care until July 1, 2019. The payment
231.16shall be made no earlier than July 1, 2019, and no later than July 31, 2019.
231.17(b) The commissioner of human services shall delay the medical assistance capitation
231.18payment to managed care plans and county-based purchasing plans due in May 2021 and
231.19the payment due in April 2021 for special needs basic care until July 1, 2021. The payment
231.20shall be made no earlier than July 1, 2021, and no later than July 31, 2021.

231.21    Sec. 49. COMMISSIONER DUTY TO SEEK FEDERAL APPROVAL.
231.22The commissioner of human services shall seek federal approval that is necessary to
231.23implement Minnesota Statutes, sections 256B.0621, subdivision 10; 256B.0924, subdivision
231.244a; and 256B.0625, subdivision 20b, for interactive video contact.

231.25    Sec. 50. LEGISLATIVE COMMISSION ON MANAGED CARE.
231.26    Subdivision 1. Establishment. (a) A legislative commission is created to study and
231.27make recommendations to the legislature on issues relating to the competitive bidding
231.28program and procurement process for the medical assistance and MinnesotaCare contracts
231.29with managed care organizations for nonelderly, nondisabled adults and children enrollees.
232.1(b) For purposes of this section, "managed care organization" means a demonstration
232.2provider as defined under Minnesota Statutes, section 256B.69, subdivision 2.
232.3    Subd. 2. Membership. (a) The commission consists of:
232.4(1) four members of the senate, two members appointed by the senate majority leader
232.5and two members appointed by the senate minority leader;
232.6(2) four members of the house of representatives, two members appointed by the speaker
232.7of the house and two members appointed by the minority leader; and
232.8(3) the commissioner of human services or the commissioner's designee.
232.9(b) The appointing authorities must make their appointments by July 1, 2017.
232.10(c) The ranking senator from the majority party appointed to the commission shall
232.11convene the first meeting no later than September 1, 2017.
232.12(d) The commission shall elect a chair among its members at the first meeting.
232.13(e) Members serve without compensation or reimbursement for expenses, except that
232.14legislative members may receive per diem and be reimbursed for expenses as provided in
232.15the rules governing their respective bodies.
232.16    Subd. 3. Staff. The commissioner of human services shall provide staff and administrative
232.17and research services, as needed, to the commission.
232.18    Subd. 4. Duties. (a) The commission shall study, review, and make recommendations
232.19on the competitive bidding process for the managed care contracts that provide services to
232.20the nonelderly, nondisabled adults and children enrolled in medical assistance and
232.21MinnesotaCare. When reviewing the competitive bidding process, the commission shall
232.22consider and make recommendations on the following:
232.23(1) the number of geographic regions to be established for competitive bidding and each
232.24procurement cycle and the criteria to be used in determining the minimum number of
232.25managed care organizations to serve each region or statistical area;
232.26(2) the specifications of the request for proposals, including whether managed care
232.27organizations must address in their proposals priority areas identified by counties;
232.28(3) the criteria to be used to determine whether managed care organizations will be
232.29requested to provide a best and final offer;
232.30(4) the evaluation process that the commissioner must consider when evaluating each
232.31proposal, including the scoring weight to be given when there is a county board resolution
233.1identifying a managed care organization preference, and whether consideration shall be
233.2given to network adequacy for such services as dental, mental health, and primary care;
233.3(5) the notification process to inform managed care organizations about the award
233.4determinations, but before the contracts are signed;
233.5(6) process for appealing the commissioner's decision on the selection of a managed
233.6care plan or county-based purchasing plan in a county or counties; and
233.7(7) whether an independent evaluation of the competitive bidding process is necessary,
233.8and if so, what the evaluation should entail.
233.9(b) The commissioner shall consider the frequency of the procurement process in terms
233.10of how often the commissioner should conduct the procurement of managed care contracts
233.11and whether procurement should be conducted on a statewide basis or at staggered times
233.12for a limited number of counties within a specified region.
233.13(c) The commission shall review proposed legislation that incorporates new federal
233.14regulations into managed care statutes, including the recodification of the managed care
233.15requirements in Minnesota Statutes, sections 256B.69 and 256B.692.
233.16(d) The commission shall study, review, and make recommendations on a process that
233.17meets federal regulations for ensuring that provider rate increases passed by the legislature
233.18and incorporated into the capitated rates paid to managed care organizations are recognized
233.19in the rates paid by the managed care organizations to the providers while still providing
233.20managed care organizations the flexibility in negotiating rates paid to their provider networks.
233.21(e) The commission shall consult with interested stakeholders and may solicit public
233.22testimony, as deemed necessary.
233.23    Subd. 5. Report. (a) The commission shall report its recommendations to the chairs and
233.24ranking minority members of the legislative committees with jurisdiction over health and
233.25human services policy and finance by February 15, 2018. The report shall include any draft
233.26legislation necessary to implement the recommendations.
233.27(b) The commission shall provide preliminary recommendations to the commissioner
233.28of human services to be used by the commissioner if the commissioner decides to conduct
233.29a procurement for managed care contracts for the 2019 contract year.
233.30    Subd. 6. Open meetings. The commission is subject to Minnesota Statutes, section
233.313.055.
233.32    Subd. 7. Expiration. This section expires June 30, 2018.

234.1    Sec. 51. HEALTH CARE ACCESS FUND ASSESSMENT.
234.2(a) The commissioner of human services, in consultation with the commissioner of
234.3management and budget, shall assess any federal health care reform legislation passed at
234.4the federal level on its effect on the MinnesotaCare program and the need for the health
234.5care access fund as its continued source of funding.
234.6(b) The commissioner shall report to the chairs and ranking minority members of the
234.7legislative committees with jurisdiction over health care policy and finance within 90 days
234.8of the passage of any federal health care reform legislation.

234.9    Sec. 52. OPIOID USE AND ACUPUNCTURE STUDY.
234.10(a) The commissioner of human services shall study the use of opiates for the treatment
234.11of chronic pain conditions when acupuncture services are also part of the treatment for
234.12chronic pain as compared to opiate use among medical assistance recipients who are not
234.13receiving acupuncture. In comparing the sample groups, the commissioner shall look at
234.14each group's opiate use and other services as identified by the commissioner.
234.15(b) The aggregate findings of the study shall be submitted by the commissioner to the
234.16chairs and ranking minority members of the legislative committees with jurisdiction over
234.17health and human services policy and finance by February 15, 2018. The report shall not
234.18contain or disclose any patient identifying data.

234.19    Sec. 53. ENCOUNTER REPORTING OF 340B ELIGIBLE DRUGS.
234.20    (a) The commissioner of human services, in consultation with federally qualified health
234.21centers, managed care organizations, and contract pharmacies shall develop a report on the
234.22feasibility of a process to identify and report at point of sale the 340B drugs that are dispensed
234.23to enrollees of managed care organizations who are patients of a federally qualified health
234.24center to exclude these claims from the Medicaid drug rebate program and ensure that
234.25duplicate discounts for drugs do not occur.
234.26    (b) By January 1, 2018, the commissioner shall present the report to the chairs and
234.27ranking minority members of the legislative committees with jurisdiction over medical
234.28assistance.

234.29    Sec. 54. RATE-SETTING ANALYSIS REPORT.
234.30The commissioner of human services shall conduct a comprehensive analysis report of
234.31the current rate-setting methodology for outpatient, professional, and physician services
235.1that do not have a cost-based, federally mandated, or contracted rate. The report shall include
235.2recommendations for changes to the existing fee schedule that utilizes the Resource-Based
235.3Relative Value System (RBRVS), and alternate payment methodologies for services that
235.4do not have relative values, to simplify the fee for service medical assistance rate structure
235.5and to improve consistency and transparency. In developing the report, the commissioner
235.6shall consult with outside experts in Medicaid financing. The commissioner shall provide
235.7a report on the analysis to the chairs and ranking minority members of the legislative
235.8committees with jurisdiction over health and human services finance by November 1, 2019.

235.9    Sec. 55. STUDY OF PAYMENT RATES FOR DURABLE MEDICAL EQUIPMENT
235.10AND SUPPLIES.
235.11The commissioner of human services shall study the impact of basing medical assistance
235.12payment for durable medical equipment and medical supplies on Medicare payment rates,
235.13as limited by the payment provisions in the 21st Century Cures Act, Public Law 114-255,
235.14on access by medical assistance enrollees to these items. The study must include
235.15recommendations for ensuring and improving access by medical assistance enrollees to
235.16durable medical equipment and medical supplies. The commissioner shall report study
235.17results and recommendations to the chairs and ranking minority members of the legislative
235.18committees with jurisdiction over health and human services policy and finance by July 1,
235.192020.

235.20    Sec. 56. REVISOR'S INSTRUCTION.
235.21The revisor of statutes, in the next edition of Minnesota Statutes, shall change the term
235.22"health care delivery system" and similar terms to "integrated health partnership" and similar
235.23terms, wherever it appears in Minnesota Statutes, section 256B.0755.

235.24    Sec. 57. REPEALER.
235.25Minnesota Statutes 2016, section 256B.64, is repealed.

235.26ARTICLE 5

235.27HEALTH INSURANCE

235.28    Section 1. Minnesota Statutes 2016, section 62A.04, subdivision 1, is amended to read:
235.29    Subdivision 1. Reference. (a) Any reference to "standard provisions" which may appear
235.30in other sections and which refer to accident and sickness or accident and health insurance
235.31shall hereinafter be construed as referring to accident and sickness policy provisions.
236.1(b) Notwithstanding paragraph (a), the following do not apply to health plans:
236.2(1) subdivision 2, clauses (4) to (10) and (12);
236.3(2) subdivision 3, clauses (1) and (3) to (7); and
236.4(3) subdivisions 6 and 10.
236.5EFFECTIVE DATE.This section is effective for policies offered, sold, issued, or
236.6renewed on or after January 1, 2018.

236.7    Sec. 2. Minnesota Statutes 2016, section 62A.21, subdivision 2a, is amended to read:
236.8    Subd. 2a. Continuation privilege. Every policy described in subdivision 1 shall contain
236.9a provision which permits continuation of coverage under the policy for the insured's former
236.10spouse and dependent children upon, which is defined as required by section 62A.302, and
236.11former spouse, who was covered on the day before the entry of a valid decree of dissolution
236.12of marriage. The coverage shall be continued until the earlier of the following dates:
236.13(a) the date the insured's former spouse becomes covered under any other group health
236.14plan; or
236.15(b) the date coverage would otherwise terminate under the policy.
236.16If the coverage is provided under a group policy, any required premium contributions
236.17for the coverage shall be paid by the insured on a monthly basis to the group policyholder
236.18for remittance to the insurer. The policy must require the group policyholder to, upon request,
236.19provide the insured with written verification from the insurer of the cost of this coverage
236.20promptly at the time of eligibility for this coverage and at any time during the continuation
236.21period. In no event shall the amount of premium charged exceed 102 percent of the cost to
236.22the plan for such period of coverage for other similarly situated spouses and dependent
236.23children with respect to whom the marital relationship has not dissolved, without regard to
236.24whether such cost is paid by the employer or employee.
236.25Upon request by the insured's former spouse, who was covered on the day before the
236.26entry of a valid decree of dissolution, or dependent child, a health carrier must provide the
236.27instructions necessary to enable the child or former spouse to elect continuation of coverage.
236.28EFFECTIVE DATE.This section is effective for policies offered, sold, issued, or
236.29renewed on or after January 1, 2018.

236.30    Sec. 3. Minnesota Statutes 2016, section 62A.3075, is amended to read:
236.3162A.3075 CANCER CHEMOTHERAPY TREATMENT COVERAGE.
237.1(a) A health plan company that provides coverage under a health plan for cancer
237.2chemotherapy treatment shall not require a higher co-payment, deductible, or coinsurance
237.3amount for a prescribed, orally administered anticancer medication that is used to kill or
237.4slow the growth of cancerous cells than what the health plan requires for an intravenously
237.5administered or injected cancer medication that is provided, regardless of formulation or
237.6benefit category determination by the health plan company.
237.7(b) A health plan company must not achieve compliance with this section by imposing
237.8an increase in co-payment, deductible, or coinsurance amount for an intravenously
237.9administered or injected cancer chemotherapy agent covered under the health plan.
237.10(c) Nothing in this section shall be interpreted to prohibit a health plan company from
237.11requiring prior authorization or imposing other appropriate utilization controls in approving
237.12coverage for any chemotherapy.
237.13(d) A plan offered by the commissioner of management and budget under section 43A.23
237.14is deemed to be at parity and in compliance with this section.
237.15(e) A health plan company is in compliance with this section if it does not include orally
237.16administered anticancer medication in the fourth tier of its pharmacy benefit.
237.17(f) A health plan company that provides coverage under a health plan for cancer
237.18chemotherapy treatment must indicate the level of coverage for orally administered anticancer
237.19medication within its pharmacy benefit filing with the commissioner.
237.20EFFECTIVE DATE.This section is effective January 1, 2018, and applies to health
237.21plans offered, sold, issued, or renewed on or after that date.

237.22    Sec. 4. Minnesota Statutes 2016, section 62D.105, is amended to read:
237.2362D.105 COVERAGE OF CURRENT SPOUSE, FORMER SPOUSE, AND
237.24CHILDREN.
237.25    Subdivision 1. Requirement. Every health maintenance contract, which in addition to
237.26covering the enrollee also provides coverage to the spouse and, dependent children, which
237.27is defined as required by section 62A.302, and former spouse who was covered on the day
237.28before the entry of a valid decree of dissolution of marriage, of the enrollee shall: (1) permit
237.29the spouse, former spouse, and dependent children to elect to continue coverage when the
237.30enrollee becomes enrolled for benefits under title XVIII of the Social Security Act
237.31(Medicare); and (2) permit the dependent children to continue coverage when they cease
237.32to be dependent children under the generally applicable requirement of the plan.
238.1    Subd. 2. Continuation privilege. The coverage described in subdivision 1 may be
238.2continued until the earlier of the following dates:
238.3(1) the date coverage would otherwise terminate under the contract;
238.4(2) 36 months after continuation by the spouse, former spouse, or dependent was elected;
238.5or
238.6(3) the date the spouse, former spouse, or dependent children become covered under
238.7another group health plan or Medicare.
238.8If coverage is provided under a group policy, any required fees for the coverage shall
238.9be paid by the enrollee on a monthly basis to the group contract holder for remittance to the
238.10health maintenance organization. In no event shall the fee charged exceed 102 percent of
238.11the cost to the plan for such coverage for other similarly situated spouse and dependent
238.12children to whom subdivision 1 is not applicable, without regard to whether such cost is
238.13paid by the employer or employee.
238.14EFFECTIVE DATE.This section is effective for policies offered, sold, issued, or
238.15renewed on or after January 1, 2018.

238.16    Sec. 5. Minnesota Statutes 2016, section 62E.04, subdivision 11, is amended to read:
238.17    Subd. 11. Essential health benefits package Affordable Care Act compliant plans.
238.18For individual or small group health plans that include the essential health benefits package
238.19and are any policy of accident and health insurance subject to the requirements of the
238.20Affordable Care Act, as defined under section 62A.011, subdivision 1a, that is offered, sold,
238.21issued, or renewed on or after January 1, 2014 2018, the requirements of this section do not
238.22apply.
238.23EFFECTIVE DATE.This section is effective for policies offered, sold, issued, or
238.24renewed on or after January 1, 2018.

238.25    Sec. 6. Minnesota Statutes 2016, section 62E.05, subdivision 1, is amended to read:
238.26    Subdivision 1. Certification. Upon application by an insurer, fraternal, or employer for
238.27certification of a plan of health coverage as a qualified plan or a qualified Medicare
238.28supplement plan for the purposes of sections 62E.01 to 62E.19, the commissioner shall
238.29make a determination within 90 days as to whether the plan is qualified. All plans of health
238.30coverage, except Medicare supplement policies, shall be labeled as "qualified" or
238.31"nonqualified" on the front of the policy or contract, or on the schedule page. All qualified
238.32plans shall indicate whether they are number one, two, or three coverage plans. For any
239.1policy of accident and health insurance subject to the requirements of the Affordable Care
239.2Act, as defined under section 62A.011, subdivision 1a, that is offered, sold, issued, or
239.3renewed on or after January 1, 2018, the requirements of this section do not apply.
239.4EFFECTIVE DATE.This section is effective for policies offered, sold, issued, or
239.5renewed on or after January 1, 2018.

239.6    Sec. 7. Minnesota Statutes 2016, section 62E.06, is amended by adding a subdivision to
239.7read:
239.8    Subd. 5. Affordable Care Act compliant plans. For any policy of accident and health
239.9insurance subject to the requirements of the Affordable Care Act, as defined under section
239.1062A.011, subdivision 1a, that is offered, sold, issued, or renewed on or after January 1,
239.112018, the requirements of this section do not apply.
239.12EFFECTIVE DATE.This section is effective for policies offered, sold, issued, or
239.13renewed on or after January 1, 2018.

239.14    Sec. 8. Minnesota Statutes 2016, section 317A.811, subdivision 1, is amended to read:
239.15    Subdivision 1. When required. (a) Except as provided in subdivision 6, the following
239.16corporations shall notify the attorney general of their intent to dissolve, merge, or consolidate,
239.17or to transfer all or substantially all of their assets:
239.18(1) a corporation that holds assets for a charitable purpose as defined in section 501B.35,
239.19subdivision 2 ; or
239.20    (2) a health maintenance organization operating under chapter 62D;
239.21    (3) a service plan corporation operating under chapter 62C; or
239.22(2) (4) a corporation that is exempt under section 501(c)(3) of the Internal Revenue Code
239.23of 1986, or any successor section.
239.24(b) The notice must include:
239.25(1) the purpose of the corporation that is giving the notice;
239.26(2) a list of assets owned or held by the corporation for charitable purposes;
239.27(3) a description of restricted assets and purposes for which the assets were received;
239.28(4) a description of debts, obligations, and liabilities of the corporation;
239.29(5) a description of tangible assets being converted to cash and the manner in which
239.30they will be sold;
240.1(6) anticipated expenses of the transaction, including attorney fees;
240.2(7) a list of persons to whom assets will be transferred, if known;
240.3(8) the purposes of persons receiving the assets; and
240.4(9) the terms, conditions, or restrictions, if any, to be imposed on the transferred assets.
240.5The notice must be signed on behalf of the corporation by an authorized person.

240.6    Sec. 9. Minnesota Statutes 2016, section 317A.811, is amended by adding a subdivision
240.7to read:
240.8    Subd. 1a. Nonprofit health care entity; notice required. A corporation that is a health
240.9maintenance organization or a service plan corporation is subject to notice requirements for
240.10certain transactions under section 317A.814.

240.11    Sec. 10. [317A.814] NONPROFIT HEALTH CARE ENTITY CONVERSIONS.
240.12    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
240.13(b) "Commissioner" means the commissioner of commerce if the nonprofit health care
240.14entity at issue is a service plan corporation operating under chapter 62C, and the
240.15commissioner of health if the nonprofit health care entity at issue is a health maintenance
240.16organization operating under chapter 62D.
240.17(c) "Conversion benefit entity" means a foundation, corporation, limited liability
240.18company, trust, partnership, or other entity that receives public benefit assets, or their value,
240.19in connection with a conversion transaction.
240.20(d) "Conversion transaction" or "transaction" means a transaction in which a nonprofit
240.21health care entity merges, consolidates, converts, or transfers all or a substantial portion of
240.22its assets to an entity that is not a nonprofit corporation organized under this chapter that is
240.23also exempt under United States Code, title 26, section 501(c)(3). The substitution of a new
240.24corporate member that transfers the control, responsibility for, or governance of a nonprofit
240.25health care entity is also considered a transaction for purposes of this section.
240.26(e) "Family member" means a spouse, parent, or child or other legal dependent.
240.27(f) "Nonprofit health care entity" means a service plan corporation operating under
240.28chapter 62C and a health maintenance organization operating under chapter 62D.
240.29(g) "Public benefit assets" means:
241.1(1) assets that represent net earnings that were required to be devoted to the nonprofit
241.2purposes of the health maintenance organization according to Minnesota Statutes 2016,
241.3section 62D.12; and
241.4(2) other assets that are identified as dedicated for a charitable or public purpose.
241.5(h) "Related organization" has the meaning given in section 317A.011.
241.6    Subd. 2. Private inurement. A nonprofit health care entity must not enter into a
241.7conversion transaction if a person who has been an officer, director, or other executive of
241.8the nonprofit health care entity, or of a related organization, or a family member of that
241.9person:
241.10(1) has or will receive any compensation or other financial benefit, directly or indirectly,
241.11in connection with the conversion transaction;
241.12(2) has held or will hold, regardless of whether guaranteed or contingent, an ownership
241.13stake, stock, securities, investment, or other financial interest in, or receive any type of
241.14onetime compensation or other financial benefit from, any entity to which the nonprofit
241.15health care entity transfers public benefit assets in connection with a conversion transaction;
241.16or
241.17(3) has held or will hold, regardless of whether guaranteed or contingent, an ownership
241.18stake, stock, securities, investment, or other financial interest in, or receive any type of
241.19compensation or other financial benefit from, any entity that has or will have a business
241.20relationship with any entity to which the nonprofit health care entity transfers public benefit
241.21assets in connection with a conversion transaction.
241.22    Subd. 3. Attorney general notice required. (a) Before entering into a conversion
241.23transaction, the nonprofit health care entity must notify the attorney general as specified
241.24under section 317A.811, subdivision 1. The notice required by this subdivision also must
241.25include an itemization of the nonprofit health care entity's public benefit assets and the
241.26valuation that the entity attributes to those assets, a proposed plan for distribution of the
241.27value of those assets to a conversion benefit entity that meets the requirements of subdivision
241.285, and other information from the health maintenance organization or the proposed conversion
241.29benefit entity that the attorney general reasonably considers necessary for review of the
241.30proposed transaction.
241.31(b) A copy of the notice and other information required under this subdivision must be
241.32given to the commissioner.
242.1    Subd. 4. Review elements. In exercising the powers under this chapter, the attorney
242.2general, in consultation with the commissioner, shall consider any factors the attorney
242.3general considers relevant, including whether:
242.4(1) the proposed transaction complies with this chapter and chapter 501B and other
242.5applicable laws;
242.6(2) the proposed transaction involves or constitutes a breach of charitable trust;
242.7(3) the nonprofit health care entity will receive full and fair value for its public benefit
242.8assets;
242.9(4) the full and fair value of the public benefit assets to be transferred has been
242.10manipulated in a manner that causes or has caused the value of the assets to decrease;
242.11(5) the proceeds of the proposed transaction will be used consistent with the public
242.12benefit for which the assets are held by the nonprofit health care entity;
242.13(6) the proposed transaction will result in a breach of fiduciary duty, as determined by
242.14the attorney general, including whether:
242.15(i) conflicts of interest exist related to payments to or benefits conferred upon officers,
242.16directors, board members, and executives of the nonprofit health care entity or a related
242.17organization;
242.18(ii) the nonprofit health care entity's board of directors exercised reasonable care and
242.19due diligence in deciding to pursue the transaction, in selecting the entity with which to
242.20pursue the transaction, and in negotiating the terms and conditions of the transaction; and
242.21(iii) the nonprofit health care entity's board of directors considered all reasonably viable
242.22alternatives, including any competing offers for its public benefit assets, or alternative
242.23transactions;
242.24(7) the transaction will result in private inurement to any person, including owners,
242.25stakeholders, or directors, officers, or key staff of the nonprofit health care entity or entity
242.26to which the nonprofit health care entity proposes to transfer public benefit assets;
242.27(8) the conversion benefit entity meets the requirements of subdivision 5; and
242.28(9) the attorney general has been provided with sufficient information by the nonprofit
242.29health care entity to adequately evaluate the proposed transaction and the effects on the
242.30public, provided the attorney general has notified the nonprofit health care entity or the
242.31proposed conversion benefit entity of any inadequacy of the information and has provided
242.32a reasonable opportunity to remedy that inadequacy.
243.1In addition, the attorney general shall consider the public comments received regarding
243.2the proposed conversion transaction and the proposed transaction's likely effect on the
243.3availability, accessibility, and affordability of health care services to the public.
243.4    Subd. 5. Conversion benefit entity requirements. (a) A conversion benefit entity must
243.5be an existing or new nonprofit corporation and also be exempt under United States Code,
243.6title 26, section 501(c)(3).
243.7(b) The conversion benefit entity must have in place procedures and policies to prohibit
243.8conflicts of interest, including but not limited to prohibiting conflicts of interests relating
243.9to any grant-making activities that may benefit:
243.10(1) the directors, officers, or other executives of the conversion benefit entity;
243.11(2) any entity to which the nonprofit health care entity transfers any public benefit assets
243.12in connection with a conversion transaction; or
243.13(3) any directors, officers, or other executives of any entity to which the nonprofit health
243.14care entity transfers any public benefit assets in connection with a conversion transaction.
243.15(c) The charitable purpose and grant-making functions of the conversion benefit entity
243.16must be dedicated to meeting the health care needs of the people of this state.
243.17    Subd. 6. Public comment. The attorney general may solicit public comment regarding
243.18the proposed conversion transaction. The attorney general may hold one or more public
243.19meetings or solicit written or electronic correspondence. If a meeting is held, notice of the
243.20meeting must be published in a qualified newspaper of general circulation in this state at
243.21least seven days before the meeting.
243.22    Subd. 7. Relation to other law. (a) This section is in addition to, and does not affect or
243.23limit any power, remedy, or responsibility of a health maintenance organization, service
243.24plan corporation, a conversion benefit entity, the attorney general, or the commissioner
243.25under this chapter, chapter 62C, 62D, 501B, or other law.
243.26(b) Nothing in this section authorizes a nonprofit health care entity to enter into a
243.27conversion transaction not otherwise permitted under this chapter.

243.28    Sec. 11. Laws 2017, chapter 2, article 1, section 5, is amended to read:
243.29    Sec. 5. SUNSET.
243.30This article sunsets June 30, other than section 2, subdivision 5, and section 3, sunsets
243.31August 31, 2018.

244.1    Sec. 12. Laws 2017, chapter 2, article 1, section 7, is amended to read:
244.2    Sec. 7. APPROPRIATIONS.
244.3(a) $311,788,000 in fiscal year 2017 is appropriated from the general fund to the
244.4commissioner of management and budget for premium assistance under section 2. This
244.5appropriation is onetime and is available through June 30 August 31, 2018.
244.6(b) $157,000 in fiscal year 2017 is appropriated from the general fund to the legislative
244.7auditor for purposes of section 3. This appropriation is onetime.
244.8(c) Any unexpended amount from the appropriation in paragraph (a) after June 30, 2018,
244.9shall be transferred on July 1 no later than August 31, 2018, from the general fund to the
244.10budget reserve account under Minnesota Statutes, section 16A.152, subdivision 1a.

244.11ARTICLE 6

244.12DIRECT CARE AND TREATMENT

244.13    Section 1. Minnesota Statutes 2016, section 253B.10, subdivision 1, is amended to read:
244.14    Subdivision 1. Administrative requirements. (a) When a person is committed, the
244.15court shall issue a warrant or an order committing the patient to the custody of the head of
244.16the treatment facility. The warrant or order shall state that the patient meets the statutory
244.17criteria for civil commitment.
244.18(b) The commissioner shall prioritize patients being admitted from jail or a correctional
244.19institution who are:
244.20(1) ordered confined in a state hospital for an examination under Minnesota Rules of
244.21Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
244.22(2) under civil commitment for competency treatment and continuing supervision under
244.23Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
244.24(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
244.25Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
244.26detained in a state hospital or other facility pending completion of the civil commitment
244.27proceedings; or
244.28(4) committed under this chapter to the commissioner after dismissal of the patient's
244.29criminal charges.
245.1Patients described in this paragraph must be admitted to a service operated by the
245.2commissioner within 48 hours. The commitment must be ordered by the court as provided
245.3in section 253B.09, subdivision 1, paragraph (c).
245.4(c) Upon the arrival of a patient at the designated treatment facility, the head of the
245.5facility shall retain the duplicate of the warrant and endorse receipt upon the original warrant
245.6or acknowledge receipt of the order. The endorsed receipt or acknowledgment must be filed
245.7in the court of commitment. After arrival, the patient shall be under the control and custody
245.8of the head of the treatment facility.
245.9(d) Copies of the petition for commitment, the court's findings of fact and conclusions
245.10of law, the court order committing the patient, the report of the examiners, and the prepetition
245.11report shall be provided promptly to the treatment facility. This information shall also be
245.12provided by the head of the treatment facility to treatment facility staff in a consistent and
245.13timely manner and pursuant to all applicable laws.

245.14    Sec. 2. Minnesota Statutes 2016, section 253B.22, subdivision 1, is amended to read:
245.15    Subdivision 1. Establishment. The commissioner shall establish a review board of three
245.16or more persons for each regional center to review the admission and retention of its patients
245.17receiving services under this chapter. The review board shall be comprised of two members
245.18and one chair. Each board member shall be selected and appointed by the commissioner.
245.19The appointed members shall be limited to one term of no more than three years and no
245.20board member can serve more than three consecutive three-year terms. One member shall
245.21be qualified in the diagnosis of mental illness, developmental disability, or chemical
245.22dependency, and one member shall be an attorney. The commissioner may, upon written
245.23request from the appropriate federal authority, establish a review panel for any federal
245.24treatment facility within the state to review the admission and retention of patients
245.25hospitalized under this chapter. For any review board established for a federal treatment
245.26facility, one of the persons appointed by the commissioner shall be the commissioner of
245.27veterans affairs or the commissioner's designee.

245.28    Sec. 3. REVIEW OF ALTERNATIVES TO STATE-OPERATED GROUP HOMES
245.29HOUSING ONE PERSON.
245.30The commissioner of human services shall review the potential for, and the viability of,
245.31alternatives to state-operated group homes housing one person. The intent is to create housing
245.32options for individuals who do not belong in an institutionalized setting, but need additional
245.33support before transitioning to a more independent community placement. The review shall
246.1include an analysis of existing housing settings operated by counties and private providers,
246.2as well as the potential for new housing settings, and determine the viability for use by
246.3state-operated services. The commissioner shall seek input from interested stakeholders as
246.4part of the review. An update, including alternatives identified, will be provided by the
246.5commissioner to the members of the legislative committees having jurisdiction over human
246.6services issues no later than January 15, 2018.

246.7ARTICLE 7

246.8CHILDREN AND FAMILIES

246.9    Section 1. Minnesota Statutes 2016, section 13.32, is amended by adding a subdivision
246.10to read:
246.11    Subd. 12. Access by welfare system. County personnel in the welfare system may
246.12request access to education data in order to coordinate services for a student or family. The
246.13request must be submitted to the chief administrative officer of the school and must include
246.14the basis for the request and a description of the information that is requested. The chief
246.15administrative officer must provide a copy of the request to the parent or legal guardian of
246.16the student who is the subject of the request, along with a form the parent or legal guardian
246.17may execute to consent to the release of specified information to the requester. Education
246.18data may be released under this subdivision only if the parent or legal guardian gives
246.19informed consent to the release.

246.20    Sec. 2. Minnesota Statutes 2016, section 13.46, subdivision 1, is amended to read:
246.21    Subdivision 1. Definitions. As used in this section:
246.22(a) "Individual" means an individual according to section 13.02, subdivision 8, but does
246.23not include a vendor of services.
246.24(b) "Program" includes all programs for which authority is vested in a component of the
246.25welfare system according to statute or federal law, including, but not limited to, Native
246.26American tribe programs that provide a service component of the welfare system, the aid
246.27to families with dependent children program formerly codified in sections 256.72 to 256.87,
246.28Minnesota family investment program, temporary assistance for needy families program,
246.29medical assistance, general assistance, general assistance medical care formerly codified in
246.30chapter 256D, child care assistance program, and child support collections.
246.31(c) "Welfare system" includes the Department of Human Services, local social services
246.32agencies, county welfare agencies, county public health agencies, county veteran services
247.1agencies, county housing agencies, private licensing agencies, the public authority responsible
247.2for child support enforcement, human services boards, community mental health center
247.3boards, state hospitals, state nursing homes, the ombudsman for mental health and
247.4developmental disabilities, Native American tribes to the extent a tribe provides a service
247.5component of the welfare system, and persons, agencies, institutions, organizations, and
247.6other entities under contract to any of the above agencies to the extent specified in the
247.7contract.
247.8(d) "Mental health data" means data on individual clients and patients of community
247.9mental health centers, established under section 245.62, mental health divisions of counties
247.10and other providers under contract to deliver mental health services, or the ombudsman for
247.11mental health and developmental disabilities.
247.12(e) "Fugitive felon" means a person who has been convicted of a felony and who has
247.13escaped from confinement or violated the terms of probation or parole for that offense.
247.14(f) "Private licensing agency" means an agency licensed by the commissioner of human
247.15services under chapter 245A to perform the duties under section 245A.16.

247.16    Sec. 3. Minnesota Statutes 2016, section 13.46, subdivision 2, is amended to read:
247.17    Subd. 2. General. (a) Data on individuals collected, maintained, used, or disseminated
247.18by the welfare system are private data on individuals, and shall not be disclosed except:
247.19    (1) according to section 13.05;
247.20    (2) according to court order;
247.21    (3) according to a statute specifically authorizing access to the private data;
247.22    (4) to an agent of the welfare system and an investigator acting on behalf of a county,
247.23the state, or the federal government, including a law enforcement person or attorney in the
247.24investigation or prosecution of a criminal, civil, or administrative proceeding relating to the
247.25administration of a program;
247.26    (5) to personnel of the welfare system who require the data to verify an individual's
247.27identity; determine eligibility, amount of assistance, and the need to provide services to an
247.28individual or family across programs; coordinate services for an individual or family;
247.29evaluate the effectiveness of programs; assess parental contribution amounts; and investigate
247.30suspected fraud;
247.31    (6) to administer federal funds or programs;
247.32    (7) between personnel of the welfare system working in the same program;
248.1    (8) to the Department of Revenue to assess parental contribution amounts for purposes
248.2of section 252.27, subdivision 2a, administer and evaluate tax refund or tax credit programs
248.3and to identify individuals who may benefit from these programs. The following information
248.4may be disclosed under this paragraph: an individual's and their dependent's names, dates
248.5of birth, Social Security numbers, income, addresses, and other data as required, upon
248.6request by the Department of Revenue. Disclosures by the commissioner of revenue to the
248.7commissioner of human services for the purposes described in this clause are governed by
248.8section 270B.14, subdivision 1. Tax refund or tax credit programs include, but are not limited
248.9to, the dependent care credit under section 290.067, the Minnesota working family credit
248.10under section 290.0671, the property tax refund and rental credit under section 290A.04,
248.11and the Minnesota education credit under section 290.0674;
248.12    (9) between the Department of Human Services, the Department of Employment and
248.13Economic Development, and when applicable, the Department of Education, for the following
248.14purposes:
248.15    (i) to monitor the eligibility of the data subject for unemployment benefits, for any
248.16employment or training program administered, supervised, or certified by that agency;
248.17    (ii) to administer any rehabilitation program or child care assistance program, whether
248.18alone or in conjunction with the welfare system;
248.19    (iii) to monitor and evaluate the Minnesota family investment program or the child care
248.20assistance program by exchanging data on recipients and former recipients of food support,
248.21cash assistance under chapter 256, 256D, 256J, or 256K, child care assistance under chapter
248.22119B, medical programs under chapter 256B or 256L, or a medical program formerly
248.23codified under chapter 256D; and
248.24    (iv) to analyze public assistance employment services and program utilization, cost,
248.25effectiveness, and outcomes as implemented under the authority established in Title II,
248.26Sections 201-204 of the Ticket to Work and Work Incentives Improvement Act of 1999.
248.27Health records governed by sections 144.291 to 144.298 and "protected health information"
248.28as defined in Code of Federal Regulations, title 45, section 160.103, and governed by Code
248.29of Federal Regulations, title 45, parts 160-164, including health care claims utilization
248.30information, must not be exchanged under this clause;
248.31    (10) to appropriate parties in connection with an emergency if knowledge of the
248.32information is necessary to protect the health or safety of the individual or other individuals
248.33or persons;
249.1    (11) data maintained by residential programs as defined in section 245A.02 may be
249.2disclosed to the protection and advocacy system established in this state according to Part
249.3C of Public Law 98-527 to protect the legal and human rights of persons with developmental
249.4disabilities or other related conditions who live in residential facilities for these persons if
249.5the protection and advocacy system receives a complaint by or on behalf of that person and
249.6the person does not have a legal guardian or the state or a designee of the state is the legal
249.7guardian of the person;
249.8    (12) to the county medical examiner or the county coroner for identifying or locating
249.9relatives or friends of a deceased person;
249.10    (13) data on a child support obligor who makes payments to the public agency may be
249.11disclosed to the Minnesota Office of Higher Education to the extent necessary to determine
249.12eligibility under section 136A.121, subdivision 2, clause (5);
249.13    (14) participant Social Security numbers and names collected by the telephone assistance
249.14program may be disclosed to the Department of Revenue to conduct an electronic data
249.15match with the property tax refund database to determine eligibility under section 237.70,
249.16subdivision 4a ;
249.17    (15) the current address of a Minnesota family investment program participant may be
249.18disclosed to law enforcement officers who provide the name of the participant and notify
249.19the agency that:
249.20    (i) the participant:
249.21    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
249.22conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
249.23jurisdiction from which the individual is fleeing; or
249.24    (B) is violating a condition of probation or parole imposed under state or federal law;
249.25    (ii) the location or apprehension of the felon is within the law enforcement officer's
249.26official duties; and
249.27    (iii) the request is made in writing and in the proper exercise of those duties;
249.28    (16) the current address of a recipient of general assistance may be disclosed to probation
249.29officers and corrections agents who are supervising the recipient and to law enforcement
249.30officers who are investigating the recipient in connection with a felony level offense;
249.31    (17) information obtained from food support applicant or recipient households may be
249.32disclosed to local, state, or federal law enforcement officials, upon their written request, for
250.1the purpose of investigating an alleged violation of the Food Stamp Act, according to Code
250.2of Federal Regulations, title 7, section 272.1(c);
250.3    (18) the address, Social Security number, and, if available, photograph of any member
250.4of a household receiving food support shall be made available, on request, to a local, state,
250.5or federal law enforcement officer if the officer furnishes the agency with the name of the
250.6member and notifies the agency that:
250.7    (i) the member:
250.8    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
250.9crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
250.10    (B) is violating a condition of probation or parole imposed under state or federal law;
250.11or
250.12    (C) has information that is necessary for the officer to conduct an official duty related
250.13to conduct described in subitem (A) or (B);
250.14    (ii) locating or apprehending the member is within the officer's official duties; and
250.15    (iii) the request is made in writing and in the proper exercise of the officer's official duty;
250.16    (19) the current address of a recipient of Minnesota family investment program, general
250.17assistance, or food support may be disclosed to law enforcement officers who, in writing,
250.18provide the name of the recipient and notify the agency that the recipient is a person required
250.19to register under section 243.166, but is not residing at the address at which the recipient is
250.20registered under section 243.166;
250.21    (20) certain information regarding child support obligors who are in arrears may be
250.22made public according to section 518A.74;
250.23    (21) data on child support payments made by a child support obligor and data on the
250.24distribution of those payments excluding identifying information on obligees may be
250.25disclosed to all obligees to whom the obligor owes support, and data on the enforcement
250.26actions undertaken by the public authority, the status of those actions, and data on the income
250.27of the obligor or obligee may be disclosed to the other party;
250.28    (22) data in the work reporting system may be disclosed under section 256.998,
250.29subdivision 7 ;
250.30    (23) to the Department of Education for the purpose of matching Department of Education
250.31student data with public assistance data to determine students eligible for free and
250.32reduced-price meals, meal supplements, and free milk according to United States Code,
251.1title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and state
251.2funds that are distributed based on income of the student's family; and to verify receipt of
251.3energy assistance for the telephone assistance plan;
251.4    (24) the current address and telephone number of program recipients and emergency
251.5contacts may be released to the commissioner of health or a community health board as
251.6defined in section 145A.02, subdivision 5, when the commissioner or community health
251.7board has reason to believe that a program recipient is a disease case, carrier, suspect case,
251.8or at risk of illness, and the data are necessary to locate the person;
251.9    (25) to other state agencies, statewide systems, and political subdivisions of this state,
251.10including the attorney general, and agencies of other states, interstate information networks,
251.11federal agencies, and other entities as required by federal regulation or law for the
251.12administration of the child support enforcement program;
251.13    (26) to personnel of public assistance programs as defined in section 256.741, for access
251.14to the child support system database for the purpose of administration, including monitoring
251.15and evaluation of those public assistance programs;
251.16    (27) to monitor and evaluate the Minnesota family investment program by exchanging
251.17data between the Departments of Human Services and Education, on recipients and former
251.18recipients of food support, cash assistance under chapter 256, 256D, 256J, or 256K, child
251.19care assistance under chapter 119B, medical programs under chapter 256B or 256L, or a
251.20medical program formerly codified under chapter 256D;
251.21    (28) to evaluate child support program performance and to identify and prevent fraud
251.22in the child support program by exchanging data between the Department of Human Services,
251.23Department of Revenue under section 270B.14, subdivision 1, paragraphs (a) and (b),
251.24without regard to the limitation of use in paragraph (c), Department of Health, Department
251.25of Employment and Economic Development, and other state agencies as is reasonably
251.26necessary to perform these functions;
251.27    (29) counties operating child care assistance programs under chapter 119B may
251.28disseminate data on program participants, applicants, and providers to the commissioner of
251.29education;
251.30    (30) child support data on the child, the parents, and relatives of the child may be
251.31disclosed to agencies administering programs under titles IV-B and IV-E of the Social
251.32Security Act, as authorized by federal law; or
252.1(31) to a health care provider governed by sections 144.291 to 144.298, to the extent
252.2necessary to coordinate services;
252.3(32) to the chief administrative officer of a school to coordinate services for a student
252.4and family; data that may be disclosed under this clause are limited to name, date of birth,
252.5gender, and address; or
252.6(33) to county correctional agencies to the extent necessary to coordinate services and
252.7diversion programs; data that may be disclosed under this clause are limited to name, client
252.8demographics, program, case status, and county worker information.
252.9    (b) Information on persons who have been treated for drug or alcohol abuse may only
252.10be disclosed according to the requirements of Code of Federal Regulations, title 42, sections
252.112.1 to 2.67.
252.12    (c) Data provided to law enforcement agencies under paragraph (a), clause (15), (16),
252.13(17), or (18), or paragraph (b), are investigative data and are confidential or protected
252.14nonpublic while the investigation is active. The data are private after the investigation
252.15becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
252.16    (d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but are
252.17not subject to the access provisions of subdivision 10, paragraph (b).
252.18    For the purposes of this subdivision, a request will be deemed to be made in writing if
252.19made through a computer interface system.

252.20    Sec. 4. Minnesota Statutes 2016, section 13.84, subdivision 5, is amended to read:
252.21    Subd. 5. Disclosure. Private or confidential court services data shall not be disclosed
252.22except:
252.23(a) pursuant to section 13.05;
252.24(b) pursuant to a statute specifically authorizing disclosure of court services data;
252.25(c) with the written permission of the source of confidential data;
252.26(d) to the court services department, parole or probation authority or state or local
252.27correctional agency or facility having statutorily granted supervision over the individual
252.28subject of the data, or to county personnel within the welfare system;
252.29(e) pursuant to subdivision 6;
252.30(f) pursuant to a valid court order; or
252.31(g) pursuant to section 611A.06, subdivision 3a.

253.1    Sec. 5. [119B.097] AUTHORIZATION WITH A SECONDARY PROVIDER.
253.2    (a) If a child uses any combination of the following providers paid by child care
253.3assistance, a parent must choose one primary provider and one secondary provider per child
253.4that can be paid by child care assistance:
253.5    (1) an individual or child care center licensed under chapter 245A;
253.6    (2) an individual or child care center or facility holding a valid child care license issued
253.7by another state or tribe; or
253.8    (3) a child care center exempt from licensing under section 245A.03.
253.9    (b) The amount of child care authorized with the secondary provider cannot exceed 20
253.10hours per two-week service period, per child, and the amount of care paid to a child's
253.11secondary provider is limited under section 119B.13, subdivision 1. The total amount of
253.12child care authorized with both the primary and secondary provider cannot exceed the
253.13amount of child care allowed based on the parents' eligible activity schedule, the child's
253.14school schedule, and any other factors relevant to the family's child care needs.
253.15EFFECTIVE DATE.This section is effective April 23, 2018.

253.16    Sec. 6. Minnesota Statutes 2016, section 119B.13, subdivision 1, is amended to read:
253.17    Subdivision 1. Subsidy restrictions. (a) Beginning February 3, 2014, the maximum
253.18rate paid for child care assistance in any county or county price cluster under the child care
253.19fund shall be the greater of the 25th percentile of the 2011 child care provider rate survey
253.20or the maximum rate effective November 28, 2011. For a child care provider located within
253.21the boundaries of a city located in two or more of the counties of Benton, Sherburne, and
253.22Stearns, the maximum rate paid for child care assistance shall be equal to the maximum
253.23rate paid in the county with the highest maximum reimbursement rates or the provider's
253.24charge, whichever is less. The commissioner may: (1) assign a county with no reported
253.25provider prices to a similar price cluster; and (2) consider county level access when
253.26determining final price clusters.
253.27    (b) A rate which includes a special needs rate paid under subdivision 3 may be in excess
253.28of the maximum rate allowed under this subdivision.
253.29    (c) The department shall monitor the effect of this paragraph on provider rates. The
253.30county shall pay the provider's full charges for every child in care up to the maximum
253.31established. The commissioner shall determine the maximum rate for each type of care on
253.32an hourly, full-day, and weekly basis, including special needs and disability care.
254.1    (d) If a child uses one provider, the maximum payment to a provider for one day of care
254.2must not exceed the daily rate. The maximum payment to a provider for one week of care
254.3must not exceed the weekly rate.
254.4    (e) If a child uses two providers under section 119B.097, the maximum payment must
254.5not exceed:
254.6    (1) the daily rate for one day of care;
254.7    (2) the weekly rate for one week of care by the child's primary provider; and
254.8    (3) two daily rates during two weeks of care by a child's secondary provider.
254.9(d) (f) Child care providers receiving reimbursement under this chapter must not be paid
254.10activity fees or an additional amount above the maximum rates for care provided during
254.11nonstandard hours for families receiving assistance.
254.12    (e) When (g) If the provider charge is greater than the maximum provider rate allowed,
254.13the parent is responsible for payment of the difference in the rates in addition to any family
254.14co-payment fee.
254.15    (f) (h) All maximum provider rates changes shall be implemented on the Monday
254.16following the effective date of the maximum provider rate.
254.17    (g) (i) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum
254.18registration fees in effect on January 1, 2013, shall remain in effect.
254.19EFFECTIVE DATE.Paragraph (a) is effective July 1, 2018. Paragraphs (d) to (i) are
254.20effective April 23, 2018.

254.21    Sec. 7. Minnesota Statutes 2016, section 245.814, subdivision 2, is amended to read:
254.22    Subd. 2. Application of coverage. Coverage shall apply to all foster homes licensed by
254.23the Department of Human Services, licensed by a federally recognized tribal government,
254.24or established by the juvenile court and certified by the commissioner of corrections pursuant
254.25to section 260B.198, subdivision 1, clause (3), item (v), to the extent that the liability is not
254.26covered by the provisions of the standard homeowner's or automobile insurance policy. The
254.27insurance shall not cover property owned by the individual foster home provider, damage
254.28caused intentionally by a person over 12 years of age, or property damage arising out of
254.29business pursuits or the operation of any vehicle, machinery, or equipment.

255.1    Sec. 8. Minnesota Statutes 2016, section 245.814, subdivision 3, is amended to read:
255.2    Subd. 3. Compensation provisions. If the commissioner of human services is unable
255.3to obtain insurance through ordinary methods for coverage of foster home providers, the
255.4appropriation shall be returned to the general fund and the state shall pay claims subject to
255.5the following limitations.
255.6(a) Compensation shall be provided only for injuries, damage, or actions set forth in
255.7subdivision 1.
255.8(b) Compensation shall be subject to the conditions and exclusions set forth in subdivision
255.92.
255.10(c) The state shall provide compensation for bodily injury, property damage, or personal
255.11injury resulting from the foster home providers activities as a foster home provider while
255.12the foster child or adult is in the care, custody, and control of the foster home provider in
255.13an amount not to exceed $250,000 for each occurrence.
255.14(d) The state shall provide compensation for damage or destruction of property caused
255.15or sustained by a foster child or adult in an amount not to exceed $250 $1,000 for each
255.16occurrence.
255.17(e) The compensation in paragraphs (c) and (d) is the total obligation for all damages
255.18because of each occurrence regardless of the number of claims made in connection with
255.19the same occurrence, but compensation applies separately to each foster home. The state
255.20shall have no other responsibility to provide compensation for any injury or loss caused or
255.21sustained by any foster home provider or foster child or foster adult.
255.22This coverage is extended as a benefit to foster home providers to encourage care of
255.23persons who need out-of-home care. Nothing in this section shall be construed to mean that
255.24foster home providers are agents or employees of the state nor does the state accept any
255.25responsibility for the selection, monitoring, supervision, or control of foster home providers
255.26which is exclusively the responsibility of the counties which shall regulate foster home
255.27providers in the manner set forth in the rules of the commissioner of human services.

255.28    Sec. 9. [245A.23] EXEMPTION FROM POSITIVE SUPPORT STRATEGIES
255.29REQUIREMENTS.
255.30(a) A program licensed as a family day care or group family day care facility under
255.31Minnesota Rules, chapter 9502, and a program licensed as a child care center under
255.32Minnesota Rules, chapter 9503, are exempt from Minnesota Rules, chapter 9544, relating
255.33to positive support strategies and restrictive interventions.
256.1(b) When providing services to a child with a developmental disability or related
256.2condition, a program licensed as a family day care or group family day care facility under
256.3Minnesota Rules, chapter 9502, or a program licensed as a child care center under Minnesota
256.4Rules, chapter 9503, is prohibited from using procedures identified in section 245D.06,
256.5subdivision 5.
256.6EFFECTIVE DATE.This section is effective the day following final enactment.

256.7    Sec. 10. Minnesota Statutes 2016, section 245A.50, subdivision 5, is amended to read:
256.8    Subd. 5. Sudden unexpected infant death and abusive head trauma training. (a)
256.9License holders must document that before staff persons, caregivers, and helpers assist in
256.10the care of infants, they are instructed on the standards in section 245A.1435 and receive
256.11training on reducing the risk of sudden unexpected infant death. In addition, license holders
256.12must document that before staff persons, caregivers, and helpers assist in the care of infants
256.13and children under school age, they receive training on reducing the risk of abusive head
256.14trauma from shaking infants and young children. The training in this subdivision may be
256.15provided as initial training under subdivision 1 or ongoing annual training under subdivision
256.167.
256.17    (b) Sudden unexpected infant death reduction training required under this subdivision
256.18must, at a minimum, address the risk factors related to sudden unexpected infant death,
256.19means of reducing the risk of sudden unexpected infant death in child care, and license
256.20holder communication with parents regarding reducing the risk of sudden unexpected infant
256.21death.
256.22    (c) Abusive head trauma training required under this subdivision must, at a minimum,
256.23address the risk factors related to shaking infants and young children, means of reducing
256.24the risk of abusive head trauma in child care, and license holder communication with parents
256.25regarding reducing the risk of abusive head trauma.
256.26    (d) Training for family and group family child care providers must be developed by the
256.27commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved
256.28by the Minnesota Center for Professional Development. Sudden unexpected infant death
256.29reduction training and abusive head trauma training may be provided in a single course of
256.30no more than two hours in length.
256.31    (e) Sudden unexpected infant death reduction training and abusive head trauma training
256.32required under this subdivision must be completed in person or as allowed under subdivision
256.3310, clause (1) or (2), at least once every two years. On the years when the license holder is
257.1not receiving training in person or as allowed under subdivision 10, clause (1) or (2), the
257.2license holder must receive sudden unexpected infant death reduction training and abusive
257.3head trauma training through a video of no more than one hour in length. The video must
257.4be developed or approved by the commissioner.
257.5(f) An individual who is related to the license holder as defined in section 245A.02,
257.6subdivision 13, and who is involved only in the care of the license holder's own infant or
257.7child under school age and who is not designated to be a caregiver, helper, or substitute, as
257.8defined in Minnesota Rules, part 9502.0315, for the licensed program, is exempt from the
257.9sudden unexpected infant death and abusive head trauma training.

257.10    Sec. 11. Minnesota Statutes 2016, section 252.27, subdivision 2a, is amended to read:
257.11    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor child,
257.12including a child determined eligible for medical assistance without consideration of parental
257.13income, must contribute to the cost of services used by making monthly payments on a
257.14sliding scale based on income, unless the child is married or has been married, parental
257.15rights have been terminated, or the child's adoption is subsidized according to chapter 259A
257.16or through title IV-E of the Social Security Act. The parental contribution is a partial or full
257.17payment for medical services provided for diagnostic, therapeutic, curing, treating, mitigating,
257.18rehabilitation, maintenance, and personal care services as defined in United States Code,
257.19title 26, section 213, needed by the child with a chronic illness or disability.
257.20    (b) For households with adjusted gross income equal to or greater than 275 percent of
257.21federal poverty guidelines, the parental contribution shall be computed by applying the
257.22following schedule of rates to the adjusted gross income of the natural or adoptive parents:
257.23    (1) if the adjusted gross income is equal to or greater than 275 percent of federal poverty
257.24guidelines and less than or equal to 545 percent of federal poverty guidelines, the parental
257.25contribution shall be determined using a sliding fee scale established by the commissioner
257.26of human services which begins at 2.23 1.6725 percent of adjusted gross income at 275
257.27percent of federal poverty guidelines and increases to 6.08 4.56 percent of adjusted gross
257.28income for those with adjusted gross income up to 545 percent of federal poverty guidelines;
257.29    (2) if the adjusted gross income is greater than 545 percent of federal poverty guidelines
257.30and less than 675 percent of federal poverty guidelines, the parental contribution shall be
257.316.08 4.56 percent of adjusted gross income;
257.32    (3) if the adjusted gross income is equal to or greater than 675 percent of federal poverty
257.33guidelines and less than 975 percent of federal poverty guidelines, the parental contribution
258.1shall be determined using a sliding fee scale established by the commissioner of human
258.2services which begins at 6.08 4.56 percent of adjusted gross income at 675 percent of federal
258.3poverty guidelines and increases to 8.1 6.075 percent of adjusted gross income for those
258.4with adjusted gross income up to 975 percent of federal poverty guidelines; and
258.5    (4) if the adjusted gross income is equal to or greater than 975 percent of federal poverty
258.6guidelines, the parental contribution shall be 10.13 7.5975 percent of adjusted gross income.
258.7    If the child lives with the parent, the annual adjusted gross income is reduced by $2,400
258.8prior to calculating the parental contribution. If the child resides in an institution specified
258.9in section 256B.35, the parent is responsible for the personal needs allowance specified
258.10under that section in addition to the parental contribution determined under this section.
258.11The parental contribution is reduced by any amount required to be paid directly to the child
258.12pursuant to a court order, but only if actually paid.
258.13    (c) The household size to be used in determining the amount of contribution under
258.14paragraph (b) includes natural and adoptive parents and their dependents, including the
258.15child receiving services. Adjustments in the contribution amount due to annual changes in
258.16the federal poverty guidelines shall be implemented on the first day of July following
258.17publication of the changes.
258.18    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
258.19natural or adoptive parents determined according to the previous year's federal tax form,
258.20except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
258.21have been used to purchase a home shall not be counted as income.
258.22    (e) The contribution shall be explained in writing to the parents at the time eligibility
258.23for services is being determined. The contribution shall be made on a monthly basis effective
258.24with the first month in which the child receives services. Annually upon redetermination
258.25or at termination of eligibility, if the contribution exceeded the cost of services provided,
258.26the local agency or the state shall reimburse that excess amount to the parents, either by
258.27direct reimbursement if the parent is no longer required to pay a contribution, or by a
258.28reduction in or waiver of parental fees until the excess amount is exhausted. All
258.29reimbursements must include a notice that the amount reimbursed may be taxable income
258.30if the parent paid for the parent's fees through an employer's health care flexible spending
258.31account under the Internal Revenue Code, section 125, and that the parent is responsible
258.32for paying the taxes owed on the amount reimbursed.
258.33    (f) The monthly contribution amount must be reviewed at least every 12 months; when
258.34there is a change in household size; and when there is a loss of or gain in income from one
259.1month to another in excess of ten percent. The local agency shall mail a written notice 30
259.2days in advance of the effective date of a change in the contribution amount. A decrease in
259.3the contribution amount is effective in the month that the parent verifies a reduction in
259.4income or change in household size.
259.5    (g) Parents of a minor child who do not live with each other shall each pay the
259.6contribution required under paragraph (a). An amount equal to the annual court-ordered
259.7child support payment actually paid on behalf of the child receiving services shall be deducted
259.8from the adjusted gross income of the parent making the payment prior to calculating the
259.9parental contribution under paragraph (b).
259.10    (h) The contribution under paragraph (b) shall be increased by an additional five percent
259.11if the local agency determines that insurance coverage is available but not obtained for the
259.12child. For purposes of this section, "available" means the insurance is a benefit of employment
259.13for a family member at an annual cost of no more than five percent of the family's annual
259.14income. For purposes of this section, "insurance" means health and accident insurance
259.15coverage, enrollment in a nonprofit health service plan, health maintenance organization,
259.16self-insured plan, or preferred provider organization.
259.17    Parents who have more than one child receiving services shall not be required to pay
259.18more than the amount for the child with the highest expenditures. There shall be no resource
259.19contribution from the parents. The parent shall not be required to pay a contribution in
259.20excess of the cost of the services provided to the child, not counting payments made to
259.21school districts for education-related services. Notice of an increase in fee payment must
259.22be given at least 30 days before the increased fee is due.
259.23    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in
259.24the 12 months prior to July 1:
259.25    (1) the parent applied for insurance for the child;
259.26    (2) the insurer denied insurance;
259.27    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a
259.28complaint or appeal, in writing, to the commissioner of health or the commissioner of
259.29commerce, or litigated the complaint or appeal; and
259.30    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
259.31    For purposes of this section, "insurance" has the meaning given in paragraph (h).
259.32    A parent who has requested a reduction in the contribution amount under this paragraph
259.33shall submit proof in the form and manner prescribed by the commissioner or county agency,
260.1including, but not limited to, the insurer's denial of insurance, the written letter or complaint
260.2of the parents, court documents, and the written response of the insurer approving insurance.
260.3The determinations of the commissioner or county agency under this paragraph are not rules
260.4subject to chapter 14.

260.5    Sec. 12. Minnesota Statutes 2016, section 256E.30, subdivision 2, is amended to read:
260.6    Subd. 2. Allocation of money. (a) State money appropriated and community service
260.7block grant money allotted to the state and all money transferred to the community service
260.8block grant from other block grants shall be allocated annually to community action agencies
260.9and Indian reservation governments under clauses (b) and (c), and to migrant and seasonal
260.10farmworker organizations under clause (d).
260.11(b) The available annual money will provide base funding to all community action
260.12agencies and the Indian reservations. Base funding amounts per agency are as follows: for
260.13agencies with low income populations up to 3,999 1,999, $25,000; 4,000 2,000 to 23,999,
260.14$50,000; and 24,000 or more, $100,000.
260.15(c) All remaining money of the annual money available after the base funding has been
260.16determined must be allocated to each agency and reservation in proportion to the size of
260.17the poverty level population in the agency's service area compared to the size of the poverty
260.18level population in the state.
260.19(d) Allocation of money to migrant and seasonal farmworker organizations must not
260.20exceed three percent of the total annual money available. Base funding allocations must be
260.21made for all community action agencies and Indian reservations that received money under
260.22this subdivision, in fiscal year 1984, and for community action agencies designated under
260.23this section with a service area population of 35,000 or greater.

260.24    Sec. 13. Minnesota Statutes 2016, section 256J.24, subdivision 5, is amended to read:
260.25    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based on the
260.26number of persons in the assistance unit eligible for both food and cash assistance. The
260.27amount of the transitional standard is published annually by the Department of Human
260.28Services. The following table represents the cash portion of the transitional standard effective
260.29March 1, 2018.

260.30	Number of eligible people	Cash portion
260.31	1	$263
260.32	2	$450
260.33	3	$545
261.1	4	$634
261.2	5	$710
261.3	6	$786
261.4	7	$863
261.5	8	$929
261.6	9	$993
261.7	10	$1,048
261.8	Over 10	add $56 for each additional eligible person

261.9    Sec. 14. Minnesota Statutes 2016, section 256J.45, subdivision 2, is amended to read:
261.10    Subd. 2. General information. The MFIP orientation must consist of a presentation
261.11that informs caregivers of:
261.12    (1) the necessity to obtain immediate employment;
261.13    (2) the work incentives under MFIP, including the availability of the federal earned
261.14income tax credit and the Minnesota working family tax credit;
261.15    (3) the requirement to comply with the employment plan and other requirements of the
261.16employment and training services component of MFIP, including a description of the range
261.17of work and training activities that are allowable under MFIP to meet the individual needs
261.18of participants;
261.19    (4) the consequences for failing to comply with the employment plan and other program
261.20requirements, and that the county agency may not impose a sanction when failure to comply
261.21is due to the unavailability of child care or other circumstances where the participant has
261.22good cause under subdivision 3;
261.23    (5) the rights, responsibilities, and obligations of participants;
261.24    (6) the types and locations of child care services available through the county agency;
261.25    (7) the availability and the benefits of the early childhood health and developmental
261.26screening under sections 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10;
261.27    (8) the caregiver's eligibility for transition year child care assistance under section
261.28119B.05 ;
261.29    (9) the availability of all health care programs, including transitional medical assistance;
261.30    (10) the caregiver's option to choose an employment and training provider and information
261.31about each provider, including but not limited to, services offered, program components,
261.32job placement rates, job placement wages, and job retention rates;
262.1    (11) the caregiver's option to request approval of an education and training plan according
262.2to section 256J.53;
262.3    (12) the work study programs available under the higher education system; and
262.4    (13) information about the 60-month time limit exemptions under the family violence
262.5waiver and referral information about shelters and programs for victims of family violence.;
262.6and
262.7    (14) information about the income exclusions under section 256P.06, subdivision 2.
262.8EFFECTIVE DATE.This section is effective December 1, 2018.

262.9    Sec. 15. [256N.261] SUPPORT FOR ADOPTIVE, FOSTER, AND KINSHIP
262.10FAMILIES.
262.11    Subdivision 1. Program established. The commissioner shall design and implement a
262.12coordinated program to reduce the need for placement changes or out-of-home placements
262.13of children and youth in foster care, adoptive placements, and permanent physical and legal
262.14custody kinship placements, and to improve the functioning and stability of these families.
262.15To the extent federal funds are available, the commissioner shall provide the following
262.16adoption and foster care-competent services and ensure that placements are trauma-informed
262.17and child and family-centered:
262.18(1) a program providing information, referrals, a parent-to-parent support network, peer
262.19support for youth, family activities, respite care, crisis services, educational support, and
262.20mental health services for children and youth in adoption, foster care, and kinship placements
262.21and adoptive, foster, and kinship families in Minnesota;
262.22(2) training offered statewide in Minnesota for adoptive and kinship families, and training
262.23for foster families, and the professionals who serve the families, on the effects of trauma,
262.24common disabilities of adopted children and children in foster care, and kinship placements,
262.25and challenges in adoption, foster care, and kinship placements; and
262.26(3) periodic evaluation of these services to ensure program effectiveness in preserving
262.27and improving the success of adoptive, foster, and kinship placements.
262.28    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.
262.29(b) "Child and family-centered" means individualized services that respond to a child's
262.30or youth's strengths, interests, and current developmental stage, including social, cognitive,
262.31emotional, physical, cultural, racial, and spiritual needs, and offer support to the entire
262.32adoptive, foster, or kinship family.
263.1(c) "Trauma-informed" means care that acknowledges the effect trauma has on children
263.2and the children's families; modifies services to respond to the effects of trauma; emphasizes
263.3skill and strength-building rather than symptom management; and focuses on the physical
263.4and psychological safety of the child and family.

263.5    Sec. 16. Minnesota Statutes 2016, section 256P.06, subdivision 2, is amended to read:
263.6    Subd. 2. Exempted individuals. (a) The following members of an assistance unit under
263.7chapters 119B and 256J are exempt from having their earned income count towards the
263.8income of an assistance unit:
263.9(1) children under six years old;
263.10(2) caregivers under 20 years of age enrolled at least half-time in school; and
263.11(3) minors enrolled in school full time.
263.12(b) The following members of an assistance unit are exempt from having their earned
263.13and unearned income count towards the income of an assistance unit for 12 consecutive
263.14calendar months, beginning the month following the marriage date, for benefits under chapter
263.15256J if the household income does not exceed 275 percent of the federal poverty guideline:
263.16(1) a new spouse to a caretaker in an existing assistance unit; and
263.17(2) the spouse designated by a newly married couple, both of whom were already
263.18members of an assistance unit under chapter 256J.
263.19(c) If members identified in paragraph (b) also receive assistance under section 119B.05,
263.20they are exempt from having their earned and unearned income count towards the income
263.21of the assistance unit if the household income prior to the exemption does not exceed 67
263.22percent of the state median income for recipients for 26 consecutive biweekly periods
263.23beginning the second biweekly period after the marriage date.
263.24EFFECTIVE DATE.This section is effective December 1, 2018.

263.25    Sec. 17. Minnesota Statutes 2016, section 260C.451, subdivision 6, is amended to read:
263.26    Subd. 6. Reentering foster care and accessing services after 18 years of age and up
263.27to 21 years of age. (a) Upon request of an individual who had been under the guardianship
263.28of the commissioner and who has left foster care without being adopted, the responsible
263.29social services agency which had been the commissioner's agent for purposes of the
263.30guardianship shall develop with the individual a plan to increase the individual's ability to
263.31live safely and independently using the plan requirements of section 260C.212, subdivision
264.11 , paragraph (c), clause (12), and to assist the individual to meet one or more of the eligibility
264.2criteria in subdivision 4 if the individual wants to reenter foster care. The responsible social
264.3services agency shall provide foster care as required to implement the plan. The responsible
264.4social services agency shall enter into a voluntary placement agreement under section
264.5260C.229 with the individual if the plan includes foster care.
264.6(b) Individuals who had not been under the guardianship of the commissioner of human
264.7services prior to 18 years of age may ask to reenter foster care after age 18 and, to the extent
264.8funds are available, the responsible social services agency that had responsibility for planning
264.9for the individual before discharge from foster care may shall provide foster care or other
264.10services to the individual for the purpose of increasing the individual's ability to live safely
264.11and independently and to meet the eligibility criteria in subdivision 3a, if the individual:
264.12(1) was in foster care for the six consecutive months prior to the person's 18th birthday,
264.13or left foster care within six months prior to the person's 18th birthday, and was not
264.14discharged home, adopted, or received into a relative's home under a transfer of permanent
264.15legal and physical custody under section 260C.515, subdivision 4; or
264.16(2) was discharged from foster care while on runaway status after age 15.
264.17(c) In conjunction with a qualifying and eligible individual under paragraph (b) and
264.18other appropriate persons, the responsible social services agency shall develop a specific
264.19plan related to that individual's vocational, educational, social, or maturational needs and,
264.20to the extent funds are available, provide foster care as required to implement the plan. The
264.21responsible social services agency shall enter into a voluntary placement agreement with
264.22the individual if the plan includes foster care.
264.23(d) A child who left foster care while under guardianship of the commissioner of human
264.24services retains eligibility for foster care for placement at any time prior to 21 years of age.

264.25    Sec. 18. MINNESOTA BIRTH TO AGE EIGHT PILOT PROJECT.
264.26    Subdivision 1. Authorization. The commissioner of human services shall award a grant
264.27to Dakota County to develop and implement pilots that will evaluate the impact of a
264.28coordinated systems and service delivery approach on key developmental milestones and
264.29outcomes that ultimately lead to reading proficiency by age eight within the target population.
264.30The pilot program is from July 1, 2017, to June 30, 2021.
264.31    Subd. 2. Pilot design and goals. The pilot will establish five key developmental milestone
264.32markers from birth to age eight. Enrollees in the pilot will be developmentally assessed and
264.33tracked by a technology solution that tracks developmental milestones along the established
265.1developmental continuum. If a child's progress falls below established milestones and the
265.2weighted scoring, the coordinated service system will focus on identified areas of concern,
265.3mobilize appropriate supportive services, and offer services to identified children and their
265.4families.
265.5    Subd. 3. Program participants in phase 1 target population. Pilot program participants
265.6must:
265.7(1) be enrolled in a Women's Infant & Children (WIC) program;
265.8(2) be participating in a family home visiting program, or nurse family practice, or
265.9Healthy Families America (HFA);
265.10(3) be children and families qualifying for and participating in early language learners
265.11(ELL) in the school district in which they reside; and
265.12(4) opt-in and provide parental consent to participate in the pilot project.
265.13    Subd. 4. Evaluation and report. The county or counties shall work with a third-party
265.14evaluator to evaluate the effectiveness of the pilot and report to the legislative committees
265.15with jurisdiction over human services policy and finance each year by February 1 with an
265.16update on the progress of the pilot. The final report on the pilot is due January 1, 2022.

265.17    Sec. 19. MINNESOTA PATHWAYS TO PROSPERITY PILOT PROJECT.
265.18    Subdivision 1. Authorization. The commissioner of human services may develop a
265.19pilot project that shall test an alternative financing model for the distribution of publicly
265.20funded benefits. The commissioner may work with interested counties to develop the pilot
265.21and determine the waivers that are necessary to implement the pilot project based on the
265.22pilot design in subdivisions 2 and 3, and outcome measures in subdivision 4.
265.23    Subd. 2. Pilot project goals. The goals of the pilot project are to:
265.24(1) reduce the historical separation among the state programs and systems affecting
265.25families who are receiving public assistance;
265.26(2) eliminate, where possible, funding restrictions to allow a more comprehensive
265.27approach to the needs of the families in the pilot project; and
265.28(3) focus on upstream, prevention-oriented supports and interventions.
265.29    Subd. 3. Project participants. The pilot project developed by the commissioner may
265.30include requirements that participants:
265.31(1) be 26 years of age or younger with a minimum of one child;
266.1(2) voluntarily agree to participate in the pilot project;
266.2(3) be eligible for, applying for, or receiving public benefits including but not limited
266.3to housing assistance, education supports, employment supports, child care, transportation
266.4supports, medical assistance, earned income tax credit, or the child care tax credit; and
266.5(4) be enrolled in an education program that is focused on obtaining a career that will
266.6likely result in a livable wage.
266.7    Subd. 4. Outcomes. The outcome measures for the pilot project must include:
266.8(1) improvement in the affordability, safety, and permanence of suitable housing;
266.9(2) improvement in family functioning and stability, including in the areas of behavioral
266.10health, incarceration, involvement with the child welfare system, or equivalent indicators;
266.11(3) improvement in education readiness and outcomes for parents and children from
266.12early childhood through high school, including reduction in absenteeism, preschool readiness
266.13scores, third grade reading competency, graduation, GPA, and standardized test improvement;
266.14(4) improvement in attachment to the workforce of one or both parents, including
266.15enhanced job stability; wage gains; career advancement; progress in career preparation; or
266.16an equivalent combination of these or related measures; and
266.17(5) improvement in health care access and health outcomes for parents and children.

266.18    Sec. 20. INDIAN CHILD WELFARE ACT COMPLIANCE SYSTEM REVIEW.
266.19    By February 1, 2018, the commissioner of human services shall report back to the
266.20legislature on a system for the review of cases reported by counties for aid payments under
266.21Minnesota Statutes, section 477A.0126, for compliance with the Indian Child Welfare Act
266.22and the Minnesota Indian Family Preservation Act. The proposed case review system may
266.23include, but is not limited to, the cases to be reviewed, the criteria to be reviewed to
266.24demonstrate compliance with the Indian Child Welfare Act and the Minnesota Indian Family
266.25Preservation Act, the rate of noncompliance, and training.

266.26    Sec. 21. MOBILE FOOD SHELF GRANTS.
266.27    Subdivision 1. Grant amount. Hunger Solutions shall award grants on a priority basis
266.28under subdivision 3. A grant to sustain an existing mobile program shall not exceed $25,000.
266.29A grant to create a new mobile program shall not exceed $75,000.
266.30    Subd. 2. Application contents. An applicant for a grant under this section must provide
266.31the following information to Hunger Solutions:
267.1(1) the location of the project;
267.2(2) a description of the mobile program, including the program's size and scope;
267.3(3) evidence regarding the unserved or underserved nature of the community in which
267.4the project is to be located;
267.5(4) evidence of community support for the project;
267.6(5) the total cost of the project;
267.7(6) the amount of the grant request and how funds will be used;
267.8(7) sources of funding or in-kind contributions for the project that may supplement any
267.9grant award;
267.10(8) the applicant's commitment to maintain the mobile program; and
267.11(9) any additional information requested by Hunger Solutions.
267.12    Subd. 3. Awarding grants. In evaluating applications and awarding grants, Hunger
267.13Solutions must give priority to an applicant who:
267.14(1) serves unserved or underserved areas;
267.15(2) creates a new mobile program or expands an existing mobile program;
267.16(3) serves areas where a high level of need is identified;
267.17(4) provides evidence of strong support for the project from residents and other institutions
267.18in the community;
267.19(5) leverages funding for the project from other private and public sources; and
267.20(6) commits to maintaining the program on a multiyear basis.

267.21    Sec. 22. CHILD CARE CORRECTION ORDER POSTING GUIDELINES.
267.22No later than November 1, 2017, the commissioner shall develop guidelines for posting
267.23public licensing data for licensed child care programs. In developing the guidelines, the
267.24commissioner shall consult with stakeholders, including licensed child care center providers,
267.25family child care providers, and county agencies.

267.26    Sec. 23. REPEALER.
267.27Minnesota Statutes 2016, sections 13.468; 179A.50; 179A.51; 179A.52; 179A.53; and
267.28256J.626, subdivision 5, are repealed.

268.1ARTICLE 8

268.2CHEMICAL AND MENTAL HEALTH SERVICES

268.3    Section 1. [245.4662] GRANT PROGRAM; MENTAL HEALTH INNOVATION.
268.4    Subdivision 1. Definitions. (a) For purposes of this section, the following terms have
268.5the meanings given them.
268.6(b) "Community partnership" means a project involving the collaboration of two or more
268.7eligible applicants.
268.8(c) "Eligible applicant" means an eligible county, Indian tribe, mental health service
268.9provider, hospital, or community partnership. Eligible applicant does not include a
268.10state-operated direct care and treatment facility or program under chapter 246.
268.11(d) "Intensive residential treatment services" has the meaning given in section 256B.0622,
268.12subdivision 2.
268.13(e) "Metropolitan area" means the seven-county metropolitan area, as defined in section
268.14473.121, subdivision 2.
268.15    Subd. 2. Grants authorized. The commissioner of human services shall, in consultation
268.16with stakeholders, award grants to eligible applicants to plan, establish, or operate programs
268.17to improve accessibility and quality of community-based, outpatient mental health services
268.18and reduce the number of clients admitted to regional treatment centers and community
268.19behavioral health hospitals. This is a onetime appropriation that is available until June 30,
268.202021. The commissioner shall award half of all grant funds to eligible applicants in the
268.21metropolitan area and half of all grant funds to eligible applicants outside the metropolitan
268.22area. An applicant may apply for and the commissioner may award grants for two-year
268.23periods.
268.24    Subd. 3. Allocation of grants. (a) An application must be on a form and contain
268.25information as specified by the commissioner but at a minimum must contain:
268.26(1) a description of the purpose or project for which grant funds will be used;
268.27(2) a description of the specific problem the grant funds will address;
268.28(3) a letter of support from the local mental health authority;
268.29(4) a description of achievable objectives, a work plan, and a timeline for implementation
268.30and completion of processes or projects enabled by the grant; and
268.31(5) a process for documenting and evaluating results of the grant.
269.1(b) The commissioner shall review each application to determine whether the application
269.2is complete and whether the applicant and the project are eligible for a grant. In evaluating
269.3applications according to paragraph (c), the commissioner shall establish criteria including,
269.4but not limited to: the eligibility of the project; the applicant's thoroughness and clarity in
269.5describing the problem grant funds are intended to address; a description of the applicant's
269.6proposed project; a description of the population demographics and service area of the
269.7proposed project; the manner in which the applicant will demonstrate the effectiveness of
269.8any projects undertaken; the proposed project's longevity and demonstrated financial
269.9sustainability after the initial grant period; and evidence of efficiencies and effectiveness
269.10gained through collaborative efforts. The commissioner may also consider other relevant
269.11factors. In evaluating applications, the commissioner may request additional information
269.12regarding a proposed project, including information on project cost. An applicant's failure
269.13to provide the information requested disqualifies an applicant. The commissioner shall
269.14determine the number of grants awarded.
269.15(c) Eligible applicants may receive grants under this section for purposes including, but
269.16not limited to, the following:
269.17(1) intensive residential treatment services providing time-limited mental health services
269.18in a residential setting;
269.19(2) the creation of stand-alone urgent care centers for mental health and psychiatric
269.20consultation services, crisis residential services, or collaboration between crisis teams and
269.21critical access hospitals;
269.22(3) establishing new community mental health services or expanding the capacity of
269.23existing services, including supportive housing; and
269.24(4) other innovative projects that improve options for mental health services in community
269.25settings and reduce the number of clients who remain in regional treatment centers and
269.26community behavioral health hospitals beyond when discharge is determined to be clinically
269.27appropriate.
269.28    Subd. 4. Report to legislature. By December 1, 2019, the commissioner of human
269.29services shall deliver a report to the chairs and ranking minority members of the legislative
269.30committees with jurisdiction over mental health issues on the outcomes of the projects
269.31funded under this section. The report shall, at a minimum, include the amount of funding
269.32awarded for each project, a description of the programs and services funded, plans for the
269.33long-term sustainability of the projects, and data on outcomes for the programs and services
270.1funded. Grantees must provide information and data requested by the commissioner to
270.2support the development of this report.

270.3    Sec. 2. Minnesota Statutes 2016, section 245.4889, subdivision 1, is amended to read:
270.4    Subdivision 1. Establishment and authority. (a) The commissioner is authorized to
270.5make grants from available appropriations to assist:
270.6    (1) counties;
270.7    (2) Indian tribes;
270.8    (3) children's collaboratives under section 124D.23 or 245.493; or
270.9    (4) mental health service providers.
270.10    (b) The following services are eligible for grants under this section:
270.11    (1) services to children with emotional disturbances as defined in section 245.4871,
270.12subdivision 15, and their families;
270.13    (2) transition services under section 245.4875, subdivision 8, for young adults under
270.14age 21 and their families;
270.15    (3) respite care services for children with severe emotional disturbances who are at risk
270.16of out-of-home placement;
270.17    (4) children's mental health crisis services;
270.18    (5) mental health services for people from cultural and ethnic minorities;
270.19    (6) children's mental health screening and follow-up diagnostic assessment and treatment;
270.20    (7) services to promote and develop the capacity of providers to use evidence-based
270.21practices in providing children's mental health services;
270.22    (8) school-linked mental health services, including transportation for children receiving
270.23school-linked mental health services when school is not in session;
270.24    (9) building evidence-based mental health intervention capacity for children birth to age
270.25five;
270.26    (10) suicide prevention and counseling services that use text messaging statewide;
270.27    (11) mental health first aid training;
271.1    (12) training for parents, collaborative partners, and mental health providers on the
271.2impact of adverse childhood experiences and trauma and development of an interactive
271.3Web site to share information and strategies to promote resilience and prevent trauma;
271.4    (13) transition age services to develop or expand mental health treatment and supports
271.5for adolescents and young adults 26 years of age or younger;
271.6    (14) early childhood mental health consultation;
271.7    (15) evidence-based interventions for youth at risk of developing or experiencing a first
271.8episode of psychosis, and a public awareness campaign on the signs and symptoms of
271.9psychosis; and
271.10    (16) psychiatric consultation for primary care practitioners.; and
271.11(17) providers to begin operations and meet program requirements when establishing a
271.12new children's mental health program. These may be start-up grants.
271.13    (c) Services under paragraph (b) must be designed to help each child to function and
271.14remain with the child's family in the community and delivered consistent with the child's
271.15treatment plan. Transition services to eligible young adults under this paragraph (b) must
271.16be designed to foster independent living in the community.
271.17EFFECTIVE DATE.Clause (17) is effective the day following final enactment.

271.18    Sec. 3. Minnesota Statutes 2016, section 245.91, subdivision 4, is amended to read:
271.19    Subd. 4. Facility or program. "Facility" or "program" means a nonresidential or
271.20residential program as defined in section 245A.02, subdivisions 10 and 14, that is required
271.21to be licensed by the commissioner of human services, and any agency, facility, or program
271.22that provides services or treatment for mental illness, developmental disabilities, chemical
271.23dependency, or emotional disturbance that is required to be licensed, certified, or registered
271.24by the commissioner of human services, health, or education; and an acute care inpatient
271.25facility that provides services or treatment for mental illness, developmental disabilities,
271.26chemical dependency, or emotional disturbance.
271.27EFFECTIVE DATE.This section is effective the day following final enactment.

271.28    Sec. 4. Minnesota Statutes 2016, section 245.91, subdivision 6, is amended to read:
271.29    Subd. 6. Serious injury. "Serious injury" means:
271.30(1) fractures;
272.1(2) dislocations;
272.2(3) evidence of internal injuries;
272.3(4) head injuries with loss of consciousness or potential for a closed head injury or
272.4concussion without loss of consciousness requiring a medical assessment by a health care
272.5professional, whether or not further medical attention was sought;
272.6(5) lacerations involving injuries to tendons or organs, and those for which complications
272.7are present;
272.8(6) extensive second-degree or third-degree burns, and other burns for which
272.9complications are present;
272.10(7) extensive second-degree or third-degree frostbite, and others for which complications
272.11are present;
272.12(8) irreversible mobility or avulsion of teeth;
272.13(9) injuries to the eyeball;
272.14(10) ingestion of foreign substances and objects that are harmful;
272.15(11) near drowning;
272.16(12) heat exhaustion or sunstroke; and
272.17(13) attempted suicide; and
272.18(14) all other injuries and incidents considered serious after an assessment by a physician
272.19health care professional, including but not limited to self-injurious behavior, a medication
272.20error requiring medical treatment, a suspected delay of medical treatment, a complication
272.21of a previous injury, or a complication of medical treatment for an injury.
272.22EFFECTIVE DATE.This section is effective the day following final enactment.

272.23    Sec. 5. Minnesota Statutes 2016, section 245.94, subdivision 1, is amended to read:
272.24    Subdivision 1. Powers. (a) The ombudsman may prescribe the methods by which
272.25complaints to the office are to be made, reviewed, and acted upon. The ombudsman may
272.26not levy a complaint fee.
272.27(b) The ombudsman is a health oversight agency as defined in Code of Federal
272.28Regulations, title 45, section 164.501. The ombudsman may access patient records according
272.29to Code of Federal Regulations, title 42, section 2.53. For purposes of this paragraph,
273.1"records" has the meaning given in Code of Federal Regulations, title 42, section
273.22.53(a)(1)(i).
273.3(c) The ombudsman may mediate or advocate on behalf of a client.
273.4(c) (d) The ombudsman may investigate the quality of services provided to clients and
273.5determine the extent to which quality assurance mechanisms within state and county
273.6government work to promote the health, safety, and welfare of clients, other than clients in
273.7acute care facilities who are receiving services not paid for by public funds. The ombudsman
273.8is a health oversight agency as defined in Code of Federal Regulations, title 45, section
273.9164.501.
273.10(d) (e) At the request of a client, or upon receiving a complaint or other information
273.11affording reasonable grounds to believe that the rights of a client one or more clients who
273.12is may not be capable of requesting assistance have been adversely affected, the ombudsman
273.13may gather information and data about and analyze, on behalf of the client, the actions of
273.14an agency, facility, or program.
273.15(e) (f) The ombudsman may gather, on behalf of a client one or more clients, records of
273.16an agency, facility, or program, or records related to clinical drug trials from the University
273.17of Minnesota Department of Psychiatry, if the records relate to a matter that is within the
273.18scope of the ombudsman's authority. If the records are private and the client is capable of
273.19providing consent, the ombudsman shall first obtain the client's consent. The ombudsman
273.20is not required to obtain consent for access to private data on clients with developmental
273.21disabilities and individuals served by the Minnesota sex offender program. The ombudsman
273.22may also take photographic or videographic evidence while reviewing the actions of an
273.23agency, facility, or program, with the consent of the client. The ombudsman is not required
273.24to obtain consent for access to private data on decedents who were receiving services for
273.25mental illness, developmental disabilities, chemical dependency, or emotional disturbance.
273.26All data collected, created, received, or maintained by the ombudsman are governed by
273.27chapter 13 and other applicable law.
273.28(f) (g) Notwithstanding any law to the contrary, the ombudsman may subpoena a person
273.29to appear, give testimony, or produce documents or other evidence that the ombudsman
273.30considers relevant to a matter under inquiry. The ombudsman may petition the appropriate
273.31court in Ramsey County to enforce the subpoena. A witness who is at a hearing or is part
273.32of an investigation possesses the same privileges that a witness possesses in the courts or
273.33under the law of this state. Data obtained from a person under this paragraph are private
273.34data as defined in section 13.02, subdivision 12.
274.1(g) (h) The ombudsman may, at reasonable times in the course of conducting a review,
274.2enter and view premises within the control of an agency, facility, or program.
274.3(h) (i) The ombudsman may attend Department of Human Services Review Board and
274.4Special Review Board proceedings; proceedings regarding the transfer of clients, as defined
274.5in section 246.50, subdivision 4, between institutions operated by the Department of Human
274.6Services; and, subject to the consent of the affected client, other proceedings affecting the
274.7rights of clients. The ombudsman is not required to obtain consent to attend meetings or
274.8proceedings and have access to private data on clients with developmental disabilities and
274.9individuals served by the Minnesota sex offender program.
274.10(i) (j) The ombudsman shall gather data of agencies, facilities, or programs classified
274.11as private or confidential as defined in section 13.02, subdivisions 3 and 12, regarding
274.12services provided to clients with developmental disabilities and individuals served by the
274.13Minnesota sex offender program.
274.14(j) (k) To avoid duplication and preserve evidence, the ombudsman shall inform relevant
274.15licensing or regulatory officials before undertaking a review of an action of the facility or
274.16program.
274.17(l) The Office of Ombudsman shall provide the services of the Civil Commitment
274.18Training and Resource Center.
274.19(k) (m) The ombudsman shall monitor the treatment of individuals participating in a
274.20University of Minnesota Department of Psychiatry clinical drug trial and ensure that all
274.21protections for human subjects required by federal law and the Institutional Review Board
274.22are provided.
274.23(l) (n) Sections 245.91 to 245.97 are in addition to other provisions of law under which
274.24any other remedy or right is provided.
274.25EFFECTIVE DATE.This section is effective the day following final enactment.

