HF 1233

Conference Committee Report - 88th Legislature (2013 - 2014) Posted on 05/17/2013 06:34pm

1.1CONFERENCE COMMITTEE REPORT ON H. F. No. 1233

1.2A bill for an act

1.3relating to state government; establishing the health and human services budget;
1.4modifying provisions related to health care, continuing care, human services
1.5licensing, chemical and mental health, managed care organizations, waiver
1.6provider standards, home care, and the Department of Health; redesigning home
1.7and community-based services; establishing payment methodologies for home
1.8and community-based services; adjusting nursing and ICF/DD facility rates;
1.9setting and modifying fees; modifying autism coverage; modifying assistance
1.10programs; requiring licensing of certain abortion facilities; requiring drug testing;
1.11making technical changes; requiring studies; requiring reports; appropriating
1.12money;amending Minnesota Statutes 2012, sections 16A.724, subdivisions
1.132, 3; 16C.10, subdivision 5; 16C.155, subdivision 1; 62A.65, subdivision
1.142, by adding a subdivision; 62J.692, subdivision 4; 62Q.19, subdivision 1;
1.15103I.005, by adding a subdivision; 103I.521; 119B.13, subdivision 7; 144.051,
1.16by adding subdivisions; 144.0724, subdivisions 4, 6; 144.123, subdivision 1;
1.17144.125, subdivision 1; 144.966, subdivisions 2, 3a; 144.98, subdivisions 3, 5,
1.18by adding subdivisions; 144.99, subdivision 4; 144A.351; 144A.43; 144A.44;
1.19144A.45; 144A.53, subdivision 2; 144D.01, subdivision 4; 145.986; 145C.01,
1.20subdivision 7; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5,
1.2116, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding
1.22subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4;
1.23149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1,
1.242, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94;
1.25149A.96, subdivision 9; 174.30, subdivision 1; 214.40, subdivision 1; 243.166,
1.26subdivisions 4b, 7; 245.4661, subdivisions 5, 6; 245.4682, subdivision 2;
1.27245A.02, subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04,
1.28subdivision 13; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08,
1.29subdivision 2a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435;
1.30245A.144; 245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5;
1.31245A.50; 245C.04, by adding a subdivision; 245C.08, subdivision 1; 245D.02;
1.32245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09; 245D.10; 246.18,
1.33subdivision 8, by adding a subdivision; 246.54; 254B.04, subdivision 1;
1.34254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions; 256.9657,
1.35subdivisions 1, 2, 3a; 256.9685, subdivision 2; 256.969, subdivisions 3a, 29;
1.36256.975, subdivision 7, by adding subdivisions; 256.9754, subdivision 5, by
1.37adding subdivisions; 256B.02, by adding subdivisions; 256B.021, by adding
1.38subdivisions; 256B.04, subdivisions 18, 21, by adding a subdivision; 256B.055,
1.39subdivisions 3a, 6, 10, 14, 15, by adding a subdivision; 256B.056, subdivisions 1,
1.401c, 3, 4, as amended, 5c, 10, by adding a subdivision; 256B.057, subdivisions 1,
1.418, 10, by adding a subdivision; 256B.06, subdivision 4; 256B.0623, subdivision
1.422; 256B.0625, subdivisions 9, 13e, 19c, 31, 39, 48, 58, by adding subdivisions;
1.43256B.0631, subdivision 1; 256B.064, subdivisions 1a, 1b, 2; 256B.0659,
2.1subdivision 21; 256B.0755, subdivision 3; 256B.0756; 256B.0911, subdivisions
2.21, 1a, 3a, 4d, 6, 7, by adding a subdivision; 256B.0913, subdivision 4, by
2.3adding a subdivision; 256B.0915, subdivisions 3a, 5, by adding a subdivision;
2.4256B.0916, by adding a subdivision; 256B.0917, subdivisions 6, 13, by
2.5adding subdivisions; 256B.092, subdivisions 11, 12, by adding subdivisions;
2.6256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952, subdivisions 1,
2.75; 256B.097, subdivisions 1, 3; 256B.431, subdivision 44; 256B.434, subdivision
2.84, by adding a subdivision; 256B.437, subdivision 6; 256B.439, subdivisions
2.91, 2, 3, 4, by adding a subdivision; 256B.441, subdivisions 13, 53; 256B.49,
2.10subdivisions 11a, 12, 14, 15, by adding subdivisions; 256B.4912, subdivisions
2.111, 2, 3, 7, by adding subdivisions; 256B.4913, subdivisions 5, 6, by adding a
2.12subdivision; 256B.492; 256B.493, subdivision 2; 256B.5011, subdivision 2;
2.13256B.5012, by adding subdivisions; 256B.69, subdivisions 5c, 31, by adding a
2.14subdivision; 256B.694; 256B.76, subdivisions 2, 4, by adding a subdivision;
2.15256B.761; 256B.764; 256B.766; 256D.024, by adding a subdivision; 256I.04,
2.16subdivision 3; 256I.05, subdivision 1e, by adding a subdivision; 256J.15, by
2.17adding a subdivision; 256J.26, subdivision 3, by adding a subdivision; 256J.35;
2.18256K.45; 256L.01, subdivisions 3a, 5, by adding subdivisions; 256L.02,
2.19subdivision 2, by adding subdivisions; 256L.03, subdivisions 1, 1a, 3, 5, 6, by
2.20adding a subdivision; 256L.04, subdivisions 1, 7, 8, 10, by adding subdivisions;
2.21256L.05, subdivisions 1, 2, 3; 256L.06, subdivision 3; 256L.07, subdivisions 1,
2.222, 3; 256L.09, subdivision 2; 256L.11, subdivision 6; 256L.15, subdivisions 1, 2;
2.23257.0755, subdivision 1; 260B.007, subdivisions 6, 16; 260C.007, subdivisions
2.246, 31; 270B.14, subdivision 1; 471.59, subdivision 1; 626.556, subdivisions 2, 3,
2.2510d; 626.557, subdivisions 4, 9, 9a, 9e; 626.5572, subdivision 13; Laws 1998,
2.26chapter 407, article 6, section 116; Laws 2011, First Special Session chapter 9,
2.27article 1, section 3; article 2, section 27; article 10, section 3, subdivision 3,
2.28as amended; proposing coding for new law in Minnesota Statutes, chapters 3;
2.2962A; 62D; 144; 144A; 145; 149A; 214; 245; 245A; 245D; 254B; 256; 256B;
2.30256L; repealing Minnesota Statutes 2012, sections 103I.005, subdivision 20;
2.31144.123, subdivision 2; 144A.46; 144A.461; 149A.025; 149A.20, subdivision
2.328; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, subdivision 6;
2.33149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a;
2.34149A.53, subdivision 9; 245A.655; 245B.01; 245B.02; 245B.03; 245B.031;
2.35245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06; 245B.07;
2.36245B.08; 245D.08; 256B.055, subdivisions 3, 5, 10b; 256B.056, subdivision 5b;
2.37256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b, 4c; 256B.0917,
2.38subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096, subdivisions 1, 2, 3, 4;
2.39256B.14, subdivision 3a; 256B.49, subdivision 16a; 256B.4913, subdivisions 1,
2.402, 3, 4; 256B.5012, subdivision 13; 256J.24, subdivision 6; 256K.45, subdivision
2.412; 256L.01, subdivision 4a; 256L.031; 256L.04, subdivisions 1b, 9, 10a;
2.42256L.05, subdivision 3b; 256L.07, subdivisions 5, 8, 9; 256L.11, subdivision 5;
2.43256L.12; 256L.17, subdivisions 1, 2, 3, 4, 5; 485.14; 609.093; Laws 2011, First
2.44Special Session chapter 9, article 7, section 54, as amended; Minnesota Rules,
2.45parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; 4668.0012; 4668.0016;
2.464668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; 4668.0050;
2.474668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
2.484668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160;
2.494668.0170; 4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220;
2.504668.0230; 4668.0240; 4668.0800; 4668.0805; 4668.0810; 4668.0815;
2.514668.0820; 4668.0825; 4668.0830; 4668.0835; 4668.0840; 4668.0845;
2.524668.0855; 4668.0860; 4668.0865; 4668.0870; 4669.0001; 4669.0010;
2.534669.0020; 4669.0030; 4669.0040; 4669.0050.
2.54May 17, 2013
2.55The Honorable Paul Thissen
2.56Speaker of the House of Representatives
3.1The Honorable Sandra L. Pappas
3.2President of the Senate
3.3We, the undersigned conferees for H. F. No. 1233 report that we have agreed upon
3.4the items in dispute and recommend as follows:
3.5That the Senate recede from its amendments and that H. F. No. 1233 be further
3.6amended as follows:
3.7Delete everything after the enacting clause and insert:

3.8"ARTICLE 1

3.9AFFORDABLE CARE ACT IMPLEMENTATION; BETTER HEALTH
3.10CARE FOR MORE MINNESOTANS

3.11    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
3.12    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
3.13participation pertaining to administrative costs of the Minnesota health care reform waiver
3.14shall be deposited as nondedicated revenue in the health care access fund. Receipts
3.15received as a result of federal participation pertaining to grants shall be deposited in the
3.16federal fund and shall offset health care access funds for payments to providers. All federal
3.17funding received by Minnesota for implementation and administration of MinnesotaCare
3.18as a basic health program, as authorized in section 1331 of the Affordable Care Act,
3.19Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and
3.20shall be deposited into the health care access fund. Federal funding that is received for
3.21implementing and administering MinnesotaCare as a basic health program and deposited in
3.22the fund shall be used only for that program to purchase health care coverage for enrollees
3.23and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.
3.24EFFECTIVE DATE.This section is effective January 1, 2015.

3.25    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
3.26    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
3.27Regulations, title 25, part 20, persons eligible for medical assistance benefits under
3.28sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
3.29the income standards of section 256B.056, subdivision 4, and persons eligible for general
3.30assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
3.31dependency fund services. State money appropriated for this paragraph must be placed in
3.32a separate account established for this purpose.
3.33Persons with dependent children who are determined to be in need of chemical
3.34dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
3.35a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
4.1local agency to access needed treatment services. Treatment services must be appropriate
4.2for the individual or family, which may include long-term care treatment or treatment in a
4.3facility that allows the dependent children to stay in the treatment facility. The county
4.4shall pay for out-of-home placement costs, if applicable.
4.5(b) A person not entitled to services under paragraph (a), but with family income
4.6that is less than 215 percent of the federal poverty guidelines for the applicable family
4.7size, shall be eligible to receive chemical dependency fund services within the limit
4.8of funds appropriated for this group for the fiscal year. If notified by the state agency
4.9of limited funds, a county must give preferential treatment to persons with dependent
4.10children who are in need of chemical dependency treatment pursuant to an assessment
4.11under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
4.126 , or 260C.212. A county may spend money from its own sources to serve persons under
4.13this paragraph. State money appropriated for this paragraph must be placed in a separate
4.14account established for this purpose.
4.15(c) Persons whose income is between 215 percent and 412 percent of the federal
4.16poverty guidelines for the applicable family size shall be eligible for chemical dependency
4.17services on a sliding fee basis, within the limit of funds appropriated for this group for the
4.18fiscal year. Persons eligible under this paragraph must contribute to the cost of services
4.19according to the sliding fee scale established under subdivision 3. A county may spend
4.20money from its own sources to provide services to persons under this paragraph. State
4.21money appropriated for this paragraph must be placed in a separate account established
4.22for this purpose.
4.23EFFECTIVE DATE.This section is effective January 1, 2014.

4.24    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
4.25to read:
4.26    Subd. 35. Federal approval. (a) The commissioner shall seek federal authority
4.27from the U.S. Department of Health and Human Services necessary to operate a health
4.28coverage program for Minnesotans with incomes up to 275 percent of the federal poverty
4.29guidelines (FPG). The proposal shall seek to secure all federal funding available from at
4.30least the following services:
4.31(1) all premium tax credits and cost sharing subsidies available under United States
4.32Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
4.33with incomes above 133 percent and at or below 275 percent of the federal poverty
4.34guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as
4.35defined in section 62V.02;
5.1(2) Medicaid funding; and
5.2(3) other funding sources identified by the commissioner that support coverage or
5.3care redesign in Minnesota.
5.4(b) Funding received shall be used to design and implement a health coverage
5.5program that creates a single streamlined program and meets the needs of Minnesotans with
5.6incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
5.7(1) payment reform characteristics included in the health care delivery system and
5.8accountable care organization payment models;
5.9(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
5.10needs in different income and health status situations and can provide a more seamless
5.11transition from public to private health care coverage;
5.12(3) flexibility in co-payment or premium structures to incent patients to seek
5.13high-quality, low-cost care settings; and
5.14(4) flexibility in premium structures to ease the transition from public to private
5.15health care coverage.
5.16(c) The commissioner shall develop and submit a proposal consistent with the above
5.17criteria and shall seek all federal authority necessary to implement the health coverage
5.18program. In developing the request, the commissioner shall consult with appropriate
5.19stakeholder groups and consumers.
5.20(d) The commissioner is authorized to seek any available waivers or federal
5.21approvals to accomplish the goals under paragraph (b) prior to 2017.
5.22(e) The commissioner shall report to the chairs and ranking minority members of
5.23the legislative committees with jurisdiction over health and human services policy and
5.24financing by January 15, 2015, on the progress of receiving a federal waiver and shall
5.25make recommendations on any legislative changes necessary to accomplish the project
5.26in this subdivision. Any implementation of the waiver that requires a state financial
5.27contribution to operate a health coverage program for Minnesotans with incomes between
5.28200 and 275 percent of the federal poverty guidelines, shall be contingent on legislative
5.29action approving the contribution.
5.30(f) The commissioner is authorized to accept and expend federal funds that support
5.31the purposes of this subdivision.

5.32    Sec. 4. Minnesota Statutes 2012, section 256.015, subdivision 1, is amended to read:
5.33    Subdivision 1. State agency has lien. When the state agency provides, pays for, or
5.34becomes liable for medical care or furnishes subsistence or other payments to a person,
5.35the agency shall have a lien for the cost of the care and payments on any and all causes of
6.1action or recovery rights under any policy, plan, or contract providing benefits for health
6.2care or injury which accrue to the person to whom the care or payments were furnished,
6.3or to the person's legal representatives, as a result of the occurrence that necessitated the
6.4medical care, subsistence, or other payments. For purposes of this section, "state agency"
6.5includes prepaid health plans under contract with the commissioner according to sections
6.6256B.69 , 256D.03, subdivision 4, paragraph (c), and 256L.12, 256L.01, subdivision 7,
6.7and 256L.03, subdivision 6; children's mental health collaboratives under section 245.493;
6.8demonstration projects for persons with disabilities under section 256B.77; nursing
6.9homes under the alternative payment demonstration project under section 256B.434; and
6.10county-based purchasing entities under section 256B.692.

6.11    Sec. 5. Minnesota Statutes 2012, section 256B.02, subdivision 17, as added by Laws
6.122013, chapter 1, section 1, is amended to read:
6.13    Subd. 17. Affordable Care Act or ACA. "Affordable Care Act" or "ACA" means
6.14Public Law 111-148, as amended by the federal Health Care and Education Reconciliation
6.15Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance
6.16issued under, those acts means the federal Patient Protection and Affordable Care Act,
6.17Public Law 111-148, as amended, including the federal Health Care and Education
6.18Reconciliation Act of 2010, Public Law 111-152, and any amendments to, and any federal
6.19guidance or regulations issued under, these acts.
6.20EFFECTIVE DATE.This section is effective July 1, 2013.

6.21    Sec. 6. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.22to read:
6.23    Subd. 18. Caretaker relative. "Caretaker relative" means a relative, by blood,
6.24adoption, or marriage, of a child under age 19 with whom the child is living and who
6.25assumes primary responsibility for the child's care.
6.26EFFECTIVE DATE.This section is effective January 1, 2014.

6.27    Sec. 7. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.28to read:
6.29    Subd. 19. Insurance affordability program. "Insurance affordability program"
6.30means one of the following programs:
6.31(1) medical assistance under this chapter;
7.1(2) a program that provides advance payments of the premium tax credits established
7.2under section 36B of the Internal Revenue Code or cost-sharing reductions established
7.3under section 1402 of the Affordable Care Act;
7.4(3) MinnesotaCare as defined in chapter 256L; and
7.5(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.
7.6EFFECTIVE DATE.This section is effective the day following final enactment.

7.7    Sec. 8. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
7.8    Subd. 18. Applications for medical assistance. (a) The state agency may take
7.9 shall accept applications for medical assistance and conduct eligibility determinations for
7.10MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web
7.11site, and through other commonly available electronic means.
7.12    (b) The commissioner of human services shall modify the Minnesota health care
7.13programs application form to add a question asking applicants whether they have ever
7.14served in the United States military.
7.15    (c) For each individual who submits an application or whose eligibility is subject to
7.16renewal or whose eligibility is being redetermined pursuant to a change in circumstances,
7.17if the agency determines the individual is not eligible for medical assistance, the agency
7.18shall determine potential eligibility for other insurance affordability programs.
7.19EFFECTIVE DATE.This section is effective January 1, 2014.

7.20    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
7.21    Subd. 3a. Families with children. Beginning July 1, 2002, Medical assistance may
7.22be paid for a person who is a child under the age of 18, or age 18 if a full-time student
7.23in a secondary school, or in the equivalent level of vocational or technical training, and
7.24reasonably expected to complete the program before reaching age 19; the parent or
7.25stepparent of a dependent child under the age of 19, including a pregnant woman; or a
7.26caretaker relative of a dependent child under the age of 19.
7.27EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
7.28approval, whichever is later. The commissioner of human services shall notify the revisor
7.29of statutes when federal approval is obtained.

7.30    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
7.31    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
7.32for a pregnant woman who has written verification of a positive pregnancy test from a
8.1physician or licensed registered nurse, who meets the other eligibility criteria of this
8.2section and whose unborn child would be eligible as a needy child under subdivision 10 if
8.3born and living with the woman. In accordance with Code of Federal Regulations, title
8.442, section 435.956, the commissioner must accept self-attestation of pregnancy unless
8.5the agency has information that is not reasonably compatible with such attestation. For
8.6purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
8.7EFFECTIVE DATE.This section is effective January 1, 2014.

8.8    Sec. 11. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
8.9    Subd. 10. Infants. Medical assistance may be paid for an infant less than one year
8.10of age, whose mother was eligible for and receiving medical assistance at the time of birth
8.11or who is less than two years of age and is in a family with countable income that is equal
8.12to or less than the income standard established under section 256B.057, subdivision 1.
8.13EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
8.14approval, whichever is later. The commissioner of human services shall notify the revisor
8.15of statutes when federal approval is obtained.

8.16    Sec. 12. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
8.17    Subd. 15. Adults without children. Medical assistance may be paid for a person
8.18who is:
8.19(1) at least age 21 and under age 65;
8.20(2) not pregnant;
8.21(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
8.22of the Social Security Act;
8.23(4) not an adult in a family with children as defined in section 256L.01, subdivision
8.243a ; and not otherwise eligible under subdivision 7 as a person who meets the categorical
8.25eligibility requirements of the supplemental security income program;
8.26(5) not enrolled under subdivision 7 as a person who would meet the categorical
8.27eligibility requirements of the supplemental security income program except for excess
8.28income or assets; and
8.29(5) (6) not described in another subdivision of this section.
8.30EFFECTIVE DATE.This section is effective January 1, 2014.

8.31    Sec. 13. Minnesota Statutes 2012, section 256B.055, is amended by adding a
8.32subdivision to read:
9.1    Subd. 17. Adults who were in foster care at the age of 18. Medical assistance may
9.2be paid for a person under 26 years of age who was in foster care under the commissioner's
9.3responsibility on the date of attaining 18 years of age, and who was enrolled in medical
9.4assistance under the state plan or a waiver of the plan while in foster care, in accordance
9.5with section 2004 of the Affordable Care Act.
9.6EFFECTIVE DATE.This section is effective January 1, 2014.

9.7    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
9.8    Subdivision 1. Residency. To be eligible for medical assistance, a person must
9.9reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
9.10 in accordance with the rules of the state agency Code of Federal Regulations, title 42,
9.11section 435.403.
9.12EFFECTIVE DATE.This section is effective January 1, 2014.

9.13    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
9.14    Subd. 1c. Families with children income methodology. (a)(1) [Expired, 1Sp2003
9.15c 14 art 12 s 17]
9.16(2) For applications processed within one calendar month prior to July 1, 2003,
9.17eligibility shall be determined by applying the income standards and methodologies in
9.18effect prior to July 1, 2003, for any months in the six-month budget period before July
9.191, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
9.20months in the six-month budget period on or after that date. The income standards for
9.21each month shall be added together and compared to the applicant's total countable income
9.22for the six-month budget period to determine eligibility.
9.23(3) For children ages one through 18 whose eligibility is determined under section
9.24256B.057, subdivision 2, the following deductions shall be applied to income counted
9.25toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
9.2616, 1996: $90 work expense, dependent care, and child support paid under court order.
9.27This clause is effective October 1, 2003.
9.28(b) For families with children whose eligibility is determined using the standard
9.29specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
9.30earned income shall be disregarded for up to four months and the following deductions
9.31shall be applied to each individual's income counted toward eligibility as allowed under
9.32the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
9.33under court order.
10.1(c) If the four-month disregard in paragraph (b) has been applied to the wage
10.2earner's income for four months, the disregard shall not be applied again until the wage
10.3earner's income has not been considered in determining medical assistance eligibility for
10.412 consecutive months.
10.5(d) (b) The commissioner shall adjust the income standards under this section each
10.6July 1 by the annual update of the federal poverty guidelines following publication by the
10.7United States Department of Health and Human Services except that the income standards
10.8shall not go below those in effect on July 1, 2009.
10.9(e) (c) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
10.10organization to or for the benefit of the child with a life-threatening illness must be
10.11disregarded from income.
10.12EFFECTIVE DATE.This section is effective January 1, 2014.