274.26    Sec. 6. Minnesota Statutes 2016, section 245.97, subdivision 6, is amended to read:
274.27    Subd. 6. Terms, compensation, and removal. The membership terms, compensation,
274.28and removal of members of the committee and the filling of membership vacancies are
274.29governed by section 15.0575 15.0597.
274.30EFFECTIVE DATE.This section is effective the day following final enactment.

275.1    Sec. 7. Minnesota Statutes 2016, section 245A.03, subdivision 2, is amended to read:
275.2    Subd. 2. Exclusion from licensure. (a) This chapter does not apply to:
275.3    (1) residential or nonresidential programs that are provided to a person by an individual
275.4who is related unless the residential program is a child foster care placement made by a
275.5local social services agency or a licensed child-placing agency, except as provided in
275.6subdivision 2a;
275.7    (2) nonresidential programs that are provided by an unrelated individual to persons from
275.8a single related family;
275.9    (3) residential or nonresidential programs that are provided to adults who do not abuse
275.10chemicals or who do not have a chemical dependency misuse substances or have a substance
275.11use disorder, a mental illness, a developmental disability, a functional impairment, or a
275.12physical disability;
275.13    (4) sheltered workshops or work activity programs that are certified by the commissioner
275.14of employment and economic development;
275.15    (5) programs operated by a public school for children 33 months or older;
275.16    (6) nonresidential programs primarily for children that provide care or supervision for
275.17periods of less than three hours a day while the child's parent or legal guardian is in the
275.18same building as the nonresidential program or present within another building that is
275.19directly contiguous to the building in which the nonresidential program is located;
275.20    (7) nursing homes or hospitals licensed by the commissioner of health except as specified
275.21under section 245A.02;
275.22    (8) board and lodge facilities licensed by the commissioner of health that do not provide
275.23children's residential services under Minnesota Rules, chapter 2960, mental health or chemical
275.24dependency treatment;
275.25    (9) homes providing programs for persons placed by a county or a licensed agency for
275.26legal adoption, unless the adoption is not completed within two years;
275.27    (10) programs licensed by the commissioner of corrections;
275.28    (11) recreation programs for children or adults that are operated or approved by a park
275.29and recreation board whose primary purpose is to provide social and recreational activities;
275.30    (12) programs operated by a school as defined in section 120A.22, subdivision 4; YMCA
275.31as defined in section 315.44; YWCA as defined in section 315.44; or JCC as defined in
276.1section 315.51, whose primary purpose is to provide child care or services to school-age
276.2children;
276.3    (13) Head Start nonresidential programs which operate for less than 45 days in each
276.4calendar year;
276.5    (14) noncertified boarding care homes unless they provide services for five or more
276.6persons whose primary diagnosis is mental illness or a developmental disability;
276.7    (15) programs for children such as scouting, boys clubs, girls clubs, and sports and art
276.8programs, and nonresidential programs for children provided for a cumulative total of less
276.9than 30 days in any 12-month period;
276.10    (16) residential programs for persons with mental illness, that are located in hospitals;
276.11    (17) the religious instruction of school-age children; Sabbath or Sunday schools; or the
276.12congregate care of children by a church, congregation, or religious society during the period
276.13used by the church, congregation, or religious society for its regular worship;
276.14    (18) camps licensed by the commissioner of health under Minnesota Rules, chapter
276.154630;
276.16    (19) mental health outpatient services for adults with mental illness or children with
276.17emotional disturbance;
276.18    (20) residential programs serving school-age children whose sole purpose is cultural or
276.19educational exchange, until the commissioner adopts appropriate rules;
276.20    (21) community support services programs as defined in section 245.462, subdivision
276.216 , and family community support services as defined in section 245.4871, subdivision 17;
276.22    (22) the placement of a child by a birth parent or legal guardian in a preadoptive home
276.23for purposes of adoption as authorized by section 259.47;
276.24    (23) settings registered under chapter 144D which provide home care services licensed
276.25by the commissioner of health to fewer than seven adults;
276.26    (24) chemical dependency or substance abuse use disorder treatment activities of licensed
276.27professionals in private practice as defined in Minnesota Rules, part 9530.6405, subpart 15,
276.28when the treatment activities are not paid for by the consolidated chemical dependency
276.29treatment fund section 245G.01, subdivision 17;
276.30(25) consumer-directed community support service funded under the Medicaid waiver
276.31for persons with developmental disabilities when the individual who provided the service
276.32is:
277.1    (i) the same individual who is the direct payee of these specific waiver funds or paid by
277.2a fiscal agent, fiscal intermediary, or employer of record; and
277.3    (ii) not otherwise under the control of a residential or nonresidential program that is
277.4required to be licensed under this chapter when providing the service;
277.5    (26) a program serving only children who are age 33 months or older, that is operated
277.6by a nonpublic school, for no more than four hours per day per child, with no more than 20
277.7children at any one time, and that is accredited by:
277.8    (i) an accrediting agency that is formally recognized by the commissioner of education
277.9as a nonpublic school accrediting organization; or
277.10    (ii) an accrediting agency that requires background studies and that receives and
277.11investigates complaints about the services provided.
277.12    A program that asserts its exemption from licensure under item (ii) shall, upon request
277.13from the commissioner, provide the commissioner with documentation from the accrediting
277.14agency that verifies: that the accreditation is current; that the accrediting agency investigates
277.15complaints about services; and that the accrediting agency's standards require background
277.16studies on all people providing direct contact services; or
277.17    (27) a program operated by a nonprofit organization incorporated in Minnesota or another
277.18state that serves youth in kindergarten through grade 12; provides structured, supervised
277.19youth development activities; and has learning opportunities take place before or after
277.20school, on weekends, or during the summer or other seasonal breaks in the school calendar.
277.21A program exempt under this clause is not eligible for child care assistance under chapter
277.22119B. A program exempt under this clause must:
277.23    (i) have a director or supervisor on site who is responsible for overseeing written policies
277.24relating to the management and control of the daily activities of the program, ensuring the
277.25health and safety of program participants, and supervising staff and volunteers;
277.26    (ii) have obtained written consent from a parent or legal guardian for each youth
277.27participating in activities at the site; and
277.28    (iii) have provided written notice to a parent or legal guardian for each youth at the site
277.29that the program is not licensed or supervised by the state of Minnesota and is not eligible
277.30to receive child care assistance payments.;
277.31(28) a county that is an eligible vendor under section 254B.05 to provide care coordination
277.32and comprehensive assessment services; or
278.1(29) a recovery community organization that is an eligible vendor under section 254B.05
278.2to provide peer recovery support services.
278.3    (b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
278.4building in which a nonresidential program is located if it shares a common wall with the
278.5building in which the nonresidential program is located or is attached to that building by
278.6skyway, tunnel, atrium, or common roof.
278.7    (c) Except for the home and community-based services identified in section 245D.03,
278.8subdivision 1 , nothing in this chapter shall be construed to require licensure for any services
278.9provided and funded according to an approved federal waiver plan where licensure is
278.10specifically identified as not being a condition for the services and funding.
278.11EFFECTIVE DATE.This section is effective January 1, 2018.

278.12    Sec. 8. Minnesota Statutes 2016, section 245A.191, is amended to read:
278.13245A.191 PROVIDER ELIGIBILITY FOR PAYMENTS FROM THE CHEMICAL
278.14DEPENDENCY CONSOLIDATED TREATMENT FUND.
278.15(a) When a chemical dependency substance use disorder treatment provider licensed
278.16under this chapter, and governed by the standards of chapter 245G or Minnesota Rules,
278.17parts 2960.0430 to 2960.0490 or 9530.6405 to 9530.6505, agrees to meet the applicable
278.18requirements under section 254B.05, subdivision 5, paragraphs (b), clauses (1) to (4) and
278.19(6), (c), and (e), to be eligible for enhanced funding from the chemical dependency
278.20consolidated treatment fund, the applicable requirements under section 254B.05 are also
278.21licensing requirements that may be monitored for compliance through licensing investigations
278.22and licensing inspections.
278.23    (b) Noncompliance with the requirements identified under paragraph (a) may result in:
278.24    (1) a correction order or a conditional license under section 245A.06, or sanctions under
278.25section 245A.07;
278.26    (2) nonpayment of claims submitted by the license holder for public program
278.27reimbursement;
278.28    (3) recovery of payments made for the service;
278.29    (4) disenrollment in the public payment program; or
278.30    (5) other administrative, civil, or criminal penalties as provided by law.
278.31EFFECTIVE DATE.This section is effective January 1, 2018.

279.1    Sec. 9. [245G.01] DEFINITIONS.
279.2    Subdivision 1. Scope. The terms used in this chapter have the meanings given them.
279.3    Subd. 2. Administration of medication. "Administration of medication" means providing
279.4a medication to a client, and includes the following tasks, performed in the following order:
279.5(1) checking the client's medication record;
279.6(2) preparing the medication for administration;
279.7(3) administering the medication to the client;
279.8(4) documenting the administration of the medication, or the reason for not administering
279.9a medication as prescribed; and
279.10(5) reporting information to a licensed practitioner or a nurse regarding a problem with
279.11the administration of medication or the client's refusal to take the medication, if applicable.
279.12    Subd. 3. Adolescent. "Adolescent" means an individual under 18 years of age.
279.13    Subd. 4. Alcohol and drug counselor. "Alcohol and drug counselor" has the meaning
279.14given in section 148F.01, subdivision 5.
279.15    Subd. 5. Applicant. "Applicant" has the meaning given in section 245A.02, subdivision
279.163.
279.17    Subd. 6. Capacity management system. "Capacity management system" means a
279.18database maintained by the department to compile and make information available to the
279.19public about the waiting list status and current admission capability of each opioid treatment
279.20program.
279.21    Subd. 7. Central registry. "Central registry" means a database maintained by the
279.22department to collect identifying information from two or more programs about an individual
279.23applying for maintenance treatment or detoxification treatment for opioid addiction to
279.24prevent an individual's concurrent enrollment in more than one program.
279.25    Subd. 8. Client. "Client" means an individual accepted by a license holder for assessment
279.26or treatment of a substance use disorder. An individual remains a client until the license
279.27holder no longer provides or intends to provide the individual with treatment service.
279.28    Subd. 9. Commissioner. "Commissioner" means the commissioner of human services.
279.29    Subd. 10. Co-occurring disorders. "Co-occurring disorders" means a diagnosis of both
279.30a substance use disorder and a mental health disorder.
279.31    Subd. 11. Department. "Department" means the Department of Human Services.
280.1    Subd. 12. Direct contact. "Direct contact" has the meaning given for "direct contact"
280.2in section 245C.02, subdivision 11.
280.3    Subd. 13. Face-to-face. "Face-to-face" means two-way, real-time, interactive and visual
280.4communication between a client and a treatment service provider and includes services
280.5delivered in person or via telemedicine.
280.6    Subd. 14. License. "License" has the meaning given in section 245A.02, subdivision 8.
280.7    Subd. 15. License holder. "License holder" has the meaning given in section 245A.02,
280.8subdivision 9.
280.9    Subd. 16. Licensed practitioner. "Licensed practitioner" means an individual who is
280.10authorized to prescribe medication as defined in section 151.01, subdivision 23.
280.11    Subd. 17. Licensed professional in private practice. "Licensed professional in private
280.12practice" means an individual who:
280.13(1) is licensed under chapter 148F, or is exempt from licensure under that chapter but
280.14is otherwise licensed to provide alcohol and drug counseling services;
280.15(2) practices solely within the permissible scope of the individual's license as defined
280.16in the law authorizing licensure; and
280.17(3) does not affiliate with other licensed or unlicensed professionals to provide alcohol
280.18and drug counseling services. Affiliation does not include conferring with another
280.19professional or making a client referral.
280.20    Subd. 18. Nurse. "Nurse" means an individual licensed and currently registered to
280.21practice professional or practical nursing as defined in section 148.171, subdivisions 14 and
280.2215.
280.23    Subd. 19. Opioid treatment program or OTP. "Opioid treatment program" or "OTP"
280.24means a program or practitioner engaged in opioid treatment of an individual that provides
280.25dispensing of an opioid agonist treatment medication, along with a comprehensive range
280.26of medical and rehabilitative services, when clinically necessary, to an individual to alleviate
280.27the adverse medical, psychological, or physical effects of an opioid addiction. OTP includes
280.28detoxification treatment, short-term detoxification treatment, long-term detoxification
280.29treatment, maintenance treatment, comprehensive maintenance treatment, and interim
280.30maintenance treatment.
280.31    Subd. 20. Paraprofessional. "Paraprofessional" means an employee, agent, or
280.32independent contractor of the license holder who performs tasks to support treatment service.
281.1A paraprofessional may be referred to by a variety of titles including but not limited to
281.2technician, case aide, or counselor assistant. If currently a client of the license holder, the
281.3client cannot be a paraprofessional for the license holder.
281.4    Subd. 21. Student intern. "Student intern" means an individual who is authorized by a
281.5licensing board to provide services under supervision of a licensed professional.
281.6    Subd. 22. Substance. "Substance" means alcohol, solvents, controlled substances as
281.7defined in section 152.01, subdivision 4, and other mood-altering substances.
281.8    Subd. 23. Substance use disorder. "Substance use disorder" has the meaning given in
281.9the current Diagnostic and Statistical Manual of Mental Disorders.
281.10    Subd. 24. Substance use disorder treatment. "Substance use disorder treatment" means
281.11treatment of a substance use disorder, including the process of assessment of a client's needs,
281.12development of planned methods, including interventions or services to address a client's
281.13needs, provision of services, facilitation of services provided by other service providers,
281.14and ongoing reassessment by a qualified professional when indicated. The goal of substance
281.15use disorder treatment is to assist or support the client's efforts to recover from a substance
281.16use disorder.
281.17    Subd. 25. Target population. "Target population" means individuals with a substance
281.18use disorder and the specified characteristics that a license holder proposes to serve.
281.19    Subd. 26. Telemedicine. "Telemedicine" means the delivery of a substance use disorder
281.20treatment service while the client is at an originating site and the licensed health care provider
281.21is at a distant site as specified in section 254B.05, subdivision 5, paragraph (f).
281.22    Subd. 27. Treatment director. "Treatment director" means an individual who meets
281.23the qualifications specified in section 245G.11, subdivisions 1 and 3, and is designated by
281.24the license holder to be responsible for all aspects of the delivery of treatment service.
281.25EFFECTIVE DATE.This section is effective January 1, 2018.

281.26    Sec. 10. [245G.02] APPLICABILITY.
281.27    Subdivision 1. Applicability. Except as provided in subdivisions 2 and 3, no person,
281.28corporation, partnership, voluntary association, controlling individual, or other organization
281.29may provide a substance use disorder treatment service to an individual with a substance
281.30use disorder unless licensed by the commissioner.
281.31    Subd. 2. Exemption from license requirement. This chapter does not apply to a county
281.32or recovery community organization that is providing a service for which the county or
282.1recovery community organization is an eligible vendor under section 254B.05. This chapter
282.2does not apply to an organization whose primary functions are information, referral,
282.3diagnosis, case management, and assessment for the purposes of client placement, education,
282.4support group services, or self-help programs. This chapter does not apply to the activities
282.5of a licensed professional in private practice.
282.6    Subd. 3. Excluded hospitals. This chapter does not apply to substance use disorder
282.7treatment provided by a hospital licensed under chapter 62J, or under sections 144.50 to
282.8144.56, unless the hospital accepts funds for substance use disorder treatment from the
282.9consolidated chemical dependency treatment fund under chapter 254B, medical assistance
282.10under chapter 256B, or MinnesotaCare or health care cost containment under chapter 256L,
282.11or general assistance medical care formerly codified in chapter 256D.
282.12    Subd. 4. Applicability of Minnesota Rules, chapter 2960. A residential adolescent
282.13substance use disorder treatment program serving an individual younger than 16 years of
282.14age must be licensed according to Minnesota Rules, chapter 2960.
282.15EFFECTIVE DATE.This section is effective January 1, 2018.

282.16    Sec. 11. [245G.03] LICENSING REQUIREMENTS.
282.17    Subdivision 1. License requirements. (a) An applicant for a license to provide substance
282.18use disorder treatment must comply with the general requirements in chapters 245A and
282.19245C, sections 626.556 and 626.557, and Minnesota Rules, chapter 9544.
282.20(b) The commissioner may grant variances to the requirements in this chapter that do
282.21not affect the client's health or safety if the conditions in section 245A.04, subdivision 9,
282.22are met.
282.23    Subd. 2. Application. Before the commissioner issues a license, an applicant must
282.24submit, on forms provided by the commissioner, any documents the commissioner requires.
282.25    Subd. 3. Change in license terms. (a) The commissioner must determine whether a
282.26new license is needed when a change in clauses (1) to (4) occurs. A license holder must
282.27notify the commissioner before a change in one of the following occurs:
282.28(1) the Department of Health's licensure of the program;
282.29(2) whether the license holder provides services specified in sections 245G.18 to 245G.22;
282.30(3) location; or
282.31(4) capacity if the license holder meets the requirements of section 245G.21.
283.1(b) A license holder must notify the commissioner and must apply for a new license if
283.2there is a change in program ownership.
283.3EFFECTIVE DATE.This section is effective January 1, 2018.

283.4    Sec. 12. [245G.04] INITIAL SERVICES PLAN.
283.5(a) The license holder must complete an initial services plan on the day of service
283.6initiation. The plan must address the client's immediate health and safety concerns, identify
283.7the needs to be addressed in the first treatment session, and make treatment suggestions for
283.8the client during the time between intake and completion of the individual treatment plan.
283.9(b) The initial services plan must include a determination of whether a client is a
283.10vulnerable adult as defined in section 626.5572, subdivision 21. An adult client of a
283.11residential program is a vulnerable adult. An individual abuse prevention plan, according
283.12to sections 245A.65, subdivision 2, paragraph (b), and 626.557, subdivision 14, paragraph
283.13(b), is required for a client who meets the definition of vulnerable adult.
283.14EFFECTIVE DATE.This section is effective January 1, 2018.

283.15    Sec. 13. [245G.05] COMPREHENSIVE ASSESSMENT AND ASSESSMENT
283.16SUMMARY.
283.17    Subdivision 1. Comprehensive assessment. (a) A comprehensive assessment of the
283.18client's substance use disorder must be administered face-to-face by an alcohol and drug
283.19counselor within three calendar days after service initiation for a residential program or
283.20during the initial session for all other programs. If the comprehensive assessment is not
283.21completed during the initial session, the client-centered reason for the delay must be
283.22documented in the client's file and the planned completion date. If the client received a
283.23comprehensive assessment that authorized the treatment service, an alcohol and drug
283.24counselor must review the assessment to determine compliance with this subdivision,
283.25including applicable timelines. If available, the alcohol and drug counselor may use current
283.26information provided by a referring agency or other source as a supplement. Information
283.27gathered more than 45 days before the date of admission is not considered current. The
283.28comprehensive assessment must include sufficient information to complete the assessment
283.29summary according to subdivision 2 and the individual treatment plan according to section
283.30245G.06. The comprehensive assessment must include information about the client's needs
283.31that relate to substance use and personal strengths that support recovery, including:
284.1(1) age, sex, cultural background, sexual orientation, living situation, economic status,
284.2and level of education;
284.3(2) circumstances of service initiation;
284.4(3) previous attempts at treatment for substance misuse or substance use disorder,
284.5compulsive gambling, or mental illness;
284.6(4) substance use history including amounts and types of substances used, frequency
284.7and duration of use, periods of abstinence, and circumstances of relapse, if any. For each
284.8substance used within the previous 30 days, the information must include the date of the
284.9most recent use and previous withdrawal symptoms;
284.10(5) specific problem behaviors exhibited by the client when under the influence of
284.11substances;
284.12(6) family status, family history, including history or presence of physical or sexual
284.13abuse, level of family support, and substance misuse or substance use disorder of a family
284.14member or significant other;
284.15(7) physical concerns or diagnoses, the severity of the concerns, and whether the concerns
284.16are being addressed by a health care professional;
284.17(8) mental health history and psychiatric status, including symptoms, disability, current
284.18treatment supports, and psychotropic medication needed to maintain stability; the assessment
284.19must utilize screening tools approved by the commissioner pursuant to section 245.4863 to
284.20identify whether the client screens positive for co-occurring disorders;
284.21(9) arrests and legal interventions related to substance use;
284.22(10) ability to function appropriately in work and educational settings;
284.23(11) ability to understand written treatment materials, including rules and the client's
284.24rights;
284.25(12) risk-taking behavior, including behavior that puts the client at risk of exposure to
284.26blood-borne or sexually transmitted diseases;
284.27(13) social network in relation to expected support for recovery and leisure time activities
284.28that are associated with substance use;
284.29(14) whether the client is pregnant and, if so, the health of the unborn child and the
284.30client's current involvement in prenatal care;
285.1(15) whether the client recognizes problems related to substance use and is willing to
285.2follow treatment recommendations; and
285.3(16) collateral information. If the assessor gathered sufficient information from the
285.4referral source or the client to apply the criteria in parts 9530.6620 and 9530.6622, a collateral
285.5contact is not required.
285.6(b) If the client is identified as having opioid use disorder or seeking treatment for opioid
285.7use disorder, the program must provide educational information to the client concerning:
285.8(1) risks for opioid use disorder and dependence;
285.9(2) treatment options, including the use of a medication for opioid use disorder;
285.10(3) the risk of and recognizing opioid overdose; and
285.11(4) the use, availability, and administration of naloxone to respond to opioid overdose.
285.12(c) The commissioner shall develop educational materials that are supported by research
285.13and updated periodically. The license holder must use the educational materials that are
285.14approved by the commissioner to comply with this requirement.
285.15(d) If the comprehensive assessment is completed to authorize treatment service for the
285.16client, at the earliest opportunity during the assessment interview the assessor shall determine
285.17if:
285.18(1) the client is in severe withdrawal and likely to be a danger to self or others;
285.19(2) the client has severe medical problems that require immediate attention; or
285.20(3) the client has severe emotional or behavioral symptoms that place the client or others
285.21at risk of harm.
285.22If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the
285.23assessment interview and follow the procedures in the program's medical services plan
285.24under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The
285.25assessment interview may resume when the condition is resolved.
285.26    Subd. 2. Assessment summary. (a) An alcohol and drug counselor must complete an
285.27assessment summary within three calendar days after service initiation for a residential
285.28program and within three sessions for all other programs. If the comprehensive assessment
285.29is used to authorize the treatment service, the alcohol and drug counselor must prepare an
285.30assessment summary on the same date the comprehensive assessment is completed. If the
285.31comprehensive assessment and assessment summary are to authorize treatment services,
286.1the assessor must determine appropriate services for the client using the dimensions in
286.2Minnesota Rules, part 9530.6622, and document the recommendations.
286.3(b) An assessment summary must include:
286.4(1) a risk description according to section 245G.05 for each dimension listed in paragraph
286.5(c);
286.6(2) a narrative summary supporting the risk descriptions; and
286.7(3) a determination of whether the client has a substance use disorder.
286.8(c) An assessment summary must contain information relevant to treatment service
286.9planning and recorded in the dimensions in clauses (1) to (6). The license holder must
286.10consider:
286.11(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with
286.12withdrawal symptoms and current state of intoxication;
286.13(2) Dimension 2, biomedical conditions and complications; the degree to which any
286.14physical disorder of the client would interfere with treatment for substance use, and the
286.15client's ability to tolerate any related discomfort. The license holder must determine the
286.16impact of continued chemical use on the unborn child, if the client is pregnant;
286.17(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications;
286.18the degree to which any condition or complication is likely to interfere with treatment for
286.19substance use or with functioning in significant life areas and the likelihood of harm to self
286.20or others;
286.21(4) Dimension 4, readiness for change; the support necessary to keep the client involved
286.22in treatment service;
286.23(5) Dimension 5, relapse, continued use, and continued problem potential; the degree
286.24to which the client recognizes relapse issues and has the skills to prevent relapse of either
286.25substance use or mental health problems; and
286.26(6) Dimension 6, recovery environment; whether the areas of the client's life are
286.27supportive of or antagonistic to treatment participation and recovery.
286.28EFFECTIVE DATE.This section is effective January 1, 2018.

286.29    Sec. 14. [245G.06] INDIVIDUAL TREATMENT PLAN.
286.30    Subdivision 1. General. Each client must have an individual treatment plan developed
286.31by an alcohol and drug counselor within seven days of service initiation for a residential
287.1program and within three sessions for all other programs. The client must have active, direct
287.2involvement in selecting the anticipated outcomes of the treatment process and developing
287.3the treatment plan. The individual treatment plan must be signed by the client and the alcohol
287.4and drug counselor and document the client's involvement in the development of the plan.
287.5The plan may be a continuation of the initial services plan required in section 245G.04.
287.6Treatment planning must include ongoing assessment of client needs. An individual treatment
287.7plan must be updated based on new information gathered about the client's condition and
287.8on whether methods identified have the intended effect. A change to the plan must be signed
287.9by the client and the alcohol and drug counselor. The plan must provide for the involvement
287.10of the client's family and people selected by the client as important to the success of treatment
287.11at the earliest opportunity, consistent with the client's treatment needs and written consent.
287.12    Subd. 2. Plan contents. An individual treatment plan must be recorded in the six
287.13dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue
287.14identified in the assessment summary, prioritized according to the client's needs and focus,
287.15and must include:
287.16(1) specific methods to address each identified need, including amount, frequency, and
287.17anticipated duration of treatment service. The methods must be appropriate to the client's
287.18language, reading skills, cultural background, and strengths;
287.19(2) resources to refer the client to when the client's needs are to be addressed concurrently
287.20by another provider; and
287.21(3) goals the client must reach to complete treatment and terminate services.
287.22    Subd. 3. Documentation of treatment services; treatment plan review. (a) A review
287.23of all treatment services must be documented weekly and include a review of:
287.24(1) care coordination activities;
287.25(2) medical and other appointments the client attended;
287.26(3) issues related to medications that are not documented in the medication administration
287.27record; and
287.28(4) issues related to attendance for treatment services, including the reason for any client
287.29absence from a treatment service.
287.30(b) A note must be entered immediately following any significant event. A significant
287.31event is an event that impacts the client's relationship with other clients, staff, the client's
287.32family, or the client's treatment plan.
288.1(c) A treatment plan review must be entered in a client's file weekly or after each treatment
288.2service, whichever is less frequent, by the staff member providing the service. The review
288.3must indicate the span of time covered by the review and each of the six dimensions listed
288.4in section 245G.05, subdivision 2, paragraph (c). The review must:
288.5(1) indicate the date, type, and amount of each treatment service provided and the client's
288.6response to each service;
288.7(2) address each goal in the treatment plan and whether the methods to address the goals
288.8are effective;
288.9(3) include monitoring of any physical and mental health problems;
288.10(4) document the participation of others;
288.11(5) document staff recommendations for changes in the methods identified in the treatment
288.12plan and whether the client agrees with the change; and
288.13(6) include a review and evaluation of the individual abuse prevention plan according
288.14to section 245A.65.
288.15(d) Each entry in a client's record must be accurate, legible, signed, and dated. A late
288.16entry must be clearly labeled "late entry." A correction to an entry must be made in a way
288.17in which the original entry can still be read.
288.18    Subd. 4. Service discharge summary. (a) An alcohol and drug counselor must write a
288.19discharge summary for each client. The summary must be completed within five days of
288.20the client's service termination or within five days from the client's or program's decision
288.21to terminate services, whichever is earlier.
288.22(b) The service discharge summary must be recorded in the six dimensions listed in
288.23section 245G.05, subdivision 2, paragraph (c), and include the following information:
288.24(1) the client's issues, strengths, and needs while participating in treatment, including
288.25services provided;
288.26(2) the client's progress toward achieving each goal identified in the individual treatment
288.27plan;
288.28(3) a risk description according to section 245G.05; and
288.29(4) the reasons for and circumstances of service termination. If a program discharges a
288.30client at staff request, the reason for discharge and the procedure followed for the decision
288.31to discharge must be documented and comply with the program's policies on staff-initiated
288.32client discharge. If a client is discharged at staff request, the program must give the client
289.1crisis and other referrals appropriate for the client's needs and offer assistance to the client
289.2to access the services.
289.3(c) For a client who successfully completes treatment, the summary must also include:
289.4(1) the client's living arrangements at service termination;
289.5(2) continuing care recommendations, including transitions between more or less intense
289.6services, or more frequent to less frequent services, and referrals made with specific attention
289.7to continuity of care for mental health, as needed;
289.8(3) service termination diagnosis; and
289.9(4) the client's prognosis.
289.10EFFECTIVE DATE.This section is effective January 1, 2018.

289.11    Sec. 15. [245G.07] TREATMENT SERVICE.
289.12    Subdivision 1. Treatment service. (a) A license holder must offer the following treatment
289.13services, unless clinically inappropriate and the justifying clinical rationale is documented:
289.14(1) individual and group counseling to help the client identify and address needs related
289.15to substance use and develop strategies to avoid harmful substance use after discharge and
289.16to help the client obtain the services necessary to establish a lifestyle free of the harmful
289.17effects of substance use disorder;
289.18(2) client education strategies to avoid inappropriate substance use and health problems
289.19related to substance use and the necessary lifestyle changes to regain and maintain health.
289.20Client education must include information on tuberculosis education on a form approved
289.21by the commissioner, the human immunodeficiency virus according to section 245A.19,
289.22other sexually transmitted diseases, drug and alcohol use during pregnancy, and hepatitis.
289.23A licensed alcohol and drug counselor must be present during an educational group;
289.24(3) a service to help the client integrate gains made during treatment into daily living
289.25and to reduce the client's reliance on a staff member for support;
289.26(4) a service to address issues related to co-occurring disorders, including client education
289.27on symptoms of mental illness, the possibility of comorbidity, and the need for continued
289.28medication compliance while recovering from substance use disorder. A group must address
289.29co-occurring disorders, as needed. When treatment for mental health problems is indicated,
289.30the treatment must be integrated into the client's individual treatment plan;
290.1(5) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support
290.2services provided one-to-one by an individual in recovery. Peer support services include
290.3education, advocacy, mentoring through self-disclosure of personal recovery experiences,
290.4attending recovery and other support groups with a client, accompanying the client to
290.5appointments that support recovery, assistance accessing resources to obtain housing,
290.6employment, education, and advocacy services, and nonclinical recovery support to assist
290.7the transition from treatment into the recovery community; and
290.8(6) on July 1, 2018, or upon federal approval, whichever is later, care coordination
290.9provided by an individual who meets the staff qualifications in section 245G.11, subdivision
290.107. Care coordination services include:
290.11(i) assistance in coordination with significant others to help in the treatment planning
290.12process whenever possible;
290.13(ii) assistance in coordination with and follow up for medical services as identified in
290.14the treatment plan;
290.15(iii) facilitation of referrals to substance use disorder services as indicated by a client's
290.16medical provider, comprehensive assessment, or treatment plan;
290.17(iv) facilitation of referrals to mental health services as identified by a client's
290.18comprehensive assessment or treatment plan;
290.19(v) assistance with referrals to economic assistance, social services, housing resources,
290.20and prenatal care according to the client's needs;
290.21(vi) life skills advocacy and support accessing treatment follow-up, disease management,
290.22and education services, including referral and linkages to long-term services and supports
290.23as needed; and
290.24(vii) documentation of the provision of care coordination services in the client's file.
290.25(b) A treatment service provided to a client must be provided according to the individual
290.26treatment plan and must consider cultural differences and special needs of a client.
290.27    Subd. 2. Additional treatment service. A license holder may provide or arrange the
290.28following additional treatment service as a part of the client's individual treatment plan:
290.29(1) relationship counseling provided by a qualified professional to help the client identify
290.30the impact of the client's substance use disorder on others and to help the client and persons
290.31in the client's support structure identify and change behaviors that contribute to the client's
290.32substance use disorder;
291.1(2) therapeutic recreation to allow the client to participate in recreational activities
291.2without the use of mood-altering chemicals and to plan and select leisure activities that do
291.3not involve the inappropriate use of chemicals;
291.4(3) stress management and physical well-being to help the client reach and maintain an
291.5appropriate level of health, physical fitness, and well-being;
291.6(4) living skills development to help the client learn basic skills necessary for independent
291.7living;
291.8(5) employment or educational services to help the client become financially independent;
291.9(6) socialization skills development to help the client live and interact with others in a
291.10positive and productive manner; and
291.11(7) room, board, and supervision at the treatment site to provide the client with a safe
291.12and appropriate environment to gain and practice new skills.
291.13    Subd. 3. Counselors. A treatment service, including therapeutic recreation, must be
291.14provided by an alcohol and drug counselor according to section 245G.11, unless the
291.15individual providing the service is specifically qualified according to the accepted credential
291.16required to provide the service. Therapeutic recreation does not include planned leisure
291.17activities.
291.18    Subd. 4. Location of service provision. The license holder may provide services at any
291.19of the license holder's licensed locations or at another suitable location including a school,
291.20government building, medical or behavioral health facility, or social service organization,
291.21upon notification and approval of the commissioner. If services are provided off site from
291.22the licensed site, the reason for the provision of services remotely must be documented.
291.23EFFECTIVE DATE.This section is effective January 1, 2018.

291.24    Sec. 16. [245G.08] MEDICAL SERVICES.
291.25    Subdivision 1. Health care services. An applicant or license holder must maintain a
291.26complete description of the health care services, nursing services, dietary services, and
291.27emergency physician services offered by the applicant or license holder.
291.28    Subd. 2. Procedures. The applicant or license holder must have written procedures for
291.29obtaining a medical intervention for a client, that are approved in writing by a physician
291.30who is licensed under chapter 147, unless:
291.31(1) the license holder does not provide a service under section 245G.21; and
292.1(2) a medical intervention is referred to 911, the emergency telephone number, or the
292.2client's physician.
292.3    Subd. 3. Standing order protocol. A license holder that maintains a supply of naloxone
292.4available for emergency treatment of opioid overdose must have a written standing order
292.5protocol by a physician who is licensed under chapter 147, that permits the license holder
292.6to maintain a supply of naloxone on site, and must require staff to undergo specific training
292.7in administration of naloxone.
292.8    Subd. 4. Consultation services. The license holder must have access to and document
292.9the availability of a licensed mental health professional to provide diagnostic assessment
292.10and treatment planning assistance.
292.11    Subd. 5. Administration of medication and assistance with self-medication. (a) A
292.12license holder must meet the requirements in this subdivision if a service provided includes
292.13the administration of medication.
292.14(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a
292.15licensed practitioner or a registered nurse the task of administration of medication or assisting
292.16with self-medication, must:
292.17(1) successfully complete a medication administration training program for unlicensed
292.18personnel through an accredited Minnesota postsecondary educational institution. A staff
292.19member's completion of the course must be documented in writing and placed in the staff
292.20member's personnel file;
292.21(2) be trained according to a formalized training program that is taught by a registered
292.22nurse and offered by the license holder. The training must include the process for
292.23administration of naloxone, if naloxone is kept on site. A staff member's completion of the
292.24training must be documented in writing and placed in the staff member's personnel records;
292.25or
292.26(3) demonstrate to a registered nurse competency to perform the delegated activity. A
292.27registered nurse must be employed or contracted to develop the policies and procedures for
292.28administration of medication or assisting with self-administration of medication, or both.
292.29(c) A registered nurse must provide supervision as defined in section 148.171, subdivision
292.3023. The registered nurse's supervision must include, at a minimum, monthly on-site
292.31supervision or more often if warranted by a client's health needs. The policies and procedures
292.32must include:
293.1(1) a provision that a delegation of administration of medication is limited to the
293.2administration of a medication that is administered orally, topically, or as a suppository, an
293.3eye drop, an ear drop, or an inhalant;
293.4(2) a provision that each client's file must include documentation indicating whether
293.5staff must conduct the administration of medication or the client must self-administer
293.6medication, or both;
293.7(3) a provision that a client may carry emergency medication such as nitroglycerin as
293.8instructed by the client's physician;
293.9(4) a provision for the client to self-administer medication when a client is scheduled to
293.10be away from the facility;
293.11(5) a provision that if a client self-administers medication when the client is present in
293.12the facility, the client must self-administer medication under the observation of a trained
293.13staff member;
293.14(6) a provision that when a license holder serves a client who is a parent with a child,
293.15the parent may only administer medication to the child under a staff member's supervision;
293.16(7) requirements for recording the client's use of medication, including staff signatures
293.17with date and time;
293.18(8) guidelines for when to inform a nurse of problems with self-administration of
293.19medication, including a client's failure to administer, refusal of a medication, adverse
293.20reaction, or error; and
293.21(9) procedures for acceptance, documentation, and implementation of a prescription,
293.22whether written, verbal, telephonic, or electronic.
293.23    Subd. 6. Control of drugs. A license holder must have and implement written policies
293.24and procedures developed by a registered nurse that contain:
293.25(1) a requirement that each drug must be stored in a locked compartment. A Schedule
293.26II drug, as defined by section 152.02, subdivision 3, must be stored in a separately locked
293.27compartment, permanently affixed to the physical plant or medication cart;
293.28(2) a system which accounts for all scheduled drugs each shift;
293.29(3) a procedure for recording the client's use of medication, including the signature of
293.30the staff member who completed the administration of the medication with the time and
293.31date;
293.32(4) a procedure to destroy a discontinued, outdated, or deteriorated medication;
294.1(5) a statement that only authorized personnel are permitted access to the keys to a locked
294.2compartment;
294.3(6) a statement that no legend drug supply for one client shall be given to another client;
294.4and
294.5(7) a procedure for monitoring the available supply of naloxone on site, replenishing
294.6the naloxone supply when needed, and destroying naloxone according to clause (4).
294.7EFFECTIVE DATE.This section is effective January 1, 2018.

294.8    Sec. 17. [245G.09] CLIENT RECORDS.
294.9    Subdivision 1. Client records required. (a) A license holder must maintain a file of
294.10current and accurate client records on the premises where the treatment service is provided
294.11or coordinated. For services provided off site, client records must be available at the program
294.12and adhere to the same clinical and administrative policies and procedures as services
294.13provided on site. The content and format of client records must be uniform and entries in
294.14each record must be signed and dated by the staff member making the entry. Client records
294.15must be protected against loss, tampering, or unauthorized disclosure according to section
294.16254A.09, chapter 13, and Code of Federal Regulations, title 42, chapter 1, part 2, subpart
294.17B, sections 2.1 to 2.67, and title 45, parts 160 to 164.
294.18(b) The program must have a policy and procedure that identifies how the program will
294.19track and record client attendance at treatment activities, including the date, duration, and
294.20nature of each treatment service provided to the client.
294.21    Subd. 2. Record retention. The client records of a discharged client must be retained
294.22by a license holder for seven years. A license holder that ceases to provide treatment service
294.23must retain client records for seven years from the date of facility closure and must notify
294.24the commissioner of the location of the client records and the name of the individual
294.25responsible for maintaining the client's records.
294.26    Subd. 3. Contents. Client records must contain the following:
294.27(1) documentation that the client was given information on client rights and
294.28responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
294.29an orientation to the program abuse prevention plan required under section 245A.65,
294.30subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record
294.31must contain documentation that the client was provided educational information according
294.32to section 245G.05, subdivision 1, paragraph (b);
295.1(2) an initial services plan completed according to section 245G.04;
295.2(3) a comprehensive assessment completed according to section 245G.05;
295.3(4) an assessment summary completed according to section 245G.05, subdivision 2;
295.4(5) an individual abuse prevention plan according to sections 245A.65, subdivision 2,
295.5and 626.557, subdivision 14, when applicable;
295.6(6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;
295.7(7) documentation of treatment services and treatment plan review according to section
295.8245G.06, subdivision 3; and
295.9(8) a summary at the time of service termination according to section 245G.06,
295.10subdivision 4.
295.11EFFECTIVE DATE.This section is effective January 1, 2018.

295.12    Sec. 18. [245G.10] STAFF REQUIREMENTS.
295.13    Subdivision 1. Treatment director. A license holder must have a treatment director.
295.14    Subd. 2. Alcohol and drug counselor supervisor. A license holder must employ an
295.15alcohol and drug counselor supervisor who meets the requirements of section 245G.11,
295.16subdivision 4. An individual may be simultaneously employed as a treatment director,
295.17alcohol and drug counselor supervisor, and an alcohol and drug counselor if the individual
295.18meets the qualifications for each position. If an alcohol and drug counselor is simultaneously
295.19employed as an alcohol and drug counselor supervisor or treatment director, that individual
295.20must be considered a 0.5 full-time equivalent alcohol and drug counselor for staff
295.21requirements under subdivision 4.
295.22    Subd. 3. Responsible staff member. A treatment director must designate a staff member
295.23who, when present in the facility, is responsible for the delivery of treatment service. A
295.24license holder must have a designated staff member during all hours of operation. A license
295.25holder providing room and board and treatment at the same site must have a responsible
295.26staff member on duty 24 hours a day. The designated staff member must know and understand
295.27the implications of this chapter and sections 245A.65, 626.556, 626.557, and 626.5572.
295.28    Subd. 4. Staff requirement. It is the responsibility of the license holder to determine
295.29an acceptable group size based on each client's needs except that treatment services provided
295.30in a group shall not exceed 16 clients. A counselor in an opioid treatment program must not
295.31supervise more than 50 clients. The license holder must maintain a record that documents
295.32compliance with this subdivision.
296.1    Subd. 5. Medical emergency. When a client is present, a license holder must have at
296.2least one staff member on the premises who has a current American Red Cross standard
296.3first aid certificate or an equivalent certificate and at least one staff member on the premises
296.4who has a current American Red Cross community, American Heart Association, or
296.5equivalent CPR certificate. A single staff member with both certifications satisfies this
296.6requirement.
296.7EFFECTIVE DATE.This section is effective January 1, 2018.

296.8    Sec. 19. [245G.11] STAFF QUALIFICATIONS.
296.9    Subdivision 1. General qualifications. (a) All staff members who have direct contact
296.10must be 18 years of age or older. At the time of employment, each staff member must meet
296.11the qualifications in this subdivision. For purposes of this subdivision, "problematic substance
296.12use" means a behavior or incident listed by the license holder in the personnel policies and
296.13procedures according to section 245G.13, subdivision 1, clause (5).
296.14(b) A treatment director, supervisor, nurse, counselor, student intern, or other professional
296.15must be free of problematic substance use for at least the two years immediately preceding
296.16employment and must sign a statement attesting to that fact.
296.17(c) A paraprofessional, recovery peer, or any other staff member with direct contact
296.18must be free of problematic substance use for at least one year immediately preceding
296.19employment and must sign a statement attesting to that fact.
296.20    Subd. 2. Employment; prohibition on problematic substance use. A staff member
296.21with direct contact must be free from problematic substance use as a condition of
296.22employment, but is not required to sign additional statements. A staff member with direct
296.23contact who is not free from problematic substance use must be removed from any
296.24responsibilities that include direct contact for the time period specified in subdivision 1.
296.25The time period begins to run on the date of the last incident of problematic substance use
296.26as described in the facility's policies and procedures according to section 245G.13,
296.27subdivision 1, clause (5).
296.28    Subd. 3. Treatment directors. A treatment director must:
296.29(1) have at least one year of work experience in direct service to an individual with
296.30substance use disorder or one year of work experience in the management or administration
296.31of direct service to an individual with substance use disorder;
296.32(2) have a baccalaureate degree or three years of work experience in administration or
296.33personnel supervision in human services; and
297.1(3) know and understand the implications of this chapter, chapter 245A, and sections
297.2626.556, 626.557, and 626.5572. Demonstration of the treatment director's knowledge must
297.3be documented in the personnel record.
297.4    Subd. 4. Alcohol and drug counselor supervisors. An alcohol and drug counselor
297.5supervisor must:
297.6(1) meet the qualification requirements in subdivision 5;
297.7(2) have three or more years of experience providing individual and group counseling
297.8to individuals with substance use disorder; and
297.9(3) know and understand the implications of this chapter and sections 245A.65, 626.556,
297.10626.557, and 626.5572.
297.11    Subd. 5. Alcohol and drug counselor qualifications. (a) An alcohol and drug counselor
297.12must either be licensed or exempt from licensure under chapter 148F.
297.13(b) An individual who is exempt from licensure under chapter 148F, must meet one of
297.14the following additional requirements:
297.15(1) completion of at least a baccalaureate degree with a major or concentration in social
297.16work, nursing, sociology, human services, or psychology, or licensure as a registered nurse;
297.17successful completion of a minimum of 120 hours of classroom instruction in which each
297.18of the core functions listed in chapter 148F is covered; and successful completion of 440
297.19hours of supervised experience as an alcohol and drug counselor, either as a student or a
297.20staff member;
297.21(2) completion of at least 270 hours of drug counselor training in which each of the core
297.22functions listed in chapter 148F is covered, and successful completion of 880 hours of
297.23supervised experience as an alcohol and drug counselor, either as a student or as a staff
297.24member;
297.25(3) current certification as an alcohol and drug counselor or alcohol and drug counselor
297.26reciprocal, through the evaluation process established by the International Certification and
297.27Reciprocity Consortium Alcohol and Other Drug Abuse, Inc.;
297.28(4) completion of a bachelor's degree including 480 hours of alcohol and drug counseling
297.29education from an accredited school or educational program and 880 hours of alcohol and
297.30drug counseling practicum; or
298.1(5) employment in a program formerly licensed under Minnesota Rules, parts 9530.5000
298.2to 9530.6400, and successful completion of 6,000 hours of supervised work experience in
298.3a licensed program as an alcohol and drug counselor prior to January 1, 2005.
298.4(c) An alcohol and drug counselor may not provide a treatment service that requires
298.5professional licensure unless the individual possesses the necessary license. For the purposes
298.6of enforcing this section, the commissioner has the authority to monitor a service provider's
298.7compliance with the relevant standards of the service provider's profession and may issue
298.8licensing actions against the license holder according to sections 245A.05, 245A.06, and
298.9245A.07, based on the commissioner's determination of noncompliance.
298.10    Subd. 6. Paraprofessionals. A paraprofessional must have knowledge of client rights,
298.11according to section 148F.165, and staff member responsibilities. A paraprofessional may
298.12not admit, transfer, or discharge a client but may be responsible for the delivery of treatment
298.13service according to section 245G.10, subdivision 3.
298.14    Subd. 7. Care coordination provider qualifications. (a) Care coordination must be
298.15provided by qualified staff. An individual is qualified to provide care coordination if the
298.16individual:
298.17(1) is skilled in the process of identifying and assessing a wide range of client needs;
298.18(2) is knowledgeable about local community resources and how to use those resources
298.19for the benefit of the client;
298.20(3) has successfully completed 30 hours of classroom instruction on care coordination
298.21for an individual with substance use disorder;
298.22(4) has either:
298.23(i) a bachelor's degree in one of the behavioral sciences or related fields; or
298.24(ii) current certification as an alcohol and drug counselor, level I, by the Upper Midwest
298.25Indian Council on Addictive Disorders; and
298.26(5) has at least 2,000 hours of supervised experience working with individuals with
298.27substance use disorder.
298.28(b) A care coordinator must receive at least one hour of supervision regarding individual
298.29service delivery from an alcohol and drug counselor weekly.
298.30    Subd. 8. Recovery peer qualifications. A recovery peer must:
298.31(1) have a high school diploma or its equivalent;
299.1(2) have a minimum of one year in recovery from substance use disorder;
299.2(3) hold a current credential from a certification body approved by the commissioner
299.3that demonstrates skills and training in the domains of ethics and boundaries, advocacy,
299.4mentoring and education, and recovery and wellness support; and
299.5(4) receive ongoing supervision in areas specific to the domains of the recovery peer's
299.6role by an alcohol and drug counselor or an individual with a certification approved by the
299.7commissioner.
299.8    Subd. 9. Volunteers. A volunteer may provide treatment service when the volunteer is
299.9supervised and can be seen or heard by a staff member meeting the criteria in subdivision
299.104 or 5, but may not practice alcohol and drug counseling unless qualified under subdivision
299.115.
299.12    Subd. 10. Student interns. A qualified staff member must supervise and be responsible
299.13for a treatment service performed by a student intern and must review and sign each
299.14assessment, progress note, and individual treatment plan prepared by a student intern. A
299.15student intern must receive the orientation and training required in section 245G.13,
299.16subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment staff may be
299.17students or licensing candidates with time documented to be directly related to the provision
299.18of treatment services for which the staff are authorized.
299.19    Subd. 11. Individuals with temporary permit. An individual with a temporary permit
299.20from the Board of Behavioral Health and Therapy may provide chemical dependency
299.21treatment service according to this subdivision if they meet the requirements of either
299.22paragraph (a) or (b).
299.23(a) An individual with a temporary permit must be supervised by a licensed alcohol and
299.24drug counselor assigned by the license holder. The supervising licensed alcohol and drug
299.25counselor must document the amount and type of supervision provided at least on a weekly
299.26basis. The supervision must relate to the clinical practice.
299.27(b) An individual with a temporary permit must be supervised by a clinical supervisor
299.28approved by the Board of Behavioral Health and Therapy. The supervision must be
299.29documented and meet the requirements of section 148F.04, subdivision 4.
299.30EFFECTIVE DATE.This section is effective January 1, 2018.

300.1    Sec. 20. [245G.12] PROVIDER POLICIES AND PROCEDURES.
300.2A license holder must develop a written policies and procedures manual, indexed
300.3according to section 245A.04, subdivision 14, paragraph (c), that provides staff members
300.4immediate access to all policies and procedures and provides a client and other authorized
300.5parties access to all policies and procedures. The manual must contain the following
300.6materials:
300.7(1) assessment and treatment planning policies, including screening for mental health
300.8concerns and treatment objectives related to the client's identified mental health concerns
300.9in the client's treatment plan;
300.10(2) policies and procedures regarding HIV according to section 245A.19;
300.11(3) the license holder's methods and resources to provide information on tuberculosis
300.12and tuberculosis screening to each client and to report a known tuberculosis infection
300.13according to section 144.4804;
300.14(4) personnel policies according to section 245G.13;
300.15(5) policies and procedures that protect a client's rights according to section 245G.15;
300.16(6) a medical services plan according to section 245G.08;
300.17(7) emergency procedures according to section 245G.16;
300.18(8) policies and procedures for maintaining client records according to section 245G.09;
300.19(9) procedures for reporting the maltreatment of minors according to section 626.556,
300.20and vulnerable adults according to sections 245A.65, 626.557, and 626.5572;
300.21(10) a description of treatment services, including the amount and type of services
300.22provided;
300.23(11) the methods used to achieve desired client outcomes;
300.24(12) the hours of operation; and
300.25(13) the target population served.
300.26EFFECTIVE DATE.This section is effective January 1, 2018.

300.27    Sec. 21. [245G.13] PROVIDER PERSONNEL POLICIES.
300.28    Subdivision 1. Personnel policy requirements. A license holder must have written
300.29personnel policies that are available to each staff member. The personnel policies must:
301.1(1) ensure that staff member retention, promotion, job assignment, or pay are not affected
301.2by a good faith communication between a staff member and the department, the Department
301.3of Health, the ombudsman for mental health and developmental disabilities, law enforcement,
301.4or a local agency for the investigation of a complaint regarding a client's rights, health, or
301.5safety;
301.6(2) contain a job description for each staff member position specifying responsibilities,
301.7degree of authority to execute job responsibilities, and qualification requirements;
301.8(3) provide for a job performance evaluation based on standards of job performance
301.9conducted on a regular and continuing basis, including a written annual review;
301.10(4) describe behavior that constitutes grounds for disciplinary action, suspension, or
301.11dismissal, including policies that address staff member problematic substance use and the
301.12requirements of section 245G.11, subdivision 1, policies prohibiting personal involvement
301.13with a client in violation of chapter 604, and policies prohibiting client abuse described in
301.14sections 245A.65, 626.556, 626.557, and 626.5572;
301.15(5) identify how the program will identify whether behaviors or incidents are problematic
301.16substance use, including a description of how the facility must address:
301.17(i) receiving treatment for substance use within the period specified for the position in
301.18the staff qualification requirements, including medication-assisted treatment;
301.19(ii) substance use that negatively impacts the staff member's job performance;
301.20(iii) chemical use that affects the credibility of treatment services with a client, referral
301.21source, or other member of the community;
301.22(iv) symptoms of intoxication or withdrawal on the job; and
301.23(v) the circumstances under which an individual who participates in monitoring by the
301.24health professional services program for a substance use or mental health disorder is able
301.25to provide services to the program's clients;
301.26(6) include a chart or description of the organizational structure indicating lines of
301.27authority and responsibilities;
301.28(7) include orientation within 24 working hours of starting for each new staff member
301.29based on a written plan that, at a minimum, must provide training related to the staff member's
301.30specific job responsibilities, policies and procedures, client confidentiality, HIV minimum
301.31standards, and client needs; and
302.1(8) include policies outlining the license holder's response to a staff member with a
302.2behavior problem that interferes with the provision of treatment service.
302.3    Subd. 2. Staff development. (a) A license holder must ensure that each staff member
302.4has the training described in this subdivision.
302.5(b) Each staff member must be trained every two years in:
302.6(1) client confidentiality rules and regulations and client ethical boundaries; and
302.7(2) emergency procedures and client rights as specified in sections 144.651, 148F.165,
302.8and 253B.03.
302.9(c) Annually each staff member with direct contact must be trained on mandatory
302.10reporting as specified in sections 245A.65, 626.556, 626.5561, 626.557, and 626.5572,
302.11including specific training covering the license holder's policies for obtaining a release of
302.12client information.
302.13(d) Upon employment and annually thereafter, each staff member with direct contact
302.14must receive training on HIV minimum standards according to section 245A.19.
302.15(e) A treatment director, supervisor, nurse, or counselor must have a minimum of 12
302.16hours of training in co-occurring disorders that includes competencies related to philosophy,
302.17trauma-informed care, screening, assessment, diagnosis and person-centered treatment
302.18planning, documentation, programming, medication, collaboration, mental health
302.19consultation, and discharge planning. A new staff member who has not obtained the training
302.20must complete the training within six months of employment. A staff member may request,
302.21and the license holder may grant, credit for relevant training obtained before employment,
302.22which must be documented in the staff member's personnel file.
302.23    Subd. 3. Personnel files. The license holder must maintain a separate personnel file for
302.24each staff member. At a minimum, the personnel file must conform to the requirements of
302.25this chapter. A personnel file must contain the following:
302.26(1) a completed application for employment signed by the staff member and containing
302.27the staff member's qualifications for employment;
302.28(2) documentation related to the staff member's background study data, according to
302.29chapter 245C;
302.30(3) for a staff member who provides psychotherapy services, employer names and
302.31addresses for the past five years for which the staff member provided psychotherapy services,
303.1and documentation of an inquiry required by sections 604.20 to 604.205 made to the staff
303.2member's former employer regarding substantiated sexual contact with a client;
303.3(4) documentation that the staff member completed orientation and training;
303.4(5) documentation that the staff member meets the requirements in section 245G.11;
303.5(6) documentation demonstrating the staff member's compliance with section 245G.08,
303.6subdivision 3, for a staff member who conducts administration of medication; and
303.7(7) documentation demonstrating the staff member's compliance with section 245G.18,
303.8subdivision 2, for a staff member that treats an adolescent client.
303.9EFFECTIVE DATE.This section is effective January 1, 2018.

303.10    Sec. 22. [245G.14] SERVICE INITIATION AND TERMINATION POLICIES.
303.11    Subdivision 1. Service initiation policy. A license holder must have a written service
303.12initiation policy containing service initiation preferences that comply with this section and
303.13Code of Federal Regulations, title 45, part 96.131, and specific service initiation criteria.
303.14The license holder must not initiate services for an individual who does not meet the service
303.15initiation criteria. The service initiation criteria must be either posted in the area of the
303.16facility where services for a client are initiated, or given to each interested person upon
303.17request. Titles of each staff member authorized to initiate services for a client must be listed
303.18in the services initiation and termination policies.
303.19    Subd. 2. License holder responsibilities. (a) The license holder must have and comply
303.20with a written protocol for (1) assisting a client in need of care not provided by the license
303.21holder, and (2) a client who poses a substantial likelihood of harm to the client or others, if
303.22the behavior is beyond the behavior management capabilities of the staff members.
303.23(b) A service termination and denial of service initiation that poses an immediate threat
303.24to the health of any individual or requires immediate medical intervention must be referred
303.25to a medical facility capable of admitting the client.
303.26(c) A service termination policy and a denial of service initiation that involves the
303.27commission of a crime against a license holder's staff member or on a license holder's
303.28premises, as provided under Code of Federal Regulations, title 42, section 2.12(c)(5), and
303.29title 45, parts 160 to 164, must be reported to a law enforcement agency with jurisdiction.
303.30    Subd. 3. Service termination policies. A license holder must have a written policy
303.31specifying the conditions when a client must be terminated from service. The service
303.32termination policy must include:
304.1(1) procedures for a client whose services were terminated under subdivision 2;
304.2(2) a description of client behavior that constitutes reason for a staff-requested service
304.3termination and a process for providing this information to a client;
304.4(3) a requirement that before discharging a client from a residential setting, for not
304.5reaching treatment plan goals, the license holder must confer with other interested persons
304.6to review the issues involved in the decision. The documentation requirements for a
304.7staff-requested service termination must describe why the decision to discharge is warranted,
304.8the reasons for the discharge, and the alternatives considered or attempted before discharging
304.9the client;
304.10(4) procedures consistent with section 253B.16, subdivision 2, that staff members must
304.11follow when a client admitted under chapter 253B is to have services terminated;
304.12(5) procedures a staff member must follow when a client leaves against staff or medical
304.13advice and when the client may be dangerous to the client or others, including a policy that
304.14requires a staff member to assist the client with assessing needs of care or other resources;
304.15(6) procedures for communicating staff-approved service termination criteria to a client,
304.16including the expectations in the client's individual treatment plan according to section
304.17245G.06; and
304.18(7) titles of each staff member authorized to terminate a client's service must be listed
304.19in the service initiation and service termination policies.
304.20EFFECTIVE DATE.This section is effective January 1, 2018.

304.21    Sec. 23. [245G.15] CLIENT RIGHTS PROTECTION.
304.22    Subdivision 1. Explanation. A client has the rights identified in sections 144.651,
304.23148F.165, 253B.03, and 254B.02, subdivision 2, as applicable. The license holder must
304.24give each client at service initiation a written statement of the client's rights and
304.25responsibilities. A staff member must review the statement with a client at that time.
304.26    Subd. 2. Grievance procedure. At service initiation, the license holder must explain
304.27the grievance procedure to the client or the client's representative. The grievance procedure
304.28must be posted in a place visible to clients, and made available upon a client's or former
304.29client's request. The grievance procedure must require that:
304.30(1) a staff member helps the client develop and process a grievance;
304.31(2) current telephone numbers and addresses of the Department of Human Services,
304.32Licensing Division; the Office of Ombudsman for Mental Health and Developmental
305.1Disabilities; the Department of Health Office of Health Facilities Complaints; and the Board
305.2of Behavioral Health and Therapy, when applicable, be made available to a client; and
305.3(3) a license holder responds to the client's grievance within three days of a staff member's
305.4receipt of the grievance, and the client may bring the grievance to the highest level of
305.5authority in the program if not resolved by another staff member.
305.6    Subd. 3. Photographs of client. (a) A photograph, video, or motion picture of a client
305.7taken in the provision of treatment service is considered client records. A photograph for
305.8identification and a recording by video or audio technology to enhance either therapy or
305.9staff member supervision may be required of a client, but may only be available for use as
305.10communications within a program. A client must be informed when the client's actions are
305.11being recorded by camera or other technology, and the client must have the right to refuse
305.12any recording or photography, except as authorized by this subdivision.
305.13(b) A license holder must have a written policy regarding the use of any personal
305.14electronic device that can record, transmit, or make images of another client. A license
305.15holder must inform each client of this policy and the client's right to refuse being
305.16photographed or recorded.
305.17EFFECTIVE DATE.This section is effective January 1, 2018.

305.18    Sec. 24. [245G.16] BEHAVIORAL EMERGENCY PROCEDURES.
305.19(a) A license holder or applicant must have written behavioral emergency procedures
305.20that staff must follow when responding to a client who exhibits behavior that is threatening
305.21to the safety of the client or others. Programs must incorporate person-centered planning
305.22and trauma-informed care in the program's behavioral emergency procedure policies. The
305.23procedures must include:
305.24(1) a plan designed to prevent a client from hurting themselves or others;
305.25(2) contact information for emergency resources that staff must consult when a client's
305.26behavior cannot be controlled by the behavioral emergency procedures;
305.27(3) types of procedures that may be used;
305.28(4) circumstances under which behavioral emergency procedures may be used; and
305.29(5) staff members authorized to implement behavioral emergency procedures.
305.30(b) Behavioral emergency procedures must not be used to enforce facility rules or for
305.31the convenience of staff. Behavioral emergency procedures must not be part of any client's
305.32treatment plan, or used at any time for any reason except in response to specific current
306.1behavior that threatens the safety of the client or others. Behavioral emergency procedures
306.2may not include the use of seclusion or restraint.
306.3EFFECTIVE DATE.This section is effective January 1, 2018.

306.4    Sec. 25. [245G.17] EVALUATION.
306.5A license holder must participate in the drug and alcohol abuse normative evaluation
306.6system by submitting information about each client to the commissioner in a manner
306.7prescribed by the commissioner. A license holder must submit additional information
306.8requested by the commissioner that is necessary to meet statutory or federal funding
306.9requirements.
306.10EFFECTIVE DATE.This section is effective January 1, 2018.

306.11    Sec. 26. [245G.18] LICENSE HOLDERS SERVING ADOLESCENTS.
306.12    Subdivision 1. License. A residential treatment program that serves an adolescent younger
306.13than 16 years of age must be licensed as a residential program for a child in out-of-home
306.14placement by the department unless the license holder is exempt under section 245A.03,
306.15subdivision 2.
306.16    Subd. 2. Alcohol and drug counselor qualifications. In addition to the requirements
306.17specified in section 245G.11, subdivisions 1 and 5, an alcohol and drug counselor providing
306.18treatment service to an adolescent must have:
306.19(1) an additional 30 hours of classroom instruction or one three-credit semester college
306.20course in adolescent development. This training need only be completed one time; and
306.21(2) at least 150 hours of supervised experience as an adolescent counselor, either as a
306.22student or as a staff member.
306.23    Subd. 3. Staff ratios. At least 25 percent of a counselor's scheduled work hours must
306.24be allocated to indirect services, including documentation of client services, coordination
306.25of services with others, treatment team meetings, and other duties. A counseling group
306.26consisting entirely of adolescents must not exceed 16 adolescents. It is the responsibility of
306.27the license holder to determine an acceptable group size based on the needs of the clients.
306.28    Subd. 4. Academic program requirements. A client who is required to attend school
306.29must be enrolled and attending an educational program that was approved by the Department
306.30of Education.
307.1    Subd. 5. Program requirements. In addition to the requirements specified in the client's
307.2treatment plan under section 245G.06, programs serving an adolescent must include:
307.3(1) coordination with the school system to address the client's academic needs;
307.4(2) when appropriate, a plan that addresses the client's leisure activities without chemical
307.5use; and
307.6(3) a plan that addresses family involvement in the adolescent's treatment.
307.7EFFECTIVE DATE.This section is effective January 1, 2018.

307.8    Sec. 27. [245G.19] LICENSE HOLDERS SERVING CLIENTS WITH CHILDREN.
307.9    Subdivision 1. Health license requirements. In addition to the requirements of sections
307.10245G.01 to 245G.17, a license holder that offers supervision of a child of a client is subject
307.11to the requirements of this section. A license holder providing room and board for a client
307.12and the client's child must have an appropriate facility license from the Department of
307.13Health.
307.14    Subd. 2. Supervision of a child. "Supervision of a child" means a caregiver is within
307.15sight or hearing of an infant, toddler, or preschooler at all times so that the caregiver can
307.16intervene to protect the child's health and safety. For a school-age child it means a caregiver
307.17is available to help and care for the child to protect the child's health and safety.
307.18    Subd. 3. Policy and schedule required. A license holder must meet the following
307.19requirements:
307.20(1) have a policy and schedule delineating the times and circumstances when the license
307.21holder is responsible for supervision of a child in the program and when the child's parents
307.22are responsible for supervision of a child. The policy must explain how the program will
307.23communicate its policy about supervision of a child responsibility to the parent; and
307.24(2) have written procedures addressing the actions a staff member must take if a child
307.25is neglected or abused, including while the child is under the supervision of the child's
307.26parent.
307.27    Subd. 4. Additional licensing requirements. During the times the license holder is
307.28responsible for the supervision of a child, the license holder must meet the following
307.29standards:
307.30(1) child and adult ratios in Minnesota Rules, part 9502.0367;
307.31(2) day care training in section 245A.50;
308.1(3) behavior guidance in Minnesota Rules, part 9502.0395;
308.2(4) activities and equipment in Minnesota Rules, part 9502.0415;
308.3(5) physical environment in Minnesota Rules, part 9502.0425; and
308.4(6) water, food, and nutrition in Minnesota Rules, part 9502.0445, unless the license
308.5holder has a license from the Department of Health.
308.6EFFECTIVE DATE.This section is effective January 1, 2018.

308.7    Sec. 28. [245G.20] LICENSE HOLDERS SERVING PERSONS WITH
308.8CO-OCCURRING DISORDERS.
308.9A license holder specializing in the treatment of a person with co-occurring disorders
308.10must:
308.11(1) demonstrate that staff levels are appropriate for treating a client with a co-occurring
308.12disorder, and that there are adequate staff members with mental health training;
308.13(2) have continuing access to a medical provider with appropriate expertise in prescribing
308.14psychotropic medication;
308.15(3) have a mental health professional available for staff member supervision and
308.16consultation;
308.17(4) determine group size, structure, and content considering the special needs of a client
308.18with a co-occurring disorder;
308.19(5) have documentation of active interventions to stabilize mental health symptoms
308.20present in the individual treatment plans and progress notes;
308.21(6) have continuing documentation of collaboration with continuing care mental health
308.22providers, and involvement of the providers in treatment planning meetings;
308.23(7) have available program materials adapted to a client with a mental health problem;
308.24(8) have policies that provide flexibility for a client who may lapse in treatment or may
308.25have difficulty adhering to established treatment rules as a result of a mental illness, with
308.26the goal of helping a client successfully complete treatment; and
308.27(9) have individual psychotherapy and case management available during treatment
308.28service.
308.29EFFECTIVE DATE.This section is effective January 1, 2018.

309.1    Sec. 29. [245G.21] REQUIREMENTS FOR LICENSED RESIDENTIAL
309.2TREATMENT.
309.3    Subdivision 1. Applicability. A license holder who provides supervised room and board
309.4at the licensed program site as a treatment component is defined as a residential program
309.5according to section 245A.02, subdivision 14, and is subject to this section.
309.6    Subd. 2. Visitors. A client must be allowed to receive visitors at times prescribed by
309.7the license holder. The license holder must set and post a notice of visiting rules and hours,
309.8including both day and evening times. A client's right to receive visitors other than a personal
309.9physician, religious adviser, county case manager, parole or probation officer, or attorney
309.10may be subject to visiting hours established by the license holder for all clients. The treatment
309.11director or designee may impose limitations as necessary for the welfare of a client provided
309.12the limitation and the reasons for the limitation are documented in the client's file. A client
309.13must be allowed to receive visits at all reasonable times from the client's personal physician,
309.14religious adviser, county case manager, parole or probation officer, and attorney.
309.15    Subd. 3. Client property management. A license holder who provides room and board
309.16and treatment services to a client in the same facility, and any license holder that accepts
309.17client property must meet the requirements for handling client funds and property in section
309.18245A.04, subdivision 13. License holders:
309.19(1) may establish policies regarding the use of personal property to ensure that treatment
309.20activities and the rights of other clients are not infringed upon;
309.21(2) may take temporary custody of a client's property for violation of a facility policy;
309.22(3) must retain the client's property for a minimum of seven days after the client's service
309.23termination if the client does not reclaim property upon service termination, or for a minimum
309.24of 30 days if the client does not reclaim property upon service termination and has received
309.25room and board services from the license holder; and
309.26(4) must return all property held in trust to the client at service termination regardless
309.27of the client's service termination status, except that:
309.28(i) a drug, drug paraphernalia, or drug container that is subject to forfeiture under section
309.29609.5316, must be given to the custody of a local law enforcement agency. If giving the
309.30property to the custody of a local law enforcement agency violates Code of Federal
309.31Regulations, title 42, sections 2.1 to 2.67, or title 45, parts 160 to 164, a drug, drug
309.32paraphernalia, or drug container must be destroyed by a staff member designated by the
309.33program director; and
310.1(ii) a weapon, explosive, and other property that can cause serious harm to the client or
310.2others must be given to the custody of a local law enforcement agency, and the client must
310.3be notified of the transfer and of the client's right to reclaim any lawful property transferred;
310.4and
310.5(iii) a medication that was determined by a physician to be harmful after examining the
310.6client must be destroyed, except when the client's personal physician approves the medication
310.7for continued use.
310.8    Subd. 4. Health facility license. A license holder who provides room and board and
310.9treatment services in the same facility must have the appropriate license from the Department
310.10of Health.
310.11    Subd. 5. Facility abuse prevention plan. A license holder must establish and enforce
310.12an ongoing facility abuse prevention plan consistent with sections 245A.65 and 626.557,
310.13subdivision 14.
310.14    Subd. 6. Individual abuse prevention plan. A license holder must prepare an individual
310.15abuse prevention plan for each client as specified under sections 245A.65, subdivision 2,
310.16and 626.557, subdivision 14.
310.17    Subd. 7. Health services. A license holder must have written procedures for assessing
310.18and monitoring a client's health, including a standardized data collection tool for collecting
310.19health-related information about each client. The policies and procedures must be approved
310.20and signed by a registered nurse.
310.21    Subd. 8. Administration of medication. A license holder must meet the administration
310.22of medications requirements of section 245G.08, subdivision 5, if services include medication
310.23administration.
310.24EFFECTIVE DATE.This section is effective January 1, 2018.

310.25    Sec. 30. [245G.22] OPIOID TREATMENT PROGRAMS.
310.26    Subdivision 1. Additional requirements. (a) An opioid treatment program licensed
310.27under this chapter must also comply with the requirements of this section and Code of
310.28Federal Regulations, title 42, part 8. When federal guidance or interpretations are issued on
310.29federal standards or requirements also required under this section, the federal guidance or
310.30interpretations shall apply.
310.31(b) Where a standard in this section differs from a standard in an otherwise applicable
310.32administrative rule or statute, the standard of this section applies.
311.1    Subd. 2. Definitions. (a) For purposes of this section, the terms defined in this subdivision
311.2have the meanings given them.
311.3(b) "Diversion" means the use of a medication for the treatment of opioid addiction being
311.4diverted from intended use of the medication.
311.5(c) "Guest dose" means administration of a medication used for the treatment of opioid
311.6addiction to a person who is not a client of the program that is administering or dispensing
311.7the medication.
311.8(d) "Medical director" means a physician licensed to practice medicine in the jurisdiction
311.9that the opioid treatment program is located who assumes responsibility for administering
311.10all medical services performed by the program, either by performing the services directly
311.11or by delegating specific responsibility to authorized program physicians and health care
311.12professionals functioning under the medical director's direct supervision.
311.13(e) "Medication used for the treatment of opioid use disorder" means a medication
311.14approved by the Food and Drug Administration for the treatment of opioid use disorder.
311.15(f) "Minnesota health care programs" has the meaning given in section 256B.0636.
311.16(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,
311.17title 42, section 8.12, and includes programs licensed under this chapter.
311.18(h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605,
311.19subpart 21a.
311.20(i) "Unsupervised use" means the use of a medication for the treatment of opioid use
311.21disorder dispensed for use by a client outside of the program setting.
311.22    Subd. 3. Medication orders. Before the program may administer or dispense a medication
311.23used for the treatment of opioid use disorder:
311.24(1) a client-specific order must be received from an appropriately credentialed physician
311.25who is enrolled as a Minnesota health care programs provider and meets all applicable
311.26provider standards;
311.27(2) the signed order must be documented in the client's record; and
311.28(3) if the physician that issued the order is not able to sign the order when issued, the
311.29unsigned order must be entered in the client record at the time it was received, and the
311.30physician must review the documentation and sign the order in the client's record within 72
311.31hours of the medication being ordered. The license holder must report to the commissioner
311.32any medication error that endangers a client's health, as determined by the medical director.
312.1    Subd. 4. High dose requirements. A client being administered or dispensed a dose
312.2beyond that set forth in subdivision 6, paragraph (a), clause (1), that exceeds 150 milligrams
312.3of methadone or 24 milligrams of buprenorphine daily, and for each subsequent increase,
312.4must meet face-to-face with a prescribing physician. The meeting must occur before the
312.5administration or dispensing of the increased medication dose.
312.6    Subd. 5. Drug testing. Each client enrolled in the program must receive a minimum of
312.7eight random drug abuse tests per 12 months of treatment. Drug abuse tests must be
312.8reasonably disbursed over the 12-month period. A license holder may elect to conduct more
312.9drug abuse tests.
312.10    Subd. 6. Criteria for unsupervised use. (a) To limit the potential for diversion of
312.11medication used for the treatment of opioid use disorder to the illicit market, medication
312.12dispensed to a client for unsupervised use shall be subject to the following requirements:
312.13(1) any client in an opioid treatment program may receive a single unsupervised use
312.14dose for a day that the clinic is closed for business, including Sundays and state and federal
312.15holidays; and
312.16(2) other treatment program decisions on dispensing medications used for the treatment
312.17of opioid use disorder to a client for unsupervised use shall be determined by the medical
312.18director.
312.19(b) In determining whether a client may be permitted unsupervised use of medications,
312.20a physician with authority to prescribe must consider the criteria in this paragraph. The
312.21criteria in this paragraph must also be considered when determining whether dispensing
312.22medication for a client's unsupervised use is appropriate to increase or to extend the amount
312.23of time between visits to the program. The criteria are:
312.24(1) absence of recent abuse of drugs including but not limited to opioids, non-narcotics,
312.25and alcohol;
312.26(2) regularity of program attendance;
312.27(3) absence of serious behavioral problems at the program;
312.28(4) absence of known recent criminal activity such as drug dealing;
312.29(5) stability of the client's home environment and social relationships;
312.30(6) length of time in comprehensive maintenance treatment;
312.31(7) reasonable assurance that unsupervised use medication will be safely stored within
312.32the client's home; and
313.1(8) whether the rehabilitative benefit the client derived from decreasing the frequency
313.2of program attendance outweighs the potential risks of diversion or unsupervised use.
313.3(c) The determination, including the basis of the determination must be documented in
313.4the client's medical record.
313.5    Subd. 7. Restrictions for unsupervised use of methadone hydrochloride. (a) If a
313.6physician with authority to prescribe determines that a client meets the criteria in subdivision
313.76 and may be dispensed a medication used for the treatment of opioid addiction, the
313.8restrictions in this subdivision must be followed when the medication to be dispensed is
313.9methadone hydrochloride.
313.10(b) During the first 90 days of treatment, the unsupervised use medication supply must
313.11be limited to a maximum of a single dose each week and the client shall ingest all other
313.12doses under direct supervision.
313.13(c) In the second 90 days of treatment, the unsupervised use medication supply must be
313.14limited to two doses per week.
313.15(d) In the third 90 days of treatment, the unsupervised use medication supply must not
313.16exceed three doses per week.
313.17(e) In the remaining months of the first year, a client may be given a maximum six-day
313.18unsupervised use medication supply.
313.19(f) After one year of continuous treatment, a client may be given a maximum two-week
313.20unsupervised use medication supply.
313.21(g) After two years of continuous treatment, a client may be given a maximum one-month
313.22unsupervised use medication supply, but must make monthly visits to the program.
313.23    Subd. 8. Restriction exceptions. When a license holder has reason to accelerate the
313.24number of unsupervised use doses of methadone hydrochloride, the license holder must
313.25comply with the requirements of Code of Federal Regulations, title 42, section 8.12, the
313.26criteria for unsupervised use and must use the exception process provided by the federal
313.27Center for Substance Abuse Treatment Division of Pharmacologic Therapies. For the
313.28purposes of enforcement of this subdivision, the commissioner has the authority to monitor
313.29a program for compliance with federal regulations and may issue licensing actions according
313.30to sections 245A.05, 245A.06, and 245A.07 based on the commissioner's determination of
313.31noncompliance.
313.32    Subd. 9. Guest dose. To receive a guest dose, the client must be enrolled in an opioid
313.33treatment program elsewhere in the state or country and be receiving the medication on a
314.1temporary basis because the client is not able to receive the medication at the program in
314.2which the client is enrolled. Such arrangements shall not exceed 30 consecutive days in any
314.3one program and must not be for the convenience or benefit of either program. A guest dose
314.4may also occur when the client's primary clinic is not open and the client is not receiving
314.5unsupervised use doses.
314.6    Subd. 10. Capacity management and waiting list system compliance. An opioid
314.7treatment program must notify the department within seven days of the program reaching
314.8both 90 and 100 percent of the program's capacity to care for clients. Each week, the program
314.9must report its capacity, currently enrolled dosing clients, and any waiting list. A program
314.10reporting 90 percent of capacity must also notify the department when the program's census
314.11increases or decreases from the 90 percent level.
314.12    Subd. 11. Waiting list. An opioid treatment program must have a waiting list system.
314.13If the person seeking admission cannot be admitted within 14 days of the date of application,
314.14each person seeking admission must be placed on the waiting list, unless the person seeking
314.15admission is assessed by the program and found ineligible for admission according to this
314.16chapter and Code of Federal Regulations, title 42, part 1, subchapter A, section 8.12(e), and
314.17title 45, parts 160 to 164. The waiting list must assign a unique client identifier for each
314.18person seeking treatment while awaiting admission. A person seeking admission on a waiting
314.19list who receives no services under section 245G.07, subdivision 1, must not be considered
314.20a client as defined in section 245G.01, subdivision 9.
314.21    Subd. 12. Client referral. An opioid treatment program must consult the capacity
314.22management system to ensure that a person on a waiting list is admitted at the earliest time
314.23to a program providing appropriate treatment within a reasonable geographic area. If the
314.24client was referred through a public payment system and if the program is not able to serve
314.25the client within 14 days of the date of application for admission, the program must contact
314.26and inform the referring agency of any available treatment capacity listed in the state capacity
314.27management system.
314.28    Subd. 13. Outreach. An opioid treatment program must carry out activities to encourage
314.29an individual in need of treatment to undergo treatment. The program's outreach model
314.30must:
314.31(1) select, train, and supervise outreach workers;
314.32(2) contact, communicate, and follow up with individuals with high-risk substance
314.33misuse, individuals with high-risk substance misuse associates, and neighborhood residents
314.34within the constraints of federal and state confidentiality requirements;
315.1(3) promote awareness among individuals who engage in substance misuse by injection
315.2about the relationship between injecting substances and communicable diseases such as
315.3HIV; and
315.4(4) recommend steps to prevent HIV transmission.
315.5    Subd. 14. Central registry. (a) A license holder must comply with requirements to
315.6submit information and necessary consents to the state central registry for each client
315.7admitted, as specified by the commissioner. The license holder must submit data concerning
315.8medication used for the treatment of opioid use disorder. The data must be submitted in a
315.9method determined by the commissioner and the original information must be kept in the
315.10client's record. The information must be submitted for each client at admission and discharge.
315.11The program must document the date the information was submitted. The client's failure to
315.12provide the information shall prohibit participation in an opioid treatment program. The
315.13information submitted must include the client's:
315.14(1) full name and all aliases;
315.15(2) date of admission;
315.16(3) date of birth;
315.17(4) Social Security number or Alien Registration Number, if any;
315.18(5) current or previous enrollment status in another opioid treatment program;
315.19(6) government-issued photo identification card number; and
315.20(7) driver's license number, if any.
315.21(b) The requirements in paragraph (a) are effective upon the commissioner's
315.22implementation of changes to the drug and alcohol abuse normative evaluation system or
315.23development of an electronic system by which to submit the data.
315.24    Subd. 15. Nonmedication treatment services; documentation. (a) The program must
315.25offer at least 50 consecutive minutes of individual or group therapy treatment services as
315.26defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first
315.27ten weeks following admission, and at least 50 consecutive minutes per month thereafter.
315.28As clinically appropriate, the program may offer these services cumulatively and not
315.29consecutively in increments of no less than 15 minutes over the required time period, and
315.30for a total of 60 minutes of treatment services over the time period, and must document the
315.31reason for providing services cumulatively in the client's record. The program may offer
315.32additional levels of service when deemed clinically necessary.
316.1(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
316.2the assessment must be completed within 21 days of service initiation.
316.3(c) Notwithstanding the requirements of individual treatment plans set forth in section
316.4245G.06:
316.5(1) treatment plan contents for a maintenance client are not required to include goals
316.6the client must reach to complete treatment and have services terminated;
316.7(2) treatment plans for a client in a taper or detox status must include goals the client
316.8must reach to complete treatment and have services terminated;
316.9(3) for the initial ten weeks after admission for all new admissions, readmissions, and
316.10transfers, progress notes must be entered in a client's file at least weekly and be recorded
316.11in each of the six dimensions upon the development of the treatment plan and thereafter.
316.12Subsequently, the counselor must document progress in the six dimensions at least once
316.13monthly or, when clinical need warrants, more frequently; and
316.14(4) upon the development of the treatment plan and thereafter, treatment plan reviews
316.15must occur weekly, or after each treatment service, whichever is less frequent, for the first
316.16ten weeks after the treatment plan is developed. Following the first ten weeks of treatment
316.17plan reviews, reviews may occur monthly, unless the client's needs warrant more frequent
316.18revisions or documentation.
316.19    Subd. 16. Prescription monitoring program. (a) The program must develop and
316.20maintain a policy and procedure that requires the ongoing monitoring of the data from the
316.21prescription monitoring program (PMP) for each client. The policy and procedure must
316.22include how the program meets the requirements in paragraph (b).
316.23(b) If a medication used for the treatment of substance use disorder is administered or
316.24dispensed to a client, the license holder shall be subject to the following requirements:
316.25(1) upon admission to a methadone clinic outpatient treatment program, a client must
316.26be notified in writing that the commissioner of human services and the medical director
316.27must monitor the PMP to review the prescribed controlled drugs a client received;
316.28(2) the medical director or the medical director's delegate must review the data from the
316.29PMP described in section 152.126 before the client is ordered any controlled substance, as
316.30defined under section 152.126, subdivision 1, paragraph (c), including medications used
316.31for the treatment of opioid addiction, and the medical director's or the medical director's
316.32delegate's subsequent reviews of the PMP data must occur at least every 90 days;
316.33(3) a copy of the PMP data reviewed must be maintained in the client's file;
317.1(4) when the PMP data contains a recent history of multiple prescribers or multiple
317.2prescriptions for controlled substances, the physician's review of the data and subsequent
317.3actions must be documented in the client's file within 72 hours and must contain the medical
317.4director's determination of whether or not the prescriptions place the client at risk of harm
317.5and the actions to be taken in response to the PMP findings. The provider must conduct
317.6subsequent reviews of the PMP on a monthly basis; and
317.7(5) if at any time the medical director believes the use of the controlled substances places
317.8the client at risk of harm, the program must seek the client's consent to discuss the client's
317.9opioid treatment with other prescribers and must seek the client's consent for the other
317.10prescriber to disclose to the opioid treatment program's medical director the client's condition
317.11that formed the basis of the other prescriptions. If the information is not obtained within
317.12seven days, the medical director must document whether or not changes to the client's
317.13medication dose or number of unsupervised use doses are necessary until the information
317.14is obtained.
317.15(c) The commissioner shall collaborate with the Minnesota Board of Pharmacy to develop
317.16and implement an electronic system for the commissioner to routinely access the PMP data
317.17to determine whether any client enrolled in an opioid addiction treatment program licensed
317.18according to this section was prescribed or dispensed a controlled substance in addition to
317.19that administered or dispensed by the opioid addiction treatment program. When the
317.20commissioner determines there have been multiple prescribers or multiple prescriptions of
317.21controlled substances for a client, the commissioner shall:
317.22(1) inform the medical director of the opioid treatment program only that the
317.23commissioner determined the existence of multiple prescribers or multiple prescriptions of
317.24controlled substances; and
317.25(2) direct the medical director of the opioid treatment program to access the data directly,
317.26review the effect of the multiple prescribers or multiple prescriptions, and document the
317.27review.
317.28(d) If determined necessary, the commissioner shall seek a federal waiver of, or exception
317.29to, any applicable provision of Code of Federal Regulations, title 42, section 2.34(c), before
317.30implementing this subdivision.
317.31    Subd. 17. Policies and procedures. (a) A license holder must develop and maintain the
317.32policies and procedures required in this subdivision.
317.33(b) For a program that is not open every day of the year, the license holder must maintain
317.34a policy and procedure that permits a client to receive a single unsupervised use of medication
318.1used for the treatment of opioid use disorder for days that the program is closed for business,
318.2including, but not limited to, Sundays and state and federal holidays as required under
318.3subdivision 6, paragraph (a), clause (1).
318.4(c) The license holder must maintain a policy and procedure that includes specific
318.5measures to reduce the possibility of diversion. The policy and procedure must:
318.6(1) specifically identify and define the responsibilities of the medical and administrative
318.7staff for performing diversion control measures; and
318.8(2) include a process for contacting no less than five percent of clients who have
318.9unsupervised use of medication, excluding clients approved solely under subdivision 6,
318.10paragraph (a), clause (1), to require clients to physically return to the program each month.
318.11The system must require clients to return to the program within a stipulated time frame and
318.12turn in all unused medication containers related to opioid use disorder treatment. The license
318.13holder must document all related contacts on a central log and the outcome of the contact
318.14for each client in the client's record.
318.15(d) Medication used for the treatment of opioid use disorder must be ordered,
318.16administered, and dispensed according to applicable state and federal regulations and the
318.17standards set by applicable accreditation entities. If a medication order requires assessment
318.18by the person administering or dispensing the medication to determine the amount to be
318.19administered or dispensed, the assessment must be completed by an individual whose
318.20professional scope of practice permits an assessment. For the purposes of enforcement of
318.21this paragraph, the commissioner has the authority to monitor the person administering or
318.22dispensing the medication for compliance with state and federal regulations and the relevant
318.23standards of the license holder's accreditation agency and may issue licensing actions
318.24according to sections 245A.05, 245A.06, and 245A.07, based on the commissioner's
318.25determination of noncompliance.
318.26    Subd. 18. Quality improvement plan. The license holder must develop and maintain
318.27a quality improvement plan that:
318.28(1) includes evaluation of the services provided to clients to identify issues that may
318.29improve service delivery and client outcomes;
318.30(2) includes goals for the program to accomplish based on the evaluation;
318.31(3) is reviewed annually by the management of the program to determine whether the
318.32goals were met and, if not, whether additional action is required;
319.1(4) is updated at least annually to include new or continued goals based on an updated
319.2evaluation of services; and
319.3(5) identifies two specific goal areas, in addition to others identified by the program,
319.4including:
319.5(i) a goal concerning oversight and monitoring of the premises around and near the
319.6exterior of the program to reduce the possibility of medication used for the treatment of
319.7opioid use disorder being inappropriately used by a client, including but not limited to the
319.8sale or transfer of the medication to others; and
319.9(ii) a goal concerning community outreach, including but not limited to communications
319.10with local law enforcement and county human services agencies, to increase coordination
319.11of services and identification of areas of concern to be addressed in the plan.
319.12    Subd. 19. Placing authorities. A program must provide certain notification and
319.13client-specific updates to placing authorities for a client who is enrolled in Minnesota health
319.14care programs. At the request of the placing authority, the program must provide
319.15client-specific updates, including but not limited to informing the placing authority of
319.16positive drug screenings and changes in medications used for the treatment of opioid use
319.17disorder ordered for the client.
319.18    Subd. 20. Duty to report suspected drug diversion. (a) To the fullest extent permitted
319.19under Code of Federal Regulations, title 42, sections 2.1 to 2.67, a program shall report to
319.20law enforcement any credible evidence that the program or its personnel knows, or reasonably
319.21should know, that is directly related to a diversion crime on the premises of the program,
319.22or a threat to commit a diversion crime.
319.23(b) "Diversion crime," for the purposes of this section, means diverting, attempting to
319.24divert, or conspiring to divert Schedule I, II, III, or IV drugs, as defined in section 152.02,
319.25on the program's premises.
319.26(c) The program must document the program's compliance with the requirement in
319.27paragraph (a) in either a client's record or an incident report. A program's failure to comply
319.28with paragraph (a) may result in sanctions as provided in sections 245A.06 and 245A.07.
319.29EFFECTIVE DATE.This section is effective July 1, 2017.