10.13    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
10.14    Subd. 3. Asset limitations for certain individuals and families. (a) To be
10.15eligible for medical assistance, a person must not individually own more than $3,000 in
10.16assets, or if a member of a household with two family members, husband and wife, or
10.17parent and child, the household must not own more than $6,000 in assets, plus $200 for
10.18each additional legal dependent. In addition to these maximum amounts, an eligible
10.19individual or family may accrue interest on these amounts, but they must be reduced to the
10.20maximum at the time of an eligibility redetermination. The accumulation of the clothing
10.21and personal needs allowance according to section 256B.35 must also be reduced to the
10.22maximum at the time of the eligibility redetermination. The value of assets that are not
10.23considered in determining eligibility for medical assistance is the value of those assets
10.24excluded under the supplemental security income program for aged, blind, and disabled
10.25persons, with the following exceptions:
10.26(1) household goods and personal effects are not considered;
10.27(2) capital and operating assets of a trade or business that the local agency determines
10.28are necessary to the person's ability to earn an income are not considered;
10.29(3) motor vehicles are excluded to the same extent excluded by the supplemental
10.30security income program;
10.31(4) assets designated as burial expenses are excluded to the same extent excluded by
10.32the supplemental security income program. Burial expenses funded by annuity contracts
10.33or life insurance policies must irrevocably designate the individual's estate as contingent
10.34beneficiary to the extent proceeds are not used for payment of selected burial expenses;
11.1(5) for a person who no longer qualifies as an employed person with a disability due
11.2to loss of earnings, assets allowed while eligible for medical assistance under section
11.3256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
11.4of ineligibility as an employed person with a disability, to the extent that the person's total
11.5assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
11.6    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
11.79 , is age 65 or older and has been enrolled during each of the 24 consecutive months
11.8before the person's 65th birthday, the assets owned by the person and the person's spouse
11.9must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
11.10when determining eligibility for medical assistance under section 256B.055, subdivision
11.117 . The income of a spouse of a person enrolled in medical assistance under section
11.12256B.057, subdivision 9 , during each of the 24 consecutive months before the person's
11.1365th birthday must be disregarded when determining eligibility for medical assistance
11.14under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
11.15the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
11.16is required to have qualified for medical assistance under section 256B.057, subdivision 9,
11.17prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
11.18(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
11.19required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
11.20Law 111-5. For purposes of this clause, an American Indian is any person who meets the
11.21definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
11.22(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
11.2315.
11.24EFFECTIVE DATE.This section is effective January 1, 2014.

11.25    Sec. 17. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by
11.26Laws 2013, chapter 1, section 5, is amended to read:
11.27    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
11.28section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
11.29the federal poverty guidelines. Effective January 1, 2000, and each successive January,
11.30recipients of supplemental security income may have an income up to the supplemental
11.31security income standard in effect on that date.
11.32(b) To be eligible for medical assistance, families and children may have an income
11.33up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
11.34AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
11.351996, shall be increased by three percent.
12.1(c) (b) Effective January 1, 2014, to be eligible for medical assistance, under section
12.2256B.055, subdivision 3a , a parent or caretaker relative may have an income up to 133
12.3percent of the federal poverty guidelines for the household size.
12.4(d) (c) To be eligible for medical assistance under section 256B.055, subdivision
12.515 , a person may have an income up to 133 percent of federal poverty guidelines for
12.6the household size.
12.7(e) (d) To be eligible for medical assistance under section 256B.055, subdivision
12.816 , a child age 19 to 20 may have an income up to 133 percent of the federal poverty
12.9guidelines for the household size.
12.10(f) (e) To be eligible for medical assistance under section 256B.055, subdivision 3a,
12.11a child under age 19 may have income up to 275 percent of the federal poverty guidelines
12.12for the household size or an equivalent standard when converted using modified adjusted
12.13gross income methodology as required under the Affordable Care Act. Children who are
12.14enrolled in medical assistance as of December 31, 2013, and are determined ineligible
12.15for medical assistance because of the elimination of income disregards under modified
12.16adjusted gross income methodology as defined in subdivision 1a remain eligible for
12.17medical assistance under the Children's Health Insurance Program Reauthorization Act
12.18of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility
12.19redetermination as required in section 256B.056, subdivision 7a.
12.20(f) In computing income to determine eligibility of persons under paragraphs (a) to
12.21(e) who are not residents of long-term care facilities, the commissioner shall disregard
12.22increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
12.23For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
12.24Administration unusual medical expense payments are considered income to the recipient.
12.25EFFECTIVE DATE.This section is effective January 1, 2014.

12.26    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
12.27    Subd. 5c. Excess income standard. (a) The excess income standard for families
12.28with children parents and caretaker relatives, pregnant women, infants, and children ages
12.29two through 20 is the standard specified in subdivision 4, paragraph (b).
12.30(b) The excess income standard for a person whose eligibility is based on blindness,
12.31disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
12.32family size. Effective July 1, 2002, the excess income standard for this paragraph shall
12.33equal 75 percent of the federal poverty guidelines.
12.34EFFECTIVE DATE.This section is effective January 1, 2014.

13.1    Sec. 19. Minnesota Statutes 2012, section 256B.056, is amended by adding a
13.2subdivision to read:
13.3    Subd. 7a. Periodic renewal of eligibility. (a) The commissioner shall make an
13.4annual redetermination of eligibility based on information contained in the enrollee's case
13.5file and other information available to the agency, including but not limited to information
13.6accessed through an electronic database, without requiring the enrollee to submit any
13.7information when sufficient data is available for the agency to renew eligibility.
13.8(b) If the commissioner cannot renew eligibility in accordance with paragraph (a),
13.9the commissioner must provide the enrollee with a prepopulated renewal form containing
13.10eligibility information available to the agency and permit the enrollee to submit the form
13.11with any corrections or additional information to the agency and sign the renewal form via
13.12any of the modes of submission specified in section 256B.04, subdivision 18.
13.13(c) An enrollee who is terminated for failure to complete the renewal process may
13.14subsequently submit the renewal form and required information within four months after
13.15the date of termination and have coverage reinstated without a lapse, if otherwise eligible
13.16under this chapter.
13.17(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
13.18required to renew eligibility every six months.
13.19EFFECTIVE DATE.This section is effective January 1, 2014.

13.20    Sec. 20. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
13.21    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
13.22are applying for the continuation of medical assistance coverage following the end of the
13.2360-day postpartum period to update their income and asset information and to submit
13.24any required income or asset verification.
13.25    (b) The commissioner shall determine the eligibility of private-sector health care
13.26coverage for infants less than one year of age eligible under section 256B.055, subdivision
13.2710 , or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
13.28if this is determined to be cost-effective.
13.29    (c) The commissioner shall verify assets and income for all applicants, and for all
13.30recipients upon renewal.
13.31    (d) The commissioner shall utilize information obtained through the electronic
13.32service established by the secretary of the United States Department of Health and Human
13.33Services and other available electronic data sources in Code of Federal Regulations, title
13.3442, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner
13.35shall establish standards to define when information obtained electronically is reasonably
14.1compatible with information provided by applicants and enrollees, including use of
14.2self-attestation, to accomplish real-time eligibility determinations and maintain program
14.3integrity.
14.4EFFECTIVE DATE.This section is effective January 1, 2014.

14.5    Sec. 21. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
14.6    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year
14.7 two years of age or a pregnant woman who has written verification of a positive pregnancy
14.8test from a physician or licensed registered nurse is eligible for medical assistance if the
14.9individual's countable family household income is equal to or less than 275 percent of the
14.10federal poverty guideline for the same family household size or an equivalent standard
14.11when converted using modified adjusted gross income methodology as required under
14.12the Affordable Care Act. For purposes of this subdivision, "countable family income"
14.13means the amount of income considered available using the methodology of the AFDC
14.14program under the state's AFDC plan as of July 16, 1996, as required by the Personal
14.15Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
14.16Law 104-193, except for the earned income disregard and employment deductions.
14.17    (2) For applications processed within one calendar month prior to the effective date,
14.18eligibility shall be determined by applying the income standards and methodologies in
14.19effect prior to the effective date for any months in the six-month budget period before
14.20that date and the income standards and methodologies in effect on the effective date for
14.21any months in the six-month budget period on or after that date. The income standards
14.22for each month shall be added together and compared to the applicant's total countable
14.23income for the six-month budget period to determine eligibility.
14.24    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
14.25    (2) For applications processed within one calendar month prior to July 1, 2003,
14.26eligibility shall be determined by applying the income standards and methodologies in
14.27effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
14.282003, and the income standards and methodologies in effect on the expiration date for any
14.29months in the six-month budget period on or after July 1, 2003. The income standards
14.30for each month shall be added together and compared to the applicant's total countable
14.31income for the six-month budget period to determine eligibility.
14.32    (3) An amount equal to the amount of earned income exceeding 275 percent of
14.33the federal poverty guideline, up to a maximum of the amount by which the combined
14.34total of 185 percent of the federal poverty guideline plus the earned income disregards
14.35and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
15.1by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
15.2Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
15.3pregnant women and infants less than one year of age.
15.4    (c) Dependent care and child support paid under court order shall be deducted from
15.5the countable income of pregnant women.
15.6    (d) (b) An infant born to a woman who was eligible for and receiving medical
15.7assistance on the date of the child's birth shall continue to be eligible for medical assistance
15.8without redetermination until the child's first birthday.
15.9EFFECTIVE DATE.This section is effective January 1, 2014.

15.10    Sec. 22. Minnesota Statutes 2012, section 256B.057, subdivision 8, is amended to read:
15.11    Subd. 8. Children under age two. Medical assistance may be paid for a child under
15.12two years of age whose countable family income is above 275 percent of the federal poverty
15.13guidelines for the same size family but less than or equal to 280 percent of the federal
15.14poverty guidelines for the same size family or an equivalent standard when converted using
15.15modified adjusted gross income methodology as required under the Affordable Care Act.
15.16EFFECTIVE DATE.This section is effective January 1, 2014.

15.17    Sec. 23. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
15.18    Subd. 10. Certain persons needing treatment for breast or cervical cancer. (a)
15.19Medical assistance may be paid for a person who:
15.20(1) has been screened for breast or cervical cancer by the Minnesota breast and
15.21cervical cancer control program, and program funds have been used to pay for the person's
15.22screening;
15.23(2) according to the person's treating health professional, needs treatment, including
15.24diagnostic services necessary to determine the extent and proper course of treatment, for
15.25breast or cervical cancer, including precancerous conditions and early stage cancer;
15.26(3) meets the income eligibility guidelines for the Minnesota breast and cervical
15.27cancer control program;
15.28(4) is under age 65;
15.29(5) is not otherwise eligible for medical assistance under United States Code, title
15.3042, section 1396a(a)(10)(A)(i); and
15.31(6) is not otherwise covered under creditable coverage, as defined under United
15.32States Code, title 42, section 1396a(aa).
16.1(b) Medical assistance provided for an eligible person under this subdivision shall
16.2be limited to services provided during the period that the person receives treatment for
16.3breast or cervical cancer.
16.4(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
16.5without meeting the eligibility criteria relating to income and assets in section 256B.056,
16.6subdivisions 1a to 5b 5a.
16.7EFFECTIVE DATE.This section is effective January 1, 2014.

16.8    Sec. 24. Minnesota Statutes 2012, section 256B.057, is amended by adding a
16.9subdivision to read:
16.10    Subd. 12. Presumptive eligibility determinations made by qualified hospitals.
16.11The commissioner shall establish a process to qualify hospitals that are participating
16.12providers under the medical assistance program to determine presumptive eligibility for
16.13medical assistance for applicants who may have a basis of eligibility using the modified
16.14adjusted gross income methodology as defined in section 256B.056, subdivision 1a,
16.15paragraph (b), clause (1).
16.16EFFECTIVE DATE.This section is effective January 1, 2014.

16.17    Sec. 25. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
16.18    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
16.19to citizens of the United States, qualified noncitizens as defined in this subdivision, and
16.20other persons residing lawfully in the United States. Citizens or nationals of the United
16.21States must cooperate in obtaining satisfactory documentary evidence of citizenship or
16.22nationality according to the requirements of the federal Deficit Reduction Act of 2005,
16.23Public Law 109-171.
16.24(b) "Qualified noncitizen" means a person who meets one of the following
16.25immigration criteria:
16.26(1) admitted for lawful permanent residence according to United States Code, title 8;
16.27(2) admitted to the United States as a refugee according to United States Code,
16.28title 8, section 1157;
16.29(3) granted asylum according to United States Code, title 8, section 1158;
16.30(4) granted withholding of deportation according to United States Code, title 8,
16.31section 1253(h);
16.32(5) paroled for a period of at least one year according to United States Code, title 8,
16.33section 1182(d)(5);
17.1(6) granted conditional entrant status according to United States Code, title 8,
17.2section 1153(a)(7);
17.3(7) determined to be a battered noncitizen by the United States Attorney General
17.4according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
17.5title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
17.6(8) is a child of a noncitizen determined to be a battered noncitizen by the United
17.7States Attorney General according to the Illegal Immigration Reform and Immigrant
17.8Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
17.9Public Law 104-200; or
17.10(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
17.11Law 96-422, the Refugee Education Assistance Act of 1980.
17.12(c) All qualified noncitizens who were residing in the United States before August
17.1322, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
17.14medical assistance with federal financial participation.
17.15(d) Beginning December 1, 1996, qualified noncitizens who entered the United
17.16States on or after August 22, 1996, and who otherwise meet the eligibility requirements
17.17of this chapter are eligible for medical assistance with federal participation for five years
17.18if they meet one of the following criteria:
17.19(1) refugees admitted to the United States according to United States Code, title 8,
17.20section 1157;
17.21(2) persons granted asylum according to United States Code, title 8, section 1158;
17.22(3) persons granted withholding of deportation according to United States Code,
17.23title 8, section 1253(h);
17.24(4) veterans of the United States armed forces with an honorable discharge for
17.25a reason other than noncitizen status, their spouses and unmarried minor dependent
17.26children; or
17.27(5) persons on active duty in the United States armed forces, other than for training,
17.28their spouses and unmarried minor dependent children.
17.29 Beginning July 1, 2010, children and pregnant women who are noncitizens
17.30described in paragraph (b) or who are lawfully present in the United States as defined
17.31in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
17.32eligibility requirements of this chapter, are eligible for medical assistance with federal
17.33financial participation as provided by the federal Children's Health Insurance Program
17.34Reauthorization Act of 2009, Public Law 111-3.
17.35(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
17.36are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
18.1subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
18.2Code, title 8, section 1101(a)(15).
18.3(f) Payment shall also be made for care and services that are furnished to noncitizens,
18.4regardless of immigration status, who otherwise meet the eligibility requirements of
18.5this chapter, if such care and services are necessary for the treatment of an emergency
18.6medical condition.
18.7(g) For purposes of this subdivision, the term "emergency medical condition" means
18.8a medical condition that meets the requirements of United States Code, title 42, section
18.91396b(v).
18.10(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
18.11of an emergency medical condition are limited to the following:
18.12(i) services delivered in an emergency room or by an ambulance service licensed
18.13under chapter 144E that are directly related to the treatment of an emergency medical
18.14condition;
18.15(ii) services delivered in an inpatient hospital setting following admission from an
18.16emergency room or clinic for an acute emergency condition; and
18.17(iii) follow-up services that are directly related to the original service provided
18.18to treat the emergency medical condition and are covered by the global payment made
18.19to the provider.
18.20    (2) Services for the treatment of emergency medical conditions do not include:
18.21(i) services delivered in an emergency room or inpatient setting to treat a
18.22nonemergency condition;
18.23(ii) organ transplants, stem cell transplants, and related care;
18.24(iii) services for routine prenatal care;
18.25(iv) continuing care, including long-term care, nursing facility services, home health
18.26care, adult day care, day training, or supportive living services;
18.27(v) elective surgery;
18.28(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
18.29part of an emergency room visit;
18.30(vii) preventative health care and family planning services;
18.31(viii) dialysis;
18.32(ix) chemotherapy or therapeutic radiation services;
18.33(x) rehabilitation services;
18.34(xi) physical, occupational, or speech therapy;
18.35(xii) transportation services;
18.36(xiii) case management;
19.1(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
19.2(xv) dental services;
19.3(xvi) hospice care;
19.4(xvii) audiology services and hearing aids;
19.5(xviii) podiatry services;
19.6(xix) chiropractic services;
19.7(xx) immunizations;
19.8(xxi) vision services and eyeglasses;
19.9(xxii) waiver services;
19.10(xxiii) individualized education programs; or
19.11(xxiv) chemical dependency treatment.
19.12(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented,
19.13nonimmigrants, or lawfully present in the United States as defined in Code of Federal
19.14Regulations, title 8, section 103.12, ineligible for federally funded medical assistance
19.15because of immigration status, are not covered by a group health plan or health insurance
19.16coverage according to Code of Federal Regulations, title 42, section 457.310, and who
19.17 otherwise meet the eligibility requirements of this chapter, are eligible for medical
19.18assistance through the period of pregnancy, including labor and delivery, and 60 days
19.19postpartum, to the extent federal funds are available under title XXI of the Social Security
19.20Act, and the state children's health insurance program.
19.21(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
19.22services from a nonprofit center established to serve victims of torture and are otherwise
19.23ineligible for medical assistance under this chapter are eligible for medical assistance
19.24without federal financial participation. These individuals are eligible only for the period
19.25during which they are receiving services from the center. Individuals eligible under this
19.26paragraph shall not be required to participate in prepaid medical assistance.
19.27EFFECTIVE DATE.This section is effective January 1, 2014.

19.28    Sec. 26. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
19.29    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
19.30for the quality of care based on standards established under subdivision 1, paragraph (b),
19.31clause (10), and the cost of care or utilization of services provided to its enrollees under
19.32subdivision 1, paragraph (b), clause (1).
19.33(b) A health care delivery system may contract and coordinate with providers and
19.34clinics for the delivery of services and shall contract with community health clinics,
20.1federally qualified health centers, community mental health centers or programs, county
20.2agencies, and rural clinics to the extent practicable.
20.3(c) A health care delivery system must indicate how it will coordinate with other
20.4services affecting its patients' health, quality of care, and cost of care that are provided by
20.5other providers, county agencies, and other organizations in the local service area. The
20.6health care delivery system must indicate how it will engage other providers, counties, and
20.7organizations, including county-based purchasing plans, that provide services to patients
20.8of the health care delivery system on issues related to local population health, including
20.9applicable local needs, priorities, and public health goals. The health care delivery system
20.10must describe how local providers, counties, organizations, including county-based
20.11purchasing plans, and other relevant purchasers were consulted in developing the
20.12application to participate in the demonstration project.
20.13EFFECTIVE DATE.This section is effective July 1, 2013, and applies to health
20.14care delivery system contracts entered into on or after that date.

20.15    Sec. 27. Minnesota Statutes 2012, section 256B.694, is amended to read:
20.16256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
20.17CONTRACT.
20.18    (a) MS 2010 [Expired, 2008 c 364 s 10]
20.19    (b) The commissioner shall consider, and may approve, contracting on a
20.20single-health plan basis with other county-based purchasing plans, or with other qualified
20.21health plans that have coordination arrangements with counties, to serve persons with a
20.22disability who voluntarily enroll enrolled in state public health care programs, in order
20.23to promote better coordination or integration of health care services, social services and
20.24other community-based services, provided that all requirements applicable to health plan
20.25purchasing, including those in section 256B.69, subdivision 23 sections 256B.69 and
20.26256B.692, are satisfied. Nothing in this paragraph supersedes or modifies the requirements
20.27in paragraph (a).

20.28    Sec. 28. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
20.29to read:
20.30    Subd. 1b. Affordable Care Act. "Affordable Care Act" means the federal Patient
20.31Protection and Affordable Care Act, Public Law 111-148, as amended, including the
20.32federal Health Care and Education Reconciliation Act of 2010, Public Law 111-152, and
20.33any amendments to, and any federal guidance or regulations issued under, these acts.

21.1    Sec. 29. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
21.2    Subd. 3a. Family with children. (a) "Family with children" means:
21.3(1) parents and their children residing in the same household; or
21.4(2) grandparents, foster parents, relative caretakers as defined in the medical
21.5assistance program, or legal guardians; and their wards who are children residing in the
21.6same household. "Family" has the meaning given for family and family size as defined
21.7in Code of Federal Regulations, title 26, section 1.36B-1.
21.8(b) The term includes children who are temporarily absent from the household in
21.9settings such as schools, camps, or parenting time with noncustodial parents.
21.10EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.11approval, whichever is later. The commissioner of human services shall notify the revisor
21.12of statutes when federal approval is obtained.

21.13    Sec. 30. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
21.14    Subd. 5. Income. (a) "Income" has the meaning given for earned and unearned
21.15income for families and children in the medical assistance program, according to the
21.16state's aid to families with dependent children plan in effect as of July 16, 1996. The
21.17definition does not include medical assistance income methodologies and deeming
21.18requirements. The earned income of full-time and part-time students under age 19 is
21.19not counted as income. Public assistance payments and supplemental security income
21.20are not excluded income modified adjusted gross income, as defined in Code of Federal
21.21Regulations, title 26, section 1.36B-1.
21.22(b) For purposes of this subdivision, and unless otherwise specified in this section,
21.23the commissioner shall use reasonable methods to calculate gross earned and unearned
21.24income including, but not limited to, projecting income based on income received within
21.25the past 30 days, the last 90 days, or the last 12 months.
21.26EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.27approval, whichever is later. The commissioner of human services shall notify the revisor
21.28of statutes when federal approval is obtained.

21.29    Sec. 31. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
21.30to read:
21.31    Subd. 6. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
21.32means the Minnesota Insurance Marketplace as defined in section 62V.02.

22.1    Sec. 32. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.2to read:
22.3    Subd. 7. Participating entity. "Participating entity" means a health carrier as
22.4defined in section 62A.01, subdivision 2; a county-based purchasing plan established
22.5under section 256B.692; an accountable care organization or other entity operating a
22.6health care delivery systems demonstration project authorized under section 256B.0755;
22.7an entity operating a county integrated health care delivery network pilot project
22.8authorized under section 256B.0756; or a network of health care providers established to
22.9offer services under MinnesotaCare.
22.10EFFECTIVE DATE.This section is effective January 1, 2015.

22.11    Sec. 33. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
22.12    Subd. 2. Commissioner's duties. (a) The commissioner shall establish an office
22.13for the state administration of this plan. The plan shall be used to provide covered health
22.14services for eligible persons. Payment for these services shall be made to all eligible
22.15providers participating entities under contract with the commissioner. The commissioner
22.16shall adopt rules to administer the MinnesotaCare program. The commissioner shall
22.17establish marketing efforts to encourage potentially eligible persons to receive information
22.18about the program and about other medical care programs administered or supervised by
22.19the Department of Human Services.
22.20(b) A toll-free telephone number and Web site must be used to provide information
22.21about medical programs and to promote access to the covered services.
22.22EFFECTIVE DATE.Paragraph (a) is effective January 1, 2015. Paragraph (b) is
22.23effective January 1, 2014, or upon federal approval, whichever is later. The commissioner
22.24of human services shall notify the revisor of statutes when federal approval is obtained.

22.25    Sec. 34. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
22.26to read:
22.27    Subd. 6. Federal approval. (a) The commissioner of human services shall seek
22.28federal approval to implement the MinnesotaCare program under this chapter as a basic
22.29health program. In any agreement with the Centers for Medicare and Medicaid Services
22.30to operate MinnesotaCare as a basic health program, the commissioner shall seek to
22.31include procedures to ensure that federal funding is predictable, stable, and sufficient
22.32to sustain ongoing operation of MinnesotaCare. These procedures must address issues
22.33related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
23.1and minimization of state financial risk. The commissioner shall consult with the
23.2commissioner of management and budget, when developing the proposal for establishing
23.3MinnesotaCare as a basic health program to be submitted to the Centers for Medicare
23.4and Medicaid Services.
23.5(b) The commissioner of human services, in consultation with the commissioner of
23.6management and budget, shall work with the Centers for Medicare and Medicaid Services
23.7to establish a process for reconciliation and adjustment of federal payments that balances
23.8state and federal liability over time. The commissioner of human services shall request that
23.9the secretary of health and human services hold the state, and enrollees, harmless in the
23.10reconciliation process for the first three years, to allow the state to develop a statistically
23.11valid methodology for predicting enrollment trends and their net effect on federal payments.
23.12EFFECTIVE DATE.This section is effective the day following final enactment.

23.13    Sec. 35. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
23.14to read:
23.15    Subd. 7. Coordination with Minnesota Insurance Marketplace. MinnesotaCare
23.16shall be considered a public health care program for purposes of chapter 62V.
23.17EFFECTIVE DATE.This section is effective January 1, 2014.

23.18    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
23.19    Subdivision 1. Covered health services. (a) "Covered health services" means the
23.20health services reimbursed under chapter 256B, with the exception of inpatient hospital
23.21services, special education services, private duty nursing services, adult dental care
23.22services other than services covered under section 256B.0625, subdivision 9, orthodontic
23.23services, nonemergency medical transportation services, personal care assistance and case
23.24management services, and nursing home or intermediate care facilities services, inpatient
23.25mental health services, and chemical dependency services.
23.26    (b) No public funds shall be used for coverage of abortion under MinnesotaCare
23.27except where the life of the female would be endangered or substantial and irreversible
23.28impairment of a major bodily function would result if the fetus were carried to term; or
23.29where the pregnancy is the result of rape or incest.
23.30    (c) Covered health services shall be expanded as provided in this section.
23.31EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
23.32approval, whichever is later. The commissioner of human services shall notify the revisor
23.33of statutes when federal approval is obtained.

24.1    Sec. 37. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
24.2    Subd. 1a. Pregnant women and Children; MinnesotaCare health care reform
24.3waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage
24.4of all services that are eligible for reimbursement under the medical assistance program
24.5according to chapter 256B, except that abortion services under MinnesotaCare shall be
24.6limited as provided under subdivision 1. Pregnant women and Children are exempt from
24.7the provisions of subdivision 5, regarding co-payments. Pregnant women and Children
24.8who are lawfully residing in the United States but who are not "qualified noncitizens" under
24.9title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
24.10Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
24.11of all services provided under the medical assistance program according to chapter 256B.
24.12EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.13approval, whichever is later. The commissioner of human services shall notify the revisor
24.14of statutes when federal approval is obtained.

24.15    Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
24.16    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
24.17inpatient hospital services, including inpatient hospital mental health services and inpatient
24.18hospital and residential chemical dependency treatment, subject to those limitations
24.19necessary to coordinate the provision of these services with eligibility under the medical
24.20assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
24.21section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
24.222 , with family gross income that exceeds 200 percent of the federal poverty guidelines or
24.23215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
24.24pregnant, is subject to an annual limit of $10,000.
24.25    (b) Admissions for inpatient hospital services paid for under section 256L.11,
24.26subdivision 3 , must be certified as medically necessary in accordance with Minnesota
24.27Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
24.28    (1) all admissions must be certified, except those authorized under rules established
24.29under section 254A.03, subdivision 3, or approved under Medicare; and
24.30    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
24.31for admissions for which certification is requested more than 30 days after the day of
24.32admission. The hospital may not seek payment from the enrollee for the amount of the
24.33payment reduction under this clause.
25.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
25.2approval, whichever is later. The commissioner of human services shall notify the revisor
25.3of statutes when federal approval is obtained.

25.4    Sec. 39. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
25.5to read:
25.6    Subd. 4a. Loss ratio. Health coverage provided through the MinnesotaCare
25.7program must have a medical loss ratio of at least 85 percent, as defined using the loss
25.8ratio methodology described in section 1001 of the Affordable Care Act.
25.9EFFECTIVE DATE.This section is effective January 1, 2015.

25.10    Sec. 40. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
25.11    Subd. 5. Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
25.12 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
25.13requirements for all enrollees:
25.14    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
25.15subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
25.16    (2) (1) $3 per prescription for adult enrollees;
25.17    (3) (2) $25 for eyeglasses for adult enrollees;
25.18    (4) (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means
25.19an episode of service which is required because of a recipient's symptoms, diagnosis, or
25.20established illness, and which is delivered in an ambulatory setting by a physician or
25.21physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
25.22audiologist, optician, or optometrist;
25.23    (5) (4) $6 for nonemergency visits to a hospital-based emergency room for services
25.24provided through December 31, 2010, and $3.50 effective January 1, 2011; and
25.25(6) (5) a family deductible equal to the maximum amount allowed under Code of
25.26Federal Regulations, title 42, part 447.54.
25.27    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
25.28children under the age of 21.
25.29    (c) (b) Paragraph (a) does not apply to pregnant women and children under the
25.30age of 21.
25.31    (d) (c) Paragraph (a), clause (4) (3), does not apply to mental health services.
25.32    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
25.33poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
26.1and who are not pregnant shall be financially responsible for the coinsurance amount, if
26.2applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
26.3    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
26.4or changes from one prepaid health plan to another during a calendar year, any charges
26.5submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
26.6expenses incurred by the enrollee for inpatient services, that were submitted or incurred
26.7prior to enrollment, or prior to the change in health plans, shall be disregarded.
26.8(g) (d) MinnesotaCare reimbursements to fee-for-service providers and payments to
26.9managed care plans or county-based purchasing plans shall not be increased as a result of
26.10the reduction of the co-payments in paragraph (a), clause (5) (4), effective January 1, 2011.
26.11(h) (e) The commissioner, through the contracting process under section 256L.12,
26.12may allow managed care plans and county-based purchasing plans to waive the family
26.13deductible under paragraph (a), clause (6) (5). The value of the family deductible shall not
26.14be included in the capitation payment to managed care plans and county-based purchasing
26.15plans. Managed care plans and county-based purchasing plans shall certify annually to the
26.16commissioner the dollar value of the family deductible.
26.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
26.18approval, whichever is later. The commissioner of human services shall notify the revisor
26.19of statutes when federal approval is obtained.

26.20    Sec. 41. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
26.21    Subd. 6. Lien. When the state agency provides, pays for, or becomes liable for
26.22covered health services, the agency shall have a lien for the cost of the covered health
26.23services upon any and all causes of action accruing to the enrollee, or to the enrollee's
26.24legal representatives, as a result of the occurrence that necessitated the payment for the
26.25covered health services. All liens under this section shall be subject to the provisions
26.26of section 256.015. For purposes of this subdivision, "state agency" includes prepaid
26.27health plans participating entities, under contract with the commissioner according to
26.28sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
26.29purchasing entities under section 256B.692 section 256L.121.
26.30EFFECTIVE DATE.This section is effective January 1, 2015.

26.31    Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
26.32    Subdivision 1. Families with children. (a) Families with children with family
26.33income above 133 percent of the federal poverty guidelines and equal to or less than 275
27.1 200 percent of the federal poverty guidelines for the applicable family size shall be eligible
27.2for MinnesotaCare according to this section. All other provisions of sections 256L.01 to
27.3256L.18 , including the insurance-related barriers to enrollment under section 256L.07,
27.4 shall apply unless otherwise specified. Children under age 19 with family income at or
27.5below 200 percent of the federal poverty guidelines and who are ineligible for medical
27.6assistance by sole reason of the application of federal household composition rules for
27.7medical assistance are eligible for MinnesotaCare.
27.8    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
27.9if the children are eligible. Children may be enrolled separately without enrollment by
27.10parents. However, if one parent in the household enrolls, both parents must enroll, unless
27.11other insurance is available. If one child from a family is enrolled, all children must
27.12be enrolled, unless other insurance is available. If one spouse in a household enrolls,
27.13the other spouse in the household must also enroll, unless other insurance is available.
27.14Families cannot choose to enroll only certain uninsured members.
27.15    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
27.16to the MinnesotaCare program. These persons are no longer counted in the parental
27.17household and may apply as a separate household.
27.18    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
27.19(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
27.208 , are exempt from the eligibility requirements of this subdivision.
27.21EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.22approval, whichever is later. The commissioner of human services shall notify the revisor
27.23of statutes when federal approval is obtained.

27.24    Sec. 43. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
27.25to read:
27.26    Subd. 1c. General requirements. To be eligible for coverage under MinnesotaCare,
27.27a person must meet the eligibility requirements of this section. A person eligible for
27.28MinnesotaCare shall not be considered a qualified individual under section 1312 of the
27.29Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
27.30through the Minnesota Insurance Marketplace under chapter 62V.
27.31EFFECTIVE DATE.This section is effective January 1, 2014.

27.32    Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
28.1    Subd. 7. Single adults and households with no children. (a) The definition of
28.2eligible persons includes all individuals and households families with no children who
28.3have gross family incomes that are above 133 percent and equal to or less than 200 percent
28.4of the federal poverty guidelines for the applicable family size.
28.5    (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
28.6and households with no children who have gross family incomes that are equal to or less
28.7than 250 percent of the federal poverty guidelines.
28.8EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
28.9approval, whichever is later. The commissioner of human services shall notify the revisor
28.10of statutes when federal approval is obtained.

28.11    Sec. 45. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
28.12    Subd. 8. Applicants potentially eligible for medical assistance. (a) Individuals
28.13who receive supplemental security income or retirement, survivors, or disability benefits
28.14due to a disability, or other disability-based pension, who qualify under subdivision 7, but
28.15who are potentially eligible for medical assistance without a spenddown shall be allowed
28.16to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
28.17conditions of eligibility. The commissioner shall identify and refer the applications of
28.18such individuals to their county social service agency. The county and the commissioner
28.19shall cooperate to ensure that the individuals obtain medical assistance coverage for any
28.20months for which they are eligible.
28.21(b) The enrollee must cooperate with the county social service agency in determining
28.22medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
28.23cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
28.24from the plan within one calendar month. Persons disenrolled for nonapplication for
28.25medical assistance may not reenroll until they have obtained a medical assistance
28.26eligibility determination. Persons disenrolled for noncooperation with medical assistance
28.27may not reenroll until they have cooperated with the county agency and have obtained a
28.28medical assistance eligibility determination.
28.29(c) Beginning January 1, 2000, Counties that choose to become MinnesotaCare
28.30enrollment sites shall consider MinnesotaCare applications to also be applications for
28.31medical assistance. Applicants who are potentially eligible for medical assistance, except
28.32for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
28.33medical assistance.
29.1(d) The commissioner shall redetermine provider payments made under
29.2MinnesotaCare to the appropriate medical assistance payments for those enrollees who
29.3subsequently become eligible for medical assistance.
29.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.5approval, whichever is later. The commissioner of human services shall notify the revisor
29.6of statutes when federal approval is obtained.

29.7    Sec. 46. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
29.8    Subd. 10. Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to
29.9citizens or nationals of the United States, qualified noncitizens, and other persons residing
29.10 and lawfully in the United States present noncitizens as defined in Code of Federal
29.11Regulations, title 8, section 103.12. Undocumented noncitizens and nonimmigrants
29.12 are ineligible for MinnesotaCare. For purposes of this subdivision, a nonimmigrant
29.13is an individual in one or more of the classes listed in United States Code, title 8,
29.14section 1101(a)(15), and an undocumented noncitizen is an individual who resides in the
29.15United States without the approval or acquiescence of the United States Citizenship and
29.16Immigration Services. Families with children who are citizens or nationals of the United
29.17States must cooperate in obtaining satisfactory documentary evidence of citizenship or
29.18nationality according to the requirements of the federal Deficit Reduction Act of 2005,
29.19Public Law 109-171.
29.20(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and
29.21individuals who are lawfully present and ineligible for medical assistance by reason of
29.22immigration status and who have incomes equal to or less than 200 percent of federal
29.23poverty guidelines.
29.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.25approval, whichever is later. The commissioner of human services shall notify the revisor
29.26of statutes when federal approval is obtained.

29.27    Sec. 47. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:
29.28    Subd. 12. Persons in detention. Beginning January 1, 1999, An applicant or
29.29enrollee residing in a correctional or detention facility is not eligible for MinnesotaCare,
29.30unless the applicant or enrollee is awaiting disposition of charges. An enrollee residing in
29.31a correctional or detention facility is not eligible at renewal of eligibility under section
29.32256L.05, subdivision 3a.
29.33EFFECTIVE DATE.This section is effective January 1, 2014.

30.1    Sec. 48. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
30.2to read:
30.3    Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
30.4medical assistance under chapter 256B are not eligible for MinnesotaCare under this
30.5section.
30.6(b) The commissioner shall coordinate eligibility and coverage to ensure that
30.7individuals transitioning between medical assistance and MinnesotaCare have seamless
30.8eligibility and access to health care services.
30.9EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
30.10approval, whichever is later. The commissioner of human services shall notify the revisor
30.11of statutes when federal approval is obtained.

30.12    Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
30.13    Subdivision 1. Application assistance and information availability. (a) Applicants
30.14may submit applications online, in person, by mail, or by phone in accordance with the
30.15Affordable Care Act, and by any other means by which medical assistance applications
30.16may be submitted. Applicants may submit applications through the Minnesota Insurance
30.17Marketplace or through the MinnesotaCare program. Applications and application
30.18assistance must be made available at provider offices, local human services agencies,
30.19school districts, public and private elementary schools in which 25 percent or more of
30.20the students receive free or reduced price lunches, community health offices, Women,
30.21Infants and Children (WIC) program sites, Head Start program sites, public housing
30.22councils, crisis nurseries, child care centers, early childhood education and preschool
30.23program sites, legal aid offices, and libraries, and at any other locations at which medical
30.24assistance applications must be made available. These sites may accept applications and
30.25forward the forms to the commissioner or local county human services agencies that
30.26choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
30.27commissioner or to participating local county human services agencies.
30.28(b) Application assistance must be available for applicants choosing to file an online
30.29application through the Minnesota Insurance Marketplace.
30.30EFFECTIVE DATE.This section is effective January 1, 2014.

30.31    Sec. 50. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
30.32    Subd. 2. Commissioner's duties. The commissioner or county agency shall use
30.33electronic verification through the Minnesota Insurance Marketplace as the primary
31.1method of income verification. If there is a discrepancy between reported income
31.2and electronically verified income, an individual may be required to submit additional
31.3verification to the extent permitted under the Affordable Care Act. In addition, the
31.4commissioner shall perform random audits to verify reported income and eligibility. The
31.5commissioner may execute data sharing arrangements with the Department of Revenue
31.6and any other governmental agency in order to perform income verification related to
31.7eligibility and premium payment under the MinnesotaCare program.
31.8EFFECTIVE DATE.This section is effective January 1, 2014.

31.9    Sec. 51. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
31.10    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
31.11first day of the month following the month in which eligibility is approved and the first
31.12premium payment has been received. As provided in section 256B.057, coverage for
31.13newborns is automatic from the date of birth and must be coordinated with other health
31.14coverage. The effective date of coverage for eligible newly adoptive children added to a
31.15family receiving covered health services is the month of placement. The effective date
31.16of coverage for other new members added to the family is the first day of the month
31.17following the month in which the change is reported. All eligibility criteria must be met
31.18by the family at the time the new family member is added. The income of the new family
31.19member is included with the family's modified adjusted gross income and the adjusted
31.20premium begins in the month the new family member is added.
31.21(b) The initial premium must be received by the last working day of the month for
31.22coverage to begin the first day of the following month.
31.23(c) Benefits are not available until the day following discharge if an enrollee is
31.24hospitalized on the first day of coverage.
31.25(d) (c) Notwithstanding any other law to the contrary, benefits under sections
31.26256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
31.27an eligible person may have coverage and the commissioner shall use cost avoidance
31.28techniques to ensure coordination of any other health coverage for eligible persons. The
31.29commissioner shall identify eligible persons who may have coverage or benefits under
31.30other plans of insurance or who become eligible for medical assistance.
31.31(e) (d) The effective date of coverage for individuals or families who are exempt
31.32from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first
31.33day of the month following the month in which verification of American Indian status
31.34is received or eligibility is approved, whichever is later.
32.1(f) The effective date of coverage for children eligible under section 256L.07,
32.2subdivision 8, is the first day of the month following the date of termination from foster
32.3care or release from a juvenile residential correctional facility.
32.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
32.5approval, whichever is later. The commissioner of human services shall notify the revisor
32.6of statutes when federal approval is obtained.

32.7    Sec. 52. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:
32.8    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective
32.9date of coverage shall be the first day of the month following termination from medical
32.10assistance for families and individuals who are eligible for MinnesotaCare and who
32.11submitted a written request for retroactive MinnesotaCare coverage with a completed
32.12application within 30 days of the mailing of notification of termination from medical
32.13assistance. The applicant must provide all required verifications within 30 days of the
32.14written request for verification. For retroactive coverage, premiums must be paid in full
32.15for any retroactive month, current month, and next month within 30 days of the premium
32.16billing. General assistance medical care recipients may qualify for retroactive coverage
32.17under this subdivision at six-month renewal. This subdivision does not apply, and shall not
32.18be implemented by the commissioner, once eligibility determination for MinnesotaCare is
32.19conducted by the Minnesota Insurance Marketplace eligibility determination system.
32.20EFFECTIVE DATE.This section is effective January 1, 2014.