319.30    Sec. 31. Minnesota Statutes 2016, section 246.18, subdivision 4, is amended to read:
319.31    Subd. 4. Collections deposited in the general fund. Except as provided in subdivisions
319.325, 6, and 7, all receipts from collection efforts for the regional treatment centers, state nursing
320.1homes, and other state facilities as defined in section 246.50, subdivision 3, must be deposited
320.2in the general fund. From that amount, receipts from collection efforts for regional treatment
320.3centers and community behavioral health hospitals must be deposited in accordance with
320.4subdivision 4a. The commissioner shall ensure that the departmental financial reporting
320.5systems and internal accounting procedures comply with federal standards for reimbursement
320.6for program and administrative expenditures and fulfill the purpose of this paragraph
320.7subdivision.

320.8    Sec. 32. Minnesota Statutes 2016, section 246.18, is amended by adding a subdivision to
320.9read:
320.10    Subd. 4a. Mental health innovation account. The mental health innovation account is
320.11established in the special revenue fund. In fiscal year 2018 and fiscal year 2019, $2,000,000
320.12of the revenue generated by collection efforts from the regional treatment centers and
320.13community behavioral health hospitals under section 246.54 must be deposited into the
320.14mental health innovation account. Beginning in fiscal year 2020, $2,500,000 of the revenue
320.15generated by collection efforts from the regional treatment centers and community behavioral
320.16health hospitals under section 246.54 must annually be deposited into the mental health
320.17innovation account. Money deposited in the mental health innovation account is appropriated
320.18to the commissioner of human services for the mental health innovation grant program
320.19under section 245.4662.

320.20    Sec. 33. Minnesota Statutes 2016, section 254A.01, is amended to read:
320.21254A.01 PUBLIC POLICY.
320.22It is hereby declared to be the public policy of this state that scientific evidence shows
320.23that addiction to alcohol or other drugs is a chronic brain disorder with potential for
320.24recurrence, and as with many other chronic conditions, people with substance use disorders
320.25can be effectively treated and can enter recovery. The interests of society are best served
320.26by reducing the stigma of substance use disorder and providing persons who are dependent
320.27upon alcohol or other drugs with a comprehensive range of rehabilitative and social services
320.28that span intensity levels and are not restricted to a particular point in time. Further, it is
320.29declared that treatment under these services shall be voluntary when possible: treatment
320.30shall not be denied on the basis of prior treatment; treatment shall be based on an individual
320.31treatment plan for each person undergoing treatment; treatment shall include a continuum
320.32of services available for a person leaving a program of treatment; treatment shall include
320.33all family members at the earliest possible phase of the treatment process.
321.1EFFECTIVE DATE.This section is effective January 1, 2018.

321.2    Sec. 34. Minnesota Statutes 2016, section 254A.02, subdivision 2, is amended to read:
321.3    Subd. 2. Approved treatment program. "Approved treatment program" means care
321.4and treatment services provided by any individual, organization or association to drug
321.5dependent persons with a substance use disorder, which meets the standards established by
321.6the commissioner of human services.
321.7EFFECTIVE DATE.This section is effective January 1, 2018.

321.8    Sec. 35. Minnesota Statutes 2016, section 254A.02, subdivision 3, is amended to read:
321.9    Subd. 3. Comprehensive program. "Comprehensive program" means the range of
321.10services which are to be made available for the purpose of prevention, care and treatment
321.11of alcohol and drug abuse substance misuse and substance use disorder.
321.12EFFECTIVE DATE.This section is effective January 1, 2018.

321.13    Sec. 36. Minnesota Statutes 2016, section 254A.02, subdivision 5, is amended to read:
321.14    Subd. 5. Drug dependent person. "Drug dependent person" means any inebriate person
321.15or any person incapable of self-management or management of personal affairs or unable
321.16to function physically or mentally in an effective manner because of the abuse of a drug,
321.17including alcohol.
321.18EFFECTIVE DATE.This section is effective January 1, 2018.

321.19    Sec. 37. Minnesota Statutes 2016, section 254A.02, subdivision 6, is amended to read:
321.20    Subd. 6. Facility. "Facility" means any treatment facility administered under an approved
321.21treatment program established under Laws 1973, chapter 572.
321.22EFFECTIVE DATE.This section is effective January 1, 2018.

321.23    Sec. 38. Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision
321.24to read:
321.25    Subd. 6a. Substance misuse. "Substance misuse" means the use of any psychoactive
321.26or mood-altering substance, without compelling medical reason, in a manner that results in
321.27mental, emotional, or physical impairment and causes socially dysfunctional or socially
321.28disordering behavior and that results in psychological dependence or physiological addiction
322.1as a function of continued use. Substance misuse has the same meaning as drug abuse or
322.2abuse of drugs.
322.3EFFECTIVE DATE.This section is effective January 1, 2018.

322.4    Sec. 39. Minnesota Statutes 2016, section 254A.02, subdivision 8, is amended to read:
322.5    Subd. 8. Other drugs. "Other drugs" means any psychoactive chemical substance other
322.6than alcohol.
322.7EFFECTIVE DATE.This section is effective January 1, 2018.

322.8    Sec. 40. Minnesota Statutes 2016, section 254A.02, subdivision 10, is amended to read:
322.9    Subd. 10. State authority. "State authority" is a division established within the
322.10Department of Human Services for the purpose of relating the authority of state government
322.11in the area of alcohol and drug abuse substance misuse and substance use disorder to the
322.12alcohol and drug abuse substance misuse and substance use disorder-related activities within
322.13the state.
322.14EFFECTIVE DATE.This section is effective January 1, 2018.

322.15    Sec. 41. Minnesota Statutes 2016, section 254A.02, is amended by adding a subdivision
322.16to read:
322.17    Subd. 10a. Substance use disorder. "Substance use disorder" has the meaning given
322.18in the current Diagnostic and Statistical Manual of Mental Disorders.
322.19EFFECTIVE DATE.This section is effective January 1, 2018.

322.20    Sec. 42. Minnesota Statutes 2016, section 254A.03, is amended to read:
322.21254A.03 STATE AUTHORITY ON ALCOHOL AND DRUG ABUSE.
322.22    Subdivision 1. Alcohol and Other Drug Abuse Section. There is hereby created an
322.23Alcohol and Other Drug Abuse Section in the Department of Human Services. This section
322.24shall be headed by a director. The commissioner may place the director's position in the
322.25unclassified service if the position meets the criteria established in section 43A.08,
322.26subdivision 1a . The section shall:
322.27(1) conduct and foster basic research relating to the cause, prevention and methods of
322.28diagnosis, treatment and rehabilitation of alcoholic and other drug dependent persons with
322.29substance misuse and substance use disorder;
323.1(2) coordinate and review all activities and programs of all the various state departments
323.2as they relate to alcohol and other drug dependency and abuse problems associated with
323.3substance misuse and substance use disorder;
323.4(3) develop, demonstrate, and disseminate new methods and techniques for the prevention,
323.5early intervention, treatment and rehabilitation of alcohol and other drug abuse and
323.6dependency problems recovery support for substance misuse and substance use disorder;
323.7(4) gather facts and information about alcoholism and other drug dependency and abuse
323.8substance misuse and substance use disorder, and about the efficiency and effectiveness of
323.9prevention, treatment, and rehabilitation recovery support services from all comprehensive
323.10programs, including programs approved or licensed by the commissioner of human services
323.11or the commissioner of health or accredited by the Joint Commission on Accreditation of
323.12Hospitals. The state authority is authorized to require information from comprehensive
323.13programs which is reasonable and necessary to fulfill these duties. When required information
323.14has been previously furnished to a state or local governmental agency, the state authority
323.15shall collect the information from the governmental agency. The state authority shall
323.16disseminate facts and summary information about alcohol and other drug abuse dependency
323.17problems associated with substance misuse and substance use disorder to public and private
323.18agencies, local governments, local and regional planning agencies, and the courts for guidance
323.19to and assistance in prevention, treatment and rehabilitation recovery support;
323.20(5) inform and educate the general public on alcohol and other drug dependency and
323.21abuse problems substance misuse and substance use disorder;
323.22(6) serve as the state authority concerning alcohol and other drug dependency and abuse
323.23substance misuse and substance use disorder by monitoring the conduct of diagnosis and
323.24referral services, research and comprehensive programs. The state authority shall submit a
323.25biennial report to the governor and the legislature containing a description of public services
323.26delivery and recommendations concerning increase of coordination and quality of services,
323.27and decrease of service duplication and cost;
323.28(7) establish a state plan which shall set forth goals and priorities for a comprehensive
323.29alcohol and other drug dependency and abuse program continuum of care for substance
323.30misuse and substance use disorder for Minnesota. All state agencies operating alcohol and
323.31other drug abuse or dependency substance misuse or substance use disorder programs or
323.32administering state or federal funds for such programs shall annually set their program goals
323.33and priorities in accordance with the state plan. Each state agency shall annually submit its
323.34plans and budgets to the state authority for review. The state authority shall certify whether
324.1proposed services comply with the comprehensive state plan and advise each state agency
324.2of review findings;
324.3(8) make contracts with and grants to public and private agencies and organizations,
324.4both profit and nonprofit, and individuals, using federal funds, and state funds as authorized
324.5to pay for costs of state administration, including evaluation, statewide programs and services,
324.6research and demonstration projects, and American Indian programs;
324.7(9) receive and administer monies money available for alcohol and drug abuse substance
324.8misuse and substance use disorder programs under the alcohol, drug abuse, and mental
324.9health services block grant, United States Code, title 42, sections 300X to 300X-9;
324.10(10) solicit and accept any gift of money or property for purposes of Laws 1973, chapter
324.11572, and any grant of money, services, or property from the federal government, the state,
324.12any political subdivision thereof, or any private source;
324.13(11) with respect to alcohol and other drug abuse substance misuse and substance use
324.14disorder programs serving the American Indian community, establish guidelines for the
324.15employment of personnel with considerable practical experience in alcohol and other drug
324.16abuse problems substance misuse and substance use disorder, and understanding of social
324.17and cultural problems related to alcohol and other drug abuse substance misuse and substance
324.18use disorder, in the American Indian community.
324.19    Subd. 2. American Indian programs. There is hereby created a section of American
324.20Indian programs, within the Alcohol and Drug Abuse Section of the Department of Human
324.21Services, to be headed by a special assistant for American Indian programs on alcoholism
324.22and drug abuse substance misuse and substance use disorder and two assistants to that
324.23position. The section shall be staffed with all personnel necessary to fully administer
324.24programming for alcohol and drug abuse substance misuse and substance use disorder
324.25services for American Indians in the state. The special assistant position shall be filled by
324.26a person with considerable practical experience in and understanding of alcohol and other
324.27drug abuse problems substance misuse and substance use disorder in the American Indian
324.28community, who shall be responsible to the director of the Alcohol and Drug Abuse Section
324.29created in subdivision 1 and shall be in the unclassified service. The special assistant shall
324.30meet and consult with the American Indian Advisory Council as described in section
324.31254A.035 and serve as a liaison to the Minnesota Indian Affairs Council and tribes to report
324.32on the status of alcohol and other drug abuse substance misuse and substance use disorder
324.33among American Indians in the state of Minnesota. The special assistant with the approval
324.34of the director shall:
325.1(1) administer funds appropriated for American Indian groups, organizations and
325.2reservations within the state for American Indian alcoholism and drug abuse substance
325.3misuse and substance use disorder programs;
325.4(2) establish policies and procedures for such American Indian programs with the
325.5assistance of the American Indian Advisory Board; and
325.6(3) hire and supervise staff to assist in the administration of the American Indian program
325.7section within the Alcohol and Drug Abuse Section of the Department of Human Services.
325.8    Subd. 3. Rules for chemical dependency substance use disorder care. (a) The
325.9commissioner of human services shall establish by rule criteria to be used in determining
325.10the appropriate level of chemical dependency care for each recipient of public assistance
325.11seeking treatment for alcohol or other drug dependency and abuse problems. substance
325.12misuse or substance use disorder. Upon federal approval of a comprehensive assessment
325.13as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding the criteria
325.14in Minnesota Rules, parts 9530.6600 to 9530.6655, an eligible vendor of comprehensive
325.15assessments under section 254B.05 may determine and approve the appropriate level of
325.16substance use disorder treatment for a recipient of public assistance. The process for
325.17determining an individual's financial eligibility for the consolidated chemical dependency
325.18treatment fund or determining an individual's enrollment in or eligibility for a publicly
325.19subsidized health plan is not affected by the individual's choice to access a comprehensive
325.20assessment for placement.
325.21    (b) The commissioner shall develop and implement a utilization review process for
325.22publicly funded treatment placements to monitor and review the clinical appropriateness
325.23and timeliness of all publicly funded placements in treatment.
325.24EFFECTIVE DATE.This section is effective January 1, 2018.

325.25    Sec. 43. Minnesota Statutes 2016, section 254A.035, subdivision 1, is amended to read:
325.26    Subdivision 1. Establishment. There is created an American Indian Advisory Council
325.27to assist the state authority on alcohol and drug abuse substance misuse and substance use
325.28disorder in proposal review and formulating policies and procedures relating to chemical
325.29dependency and the abuse of alcohol and other drugs substance misuse and substance use
325.30disorder by American Indians.
325.31EFFECTIVE DATE.This section is effective January 1, 2018.

326.1    Sec. 44. Minnesota Statutes 2016, section 254A.04, is amended to read:
326.2254A.04 CITIZENS ADVISORY COUNCIL.
326.3    There is hereby created an Alcohol and Other Drug Abuse Advisory Council to advise
326.4the Department of Human Services concerning the problems of alcohol and other drug
326.5dependency and abuse substance misuse and substance use disorder, composed of ten
326.6members. Five members shall be individuals whose interests or training are in the field of
326.7alcohol dependency alcohol-specific substance use disorder and abuse alcohol misuse; and
326.8five members whose interests or training are in the field of dependency substance use
326.9disorder and abuse of drugs misuse of substances other than alcohol. The terms, compensation
326.10and removal of members shall be as provided in section 15.059. The council expires June
326.1130, 2018. The commissioner of human services shall appoint members whose terms end in
326.12even-numbered years. The commissioner of health shall appoint members whose terms end
326.13in odd-numbered years.
326.14EFFECTIVE DATE.This section is effective January 1, 2018.

326.15    Sec. 45. Minnesota Statutes 2016, section 254A.08, is amended to read:
326.16254A.08 DETOXIFICATION CENTERS.
326.17    Subdivision 1. Detoxification services. Every county board shall provide detoxification
326.18services for drug dependent persons any person incapable of self-management or management
326.19of personal affairs or unable to function physically or mentally in an effective manner
326.20because of the use of a drug, including alcohol. The board may utilize existing treatment
326.21programs and other agencies to meet this responsibility.
326.22    Subd. 2. Program requirements. For the purpose of this section, a detoxification
326.23program means a social rehabilitation program licensed by the Department of Human
326.24Services under chapter 245A, and governed by the standards of Minnesota Rules, parts
326.259530.6510 to 9530.6590, and established for the purpose of facilitating access into care and
326.26treatment by detoxifying and evaluating the person and providing entrance into a
326.27comprehensive program. Evaluation of the person shall include verification by a professional,
326.28after preliminary examination, that the person is intoxicated or has symptoms of chemical
326.29dependency substance misuse or substance use disorder and appears to be in imminent
326.30danger of harming self or others. A detoxification program shall have available the services
326.31of a licensed physician for medical emergencies and routine medical surveillance. A
326.32detoxification program licensed by the Department of Human Services to serve both adults
326.33and minors at the same site must provide for separate sleeping areas for adults and minors.
327.1EFFECTIVE DATE.This section is effective January 1, 2018.

327.2    Sec. 46. Minnesota Statutes 2016, section 254A.09, is amended to read:
327.3254A.09 CONFIDENTIALITY OF RECORDS.
327.4The Department of Human Services shall assure confidentiality to individuals who are
327.5the subject of research by the state authority or are recipients of alcohol or drug abuse
327.6substance misuse or substance use disorder information, assessment, or treatment from a
327.7licensed or approved program. The commissioner shall withhold from all persons not
327.8connected with the conduct of the research the names or other identifying characteristics
327.9of a subject of research unless the individual gives written permission that information
327.10relative to treatment and recovery may be released. Persons authorized to protect the privacy
327.11of subjects of research may not be compelled in any federal, state or local, civil, criminal,
327.12administrative or other proceeding to identify or disclose other confidential information
327.13about the individuals. Identifying information and other confidential information related to
327.14alcohol or drug abuse substance misuse or substance use disorder information, assessment,
327.15treatment, or aftercare services may be ordered to be released by the court for the purpose
327.16of civil or criminal investigations or proceedings if, after review of the records considered
327.17for disclosure, the court determines that the information is relevant to the purpose for which
327.18disclosure is requested. The court shall order disclosure of only that information which is
327.19determined relevant. In determining whether to compel disclosure, the court shall weigh
327.20the public interest and the need for disclosure against the injury to the patient, to the treatment
327.21relationship in the program affected and in other programs similarly situated, and the actual
327.22or potential harm to the ability of programs to attract and retain patients if disclosure occurs.
327.23This section does not exempt any person from the reporting obligations under section
327.24626.556 , nor limit the use of information reported in any proceeding arising out of the abuse
327.25or neglect of a child. Identifying information and other confidential information related to
327.26alcohol or drug abuse information substance misuse or substance use disorder, assessment,
327.27treatment, or aftercare services may be ordered to be released by the court for the purpose
327.28of civil or criminal investigations or proceedings. No information may be released pursuant
327.29to this section that would not be released pursuant to section 595.02, subdivision 2.
327.30EFFECTIVE DATE.This section is effective January 1, 2018.

327.31    Sec. 47. Minnesota Statutes 2016, section 254A.19, subdivision 3, is amended to read:
327.32    Subd. 3. Financial conflicts of interest. (a) Except as provided in paragraph (b) or, (c),
327.33or (d), an assessor conducting a chemical use assessment under Minnesota Rules, parts
328.19530.6600 to 9530.6655, may not have any direct or shared financial interest or referral
328.2relationship resulting in shared financial gain with a treatment provider.
328.3    (b) A county may contract with an assessor having a conflict described in paragraph (a)
328.4if the county documents that:
328.5    (1) the assessor is employed by a culturally specific service provider or a service provider
328.6with a program designed to treat individuals of a specific age, sex, or sexual preference;
328.7    (2) the county does not employ a sufficient number of qualified assessors and the only
328.8qualified assessors available in the county have a direct or shared financial interest or a
328.9referral relationship resulting in shared financial gain with a treatment provider; or
328.10    (3) the county social service agency has an existing relationship with an assessor or
328.11service provider and elects to enter into a contract with that assessor to provide both
328.12assessment and treatment under circumstances specified in the county's contract, provided
328.13the county retains responsibility for making placement decisions.
328.14    (c) The county may contract with a hospital to conduct chemical assessments if the
328.15requirements in subdivision 1a are met.
328.16    An assessor under this paragraph may not place clients in treatment. The assessor shall
328.17gather required information and provide it to the county along with any required
328.18documentation. The county shall make all placement decisions for clients assessed by
328.19assessors under this paragraph.
328.20    (d) An eligible vendor under section 254B.05 conducting a comprehensive assessment
328.21for an individual seeking treatment shall approve the nature, intensity level, and duration
328.22of treatment service if a need for services is indicated, but the individual assessed can access
328.23any enrolled provider that is licensed to provide the level of service authorized, including
328.24the provider or program that completed the assessment. If an individual is enrolled in a
328.25prepaid health plan, the individual must comply with any provider network requirements
328.26or limitations.
328.27EFFECTIVE DATE.This section is effective January 1, 2018.

328.28    Sec. 48. Minnesota Statutes 2016, section 254B.01, subdivision 3, is amended to read:
328.29    Subd. 3. Chemical dependency Substance use disorder treatment services. "Chemical
328.30dependency Substance use disorder treatment services" means a planned program of care
328.31for the treatment of chemical dependency substance misuse or chemical abuse substance
328.32use disorder to minimize or prevent further chemical abuse substance misuse by the person.
329.1Diagnostic, evaluation, prevention, referral, detoxification, and aftercare services that are
329.2not part of a program of care licensable as a residential or nonresidential chemical dependency
329.3substance use disorder treatment program are not chemical dependency substance use
329.4disorder services for purposes of this section. For pregnant and postpartum women, chemical
329.5dependency substance use disorder services include halfway house services, aftercare
329.6services, psychological services, and case management.
329.7EFFECTIVE DATE.This section is effective January 1, 2018.

329.8    Sec. 49. Minnesota Statutes 2016, section 254B.01, is amended by adding a subdivision
329.9to read:
329.10    Subd. 8. Recovery community organization. "Recovery community organization"
329.11means an independent organization led and governed by representatives of local communities
329.12of recovery. A recovery community organization mobilizes resources within and outside
329.13of the recovery community to increase the prevalence and quality of long-term recovery
329.14from alcohol and other drug addiction. Recovery community organizations provide
329.15peer-based recovery support activities such as training of recovery peers. Recovery
329.16community organizations provide mentorship and ongoing support to individuals dealing
329.17with a substance use disorder and connect them with the resources that can support each
329.18person's recovery. A recovery community organization also promotes a recovery-focused
329.19orientation in community education and outreach programming, and organize
329.20recovery-focused policy advocacy activities to foster healthy communities and reduce the
329.21stigma of substance use disorder.
329.22EFFECTIVE DATE.This section is effective January 1, 2018.

329.23    Sec. 50. Minnesota Statutes 2016, section 254B.03, subdivision 2, is amended to read:
329.24    Subd. 2. Chemical dependency fund payment. (a) Payment from the chemical
329.25dependency fund is limited to payments for services other than detoxification licensed under
329.26Minnesota Rules, parts 9530.6510 to 9530.6590, that, if located outside of federally
329.27recognized tribal lands, would be required to be licensed by the commissioner as a chemical
329.28dependency treatment or rehabilitation program under sections 245A.01 to 245A.16, and
329.29services other than detoxification provided in another state that would be required to be
329.30licensed as a chemical dependency program if the program were in the state. Out of state
329.31vendors must also provide the commissioner with assurances that the program complies
329.32substantially with state licensing requirements and possesses all licenses and certifications
329.33required by the host state to provide chemical dependency treatment. Except for chemical
330.1dependency transitional rehabilitation programs, Vendors receiving payments from the
330.2chemical dependency fund must not require co-payment from a recipient of benefits for
330.3services provided under this subdivision. The vendor is prohibited from using the client's
330.4public benefits to offset the cost of services paid under this section. The vendor shall not
330.5require the client to use public benefits for room or board costs. This includes but is not
330.6limited to cash assistance benefits under chapters 119B, 256D, and 256J, or SNAP benefits.
330.7Retention of SNAP benefits is a right of a client receiving services through the consolidated
330.8chemical dependency treatment fund or through state contracted managed care entities.
330.9Payment from the chemical dependency fund shall be made for necessary room and board
330.10costs provided by vendors certified according to section 254B.05, or in a community hospital
330.11licensed by the commissioner of health according to sections 144.50 to 144.56 to a client
330.12who is:
330.13(1) determined to meet the criteria for placement in a residential chemical dependency
330.14treatment program according to rules adopted under section 254A.03, subdivision 3; and
330.15(2) concurrently receiving a chemical dependency treatment service in a program licensed
330.16by the commissioner and reimbursed by the chemical dependency fund.
330.17(b) A county may, from its own resources, provide chemical dependency services for
330.18which state payments are not made. A county may elect to use the same invoice procedures
330.19and obtain the same state payment services as are used for chemical dependency services
330.20for which state payments are made under this section if county payments are made to the
330.21state in advance of state payments to vendors. When a county uses the state system for
330.22payment, the commissioner shall make monthly billings to the county using the most recent
330.23available information to determine the anticipated services for which payments will be made
330.24in the coming month. Adjustment of any overestimate or underestimate based on actual
330.25expenditures shall be made by the state agency by adjusting the estimate for any succeeding
330.26month.
330.27(c) The commissioner shall coordinate chemical dependency services and determine
330.28whether there is a need for any proposed expansion of chemical dependency treatment
330.29services. The commissioner shall deny vendor certification to any provider that has not
330.30received prior approval from the commissioner for the creation of new programs or the
330.31expansion of existing program capacity. The commissioner shall consider the provider's
330.32capacity to obtain clients from outside the state based on plans, agreements, and previous
330.33utilization history, when determining the need for new treatment services.
330.34EFFECTIVE DATE.This section is effective January 1, 2018.

331.1    Sec. 51. Minnesota Statutes 2016, section 254B.04, subdivision 1, is amended to read:
331.2    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
331.3Regulations, title 25, part 20, and persons eligible for medical assistance benefits under
331.4sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 5, and 6, or who meet the
331.5income standards of section 256B.056, subdivision 4, are entitled to chemical dependency
331.6fund services. State money appropriated for this paragraph must be placed in a separate
331.7account established for this purpose.
331.8Persons with dependent children who are determined to be in need of chemical
331.9dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
331.10a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
331.11local agency to access needed treatment services. Treatment services must be appropriate
331.12for the individual or family, which may include long-term care treatment or treatment in a
331.13facility that allows the dependent children to stay in the treatment facility. The county shall
331.14pay for out-of-home placement costs, if applicable.
331.15(b) A person not entitled to services under paragraph (a), but with family income that
331.16is less than 215 percent of the federal poverty guidelines for the applicable family size, shall
331.17be eligible to receive chemical dependency fund services within the limit of funds
331.18appropriated for this group for the fiscal year. If notified by the state agency of limited
331.19funds, a county must give preferential treatment to persons with dependent children who
331.20are in need of chemical dependency treatment pursuant to an assessment under section
331.21626.556, subdivision 10 , or a case plan under section 260C.201, subdivision 6, or 260C.212.
331.22A county may spend money from its own sources to serve persons under this paragraph.
331.23State money appropriated for this paragraph must be placed in a separate account established
331.24for this purpose.
331.25(c) Persons whose income is between 215 percent and 412 percent of the federal poverty
331.26guidelines for the applicable family size shall be eligible for chemical dependency services
331.27on a sliding fee basis, within the limit of funds appropriated for this group for the fiscal
331.28year. Persons eligible under this paragraph must contribute to the cost of services according
331.29to the sliding fee scale established under subdivision 3. A county may spend money from
331.30its own sources to provide services to persons under this paragraph. State money appropriated
331.31for this paragraph must be placed in a separate account established for this purpose.
331.32EFFECTIVE DATE.This section is effective January 1, 2018.

332.1    Sec. 52. Minnesota Statutes 2016, section 254B.04, subdivision 2b, is amended to read:
332.2    Subd. 2b. Eligibility for placement in opioid treatment programs. (a) Notwithstanding
332.3provisions of Minnesota Rules, part 9530.6622, subpart 5, related to a placement authority's
332.4requirement to authorize services or service coordination in a program that complies with
332.5Minnesota Rules, part 9530.6500, or Code of Federal Regulations, title 42, part 8, and after
332.6taking into account an individual's preference for placement in an opioid treatment program,
332.7a placement authority may, but is not required to, authorize services or service coordination
332.8or otherwise place an individual in an opioid treatment program. Prior to making a
332.9determination of placement for an individual, the placing authority must consult with the
332.10current treatment provider, if any.
332.11(b) Prior to placement of an individual who is determined by the assessor to require
332.12treatment for opioid addiction, the assessor must provide educational information concerning
332.13treatment options for opioid addiction, including the use of a medication for the use of
332.14opioid addiction. The commissioner shall develop educational materials supported by
332.15research and updated periodically that must be used by assessors to comply with this
332.16requirement.
332.17EFFECTIVE DATE.This section is effective January 1, 2018.

332.18    Sec. 53. Minnesota Statutes 2016, section 254B.05, subdivision 1, is amended to read:
332.19    Subdivision 1. Licensure required. (a) Programs licensed by the commissioner are
332.20eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
332.21notwithstanding the provisions of section 245A.03. American Indian programs that provide
332.22chemical dependency primary substance use disorder treatment, extended care, transitional
332.23residence, or outpatient treatment services, and are licensed by tribal government are eligible
332.24vendors.
332.25(b) On July 1, 2018, or upon federal approval, whichever is later, a licensed professional
332.26in private practice who meets the requirements of section 245G.11, subdivisions 1 and 4,
332.27is an eligible vendor of a comprehensive assessment and assessment summary provided
332.28according to section 245G.05, and treatment services provided according to sections 245G.06
332.29and 245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2.
332.30(c) On July 1, 2018, or upon federal approval, whichever is later, a county is an eligible
332.31vendor for a comprehensive assessment and assessment summary when provided by an
332.32individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 4, and
332.33completed according to the requirements of section 245G.05. A county is an eligible vendor
333.1of care coordination services when provided by an individual who meets the staffing
333.2credentials of section 245G.11, subdivisions 1 and 7, and provided according to the
333.3requirements of section 245G.07, subdivision 1, clause (7).
333.4(d) On July 1, 2018, or upon federal approval, whichever is later, a recovery community
333.5organization that meets certification requirements identified by the commissioner is an
333.6eligible vendor of peer support services.
333.7(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
333.89530.6590, are not eligible vendors. Programs that are not licensed as a chemical dependency
333.9residential or nonresidential substance use disorder treatment or withdrawal management
333.10program by the commissioner or by tribal government or do not meet the requirements of
333.11subdivisions 1a and 1b are not eligible vendors.
333.12EFFECTIVE DATE.This section is effective January 1, 2018.

333.13    Sec. 54. Minnesota Statutes 2016, section 254B.05, subdivision 1a, is amended to read:
333.14    Subd. 1a. Room and board provider requirements. (a) Effective January 1, 2000,
333.15vendors of room and board are eligible for chemical dependency fund payment if the vendor:
333.16(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
333.17while residing in the facility and provide consequences for infractions of those rules;
333.18(2) is determined to meet applicable health and safety requirements;
333.19(3) is not a jail or prison;
333.20(4) is not concurrently receiving funds under chapter 256I for the recipient;
333.21(5) admits individuals who are 18 years of age or older;
333.22(6) is registered as a board and lodging or lodging establishment according to section
333.23157.17 ;
333.24(7) has awake staff on site 24 hours per day;
333.25(8) has staff who are at least 18 years of age and meet the requirements of Minnesota
333.26Rules, part 9530.6450, subpart 1, item A section 245G.11, subdivision 1, paragraph (a);
333.27(9) has emergency behavioral procedures that meet the requirements of Minnesota Rules,
333.28part 9530.6475 section 245G.16;
333.29(10) meets the requirements of Minnesota Rules, part 9530.6435, subparts 3 and 4, items
333.30A and B section 245G.08, subdivision 5, if administering medications to clients;
334.1(11) meets the abuse prevention requirements of section 245A.65, including a policy on
334.2fraternization and the mandatory reporting requirements of section 626.557;
334.3(12) documents coordination with the treatment provider to ensure compliance with
334.4section 254B.03, subdivision 2;
334.5(13) protects client funds and ensures freedom from exploitation by meeting the
334.6provisions of section 245A.04, subdivision 13;
334.7(14) has a grievance procedure that meets the requirements of Minnesota Rules, part
334.89530.6470, subpart 2 section 245G.15, subdivision 2; and
334.9(15) has sleeping and bathroom facilities for men and women separated by a door that
334.10is locked, has an alarm, or is supervised by awake staff.
334.11(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
334.12paragraph (a), clauses (5) to (15).
334.13EFFECTIVE DATE.This section is effective January 1, 2018.

334.14    Sec. 55. Minnesota Statutes 2016, section 254B.05, subdivision 5, is amended to read:
334.15    Subd. 5. Rate requirements. (a) The commissioner shall establish rates for chemical
334.16dependency substance use disorder services and service enhancements funded under this
334.17chapter.
334.18(b) Eligible chemical dependency substance use disorder treatment services include:
334.19(1) outpatient treatment services that are licensed according to Minnesota Rules, parts
334.209530.6405 to 9530.6480 sections 245G.01 to 245G.17, or applicable tribal license;
334.21(2) on July 1, 2018, or upon federal approval, whichever is later, comprehensive
334.22assessments provided according to sections 245.4863, paragraph (a), and 245G.05, and
334.23Minnesota Rules, part 9530.6422;
334.24(3) on July 1, 2018, or upon federal approval, whichever is later, care coordination
334.25services provided according to section 245G.07, subdivision 1, paragraph (a), clause (6);
334.26(4) on July 1, 2018, or upon federal approval, whichever is later, peer recovery support
334.27services provided according to section 245G.07, subdivision 1, paragraph (a), clause (5);
334.28(5) on July 1, 2018, or upon federal approval, whichever is later, withdrawal management
334.29services provided according to chapter 245F;
335.1(2) (6) medication-assisted therapy services that are licensed according to Minnesota
335.2Rules, parts 9530.6405 to 9530.6480 and 9530.6500 section 245G.07, subdivision 1, or
335.3applicable tribal license;
335.4(3) (7) medication-assisted therapy plus enhanced treatment services that meet the
335.5requirements of clause (2) (6) and provide nine hours of clinical services each week;
335.6(4) (8) high, medium, and low intensity residential treatment services that are licensed
335.7according to Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, sections
335.8245G.01 to 245G.17 and 245G.22 or applicable tribal license which provide, respectively,
335.930, 15, and five hours of clinical services each week;
335.10(5) (9) hospital-based treatment services that are licensed according to Minnesota Rules,
335.11parts 9530.6405 to 9530.6480, sections 245G.01 to 245G.17 or applicable tribal license and
335.12licensed as a hospital under sections 144.50 to 144.56;
335.13(6) (10) adolescent treatment programs that are licensed as outpatient treatment programs
335.14according to Minnesota Rules, parts 9530.6405 to 9530.6485, sections 245G.01 to 245G.18
335.15or as residential treatment programs according to Minnesota Rules, parts 2960.0010 to
335.162960.0220, and 2960.0430 to 2960.0490, or applicable tribal license;
335.17(7) (11) high-intensity residential treatment services that are licensed according to
335.18Minnesota Rules, parts 9530.6405 to 9530.6480 and 9530.6505, sections 245G.01 to 245G.17
335.19and 245G.21 or applicable tribal license, which provide 30 hours of clinical services each
335.20week provided by a state-operated vendor or to clients who have been civilly committed to
335.21the commissioner, present the most complex and difficult care needs, and are a potential
335.22threat to the community; and
335.23(8) (12) room and board facilities that meet the requirements of subdivision 1a.
335.24(c) The commissioner shall establish higher rates for programs that meet the requirements
335.25of paragraph (b) and one of the following additional requirements:
335.26(1) programs that serve parents with their children if the program:
335.27(i) provides on-site child care during the hours of treatment activity that:
335.28(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
335.299503; or
335.30(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
335.31(a), clause (6), and meets the requirements under Minnesota Rules, part 9530.6490, subpart
335.324 section 245G.19, subdivision 4; or
336.1(ii) arranges for off-site child care during hours of treatment activity at a facility that is
336.2licensed under chapter 245A as:
336.3(A) a child care center under Minnesota Rules, chapter 9503; or
336.4(B) a family child care home under Minnesota Rules, chapter 9502;
336.5(2) culturally specific programs as defined in section 254B.01, subdivision 4a, or
336.6programs or subprograms serving special populations, if the program or subprogram meets
336.7the following requirements:
336.8(i) is designed to address the unique needs of individuals who share a common language,
336.9racial, ethnic, or social background;
336.10(ii) is governed with significant input from individuals of that specific background; and
336.11(iii) employs individuals to provide individual or group therapy, at least 50 percent of
336.12whom are of that specific background, except when the common social background of the
336.13individuals served is a traumatic brain injury or cognitive disability and the program employs
336.14treatment staff who have the necessary professional training, as approved by the
336.15commissioner, to serve clients with the specific disabilities that the program is designed to
336.16serve;
336.17(3) programs that offer medical services delivered by appropriately credentialed health
336.18care staff in an amount equal to two hours per client per week if the medical needs of the
336.19client and the nature and provision of any medical services provided are documented in the
336.20client file; and
336.21(4) programs that offer services to individuals with co-occurring mental health and
336.22chemical dependency problems if:
336.23(i) the program meets the co-occurring requirements in Minnesota Rules, part 9530.6495
336.24section 245G.20;
336.25(ii) 25 percent of the counseling staff are licensed mental health professionals, as defined
336.26in section 245.462, subdivision 18, clauses (1) to (6), or are students or licensing candidates
336.27under the supervision of a licensed alcohol and drug counselor supervisor and licensed
336.28mental health professional, except that no more than 50 percent of the mental health staff
336.29may be students or licensing candidates with time documented to be directly related to
336.30provisions of co-occurring services;
336.31(iii) clients scoring positive on a standardized mental health screen receive a mental
336.32health diagnostic assessment within ten days of admission;
337.1(iv) the program has standards for multidisciplinary case review that include a monthly
337.2review for each client that, at a minimum, includes a licensed mental health professional
337.3and licensed alcohol and drug counselor, and their involvement in the review is documented;
337.4(v) family education is offered that addresses mental health and substance abuse disorders
337.5and the interaction between the two; and
337.6(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
337.7training annually.
337.8(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
337.9that provides arrangements for off-site child care must maintain current documentation at
337.10the chemical dependency facility of the child care provider's current licensure to provide
337.11child care services. Programs that provide child care according to paragraph (c), clause (1),
337.12must be deemed in compliance with the licensing requirements in Minnesota Rules, part
337.139530.6490 section 245G.19.
337.14(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
337.15parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
337.16in paragraph (c), clause (4), items (i) to (iv).
337.17(f) Subject to federal approval, chemical dependency services that are otherwise covered
337.18as direct face-to-face services may be provided via two-way interactive video. The use of
337.19two-way interactive video must be medically appropriate to the condition and needs of the
337.20person being served. Reimbursement shall be at the same rates and under the same conditions
337.21that would otherwise apply to direct face-to-face services. The interactive video equipment
337.22and connection must comply with Medicare standards in effect at the time the service is
337.23provided.
337.24EFFECTIVE DATE.This section is effective January 1, 2018.

337.25    Sec. 56. Minnesota Statutes 2016, section 254B.051, is amended to read:
337.26254B.051 SUBSTANCE ABUSE USE DISORDER TREATMENT
337.27EFFECTIVENESS.
337.28    In addition to the substance abuse use disorder treatment program performance outcome
337.29measures that the commissioner of human services collects annually from treatment providers,
337.30the commissioner shall request additional data from programs that receive appropriations
337.31from the consolidated chemical dependency treatment fund. This data shall include number
337.32of client readmissions six months after release from inpatient treatment, and the cost of
338.1treatment per person for each program receiving consolidated chemical dependency treatment
338.2funds. The commissioner may post this data on the department Web site.
338.3EFFECTIVE DATE.This section is effective January 1, 2018.

338.4    Sec. 57. Minnesota Statutes 2016, section 254B.07, is amended to read:
338.5254B.07 THIRD-PARTY LIABILITY.
338.6The state agency provision and payment of, or liability for, chemical dependency
338.7substance use disorder medical care is the same as in section 256B.042.
338.8EFFECTIVE DATE.This section is effective January 1, 2018.

338.9    Sec. 58. Minnesota Statutes 2016, section 254B.08, is amended to read:
338.10254B.08 FEDERAL WAIVERS.
338.11The commissioner shall apply for any federal waivers necessary to secure, to the extent
338.12allowed by law, federal financial participation for the provision of services to persons who
338.13need chemical dependency substance use disorder services. The commissioner may seek
338.14amendments to the waivers or apply for additional waivers to contain costs. The
338.15commissioner shall ensure that payment for the cost of providing chemical dependency
338.16substance use disorder services under the federal waiver plan does not exceed the cost of
338.17chemical dependency substance use disorder services that would have been provided without
338.18the waivered services.
338.19EFFECTIVE DATE.This section is effective January 1, 2018.

338.20    Sec. 59. Minnesota Statutes 2016, section 254B.09, is amended to read:
338.21254B.09 INDIAN RESERVATION ALLOCATION OF CHEMICAL
338.22DEPENDENCY FUND.
338.23    Subdivision 1. Vendor payments. The commissioner shall pay eligible vendors for
338.24chemical dependency substance use disorder services to American Indians on the same
338.25basis as other payments, except that no local match is required when an invoice is submitted
338.26by the governing authority of a federally recognized American Indian tribal body or a county
338.27if the tribal governing body has not entered into an agreement under subdivision 2 on behalf
338.28of a current resident of the reservation under this section.
338.29    Subd. 2. American Indian agreements. The commissioner may enter into agreements
338.30with federally recognized tribal units to pay for chemical dependency substance use disorder
339.1treatment services provided under Laws 1986, chapter 394, sections 8 to 20. The agreements
339.2must clarify how the governing body of the tribal unit fulfills local agency responsibilities
339.3regarding:
339.4(1) the form and manner of invoicing; and
339.5(2) provide that only invoices for eligible vendors according to section 254B.05 will be
339.6included in invoices sent to the commissioner for payment, to the extent that money allocated
339.7under subdivisions 4 and 5 is used.
339.8    Subd. 6. American Indian tribal placements. After entering into an agreement under
339.9subdivision 2, the governing authority of each reservation may submit invoices to the state
339.10for the cost of providing chemical dependency substance use disorder services to residents
339.11of the reservation according to the placement rules governing county placements, except
339.12that local match requirements are waived. The governing body may designate an agency to
339.13act on its behalf to provide placement services and manage invoices by written notice to
339.14the commissioner and evidence of agreement by the agency designated.
339.15    Subd. 8. Payments to improve services to American Indians. The commissioner may
339.16set rates for chemical dependency substance use disorder services to American Indians
339.17according to the American Indian Health Improvement Act, Public Law 94-437, for eligible
339.18vendors. These rates shall supersede rates set in county purchase of service agreements
339.19when payments are made on behalf of clients eligible according to Public Law 94-437.
339.20EFFECTIVE DATE.This section is effective January 1, 2018.

339.21    Sec. 60. Minnesota Statutes 2016, section 254B.12, subdivision 2, is amended to read:
339.22    Subd. 2. Payment methodology for highly specialized vendors. Notwithstanding
339.23subdivision 1, the commissioner shall seek federal authority to develop separate payment
339.24methodologies for chemical dependency substance use disorder treatment services provided
339.25under the consolidated chemical dependency treatment fund: (1) by a state-operated vendor;
339.26or (2) for persons who have been civilly committed to the commissioner, present the most
339.27complex and difficult care needs, and are a potential threat to the community. A payment
339.28methodology under this subdivision is effective for services provided on or after October
339.291, 2015, or on or after the receipt of federal approval, whichever is later.
339.30EFFECTIVE DATE.This section is effective January 1, 2018.

340.1    Sec. 61. Minnesota Statutes 2016, section 254B.12, is amended by adding a subdivision
340.2to read:
340.3    Subd. 3. Chemical dependency provider rate increase. For the chemical dependency
340.4services listed in section 254B.05, subdivision 5, and provided on or after July 1, 2017,
340.5payment rates shall be increased by three percent over the rates in effect on January 1, 2017,
340.6for vendors who meet the requirements of section 254B.05.

340.7    Sec. 62. Minnesota Statutes 2016, section 254B.13, subdivision 2a, is amended to read:
340.8    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for participation
340.9in a navigator pilot program, an individual must:
340.10(1) be a resident of a county with an approved navigator program;
340.11(2) be eligible for consolidated chemical dependency treatment fund services;
340.12(3) be a voluntary participant in the navigator program;
340.13(4) satisfy one of the following items:
340.14(i) have at least one severity rating of three or above in dimension four, five, or six in a
340.15comprehensive assessment under Minnesota Rules, part 9530.6422 section 245G.05,
340.16paragraph (c), clauses (4) to (6); or
340.17(ii) have at least one severity rating of two or above in dimension four, five, or six in a
340.18comprehensive assessment under Minnesota Rules, part 9530.6422, section 245G.05,
340.19paragraph (c), clauses (4) to (6), and be currently participating in a Rule 31 treatment program
340.20under Minnesota Rules, parts 9530.6405 to 9530.6505, chapter 245G or be within 60 days
340.21following discharge after participation in a Rule 31 treatment program; and
340.22(5) have had at least two treatment episodes in the past two years, not limited to episodes
340.23reimbursed by the consolidated chemical dependency treatment funds. An admission to an
340.24emergency room, a detoxification program, or a hospital may be substituted for one treatment
340.25episode if it resulted from the individual's substance use disorder.
340.26(b) New eligibility criteria may be added as mutually agreed upon by the commissioner
340.27and participating navigator programs.
340.28EFFECTIVE DATE.This section is effective January 1, 2018.

341.1    Sec. 63. Minnesota Statutes 2016, section 256B.0625, subdivision 45a, is amended to
341.2read:
341.3    Subd. 45a. Psychiatric residential treatment facility services for persons under 21
341.4years of age. (a) Medical assistance covers psychiatric residential treatment facility services,
341.5according to section 256B.0941, for persons under younger than 21 years of age. Individuals
341.6who reach age 21 at the time they are receiving services are eligible to continue receiving
341.7services until they no longer require services or until they reach age 22, whichever occurs
341.8first.
341.9(b) For purposes of this subdivision, "psychiatric residential treatment facility" means
341.10a facility other than a hospital that provides psychiatric services, as described in Code of
341.11Federal Regulations, title 42, sections 441.151 to 441.182, to individuals under age 21 in
341.12an inpatient setting.
341.13(c) The commissioner shall develop admissions and discharge procedures and establish
341.14rates consistent with guidelines from the federal Centers for Medicare and Medicaid Services.
341.15(d) The commissioner shall enroll up to 150 certified psychiatric residential treatment
341.16facility services beds at up to six sites. The commissioner shall select psychiatric residential
341.17treatment facility services providers through a request for proposals process. Providers of
341.18state-operated services may respond to the request for proposals.
341.19EFFECTIVE DATE.This section is effective the day following final enactment.

341.20    Sec. 64. [256B.0941] PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY
341.21FOR PERSONS UNDER 21 YEARS OF AGE.
341.22    Subdivision 1. Eligibility. (a) An individual who is eligible for mental health treatment
341.23services in a psychiatric residential treatment facility must meet all of the following criteria:
341.24(1) before admission, services are determined to be medically necessary by the state's
341.25medical review agent according to Code of Federal Regulations, title 42, section 441.152;
341.26(2) is younger than 21 years of age at the time of admission. Services may continue until
341.27the individual meets criteria for discharge or reaches 22 years of age, whichever occurs
341.28first;
341.29(3) has a mental health diagnosis as defined in the most recent edition of the Diagnostic
341.30and Statistical Manual for Mental Disorders, as well as clinical evidence of severe aggression,
341.31or a finding that the individual is a risk to self or others;
342.1(4) has functional impairment and a history of difficulty in functioning safely and
342.2successfully in the community, school, home, or job; an inability to adequately care for
342.3one's physical needs; or caregivers, guardians, or family members are unable to safely fulfill
342.4the individual's needs;
342.5(5) requires psychiatric residential treatment under the direction of a physician to improve
342.6the individual's condition or prevent further regression so that services will no longer be
342.7needed;
342.8(6) utilized and exhausted other community-based mental health services, or clinical
342.9evidence indicates that such services cannot provide the level of care needed; and
342.10(7) was referred for treatment in a psychiatric residential treatment facility by a qualified
342.11mental health professional licensed as defined in section 245.4871, subdivision 27, clauses
342.12(1) to (6).
342.13(b) A mental health professional making a referral shall submit documentation to the
342.14state's medical review agent containing all information necessary to determine medical
342.15necessity, including a standard diagnostic assessment completed within 180 days of the
342.16individual's admission. Documentation shall include evidence of family participation in the
342.17individual's treatment planning and signed consent for services.
342.18    Subd. 2. Services. Psychiatric residential treatment facility service providers must offer
342.19and have the capacity to provide the following services:
342.20(1) development of the individual plan of care, review of the individual plan of care
342.21every 30 days, and discharge planning by required members of the treatment team according
342.22to Code of Federal Regulations, title 42, sections 441.155 to 441.156;
342.23(2) any services provided by a psychiatrist or physician for development of an individual
342.24plan of care, conducting a review of the individual plan of care every 30 days, and discharge
342.25planning by required members of the treatment team according to Code of Federal
342.26Regulations, title 42, sections 441.155 to 441.156;
342.27(3) active treatment seven days per week that may include individual, family, or group
342.28therapy as determined by the individual care plan;
342.29(4) individual therapy, provided a minimum of twice per week;
342.30(5) family engagement activities, provided a minimum of once per week;
343.1(6) consultation with other professionals, including case managers, primary care
343.2professionals, community-based mental health providers, school staff, or other support
343.3planners;
343.4(7) coordination of educational services between local and resident school districts and
343.5the facility;
343.6(8) 24-hour nursing; and
343.7(9) direct care and supervision, supportive services for daily living and safety, and
343.8positive behavior management.
343.9    Subd. 3. Per diem rate. (a) The commissioner shall establish a statewide per diem rate
343.10for psychiatric residential treatment facility services for individuals 21 years of age or
343.11younger. The rate for a provider must not exceed the rate charged by that provider for the
343.12same service to other payers. Payment must not be made to more than one entity for each
343.13individual for services provided under this section on a given day. The commissioner shall
343.14set rates prospectively for the annual rate period. The commissioner shall require providers
343.15to submit annual cost reports on a uniform cost reporting form and shall use submitted cost
343.16reports to inform the rate-setting process. The cost reporting shall be done according to
343.17federal requirements for Medicare cost reports.
343.18(b) The following are included in the rate:
343.19(1) costs necessary for licensure and accreditation, meeting all staffing standards for
343.20participation, meeting all service standards for participation, meeting all requirements for
343.21active treatment, maintaining medical records, conducting utilization review, meeting
343.22inspection of care, and discharge planning. The direct services costs must be determined
343.23using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
343.24and service-related transportation; and
343.25(2) payment for room and board provided by facilities meeting all accreditation and
343.26licensing requirements for participation.
343.27(c) A facility may submit a claim for payment outside of the per diem for professional
343.28services arranged by and provided at the facility by an appropriately licensed professional
343.29who is enrolled as a provider with Minnesota health care programs. Arranged services must
343.30be billed by the facility on a separate claim, and the facility shall be responsible for payment
343.31to the provider. These services must be included in the individual plan of care and are subject
343.32to prior authorization by the state's medical review agent.
344.1(d) Medicaid shall reimburse for concurrent services as approved by the commissioner
344.2to support continuity of care and successful discharge from the facility. "Concurrent services"
344.3means services provided by another entity or provider while the individual is admitted to a
344.4psychiatric residential treatment facility. Payment for concurrent services may be limited
344.5and these services are subject to prior authorization by the state's medical review agent.
344.6Concurrent services may include targeted case management, assertive community treatment,
344.7clinical care consultation, team consultation, and treatment planning.
344.8(e) Payment rates under this subdivision shall not include the costs of providing the
344.9following services:
344.10(1) educational services;
344.11(2) acute medical care or specialty services for other medical conditions;
344.12(3) dental services; and
344.13(4) pharmacy drug costs.
344.14(f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
344.15reasonable, and consistent with federal reimbursement requirements in Code of Federal
344.16Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
344.17Management and Budget Circular Number A-122, relating to nonprofit entities.
344.18    Subd. 4. Leave days. (a) Medical assistance covers therapeutic and hospital leave days,
344.19provided the recipient was not discharged from the psychiatric residential treatment facility
344.20and is expected to return to the psychiatric residential treatment facility. A reserved bed
344.21must be held for a recipient on hospital leave or therapeutic leave.
344.22(b) A therapeutic leave day to home shall be used to prepare for discharge and
344.23reintegration and shall be included in the individual plan of care. The state shall reimburse
344.2475 percent of the per diem rate for a reserve bed day while the recipient is on therapeutic
344.25leave. A therapeutic leave visit may not exceed three days without prior authorization.
344.26(c) A hospital leave day shall be a day for which a recipient has been admitted to a
344.27hospital for medical or acute psychiatric care and is temporarily absent from the psychiatric
344.28residential treatment facility. The state shall reimburse 50 percent of the per diem rate for
344.29a reserve bed day while the recipient is receiving medical or psychiatric care in a hospital.
344.30EFFECTIVE DATE.This section is effective the day following final enactment.

345.1    Sec. 65. Minnesota Statutes 2016, section 256B.0943, subdivision 13, is amended to read:
345.2    Subd. 13. Exception to excluded services. Notwithstanding subdivision 12, up to 15
345.3hours of children's therapeutic services and supports provided within a six-month period to
345.4a child with severe emotional disturbance who is residing in a hospital; a group home as
345.5defined in Minnesota Rules, parts 2960.0130 to 2960.0220; a residential treatment facility
345.6licensed under Minnesota Rules, parts 2960.0580 to 2960.0690; a psychiatric residential
345.7treatment facility under section 256B.0625, subdivision 45a; a regional treatment center;
345.8or other institutional group setting or who is participating in a program of partial
345.9hospitalization are eligible for medical assistance payment if part of the discharge plan.
345.10EFFECTIVE DATE.This section is effective the day following final enactment.

345.11    Sec. 66. Minnesota Statutes 2016, section 256B.0945, subdivision 2, is amended to read:
345.12    Subd. 2. Covered services. All services must be included in a child's individualized
345.13treatment or multiagency plan of care as defined in chapter 245.
345.14For facilities that are not institutions for mental diseases according to federal statute and
345.15regulation, medical assistance covers mental health-related services that are required to be
345.16provided by a residential facility under section 245.4882 and administrative rules promulgated
345.17thereunder, except for room and board. For residential facilities determined by the federal
345.18Centers for Medicare and Medicaid Services to be an institution for mental diseases, medical
345.19assistance covers medically necessary mental health services provided by the facility
345.20according to section 256B.055, subdivision 13, except for room and board.

345.21    Sec. 67. Minnesota Statutes 2016, section 256B.0945, subdivision 4, is amended to read:
345.22    Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041, payments
345.23to counties for residential services provided under this section by a residential facility shall:
345.24(1) for services provided by a residential facility that is not an institution for mental
345.25diseases, only be made of federal earnings for services provided under this section, and the
345.26nonfederal share of costs for services provided under this section shall be paid by the county
345.27from sources other than federal funds or funds used to match other federal funds. Payment
345.28to counties for services provided according to this section shall be a proportion of the per
345.29day contract rate that relates to rehabilitative mental health services and shall not include
345.30payment for costs or services that are billed to the IV-E program as room and board.; and
345.31(2) for services provided by a residential facility that is determined to be an institution
345.32for mental diseases, be equivalent to the federal share of the payment that would have been
346.1made if the residential facility were not an institution for mental diseases. The portion of
346.2the payment representing what would be the nonfederal shares shall be paid by the county.
346.3Payment to counties for services provided according to this section shall be a proportion of
346.4the per day contract rate that relates to rehabilitative mental health services and shall not
346.5include payment for costs or services that are billed to the IV-E program as room and board.
346.6    (b) Per diem rates paid to providers under this section by prepaid plans shall be the
346.7proportion of the per-day contract rate that relates to rehabilitative mental health services
346.8and shall not include payment for group foster care costs or services that are billed to the
346.9county of financial responsibility. Services provided in facilities located in bordering states
346.10are eligible for reimbursement on a fee-for-service basis only as described in paragraph (a)
346.11and are not covered under prepaid health plans.
346.12    (c) Payment for mental health rehabilitative services provided under this section by or
346.13under contract with an American Indian tribe or tribal organization or by agencies operated
346.14by or under contract with an American Indian tribe or tribal organization must be made
346.15according to section 256B.0625, subdivision 34, or other relevant federally approved
346.16rate-setting methodology.
346.17(d) The commissioner shall set aside a portion not to exceed five percent of the federal
346.18funds earned for county expenditures under this section to cover the state costs of
346.19administering this section. Any unexpended funds from the set-aside shall be distributed to
346.20the counties in proportion to their earnings under this section.

346.21    Sec. 68. Minnesota Statutes 2016, section 256B.763, is amended to read:
346.22256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
346.23    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007, payment
346.24rates shall be increased by 23.7 percent over the rates in effect on January 1, 2006, for:
346.25    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
346.26    (2) community mental health centers under section 256B.0625, subdivision 5; and
346.27    (3) mental health clinics and centers certified under Minnesota Rules, parts 9520.0750
346.28to 9520.0870, or hospital outpatient psychiatric departments that are designated as essential
346.29community providers under section 62Q.19.
346.30    (b) This increase applies to group skills training when provided as a component of
346.31children's therapeutic services and support, psychotherapy, medication management,
347.1evaluation and management, diagnostic assessment, explanation of findings, psychological
347.2testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.
347.3    (c) This increase does not apply to rates that are governed by section 256B.0625,
347.4subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated
347.5with the county, rates that are established by the federal government, or rates that increased
347.6between January 1, 2004, and January 1, 2005.
347.7    (d) The commissioner shall adjust rates paid to prepaid health plans under contract with
347.8the commissioner to reflect the rate increases provided in paragraphs (a), (e), and (f). The
347.9prepaid health plan must pass this rate increase to the providers identified in paragraphs (a),
347.10(e), (f), and (g).
347.11    (e) Payment rates shall be increased by 23.7 percent over the rates in effect on December
347.1231, 2007, for:
347.13    (1) medication education services provided on or after January 1, 2008, by adult
347.14rehabilitative mental health services providers certified under section 256B.0623; and
347.15    (2) mental health behavioral aide services provided on or after January 1, 2008, by
347.16children's therapeutic services and support providers certified under section 256B.0943.
347.17    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
347.18children's therapeutic services and support providers certified under section 256B.0943 and
347.19not already included in paragraph (a), payment rates shall be increased by 23.7 percent over
347.20the rates in effect on December 31, 2007.
347.21    (g) Payment rates shall be increased by 2.3 percent over the rates in effect on December
347.2231, 2007, for individual and family skills training provided on or after January 1, 2008, by
347.23children's therapeutic services and support providers certified under section 256B.0943.
347.24(h) For services described in paragraphs (b), (e), and (g) and rendered on or after July
347.251, 2017, payment rates for mental health clinics and centers certified under Minnesota Rules,
347.26parts 9520.0750 to 9520.0870, that are not designated as essential community providers
347.27under section 62Q.19 shall be equal to payment rates for mental health clinics and centers
347.28certified under Minnesota Rules, parts 9520.0750 to 9520.0870, that are designated as
347.29essential community providers under section 62Q.19. In order to receive increased payment
347.30rates under this paragraph, a provider must demonstrate a commitment to serve low-income
347.31and underserved populations by:
347.32(1) charging for services on a sliding-fee schedule based on current poverty income
347.33guidelines; and
348.1(2) not restricting access or services because of a client's financial limitation.

348.2    Sec. 69. CHILDREN'S MENTAL HEALTH REPORT AND RECOMMENDATIONS.
348.3The commissioner of human services shall conduct a comprehensive analysis of
348.4Minnesota's continuum of intensive mental health services and shall develop
348.5recommendations for a sustainable and community-driven continuum of care for children
348.6with serious mental health needs, including children currently being served in residential
348.7treatment. The commissioner's analysis shall include, but not be limited to:
348.8(1) data related to access, utilization, efficacy, and outcomes for Minnesota's current
348.9system of residential mental health treatment for a child with a severe emotional disturbance;
348.10(2) potential expansion of the state's psychiatric residential treatment facility (PRTF)
348.11capacity, including increasing the number of PRTF beds and conversion of existing children's
348.12mental health residential treatment programs into PRTFs;
348.13(3) the capacity need for PRTF and other group settings within the state if adequate
348.14community-based alternatives are accessible, equitable, and effective statewide;
348.15(4) recommendations for expanding alternative community-based service models to
348.16meet the needs of a child with a serious mental health disorder who would otherwise require
348.17residential treatment and potential service models that could be utilized, including data
348.18related to access, utilization, efficacy, and outcomes;
348.19(5) models of care used in other states; and
348.20(6) analysis and specific recommendations for the design and implementation of new
348.21service models, including analysis to inform rate setting as necessary.
348.22The analysis shall be supported and informed by extensive stakeholder engagement.
348.23Stakeholders include individuals who receive services, family members of individuals who
348.24receive services, providers, counties, health plans, advocates, and others. Stakeholder
348.25engagement shall include interviews with key stakeholders, intentional outreach to individuals
348.26who receive services and the individual's family members, and regional listening sessions.
348.27The commissioner shall provide a report with specific recommendations and timelines
348.28for implementation to the legislative committees with jurisdiction over children's mental
348.29health policy and finance by November 15, 2018.

349.1    Sec. 70. RESIDENTIAL TREATMENT AND PAYMENT RATE REFORM.
349.2The commissioner shall contract with an outside expert to identify recommendations
349.3for the development of a substance use disorder residential treatment program model and
349.4payment structure that is not subject to the federal institutions for mental diseases exclusion
349.5and that is financially sustainable for providers, while incentivizing best practices and
349.6improved treatment outcomes. The analysis must include recommendations and a timeline
349.7for supporting providers to transition to the new models of care delivery. No later than
349.8December 15, 2018, the commissioner shall deliver a report with recommendations to the
349.9chairs and ranking minority members of the legislative committees with jurisdiction over
349.10health and human services policy and finance.

349.11    Sec. 71. REVISOR'S INSTRUCTION.
349.12In Minnesota Statutes and Minnesota Rules, the revisor of statutes, in consultation with
349.13the with the Department of Human Services, shall make necessary cross-reference changes
349.14that are needed as a result of the enactment of sections 7 to 28 and 70. The revisor shall
349.15make any necessary technical and grammatical changes to preserve the meaning of the text.
349.16EFFECTIVE DATE.This section is effective the day following final enactment.

349.17    Sec. 72. REPEALER.
349.18(a) Minnesota Statutes 2016, sections 245A.1915; 245A.192; and 254A.02, subdivision
349.194, are repealed.
349.20(b) Minnesota Rules, parts 9530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11,
349.2112, 13, 14, 14a, 15, 15a, 16, 17, 17a, 17b, 17c, 18, 20, and 21; 9530.6410; 9530.6415;
349.229530.6420; 9530.6422; 9530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445;
349.239530.6450; 9530.6455; 9530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480;
349.249530.6485; 9530.6490; 9530.6495; 9530.6500; and 9530.6505, are repealed.
349.25(c) Minnesota Statutes 2016, section 256B.7631, is repealed.
349.26EFFECTIVE DATE.Paragraphs (a) and (b) are effective January 1, 2018. Paragraph
349.27(c) is effective the day following final enactment.

349.28ARTICLE 9

349.29OPERATIONS

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

350.3    Sec. 2. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to
350.4read:
350.5    Subd. 2c. Annual or annually; family child care training requirements. For the
350.6purposes of section 245A.50, subdivisions 1 to 9, "annual" or "annually" means the 12-month
350.7period beginning on the license effective date or the annual anniversary of the effective date
350.8and ending on the day prior to the annual anniversary of the license effective date.

350.9    Sec. 3. Minnesota Statutes 2016, section 245A.04, subdivision 4, is amended to read:
350.10    Subd. 4. Inspections; waiver. (a) Before issuing an initial license, the commissioner
350.11shall conduct an inspection of the program. The inspection must include but is not limited
350.12to:
350.13(1) an inspection of the physical plant;
350.14(2) an inspection of records and documents;
350.15(3) an evaluation of the program by consumers of the program; and
350.16(4) observation of the program in operation.
350.17For the purposes of this subdivision, "consumer" means a person who receives the
350.18services of a licensed program, the person's legal guardian, or the parent or individual having
350.19legal custody of a child who receives the services of a licensed program.
350.20(b) The evaluation required in paragraph (a), clause (3), or the observation in paragraph
350.21(a), clause (4), is not required prior to issuing an initial license under subdivision 7. If the
350.22commissioner issues an initial license under subdivision 7, these requirements must be
350.23completed within one year after the issuance of an initial license.
350.24(c) Before completing a licensing inspection in a family child care program or child care
350.25center, the licensing agency must offer the license holder an exit interview to discuss
350.26violations of law or rule observed during the inspection and offer technical assistance on
350.27how to comply with applicable laws and rules. Nothing in this paragraph limits the ability
350.28of the commissioner to issue a correction order or negative action for violations of law or
350.29rule not discussed in an exit interview or in the event that a license holder chooses not to
350.30participate in an exit interview.
350.31EFFECTIVE DATE.This section is effective October 1, 2017.

351.1    Sec. 4. 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
351.3believes that the contents of the commissioner's correction order are in error, the applicant
351.4or license holder may ask the Department of Human Services to reconsider the parts of the
351.5correction order that are alleged to be in error. The request for reconsideration must be made
351.6in writing and must be postmarked and sent to the commissioner within 20 calendar days
351.7after 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.
351.11A request for reconsideration does not stay any provisions or requirements of the
351.12correction order. The commissioner's disposition of a request for reconsideration is final
351.13and not subject to appeal under chapter 14.
351.14(b) This paragraph applies only to licensed family child care providers. A licensed family
351.15child care provider who requests reconsideration of a correction order under paragraph (a)
351.16may also request, on a form and in the manner prescribed by the commissioner, that the
351.17commissioner expedite the review if:
351.18(1) the provider is challenging a violation and provides a description of how complying
351.19with the corrective action for that violation would require the substantial expenditure of
351.20funds 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
351.22to ensure the health and safety of children in care pending the commissioner's review of the
351.23correction order.

351.24    Sec. 5. Minnesota Statutes 2016, section 245A.06, subdivision 8, is amended to read:
351.25    Subd. 8. Requirement to post correction order. (a) For licensed family child care
351.26providers and child care centers, upon receipt of any correction order or order of conditional
351.27license issued by the commissioner under this section, and notwithstanding a pending request
351.28for reconsideration of the correction order or order of conditional license by the license
351.29holder, the license holder shall post the correction order or order of conditional license in
351.30a place that is conspicuous to the people receiving services and all visitors to the facility
351.31for two years. When the correction order or order of conditional license is accompanied by
351.32a maltreatment investigation memorandum prepared under section 626.556 or 626.557, the
352.1investigation memoranda must be posted with the correction order or order of conditional
352.2license.
352.3(b) If the commissioner reverses or rescinds a violation in a correction order upon
352.4reconsideration under subdivision 2, the commissioner shall issue an amended correction
352.5order and the license holder shall post the amended order according to paragraph (a).
352.6(c) If the correction order is rescinded or reversed in full upon reconsideration under
352.7subdivision 2, the license holder shall remove the original correction order posted according
352.8to paragraph (a).

352.9    Sec. 6. Minnesota Statutes 2016, section 245A.06, is amended by adding a subdivision to
352.10read:
352.11    Subd. 9. Child care correction order quotas prohibited. The commissioner and county
352.12licensing agencies shall not order, mandate, require, or suggest to any person responsible
352.13for licensing or inspecting a licensed family child care provider or child care center a quota
352.14for the issuance of correction orders on a daily, weekly, monthly, quarterly, or yearly basis.

352.15    Sec. 7. [245A.065] CHILD CARE FIX-IT TICKET.
352.16(a) In lieu of a correction order under section 245A.06, the commissioner shall issue a
352.17fix-it ticket to a family child care or child care center license holder if the commissioner
352.18finds that:
352.19(1) the license holder has failed to comply with a requirement in this chapter or Minnesota
352.20Rules, chapter 9502 or 9503, that the commissioner determines to be eligible for a fix-it
352.21ticket;
352.22(2) the violation does not imminently endanger the health, safety, or rights of the persons
352.23served by the program;
352.24(3) the license holder did not receive a fix-it ticket or correction order for the violation
352.25at the license holder's last licensing inspection;
352.26(4) the violation can be corrected at the time of inspection or within 48 hours, excluding
352.27Saturdays, Sundays, and holidays; and
352.28(5) the license holder corrects the violation at the time of inspection or agrees to correct
352.29the violation within 48 hours, excluding Saturdays, Sundays, and holidays.
352.30(b) The fix-it ticket must state:
352.31(1) the conditions that constitute a violation of the law or rule;
353.1(2) the specific law or rule violated; and
353.2(3) that the violation was corrected at the time of inspection or must be corrected within
353.348 hours, excluding Saturdays, Sundays, and holidays.
353.4(c) The commissioner shall not publicly publish a fix-it ticket on the department's Web
353.5site.
353.6(d) Within 48 hours, excluding Saturdays, Sundays, and holidays, of receiving a fix-it
353.7ticket, the license holder must correct the violation and within one week submit evidence
353.8to the licensing agency that the violation was corrected.
353.9(e) If the violation is not corrected at the time of inspection or within 48 hours, excluding
353.10Saturdays, Sundays, and holidays, or the evidence submitted is insufficient to establish that
353.11the license holder corrected the violation, the commissioner must issue a correction order
353.12for the violation of Minnesota law or rule identified in the fix-it ticket according to section
353.13245A.06.
353.14(f) The commissioner shall, following consultation with family child care license holders,
353.15child care center license holders, and county agencies, issue a report by October 1, 2017,
353.16that identifies the violations of this chapter and Minnesota Rules, chapters 9502 and 9503,
353.17that are eligible for a fix-it ticket. The commissioner shall provide the report to county
353.18agencies and the chairs and ranking minority members of the legislative committees with
353.19jurisdiction over child care, and shall post the report to the department's Web site.
353.20EFFECTIVE DATE.This section is effective October 1, 2017.

353.21    Sec. 8. Minnesota Statutes 2016, section 245A.07, subdivision 3, is amended to read:
353.22    Subd. 3. License suspension, revocation, or fine. (a) The commissioner may suspend
353.23or revoke a license, or impose a fine if:
353.24(1) a license holder fails to comply fully with applicable laws or rules;
353.25(2) a license holder, a controlling individual, or an individual living in the household
353.26where the licensed services are provided or is otherwise subject to a background study has
353.27a disqualification which has not been set aside under section 245C.22;
353.28(3) a license holder knowingly withholds relevant information from or gives false or
353.29misleading information to the commissioner in connection with an application for a license,
353.30in connection with the background study status of an individual, during an investigation,
353.31or regarding compliance with applicable laws or rules; or
354.1(4) after July 1, 2012, and upon request by the commissioner, a license holder fails to
354.2submit the information required of an applicant under section 245A.04, subdivision 1,
354.3paragraph (f) or (g).
354.4A license holder who has had a license suspended, revoked, or has been ordered to pay
354.5a fine must be given notice of the action by certified mail or personal service. If mailed, the
354.6notice must be mailed to the address shown on the application or the last known address of
354.7the license holder. The notice must state the reasons the license was suspended, revoked,
354.8or a fine was ordered.
354.9    (b) If the license was suspended or revoked, the notice must inform the license holder
354.10of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
354.111400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
354.12a license. The appeal of an order suspending or revoking a license must be made in writing
354.13by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
354.14the commissioner within ten calendar days after the license holder receives notice that the
354.15license has been suspended or revoked. If a request is made by personal service, it must be
354.16received by the commissioner within ten calendar days after the license holder received the
354.17order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits a
354.18timely appeal of an order suspending or revoking a license, the license holder may continue
354.19to operate the program as provided in section 245A.04, subdivision 7, paragraphs (g) and
354.20(h), until the commissioner issues a final order on the suspension or revocation.
354.21    (c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
354.22holder of the responsibility for payment of fines and the right to a contested case hearing
354.23under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
354.24order to pay a fine must be made in writing by certified mail or personal service. If mailed,
354.25the appeal must be postmarked and sent to the commissioner within ten calendar days after
354.26the license holder receives notice that the fine has been ordered. If a request is made by
354.27personal service, it must be received by the commissioner within ten calendar days after
354.28the license holder received the order.
354.29    (2) The license holder shall pay the fines assessed on or before the payment date specified.
354.30If the license holder fails to fully comply with the order, the commissioner may issue a
354.31second fine or suspend the license until the license holder complies. If the license holder
354.32receives state funds, the state, county, or municipal agencies or departments responsible for
354.33administering the funds shall withhold payments and recover any payments made while the
354.34license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
354.35until the commissioner issues a final order.
355.1    (3) A license holder shall promptly notify the commissioner of human services, in writing,
355.2when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
355.3commissioner determines that a violation has not been corrected as indicated by the order
355.4to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
355.5the license holder by certified mail or personal service that a second fine has been assessed.
355.6The license holder may appeal the second fine as provided under this subdivision.
355.7    (4) Fines shall be assessed as follows:
355.8    (i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
355.9child under section 626.556 or the maltreatment of a vulnerable adult under section 626.557
355.10for which the license holder is determined responsible for the maltreatment under section
355.11626.556, subdivision 10e , paragraph (i), or 626.557, subdivision 9c, paragraph (c);
355.12(ii) if the commissioner determines that a determination of maltreatment for which the
355.13license holder is responsible is the result of maltreatment that meets the definition of serious
355.14maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
355.15$5,000;
355.16(iii) for a program that operates out of the license holder's home and a program licensed
355.17under Minnesota Rules, parts 9502.0300 to 9502.0495, the fine assessed against the license
355.18holder shall not exceed $1,000 for each determination of maltreatment;
355.19    (iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule
355.20governing matters of health, safety, or supervision, including but not limited to the provision
355.21of adequate staff-to-child or adult ratios, and failure to comply with background study
355.22requirements under chapter 245C; and
355.23    (v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule
355.24other than those subject to a $5,000, $1,000, or $200 fine above in items (i) to (iv).
355.25    For purposes of this section, "occurrence" means each violation identified in the
355.26commissioner's fine order. Fines assessed against a license holder that holds a license to
355.27provide home and community-based services, as identified in section 245D.03, subdivision
355.281 , and a community residential setting or day services facility license under chapter 245D
355.29where the services are provided, may be assessed against both licenses for the same
355.30occurrence, but the combined amount of the fines shall not exceed the amount specified in
355.31this clause for that occurrence.
355.32    (5) When a fine has been assessed, the license holder may not avoid payment by closing,
355.33selling, or otherwise transferring the licensed program to a third party. In such an event, the
356.1license holder will be personally liable for payment. In the case of a corporation, each
356.2controlling individual is personally and jointly liable for payment.
356.3(d) Except for background study violations involving the failure to comply with an order
356.4to immediately remove an individual or an order to provide continuous, direct supervision,
356.5the commissioner shall not issue a fine under paragraph (c) relating to a background study
356.6violation to a license holder who self-corrects a background study violation before the
356.7commissioner discovers the violation. A license holder who has previously exercised the
356.8provisions of this paragraph to avoid a fine for a background study violation may not avoid
356.9a fine for a subsequent background study violation unless at least 365 days have passed
356.10since the license holder self-corrected the earlier background study violation.
356.11EFFECTIVE DATE.This section is effective August 1, 2017.

356.12    Sec. 9. [245A.1434] INFORMATION FOR CHILD CARE LICENSE HOLDERS.
356.13The commissioner shall inform family child care and child care center license holders
356.14on a timely basis of changes to state and federal statute, rule, regulation, and policy relating
356.15to the provision of licensed child care, the child care assistance program under chapter 119B,
356.16the quality rating and improvement system under section 124D.142, and child care licensing
356.17functions delegated to counties. Communications under this section shall include information
356.18to promote license holder compliance with identified changes. Communications under this
356.19section may be accomplished by electronic means and shall be made available to the public
356.20online.

356.21    Sec. 10. [245A.153] REPORT TO LEGISLATURE ON THE STATUS OF CHILD
356.22CARE.
356.23    Subdivision 1. Reporting requirements. Beginning on February 1, 2018, and no later
356.24than February 1 of each year thereafter, the commissioner of human services shall provide
356.25a report on the status of child care in Minnesota to the chairs and ranking minority members
356.26of the legislative committees with jurisdiction over child care.
356.27    Subd. 2. Contents of report. (a) The report must include the following:
356.28(1) summary data on trends in child care center and family child care capacity and
356.29availability throughout the state, including the number of centers and programs that have
356.30opened and closed and the geographic locations of those centers and programs;
356.31(2) a description of any changes to statutes, administrative rules, or agency policies and
356.32procedures that were implemented in the year preceding the report;
357.1(3) a description of the actions the department has taken to address or implement the
357.2recommendations from the Legislative Task Force on Access to Affordable Child Care
357.3Report dated January 15, 2017, including but not limited to actions taken in the areas of:
357.4(i) encouraging uniformity in implementing and interpreting statutes, administrative
357.5rules, and agency policies and procedures relating to child care licensing and access;
357.6(ii) improving communication with county licensors and child care providers regarding
357.7changes to statutes, administrative rules, and agency policies and procedures, ensuring that
357.8information is directly and regularly transmitted;
357.9(iii) providing notice to child care providers before issuing correction orders or negative
357.10actions relating to recent changes to statutes, administrative rules, and agency policies and
357.11procedures;
357.12(iv) implementing confidential, anonymous communication processes for child care
357.13providers to ask questions and receive prompt, clear answers from the department;
357.14(v) streamlining processes to reduce duplication or overlap in paperwork and training
357.15requirements for child care providers; and
357.16(vi) compiling and distributing information detailing trends in the violations for which
357.17correction orders and negative actions are issued;
357.18(4) a description of the department's efforts to cooperate with counties while addressing
357.19and implementing the task force recommendations;
357.20(5) summary data on child care assistance programs including but not limited to state
357.21funding and numbers of families served; and
357.22(6) summary data on family child care correction orders, including:
357.23(i) the number of licensed family child care provider appeals or requests for
357.24reconsideration of correction orders to the Department of Human Services;
357.25(ii) the number of family child care correction order appeals or requests for
357.26reconsideration that the Department of Human Services grants; and
357.27(iii) the number of family child care correction order appeals or requests for
357.28reconsideration that the Department of Human Services denies.
357.29(b) The commissioner may offer recommendations for legislative action.
357.30    Subd. 3. Sunset. This section expires February 2, 2020.

358.1    Sec. 11. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
358.2    Subd. 3c. Local welfare agency, Department of Human Services or Department of
358.3Health responsible for assessing or investigating reports of maltreatment. (a) The county
358.4local welfare agency is the agency responsible for assessing or investigating allegations of
358.5maltreatment in child foster care, family child care, legally unlicensed nonlicensed child
358.6care, juvenile correctional facilities licensed under section 241.021 located in the local
358.7welfare agency's county, and reports involving children served by an unlicensed personal
358.8care provider organization under section 256B.0659. Copies of findings related to personal
358.9care provider organizations under section 256B.0659 must be forwarded to the Department
358.10of Human Services provider enrollment.
358.11(b) The Department of Human Services is the agency responsible for assessing or
358.12investigating allegations of maltreatment in juvenile correctional facilities listed under
358.13section 241.021 located in the local welfare agency's county and in facilities licensed or
358.14certified under chapters 245A and 245D, except for child foster care and family child care.
358.15(c) The Department of Health is the agency responsible for assessing or investigating
358.16allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and
358.17144A.43 to 144A.482.

358.18ARTICLE 10

358.19HEALTH DEPARTMENT

358.20    Section 1. Minnesota Statutes 2016, section 103I.101, subdivision 2, is amended to read:
358.21    Subd. 2. Duties. The commissioner shall:
358.22(1) regulate the drilling, construction, modification, repair, and sealing of wells and
358.23borings;
358.24(2) examine and license:
358.25(i) well contractors;
358.26(ii) persons constructing, repairing, and sealing bored geothermal heat exchangers;
358.27(iii) persons modifying or repairing well casings, well screens, or well diameters;
358.28(iv) persons constructing, repairing, and sealing drive point wells or dug wells;
358.29(v) persons installing well pumps or pumping equipment;
358.30(vi) persons constructing, repairing, and sealing dewatering wells;
359.1(vii) persons sealing wells; persons installing well pumps or pumping equipment or
359.2borings; and
359.3(viii) persons excavating or drilling holes for the installation of elevator borings or
359.4hydraulic cylinders;
359.5(3) register license and examine monitoring well contractors;
359.6(4) license explorers engaged in exploratory boring and examine individuals who
359.7supervise or oversee exploratory boring;
359.8(5) after consultation with the commissioner of natural resources and the Pollution
359.9Control Agency, establish standards for the design, location, construction, repair, and sealing
359.10of wells and borings within the state; and
359.11(6) issue permits for wells, groundwater thermal devices, bored geothermal heat
359.12exchangers, and elevator borings.

359.13    Sec. 2. Minnesota Statutes 2016, section 103I.101, subdivision 5, is amended to read:
359.14    Subd. 5. Commissioner to adopt rules. The commissioner shall adopt rules including:
359.15(1) issuance of licenses for:
359.16(i) qualified well contractors,;
359.17(ii) persons modifying or repairing well casings, well screens, or well diameters;
359.18(ii) (iii) persons constructing, repairing, and sealing drive point wells or dug wells;
359.19(iii) (iv) persons constructing, repairing, and sealing dewatering wells;
359.20(iv) (v) persons sealing wells or borings;
359.21(v) (vi) persons installing well pumps or pumping equipment;
359.22(vi) (vii) persons constructing, repairing, and sealing bored geothermal heat exchangers;
359.23and
359.24(vii) (viii) persons constructing, repairing, and sealing elevator borings;
359.25(2) issuance of registration licenses for monitoring well contractors;
359.26(3) establishment of conditions for examination and review of applications for license
359.27and registration certification;
359.28(4) establishment of conditions for revocation and suspension of license and registration
359.29certification;
360.1(5) establishment of minimum standards for design, location, construction, repair, and
360.2sealing of wells and borings to implement the purpose and intent of this chapter;
360.3(6) establishment of a system for reporting on wells and borings drilled and sealed;
360.4(7) establishment of standards for the construction, maintenance, sealing, and water
360.5quality monitoring of wells in areas of known or suspected contamination;
360.6(8) establishment of wellhead protection measures for wells serving public water supplies;
360.7(9) establishment of procedures to coordinate collection of well and boring data with
360.8other state and local governmental agencies;
360.9(10) establishment of criteria and procedures for submission of well and boring logs,
360.10formation samples or well or boring cuttings, water samples, or other special information
360.11required for and water resource mapping; and
360.12(11) establishment of minimum standards for design, location, construction, maintenance,
360.13repair, sealing, safety, and resource conservation related to borings, including exploratory
360.14borings as defined in section 103I.005, subdivision 9.

360.15    Sec. 3. Minnesota Statutes 2016, section 103I.111, subdivision 6, is amended to read:
360.16    Subd. 6. Unsealed wells and borings are public health nuisances. A well or boring
360.17that is required to be sealed under section 103I.301 but is not sealed is a public health
360.18nuisance. A county may abate the unsealed well or boring with the same authority of a
360.19community health board to abate a public health nuisance under section 145A.04, subdivision
360.208 .

360.21    Sec. 4. Minnesota Statutes 2016, section 103I.111, subdivision 7, is amended to read:
360.22    Subd. 7. Local license or registration fees prohibited. (a) A political subdivision may
360.23not require a licensed well contractor to pay a license or registration fee.
360.24(b) The commissioner of health must provide a political subdivision with a list of licensed
360.25well contractors upon request.

360.26    Sec. 5. Minnesota Statutes 2016, section 103I.111, subdivision 8, is amended to read:
360.27    Subd. 8. Municipal regulation of drilling. A municipality may regulate all drilling,
360.28except well, elevator shaft boring, and exploratory drilling that is subject to the provisions
360.29of this chapter, above, in, through, and adjacent to subsurface areas designated for mined
361.1underground space development and existing mined underground space. The regulations
361.2may prohibit, restrict, control, and require permits for the drilling.

361.3    Sec. 6. Minnesota Statutes 2016, section 103I.205, is amended to read:
361.4103I.205 WELL AND BORING CONSTRUCTION.
361.5    Subdivision 1. Notification required. (a) Except as provided in paragraphs (d) and (e),
361.6a person may not construct a well until a notification of the proposed well on a form
361.7prescribed by the commissioner is filed with the commissioner with the filing fee in section
361.8103I.208 , and, when applicable, the person has met the requirements of paragraph (f). If
361.9after filing the well notification an attempt to construct a well is unsuccessful, a new
361.10notification is not required unless the information relating to the successful well has
361.11substantially changed.
361.12(b) The property owner, the property owner's agent, or the well licensed contractor where
361.13a well is to be located must file the well notification with the commissioner.
361.14(c) The well notification under this subdivision preempts local permits and notifications,
361.15and counties or home rule charter or statutory cities may not require a permit or notification
361.16for wells unless the commissioner has delegated the permitting or notification authority
361.17under section 103I.111.
361.18(d) A person who is an individual that constructs a drive point water-supply well on
361.19property owned or leased by the individual for farming or agricultural purposes or as the
361.20individual's place of abode must notify the commissioner of the installation and location of
361.21the well. The person must complete the notification form prescribed by the commissioner
361.22and mail it to the commissioner by ten days after the well is completed. A fee may not be
361.23charged for the notification. A person who sells drive point wells at retail must provide
361.24buyers with notification forms and informational materials including requirements regarding
361.25wells, their location, construction, and disclosure. The commissioner must provide the
361.26notification forms and informational materials to the sellers.
361.27(e) A person may not construct a monitoring well until a permit is issued by the
361.28commissioner for the construction. If after obtaining a permit an attempt to construct a well
361.29is unsuccessful, a new permit is not required as long as the initial permit is modified to
361.30indicate the location of the successful well.
361.31(f) When the operation of a well will require an appropriation permit from the
361.32commissioner of natural resources, a person may not begin construction of the well until
361.33the person submits the following information to the commissioner of natural resources:
362.1(1) the location of the well;
362.2(2) the formation or aquifer that will serve as the water source;
362.3(3) the maximum daily, seasonal, and annual pumpage rates and volumes that will be
362.4requested in the appropriation permit; and
362.5(4) other information requested by the commissioner of natural resources that is necessary
362.6to conduct the preliminary assessment required under section 103G.287, subdivision 1,
362.7paragraph (c).
362.8The person may begin construction after receiving preliminary approval from the
362.9commissioner of natural resources.
362.10    Subd. 2. Emergency permit and notification exemptions. The commissioner may
362.11adopt rules that modify the procedures for filing a well or boring notification or well or
362.12boring permit if conditions occur that:
362.13(1) endanger the public health and welfare or cause a need to protect the groundwater;
362.14or
362.15(2) require the monitoring well contractor, limited well/boring contractor, or well
362.16contractor to begin constructing a well before obtaining a permit or notification.
362.17    Subd. 3. Maintenance permit. (a) Except as provided under paragraph (b), a well that
362.18is not in use must be sealed or have a maintenance permit.
362.19(b) If a monitoring well or a dewatering well is not sealed by 14 months after completion
362.20of construction, the owner of the property on which the well is located must obtain and
362.21annually renew a maintenance permit from the commissioner.
362.22    Subd. 4. License required. (a) Except as provided in paragraph (b), (c), (d), or (e),
362.23section 103I.401, subdivision 2, or 103I.601, subdivision 2, a person may not drill, construct,
362.24repair, or seal a well or boring unless the person has a well contractor's license in possession.
362.25(b) A person may construct, repair, and seal a monitoring well if the person:
362.26(1) is a professional engineer licensed under sections 326.02 to 326.15 in the branches
362.27of civil or geological engineering;
362.28(2) is a hydrologist or hydrogeologist certified by the American Institute of Hydrology;
362.29(3) is a professional geoscientist licensed under sections 326.02 to 326.15;
362.30(4) is a geologist certified by the American Institute of Professional Geologists; or
362.31(5) meets the qualifications established by the commissioner in rule.
363.1A person must register with be licensed by the commissioner as a monitoring well
363.2contractor on forms provided by the commissioner.
363.3(c) A person may do the following work with a limited well/boring contractor's license
363.4in possession. A separate license is required for each of the six activities:
363.5(1) installing or repairing well screens or pitless units or pitless adaptors and well casings
363.6from the pitless adaptor or pitless unit to the upper termination of the well casing;
363.7(2) constructing, repairing, and sealing drive point wells or dug wells;
363.8(3) installing well pumps or pumping equipment;
363.9(4) sealing wells or borings;
363.10(5) constructing, repairing, or sealing dewatering wells; or
363.11(6) constructing, repairing, or sealing bored geothermal heat exchangers.
363.12(d) A person may construct, repair, and seal an elevator boring with an elevator boring
363.13contractor's license.
363.14(e) Notwithstanding other provisions of this chapter requiring a license or registration,
363.15a license or registration is not required for a person who complies with the other provisions
363.16of this chapter if the person is:
363.17(1) an individual who constructs a well on land that is owned or leased by the individual
363.18and is used by the individual for farming or agricultural purposes or as the individual's place
363.19of abode;
363.20(2) an individual who performs labor or services for a contractor licensed or registered
363.21under the provisions of this chapter in connection with the construction, sealing, or repair
363.22of a well or boring at the direction and under the personal supervision of a contractor licensed
363.23or registered under the provisions of this chapter; or
363.24(3) a licensed plumber who is repairing submersible pumps or water pipes associated
363.25with well water systems if: (i) the repair location is within an area where there is no licensed
363.26or registered well contractor within 50 miles, and (ii) the licensed plumber complies with
363.27all relevant sections of the plumbing code.
363.28    Subd. 5. At-grade monitoring wells. At-grade monitoring wells are authorized without
363.29variance and may be installed for the purpose of evaluating groundwater conditions or for
363.30use as a leak detection device. An at-grade monitoring well must be installed in accordance
363.31with the rules of the commissioner. The at-grade monitoring wells must be installed with
364.1an impermeable double locking cap approved by the commissioner and must be labeled
364.2monitoring wells.
364.3    Subd. 6. Distance requirements for sources of contamination, buildings, gas pipes,
364.4liquid propane tanks, and electric lines. (a) A person may not place, construct, or install
364.5an actual or potential source of contamination, building, gas pipe, liquid propane tank, or
364.6electric line any closer to a well or boring than the isolation distances prescribed by the
364.7commissioner by rule unless a variance has been prescribed by rule.
364.8(b) The commissioner shall establish by rule reduced isolation distances for facilities
364.9which have safeguards in accordance with sections 18B.01, subdivision 26, and 18C.005,
364.10subdivision 29 .
364.11    Subd. 7. Well identification label required. After a well has been constructed, the
364.12person constructing the well must attach a label to the well showing the unique well number.
364.13    Subd. 8. Wells on property of another. A person may not construct or have constructed
364.14a well for the person's own use on the property of another until the owner of the property
364.15on which the well is to be located and the intended well user sign a written agreement that
364.16identifies which party will be responsible for obtaining all permits or filing notification,
364.17paying applicable fees and for sealing the well. If the property owner refuses to sign the
364.18agreement, the intended well user may, in lieu of a written agreement, state in writing to
364.19the commissioner that the well user will be responsible for obtaining permits, filing
364.20notification, paying applicable fees, and sealing the well. Nothing in this subdivision
364.21eliminates the responsibilities of the property owner under this chapter, or allows a person
364.22to construct a well on the property of another without consent or other legal authority.
364.23    Subd. 9. Report of work. Within 30 days after completion or sealing of a well or boring,
364.24the person doing the work must submit a verified report to the commissioner containing the
364.25information specified by rules adopted under this chapter.
364.26Within 30 days after receiving the report, the commissioner shall send or otherwise
364.27provide access to a copy of the report to the commissioner of natural resources, to the local
364.28soil and water conservation district where the well is located, and to the director of the
364.29Minnesota Geological Survey.

364.30    Sec. 7. Minnesota Statutes 2016, section 103I.301, is amended to read:
364.31103I.301 WELL AND BORING SEALING REQUIREMENTS.
364.32    Subdivision 1. Wells and borings. (a) A property owner must have a well or boring
364.33sealed if:
365.1(1) the well or boring is contaminated or may contribute to the spread of contamination;
365.2(2) the well or boring was attempted to be sealed but was not sealed according to the
365.3provisions of this chapter; or
365.4(3) the well or boring is located, constructed, or maintained in a manner that its continued
365.5use or existence endangers groundwater quality or is a safety or health hazard.
365.6(b) A well or boring that is not in use must be sealed unless the property owner has a
365.7maintenance permit for the well.
365.8(c) The property owner must have a well or boring sealed by a registered or licensed
365.9person authorized to seal the well or boring, consistent with provisions of this chapter.
365.10    Subd. 2. Monitoring wells. The owner of the property where a monitoring well is located
365.11must have the monitoring well sealed when the well is no longer in use. The owner must
365.12have a well contractor, limited well/boring sealing contractor, or a monitoring well contractor
365.13seal the monitoring well.
365.14    Subd. 3. Dewatering wells. (a) The owner of the property where a dewatering well is
365.15located must have the dewatering well sealed when the dewatering well is no longer in use.
365.16(b) A well contractor, limited well/boring sealing contractor, or limited dewatering well
365.17contractor shall seal the dewatering well.
365.18    Subd. 4. Sealing procedures. Wells and borings must be sealed according to rules
365.19adopted by the commissioner.
365.20    Subd. 6. Notification required. A person may not seal a well until a notification of the
365.21proposed sealing is filed as prescribed by the commissioner.

365.22    Sec. 8. Minnesota Statutes 2016, section 103I.501, is amended to read:
365.23103I.501 LICENSING AND REGULATION OF WELLS AND BORINGS.
365.24(a) The commissioner shall regulate and license:
365.25(1) drilling, constructing, and repair of wells;
365.26(2) sealing of wells;
365.27(3) installing of well pumps and pumping equipment;
365.28(4) excavating, drilling, repairing, and sealing of elevator borings;
365.29(5) construction, repair, and sealing of environmental bore holes; and
365.30(6) construction, repair, and sealing of bored geothermal heat exchangers.
366.1(b) The commissioner shall examine and license well contractors, limited well/boring
366.2contractors, and elevator boring contractors, and examine and register monitoring well
366.3contractors.
366.4(c) The commissioner shall license explorers engaged in exploratory boring and shall
366.5examine persons who supervise or oversee exploratory boring.

366.6    Sec. 9. Minnesota Statutes 2016, section 103I.505, is amended to read:
366.7103I.505 RECIPROCITY OF LICENSES AND REGISTRATIONS
366.8CERTIFICATIONS.
366.9    Subdivision 1. Reciprocity authorized. The commissioner may issue a license or register
366.10certify a person under this chapter, without giving an examination, if the person is licensed
366.11or registered certified in another state and:
366.12(1) the requirements for licensing or registration certification under which the well or
366.13boring contractor was licensed or registered person was certified do not conflict with this
366.14chapter;
366.15(2) the requirements are of a standard not lower than that specified by the rules adopted
366.16under this chapter; and
366.17(3) equal reciprocal privileges are granted to licensees or registrants certified persons
366.18of this state.
366.19    Subd. 2. Fees required. A well or boring contractor or certified person must apply for
366.20the license or registration certification and pay the fees under the provisions of this chapter
366.21to receive a license or registration certification under this section.

366.22    Sec. 10. Minnesota Statutes 2016, section 103I.515, is amended to read:
366.23103I.515 LICENSES NOT TRANSFERABLE.
366.24A license or registration certification issued under this chapter is not transferable.

366.25    Sec. 11. Minnesota Statutes 2016, section 103I.535, subdivision 3, is amended to read:
366.26    Subd. 3. Certification examination. After the commissioner has approved the
366.27application, the applicant must take an examination given by the commissioner.

367.1    Sec. 12. Minnesota Statutes 2016, section 103I.535, is amended by adding a subdivision
367.2to read:
367.3    Subd. 3b. Certification renewal. (a) A representative must file an application and a
367.4renewal application fee to renew the certification by the date stated in the certification.
367.5(b) The renewal application must include information that the certified representative
367.6has met continuing education requirements established by the commissioner by rule.

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

367.9    Sec. 14. Minnesota Statutes 2016, section 103I.541, is amended to read:
367.10103I.541 MONITORING WELL CONTRACTOR'S REGISTRATION LICENSE;
367.11REPRESENTATIVE'S CERTIFICATION.
367.12    Subdivision 1. Registration Certification. A person seeking registration as certification
367.13to represent a monitoring well contractor must meet examination and experience requirements
367.14adopted by the commissioner by rule.
367.15    Subd. 2. Validity. A monitoring well contractor's registration certification is valid until
367.16the date prescribed in the registration certification by the commissioner.
367.17    Subd. 2a. Certification application. (a) An individual must submit an application and
367.18application fee to the commissioner to apply for certification as a representative of a
367.19monitoring well contractor.
367.20(b) The application must be on forms prescribed by the commissioner. The application
367.21must state the applicant's qualifications for the certification, and other information required
367.22by the commissioner.
367.23    Subd. 2b. Issuance of registration. If a person employs a certified representative,
367.24submits the bond under subdivision 3, and pays the registration fee of $75 for a monitoring
367.25well contractor registration, the commissioner shall issue a monitoring well contractor
367.26registration to the applicant. The fee for an individual registration is $75. The commissioner
367.27may not act on an application until the application fee is paid.
367.28    Subd. 2c. Certification fee. (a) The application fee for certification as a representative
367.29of a monitoring well contractor is $75. The commissioner may not act on an application
367.30until the application fee is paid.
368.1(b) The renewal fee for certification as a representative of a monitoring well contractor
368.2is $75. The commissioner may not renew a certification until the renewal fee is paid.
368.3    Subd. 2d. Examination. After the commissioner has approved an application, the
368.4applicant must take an examination given by the commissioner.
368.5    Subd. 2e. Issuance of certification. If the applicant meets the experience requirements
368.6established by rule and passes the examination as determined by the commissioner, the
368.7commissioner shall issue the applicant a certification to represent a monitoring well
368.8contractor.
368.9    Subd. 2f. Certification renewal. (a) A representative must file an application and a
368.10renewal application fee to renew the certification by the date stated in the certification.
368.11(b) The renewal application must include information that the certified representative
368.12has met continuing education requirements established by the commissioner by rule.
368.13    Subd. 2g. Issuance of license. (a) If a person employs a certified representative, submits
368.14the bond under subdivision 3, and pays the license fee of $75 for a monitoring well contractor
368.15license, the commissioner shall issue a monitoring well contractor license to the applicant.
368.16(b) The commissioner may not act on an application until the application fee is paid.
368.17    Subd. 3. Bond. (a) As a condition of being issued a monitoring well contractor's
368.18registration license, the applicant must submit a corporate surety bond for $10,000 approved
368.19by the commissioner. The bond must be conditioned to pay the state on performance of
368.20work in this state that is not in compliance with this chapter or rules adopted under this
368.21chapter. The bond is in lieu of other license bonds required by a political subdivision of the
368.22state.
368.23(b) From proceeds of the bond, the commissioner may compensate persons injured or
368.24suffering financial loss because of a failure of the applicant to perform work or duties in
368.25compliance with this chapter or rules adopted under this chapter.
368.26    Subd. 4. License renewal. (a) A person must file an application and a renewal application
368.27fee to renew the registration license by the date stated in the registration license.
368.28(b) The renewal application fee for a monitoring well contractor's registration license is
368.29$75.
368.30(c) The renewal application must include information that the certified representative
368.31of the applicant has met continuing education requirements established by the commissioner
368.32by rule.
369.1(d) At the time of the renewal, the commissioner must have on file all well and boring
369.2construction reports, well and boring sealing reports, well permits, and notifications for
369.3work conducted by the registered licensed person since the last registration license renewal.
369.4    Subd. 5. Incomplete or late renewal. If a registered licensed person submits a renewal
369.5application after the required renewal date:
369.6(1) the registered licensed person must include a late fee of $75; and
369.7(2) the registered licensed person may not conduct activities authorized by the monitoring
369.8well contractor's registration license until the renewal application, renewal application fee,
369.9late fee, and all other information required in subdivision 4 are submitted.

369.10    Sec. 15. Minnesota Statutes 2016, section 103I.545, subdivision 1, is amended to read:
369.11    Subdivision 1. Drilling machine. (a) A person may not use a drilling machine such as
369.12a cable tool, rotary tool, hollow rod tool, or auger for a drilling activity requiring a license
369.13or registration under this chapter unless the drilling machine is registered with the
369.14commissioner.
369.15(b) A person must apply for the registration on forms prescribed by the commissioner
369.16and submit a $75 registration fee.
369.17(c) A registration is valid for one year.

369.18    Sec. 16. Minnesota Statutes 2016, section 103I.545, subdivision 2, is amended to read:
369.19    Subd. 2. Hoist. (a) A person may not use a machine such as a hoist for an activity
369.20requiring a license or registration under this chapter to repair wells or borings, seal wells
369.21or borings, or install pumps unless the machine is registered with the commissioner.
369.22(b) A person must apply for the registration on forms prescribed by the commissioner
369.23and submit a $75 registration fee.
369.24(c) A registration is valid for one year.

369.25    Sec. 17. Minnesota Statutes 2016, section 103I.711, subdivision 1, is amended to read:
369.26    Subdivision 1. Impoundment. The commissioner may apply to district court for a
369.27warrant authorizing seizure and impoundment of all drilling machines or hoists owned or
369.28used by a person. The court shall issue an impoundment order upon the commissioner's
369.29showing that a person is constructing, repairing, or sealing wells or borings or installing
369.30pumps or pumping equipment or excavating holes for installing elevator shafts borings
370.1without a license or registration as required under this chapter. A sheriff on receipt of the
370.2warrant must seize and impound all drilling machines and hoists owned or used by the
370.3person. A person from whom equipment is seized under this subdivision may file an action
370.4in district court for the purpose of establishing that the equipment was wrongfully seized.

370.5    Sec. 18. Minnesota Statutes 2016, section 103I.715, subdivision 2, is amended to read:
370.6    Subd. 2. Gross misdemeanors. A person is guilty of a gross misdemeanor who:
370.7(1) willfully violates a provision of this chapter or order of the commissioner;
370.8(2) engages in the business of drilling or making wells, sealing wells, installing pumps
370.9or pumping equipment, or constructing elevator shafts borings without a license required
370.10by this chapter; or
370.11(3) engages in the business of exploratory boring without an exploratory borer's license
370.12under this chapter.

370.13    Sec. 19. [144.059] PALLIATIVE CARE ADVISORY COUNCIL.
370.14    Subdivision 1. Membership. The Palliative Care Advisory Council shall consist of 18
370.15public members.
370.16    Subd. 2. Public members. (a) The commissioner shall appoint, in the manner provided
370.17in section 15.0597, 18 public members, including the following:
370.18(1) two physicians, of which one is certified by the American Board of Hospice and
370.19Palliative Medicine;
370.20(2) two registered nurses or advanced practice registered nurses, of which one is certified
370.21by the National Board for Certification of Hospice and Palliative Nurses;
370.22(3) one care coordinator experienced in working with people with serious or chronic
370.23illness and their families;
370.24(4) one spiritual counselor experienced in working with people with serious or chronic
370.25illness and their families;
370.26(5) three licensed health professionals, such as complementary and alternative health
370.27care practitioners, dietitians or nutritionists, pharmacists, or physical therapists, who are
370.28neither physicians nor nurses, but who have experience as members of a palliative care
370.29interdisciplinary team working with people with serious or chronic illness and their families;
371.1(6) one licensed social worker experienced in working with people with serious or chronic
371.2illness and their families;
371.3(7) four patients or personal caregivers experienced with serious or chronic illness;
371.4(8) one representative of a health plan company;
371.5(9) one physician assistant that is a member of the American Academy of Hospice and
371.6Palliative Medicine; and
371.7(10) two members from any of the categories described in clauses (1) to (9).
371.8(b) Council membership must include, where possible, representation that is racially,
371.9culturally, linguistically, geographically, and economically diverse.
371.10(c) The council must include at least six members who reside outside Anoka, Carver,
371.11Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Ramsey, Scott, Sherburne, Sibley, Stearns,
371.12Washington, or Wright Counties.
371.13(d) To the extent possible, council membership must include persons who have experience
371.14in palliative care research, palliative care instruction in a medical or nursing school setting,
371.15palliative care services for veterans as a provider or recipient, or pediatric care.
371.16(e) Council membership must include health professionals who have palliative care work
371.17experience or expertise in palliative care delivery models in a variety of inpatient, outpatient,
371.18and community settings, including acute care, long-term care, or hospice, with a variety of
371.19populations, including pediatric, youth, and adult patients.
371.20    Subd. 3. Term. Members of the council shall serve for a term of three years and may
371.21be reappointed. Members shall serve until their successors have been appointed.
371.22    Subd. 4. Administration. The commissioner or the commissioner's designee shall
371.23provide meeting space and administrative services for the council.
371.24    Subd. 5. Chairs. At the council's first meeting, and biannually thereafter, the members
371.25shall elect a chair and a vice-chair whose duties shall be established by the council.
371.26    Subd. 6. Meeting. The council shall meet at least twice yearly.
371.27    Subd. 7. No compensation. Public members of the council serve without compensation
371.28or reimbursement for expenses.
371.29    Subd. 8. Duties. (a) The council shall consult with and advise the commissioner on
371.30matters related to the establishment, maintenance, operation, and outcomes evaluation of
371.31palliative care initiatives in the state.
372.1(b) By February 15 of each year, the council shall submit to the chairs and ranking
372.2minority members of the committees of the senate and the house of representatives with
372.3primary jurisdiction over health care a report containing:
372.4(1) the advisory council's assessment of the availability of palliative care in the state;
372.5(2) the advisory council's analysis of barriers to greater access to palliative care; and
372.6(3) recommendations for legislative action, with draft legislation to implement the
372.7recommendations.
372.8(c) The Department of Health shall publish the report each year on the department's Web
372.9site.
372.10    Subd. 9. Open meetings. The council is subject to the requirements of chapter 13D.
372.11    Subd. 10. Sunset. The council shall sunset January 1, 2025.

372.12    Sec. 20. [144.1215] AUTHORIZATION TO USE HANDHELD DENTAL X-RAY
372.13EQUIPMENT.
372.14    Subdivision 1. Definition; handheld dental x-ray equipment. For purposes of this
372.15section, "handheld dental x-ray equipment" means x-ray equipment that is used to take
372.16dental radiographs, is designed to be handheld during operation, and is operated by an
372.17individual authorized to take dental radiographs under chapter 150A.
372.18    Subd. 2. Use authorized. (a) Handheld dental x-ray equipment may be used if the
372.19equipment:
372.20(1) has been approved for human use by the United States Food and Drug Administration
372.21and is being used in a manner consistent with that approval; and
372.22(2) utilizes a backscatter shield that:
372.23(i) is composed of a leaded polymer or a substance with a substantially equivalent
372.24protective capacity;
372.25(ii) has at least 0.25 millimeters of lead or lead-shielding equivalent; and
372.26(iii) is permanently affixed to the handheld dental x-ray equipment.
372.27(b) The use of handheld dental x-ray equipment is prohibited if the equipment's
372.28backscatter shield is broken or not permanently affixed to the system.
372.29(c) The use of handheld dental x-ray equipment shall not be limited to situations in which
372.30it is impractical to transfer the patient to a stationary x-ray system.
373.1(d) Handheld dental x-ray equipment must be stored when not in use, by being secured
373.2in a restricted, locked area of the facility.
373.3(e) Handheld dental x-ray equipment must be calibrated initially and at intervals that
373.4must not exceed 24 months. Calibration must include the test specified in Minnesota Rules,
373.5part 4732.1100, subpart 11.
373.6(f) Notwithstanding Minnesota Rules, part 4732.0880, subpart 2, item C, the tube housing
373.7and the position-indicating device of handheld dental x-ray equipment may be handheld
373.8during an exposure.
373.9    Subd. 3. Exemptions from certain shielding requirements. Handheld dental x-ray
373.10equipment used according to this section and according to manufacturer instructions is
373.11exempt from the following requirements for the equipment:
373.12(1) shielding requirements in Minnesota Rules, part 4732.0365, item B; and
373.13(2) requirements for the location of the x-ray control console or utilization of a protective
373.14barrier in Minnesota Rules, part 4732.0800, subpart 2, item B, subitems (2) and (3), provided
373.15the equipment utilizes a backscatter shield that satisfies the requirements in subdivision 2,
373.16paragraph (a), clause (2).
373.17    Subd. 4. Compliance with rules. A registrant using handheld dental x-ray equipment
373.18shall otherwise comply with Minnesota Rules, chapter 4732.

373.19    Sec. 21. Minnesota Statutes 2016, section 144.122, is amended to read:
373.20144.122 LICENSE, PERMIT, AND SURVEY FEES.
373.21    (a) The state commissioner of health, by rule, may prescribe procedures and fees for
373.22filing with the commissioner as prescribed by statute and for the issuance of original and
373.23renewal permits, licenses, registrations, and certifications issued under authority of the
373.24commissioner. The expiration dates of the various licenses, permits, registrations, and
373.25certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
373.26application and examination fees and a penalty fee for renewal applications submitted after
373.27the expiration date of the previously issued permit, license, registration, and certification.
373.28The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
373.29registrations, and certifications when the application therefor is submitted during the last
373.30three months of the permit, license, registration, or certification period. Fees proposed to
373.31be prescribed in the rules shall be first approved by the Department of Management and
373.32Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
373.33in an amount so that the total fees collected by the commissioner will, where practical,
374.1approximate the cost to the commissioner in administering the program. All fees collected
374.2shall be deposited in the state treasury and credited to the state government special revenue
374.3fund unless otherwise specifically appropriated by law for specific purposes.
374.4    (b) The commissioner may charge a fee for voluntary certification of medical laboratories
374.5and environmental laboratories, and for environmental and medical laboratory services
374.6provided by the department, without complying with paragraph (a) or chapter 14. Fees
374.7charged for environment and medical laboratory services provided by the department must
374.8be approximately equal to the costs of providing the services.
374.9    (c) The commissioner may develop a schedule of fees for diagnostic evaluations
374.10conducted at clinics held by the services for children with disabilities program. All receipts
374.11generated by the program are annually appropriated to the commissioner for use in the
374.12maternal and child health program.
374.13    (d) The commissioner shall set license fees for hospitals and nursing homes that are not
374.14boarding care homes at the following levels:

374.15 374.16 374.17 374.18	Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals	$7,655 plus $16 per bed
374.19	Non-JCAHO and non-AOA hospitals	$5,280 plus $250 per bed
374.20	Nursing home	$183 plus $91 per bed

374.21    The commissioner shall set license fees for outpatient surgical centers, boarding care
374.22homes, and supervised living facilities at the following levels:

374.23	Outpatient surgical centers	$3,712
374.24	Boarding care homes	$183 plus $91 per bed
374.25	Supervised living facilities	$183 plus $91 per bed.

374.26Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
374.27received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
374.28or later.
374.29    (e) Unless prohibited by federal law, the commissioner of health shall charge applicants
374.30the following fees to cover the cost of any initial certification surveys required to determine
374.31a provider's eligibility to participate in the Medicare or Medicaid program:

374.32	Prospective payment surveys for hospitals	$	900
374.33	Swing bed surveys for nursing homes	$	1,200
374.34	Psychiatric hospitals	$	1,400
374.35	Rural health facilities	$	1,100
375.1	Portable x-ray providers	$	500
375.2	Home health agencies	$	1,800
375.3	Outpatient therapy agencies	$	800
375.4	End stage renal dialysis providers	$	2,100
375.5	Independent therapists	$	800
375.6	Comprehensive rehabilitation outpatient facilities	$	1,200
375.7	Hospice providers	$	1,700
375.8	Ambulatory surgical providers	$	1,800
375.9	Hospitals	$	4,200
375.10 375.11 375.12	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.

375.13    These fees shall be submitted at the time of the application for federal certification and
375.14shall not be refunded. All fees collected after the date that the imposition of fees is not
375.15prohibited by federal law shall be deposited in the state treasury and credited to the state
375.16government special revenue fund.

375.17    Sec. 22. Minnesota Statutes 2016, section 144.1501, subdivision 2, is amended to read:
375.18    Subd. 2. Creation of account. (a) A health professional education loan forgiveness
375.19program account is established. The commissioner of health shall use money from the
375.20account to establish a loan forgiveness program:
375.21    (1) for medical residents and mental health professionals agreeing to practice in designated
375.22rural areas or underserved urban communities or specializing in the area of pediatric
375.23psychiatry;
375.24    (2) for midlevel practitioners agreeing to practice in designated rural areas or to teach
375.25at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
375.26at the undergraduate level or the equivalent at the graduate level;
375.27    (3) for nurses who agree to practice in a Minnesota nursing home; an intermediate care
375.28facility for persons with developmental disability; or a hospital if the hospital owns and
375.29operates a Minnesota nursing home and a minimum of 50 percent of the hours worked by
375.30the nurse is in the nursing home; a housing with services establishment as defined in section
375.31144D.01, subdivision 4; or for a home care provider as defined in section 144A.43,
375.32subdivision 4; or agree to teach at least 12 credit hours, or 720 hours per year in the nursing
375.33field in a postsecondary program at the undergraduate level or the equivalent at the graduate
375.34level;
376.1    (4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
376.2hours per year in their designated field in a postsecondary program at the undergraduate
376.3level or the equivalent at the graduate level. The commissioner, in consultation with the
376.4Healthcare Education-Industry Partnership, shall determine the health care fields where the
376.5need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory
376.6technology, radiologic technology, and surgical technology;
376.7    (5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
376.8who agree to practice in designated rural areas; and
376.9    (6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
376.10encounters to state public program enrollees or patients receiving sliding fee schedule
376.11discounts through a formal sliding fee schedule meeting the standards established by the
376.12United States Department of Health and Human Services under Code of Federal Regulations,
376.13title 42, section 51, chapter 303.
376.14    (b) Appropriations made to the account do not cancel and are available until expended,
376.15except that at the end of each biennium, any remaining balance in the account that is not
376.16committed by contract and not needed to fulfill existing commitments shall cancel to the
376.17fund.

376.18    Sec. 23. [144.1504] SENIOR CARE WORKFORCE INNOVATION GRANT
376.19PROGRAM.
376.20    Subdivision 1. Establishment. The senior care workforce innovation grant program is
376.21established to assist eligible applicants to fund pilot programs or expand existing programs
376.22that increase the pool of caregivers working in the field of senior care services.
376.23    Subd. 2. Competitive grants. The commissioner shall make competitive grants available
376.24to eligible applicants to expand the workforce for senior care services.
376.25    Subd. 3. Eligibility. (a) Eligible applicants must recruit and train individuals to work
376.26with individuals who are primarily 65 years of age or older and receiving services through:
376.27(1) a home and community-based setting, including housing with services establishments
376.28as defined in section 144D.01, subdivision 4;
376.29(2) adult day care as defined in section 245A.02, subdivision 2a;
376.30(3) home care services as defined in section 144A.43, subdivision 3; or
376.31(4) a nursing home as defined in section 144A.01, subdivision 5.
377.1(b) Applicants must apply for a senior care workforce innovation grant as specified in
377.2subdivision 4.
377.3    Subd. 4. Application. (a) Eligible applicants must apply for a grant on the forms and
377.4according to the timelines established by the commissioner.
377.5(b) Each applicant must propose a project or initiative to expand the number of workers
377.6in the field of senior care services. At a minimum, a proposal must include:
377.7(1) a description of the senior care workforce innovation project or initiative being
377.8proposed, including the process by which the applicant will expand the senior care workforce;
377.9(2) whether the applicant is proposing to target the proposed project or initiative to any
377.10of the groups described in paragraph (c);
377.11(3) information describing the applicant's current senior care workforce project or
377.12initiative, if applicable;
377.13(4) the amount of funding the applicant is seeking through the grant program;
377.14(5) any other sources of funding the applicant has for the project or initiative;
377.15(6) a proposed budget detailing how the grant funds will be spent; and
377.16(7) outcomes established by the applicant to measure the success of the project or
377.17initiative.
377.18    Subd. 5. Commissioner's duties; requests for proposals; grantee selections. (a) By
377.19September 1, 2017, and annually thereafter, the commissioner shall publish a request for
377.20proposals in the State Register specifying applicant eligibility requirements, qualifying
377.21senior care workforce innovation program criteria, applicant selection criteria, documentation
377.22required for program participation, maximum award amount, and methods of evaluation.
377.23(b) Priority must be given to proposals that target employment of individuals who have
377.24multiple barriers to employment, individuals who have been unemployed long-term, and
377.25veterans.
377.26(c) The commissioner shall determine the maximum award for grants and make grant
377.27selections based on the information provided in the grant application, including the targeted
377.28employment population, the applicant's proposed budget, the proposed measurable outcomes,
377.29and other criteria as determined by the commissioner.
377.30    Subd. 6. Grant funding. Notwithstanding any law or rule to the contrary, funds awarded
377.31to grantees in a grant agreement under this section do not lapse until the grant agreement
377.32expires.
378.1    Subd. 7. Reporting requirements. (a) Grant recipients shall report to the commissioner
378.2on the forms and according to the timelines established by the commissioner.
378.3(b) The commissioner shall report to the chairs and ranking minority members of the
378.4house of representatives and senate committees with jurisdiction over health by January 15,
378.52019, and annually thereafter, on the grant program. The report must include:
378.6(1) information on each grant recipient;
378.7(2) a summary of all projects or initiatives undertaken with each grant;
378.8(3) the measurable outcomes established by each grantee, an explanation of the evaluation
378.9process used to determine whether the outcomes were met, and the results of the evaluation;
378.10and
378.11(4) an accounting of how the grant funds were spent.
378.12(c) During the grant period, the commissioner may require and collect from grant
378.13recipients additional information necessary to evaluate the grant program.

378.14    Sec. 24. [144.1505] HEALTH PROFESSIONALS CLINICAL TRAINING
378.15EXPANSION GRANT PROGRAM.
378.16    Subdivision 1. Definitions. For purposes of this section, the following definitions apply:
378.17(1) "eligible advanced practice registered nurse program" means a program that is located
378.18in Minnesota and is currently accredited as a master's, doctoral, or postgraduate level
378.19advanced practice registered nurse program by the Commission on Collegiate Nursing
378.20Education or by the Accreditation Commission for Education in Nursing, or is a candidate
378.21for accreditation;
378.22(2) "eligible dental therapy program" means a dental therapy education program or
378.23advanced dental therapy education program that is located in Minnesota and is either:
378.24(i) approved by the Board of Dentistry; or
378.25(ii) currently accredited by the Commission on Dental Accreditation;
378.26(3) "eligible mental health professional program" means a program that is located in
378.27Minnesota and is listed as a mental health professional program by the appropriate accrediting
378.28body for clinical social work, psychology, marriage and family therapy, or licensed
378.29professional clinical counseling, or is a candidate for accreditation;
379.1(4) "eligible pharmacy program" means a program that is located in Minnesota and is
379.2currently accredited as a doctor of pharmacy program by the Accreditation Council on
379.3Pharmacy Education;
379.4(5) "eligible physician assistant program" means a program that is located in Minnesota
379.5and is currently accredited as a physician assistant program by the Accreditation Review
379.6Commission on Education for the Physician Assistant, or is a candidate for accreditation;
379.7(6) "mental health professional" means an individual providing clinical services in the
379.8treatment of mental illness who meets one of the qualifications under section 245.462,
379.9subdivision 18; and
379.10(7) "project" means a project to establish or expand clinical training for physician
379.11assistants, advanced practice registered nurses, pharmacists, dental therapists, advanced
379.12dental therapists, or mental health professionals in Minnesota.
379.13    Subd. 2. Program. (a) The commissioner of health shall award health professional
379.14training site grants to eligible physician assistant, advanced practice registered nurse,
379.15pharmacy, dental therapy, and mental health professional programs to plan and implement
379.16expanded clinical training. A planning grant shall not exceed $75,000, and a training grant
379.17shall not exceed $150,000 for the first year, $100,000 for the second year, and $50,000 for
379.18the third year per program.
379.19(b) Funds may be used for:
379.20(1) establishing or expanding clinical training for physician assistants, advanced practice
379.21registered nurses, pharmacists, dental therapists, advanced dental therapists, and mental
379.22health professionals in Minnesota;
379.23(2) recruitment, training, and retention of students and faculty;
379.24(3) connecting students with appropriate clinical training sites, internships, practicums,
379.25or externship activities;
379.26(4) travel and lodging for students;
379.27(5) faculty, student, and preceptor salaries, incentives, or other financial support;
379.28(6) development and implementation of cultural competency training;
379.29(7) evaluations;
379.30(8) training site improvements, fees, equipment, and supplies required to establish,
379.31maintain, or expand a physician assistant, advanced practice registered nurse, pharmacy,
379.32dental therapy, or mental health professional training program; and
380.1(9) supporting clinical education in which trainees are part of a primary care team model.
380.2    Subd. 3. Applications. Eligible physician assistant, advanced practice registered nurse,
380.3pharmacy, dental therapy, and mental health professional programs seeking a grant shall
380.4apply to the commissioner. Applications must include a description of the number of
380.5additional students who will be trained using grant funds; attestation that funding will be
380.6used to support an increase in the number of clinical training slots; a description of the
380.7problem that the proposed project will address; a description of the project, including all
380.8costs associated with the project, sources of funds for the project, detailed uses of all funds
380.9for the project, and the results expected; and a plan to maintain or operate any component
380.10included in the project after the grant period. The applicant must describe achievable
380.11objectives, a timetable, and roles and capabilities of responsible individuals in the
380.12organization.
380.13    Subd. 4. Consideration of applications. The commissioner shall review each application
380.14to determine whether or not the application is complete and whether the program and the
380.15project are eligible for a grant. In evaluating applications, the commissioner shall score each
380.16application based on factors including, but not limited to, the applicant's clarity and
380.17thoroughness in describing the project and the problems to be addressed, the extent to which
380.18the applicant has demonstrated that the applicant has made adequate provisions to ensure
380.19proper and efficient operation of the training program once the grant project is completed,
380.20the extent to which the proposed project is consistent with the goal of increasing access to
380.21primary care and mental health services for rural and underserved urban communities, the
380.22extent to which the proposed project incorporates team-based primary care, and project
380.23costs and use of funds.
380.24    Subd. 5. Program oversight. The commissioner shall determine the amount of a grant
380.25to be given to an eligible program based on the relative score of each eligible program's
380.26application, other relevant factors discussed during the review, and the funds available to
380.27the commissioner. Appropriations made to the program do not cancel and are available until
380.28expended. During the grant period, the commissioner may require and collect from programs
380.29receiving grants any information necessary to evaluate the program.

380.30    Sec. 25. Minnesota Statutes 2016, section 144.1506, is amended to read:
380.31144.1506 PRIMARY CARE PHYSICIAN RESIDENCY EXPANSION GRANT
380.32PROGRAM.
380.33    Subdivision 1. Definitions. For purposes of this section, the following definitions apply:
381.1(1) "eligible primary care physician residency program" means a program that meets
381.2the following criteria:
381.3(i) is located in Minnesota;
381.4(ii) trains medical residents in the specialties of family medicine, general internal
381.5medicine, general pediatrics, psychiatry, geriatrics, or general surgery, obstetrics and
381.6gynecology, or other physician specialties with training programs that incorporate rural
381.7training components; and
381.8(iii) is accredited by the Accreditation Council for Graduate Medical Education or
381.9presents a credible plan to obtain accreditation;
381.10(2) "eligible project" means a project to establish a new eligible primary care physician
381.11residency program or create at least one new residency slot in an existing eligible primary
381.12care physician residency program; and
381.13(3) "new residency slot" means the creation of a new residency position and the execution
381.14of a contract with a new resident in a residency program.
381.15    Subd. 2. Expansion grant program. (a) The commissioner of health shall award primary
381.16care physician residency expansion grants to eligible primary care physician residency
381.17programs to plan and implement new residency slots. A planning grant shall not exceed
381.18$75,000, and a training grant shall not exceed $150,000 per new residency slot for the first
381.19year, $100,000 for the second year, and $50,000 for the third year of the new residency slot.
381.20(b) Funds may be spent to cover the costs of:
381.21(1) planning related to establishing an accredited primary care physician residency
381.22program;
381.23(2) obtaining accreditation by the Accreditation Council for Graduate Medical Education
381.24or another national body that accredits residency programs;
381.25(3) establishing new residency programs or new resident training slots;
381.26(4) recruitment, training, and retention of new residents and faculty;
381.27(5) travel and lodging for new residents;
381.28(6) faculty, new resident, and preceptor salaries related to new residency slots;
381.29(7) training site improvements, fees, equipment, and supplies required for new primary
381.30care physician resident training slots; and
381.31(8) supporting clinical education in which trainees are part of a primary care team model.
382.1    Subd. 3. Applications for expansion grants. Eligible primary care physician residency
382.2programs seeking a grant shall apply to the commissioner. Applications must include the
382.3number of new primary care physician residency slots planned or under contract; attestation
382.4that funding will be used to support an increase in the number of available residency slots;
382.5a description of the training to be received by the new residents, including the location of
382.6training; a description of the project, including all costs associated with the project; all
382.7sources of funds for the project; detailed uses of all funds for the project; the results expected;
382.8and a plan to maintain the new residency slot after the grant period. The applicant must
382.9describe achievable objectives, a timetable, and roles and capabilities of responsible
382.10individuals in the organization.
382.11    Subd. 4. Consideration of expansion grant applications. The commissioner shall
382.12review each application to determine whether or not the residency program application is
382.13complete and whether the proposed new residency program and any new residency slots
382.14are eligible for a grant. The commissioner shall award grants to support up to six family
382.15medicine, general internal medicine, or general pediatrics residents; four psychiatry residents;
382.16two geriatrics residents; and two four general surgery residents; two obstetrics and
382.17gynecology residents; and four specialty physician residents participating in training programs
382.18that incorporate rural training components. If insufficient applications are received from
382.19any eligible specialty, funds may be redistributed to applications from other eligible
382.20specialties.
382.21    Subd. 5. Program oversight. During the grant period, the commissioner may require
382.22and collect from grantees any information necessary to evaluate the program. Appropriations
382.23made to the program do not cancel and are available until expended.

382.24    Sec. 26. [144.397] STATEWIDE TOBACCO QUITLINE SERVICES.
382.25(a) The commissioner of health shall administer, or contract for the administration of,
382.26a statewide tobacco quitline service to assist Minnesotans who are seeking advice or services
382.27to help them quit using tobacco products. The commissioner shall establish statewide public
382.28awareness activities to inform the public of the availability of the service and encourage
382.29the public to utilize the services because of the dangers and harm of tobacco use and
382.30dependence.
382.31(b) Services to be provided include, but are not limited to:
382.32(1) telephone-based coaching and counseling;
382.33(2) referrals;
383.1(3) written materials mailed upon request;
383.2(4) Web-based texting or e-mail services; and
383.3(5) free Food and Drug Administration-approved tobacco cessation medications.
383.4(c) Services provided must be consistent with evidence-based best practices in tobacco
383.5cessation services. Services provided must be coordinated with employer, health plan
383.6company, and private sector tobacco prevention and cessation services that may be available
383.7to individuals depending on their employment or health coverage.

383.8    Sec. 27. Minnesota Statutes 2016, section 144.551, subdivision 1, is amended to read:
383.9    Subdivision 1. Restricted construction or modification. (a) The following construction
383.10or modification may not be commenced:
383.11(1) any erection, building, alteration, reconstruction, modernization, improvement,
383.12extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
383.13capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
383.14to another, or otherwise results in an increase or redistribution of hospital beds within the
383.15state; and
383.16(2) the establishment of a new hospital.
383.17(b) This section does not apply to:
383.18(1) construction or relocation within a county by a hospital, clinic, or other health care
383.19facility that is a national referral center engaged in substantial programs of patient care,
383.20medical research, and medical education meeting state and national needs that receives more
383.21than 40 percent of its patients from outside the state of Minnesota;
383.22(2) a project for construction or modification for which a health care facility held an
383.23approved certificate of need on May 1, 1984, regardless of the date of expiration of the
383.24certificate;
383.25(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
383.26appeal results in an order reversing the denial;
383.27(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
383.28section 2;
383.29(5) a project involving consolidation of pediatric specialty hospital services within the
383.30Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
383.31of pediatric specialty hospital beds among the hospitals being consolidated;
384.1(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
384.2an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
384.3pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
384.4the number of hospital beds. Upon completion of the reconstruction, the licenses of both
384.5hospitals must be reinstated at the capacity that existed on each site before the relocation;
384.6(7) the relocation or redistribution of hospital beds within a hospital building or
384.7identifiable complex of buildings provided the relocation or redistribution does not result
384.8in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
384.9one physical site or complex to another; or (iii) redistribution of hospital beds within the
384.10state or a region of the state;
384.11(8) relocation or redistribution of hospital beds within a hospital corporate system that
384.12involves the transfer of beds from a closed facility site or complex to an existing site or
384.13complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
384.14transferred; (ii) the capacity of the site or complex to which the beds are transferred does
384.15not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
384.16health systems agency boundary in place on July 1, 1983; and (iv) the relocation or
384.17redistribution does not involve the construction of a new hospital building;
384.18(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
384.19County that primarily serves adolescents and that receives more than 70 percent of its
384.20patients from outside the state of Minnesota;
384.21(10) a project to replace a hospital or hospitals with a combined licensed capacity of
384.22130 beds or less if: (i) the new hospital site is located within five miles of the current site;
384.23and (ii) the total licensed capacity of the replacement hospital, either at the time of
384.24construction of the initial building or as the result of future expansion, will not exceed 70
384.25licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;
384.26(11) the relocation of licensed hospital beds from an existing state facility operated by
384.27the commissioner of human services to a new or existing facility, building, or complex
384.28operated by the commissioner of human services; from one regional treatment center site
384.29to another; or from one building or site to a new or existing building or site on the same
384.30campus;
384.31(12) the construction or relocation of hospital beds operated by a hospital having a
384.32statutory obligation to provide hospital and medical services for the indigent that does not
384.33result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
385.1beds, of which 12 serve mental health needs, may be transferred from Hennepin County
385.2Medical Center to Regions Hospital under this clause;
385.3(13) a construction project involving the addition of up to 31 new beds in an existing
385.4nonfederal hospital in Beltrami County;
385.5(14) a construction project involving the addition of up to eight new beds in an existing
385.6nonfederal hospital in Otter Tail County with 100 licensed acute care beds;
385.7(15) a construction project involving the addition of 20 new hospital beds used for
385.8rehabilitation services in an existing hospital in Carver County serving the southwest
385.9suburban metropolitan area. Beds constructed under this clause shall not be eligible for
385.10reimbursement under medical assistance or MinnesotaCare;
385.11(16) a project for the construction or relocation of up to 20 hospital beds for the operation
385.12of up to two psychiatric facilities or units for children provided that the operation of the
385.13facilities or units have received the approval of the commissioner of human services;
385.14(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
385.15services in an existing hospital in Itasca County;
385.16(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
385.17that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
385.18rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
385.19purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;
385.20(19) a critical access hospital established under section 144.1483, clause (9), and section
385.211820 of the federal Social Security Act, United States Code, title 42, section 1395i-4, that
385.22delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
385.23to the extent that the critical access hospital does not seek to exceed the maximum number
385.24of beds permitted such hospital under federal law;
385.25(20) notwithstanding section 144.552, a project for the construction of a new hospital
385.26in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:
385.27(i) the project, including each hospital or health system that will own or control the entity
385.28that will hold the new hospital license, is approved by a resolution of the Maple Grove City
385.29Council as of March 1, 2006;
385.30(ii) the entity that will hold the new hospital license will be owned or controlled by one
385.31or more not-for-profit hospitals or health systems that have previously submitted a plan or
385.32plans for a project in Maple Grove as required under section 144.552, and the plan or plans
386.1have been found to be in the public interest by the commissioner of health as of April 1,
386.22005;
386.3(iii) the new hospital's initial inpatient services must include, but are not limited to,
386.4medical and surgical services, obstetrical and gynecological services, intensive care services,
386.5orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
386.6services, and emergency room services;
386.7(iv) the new hospital:
386.8(A) will have the ability to provide and staff sufficient new beds to meet the growing
386.9needs of the Maple Grove service area and the surrounding communities currently being
386.10served by the hospital or health system that will own or control the entity that will hold the
386.11new hospital license;
386.12(B) will provide uncompensated care;
386.13(C) will provide mental health services, including inpatient beds;
386.14(D) will be a site for workforce development for a broad spectrum of health-care-related
386.15occupations and have a commitment to providing clinical training programs for physicians
386.16and other health care providers;
386.17(E) will demonstrate a commitment to quality care and patient safety;
386.18(F) will have an electronic medical records system, including physician order entry;
386.19(G) will provide a broad range of senior services;
386.20(H) will provide emergency medical services that will coordinate care with regional
386.21providers of trauma services and licensed emergency ambulance services in order to enhance
386.22the continuity of care for emergency medical patients; and
386.23(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
386.24the control of the entity holding the new hospital license; and
386.25(v) as of 30 days following submission of a written plan, the commissioner of health
386.26has not determined that the hospitals or health systems that will own or control the entity
386.27that will hold the new hospital license are unable to meet the criteria of this clause;
386.28(21) a project approved under section 144.553;
386.29(22) a project for the construction of a hospital with up to 25 beds in Cass County within
386.30a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
386.31is approved by the Cass County Board;
387.1(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
387.2from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
387.3a separately licensed 13-bed skilled nursing facility;
387.4(24) notwithstanding section 144.552, a project for the construction and expansion of a
387.5specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
387.6who are under 21 years of age on the date of admission. The commissioner conducted a
387.7public interest review of the mental health needs of Minnesota and the Twin Cities
387.8metropolitan area in 2008. No further public interest review shall be conducted for the
387.9construction or expansion project under this clause;
387.10(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
387.11commissioner finds the project is in the public interest after the public interest review
387.12conducted under section 144.552 is complete; or
387.13(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
387.14of Maple Grove, exclusively for patients who are under 21 years of age on the date of
387.15admission, if the commissioner finds the project is in the public interest after the public
387.16interest review conducted under section 144.552 is complete;
387.17(ii) this project shall serve patients in the continuing care benefit program under section
387.18256.9693 . The project may also serve patients not in the continuing care benefit program;
387.19and
387.20(iii) if the project ceases to participate in the continuing care benefit program, the
387.21commissioner must complete a subsequent public interest review under section 144.552. If
387.22the project is found not to be in the public interest, the license must be terminated six months
387.23from the date of that finding. If the commissioner of human services terminates the contract
387.24without cause or reduces per diem payment rates for patients under the continuing care
387.25benefit program below the rates in effect for services provided on December 31, 2015, the
387.26project may cease to participate in the continuing care benefit program and continue to
387.27operate without a subsequent public interest review; or
387.28(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
387.29in Hennepin County that is exclusively for patients who are under 21 years of age on the
387.30date of admission.
387.31EFFECTIVE DATE.This section is effective the day following final enactment.

388.1    Sec. 28. [144.88] MINNESOTA BIOMEDICINE AND BIOETHICS INNOVATION
388.2GRANTS.
388.3    Subdivision 1. Grants. (a) The commissioner of health, in consultation with interested
388.4parties with relevant knowledge and expertise as specified in subdivision 2, shall award
388.5grants to entities that apply for a grant under this subdivision to fund innovations and research
388.6in biomedicine and bioethics. Grant funds must be used to fund biomedical and bioethical
388.7research, and related clinical translation and commercialization activities in this state. Entities
388.8applying for a grant must do so in a form and manner specified by the commissioner. The
388.9commissioner and interested parties shall use the following criteria to award grants under
388.10this subdivision:
388.11(1) the likelihood that the research will lead to a new discovery;
388.12(2) the prospects for commercialization of the research;
388.13(3) the likelihood that the research will strengthen Minnesota's economy through the
388.14creation of new businesses, increased public or private funding for research in Minnesota,
388.15or attracting additional clinicians and researchers to Minnesota; and
388.16(4) whether the proposed research includes a bioethics research plan to ensure the research
388.17is conducted using ethical research practices.
388.18(b) Projects that include the acquisition or use of human fetal tissue are not eligible for
388.19grants under this subdivision. For purposes of this paragraph, "human fetal tissue" has the
388.20meaning given in United States Code, title 42, section 289g-1(f).
388.21    Subd. 2. Consultation. In awarding grants under subdivision 1, the commissioner must
388.22consult with interested parties who are able to provide the commissioner with technical
388.23information, advice, and recommendations on grant projects and awards. Interested parties
388.24with whom the commissioner must consult include but are not limited to representatives of
388.25the University of Minnesota, Mayo Clinic, and private industries who have expertise in
388.26biomedical research, bioethical research, clinical translation, commercialization, and medical
388.27venture financing.

388.28    Sec. 29. Minnesota Statutes 2016, section 144.99, subdivision 1, is amended to read:
388.29    Subdivision 1. Remedies available. The provisions of chapters 103I and 157 and sections
388.30115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14),
388.31and (15) ; 144.1201 to 144.1204; 144.121; 144.1215; 144.1222; 144.35; 144.381 to 144.385;
388.32144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.97 to 144.98;
388.33144.992 ; 326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders,
389.1stipulation agreements, settlements, compliance agreements, licenses, registrations,
389.2certificates, and permits adopted or issued by the department or under any other law now
389.3in force or later enacted for the preservation of public health may, in addition to provisions
389.4in other statutes, be enforced under this section.

389.5    Sec. 30. Minnesota Statutes 2016, section 144A.472, subdivision 7, is amended to read:
389.6    Subd. 7. Fees; application, change of ownership, and renewal. (a) An initial applicant
389.7seeking temporary home care licensure must submit the following application fee to the
389.8commissioner along with a completed application:
389.9(1) for a basic home care provider, $2,100; or
389.10(2) for a comprehensive home care provider, $4,200.
389.11(b) A home care provider who is filing a change of ownership as required under
389.12subdivision 5 must submit the following application fee to the commissioner, along with
389.13the documentation required for the change of ownership:
389.14(1) for a basic home care provider, $2,100; or
389.15(2) for a comprehensive home care provider, $4,200.
389.16(c) A home care provider who is seeking to renew the provider's license shall pay a fee
389.17to the commissioner based on revenues derived from the provision of home care services
389.18during the calendar year prior to the year in which the application is submitted, according
389.19to the following schedule:
389.20License Renewal Fee

389.21	Provider Annual Revenue	Fee
389.22	greater than $1,500,000	$6,625
389.23 389.24	greater than $1,275,000 and no more than $1,500,000	$5,797
389.25 389.26	greater than $1,100,000 and no more than $1,275,000	$4,969
389.27 389.28	greater than $950,000 and no more than $1,100,000	$4,141
389.29	greater than $850,000 and no more than $950,000	$3,727
389.30	greater than $750,000 and no more than $850,000	$3,313
389.31	greater than $650,000 and no more than $750,000	$2,898
389.32	greater than $550,000 and no more than $650,000	$2,485
389.33	greater than $450,000 and no more than $550,000	$2,070
389.34	greater than $350,000 and no more than $450,000	$1,656
390.1	greater than $250,000 and no more than $350,000	$1,242
390.2	greater than $100,000 and no more than $250,000	$828
390.3	greater than $50,000 and no more than $100,000	$500
390.4	greater than $25,000 and no more than $50,000	$400
390.5	no more than $25,000	$200

390.6(d) If requested, the home care provider shall provide the commissioner information to
390.7verify the provider's annual revenues or other information as needed, including copies of
390.8documents submitted to the Department of Revenue.
390.9(e) At each annual renewal, a home care provider may elect to pay the highest renewal
390.10fee for its license category, and not provide annual revenue information to the commissioner.
390.11(f) A temporary license or license applicant, or temporary licensee or licensee that
390.12knowingly provides the commissioner incorrect revenue amounts for the purpose of paying
390.13a lower license fee, shall be subject to a civil penalty in the amount of double the fee the
390.14provider should have paid.
390.15(g) Fees and penalties collected under this section shall be deposited in the state treasury
390.16and credited to the state government special revenue fund. All fees are nonrefundable. Fees
390.17collected under paragraph (c) are nonrefundable even if received before July 1, 2017, for
390.18temporary licenses or licenses being issued effective July 1, 2017, or later.
390.19(h) The license renewal fee schedule in this subdivision is effective July 1, 2016.

390.20    Sec. 31. Minnesota Statutes 2016, section 144A.474, subdivision 11, is amended to read:
390.21    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be assessed
390.22based on the level and scope of the violations described in paragraph (c) as follows:
390.23(1) Level 1, no fines or enforcement;
390.24(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
390.25mechanisms authorized in section 144A.475 for widespread violations;
390.26(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement
390.27mechanisms authorized in section 144A.475; and
390.28(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the enforcement
390.29mechanisms authorized in section 144A.475.
390.30(b) Correction orders for violations are categorized by both level and scope and fines
390.31shall be assessed as follows:
391.1(1) level of violation:
391.2(i) Level 1 is a violation that has no potential to cause more than a minimal impact on
391.3the client and does not affect health or safety;
391.4(ii) Level 2 is a violation that did not harm a client's health or safety but had the potential
391.5to have harmed a client's health or safety, but was not likely to cause serious injury,
391.6impairment, or death;
391.7(iii) Level 3 is a violation that harmed a client's health or safety, not including serious
391.8injury, impairment, or death, or a violation that has the potential to lead to serious injury,
391.9impairment, or death; and
391.10(iv) Level 4 is a violation that results in serious injury, impairment, or death.
391.11(2) scope of violation:
391.12(i) isolated, when one or a limited number of clients are affected or one or a limited
391.13number of staff are involved or the situation has occurred only occasionally;
391.14(ii) pattern, when more than a limited number of clients are affected, more than a limited
391.15number of staff are involved, or the situation has occurred repeatedly but is not found to be
391.16pervasive; and
391.17(iii) widespread, when problems are pervasive or represent a systemic failure that has
391.18affected or has the potential to affect a large portion or all of the clients.
391.19(c) If the commissioner finds that the applicant or a home care provider required to be
391.20licensed under sections 144A.43 to 144A.482 has not corrected violations by the date
391.21specified in the correction order or conditional license resulting from a survey or complaint
391.22investigation, the commissioner may impose a fine. A notice of noncompliance with a
391.23correction order must be mailed to the applicant's or provider's last known address. The
391.24noncompliance notice must list the violations not corrected.
391.25(d) The license holder must pay the fines assessed on or before the payment date specified.
391.26If the license holder fails to fully comply with the order, the commissioner may issue a
391.27second fine or suspend the license until the license holder complies by paying the fine. A
391.28timely appeal shall stay payment of the fine until the commissioner issues a final order.
391.29(e) A license holder shall promptly notify the commissioner in writing when a violation
391.30specified in the order is corrected. If upon reinspection the commissioner determines that
391.31a violation has not been corrected as indicated by the order, the commissioner may issue a
391.32second fine. The commissioner shall notify the license holder by mail to the last known
392.1address in the licensing record that a second fine has been assessed. The license holder may
392.2appeal the second fine as provided under this subdivision.
392.3(f) A home care provider that has been assessed a fine under this subdivision has a right
392.4to a reconsideration or a hearing under this section and chapter 14.
392.5(g) When a fine has been assessed, the license holder may not avoid payment by closing,
392.6selling, or otherwise transferring the licensed program to a third party. In such an event, the
392.7license holder shall be liable for payment of the fine.
392.8(h) In addition to any fine imposed under this section, the commissioner may assess
392.9costs related to an investigation that results in a final order assessing a fine or other
392.10enforcement action authorized by this chapter.
392.11(i) Fines collected under this subdivision shall be deposited in the state government
392.12special revenue fund and credited to an account separate from the revenue collected under
392.13section 144A.472. Subject to an appropriation by the legislature, the revenue from the fines
392.14collected may must be used by the commissioner for special projects to improve home care
392.15in Minnesota as recommended by the advisory council established in section 144A.4799.

392.16    Sec. 32. Minnesota Statutes 2016, section 144A.4799, subdivision 3, is amended to read:
392.17    Subd. 3. Duties. (a) At the commissioner's request, the advisory council shall provide
392.18advice regarding regulations of Department of Health licensed home care providers in this
392.19chapter, including advice on the following:
392.20(1) community standards for home care practices;
392.21(2) enforcement of licensing standards and whether certain disciplinary actions are
392.22appropriate;
392.23(3) ways of distributing information to licensees and consumers of home care;
392.24(4) training standards;
392.25(5) identifying emerging issues and opportunities in the home care field, including the
392.26use of technology in home and telehealth capabilities;
392.27(6) allowable home care licensing modifications and exemptions, including a method
392.28for an integrated license with an existing license for rural licensed nursing homes to provide
392.29limited home care services in an adjacent independent living apartment building owned by
392.30the licensed nursing home; and
393.1(7) recommendations for studies using the data in section 62U.04, subdivision 4, including
393.2but not limited to studies concerning costs related to dementia and chronic disease among
393.3an elderly population over 60 and additional long-term care costs, as described in section
393.462U.10, subdivision 6 .
393.5(b) The advisory council shall perform other duties as directed by the commissioner.
393.6(c) The advisory council shall annually review the balance of the account in the state
393.7government special revenue fund described in section 144A.474, subdivision 11, paragraph
393.8(i), and make annual recommendations by January 15 directly to the chairs and ranking
393.9minority members of the legislative committees with jurisdiction over health and human
393.10services regarding appropriations to the commissioner for the purposes in section 144A.474,
393.11subdivision 11, paragraph (i).

393.12    Sec. 33. Minnesota Statutes 2016, section 144A.70, is amended by adding a subdivision
393.13to read:
393.14    Subd. 4a. Nurse. "Nurse" means a licensed practical nurse as defined in section 148.171,
393.15subdivision 8, or a registered nurse as defined in section 148.171, subdivision 20.
393.16EFFECTIVE DATE.This section is effective the day following final enactment.

393.17    Sec. 34. Minnesota Statutes 2016, section 144A.70, subdivision 6, is amended to read:
393.18    Subd. 6. Supplemental nursing services agency. "Supplemental nursing services
393.19agency" means a person, firm, corporation, partnership, or association engaged for hire in
393.20the business of providing or procuring temporary employment in health care facilities for
393.21nurses, nursing assistants, nurse aides, and orderlies, and other licensed health professionals.
393.22Supplemental nursing services agency does not include an individual who only engages in
393.23providing the individual's services on a temporary basis to health care facilities. Supplemental
393.24nursing services agency does not include a professional home care agency licensed under
393.25section 144A.471 that only provides staff to other home care providers.
393.26EFFECTIVE DATE.This section is effective the day following final enactment.

393.27    Sec. 35. Minnesota Statutes 2016, section 144D.06, is amended to read:
393.28144D.06 OTHER LAWS.
393.29In addition to registration under this chapter, a housing with services establishment must
393.30comply with chapter 504B and the provisions of section 325F.72, and shall obtain and
393.31maintain all other licenses, permits, registrations, or other governmental approvals required
394.1of it in addition to registration under this chapter. A housing with services establishment is
394.2subject to the provisions of section 325F.72 and chapter 504B not required to obtain a
394.3lodging license under chapter 157 and related rules.
394.4EFFECTIVE DATE.This section is effective August 1, 2017.

394.5    Sec. 36. [144H.01] DEFINITIONS.
394.6    Subdivision 1. Application. The terms defined in this section apply to this chapter.
394.7    Subd. 2. Basic services. "Basic services" includes but is not limited to:
394.8(1) the development, implementation, and monitoring of a comprehensive protocol of
394.9care that is developed in conjunction with the parent or guardian of a medically complex
394.10or technologically dependent child and that specifies the medical, nursing, psychosocial,
394.11and developmental therapies required by the medically complex or technologically dependent
394.12child; and
394.13(2) the caregiver training needs of the child's parent or guardian.
394.14    Subd. 3. Commissioner. "Commissioner" means the commissioner of health.
394.15    Subd. 4. Licensee. "Licensee" means an owner of a prescribed pediatric extended care
394.16(PPEC) center licensed under this chapter.
394.17    Subd. 5. Medically complex or technologically dependent child. "Medically complex
394.18or technologically dependent child" means a child under 21 years of age who, because of
394.19a medical condition, requires continuous therapeutic interventions or skilled nursing
394.20supervision which must be prescribed by a licensed physician and administered by, or under
394.21the direct supervision of, a licensed registered nurse.
394.22    Subd. 6. Owner. "Owner" means an individual whose ownership interest provides
394.23sufficient authority or control to affect or change decisions regarding the operation of the
394.24PPEC center. An owner includes a sole proprietor, a general partner, or any other individual
394.25whose ownership interest has the ability to affect the management and direction of the PPEC
394.26center's policies.
394.27    Subd. 7. Prescribed pediatric extended care center, PPEC center, or center.
394.28"Prescribed pediatric extended care center," "PPEC center," or "center" means any facility
394.29that provides nonresidential basic services to three or more medically complex or
394.30technologically dependent children who require such services and who are not related to
394.31the owner by blood, marriage, or adoption.
395.1    Subd. 8. Supportive services or contracted services. "Supportive services or contracted
395.2services" include but are not limited to speech therapy, occupational therapy, physical
395.3therapy, social work services, developmental services, child life services, and psychology
395.4services.

395.5    Sec. 37. [144H.02] LICENSURE REQUIRED.
395.6A person may not own or operate a prescribed pediatric extended care center in this state
395.7unless the person holds a temporary or current license issued under this chapter. A separate
395.8license must be obtained for each PPEC center maintained on separate premises, even if
395.9the same management operates the PPEC centers. Separate licenses are not required for
395.10separate buildings on the same grounds. A center shall not be operated on the same grounds
395.11as a child care center licensed under Minnesota Rules, chapter 9503.

395.12    Sec. 38. [144H.03] EXEMPTIONS.
395.13This chapter does not apply to:
395.14(1) a facility operated by the United States government or a federal agency; or
395.15(2) a health care facility licensed under chapter 144 or 144A.

395.16    Sec. 39. [144H.04] LICENSE APPLICATION AND RENEWAL.
395.17    Subdivision 1. Licenses. A person seeking licensure for a PPEC center must submit a
395.18completed application for licensure to the commissioner, in a form and manner determined
395.19by the commissioner. The applicant must also submit the application fee, in the amount
395.20specified in section 144H.05, subdivision 1. Effective January 1, 2018, the commissioner
395.21shall issue a license for a PPEC center if the commissioner determines that the applicant
395.22and center meet the requirements of this chapter and rules that apply to PPEC centers. A
395.23license issued under this subdivision is valid for two years.
395.24    Subd. 2. License renewal. A license issued under subdivision 1 may be renewed for a
395.25period of two years if the licensee:
395.26(1) submits an application for renewal in a form and manner determined by the
395.27commissioner, at least 30 days before the license expires. An application for renewal
395.28submitted after the renewal deadline date must be accompanied by a late fee in the amount
395.29specified in section 144H.05, subdivision 3;
395.30(2) submits the renewal fee in the amount specified in section 144H.05, subdivision 2;
396.1(3) demonstrates that the licensee has provided basic services at the PPEC center within
396.2the past two years;
396.3(4) provides evidence that the applicant meets the requirements for licensure; and
396.4(5) provides other information required by the commissioner.
396.5    Subd. 3. License not transferable. A PPEC center license issued under this section is
396.6not transferable to another party. Before acquiring ownership of a PPEC center, a prospective
396.7applicant must apply to the commissioner for a new license.

396.8    Sec. 40. [144H.05] FEES.
396.9    Subdivision 1. Initial application fee. The initial application fee for PPEC center
396.10licensure is $3,820.
396.11    Subd. 2. License renewal. The fee for renewal of a PPEC center license is $1,800.
396.12    Subd. 3. Late fee. The fee for late submission of an application to renew a PPEC center
396.13license is $25.
396.14    Subd. 4. Change of ownership. The fee for change of ownership of a PPEC center is
396.15$4,200.
396.16    Subd. 5. Nonrefundable; state government special revenue fund. All fees collected
396.17under this chapter are nonrefundable and must be deposited in the state treasury and credited
396.18to the state government special revenue fund.

396.19    Sec. 41. [144H.06] APPLICATION OF RULES FOR HOSPICE SERVICES AND
396.20RESIDENTIAL HOSPICE FACILITIES.
396.21Minnesota Rules, chapter 4664, shall apply to PPEC centers licensed under this chapter,
396.22except that the following parts, subparts, items, and subitems do not apply:
396.23(1) Minnesota Rules, part 4664.0003, subparts 2, 6, 7, 11, 12, 13, 14, and 38;
396.24(2) Minnesota Rules, part 4664.0008;
396.25(3) Minnesota Rules, part 4664.0010, subparts 3; 4, items A, subitem (6), and B; and 8;
396.26(4) Minnesota Rules, part 4664.0020, subpart 13;
396.27(5) Minnesota Rules, part 4664.0370, subpart 1;
396.28(6) Minnesota Rules, part 4664.0390, subpart 1, items A, C, and E;
396.29(7) Minnesota Rules, part 4664.0420;
397.1(8) Minnesota Rules, part 4664.0425, subparts 3, item A; 4; and 6;
397.2(9) Minnesota Rules, part 4664.0430, subparts 3, 4, 5, 7, 8, 9, 10, 11, and 12;
397.3(10) Minnesota Rules, part 4664.0490; and
397.4(11) Minnesota Rules, part 4664.0520.

397.5    Sec. 42. [144H.07] SERVICES; LIMITATIONS.
397.6    Subdivision 1. Services. A PPEC center must provide basic services to medically complex
397.7or technologically dependent children, based on a protocol of care established for each child.
397.8A PPEC center may provide services up to 14 hours a day and up to six days a week.
397.9    Subd. 2. Limitations. A PPEC center must comply with the following standards related
397.10to services:
397.11(1) a child is prohibited from attending a PPEC center for more than 14 hours within a
397.1224-hour period;
397.13(2) a PPEC center is prohibited from providing services other than those provided to
397.14medically complex or technologically dependent children; and
397.15(3) the maximum capacity for medically complex or technologically dependent children
397.16at a center shall not exceed 45 children.

397.17    Sec. 43. [144H.08] ADMINISTRATION AND MANAGEMENT.
397.18    Subdivision 1. Duties of owner. (a) The owner of a PPEC center shall have full legal
397.19authority and responsibility for the operation of the center. A PPEC center must be organized
397.20according to a written table of organization, describing the lines of authority and
397.21communication to the child care level. The organizational structure must be designed to
397.22ensure an integrated continuum of services for the children served.
397.23(b) The owner must designate one person as a center administrator, who is responsible
397.24and accountable for overall management of the center.
397.25    Subd. 2. Duties of administrator. The center administrator is responsible and accountable
397.26for overall management of the center. The administrator must:
397.27(1) designate in writing a person to be responsible for the center when the administrator
397.28is absent from the center for more than 24 hours;
397.29(2) maintain the following written records, in a place and form and using a system that
397.30allows for inspection of the records by the commissioner during normal business hours:
398.1(i) a daily census record, which indicates the number of children currently receiving
398.2services at the center;
398.3(ii) a record of all accidents or unusual incidents involving any child or staff member
398.4that caused, or had the potential to cause, injury or harm to a person at the center or to center
398.5property;
398.6(iii) copies of all current agreements with providers of supportive services or contracted
398.7services;
398.8(iv) copies of all current agreements with consultants employed by the center,
398.9documentation of each consultant's visits, and written, dated reports; and
398.10(v) a personnel record for each employee, which must include an application for
398.11employment, references, employment history for the preceding five years, and copies of all
398.12performance evaluations;
398.13(3) develop and maintain a current job description for each employee;
398.14(4) provide necessary qualified personnel and ancillary services to ensure the health,
398.15safety, and proper care for each child; and
398.16(5) develop and implement infection control policies that comply with rules adopted by
398.17the commissioner regarding infection control.

398.18    Sec. 44. [144H.09] ADMISSION, TRANSFER, AND DISCHARGE POLICIES;
398.19CONSENT FORM.
398.20    Subdivision 1. Written policies. A PPEC center must have written policies and
398.21procedures governing the admission, transfer, and discharge of children.
398.22    Subd. 2. Notice of discharge. At least ten days prior to a child's discharge from a PPEC
398.23center, the PPEC center shall provide notice of the discharge to the child's parent or guardian.
398.24    Subd. 3. Consent form. A parent or guardian must sign a consent form outlining the
398.25purpose of a PPEC center, specifying family responsibilities, authorizing treatment and
398.26services, providing appropriate liability releases, and specifying emergency disposition
398.27plans, before the child's admission to the center. The center must provide the child's parents
398.28or guardians with a copy of the consent form and must maintain the consent form in the
398.29child's medical record.

399.1    Sec. 45. [144H.10] MEDICAL DIRECTOR.
399.2A PPEC center must have a medical director who is a physician licensed in Minnesota
399.3and certified by the American Board of Pediatrics.

399.4    Sec. 46. [144H.11] NURSING SERVICES.
399.5    Subdivision 1. Nursing director. A PPEC center must have a nursing director who is
399.6a registered nurse licensed in Minnesota, holds a current certification in cardiopulmonary
399.7resuscitation, and has at least four years of general pediatric nursing experience, at least
399.8one year of which must have been spent caring for medically fragile infants or children in
399.9a pediatric intensive care, neonatal intensive care, PPEC center, or home care setting during
399.10the previous five years. The nursing director is responsible for the daily operation of the
399.11PPEC center.
399.12    Subd. 2. Registered nurses. A registered nurse employed by a PPEC center must be a
399.13registered nurse licensed in Minnesota, hold a current certification in cardiopulmonary
399.14resuscitation, and have experience in the previous 24 months in being responsible for the
399.15care of acutely ill or chronically ill children.
399.16    Subd. 3. Licensed practical nurses. A licensed practical nurse employed by a PPEC
399.17center must be supervised by a registered nurse and must be a licensed practical nurse
399.18licensed in Minnesota, have at least two years of experience in pediatrics, and hold a current
399.19certification in cardiopulmonary resuscitation.
399.20    Subd. 4. Other direct care personnel. (a) Direct care personnel governed by this
399.21subdivision include nursing assistants and individuals with training and experience in the
399.22field of education, social services, or child care.
399.23(b) All direct care personnel employed by a PPEC center must work under the supervision
399.24of a registered nurse and are responsible for providing direct care to children at the center.
399.25Direct care personnel must have extensive, documented education and skills training in
399.26providing care to infants and toddlers, provide employment references documenting skill
399.27in the care of infants and children, and hold a current certification in cardiopulmonary
399.28resuscitation.

400.1    Sec. 47. [144H.12] TOTAL STAFFING FOR NURSING SERVICES AND DIRECT
400.2CARE PERSONNEL.
400.3A PPEC center must provide total staffing for nursing services and direct care personnel
400.4at a ratio of one staff person for every three children at the center. The staffing ratio required
400.5in this section is the minimum staffing permitted.

400.6    Sec. 48. [144H.13] MEDICAL RECORD; PROTOCOL OF CARE.
400.7A medical record and an individualized nursing protocol of care must be developed for
400.8each child admitted to a PPEC center, must be maintained for each child, and must be signed
400.9by authorized personnel.

400.10    Sec. 49. [144H.14] QUALITY ASSURANCE PROGRAM.
400.11A PPEC center must have a quality assurance program, in which quarterly reviews are
400.12conducted of the PPEC center's medical records and protocols of care for at least half of
400.13the children served by the PPEC center. The quarterly review sample must be randomly
400.14selected so each child at the center has an equal opportunity to be included in the review.
400.15The committee conducting quality assurance reviews must include the medical director,
400.16administrator, nursing director, and three other committee members determined by the PPEC
400.17center.

400.18    Sec. 50. [144H.15] INSPECTIONS.
400.19(a) The commissioner may inspect a PPEC center, including records held at the center,
400.20at reasonable times as necessary to ensure compliance with this chapter and the rules that
400.21apply to PPEC centers. During an inspection, a center must provide the commissioner with
400.22access to all center records.
400.23(b) The commissioner must inspect a PPEC center before issuing or renewing a license
400.24under this chapter.

400.25    Sec. 51. [144H.16] COMPLIANCE WITH OTHER LAWS.
400.26    Subdivision 1. Reporting of maltreatment of minors. A PPEC center must develop
400.27policies and procedures for reporting suspected child maltreatment that fulfill the
400.28requirements of section 626.556. The policies and procedures must include the telephone
400.29numbers of the local county child protection agency for reporting suspected maltreatment.
400.30The policies and procedures specified in this subdivision must be provided to the parents
401.1or guardians of all children at the time of admission to the PPEC center and must be available
401.2upon request.
401.3    Subd. 2. Crib safety requirements. A PPEC center must comply with the crib safety
401.4requirements in section 245A.146, to the extent they are applicable.

401.5    Sec. 52. [144H.17] DENIAL, SUSPENSION, REVOCATION, REFUSAL TO RENEW
401.6A LICENSE.
401.7(a) The commissioner may deny, suspend, revoke, or refuse to renew a license issued
401.8under this chapter for:
401.9(1) a violation of this chapter or rules adopted that apply to PPEC centers; or
401.10(2) an intentional or negligent act by an employee or contractor at the center that
401.11detrimentally affects the health or safety of children at the PPEC center.
401.12(b) Prior to any suspension, revocation, or refusal to renew a license, a licensee shall be
401.13entitled to a hearing and review as provided in sections 14.57 to 14.69.

401.14    Sec. 53. [144H.18] FINES; CORRECTIVE ACTION PLANS.
401.15    Subdivision 1. Corrective action plans. If the commissioner determines that a PPEC
401.16center is not in compliance with this chapter or rules that apply to PPEC centers, the
401.17commissioner may require the center to submit a corrective action plan that demonstrates
401.18a good-faith effort to remedy each violation by a specific date, subject to approval by the
401.19commissioner.
401.20    Subd. 2. Fines. The commissioner may issue a fine to a PPEC center, employee, or
401.21contractor if the commissioner determines the center, employee, or contractor violated this
401.22chapter or rules that apply to PPEC centers. The fine amount shall not exceed an amount
401.23for each violation and an aggregate amount established by the commissioner. The failure
401.24to correct a violation by the date set by the commissioner, or a failure to comply with an
401.25approved corrective action plan, constitutes a separate violation for each day the failure
401.26continues, unless the commissioner approves an extension to a specific date. In determining
401.27if a fine is to be imposed and establishing the amount of the fine, the commissioner shall
401.28consider:
401.29(1) the gravity of the violation, including the probability that death or serious physical
401.30or emotional harm to a child will result or has resulted, the severity of the actual or potential
401.31harm, and the extent to which the applicable laws were violated;
402.1(2) actions taken by the owner or administrator to correct violations;
402.2(3) any previous violations; and
402.3(4) the financial benefit to the PPEC center of committing or continuing the violation.
402.4    Subd. 3. Fines for violations of other statutes. The commissioner shall impose a fine
402.5of $250 on a PPEC center, employee, or contractor for each violation by that PPEC center,
402.6employee, or contractor of section 144H.16, subdivision 2, or 626.556.

402.7    Sec. 54. [144H.19] CLOSING A PPEC CENTER.
402.8When a PPEC center voluntarily closes, it must, at least 30 days before closure, inform
402.9each child's parents or guardians of the closure and when the closure will occur.

402.10    Sec. 55. [144H.20] PHYSICAL ENVIRONMENT.
402.11    Subdivision 1. General requirements. A PPEC center shall conform with or exceed
402.12the physical environment requirements in this section and the physical environment
402.13requirements for day care facilities in Minnesota Rules, part 9502.0425. If the physical
402.14environment requirements in this section differ from the physical environment requirements
402.15for day care facilities in Minnesota Rules, part 9502.0425, the requirements in this section
402.16shall prevail. A PPEC center must have sufficient indoor and outdoor space to accommodate
402.17at least six medically complex or technologically dependent children.
402.18    Subd. 2. Specific requirements. (a) The entrance to a PPEC center must be barrier-free,
402.19have a wheelchair ramp, provide for traffic flow with a driveway area for entering and
402.20exiting, and have storage space for supplies from home.
402.21(b) A PPEC center must have a treatment room with a medication preparation area. The
402.22medication preparation area must contain a work counter, refrigerator, sink with hot and
402.23cold running water, and locked storage for biologicals and prescription drugs.
402.24(c) A PPEC center must develop isolation procedures to prevent cross-infections and
402.25must have an isolation room with at least one glass area for observation of a child in the
402.26isolation room. The isolation room must be at least 100 square feet in size.
402.27(d) A PPEC center must have:
402.28(1) an outdoor play space adjacent to the center of at least 35 square feet per child in
402.29attendance at the center, for regular use; or
402.30(2) a park, playground, or play space within 1,500 feet of the center.
403.1(e) A PPEC center must have at least 50 square feet of usable indoor space per child in
403.2attendance at the center.
403.3(f) Notwithstanding the Minnesota State Building Code and the Minnesota State Fire
403.4Code, a new construction PPEC center or an existing building converted into a PPEC center
403.5must meet the requirements of the International Building Code in Minnesota Rules, chapter
403.61305, for:
403.7(1) Group R, Division 4 occupancy, if serving 12 or fewer children; or
403.8(2) Group E, Division 4 occupancy or Group I, Division 4 occupancy, if serving 13 or
403.9more children.

403.10    Sec. 56. Minnesota Statutes 2016, section 145.4131, subdivision 1, is amended to read:
403.11    Subdivision 1. Forms. (a) Within 90 days of July 1, 1998, the commissioner shall prepare
403.12a reporting form for use by physicians or facilities performing abortions. A copy of this
403.13section shall be attached to the form. A physician or facility performing an abortion shall
403.14obtain a form from the commissioner.
403.15    (b) The form shall require the following information:
403.16    (1) the number of abortions performed by the physician in the previous calendar year,
403.17reported by month;
403.18    (2) the method used for each abortion;
403.19    (3) the approximate gestational age expressed in one of the following increments:
403.20    (i) less than nine weeks;
403.21    (ii) nine to ten weeks;
403.22    (iii) 11 to 12 weeks;
403.23    (iv) 13 to 15 weeks;
403.24    (v) 16 to 20 weeks;
403.25    (vi) 21 to 24 weeks;
403.26    (vii) 25 to 30 weeks;
403.27    (viii) 31 to 36 weeks; or
403.28    (ix) 37 weeks to term;
403.29    (4) the age of the woman at the time the abortion was performed;
404.1    (5) the specific reason for the abortion, including, but not limited to, the following:
404.2    (i) the pregnancy was a result of rape;
404.3    (ii) the pregnancy was a result of incest;
404.4    (iii) economic reasons;
404.5    (iv) the woman does not want children at this time;
404.6    (v) the woman's emotional health is at stake;
404.7    (vi) the woman's physical health is at stake;
404.8    (vii) the woman will suffer substantial and irreversible impairment of a major bodily
404.9function if the pregnancy continues;
404.10    (viii) the pregnancy resulted in fetal anomalies; or
404.11    (ix) unknown or the woman refused to answer;
404.12    (6) the number of prior induced abortions;
404.13    (7) the number of prior spontaneous abortions;
404.14    (8) whether the abortion was paid for by:
404.15    (i) private coverage;
404.16    (ii) public assistance health coverage; or
404.17    (iii) self-pay;
404.18    (9) whether coverage was under:
404.19    (i) a fee-for-service plan;
404.20    (ii) a capitated private plan; or
404.21    (iii) other;
404.22    (10) complications, if any, for each abortion and for the aftermath of each abortion.
404.23Space for a description of any complications shall be available on the form;
404.24    (11) the medical specialty of the physician performing the abortion; and
404.25    (12) if the abortion was performed via telemedicine, the facility code for the patient and
404.26the facility code for the physician; and
404.27    (12) (13) whether the abortion resulted in a born alive infant, as defined in section
404.28145.423, subdivision 4 , and:
405.1    (i) any medical actions taken to preserve the life of the born alive infant;
405.2    (ii) whether the born alive infant survived; and
405.3    (iii) the status of the born alive infant, should the infant survive, if known.
405.4EFFECTIVE DATE.This section is effective January 1, 2018.