32.21    Sec. 53. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
32.22    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
32.23commissioner for MinnesotaCare.
32.24    (b) The commissioner shall develop and implement procedures to: (1) require
32.25enrollees to report changes in income; (2) adjust sliding scale premium payments, based
32.26upon both increases and decreases in enrollee income, at the time the change in income
32.27is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
32.28premiums. Failure to pay includes payment with a dishonored check, a returned automatic
32.29bank withdrawal, or a refused credit card or debit card payment. The commissioner may
32.30demand a guaranteed form of payment, including a cashier's check or a money order, as
32.31the only means to replace a dishonored, returned, or refused payment.
32.32    (c) Premiums are calculated on a calendar month basis and may be paid on a
32.33monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
33.1commissioner of the premium amount required. The commissioner shall inform applicants
33.2and enrollees of these premium payment options. Premium payment is required before
33.3enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
33.4received before noon are credited the same day. Premium payments received after noon
33.5are credited on the next working day.
33.6    (d) Nonpayment of the premium will result in disenrollment from the plan effective
33.7for the calendar month for which the premium was due. Persons disenrolled for
33.8nonpayment or who voluntarily terminate coverage from the program may not reenroll
33.9until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
33.10all past due premiums as well as current premiums due, including premiums due for the
33.11period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
33.12to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
33.13terminate coverage from the program may not reenroll for four calendar months unless
33.14the person demonstrates good cause for nonpayment. Good cause does not exist if a
33.15person chooses to pay other family expenses instead of the premium. The commissioner
33.16shall define good cause in rule.
33.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.18approval, whichever is later. The commissioner of human services shall notify the revisor
33.19of statutes when federal approval is obtained.

33.20    Sec. 54. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
33.21    Subdivision 1. General requirements. (a) Children enrolled in the original
33.22children's health plan as of September 30, 1992, children who enrolled in the
33.23MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
33.24article 4, section 17, and children who have family gross incomes that are equal to or
33.25less than 200 percent of the federal poverty guidelines are eligible without meeting the
33.26requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
33.27they maintain continuous coverage in the MinnesotaCare program or medical assistance.
33.28    Parents Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 1,
33.29and individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose
33.30income increases above 275 200 percent of the federal poverty guidelines, are no longer
33.31eligible for the program and shall be disenrolled by the commissioner. Beginning January
33.321, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision
33.337 , whose income increases above 200 percent of the federal poverty guidelines or 250
33.34percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
33.35the program and shall be disenrolled by the commissioner. For persons disenrolled under
34.1this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
34.2following the month in which the commissioner determines that the income of a family or
34.3individual exceeds program income limits.
34.4    (b) Children may remain enrolled in MinnesotaCare if their gross family income as
34.5defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty
34.6guidelines. The premium for children remaining eligible under this paragraph shall be the
34.7maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
34.8    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
34.9gross household income exceeds $57,500 for the 12-month period of eligibility.
34.10EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.11approval, whichever is later. The commissioner of human services shall notify the revisor
34.12of statutes when federal approval is obtained.

34.13    Sec. 55. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
34.14    Subd. 2. Must not have access to employer-subsidized minimum essential
34.15 coverage. (a) To be eligible, a family or individual must not have access to subsidized
34.16health coverage through an employer and must not have had access to employer-subsidized
34.17coverage through a current employer for 18 months prior to application or reapplication.
34.18A family or individual whose employer-subsidized coverage is lost due to an employer
34.19terminating health care coverage as an employee benefit during the previous 18 months is
34.20not eligible that is affordable and provides minimum value as defined in Code of Federal
34.21Regulations, title 26, section 1.36B-2.
34.22(b) This subdivision does not apply to a family or individual who was enrolled
34.23in MinnesotaCare within six months or less of reapplication and who no longer has
34.24employer-subsidized coverage due to the employer terminating health care coverage as an
34.25employee benefit. This subdivision does not apply to children with family gross incomes
34.26that are equal to or less than 200 percent of federal poverty guidelines.
34.27(c) For purposes of this requirement, subsidized health coverage means health
34.28coverage for which the employer pays at least 50 percent of the cost of coverage for
34.29the employee or dependent, or a higher percentage as specified by the commissioner.
34.30Children are eligible for employer-subsidized coverage through either parent, including
34.31the noncustodial parent. The commissioner must treat employer contributions to Internal
34.32Revenue Code Section 125 plans and any other employer benefits intended to pay
34.33health care costs as qualified employer subsidies toward the cost of health coverage for
34.34employees for purposes of this subdivision.
35.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
35.2approval, whichever is later. The commissioner of human services shall notify the revisor
35.3of statutes when federal approval is obtained.

35.4    Sec. 56. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
35.5    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
35.6MinnesotaCare program must have no To be eligible, a family or individual must not have
35.7minimum essential health coverage while enrolled, as defined by section 5000A of the
35.8Internal Revenue Code. Children with family gross incomes equal to or greater than 200
35.9percent of federal poverty guidelines, and adults, must have had no health coverage for
35.10at least four months prior to application and renewal. Children enrolled in the original
35.11children's health plan and children in families with income equal to or less than 200
35.12percent of the federal poverty guidelines, who have other health insurance, are eligible if
35.13the coverage:
35.14(1) lacks two or more of the following:
35.15(i) basic hospital insurance;
35.16(ii) medical-surgical insurance;
35.17(iii) prescription drug coverage;
35.18(iv) dental coverage; or
35.19(v) vision coverage;
35.20(2) requires a deductible of $100 or more per person per year; or
35.21(3) lacks coverage because the child has exceeded the maximum coverage for a
35.22particular diagnosis or the policy excludes a particular diagnosis.
35.23The commissioner may change this eligibility criterion for sliding scale premiums
35.24in order to remain within the limits of available appropriations. The requirement of no
35.25health coverage does not apply to newborns.
35.26(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
35.27assistance, and the Civilian Health and Medical Program of the Uniformed Service,
35.28CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
35.29part II, chapter 55, are not considered insurance or health coverage for purposes of the
35.30four-month requirement described in this subdivision.
35.31(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
35.32Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
35.33Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
35.34to have minimum essential health coverage. An applicant or enrollee who is entitled to
36.1premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
36.2to establish eligibility for MinnesotaCare.
36.3(d) Applicants who were recipients of medical assistance within one month of
36.4application must meet the provisions of this subdivision and subdivision 2.
36.5(e) Cost-effective health insurance that was paid for by medical assistance is not
36.6considered health coverage for purposes of the four-month requirement under this
36.7section, except if the insurance continued after medical assistance no longer considered it
36.8cost-effective or after medical assistance closed.
36.9EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.10approval, whichever is later. The commissioner of human services shall notify the revisor
36.11of statutes when federal approval is obtained.

36.12    Sec. 57. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
36.13    Subd. 2. Residency requirement. To be eligible for health coverage under the
36.14MinnesotaCare program, pregnant women, individuals, and families with children must
36.15meet the residency requirements as provided by Code of Federal Regulations, title 42,
36.16section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply
36.17upon receipt of federal approval.
36.18EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.19approval, whichever is later. The commissioner of human services shall notify the revisor
36.20of statutes when federal approval is obtained.

36.21    Sec. 58. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:
36.22    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers
36.23under sections 256L.01 to 256L.11 this chapter shall be at the same rates and conditions
36.24established for medical assistance, except as provided in subdivisions 2 to 6 this section.
36.25(b) Effective for services provided on or after July 1, 2009, total payments for basic
36.26care services shall be reduced by three percent, in accordance with section 256B.766.
36.27Payments made to managed care and county-based purchasing plans shall be reduced for
36.28services provided on or after October 1, 2009, to reflect this reduction.
36.29(c) Effective for services provided on or after July 1, 2009, payment rates for
36.30physician and professional services shall be reduced as described under section 256B.76,
36.31subdivision 1, paragraph (c). Payments made to managed care and county-based
36.32purchasing plans shall be reduced for services provided on or after October 1, 2009,
36.33to reflect this reduction.
37.1EFFECTIVE DATE.This section is effective January 1, 2014.

37.2    Sec. 59. Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:
37.3    Subd. 3. Inpatient hospital services. Inpatient hospital services provided under
37.4section 256L.03, subdivision 3, shall be paid for as provided in subdivisions 4 to 6 at the
37.5medical assistance rate.
37.6EFFECTIVE DATE.This section is effective January 1, 2014.

37.7    Sec. 60. Minnesota Statutes 2012, section 256L.12, subdivision 1, is amended to read:
37.8    Subdivision 1. Selection of vendors. In order to contain costs, the commissioner of
37.9human services shall select vendors of medical care who can provide the most economical
37.10care consistent with high medical standards and shall, where possible, contract with
37.11organizations on a prepaid capitation basis to provide these services. The commissioner
37.12shall consider proposals by counties and vendors for managed care plans and managed
37.13care-like entities as defined by the final regulation implementing section 1331 of the
37.14Affordable Care Act regarding basic health plans, which may include: prepaid capitation
37.15programs, competitive bidding programs, or other vendor payment mechanisms designed
37.16to provide services in an economical manner or to control utilization, with safeguards to
37.17ensure that necessary services are provided.

37.18    Sec. 61. [256L.121] SERVICE DELIVERY.
37.19    Subdivision 1. Competitive process. The commissioner of human services shall
37.20establish a competitive process for entering into contracts with participating entities for
37.21the offering of standard health plans through MinnesotaCare. Coverage through standard
37.22health plans must be available to enrollees beginning January 1, 2015. Each standard
37.23health plan must cover the health services listed in and meet the requirements of section
37.24256L.03. The competitive process must meet the requirements of section 1331 of the
37.25Affordable Care Act and be designed to ensure enrollee access to high-quality health care
37.26coverage options. The commissioner, to the extent feasible, shall seek to ensure that
37.27enrollees have a choice of coverage from more than one participating entity within a
37.28geographic area. In counties that were part of a county-based purchasing plan on January
37.291, 2013, the commissioner shall use the medical assistance competitive procurement
37.30process under section 256B.69, subdivisions 1 to 32, under which selection of entities is
37.31based on criteria related to provider network access, coordination of health care with other
37.32local services, alignment with local public health goals, and other factors.
38.1    Subd. 2. Other requirements for participating entities. The commissioner shall
38.2require participating entities, as a condition of contract, to document to the commissioner:
38.3(1) the provision of culturally and linguistically appropriate services, including
38.4marketing materials, to MinnesotaCare enrollees; and
38.5(2) the inclusion in provider networks of providers designated as essential
38.6community providers under section 62Q.19.
38.7    Subd. 3. Coordination with state-administered health programs. The
38.8commissioner shall coordinate the administration of the MinnesotaCare program with
38.9medical assistance to maximize efficiency and improve the continuity of care. This
38.10includes, but is not limited to:
38.11(1) establishing geographic areas for MinnesotaCare that are consistent with the
38.12geographic areas of the medical assistance program, within which participating entities
38.13may offer health plans;
38.14(2) requiring, as a condition of participation in MinnesotaCare, participating entities
38.15to also participate in the medical assistance program;
38.16(3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and
38.17256B.694, when contracting with MinnesotaCare participating entities;
38.18(4) providing MinnesotaCare enrollees, to the extent possible, with the option to
38.19remain in the same health plan and provider network, if they later become eligible for
38.20medical assistance or coverage through the Minnesota health benefit exchange and if, in
38.21the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health
38.22plan is also a medical assistance health plan in the enrollee's county of residence; and
38.23(5) establishing requirements and criteria for selection that ensure that covered
38.24health care services will be coordinated with local public health services, social services,
38.25long-term care services, mental health services, and other local services affecting
38.26enrollees' health, access, and quality of care.
38.27EFFECTIVE DATE.This section is effective the day following final enactment.

38.28    Sec. 62. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
38.29    Subdivision 1. Premium determination. (a) Families with children and individuals
38.30shall pay a premium determined according to subdivision 2.
38.31    (b) Pregnant women and children under age two are exempt from the provisions
38.32of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
38.33for failure to pay premiums. For pregnant women, this exemption continues until the
38.34first day of the month following the 60th day postpartum. Women who remain enrolled
38.35during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
39.1disenrolled on the first of the month following the 60th day postpartum for the penalty
39.2period that otherwise applies under section 256L.06, unless they begin paying premiums.
39.3    (c) (b) Members of the military and their families who meet the eligibility criteria
39.4for MinnesotaCare upon eligibility approval made within 24 months following the end
39.5of the member's tour of active duty shall have their premiums paid by the commissioner.
39.6The effective date of coverage for an individual or family who meets the criteria of this
39.7paragraph shall be the first day of the month following the month in which eligibility is
39.8approved. This exemption applies for 12 months.
39.9(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
39.10their families shall have their premiums waived by the commissioner in accordance with
39.11section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
39.12An individual must document status as an American Indian, as defined under Code of
39.13Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
39.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
39.15approval, whichever is later. The commissioner of human services shall notify the revisor
39.16of statutes when federal approval is obtained.

39.17    Sec. 63. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
39.18    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
39.19commissioner shall establish a sliding fee scale to determine the percentage of monthly
39.20gross individual or family income that households at different income levels must pay to
39.21obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
39.22on the enrollee's monthly gross individual or family income. The sliding fee scale must
39.23contain separate tables based on enrollment of one, two, or three or more persons. Until
39.24June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
39.25individual or family income for individuals or families with incomes below the limits for
39.26the medical assistance program for families and children in effect on January 1, 1999, and
39.27proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
39.288.8 percent. These percentages are matched to evenly spaced income steps ranging from
39.29the medical assistance income limit for families and children in effect on January 1, 1999,
39.30to 275 percent of the federal poverty guidelines for the applicable family size, up to a
39.31family size of five. The sliding fee scale for a family of five must be used for families of
39.32more than five. The sliding fee scale and percentages are not subject to the provisions of
39.33chapter 14. If a family or individual reports increased income after enrollment, premiums
39.34shall be adjusted at the time the change in income is reported.
40.1    (b) Children in families whose gross income is above 275 percent of the federal
40.2poverty guidelines shall pay the maximum premium. The maximum premium is defined
40.3as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
40.4cases paid the maximum premium, the total revenue would equal the total cost of
40.5MinnesotaCare medical coverage and administration. In this calculation, administrative
40.6costs shall be assumed to equal ten percent of the total. The costs of medical coverage
40.7for pregnant women and children under age two and the enrollees in these groups shall
40.8be excluded from the total. The maximum premium for two enrollees shall be twice the
40.9maximum premium for one, and the maximum premium for three or more enrollees shall
40.10be three times the maximum premium for one.
40.11    (c) Beginning July 1, 2009 January 1, 2014, MinnesotaCare enrollees shall pay
40.12premiums according to the premium scale specified in paragraph (d) (c) with the exception
40.13that children 20 years of age and younger in families with income at or below 200 percent
40.14of the federal poverty guidelines shall pay no premiums. For purposes of paragraph (d),
40.15"minimum" means a monthly premium of $4.
40.16    (d) (c) The following premium scale is established for individuals and families
40.17with gross family incomes of 275 percent of the federal poverty guidelines or less each
40.18individual in the household who is 21 years of age or older and enrolled in MinnesotaCare:

40.19	Federal Poverty Guideline Range	Percent of Average Gross Monthly Income
40.20	0-45%	minimum
40.21 40.22	46-54%	$4 or 1.1% of family income, whichever is greater
40.23	55-81%	1.6%
40.24	82-109%	2.2%
40.25	110-136%	2.9%
40.26	137-164%	3.6%
40.27	165-191%	4.6%
40.28	192-219%	5.6%
40.29	220-248%	6.5%
40.30	249-275%	7.2%

40.31 40.32	Federal Poverty Guideline Greater than or Equal to	Less than	Individual Premium Amount
40.33	0%	55%	$4
40.34	55%	80%	$6
40.35	80%	90%	$8
40.36	90%	100%	$10
40.37	100%	110%	$12
40.38	110%	120%	$15
40.39	120%	130%	$18
40.40	130%	140%	$21
41.1	140%	150%	$25
41.2	150%	160%	$29
41.3	160%	170%	$33
41.4	170%	180%	$38
41.5	180%	190%	$43
41.6	190%		$50

41.7EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
41.8approval, whichever is later. The commissioner of human services shall notify the revisor
41.9of statutes when federal approval is obtained.

41.10    Sec. 64. DETERMINATION OF FUNDING ADEQUACY FOR
41.11MINNESOTACARE.
41.12The commissioners of revenue and management and budget, in consultation with
41.13the commissioner of human services, shall conduct an assessment of health care taxes,
41.14including the gross premiums tax, the provider tax, and Medicaid surcharges, and their
41.15relationship to the long-term solvency of the health care access fund, as part of the state
41.16revenue and expenditure forecast in November 2013. The commissioners shall determine
41.17the amount of state funding that will be required after December 31, 2019, in addition
41.18to the federal payments made available under section 1331 of the Affordable Care Act,
41.19for the MinnesotaCare program. The commissioners shall evaluate the stability and
41.20likelihood of long-term federal funding for the MinnesotaCare program under section
41.211331. The commissioners shall report the results of this assessment to the chairs and
41.22ranking minority members of the legislative committees with jurisdiction over human
41.23services, finances, and taxes by January 15, 2014, along with recommendations for
41.24changes to state revenue for the health care access fund, if state funding continues to
41.25be required beyond December 31, 2019.

41.26    Sec. 65. STATE-BASED RISK ADJUSTMENT SYSTEM ASSESSMENT.
41.27(a) Notwithstanding Minnesota Rules, chapter 4653, the commissioner of health,
41.28as part of the commissioner's responsibilities under Minnesota Statutes, section 62U.04,
41.29subdivision 4, paragraph (b), shall collect from health carriers in the individual and
41.30small group health insurance market, beginning on January 1, 2014, for service dates
41.31beginning October 1, 2013, through December 31, 2014, all data required for conducting
41.32risk adjustment with standard risk adjusters such as the Adjusted Clinical Groups or the
41.33Hierarchical Condition Category System, including, but not limited to:
41.34(1) an indicator identifying the health plan product under which an enrollee is covered;
42.1(2) an indicator identifying whether an enrollee's policy is an individual or small
42.2group market policy;
42.3(3) an indicator identifying, if applicable, the metal level of an enrollee's health plan
42.4product, and whether the policy is a catastrophic policy; and
42.5(4) additional identified demographic data necessary to link individuals' data across
42.6health carriers and insurance affordability programs with 95 percent accuracy. The
42.7commissioner shall not collect more than the last four digits of an individual's Social
42.8Security number.
42.9(b) The commissioner of health shall assess the extent to which data collected under
42.10paragraph (a) and under Minnesota Statutes, section 62U.04, subdivision 4, paragraph (a),
42.11are sufficient for developing and operating a state alternative risk adjustment methodology
42.12consistent with applicable federal rules by evaluating:
42.13(1) if the data submitted are adequately complete, accurate, and timely;
42.14(2) if the data should be further enriched by nontraditional risk adjusters that help
42.15in better explaining variation in health care costs of a given population and account for
42.16risk selection across metal levels;
42.17(3) whether additional data or identifiers have the potential to strengthen a
42.18Minnesota-based risk adjustment approach; and
42.19(4) what, if any, changes to the technical infrastructure will be necessary to
42.20effectively perform state-based risk adjustment.
42.21(c) For purposes of paragraph (b), the commissioner of health shall have the
42.22authority to use identified data to validate and audit a statistically valid sample of data for
42.23each health carrier in the individual and small group health insurance market.
42.24(d) If the assessment conducted in paragraph (b) finds that the data collected
42.25under Minnesota Statutes, section 62U.04, subdivision 4, are sufficient for developing
42.26and operating a state alternative risk adjustment methodology consistent with applicable
42.27federal rules, the commissioners of health and human services, in consultation with the
42.28commissioner of commerce and the Board of MNsure, shall study whether Minnesota-based
42.29risk adjustment of the individual and small group health insurance market, using either the
42.30federal risk adjustment model or a state-based alternative, can be more cost-effective and
42.31perform better than risk adjustment conducted by federal agencies. The study shall assess
42.32the policies, infrastructure, and resources necessary to satisfy the requirements of Code of
42.33Federal Regulations, title 45, section 153, subpart D. The study shall also evaluate the
42.34extent to which Minnesota-based risk adjustment could meet requirements established in
42.35Code of Federal Regulations, title 45, section 153.330, including:
42.36(1) explaining the variation in health care costs of a given population;
43.1(2) linking risk factors to daily clinical practices and that which is clinically
43.2meaningful to providers;
43.3(3) encouraging favorable behavior among health care market participants and
43.4discouraging unfavorable behavior;
43.5(4) whether risk adjustment factors are relatively easy for stakeholders to understand
43.6and participate in;
43.7(5) providing stable risk scores over time and across health plan products;
43.8(6) minimizing administrative costs;
43.9(7) accounting for risk selection across metal levels;
43.10(8) aligning each of the elements of the methodology; and
43.11(9) can be conducted at per-member cost equal to or lower than the projected cost of
43.12the federal risk adjustment model.
43.13(e) In conducting the study described in paragraph (d), the commissioner of health
43.14shall contract with entities that do not have an economic interest in the outcome of
43.15Minnesota-based risk adjustment, but have demonstrated expertise in actuarial science
43.16or health economics and demonstrated experience with designing and implementing risk
43.17adjustment models. The commissioner of human services shall evaluate opportunities
43.18to maximize federal funding under section 1331 of the Affordable Care Act. The
43.19commissioner of human services shall make recommendations on risk adjustment
43.20strategies to maximize federal funding to the state of Minnesota.
43.21(f) The commissioner of health shall submit an interim report to the legislature by
43.22March 15, 2014, with preliminary findings from the assessment conducted in paragraph
43.23(b). The interim report shall include legislative recommendations for any necessary
43.24changes to Minnesota Statutes, section 62Q.03. The commissioners of health and human
43.25services shall submit a final report to the legislature by October 1, 2015. The final report
43.26must include findings from the overall assessment conducted under paragraph (e), and a
43.27recommendation on whether to conduct state-based risk adjustment.
43.28(g) The Board of MNsure shall apply for federal funding under section 1311 or
43.291321 of the Affordable Care Act, to fund the work under paragraphs (a), (b), (d), and (e).
43.30Federal funding awarded to MNsure for this purpose is approved and appropriated for
43.31this purpose. The commissioners of health and human services may only proceed with
43.32activities under paragraphs (a) to (e) if funding has been made available for this purpose.
43.33(h) For purposes of this section, the Board of MNsure means the board established
43.34under Minnesota Statutes, section 62V.03, and the Affordable Care Act has the meaning
43.35given in Minnesota Statutes, section 256B.02, subdivision 17.

44.1    Sec. 66. REQUEST FOR FEDERAL AUTHORITY.
44.2The commissioner of human services shall seek authority from the federal Centers
44.3for Medicare and Medicaid Services to allow persons under age 65, participating in
44.4a home and community-based services waiver under section 1915(c) of the Social
44.5Security Act, to continue to disregard spousal income and assets, in place of the spousal
44.6impoverishment provisions under the federal Patient Protection and Affordable Care Act,
44.7Public Law 111-148, section 2404, as amended by the federal Health Care and Education
44.8Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations
44.9and guidance issued under, those acts.

44.10    Sec. 67. REVISOR'S INSTRUCTION.
44.11The revisor of statutes shall: (1) remove cross-references to the sections repealed
44.12in this article wherever they appear in Minnesota Statutes and Minnesota Rules; (2)
44.13change the term "Minnesota Insurance Marketplace" to "MNsure" wherever it appears
44.14in this article and in Minnesota Statutes; and (3) make changes necessary to correct the
44.15punctuation, grammar, or structure of the remaining text and preserve its meaning.

44.16    Sec. 68. REPEALER.
44.17Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.031; 256L.04,
44.18subdivisions 1b, 9, and 10a; 256L.05, subdivision 3b; 256L.07, subdivisions 1, 5, 8, and 9;
44.19256L.11, subdivisions 5 and 6; and 256L.17, subdivisions 1, 2, 3, 4, and 5, are repealed
44.20effective January 1, 2014.
44.21(b) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b;
44.22256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed effective
44.23January 1, 2014.

44.24ARTICLE 2

44.25CONTINGENT REFORM 2020; REDESIGNING HOME AND
44.26COMMUNITY-BASED SERVICES

44.27    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
44.28    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
44.29electronically submit to the commissioner of health case mix assessments that conform
44.30with the assessment schedule defined by Code of Federal Regulations, title 42, section
44.31483.20, and published by the United States Department of Health and Human Services,
44.32Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
44.33Instrument User's Manual, version 3.0, and subsequent updates when issued by the
44.34Centers for Medicare and Medicaid Services. The commissioner of health may substitute
45.1successor manuals or question and answer documents published by the United States
45.2Department of Health and Human Services, Centers for Medicare and Medicaid Services,
45.3to replace or supplement the current version of the manual or document.
45.4(b) The assessments used to determine a case mix classification for reimbursement
45.5include the following:
45.6(1) a new admission assessment must be completed by day 14 following admission;
45.7(2) an annual assessment which must have an assessment reference date (ARD)
45.8within 366 days of the ARD of the last comprehensive assessment;
45.9(3) a significant change assessment must be completed within 14 days of the
45.10identification of a significant change; and
45.11(4) all quarterly assessments must have an assessment reference date (ARD) within
45.1292 days of the ARD of the previous assessment.
45.13(c) In addition to the assessments listed in paragraph (b), the assessments used to
45.14determine nursing facility level of care include the following:
45.15(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a
45.16county, tribe, or managed care organization under contract with the Department of Human
45.17Services 256.975, subdivision 7a, by the Senior LinkAge Line or other organization under
45.18contract with the Minnesota Board on Aging; and
45.19(2) a nursing facility level of care determination as provided for under section
45.20256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
45.21completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
45.22managed care organization under contract with the Department of Human Services.

45.23    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
45.24144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
45.25REPORT AND STUDY REQUIRED.
45.26    Subdivision 1. Report requirements. The commissioners of health and human
45.27services, with the cooperation of counties and in consultation with stakeholders, including
45.28persons who need or are using long-term care services and supports, lead agencies,
45.29regional entities, senior, disability, and mental health organization representatives, service
45.30providers, and community members shall prepare a report to the legislature by August 15,
45.312013, and biennially thereafter, regarding the status of the full range of long-term care
45.32services and supports for the elderly and children and adults with disabilities and mental
45.33illnesses in Minnesota. The report shall address:
45.34    (1) demographics and need for long-term care services and supports in Minnesota;
46.1    (2) summary of county and regional reports on long-term care gaps, surpluses,
46.2imbalances, and corrective action plans;
46.3    (3) status of long-term care services and related mental health services, housing
46.4options, and supports by county and region including:
46.5    (i) changes in availability of the range of long-term care services and housing options;
46.6    (ii) access problems, including access to the least restrictive and most integrated
46.7services and settings, regarding long-term care services; and
46.8    (iii) comparative measures of long-term care services availability, including serving
46.9people in their home areas near family, and changes over time; and
46.10    (4) recommendations regarding goals for the future of long-term care services and
46.11supports, policy and fiscal changes, and resource development and transition needs.
46.12    Subd. 2. Critical access study. The commissioner of human services shall conduct
46.13a onetime study to assess local capacity and availability of home and community-based
46.14services for older adults, people with disabilities, and people with mental illnesses. The
46.15study must assess critical access at the community level and identify potential strategies
46.16to build home and community-based service capacity in critical access areas. The report
46.17shall be submitted to the legislature no later than August 15, 2015.

46.18    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
46.19    Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
46.20licensure of city, county, and state agency social workers is voluntary, except an individual
46.21who is newly employed by a city or state agency after July 1, 2016, must be licensed
46.22if the individual who provides social work services, as those services are defined in
46.23section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title
46.24incorporating the words "social work" or "social worker."
46.25(b) City, county, and state agencies employing social workers and staff who are
46.26designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
46.27256.01, subdivision 24, are not required to employ licensed social workers.

46.28    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
46.29    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
46.302 , the commissioner of human services shall carry out the specific duties in paragraphs (a)
46.31through (cc) (dd):
46.32    (a) Administer and supervise all forms of public assistance provided for by state law
46.33and other welfare activities or services as are vested in the commissioner. Administration
46.34and supervision of human services activities or services includes, but is not limited to,
47.1assuring timely and accurate distribution of benefits, completeness of service, and quality
47.2program management. In addition to administering and supervising human services
47.3activities vested by law in the department, the commissioner shall have the authority to:
47.4    (1) require county agency participation in training and technical assistance programs
47.5to promote compliance with statutes, rules, federal laws, regulations, and policies
47.6governing human services;
47.7    (2) monitor, on an ongoing basis, the performance of county agencies in the
47.8operation and administration of human services, enforce compliance with statutes, rules,
47.9federal laws, regulations, and policies governing welfare services and promote excellence
47.10of administration and program operation;
47.11    (3) develop a quality control program or other monitoring program to review county
47.12performance and accuracy of benefit determinations;
47.13    (4) require county agencies to make an adjustment to the public assistance benefits
47.14issued to any individual consistent with federal law and regulation and state law and rule
47.15and to issue or recover benefits as appropriate;
47.16    (5) delay or deny payment of all or part of the state and federal share of benefits and
47.17administrative reimbursement according to the procedures set forth in section 256.017;
47.18    (6) make contracts with and grants to public and private agencies and organizations,
47.19both profit and nonprofit, and individuals, using appropriated funds; and
47.20    (7) enter into contractual agreements with federally recognized Indian tribes with
47.21a reservation in Minnesota to the extent necessary for the tribe to operate a federally
47.22approved family assistance program or any other program under the supervision of the
47.23commissioner. The commissioner shall consult with the affected county or counties in
47.24the contractual agreement negotiations, if the county or counties wish to be included,
47.25in order to avoid the duplication of county and tribal assistance program services. The
47.26commissioner may establish necessary accounts for the purposes of receiving and
47.27disbursing funds as necessary for the operation of the programs.
47.28    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
47.29regulation, and policy necessary to county agency administration of the programs.
47.30    (c) Administer and supervise all child welfare activities; promote the enforcement of
47.31laws protecting disabled, dependent, neglected and delinquent children, and children born
47.32to mothers who were not married to the children's fathers at the times of the conception
47.33nor at the births of the children; license and supervise child-caring and child-placing
47.34agencies and institutions; supervise the care of children in boarding and foster homes or
47.35in private institutions; and generally perform all functions relating to the field of child
47.36welfare now vested in the State Board of Control.
48.1    (d) Administer and supervise all noninstitutional service to disabled persons,
48.2including those who are visually impaired, hearing impaired, or physically impaired
48.3or otherwise disabled. The commissioner may provide and contract for the care and
48.4treatment of qualified indigent children in facilities other than those located and available
48.5at state hospitals when it is not feasible to provide the service in state hospitals.
48.6    (e) Assist and actively cooperate with other departments, agencies and institutions,
48.7local, state, and federal, by performing services in conformity with the purposes of Laws
48.81939, chapter 431.
48.9    (f) Act as the agent of and cooperate with the federal government in matters of
48.10mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
48.11431, including the administration of any federal funds granted to the state to aid in the
48.12performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
48.13and including the promulgation of rules making uniformly available medical care benefits
48.14to all recipients of public assistance, at such times as the federal government increases its
48.15participation in assistance expenditures for medical care to recipients of public assistance,
48.16the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
48.17    (g) Establish and maintain any administrative units reasonably necessary for the
48.18performance of administrative functions common to all divisions of the department.
48.19    (h) Act as designated guardian of both the estate and the person of all the wards of
48.20the state of Minnesota, whether by operation of law or by an order of court, without any
48.21further act or proceeding whatever, except as to persons committed as developmentally
48.22disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
48.23recognized by the Secretary of the Interior whose interests would be best served by
48.24adoptive placement, the commissioner may contract with a licensed child-placing agency
48.25or a Minnesota tribal social services agency to provide adoption services. A contract
48.26with a licensed child-placing agency must be designed to supplement existing county
48.27efforts and may not replace existing county programs or tribal social services, unless the
48.28replacement is agreed to by the county board and the appropriate exclusive bargaining
48.29representative, tribal governing body, or the commissioner has evidence that child
48.30placements of the county continue to be substantially below that of other counties. Funds
48.31encumbered and obligated under an agreement for a specific child shall remain available
48.32until the terms of the agreement are fulfilled or the agreement is terminated.
48.33    (i) Act as coordinating referral and informational center on requests for service for
48.34newly arrived immigrants coming to Minnesota.
48.35    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
48.36way be construed to be a limitation upon the general transfer of powers herein contained.
49.1    (k) Establish county, regional, or statewide schedules of maximum fees and charges
49.2which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
49.3nursing home care and medicine and medical supplies under all programs of medical
49.4care provided by the state and for congregate living care under the income maintenance
49.5programs.
49.6    (l) Have the authority to conduct and administer experimental projects to test methods
49.7and procedures of administering assistance and services to recipients or potential recipients
49.8of public welfare. To carry out such experimental projects, it is further provided that the
49.9commissioner of human services is authorized to waive the enforcement of existing specific
49.10statutory program requirements, rules, and standards in one or more counties. The order
49.11establishing the waiver shall provide alternative methods and procedures of administration,
49.12shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
49.13in no event shall the duration of a project exceed four years. It is further provided that no
49.14order establishing an experimental project as authorized by the provisions of this section
49.15shall become effective until the following conditions have been met:
49.16    (1) the secretary of health and human services of the United States has agreed, for
49.17the same project, to waive state plan requirements relative to statewide uniformity; and
49.18    (2) a comprehensive plan, including estimated project costs, shall be approved by
49.19the Legislative Advisory Commission and filed with the commissioner of administration.
49.20    (m) According to federal requirements, establish procedures to be followed by
49.21local welfare boards in creating citizen advisory committees, including procedures for
49.22selection of committee members.
49.23    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
49.24control error rates for the aid to families with dependent children program formerly
49.25codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
49.26following manner:
49.27    (1) one-half of the total amount of the disallowance shall be borne by the county
49.28boards responsible for administering the programs. For the medical assistance and the
49.29AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
49.30shared by each county board in the same proportion as that county's expenditures for the
49.31sanctioned program are to the total of all counties' expenditures for the AFDC program
49.32formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
49.33food stamp program, sanctions shall be shared by each county board, with 50 percent of
49.34the sanction being distributed to each county in the same proportion as that county's
49.35administrative costs for food stamps are to the total of all food stamp administrative costs
49.36for all counties, and 50 percent of the sanctions being distributed to each county in the
50.1same proportion as that county's value of food stamp benefits issued are to the total of
50.2all benefits issued for all counties. Each county shall pay its share of the disallowance
50.3to the state of Minnesota. When a county fails to pay the amount due hereunder, the
50.4commissioner may deduct the amount from reimbursement otherwise due the county, or
50.5the attorney general, upon the request of the commissioner, may institute civil action
50.6to recover the amount due; and
50.7    (2) notwithstanding the provisions of clause (1), if the disallowance results from
50.8knowing noncompliance by one or more counties with a specific program instruction, and
50.9that knowing noncompliance is a matter of official county board record, the commissioner
50.10may require payment or recover from the county or counties, in the manner prescribed in
50.11clause (1), an amount equal to the portion of the total disallowance which resulted from the
50.12noncompliance, and may distribute the balance of the disallowance according to clause (1).
50.13    (o) Develop and implement special projects that maximize reimbursements and
50.14result in the recovery of money to the state. For the purpose of recovering state money,
50.15the commissioner may enter into contracts with third parties. Any recoveries that result
50.16from projects or contracts entered into under this paragraph shall be deposited in the
50.17state treasury and credited to a special account until the balance in the account reaches
50.18$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
50.19transferred and credited to the general fund. All money in the account is appropriated to
50.20the commissioner for the purposes of this paragraph.
50.21    (p) Have the authority to make direct payments to facilities providing shelter
50.22to women and their children according to section 256D.05, subdivision 3. Upon
50.23the written request of a shelter facility that has been denied payments under section
50.24256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
50.25a determination within 30 days of the request for review regarding issuance of direct
50.26payments to the shelter facility. Failure to act within 30 days shall be considered a
50.27determination not to issue direct payments.
50.28    (q) Have the authority to establish and enforce the following county reporting
50.29requirements:
50.30    (1) the commissioner shall establish fiscal and statistical reporting requirements
50.31necessary to account for the expenditure of funds allocated to counties for human
50.32services programs. When establishing financial and statistical reporting requirements, the
50.33commissioner shall evaluate all reports, in consultation with the counties, to determine if
50.34the reports can be simplified or the number of reports can be reduced;
50.35    (2) the county board shall submit monthly or quarterly reports to the department
50.36as required by the commissioner. Monthly reports are due no later than 15 working days
51.1after the end of the month. Quarterly reports are due no later than 30 calendar days after
51.2the end of the quarter, unless the commissioner determines that the deadline must be
51.3shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
51.4or risking a loss of federal funding. Only reports that are complete, legible, and in the
51.5required format shall be accepted by the commissioner;
51.6    (3) if the required reports are not received by the deadlines established in clause (2),
51.7the commissioner may delay payments and withhold funds from the county board until
51.8the next reporting period. When the report is needed to account for the use of federal
51.9funds and the late report results in a reduction in federal funding, the commissioner shall
51.10withhold from the county boards with late reports an amount equal to the reduction in
51.11federal funding until full federal funding is received;
51.12    (4) a county board that submits reports that are late, illegible, incomplete, or not
51.13in the required format for two out of three consecutive reporting periods is considered
51.14noncompliant. When a county board is found to be noncompliant, the commissioner
51.15shall notify the county board of the reason the county board is considered noncompliant
51.16and request that the county board develop a corrective action plan stating how the
51.17county board plans to correct the problem. The corrective action plan must be submitted
51.18to the commissioner within 45 days after the date the county board received notice
51.19of noncompliance;
51.20    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
51.21after the date the report was originally due. If the commissioner does not receive a report
51.22by the final deadline, the county board forfeits the funding associated with the report for
51.23that reporting period and the county board must repay any funds associated with the
51.24report received for that reporting period;
51.25    (6) the commissioner may not delay payments, withhold funds, or require repayment
51.26under clause (3) or (5) if the county demonstrates that the commissioner failed to
51.27provide appropriate forms, guidelines, and technical assistance to enable the county to
51.28comply with the requirements. If the county board disagrees with an action taken by the
51.29commissioner under clause (3) or (5), the county board may appeal the action according
51.30to sections 14.57 to 14.69; and
51.31    (7) counties subject to withholding of funds under clause (3) or forfeiture or
51.32repayment of funds under clause (5) shall not reduce or withhold benefits or services to
51.33clients to cover costs incurred due to actions taken by the commissioner under clause
51.34(3) or (5).
52.1    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
52.2federal fiscal disallowances or sanctions are based on a statewide random sample in direct
52.3proportion to each county's claim for that period.
52.4    (s) Be responsible for ensuring the detection, prevention, investigation, and
52.5resolution of fraudulent activities or behavior by applicants, recipients, and other
52.6participants in the human services programs administered by the department.
52.7    (t) Require county agencies to identify overpayments, establish claims, and utilize
52.8all available and cost-beneficial methodologies to collect and recover these overpayments
52.9in the human services programs administered by the department.
52.10    (u) Have the authority to administer a drug rebate program for drugs purchased
52.11pursuant to the prescription drug program established under section 256.955 after the
52.12beneficiary's satisfaction of any deductible established in the program. The commissioner
52.13shall require a rebate agreement from all manufacturers of covered drugs as defined in
52.14section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
52.15or after July 1, 2002, must include rebates for individuals covered under the prescription
52.16drug program who are under 65 years of age. For each drug, the amount of the rebate shall
52.17be equal to the rebate as defined for purposes of the federal rebate program in United
52.18States Code, title 42, section 1396r-8. The manufacturers must provide full payment
52.19within 30 days of receipt of the state invoice for the rebate within the terms and conditions
52.20used for the federal rebate program established pursuant to section 1927 of title XIX of
52.21the Social Security Act. The manufacturers must provide the commissioner with any
52.22information necessary to verify the rebate determined per drug. The rebate program shall
52.23utilize the terms and conditions used for the federal rebate program established pursuant to
52.24section 1927 of title XIX of the Social Security Act.
52.25    (v) Have the authority to administer the federal drug rebate program for drugs
52.26purchased under the medical assistance program as allowed by section 1927 of title XIX
52.27of the Social Security Act and according to the terms and conditions of section 1927.
52.28Rebates shall be collected for all drugs that have been dispensed or administered in an
52.29outpatient setting and that are from manufacturers who have signed a rebate agreement
52.30with the United States Department of Health and Human Services.
52.31    (w) Have the authority to administer a supplemental drug rebate program for drugs
52.32purchased under the medical assistance program. The commissioner may enter into
52.33supplemental rebate contracts with pharmaceutical manufacturers and may require prior
52.34authorization for drugs that are from manufacturers that have not signed a supplemental
52.35rebate contract. Prior authorization of drugs shall be subject to the provisions of section
52.36256B.0625, subdivision 13 .
53.1    (x) Operate the department's communication systems account established in Laws
53.21993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
53.3communication costs necessary for the operation of the programs the commissioner
53.4supervises. A communications account may also be established for each regional
53.5treatment center which operates communications systems. Each account must be used
53.6to manage shared communication costs necessary for the operations of the programs the
53.7commissioner supervises. The commissioner may distribute the costs of operating and
53.8maintaining communication systems to participants in a manner that reflects actual usage.
53.9Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
53.10other costs as determined by the commissioner. Nonprofit organizations and state, county,
53.11and local government agencies involved in the operation of programs the commissioner
53.12supervises may participate in the use of the department's communications technology and
53.13share in the cost of operation. The commissioner may accept on behalf of the state any
53.14gift, bequest, devise or personal property of any kind, or money tendered to the state for
53.15any lawful purpose pertaining to the communication activities of the department. Any
53.16money received for this purpose must be deposited in the department's communication
53.17systems accounts. Money collected by the commissioner for the use of communication
53.18systems must be deposited in the state communication systems account and is appropriated
53.19to the commissioner for purposes of this section.
53.20    (y) Receive any federal matching money that is made available through the medical
53.21assistance program for the consumer satisfaction survey. Any federal money received for
53.22the survey is appropriated to the commissioner for this purpose. The commissioner may
53.23expend the federal money received for the consumer satisfaction survey in either year of
53.24the biennium.
53.25    (z) Designate community information and referral call centers and incorporate
53.26cost reimbursement claims from the designated community information and referral
53.27call centers into the federal cost reimbursement claiming processes of the department
53.28according to federal law, rule, and regulations. Existing information and referral centers
53.29provided by Greater Twin Cities United Way or existing call centers for which Greater
53.30Twin Cities United Way has legal authority to represent, shall be included in these
53.31designations upon review by the commissioner and assurance that these services are
53.32accredited and in compliance with national standards. Any reimbursement is appropriated
53.33to the commissioner and all designated information and referral centers shall receive
53.34payments according to normal department schedules established by the commissioner
53.35upon final approval of allocation methodologies from the United States Department of
53.36Health and Human Services Division of Cost Allocation or other appropriate authorities.
54.1    (aa) Develop recommended standards for foster care homes that address the
54.2components of specialized therapeutic services to be provided by foster care homes with
54.3those services.
54.4    (bb) Authorize the method of payment to or from the department as part of the
54.5human services programs administered by the department. This authorization includes the
54.6receipt or disbursement of funds held by the department in a fiduciary capacity as part of
54.7the human services programs administered by the department.
54.8    (cc) Have the authority to administer a drug rebate program for drugs purchased for
54.9persons eligible for general assistance medical care under section 256D.03, subdivision 3.
54.10For manufacturers that agree to participate in the general assistance medical care rebate
54.11program, the commissioner shall enter into a rebate agreement for covered drugs as
54.12defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
54.13rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
54.14United States Code, title 42, section 1396r-8. The manufacturers must provide payment
54.15within the terms and conditions used for the federal rebate program established under
54.16section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
54.17the terms and conditions used for the federal rebate program established under section
54.181927 of title XIX of the Social Security Act.
54.19    Effective January 1, 2006, drug coverage under general assistance medical care shall
54.20be limited to those prescription drugs that:
54.21    (1) are covered under the medical assistance program as described in section
54.22256B.0625, subdivisions 13 and 13d ; and
54.23    (2) are provided by manufacturers that have fully executed general assistance
54.24medical care rebate agreements with the commissioner and comply with such agreements.
54.25Prescription drug coverage under general assistance medical care shall conform to
54.26coverage under the medical assistance program according to section 256B.0625,
54.27subdivisions 13 to 13g .
54.28    The rebate revenues collected under the drug rebate program are deposited in the
54.29general fund.
54.30(dd) Designate the agencies that operate the Senior LinkAge Line under section
54.31256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
54.32of Minnesota Aging and the Disability Resource Centers under United States Code, title
54.3342, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost
54.34reimbursement claims from the designated centers into the federal cost reimbursement
54.35claiming processes of the department according to federal law, rule, and regulations. Any
54.36reimbursement must be appropriated to the commissioner and treated consistent with
55.1section 256.011. All Aging and Disability Resource Center designated agencies shall
55.2receive payments of grant funding that supports the activity and generates the federal
55.3financial participation according to Board on Aging administrative granting mechanisms.