405.5    Sec. 57. Minnesota Statutes 2016, section 145.4716, subdivision 2, is amended to read:
405.6    Subd. 2. Duties of director. The director of child sex trafficking prevention is responsible
405.7for the following:
405.8    (1) developing and providing comprehensive training on sexual exploitation of youth
405.9for social service professionals, medical professionals, public health workers, and criminal
405.10justice professionals;
405.11    (2) collecting, organizing, maintaining, and disseminating information on sexual
405.12exploitation and services across the state, including maintaining a list of resources on the
405.13Department of Health Web site;
405.14    (3) monitoring and applying for federal funding for antitrafficking efforts that may
405.15benefit victims in the state;
405.16    (4) managing grant programs established under sections 145.4716 to 145.4718, and;
405.17609.3241 , paragraph (c), clause (3); and 609.5315, subdivision 5c, clause (3);
405.18    (5) managing the request for proposals for grants for comprehensive services, including
405.19trauma-informed, culturally specific services;
405.20    (6) identifying best practices in serving sexually exploited youth, as defined in section
405.21260C.007, subdivision 31 ;
405.22    (7) providing oversight of and technical support to regional navigators pursuant to section
405.23145.4717 ;
405.24    (8) conducting a comprehensive evaluation of the statewide program for safe harbor of
405.25sexually exploited youth; and
405.26    (9) developing a policy consistent with the requirements of chapter 13 for sharing data
405.27related to sexually exploited youth, as defined in section 260C.007, subdivision 31, among
405.28regional navigators and community-based advocates.

406.1    Sec. 58. [145.9263] OPIOID PRESCRIBER EDUCATION AND PUBLIC
406.2AWARENESS GRANTS.
406.3The commissioner of health, in coordination with the commissioner of human services,
406.4shall award grants to nonprofit organizations for the purpose of expanding prescriber
406.5education, public awareness and outreach on the opioid epidemic and overdose prevention
406.6programs. The grantees must coordinate with health care systems, professional associations,
406.7and emergency medical services providers. Each grantee receiving funds under this section
406.8shall report to the commissioner on how the funds were spent and the outcomes achieved.

406.9    Sec. 59. Minnesota Statutes 2016, section 145.928, subdivision 13, is amended to read:
406.10    Subd. 13. Reports. (a) The commissioner shall submit a biennial report to the legislature
406.11on the local community projects, tribal government, and community health board prevention
406.12activities funded under this section. These reports must include information on grant
406.13recipients, activities that were conducted using grant funds, evaluation data, and outcome
406.14measures, if available. These reports are due by January 15 of every other year, beginning
406.15in the year 2003.
406.16(b) The commissioner shall release an annual report to the public and submit an the
406.17annual report to the chairs and ranking minority members of the house of representatives
406.18and senate committees with jurisdiction over public health on grants made under subdivision
406.197 to decrease racial and ethnic disparities in infant mortality rates. The report must provide
406.20specific information on the amount of each grant awarded to each agency or organization,
406.21an itemized list submitted to the commissioner by each agency or organization awarded a
406.22grant specifying all uses of grant funds and the amount expended for each use, the population
406.23served by each agency or organization, outcomes of the programs funded by each grant,
406.24and the amount of the appropriation retained by the commissioner for administrative and
406.25associated expenses. The commissioner shall issue a report each January 15 for the previous
406.26fiscal year beginning January 15, 2016.

406.27    Sec. 60. Minnesota Statutes 2016, section 145.986, subdivision 1a, is amended to read:
406.28    Subd. 1a. Grants to local communities. (a) Beginning July 1, 2009, the commissioner
406.29of health shall award competitive grants to community health boards and tribal governments
406.30to convene, coordinate, and implement evidence-based strategies targeted at reducing the
406.31percentage of Minnesotans who are obese or overweight and to reduce the use of tobacco.
406.32Grants shall be awarded to all community health boards and tribal governments whose
407.1proposals demonstrate the ability to implement programs designed to achieve the purposes
407.2in subdivision 1 and other requirements of this section.
407.3    (b) Grantee activities shall:
407.4    (1) be based on scientific evidence;
407.5    (2) be based on community input;
407.6    (3) address behavior change at the individual, community, and systems levels;
407.7    (4) occur in community, school, work site, and health care settings;
407.8    (5) be focused on policy, systems, and environmental changes that support healthy
407.9behaviors; and
407.10(6) address the health disparities and inequities that exist in the grantee's community.
407.11    (c) To receive a grant under this section, community health boards and tribal governments
407.12must submit proposals to the commissioner. A local match of ten percent of the total funding
407.13allocation is required. This local match may include funds donated by community partners.
407.14    (d) In order to receive a grant, community health boards and tribal governments must
407.15submit a health improvement plan to the commissioner of health for approval. The
407.16commissioner may require the plan to identify a community leadership team, community
407.17partners, and a community action plan that includes an assessment of area strengths and
407.18needs, proposed action strategies, technical assistance needs, and a staffing plan.
407.19    (e) The grant recipient must implement the health improvement plan, evaluate the
407.20effectiveness of the strategies, and modify or discontinue strategies found to be ineffective.
407.21    (f) Grant recipients shall report their activities and their progress toward the outcomes
407.22established under subdivision 2 to the commissioner in a format and at a time specified by
407.23the commissioner.
407.24    (g) All grant recipients shall be held accountable for making progress toward the
407.25measurable outcomes established in subdivision 2. The commissioner shall require a
407.26corrective action plan and may reduce the funding level of grant recipients that do not make
407.27adequate progress toward the measurable outcomes.
407.28(h) Beginning November 1, 2015, the commissioner shall offer grant recipients the
407.29option of using a grant awarded under this subdivision to implement health improvement
407.30strategies that improve the health status, delay the expression of dementia, or slow the
407.31progression of dementia, for a targeted population at risk for dementia and shall award at
407.32least two of the grants awarded on November 1, 2015, for these purposes. The grants must
408.1meet all other requirements of this section. The commissioner shall coordinate grant planning
408.2activities with the commissioner of human services, the Minnesota Board on Aging, and
408.3community-based organizations with a focus on dementia. Each grant must include selected
408.4outcomes and evaluation measures related to the incidence or progression of dementia
408.5among the targeted population using the procedure described in subdivision 2.
408.6(i) Beginning July 1, 2017, the commissioner shall offer grant recipients the option of
408.7using a grant awarded under this subdivision to confront the opioid addiction and overdose
408.8epidemic, and shall award at least two of the grants awarded on or after July 1, 2017, for
408.9these purposes. The grants awarded under this paragraph must meet all other requirements
408.10of this section. The commissioner shall coordinate grant planning activities with the
408.11commissioner of human services. Each grant shall include selected outcomes and evaluation
408.12measures related to addressing the opioid epidemic.

408.13    Sec. 61. Minnesota Statutes 2016, section 148.5194, subdivision 7, is amended to read:
408.14    Subd. 7. Audiologist biennial licensure fee. (a) The licensure fee for initial applicants
408.15is $435. The biennial licensure fee for audiologists for clinical fellowship, doctoral externship,
408.16temporary, initial applicants, and renewal licensees licenses is $435.
408.17(b) The audiologist fee is for practical examination costs greater than audiologist exam
408.18fee receipts and for complaint investigation, enforcement action, and consumer information
408.19and assistance expenditures related to hearing instrument dispensing.

408.20    Sec. 62. Minnesota Statutes 2016, section 152.25, subdivision 1, is amended to read:
408.21    Subdivision 1. Medical cannabis manufacturer registration. (a) The commissioner
408.22shall register two in-state manufacturers for the production of all medical cannabis within
408.23the state by December 1, 2014, unless the commissioner obtains an adequate supply of
408.24federally sourced medical cannabis by August 1, 2014. The commissioner shall register
408.25new manufacturers or reregister the existing manufacturers by December 1 every two years,
408.26using the factors described in paragraph paragraphs (c) and (d). The commissioner shall
408.27continue to accept applications after December 1, 2014, if two manufacturers that meet the
408.28qualifications set forth in this subdivision do not apply before December 1, 2014. The
408.29commissioner's determination that no manufacturer exists to fulfill the duties under sections
408.30152.22 to 152.37 is subject to judicial review in Ramsey County District Court. Data
408.31submitted during the application process are private data on individuals or nonpublic data
408.32as defined in section 13.02 until the manufacturer is registered under this section. Data on
409.1a manufacturer that is registered are public data, unless the data are trade secret or security
409.2information under section 13.37.
409.3(b) As a condition for registration, a manufacturer must agree to:
409.4(1) begin supplying medical cannabis to patients by July 1, 2015; and
409.5(2) comply with all requirements under sections 152.22 to 152.37.
409.6(c) The commissioner shall consider the following factors when determining which
409.7manufacturer to register:
409.8(1) the technical expertise of the manufacturer in cultivating medical cannabis and
409.9converting the medical cannabis into an acceptable delivery method under section 152.22,
409.10subdivision 6;
409.11(2) the qualifications of the manufacturer's employees;
409.12(3) the long-term financial stability of the manufacturer;
409.13(4) the ability to provide appropriate security measures on the premises of the
409.14manufacturer;
409.15(5) whether the manufacturer has demonstrated an ability to meet the medical cannabis
409.16production needs required by sections 152.22 to 152.37; and
409.17(6) the manufacturer's projection and ongoing assessment of fees on patients with a
409.18qualifying medical condition.
409.19(d) The commissioner shall not renew the registration of an existing manufacturer if an
409.20officer, director, or controlling person of the manufacturer pleads or is found guilty of
409.21intentionally diverting medical cannabis to a person other than allowed by law under section
409.22152.33, subdivision 1, provided the violation occurred while the person was an officer,
409.23director, or controlling person of the manufacturer.
409.24(d) (e) The commissioner shall require each medical cannabis manufacturer to contract
409.25with an independent laboratory to test medical cannabis produced by the manufacturer. The
409.26commissioner shall approve the laboratory chosen by each manufacturer and require that
409.27the laboratory report testing results to the manufacturer in a manner determined by the
409.28commissioner.
409.29EFFECTIVE DATE.This section is effective the day following final enactment.

410.1    Sec. 63. Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision to
410.2read:
410.3    Subd. 1a. Revocation, nonrenewal, or denial of consent to transfer a medical cannabis
410.4manufacturer registration. If the commissioner intends to revoke, not renew, or deny
410.5consent to transfer a registration issued under this section, the commissioner must first notify
410.6in writing the manufacturer against whom the action is to be taken and provide the
410.7manufacturer with an opportunity to request a hearing under the contested case provisions
410.8of chapter 14. If the manufacturer does not request a hearing by notifying the commissioner
410.9in writing within 20 days after receipt of the notice of proposed action, the commissioner
410.10may proceed with the action without a hearing. For revocations, the registration of a
410.11manufacturer is considered revoked on the date specified in the commissioner's written
410.12notice of revocation.
410.13EFFECTIVE DATE.This section is effective the day following final enactment.

410.14    Sec. 64. Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision to
410.15read:
410.16    Subd. 1b. Temporary suspension proceedings. The commissioner may institute
410.17proceedings to temporarily suspend the registration of a medical cannabis manufacturer for
410.18a period of up to 90 days by notifying the manufacturer in writing if any action by an officer,
410.19director, or controlling person of the manufacturer:
410.20(1) violates any of the requirements of sections 152.21 to 152.37 or the rules adopted
410.21thereunder;
410.22(2) permits, aids, or abets the commission of any violation of state law at the
410.23manufacturer's location for cultivation, harvesting, manufacturing, packaging, and processing
410.24or at any site for distribution of medical cannabis;
410.25(3) performs any act contrary to the welfare of a patient or registered designated caregiver;
410.26or
410.27(4) obtains, or attempts to obtain, a registration by fraudulent means or misrepresentation.
410.28EFFECTIVE DATE.This section is effective the day following final enactment.

411.1    Sec. 65. Minnesota Statutes 2016, section 152.25, is amended by adding a subdivision to
411.2read:
411.3    Subd. 1c. Notice to patients. Upon the revocation or nonrenewal of a manufacturer's
411.4registration under subdivision 1a or temporary suspension under subdivision 1b, the
411.5commissioner shall notify in writing each patient and the patient's registered designated
411.6caregiver or registered parent or legal guardian about the outcome of the proceeding and
411.7information regarding alternative registered manufacturers. This notice must be provided
411.8two or more business days prior to the effective date of the revocation, nonrenewal, or
411.9suspension.
411.10EFFECTIVE DATE.This section is effective the day following final enactment.

411.11    Sec. 66. Minnesota Statutes 2016, section 152.33, is amended by adding a subdivision to
411.12read:
411.13    Subd. 1a. Intentional diversion outside the state; penalties. In addition to any other
411.14applicable penalty in law, the commissioner shall levy a fine of $500,000 against a
411.15manufacturer and immediately initiate proceedings to revoke the manufacturer's registration,
411.16using the procedure in section 152.25, subdivision 1a, if:
411.17(1) an officer, director, or controlling person of the manufacturer pleads or is found
411.18guilty under subdivision 1 of intentionally transferring medical cannabis, while the person
411.19was an officer, director, or controlling person of the manufacturer, to a person other than
411.20allowed by law; and
411.21(2) in intentionally transferring medical cannabis to a person other than allowed by law,
411.22the officer, director, or controlling person transported or directed the transport of medical
411.23cannabis outside of Minnesota.
411.24EFFECTIVE DATE.This section is effective the day following final enactment, and
411.25applies to crimes committed on or after that date.

411.26    Sec. 67. Minnesota Statutes 2016, section 157.16, subdivision 1, is amended to read:
411.27    Subdivision 1. License required annually. A license is required annually for every
411.28person, firm, or corporation engaged in the business of conducting a food and beverage
411.29service establishment, youth camp, hotel, motel, lodging establishment, public pool, or
411.30resort. Any person wishing to operate a place of business licensed in this section shall first
411.31make application, pay the required fee specified in this section, and receive approval for
411.32operation, including plan review approval. Special event food stands are not required to
412.1submit plans. Nonprofit organizations operating a special event food stand with multiple
412.2locations at an annual one-day event shall be issued only one license. Application shall be
412.3made on forms provided by the commissioner and shall require the applicant to state the
412.4full name and address of the owner of the building, structure, or enclosure, the lessee and
412.5manager of the food and beverage service establishment, hotel, motel, lodging establishment,
412.6public pool, or resort; the name under which the business is to be conducted; and any other
412.7information as may be required by the commissioner to complete the application for license.
412.8All fees collected under this section shall be deposited in the state government special
412.9revenue fund.

412.10    Sec. 68. Minnesota Statutes 2016, section 256B.0625, is amended by adding a subdivision
412.11to read:
412.12    Subd. 65. Prescribed pediatric extended care centers. Medical assistance covers
412.13services provided at a prescribed pediatric extended care center licensed under chapter
412.14144H, when the services are provided in accordance with this chapter.
412.15EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
412.16of human services shall notify the revisor of statutes when federal approval is obtained.

412.17    Sec. 69. [256B.7651] PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS.
412.18The commissioner shall set payment rates for services provided at prescribed pediatric
412.19extended care centers licensed under chapter 144H in one-hour increments, at a rate equal
412.20to 85 percent of the payment rate for one hour of complex home care nursing services. The
412.21payment rate shall include services provided by nursing staff and direct care staff specified
412.22in section 144H.11.
412.23EFFECTIVE DATE.This section is effective upon federal approval. The commissioner
412.24of human services shall notify the revisor of statutes when federal approval is obtained.

412.25    Sec. 70. Minnesota Statutes 2016, section 327.15, subdivision 3, is amended to read:
412.26    Subd. 3. Fees, manufactured home parks and recreational camping areas. (a) The
412.27following fees are required for manufactured home parks and recreational camping areas
412.28licensed under this chapter. Fees collected under this section shall be deposited in the state
412.29government special revenue fund. Recreational camping areas and manufactured home
412.30parks shall pay the highest applicable base fee under paragraph (b). The license fee for new
412.31operators of a manufactured home park or recreational camping area previously licensed
412.32under this chapter for the same calendar year is one-half of the appropriate annual license
413.1fee, plus any penalty that may be required. The license fee for operators opening on or after
413.2October 1 is one-half of the appropriate annual license fee, plus any penalty that may be
413.3required.
413.4(b) All manufactured home parks and recreational camping areas shall pay the following
413.5annual base fee:
413.6(1) a manufactured home park, $150; and
413.7(2) a recreational camping area with:
413.8(i) 24 or less sites, $50;
413.9(ii) 25 to 99 sites, $212; and
413.10(iii) 100 or more sites, $300.
413.11In addition to the base fee, manufactured home parks and recreational camping areas shall
413.12pay $4 for each licensed site. This paragraph does not apply to special event recreational
413.13camping areas. Operators of a manufactured home park or a recreational camping area also
413.14licensed under section 157.16 for the same location shall pay only one base fee, whichever
413.15is the highest of the base fees found in this section or section 157.16.
413.16(c) In addition to the fee in paragraph (b), each manufactured home park or recreational
413.17camping area shall pay an additional annual fee for each fee category specified in this
413.18paragraph:
413.19(1) Manufactured home parks and recreational camping areas with public swimming
413.20pools and spas shall pay the appropriate fees specified in section 157.16.
413.21(2) Individual private sewer or water, $60. "Individual private water" means a fee category
413.22with a water supply other than a community public water supply as defined in Minnesota
413.23Rules, chapter 4720. "Individual private sewer" means a fee category with a subsurface
413.24sewage treatment system which uses subsurface treatment and disposal.
413.25(d) The following fees must accompany a plan review application for initial construction
413.26of a manufactured home park or recreational camping area:
413.27(1) for initial construction of less than 25 sites, $375;
413.28(2) for initial construction of 25 to 99 sites, $400; and
413.29(3) for initial construction of 100 or more sites, $500.
413.30(e) The following fees must accompany a plan review application when an existing
413.31manufactured home park or recreational camping area is expanded:
414.1(1) for expansion of less than 25 sites, $250;
414.2(2) for expansion of 25 to 99 sites, $300; and
414.3(3) for expansion of 100 or more sites, $450.

414.4    Sec. 71. Minnesota Statutes 2016, section 609.5315, subdivision 5c, is amended to read:
414.5    Subd. 5c. Disposition of money; prostitution. Money forfeited under section 609.5312,
414.6subdivision 1 , paragraph (b), must be distributed as follows:
414.7(1) 40 percent must be forwarded to the appropriate agency for deposit as a supplement
414.8to the agency's operating fund or similar fund for use in law enforcement;
414.9(2) 20 percent must be forwarded to the prosecuting authority that handled the forfeiture
414.10for deposit as a supplement to its operating fund or similar fund for prosecutorial purposes;
414.11and
414.12(3) the remaining 40 percent must be forwarded to the commissioner of public safety
414.13health to be deposited in the safe harbor for youth account in the special revenue fund and
414.14is appropriated to the commissioner for distribution to crime victims services organizations
414.15that provide services to sexually exploited youth, as defined in section 260C.007, subdivision
414.1631 .

414.17    Sec. 72. Minnesota Statutes 2016, section 626.556, subdivision 2, is amended to read:
414.18    Subd. 2. Definitions. As used in this section, the following terms have the meanings
414.19given them unless the specific content indicates otherwise:
414.20    (a) "Accidental" means a sudden, not reasonably foreseeable, and unexpected occurrence
414.21or event which:
414.22    (1) is not likely to occur and could not have been prevented by exercise of due care; and
414.23    (2) if occurring while a child is receiving services from a facility, happens when the
414.24facility and the employee or person providing services in the facility are in compliance with
414.25the laws and rules relevant to the occurrence or event.
414.26    (b) "Commissioner" means the commissioner of human services.
414.27    (c) "Facility" means:
414.28    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
414.29sanitarium, or other facility or institution required to be licensed under sections 144.50 to
414.30144.58 , 241.021, or 245A.01 to 245A.16, or chapter 144H or 245D;
415.1    (2) a school as defined in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E;
415.2or
415.3    (3) a nonlicensed personal care provider organization as defined in section 256B.0625,
415.4subdivision 19a .
415.5    (d) "Family assessment" means a comprehensive assessment of child safety, risk of
415.6subsequent child maltreatment, and family strengths and needs that is applied to a child
415.7maltreatment report that does not allege sexual abuse or substantial child endangerment.
415.8Family assessment does not include a determination as to whether child maltreatment
415.9occurred but does determine the need for services to address the safety of family members
415.10and the risk of subsequent maltreatment.
415.11    (e) "Investigation" means fact gathering related to the current safety of a child and the
415.12risk of subsequent maltreatment that determines whether child maltreatment occurred and
415.13whether child protective services are needed. An investigation must be used when reports
415.14involve sexual abuse or substantial child endangerment, and for reports of maltreatment in
415.15facilities required to be licensed under chapter 245A or 245D; under sections 144.50 to
415.16144.58 and 241.021; in a school as defined in section 120A.05, subdivisions 9, 11, and 13,
415.17and chapter 124E; or in a nonlicensed personal care provider association as defined in section
415.18256B.0625, subdivision 19a .
415.19    (f) "Mental injury" means an injury to the psychological capacity or emotional stability
415.20of a child as evidenced by an observable or substantial impairment in the child's ability to
415.21function within a normal range of performance and behavior with due regard to the child's
415.22culture.
415.23    (g) "Neglect" means the commission or omission of any of the acts specified under
415.24clauses (1) to (9), other than by accidental means:
415.25    (1) failure by a person responsible for a child's care to supply a child with necessary
415.26food, clothing, shelter, health, medical, or other care required for the child's physical or
415.27mental health when reasonably able to do so;
415.28    (2) failure to protect a child from conditions or actions that seriously endanger the child's
415.29physical or mental health when reasonably able to do so, including a growth delay, which
415.30may be referred to as a failure to thrive, that has been diagnosed by a physician and is due
415.31to parental neglect;
415.32    (3) failure to provide for necessary supervision or child care arrangements appropriate
415.33for a child after considering factors as the child's age, mental ability, physical condition,
416.1length of absence, or environment, when the child is unable to care for the child's own basic
416.2needs or safety, or the basic needs or safety of another child in their care;
416.3    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
416.4260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's
416.5child with sympathomimetic medications, consistent with section 125A.091, subdivision
416.65 ;
416.7    (5) nothing in this section shall be construed to mean that a child is neglected solely
416.8because the child's parent, guardian, or other person responsible for the child's care in good
416.9faith selects and depends upon spiritual means or prayer for treatment or care of disease or
416.10remedial care of the child in lieu of medical care; except that a parent, guardian, or caretaker,
416.11or a person mandated to report pursuant to subdivision 3, has a duty to report if a lack of
416.12medical care may cause serious danger to the child's health. This section does not impose
416.13upon persons, not otherwise legally responsible for providing a child with necessary food,
416.14clothing, shelter, education, or medical care, a duty to provide that care;
416.15    (6) prenatal exposure to a controlled substance, as defined in section 253B.02, subdivision
416.162, used by the mother for a nonmedical purpose, as evidenced by withdrawal symptoms in
416.17the child at birth, results of a toxicology test performed on the mother at delivery or the
416.18child at birth, medical effects or developmental delays during the child's first year of life
416.19that medically indicate prenatal exposure to a controlled substance, or the presence of a
416.20fetal alcohol spectrum disorder;
416.21    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
416.22    (8) chronic and severe use of alcohol or a controlled substance by a parent or person
416.23responsible for the care of the child that adversely affects the child's basic needs and safety;
416.24or
416.25    (9) emotional harm from a pattern of behavior which contributes to impaired emotional
416.26functioning of the child which may be demonstrated by a substantial and observable effect
416.27in the child's behavior, emotional response, or cognition that is not within the normal range
416.28for the child's age and stage of development, with due regard to the child's culture.
416.29(h) "Nonmaltreatment mistake" means:
416.30(1) at the time of the incident, the individual was performing duties identified in the
416.31center's child care program plan required under Minnesota Rules, part 9503.0045;
416.32(2) the individual has not been determined responsible for a similar incident that resulted
416.33in a finding of maltreatment for at least seven years;
417.1(3) the individual has not been determined to have committed a similar nonmaltreatment
417.2mistake under this paragraph for at least four years;
417.3(4) any injury to a child resulting from the incident, if treated, is treated only with
417.4remedies that are available over the counter, whether ordered by a medical professional or
417.5not; and
417.6(5) except for the period when the incident occurred, the facility and the individual
417.7providing services were both in compliance with all licensing requirements relevant to the
417.8incident.
417.9This definition only applies to child care centers licensed under Minnesota Rules, chapter
417.109503. If clauses (1) to (5) apply, rather than making a determination of substantiated
417.11maltreatment by the individual, the commissioner of human services shall determine that a
417.12nonmaltreatment mistake was made by the individual.
417.13    (i) "Operator" means an operator or agency as defined in section 245A.02.
417.14    (j) "Person responsible for the child's care" means (1) an individual functioning within
417.15the family unit and having responsibilities for the care of the child such as a parent, guardian,
417.16or other person having similar care responsibilities, or (2) an individual functioning outside
417.17the family unit and having responsibilities for the care of the child such as a teacher, school
417.18administrator, other school employees or agents, or other lawful custodian of a child having
417.19either full-time or short-term care responsibilities including, but not limited to, day care,
417.20babysitting whether paid or unpaid, counseling, teaching, and coaching.
417.21    (k) "Physical abuse" means any physical injury, mental injury, or threatened injury,
417.22inflicted by a person responsible for the child's care on a child other than by accidental
417.23means, or any physical or mental injury that cannot reasonably be explained by the child's
417.24history of injuries, or any aversive or deprivation procedures, or regulated interventions,
417.25that have not been authorized under section 125A.0942 or 245.825.
417.26    Abuse does not include reasonable and moderate physical discipline of a child
417.27administered by a parent or legal guardian which does not result in an injury. Abuse does
417.28not include the use of reasonable force by a teacher, principal, or school employee as allowed
417.29by section 121A.582. Actions which are not reasonable and moderate include, but are not
417.30limited to, any of the following:
417.31    (1) throwing, kicking, burning, biting, or cutting a child;
417.32    (2) striking a child with a closed fist;
417.33    (3) shaking a child under age three;
418.1    (4) striking or other actions which result in any nonaccidental injury to a child under 18
418.2months of age;
418.3    (5) unreasonable interference with a child's breathing;
418.4    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
418.5    (7) striking a child under age one on the face or head;
418.6    (8) striking a child who is at least age one but under age four on the face or head, which
418.7results in an injury;
418.8    (9) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
418.9substances which were not prescribed for the child by a practitioner, in order to control or
418.10punish the child; or other substances that substantially affect the child's behavior, motor
418.11coordination, or judgment or that results in sickness or internal injury, or subjects the child
418.12to medical procedures that would be unnecessary if the child were not exposed to the
418.13substances;
418.14    (10) unreasonable physical confinement or restraint not permitted under section 609.379,
418.15including but not limited to tying, caging, or chaining; or
418.16    (11) in a school facility or school zone, an act by a person responsible for the child's
418.17care that is a violation under section 121A.58.
418.18    (l) "Practice of social services," for the purposes of subdivision 3, includes but is not
418.19limited to employee assistance counseling and the provision of guardian ad litem and
418.20parenting time expeditor services.
418.21    (m) "Report" means any communication received by the local welfare agency, police
418.22department, county sheriff, or agency responsible for child protection pursuant to this section
418.23that describes neglect or physical or sexual abuse of a child and contains sufficient content
418.24to identify the child and any person believed to be responsible for the neglect or abuse, if
418.25known.
418.26    (n) "Sexual abuse" means the subjection of a child by a person responsible for the child's
418.27care, by a person who has a significant relationship to the child, as defined in section 609.341,
418.28or by a person in a position of authority, as defined in section 609.341, subdivision 10, to
418.29any act which constitutes a violation of section 609.342 (criminal sexual conduct in the first
418.30degree), 609.343 (criminal sexual conduct in the second degree), 609.344 (criminal sexual
418.31conduct in the third degree), 609.345 (criminal sexual conduct in the fourth degree), or
418.32609.3451 (criminal sexual conduct in the fifth degree). Sexual abuse also includes any act
418.33which involves a minor which constitutes a violation of prostitution offenses under sections
419.1609.321 to 609.324 or 617.246. Effective May 29, 2017, sexual abuse includes all reports
419.2of known or suspected child sex trafficking involving a child who is identified as a victim
419.3of sex trafficking. Sexual abuse includes child sex trafficking as defined in section 609.321,
419.4subdivisions 7a and 7b. Sexual abuse includes threatened sexual abuse which includes the
419.5status of a parent or household member who has committed a violation which requires
419.6registration as an offender under section 243.166, subdivision 1b, paragraph (a) or (b), or
419.7required registration under section 243.166, subdivision 1b, paragraph (a) or (b).
419.8    (o) "Substantial child endangerment" means a person responsible for a child's care, by
419.9act or omission, commits or attempts to commit an act against a child under their care that
419.10constitutes any of the following:
419.11    (1) egregious harm as defined in section 260C.007, subdivision 14;
419.12    (2) abandonment under section 260C.301, subdivision 2;
419.13    (3) neglect as defined in paragraph (g), clause (2), that substantially endangers the child's
419.14physical or mental health, including a growth delay, which may be referred to as failure to
419.15thrive, that has been diagnosed by a physician and is due to parental neglect;
419.16    (4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;
419.17    (5) manslaughter in the first or second degree under section 609.20 or 609.205;
419.18    (6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;
419.19    (7) solicitation, inducement, and promotion of prostitution under section 609.322;
419.20    (8) criminal sexual conduct under sections 609.342 to 609.3451;
419.21    (9) solicitation of children to engage in sexual conduct under section 609.352;
419.22    (10) malicious punishment or neglect or endangerment of a child under section 609.377
419.23or 609.378;
419.24    (11) use of a minor in sexual performance under section 617.246; or
419.25    (12) parental behavior, status, or condition which mandates that the county attorney file
419.26a termination of parental rights petition under section 260C.503, subdivision 2.
419.27    (p) "Threatened injury" means a statement, overt act, condition, or status that represents
419.28a substantial risk of physical or sexual abuse or mental injury. Threatened injury includes,
419.29but is not limited to, exposing a child to a person responsible for the child's care, as defined
419.30in paragraph (j), clause (1), who has:
420.1    (1) subjected a child to, or failed to protect a child from, an overt act or condition that
420.2constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a similar law
420.3of another jurisdiction;
420.4    (2) been found to be palpably unfit under section 260C.301, subdivision 1, paragraph
420.5(b), clause (4), or a similar law of another jurisdiction;
420.6    (3) committed an act that has resulted in an involuntary termination of parental rights
420.7under section 260C.301, or a similar law of another jurisdiction; or
420.8    (4) committed an act that has resulted in the involuntary transfer of permanent legal and
420.9physical custody of a child to a relative under Minnesota Statutes 2010, section 260C.201,
420.10subdivision 11, paragraph (d), clause (1), section 260C.515, subdivision 4, or a similar law
420.11of another jurisdiction.
420.12A child is the subject of a report of threatened injury when the responsible social services
420.13agency receives birth match data under paragraph (q) from the Department of Human
420.14Services.
420.15(q) Upon receiving data under section 144.225, subdivision 2b, contained in a birth
420.16record or recognition of parentage identifying a child who is subject to threatened injury
420.17under paragraph (p), the Department of Human Services shall send the data to the responsible
420.18social services agency. The data is known as "birth match" data. Unless the responsible
420.19social services agency has already begun an investigation or assessment of the report due
420.20to the birth of the child or execution of the recognition of parentage and the parent's previous
420.21history with child protection, the agency shall accept the birth match data as a report under
420.22this section. The agency may use either a family assessment or investigation to determine
420.23whether the child is safe. All of the provisions of this section apply. If the child is determined
420.24to be safe, the agency shall consult with the county attorney to determine the appropriateness
420.25of filing a petition alleging the child is in need of protection or services under section
420.26260C.007, subdivision 6 , clause (16), in order to deliver needed services. If the child is
420.27determined not to be safe, the agency and the county attorney shall take appropriate action
420.28as required under section 260C.503, subdivision 2.
420.29    (r) Persons who conduct assessments or investigations under this section shall take into
420.30account accepted child-rearing practices of the culture in which a child participates and
420.31accepted teacher discipline practices, which are not injurious to the child's health, welfare,
420.32and safety.

421.1    Sec. 73. Minnesota Statutes 2016, section 626.556, subdivision 3, is amended to read:
421.2    Subd. 3. Persons mandated to report; persons voluntarily reporting. (a) A person
421.3who knows or has reason to believe a child is being neglected or physically or sexually
421.4abused, as defined in subdivision 2, or has been neglected or physically or sexually abused
421.5within the preceding three years, shall immediately report the information to the local welfare
421.6agency, agency responsible for assessing or investigating the report, police department,
421.7county sheriff, tribal social services agency, or tribal police department if the person is:
421.8    (1) a professional or professional's delegate who is engaged in the practice of the healing
421.9arts, social services, hospital administration, psychological or psychiatric treatment, child
421.10care, education, correctional supervision, probation and correctional services, or law
421.11enforcement; or
421.12    (2) employed as a member of the clergy and received the information while engaged in
421.13ministerial duties, provided that a member of the clergy is not required by this subdivision
421.14to report information that is otherwise privileged under section 595.02, subdivision 1,
421.15paragraph (c).
421.16    (b) Any person may voluntarily report to the local welfare agency, agency responsible
421.17for assessing or investigating the report, police department, county sheriff, tribal social
421.18services agency, or tribal police department if the person knows, has reason to believe, or
421.19suspects a child is being or has been neglected or subjected to physical or sexual abuse.
421.20    (c) A person mandated to report physical or sexual child abuse or neglect occurring
421.21within a licensed facility shall report the information to the agency responsible for licensing
421.22the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or chapter 144H
421.23or 245D; or a nonlicensed personal care provider organization as defined in section
421.24256B.0625, subdivision 19 19a. A health or corrections agency receiving a report may
421.25request the local welfare agency to provide assistance pursuant to subdivisions 10, 10a, and
421.2610b. A board or other entity whose licensees perform work within a school facility, upon
421.27receiving a complaint of alleged maltreatment, shall provide information about the
421.28circumstances of the alleged maltreatment to the commissioner of education. Section 13.03,
421.29subdivision 4 , applies to data received by the commissioner of education from a licensing
421.30entity.
421.31    (d) Notification requirements under subdivision 10 apply to all reports received under
421.32this section.
421.33    (e) For purposes of this section, "immediately" means as soon as possible but in no event
421.34longer than 24 hours.

422.1    Sec. 74. Minnesota Statutes 2016, section 626.556, subdivision 3c, is amended to read:
422.2    Subd. 3c. Local welfare agency, Department of Human Services or Department of
422.3Health responsible for assessing or investigating reports of maltreatment. (a) The county
422.4local welfare agency is the agency responsible for assessing or investigating allegations of
422.5maltreatment in child foster care, family child care, legally unlicensed child care, juvenile
422.6correctional facilities licensed under section 241.021 located in the local welfare agency's
422.7county, and reports involving children served by an unlicensed personal care provider
422.8organization under section 256B.0659. Copies of findings related to personal care provider
422.9organizations under section 256B.0659 must be forwarded to the Department of Human
422.10Services provider enrollment.
422.11(b) The Department of Human Services is the agency responsible for assessing or
422.12investigating allegations of maltreatment in facilities licensed under chapters 245A and
422.13245D, except for child foster care and family child care.
422.14(c) The Department of Health is the agency responsible for assessing or investigating
422.15allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 and
422.16144A.43 to 144A.482 or chapter 144H.

422.17    Sec. 75. Minnesota Statutes 2016, section 626.556, subdivision 10d, is amended to read:
422.18    Subd. 10d. Notification of neglect or abuse in facility. (a) When a report is received
422.19that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while in the
422.20care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
422.21sanitarium, or other facility or institution required to be licensed according to sections 144.50
422.22to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 144H or 245D, or a school as defined
422.23in section 120A.05, subdivisions 9, 11, and 13; and chapter 124E; or a nonlicensed personal
422.24care provider organization as defined in section 256B.0625, subdivision 19a, the
422.25commissioner of the agency responsible for assessing or investigating the report or local
422.26welfare agency investigating the report shall provide the following information to the parent,
422.27guardian, or legal custodian of a child alleged to have been neglected, physically abused,
422.28sexually abused, or the victim of maltreatment of a child in the facility: the name of the
422.29facility; the fact that a report alleging neglect, physical abuse, sexual abuse, or maltreatment
422.30of a child in the facility has been received; the nature of the alleged neglect, physical abuse,
422.31sexual abuse, or maltreatment of a child in the facility; that the agency is conducting an
422.32assessment or investigation; any protective or corrective measures being taken pending the
422.33outcome of the investigation; and that a written memorandum will be provided when the
422.34investigation is completed.
423.1(b) The commissioner of the agency responsible for assessing or investigating the report
423.2or local welfare agency may also provide the information in paragraph (a) to the parent,
423.3guardian, or legal custodian of any other child in the facility if the investigative agency
423.4knows or has reason to believe the alleged neglect, physical abuse, sexual abuse, or
423.5maltreatment of a child in the facility has occurred. In determining whether to exercise this
423.6authority, the commissioner of the agency responsible for assessing or investigating the
423.7report or local welfare agency shall consider the seriousness of the alleged neglect, physical
423.8abuse, sexual abuse, or maltreatment of a child in the facility; the number of children
423.9allegedly neglected, physically abused, sexually abused, or victims of maltreatment of a
423.10child in the facility; the number of alleged perpetrators; and the length of the investigation.
423.11The facility shall be notified whenever this discretion is exercised.
423.12(c) When the commissioner of the agency responsible for assessing or investigating the
423.13report or local welfare agency has completed its investigation, every parent, guardian, or
423.14legal custodian previously notified of the investigation by the commissioner or local welfare
423.15agency shall be provided with the following information in a written memorandum: the
423.16name of the facility investigated; the nature of the alleged neglect, physical abuse, sexual
423.17abuse, or maltreatment of a child in the facility; the investigator's name; a summary of the
423.18investigation findings; a statement whether maltreatment was found; and the protective or
423.19corrective measures that are being or will be taken. The memorandum shall be written in a
423.20manner that protects the identity of the reporter and the child and shall not contain the name,
423.21or to the extent possible, reveal the identity of the alleged perpetrator or of those interviewed
423.22during the investigation. If maltreatment is determined to exist, the commissioner or local
423.23welfare agency shall also provide the written memorandum to the parent, guardian, or legal
423.24custodian of each child in the facility who had contact with the individual responsible for
423.25the maltreatment. When the facility is the responsible party for maltreatment, the
423.26commissioner or local welfare agency shall also provide the written memorandum to the
423.27parent, guardian, or legal custodian of each child who received services in the population
423.28of the facility where the maltreatment occurred. This notification must be provided to the
423.29parent, guardian, or legal custodian of each child receiving services from the time the
423.30maltreatment occurred until either the individual responsible for maltreatment is no longer
423.31in contact with a child or children in the facility or the conclusion of the investigation. In
423.32the case of maltreatment within a school facility, as defined in section 120A.05, subdivisions
423.339, 11, and 13 , and chapter 124E, the commissioner of education need not provide notification
423.34to parents, guardians, or legal custodians of each child in the facility, but shall, within ten
423.35days after the investigation is completed, provide written notification to the parent, guardian,
423.36or legal custodian of any student alleged to have been maltreated. The commissioner of
424.1education may notify the parent, guardian, or legal custodian of any student involved as a
424.2witness to alleged maltreatment.

424.3    Sec. 76. BRAIN HEALTH PILOT PROGRAMS.
424.4    Subdivision 1. Pilot programs selected. (a) The commissioner shall competitively
424.5award grants for up to five pilot programs to improve brain health in youth sports in
424.6Minnesota. The commissioner shall issue a competitive request for pilot program proposals
424.7by October 31, 2017, based on input from the youth sports concussion working group. The
424.8commissioner shall include members of the working group in the scoring of proposals
424.9received, but shall exclude any member of the working group with a financial interest in a
424.10pilot program proposal.
424.11(b) Each pilot program selected for a funding award must offer promise for improving
424.12at least one of the following areas:
424.13(1) objective identification of brain injury;
424.14(2) assessment and treatment of brain injury;
424.15(3) coordination of school and medical support services; or
424.16(4) policy reform to improve brain health outcomes.
424.17(c) The programs must be selected so that youth are served in each of the following
424.18regions of the state:
424.19(1) Central or West Central Minnesota;
424.20(2) Southern, Southwest, or Southeast Minnesota;
424.21(3) Northwest or Northland Minnesota; and
424.22(4) the Twin Cities Metropolitan Area.
424.23    Subd. 2. Funding for pilot programs. Pilot programs selected under this section shall
424.24receive funding for one year beginning January 1, 2018. No later than March 1, 2019, the
424.25commissioner must report on the progress and outcomes of the pilot programs to the
424.26legislative committees with jurisdiction over health policy and finance.

424.27    Sec. 77. RECOMMENDATIONS FOR SAFETY AND QUALITY IMPROVEMENT
424.28PRACTICES FOR LONG-TERM CARE SERVICES AND SUPPORTS.
424.29The commissioner of health shall consult with interested stakeholders to explore and
424.30make recommendations on how to apply proven safety and quality improvement practices
425.1and infrastructure to long-term care services and supports. Interested stakeholders with
425.2whom the commissioner must consult shall include but are not limited to representatives
425.3of the Minnesota Alliance for Patient Safety partner organizations, the Office of Ombudsman
425.4for Long-Term Care, the Minnesota Elder Justice Center, providers of older adult services,
425.5the Department of Health, and the Department of Human Services, and experts in the field
425.6of long-term care safety and quality improvement. The recommendations shall include
425.7mechanisms to apply a patient safety model to the senior care sector, including a system
425.8for reporting adverse health events, education and prevention activities, and interim actions
425.9to improve systems for processing reports and complaints submitted to the Office of Health
425.10Facility Complaints. By January 15, 2018, the commissioner shall submit the
425.11recommendations developed under this section, along with draft legislation to implement
425.12the recommendations, to the chairs and ranking minority members of the legislative
425.13committees with jurisdiction over long-term care.

425.14    Sec. 78. STUDY AND REPORT ON HOME CARE NURSING WORKFORCE
425.15SHORTAGE.
425.16(a) The chair and ranking minority member of the senate Human Services Reform
425.17Finance and Policy Committee and the chair and ranking minority member of the house of
425.18representatives Health and Human Services Finance Committee shall convene a working
425.19group to study and report on the shortage of registered nurses and licensed practical nurses
425.20available to provide low-complexity regular home care services to clients in need of such
425.21services, especially clients covered by medical assistance, and to provide recommendations
425.22for ways to address the workforce shortage. The working group shall consist of 14 members
425.23appointed as follows:
425.24(1) the chair of the senate Human Services Reform Finance and Policy Committee or a
425.25designee;
425.26(2) the ranking minority member of the senate Human Services Reform Finance and
425.27Policy Committee or a designee;
425.28(3) the chair of the house of representatives Health and Human Services Finance
425.29Committee or a designee;
425.30(4) the ranking minority member of the house of representatives Health and Human
425.31Services Finance Committee or a designee;
425.32(5) the commissioner of human services or a designee;
425.33(6) the commissioner of health or a designee;
426.1(7) one representative appointed by the Professional Home Care Coalition;
426.2(8) one representative appointed by the Minnesota Home Care Association;
426.3(9) one representative appointed by the Minnesota Board of Nursing;
426.4(10) one representative appointed by the Minnesota Nurses Association;
426.5(11) one representative appointed by the Minnesota Licensed Practical Nurses
426.6Association;
426.7(12) one representative appointed by the Minnesota Society of Medical Assistants;
426.8(13) one client who receives regular home care nursing services and is covered by medical
426.9assistance appointed by the commissioner of human services after consulting with the
426.10appointing authorities identified in clauses (7) to (12); and
426.11(14) one assessor appointed by the commissioner of human services. The assessor must
426.12be certified under Minnesota Statutes, section 256B.0911, and must be a registered nurse.
426.13(b) The appointing authorities must appoint members by August 1, 2017.
426.14(c) The convening authorities shall convene the first meeting of the working group no
426.15later than August 15, 2017, and caucus staff shall provide support and meeting space for
426.16the working group. The Department of Health and the Department of Human Services shall
426.17provide technical assistance to the working group by providing existing data and analysis
426.18documenting the current and projected workforce shortages in the area of regular home care
426.19nursing. The home care and assisted living program advisory council established under
426.20Minnesota Statutes, section 144A.4799, shall provide advice and recommendations to the
426.21working group. Working group members shall serve without compensation and shall not
426.22be reimbursed for expenses.
426.23(d) The working group shall:
426.24(1) quantify the number of low-complexity regular home care nursing hours that are
426.25authorized but not provided to clients covered by medical assistance, due to the shortage
426.26of registered nurses and licensed practical nurses available to provide these home care
426.27services;
426.28(2) quantify the current and projected workforce shortages of registered nurses and
426.29licensed practical nurses available to provide low-complexity regular home care nursing
426.30services to clients, especially clients covered by medical assistance;
426.31(3) develop recommendations for actions to take in the next two years to address the
426.32regular home care nursing workforce shortage, including identifying other health care
427.1professionals who may be able to provide low-complexity regular home care nursing services
427.2with additional training; what additional training may be necessary for these health care
427.3professionals; and how to address scope of practice and licensing issues;
427.4(4) compile reimbursement rates for regular home care nursing from other states and
427.5determine Minnesota's national ranking with respect to reimbursement for regular home
427.6care nursing;
427.7(5) determine whether reimbursement rates for regular home care nursing fully reimburse
427.8providers for the cost of providing the service and whether the discrepancy, if any, between
427.9rates and costs contributes to lack of access to regular home care nursing; and
427.10(6) by January 15, 2018, report on the findings and recommendations of the working
427.11group to the chairs and ranking minority members of the legislative committees with
427.12jurisdiction over health and human services policy and finance. The working group's report
427.13shall include draft legislation.
427.14(e) The working group shall elect a chair from among its members at its first meeting.
427.15(f) The meetings of the working group shall be open to the public.
427.16(g) This section expires January 16, 2018, or the day after submitting the report required
427.17by this section, whichever is earlier.
427.18EFFECTIVE DATE.This section is effective the day following final enactment.

427.19    Sec. 79. OPIOID ABUSE PREVENTION PILOT PROJECTS.
427.20(a) The commissioner of health shall establish opioid abuse prevention pilot projects in
427.21geographic areas throughout the state, to reduce opioid abuse through the use of controlled
427.22substance care teams and community-wide coordination of abuse-prevention initiatives.
427.23The commissioner shall award grants to health care providers, health plan companies, local
427.24units of government, or other entities to establish pilot projects.
427.25(b) Each pilot project must:
427.26(1) be designed to reduce emergency room and other health care provider visits resulting
427.27from opioid use or abuse, and reduce rates of opioid addiction in the community;
427.28(2) establish multidisciplinary controlled substance care teams, that may consist of
427.29physicians, pharmacists, social workers, nurse care coordinators, and mental health
427.30professionals;
428.1(3) deliver health care services and care coordination, through controlled substance care
428.2teams, to reduce the inappropriate use of opioids by patients and rates of opioid addiction;
428.3(4) address any unmet social service needs that create barriers to managing pain
428.4effectively and obtaining optimal health outcomes;
428.5(5) provide prescriber and dispenser education and assistance to reduce the inappropriate
428.6prescribing and dispensing of opioids;
428.7(6) promote the adoption of best practices related to opioid disposal and reducing
428.8opportunities for illegal access to opioids; and
428.9(7) engage partners outside of the health care system, including schools, law enforcement,
428.10and social services, to address root causes of opioid abuse and addiction at the community
428.11level.
428.12(c) The commissioner shall contract with an accountable community for health that
428.13operates an opioid abuse prevention project, and can document success in reducing opioid
428.14use through the use of controlled substance care teams, to assist the commissioner in
428.15administering this section, and to provide technical assistance to the commissioner and to
428.16entities selected to operate a pilot project.
428.17(d) The contract under paragraph (c) shall require the accountable community for health
428.18to evaluate the extent to which the pilot projects were successful in reducing the inappropriate
428.19use of opioids. The evaluation must analyze changes in the number of opioid prescriptions,
428.20the number of emergency room visits related to opioid use, and other relevant measures.
428.21The accountable community for health shall report evaluation results to the chairs and
428.22ranking minority members of the legislative committees with jurisdiction over health and
428.23human services policy and finance and public safety by December 15, 2019.

428.24    Sec. 80. SAFE HARBOR FOR ALL; STATEWIDE SEX TRAFFICKING VICTIMS
428.25STRATEGIC PLAN.
428.26(a) By October 1, 2018, the commissioner of health, in consultation with the
428.27commissioners of public safety and human services, shall adopt a comprehensive strategic
428.28plan to address the needs of sex trafficking victims statewide.
428.29(b) The commissioner of health shall issue a request for proposals to select an organization
428.30to develop the comprehensive strategic plan. The selected organization shall seek
428.31recommendations from professionals, community members, and stakeholders from across
428.32the state, with an emphasis on the communities most impacted by sex trafficking. At a
428.33minimum, the selected organization must seek input from the following groups: sex
429.1trafficking survivors and their family members, statewide crime victim services coalitions,
429.2victim services providers, nonprofit organizations, task forces, prosecutors, public defenders,
429.3tribal governments, public safety and corrections professionals, public health professionals,
429.4human services professionals, and impacted community members. The strategic plan shall
429.5include recommendations regarding the expansion of Minnesota's Safe Harbor Law to adult
429.6victims of sex trafficking.
429.7(c) By January 15, 2019, the commissioner of health shall report to the chairs and ranking
429.8minority members of the legislative committees with jurisdiction over health and human
429.9services and criminal justice finance and policy on developing the statewide strategic plan,
429.10including recommendations for additional legislation and funding.
429.11(d) As used in this section, "sex trafficking victim" has the meaning given in Minnesota
429.12Statutes, section 609.321, subdivision 7b.

429.13    Sec. 81. DIRECTION TO THE COMMISSIONER OF HEALTH.
429.14The commissioner of health shall work with interested stakeholders to evaluate whether
429.15existing laws, including laws governing housing with services establishments, board and
429.16lodging establishments with special services, assisted living designations, and home care
429.17providers, as well as building code requirements and landlord tenancy laws, sufficiently
429.18protect the health and safety of persons diagnosed with Alzheimer's disease or a related
429.19dementia.

429.20    Sec. 82. PALLIATIVE CARE ADVISORY COUNCIL.
429.21The appointing authorities shall appoint the first members of the Palliative Care Advisory
429.22Council under Minnesota Statutes, section 144.059, by October 1, 2017. The commissioner
429.23of health shall convene the first meeting by November 15, 2017, and the commissioner or
429.24the commissioner's designee shall act as chair until the council elects a chair at its first
429.25meeting.

429.26    Sec. 83. YOUTH SPORTS CONCUSSION WORKING GROUP.
429.27    Subdivision 1. Working group established; duties and membership. (a) The
429.28commissioner of health shall convene a youth sports concussion working group of up to 30
429.29members to:
429.30(1) develop the report described in subdivision 4 to assess the causes and incidence of
429.31brain injury in Minnesota youth sports; and
430.1(2) evaluate the implementation of Minnesota Statutes, sections 121A.37 and 121A.38,
430.2regarding concussions in youth athletic activity, and best practices for preventing, identifying,
430.3evaluating, and treating brain injury in youth sports.
430.4(b) In forming the working group, the commissioner shall solicit nominees from
430.5individuals with expertise and experience in the areas of traumatic brain injury in youth and
430.6sports, neuroscience, law and policy related to brain health, public health, neurotrauma,
430.7provision of care to brain injured youth, and related fields. In selecting members of the
430.8working group, the commissioner shall ensure geographic and professional diversity. The
430.9working group shall elect a chair from among its members. The commissioner shall be
430.10responsible for organizing meetings and preparing a draft report. Members of the working
430.11group shall not receive monetary compensation for their participation in the group.
430.12    Subd. 2. Working group goals defined. The working group shall, at a minimum:
430.13(1) gather and analyze available data on:
430.14(i) the prevalence and causes of youth sports-related concussions including, where
430.15possible, data on the number of officials and coaches receiving concussion training;
430.16(ii) the number of coaches, officials, youth athletes, and parents or guardians receiving
430.17information about the nature and risks of concussions;
430.18(iii) the number of youth athletes removed from play and the nature and duration of
430.19treatment before return to play; and
430.20(iv) policies and procedures related to return to learn in the classroom;
430.21(2) review the rules associated with relevant youth athletic activities and the concussion
430.22education policies currently employed;
430.23(3) identify innovative pilot projects in areas such as:
430.24(i) objectively defining and measuring concussions;
430.25(ii) rule changes designed to promote brain health;
430.26(iii) use of technology to identify and treat concussions;
430.27(iv) recognition of cumulative subconcussive effects; and
430.28(v) postconcussion treatment, and return to learn protocols; and
430.29(4) identify regulatory and legal barriers and burdens to achieving better brain health
430.30outcomes.
431.1    Subd. 3. Voluntary participation; no new reporting requirements created.
431.2Participation in the working group study by schools, school districts, school governing
431.3bodies, parents, athletes, and related individuals and organizations shall be voluntary, and
431.4this study shall create no new reporting requirements by schools, school districts, school
431.5governing bodies, parents, athletes, and related individuals and organizations.
431.6    Subd. 4. Report. By December 31, 2018, the youth sports concussion working group
431.7shall provide an interim report, and by December 31, 2019, the working group shall provide
431.8a final report to the chairs and ranking minority members of the legislative committees with
431.9jurisdiction over health and education with recommendations and proposals for a Minnesota
431.10model for reducing brain injury in youth sports. The report shall make recommendations
431.11regarding:
431.12(1) best practices for reducing and preventing concussions in youth sports;
431.13(2) best practices for schools to employ in order to identify and respond to occurrences
431.14of concussions, including return to play and return to learn;
431.15(3) opportunities to highlight and strengthen best practices with external grant support;
431.16(4) opportunities to leverage Minnesota's strengths in brain science research and clinical
431.17care for brain injury; and
431.18(5) proposals to develop an innovative Minnesota model for identifying, evaluating, and
431.19treating youth sports concussions.
431.20    Subd. 5. Sunset. The working group expires the day after submitting the report required
431.21under subdivision 4, or January 15, 2020, whichever is earlier.

431.22    Sec. 84. REPEALER.
431.23(a) Minnesota Statutes 2016, section 144.4961, is repealed the day following final
431.24enactment.
431.25(b) Laws 2014, chapter 312, article 23, section 9, subdivision 5, is repealed.

431.26ARTICLE 11

431.27HEALTH LICENSING BOARDS

431.28    Section 1. Minnesota Statutes 2016, section 147.01, subdivision 7, is amended to read:
431.29    Subd. 7. Physician application fee and license fees. (a) The board may charge a the
431.30following nonrefundable application and license fees processed pursuant to sections 147.02,
431.31147.03, 147.037, 147.0375, and 147.38:
432.1(1) physician application fee of, $200.;
432.2(2) physician annual registration renewal fee, $192;
432.3(3) physician endorsement to other states, $40;
432.4(4) physician emeritus license, $50;
432.5(5) physician temporary licenses, $60;
432.6(6) physician late fee, $60;
432.7(7) duplicate license fee, $20;
432.8(8) certification letter fee, $25;
432.9(9) education or training program approval fee, $100;
432.10(10) report creation and generation fee, $60;
432.11(11) examination administration fee (half day), $50;
432.12(12) examination administration fee (full day), $80; and
432.13(13) fees developed by the Interstate Commission for determining physician qualification
432.14to register and participate in the interstate medical licensure compact, as established in rules
432.15authorized in and pursuant to section 147.38, not to exceed $1,000.
432.16(b) The board may prorate the initial annual license fee. All licensees are required to
432.17pay the full fee upon license renewal. The revenue generated from the fee must be deposited
432.18in an account in the state government special revenue fund.

432.19    Sec. 2. Minnesota Statutes 2016, section 147.02, subdivision 1, is amended to read:
432.20    Subdivision 1. United States or Canadian medical school graduates. The board shall
432.21issue a license to practice medicine to a person not currently licensed in another state or
432.22Canada and who meets the requirements in paragraphs (a) to (i).
432.23    (a) An applicant for a license shall file a written application on forms provided by the
432.24board, showing to the board's satisfaction that the applicant is of good moral character and
432.25satisfies the requirements of this section.
432.26    (b) The applicant shall present evidence satisfactory to the board of being a graduate of
432.27a medical or osteopathic medical school located in the United States, its territories or Canada,
432.28and approved by the board based upon its faculty, curriculum, facilities, accreditation by a
432.29recognized national accrediting organization approved by the board, and other relevant data,
432.30or is currently enrolled in the final year of study at the school.
433.1    (c) The applicant must have passed an examination as described in clause (1) or (2).
433.2    (1) The applicant must have passed a comprehensive examination for initial licensure
433.3prepared and graded by the National Board of Medical Examiners, the Federation of State
433.4Medical Boards, the Medical Council of Canada, the National Board of Osteopathic
433.5Examiners, or the appropriate state board that the board determines acceptable. The board
433.6shall by rule determine what constitutes a passing score in the examination.
433.7    (2) The applicant taking the United States Medical Licensing Examination (USMLE)
433.8or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) must
433.9have passed steps or levels one, two, and three. Step or level three must be passed within
433.10five years of passing step or level two, or before the end of residency training. The applicant
433.11must pass each of steps or levels one, two, and three with passing scores as recommended
433.12by the USMLE program or National Board of Osteopathic Medical Examiners within three
433.13attempts. The applicant taking combinations of Federation of State Medical Boards, National
433.14Board of Medical Examiners, and USMLE may be accepted only if the combination is
433.15approved by the board as comparable to existing comparable examination sequences and
433.16all examinations are completed prior to the year 2000.
433.17    (d) The applicant shall present evidence satisfactory to the board of the completion of
433.18one year of graduate, clinical medical training in a program accredited by a national
433.19accrediting organization approved by the board or other graduate training approved in
433.20advance by the board as meeting standards similar to those of a national accrediting
433.21organization.
433.22    (e) The applicant may make arrangements with the executive director to appear in person
433.23before the board or its designated representative to show that the applicant satisfies the
433.24requirements of this section. The board may establish as internal operating procedures the
433.25procedures or requirements for the applicant's personal presentation.
433.26    (f) The applicant shall pay a nonrefundable fee established by the board by rule. The
433.27fee may not be refunded. Upon application or notice of license renewal, the board must
433.28provide notice to the applicant and to the person whose license is scheduled to be issued or
433.29renewed of any additional fees, surcharges, or other costs which the person is obligated to
433.30pay as a condition of licensure. The notice must:
433.31    (1) state the dollar amount of the additional costs; and
433.32    (2) clearly identify to the applicant the payment schedule of additional costs.
434.1    (g) The applicant must not be under license suspension or revocation by the licensing
434.2board of the state or jurisdiction in which the conduct that caused the suspension or revocation
434.3occurred.
434.4    (h) The applicant must not have engaged in conduct warranting disciplinary action
434.5against a licensee, or have been subject to disciplinary action other than as specified in
434.6paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph,
434.7the board may issue a license only on the applicant's showing that the public will be protected
434.8through issuance of a license with conditions and limitations the board considers appropriate.
434.9    (i) If the examination in paragraph (c) was passed more than ten years ago, the applicant
434.10must either:
434.11    (1) pass the special purpose examination of the Federation of State Medical Boards with
434.12a score of 75 or better within three attempts; or
434.13    (2) have a current certification by a specialty board of the American Board of Medical
434.14Specialties, of the American Osteopathic Association, the Royal College of Physicians and
434.15Surgeons of Canada, or of the College of Family Physicians of Canada.

434.16    Sec. 3. Minnesota Statutes 2016, section 147.03, subdivision 1, is amended to read:
434.17    Subdivision 1. Endorsement; reciprocity. (a) The board may issue a license to practice
434.18medicine to any person who satisfies the requirements in paragraphs (b) to (f)(e).
434.19    (b) The applicant shall satisfy all the requirements established in section 147.02,
434.20subdivision 1 , paragraphs (a), (b), (d), (e), and (f).
434.21    (c) The applicant shall:
434.22    (1) have passed an examination prepared and graded by the Federation of State Medical
434.23Boards, the National Board of Medical Examiners, or the United States Medical Licensing
434.24Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph
434.25(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council
434.26of Canada; and
434.27    (2) have a current license from the equivalent licensing agency in another state or Canada
434.28and, if the examination in clause (1) was passed more than ten years ago, either:
434.29    (i) pass the Special Purpose Examination of the Federation of State Medical Boards with
434.30a score of 75 or better within three attempts; or
435.1    (ii) have a current certification by a specialty board of the American Board of Medical
435.2Specialties, of the American Osteopathic Association, the Royal College of Physicians and
435.3Surgeons of Canada, or of the College of Family Physicians of Canada; or
435.4    (3) if the applicant fails to meet the requirement established in section 147.02, subdivision
435.51, paragraph (c), clause (2), because the applicant failed to pass each of steps one, two, and
435.6three of the USMLE within the required three attempts, the applicant may be granted a
435.7license provided the applicant:
435.8    (i) has passed each of steps one, two, and three with passing scores as recommended by
435.9the USMLE program within no more than four attempts for any of the three steps;
435.10    (ii) is currently licensed in another state; and
435.11    (iii) has current certification by a specialty board of the American Board of Medical
435.12Specialties, the American Osteopathic Association Bureau of Professional Education, the
435.13Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians
435.14of Canada.
435.15    (d) The applicant shall pay a fee established by the board by rule. The fee may not be
435.16refunded.
435.17    (e) (d) The applicant must not be under license suspension or revocation by the licensing
435.18board of the state or jurisdiction in which the conduct that caused the suspension or revocation
435.19occurred.
435.20    (f) (e) The applicant must not have engaged in conduct warranting disciplinary action
435.21against a licensee, or have been subject to disciplinary action other than as specified in
435.22paragraph (e) (d). If an applicant does not satisfy the requirements stated in this paragraph,
435.23the board may issue a license only on the applicant's showing that the public will be protected
435.24through issuance of a license with conditions or limitations the board considers appropriate.
435.25    (g) (f) Upon the request of an applicant, the board may conduct the final interview of
435.26the applicant by teleconference.

435.27    Sec. 4. [147A.28] PHYSICIAN ASSISTANT APPLICATION AND LICENSE FEES.
435.28(a) The board may charge the following nonrefundable fees:
435.29(1) physician assistant application fee, $120;
435.30(2) physician assistant annual registration renewal fee (prescribing authority), $135;
435.31(3) physician assistant annual registration renewal fee (no prescribing authority), $115;
436.1(4) physician assistant temporary registration, $115;
436.2(5) physician assistant temporary permit, $60;
436.3(6) physician assistant locum tenens permit, $25;
436.4(7) physician assistant late fee, $50;
436.5(8) duplicate license fee, $20;
436.6(9) certification letter fee, $25;
436.7(10) education or training program approval fee, $100; and
436.8(11) report creation and generation fee, $60.
436.9(b) The board may prorate the initial annual license fee. All licensees are required to
436.10pay the full fee upon license renewal. The revenue generated from the fees must be deposited
436.11in an account in the state government special revenue fund.

436.12    Sec. 5. Minnesota Statutes 2016, section 147B.08, is amended by adding a subdivision to
436.13read:
436.14    Subd. 4. Acupuncturist application and license fees. (a) The board may charge the
436.15following nonrefundable fees:
436.16(1) acupuncturist application fee, $150;
436.17(2) acupuncturist annual registration renewal fee, $150;
436.18(3) acupuncturist temporary registration fee, $60;
436.19(4) acupuncturist inactive status fee, $50;
436.20(5) acupuncturist late fee, $50;
436.21(6) duplicate license fee, $20;
436.22(7) certification letter fee, $25;
436.23(8) education or training program approval fee, $100; and
436.24(9) report creation and generation fee, $60.
436.25(b) The board may prorate the initial annual license fee. All licensees are required to
436.26pay the full fee upon license renewal. The revenue generated from the fees must be deposited
436.27in an account in the state government special revenue fund.

437.1    Sec. 6. Minnesota Statutes 2016, section 147C.40, is amended by adding a subdivision to
437.2read:
437.3    Subd. 5. Respiratory therapist application and license fees. (a) The board may charge
437.4the following nonrefundable fees:
437.5(1) respiratory therapist application fee, $100;
437.6(2) respiratory therapist annual registration renewal fee, $90;
437.7(3) respiratory therapist inactive status fee, $50;
437.8(4) respiratory therapist temporary registration fee, $90;
437.9(5) respiratory therapist temporary permit, $60;
437.10(6) respiratory therapist late fee, $50;
437.11(7) duplicate license fee, $20;
437.12(8) certification letter fee, $25;
437.13(9) education or training program approval fee, $100; and
437.14(10) report creation and generation fee, $60.
437.15(b) The board may prorate the initial annual license fee. All licensees are required to
437.16pay the full fee upon license renewal. The revenue generated from the fees must be deposited
437.17in an account in the state government special revenue fund.

437.18    Sec. 7. Minnesota Statutes 2016, section 148.6402, subdivision 4, is amended to read:
437.19    Subd. 4. Commissioner Board. "Commissioner Board" means the commissioner of
437.20health or a designee Board of Occupational Therapy Practice established in section 148.6449.
437.21EFFECTIVE DATE.This section is effective January 1, 2018.

437.22    Sec. 8. Minnesota Statutes 2016, section 148.6405, is amended to read:
437.23148.6405 LICENSURE APPLICATION REQUIREMENTS: PROCEDURES AND
437.24QUALIFICATIONS.
437.25(a) An applicant for licensure must comply with the application requirements in section
437.26148.6420 . To qualify for licensure, an applicant must satisfy one of the requirements in
437.27paragraphs (b) to (f) and not be subject to denial of licensure under section 148.6448.
438.1(b) A person who applies for licensure as an occupational therapist and who has not
438.2been credentialed by the National Board for Certification in Occupational Therapy or another
438.3jurisdiction must meet the requirements in section 148.6408.
438.4(c) A person who applies for licensure as an occupational therapy assistant and who has
438.5not been credentialed by the National Board for Certification in Occupational Therapy or
438.6another jurisdiction must meet the requirements in section 148.6410.
438.7(d) A person who is certified by the National Board for Certification in Occupational
438.8Therapy may apply for licensure by equivalency and must meet the requirements in section
438.9148.6412 .
438.10(e) A person who is credentialed in another jurisdiction may apply for licensure by
438.11reciprocity and must meet the requirements in section 148.6415.
438.12(f) A person who applies for temporary licensure must meet the requirements in section
438.13148.6418 .
438.14(g) A person who applies for licensure under paragraph (b), (c), or (f) more than two
438.15and less than four years after meeting the requirements in section 148.6408 or 148.6410
438.16must submit the following:
438.17(1) a completed and signed application for licensure on forms provided by the
438.18commissioner board;
438.19(2) the license application fee required under section 148.6445;
438.20(3) if applying for occupational therapist licensure, proof of having met a minimum of
438.2124 contact hours of continuing education in the two years preceding licensure application,
438.22or if applying for occupational therapy assistant licensure, proof of having met a minimum
438.23of 18 contact hours of continuing education in the two years preceding licensure application;
438.24(4) verified documentation of successful completion of 160 hours of supervised practice
438.25approved by the commissioner board under a limited license specified in section 148.6425,
438.26subdivision 3 , paragraph (c); and
438.27(5) additional information as requested by the commissioner board to clarify information
438.28in the application, including information to determine whether the individual has engaged
438.29in conduct warranting disciplinary action under section 148.6448. The information must be
438.30submitted within 30 days after the commissioner's board's request.
438.31(h) A person who applied for licensure under paragraph (b), (c), or (f) four years or more
438.32after meeting the requirements in section 148.6408 or 148.6410 must meet all the
439.1requirements in paragraph (g) except clauses (3) and (4), submit documentation of having
439.2retaken and passed the credentialing examination for occupational therapist or occupational
439.3therapy assistant, or of having completed an occupational therapy refresher program that
439.4contains both a theoretical and clinical component approved by the commissioner board,
439.5and verified documentation of successful completion of 480 hours of supervised practice
439.6approved by the commissioner board under a limited license specified in section 148.6425,
439.7subdivision 3 , paragraph (c). The 480 hours of supervised practice must be completed in
439.8six months and may be completed at the applicant's place of work. Only refresher courses
439.9completed within one year prior to the date of application qualify for approval.
439.10EFFECTIVE DATE.This section is effective January 1, 2018.

439.11    Sec. 9. Minnesota Statutes 2016, section 148.6408, subdivision 2, is amended to read:
439.12    Subd. 2. Qualifying examination score required. (a) An applicant must achieve a
439.13qualifying score on the credentialing examination for occupational therapist.
439.14(b) The commissioner board shall determine the qualifying score for the credentialing
439.15examination for occupational therapist. In determining the qualifying score, the commissioner
439.16board shall consider the cut score recommended by the National Board for Certification in
439.17Occupational Therapy, or other national credentialing organization approved by the
439.18commissioner board, using the modified Angoff method for determining cut score or another
439.19method for determining cut score that is recognized as appropriate and acceptable by industry
439.20standards.
439.21(c) The applicant is responsible for:
439.22(1) making arrangements to take the credentialing examination for occupational therapist;
439.23(2) bearing all expenses associated with taking the examination; and
439.24(3) having the examination scores sent directly to the commissioner board from the
439.25testing service that administers the examination.
439.26EFFECTIVE DATE.This section is effective January 1, 2018.

439.27    Sec. 10. Minnesota Statutes 2016, section 148.6410, subdivision 2, is amended to read:
439.28    Subd. 2. Qualifying examination score required. (a) An applicant for licensure must
439.29achieve a qualifying score on the credentialing examination for occupational therapy
439.30assistants.
440.1(b) The commissioner board shall determine the qualifying score for the credentialing
440.2examination for occupational therapy assistants. In determining the qualifying score, the
440.3commissioner board shall consider the cut score recommended by the National Board for
440.4Certification in Occupational Therapy, or other national credentialing organization approved
440.5by the commissioner board, using the modified Angoff method for determining cut score
440.6or another method for determining cut score that is recognized as appropriate and acceptable
440.7by industry standards.
440.8(c) The applicant is responsible for:
440.9(1) making all arrangements to take the credentialing examination for occupational
440.10therapy assistants;
440.11(2) bearing all expense associated with taking the examination; and
440.12(3) having the examination scores sent directly to the commissioner board from the
440.13testing service that administers the examination.
440.14EFFECTIVE DATE.This section is effective January 1, 2018.

440.15    Sec. 11. Minnesota Statutes 2016, section 148.6412, subdivision 2, is amended to read:
440.16    Subd. 2. Persons certified by National Board for Certification in Occupational
440.17Therapy after June 17, 1996. The commissioner board may license any person certified
440.18by the National Board for Certification in Occupational Therapy as an occupational therapist
440.19after June 17, 1996, if the commissioner board determines the requirements for certification
440.20are equivalent to or exceed the requirements for licensure as an occupational therapist under
440.21section 148.6408. The commissioner board may license any person certified by the National
440.22Board for Certification in Occupational Therapy as an occupational therapy assistant after
440.23June 17, 1996, if the commissioner board determines the requirements for certification are
440.24equivalent to or exceed the requirements for licensure as an occupational therapy assistant
440.25under section 148.6410. Nothing in this section limits the commissioner's board's authority
440.26to deny licensure based upon the grounds for discipline in sections 148.6401 to 148.6450
440.27148.6449.
440.28EFFECTIVE DATE.This section is effective January 1, 2018.

440.29    Sec. 12. Minnesota Statutes 2016, section 148.6415, is amended to read:
440.30148.6415 LICENSURE BY RECIPROCITY.
441.1A person who holds a current credential as an occupational therapist in the District of
441.2Columbia or a state or territory of the United States whose standards for credentialing are
441.3determined by the commissioner board to be equivalent to or exceed the requirements for
441.4licensure under section 148.6408 may be eligible for licensure by reciprocity as an
441.5occupational therapist. A person who holds a current credential as an occupational therapy
441.6assistant in the District of Columbia or a state or territory of the United States whose
441.7standards for credentialing are determined by the commissioner board to be equivalent to
441.8or exceed the requirements for licensure under section 148.6410 may be eligible for licensure
441.9by reciprocity as an occupational therapy assistant. Nothing in this section limits the
441.10commissioner's board's authority to deny licensure based upon the grounds for discipline
441.11in sections 148.6401 to 148.6450 148.6449. An applicant must provide:
441.12(1) the application materials as required by section 148.6420, subdivisions 1, 3, and 4;
441.13(2) the fees required by section 148.6445;
441.14(3) a copy of a current and unrestricted credential for the practice of occupational therapy
441.15as either an occupational therapist or occupational therapy assistant;
441.16(4) a letter from the jurisdiction that issued the credential describing the applicant's
441.17qualifications that entitled the applicant to receive the credential; and
441.18(5) other information necessary to determine whether the credentialing standards of the
441.19jurisdiction that issued the credential are equivalent to or exceed the requirements for
441.20licensure under sections 148.6401 to 148.6450 148.6449.
441.21EFFECTIVE DATE.This section is effective January 1, 2018.

441.22    Sec. 13. Minnesota Statutes 2016, section 148.6418, subdivision 1, is amended to read:
441.23    Subdivision 1. Application. The commissioner board shall issue temporary licensure
441.24as an occupational therapist or occupational therapy assistant to applicants who are not the
441.25subject of a disciplinary action or past disciplinary action, nor disqualified on the basis of
441.26items listed in section 148.6448, subdivision 1.
441.27EFFECTIVE DATE.This section is effective January 1, 2018.

441.28    Sec. 14. Minnesota Statutes 2016, section 148.6418, subdivision 2, is amended to read:
441.29    Subd. 2. Procedures. To be eligible for temporary licensure, an applicant must submit
441.30a completed application for temporary licensure on forms provided by the commissioner
441.31board, the fees required by section 148.6445, and one of the following:
442.1(1) evidence of successful completion of the requirements in section 148.6408,
442.2subdivision 1 , or 148.6410, subdivision 1;
442.3(2) a copy of a current and unrestricted credential for the practice of occupational therapy
442.4as either an occupational therapist or occupational therapy assistant in another jurisdiction;
442.5or
442.6(3) a copy of a current and unrestricted certificate from the National Board for
442.7Certification in Occupational Therapy stating that the applicant is certified as an occupational
442.8therapist or occupational therapy assistant.
442.9EFFECTIVE DATE.This section is effective January 1, 2018.

442.10    Sec. 15. Minnesota Statutes 2016, section 148.6418, subdivision 4, is amended to read:
442.11    Subd. 4. Supervision required. An applicant who has graduated from an accredited
442.12occupational therapy program, as required by section 148.6408, subdivision 1, or 148.6410,
442.13subdivision 1 , and who has not passed the examination required by section 148.6408,
442.14subdivision 2 , or 148.6410, subdivision 2, must practice under the supervision of a licensed
442.15occupational therapist. The supervising therapist must, at a minimum, supervise the person
442.16working under temporary licensure in the performance of the initial evaluation, determination
442.17of the appropriate treatment plan, and periodic review and modification of the treatment
442.18plan. The supervising therapist must observe the person working under temporary licensure
442.19in order to assure service competency in carrying out evaluation, treatment planning, and
442.20treatment implementation. The frequency of face-to-face collaboration between the person
442.21working under temporary licensure and the supervising therapist must be based on the
442.22condition of each patient or client, the complexity of treatment and evaluation procedures,
442.23and the proficiencies of the person practicing under temporary licensure. The occupational
442.24therapist or occupational therapy assistant working under temporary licensure must provide
442.25verification of supervision on the application form provided by the commissioner board.
442.26EFFECTIVE DATE.This section is effective January 1, 2018.

442.27    Sec. 16. Minnesota Statutes 2016, section 148.6418, subdivision 5, is amended to read:
442.28    Subd. 5. Expiration of temporary licensure. A temporary license issued to a person
442.29pursuant to subdivision 2, clause (1), expires six months from the date of issuance for
442.30occupational therapists and occupational therapy assistants or on the date the commissioner
442.31board grants or denies licensure, whichever occurs first. A temporary license issued to a
442.32person pursuant to subdivision 2, clause (2) or (3), expires 90 days after it is issued. Upon
443.1application for renewal, a temporary license shall be renewed once to persons who have
443.2not met the examination requirement under section 148.6408, subdivision 2, or 148.6410,
443.3subdivision 2 , within the initial temporary licensure period and who are not the subject of
443.4a disciplinary action nor disqualified on the basis of items in section 148.6448, subdivision
443.51 . Upon application for renewal, a temporary license shall be renewed once to persons who
443.6are able to demonstrate good cause for failure to meet the requirements for licensure under
443.7section 148.6412 or 148.6415 within the initial temporary licensure period and who are not
443.8the subject of a disciplinary action nor disqualified on the basis of items in section 148.6448,
443.9subdivision 1 .
443.10EFFECTIVE DATE.This section is effective January 1, 2018.

443.11    Sec. 17. Minnesota Statutes 2016, section 148.6420, subdivision 1, is amended to read:
443.12    Subdivision 1. Applications for licensure. An applicant for licensure must:
443.13(1) submit a completed application for licensure on forms provided by the commissioner
443.14board and must supply the information requested on the application, including:
443.15(i) the applicant's name, business address and business telephone number, business
443.16setting, and daytime telephone number;
443.17(ii) the name and location of the occupational therapy program the applicant completed;
443.18(iii) a description of the applicant's education and training, including a list of degrees
443.19received from educational institutions;
443.20(iv) the applicant's work history for the six years preceding the application, including
443.21the number of hours worked;
443.22(v) a list of all credentials currently and previously held in Minnesota and other
443.23jurisdictions;
443.24(vi) a description of any jurisdiction's refusal to credential the applicant;
443.25(vii) a description of all professional disciplinary actions initiated against the applicant
443.26in any jurisdiction;
443.27(viii) information on any physical or mental condition or chemical dependency that
443.28impairs the person's ability to engage in the practice of occupational therapy with reasonable
443.29judgment or safety;
443.30(ix) a description of any misdemeanor or felony conviction that relates to honesty or to
443.31the practice of occupational therapy;
444.1(x) a description of any state or federal court order, including a conciliation court
444.2judgment or a disciplinary order, related to the individual's occupational therapy practice;
444.3and
444.4(xi) a statement indicating the physical agent modalities the applicant will use and
444.5whether the applicant will use the modalities as an occupational therapist or an occupational
444.6therapy assistant under direct supervision;
444.7(2) submit with the application all fees required by section 148.6445;
444.8(3) sign a statement that the information in the application is true and correct to the best
444.9of the applicant's knowledge and belief;
444.10(4) sign a waiver authorizing the commissioner board to obtain access to the applicant's
444.11records in this or any other state in which the applicant holds or previously held a credential
444.12for the practice of an occupation, has completed an accredited occupational therapy education
444.13program, or engaged in the practice of occupational therapy;
444.14(5) submit additional information as requested by the commissioner board; and
444.15(6) submit the additional information required for licensure by equivalency, licensure
444.16by reciprocity, and temporary licensure as specified in sections 148.6408 to 148.6418.
444.17EFFECTIVE DATE.This section is effective January 1, 2018.

444.18    Sec. 18. Minnesota Statutes 2016, section 148.6420, subdivision 3, is amended to read:
444.19    Subd. 3. Applicants certified by National Board for Certification in Occupational
444.20Therapy. An applicant who is certified by the National Board for Certification in
444.21Occupational Therapy must provide the materials required in subdivision 1 and the following:
444.22(1) verified documentation from the National Board for Certification in Occupational
444.23Therapy stating that the applicant is certified as an occupational therapist, registered or
444.24certified occupational therapy assistant, the date certification was granted, and the applicant's
444.25certification number. The document must also include a statement regarding disciplinary
444.26actions. The applicant is responsible for obtaining this documentation by sending a form
444.27provided by the commissioner board to the National Board for Certification in Occupational
444.28Therapy; and
444.29(2) a waiver authorizing the commissioner board to obtain access to the applicant's
444.30records maintained by the National Board for Certification in Occupational Therapy.
444.31EFFECTIVE DATE.This section is effective January 1, 2018.

445.1    Sec. 19. Minnesota Statutes 2016, section 148.6420, subdivision 5, is amended to read:
445.2    Subd. 5. Action on applications for licensure. (a) The commissioner board shall
445.3approve, approve with conditions, or deny licensure. The commissioner board shall act on
445.4an application for licensure according to paragraphs (b) to (d).
445.5(b) The commissioner board shall determine if the applicant meets the requirements for
445.6licensure. The commissioner board, or the advisory council at the commissioner's board's
445.7request, may investigate information provided by an applicant to determine whether the
445.8information is accurate and complete.
445.9(c) The commissioner board shall notify an applicant of action taken on the application
445.10and, if licensure is denied or approved with conditions, the grounds for the commissioner's
445.11board's determination.
445.12(d) An applicant denied licensure or granted licensure with conditions may make a
445.13written request to the commissioner board, within 30 days of the date of the commissioner's
445.14board's determination, for reconsideration of the commissioner's board's determination.
445.15Individuals requesting reconsideration may submit information which the applicant wants
445.16considered in the reconsideration. After reconsideration of the commissioner's board's
445.17determination to deny licensure or grant licensure with conditions, the commissioner board
445.18shall determine whether the original determination should be affirmed or modified. An
445.19applicant is allowed no more than one request in any one biennial licensure period for
445.20reconsideration of the commissioner's board's determination to deny licensure or approve
445.21licensure with conditions.
445.22EFFECTIVE DATE.This section is effective January 1, 2018.

445.23    Sec. 20. Minnesota Statutes 2016, section 148.6423, is amended to read:
445.24148.6423 LICENSURE RENEWAL.
445.25    Subdivision 1. Renewal requirements. To be eligible for licensure renewal, a licensee
445.26must:
445.27(1) submit a completed and signed application for licensure renewal on forms provided
445.28by the commissioner board;
445.29(2) submit the renewal fee required under section 148.6445;
445.30(3) submit proof of having met the continuing education requirement of section 148.6443
445.31on forms provided by the commissioner board; and
446.1(4) submit additional information as requested by the commissioner board to clarify
446.2information presented in the renewal application. The information must be submitted within
446.330 days after the commissioner's board's request.
446.4    Subd. 2. Renewal deadline. (a) Except as provided in paragraph (c), licenses must be
446.5renewed every two years. Licensees must comply with the following procedures in paragraphs
446.6(b) to (e):
446.7(b) Each license must state an expiration date. An application for licensure renewal must
446.8be received by the Department of Health board or postmarked at least 30 calendar days
446.9before the expiration date. If the postmark is illegible, the application shall be considered
446.10timely if received at least 21 calendar days before the expiration date.
446.11(c) If the commissioner board changes the renewal schedule and the expiration date is
446.12less than two years, the fee and the continuing education contact hours to be reported at the
446.13next renewal must be prorated.
446.14(d) An application for licensure renewal not received within the time required under
446.15paragraph (b), but received on or before the expiration date, must be accompanied by a late
446.16fee in addition to the renewal fee specified by section 148.6445.
446.17(e) Licensure renewals received after the expiration date shall not be accepted and persons
446.18seeking licensed status must comply with the requirements of section 148.6425.
446.19    Subd. 3. Licensure renewal notice. At least 60 calendar days before the expiration date
446.20in subdivision 2, the commissioner board shall mail a renewal notice to the licensee's last
446.21known address on file with the commissioner board. The notice must include an application
446.22for licensure renewal and notice of fees required for renewal. The licensee's failure to receive
446.23notice does not relieve the licensee of the obligation to meet the renewal deadline and other
446.24requirements for licensure renewal.
446.25EFFECTIVE DATE.This section is effective January 1, 2018.

446.26    Sec. 21. Minnesota Statutes 2016, section 148.6425, subdivision 2, is amended to read:
446.27    Subd. 2. Licensure renewal after licensure expiration date. An individual whose
446.28application for licensure renewal is received after the licensure expiration date must submit
446.29the following:
446.30(1) a completed and signed application for licensure following lapse in licensed status
446.31on forms provided by the commissioner board;
446.32(2) the renewal fee and the late fee required under section 148.6445;
447.1(3) proof of having met the continuing education requirements in section 148.6443,
447.2subdivision 1 ; and
447.3(4) additional information as requested by the commissioner board to clarify information
447.4in the application, including information to determine whether the individual has engaged
447.5in conduct warranting disciplinary action as set forth in section 148.6448. The information
447.6must be submitted within 30 days after the commissioner's board's request.
447.7EFFECTIVE DATE.This section is effective January 1, 2018.