55.4    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
55.5    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
55.6Linkage Line, to which shall serve people with disabilities as the designated Aging and
55.7Disability Resource Center under United States Code, title 42, section 3001, the Older
55.8Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and
55.9shall serve as Minnesota's neutral access point for statewide disability information and
55.10assistance and must be available during business hours through a statewide toll-free
55.11number and the Internet. The Disability Linkage Line shall:
55.12(1) deliver information and assistance based on national and state standards;
55.13    (2) provide information about state and federal eligibility requirements, benefits,
55.14and service options;
55.15(3) provide benefits and options counseling;
55.16    (4) make referrals to appropriate support entities;
55.17    (5) educate people on their options so they can make well-informed choices and link
55.18them to quality profiles;
55.19    (6) help support the timely resolution of service access and benefit issues;
55.20(7) inform people of their long-term community services and supports;
55.21(8) provide necessary resources and supports that can lead to employment and
55.22increased economic stability of people with disabilities; and
55.23(9) serve as the technical assistance and help center for the Web-based tool,
55.24Minnesota's Disability Benefits 101.org.

55.25    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
55.26    Subd. 7. Consumer information and assistance and long-term care options
55.27counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
55.28statewide service to aid older Minnesotans and their families in making informed choices
55.29about long-term care options and health care benefits. Language services to persons
55.30with limited English language skills may be made available. The service, known as
55.31Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
55.32Resource Center under United States Code, title 42, section 3001, the Older Americans
55.33Act Amendments of 2006 in partnership with the Disability LinkAge Line under section
55.34256.01, subdivision 24, and must be available during business hours through a statewide
56.1toll-free number and must also be available through the Internet. The Minnesota Board
56.2on Aging shall consult with, and when appropriate work through, the area agencies on
56.3aging counties, and other entities that serve aging and disabled populations of all ages,
56.4to provide and maintain the telephone infrastructure and related support for the Aging
56.5and Disability Resource Center partners which agree by memorandum to access the
56.6infrastructure, including the designated providers of the Senior LinkAge Line and the
56.7Disability Linkage Line.
56.8    (b) The service must provide long-term care options counseling by assisting older
56.9adults, caregivers, and providers in accessing information and options counseling about
56.10choices in long-term care services that are purchased through private providers or available
56.11through public options. The service must:
56.12    (1) develop and provide for regular updating of a comprehensive database that
56.13includes detailed listings in both consumer- and provider-oriented formats that can provide
56.14search results down to the neighborhood level;
56.15    (2) make the database accessible on the Internet and through other telecommunication
56.16and media-related tools;
56.17    (3) link callers to interactive long-term care screening tools and make these tools
56.18available through the Internet by integrating the tools with the database;
56.19    (4) develop community education materials with a focus on planning for long-term
56.20care and evaluating independent living, housing, and service options;
56.21    (5) conduct an outreach campaign to assist older adults and their caregivers in
56.22finding information on the Internet and through other means of communication;
56.23    (6) implement a messaging system for overflow callers and respond to these callers
56.24by the next business day;
56.25    (7) link callers with county human services and other providers to receive more
56.26in-depth assistance and consultation related to long-term care options;
56.27    (8) link callers with quality profiles for nursing facilities and other home and
56.28community-based services providers developed by the commissioner commissioners of
56.29health and human services;
56.30(9) develop an outreach plan to seniors and their caregivers with a particular focus
56.31on establishing a clear presence in places that seniors recognize and:
56.32(i) place a significant emphasis on improved outreach and service to seniors and
56.33their caregivers by establishing annual plans by neighborhood, city, and county, as
56.34necessary, to address the unique needs of geographic areas in the state where there are
56.35dense populations of seniors;
57.1(ii) establish an efficient workforce management approach and assign community
57.2living specialist staff and volunteers to geographic areas as well as aging and disability
57.3resource center sites so that seniors and their caregivers and professionals recognize the
57.4Senior LinkAge Line as the place to call for aging services and information;
57.5(iii) recognize the size and complexity of the metropolitan area service system by
57.6working with metropolitan counties to establish a clear partnership with them, including
57.7seeking county advice on the establishment of local aging and disabilities resource center
57.8sites; and
57.9(iv) maintain dashboards with metrics that demonstrate how the service is expanding
57.10and extending or enhancing its outreach efforts in dispersed or hard to reach locations in
57.11varied population centers;
57.12    (9) (10) incorporate information about the availability of housing options, as well
57.13as registered housing with services and consumer rights within the MinnesotaHelp.info
57.14network long-term care database to facilitate consumer comparison of services and costs
57.15among housing with services establishments and with other in-home services and to
57.16support financial self-sufficiency as long as possible. Housing with services establishments
57.17and their arranged home care providers shall provide information that will facilitate price
57.18comparisons, including delineation of charges for rent and for services available. The
57.19commissioners of health and human services shall align the data elements required by
57.20section 144G.06, the Uniform Consumer Information Guide, and this section to provide
57.21consumers standardized information and ease of comparison of long-term care options.
57.22The commissioner of human services shall provide the data to the Minnesota Board on
57.23Aging for inclusion in the MinnesotaHelp.info network long-term care database;
57.24(10) (11) provide long-term care options counseling. Long-term care options
57.25counselors shall:
57.26(i) for individuals not eligible for case management under a public program or public
57.27funding source, provide interactive decision support under which consumers, family
57.28members, or other helpers are supported in their deliberations to determine appropriate
57.29long-term care choices in the context of the consumer's needs, preferences, values, and
57.30individual circumstances, including implementing a community support plan;
57.31(ii) provide Web-based educational information and collateral written materials to
57.32familiarize consumers, family members, or other helpers with the long-term care basics,
57.33issues to be considered, and the range of options available in the community;
57.34(iii) provide long-term care futures planning, which means providing assistance to
57.35individuals who anticipate having long-term care needs to develop a plan for the more
57.36distant future; and
58.1(iv) provide expertise in benefits and financing options for long-term care, including
58.2Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
58.3private pay options, and ways to access low or no-cost services or benefits through
58.4volunteer-based or charitable programs;
58.5(11) (12) using risk management and support planning protocols, provide long-term
58.6care options counseling to current residents of nursing homes deemed appropriate for
58.7discharge by the commissioner and older adults who request service after consultation
58.8with the Senior LinkAge Line under clause (12). In order to meet this requirement, The
58.9Senior LinkAge Line shall also receive referrals from the residents or staff of nursing
58.10homes. The Senior LinkAge Line shall identify and contact residents deemed appropriate
58.11for discharge by developing targeting criteria in consultation with the commissioner who
58.12shall provide designated Senior LinkAge Line contact centers with a list of nursing
58.13home residents that meet the criteria as being appropriate for discharge planning via a
58.14secure Web portal. Senior LinkAge Line shall provide these residents, if they indicate a
58.15preference to receive long-term care options counseling, with initial assessment, review of
58.16risk factors, independent living support consultation, or and, if appropriate, a referral to:
58.17(i) long-term care consultation services under section 256B.0911;
58.18(ii) designated care coordinators of contracted entities under section 256B.035 for
58.19persons who are enrolled in a managed care plan; or
58.20(iii) the long-term care consultation team for those who are appropriate eligible
58.21 for relocation service coordination due to high-risk factors or psychological or physical
58.22disability; and
58.23(12) (13) develop referral protocols and processes that will assist certified health
58.24care homes and hospitals to identify at-risk older adults and determine when to refer these
58.25individuals to the Senior LinkAge Line for long-term care options counseling under this
58.26section. The commissioner is directed to work with the commissioner of health to develop
58.27protocols that would comply with the health care home designation criteria and protocols
58.28available at the time of hospital discharge. The commissioner shall keep a record of the
58.29number of people who choose long-term care options counseling as a result of this section.

58.30    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
58.31to read:
58.32    Subd. 7a. Preadmission screening activities related to nursing facility
58.33admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
58.34including certified boarding care facilities, must be screened prior to admission regardless
58.35of income, assets, or funding sources for nursing facility care, except as described in
59.1subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
59.2need for nursing facility level of care as described in section 256B.0911, subdivision
59.34e, and to complete activities required under federal law related to mental illness and
59.4developmental disability as outlined in paragraph (b).
59.5(b) A person who has a diagnosis or possible diagnosis of mental illness or
59.6developmental disability must receive a preadmission screening before admission
59.7regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
59.8the need for further evaluation and specialized services, unless the admission prior to
59.9screening is authorized by the local mental health authority or the local developmental
59.10disabilities case manager, or unless authorized by the county agency according to Public
59.11Law 101-508.
59.12(c) The following criteria apply to the preadmission screening:
59.13(1) requests for preadmission screenings must be submitted via an online form
59.14developed by the commissioner;
59.15(2) the Senior LinkAge Line must use forms and criteria developed by the
59.16commissioner to identify persons who require referral for further evaluation and
59.17determination of the need for specialized services; and
59.18(3) the evaluation and determination of the need for specialized services must be
59.19done by:
59.20(i) a qualified independent mental health professional, for persons with a primary or
59.21secondary diagnosis of a serious mental illness; or
59.22(ii) a qualified developmental disability professional, for persons with a primary or
59.23secondary diagnosis of developmental disability. For purposes of this requirement, a
59.24qualified developmental disability professional must meet the standards for a qualified
59.25developmental disability professional under Code of Federal Regulations, title 42, section
59.26483.430.
59.27(d) The local county mental health authority or the state developmental disability
59.28authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
59.29nursing facility if the individual does not meet the nursing facility level of care criteria or
59.30needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
59.31purposes of this section, "specialized services" for a person with developmental disability
59.32means active treatment as that term is defined under Code of Federal Regulations, title
59.3342, section 483.440(a)(1).
59.34(e) In assessing a person's needs, the screener shall:
59.35(1) use an automated system designated by the commissioner;
59.36(2) consult with care transitions coordinators or physician; and
60.1(3) consider the assessment of the individual's physician.
60.2Other personnel may be included in the level of care determination as deemed
60.3necessary by the screener.
60.4EFFECTIVE DATE.This section is effective October 1, 2013.

60.5    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
60.6to read:
60.7    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
60.8screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
60.9(1) a person who, having entered an acute care facility from a certified nursing
60.10facility, is returning to a certified nursing facility; or
60.11(2) a person transferring from one certified nursing facility in Minnesota to another
60.12certified nursing facility in Minnesota.
60.13(b) Persons who are exempt from preadmission screening for purposes of level of
60.14care determination include:
60.15(1) persons described in paragraph (a);
60.16(2) an individual who has a contractual right to have nursing facility care paid for
60.17indefinitely by the Veterans' Administration;
60.18(3) an individual enrolled in a demonstration project under section 256B.69,
60.19subdivision 8, at the time of application to a nursing facility; and
60.20(4) an individual currently being served under the alternative care program or under
60.21a home and community-based services waiver authorized under section 1915(c) of the
60.22federal Social Security Act.
60.23(c) Persons admitted to a Medicaid-certified nursing facility from the community
60.24on an emergency basis as described in paragraph (d) or from an acute care facility on a
60.25nonworking day must be screened the first working day after admission.
60.26(d) Emergency admission to a nursing facility prior to screening is permitted when
60.27all of the following conditions are met:
60.28(1) a person is admitted from the community to a certified nursing or certified
60.29boarding care facility during Senior LinkAge Line nonworking hours;
60.30(2) a physician has determined that delaying admission until preadmission screening
60.31is completed would adversely affect the person's health and safety;
60.32(3) there is a recent precipitating event that precludes the client from living safely in
60.33the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
60.34inability to continue to provide care;
61.1(4) the attending physician has authorized the emergency placement and has
61.2documented the reason that the emergency placement is recommended; and
61.3(5) the Senior LinkAge Line is contacted on the first working day following the
61.4emergency admission.
61.5Transfer of a patient from an acute care hospital to a nursing facility is not considered
61.6an emergency except for a person who has received hospital services in the following
61.7situations: hospital admission for observation, care in an emergency room without hospital
61.8admission, or following hospital 24-hour bed care and from whom admission is being
61.9sought on a nonworking day.
61.10(e) A nursing facility must provide written information to all persons admitted
61.11regarding the person's right to request and receive long-term care consultation services as
61.12defined in section 256B.0911, subdivision 1a. The information must be provided prior to
61.13the person's discharge from the facility and in a format specified by the commissioner.
61.14EFFECTIVE DATE.This section is effective October 1, 2013.

61.15    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
61.16to read:
61.17    Subd. 7c. Screening requirements. (a) A person may be screened for nursing
61.18facility admission by telephone or in a face-to-face screening interview. The Senior
61.19LinkAge Line shall identify each individual's needs using the following categories:
61.20(1) the person needs no face-to-face long-term care consultation assessment
61.21completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
61.22managed care organization under contract with the Department of Human Services to
61.23determine the need for nursing facility level of care based on information obtained from
61.24other health care professionals;
61.25(2) the person needs an immediate face-to-face long-term care consultation
61.26assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
61.27tribe, or managed care organization under contract with the Department of Human
61.28Services to determine the need for nursing facility level of care and complete activities
61.29required under subdivision 7a; or
61.30(3) the person may be exempt from screening requirements as outlined in subdivision
61.317b, but will need transitional assistance after admission or in-person follow-along after
61.32a return home.
61.33(b) Individuals under 65 years of age who are admitted to nursing facilities with
61.34only a telephone screening must receive a face-to-face assessment from the long-term
61.35care consultation team member of the county in which the facility is located or from the
62.1recipient's county case manager within 40 calendar days of admission as described in
62.2section 256B.0911, subdivision 4d, paragraph (c).
62.3(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
62.4facility must be screened prior to admission.
62.5(d) Screenings provided by the Senior LinkAge Line must include processes
62.6to identify persons who may require transition assistance described in subdivision 7,
62.7paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
62.8EFFECTIVE DATE.This section is effective October 1, 2013.

62.9    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
62.10to read:
62.11    Subd. 7d. Payment for preadmission screening. Funding for preadmission
62.12screening shall be provided to the Minnesota Board on Aging by the Department of
62.13Human Services to cover screener salaries and expenses to provide the services described
62.14in subdivisions 7a to 7c. The Minnesota Board on Aging shall employ, or contract with
62.15other agencies to employ, within the limits of available funding, sufficient personnel to
62.16provide preadmission screening and level of care determination services and shall seek to
62.17maximize federal funding for the service as provided under section 256.01, subdivision
62.182, paragraph (dd).
62.19EFFECTIVE DATE.This section is effective October 1, 2013.

62.20    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
62.21subdivision to read:
62.22    Subd. 3a. Priority for other grants. The commissioner of health shall give priority
62.23to a grantee selected under subdivision 3 when awarding technology-related grants, if the
62.24grantee is using technology as part of the proposal unless that priority conflicts with
62.25existing state or federal guidance related to grant awards by the Department of Health.
62.26The commissioner of transportation shall give priority to a grantee under subdivision 3
62.27when distributing transportation-related funds to create transportation options for older
62.28adults unless that preference conflicts with existing state or federal guidance related to
62.29grant awards by the Department of Transportation.

62.30    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
62.31subdivision to read:
63.1    Subd. 3b. State waivers. The commissioner of health may waive applicable state
63.2laws and rules on a time-limited basis if the commissioner of health determines that a
63.3participating grantee requires a waiver in order to achieve demonstration project goals.

63.4    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
63.5    Subd. 5. Grant preference. The commissioner of human services shall give
63.6preference when awarding grants under this section to areas where nursing facility
63.7closures have occurred or are occurring or areas with service needs identified by section
63.8144A.351. The commissioner may award grants to the extent grant funds are available
63.9and to the extent applications are approved by the commissioner. Denial of approval of an
63.10application in one year does not preclude submission of an application in a subsequent
63.11year. The maximum grant amount is limited to $750,000.

63.12    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
63.13subdivision to read:
63.14    Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
63.15subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
63.16(1) an impact assessment focusing on program outcomes, especially those
63.17experienced directly by the person receiving services;
63.18(2) study samples drawn from the population of interest for each project; and
63.19(3) a time series analysis to examine aggregate trends in average monthly
63.20utilization, expenditures, and other outcomes in the targeted populations before and after
63.21implementation of the initiatives.

63.22    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
63.23subdivision to read:
63.24    Subd. 6. Work, empower, and encourage independence. As provided under
63.25subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
63.26demonstration project to provide navigation, employment supports, and benefits planning
63.27services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
63.28This demonstration shall promote economic stability, increase independence, and reduce
63.29applications for disability benefits while providing a positive impact on the health and
63.30future of participants.

63.31    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
63.32subdivision to read:
64.1    Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
64.2upon federal approval, the commissioner shall establish a demonstration project to provide
64.3service coordination, outreach, in-reach, tenancy support, and community living assistance
64.4to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
64.5demonstration shall promote housing stability, reduce costly medical interventions, and
64.6increase opportunities for independent community living.

64.7    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
64.8    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
64.9services is to assist persons with long-term or chronic care needs in making care
64.10decisions and selecting support and service options that meet their needs and reflect
64.11their preferences. The availability of, and access to, information and other types of
64.12assistance, including assessment and support planning, is also intended to prevent or delay
64.13institutional placements and to provide access to transition assistance after admission.
64.14Further, the goal of these services is to contain costs associated with unnecessary
64.15institutional admissions. Long-term consultation services must be available to any person
64.16regardless of public program eligibility. The commissioner of human services shall seek
64.17to maximize use of available federal and state funds and establish the broadest program
64.18possible within the funding available.
64.19(b) These services must be coordinated with long-term care options counseling
64.20provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and
64.21section 256.01, subdivision 24. The lead agency providing long-term care consultation
64.22services shall encourage the use of volunteers from families, religious organizations, social
64.23clubs, and similar civic and service organizations to provide community-based services.