447.8    Sec. 22. Minnesota Statutes 2016, section 148.6425, subdivision 3, is amended to read:
447.9    Subd. 3. Licensure renewal four years or more after licensure expiration date. (a)
447.10An individual who requests licensure renewal four years or more after the licensure expiration
447.11date must submit the following:
447.12(1) a completed and signed application for licensure on forms provided by the
447.13commissioner board;
447.14(2) the renewal fee and the late fee required under section 148.6445 if renewal application
447.15is based on paragraph (b), clause (1), (2), or (3), or the renewal fee required under section
447.16148.6445 if renewal application is based on paragraph (b), clause (4);
447.17(3) proof of having met the continuing education requirement in section 148.6443,
447.18subdivision 1 , except the continuing education must be obtained in the two years immediately
447.19preceding application renewal; and
447.20(4) at the time of the next licensure renewal, proof of having met the continuing education
447.21requirement, which shall be prorated based on the number of months licensed during the
447.22two-year licensure period.
447.23(b) In addition to the requirements in paragraph (a), the applicant must submit proof of
447.24one of the following:
447.25(1) verified documentation of successful completion of 160 hours of supervised practice
447.26approved by the commissioner board as described in paragraph (c);
447.27(2) verified documentation of having achieved a qualifying score on the credentialing
447.28examination for occupational therapists or the credentialing examination for occupational
447.29therapy assistants administered within the past year;
447.30(3) documentation of having completed a combination of occupational therapy courses
447.31or an occupational therapy refresher program that contains both a theoretical and clinical
447.32component approved by the commissioner board. Only courses completed within one year
448.1preceding the date of the application or one year after the date of the application qualify for
448.2approval; or
448.3(4) evidence that the applicant holds a current and unrestricted credential for the practice
448.4of occupational therapy in another jurisdiction and that the applicant's credential from that
448.5jurisdiction has been held in good standing during the period of lapse.
448.6(c) To participate in a supervised practice as described in paragraph (b), clause (1), the
448.7applicant shall obtain limited licensure. To apply for limited licensure, the applicant shall
448.8submit the completed limited licensure application, fees, and agreement for supervision of
448.9an occupational therapist or occupational therapy assistant practicing under limited licensure
448.10signed by the supervising therapist and the applicant. The supervising occupational therapist
448.11shall state the proposed level of supervision on the supervision agreement form provided
448.12by the commissioner board. The supervising therapist shall determine the frequency and
448.13manner of supervision based on the condition of the patient or client, the complexity of the
448.14procedure, and the proficiencies of the supervised occupational therapist. At a minimum, a
448.15supervising occupational therapist shall be on the premises at all times that the person
448.16practicing under limited licensure is working; be in the room ten percent of the hours worked
448.17each week by the person practicing under limited licensure; and provide daily face-to-face
448.18collaboration for the purpose of observing service competency of the occupational therapist
448.19or occupational therapy assistant, discussing treatment procedures and each client's response
448.20to treatment, and reviewing and modifying, as necessary, each treatment plan. The supervising
448.21therapist shall document the supervision provided. The occupational therapist participating
448.22in a supervised practice is responsible for obtaining the supervision required under this
448.23paragraph and must comply with the commissioner's board's requirements for supervision
448.24during the entire 160 hours of supervised practice. The supervised practice must be completed
448.25in two months and may be completed at the applicant's place of work.
448.26(d) In addition to the requirements in paragraphs (a) and (b), the applicant must submit
448.27additional information as requested by the commissioner board to clarify information in the
448.28application, including information to determine whether the applicant has engaged in conduct
448.29warranting disciplinary action as set forth in section 148.6448. The information must be
448.30submitted within 30 days after the commissioner's board's request.
448.31EFFECTIVE DATE.This section is effective January 1, 2018.

448.32    Sec. 23. Minnesota Statutes 2016, section 148.6428, is amended to read:
448.33148.6428 CHANGE OF NAME, ADDRESS, OR EMPLOYMENT.
449.1A licensee who changes a name, address, or employment must inform the commissioner
449.2board, in writing, of the change of name, address, employment, business address, or business
449.3telephone number within 30 days. A change in name must be accompanied by a copy of a
449.4marriage certificate or court order. All notices or other correspondence mailed to or served
449.5on a licensee by the commissioner board at the licensee's address on file with the
449.6commissioner board shall be considered as having been received by the licensee.
449.7EFFECTIVE DATE.This section is effective January 1, 2018.

449.8    Sec. 24. Minnesota Statutes 2016, section 148.6443, subdivision 5, is amended to read:
449.9    Subd. 5. Reporting continuing education contact hours. Within one month following
449.10licensure expiration, each licensee shall submit verification that the licensee has met the
449.11continuing education requirements of this section on the continuing education report form
449.12provided by the commissioner board. The continuing education report form may require
449.13the following information:
449.14(1) title of continuing education activity;
449.15(2) brief description of the continuing education activity;
449.16(3) sponsor, presenter, or author;
449.17(4) location and attendance dates;
449.18(5) number of contact hours; and
449.19(6) licensee's notarized affirmation that the information is true and correct.
449.20EFFECTIVE DATE.This section is effective January 1, 2018.

449.21    Sec. 25. Minnesota Statutes 2016, section 148.6443, subdivision 6, is amended to read:
449.22    Subd. 6. Auditing continuing education reports. (a) The commissioner board may
449.23audit a percentage of the continuing education reports based on random selection. A licensee
449.24shall maintain all documentation required by this section for two years after the last day of
449.25the biennial licensure period in which the contact hours were earned.
449.26(b) All renewal applications that are received after the expiration date may be subject
449.27to a continuing education report audit.
449.28(c) Any licensee against whom a complaint is filed may be subject to a continuing
449.29education report audit.
450.1(d) The licensee shall make the following information available to the commissioner
450.2board for auditing purposes:
450.3(1) a copy of the completed continuing education report form for the continuing education
450.4reporting period that is the subject of the audit including all supporting documentation
450.5required by subdivision 5;
450.6(2) a description of the continuing education activity prepared by the presenter or sponsor
450.7that includes the course title or subject matter, date, place, number of program contact hours,
450.8presenters, and sponsors;
450.9(3) documentation of self-study programs by materials prepared by the presenter or
450.10sponsor that includes the course title, course description, name of sponsor or author, and
450.11the number of hours required to complete the program;
450.12(4) documentation of university, college, or vocational school courses by a course
450.13syllabus, listing in a course bulletin, or equivalent documentation that includes the course
450.14title, instructor's name, course dates, number of contact hours, and course content, objectives,
450.15or goals; and
450.16(5) verification of attendance by:
450.17(i) a signature of the presenter or a designee at the continuing education activity on the
450.18continuing education report form or a certificate of attendance with the course name, course
450.19date, and licensee's name;
450.20(ii) a summary or outline of the educational content of an audio or video educational
450.21activity to verify the licensee's participation in the activity if a designee is not available to
450.22sign the continuing education report form;
450.23(iii) verification of self-study programs by a certificate of completion or other
450.24documentation indicating that the individual has demonstrated knowledge and has
450.25successfully completed the program; or
450.26(iv) verification of attendance at a university, college, or vocational course by an official
450.27transcript.
450.28EFFECTIVE DATE.This section is effective January 1, 2018.

450.29    Sec. 26. Minnesota Statutes 2016, section 148.6443, subdivision 7, is amended to read:
450.30    Subd. 7. Waiver of continuing education requirements. The commissioner board may
450.31grant a waiver of the requirements of this section in cases where the requirements would
450.32impose an extreme hardship on the licensee. The request for a waiver must be in writing,
451.1state the circumstances that constitute extreme hardship, state the period of time the licensee
451.2wishes to have the continuing education requirement waived, and state the alternative
451.3measures that will be taken if a waiver is granted. The commissioner board shall set forth,
451.4in writing, the reasons for granting or denying the waiver. Waivers granted by the
451.5commissioner board shall specify, in writing, the time limitation and required alternative
451.6measures to be taken by the licensee. A request for waiver shall be denied if the commissioner
451.7board finds that the circumstances stated by the licensee do not support a claim of extreme
451.8hardship, the requested time period for waiver is unreasonable, the alternative measures
451.9proposed by the licensee are not equivalent to the continuing education activity being waived,
451.10or the request for waiver is not submitted to the commissioner board within 60 days after
451.11the expiration date.
451.12EFFECTIVE DATE.This section is effective January 1, 2018.

451.13    Sec. 27. Minnesota Statutes 2016, section 148.6443, subdivision 8, is amended to read:
451.14    Subd. 8. Penalties for noncompliance. The commissioner board shall refuse to renew
451.15or grant, or shall suspend, condition, limit, or qualify the license of any person who the
451.16commissioner board determines has failed to comply with the continuing education
451.17requirements of this section. A licensee may request reconsideration of the commissioner's
451.18board's determination of noncompliance or the penalty imposed under this section by making
451.19a written request to the commissioner board within 30 days of the date of notification to the
451.20applicant. Individuals requesting reconsideration may submit information that the licensee
451.21wants considered in the reconsideration.
451.22EFFECTIVE DATE.This section is effective January 1, 2018.

451.23    Sec. 28. Minnesota Statutes 2016, section 148.6445, subdivision 1, is amended to read:
451.24    Subdivision 1. Initial licensure fee. The initial licensure fee for occupational therapists
451.25is $145. The initial licensure fee for occupational therapy assistants is $80. The commissioner
451.26board shall prorate fees based on the number of quarters remaining in the biennial licensure
451.27period.
451.28EFFECTIVE DATE.This section is effective January 1, 2018.

451.29    Sec. 29. Minnesota Statutes 2016, section 148.6445, subdivision 10, is amended to read:
451.30    Subd. 10. Use of fees. All fees are nonrefundable. The commissioner board shall only
451.31use fees collected under this section for the purposes of administering this chapter. The
451.32legislature must not transfer money generated by these fees from the state government
452.1special revenue fund to the general fund. Surcharges collected by the commissioner of health
452.2under section 16E.22 are not subject to this subdivision.
452.3EFFECTIVE DATE.This section is effective January 1, 2018.

452.4    Sec. 30. Minnesota Statutes 2016, section 148.6448, is amended to read:
452.5148.6448 GROUNDS FOR DENIAL OF LICENSURE OR DISCIPLINE;
452.6INVESTIGATION PROCEDURES; DISCIPLINARY ACTIONS.
452.7    Subdivision 1. Grounds for denial of licensure or discipline. The commissioner board
452.8may deny an application for licensure, may approve licensure with conditions, or may
452.9discipline a licensee using any disciplinary actions listed in subdivision 3 on proof that the
452.10individual has:
452.11(1) intentionally submitted false or misleading information to the commissioner board
452.12or the advisory council;
452.13(2) failed, within 30 days, to provide information in response to a written request by the
452.14commissioner board or advisory council;
452.15(3) performed services of an occupational therapist or occupational therapy assistant in
452.16an incompetent manner or in a manner that falls below the community standard of care;
452.17(4) failed to satisfactorily perform occupational therapy services during a period of
452.18temporary licensure;
452.19(5) violated sections 148.6401 to 148.6450 148.6449;
452.20(6) failed to perform services with reasonable judgment, skill, or safety due to the use
452.21of alcohol or drugs, or other physical or mental impairment;
452.22(7) been convicted of violating any state or federal law, rule, or regulation which directly
452.23relates to the practice of occupational therapy;
452.24(8) aided or abetted another person in violating any provision of sections 148.6401 to
452.25148.6450 148.6449;
452.26(9) been disciplined for conduct in the practice of an occupation by the state of Minnesota,
452.27another jurisdiction, or a national professional association, if any of the grounds for discipline
452.28are the same or substantially equivalent to those in sections 148.6401 to 148.6450 148.6449;
452.29(10) not cooperated with the commissioner or advisory council board in an investigation
452.30conducted according to subdivision 2;
452.31(11) advertised in a manner that is false or misleading;
453.1(12) engaged in dishonest, unethical, or unprofessional conduct in connection with the
453.2practice of occupational therapy that is likely to deceive, defraud, or harm the public;
453.3(13) demonstrated a willful or careless disregard for the health, welfare, or safety of a
453.4client;
453.5(14) performed medical diagnosis or provided treatment, other than occupational therapy,
453.6without being licensed to do so under the laws of this state;
453.7(15) paid or promised to pay a commission or part of a fee to any person who contacts
453.8the occupational therapist for consultation or sends patients to the occupational therapist
453.9for treatment;
453.10(16) engaged in an incentive payment arrangement, other than that prohibited by clause
453.11(15), that promotes occupational therapy overutilization, whereby the referring person or
453.12person who controls the availability of occupational therapy services to a client profits
453.13unreasonably as a result of client treatment;
453.14(17) engaged in abusive or fraudulent billing practices, including violations of federal
453.15Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical
453.16assistance laws;
453.17(18) obtained money, property, or services from a consumer through the use of undue
453.18influence, high pressure sales tactics, harassment, duress, deception, or fraud;
453.19(19) performed services for a client who had no possibility of benefiting from the services;
453.20(20) failed to refer a client for medical evaluation when appropriate or when a client
453.21indicated symptoms associated with diseases that could be medically or surgically treated;
453.22(21) engaged in conduct with a client that is sexual or may reasonably be interpreted by
453.23the client as sexual, or in any verbal behavior that is seductive or sexually demeaning to a
453.24patient;
453.25(22) violated a federal or state court order, including a conciliation court judgment, or
453.26a disciplinary order issued by the commissioner board, related to the person's occupational
453.27therapy practice; or
453.28(23) any other just cause related to the practice of occupational therapy.
453.29    Subd. 2. Investigation of complaints. The commissioner, or the advisory council when
453.30authorized by the commissioner, board may initiate an investigation upon receiving a
453.31complaint or other oral or written communication that alleges or implies that a person has
453.32violated sections 148.6401 to 148.6450 148.6449. In the receipt, investigation, and hearing
454.1of a complaint that alleges or implies a person has violated sections 148.6401 to 148.6450
454.2148.6449, the commissioner board shall follow the procedures in section 214.10.
454.3    Subd. 3. Disciplinary actions. If the commissioner board finds that an occupational
454.4therapist or occupational therapy assistant should be disciplined according to subdivision
454.51, the commissioner board may take any one or more of the following actions:
454.6(1) refuse to grant or renew licensure;
454.7(2) approve licensure with conditions;
454.8(3) revoke licensure;
454.9(4) suspend licensure;
454.10(5) any reasonable lesser action including, but not limited to, reprimand or restriction
454.11on licensure; or
454.12(6) any action authorized by statute.
454.13    Subd. 4. Effect of specific disciplinary action on use of title. Upon notice from the
454.14commissioner board denying licensure renewal or upon notice that disciplinary actions have
454.15been imposed and the person is no longer entitled to practice occupational therapy and use
454.16the occupational therapy and licensed titles, the person shall cease to practice occupational
454.17therapy, to use titles protected by sections 148.6401 to 148.6450 148.6449, and to represent
454.18to the public that the person is licensed by the commissioner board.
454.19    Subd. 5. Reinstatement requirements after disciplinary action. A person who has
454.20had licensure suspended may request and provide justification for reinstatement following
454.21the period of suspension specified by the commissioner board. The requirements of sections
454.22148.6423 and 148.6425 for renewing licensure and any other conditions imposed with the
454.23suspension must be met before licensure may be reinstated.
454.24    Subd. 6. Authority to contract. The commissioner board shall contract with the health
454.25professionals services program as authorized by sections 214.31 to 214.37 to provide these
454.26services to practitioners under this chapter. The health professionals services program does
454.27not affect the commissioner's board's authority to discipline violations of sections 148.6401
454.28to 148.6450 148.6449.
454.29EFFECTIVE DATE.This section is effective January 1, 2018.

455.1    Sec. 31. [148.6449] BOARD OF OCCUPATIONAL THERAPY PRACTICE.
455.2    Subdivision 1. Creation. The Board of Occupational Therapy Practice consists of 11
455.3members appointed by the governor. The members are:
455.4(1) five occupational therapists licensed under sections 148.6401 to 148.6449;
455.5(2) three occupational therapy assistants licensed under sections 148.6401 to 148.6449;
455.6and
455.7(3) three public members, including two members who have received occupational
455.8therapy services or have a family member who has received occupational therapy services,
455.9and one member who is a health care professional or health care provider licensed in
455.10Minnesota.
455.11    Subd. 2. Qualifications of board members. (a) The occupational therapy practitioners
455.12appointed to the board must represent a variety of practice areas and settings.
455.13(b) At least two occupational therapy practitioners must be employed outside the
455.14seven-county metropolitan area.
455.15(c) Board members shall serve for not more than two consecutive terms.
455.16    Subd. 3. Recommendations for appointment. Prior to the end of the term of a member
455.17of the board, or within 60 days after a position on the board becomes vacant, the Minnesota
455.18Occupational Therapy Association and other interested persons and organizations may
455.19recommend to the governor members qualified to serve on the board. The governor may
455.20appoint members to the board from the list of persons recommended or from among other
455.21qualified candidates.
455.22    Subd. 4. Officers. The board shall biennially elect from its membership a chair, vice-chair,
455.23and secretary-treasurer. Each officer shall serve until a successor is elected.
455.24    Subd. 5. Executive director. The board shall appoint and employ an executive director
455.25who is not a member of the board. The employment of the executive director shall be subject
455.26to the terms described in section 214.04, subdivision 2a.
455.27    Subd. 6. Terms; compensation; removal of members. Membership terms, compensation
455.28of members, removal of members, the filling of membership vacancies, and fiscal year and
455.29reporting requirements shall be as provided in chapter 214. The provision of staff,
455.30administrative services, and office space; the review and processing of complaints; the
455.31setting of board fees; and other activities relating to board operations shall be conducted
455.32according to chapter 214.
456.1    Subd. 7. Duties of the Board of Occupational Therapy Practice. (a) The board shall:
456.2(1) adopt and enforce rules and laws necessary for licensing occupational therapy
456.3practitioners;
456.4(2) adopt and enforce rules for regulating the professional conduct of the practice of
456.5occupational therapy;
456.6(3) issue licenses to qualified individuals in accordance with sections 148.6401 to
456.7148.6449;
456.8(4) assess and collect fees for the issuance and renewal of licenses;
456.9(5) educate the public about the requirements for licensing occupational therapy
456.10practitioners, educate occupational therapy practitioners about the rules of conduct, and
456.11enable the public to file complaints against applicants and licensees who may have violated
456.12sections 148.6401 to 148.6449; and
456.13(6) investigate individuals engaging in practices that violate sections 148.6401 to
456.14148.6449 and take necessary disciplinary, corrective, or other action according to section
456.15148.6448.
456.16(b) The board may adopt rules necessary to define standards or carry out the provisions
456.17of sections 148.6401 to 148.6449. Rules shall be adopted according to chapter 14.
456.18EFFECTIVE DATE.This section is effective January 1, 2018.

456.19    Sec. 32. Minnesota Statutes 2016, section 148.881, is amended to read:
456.20148.881 DECLARATION OF POLICY.
456.21The practice of psychology in Minnesota affects the public health, safety, and welfare.
456.22The regulations in sections 148.88 to 148.98 the Minnesota Psychology Practice Act as
456.23enforced by the Board of Psychology protect the public from the practice of psychology by
456.24unqualified persons and from unethical or unprofessional conduct by persons licensed to
456.25practice psychology through licensure and regulation to promote access to safe, ethical, and
456.26competent psychological services.

456.27    Sec. 33. Minnesota Statutes 2016, section 148.89, is amended to read:
456.28148.89 DEFINITIONS.
456.29    Subdivision 1. Applicability. For the purposes of sections 148.88 to 148.98, the following
456.30terms have the meanings given them.
457.1    Subd. 2. Board of Psychology or board. "Board of Psychology" or "board" means the
457.2board established under section 148.90.
457.3    Subd. 2a. Client. "Client" means each individual or legal, religious, academic,
457.4organizational, business, governmental, or other entity that receives, received, or should
457.5have received, or arranged for another individual or entity to receive services from an
457.6individual regulated under sections 148.88 to 148.98. Client also means an individual's
457.7legally authorized representative, such as a parent or guardian. For the purposes of sections
457.8148.88 to 148.98, "client" may include patient, resident, counselee, evaluatee, and, as limited
457.9in the rules of conduct, student, supervisee, or research subject. In the case of dual clients,
457.10the licensee or applicant for licensure must be aware of the responsibilities to each client,
457.11and of the potential for divergent interests of each client a direct recipient of psychological
457.12services within the context of a professional relationship that may include a child, adolescent,
457.13adult, couple, family, group, organization, community, or other entity. The client may be
457.14the person requesting the psychological services or the direct recipient of the services.
457.15    Subd. 2b. Credentialed. "Credentialed" means having a license, certificate, charter,
457.16registration, or similar authority to practice in an occupation regulated by a governmental
457.17board or agency.
457.18    Subd. 2c. Designated supervisor. "Designated supervisor" means a qualified individual
457.19who is designated identified and assigned by the primary supervisor to provide additional
457.20supervision and training to a licensed psychological practitioner or to an individual who is
457.21obtaining required predegree supervised professional experience or postdegree supervised
457.22psychological employment.
457.23    Subd. 2d. Direct services. "Direct services" means the delivery of preventive, diagnostic,
457.24assessment, or therapeutic intervention services where the primary purpose is to benefit a
457.25client who is the direct recipient of the service.
457.26    Subd. 2e. Full-time employment. "Full-time employment" means a minimum of 35
457.27clock hours per week.
457.28    Subd. 3. Independent practice. "Independent practice" means the practice of psychology
457.29without supervision.
457.30    Subd. 3a. Jurisdiction. "Jurisdiction" means the United States, United States territories,
457.31or Canadian provinces or territories.
457.32    Subd. 4. Licensee. "Licensee" means a person who is licensed by the board as a licensed
457.33psychologist or as a licensed psychological practitioner.
458.1    Subd. 4a. Provider or provider of services. "Provider" or "provider of services" means
458.2any individual who is regulated by the board, and includes a licensed psychologist, a licensed
458.3psychological practitioner, a licensee, or an applicant.
458.4    Subd. 4b. Primary supervisor. "Primary supervisor" means a psychologist licensed in
458.5Minnesota or other qualified individual who provides the principal supervision to a licensed
458.6psychological practitioner or to an individual who is obtaining required predegree supervised
458.7professional experience or postdegree supervised psychological employment.
458.8    Subd. 5. Practice of psychology. "Practice of psychology" means the observation,
458.9description, evaluation, interpretation, or prediction, or modification of human behavior by
458.10the application of psychological principles, methods, or procedures for any reason, including
458.11to prevent, eliminate, or manage the purpose of preventing, eliminating, evaluating, assessing,
458.12or predicting symptomatic, maladaptive, or undesired behavior; applying psychological
458.13principles in legal settings; and to enhance enhancing interpersonal relationships, work, life
458.14and developmental adjustment, personal and organizational effectiveness, behavioral health,
458.15and mental health. The practice of psychology includes, but is not limited to, the following
458.16services, regardless of whether the provider receives payment for the services:
458.17(1) psychological research and teaching of psychology subject to the exemptions in
458.18section 148.9075;
458.19(2) assessment, including psychological testing and other means of evaluating personal
458.20characteristics such as intelligence, personality, abilities, interests, aptitudes, and
458.21neuropsychological functioning psychological testing and the evaluation or assessment of
458.22personal characteristics, such as intelligence, personality, cognitive, physical and emotional
458.23abilities, skills, interests, aptitudes, and neuropsychological functioning;
458.24(3) a psychological report, whether written or oral, including testimony of a provider as
458.25an expert witness, concerning the characteristics of an individual or entity counseling,
458.26psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy;
458.27(4) psychotherapy, including but not limited to, categories such as behavioral, cognitive,
458.28emotive, systems, psychophysiological, or insight-oriented therapies; counseling; hypnosis;
458.29and diagnosis and treatment of:
458.30(i) mental and emotional disorder or disability;
458.31(ii) alcohol and substance dependence or abuse;
458.32(iii) disorders of habit or conduct;
459.1(iv) the psychological aspects of physical illness or condition, accident, injury, or
459.2disability, including the psychological impact of medications;
459.3(v) life adjustment issues, including work-related and bereavement issues; and
459.4(vi) child, family, or relationship issues
459.5(4) diagnosis, treatment, and management of mental or emotional disorders or disabilities,
459.6substance use disorders, disorders of habit or conduct, and the psychological aspects of
459.7physical illness, accident, injury, or disability;
459.8(5) psychoeducational services and treatment psychoeducational evaluation, therapy,
459.9and remediation; and
459.10(6) consultation and supervision with physicians, other health care professionals, and
459.11clients regarding available treatment options, including medication, with respect to the
459.12provision of care for a specific client;
459.13(7) provision of direct services to individuals or groups for the purpose of enhancing
459.14individual and organizational effectiveness, using psychological principles, methods, and
459.15procedures to assess and evaluate individuals on personal characteristics for individual
459.16development or behavior change or for making decisions about the individual; and
459.17(8) supervision and consultation related to any of the services described in this
459.18subdivision.
459.19    Subd. 6. Telesupervision. "Telesupervision" means the clinical supervision of
459.20psychological services through a synchronous audio and video format where the supervisor
459.21is not physically in the same facility as the supervisee.

459.22    Sec. 34. Minnesota Statutes 2016, section 148.90, subdivision 1, is amended to read:
459.23    Subdivision 1. Board of Psychology. (a) The Board of Psychology is created with the
459.24powers and duties described in this section. The board has 11 members who consist of:
459.25(1) three four individuals licensed as licensed psychologists who have doctoral degrees
459.26in psychology;
459.27(2) two individuals licensed as licensed psychologists who have master's degrees in
459.28psychology;
459.29(3) two psychologists, not necessarily licensed, one with a who have doctoral degree
459.30degrees in psychology and one with either a doctoral or master's degree in psychology
459.31representing different training programs in psychology;
460.1(4) one individual licensed or qualified to be licensed as: (i) through December 31, 2010,
460.2a licensed psychological practitioner; and (ii) after December 31, 2010, a licensed
460.3psychologist; and
460.4(5) (4) three public members.
460.5(b) After the date on which fewer than 30 percent of the individuals licensed by the
460.6board as licensed psychologists qualify for licensure under section 148.907, subdivision 3,
460.7paragraph (b), vacancies filled under paragraph (a), clause (2), shall be filled by an individual
460.8with either a master's or doctoral degree in psychology licensed or qualified to be licensed
460.9as a licensed psychologist.
460.10(c) After the date on which fewer than 15 percent of the individuals licensed by the board
460.11as licensed psychologists qualify for licensure under section 148.907, subdivision 3,
460.12paragraph (b), vacancies under paragraph (a), clause (2), shall be filled by an individual
460.13with either a master's or doctoral degree in psychology licensed or qualified to be licensed
460.14as a licensed psychologist.

460.15    Sec. 35. Minnesota Statutes 2016, section 148.90, subdivision 2, is amended to read:
460.16    Subd. 2. Members. (a) The members of the board shall:
460.17(1) be appointed by the governor;
460.18(2) be residents of the state;
460.19(3) serve for not more than two consecutive terms;
460.20(4) designate the officers of the board; and
460.21(5) administer oaths pertaining to the business of the board.
460.22(b) A public member of the board shall represent the public interest and shall not:
460.23(1) be a psychologist, psychological practitioner, or have engaged in the practice of
460.24psychology;
460.25(2) be an applicant or former applicant for licensure;
460.26(3) be a member of another health profession and be licensed by a health-related licensing
460.27board as defined under section 214.01, subdivision 2; the commissioner of health; or licensed,
460.28certified, or registered by another jurisdiction;
460.29(4) be a member of a household that includes a psychologist or psychological practitioner;
460.30or
461.1(5) have conflicts of interest or the appearance of conflicts with duties as a board member.

461.2    Sec. 36. Minnesota Statutes 2016, section 148.905, subdivision 1, is amended to read:
461.3    Subdivision 1. General. The board shall:
461.4(1) adopt and enforce rules for licensing psychologists and psychological practitioners
461.5and for regulating their professional conduct;
461.6(2) adopt and enforce rules of conduct governing the practice of psychology;
461.7(3) adopt and implement rules for examinations which shall be held at least once a year
461.8to assess applicants' knowledge and skills. The examinations may be written or oral or both,
461.9and may be administered by the board or by institutions or individuals designated by the
461.10board;. Before the adoption and implementation of a new national examination, the board
461.11must consider whether the examination:
461.12(i) demonstrates reasonable reliability and external validity;
461.13(ii) is normed on a reasonable representative and diverse national sample; and
461.14(iii) is intended to assess an applicant's education, training, and experience for the purpose
461.15of public protection;
461.16(4) issue licenses to individuals qualified under sections 148.907 and 148.908, 148.909,
461.17148.915, and 148.916, according to the procedures for licensing in Minnesota Rules;
461.18(5) issue copies of the rules for licensing to all applicants;
461.19(6) establish and maintain annually a register of current licenses;
461.20(7) establish and collect fees for the issuance and renewal of licenses and other services
461.21by the board. Fees shall be set to defray the cost of administering the provisions of sections
461.22148.88 to 148.98 including costs for applications, examinations, enforcement, materials,
461.23and the operations of the board;
461.24(8) educate the public about on the requirements for licensing of psychologists and of
461.25psychological practitioners licenses issued by the board and about on the rules of conduct,
461.26to;
461.27(9) enable the public to file complaints against applicants or licensees who may have
461.28violated the Psychology Practice Act; and
461.29(9) (10) adopt and implement requirements for continuing education; and
462.1(11) establish or approve programs that qualify for professional psychology continuing
462.2educational credit. The board may hire consultants, agencies, or professional psychological
462.3associations to establish and approve continuing education courses.

462.4    Sec. 37. Minnesota Statutes 2016, section 148.907, subdivision 1, is amended to read:
462.5    Subdivision 1. Effective date. After August 1, 1991, No person shall engage in the
462.6independent practice of psychology unless that person is licensed as a licensed psychologist
462.7or is exempt under section 148.9075.

462.8    Sec. 38. Minnesota Statutes 2016, section 148.907, subdivision 2, is amended to read:
462.9    Subd. 2. Requirements for licensure as licensed psychologist. To become licensed
462.10by the board as a licensed psychologist, an applicant shall comply with the following
462.11requirements:
462.12(1) pass an examination in psychology;
462.13(2) pass a professional responsibility examination on the practice of psychology;
462.14(3) pass any other examinations as required by board rules;
462.15(4) pay nonrefundable fees to the board for applications, processing, testing, renewals,
462.16and materials;
462.17(5) have attained the age of majority, be of good moral character, and have no unresolved
462.18disciplinary action or complaints pending in the state of Minnesota or any other jurisdiction;
462.19(6) have earned a doctoral degree with a major in psychology from a regionally accredited
462.20educational institution meeting the standards the board has established by rule; and
462.21(7) have completed at least one full year or the equivalent in part time of postdoctoral
462.22supervised psychological employment in no less than 12 months and no more than 60
462.23months. If the postdoctoral supervised psychological employment goes beyond 60 months,
462.24the board may grant a variance to this requirement.

462.25    Sec. 39. [148.9075] EXEMPTIONS TO LICENSE REQUIREMENT.
462.26    Subdivision 1. General. (a) Nothing in sections 148.88 to 148.98 shall prevent members
462.27of other professions or occupations from performing functions for which they are competent
462.28and properly authorized by law. The following individuals are exempt from the licensure
462.29requirements of the Minnesota Psychology Practice Act, provided they operate in compliance
462.30with the stated exemption:
463.1(1) individuals licensed by a health-related licensing board as defined under section
463.2214.01, subdivision 2, or by the commissioner of health;
463.3(2) individuals authorized as mental health practitioners as defined under section 245.462,
463.4subdivision 17; and
463.5(3) individuals authorized as mental health professionals under section 245.462,
463.6subdivision 18.
463.7(b) Any of these individuals must not hold themselves out to the public by any title or
463.8description stating or implying they are licensed to engage in the practice of psychology
463.9unless they are licensed under sections 148.88 to 148.98 or are using a title in compliance
463.10with section 148.96.
463.11    Subd. 2. Business or industrial organization. Nothing in sections 148.88 to 148.98
463.12shall prevent the use of psychological techniques by a business or industrial organization
463.13for its own personnel purposes or by an employment agency or state vocational rehabilitation
463.14agency for the evaluation of the agency's clients prior to a recommendation for employment.
463.15However, a representative of an industrial or business firm or corporation may not sell,
463.16offer, or provide psychological services as specified in section 148.89, unless the services
463.17are performed or supervised by an individual licensed under sections 148.88 to 148.98.
463.18    Subd. 3. School psychologist. (a) Nothing in sections 148.88 to 148.98 shall be construed
463.19to prevent a person who holds a license or certificate issued by the State Board of Teaching
463.20in accordance with chapters 122A and 129 from practicing school psychology within the
463.21scope of employment if authorized by a board of education or by a private school that meets
463.22the standards prescribed by the State Board of Teaching, or from practicing as a school
463.23psychologist within the scope of employment in a program for children with disabilities.
463.24(b) Any person exempted under this subdivision shall not offer psychological services
463.25to any other individual, organization, or group for remuneration, monetary or otherwise,
463.26unless the person is licensed by the Board of Psychology under sections 148.88 to 148.98.
463.27    Subd. 4. Clergy or religious officials. Nothing in sections 148.88 to 148.98 shall be
463.28construed to prevent recognized religious officials, including ministers, priests, rabbis,
463.29imams, Christian Science practitioners, and other persons recognized by the board, from
463.30conducting counseling activities that are within the scope of the performance of their regular
463.31recognizable religious denomination or sect, as defined in current federal tax regulations,
463.32if the religious official does not refer to the official's self as a psychologist and the official
463.33remains accountable to the established authority of the religious denomination or sect.
464.1    Subd. 5. Teaching and research. Nothing in sections 148.88 to 148.98 shall be construed
464.2to prevent a person employed in a secondary, postsecondary, or graduate institution from
464.3teaching and conducting research in psychology within an educational institution that is
464.4recognized by a regional accrediting organization or by a federal, state, county, or local
464.5government institution, agency, or research facility, so long as:
464.6(1) the institution, agency, or facility provides appropriate oversight mechanisms to
464.7ensure public protections; and
464.8(2) the person is not providing direct clinical services to a client or clients as defined in
464.9sections 148.88 to 148.98.
464.10    Subd. 6. Psychologist in disaster or emergency relief. Nothing in sections 148.88 to
464.11148.98 shall be construed to prevent a psychologist sent to this state for the sole purpose of
464.12responding to a disaster or emergency relief effort of the state government, the federal
464.13government, the American Red Cross, or other disaster or emergency relief organization as
464.14long as the psychologist is not practicing in Minnesota longer than 30 days and the sponsoring
464.15organization can certify the psychologist's assignment to this state. The board or its designee,
464.16at its discretion, may grant an extension to the 30-day time limitation of this subdivision.
464.17    Subd. 7. Psychological consultant. A license under sections 148.88 to 148.98 is not
464.18required by a nonresident of the state, serving as an expert witness, organizational consultant,
464.19presenter, or educator on a limited basis provided the person is appropriately trained,
464.20educated, or has been issued a license, certificate, or registration by another jurisdiction.
464.21    Subd. 8. Students. Nothing in sections 148.88 to 148.98 shall prohibit the practice of
464.22psychology under qualified supervision by a practicum psychology student, a predoctoral
464.23psychology intern, or an individual who has earned a doctoral degree in psychology and is
464.24in the process of completing their postdoctoral supervised psychological employment. A
464.25student trainee or intern shall use the titles as required under section 148.96, subdivision 3.
464.26    Subd. 9. Other professions. Nothing in sections 148.88 to 148.98 shall be construed to
464.27authorize a person licensed under sections 148.88 to 148.98 to engage in the practice of any
464.28profession regulated under Minnesota law, unless the individual is duly licensed or registered
464.29in that profession.

464.30    Sec. 40. [148.9077] RELICENSURE.
464.31A former licensee may apply to the board for licensure after complying with all laws
464.32and rules required for applicants for licensure that were in effect on the date the initial
464.33Minnesota license was granted. The former licensee must verify to the board that the former
465.1licensee has not engaged in the practice of psychology in this state since the last date of
465.2active licensure, except as permitted under statutory licensure exemption, and must submit
465.3a fee for relicensure.

465.4    Sec. 41. Minnesota Statutes 2016, section 148.9105, subdivision 1, is amended to read:
465.5    Subdivision 1. Application. Retired providers who are licensed or were formerly licensed
465.6to practice psychology in the state according to the Minnesota Psychology Practice Act may
465.7apply to the board for psychologist emeritus registration or psychological practitioner
465.8emeritus registration if they declare that they are retired from the practice of psychology in
465.9Minnesota, have not been the subject of disciplinary action in any jurisdiction, and have no
465.10unresolved complaints in any jurisdiction. Retired providers shall complete the necessary
465.11forms provided by the board and pay a onetime, nonrefundable fee of $150 at the time of
465.12application.

465.13    Sec. 42. Minnesota Statutes 2016, section 148.9105, subdivision 4, is amended to read:
465.14    Subd. 4. Documentation of status. A provider granted emeritus registration shall receive
465.15a document certifying that emeritus status has been granted by the board and that the
465.16registrant has completed the registrant's active career as a psychologist or psychological
465.17practitioner licensed in good standing with the board.

465.18    Sec. 43. Minnesota Statutes 2016, section 148.9105, subdivision 5, is amended to read:
465.19    Subd. 5. Representation to public. In addition to the descriptions allowed in section
465.20148.96, subdivision 3 , paragraph (e), former licensees who have been granted emeritus
465.21registration may represent themselves as "psychologist emeritus" or "psychological
465.22practitioner emeritus," but shall not represent themselves or allow themselves to be
465.23represented to the public as "licensed" or otherwise as current licensees of the board.

465.24    Sec. 44. Minnesota Statutes 2016, section 148.916, subdivision 1, is amended to read:
465.25    Subdivision 1. Generally. If (a) A nonresident of the state of Minnesota, who is not
465.26seeking licensure in this state, and who has been issued a license, certificate, or registration
465.27by another jurisdiction to practice psychology at the doctoral level, wishes and who intends
465.28to practice in Minnesota for more than seven calendar 30 days, the person shall apply to the
465.29board for guest licensure, provided that. The psychologist's practice in Minnesota is limited
465.30to no more than nine consecutive months per calendar year. Application under this section
465.31shall be made no less than 30 days prior to the expected date of practice in Minnesota and
466.1shall be subject to approval by the board or its designee. The board shall charge a
466.2nonrefundable fee for guest licensure. The board shall adopt rules to implement this section.
466.3(b) To be eligible for licensure under this section, the applicant must:
466.4(1) have a license, certification, or registration to practice psychology from another
466.5jurisdiction;
466.6(2) have a doctoral degree in psychology from a regionally accredited institution;
466.7(3) be of good moral character;
466.8(4) have no pending complaints or active disciplinary or corrective actions in any
466.9jurisdiction;
466.10(5) pass a professional responsibility examination designated by the board; and
466.11(6) pay a fee to the board.

466.12    Sec. 45. Minnesota Statutes 2016, section 148.916, subdivision 1a, is amended to read:
466.13    Subd. 1a. Applicants for licensure. (a) An applicant who is seeking licensure in this
466.14state, and who, at the time of application, is licensed, certified, or registered to practice
466.15psychology in another jurisdiction at the doctoral level may apply to the board for guest
466.16licensure in order to begin practicing psychology in this state while their application is being
466.17processed if the applicant is of good moral character and has no complaints, corrective, or
466.18disciplinary action pending in any jurisdiction.
466.19(b) Application under this section subdivision shall be made no less than 30 days prior
466.20to the expected date of practice in this state, and must be made concurrently or after
466.21submission of an application for licensure as a licensed psychologist if applicable.
466.22Applications under this section subdivision are subject to approval by the board or its
466.23designee. The board shall charge a fee for guest licensure under this subdivision.
466.24(b) The board shall charge a nonrefundable fee for guest licensure under this subdivision.
466.25(c) A guest license issued under this subdivision shall be valid for one year from the
466.26date of issuance, or until the board has either issued a license or has denied the applicant's
466.27application for licensure, whichever is earlier. Guest licenses issued under this section
466.28subdivision may be renewed annually until the board has denied the applicant's application
466.29for licensure.

467.1    Sec. 46. Minnesota Statutes 2016, section 148.925, is amended to read:
467.2148.925 SUPERVISION.
467.3    Subdivision 1. Supervision. For the purpose of meeting the requirements of this section
467.4the Minnesota Psychology Practice Act, supervision means documented in-person
467.5consultation, which may include interactive, visual electronic communication, between
467.6either: (1) a primary supervisor and a licensed psychological practitioner; or (2) a that
467.7employs a collaborative relationship that has both facilitative and evaluative components
467.8with the goal of enhancing the professional competence and science, and practice-informed
467.9professional work of the supervisee. Supervision may include telesupervision between
467.10primary or designated supervisor supervisors and an applicant for licensure as a licensed
467.11psychologist the supervisee. The supervision shall be adequate to assure the quality and
467.12competence of the activities supervised. Supervisory consultation shall include discussions
467.13on the nature and content of the practice of the supervisee, including, but not limited to, a
467.14review of a representative sample of psychological services in the supervisee's practice.
467.15    Subd. 2. Postdegree supervised psychological employment. Postdegree supervised
467.16psychological employment means required paid or volunteer work experience and postdegree
467.17training of an individual seeking to be licensed as a licensed psychologist that involves the
467.18professional oversight by a primary supervisor and satisfies the supervision requirements
467.19in subdivisions 3 and 5 the Minnesota Psychology Practice Act.
467.20    Subd. 3. Individuals qualified to provide supervision. (a) Supervision of a master's
467.21level applicant for licensure as a licensed psychologist shall be provided by an individual:
467.22(1) who is a psychologist licensed in Minnesota with competence both in supervision
467.23in the practice of psychology and in the activities being supervised;
467.24(2) who has a doctoral degree with a major in psychology, who is employed by a
467.25regionally accredited educational institution or employed by a federal, state, county, or local
467.26government institution, agency, or research facility, and who has competence both in
467.27supervision in the practice of psychology and in the activities being supervised, provided
467.28the supervision is being provided and the activities being supervised occur within that
467.29regionally accredited educational institution or federal, state, county, or local government
467.30institution, agency, or research facility;
467.31(3) who is licensed or certified as a psychologist in another jurisdiction and who has
467.32competence both in supervision in the practice of psychology and in the activities being
467.33supervised; or
468.1(4) who, in the case of a designated supervisor, is a master's or doctorally prepared
468.2mental health professional.
468.3(b) Supervision of a doctoral level an applicant for licensure as a licensed psychologist
468.4shall be provided by an individual:
468.5(1) who is a psychologist licensed in Minnesota with a doctoral degree and competence
468.6both in supervision in the practice of psychology and in the activities being supervised;
468.7(2) who has a doctoral degree with a major in psychology, who is employed by a
468.8regionally accredited educational institution or is employed by a federal, state, county, or
468.9local government institution, agency, or research facility, and who has competence both in
468.10supervision in the practice of psychology and in the activities being supervised, provided
468.11the supervision is being provided and the activities being supervised occur within that
468.12regionally accredited educational institution or federal, state, county, or local government
468.13institution, agency, or research facility;
468.14(3) who is licensed or certified as a psychologist in another jurisdiction and who has
468.15competence both in supervision in the practice of psychology and in the activities being
468.16supervised;
468.17(4) who is a psychologist licensed in Minnesota who was licensed before August 1,
468.181991, with competence both in supervision in the practice of psychology and in the activities
468.19being supervised; or
468.20(5) who, in the case of a designated supervisor, is a master's or doctorally prepared
468.21mental health professional.
468.22    Subd. 4. Supervisory consultation for a licensed psychological practitioner.
468.23Supervisory consultation between a supervising licensed psychologist and a supervised
468.24licensed psychological practitioner shall be at least one hour in duration and shall occur on
468.25an individual, in-person basis. A minimum of one hour of supervision per month is required
468.26for the initial 20 or fewer hours of psychological services delivered per month. For each
468.27additional 20 hours of psychological services delivered per month, an additional hour of
468.28supervision per month is required. When more than 20 hours of psychological services are
468.29provided in a week, no more than one hour of supervision is required per week.
468.30    Subd. 5. Supervisory consultation for an applicant for licensure as a licensed
468.31psychologist. Supervision of an applicant for licensure as a licensed psychologist shall
468.32include at least two hours of regularly scheduled in-person consultations per week for
468.33full-time employment, one hour of which shall be with the supervisor on an individual basis.
469.1The remaining hour may be with a designated supervisor. The board may approve an
469.2exception to the weekly supervision requirement for a week when the supervisor was ill or
469.3otherwise unable to provide supervision. The board may prorate the two hours per week of
469.4supervision for individuals preparing for licensure on a part-time basis. Supervised
469.5psychological employment does not qualify for licensure when the supervisory consultation
469.6is not adequate as described in subdivision 1, or in the board rules.
469.7    Subd. 6. Supervisee duties. Individuals Applicants preparing for licensure as a licensed
469.8psychologist during their postdegree supervised psychological employment may perform
469.9as part of their training any functions of the services specified in section 148.89, subdivision
469.105 , but only under qualified supervision.
469.11    Subd. 7. Variance from supervision requirements. (a) An applicant for licensure as
469.12a licensed psychologist who entered supervised employment before August 1, 1991, may
469.13request a variance from the board from the supervision requirements in this section in order
469.14to continue supervision under the board rules in effect before August 1, 1991.
469.15(b) After a licensed psychological practitioner has completed two full years, or the
469.16equivalent, of supervised post-master's degree employment meeting the requirements of
469.17subdivision 5 as it relates to preparation for licensure as a licensed psychologist, the board
469.18shall grant a variance from the supervision requirements of subdivision 4 or 5 if the licensed
469.19psychological practitioner presents evidence of:
469.20(1) endorsement for specific areas of competency by the licensed psychologist who
469.21provided the two years of supervision;
469.22(2) employment by a hospital or by a community mental health center or nonprofit mental
469.23health clinic or social service agency providing services as a part of the mental health service
469.24plan required by the Comprehensive Mental Health Act;
469.25(3) the employer's acceptance of clinical responsibility for the care provided by the
469.26licensed psychological practitioner; and
469.27(4) a plan for supervision that includes at least one hour of regularly scheduled individual
469.28in-person consultations per week for full-time employment. The board may approve an
469.29exception to the weekly supervision requirement for a week when the supervisor was ill or
469.30otherwise unable to provide supervision.
469.31(c) Following the granting of a variance under paragraph (b), and completion of two
469.32additional full years or the equivalent of supervision and post-master's degree employment
470.1meeting the requirements of paragraph (b), the board shall grant a variance to a licensed
470.2psychological practitioner who presents evidence of:
470.3(1) endorsement for specific areas of competency by the licensed psychologist who
470.4provided the two years of supervision under paragraph (b);
470.5(2) employment by a hospital or by a community mental health center or nonprofit mental
470.6health clinic or social service agency providing services as a part of the mental health service
470.7plan required by the Comprehensive Mental Health Act;
470.8(3) the employer's acceptance of clinical responsibility for the care provided by the
470.9licensed psychological practitioner; and
470.10(4) a plan for supervision which includes at least one hour of regularly scheduled
470.11individual in-person supervision per month.
470.12(d) The variance allowed under this section must be deemed to have been granted to an
470.13individual who previously received a variance under paragraph (b) or (c) and is seeking a
470.14new variance because of a change of employment to a different employer or employment
470.15setting. The deemed variance continues until the board either grants or denies the variance.
470.16An individual who has been denied a variance under this section is entitled to seek
470.17reconsideration by the board.

470.18    Sec. 47. Minnesota Statutes 2016, section 148.96, subdivision 3, is amended to read:
470.19    Subd. 3. Requirements for representations to public. (a) Unless licensed under sections
470.20148.88 to 148.98, except as provided in paragraphs (b) through (e), persons shall not represent
470.21themselves or permit themselves to be represented to the public by:
470.22(1) using any title or description of services incorporating the words "psychology,"
470.23"psychological," "psychological practitioner," or "psychologist"; or
470.24(2) representing that the person has expert qualifications in an area of psychology.
470.25(b) Psychologically trained individuals who are employed by an educational institution
470.26recognized by a regional accrediting organization, by a federal, state, county, or local
470.27government institution, agency, or research facility, may represent themselves by the title
470.28designated by that organization provided that the title does not indicate that the individual
470.29is credentialed by the board.
470.30(c) A psychologically trained individual from an institution described in paragraph (b)
470.31may offer lecture services and is exempt from the provisions of this section.
471.1(d) A person who is preparing for the practice of psychology under supervision in
471.2accordance with board statutes and rules may be designated as a "psychological intern,"
471.3"psychology fellow," "psychological trainee," or by other terms clearly describing the
471.4person's training status.
471.5(e) Former licensees who are completely retired from the practice of psychology may
471.6represent themselves using the descriptions in paragraph (a), clauses (1) and (2), but shall
471.7not represent themselves or allow themselves to be represented as current licensees of the
471.8board.
471.9(f) Nothing in this section shall be construed to prohibit the practice of school psychology
471.10by a person licensed in accordance with chapters 122A and 129.

471.11    Sec. 48. Minnesota Statutes 2016, section 148B.53, subdivision 1, is amended to read:
471.12    Subdivision 1. General requirements. (a) To be licensed as a licensed professional
471.13counselor (LPC), an applicant must provide evidence satisfactory to the board that the
471.14applicant:
471.15    (1) is at least 18 years of age;
471.16    (2) is of good moral character;
471.17    (3) has completed a master's or doctoral degree program in counseling or a related field,
471.18as determined by the board based on the criteria in paragraph (b), that includes a minimum
471.19of 48 semester hours or 72 quarter hours and a supervised field experience of not fewer than
471.20700 hours that is counseling in nature;
471.21    (4) has submitted to the board a plan for supervision during the first 2,000 hours of
471.22professional practice or has submitted proof of supervised professional practice that is
471.23acceptable to the board; and
471.24    (5) has demonstrated competence in professional counseling by passing the National
471.25Counseling Exam (NCE) administered by the National Board for Certified Counselors, Inc.
471.26(NBCC) or an equivalent national examination as determined by the board, and ethical,
471.27oral, and situational examinations if prescribed by the board.
471.28    (b) The degree described in paragraph (a), clause (3), must be from a counseling program
471.29recognized by the Council for Accreditation of Counseling and Related Education Programs
471.30(CACREP) or from an institution of higher education that is accredited by a regional
471.31accrediting organization recognized by the Council for Higher Education Accreditation
472.1(CHEA). Specific academic course content and training must include course work in each
472.2of the following subject areas:
472.3    (1) the helping relationship, including counseling theory and practice;
472.4    (2) human growth and development;
472.5    (3) lifestyle and career development;
472.6    (4) group dynamics, processes, counseling, and consulting;
472.7    (5) assessment and appraisal;
472.8    (6) social and cultural foundations, including multicultural issues;
472.9    (7) principles of etiology, treatment planning, and prevention of mental and emotional
472.10disorders and dysfunctional behavior;
472.11    (8) family counseling and therapy;
472.12    (9) research and evaluation; and
472.13    (10) professional counseling orientation and ethics.
472.14    (c) To be licensed as a professional counselor, a psychological practitioner licensed
472.15under section 148.908 need only show evidence of licensure under that section and is not
472.16required to comply with paragraph (a), clauses (1) to (3) and (5), or paragraph (b).
472.17    (d) (c) To be licensed as a professional counselor, a Minnesota licensed psychologist
472.18need only show evidence of licensure from the Minnesota Board of Psychology and is not
472.19required to comply with paragraph (a) or (b).

472.20    Sec. 49. Minnesota Statutes 2016, section 150A.06, subdivision 3, is amended to read:
472.21    Subd. 3. Waiver of examination. (a) All or any part of the examination for dentists or,
472.22dental therapists, dental hygienists, or dental assistants, except that pertaining to the law of
472.23Minnesota relating to dentistry and the rules of the board, may, at the discretion of the board,
472.24be waived for an applicant who presents a certificate of having passed all components of
472.25the National Board Dental Examinations or evidence of having maintained an adequate
472.26scholastic standing as determined by the board, in dental school as to dentists, or dental
472.27hygiene school as to dental hygienists.
472.28(b) The board shall waive the clinical examination required for licensure for any dentist
472.29applicant who is a graduate of a dental school accredited by the Commission on Dental
472.30Accreditation, who has passed all components of the National Board Dental Examinations,
472.31and who has satisfactorily completed a Minnesota-based postdoctoral general dentistry
473.1residency program (GPR) or an advanced education in general dentistry (AEGD) program
473.2after January 1, 2004. The postdoctoral program must be accredited by the Commission on
473.3Dental Accreditation, be of at least one year's duration, and include an outcome assessment
473.4evaluation assessing the resident's competence to practice dentistry. The board may require
473.5the applicant to submit any information deemed necessary by the board to determine whether
473.6the waiver is applicable.

473.7    Sec. 50. Minnesota Statutes 2016, section 150A.06, subdivision 8, is amended to read:
473.8    Subd. 8. Licensure by credentials. (a) Any dental assistant may, upon application and
473.9payment of a fee established by the board, apply for licensure based on an evaluation of the
473.10applicant's education, experience, and performance record in lieu of completing a
473.11board-approved dental assisting program for expanded functions as defined in rule, and
473.12may be interviewed by the board to determine if the applicant:
473.13(1) has graduated from an accredited dental assisting program accredited by the
473.14Commission on Dental Accreditation, or and is currently certified by the Dental Assisting
473.15National Board;
473.16(2) is not subject to any pending or final disciplinary action in another state or Canadian
473.17province, or if not currently certified or registered, previously had a certification or
473.18registration in another state or Canadian province in good standing that was not subject to
473.19any final or pending disciplinary action at the time of surrender;
473.20(3) is of good moral character and abides by professional ethical conduct requirements;
473.21(4) at board discretion, has passed a board-approved English proficiency test if English
473.22is not the applicant's primary language; and
473.23(5) has met all expanded functions curriculum equivalency requirements of a Minnesota
473.24board-approved dental assisting program.
473.25(b) The board, at its discretion, may waive specific licensure requirements in paragraph
473.26(a).
473.27(c) An applicant who fulfills the conditions of this subdivision and demonstrates the
473.28minimum knowledge in dental subjects required for licensure under subdivision 2a must
473.29be licensed to practice the applicant's profession.
473.30(d) If the applicant does not demonstrate the minimum knowledge in dental subjects
473.31required for licensure under subdivision 2a, the application must be denied. If licensure is
473.32denied, the board may notify the applicant of any specific remedy that the applicant could
474.1take which, when passed, would qualify the applicant for licensure. A denial does not
474.2prohibit the applicant from applying for licensure under subdivision 2a.
474.3(e) A candidate whose application has been denied may appeal the decision to the board
474.4according to subdivision 4a.

474.5    Sec. 51. Minnesota Statutes 2016, section 150A.10, subdivision 4, is amended to read:
474.6    Subd. 4. Restorative procedures. (a) Notwithstanding subdivisions 1, 1a, and 2, a
474.7licensed dental hygienist or licensed dental assistant may perform the following restorative
474.8procedures:
474.9(1) place, contour, and adjust amalgam restorations;
474.10(2) place, contour, and adjust glass ionomer;
474.11(3) adapt and cement stainless steel crowns; and
474.12(4) place, contour, and adjust class I and class V supragingival composite restorations
474.13where the margins are entirely within the enamel; and
474.14(5) (4) place, contour, and adjust class I, II, and class V supragingival composite
474.15restorations on primary teeth and permanent dentition.
474.16(b) The restorative procedures described in paragraph (a) may be performed only if:
474.17(1) the licensed dental hygienist or licensed dental assistant has completed a
474.18board-approved course on the specific procedures;
474.19(2) the board-approved course includes a component that sufficiently prepares the licensed
474.20dental hygienist or licensed dental assistant to adjust the occlusion on the newly placed
474.21restoration;
474.22(3) a licensed dentist or licensed advanced dental therapist has authorized the procedure
474.23to be performed; and
474.24(4) a licensed dentist or licensed advanced dental therapist is available in the clinic while
474.25the procedure is being performed.
474.26(c) The dental faculty who teaches the educators of the board-approved courses specified
474.27in paragraph (b) must have prior experience teaching these procedures in an accredited
474.28dental education program.

475.1    Sec. 52. Minnesota Statutes 2016, section 214.01, subdivision 2, is amended to read:
475.2    Subd. 2. Health-related licensing board. "Health-related licensing board" means the
475.3Board of Examiners of Nursing Home Administrators established pursuant to section
475.4144A.19 , the Office of Unlicensed Complementary and Alternative Health Care Practice
475.5established pursuant to section 146A.02, the Board of Medical Practice created pursuant to
475.6section 147.01, the Board of Nursing created pursuant to section 148.181, the Board of
475.7Chiropractic Examiners established pursuant to section 148.02, the Board of Optometry
475.8established pursuant to section 148.52, the Board of Occupational Therapy Practice
475.9established pursuant to section 148.6449, the Board of Physical Therapy established pursuant
475.10to section 148.67, the Board of Psychology established pursuant to section 148.90, the Board
475.11of Social Work pursuant to section 148E.025, the Board of Marriage and Family Therapy
475.12pursuant to section 148B.30, the Board of Behavioral Health and Therapy established by
475.13section 148B.51, the Board of Dietetics and Nutrition Practice established under section
475.14148.622 , the Board of Dentistry established pursuant to section 150A.02, the Board of
475.15Pharmacy established pursuant to section 151.02, the Board of Podiatric Medicine established
475.16pursuant to section 153.02, and the Board of Veterinary Medicine established pursuant to
475.17section 156.01.
475.18EFFECTIVE DATE.This section is effective January 1, 2018.

475.19    Sec. 53. BOARD OF OCCUPATIONAL THERAPY PRACTICE.
475.20The governor shall appoint all members to the Board of Occupational Therapy Practice
475.21under Minnesota Statutes, section 148.6449, by October 1, 2017. The governor shall designate
475.22one member of the board to convene the first meeting of the board by November 1, 2017.
475.23The board shall elect officers at its first meeting.
475.24EFFECTIVE DATE.This section is effective July 1, 2017.

475.25    Sec. 54. REVISOR'S INSTRUCTION.
475.26In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall replace references
475.27to Minnesota Statutes, section 148.6450, with Minnesota Statutes, section 148.6449.
475.28EFFECTIVE DATE.This section is effective January 1, 2018.

475.29    Sec. 55. REVISOR'S INSTRUCTION.
475.30The revisor of statutes shall change the headnote of Minnesota Statutes, section 147.0375,
475.31to read "LICENSURE OF EMINENT PHYSICIANS."
476.1EFFECTIVE DATE.This section is effective the day following final enactment.

476.2    Sec. 56. REPEALER.
476.3(a) Minnesota Statutes 2016, sections 147A.21; 147B.08, subdivisions 1, 2, and 3;
476.4147C.40, subdivisions 1, 2, 3, and 4; 148.906; 148.907, subdivision 5; 148.908; 148.909,
476.5subdivision 7; and 148.96, subdivisions 4 and 5, are repealed.
476.6(b) Minnesota Statutes 2016, sections 148.6402, subdivision 2; and 148.6450, are
476.7repealed.
476.8(c) Minnesota Rules, part 5600.2500, is repealed.
476.9(d) Minnesota Statutes 2016, section 147.0375, subdivision 7, is repealed.
476.10EFFECTIVE DATE.Paragraphs (a) and (c) are effective July 1, 2017. Paragraph (b)
476.11is effective January 1, 2018. Paragraph (d) is effective the day following final enactment.

476.12ARTICLE 12

476.13OPIATE ABUSE PREVENTION

476.14    Section 1. Minnesota Statutes 2016, section 151.212, subdivision 2, is amended to read:
476.15    Subd. 2. Controlled substances. (a) In addition to the requirements of subdivision 1,
476.16when the use of any drug containing a controlled substance, as defined in chapter 152, or
476.17any other drug determined by the board, either alone or in conjunction with alcoholic
476.18beverages, may impair the ability of the user to operate a motor vehicle, the board shall
476.19require by rule that notice be prominently set forth on the label or container. Rules
476.20promulgated by the board shall specify exemptions from this requirement when there is
476.21evidence that the user will not operate a motor vehicle while using the drug.
476.22(b) In addition to the requirements of subdivision 1, whenever a prescription drug
476.23containing an opiate is dispensed to a patient for outpatient use, the pharmacy or practitioner
476.24dispensing the drug must prominently display on the label or container a notice that states
476.25"Caution: Opioid. Risk of overdose and addiction."

476.26    Sec. 2. Minnesota Statutes 2016, section 152.11, is amended by adding a subdivision to
476.27read:
476.28    Subd. 4. Limit on quantity of opiates prescribed for acute dental and ophthalmic
476.29pain. (a) When used for the treatment of acute dental pain or acute pain associated with
476.30refractive surgery, prescriptions for opiate or narcotic pain relievers listed in Schedules II
477.1through IV of section 152.02 shall not exceed a four-day supply. The quantity prescribed
477.2shall be consistent with the dosage listed in the professional labeling for the drug that has
477.3been approved by the United States Food and Drug Administration.
477.4(b) For the purposes of this subdivision, "acute pain" means pain resulting from disease,
477.5accidental or intentional trauma, surgery, or another cause, that the practitioner reasonably
477.6expects to last only a short period of time. Acute pain does not include chronic pain or pain
477.7being treated as part of cancer care, palliative care, or hospice or other end-of-life care.
477.8(c) Notwithstanding paragraph (a), if in the professional clinical judgment of a practitioner
477.9more than a four-day supply of a prescription listed in Schedules II through IV of section
477.10152.02 is required to treat a patient's acute pain, the practitioner may issue a prescription
477.11for the quantity needed to treat such acute pain.

477.12    Sec. 3. Minnesota Statutes 2016, section 256B.0625, subdivision 13e, is amended to read:
477.13    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment shall
477.14be the lower of the actual acquisition costs of the drugs or the maximum allowable cost by
477.15the commissioner plus the fixed dispensing fee; or the usual and customary price charged
477.16to the public. The amount of payment basis must be reduced to reflect all discount amounts
477.17applied to the charge by any provider/insurer agreement or contract for submitted charges
477.18to medical assistance programs. The net submitted charge may not be greater than the patient
477.19liability for the service. The pharmacy dispensing fee shall be $3.65 for legend prescription
477.20drugs, except that the dispensing fee for intravenous solutions which must be compounded
477.21by the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and
477.22$30 per bag for total parenteral nutritional products dispensed in one liter quantities, or $44
477.23per bag for total parenteral nutritional products dispensed in quantities greater than one liter.
477.24The pharmacy dispensing fee for over-the-counter drugs shall be $3.65, except that the fee
477.25shall be $1.31 for retrospectively billing pharmacies when billing for quantities less than
477.26the number of units contained in the manufacturer's original package. Actual acquisition
477.27cost includes quantity and other special discounts except time and cash discounts. The actual
477.28acquisition cost of a drug shall be estimated by the commissioner at wholesale acquisition
477.29cost plus four percent for independently owned pharmacies located in a designated rural
477.30area within Minnesota, and at wholesale acquisition cost plus two percent for all other
477.31pharmacies. A pharmacy is "independently owned" if it is one of four or fewer pharmacies
477.32under the same ownership nationally. A "designated rural area" means an area defined as
477.33a small rural area or isolated rural area according to the four-category classification of the
477.34Rural Urban Commuting Area system developed for the United States Health Resources
478.1and Services Administration. Effective January 1, 2014, the actual acquisition cost of a drug
478.2acquired through the federal 340B Drug Pricing Program shall be estimated by the
478.3commissioner at wholesale acquisition cost minus 40 percent. Wholesale acquisition cost
478.4is defined as the manufacturer's list price for a drug or biological to wholesalers or direct
478.5purchasers in the United States, not including prompt pay or other discounts, rebates, or
478.6reductions in price, for the most recent month for which information is available, as reported
478.7in wholesale price guides or other publications of drug or biological pricing data. The
478.8maximum allowable cost of a multisource drug may be set by the commissioner and it shall
478.9be comparable to, but no higher than, the maximum amount paid by other third-party payors
478.10in this state who have maximum allowable cost programs. Establishment of the amount of
478.11payment for drugs shall not be subject to the requirements of the Administrative Procedure
478.12Act.
478.13    (b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
478.14an automated drug distribution system meeting the requirements of section 151.58, or a
478.15packaging system meeting the packaging standards set forth in Minnesota Rules, part
478.166800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
478.17retrospective billing for prescription drugs dispensed to long-term care facility residents. A
478.18retrospectively billing pharmacy must submit a claim only for the quantity of medication
478.19used by the enrolled recipient during the defined billing period. A retrospectively billing
478.20pharmacy must use a billing period not less than one calendar month or 30 days.
478.21    (c) An additional dispensing fee of $.30 may be added to the dispensing fee paid to
478.22pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities
478.23when a unit dose blister card system, approved by the department, is used. Under this type
478.24of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National
478.25Drug Code (NDC) from the drug container used to fill the blister card must be identified
478.26on the claim to the department. The unit dose blister card containing the drug must meet
478.27the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return
478.28of unused drugs to the pharmacy for reuse. A pharmacy provider using packaging that meets
478.29the standards set forth in Minnesota Rules, part 6800.2700, is required to credit the
478.30department for the actual acquisition cost of all unused drugs that are eligible for reuse,
478.31unless the pharmacy is using retrospective billing. The commissioner may permit the drug
478.32clozapine to be dispensed in a quantity that is less than a 30-day supply.
478.33    (d) Whenever a maximum allowable cost has been set for a multisource drug, payment
478.34shall be the lower of the usual and customary price charged to the public or the maximum
478.35allowable cost established by the commissioner unless prior authorization for the brand
479.1name product has been granted according to the criteria established by the Drug Formulary
479.2Committee as required by subdivision 13f, paragraph (a), and the prescriber has indicated
479.3"dispense as written" on the prescription in a manner consistent with section 151.21,
479.4subdivision 2 .
479.5    (e) The basis for determining the amount of payment for drugs administered in an
479.6outpatient setting shall be the lower of the usual and customary cost submitted by the
479.7provider, 106 percent of the average sales price as determined by the United States
479.8Department of Health and Human Services pursuant to title XVIII, section 1847a of the
479.9federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
479.10set by the commissioner. If average sales price is unavailable, the amount of payment must
479.11be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
479.12cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
479.13Effective January 1, 2014, the commissioner shall discount the payment rate for drugs
479.14obtained through the federal 340B Drug Pricing Program by 20 percent. With the exception
479.15of paragraph (f), the payment for drugs administered in an outpatient setting shall be made
479.16to the administering facility or practitioner. A retail or specialty pharmacy dispensing a drug
479.17for administration in an outpatient setting is not eligible for direct reimbursement.
479.18    (f) Payment for nonscheduled injectable drugs used to treat substance abuse administered
479.19by a practitioner in an outpatient setting shall be made directly to the dispensing pharmacy.
479.20The dispensing pharmacy shall submit the claim if the pharmacy dispenses the drug pursuant
479.21to a prescription issued by the practitioner and delivers the filled prescription to the
479.22practitioner for subsequent administration. Payment shall be made according to this section.
479.23A pharmacy shall not dispense a practitioner-administered injectable drug described in this
479.24paragraph directly to an enrollee. The commissioner may conduct postpayment review to
479.25evaluate the effect of this paragraph on patient access, and shall report any findings to the
479.26chairs and ranking minority members of the legislative committees with jurisdiction over
479.27health and human service policy and finance by January 1, 2019.
479.28    (g) The commissioner may negotiate lower reimbursement rates for specialty pharmacy
479.29products than the rates specified in paragraph (a). The commissioner may require individuals
479.30enrolled in the health care programs administered by the department to obtain specialty
479.31pharmacy products from providers with whom the commissioner has negotiated lower
479.32reimbursement rates. Specialty pharmacy products are defined as those used by a small
479.33number of recipients or recipients with complex and chronic diseases that require expensive
479.34and challenging drug regimens. Examples of these conditions include, but are not limited
479.35to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C, growth hormone deficiency,
480.1Crohn's Disease, rheumatoid arthritis, and certain forms of cancer. Specialty pharmaceutical
480.2products include injectable and infusion therapies, biotechnology drugs, antihemophilic
480.3factor products, high-cost therapies, and therapies that require complex care. The
480.4commissioner shall consult with the formulary committee to develop a list of specialty
480.5pharmacy products subject to this paragraph. In consulting with the formulary committee
480.6in developing this list, the commissioner shall take into consideration the population served
480.7by specialty pharmacy products, the current delivery system and standard of care in the
480.8state, and access to care issues. The commissioner shall have the discretion to adjust the
480.9reimbursement rate to prevent access to care issues.
480.10(g) (h) Home infusion therapy services provided by home infusion therapy pharmacies
480.11must be paid at rates according to subdivision 8d.

480.12    Sec. 4. REPORT ON OPIOID CRISIS GRANT; USE OF GRANT FUNDS.
480.13(a) The commissioner of human services, within two weeks of the annual project report
480.14being submitted to the federal funder, shall report to the chairs and ranking minority members
480.15of the legislative committees with jurisdiction over health and human services policy and
480.16finance on:
480.17(1) funds received under the 21st Century Cures Act, Public Law 114-255, section 1003,
480.18Substance Abuse and Mental Health Services Administration (SAMHSA) State Targeted
480.19Response to the Opioid Crisis Grants; and
480.20(2) uses of the funds received, including a listing of grants provided and the amount
480.21expended on personnel and administrative costs, travel, and public service announcements.
480.22(b) The commissioner shall use remaining Opioid Crisis Grant funds, and any additional
480.23funds received from other sources, to provide grants to counties for opioid abuse prevention
480.24initiatives, increase public awareness of opioid abuse, and prevent opioid abuse through the
480.25use of data analytics.

480.26    Sec. 5. CHRONIC PAIN REHABILITATION THERAPY DEMONSTRATION
480.27PROJECT.
480.28    Subdivision 1. Establishment. The commissioner of human services shall award a
480.29two-year grant to a rehabilitation institute located in Minneapolis operated by a nonprofit
480.30foundation to participate in a bundled payment arrangement for chronic pain rehabilitation
480.31therapy for adults who are eligible for fee-for-service medical assistance under Minnesota
480.32Statutes, section 256B.055. The chronic pain rehabilitation therapy demonstration project
481.1must include: nonnarcotic medication management, including opioid tapering;
481.2interdisciplinary care coordination; and group and individual therapy in cognitive behavioral
481.3therapy and physical therapy. The project may include self-management education in
481.4nutrition, stress, mental health, substance use, or other modalities, if clinically appropriate.
481.5The commissioner shall award the grant on a sole-source basis and the program design must
481.6be mutually agreed upon by the commissioner and the grant recipient. Grant funds are
481.7available until expended.
481.8    Subd. 2. Performance measures. The commissioner shall develop performance measures
481.9to evaluate the demonstration project. These measures may include:
481.10(1) reduction in medications, including opioids, taken for pain;
481.11(2) reduction in emergency department and outpatient clinic utilization related to pain;
481.12(3) improved ability to return to work, job search, or school;
481.13(4) patient functional status and satisfaction; and
481.14(5) rate of program completion.
481.15    Subd. 3. Eligibility. (a) To be eligible to participate in the demonstration project, an
481.16individual must:
481.17(1) be 21 years of age or older;
481.18(2) be eligible for fee-for-service medical assistance under Minnesota Statutes, section
481.19256B.055, and not have other health coverage; and
481.20(3) meet criteria appropriate for chronic pain rehabilitation.
481.21(b) In determining the criteria under paragraph (a), clause (3), the commissioner shall
481.22consider, but is not required to include, the following:
481.23(1) moderate to severe pain lasting longer than four months;
481.24(2) an impairment in daily functioning, including work or activities of daily living;
481.25(3) a referral from a physician or other qualified medical professional indicating that all
481.26reasonable medical and surgical options have been exhausted; and
481.27(4) willingness of the patient to engage in chronic pain rehabilitation therapies, including
481.28opioid tapering.
481.29    Subd. 4. Payment for services. The bundled payment shall be billed on a per-person,
481.30per-day payment and only for days the patient receives services from the grant recipient.
481.31The grant recipient shall not receive a bundled payment for services provided to the patient
482.1if a nonbundled medical assistance payment for a service that is part of the bundle is received
482.2for the same day of service.
482.3    Subd. 5. Report. The rehabilitation institute, for the duration of the demonstration
482.4project, must annually report on cost savings and performance indicators described in
482.5subdivision 2 to the commissioner of human services. One year after the completion of the
482.6demonstration project, the commissioner of human services shall submit a report to the
482.7chairs and ranking minority members of the legislative committees with jurisdiction over
482.8health care. The report shall include an evaluation of the demonstration project, based on
482.9the performance measures developed under subdivision 2, and may also include
482.10recommendations to increase individual access to chronic pain rehabilitation therapy through
482.11Minnesota health care programs.

482.12ARTICLE 13

482.13MISCELLANEOUS

482.14    Section 1. Minnesota Statutes 2016, section 62K.15, is amended to read:
482.1562K.15 ANNUAL OPEN ENROLLMENT PERIODS; SPECIAL ENROLLMENT
482.16PERIODS.
482.17(a) Health carriers offering individual health plans must limit annual enrollment in the
482.18individual market to the annual open enrollment periods for MNsure. Nothing in this section
482.19limits the application of special or limited open enrollment periods as defined under the
482.20Affordable Care Act.
482.21(b) Health carriers offering individual health plans must inform all applicants at the time
482.22of application and enrollees at least annually of the open and special enrollment periods as
482.23defined under the Affordable Care Act.
482.24(c) Health carriers offering individual health plans must provide a special enrollment
482.25period for enrollment in the individual market by employees of a small employer that offers
482.26a qualified small employer health reimbursement arrangement in accordance with United
482.27States Code, title 26, section 9831(d). The special enrollment period shall be available only
482.28to employees newly hired by a small employer offering a qualified small employer health
482.29reimbursement arrangement, and to employees employed by the small employer at the time
482.30the small employer initially offers a qualified small employer health reimbursement
482.31arrangement. For employees newly hired by the small employer, the special enrollment
482.32period shall last for 30 days after the employee's first day of employment. For employees
482.33employed by the small employer at the time the small employer initially offers a qualified
483.1small employer health reimbursement arrangement, the special enrollment period shall last
483.2for 30 days after the date the arrangement is initially offered to employees.
483.3(c) (d) The commissioner of commerce shall enforce this section.

483.4    Sec. 2. Minnesota Statutes 2016, section 245A.02, subdivision 5a, is amended to read:
483.5    Subd. 5a. Controlling individual. (a) "Controlling individual" means a public body,
483.6governmental agency, business entity, officer, owner, or managerial official whose
483.7responsibilities include the direction of the management or policies of a program. For
483.8purposes of this subdivision, owner means an individual who has direct or indirect ownership
483.9interest in a corporation, partnership, or other business association issued a license under
483.10this chapter. For purposes of this subdivision, managerial official means those individuals
483.11who have the decision-making authority related to the operation of the program, and the
483.12responsibility for the ongoing management of or direction of the policies, services, or
483.13employees of the program. A site director who has no ownership interest in the program is
483.14not considered to be a managerial official for purposes of this definition. Controlling
483.15individual does not include an owner of a program or service provider licensed under this
483.16chapter and the following individuals, if applicable:
483.17(1) each officer of the organization, including the chief executive officer and chief
483.18financial officer;
483.19(2) the individual designated as the authorized agent under section 245A.04, subdivision
483.201, paragraph (b);
483.21(3) the individual designated as the compliance officer under section 256B.04, subdivision
483.2221, paragraph (b); and
483.23(4) each managerial official whose responsibilities include the direction of the
483.24management or policies of a program.
483.25(b) Controlling individual does not include:
483.26    (1) a bank, savings bank, trust company, savings association, credit union, industrial
483.27loan and thrift company, investment banking firm, or insurance company unless the entity
483.28operates a program directly or through a subsidiary;
483.29    (2) an individual who is a state or federal official, or state or federal employee, or a
483.30member or employee of the governing body of a political subdivision of the state or federal
483.31government that operates one or more programs, unless the individual is also an officer,
484.1owner, or managerial official of the program, receives remuneration from the program, or
484.2owns any of the beneficial interests not excluded in this subdivision;
484.3    (3) an individual who owns less than five percent of the outstanding common shares of
484.4a corporation:
484.5    (i) whose securities are exempt under section 80A.45, clause (6); or
484.6    (ii) whose transactions are exempt under section 80A.46, clause (2); or
484.7    (4) an individual who is a member of an organization exempt from taxation under section
484.8290.05, unless the individual is also an officer, owner, or managerial official of the program
484.9or owns any of the beneficial interests not excluded in this subdivision. This clause does
484.10not exclude from the definition of controlling individual an organization that is exempt from
484.11taxation.; or
484.12(5) an employee stock ownership plan trust, or a participant or board member of an
484.13employee stock ownership plan, unless the participant or board member is a controlling
484.14individual according to paragraph (a).
484.15(c) For purposes of this subdivision, "managerial official" means an individual who has
484.16the decision-making authority related to the operation of the program, and the responsibility
484.17for the ongoing management of or direction of the policies, services, or employees of the
484.18program. A site director who has no ownership interest in the program is not considered to
484.19be a managerial official for purposes of this definition.

484.20    Sec. 3. Minnesota Statutes 2016, section 245A.02, is amended by adding a subdivision to
484.21read:
484.22    Subd. 10b. Owner. "Owner" means an individual or organization that has a direct or
484.23indirect ownership interest of five percent or more in a program licensed under this chapter.
484.24For purposes of this subdivision, "direct ownership interest" means the possession of equity
484.25in capital, stock, or profits of an organization, and "indirect ownership interest" means a
484.26direct ownership interest in an entity that has a direct or indirect ownership interest in a
484.27licensed program. For purposes of this chapter, "owner of a nonprofit corporation" means
484.28the president and treasurer of the board of directors or, for an entity owned by an employee
484.29stock ownership plan, means the president and treasurer of the entity. A government entity
484.30that is issued a license under this chapter shall be designated the owner.

485.1    Sec. 4. [256.999] LEGISLATIVE NOTICE AND APPROVAL REQUIRED FOR
485.2CERTAIN FEDERAL WAIVERS OR APPROVALS.
485.3(a) Before submitting an application for a federal waiver or approval (1) under section
485.41332 of the Affordable Care Act or section 1115 of the Social Security Act, or (2) to modify
485.5or add a benefit covered by medical assistance or otherwise amend the state's Medicaid
485.6plan, the commissioner, governing board, or director of a state agency seeking the federal
485.7waiver or approval must provide notice and a copy of the application for the federal waiver
485.8or approval to the chairs and ranking minority members of the legislative committees with
485.9jurisdiction over health and human services policy and finance and commerce.
485.10(b) If a federal waiver or approval (1) under section 1332 of the Affordable Care Act or
485.11section 1115 of the Social Security Act, or (2) to modify or add a benefit covered by medical
485.12assistance or otherwise amend the state's Medicaid plan, is received or granted during a
485.13legislative session, a commissioner, governing board, or director of a state agency is
485.14prohibited from implementing or otherwise acting on the federal waiver or approval received
485.15or granted, unless the federal waiver or approval is specifically authorized by law on a date
485.16after receipt of the federal waiver or approval.
485.17(c) If a federal waiver or approval (1) under section 1332 of the Affordable Care Act or
485.18section 1115 of the Social Security Act, or (2) to modify or add a benefit covered by medical
485.19assistance or otherwise amend the state's Medicaid plan, is received or granted while the
485.20legislature is not in session, a commissioner, governing board, or director of a state agency
485.21is prohibited from implementing or otherwise acting on the federal waiver or approval
485.22received or granted, unless the federal waiver or approval is submitted to the Legislative
485.23Advisory Commission and the commission makes a positive recommendation. If the
485.24commission makes no recommendation, a negative recommendation, or a recommendation
485.25for further review, the commissioner, governing board, or director shall not implement or
485.26otherwise act on the federal waiver or approval received or granted.
485.27EFFECTIVE DATE.This section is effective the day following final enactment and
485.28applies to initial requests for federal waivers or approvals sought on or after that date.

485.29    Sec. 5. ESTABLISHMENT OF FEDERALLY FACILITATED MARKETPLACE.
485.30    Subdivision 1. Establishment. (a) The commissioner of commerce, in cooperation with
485.31the secretary of the United States Department of Health and Human Services, shall establish
485.32a federally facilitated marketplace for Minnesota for coverage beginning January 1, 2019.
485.33The federally facilitated marketplace shall take the place of MNsure, established under
485.34Minnesota Statutes, chapter 62V. In working with the secretary of the United States
486.1Department of Health and Human Services to implement the federally facilitated marketplace
486.2in Minnesota, the commissioner of commerce shall:
486.3(1) seek to incorporate, where appropriate and cost-effective, elements of the Minnesota
486.4eligibility system as defined in Minnesota Statutes, section 62V.055, subdivision 1;
486.5(2) regularly consult with stakeholder groups, including but not limited to representatives
486.6of state agencies, health care providers, health plan companies, brokers, and consumers;
486.7and
486.8(3) seek all available federal grants and funds for state planning and development costs.
486.9(b) All health plans that are offered to Minnesota residents through the federally facilitated
486.10marketplace, when implemented, and that are offered by a health carrier that meets the
486.11applicability criteria in Minnesota Statutes, section 62K.10, subdivision 1, must satisfy
486.12requirements for:
486.13(1) geographic accessibility to providers that at least satisfy the maximum distance or
486.14travel times specified in Minnesota Statutes, section 62K.10, subdivisions 2 and 3; and
486.15(2) provider network adequacy that guarantees at least the level of network adequacy
486.16required by Minnesota Statutes, section 62K.10, subdivision 4.
486.17For purposes of this paragraph, "health plan" has the meaning given in Minnesota Statutes,
486.18section 62A.011, subdivision 3, and "health carrier" has the meaning given in Minnesota
486.19Statutes, section 62A.011, subdivision 2.
486.20    Subd. 2. Implementation plan; draft legislation. The commissioner of commerce, in
486.21consultation with the commissioner of human services, the chief information officer of
486.22MN.IT, and the MNsure board, shall develop and present to the 2018 legislature an
486.23implementation plan for conversion to a federally facilitated marketplace. The plan must:
486.24(1) address and provide recommendations on the following issues:
486.25(i) the state agency or other entity responsible for state oversight and administration
486.26related to the state's use of the federally facilitated marketplace;
486.27(ii) plan management functions, including certification of qualified health plans;
486.28(iii) the operation of navigator and in-person assister programs, and the operation of a
486.29call center and Web site;
486.30(iv) funding for federally facilitated marketplace activities, including a user fee rate that
486.31shall not exceed the federal platform user fee rate of two percent of premiums charged for
486.32a coverage year; and
487.1(v) administration of MinnesotaCare as a basic health plan by the commissioner of
487.2human services;
487.3(2) address and provide recommendations on the funding and operation of the system
487.4to be used for public health care program eligibility determinations. These recommendations
487.5must be developed in consultation with the Minnesota eligibility system executive steering
487.6committee established under Minnesota Statutes, section 62V.055; and
487.7(3) include draft legislation for any changes in state law necessary to implement a
487.8federally facilitated marketplace, including but not limited to necessary changes to Laws
487.92013, chapter 84, and technical and conforming changes related to the repeal of Minnesota
487.10Statutes, chapter 62V.
487.11    Subd. 3. Vendor contract. The commissioner of commerce, in consultation with the
487.12commissioner of human services, the chief information officer of MN.IT, and the MNsure
487.13board, shall contract with a vendor to provide technical assistance in developing and
487.14implementing the plan for conversion to a federally facilitated marketplace.

487.15    Sec. 6. REPEALER.
487.16Minnesota Statutes 2016, sections 62V.01; 62V.02; 62V.03; 62V.04; 62V.05; 62V.051;
487.1762V.055; 62V.06; 62V.07; 62V.08; 62V.09; 62V.10; and 62V.11, are repealed effective
487.18January 1, 2019.

487.19ARTICLE 14

487.20NURSING FACILITY TECHNICAL CORRECTIONS

487.21    Section 1. Minnesota Statutes 2016, section 144.0722, subdivision 1, is amended to read:
487.22    Subdivision 1. Resident reimbursement classifications. The commissioner of health
487.23shall establish resident reimbursement classifications based upon the assessments of residents
487.24of nursing homes and boarding care homes conducted under section 144.0721, or under
487.25rules established by the commissioner of human services under sections 256B.41 to 256B.48
487.26chapter 256R. The reimbursement classifications established by the commissioner must
487.27conform to the rules established by the commissioner of human services.

487.28    Sec. 2. Minnesota Statutes 2016, section 144.0724, subdivision 1, is amended to read:
487.29    Subdivision 1. Resident reimbursement case mix classifications. The commissioner
487.30of health shall establish resident reimbursement classifications based upon the assessments
488.1of residents of nursing homes and boarding care homes conducted under this section and
488.2according to section 256B.438 256R.17.

488.3    Sec. 3. Minnesota Statutes 2016, section 144.0724, subdivision 2, is amended to read:
488.4    Subd. 2. Definitions. For purposes of this section, the following terms have the meanings
488.5given.
488.6(a) "Assessment reference date" or "ARD" means the specific end point for look-back
488.7periods in the MDS assessment process. This look-back period is also called the observation
488.8or assessment period.
488.9(b) "Case mix index" means the weighting factors assigned to the RUG-IV classifications.
488.10(c) "Index maximization" means classifying a resident who could be assigned to more
488.11than one category, to the category with the highest case mix index.
488.12(d) "Minimum data set" or "MDS" means a core set of screening, clinical assessment,
488.13and functional status elements, that include common definitions and coding categories
488.14specified by the Centers for Medicare and Medicaid Services and designated by the
488.15Minnesota Department of Health.
488.16(e) "Representative" means a person who is the resident's guardian or conservator, the
488.17person authorized to pay the nursing home expenses of the resident, a representative of the
488.18Office of Ombudsman for Long-Term Care whose assistance has been requested, or any
488.19other individual designated by the resident.
488.20(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
488.21facility's residents according to their clinical and functional status identified in data supplied
488.22by the facility's minimum data set.
488.23(g) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility,
488.24positioning, eating, and toileting.
488.25(h) "Nursing facility level of care determination" means the assessment process that
488.26results in a determination of a resident's or prospective resident's need for nursing facility
488.27level of care as established in subdivision 11 for purposes of medical assistance payment
488.28of long-term care services for:
488.29(1) nursing facility services under section 256B.434 or 256B.441 chapter 256R;
488.30(2) elderly waiver services under section 256B.0915;
488.31(3) CADI and BI waiver services under section 256B.49; and
489.1(4) state payment of alternative care services under section 256B.0913.