64.24    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
64.25read:
64.26    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
64.27    (a) Until additional requirements apply under paragraph (b), "long-term care
64.28consultation services" means:
64.29    (1) intake for and access to assistance in identifying services needed to maintain an
64.30individual in the most inclusive environment;
64.31    (2) providing recommendations for and referrals to cost-effective community
64.32services that are available to the individual;
64.33    (3) development of an individual's person-centered community support plan;
64.34    (4) providing information regarding eligibility for Minnesota health care programs;
65.1    (5) face-to-face long-term care consultation assessments, which may be completed
65.2in a hospital, nursing facility, intermediate care facility for persons with developmental
65.3disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
65.4residence;
65.5    (6) federally mandated preadmission screening activities described under
65.6subdivisions 4a and 4b;
65.7    (7) (6) determination of home and community-based waiver and other service
65.8eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level
65.9of care determination for individuals who need an institutional level of care as determined
65.10under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and
65.11community support plan development, appropriate referrals to obtain necessary diagnostic
65.12information, and including an eligibility determination for consumer-directed community
65.13supports;
65.14    (8) (7) providing recommendations for institutional placement when there are no
65.15cost-effective community services available;
65.16    (9) (8) providing access to assistance to transition people back to community settings
65.17after institutional admission; and
65.18(10) (9) providing information about competitive employment, with or without
65.19supports, for school-age youth and working-age adults and referrals to the Disability
65.20Linkage Line and Disability Benefits 101 to ensure that an informed choice about
65.21competitive employment can be made. For the purposes of this subdivision, "competitive
65.22employment" means work in the competitive labor market that is performed on a full-time
65.23or part-time basis in an integrated setting, and for which an individual is compensated at or
65.24above the minimum wage, but not less than the customary wage and level of benefits paid
65.25by the employer for the same or similar work performed by individuals without disabilities.
65.26(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
65.272c, and 3a, "long-term care consultation services" also means:
65.28(1) service eligibility determination for state plan home care services identified in:
65.29(i) section 256B.0625, subdivisions 7, 19a, and 19c;
65.30(ii) section 256B.0657; or
65.31(iii) consumer support grants under section 256.476;
65.32(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
65.33determination of eligibility for case management services available under sections
65.34256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part
65.359525.0016;
66.1(3) determination of institutional level of care, home and community-based service
66.2waiver, and other service eligibility as required under section 256B.092, determination
66.3of eligibility for family support grants under section 252.32, semi-independent living
66.4services under section 252.275, and day training and habilitation services under section
66.5256B.092 ; and
66.6(4) obtaining necessary diagnostic information to determine eligibility under clauses
66.7(2) and (3).
66.8    (c) "Long-term care options counseling" means the services provided by the linkage
66.9lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and
66.10also includes telephone assistance and follow up once a long-term care consultation
66.11assessment has been completed.
66.12    (d) "Minnesota health care programs" means the medical assistance program under
66.13chapter 256B and the alternative care program under section 256B.0913.
66.14    (e) "Lead agencies" means counties administering or tribes and health plans under
66.15contract with the commissioner to administer long-term care consultation assessment and
66.16support planning services.

66.17    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
66.18read:
66.19    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
66.20services planning, or other assistance intended to support community-based living,
66.21including persons who need assessment in order to determine waiver or alternative care
66.22program eligibility, must be visited by a long-term care consultation team within 20
66.23calendar days after the date on which an assessment was requested or recommended.
66.24Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
66.25applies to an assessment of a person requesting personal care assistance services and
66.26private duty nursing. The commissioner shall provide at least a 90-day notice to lead
66.27agencies prior to the effective date of this requirement. Face-to-face assessments must be
66.28conducted according to paragraphs (b) to (i).
66.29    (b) The lead agency may utilize a team of either the social worker or public health
66.30nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
66.31use certified assessors to conduct the assessment. The consultation team members must
66.32confer regarding the most appropriate care for each individual screened or assessed. For
66.33a person with complex health care needs, a public health or registered nurse from the
66.34team must be consulted.
67.1    (c) The assessment must be comprehensive and include a person-centered assessment
67.2of the health, psychological, functional, environmental, and social needs of referred
67.3individuals and provide information necessary to develop a community support plan that
67.4meets the consumers needs, using an assessment form provided by the commissioner.
67.5    (d) The assessment must be conducted in a face-to-face interview with the person
67.6being assessed and the person's legal representative, and other individuals as requested by
67.7the person, who can provide information on the needs, strengths, and preferences of the
67.8person necessary to develop a community support plan that ensures the person's health and
67.9safety, but who is not a provider of service or has any financial interest in the provision
67.10of services. For persons who are to be assessed for elderly waiver customized living
67.11services under section 256B.0915, with the permission of the person being assessed or
67.12the person's designated or legal representative, the client's current or proposed provider
67.13of services may submit a copy of the provider's nursing assessment or written report
67.14outlining its recommendations regarding the client's care needs. The person conducting
67.15the assessment will notify the provider of the date by which this information is to be
67.16submitted. This information shall be provided to the person conducting the assessment
67.17prior to the assessment.
67.18    (e) If the person chooses to use community-based services, the person or the person's
67.19legal representative must be provided with a written community support plan within 40
67.20calendar days of the assessment visit, regardless of whether the individual is eligible for
67.21Minnesota health care programs. The written community support plan must include:
67.22(1) a summary of assessed needs as defined in paragraphs (c) and (d);
67.23(2) the individual's options and choices to meet identified needs, including all
67.24available options for case management services and providers;
67.25(3) identification of health and safety risks and how those risks will be addressed,
67.26including personal risk management strategies;
67.27(4) referral information; and
67.28(5) informal caregiver supports, if applicable.
67.29For a person determined eligible for state plan home care under subdivision 1a,
67.30paragraph (b), clause (1), the person or person's representative must also receive a copy of
67.31the home care service plan developed by the certified assessor.
67.32(f) A person may request assistance in identifying community supports without
67.33participating in a complete assessment. Upon a request for assistance identifying
67.34community support, the person must be transferred or referred to long-term care options
67.35counseling services available under sections 256.975, subdivision 7, and 256.01,
67.36subdivision 24, for telephone assistance and follow up.
68.1    (g) The person has the right to make the final decision between institutional
68.2placement and community placement after the recommendations have been provided,
68.3except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
68.4    (h) The lead agency must give the person receiving assessment or support planning,
68.5or the person's legal representative, materials, and forms supplied by the commissioner
68.6containing the following information:
68.7    (1) written recommendations for community-based services and consumer-directed
68.8options;
68.9(2) documentation that the most cost-effective alternatives available were offered to
68.10the individual. For purposes of this clause, "cost-effective" means community services and
68.11living arrangements that cost the same as or less than institutional care. For an individual
68.12found to meet eligibility criteria for home and community-based service programs under
68.13section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
68.14approved waiver plan for each program;
68.15(3) the need for and purpose of preadmission screening conducted by long-term care
68.16options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
68.17nursing facility placement. If the individual selects nursing facility placement, the lead
68.18agency shall forward information needed to complete the level of care determinations and
68.19screening for developmental disability and mental illness collected during the assessment
68.20to the long-term care options counselor using forms provided by the commissioner;
68.21    (4) the role of long-term care consultation assessment and support planning in
68.22eligibility determination for waiver and alternative care programs, and state plan home
68.23care, case management, and other services as defined in subdivision 1a, paragraphs (a),
68.24clause (7), and (b);
68.25    (5) information about Minnesota health care programs;
68.26    (6) the person's freedom to accept or reject the recommendations of the team;
68.27    (7) the person's right to confidentiality under the Minnesota Government Data
68.28Practices Act, chapter 13;
68.29    (8) the certified assessor's decision regarding the person's need for institutional level
68.30of care as determined under criteria established in section 256B.0911, subdivision 4a,
68.31paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services
68.32and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
68.33    (9) the person's right to appeal the certified assessor's decision regarding eligibility
68.34for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
68.35(b), and incorporating the decision regarding the need for institutional level of care or the
69.1lead agency's final decisions regarding public programs eligibility according to section
69.2256.045, subdivision 3 .
69.3    (i) Face-to-face assessment completed as part of eligibility determination for
69.4the alternative care, elderly waiver, community alternatives for disabled individuals,
69.5community alternative care, and brain injury waiver programs under sections 256B.0913,
69.6256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60
69.7calendar days after the date of assessment.
69.8(j) The effective eligibility start date for programs in paragraph (i) can never be
69.9prior to the date of assessment. If an assessment was completed more than 60 days
69.10before the effective waiver or alternative care program eligibility start date, assessment
69.11and support plan information must be updated in a face-to-face visit and documented in
69.12the department's Medicaid Management Information System (MMIS). Notwithstanding
69.13retroactive medical assistance coverage of state plan services, the effective date of
69.14eligibility for programs included in paragraph (i) cannot be prior to the date the most
69.15recent updated assessment is completed.

69.16    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
69.17read:
69.18    Subd. 4d. Preadmission screening of individuals under 65 years of age. (a)
69.19It is the policy of the state of Minnesota to ensure that individuals with disabilities or
69.20chronic illness are served in the most integrated setting appropriate to their needs and have
69.21the necessary information to make informed choices about home and community-based
69.22service options.
69.23    (b) Individuals under 65 years of age who are admitted to a Medicaid-certified
69.24 nursing facility from a hospital must be screened prior to admission as outlined in
69.25subdivisions 4a through 4c according to the requirements outlined in section 256.975,
69.26subdivisions 7a to 7c. This shall be provided by the Senior LinkAge Line as required
69.27under section 256.975, subdivision 7.
69.28    (c) Individuals under 65 years of age who are admitted to nursing facilities with
69.29only a telephone screening must receive a face-to-face assessment from the long-term
69.30care consultation team member of the county in which the facility is located or from the
69.31recipient's county case manager within 40 calendar days of admission.
69.32    (d) Individuals under 65 years of age who are admitted to a nursing facility
69.33without preadmission screening according to the exemption described in subdivision 4b,
69.34paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
69.35a face-to-face assessment within 40 days of admission.
70.1    (e) (d) At the face-to-face assessment, the long-term care consultation team member
70.2or county case manager must perform the activities required under subdivision 3b.
70.3    (f) (e) For individuals under 21 years of age, a screening interview which
70.4recommends nursing facility admission must be face-to-face and approved by the
70.5commissioner before the individual is admitted to the nursing facility.
70.6    (g) (f) In the event that an individual under 65 years of age is admitted to a nursing
70.7facility on an emergency basis, the county Senior LinkAge Line must be notified of
70.8the admission on the next working day, and a face-to-face assessment as described in
70.9paragraph (c) must be conducted within 40 calendar days of admission.
70.10    (h) (g) At the face-to-face assessment, the long-term care consultation team member
70.11or the case manager must present information about home and community-based options,
70.12including consumer-directed options, so the individual can make informed choices. If the
70.13individual chooses home and community-based services, the long-term care consultation
70.14team member or case manager must complete a written relocation plan within 20 working
70.15days of the visit. The plan shall describe the services needed to move out of the facility
70.16and a time line for the move which is designed to ensure a smooth transition to the
70.17individual's home and community.
70.18    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive
70.19a face-to-face assessment at least every 12 months to review the person's service choices
70.20and available alternatives unless the individual indicates, in writing, that annual visits are
70.21not desired. In this case, the individual must receive a face-to-face assessment at least
70.22once every 36 months for the same purposes.
70.23    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay
70.24county agencies directly for face-to-face assessments for individuals under 65 years of age
70.25who are being considered for placement or residing in a nursing facility.
70.26(j) Funding for preadmission screening follow-up shall be provided to the Disability
70.27Linkage Line for the under 60 population by the Department of Human Services to
70.28cover options counseling salaries and expenses to provide the services described in
70.29subdivisions 7a to 7c. The Disability Linkage Line shall employ, or contract with other
70.30agencies to employ, within the limits of available funding, sufficient personnel to provide
70.31preadmission screening follow-up services and shall seek to maximize federal funding for
70.32the service as provided under section 256.01, subdivision 2, paragraph (dd).
70.33EFFECTIVE DATE.This section is effective October 1, 2013.

70.34    Sec. 21. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
70.35subdivision to read:
71.1    Subd. 4e. Determination of institutional level of care. The determination of the
71.2need for nursing facility, hospital, and intermediate care facility levels of care must be
71.3made according to criteria developed by the commissioner, and in section 256B.092,
71.4using forms developed by the commissioner. Effective January 1, 2014, for individuals
71.5age 21 and older, the determination of need for nursing facility level of care shall be
71.6based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
71.7determination of the need for nursing facility level of care must be made according to
71.8criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
71.9becomes effective on or after October 1, 2019.

71.10    Sec. 22. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
71.11    Subd. 6. Payment for long-term care consultation services. (a) Until September
71.1230, 2013, payment for long-term care consultation face-to-face assessment shall be made
71.13as described in this subdivision.
71.14    (b) The total payment for each county must be paid monthly by certified nursing
71.15facilities in the county. The monthly amount to be paid by each nursing facility for each
71.16fiscal year must be determined by dividing the county's annual allocation for long-term
71.17care consultation services by 12 to determine the monthly payment and allocating the
71.18monthly payment to each nursing facility based on the number of licensed beds in the
71.19nursing facility. Payments to counties in which there is no certified nursing facility must be
71.20made by increasing the payment rate of the two facilities located nearest to the county seat.
71.21    (b) (c) The commissioner shall include the total annual payment determined under
71.22paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434,
71.23or 256B.441.
71.24    (c) (d) In the event of the layaway, delicensure and decertification, or removal
71.25from layaway of 25 percent or more of the beds in a facility, the commissioner may
71.26adjust the per diem payment amount in paragraph (b) (c) and may adjust the monthly
71.27payment amount in paragraph (a) (b). The effective date of an adjustment made under this
71.28paragraph shall be on or after the first day of the month following the effective date of the
71.29layaway, delicensure and decertification, or removal from layaway.
71.30    (d) (e) Payments for long-term care consultation services are available to the county
71.31or counties to cover staff salaries and expenses to provide the services described in
71.32subdivision 1a. The county shall employ, or contract with other agencies to employ,
71.33within the limits of available funding, sufficient personnel to provide long-term care
71.34consultation services while meeting the state's long-term care outcomes and objectives as
71.35defined in subdivision 1. The county shall be accountable for meeting local objectives
72.1as approved by the commissioner in the biennial home and community-based services
72.2quality assurance plan on a form provided by the commissioner.
72.3    (e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment
72.4of the screening costs under the medical assistance program may not be recovered from
72.5a facility.
72.6    (f) (g) The commissioner of human services shall amend the Minnesota medical
72.7assistance plan to include reimbursement for the local consultation teams.
72.8    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented,
72.9the county may bill, as case management services, assessments, support planning, and
72.10follow-along provided to persons determined to be eligible for case management under
72.11Minnesota health care programs. No individual or family member shall be charged for an
72.12initial assessment or initial support plan development provided under subdivision 3a or 3b.
72.13(h) (i) The commissioner shall develop an alternative payment methodology,
72.14effective on October 1, 2013, for long-term care consultation services that includes
72.15the funding available under this subdivision, and for assessments authorized under
72.16sections 256B.092 and 256B.0659. In developing the new payment methodology, the
72.17commissioner shall consider the maximization of other funding sources, including federal
72.18administrative reimbursement through federal financial participation funding, for all
72.19long-term care consultation and preadmission screening activity. The alternative payment
72.20methodology shall include the use of the appropriate time studies and the state financing
72.21of nonfederal share as part of the state's medical assistance program.

72.22    Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
72.23    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
72.24reimbursement for nursing facilities shall be authorized for a medical assistance recipient
72.25only if a preadmission screening has been conducted prior to admission or the county has
72.26authorized an exemption. Medical assistance reimbursement for nursing facilities shall
72.27not be provided for any recipient who the local screener has determined does not meet the
72.28level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
72.29if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
72.30Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
72.31mental illness is approved by the local mental health authority or an admission for a
72.32recipient with developmental disability is approved by the state developmental disability
72.33authority.
72.34    (b) The nursing facility must not bill a person who is not a medical assistance
72.35recipient for resident days that preceded the date of completion of screening activities
73.1as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing
73.2facility must include unreimbursed resident days in the nursing facility resident day totals
73.3reported to the commissioner.

73.4    Sec. 24. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
73.5    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
73.6    (a) Funding for services under the alternative care program is available to persons who
73.7meet the following criteria:
73.8    (1) the person has been determined by a community assessment under section
73.9256B.0911 to be a person who would require the level of care provided in a nursing
73.10facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for
73.11the provision of services under the alternative care program;
73.12    (2) the person is age 65 or older;
73.13    (3) the person would be eligible for medical assistance within 135 days of admission
73.14to a nursing facility;
73.15    (4) the person is not ineligible for the payment of long-term care services by the
73.16medical assistance program due to an asset transfer penalty under section 256B.0595 or
73.17equity interest in the home exceeding $500,000 as stated in section 256B.056;
73.18    (5) the person needs long-term care services that are not funded through other
73.19state or federal funding, or other health insurance or other third-party insurance such as
73.20long-term care insurance;
73.21    (6) except for individuals described in clause (7), the monthly cost of the alternative
73.22care services funded by the program for this person does not exceed 75 percent of the
73.23monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
73.24does not prohibit the alternative care client from payment for additional services, but in no
73.25case may the cost of additional services purchased under this section exceed the difference
73.26between the client's monthly service limit defined under section 256B.0915, subdivision
73.273 , and the alternative care program monthly service limit defined in this paragraph. If
73.28care-related supplies and equipment or environmental modifications and adaptations are or
73.29will be purchased for an alternative care services recipient, the costs may be prorated on a
73.30monthly basis for up to 12 consecutive months beginning with the month of purchase.
73.31If the monthly cost of a recipient's other alternative care services exceeds the monthly
73.32limit established in this paragraph, the annual cost of the alternative care services shall be
73.33determined. In this event, the annual cost of alternative care services shall not exceed 12
73.34times the monthly limit described in this paragraph;
74.1    (7) for individuals assigned a case mix classification A as described under section
74.2256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
74.3living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
74.4when the dependency score in eating is three or greater as determined by an assessment
74.5performed under section 256B.0911, the monthly cost of alternative care services funded
74.6by the program cannot exceed $593 per month for all new participants enrolled in
74.7the program on or after July 1, 2011. This monthly limit shall be applied to all other
74.8participants who meet this criteria at reassessment. This monthly limit shall be increased
74.9annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly
74.10limit does not prohibit the alternative care client from payment for additional services, but
74.11in no case may the cost of additional services purchased exceed the difference between the
74.12client's monthly service limit defined in this clause and the limit described in clause (6)
74.13for case mix classification A; and
74.14(8) the person is making timely payments of the assessed monthly fee.
74.15A person is ineligible if payment of the fee is over 60 days past due, unless the person
74.16agrees to:
74.17    (i) the appointment of a representative payee;
74.18    (ii) automatic payment from a financial account;
74.19    (iii) the establishment of greater family involvement in the financial management of
74.20payments; or
74.21    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
74.22    The lead agency may extend the client's eligibility as necessary while making
74.23arrangements to facilitate payment of past-due amounts and future premium payments.
74.24Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
74.25reinstated for a period of 30 days.
74.26    (b) Alternative care funding under this subdivision is not available for a person who
74.27is a medical assistance recipient or who would be eligible for medical assistance without a
74.28spenddown or waiver obligation. A person whose initial application for medical assistance
74.29and the elderly waiver program is being processed may be served under the alternative care
74.30program for a period up to 60 days. If the individual is found to be eligible for medical
74.31assistance, medical assistance must be billed for services payable under the federally
74.32approved elderly waiver plan and delivered from the date the individual was found eligible
74.33for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
74.34care funds may not be used to pay for any service the cost of which: (i) is payable by
74.35medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
75.1pay a medical assistance income spenddown for a person who is eligible to participate in the
75.2federally approved elderly waiver program under the special income standard provision.
75.3    (c) Alternative care funding is not available for a person who resides in a licensed
75.4nursing home, certified boarding care home, hospital, or intermediate care facility, except
75.5for case management services which are provided in support of the discharge planning
75.6process for a nursing home resident or certified boarding care home resident to assist with
75.7a relocation process to a community-based setting.
75.8    (d) Alternative care funding is not available for a person whose income is greater
75.9than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
75.10to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
75.11year for which alternative care eligibility is determined, who would be eligible for the
75.12elderly waiver with a waiver obligation.

75.13    Sec. 25. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
75.14    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
75.15shall receive an initial assessment of strengths, informal supports, and need for services
75.16in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
75.17client served under the elderly waiver must be conducted at least every 12 months and at
75.18other times when the case manager determines that there has been significant change in
75.19the client's functioning. This may include instances where the client is discharged from
75.20the hospital. There must be a determination that the client requires nursing facility level
75.21of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and
75.22subsequent assessments to initiate and maintain participation in the waiver program.
75.23(b) Regardless of other assessments identified in section 144.0724, subdivision
75.244, as appropriate to determine nursing facility level of care for purposes of medical
75.25assistance payment for nursing facility services, only face-to-face assessments conducted
75.26according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
75.27level of care determination will be accepted for purposes of initial and ongoing access to
75.28waiver service payment.