489.2    Sec. 4. Minnesota Statutes 2016, section 144.0724, subdivision 9, is amended to read:
489.3    Subd. 9. Audit authority. (a) The commissioner shall audit the accuracy of resident
489.4assessments performed under section 256B.438 256R.17 through any of the following: desk
489.5audits; on-site review of residents and their records; and interviews with staff, residents, or
489.6residents' families. The commissioner shall reclassify a resident if the commissioner
489.7determines that the resident was incorrectly classified.
489.8(b) The commissioner is authorized to conduct on-site audits on an unannounced basis.
489.9(c) A facility must grant the commissioner access to examine the medical records relating
489.10to the resident assessments selected for audit under this subdivision. The commissioner may
489.11also observe and speak to facility staff and residents.
489.12(d) The commissioner shall consider documentation under the time frames for coding
489.13items on the minimum data set as set out in the Long-Term Care Facility Resident Assessment
489.14Instrument User's Manual published by the Centers for Medicare and Medicaid Services.
489.15(e) The commissioner shall develop an audit selection procedure that includes the
489.16following factors:
489.17(1) Each facility shall be audited annually. If a facility has two successive audits in which
489.18the percentage of change is five percent or less and the facility has not been the subject of
489.19a special audit in the past 36 months, the facility may be audited biannually. A stratified
489.20sample of 15 percent, with a minimum of ten assessments, of the most current assessments
489.21shall be selected for audit. If more than 20 percent of the RUG-IV classifications are changed
489.22as a result of the audit, the audit shall be expanded to a second 15 percent sample, with a
489.23minimum of ten assessments. If the total change between the first and second samples is
489.2435 percent or greater, the commissioner may expand the audit to all of the remaining
489.25assessments.
489.26(2) If a facility qualifies for an expanded audit, the commissioner may audit the facility
489.27again within six months. If a facility has two expanded audits within a 24-month period,
489.28that facility will be audited at least every six months for the next 18 months.
489.29(3) The commissioner may conduct special audits if the commissioner determines that
489.30circumstances exist that could alter or affect the validity of case mix classifications of
489.31residents. These circumstances include, but are not limited to, the following:
489.32(i) frequent changes in the administration or management of the facility;
490.1(ii) an unusually high percentage of residents in a specific case mix classification;
490.2(iii) a high frequency in the number of reconsideration requests received from a facility;
490.3(iv) frequent adjustments of case mix classifications as the result of reconsiderations or
490.4audits;
490.5(v) a criminal indictment alleging provider fraud;
490.6(vi) other similar factors that relate to a facility's ability to conduct accurate assessments;
490.7(vii) an atypical pattern of scoring minimum data set items;
490.8(viii) nonsubmission of assessments;
490.9(ix) late submission of assessments; or
490.10(x) a previous history of audit changes of 35 percent or greater.
490.11(f) Within 15 working days of completing the audit process, the commissioner shall
490.12make available electronically the results of the audit to the facility. If the results of the audit
490.13reflect a change in the resident's case mix classification, a case mix classification notice
490.14will be made available electronically to the facility, using the procedure in subdivision 7,
490.15paragraph (a). The notice must contain the resident's classification and a statement informing
490.16the resident, the resident's authorized representative, and the facility of their right to review
490.17the commissioner's documents supporting the classification and to request a reconsideration
490.18of the classification. This notice must also include the address and telephone number of the
490.19Office of Ombudsman for Long-Term Care.

490.20    Sec. 5. Minnesota Statutes 2016, section 144A.071, subdivision 3, is amended to read:
490.21    Subd. 3. Exceptions authorizing increase in beds; hardship areas. (a) The
490.22commissioner of health, in coordination with the commissioner of human services, may
490.23approve the addition of new licensed and Medicare and Medicaid certified nursing home
490.24beds, using the criteria and process set forth in this subdivision.
490.25(b) The commissioner, in cooperation with the commissioner of human services, shall
490.26consider the following criteria when determining that an area of the state is a hardship area
490.27with regard to access to nursing facility services:
490.28(1) a low number of beds per thousand in a specified area using as a standard the beds
490.29per thousand people age 65 and older, in five year age groups, using data from the most
490.30recent census and population projections, weighted by each group's most recent nursing
491.1home utilization, of the county at the 20th percentile, as determined by the commissioner
491.2of human services;
491.3(2) a high level of out-migration for nursing facility services associated with a described
491.4area from the county or counties of residence to other Minnesota counties, as determined
491.5by the commissioner of human services, using as a standard an amount greater than the
491.6out-migration of the county ranked at the 50th percentile;
491.7(3) an adequate level of availability of noninstitutional long-term care services measured
491.8as public spending for home and community-based long-term care services per individual
491.9age 65 and older, in five year age groups, using data from the most recent census and
491.10population projections, weighted by each group's most recent nursing home utilization, as
491.11determined by the commissioner of human services using as a standard an amount greater
491.12than the 50th percentile of counties;
491.13(4) there must be a declaration of hardship resulting from insufficient access to nursing
491.14home beds by local county agencies and area agencies on aging; and
491.15(5) other factors that may demonstrate the need to add new nursing facility beds.
491.16(c) On August 15 of odd-numbered years, the commissioner, in cooperation with the
491.17commissioner of human services, may publish in the State Register a request for information
491.18in which interested parties, using the data provided under section 144A.351, along with any
491.19other relevant data, demonstrate that a specified area is a hardship area with regard to access
491.20to nursing facility services. For a response to be considered, the commissioner must receive
491.21it by November 15. The commissioner shall make responses to the request for information
491.22available to the public and shall allow 30 days for comment. The commissioner shall review
491.23responses and comments and determine if any areas of the state are to be declared hardship
491.24areas.
491.25(d) For each designated hardship area determined in paragraph (c), the commissioner
491.26shall publish a request for proposals in accordance with section 144A.073 and Minnesota
491.27Rules, parts 4655.1070 to 4655.1098. The request for proposals must be published in the
491.28State Register by March 15 following receipt of responses to the request for information.
491.29The request for proposals must specify the number of new beds which may be added in the
491.30designated hardship area, which must not exceed the number which, if added to the existing
491.31number of beds in the area, including beds in layaway status, would have prevented it from
491.32being determined to be a hardship area under paragraph (b), clause (1). Beginning July 1,
491.332011, the number of new beds approved must not exceed 200 beds statewide per biennium.
491.34After June 30, 2019, the number of new beds that may be approved in a biennium must not
492.1exceed 300 statewide. For a proposal to be considered, the commissioner must receive it
492.2within six months of the publication of the request for proposals. The commissioner shall
492.3review responses to the request for proposals and shall approve or disapprove each proposal
492.4by the following July 15, in accordance with section 144A.073 and Minnesota Rules, parts
492.54655.1070 to 4655.1098. The commissioner shall base approvals or disapprovals on a
492.6comparison and ranking of proposals using only the criteria in subdivision 4a. Approval of
492.7a proposal expires after 18 months unless the facility has added the new beds using existing
492.8space, subject to approval by the commissioner, or has commenced construction as defined
492.9in section 144A.071, subdivision 1a, paragraph (d). If, after the approved beds have been
492.10added, fewer than 50 percent of the beds in a facility are newly licensed, the operating
492.11payment rates previously in effect shall remain. If, after the approved beds have been added,
492.1250 percent or more of the beds in a facility are newly licensed, operating payment rates shall
492.13be determined according to Minnesota Rules, part 9549.0057, using the limits under section
492.14256B.441 sections 256R.23, subdivision 5, and 256R.24, subdivision 3. External fixed costs
492.15payment rates must be determined according to section 256B.441, subdivision 53 256R.25.
492.16Property payment rates for facilities with beds added under this subdivision must be
492.17determined in the same manner as rate determinations resulting from projects approved and
492.18completed under section 144A.073.
492.19(e) The commissioner may:
492.20(1) certify or license new beds in a new facility that is to be operated by the commissioner
492.21of veterans affairs or when the costs of constructing and operating the new beds are to be
492.22reimbursed by the commissioner of veterans affairs or the United States Veterans
492.23Administration; and
492.24(2) license or certify beds in a facility that has been involuntarily delicensed or decertified
492.25for participation in the medical assistance program, provided that an application for
492.26relicensure or recertification is submitted to the commissioner by an organization that is
492.27not a related organization as defined in section 256B.441, subdivision 34 256R.02,
492.28subdivision 43, to the prior licensee within 120 days after delicensure or decertification.

492.29    Sec. 6. Minnesota Statutes 2016, section 144A.071, subdivision 4a, is amended to read:
492.30    Subd. 4a. Exceptions for replacement beds. It is in the best interest of the state to
492.31ensure that nursing homes and boarding care homes continue to meet the physical plant
492.32licensing and certification requirements by permitting certain construction projects. Facilities
492.33should be maintained in condition to satisfy the physical and emotional needs of residents
492.34while allowing the state to maintain control over nursing home expenditure growth.
493.1    The commissioner of health in coordination with the commissioner of human services,
493.2may approve the renovation, replacement, upgrading, or relocation of a nursing home or
493.3boarding care home, under the following conditions:
493.4    (a) to license or certify beds in a new facility constructed to replace a facility or to make
493.5repairs in an existing facility that was destroyed or damaged after June 30, 1987, by fire,
493.6lightning, or other hazard provided:
493.7    (i) destruction was not caused by the intentional act of or at the direction of a controlling
493.8person of the facility;
493.9    (ii) at the time the facility was destroyed or damaged the controlling persons of the
493.10facility maintained insurance coverage for the type of hazard that occurred in an amount
493.11that a reasonable person would conclude was adequate;
493.12    (iii) the net proceeds from an insurance settlement for the damages caused by the hazard
493.13are applied to the cost of the new facility or repairs;
493.14    (iv) the number of licensed and certified beds in the new facility does not exceed the
493.15number of licensed and certified beds in the destroyed facility; and
493.16    (v) the commissioner determines that the replacement beds are needed to prevent an
493.17inadequate supply of beds.
493.18Project construction costs incurred for repairs authorized under this clause shall not be
493.19considered in the dollar threshold amount defined in subdivision 2;
493.20    (b) to license or certify beds that are moved from one location to another within a nursing
493.21home facility, provided the total costs of remodeling performed in conjunction with the
493.22relocation of beds does not exceed $1,000,000;
493.23    (c) to license or certify beds in a project recommended for approval under section
493.24144A.073 ;
493.25    (d) to license or certify beds that are moved from an existing state nursing home to a
493.26different state facility, provided there is no net increase in the number of state nursing home
493.27beds;
493.28    (e) to certify and license as nursing home beds boarding care beds in a certified boarding
493.29care facility if the beds meet the standards for nursing home licensure, or in a facility that
493.30was granted an exception to the moratorium under section 144A.073, and if the cost of any
493.31remodeling of the facility does not exceed $1,000,000. If boarding care beds are licensed
493.32as nursing home beds, the number of boarding care beds in the facility must not increase
494.1beyond the number remaining at the time of the upgrade in licensure. The provisions
494.2contained in section 144A.073 regarding the upgrading of the facilities do not apply to
494.3facilities that satisfy these requirements;
494.4    (f) to license and certify up to 40 beds transferred from an existing facility owned and
494.5operated by the Amherst H. Wilder Foundation in the city of St. Paul to a new unit at the
494.6same location as the existing facility that will serve persons with Alzheimer's disease and
494.7other related disorders. The transfer of beds may occur gradually or in stages, provided the
494.8total number of beds transferred does not exceed 40. At the time of licensure and certification
494.9of a bed or beds in the new unit, the commissioner of health shall delicense and decertify
494.10the same number of beds in the existing facility. As a condition of receiving a license or
494.11certification under this clause, the facility must make a written commitment to the
494.12commissioner of human services that it will not seek to receive an increase in its
494.13property-related payment rate as a result of the transfers allowed under this paragraph;
494.14    (g) to license and certify nursing home beds to replace currently licensed and certified
494.15boarding care beds which may be located either in a remodeled or renovated boarding care
494.16or nursing home facility or in a remodeled, renovated, newly constructed, or replacement
494.17nursing home facility within the identifiable complex of health care facilities in which the
494.18currently licensed boarding care beds are presently located, provided that the number of
494.19boarding care beds in the facility or complex are decreased by the number to be licensed as
494.20nursing home beds and further provided that, if the total costs of new construction,
494.21replacement, remodeling, or renovation exceed ten percent of the appraised value of the
494.22facility or $200,000, whichever is less, the facility makes a written commitment to the
494.23commissioner of human services that it will not seek to receive an increase in its
494.24property-related payment rate by reason of the new construction, replacement, remodeling,
494.25or renovation. The provisions contained in section 144A.073 regarding the upgrading of
494.26facilities do not apply to facilities that satisfy these requirements;
494.27    (h) to license as a nursing home and certify as a nursing facility a facility that is licensed
494.28as a boarding care facility but not certified under the medical assistance program, but only
494.29if the commissioner of human services certifies to the commissioner of health that licensing
494.30the facility as a nursing home and certifying the facility as a nursing facility will result in
494.31a net annual savings to the state general fund of $200,000 or more;
494.32    (i) to certify, after September 30, 1992, and prior to July 1, 1993, existing nursing home
494.33beds in a facility that was licensed and in operation prior to January 1, 1992;
495.1    (j) to license and certify new nursing home beds to replace beds in a facility acquired
495.2by the Minneapolis Community Development Agency as part of redevelopment activities
495.3in a city of the first class, provided the new facility is located within three miles of the site
495.4of the old facility. Operating and property costs for the new facility must be determined and
495.5allowed under section 256B.431 or 256B.434 or chapter 256R;
495.6    (k) to license and certify up to 20 new nursing home beds in a community-operated
495.7hospital and attached convalescent and nursing care facility with 40 beds on April 21, 1991,
495.8that suspended operation of the hospital in April 1986. The commissioner of human services
495.9shall provide the facility with the same per diem property-related payment rate for each
495.10additional licensed and certified bed as it will receive for its existing 40 beds;
495.11    (l) to license or certify beds in renovation, replacement, or upgrading projects as defined
495.12in section 144A.073, subdivision 1, so long as the cumulative total costs of the facility's
495.13remodeling projects do not exceed $1,000,000;
495.14    (m) to license and certify beds that are moved from one location to another for the
495.15purposes of converting up to five four-bed wards to single or double occupancy rooms in
495.16a nursing home that, as of January 1, 1993, was county-owned and had a licensed capacity
495.17of 115 beds;
495.18    (n) to allow a facility that on April 16, 1993, was a 106-bed licensed and certified nursing
495.19facility located in Minneapolis to layaway all of its licensed and certified nursing home
495.20beds. These beds may be relicensed and recertified in a newly constructed teaching nursing
495.21home facility affiliated with a teaching hospital upon approval by the legislature. The
495.22proposal must be developed in consultation with the interagency committee on long-term
495.23care planning. The beds on layaway status shall have the same status as voluntarily delicensed
495.24and decertified beds, except that beds on layaway status remain subject to the surcharge in
495.25section 256.9657. This layaway provision expires July 1, 1998;
495.26    (o) to allow a project which will be completed in conjunction with an approved
495.27moratorium exception project for a nursing home in southern Cass County and which is
495.28directly related to that portion of the facility that must be repaired, renovated, or replaced,
495.29to correct an emergency plumbing problem for which a state correction order has been
495.30issued and which must be corrected by August 31, 1993;
495.31    (p) to allow a facility that on April 16, 1993, was a 368-bed licensed and certified nursing
495.32facility located in Minneapolis to layaway, upon 30 days prior written notice to the
495.33commissioner, up to 30 of the facility's licensed and certified beds by converting three-bed
495.34wards to single or double occupancy. Beds on layaway status shall have the same status as
496.1voluntarily delicensed and decertified beds except that beds on layaway status remain subject
496.2to the surcharge in section 256.9657, remain subject to the license application and renewal
496.3fees under section 144A.07 and shall be subject to a $100 per bed reactivation fee. In
496.4addition, at any time within three years of the effective date of the layaway, the beds on
496.5layaway status may be:
496.6    (1) relicensed and recertified upon relocation and reactivation of some or all of the beds
496.7to an existing licensed and certified facility or facilities located in Pine River, Brainerd, or
496.8International Falls; provided that the total project construction costs related to the relocation
496.9of beds from layaway status for any facility receiving relocated beds may not exceed the
496.10dollar threshold provided in subdivision 2 unless the construction project has been approved
496.11through the moratorium exception process under section 144A.073;
496.12    (2) relicensed and recertified, upon reactivation of some or all of the beds within the
496.13facility which placed the beds in layaway status, if the commissioner has determined a need
496.14for the reactivation of the beds on layaway status.
496.15    The property-related payment rate of a facility placing beds on layaway status must be
496.16adjusted by the incremental change in its rental per diem after recalculating the rental per
496.17diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
496.18payment rate for a facility relicensing and recertifying beds from layaway status must be
496.19adjusted by the incremental change in its rental per diem after recalculating its rental per
496.20diem using the number of beds after the relicensing to establish the facility's capacity day
496.21divisor, which shall be effective the first day of the month following the month in which
496.22the relicensing and recertification became effective. Any beds remaining on layaway status
496.23more than three years after the date the layaway status became effective must be removed
496.24from layaway status and immediately delicensed and decertified;
496.25    (q) to license and certify beds in a renovation and remodeling project to convert 12
496.26four-bed wards into 24 two-bed rooms, expand space, and add improvements in a nursing
496.27home that, as of January 1, 1994, met the following conditions: the nursing home was located
496.28in Ramsey County; had a licensed capacity of 154 beds; and had been ranked among the
496.29top 15 applicants by the 1993 moratorium exceptions advisory review panel. The total
496.30project construction cost estimate for this project must not exceed the cost estimate submitted
496.31in connection with the 1993 moratorium exception process;
496.32    (r) to license and certify up to 117 beds that are relocated from a licensed and certified
496.33138-bed nursing facility located in St. Paul to a hospital with 130 licensed hospital beds
496.34located in South St. Paul, provided that the nursing facility and hospital are owned by the
497.1same or a related organization and that prior to the date the relocation is completed the
497.2hospital ceases operation of its inpatient hospital services at that hospital. After relocation,
497.3the nursing facility's status shall be the same as it was prior to relocation. The nursing
497.4facility's property-related payment rate resulting from the project authorized in this paragraph
497.5shall become effective no earlier than April 1, 1996. For purposes of calculating the
497.6incremental change in the facility's rental per diem resulting from this project, the allowable
497.7appraised value of the nursing facility portion of the existing health care facility physical
497.8plant prior to the renovation and relocation may not exceed $2,490,000;
497.9    (s) to license and certify two beds in a facility to replace beds that were voluntarily
497.10delicensed and decertified on June 28, 1991;
497.11    (t) to allow 16 licensed and certified beds located on July 1, 1994, in a 142-bed nursing
497.12home and 21-bed boarding care home facility in Minneapolis, notwithstanding the licensure
497.13and certification after July 1, 1995, of the Minneapolis facility as a 147-bed nursing home
497.14facility after completion of a construction project approved in 1993 under section 144A.073,
497.15to be laid away upon 30 days' prior written notice to the commissioner. Beds on layaway
497.16status shall have the same status as voluntarily delicensed or decertified beds except that
497.17they shall remain subject to the surcharge in section 256.9657. The 16 beds on layaway
497.18status may be relicensed as nursing home beds and recertified at any time within five years
497.19of the effective date of the layaway upon relocation of some or all of the beds to a licensed
497.20and certified facility located in Watertown, provided that the total project construction costs
497.21related to the relocation of beds from layaway status for the Watertown facility may not
497.22exceed the dollar threshold provided in subdivision 2 unless the construction project has
497.23been approved through the moratorium exception process under section 144A.073.
497.24    The property-related payment rate of the facility placing beds on layaway status must
497.25be adjusted by the incremental change in its rental per diem after recalculating the rental
497.26per diem as provided in section 256B.431, subdivision 3a, paragraph (c). The property-related
497.27payment rate for the facility relicensing and recertifying beds from layaway status must be
497.28adjusted by the incremental change in its rental per diem after recalculating its rental per
497.29diem using the number of beds after the relicensing to establish the facility's capacity day
497.30divisor, which shall be effective the first day of the month following the month in which
497.31the relicensing and recertification became effective. Any beds remaining on layaway status
497.32more than five years after the date the layaway status became effective must be removed
497.33from layaway status and immediately delicensed and decertified;
497.34    (u) to license and certify beds that are moved within an existing area of a facility or to
497.35a newly constructed addition which is built for the purpose of eliminating three- and four-bed
498.1rooms and adding space for dining, lounge areas, bathing rooms, and ancillary service areas
498.2in a nursing home that, as of January 1, 1995, was located in Fridley and had a licensed
498.3capacity of 129 beds;
498.4    (v) to relocate 36 beds in Crow Wing County and four beds from Hennepin County to
498.5a 160-bed facility in Crow Wing County, provided all the affected beds are under common
498.6ownership;
498.7    (w) to license and certify a total replacement project of up to 49 beds located in Norman
498.8County that are relocated from a nursing home destroyed by flood and whose residents were
498.9relocated to other nursing homes. The operating cost payment rates for the new nursing
498.10facility shall be determined based on the interim and settle-up payment provisions of
498.11Minnesota Rules, part 9549.0057, and the reimbursement provisions of section 256B.431
498.12chapter 256R. Property-related reimbursement rates shall be determined under section
498.13256B.431 256R.26, taking into account any federal or state flood-related loans or grants
498.14provided to the facility;
498.15    (x) to license and certify to the licensee of a nursing home in Polk County that was
498.16destroyed by flood in 1997 replacement projects with a total of up to 129 beds, with at least
498.1725 beds to be located in Polk County and up to 104 beds distributed among up to three other
498.18counties. These beds may only be distributed to counties with fewer than the median number
498.19of age intensity adjusted beds per thousand, as most recently published by the commissioner
498.20of human services. If the licensee chooses to distribute beds outside of Polk County under
498.21this paragraph, prior to distributing the beds, the commissioner of health must approve the
498.22location in which the licensee plans to distribute the beds. The commissioner of health shall
498.23consult with the commissioner of human services prior to approving the location of the
498.24proposed beds. The licensee may combine these beds with beds relocated from other nursing
498.25facilities as provided in section 144A.073, subdivision 3c. The operating payment rates for
498.26the new nursing facilities shall be determined based on the interim and settle-up payment
498.27provisions of section 256B.431, 256B.434, or 256B.441 or Minnesota Rules, parts 9549.0010
498.28to 9549.0080. Property-related reimbursement rates shall be determined under section
498.29256B.431 , 256B.434, or 256B.441 256R.26. If the replacement beds permitted under this
498.30paragraph are combined with beds from other nursing facilities, the rates shall be calculated
498.31as the weighted average of rates determined as provided in this paragraph and section
498.32256B.441, subdivision 60 256R.50;
498.33    (y) to license and certify beds in a renovation and remodeling project to convert 13
498.34three-bed wards into 13 two-bed rooms and 13 single-bed rooms, expand space, and add
498.35improvements in a nursing home that, as of January 1, 1994, met the following conditions:
499.1the nursing home was located in Ramsey County, was not owned by a hospital corporation,
499.2had a licensed capacity of 64 beds, and had been ranked among the top 15 applicants by
499.3the 1993 moratorium exceptions advisory review panel. The total project construction cost
499.4estimate for this project must not exceed the cost estimate submitted in connection with the
499.51993 moratorium exception process;
499.6    (z) to license and certify up to 150 nursing home beds to replace an existing 285 bed
499.7nursing facility located in St. Paul. The replacement project shall include both the renovation
499.8of existing buildings and the construction of new facilities at the existing site. The reduction
499.9in the licensed capacity of the existing facility shall occur during the construction project
499.10as beds are taken out of service due to the construction process. Prior to the start of the
499.11construction process, the facility shall provide written information to the commissioner of
499.12health describing the process for bed reduction, plans for the relocation of residents, and
499.13the estimated construction schedule. The relocation of residents shall be in accordance with
499.14the provisions of law and rule;
499.15    (aa) to allow the commissioner of human services to license an additional 36 beds to
499.16provide residential services for the physically disabled under Minnesota Rules, parts
499.179570.2000 to 9570.3400, in a 198-bed nursing home located in Red Wing, provided that
499.18the total number of licensed and certified beds at the facility does not increase;
499.19    (bb) to license and certify a new facility in St. Louis County with 44 beds constructed
499.20to replace an existing facility in St. Louis County with 31 beds, which has resident rooms
499.21on two separate floors and an antiquated elevator that creates safety concerns for residents
499.22and prevents nonambulatory residents from residing on the second floor. The project shall
499.23include the elimination of three- and four-bed rooms;
499.24    (cc) to license and certify four beds in a 16-bed certified boarding care home in
499.25Minneapolis to replace beds that were voluntarily delicensed and decertified on or before
499.26March 31, 1992. The licensure and certification is conditional upon the facility periodically
499.27assessing and adjusting its resident mix and other factors which may contribute to a potential
499.28institution for mental disease declaration. The commissioner of human services shall retain
499.29the authority to audit the facility at any time and shall require the facility to comply with
499.30any requirements necessary to prevent an institution for mental disease declaration, including
499.31delicensure and decertification of beds, if necessary;
499.32    (dd) to license and certify 72 beds in an existing facility in Mille Lacs County with 80
499.33beds as part of a renovation project. The renovation must include construction of an addition
499.34to accommodate ten residents with beginning and midstage dementia in a self-contained
500.1living unit; creation of three resident households where dining, activities, and support spaces
500.2are located near resident living quarters; designation of four beds for rehabilitation in a
500.3self-contained area; designation of 30 private rooms; and other improvements;
500.4    (ee) to license and certify beds in a facility that has undergone replacement or remodeling
500.5as part of a planned closure under section 256B.437 256R.40;
500.6    (ff) to license and certify a total replacement project of up to 124 beds located in Wilkin
500.7County that are in need of relocation from a nursing home significantly damaged by flood.
500.8The operating cost payment rates for the new nursing facility shall be determined based on
500.9the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and the
500.10reimbursement provisions of section 256B.431 chapter 256R. Property-related reimbursement
500.11rates shall be determined under section 256B.431 256R.26, taking into account any federal
500.12or state flood-related loans or grants provided to the facility;
500.13    (gg) to allow the commissioner of human services to license an additional nine beds to
500.14provide residential services for the physically disabled under Minnesota Rules, parts
500.159570.2000 to 9570.3400, in a 240-bed nursing home located in Duluth, provided that the
500.16total number of licensed and certified beds at the facility does not increase;
500.17    (hh) to license and certify up to 120 new nursing facility beds to replace beds in a facility
500.18in Anoka County, which was licensed for 98 beds as of July 1, 2000, provided the new
500.19facility is located within four miles of the existing facility and is in Anoka County. Operating
500.20and property rates shall be determined and allowed under section 256B.431 chapter 256R
500.21and Minnesota Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 256B.441; or
500.22    (ii) to transfer up to 98 beds of a 129-licensed bed facility located in Anoka County that,
500.23as of March 25, 2001, is in the active process of closing, to a 122-licensed bed nonprofit
500.24nursing facility located in the city of Columbia Heights or its affiliate. The transfer is effective
500.25when the receiving facility notifies the commissioner in writing of the number of beds
500.26accepted. The commissioner shall place all transferred beds on layaway status held in the
500.27name of the receiving facility. The layaway adjustment provisions of section 256B.431,
500.28subdivision 30, do not apply to this layaway. The receiving facility may only remove the
500.29beds from layaway for recertification and relicensure at the receiving facility's current site,
500.30or at a newly constructed facility located in Anoka County. The receiving facility must
500.31receive statutory authorization before removing these beds from layaway status, or may
500.32remove these beds from layaway status if removal from layaway status is part of a
500.33moratorium exception project approved by the commissioner under section 144A.073.

501.1    Sec. 7. Minnesota Statutes 2016, section 144A.071, subdivision 4c, is amended to read:
501.2    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The commissioner
501.3of health, in coordination with the commissioner of human services, may approve the
501.4renovation, replacement, upgrading, or relocation of a nursing home or boarding care home,
501.5under the following conditions:
501.6    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be
501.7constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
501.8attached to a hospital that is also being replaced. The threshold allowed for this project
501.9under section 144A.073 shall be the maximum amount available to pay the additional
501.10medical assistance costs of the new facility;
501.11    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St. Louis
501.12County, provided that the 29 beds must be transferred from active or layaway status at an
501.13existing facility in St. Louis County that had 235 beds on April 1, 2003.
501.14The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
501.15rate at that facility shall not be adjusted as a result of this transfer. The operating payment
501.16rate of the facility adding beds after completion of this project shall be the same as it was
501.17on the day prior to the day the beds are licensed and certified. This project shall not proceed
501.18unless it is approved and financed under the provisions of section 144A.073;
501.19    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of the new
501.20beds are transferred from a 45-bed facility in Austin under common ownership that is closed
501.21and 15 of the new beds are transferred from a 182-bed facility in Albert Lea under common
501.22ownership; (ii) the commissioner of human services is authorized by the 2004 legislature
501.23to negotiate budget-neutral planned nursing facility closures; and (iii) money is available
501.24from planned closures of facilities under common ownership to make implementation of
501.25this clause budget-neutral to the state. The bed capacity of the Albert Lea facility shall be
501.26reduced to 167 beds following the transfer. Of the 60 beds at the new facility, 20 beds shall
501.27be used for a special care unit for persons with Alzheimer's disease or related dementias;
501.28    (4) to license and certify up to 80 beds transferred from an existing state-owned nursing
501.29facility in Cass County to a new facility located on the grounds of the Ah-Gwah-Ching
501.30campus. The operating cost payment rates for the new facility shall be determined based
501.31on the interim and settle-up payment provisions of Minnesota Rules, part 9549.0057, and
501.32the reimbursement provisions of section 256B.431 chapter 256R. The property payment
501.33rate for the first three years of operation shall be $35 per day. For subsequent years, the
501.34property payment rate of $35 per day shall be adjusted for inflation as provided in section
502.1256B.434 , subdivision 4, paragraph (c), as long as the facility has a contract under section
502.2256B.434 ;
502.3    (5) to initiate a pilot program to license and certify up to 80 beds transferred from an
502.4existing county-owned nursing facility in Steele County relocated to the site of a new acute
502.5care facility as part of the county's Communities for a Lifetime comprehensive plan to create
502.6innovative responses to the aging of its population. Upon relocation to the new site, the
502.7nursing facility shall delicense 28 beds. The payment rate for external fixed costs for the
502.8new facility shall be increased by an amount as calculated according to items (i) to (v):
502.9    (i) compute the estimated decrease in medical assistance residents served by the nursing
502.10facility by multiplying the decrease in licensed beds by the historical percentage of medical
502.11assistance resident days;
502.12    (ii) compute the annual savings to the medical assistance program from the delicensure
502.13of 28 beds by multiplying the anticipated decrease in medical assistance residents, determined
502.14in item (i), by the existing facility's weighted average payment rate multiplied by 365;
502.15    (iii) compute the anticipated annual costs for community-based services by multiplying
502.16the anticipated decrease in medical assistance residents served by the nursing facility,
502.17determined in item (i), by the average monthly elderly waiver service costs for individuals
502.18in Steele County multiplied by 12;
502.19    (iv) subtract the amount in item (iii) from the amount in item (ii);
502.20    (v) divide the amount in item (iv) by an amount equal to the relocated nursing facility's
502.21occupancy factor under section 256B.431, subdivision 3f, paragraph (c), multiplied by the
502.22historical percentage of medical assistance resident days; and
502.23(6) to consolidate and relocate nursing facility beds to a new site in Goodhue County
502.24and to integrate these services with other community-based programs and services under a
502.25communities for a lifetime pilot program and comprehensive plan to create innovative
502.26responses to the aging of its population. Two nursing facilities, one for 84 beds and one for
502.2765 beds, in the city of Red Wing licensed on July 1, 2015, shall be consolidated into a newly
502.28renovated 64-bed nursing facility resulting in the delicensure of 85 beds. Notwithstanding
502.29the carryforward of the approval authority in section 144A.073, subdivision 11, the funding
502.30approved in April 2009 by the commissioner of health for a project in Goodhue County
502.31shall not carry forward. The closure of the 85 beds shall not be eligible for a planned closure
502.32rate adjustment under section 256B.437 256R.40. The construction project permitted in this
502.33clause shall not be eligible for a threshold project rate adjustment under section 256B.434,
503.1subdivision 4f . The payment rate for external fixed costs for the new facility shall be
503.2increased by an amount as calculated according to items (i) to (vi):
503.3(i) compute the estimated decrease in medical assistance residents served by both nursing
503.4facilities by multiplying the difference between the occupied beds of the two nursing facilities
503.5for the reporting year ending September 30, 2009, and the projected occupancy of the facility
503.6at 95 percent occupancy by the historical percentage of medical assistance resident days;
503.7(ii) compute the annual savings to the medical assistance program from the delicensure
503.8by multiplying the anticipated decrease in the medical assistance residents, determined in
503.9item (i), by the hospital-owned nursing facility weighted average payment rate multiplied
503.10by 365;
503.11(iii) compute the anticipated annual costs for community-based services by multiplying
503.12the anticipated decrease in medical assistance residents served by the facilities, determined
503.13in item (i), by the average monthly elderly waiver service costs for individuals in Goodhue
503.14County multiplied by 12;
503.15(iv) subtract the amount in item (iii) from the amount in item (ii);
503.16(v) multiply the amount in item (iv) by 57.2 percent; and
503.17(vi) divide the difference of the amount in item (iv) and the amount in item (v) by an
503.18amount equal to the relocated nursing facility's occupancy factor under section 256B.431,
503.19subdivision 3f, paragraph (c), multiplied by the historical percentage of medical assistance
503.20resident days.
503.21    (b) Projects approved under this subdivision shall be treated in a manner equivalent to
503.22projects approved under subdivision 4a.

503.23    Sec. 8. Minnesota Statutes 2016, section 144A.071, subdivision 4d, is amended to read:
503.24    Subd. 4d. Consolidation of nursing facilities. (a) The commissioner of health, in
503.25consultation with the commissioner of human services, may approve a request for
503.26consolidation of nursing facilities which includes the closure of one or more facilities and
503.27the upgrading of the physical plant of the remaining nursing facility or facilities, the costs
503.28of which exceed the threshold project limit under subdivision 2, clause (a). The
503.29commissioners shall consider the criteria in this section, section 144A.073, and section
503.30256B.437 256R.40, in approving or rejecting a consolidation proposal. In the event the
503.31commissioners approve the request, the commissioner of human services shall calculate an
503.32external fixed costs rate adjustment according to clauses (1) to (3):
504.1(1) the closure of beds shall not be eligible for a planned closure rate adjustment under
504.2section 256B.437, subdivision 6 256R.40, subdivision 5;
504.3(2) the construction project permitted in this clause shall not be eligible for a threshold
504.4project rate adjustment under section 256B.434, subdivision 4f, or a moratorium exception
504.5adjustment under section 144A.073; and
504.6(3) the payment rate for external fixed costs for a remaining facility or facilities shall
504.7be increased by an amount equal to 65 percent of the projected net cost savings to the state
504.8calculated in paragraph (b), divided by the state's medical assistance percentage of medical
504.9assistance dollars, and then divided by estimated medical assistance resident days, as
504.10determined in paragraph (c), of the remaining nursing facility or facilities in the request in
504.11this paragraph. The rate adjustment is effective on the later of the first day of the month
504.12following completion of the construction upgrades in the consolidation plan or the first day
504.13of the month following the complete closure of a facility designated for closure in the
504.14consolidation plan. If more than one facility is receiving upgrades in the consolidation plan,
504.15each facility's date of construction completion must be evaluated separately.
504.16(b) For purposes of calculating the net cost savings to the state, the commissioner shall
504.17consider clauses (1) to (7):
504.18(1) the annual savings from estimated medical assistance payments from the net number
504.19of beds closed taking into consideration only beds that are in active service on the date of
504.20the request and that have been in active service for at least three years;
504.21(2) the estimated annual cost of increased case load of individuals receiving services
504.22under the elderly waiver;
504.23(3) the estimated annual cost of elderly waiver recipients receiving support under group
504.24residential housing;
504.25(4) the estimated annual cost of increased case load of individuals receiving services
504.26under the alternative care program;
504.27(5) the annual loss of license surcharge payments on closed beds;
504.28(6) the savings from not paying planned closure rate adjustments that the facilities would
504.29otherwise be eligible for under section 256B.437 256R.40; and
504.30(7) the savings from not paying external fixed costs payment rate adjustments from
504.31submission of renovation costs that would otherwise be eligible as threshold projects under
504.32section 256B.434, subdivision 4f.
505.1(c) For purposes of the calculation in paragraph (a), clause (3), the estimated medical
505.2assistance resident days of the remaining facility or facilities shall be computed assuming
505.395 percent occupancy multiplied by the historical percentage of medical assistance resident
505.4days of the remaining facility or facilities, as reported on the facility's or facilities' most
505.5recent nursing facility statistical and cost report filed before the plan of closure is submitted,
505.6multiplied by 365.
505.7(d) For purposes of net cost of savings to the state in paragraph (b), the average occupancy
505.8percentages will be those reported on the facility's or facilities' most recent nursing facility
505.9statistical and cost report filed before the plan of closure is submitted, and the average
505.10payment rates shall be calculated based on the approved payment rates in effect at the time
505.11the consolidation request is submitted.
505.12(e) To qualify for the external fixed costs payment rate adjustment under this subdivision,
505.13the closing facilities shall:
505.14(1) submit an application for closure according to section 256B.437, subdivision 3
505.15256R.40, subdivision 2; and
505.16(2) follow the resident relocation provisions of section 144A.161.
505.17(f) The county or counties in which a facility or facilities are closed under this subdivision
505.18shall not be eligible for designation as a hardship area under subdivision 3 for five years
505.19from the date of the approval of the proposed consolidation. The applicant shall notify the
505.20county of this limitation and the county shall acknowledge this in a letter of support.

505.21    Sec. 9. Minnesota Statutes 2016, section 144A.073, subdivision 3c, is amended to read:
505.22    Subd. 3c. Cost neutral relocation projects. (a) Notwithstanding subdivision 3, the
505.23commissioner may at any time accept proposals, or amendments to proposals previously
505.24approved under this section, for relocations that are cost neutral with respect to state costs
505.25as defined in section 144A.071, subdivision 5a. The commissioner, in consultation with the
505.26commissioner of human services, shall evaluate proposals according to subdivision 4a,
505.27clauses (1), (4), (5), (6), and (8), and other criteria established in rule or law. The
505.28commissioner of human services shall determine the allowable payment rates of the facility
505.29receiving the beds in accordance with section 256B.441, subdivision 60 256R.50. The
505.30commissioner shall approve or disapprove a project within 90 days.
505.31    (b) For the purposes of paragraph (a), cost neutrality shall be measured over the first
505.32three 12-month periods of operation after completion of the project.

506.1    Sec. 10. Minnesota Statutes 2016, section 144A.10, subdivision 4, is amended to read:
506.2    Subd. 4. Correction orders. Whenever a duly authorized representative of the
506.3commissioner of health finds upon inspection of a nursing home, that the facility or a
506.4controlling person or an employee of the facility is not in compliance with sections 144.411
506.5to 144.417, 144.651, 144.6503, 144A.01 to 144A.155, or 626.557 or the rules promulgated
506.6thereunder, a correction order shall be issued to the facility. The correction order shall state
506.7the deficiency, cite the specific rule or statute violated, state the suggested method of
506.8correction, and specify the time allowed for correction. If the commissioner finds that the
506.9nursing home had uncorrected or repeated violations which create a risk to resident care,
506.10safety, or rights, the commissioner shall notify the commissioner of human services who
506.11shall require the facility to use any efficiency incentive payments received under section
506.12256B.431, subdivision 2b , paragraph (d), to correct the violations and shall require the
506.13facility to forfeit incentive payments for failure to correct the violations as provided in
506.14section 256B.431, subdivision 2n. The forfeiture shall not apply to correction orders issued
506.15for physical plant deficiencies.

506.16    Sec. 11. Minnesota Statutes 2016, section 144A.15, subdivision 2, is amended to read:
506.17    Subd. 2. Appointment of receiver, rental. If, after hearing, the court finds that
506.18receivership is necessary as a means of protecting the health, safety, or welfare of a resident
506.19of the facility, the court shall appoint the commissioner of health as a receiver to take charge
506.20of the facility. The commissioner may enter into an agreement for a managing agent to work
506.21on the commissioner's behalf in operating the facility during the receivership. The court
506.22shall determine a fair monthly rental for the facility, taking into account all relevant factors
506.23including the condition of the facility. This rental fee shall be paid by the receiver to the
506.24appropriate controlling person for each month that the receivership remains in effect but
506.25shall be reduced by the amount that the costs of the receivership provided under section
506.26256B.495 256R.52 are in excess of the facility rate. The controlling person may agree to
506.27waive the fair monthly rent by affidavit to the court. Notwithstanding any other law to the
506.28contrary, no payment made to a controlling person by any state agency during a period of
506.29receivership shall include any allowance for profit or be based on any formula which includes
506.30an allowance for profit.
506.31Notwithstanding state contracting requirements in chapter 16C, the commissioner shall
506.32establish and maintain a list of qualified licensed nursing home administrators, or other
506.33qualified persons or organizations with experience in delivering skilled health care services
506.34and the operation of long-term care facilities for those interested in being a managing agent
507.1on the commissioner's behalf during a state receivership of a facility. This list will be a
507.2resource for choosing a managing agent and the commissioner may update the list at any
507.3time. A managing agent cannot be someone who: (1) is the owner, licensee, or administrator
507.4of the facility; (2) has a financial interest in the facility at the time of the receivership or is
507.5a related party to the owner, licensee, or administrator; or (3) has owned or operated any
507.6nursing facility or boarding care home that has been ordered into receivership.

507.7    Sec. 12. Minnesota Statutes 2016, section 144A.154, is amended to read:
507.8144A.154 RATE RECOMMENDATION.
507.9The commissioner may recommend to the commissioner of human services a review of
507.10the rates for a nursing home or boarding care home that participates in the medical assistance
507.11program that is in voluntary or involuntary receivership, and that has needs or deficiencies
507.12documented by the Department of Health. If the commissioner of health determines that a
507.13review of the rate under section 256B.495 256R.52 is needed, the commissioner shall provide
507.14the commissioner of human services with:
507.15(1) a copy of the order or determination that cites the deficiency or need; and
507.16(2) the commissioner's recommendation for additional staff and additional annual hours
507.17by type of employee and additional consultants, services, supplies, equipment, or repairs
507.18necessary to satisfy the need or deficiency.

507.19    Sec. 13. Minnesota Statutes 2016, section 144A.161, subdivision 10, is amended to read:
507.20    Subd. 10. Facility closure rate adjustment. Upon the request of a closing facility, the
507.21commissioner of human services must allow the facility a closure rate adjustment equal to
507.22a 50 percent payment rate increase to reimburse relocation costs or other costs related to
507.23facility closure. This rate increase is effective on the date the facility's occupancy decreases
507.24to 90 percent of capacity days after the written notice of closure is distributed under
507.25subdivision 5 and shall remain in effect for a period of up to 60 days. The commissioner
507.26shall delay the implementation of rate adjustments under section 256B.437, subdivisions
507.273, paragraph (b) , and 6, paragraph (a) 256R.40, subdivisions 5 and 6, to offset the cost of
507.28this rate adjustment.

507.29    Sec. 14. Minnesota Statutes 2016, section 144A.1888, is amended to read:
507.30144A.1888 REUSE OF FACILITIES.
508.1Notwithstanding any local ordinance related to development, planning, or zoning to the
508.2contrary, the conversion or reuse of a nursing home that closes or that curtails, reduces, or
508.3changes operations shall be considered a conforming use permitted under local law, provided
508.4that the facility is converted to another long-term care service approved by a regional
508.5planning group under section 256B.437 256R.40 that serves a smaller number of persons
508.6than the number of persons served before the closure or curtailment, reduction, or change
508.7in operations.

508.8    Sec. 15. Minnesota Statutes 2016, section 144A.611, subdivision 1, is amended to read:
508.9    Subdivision 1. Nursing homes and certified boarding care homes. The actual costs
508.10of tuition and textbooks and reasonable expenses for the competency evaluation or the
508.11nursing assistant training program and competency evaluation approved under section
508.12144A.61 , which are paid to nursing assistants or adult training programs pursuant to
508.13subdivisions 2 and 4, are a reimbursable expense for nursing homes and certified boarding
508.14care homes under section 256B.431, subdivision 36 256R.37.

508.15    Sec. 16. Minnesota Statutes 2016, section 144A.74, is amended to read:
508.16144A.74 MAXIMUM CHARGES.
508.17A supplemental nursing services agency must not bill or receive payments from a nursing
508.18home licensed under this chapter at a rate higher than 150 percent of the sum of the weighted
508.19average wage rate, plus a factor determined by the commissioner to incorporate payroll
508.20taxes as defined in Minnesota Rules, part 9549.0020, subpart 33 section 256R.02, subdivision
508.2137, for the applicable employee classification for the geographic group to which the nursing
508.22home is assigned under Minnesota Rules, part 9549.0052. The weighted average wage rates
508.23must be determined by the commissioner of human services and reported to the commissioner
508.24of health on an annual basis. Wages are defined as hourly rate of pay and shift differential,
508.25including weekend shift differential and overtime. Facilities shall provide information
508.26necessary to determine weighted average wage rates to the commissioner of human services
508.27in a format requested by the commissioner. The maximum rate must include all charges for
508.28administrative fees, contract fees, or other special charges in addition to the hourly rates for
508.29the temporary nursing pool personnel supplied to a nursing home.

508.30    Sec. 17. Minnesota Statutes 2016, section 256.9657, subdivision 1, is amended to read:
508.31    Subdivision 1. Nursing home license surcharge. (a) Effective July 1, 1993, each
508.32non-state-operated nursing home licensed under chapter 144A shall pay to the commissioner
509.1an annual surcharge according to the schedule in subdivision 4. The surcharge shall be
509.2calculated as $620 per licensed bed. If the number of licensed beds is reduced, the surcharge
509.3shall be based on the number of remaining licensed beds the second month following the
509.4receipt of timely notice by the commissioner of human services that beds have been
509.5delicensed. The nursing home must notify the commissioner of health in writing when beds
509.6are delicensed. The commissioner of health must notify the commissioner of human services
509.7within ten working days after receiving written notification. If the notification is received
509.8by the commissioner of human services by the 15th of the month, the invoice for the second
509.9following month must be reduced to recognize the delicensing of beds. Beds on layaway
509.10status continue to be subject to the surcharge. The commissioner of human services must
509.11acknowledge a medical care surcharge appeal within 30 days of receipt of the written appeal
509.12from the provider.
509.13(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.
509.14(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased to
509.15$990.
509.16(d) Effective July 15, 2003, the surcharge under paragraph (c) shall be increased to
509.17$2,815.
509.18(e) The commissioner may reduce, and may subsequently restore, the surcharge under
509.19paragraph (d) based on the commissioner's determination of a permissible surcharge.
509.20(f) Between April 1, 2002, and August 15, 2004, a facility governed by this subdivision
509.21may elect to assume full participation in the medical assistance program by agreeing to
509.22comply with all of the requirements of the medical assistance program, including the rate
509.23equalization law in section 256B.48, subdivision 1, paragraph (a), and all other requirements
509.24established in law or rule, and to begin intake of new medical assistance recipients. Rates
509.25will be determined under Minnesota Rules, parts 9549.0010 to 9549.0080. Rate calculations
509.26will be subject to limits as prescribed in rule and law. Other than the adjustments in sections
509.27256B.431 , subdivisions 30 and 32; 256B.437, subdivision 3, paragraph (b), Minnesota
509.28Rules, part 9549.0057, and any other applicable legislation enacted prior to the finalization
509.29of rates, facilities assuming full participation in medical assistance under this paragraph are
509.30not eligible for any rate adjustments until the July 1 following their settle-up period.

509.31    Sec. 18. Minnesota Statutes 2016, section 256B.0915, subdivision 3e, is amended to read:
509.32    Subd. 3e. Customized living service rate. (a) Payment for customized living services
509.33shall be a monthly rate authorized by the lead agency within the parameters established by
510.1the commissioner. The payment agreement must delineate the amount of each component
510.2service included in the recipient's customized living service plan. The lead agency, with
510.3input from the provider of customized living services, shall ensure that there is a documented
510.4need within the parameters established by the commissioner for all component customized
510.5living services authorized.
510.6(b) The payment rate must be based on the amount of component services to be provided
510.7utilizing component rates established by the commissioner. Counties and tribes shall use
510.8tools issued by the commissioner to develop and document customized living service plans
510.9and rates.
510.10(c) Component service rates must not exceed payment rates for comparable elderly
510.11waiver or medical assistance services and must reflect economies of scale. Customized
510.12living services must not include rent or raw food costs.
510.13    (d) With the exception of individuals described in subdivision 3a, paragraph (b), the
510.14individualized monthly authorized payment for the customized living service plan shall not
510.15exceed 50 percent of the greater of either the statewide or any of the geographic groups'
510.16weighted average monthly nursing facility rate of the case mix resident class to which the
510.17elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0051
510.18to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph
510.19(a). Effective on July 1 of the state fiscal year in which the resident assessment system as
510.20described in section 256B.438 256R.17 for nursing home rate determination is implemented
510.21and July 1 of each subsequent state fiscal year, the individualized monthly authorized
510.22payment for the services described in this clause shall not exceed the limit which was in
510.23effect on June 30 of the previous state fiscal year updated annually based on legislatively
510.24adopted changes to all service rate maximums for home and community-based service
510.25providers.
510.26(e) Effective July 1, 2011, the individualized monthly payment for the customized living
510.27service plan for individuals described in subdivision 3a, paragraph (b), must be the monthly
510.28authorized payment limit for customized living for individuals classified as case mix A,
510.29reduced by 25 percent. This rate limit must be applied to all new participants enrolled in
510.30the program on or after July 1, 2011, who meet the criteria described in subdivision 3a,
510.31paragraph (b). This monthly limit also applies to all other participants who meet the criteria
510.32described in subdivision 3a, paragraph (b), at reassessment.
510.33    (f) Customized living services are delivered by a provider licensed by the Department
510.34of Health as a class A or class F home care provider and provided in a building that is
511.1registered as a housing with services establishment under chapter 144D. Licensed home
511.2care providers are subject to section 256B.0651, subdivision 14.
511.3(g) A provider may not bill or otherwise charge an elderly waiver participant or their
511.4family for additional units of any allowable component service beyond those available under
511.5the service rate limits described in paragraph (d), nor for additional units of any allowable
511.6component service beyond those approved in the service plan by the lead agency.
511.7(h) Effective July 1, 2016, and each July 1 thereafter, individualized service rate limits
511.8for customized living services under this subdivision shall be increased by the difference
511.9between any legislatively adopted home and community-based provider rate increases
511.10effective on July 1 or since the previous July 1 and the average statewide percentage increase
511.11in nursing facility operating payment rates under sections 256B.431, 256B.434, and 256B.441
511.12chapter 256R, effective the previous January 1. This paragraph shall only apply if the average
511.13statewide percentage increase in nursing facility operating payment rates is greater than any
511.14legislatively adopted home and community-based provider rate increases effective on July
511.151, or occurring since the previous July 1.

511.16    Sec. 19. Minnesota Statutes 2016, section 256B.35, subdivision 4, is amended to read:
511.17    Subd. 4. Field audits required. The commissioner of human services shall conduct
511.18field audits at the same time as cost report audits required under section 256B.27, subdivision
511.192a 256R.13, subdivision 1, and at any other time but at least once every four years, without
511.20notice, to determine whether this section was complied with and that the funds provided
511.21residents for their personal needs were actually expended for that purpose.

511.22    Sec. 20. Minnesota Statutes 2016, section 256B.431, subdivision 30, is amended to read:
511.23    Subd. 30. Bed layaway and delicensure. (a) For rate years beginning on or after July
511.241, 2000, a nursing facility reimbursed under this section which has placed beds on layaway
511.25shall, for purposes of application of the downsizing incentive in subdivision 3a, paragraph
511.26(c), and calculation of the rental per diem, have those beds given the same effect as if the
511.27beds had been delicensed so long as the beds remain on layaway. At the time of a layaway,
511.28a facility may change its single bed election for use in calculating capacity days under
511.29Minnesota Rules, part 9549.0060, subpart 11. The property payment rate increase shall be
511.30effective the first day of the month following the month in which the layaway of the beds
511.31becomes effective under section 144A.071, subdivision 4b.
511.32(b) For rate years beginning on or after July 1, 2000, notwithstanding any provision to
511.33the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under
512.1that section or chapter which has placed beds on layaway shall, for so long as the beds
512.2remain on layaway, be allowed to:
512.3(1) aggregate the applicable investment per bed limits based on the number of beds
512.4licensed immediately prior to entering the alternative payment system;
512.5(2) retain or change the facility's single bed election for use in calculating capacity days
512.6under Minnesota Rules, part 9549.0060, subpart 11; and
512.7(3) establish capacity days based on the number of beds immediately prior to the layaway
512.8and the number of beds after the layaway.
512.9    The commissioner shall increase the facility's property payment rate by the incremental
512.10increase in the rental per diem resulting from the recalculation of the facility's rental per
512.11diem applying only the changes resulting from the layaway of beds and clauses (1), (2), and
512.12(3). If a facility reimbursed under section 256B.434 or chapter 256R completes a moratorium
512.13exception project after its base year, the base year property rate shall be the moratorium
512.14project property rate. The base year rate shall be inflated by the factors in section 256B.434,
512.15subdivision 4 , paragraph (c). The property payment rate increase shall be effective the first
512.16day of the month following the month in which the layaway of the beds becomes effective.
512.17(c) If a nursing facility removes a bed from layaway status in accordance with section
512.18144A.071, subdivision 4b , the commissioner shall establish capacity days based on the
512.19number of licensed and certified beds in the facility not on layaway and shall reduce the
512.20nursing facility's property payment rate in accordance with paragraph (b).
512.21(d) For the rate years beginning on or after July 1, 2000, notwithstanding any provision
512.22to the contrary under section 256B.434 or chapter 256R, a nursing facility reimbursed under
512.23that section or chapter, which has delicensed beds after July 1, 2000, by giving notice of
512.24the delicensure to the commissioner of health according to the notice requirements in section
512.25144A.071, subdivision 4b , shall be allowed to:
512.26(1) aggregate the applicable investment per bed limits based on the number of beds
512.27licensed immediately prior to entering the alternative payment system;
512.28(2) retain or change the facility's single bed election for use in calculating capacity days
512.29under Minnesota Rules, part 9549.0060, subpart 11; and
512.30(3) establish capacity days based on the number of beds immediately prior to the
512.31delicensure and the number of beds after the delicensure.
512.32    The commissioner shall increase the facility's property payment rate by the incremental
512.33increase in the rental per diem resulting from the recalculation of the facility's rental per
513.1diem applying only the changes resulting from the delicensure of beds and clauses (1), (2),
513.2and (3). If a facility reimbursed under section 256B.434 completes a moratorium exception
513.3project after its base year, the base year property rate shall be the moratorium project property
513.4rate. The base year rate shall be inflated by the factors in section 256B.434, subdivision 4,
513.5paragraph (c). The property payment rate increase shall be effective the first day of the
513.6month following the month in which the delicensure of the beds becomes effective.
513.7(e) For nursing facilities reimbursed under this section or, section 256B.434, or chapter
513.8256R, any beds placed on layaway shall not be included in calculating facility occupancy
513.9as it pertains to leave days defined in Minnesota Rules, part 9505.0415.
513.10(f) For nursing facilities reimbursed under this section or, section 256B.434, or chapter
513.11256R, the rental rate calculated after placing beds on layaway may not be less than the rental
513.12rate prior to placing beds on layaway.
513.13(g) A nursing facility receiving a rate adjustment as a result of this section shall comply
513.14with section 256B.47, subdivision 2 256R.06, subdivision 5.
513.15(h) A facility that does not utilize the space made available as a result of bed layaway
513.16or delicensure under this subdivision to reduce the number of beds per room or provide
513.17more common space for nursing facility uses or perform other activities related to the
513.18operation of the nursing facility shall have its property rate increase calculated under this
513.19subdivision reduced by the ratio of the square footage made available that is not used for
513.20these purposes to the total square footage made available as a result of bed layaway or
513.21delicensure.

513.22    Sec. 21. Minnesota Statutes 2016, section 256B.50, subdivision 1, is amended to read:
513.23    Subdivision 1. Scope. A provider may appeal from a determination of a payment rate
513.24established pursuant to this chapter or allowed costs under section 256B.441 chapter 256R
513.25if the appeal, if successful, would result in a change to the provider's payment rate or to the
513.26calculation of maximum charges to therapy vendors as provided by section 256B.433,
513.27subdivision 3 256R.54. Appeals must be filed in accordance with procedures in this section.
513.28This section does not apply to a request from a resident or long-term care facility for
513.29reconsideration of the classification of a resident under section 144.0722.

513.30    Sec. 22. EFFECTIVE DATE.
513.31Sections 1 to 21 are effective the day following final enactment.

514.1ARTICLE 15

514.2HUMAN SERVICES FORECAST ADJUSTMENTS

514.3

Section 1. DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

514.4The dollar amounts shown are added to or, if shown in parentheses, are subtracted from
514.5the appropriations in Laws 2015, chapter 71, article 14, as amended by Laws 2016, chapter
514.6189, articles 22 and 23, from the general fund, or any other fund named, to the Department
514.7of Human Services for the purposes specified in this article, to be available for the fiscal
514.8years indicated for each purpose. The figure "2017" used in this article means that the
514.9appropriations listed are available for the fiscal year ending June 30, 2017.

514.10				APPROPRIATIONS
514.11				Available for the Year
514.12				Ending June 30
514.13					2017

514.14 514.15

Sec. 2. COMMISSIONER OF HUMAN SERVICES

514.16

Subdivision 1.Total Appropriation

$

(342,045,000)

514.17	Appropriations by Fund
514.18		2017
514.19	General Fund	(198,450,000)
514.20	Health Care Access	(146,590,000)
514.21	TANF	2,995,000

514.22	Subd. 2.Forecasted Programs
514.23	(a) MFIP/DWP Grants

514.24	Appropriations by Fund
514.25	General Fund	(2,111,000)
514.26	TANF	2,579,000

514.27

(b) MFIP Child Care Assistance Grants

(6,513,000)

514.28

(c) General Assistance Grants

(4,219,000)

514.29

(d) Minnesota Supplemental Aid Grants

(581,000)

514.30

(e) Group Residential Housing Grants

(533,000)

514.31

(f) Northstar Care for Children

2,613,000

514.32

(g) MinnesotaCare Grants

(145,883,000)

515.1This appropriation is from the health care
515.2access fund.

515.3

(h) Medical Assistance Grants

515.4	Appropriations by Fund
515.5	General Fund	(192,744,000)
515.6	Health Care Access	(707,000)

515.7

(i) Alternative Care Grants

-0-

515.8

(j) CD Entitlement Grants

5,638,000

515.9

Subd. 3.Technical Activities

416,000

515.10This appropriation is from the TANF fund.

515.11    Sec. 3. EFFECTIVE DATE.
515.12Sections 1 and 2 are effective the day following final enactment.

515.13ARTICLE 16

515.14APPROPRIATIONS

515.15

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

515.16The sums shown in the columns marked "Appropriations" are appropriated to the agencies
515.17and for the purposes specified in this article. The appropriations are from the general fund,
515.18or another named fund, and are available for the fiscal years indicated for each purpose.
515.19The figures "2018" and "2019" used in this article mean that the appropriations listed under
515.20them are available for the fiscal year ending June 30, 2018, or June 30, 2019, respectively.
515.21"The first year" is fiscal year 2018. "The second year" is fiscal year 2019. "The biennium"
515.22is fiscal years 2018 and 2019.

515.23				APPROPRIATIONS
515.24				Available for the Year
515.25				Ending June 30
515.26					2018		2019

515.27 515.28

Sec. 2. COMMISSIONER OF HUMAN SERVICES

515.29

Subdivision 1.Total Appropriation

$

7,360,594,000

$

7,396,706,000

516.1	Appropriations by Fund
516.2		2018	2019
516.3	General	6,810,781,000	6,837,640,000
516.4 516.5	State Government Special Revenue	4,274,000	4,274,000
516.6	Health Care Access	266,707,000	282,194,000
516.7	Federal TANF	276,936,000	270,702,000
516.8	Lottery Prize	1,896,000	1,896,000

516.9The amounts that may be spent for each
516.10purpose are specified in the following
516.11subdivisions.

516.12

Subd. 2.TANF Maintenance of Effort

516.13(a) The commissioner shall ensure that
516.14sufficient qualified nonfederal expenditures
516.15are made each year to meet the state's
516.16maintenance of effort (MOE) requirements of
516.17the TANF block grant specified under Code
516.18of Federal Regulations, title 45, section 263.1.
516.19In order to meet these basic TANF/MOE
516.20requirements, the commissioner may report
516.21as TANF/MOE expenditures only nonfederal
516.22money expended for allowable activities listed
516.23in the following clauses:
516.24(1) MFIP cash, diversionary work program,
516.25and food assistance benefits under Minnesota
516.26Statutes, chapter 256J;
516.27(2) the child care assistance programs under
516.28Minnesota Statutes, sections 119B.03 and
516.29119B.05, and county child care administrative
516.30costs under Minnesota Statutes, section
516.31119B.15;
516.32(3) state and county MFIP administrative costs
516.33under Minnesota Statutes, chapters 256J and
516.34256K;
517.1(4) state, county, and tribal MFIP employment
517.2services under Minnesota Statutes, chapters
517.3256J and 256K;
517.4(5) expenditures made on behalf of legal
517.5noncitizen MFIP recipients who qualify for
517.6the MinnesotaCare program under Minnesota
517.7Statutes, chapter 256L;
517.8(6) qualifying working family credit
517.9expenditures under Minnesota Statutes, section
517.10290.0671;
517.11(7) qualifying Minnesota education credit
517.12expenditures under Minnesota Statutes, section
517.13290.0674; and
517.14(8) qualifying Head Start expenditures under
517.15Minnesota Statutes, section 119A.50.
517.16(b) For the activities listed in paragraph (a),
517.17clauses (2) to (8), the commissioner may
517.18report only expenditures that are excluded
517.19from the definition of assistance under Code
517.20of Federal Regulations, title 45, section
517.21260.31.
517.22(c) The commissioner shall ensure that the
517.23MOE used by the commissioner of
517.24management and budget for the February and
517.25November forecasts required under Minnesota
517.26Statutes, section 16A.103, contains
517.27expenditures under paragraph (a), clause (1),
517.28equal to at least 16 percent of the total required
517.29under Code of Federal Regulations, title 45,
517.30section 263.1.
517.31(d) The commissioner may not claim an
517.32amount of TANF/MOE in excess of the 75
517.33percent standard in Code of Federal
518.1Regulations, title 45, section 263.1(a)(2),
518.2except:
518.3(1) to the extent necessary to meet the 80
518.4percent standard under Code of Federal
518.5Regulations, title 45, section 263.1(a)(1), if it
518.6is determined by the commissioner that the
518.7state will not meet the TANF work
518.8participation target rate for the current year;
518.9(2) to provide any additional amounts under
518.10Code of Federal Regulations, title 45, section
518.11264.5, that relate to replacement of TANF
518.12funds due to the operation of TANF penalties;
518.13and
518.14(3) to provide any additional amounts that may
518.15contribute to avoiding or reducing TANF work
518.16participation penalties through the operation
518.17of the excess MOE provisions of Code of
518.18Federal Regulations, title 45, section 261.43
518.19(a)(2).
518.20(e) For the purposes of paragraph (d), the
518.21commissioner may supplement the MOE claim
518.22with working family credit expenditures or
518.23other qualified expenditures to the extent such
518.24expenditures are otherwise available after
518.25considering the expenditures allowed in this
518.26subdivision.
518.27(f) The requirement in Minnesota Statutes,
518.28section 256.011, subdivision 3, that federal
518.29grants or aids secured or obtained under that
518.30subdivision be used to reduce any direct
518.31appropriations provided by law, does not apply
518.32if the grants or aids are federal TANF funds.
518.33(g) IT Appropriations Generally. This
518.34appropriation includes funds for information
519.1technology projects, services, and support.
519.2Notwithstanding Minnesota Statutes, section
519.316E.0466, funding for information technology
519.4project costs shall be incorporated into the
519.5service level agreement and paid to the Office
519.6of MN.IT Services by the Department of
519.7Human Services under the rates and
519.8mechanism specified in that agreement.
519.9(h) Receipts for Systems Project.
519.10Appropriations and federal receipts for
519.11information systems projects for MAXIS,
519.12PRISM, MMIS, ISDS, METS, and SSIS must
519.13be deposited in the state systems account
519.14authorized in Minnesota Statutes, section
519.15256.014. Money appropriated for computer
519.16projects approved by the commissioner of the
519.17Office of MN.IT Services, funded by the
519.18legislature, and approved by the commissioner
519.19of management and budget may be transferred
519.20from one project to another and from
519.21development to operations as the
519.22commissioner of human services considers
519.23necessary. Any unexpended balance in the
519.24appropriation for these projects does not
519.25cancel and is available for ongoing
519.26development and operations.
519.27(i) Federal SNAP Education and Training
519.28Grants. Federal funds available during fiscal
519.29years 2017, 2018, and 2019 for Supplemental
519.30Nutrition Assistance Program Education and
519.31Training and SNAP Quality Control
519.32Performance Bonus grants are appropriated
519.33to the commissioner of human services for the
519.34purposes allowable under the terms of the
520.1federal award. This paragraph is effective the
520.2day following final enactment.

520.3

Subd. 3.Central Office; Operations

520.4	Appropriations by Fund
520.5	General	102,300,000	100,237,000
520.6 520.7	State Government Special Revenue	4,149,000	4,149,000
520.8	Health Care Access	20,025,000	20,025,000
520.9	Federal TANF	100,000	100,000

520.10(a) Administrative Recovery; Set-Aside. The
520.11commissioner may invoice local entities
520.12through the SWIFT accounting system as an
520.13alternative means to recover the actual cost of
520.14administering the following provisions:
520.15(1) Minnesota Statutes, section 125A.744,
520.16subdivision 3;
520.17(2) Minnesota Statutes, section 245.495,
520.18paragraph (b);
520.19(3) Minnesota Statutes, section 256B.0625,
520.20subdivision 20, paragraph (k);
520.21(4) Minnesota Statutes, section 256B.0924,
520.22subdivision 6, paragraph (g);
520.23(5) Minnesota Statutes, section 256B.0945,
520.24subdivision 4, paragraph (d); and
520.25(6) Minnesota Statutes, section 256F.10,
520.26subdivision 6, paragraph (b).
520.27(b) Transfer to Office of Legislative
520.28Auditor. $600,000 in fiscal year 2018 and
520.29$600,000 in fiscal year 2019 are for transfer
520.30to the Office of the Legislative Auditor for
520.31audit activities under Minnesota Statutes,
520.32section 3.972, subdivision 2b.
521.1(c) Base Level Adjustment. The general fund
521.2base is $98,094,000 in fiscal year 2020 and
521.3$98,085,000 in fiscal year 2021.

521.4

Subd. 4.Central Office; Children and Families

521.5	Appropriations by Fund
521.6	General	9,043,000	8,931,000
521.7	Federal TANF	2,582,000	2,582,000

521.8(a) Financial Institution Data Match and
521.9Payment of Fees. The commissioner is
521.10authorized to allocate up to $310,000 each
521.11year in fiscal year 2018 and fiscal year 2019
521.12from the systems special revenue account to
521.13make payments to financial institutions in
521.14exchange for performing data matches
521.15between account information held by financial
521.16institutions and the public authority's database
521.17of child support obligors as authorized by
521.18Minnesota Statutes, section 13B.06,
521.19subdivision 7.
521.20(b) Base Level Adjustment. The general fund
521.21base is $8,871,000 in fiscal year 2020 and
521.22$8,871,000 in fiscal year 2021.

521.23

Subd. 5.Central Office; Health Care

521.24	Appropriations by Fund
521.25	General	17,877,000	16,963,000
521.26	Health Care Access	21,641,000	21,748,000

521.27(a) Trust Guide. $200,000 in fiscal year 2018
521.28and $150,000 in fiscal year 2019 are from the
521.29general fund for the development of a special
521.30needs trust guide that directs the state medical
521.31assistance program's trust recovery process
521.32and establishes guidelines for the public. This
521.33is a onetime appropriation.
522.1(b) Rates Study. $227,000 in fiscal year 2018
522.2is from the general fund for the medical
522.3assistance payment rate study. This is a
522.4onetime appropriation.
522.5(c) Integrated Health Partnership Health
522.6Information Exchange. $125,000 in fiscal
522.7year 2018 and $250,000 in fiscal year 2019
522.8are from the general fund to contract with
522.9state-certified health information exchange
522.10vendors to support providers participating in
522.11an integrated health partnership under
522.12Minnesota Statutes, section 256B.0755, to
522.13connect enrollees with community supports
522.14and social services and improve collaboration
522.15among participating and authorized providers.
522.16(d) Implementation and Operation of an
522.17Electronic Service Delivery Documentation
522.18System. $225,000 in fiscal year 2018 and
522.19$183,000 in fiscal year 2019 are from the
522.20general fund for the development and
522.21implementation of an electronic service
522.22delivery documentation system. This is a
522.23onetime appropriation.
522.24(e) Transfer to Legislative Auditor.
522.25$153,000 in fiscal year 2018 and $153,000 in
522.26fiscal year 2019 are from the general fund for
522.27transfer to the Office of the Legislative
522.28Auditor for the auditor to establish and
522.29maintain a team of auditors with the training
522.30and experience necessary to fulfill the
522.31requirements in Minnesota Statutes, section
522.323.972, subdivision 2a.
522.33(f) Savings from Improved Eligibility
522.34Verification. The commissioner of human
522.35services shall implement periodic data
523.1matching under Minnesota Statutes, section
523.2256B.0561, the recommendations of the
523.3legislative auditor provided under Minnesota
523.4Statutes, section 3.972, subdivision 2a, and
523.5other eligibility verification initiatives for
523.6enrollees or beneficiaries of all health care,
523.7income maintenance, and social service
523.8programs administered by the commissioner,
523.9in a manner sufficient to achieve savings of
523.10$65,548,000 in fiscal year 2018 and
523.11$74,689,000 in fiscal year 2019.
523.12(g) Chronic Pain Rehabilitation Therapy
523.13Demonstration Project. $1,000,000 in fiscal
523.14year 2018 is from the general fund for a
523.15chronic pain rehabilitation therapy
523.16demonstration project with a rehabilitation
523.17institute. This is a onetime appropriation.
523.18(h) Base Level Adjustment. The general fund
523.19base is $16,221,000 in fiscal year 2020 and
523.20$16,219,000 in fiscal year 2021.

523.21 523.22

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

523.23	Appropriations by Fund
523.24	General	14,565,000	14,061,000
523.25 523.26	State Government Special Revenue	125,000	125,000

523.27(a) Vulnerable Adults Complaints Case
523.28Management System. $258,000 in fiscal year
523.292018 is from the general fund for the Office
523.30of Inspector General to implement a case
523.31management system for tracking and
523.32managing complaints and investigations
523.33involving vulnerable adults. In consultation
523.34with the Department of Health, Office of
523.35Health Facility Complaints, the Office of
524.1Inspector General shall ensure that the case
524.2management system is capable of:
524.3(1) uniquely tracking each complaint received
524.4by the Office of Inspector General and the
524.5Office of Health Facility Complaints, whether
524.6the complaint is received through the
524.7Minnesota Adult Abuse Reporting Center, by
524.8telephone, by referral from another agency or
524.9division, or by any other means;
524.10(2) linking each complaint to any and all
524.11investigations related to that complaint;
524.12(3) tracking and coordinating referrals and
524.13communication between state agencies,
524.14including the Office of Ombudsman for
524.15Long-Term Care and the Office of
524.16Ombudsman for Mental Health and
524.17Developmental Disabilities; and
524.18(4) securing data as required under the
524.19Vulnerable Adults Act and the Government
524.20Data Practices Act.
524.21Products and services for the case management
524.22system design, implementation, and
524.23application hosting must be acquired using a
524.24request for proposals. This is a onetime
524.25appropriation and is available until June 30,
524.262019.
524.27(b) Alzheimer's Disease Working Group.
524.28$127,000 in fiscal year 2018 and $110,000 in
524.29fiscal year 2019 are from the general fund for
524.30the Alzheimer's disease working group. This
524.31is a onetime appropriation.
524.32(c) Base Level Adjustment. The general fund
524.33base is $13,909,000 in fiscal year 2020 and
524.34$13,909,000 in fiscal year 2021.

525.1

Subd. 7.Central Office; Community Supports

525.2	Appropriations by Fund
525.3	General	26,358,000	26,021,000
525.4	Lottery Prize	163,000	163,000

525.5(a) Transportation Study. $250,000 in fiscal
525.6year 2018 and $250,000 in fiscal year 2019
525.7are for a study to identify opportunities to
525.8increase access to transportation services for
525.9individuals who receive home and
525.10community-based services. This is a onetime
525.11appropriation.
525.12(b) Deaf and Hard-of-Hearing Services.
525.13$850,000 in fiscal year 2018 and $700,000 in
525.14fiscal year 2019 are from the general fund for
525.15the Deaf and Hard-of-Hearing Services
525.16Division under Minnesota Statutes, section
525.17256C.233. $150,000 of this appropriation each
525.18year must be used for technology
525.19improvements, technology support, and
525.20training for staff on the use of technology for
525.21external facing services to implement
525.22Minnesota Statutes, section 256C.24,
525.23subdivision 2, clause (12).
525.24(c) Individual Budgeting Model. $435,000
525.25in fiscal year 2018 and $65,000 in fiscal year
525.262019 are from the general fund to study and
525.27develop an individual budgeting model for
525.28disability waiver recipients and those
525.29accessing services through consumer-directed
525.30community supports. The commissioner shall
525.31submit recommendations to the chairs and
525.32ranking minority members of the legislative
525.33committees with jurisdiction over these
525.34programs by January 15, 2019. This is a
525.35onetime appropriation.
526.1(d) Substance Use Disorder System Study.
526.2$150,000 in fiscal year 2018 and $150,000 in
526.3fiscal year 2019 are for a substance use
526.4disorder system study. This is a onetime
526.5appropriation.
526.6(e) Children's Mental Health Report and
526.7Recommendations. $125,000 in fiscal year
526.82018 and $125,000 in fiscal year 2019 are for
526.9a comprehensive analysis of Minnesota's
526.10continuum of intensive mental health services
526.11for children with serious mental health needs.
526.12This is a onetime appropriation.
526.13(f) Base Level Adjustment. The general fund
526.14base is $24,650,000 in fiscal year 2020 and
526.15$24,533,000 in fiscal year 2021.

526.16

Subd. 8.Forecasted Programs; MFIP/DWP

526.17	Appropriations by Fund
526.18	General	88,530,000	97,912,000
526.19	Federal TANF	94,617,000	88,230,000

526.20 526.21

Subd. 9.Forecasted Programs; MFIP Child Care Assistance

107,385,000

103,796,000

526.22 526.23

Subd. 10.Forecasted Programs; General Assistance

55,536,000

57,221,000

526.24(a) General Assistance Standard. The
526.25commissioner shall set the monthly standard
526.26of assistance for general assistance units
526.27consisting of an adult recipient who is
526.28childless and unmarried or living apart from
526.29parents or a legal guardian at $203. The
526.30commissioner may reduce this amount
526.31according to Laws 1997, chapter 85, article 3,
526.32section 54.
526.33(b) Emergency General Assistance Limit.
526.34The amount appropriated for emergency
526.35general assistance is limited to no more than
527.1$6,729,812 in fiscal year 2018 and $6,729,812
527.2in fiscal year 2019. Funds to counties shall be
527.3allocated by the commissioner using the
527.4allocation method under Minnesota Statutes,
527.5section 256D.06.

527.6 527.7

Subd. 11.Forecasted Programs; Minnesota Supplemental Aid

40,484,000

41,634,000

527.8 527.9

Subd. 12.Forecasted Programs; Group Residential Housing

170,337,000

180,668,000

527.10 527.11

Subd. 13.Forecasted Programs; Northstar Care for Children

80,542,000

96,433,000

527.12

Subd. 14.Forecasted Programs; MinnesotaCare

12,224,000

12,834,000

527.13This appropriation is from the health care
527.14access fund.

527.15 527.16

Subd. 15.Forecasted Programs; Medical Assistance

527.17	Appropriations by Fund
527.18	General	5,211,349,000	5,192,343,000
527.19	Health Care Access	210,159,000	224,929,000

527.20(a) Behavioral Health Services. $1,000,000
527.21in fiscal year 2018 and $1,000,000 in fiscal
527.22year 2019 are for behavioral health services
527.23provided by hospitals identified under
527.24Minnesota Statutes, section 256.969,
527.25subdivision 2b, paragraph (a), clause (4). The
527.26increase in payments shall be made by
527.27increasing the adjustment under Minnesota
527.28Statutes, section 256.969, subdivision 2b,
527.29paragraph (e), clause (2).
527.30(b) Limits to Increases in Medical
527.31Assistance Program Payments. Beginning
527.32July 1, 2017, the commissioner shall limit
527.33increases in payments to managed care plans
527.34and county-based purchasing plans in the
527.35medical assistance program to achieve the
528.1following reductions on a statewide aggregate
528.2basis for each fiscal year:
528.3(1) in fiscal year 2018, $32,682,000;
528.4(2) in fiscal year 2019, $118,257,000;
528.5(3) in fiscal year 2020, $218,025,000; and
528.6(4) in fiscal year 2021, $327,396,000.
528.7Notwithstanding any provision to the contrary
528.8in this article, this paragraph expires July 1,
528.92021.
528.10(c) Reform of MnCHOICES
528.11Administration.The commissioner shall
528.12reduce expenditures for MnCHOICES by
528.13$30,753,000 in fiscal year 2018 and
528.14$30,753,000 in fiscal year 2019.

528.15 528.16

Subd. 16.Forecasted Programs; Alternative Care

44,587,000

45,477,000

528.17Alternative Care Transfer. Any money
528.18allocated to the alternative care program that
528.19is not spent for the purposes indicated does
528.20not cancel but must be transferred to the
528.21medical assistance account.

528.22 528.23

Subd. 17.Forecasted Programs; Chemical Dependency Treatment Fund

119,251,000

139,321,000

528.24 528.25

Subd. 18.Grant Programs; Support Services Grants

528.26	Appropriations by Fund
528.27	General	8,715,000	8,715,000
528.28	Federal TANF	93,311,000	93,311,000

528.29 528.30

Subd. 19.Grant Programs; Basic Sliding Fee Child Care Assistance Grants

51,945,000

48,660,000

528.31Base Level Adjustment. The general fund
528.32base is $48,737,000 in fiscal year 2020 and
528.33$48,809,000 in fiscal year 2021.

529.1 529.2

Subd. 20.Grant Programs; Child Care Development Grants

1,737,000

1,737,000

529.3 529.4

Subd. 21.Grant Programs; Child Support Enforcement Grants

50,000

50,000

529.5 529.6

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

529.7	Appropriations by Fund
529.8	General	41,140,000	40,265,000
529.9	Federal TANF	140,000	140,000

529.10(a) Title IV-E Adoption Assistance. (1) The
529.11commissioner shall allocate funds from the
529.12Title IV-E reimbursement to the state from
529.13the Fostering Connections to Success and
529.14Increasing Adoptions Act for adoptive, foster,
529.15and kinship families as required in Minnesota
529.16Statutes, section 256N.621.
529.17(2) Additional federal reimbursement to the
529.18state as a result of the Fostering Connections
529.19to Success and Increasing Adoptions Act's
529.20expanded eligibility for title IV-E adoption
529.21assistance is for postadoption, foster care,
529.22adoption, and kinship services, including a
529.23parent-to-parent support network.
529.24(b) Adoption Assistance Incentive Grants.
529.25(1) The commissioner shall allocate federal
529.26funds available for adoption and guardianship
529.27assistance incentive grants for postadoption
529.28services to support adoptive, foster, and
529.29kinship families as required in Minnesota
529.30Statutes, section 256N.621.
529.31(2) Federal funds available during fiscal years
529.322018 and 2019 for adoption incentive grants
529.33must be used for foster care, adoption, and
529.34kinship services, including a parent-to-parent
529.35support network.
530.1(c) Adoption Support Services. The
530.2commissioner shall allocate 20 percent of
530.3federal funds from title IV-B, subpart 2, of the
530.4Social Security Act, Promoting Safe and
530.5Stable Families, for adoption support services
530.6under Minnesota Statutes, section 256N.261.
530.7(d) American Indian Child Welfare
530.8Initiative. $800,000 in fiscal year 2018 is for
530.9planning efforts to expand the American
530.10Indian Child Welfare Initiative under
530.11Minnesota Statutes, section 256.01,
530.12subdivision 14b. Of this amount, $400,000 is
530.13for a grant to the Mille Lacs Band of Ojibwe
530.14and $400,000 is for a grant to the Red Lake
530.15Nation. This is a onetime appropriation.
530.16(e) Anoka County Family Foster Care.
530.17$75,000 in fiscal year 2018 is from the general
530.18fund for a grant to Anoka County to establish
530.19and promote family foster care recruitment
530.20models. The county shall use the grant funds
530.21for the purpose of increasing foster care
530.22providers through administrative
530.23simplification, nontraditional recruitment
530.24models, and family incentive options, and
530.25develop a strategic planning model to recruit
530.26family foster care providers. This is a onetime
530.27appropriation.
530.28(f) White Earth Band of Ojibwe Child
530.29Welfare Services. $1,600,000 in fiscal year
530.302018 and $1,600,000 in fiscal year 2019 are
530.31from the general fund for a grant to the White
530.32Earth Band of Ojibwe to deliver child welfare
530.33services.

530.34 530.35

Subd. 23.Grant Programs; Children and Community Service Grants

58,201,000

58,201,000

531.1 531.2

Subd. 24.Grant Programs; Children and Economic Support Grants

35,851,000

32,891,000

531.3(a) Minnesota Food Assistance Program.
531.4Unexpended funds for the Minnesota food
531.5assistance program for fiscal year 2018 do not
531.6cancel but are available for this purpose in
531.7fiscal year 2019.
531.8(b) At-Home Infant Child Care. $961,000
531.9in fiscal year 2018 and $961,000 in fiscal year
531.102019 are from the general fund for the at-home
531.11infant child care program under Minnesota
531.12Statutes, section 119B.035. The base for these
531.13grants is $922,000 in fiscal year 2020 and
531.14$922,000 in fiscal year 2021.
531.15(c) Long-term Homeless Supportive
531.16Services. $500,000 in fiscal year 2018 and
531.17$500,000 in fiscal year 2019 are for the
531.18long-term homeless supportive services fund
531.19under Minnesota Statutes, section 256K.26.
531.20This is a onetime appropriation.
531.21(d) Community Action Grants. $750,000 in
531.22fiscal year 2018 and $750,000 in fiscal year
531.232019 are for community action grants under
531.24Minnesota Statutes, sections 256E.30 to
531.25256E.32.
531.26(e) Transitional Housing. $250,000 in fiscal
531.27year 2018 and $250,000 in fiscal year 2019
531.28are for the transitional housing program under
531.29Minnesota Statutes, section 256E.33. This is
531.30a onetime appropriation.
531.31(f) Family Assets for Independence.
531.32$250,000 in fiscal year 2018 and $250,000 in
531.33fiscal year 2019 are for the family assets for
532.1independence program under Minnesota
532.2Statutes, section 256E.35.
532.3(g) Safe Harbor for Sexually Exploited
532.4Youth. (1) $500,000 in fiscal year 2018 and
532.5$500,000 in fiscal year 2019 are for
532.6emergency shelter and transitional and
532.7long-term housing beds for sexually exploited
532.8youth and youth at risk of sexual exploitation.
532.9(2) $100,000 in fiscal year 2018 and $100,000
532.10in fiscal year 2019 are for statewide youth
532.11outreach workers connecting sexually
532.12exploited youth and youth at risk of sexual
532.13exploitation with shelter and services.
532.14(3) Youth 24 years of age or younger are
532.15eligible for shelter, housing beds, and services
532.16under this paragraph. In funding shelter,
532.17housing beds, and outreach workers under this
532.18paragraph, the commissioner shall emphasize
532.19activities that promote capacity-building and
532.20development of resources in greater
532.21Minnesota.
532.22(h) Emergency Services Program. $125,000
532.23in fiscal year 2018 and $125,000 in fiscal year
532.242019 are for the emergency services program,
532.25which provides services and emergency shelter
532.26for homeless Minnesotans under Minnesota
532.27Statutes, section 256E.36. This is a onetime
532.28appropriation.
532.29(i) Dakota County Child Data Tracking.
532.30$200,000 in fiscal year 2018 is for the
532.31Minnesota Birth to Eight pilot project for the
532.32development of the information technology
532.33solution that will track the established
533.1developmental milestone progress of each
533.2child participating in the pilot up to age eight.
533.3(j) Mobile Food Shelf Grants. $2,000,000 in
533.4fiscal year 2018 is for mobile food shelf
533.5grants. Of this amount, $1,000,000 is for
533.6sustaining existing mobile programs and
533.7$1,000,000 is for creating new mobile
533.8programs. This is a onetime appropriation.
533.9(k) Food Shelf Programs. $565,000 in fiscal
533.10year 2018 and $565,000 in fiscal year 2019
533.11are for food shelf programs under Minnesota
533.12Statutes, section 256E.34. This appropriation
533.13may be used to purchase proteins, fruits,
533.14vegetables, and diapers.
533.15(l) Housing Benefit Web Site. $130,000 in
533.16fiscal year 2018 and $130,000 in fiscal year
533.172019 are to operate the housing benefit 101
533.18Web site to help people who need affordable
533.19housing, and supports to maintain that
533.20housing, understand the range of housing
533.21options and support services available.
533.22(m) Coparenting Education. $200,000 in
533.23fiscal year 2018 and $200,000 in fiscal year
533.242019 are for a grant to a health and wellness
533.25center located in North Minneapolis that is a
533.26federally qualified health center. This is a
533.27onetime appropriation. The center must use
533.28the grant money to offer coparent services to
533.29unmarried parents. The center must develop
533.30a process to inform and educate unmarried
533.31parents about the center's coparent services.
533.32The coparent services must include the
533.33following:
534.1(1) coparenting workshops for the unmarried
534.2parents;
534.3(2) assistance to the unmarried parents in
534.4developing a parenting plan that specifies a
534.5schedule of the time each parent spends with
534.6the child, child support obligations, and a
534.7designation of decision-making responsibilities
534.8regarding the child's education, medical needs,
534.9and religious upbringing;
534.10(3) an assessment of social services needs for
534.11each parent; and
534.12(4) additional social services support,
534.13including support related to employment,
534.14education, and housing.
534.15The parenting plan assistance must include
534.16the option of using private mediation.
534.17The coparent workshops must focus at a
534.18minimum on (i) the benefits to the child of
534.19having both parents involved in a child's life,
534.20(ii) promoting both parents' participation in a
534.21child's life, (iii) building coparenting and
534.22communication skills, (iv) information on
534.23establishing paternity, (v) assisting parents in
534.24developing a parenting plan, and (vi) educating
534.25participants on how to foster a nonresident
534.26parent's continued involvement in a child's
534.27life.
534.28(n) Safe Harbor Shelter and Housing
534.29Project. $970,000 in fiscal year 2018 is for a
534.30grant to a girls' ranch in Benson that provides
534.31housing, supportive services, educational
534.32services, and equine therapy, for purposes of
534.33predesigning, designing, constructing,
534.34furnishing, and equipping a house with
535.1capacity for ten beds, and a second horse
535.2riding arena. This is a onetime appropriation.
535.3(o) Base Level Adjustments. The general
535.4fund base is $32,230,000 in fiscal year 2020
535.5and $32,230,000 in fiscal year 2021. The
535.6general fund base includes $453,000 in fiscal
535.7year 2020 and $453,000 in fiscal year 2021
535.8for community living infrastructure grant
535.9allocations under Minnesota Statutes, section
535.10256I.09.

535.11

Subd. 25.Grant Programs; Health Care Grants

535.12	Appropriations by Fund
535.13	General	4,994,000	4,461,000
535.14	Health Care Access	1,908,000	1,908,000

535.15(a) Integrated Health Partnerships.
535.16$375,000 in fiscal year 2018 and $250,000 in
535.17fiscal year 2019 are from the general fund to
535.18provide financial assistance to participating
535.19providers for costs required to establish an
535.20integrated health partnership, including but
535.21not limited to collecting and reporting
535.22information on health outcomes, quality of
535.23care, and health care costs; training
535.24practitioners and staff to use new care models
535.25and participate in care coordination; or
535.26participating in research and evaluation of the
535.27projects. This is a onetime appropriation.
535.28(b) Dental Services Grants. $500,000 in
535.29fiscal year 2018 and $500,000 in fiscal year
535.302019 are to award dental services grants. This
535.31is a onetime appropriation. The commissioner
535.32may award grants under this paragraph to:
535.33(1) nonprofit community clinics;
536.1(2) federally qualified health centers, rural
536.2health clinics, and public health clinics;
536.3(3) hospital-based dental clinics owned and
536.4operated by a city, county, or former state
536.5hospital as defined in Minnesota Statutes,
536.6section 62Q.19, subdivision 1, paragraph (a),
536.7clause (4); and
536.8(4) a dental clinic owned and operated by the
536.9University of Minnesota or the Minnesota
536.10State Colleges and Universities system.
536.11Grants may be used to fund costs related to
536.12maintaining, coordinating, and improving
536.13access for medical assistance and
536.14MinnesotaCare enrollees to dental care in a
536.15region.
536.16The commissioner shall consider the following
536.17in awarding the grants: experience in
536.18delivering dental services to medical assistance
536.19and MinnesotaCare enrollees in urban and
536.20rural communities; the potential to
536.21successfully maintain or expand access to
536.22dental services for medical assistance and
536.23MinnesotaCare enrollees; and demonstrated
536.24capability to provide access to care for
536.25children, adults, and seniors with special
536.26needs, individuals with complex medical and
536.27dental needs, recent immigrants and
536.28non-English speakers, and students attending
536.29schools with a high percentage of low-income
536.30students.
536.31(c) Base Level Adjustment. The general fund
536.32base is $3,711,000 in fiscal year 2020 and
536.33$3,711,000 in fiscal year 2021.

536.34 536.35

Subd. 26.Grant Programs; Other Long-Term Care Grants

3,053,000

3,478,000

537.1(a) Home and Community-Based Incentive
537.2Pool. $1,553,000 in fiscal year 2018 and
537.3$1,553,000 in fiscal year 2019 are for
537.4incentive payments under Minnesota Statutes,
537.5section 256B.0921. The base for these grants
537.6is $1,059,000 in fiscal year 2020 and
537.7$1,059,000 in fiscal year 2021.
537.8(b) Base Level Adjustment. The general fund
537.9base is $2,984,000 in fiscal year 2020 and
537.10$2,984,000 in fiscal year 2021.

537.11 537.12

Subd. 27.Grant Programs; Aging and Adult Services Grants

30,986,000

32,637,000

537.13(a) Caregiver Support Programs. $200,000
537.14in fiscal year 2018 and $200,000 in fiscal year
537.152019 are for caregiver support programs under
537.16Minnesota Statutes, section 256.9755.
537.17(b) Advanced In-Home Activity-Monitoring
537.18Systems. $40,000 in fiscal year 2018 is for a
537.19grant to a local research organization with
537.20expertise in identifying current and potential
537.21support systems and examining the capacity
537.22of those systems to meet the needs of the
537.23growing population of elderly persons to
537.24conduct a comprehensive assessment of
537.25current literature, past research, and an
537.26environmental scan of the field related to
537.27advanced in-home activity-monitoring systems
537.28for elderly persons. The commissioner must
537.29report the results of the assessment by January
537.3015, 2018, to the legislative committees and
537.31divisions with jurisdiction over health and
537.32human services policy and finance. This is a
537.33onetime appropriation.
537.34(c) Base Level Adjustments. The general
537.35fund base is $33,011,000 in fiscal year 2020
538.1and $33,195,000 in fiscal year 2021. The
538.2general fund base includes $334,000 in fiscal
538.3year 2020 and $477,000 in fiscal year 2021
538.4for the Minnesota Board on Aging for
538.5self-directed caregiver grants under Minnesota
538.6Statutes, section 256.975, subdivision 12.

538.7 538.8

Subd. 28.Grant Programs; Deaf and Hard-of-Hearing Grants

2,625,000

2,775,000

538.9Expanded Services Grants. $750,000 in
538.10fiscal year 2018 and $900,000 in fiscal year
538.112019 are for deaf and hard-of-hearing grants.
538.12The funds must be used to provide services to
538.13Minnesotans who are deafblind under
538.14Minnesota Statutes, section 256C.261, to
538.15provide culturally affirmative psychiatric
538.16services, and to provide linguistically and
538.17culturally appropriate mental health services
538.18to children who are deaf, children who are
538.19deafblind, and children who are
538.20hard-of-hearing. Of this amount, $103,000 in
538.21each year is to increase the grant to provide
538.22mentors who have hearing loss to parents of
538.23infants and children with newly identified
538.24hearing loss. Each year the division must
538.25provide funds for training in ProTactile
538.26American Sign Language or other
538.27communication systems used by people who
538.28are deafblind. Training shall be provided to
538.29persons who are deafblind and to interpreters,
538.30support service providers, and intervenors who
538.31work with persons who are deafblind.

538.32

Subd. 29.Grant Programs; Disabilities Grants

21,300,000

21,301,000

538.33(a) Disability Waiver Rate System
538.34Transition Grants. $30,000 in fiscal year
538.352018 and $31,000 in fiscal year 2019 are for
539.1grants to home and community-based
539.2disability waiver services providers that are
539.3projected to receive at least a ten percent
539.4decrease in revenues due to transition to rates
539.5calculated under Minnesota Statutes, section
539.6256B.4914.The commissioner shall award
539.7grants to ensure ongoing access for individuals
539.8currently receiving these services and provide
539.9stability to providers as they transition to new
539.10service delivery models. The general fund base
539.11for the grants under this paragraph is $287,000
539.12in fiscal year 2020 and $288,000 in fiscal year
539.132021.
539.14(b) Self-Advocacy Grants. $133,000 in fiscal
539.15year 2018 and $133,000 in fiscal year 2019
539.16are for grants under Minnesota Statutes,
539.17section 256.477, paragraph (a).
539.18(c) Services for Persons with Intellectual
539.19and Developmental Disabilities. $143,000
539.20in fiscal year 2018 and $143,000 in fiscal year
539.212019 are for a grant to an organization
539.22described under Minnesota Statutes, section
539.23256.477. This is a onetime appropriation.
539.24Grant funds must be used for the following
539.25purposes:
539.26(1) to maintain the infrastructure needed to
539.27train and support the activities of a statewide
539.28network of peer-to-peer mentors for persons
539.29with developmental disabilities, focused on
539.30building awareness of service options and
539.31advocacy skills necessary to move toward full
539.32inclusion in community life, including the
539.33development and delivery of the curriculum
539.34to support the peer-to-peer network;
540.1(2) to provide outreach activities, including
540.2statewide conferences and disability
540.3networking opportunities focused on
540.4self-advocacy, informed choice, and
540.5community engagement skills;
540.6(3) to provide an annual leadership program
540.7for persons with intellectual and
540.8developmental disabilities; and
540.9(4) to provide for administrative and general
540.10operating costs associated with managing and
540.11maintaining facilities, program delivery,
540.12evaluation, staff, and technology.
540.13(d) Outreach to Persons in Institutional
540.14Settings. $105,000 in fiscal year 2018 and
540.15$105,000 in fiscal year 2019 are for a grant to
540.16an organization described under Minnesota
540.17Statutes, section 256.477, to be used for
540.18subgrants to organizations in Minnesota to
540.19conduct outreach to persons working and
540.20living in institutional settings to provide
540.21education and information about community
540.22options. This is a onetime appropriation. Grant
540.23funds must be used to deliver peer-led skill
540.24training sessions in six regions of the state to
540.25help persons with intellectual and
540.26developmental disabilities understand
540.27community service options related to:
540.28(1) housing;
540.29(2) employment;
540.30(3) education;
540.31(4) transportation;
540.32(5) emerging service reform initiatives
540.33contained in the state's Olmstead plan; the
541.1Workforce Innovation and Opportunity Act,
541.2Public Law 113-128; and federal home and
541.3community-based services regulations; and
541.4(6) connecting with individuals who can help
541.5persons with intellectual and developmental
541.6disabilities make an informed choice and plan
541.7for a transition in services.
541.8(e) Individual Community Living Grants.
541.9To the extent funding is available, the
541.10commissioner may transfer funds from the
541.11semi-independent living services grant to new
541.12individual community living grants to pay for
541.13transitional costs and facilitate the transition
541.14of individuals from corporate foster care to
541.15community living.
541.16(f) Gap Analysis. $217,000 in fiscal year 2018
541.17and $218,000 in fiscal year 2019 are for
541.18analysis of gaps in long-term care services
541.19under Minnesota Statutes, section 144A.351.
541.20(g) Life Skills Training for Individuals with
541.21Autism Spectrum Disorder. $250,000 in
541.22fiscal year 2018 and $250,000 in fiscal year
541.232019 are for a grant to an organization located
541.24in Richfield that provides life skills training
541.25to young adults with learning disabilities to
541.26meet the needs of individuals with autism
541.27spectrum disorder. This appropriation may be
541.28used to:
541.29(1) create a best practices curriculum for
541.30serving individuals with autism spectrum
541.31disorder in residential placements with
541.32therapeutic programming; and
541.33(2) expand facilities by adding safety features,
541.34living spaces, and academic areas.
542.1(h) Base Level Adjustment. The general fund
542.2base is $21,309,000 in fiscal year 2020 and
542.3$21,310,000 in fiscal year 2021.

542.4 542.5

Subd. 30.Grant Programs; Adult Mental Health Grants

542.6	Appropriations by Fund
542.7	General	85,402,000	85,302,000
542.8	Health Care Access	750,000	750,000

542.9(a) Peer-Run Respite Services in Wadena
542.10County. $100,000 in fiscal year 2018 is from
542.11the general fund for a grant to Wadena County
542.12for the planning and development of a peer-run
542.13respite center for individuals experiencing
542.14mental health conditions or co-occurring
542.15substance abuse disorder. This is a onetime
542.16appropriation and is available until June 30,
542.172021. The grant is contingent on Wadena
542.18County providing to the commissioner of
542.19human services a plan to fund, operate, and
542.20sustain the program and services after the
542.21onetime state grant is expended. Wadena
542.22County must outline the proposed funding
542.23stream or mechanism, and any necessary local
542.24funding commitment, which will ensure the
542.25program will result in a sustainable program.
542.26The funding stream may include state funding
542.27for programs and services for which the
542.28individuals served under this paragraph may
542.29be eligible. The commissioner of human
542.30services, in collaboration with Wadena
542.31County, may explore a plan for continued
542.32funding using existing appropriations through
542.33eligibility for group residential housing under
542.34Minnesota Statutes, chapter 256I.
542.35The peer-run respite center must:
543.1(1) admit individuals who are in need of peer
543.2support and supportive services while
543.3addressing an increase in symptoms or
543.4stressors or exacerbation of their mental health
543.5or substance abuse;
543.6(2) admit individuals to reside at the center on
543.7a short-term basis, no longer than five days;
543.8(3) be operated by a nonprofit organization;
543.9(4) employ individuals who have personal
543.10experience with mental health or co-occurring
543.11substance abuse conditions who meet the
543.12qualifications of a mental health certified peer
543.13specialist under Minnesota Statutes, section
543.14256B.0615, or a recovery peer;
543.15(5) provide at least three but no more than six
543.16beds in private rooms; and
543.17(6) not provide clinical services.
543.18By November 1, 2018, the commissioner of
543.19human services, in consultation with Wadena
543.20County, shall report to the committees in the
543.21senate and house of representatives with
543.22jurisdiction over mental health issues, the
543.23status of planning and development of the
543.24peer-run respite center, and the plan to
543.25financially support the program and services
543.26after the state grant is expended.
543.27(b) Housing Options for Persons with
543.28Serious Mental Illness. $1,250,000 in fiscal
543.29year 2018 and $1,250,000 in fiscal year 2019
543.30are from the general fund for adult mental
543.31health grants under Minnesota Statutes, section
543.32245.4661, subdivision 9, paragraph (a), clause
543.33(2), to support increased availability of
543.34housing options with supports for persons with
544.1serious mental illness. This is a onetime
544.2appropriation.
544.3(c) Assertive Community Treatment.
544.4$500,000 in fiscal year 2018 and $500,000 in
544.5fiscal year 2019 are from the general fund for
544.6adult mental health grants under Minnesota
544.7Statutes, section 256B.0622, subdivision 12,
544.8to expand assertive community treatment
544.9services. This is a onetime appropriation.
544.10(d) Mental Health Crisis Services.
544.11$1,000,000 in fiscal year 2018 and $1,000,000
544.12in fiscal year 2019 are from the general fund
544.13for adult mental health grants under Minnesota
544.14Statutes, section 245.4661, and children's
544.15mental health grants under Minnesota Statutes,
544.16section 245.4889, to expand mental health
544.17crisis services, including:
544.18(1) mobile crisis services;
544.19(2) residential crisis services;
544.20(3) colocation of mobile crisis services in
544.21urgent care clinics and psychiatric emergency
544.22departments; and
544.23(4) development of co-responder mental health
544.24crisis response models.
544.25This is a onetime appropriation.
544.26(e) Housing with Supports. $750,000 in fiscal
544.27year 2018 and $750,000 in fiscal year 2019
544.28are for the housing with supports for adults
544.29with serious mental illness grant under
544.30Minnesota Statutes, section 245.4661,
544.31subdivision 9, paragraph (a), clause (2). This
544.32is a onetime appropriation.
545.1(f) Base Level Adjustment. The general fund
545.2base is $79,802,000 in fiscal year 2020 and
545.3$79,802,000 in fiscal year 2021.

545.4 545.5

Subd. 31.Grant Programs; Child Mental Health Grants

23,050,000

22,458,000

545.6(a) Children's Mental Health Collaborative
545.7Grants. $600,000 in fiscal year 2018 and
545.8$600,000 in fiscal year 2019 are for a grant
545.9for a rural multicounty demonstration project
545.10to assist transition-aged youth and young
545.11adults with emotional behavioral disturbance
545.12or mental illnesses in making a successful
545.13transition into adulthood. This is a onetime
545.14appropriation.
545.15Children's mental health collaboratives under
545.16Minnesota Statutes, section 245.493, are
545.17eligible to apply for the grant under this
545.18paragraph. The commissioner shall solicit
545.19proposals and award the grant to one proposal
545.20that best meets the requirement that a
545.21demonstration project must:
545.22(1) build on and streamline transition services
545.23by identifying rural youth 15 to 25 years of
545.24age currently in the mental health system or
545.25with emerging mental health conditions;
545.26(2) support youth to achieve, within the youth's
545.27potential, personal goals in employment,
545.28education, housing, and community life
545.29functioning;
545.30(3) provide individualized motivational
545.31coaching;
545.32(4) build on needed social supports;
545.33(5) demonstrate how services can be enhanced
545.34for youth to successfully navigate the
546.1complexities associated with their unique
546.2needs;
546.3(6) use all available funding streams;
546.4(7) demonstrate collaboration with the local
546.5children's mental health collaborative in
546.6designing and implementing the demonstration
546.7project;
546.8(8) evaluate the effectiveness of the project
546.9by specifying and measuring outcomes
546.10showing the level of progress for involved
546.11youth; and
546.12(9) compare differences in outcomes and costs
546.13to youth without previous access to this
546.14project.
546.15By January 15, 2019, the commissioner shall
546.16report to the legislative committees with
546.17jurisdiction over mental health issues on the
546.18status and outcomes of the demonstration
546.19project. The children's mental health
546.20collaborative administering the demonstration
546.21project shall collect and report outcome data,
546.22as requested by the commissioner, to support
546.23the development of the report.
546.24(b) First Psychotic Episode Funding.
546.25$750,000 in fiscal year 2018 and $750,000 in
546.26fiscal year 2019 are for grants under
546.27Minnesota Statutes, section 245.4889,
546.28subdivision 1, paragraph (b), clause (15).
546.29Funding shall be used to:
546.30(1) provide intensive treatment and supports
546.31to adolescents and adults experiencing or at
546.32risk of a first psychotic episode. Intensive
546.33treatment and support includes medication
546.34management, psychoeducation for the
547.1individual and family, case management,
547.2employment supports, education supports,
547.3cognitive behavioral approaches, social skills
547.4training, peer support, crisis planning, and
547.5stress management. Projects must use all
547.6available funding streams;
547.7(2) conduct outreach, training, and guidance
547.8to mental health and health care professionals,
547.9including postsecondary health clinics, on
547.10early psychosis symptoms, screening tools,
547.11and best practices; and
547.12(3) ensure access to first psychotic episode
547.13psychosis services under this section,
547.14including ensuring access for individuals who
547.15live in rural areas. Funds may be used to pay
547.16for housing or travel or to address other
547.17barriers to individuals and their families
547.18participating in first psychotic episode
547.19services.
547.20(c) Children's School-Linked Mental Health
547.21Grants. $2,000,000 in fiscal year 2018 and
547.22$2,000,000 in fiscal year 2019 are for
547.23children's school-linked mental health grants
547.24under Minnesota Statutes, section 245.4889,
547.25subdivision 1, paragraph (b), clause (8), to
547.26expand services to school districts or counties
547.27in which school-linked mental health services
547.28are not available and to fund transportation
547.29for children using school-linked mental health
547.30services when school is not in session. The
547.31commissioner shall require grantees to use all
547.32available third-party reimbursement sources
547.33as a condition of the receipt of grant funds.
547.34For purposes of this appropriation, a
547.35third-party reimbursement source does not
548.1include a public school under Minnesota
548.2Statutes, section 120A.20, subdivision 1.
548.3(d) Respite Care Services. $282,000 in fiscal
548.4year 2018 and $282,000 in fiscal year 2019
548.5are for children's mental health grants under
548.6Minnesota Statutes, section 245.4889,
548.7subdivision 1, paragraph (b), clause (3), to
548.8provide respite care services to families of
548.9children with serious mental illness. This is a
548.10onetime appropriation.
548.11(e) Text Message Suicide Prevention and
548.12Mental Health Crisis Response Program.
548.13$657,000 in fiscal year 2018 is from the
548.14general fund for a grant to a nonprofit to make
548.15the text message suicide prevention and mental
548.16health crisis response program available
548.17statewide. This is a onetime appropriation.
548.18The nonprofit shall use grant funds to:
548.19(1) operate the text message suicide prevention
548.20and mental health crisis response program
548.21statewide and provide a method of response
548.22that triages inquiries, provides immediate
548.23access to suicide prevention and crisis
548.24counseling over the telephone or via text
548.25messaging, and provides individual, family,
548.26or community education;
548.27(2) connect individuals with trained crisis
548.28counselors and access to local resources,
548.29including referrals to community mental health
548.30options, emergency departments, and locally
548.31available mobile crisis teams, when
548.32appropriate;
548.33(3) maximize availability of services and
548.34access across the state, in conjunction with
549.1other suicide prevention programs and
549.2services; and
549.3(4) provide community education on the
549.4availability of the program and how to access
549.5the program.
549.6(f) Base Level Adjustment. The general fund
549.7base is $20,826,000 in fiscal year 2020 and
549.8$20,826,000 in fiscal year 2021.

549.9 549.10

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

549.11	Appropriations by Fund
549.12	General	2,636,000	2,636,000
549.13	Lottery Prize	1,733,000	1,733,000

549.14(a) Problem Gambling. $225,000 in fiscal
549.15year 2018 and $225,000 in fiscal year 2019
549.16are from the lottery prize fund for a grant to
549.17the state affiliate recognized by the National
549.18Council on Problem Gambling. The affiliate
549.19must provide services to increase public
549.20awareness of problem gambling, education,
549.21and training for individuals and organizations
549.22providing effective treatment services to
549.23problem gamblers and their families, and
549.24research related to problem gambling.
549.25(b) Minnesota Organization on Fetal
549.26Alcohol Syndrome. $500,000 in fiscal year
549.272018 and $500,000 in fiscal year 2019 are for
549.28a grant to the Minnesota Organization on Fetal
549.29Alcohol Syndrome (MOFAS). This is a
549.30onetime appropriation. Of this amount,
549.31MOFAS shall make grants to eligible regional
549.32collaboratives that fulfill the requirements in
549.33this paragraph. "Eligible regional
549.34collaboratives" means a partnership between
549.35at least one local government and at least one
550.1community-based organization and, where
550.2available, a family home visiting program. For
550.3purposes of this paragraph, a local government
550.4includes a county or multicounty organization,
550.5a tribal government, a county-based
550.6purchasing entity, or a community health
550.7board. Eligible regional collaboratives must
550.8use grant funds to reduce the incidence of fetal
550.9alcohol syndrome disorders and other prenatal
550.10drug-related effects in children in Minnesota
550.11by identifying and serving pregnant women
550.12suspected of or known to use or abuse alcohol
550.13or other drugs. The eligible regional
550.14collaboratives must provide intensive services
550.15to chemically dependent women to increase
550.16positive birth outcomes. MOFAS must make
550.17grants to eligible regional collaboratives from
550.18both rural and urban areas. A grant recipient
550.19must report to the commissioner of human
550.20services annually by January 15 on the
550.21services and programs funded by the
550.22appropriation. The report must include
550.23measurable outcomes for the previous year,
550.24including the number of pregnant women
550.25served and the number of toxic-free babies
550.26born.
550.27(c) Base Level Adjustment. The general fund
550.28base is $2,136,000 in fiscal year 2020 and
550.29$2,136,000 in fiscal year 2021.

550.30

Subd. 33.Direct Care and Treatment - Generally

550.31(a) Transfer Authority. Money appropriated
550.32to budget activities under subdivisions 34, 35,
550.3336, 37, and 38 may be transferred between
550.34budget activities and between years of the
551.1biennium with the approval of the
551.2commissioner of management and budget.
551.3(b) Dedicated Receipts Available. Of the
551.4revenue received under Minnesota Statutes,
551.5section 246.18, subdivision 8, paragraph (a),
551.6up to $1,000,000 each year is available for the
551.7purposes of Minnesota Statutes, section
551.8246.18, subdivision 8, paragraph (b), clause
551.9(1); and up to $2,713,000 each year is
551.10available for the purposes of Minnesota
551.11Statutes, section 246.18, subdivision 8,
551.12paragraph (b), clause (2).

551.13 551.14

Subd. 34.Direct Care and Treatment - Mental Health and Substance Abuse

114,521,000

114,607,000

551.15(a) Child and Adolescent Behavioral Health
551.16Services. $405,000 in fiscal year 2018 and
551.17$491,000 in fiscal year 2019 are to continue
551.18to operate the child and adolescent behavioral
551.19health services program under Minnesota
551.20Statutes, section 246.014. This is a onetime
551.21appropriation.
551.22(b) Base Level Adjustment. The general fund
551.23base is $114,116,000 in fiscal year 2020 and
551.24$114,116,000 in fiscal year 2021.

551.25 551.26

Subd. 35.Direct Care and Treatment - Community-Based Services

15,298,000

15,298,000

551.27 551.28

Subd. 36.Direct Care and Treatment - Forensic Services

91,658,000

91,675,000

551.29 551.30

Subd. 37.Direct Care and Treatment - Sex Offender Program

86,731,000

86,731,000

551.31Transfer Authority. Money appropriated for
551.32the Minnesota sex offender program may be
551.33transferred between fiscal years of the
551.34biennium with the approval of the
551.35commissioner of management and budget.

552.1 552.2

Subd. 38.Direct Care and Treatment - Operations

42,744,000

42,744,000

552.3

Subd. 39.Technical Activities

86,186,000

86,339,000

552.4(a) This appropriation is from the federal
552.5TANF fund.
552.6(b) Base Level Adjustment. The TANF fund
552.7base is $86,346,000 in fiscal year 2020 and
552.8$86,355,000 in fiscal year 2021.

552.9

Sec. 3. COMMISSIONER OF HEALTH

552.10

Subdivision 1.Total Appropriation

$

206,445,000

$

198,015,000

552.11	Appropriations by Fund
552.12		2018	2019
552.13	General	105,966,000	98,389,000
552.14 552.15	State Government Special Revenue	52,356,000	52,090,000
552.16	Health Care Access	37,566,000	36,979,000
552.17	Federal TANF	10,557,000	10,557,000

552.18The amounts that may be spent for each
552.19purpose are specified in the following
552.20subdivisions.

552.21

Subd. 2.Health Improvement

552.22	Appropriations by Fund
552.23	General	83,839,000	76,336,000
552.24 552.25	State Government Special Revenue	6,215,000	6,182,000
552.26	Health Care Access	37,566,000	36,979,000
552.27	Federal TANF	10,557,000	10,557,000

552.28(a) TANF Appropriations. (1) $3,579,000
552.29of the TANF fund each year is for home
552.30visiting and nutritional services listed under
552.31Minnesota Statutes, section 145.882,
552.32subdivision 7, clauses (6) and (7). Funds must
552.33be distributed to community health boards
552.34according to Minnesota Statutes, section
552.35145A.131, subdivision 1.
553.1(2) $2,000,000 of the TANF fund each year
553.2is for decreasing racial and ethnic disparities
553.3in infant mortality rates under Minnesota
553.4Statutes, section 145.928, subdivision 7.
553.5(3) $4,978,000 of the TANF fund each year
553.6is for the family home visiting grant program
553.7according to Minnesota Statutes, section
553.8145A.17. $4,000,000 of the funding must be
553.9distributed to community health boards
553.10according to Minnesota Statutes, section
553.11145A.131, subdivision 1. $978,000 of the
553.12funding must be distributed to tribal
553.13governments according to Minnesota Statutes,
553.14section 145A.14, subdivision 2a.
553.15(4) The commissioner may use up to 6.23
553.16percent of the funds appropriated each year to
553.17conduct the ongoing evaluations required
553.18under Minnesota Statutes, section 145A.17,
553.19subdivision 7, and training and technical
553.20assistance as required under Minnesota
553.21Statutes, section 145A.17, subdivisions 4 and
553.225.
553.23(b) TANF Carryforward. Any unexpended
553.24balance of the TANF appropriation in the first
553.25year of the biennium does not cancel but is
553.26available for the second year.
553.27(c) Evidence-Based Home Visiting.
553.28$1,500,000 in fiscal year 2018 and $1,500,000
553.29in fiscal year 2019 are from the general fund
553.30to provide start-up and expansion grants to
553.31community health boards, nonprofit
553.32organizations, and tribal nations to start up or
553.33expand evidence-based home visiting
553.34programs. Grant funds must be used to start
553.35up or expand evidence-based home visiting
554.1programs in the county, reservation, or region
554.2to serve families, such as parents with high
554.3risk or high needs, parents with a history of
554.4mental illness, domestic abuse, or substance
554.5abuse, or first-time mothers prenatally until
554.6the child is four years of age, who are eligible
554.7for medical assistance under Minnesota
554.8Statutes, chapter 256B, or the federal Special
554.9Supplemental Nutrition Program for Women,
554.10Infants, and Children. The commissioner shall
554.11award grants to community health boards,
554.12nonprofits, or tribal nations in metropolitan
554.13and rural areas of the state. Priority for grants
554.14to rural areas shall be given to community
554.15health boards, nonprofits, and tribal nations
554.16that expand services within regional
554.17partnerships that provide the evidence-based
554.18home visiting programs. This funding shall
554.19only be used to supplement, not to replace,
554.20funds being used for evidence-based home
554.21visiting services as of June 30, 2017. The
554.22general fund base for these grants is $750,000
554.23in fiscal year 2020 and $750,000 in fiscal year
554.242021.
554.25(d) Safe Harbor for Sexually Exploited
554.26Youth Services. $325,000 in fiscal year 2018
554.27and $325,000 in fiscal year 2019 are from the
554.28general fund for trauma-informed, culturally
554.29specific services for sexually exploited youth.
554.30Youth 24 years of age or younger are eligible
554.31for services under this paragraph.
554.32(e) Safe Harbor Program Technical
554.33Assistance and Evaluation. $225,000 in
554.34fiscal year 2018 and $225,000 in fiscal year
554.352019 are from the general fund for training,
555.1technical assistance, protocol implementation,
555.2and evaluation activities related to the safe
555.3harbor program. Of these amounts:
555.4(1) $100,000 each fiscal year is for providing
555.5training and technical assistance to individuals
555.6and organizations that provide safe harbor
555.7services and receive funds for that purpose
555.8from the commissioner of human services or
555.9commissioner of health;
555.10(2) $100,000 each fiscal year is for protocol
555.11implementation, which includes providing
555.12technical assistance in establishing best
555.13practices-based systems for effectively
555.14identifying, interacting with, and referring
555.15sexually exploited youth to appropriate
555.16resources; and
555.17(3) $25,000 each fiscal year is for program
555.18evaluation activities in compliance with
555.19Minnesota Statutes, section 145.4718.
555.20(f) Promoting Safe Harbor Capacity. In
555.21funding services and activities under
555.22paragraphs (d) and (e), the commissioner shall
555.23emphasize activities that promote
555.24capacity-building and development of
555.25resources in greater Minnesota.
555.26(g) Administration of Safe Harbor
555.27Program. $60,000 in fiscal year 2018 and
555.28$60,000 in fiscal year 2019 are for
555.29administration of the safe harbor for sexually
555.30exploited youth program.
555.31(h) Palliative Care Advisory Council.
555.32$44,000 in fiscal year 2018 and $44,000 in
555.33fiscal year 2019 are from the general fund for
556.1the Palliative Care Advisory Council under
556.2Minnesota Statutes, section 144.059.
556.3(i) Grants for Drug Deactivation and
556.4Disposal. $500,000 in fiscal year 2018 and
556.5$500,000 in fiscal year 2019 are from the
556.6general fund to provide grants to pharmacists
556.7and other prescription drug dispensers, local
556.8public health and human services agencies,
556.9local law enforcement, health care providers,
556.10and other entities to purchase
556.11omni-degradable, at-home prescription drug
556.12deactivation and disposal products to assist
556.13the public in the disposal of prescription drugs
556.14in a safe, environmentally sound manner. A
556.15grant recipient must provide these deactivation
556.16and disposal products free of charge to
556.17members of the public. This is a onetime
556.18appropriation.
556.19(j) Early Dental Disease Prevention Pilot
556.20Program. $500,000 in fiscal year 2018 and
556.21$500,000 in fiscal year 2019 are from the
556.22general fund for early dental disease
556.23prevention and awareness activities under
556.24Minnesota Statutes, section 144.061. This is
556.25a onetime appropriation. Funding shall be used
556.26to:
556.27(1) award grants to five designated
556.28communities of color or communities of recent
556.29immigrants to participate in a pilot program
556.30to increase awareness and encourage early
556.31preventive dental disease intervention for
556.32infants and toddlers. At least two of the
556.33designated communities receiving grants under
556.34this clause must be located outside the
556.35seven-county metropolitan area;
557.1(2) in consultation with members of the
557.2designated communities, distribute or cause
557.3to be distributed the educational materials
557.4developed under Minnesota Statutes, section
557.5144.061, paragraph (b), to expectant and new
557.6parents within the designated communities.
557.7The materials shall be distributed as provided
557.8in Minnesota Statutes, section 144.061,
557.9paragraph (c), and through a variety of
557.10communicative means, including oral, visual,
557.11audio, and print. The commissioner shall assist
557.12designated communities with developing
557.13strategies, including outreach through ethnic
557.14radio, Webcasts, and local cable programs,
557.15and incentives to ensure the educational
557.16materials and information are distributed and
557.17to encourage and provide early preventive
557.18dental disease intervention and care for infants
557.19and toddlers that are geared toward the ethnic
557.20groups residing in the designated community;
557.21(3) develop measurable outcomes, establish a
557.22baseline measurement, and evaluate
557.23performance within each designated
557.24community to measure whether the
557.25educational materials, information, strategies,
557.26and incentives increased the number of infants
557.27and toddlers receiving early preventative
557.28dental disease intervention and care; and
557.29(4) by March 15, 2019, report to the chairs
557.30and ranking minority members of the
557.31legislative committees with jurisdiction over
557.32health care on the details of the program
557.33funded under this paragraph, communities
557.34designated for the program, strategies and any
558.1incentives implemented, and the results of the
558.2evaluation for each designated community.
558.3(k) Minnesota Biomedicine and Bioethics
558.4Innovation Grants. $5,000,000 in fiscal year
558.52018 is from the general fund for Minnesota
558.6biomedicine and bioethics innovation grants
558.7under Minnesota Statutes, section 144.88. This
558.8is a onetime appropriation and is available
558.9until June 30, 2021.
558.10(l) Statewide Strategic Plan for Victims of
558.11Sex Trafficking. $73,000 in fiscal year 2018
558.12is from the general fund for the development
558.13of a comprehensive statewide strategic plan
558.14and report to address the needs of sex
558.15trafficking victims statewide. This is a onetime
558.16appropriation.
558.17(m) Statewide Tobacco Quitline Service. Of
558.18the health care access fund appropriation for
558.19the statewide health improvement program,
558.20$461,000 in fiscal year 2018 and $2,969,000
558.21in fiscal year 2019 are for administering or
558.22contracting for the administration of the
558.23statewide tobacco quitline service established
558.24under Minnesota Statutes, section 144.397.
558.25(n) Home and Community-Based Services
558.26Employee Scholarship Program. $1,000,000
558.27in fiscal year 2018 and $1,000,000 in fiscal
558.28year 2019 are from the general fund for the
558.29home and community-based services
558.30employee scholarship program under
558.31Minnesota Statutes, section 144.1503.
558.32(o) Comprehensive Advanced Life Support
558.33Educational Program. $100,000 in fiscal
558.34year 2018 and $100,000 in fiscal year 2019
559.1are from the general fund for the
559.2comprehensive advanced life support
559.3educational program under Minnesota Statutes,
559.4section 144.6062. This is a onetime
559.5appropriation.
559.6(p) Senior Care Workforce Innovation
559.7Grant Program. $1,000,000 in fiscal year
559.82018 and $1,000,000 in fiscal year 2019 are
559.9from the general fund for the senior care
559.10workforce innovation grant program under
559.11Minnesota Statutes, section 144.1504.
559.12(q) Physician Residency Expansion Grant
559.13Program. $1,500,00 in fiscal year 2018 and
559.14$1,500,000 in fiscal 2019 are from the health
559.15care access fund for the physician residency
559.16expansion grant program under Minnesota
559.17Statutes, section 144.1506.
559.18(r) Opioid Abuse Prevention. $2,028,000 in
559.19fiscal year 2018 is to establish accountable
559.20community for health opioid abuse prevention
559.21pilot projects. $28,000 of this amount is for
559.22administration. This is a onetime
559.23appropriation.
559.24(s) Opioid Prescriber Education. $535,000
559.25in fiscal year 2018 and $535,000 in fiscal year
559.262019 are for opioid prescriber education and
559.27public awareness grants under Minnesota
559.28Statutes, section 145.9263. $35,000 in fiscal
559.29year 2018 and $35,000 in fiscal year 2019 are
559.30for administration.
559.31(t) Advanced Care Planning. $500,000 in
559.32fiscal year 2018 and $500,000 in fiscal year
559.332019 are from the general fund for a grant to
559.34a statewide advanced care planning resource
560.1organization that has expertise in convening
560.2and coordinating community-based strategies
560.3to encourage individuals, families, caregivers,
560.4and health care providers to begin
560.5conversations regarding end-of-life care
560.6choices that express an individual's health care
560.7values and preferences and are based on
560.8informed health care decisions. Of this
560.9amount, $9,000 each year is for administration.
560.10(u) Health Professionals Clinical Training
560.11Expansion Grant Program. $1,000,000 in
560.12fiscal year 2018 and $1,000,000 in fiscal year
560.132019 are from the general fund for the primary
560.14care and mental health professions clinical
560.15training expansion grant program under
560.16Minnesota Statutes, section 144.1505.
560.17(v) Youth Sports Concussion Working
560.18Group and Brain Health Pilot Programs.
560.19$450,000 in fiscal year 2018 is from the
560.20general fund for the youth sports concussion
560.21working group and brain health pilot
560.22programs. This is a onetime appropriation. Of
560.23this appropriation:
560.24(1) $150,000 is for the youth sports concussion
560.25working group, including any required
560.26incidence research; and
560.27(2) $300,000 is for the brain health pilot
560.28programs.
560.29(w) Base Level Adjustments. The general
560.30fund base is $74,436,000 in fiscal year 2020
560.31and $74,486,000 in fiscal year 2021. The
560.32health care access fund base is $37,579,000
560.33in fiscal year 2020 and $36,979,000 in fiscal
560.34year 2021.

561.1

Subd. 3.Health Protection

561.2	Appropriations by Fund
561.3	General	14,552,000	14,478,000
561.4 561.5	State Government Special Revenue	46,141,000	45,908,000

561.6(a) Prescribed Pediatric Extended Care
561.7Center Licensure Activities. $64,000 in fiscal
561.8year 2018 and $17,000 in fiscal year 2019 are
561.9from the state government special revenue
561.10fund for licensure of prescribed pediatric
561.11extended care centers under Minnesota
561.12Statutes, chapter 144H.
561.13(b) Vulnerable Adults in Health Care
561.14Settings. $633,000 in fiscal year 2018 and
561.15$559,000 in fiscal year 2019 are from the
561.16general fund for regulating health care and
561.17home care settings.
561.18(c) Base Level Adjustment. The general fund
561.19base is $14,867,000 in fiscal year 2020 and
561.20$14,777,000 in fiscal year 2021. The state
561.21government special revenue fund base is
561.22$45,881,000 in fiscal year 2020 and
561.23$45,873,000 in fiscal year 2021.

561.24

Subd. 4.Health Operations

7,575,000

7,575,000

561.25

Sec. 4. HEALTH-RELATED BOARDS

561.26

Subdivision 1.Total Appropriation

$

24,986,000

$

23,279,000

561.27This appropriation is from the state
561.28government special revenue fund. The
561.29amounts that may be spent for each purpose
561.30are specified in the following subdivisions.

561.31

Subd. 2.Board of Chiropractic Examiners

565,000

571,000

562.1Base Level Adjustment. The base is $576,000
562.2in fiscal year 2020 and $576,000 in fiscal year
562.32021.

562.4

Subd. 3.Board of Dentistry

1,396,000

1,408,000

562.5 562.6

Subd. 4.Board of Dietetics and Nutrition Practice

130,000

132,000

562.7

Subd. 5.Board of Marriage and Family Therapy

360,000

357,000

562.8Base Level Adjustment. The base is $360,000
562.9in fiscal year 2020 and $362,000 in fiscal year
562.102021.

562.11

Subd. 6.Board of Medical Practice

5,194,000

5,330,000

562.12This appropriation includes $964,000 in fiscal
562.13year 2018 and $964,000 in fiscal year 2019
562.14for the health professional services program.
562.15The base for this program is $924,000 in fiscal
562.16year 2020 and $924,000 in fiscal year 2021.
562.17Base Level Adjustment. The base is
562.18$5,292,000 in fiscal year 2020 and $5,292,000
562.19in fiscal year 2021.

562.20

Subd. 7.Board of Nursing

6,380,000

4,783,000

562.21

Subd. 8.Board of Nursing Home Administrators

3,397,000

3,202,000

562.22(a) Administrative Services Unit - Operating
562.23Costs. Of this appropriation, $2,260,000 in
562.24fiscal year 2018 and $2,287,000 in fiscal year
562.252019 are for operating costs of the
562.26administrative services unit. The
562.27administrative services unit may receive and
562.28expend reimbursements for services it
562.29performs for other agencies.
562.30(b) Administrative Services Unit - Volunteer
562.31Health Care Provider Program. Of this
562.32appropriation, $150,000 in fiscal year 2018
562.33and $150,000 in fiscal year 2019 are to pay
562.34for medical professional liability coverage
563.1required under Minnesota Statutes, section
563.2214.40.
563.3(c) Administrative Services Unit -
563.4Retirement Costs. Of this appropriation,
563.5$378,000 in fiscal year 2019 is a onetime
563.6appropriation to the administrative services
563.7unit to pay for the retirement costs of
563.8health-related board employees. This funding
563.9may be transferred to the health board
563.10incurring retirement costs. Any board that has
563.11an unexpended balance for an amount
563.12transferred under this paragraph shall transfer
563.13the unexpended amount to the administrative
563.14services unit. These funds are available either
563.15year of the biennium.
563.16(d) Administrative Services Unit -
563.17Health-Related Licensing Boards Operating
563.18Costs. Of this appropriation, $194,000 in
563.19fiscal year 2018 and $350,000 in fiscal year
563.202019 shall be transferred to the health-related
563.21boards funded under this section for operating
563.22costs. The administrative services unit shall
563.23determine transfer amounts in consultation
563.24with the health-related boards funded under
563.25this section.
563.26(e) Administrative Services Unit - Contested
563.27Cases and Other Legal Proceedings. Of this
563.28appropriation, $200,000 in fiscal year 2018
563.29and $200,000 in fiscal year 2019 are for costs
563.30of contested case hearings and other
563.31unanticipated costs of legal proceedings
563.32involving health-related boards funded under
563.33this section. Upon certification by a
563.34health-related board to the administrative
563.35services unit that costs will be incurred and
564.1that there is insufficient money available to
564.2pay for the costs out of money currently
564.3available to that board, the administrative
564.4services unit is authorized to transfer money
564.5from this appropriation to the board for
564.6payment of those costs with the approval of
564.7the commissioner of management and budget.
564.8The commissioner of management and budget
564.9must require any board that has an unexpended
564.10balance for an amount transferred under this
564.11paragraph to transfer the unexpended amount
564.12to the administrative services unit to be
564.13deposited in the state government special
564.14revenue fund.

564.15

Subd. 9.Board of Optometry

156,000

157,000

564.16

Subd. 10.Board of Pharmacy

3,124,000

3,164,000

564.17Base Level Adjustment. The base is
564.18$3,189,000 in fiscal year 2020 and $3,226,000
564.19in fiscal year 2021.

564.20

Subd. 11.Board of Physical Therapy

521,000

522,000

564.21Base Level Adjustment. The base is $524,000
564.22in fiscal year 2020 and $526,000 in fiscal year
564.232021.

564.24

Subd. 12.Board of Podiatric Medicine

204,000

204,000

564.25

Subd. 13.Board of Psychology

1,220,000

1,240,000

564.26Base Level Adjustment. The base is
564.27$1,247,000 in fiscal year 2020 and $1,247,000
564.28in fiscal year 2021.

564.29

Subd. 14.Board of Social Work

1,254,000

1,246,000

564.30Base Level Adjustment. The base is
564.31$1,248,000 in fiscal year 2020 and $1,250,000
564.32in fiscal year 2021.

564.33

Subd. 15.Board of Veterinary Medicine

314,000

320,000

565.1Base Level Adjustment. The base is $327,000
565.2in fiscal year 2020 and $333,000 in fiscal year
565.32021.

565.4 565.5

Subd. 16.Board of Behavioral Health and Therapy

771,000

643,000

565.6 565.7

Subd. 17.Board of Occupational Therapy Practice

374,000

328,000

565.8 565.9

Sec. 5. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

4,509,000

$

4,438,000

565.10(a) Cooper/Sams Volunteer Ambulance
565.11Program. $1,300,000 in fiscal year 2018 and
565.12$1,300,000 in fiscal year 2019 are for the
565.13Cooper/Sams volunteer ambulance program
565.14under Minnesota Statutes, section 144E.40.
565.15The base for this program is $700,000 in fiscal
565.16year 2020 and $700,000 in fiscal year 2021.
565.17(1) Of this amount, $1,211,000 in fiscal year
565.182018 and $1,211,000 in fiscal year 2019 are
565.19for the ambulance service personnel longevity
565.20award and incentive program under Minnesota
565.21Statutes, section 144E.40. The base for this
565.22program is $611,000 in fiscal year 2020 and
565.23$611,000 in fiscal year 2021.
565.24(2) Of this amount, $89,000 in fiscal year 2018
565.25and $89,000 in fiscal year 2019 are for the
565.26operations of the ambulance service personnel
565.27longevity award and incentive program under
565.28Minnesota Statutes, section 144E.40.
565.29(b) EMSRB Board Operations. $1,360,000
565.30in fiscal year 2018 and $1,360,000 in fiscal
565.31year 2019 are for board operations.
565.32(c) Regional Grants. $585,000 in fiscal year
565.332018 and $585,000 in fiscal year 2019 are for
565.34regional emergency medical services
566.1programs, to be distributed equally to the eight
566.2emergency medical service regions under
566.3Minnesota Statutes, section 144E.50.
566.4(d) Ambulance Training Grant. $361,000
566.5in fiscal year 2018 and $361,000 in fiscal year
566.62019 are for training grants under Minnesota
566.7Statutes, section 144E.35.
566.8(e) Base Level Adjustment. The base is
566.9$3,840,000 in fiscal year 2020 and $3,840,000
566.10in fiscal year 2021.

566.11

Sec. 6. COUNCIL ON DISABILITY

$

1,002,000

$

1,002,000

566.12Base Level Adjustment. The base is $966,000
566.13in fiscal year 2020 and $968,000 in fiscal year
566.142021.

566.15 566.16 566.17

Sec. 7. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

2,407,000

$

2,427,000

566.18Department of Psychiatry Monitoring.
566.19$100,000 in fiscal year 2018 and $100,000 in
566.20fiscal year 2019 are for monitoring the
566.21Department of Psychiatry at the University of
566.22Minnesota.

566.23

Sec. 8. OMBUDSPERSONS FOR FAMILIES

$

543,000

$

551,000

566.24

Sec. 9. COMMISSIONER OF COMMERCE

$

1,194,000

$

1,194,000

566.25Base Level Adjustment. The base for this
566.26appropriation is $1,194,000 in fiscal year 2020
566.27and $594,000 in fiscal year 2021.

566.28    Sec. 10. Laws 2009, chapter 101, article 1, section 12, is amended to read:

566.29

Sec. 12. ADMINISTRATION

566.30

Subdivision 1.Total Appropriation

$

19,973,000

$

19,617,000

566.31	Appropriations by Fund
567.1		2010	2011
567.2	General	19,723,000	19,617,000
567.3 567.4	Special Revenue Fund	250,000	0

567.5The amounts that may be spent for each
567.6purpose are specified in the following
567.7subdivisions.

567.8

Subd. 2.Government and Citizen Services

18,097,000

17,766,000

567.9	Appropriations by Fund
567.10	General	17,847,000	17,766,000
567.11 567.12	Special Revenue Fund	250,000	0

567.13(a) $802,000 the first year and $802,000 the
567.14second year are for the Minnesota Geospatial
567.15Information Office. Of the total appropriation,
567.16$10,000 per year is intended for preparation
567.17of township acreage data in Laws 2008,
567.18chapter 366, article 17, section 7, subdivision
567.193.
567.20(b) $74,000 the first year and $74,000 the
567.21second year are for the Council on
567.22Developmental Disabilities.
567.23(c) $127,000 the first year and $127,000 the
567.24second year are for transfer to the
567.25commissioner of human services for a grant
567.26to the Council on Developmental Disabilities
567.27for the purpose of establishing a statewide
567.28self-advocacy network for persons with
567.29intellectual and developmental disabilities
567.30(ID/DD). The self-advocacy network shall:
567.31(1) ensure that persons with ID/DD are
567.32informed of their rights in employment,
567.33housing, transportation, voting, government
567.34policy, and other issues pertinent to the ID/DD
567.35community; (2) provide public education and
568.1awareness of the civil and human rights issues
568.2persons with ID/DD face; (3) provide funds,
568.3technical assistance, and other resources for
568.4self-advocacy groups across the state; and (4)
568.5organize systems of communications to
568.6facilitate an exchange of information between
568.7self-advocacy groups. This appropriation must
568.8be included in the base budget for the
568.9commissioner of human services for the
568.10biennium beginning July 1, 2011.
568.11(d) $250,000 the first year and $170,000 the
568.12second year are to fund activities to prepare
568.13for and promote the 2010 census.
568.14(e) $206,000 the first year and $206,000 the
568.15second year are for the Office of the State
568.16Archaeologist.
568.17(f) $8,388,000 the first year and $8,388,000
568.18the second year are for office space costs of
568.19the legislature and veterans organizations, for
568.20ceremonial space, and for statutorily free
568.21space.
568.22(g) $3,500,000 of the balance in the facilities
568.23repair and replacement account in the special
568.24revenue fund is canceled to the general fund
568.25on July 1, 2009. This is a onetime cancellation.
568.26(h) The requirements imposed on the
568.27commissioner of finance and the commissioner
568.28of administration under Laws 2007, chapter
568.29148, article 1, section 12, subdivision 2,
568.30paragraph (b), relating to the savings
568.31attributable to the real property portfolio
568.32management system are inoperative.
568.33(i) $250,000 is appropriated to the
568.34commissioner of administration from the
569.1information and telecommunications account
569.2in the special revenue fund to continue
569.3planning for data center consolidation,
569.4including beginning a predesign study and
569.5lifecycle cost analysis, and exploring
569.6technologies to reduce energy consumption
569.7and operating costs.

569.8

Subd. 3.Administrative Management Support

1,876,000

1,851,000

569.9$125,000 each year is for the Office of Grant
569.10Management. During the biennium ending
569.11June 30, 2011, the commissioner must recover
569.12this amount through deductions in state grants
569.13subject to the jurisdiction of the office. The
569.14commissioner may not deduct more than 2.5
569.15percent from the amount of any grant. The
569.16amount deducted from appropriations for these
569.17grants must be deposited in the general fund.
569.18$25,000 the first year is for the Office of
569.19Grants Management to study and make
569.20recommendations on improving collaborative
569.21activities between the state, nonprofit entities,
569.22and the private sector, including: (1)
569.23recommendations for expanding successful
569.24initiatives involving not-for-profit
569.25organizations that have demonstrated
569.26measurable, positive results in addressing
569.27high-priority community issues; and (2)
569.28recommendations on grant requirements and
569.29design to encourage programs receiving grants
569.30to become self-sufficient. The office may
569.31appoint an advisory group to assist in the study
569.32and recommendations. The office must report
569.33its recommendations to the legislature by
569.34January 15, 2010.

570.1    Sec. 11. Laws 2012, chapter 247, article 6, section 2, subdivision 2, is amended to read:

570.2

Subd. 2.Central Office Operations

570.3

(a) Operations

118,000

356,000

570.4Base Level Adjustment. The general fund
570.5base is increased by $91,000 in fiscal year
570.62014 and $44,000 in fiscal year 2015.

570.7

(b) Health Care

24,000

346,000

570.8This is a onetime appropriation.
570.9Managed Care Audit Activities. In fiscal
570.10year 2014, and in each even-numbered year
570.11thereafter, the commissioner shall transfer
570.12from the health care access fund $1,740,000
570.13to the legislative auditor for managed care
570.14audit services under Minnesota Statutes,
570.15section 256B.69, subdivision 9d. This is a
570.16biennial appropriation. The health care access
570.17fund base is increased by $1,842,000 in fiscal
570.18year 2014. Notwithstanding any contrary
570.19provision in this article, this paragraph does
570.20not expire.

570.21

(c) Continuing Care

19,000

375,000

570.22Base Level Adjustment. The general fund
570.23base is decreased by $159,000 in fiscal years
570.242014 and 2015.
570.25EFFECTIVE DATE.This section is effective the day following final enactment.

570.26    Sec. 12. Laws 2013, chapter 108, article 15, section 2, subdivision 2, is amended to read:

570.27

Subd. 2.Central Office

570.28The amounts that may be spent from this
570.29appropriation for each purpose are as follows:

570.30

(a) Operations

2,909,000

8,957,000

571.1Base Adjustment. The general fund base is
571.2decreased by $8,916,000 in fiscal year 2016
571.3and $8,916,000 in fiscal year 2017.

571.4

(b) Children and Families

109,000

206,000

571.5

(c) Continuing Care

2,849,000

3,574,000

571.6Base Adjustment. The general fund base is
571.7decreased by $2,000 in fiscal year 2016 and
571.8by $27,000 in fiscal year 2017.

571.9

(d) Group Residential Housing

(1,166,000)

(8,602,000)

571.10

(e) Medical Assistance

(3,950,000)

(6,420,000)

571.11

(f) Alternative Care

(7,386,000)

(6,851,000)

571.12

(g) Child and Community Service Grants

3,000,000

3,000,000

571.13

(h) Aging and Adult Services Grants

5,365,000

5,936,000

571.14Gaps Analysis. In fiscal year 2014, and in
571.15each even-numbered year thereafter, $435,000
571.16is appropriated to conduct an analysis of gaps
571.17in long-term care services under Minnesota
571.18Statutes, section 144A.351. This is a biennial
571.19appropriation. The base is increased by
571.20$435,000 in fiscal year 2016. Notwithstanding
571.21any contrary provisions in this article, this
571.22provision does not expire.
571.23Base Adjustment. The general fund base is
571.24increased by $498,000 in fiscal year 2016, and
571.25decreased by $124,000 in fiscal year 2017.

571.26

(i) Disabilities Grants

414,000

414,000

571.27    Sec. 13. Laws 2015, chapter 71, article 14, section 3, subdivision 2, as amended by Laws
571.282015, First Special Session chapter 6, section 2, is amended to read:

571.29

Subd. 2.Health Improvement

571.30	Appropriations by Fund
571.31	General	68,653,000	68,984,000
571.32 571.33	State Government Special Revenue	6,264,000	6,182,000
572.1	Health Care Access	33,987,000	33,421,000
572.2	Federal TANF	11,713,000	11,713,000

572.3Violence Against Asian Women Working
572.4Group. $200,000 in fiscal year 2016 from the
572.5general fund is for the working group on
572.6violence against Asian women and children.
572.7MERC Program. $1,000,000 in fiscal year
572.82016 and $1,000,000 in fiscal year 2017 are
572.9from the general fund for the MERC program
572.10under Minnesota Statutes, section 62J.692,
572.11subdivision 4 .
572.12Poison Information Center Grants.
572.13$750,000 in fiscal year 2016 and $750,000 in
572.14fiscal year 2017 are from the general fund for
572.15regional poison information center grants
572.16under Minnesota Statutes, section 145.93.
572.17Advanced Care Planning. $250,000 in fiscal
572.18year 2016 is from the general fund to award
572.19a grant to a statewide advance care planning
572.20resource organization that has expertise in
572.21convening and coordinating community-based
572.22strategies to encourage individuals, families,
572.23caregivers, and health care providers to begin
572.24conversations regarding end-of-life care
572.25choices that express an individual's health care
572.26values and preferences and are based on
572.27informed health care decisions. This is a
572.28onetime appropriation.
572.29Early Dental Prevention Initiatives.
572.30$172,000 in fiscal year 2016 and $140,000 in
572.31fiscal year 2017 are for the development and
572.32distribution of the early dental prevention
572.33initiative under Minnesota Statutes, section
572.34144.3875 .
573.1International Medical Graduate Assistance
573.2Program. (a) $500,000 in fiscal year 2016
573.3and $500,000 in fiscal year 2017 are from the
573.4health care access fund for the grant programs
573.5and necessary contracts under Minnesota
573.6Statutes, section 144.1911, subdivisions 3,
573.7paragraph (a), clause (4), and 4 and 5. The
573.8commissioner may use up to $133,000 per
573.9year of the appropriation for international
573.10medical graduate assistance program
573.11administration duties in Minnesota Statutes,
573.12section 144.1911, subdivisions 3, 9, and 10,
573.13and for administering the grant programs
573.14under Minnesota Statutes, section 144.1911,
573.15subdivisions 4 , 5, and 6. The commissioner
573.16shall develop recommendations for any
573.17additional funding required for initiatives
573.18needed to achieve the objectives of Minnesota
573.19Statutes, section 144.1911. The commissioner
573.20shall report the funding recommendations to
573.21the legislature by January 15, 2016, in the
573.22report required under Minnesota Statutes,
573.23section 144.1911, subdivision 10. The base
573.24for this purpose is $1,000,000 in fiscal years
573.252018 and 2019.
573.26(b) $500,000 in fiscal year 2016 and $500,000
573.27in fiscal year 2017 are from the health care
573.28access fund for transfer to the revolving
573.29international medical graduate residency
573.30account established in Minnesota Statutes,
573.31section 144.1911, subdivision 6. This is a
573.32onetime appropriation.
573.33Federally Qualified Health Centers.
573.34$1,000,000 in fiscal year 2016 and $1,000,000
573.35in fiscal year 2017 are from the general fund
574.1to provide subsidies to federally qualified
574.2health centers under Minnesota Statutes,
574.3section 145.9269. This is a onetime
574.4appropriation.
574.5Organ Donation. $200,000 in fiscal year 2016
574.6is from the general fund to establish a grant
574.7program to develop and create culturally
574.8appropriate outreach programs that provide
574.9education about the importance of organ
574.10donation. Grants shall be awarded to a
574.11federally designated organ procurement
574.12organization and hospital system that performs
574.13transplants. This is a onetime appropriation.
574.14Primary Care Residency. $1,500,000 in
574.15fiscal year 2016 and $1,500,000 in fiscal year
574.162017 are from the general fund for the
574.17purposes of the primary care residency
574.18expansion grant program under Minnesota
574.19Statutes, section 144.1506.
574.20Somali Women's Health Pilot Autism
574.21Program. (a) The commissioner of health
574.22shall establish a pilot program between one or
574.23more federally qualified health centers, as
574.24defined under Minnesota Statutes, section
574.25145.9269 , a nonprofit organization that helps
574.26Somali women, and the Minnesota Evaluation
574.27Studies Institute, to develop a promising
574.28strategy to address the preventative and
574.29primary health care needs of, and address
574.30health inequities experienced by, first
574.31generation Somali women. The pilot program
574.32must collaboratively develop a patient flow
574.33process for first generation Somali women by:
574.34(1) addressing and identifying clinical and
574.35cultural barriers to Somali women accessing
575.1preventative and primary care, including, but
575.2not limited to, cervical and breast cancer
575.3screenings;
575.4(2) developing a culturally appropriate health
575.5curriculum for Somali women based on the
575.6outcomes from the community-based
575.7participatory research report "Cultural
575.8Traditions and the Reproductive Health of
575.9Somali Refugees and Immigrants" to increase
575.10the health literacy of Somali women and
575.11develop culturally specific health care
575.12information; and
575.13(3) training the federally qualified health
575.14center's providers and staff to enhance
575.15provider and staff cultural competence
575.16regarding the cultural barriers, including
575.17female genital cutting.
575.18(b) The pilot program must develop a process
575.19that results in increased screening rates for
575.20cervical and breast cancer and can be
575.21replicated by other providers serving ethnic
575.22minorities. The pilot program must conduct
575.23an evaluation of the new patient flow process
575.24used by Somali women to access federally
575.25qualified health centers services award a grant
575.26to Dakota County to partner with a
575.27community-based organization with expertise
575.28in serving Somali children with autism. The
575.29grant must address barriers to accessing health
575.30care and other resources by providing outreach
575.31to Somali families on available support and
575.32training to providers on Somali culture.
575.33(c) The pilot program must report the
575.34outcomes to the commissioner by June 30,
575.352017. The grantee shall report to the
576.1commissioner and the chairs and ranking
576.2minority members of the legislative
576.3committees with jurisdiction over health care
576.4policy and finance on the grant funds used and
576.5any notable outcomes achieved by January 15,
576.62019.
576.7(d) $110,000 in fiscal year 2016 is for the
576.8Somali women's health pilot program grant to
576.9Dakota County. Of this appropriation, the
576.10commissioner may use up to $10,000 to
576.11administer the program grant to Dakota
576.12County. This appropriation is available until
576.13June 30, 2017. This is a onetime appropriation.
576.14Menthol Cigarette Usage in
576.15African-American Community Intervention
576.16Grants. Of the health care access fund
576.17appropriation for the statewide health
576.18improvement program, $200,000 in fiscal year
576.192016 is for at least one grant that must be
576.20awarded by the commissioner to implement
576.21strategies and interventions to reduce the
576.22disproportionately high usage of cigarettes by
576.23African-Americans, especially the use of
576.24menthol-flavored cigarettes, as well as the
576.25disproportionate harm tobacco causes in that
576.26community. The grantee shall engage
576.27members of the African-American community
576.28and community-based organizations. This
576.29grant shall be awarded as part of the statewide
576.30health improvement program grants awarded
576.31on November 1, 2015, and must meet the
576.32requirements of Minnesota Statutes, section
576.33145.986 .
576.34Targeted Home Visiting System. (a) $75,000
576.35in fiscal year 2016 is for the commissioner of
577.1health, in consultation with the commissioners
577.2of human services and education, community
577.3health boards, tribal nations, and other home
577.4visiting stakeholders, to design baseline
577.5training for new home visitors to ensure
577.6statewide coordination across home visiting
577.7programs.
577.8(b) $575,000 in fiscal year 2016 and
577.9$2,000,000 fiscal year 2017 are to provide
577.10grants to community health boards and tribal
577.11nations for start-up grants for new
577.12nurse-family partnership programs and for
577.13grants to expand existing programs to serve
577.14first-time mothers, prenatally by 28 weeks
577.15gestation until the child is two years of age,
577.16who are eligible for medical assistance under
577.17Minnesota Statutes, chapter 256B, or the
577.18federal Special Supplemental Nutrition
577.19Program for Women, Infants, and Children.
577.20The commissioner shall award grants to
577.21community health boards or tribal nations in
577.22metropolitan and rural areas of the state.
577.23Priority for all grants shall be given to
577.24nurse-family partnership programs that
577.25provide services through a Minnesota health
577.26care program-enrolled provider that accepts
577.27medical assistance. Additionally, priority for
577.28grants to rural areas shall be given to
577.29community health boards and tribal nations
577.30that expand services within regional
577.31partnerships that provide the nurse-family
577.32partnership program. Funding available under
577.33this paragraph may only be used to
577.34supplement, not to replace, funds being used
577.35for nurse-family partnership home visiting
577.36services as of June 30, 2015.
578.1Opiate Antagonists. $270,000 in fiscal year
578.22016 and $20,000 in fiscal year 2017 are from
578.3the general fund for grants to the eight regional
578.4emergency medical services programs to
578.5purchase opiate antagonists and educate and
578.6train emergency medical services persons, as
578.7defined in Minnesota Statutes, section
578.8144.7401, subdivision 4 , clauses (1) and (2),
578.9in the use of these antagonists in the event of
578.10an opioid or heroin overdose. For the purposes
578.11of this paragraph, "opiate antagonist" means
578.12naloxone hydrochloride or any similarly acting
578.13drug approved by the federal Food and Drug
578.14Administration for the treatment of drug
578.15overdose. Grants under this paragraph must
578.16be distributed to all eight regional emergency
578.17medical services programs. This is a onetime
578.18appropriation and is available until June 30,
578.192017. The commissioner may use up to
578.20$20,000 of the amount for opiate antagonists
578.21for administration.
578.22Local and Tribal Public Health Grants. (a)
578.23$894,000 in fiscal year 2016 and $894,000 in
578.24fiscal year 2017 are for an increase in local
578.25public health grants for community health
578.26boards under Minnesota Statutes, section
578.27145A.131, subdivision 1 , paragraph (e).
578.28(b) $106,000 in fiscal year 2016 and $106,000
578.29in fiscal year 2017 are for an increase in
578.30special grants to tribal governments under
578.31Minnesota Statutes, section 145A.14,
578.32subdivision 2a .
578.33HCBS Employee Scholarships. $1,000,000
578.34in fiscal year 2016 and $1,000,000 in fiscal
578.35year 2017 are from the general fund for the
579.1home and community-based services
579.2employee scholarship program under
579.3Minnesota Statutes, section 144.1503. The
579.4commissioner may use up to $50,000 of the
579.5amount for the HCBS employee scholarships
579.6for administration.
579.7Family Planning Special Projects.
579.8$1,000,000 in fiscal year 2016 and $1,000,000
579.9in fiscal year 2017 are from the general fund
579.10for family planning special project grants
579.11under Minnesota Statutes, section 145.925.
579.12Positive Alternatives. $1,000,000 in fiscal
579.13year 2016 and $1,000,000 in fiscal year 2017
579.14are from the general fund for positive abortion
579.15alternatives under Minnesota Statutes, section
579.16145.4235 .
579.17Safe Harbor for Sexually Exploited Youth.
579.18$700,000 in fiscal year 2016 and $700,000 in
579.19fiscal year 2017 are from the general fund for
579.20the safe harbor program under Minnesota
579.21Statutes, sections 145.4716 to 145.4718. Funds
579.22shall be used for grants to increase the number
579.23of regional navigators; training for
579.24professionals who engage with exploited or
579.25at-risk youth; implementing statewide
579.26protocols and best practices for effectively
579.27identifying, interacting with, and referring
579.28sexually exploited youth to appropriate
579.29resources; and program operating costs.
579.30Health Care Grants for Uninsured
579.31Individuals. (a) $62,500 in fiscal year 2016
579.32and $62,500 in fiscal year 2017 are from the
579.33health care access fund for dental provider
579.34grants in Minnesota Statutes, section 145.929,
579.35subdivision 1 .
580.1(b) $218,750 in fiscal year 2016 and $218,750
580.2in fiscal year 2017 are from the health care
580.3access fund for community mental health
580.4program grants in Minnesota Statutes, section
580.5145.929, subdivision 2 .
580.6(c) $750,000 in fiscal year 2016 and $750,000
580.7in fiscal year 2017 are from the health care
580.8access fund for the emergency medical
580.9assistance outlier grant program in Minnesota
580.10Statutes, section 145.929, subdivision 3.
580.11(d) $218,750 of the health care access fund
580.12appropriation in fiscal year 2016 and $218,750
580.13in fiscal year 2017 are for community health
580.14center grants under Minnesota Statutes, section
580.15145.9269 . A community health center that
580.16receives a grant from this appropriation is not
580.17eligible for a grant under paragraph (b).
580.18(e) The commissioner may use up to $25,000
580.19of the appropriations for health care grants for
580.20uninsured individuals in fiscal years 2016 and
580.212017 for grant administration.
580.22TANF Appropriations. (a) $1,156,000 of the
580.23TANF funds is appropriated each year of the
580.24biennium to the commissioner for family
580.25planning grants under Minnesota Statutes,
580.26section 145.925.
580.27(b) $3,579,000 of the TANF funds is
580.28appropriated each year of the biennium to the
580.29commissioner for home visiting and nutritional
580.30services listed under Minnesota Statutes,
580.31section 145.882, subdivision 7, clauses (6) and
580.32(7). Funds must be distributed to community
580.33health boards according to Minnesota Statutes,
580.34section 145A.131, subdivision 1.
581.1(c) $2,000,000 of the TANF funds is
581.2appropriated each year of the biennium to the
581.3commissioner for decreasing racial and ethnic
581.4disparities in infant mortality rates under
581.5Minnesota Statutes, section 145.928,
581.6subdivision 7 .
581.7(d) $4,978,000 of the TANF funds is
581.8appropriated each year of the biennium to the
581.9commissioner for the family home visiting
581.10grant program according to Minnesota
581.11Statutes, section 145A.17. $4,000,000 of the
581.12funding must be distributed to community
581.13health boards according to Minnesota Statutes,
581.14section 145A.131, subdivision 1. $978,000 of
581.15the funding must be distributed to tribal
581.16governments as provided in Minnesota
581.17Statutes, section 145A.14, subdivision 2a.
581.18(e) The commissioner may use up to 6.23
581.19percent of the funds appropriated each fiscal
581.20year to conduct the ongoing evaluations
581.21required under Minnesota Statutes, section
581.22145A.17, subdivision 7 , and training and
581.23technical assistance as required under
581.24Minnesota Statutes, section 145A.17,
581.25subdivisions 4 and 5.
581.26TANF Carryforward. Any unexpended
581.27balance of the TANF appropriation in the first
581.28year of the biennium does not cancel but is
581.29available for the second year.
581.30Health Professional Loan Forgiveness.
581.31$2,631,000 in fiscal year 2016 and $2,631,000
581.32in fiscal year 2017 are from the health care
581.33access fund for the purposes of Minnesota
581.34Statutes, section 144.1501. Of this
581.35appropriation, the commissioner may use up
582.1to $131,000 each year to administer the
582.2program.
582.3Minnesota Stroke System. $350,000 in fiscal
582.4year 2016 and $350,000 in fiscal year 2017
582.5are from the general fund for the Minnesota
582.6stroke system.
582.7Prevention of Violence in Health Care.
582.8$50,000 in fiscal year 2016 is to continue the
582.9prevention of violence in health care program
582.10and creating violence prevention resources for
582.11hospitals and other health care providers to
582.12use in training their staff on violence
582.13prevention. This is a onetime appropriation
582.14and is available until June 30, 2017.
582.15Health Care Savings Determinations. (a)
582.16The health care access fund base for the state
582.17health improvement program is decreased by
582.18$261,000 in fiscal year 2016 and decreased
582.19by $110,000 in fiscal year 2017.
582.20(b) $261,000 in fiscal year 2016 and $110,000
582.21in fiscal year 2017 are from the health care
582.22access fund for the forecasting, cost reporting,
582.23and analysis required by Minnesota Statutes,
582.24section 62U.10, subdivisions 6 and 7.
582.25Base Level Adjustments. The general fund
582.26base is decreased by $1,070,000 in fiscal year
582.272018 and by $1,020,000 in fiscal year 2019.
582.28The state government special revenue fund
582.29base is increased by $33,000 in fiscal year
582.302018. The health care access fund base is
582.31increased by $610,000 in fiscal year 2018 and
582.32by $23,000 in fiscal year 2019.

583.1    Sec. 14. TRANSFERS.
583.2    Subdivision 1. Grants. The commissioner of human services, with the approval of the
583.3commissioner of management and budget, may transfer unencumbered appropriation balances
583.4for the biennium ending June 30, 2019, within fiscal years among the MFIP, general
583.5assistance, medical assistance, MinnesotaCare, MFIP child care assistance under Minnesota
583.6Statutes, section 119B.05, Minnesota supplemental aid, and group residential housing
583.7programs, the entitlement portion of Northstar Care for Children under Minnesota Statutes,
583.8chapter 256N, and the entitlement portion of the chemical dependency consolidated treatment
583.9fund, and between fiscal years of the biennium. The commissioner shall inform the chairs
583.10and ranking minority members of the senate Health and Human Services Finance and Policy
583.11Committee, the senate Human Services Reform Finance and Policy Committee, and the
583.12house of representatives Health and Human Services Finance Committee quarterly about
583.13transfers made under this subdivision.
583.14    Subd. 2. Administration. Positions, salary money, and nonsalary administrative money
583.15may be transferred within the Departments of Health and Human Services as the
583.16commissioners consider necessary, with the advance approval of the commissioner of
583.17management and budget. The commissioner shall inform the chairs and ranking minority
583.18members of the senate Health and Human Services Finance and Policy Committee, the
583.19senate Human Services Reform Finance and Policy Committee, and the house of
583.20representatives Health and Human Services Finance Committee quarterly about transfers
583.21made under this subdivision.

583.22    Sec. 15. INDIRECT COSTS NOT TO FUND PROGRAMS.
583.23The commissioners of health and human services shall not use indirect cost allocations
583.24to pay for the operational costs of any program for which they are responsible.

583.25    Sec. 16. EXPIRATION OF UNCODIFIED LANGUAGE.
583.26All uncodified language contained in this article expires on June 30, 2019, unless a
583.27different expiration date is explicit.

583.28    Sec. 17. EFFECTIVE DATE.
583.29This article is effective July 1, 2017, unless a different effective date is specified."
583.30Delete the title and insert:

584.1"A bill for an act

584.2relating to state government; establishing the health and human services budget;
584.3modifying provisions governing community supports, housing, continuing care,
584.4health care, health insurance, direct care and treatment, children and families,
584.5chemical and mental health services, Department of Human Services operations,
584.6Health Department, health licensing boards, and opiate abuse prevention; making
584.7technical changes; modifying terminology and definitions; establishing licensing
584.8fix-it tickets; establishing federally facilitated marketplace; requiring legislative
584.9approval for certain federal waivers and approval; repealing MNsure; requiring
584.10reports; modifying fees; making forecast adjustments; appropriating money;
584.11amending Minnesota Statutes 2016, sections 3.972, by adding subdivisions; 13.32,
584.12by adding a subdivision; 13.46, subdivisions 1, 2; 13.69, subdivision 1; 13.84,
584.13subdivision 5; 62A.04, subdivision 1; 62A.21, subdivision 2a; 62A.3075; 62D.105;
584.1462E.04, subdivision 11; 62E.05, subdivision 1; 62E.06, by adding a subdivision;
584.1562K.15; 103I.101, subdivisions 2, 5; 103I.111, subdivisions 6, 7, 8; 103I.205;
584.16103I.301; 103I.501; 103I.505; 103I.515; 103I.535, subdivisions 3, 6, by adding a
584.17subdivision; 103I.541; 103I.545, subdivisions 1, 2; 103I.711, subdivision 1;
584.18103I.715, subdivision 2; 119B.13, subdivision 1; 144.0722, subdivision 1; 144.0724,
584.19subdivisions 1, 2, 4, 6, 9; 144.122; 144.1501, subdivision 2; 144.1506; 144.551,
584.20subdivision 1; 144.562, subdivision 2; 144.99, subdivision 1; 144A.071,
584.21subdivisions 3, 4a, 4c, 4d; 144A.073, subdivision 3c; 144A.10, subdivision 4;
584.22144A.15, subdivision 2; 144A.154; 144A.161, subdivision 10; 144A.1888;
584.23144A.351, subdivision 1; 144A.472, subdivision 7; 144A.474, subdivision 11;
584.24144A.4799, subdivision 3; 144A.611, subdivision 1; 144A.70, subdivision 6, by
584.25adding a subdivision; 144A.74; 144D.04, subdivision 2, by adding a subdivision;
584.26144D.06; 145.4131, subdivision 1; 145.4716, subdivision 2; 145.928, subdivision
584.2713; 145.986, subdivision 1a; 147.01, subdivision 7; 147.02, subdivision 1; 147.03,
584.28subdivision 1; 147B.08, by adding a subdivision; 147C.40, by adding a subdivision;
584.29148.5194, subdivision 7; 148.6402, subdivision 4; 148.6405; 148.6408, subdivision
584.302; 148.6410, subdivision 2; 148.6412, subdivision 2; 148.6415; 148.6418,
584.31subdivisions 1, 2, 4, 5; 148.6420, subdivisions 1, 3, 5; 148.6423; 148.6425,
584.32subdivisions 2, 3; 148.6428; 148.6443, subdivisions 5, 6, 7, 8; 148.6445,
584.33subdivisions 1, 10; 148.6448; 148.881; 148.89; 148.90, subdivisions 1, 2; 148.905,
584.34subdivision 1; 148.907, subdivisions 1, 2; 148.9105, subdivisions 1, 4, 5; 148.916,
584.35subdivisions 1, 1a; 148.925; 148.96, subdivision 3; 148B.53, subdivision 1;
584.36150A.06, subdivisions 3, 8; 150A.10, subdivision 4; 151.212, subdivision 2; 152.11,
584.37by adding a subdivision; 152.25, subdivision 1, by adding subdivisions; 152.33,
584.38by adding a subdivision; 157.16, subdivision 1; 214.01, subdivision 2; 245.4889,
584.39subdivision 1; 245.814, subdivisions 2, 3; 245.91, subdivisions 4, 6; 245.94,
584.40subdivision 1; 245.97, subdivision 6; 245A.02, subdivisions 2b, 5a, by adding
584.41subdivisions; 245A.03, subdivisions 2, 7; 245A.04, subdivisions 4, 14; 245A.06,
584.42subdivisions 2, 8, by adding a subdivision; 245A.07, subdivision 3; 245A.11, by
584.43adding subdivisions; 245A.191; 245A.50, subdivision 5; 245D.03, subdivision 1;
584.44245D.04, subdivision 3; 245D.071, subdivision 3; 245D.11, subdivision 4; 245D.24,
584.45subdivision 3; 246.18, subdivision 4, by adding a subdivision; 252.27, subdivision
584.462a; 252.41, subdivision 3; 253B.10, subdivision 1; 253B.22, subdivision 1;
584.47254A.01; 254A.02, subdivisions 2, 3, 5, 6, 8, 10, by adding subdivisions; 254A.03;
584.48254A.035, subdivision 1; 254A.04; 254A.08; 254A.09; 254A.19, subdivision 3;
584.49254B.01, subdivision 3, by adding a subdivision; 254B.03, subdivision 2; 254B.04,
584.50subdivisions 1, 2b; 254B.05, subdivisions 1, 1a, 5; 254B.051; 254B.07; 254B.08;
584.51254B.09; 254B.12, subdivision 2, by adding a subdivision; 254B.13, subdivision
584.522a; 256.045, subdivision 3; 256.9657, subdivision 1; 256.9686, subdivision 8;
584.53256.969, subdivisions 1, 2b, 3a, 8, 8c, 9, 12; 256.975, subdivision 7, by adding a
584.54subdivision; 256B.04, subdivision 12; 256B.056, subdivision 5c; 256B.0621,
584.55subdivision 10; 256B.0625, subdivisions 3b, 6a, 7, 13, 13e, 17, 17b, 18h, 20, 30,
584.5631, 45a, 64, by adding subdivisions; 256B.0653, subdivisions 2, 3, 4, 5, 6, by
584.57adding a subdivision; 256B.0659, subdivisions 1, 2, 11, 21, by adding a subdivision;
584.58256B.072; 256B.0755, subdivisions 1, 3, 4, by adding a subdivision; 256B.0911,
585.1subdivisions 1a, 2b, 3a, 4d, 5, by adding a subdivision; 256B.0915, subdivisions
585.21, 3a, 3e, 3h, 5, by adding subdivisions; 256B.092, subdivision 4; 256B.0921;
585.3256B.0922, subdivision 1; 256B.0924, by adding a subdivision; 256B.0943,
585.4subdivision 13; 256B.0945, subdivisions 2, 4; 256B.196, subdivisions 2, 3, 4;
585.5256B.35, subdivision 4; 256B.431, subdivisions 10, 16, 30; 256B.434, subdivisions
585.64, 4f; 256B.49, subdivisions 11, 15; 256B.4913, subdivision 4a, by adding a
585.7subdivision; 256B.4914, subdivisions 2, 3, 5, 6, 7, 8, 9, 10, 16; 256B.493,
585.8subdivisions 1, 2, by adding a subdivision; 256B.50, subdivisions 1, 1b; 256B.5012,
585.9by adding subdivisions; 256B.69, subdivisions 5a, 9e, by adding a subdivision;
585.10256B.75; 256B.763; 256B.766; 256C.23, subdivision 2, by adding subdivisions;
585.11256C.233, subdivisions 1, 2; 256C.24, subdivisions 1, 2; 256C.261; 256D.44,
585.12subdivisions 4, 5; 256E.30, subdivision 2; 256I.03, subdivision 8; 256I.04,
585.13subdivisions 1, 2d, 2g, 3; 256I.05, subdivisions 1a, 1c, 1e, 1j, 1m, by adding
585.14subdivisions; 256I.06, subdivisions 2, 8; 256J.24, subdivision 5; 256J.45,
585.15subdivision 2; 256P.06, subdivision 2; 256R.02, subdivisions 4, 17, 18, 19, 22,
585.1642, 52, by adding subdivisions; 256R.06, subdivision 5; 256R.07, by adding a
585.17subdivision; 256R.10, by adding a subdivision; 256R.37; 256R.40, subdivisions
585.181, 5; 256R.41; 256R.47; 256R.49, subdivision 1; 256R.53, subdivision 2; 260C.451,
585.19subdivision 6; 317A.811, subdivision 1, by adding a subdivision; 327.15,
585.20subdivision 3; 609.5315, subdivision 5c; 626.556, subdivisions 2, 3, 3c, 10d; Laws
585.212009, chapter 101, article 1, section 12; Laws 2012, chapter 247, article 6, section
585.222, subdivision 2; Laws 2013, chapter 108, article 15, section 2, subdivision 2; Laws
585.232015, chapter 71, article 14, section 3, subdivision 2, as amended; Laws 2017,
585.24chapter 2, article 1, sections 5; 7; proposing coding for new law in Minnesota
585.25Statutes, chapters 62J; 119B; 144; 145; 147A; 148; 245; 245A; 256; 256B; 256I;
585.26256N; 256R; 317A; proposing coding for new law as Minnesota Statutes, chapters
585.27144H; 245G; repealing Minnesota Statutes 2016, sections 13.468; 62V.01; 62V.02;
585.2862V.03; 62V.04; 62V.05; 62V.051; 62V.055; 62V.06; 62V.07; 62V.08; 62V.09;
585.2962V.10; 62V.11; 144.4961; 144A.351, subdivision 2; 147.0375, subdivision 7;
585.30147A.21; 147B.08, subdivisions 1, 2, 3; 147C.40, subdivisions 1, 2, 3, 4; 148.6402,
585.31subdivision 2; 148.6450; 148.906; 148.907, subdivision 5; 148.908; 148.909,
585.32subdivision 7; 148.96, subdivisions 4, 5; 179A.50; 179A.51; 179A.52; 179A.53;
585.33245A.1915; 245A.192; 254A.02, subdivision 4; 256B.4914, subdivision 16;
585.34256B.64; 256B.7631; 256C.23, subdivision 3; 256C.233, subdivision 4; 256C.25,
585.35subdivisions 1, 2; 256J.626, subdivision 5; Laws 2012, chapter 247, article 4,
585.36section 47, as amended; Laws 2014, chapter 312, article 23, section 9, subdivision
585.375; Laws 2015, chapter 71, article 7, section 54; Minnesota Rules, parts 5600.2500;
585.389530.6405, subparts 1, 1a, 2, 3, 4, 5, 6, 7, 7a, 8, 9, 10, 11, 12, 13, 14, 14a, 15, 15a,
585.3916, 17, 17a, 17b, 17c, 18, 20, 21; 9530.6410; 9530.6415; 9530.6420; 9530.6422;
585.409530.6425; 9530.6430; 9530.6435; 9530.6440; 9530.6445; 9530.6450; 9530.6455;
585.419530.6460; 9530.6465; 9530.6470; 9530.6475; 9530.6480; 9530.6485; 9530.6490;
585.429530.6495; 9530.6500; 9530.6505."

586.1	We request the adoption of this report and repassage of the bill.
586.2	Senate Conferees:
586.3	.....		.....
586.4	Michelle R. Benson		Jim Abeler
586.5	.....		.....
586.6	Karin Housley		Paul Utke
586.7	.....
586.8	Tony Lourey
586.9	House Conferees:
586.10	.....		.....
586.11	Matt Dean		Joe Schomacker
586.12	.....		.....
586.13	Tony Albright		Debra Kiel
586.14	.....
586.15	Jennifer Schultz