75.29    Sec. 26. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
75.30subdivision to read:
75.31    Subd. 1a. Home and community-based services for older adults. (a) The purpose
75.32of projects selected by the commissioner of human services under this section is to
75.33make strategic changes in the long-term services and supports system for older adults
75.34including statewide capacity for local service development and technical assistance, and
76.1statewide availability of home and community-based services for older adult services,
76.2caregiver support and respite care services, and other supports in the state of Minnesota.
76.3These projects are intended to create incentives for new and expanded home and
76.4community-based services in Minnesota in order to:
76.5(1) reach older adults early in the progression of their need for long-term services
76.6and supports, providing them with low-cost, high-impact services that will prevent or
76.7delay the use of more costly services;
76.8(2) support older adults to live in the most integrated, least restrictive community
76.9setting;
76.10(3) support the informal caregivers of older adults;
76.11(4) develop and implement strategies to integrate long-term services and supports
76.12with health care services, in order to improve the quality of care and enhance the quality
76.13of life of older adults and their informal caregivers;
76.14(5) ensure cost-effective use of financial and human resources;
76.15(6) build community-based approaches and community commitment to delivering
76.16long-term services and supports for older adults in their own homes;
76.17(7) achieve a broad awareness and use of lower-cost in-home services as an
76.18alternative to nursing homes and other residential services;
76.19(8) strengthen and develop additional home and community-based services and
76.20alternatives to nursing homes and other residential services; and
76.21(9) strengthen programs that use volunteers.
76.22(b) The services provided by these projects are available to older adults who are
76.23eligible for medical assistance and the elderly waiver under section 256B.0915, the
76.24alternative care program under section 256B.0913, or essential community supports grant
76.25under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
76.26services.

76.27    Sec. 27. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
76.28subdivision to read:
76.29    Subd. 1b. Definitions. (a) For purposes of this section, the following terms have
76.30the meanings given.
76.31(b) "Community" means a town; township; city; or targeted neighborhood within a
76.32city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
76.33(c) "Core home and community-based services provider" means a Faith in Action,
76.34Living at Home Block Nurse, Congregational Nurse, or similar community-based
76.35program governed by a board, the majority of whose members reside within the program's
77.1service area, that organizes and uses volunteers and paid staff to deliver nonmedical
77.2services intended to assist older adults to identify and manage risks and to maintain their
77.3community living and integration in the community.
77.4(d) "Eldercare development partnership" means a team of representatives of county
77.5social service and public health agencies, the area agency on aging, local nursing home
77.6providers, local home care providers, and other appropriate home and community-based
77.7providers in the area agency's planning and service area.
77.8(e) "Long-term services and supports" means any service available under the
77.9elderly waiver program or alternative care grant programs, nursing facility services,
77.10transportation services, caregiver support and respite care services, and other home and
77.11community-based services identified as necessary either to maintain lifestyle choices for
77.12older adults or to support them to remain in their own home.
77.13(f) "Older adult" refers to an individual who is 65 years of age or older.

77.14    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
77.15subdivision to read:
77.16    Subd. 1c. Eldercare development partnerships. The commissioner of human
77.17services shall select and contract with eldercare development partnerships sufficient to
77.18provide statewide availability of service development and technical assistance using a
77.19request for proposals process. Eldercare development partnerships shall:
77.20(1) develop a local long-term services and supports strategy consistent with state
77.21goals and objectives;
77.22(2) identify and use existing local skills, knowledge, and relationships, and build
77.23on these assets;
77.24(3) coordinate planning for funds to provide services to older adults, including funds
77.25received under Title III of the Older Americans Act, Title XX of the Social Security Act,
77.26and the Local Public Health Act;
77.27(4) target service development and technical assistance where nursing facility
77.28closures have occurred or are occurring or in areas where service needs have been
77.29identified through activities under section 144A.351;
77.30(5) provide sufficient staff for development and technical support in its designated
77.31area; and
77.32(6) designate a single public or nonprofit member of the eldercare development
77.33partnerships to apply grant funding and manage the project.

77.34    Sec. 29. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
78.1    Subd. 6. Caregiver support and respite care projects. (a) The commissioner
78.2shall establish up to 36 projects to expand the respite care network in the state and to
78.3support caregivers in their responsibilities for care. The purpose of each project shall
78.4be to availability of caregiver support and respite care services for family and other
78.5caregivers. The commissioner shall use a request for proposals to select nonprofit entities
78.6to administer the projects. Projects shall:
78.7(1) establish a local coordinated network of volunteer and paid respite workers;
78.8(2) coordinate assignment of respite workers care services to clients and care
78.9receivers and assure the health and safety of the client; and caregivers of older adults;
78.10(3) provide training for caregivers and ensure that support groups are available
78.11in the community.
78.12(b) The caregiver support and respite care funds shall be available to the four to six
78.13local long-term care strategy projects designated in subdivisions 1 to 5.
78.14(c) The commissioner shall publish a notice in the State Register to solicit proposals
78.15from public or private nonprofit agencies for the projects not included in the four to six
78.16local long-term care strategy projects defined in subdivision 2. A county agency may,
78.17alone or in combination with other county agencies, apply for caregiver support and
78.18respite care project funds. A public or nonprofit agency within a designated SAIL project
78.19area may apply for project funds if the agency has a letter of agreement with the county
78.20or counties in which services will be developed, stating the intention of the county or
78.21counties to coordinate their activities with the agency requesting a grant.
78.22(d) The commissioner shall select grantees based on the following criteria:
78.23(1) the ability of the proposal to demonstrate need in the area served, as evidenced
78.24by a community needs assessment or other demographic data;
78.25(2) the ability of the proposal to clearly describe how the project
78.26(3) assure the health and safety of the older adults;
78.27(4) identify at-risk caregivers;
78.28(5) provide information, education, and training for caregivers in the designated
78.29community; and
78.30(6) demonstrate the need in the proposed service area particularly where nursing
78.31facility closures have occurred or are occurring or areas with service needs identified
78.32by section 144A.351. Preference must be given for projects that reach underserved
78.33populations.
78.34(b) Projects must clearly describe:
78.35(1) how they will achieve the their purpose defined in paragraph (b);
78.36(3) the ability of the proposal to reach underserved populations;
79.1(4) the ability of the proposal to demonstrate community commitment to the project,
79.2as evidenced by letters of support and cooperation as well as formation of a community
79.3task force;
79.4(5) the ability of the proposal to clearly describe (2) the process for recruiting,
79.5training, and retraining volunteers; and
79.6(6) the inclusion in the proposal of the (3) a plan to promote the project in the
79.7designated community, including outreach to persons needing the services.
79.8(e) (c) Funds for all projects under this subdivision may be used to:
79.9(1) hire a coordinator to develop a coordinated network of volunteer and paid respite
79.10care services and assign workers to clients;
79.11(2) recruit and train volunteer providers;
79.12(3) train provide information, training, and education to caregivers;
79.13(4) ensure the development of support groups for caregivers;
79.14(5) (4) advertise the availability of the caregiver support and respite care project; and
79.15(6) (5) purchase equipment to maintain a system of assigning workers to clients.
79.16(f) (d) Project funds may not be used to supplant existing funding sources.

79.17    Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
79.18subdivision to read:
79.19    Subd. 7a. Core home and community-based services. The commissioner shall
79.20select and contract with core home and community-based services providers for projects
79.21to provide services and supports to older adults both with and without family and other
79.22informal caregivers using a request for proposals process. Projects must:
79.23(1) have a credible, public, or private nonprofit sponsor providing ongoing financial
79.24support;
79.25(2) have a specific, clearly defined geographic service area;
79.26(3) use a practice framework designed to identify high-risk older adults and help them
79.27take action to better manage their chronic conditions and maintain their community living;
79.28(4) have a team approach to coordination and care, ensuring that the older adult
79.29participants, their families, and the formal and informal providers are all part of planning
79.30and providing services;
79.31(5) provide information, support services, homemaking services, counseling, and
79.32training for the older adults and family caregivers;
79.33(6) encourage service area or neighborhood residents and local organizations to
79.34collaborate in meeting the needs of older adults in their geographic service areas;
80.1(7) recruit, train, and direct the use of volunteers to provide informal services and
80.2other appropriate support to older adults and their caregivers; and
80.3(8) provide coordination and management of formal and informal services to older
80.4adults and their families using less expensive alternatives.

80.5    Sec. 31. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to
80.6read:
80.7    Subd. 13. Community service grants. The commissioner shall award contracts
80.8for grants to public and private nonprofit agencies to establish services that strengthen
80.9a community's ability to provide a system of home and community-based services
80.10for elderly persons. The commissioner shall use a request for proposal process. The
80.11commissioner shall give preference when awarding grants under this section to areas
80.12where nursing facility closures have occurred or are occurring or to areas with service
80.13needs identified under section 144A.351. The commissioner shall consider grants for:
80.14(1) caregiver support and respite care projects under subdivision 6;
80.15(2) the living-at-home/block nurse grant under subdivisions 7 to 10; and
80.16(3) services identified as needed for community transition.

80.17    Sec. 32. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
80.18    Subd. 3. Consumer surveys of nursing facilities residents. Following
80.19identification of the quality measurement tool, the commissioners shall conduct surveys
80.20of long-term care service consumers of nursing facilities to develop quality profiles
80.21of providers. To the extent possible, surveys must be conducted face-to-face by state
80.22employees or contractors. At the discretion of the commissioners, surveys may be
80.23conducted by telephone or by provider staff. Surveys must be conducted periodically to
80.24update quality profiles of individual service nursing facilities providers.

80.25    Sec. 33. Minnesota Statutes 2012, section 256B.439, is amended by adding a
80.26subdivision to read:
80.27    Subd. 3a. Home and community-based services report card in cooperation with
80.28the commissioner of health. The commissioner shall work with existing Department
80.29of Human Services advisory groups to develop recommendations for a home and
80.30community-based services report card. Health and human services staff that regulate
80.31home and community-based services as provided in chapter 245D and licensed home care
80.32as provided in chapter 144A shall be consulted. The advisory groups shall consider the
80.33requirements from the Minnesota consumer information guide under section 144G.06 as a
81.1base for development of the home and community-based services report card to compare
81.2the housing options available to consumers. Other items to be considered by the advisory
81.3groups in developing recommendations include:
81.4(1) defining the goals of the report card, including measuring outcomes, providing
81.5consumer information, and defining vehicle-for-pay performance;
81.6(2) developing separate measures for programs for the elderly population and for
81.7persons with disabilities;
81.8(3) the sources of information needed that are standardized and contain sufficient data;
81.9(4) the financial support needed for creating and publicizing the housing information
81.10guide, and ongoing funding for data collection and staffing to monitor, report, and analyze;
81.11(5) a recognition that home and community-based services settings exist with
81.12significant variations in size, settings, and services available;
81.13(6) ensuring that consumer choice and consumer information is retained and valued;
81.14(7) the applicability of these measures to providers based on payor source, size,
81.15and population served; and
81.16(8) dissemination of quality profiles.
81.17The advisory groups shall discuss whether there are additional funding, resources,
81.18and research needed. The commissioner shall report recommendations to the chairs and
81.19ranking minority members of the legislative committees and divisions with jurisdiction
81.20over health and human services issues by August 1, 2014. The report card shall be
81.21available on July 1, 2015.

81.22    Sec. 34. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
81.23    Subd. 4. Dissemination of quality profiles. By July 1, 2003 2014, the
81.24commissioners shall implement a system public awareness effort to disseminate the quality
81.25profiles developed from consumer surveys using the quality measurement tool. Profiles
81.26may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and
81.27to consumers, providers, and purchasers of long-term care services through all feasible
81.28printed and electronic outlets. The commissioners may conduct a public awareness
81.29campaign to inform potential users regarding profile contents and potential uses.

81.30    Sec. 35. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
81.31    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
81.32nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
81.33section 144.122; until September 30, 2013, long-term care consultation fees under
81.34section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
82.1scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
82.2under section 256B.437; or single bed room incentives under section 256B.431,
82.3subdivision 42 ; property taxes and property insurance; and PERA.

82.4    Sec. 36. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
82.5    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
82.6shall calculate a payment rate for external fixed costs.
82.7    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
82.8shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
82.9home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
82.10result of its number of nursing home beds divided by its total number of licensed beds.
82.11    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
82.12shall be the amount of the fee divided by actual resident days.
82.13    (c) The portion related to scholarships shall be determined under section 256B.431,
82.14subdivision 36.
82.15    (d) Until September 30, 2013, the portion related to long-term care consultation shall
82.16be determined according to section 256B.0911, subdivision 6.
82.17    (e) The portion related to development and education of resident and family advisory
82.18councils under section 144A.33 shall be $5 divided by 365.
82.19    (f) The portion related to planned closure rate adjustments shall be as determined
82.20under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
82.21Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
82.22be included in the payment rate for external fixed costs beginning October 1, 2016.
82.23Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
82.24longer be included in the payment rate for external fixed costs beginning on October 1 of
82.25the first year not less than two years after their effective date.
82.26    (g) The portions related to property insurance, real estate taxes, special assessments,
82.27and payments made in lieu of real estate taxes directly identified or allocated to the nursing
82.28facility shall be the actual amounts divided by actual resident days.
82.29    (h) The portion related to the Public Employees Retirement Association shall be
82.30actual costs divided by resident days.
82.31    (i) The single bed room incentives shall be as determined under section 256B.431,
82.32subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
82.33no longer be included in the payment rate for external fixed costs beginning October 1,
82.342016. Single bed room incentives that take effect on or after October 1, 2014, shall no
83.1longer be included in the payment rate for external fixed costs beginning on October 1 of
83.2the first year not less than two years after their effective date.
83.3    (j) The payment rate for external fixed costs shall be the sum of the amounts in
83.4paragraphs (a) to (i).

83.5    Sec. 37. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
83.6    Subd. 12. Informed choice. Persons who are determined likely to require the level
83.7of care provided in a nursing facility as determined under section 256B.0911, subdivision
83.84e, or a hospital shall be informed of the home and community-based support alternatives
83.9to the provision of inpatient hospital services or nursing facility services. Each person
83.10must be given the choice of either institutional or home and community-based services
83.11using the provisions described in section 256B.77, subdivision 2, paragraph (p).

83.12    Sec. 38. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
83.13    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
83.14shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
83.15With the permission of the recipient or the recipient's designated legal representative,
83.16the recipient's current provider of services may submit a written report outlining their
83.17recommendations regarding the recipient's care needs prepared by a direct service
83.18employee with at least 20 hours of service to that client. The person conducting the
83.19assessment or reassessment must notify the provider of the date by which this information
83.20is to be submitted. This information shall be provided to the person conducting the
83.21assessment and the person or the person's legal representative and must be considered
83.22prior to the finalization of the assessment or reassessment.
83.23(b) There must be a determination that the client requires a hospital level of care or a
83.24nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
83.25(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the
83.26waiver program.
83.27(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
83.28appropriate to determine nursing facility level of care for purposes of medical assistance
83.29payment for nursing facility services, only face-to-face assessments conducted according
83.30to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
83.31determination or a nursing facility level of care determination must be accepted for
83.32purposes of initial and ongoing access to waiver services payment.
84.1(d) Recipients who are found eligible for home and community-based services under
84.2this section before their 65th birthday may remain eligible for these services after their
84.365th birthday if they continue to meet all other eligibility factors.
84.4(e) The commissioner shall develop criteria to identify recipients whose level of
84.5functioning is reasonably expected to improve and reassess these recipients to establish
84.6a baseline assessment. Recipients who meet these criteria must have a comprehensive
84.7transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
84.8reassessed every six months until there has been no significant change in the recipient's
84.9functioning for at least 12 months. After there has been no significant change in the
84.10recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
84.11informal support systems, and need for services shall be conducted at least every 12
84.12months and at other times when there has been a significant change in the recipient's
84.13functioning. Counties, case managers, and service providers are responsible for
84.14conducting these reassessments and shall complete the reassessments out of existing funds.

84.15    Sec. 39. Minnesota Statutes 2012, section 256B.69, subdivision 8, is amended to read:
84.16    Subd. 8. Preadmission screening waiver. Except as applicable to the project's
84.17operation, the provisions of section sections 256.975 and 256B.0911 are waived for the
84.18purposes of this section for recipients enrolled with demonstration providers or in the
84.19prepaid medical assistance program for seniors.

84.20    Sec. 40. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
84.21to read:
84.22    Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
84.23negotiate a supplementary service rate under this section for any individual that has been
84.24determined to be eligible for Housing Stability Services as approved by the Centers
84.25for Medicare and Medicaid Services, and who resides in an establishment voluntarily
84.26registered under section 144D.025, as a supportive housing establishment or participates
84.27in the Minnesota supportive housing demonstration program under section 256I.04,
84.28subdivision 3, paragraph (a), clause (4).

84.29    Sec. 41. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
84.30    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
84.31shall immediately make an oral report to the common entry point. The common entry
84.32point may accept electronic reports submitted through a Web-based reporting system
84.33established by the commissioner. Use of a telecommunications device for the deaf or other
85.1similar device shall be considered an oral report. The common entry point may not require
85.2written reports. To the extent possible, the report must be of sufficient content to identify
85.3the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
85.4any evidence of previous maltreatment, the name and address of the reporter, the time,
85.5date, and location of the incident, and any other information that the reporter believes
85.6might be helpful in investigating the suspected maltreatment. A mandated reporter may
85.7disclose not public data, as defined in section 13.02, and medical records under sections
85.8144.291 to 144.298, to the extent necessary to comply with this subdivision.
85.9(b) A boarding care home that is licensed under sections 144.50 to 144.58 and
85.10certified under Title 19 of the Social Security Act, a nursing home that is licensed under
85.11section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a
85.12hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under
85.13Code of Federal Regulations, title 42, section 482.66, may submit a report electronically
85.14to the common entry point instead of submitting an oral report. The report may be a
85.15duplicate of the initial report the facility submits electronically to the commissioner of
85.16health to comply with the reporting requirements under Code of Federal Regulations, title
85.1742, section 483.13. The commissioner of health may modify these reporting requirements
85.18to include items required under paragraph (a) that are not currently included in the
85.19electronic reporting form.
85.20EFFECTIVE DATE.This section is effective July 1, 2014.

85.21    Sec. 42. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
85.22    Subd. 9. Common entry point designation. (a) Each county board shall designate
85.23a common entry point for reports of suspected maltreatment. Two or more county boards
85.24may jointly designate a single The commissioner of human services shall establish a
85.25 common entry point effective July 1, 2014. The common entry point is the unit responsible
85.26for receiving the report of suspected maltreatment under this section.
85.27(b) The common entry point must be available 24 hours per day to take calls from
85.28reporters of suspected maltreatment. The common entry point shall use a standard intake
85.29form that includes:
85.30(1) the time and date of the report;
85.31(2) the name, address, and telephone number of the person reporting;
85.32(3) the time, date, and location of the incident;
85.33(4) the names of the persons involved, including but not limited to, perpetrators,
85.34alleged victims, and witnesses;
85.35(5) whether there was a risk of imminent danger to the alleged victim;
86.1(6) a description of the suspected maltreatment;
86.2(7) the disability, if any, of the alleged victim;
86.3(8) the relationship of the alleged perpetrator to the alleged victim;
86.4(9) whether a facility was involved and, if so, which agency licenses the facility;
86.5(10) any action taken by the common entry point;
86.6(11) whether law enforcement has been notified;
86.7(12) whether the reporter wishes to receive notification of the initial and final
86.8reports; and
86.9(13) if the report is from a facility with an internal reporting procedure, the name,
86.10mailing address, and telephone number of the person who initiated the report internally.
86.11(c) The common entry point is not required to complete each item on the form prior
86.12to dispatching the report to the appropriate lead investigative agency.
86.13(d) The common entry point shall immediately report to a law enforcement agency
86.14any incident in which there is reason to believe a crime has been committed.
86.15(e) If a report is initially made to a law enforcement agency or a lead investigative
86.16agency, those agencies shall take the report on the appropriate common entry point intake
86.17forms and immediately forward a copy to the common entry point.
86.18(f) The common entry point staff must receive training on how to screen and
86.19dispatch reports efficiently and in accordance with this section.
86.20(g) The commissioner of human services shall maintain a centralized database
86.21for the collection of common entry point data, lead investigative agency data including
86.22maltreatment report disposition, and appeals data. The common entry point shall
86.23have access to the centralized database and must log the reports into the database and
86.24immediately identify and locate prior reports of abuse, neglect, or exploitation.
86.25(h) When appropriate, the common entry point staff must refer calls that do not
86.26allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
86.27that might resolve the reporter's concerns.
86.28(i) a common entry point must be operated in a manner that enables the
86.29commissioner of human services to:
86.30(1) track critical steps in the reporting, evaluation, referral, response, disposition,
86.31and investigative process to ensure compliance with all requirements for all reports;
86.32(2) maintain data to facilitate the production of aggregate statistical reports for
86.33monitoring patterns of abuse, neglect, or exploitation;
86.34(3) serve as a resource for the evaluation, management, and planning of preventative
86.35and remedial services for vulnerable adults who have been subject to abuse, neglect,
86.36or exploitation;
87.1(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
87.2of the common entry point; and
87.3(5) track and manage consumer complaints related to the common entry point.
87.4(j) The commissioners of human services and health shall collaborate on the
87.5creation of a system for referring reports to the lead investigative agencies. This system
87.6shall enable the commissioner of human services to track critical steps in the reporting,
87.7evaluation, referral, response, disposition, investigation, notification, determination, and
87.8appeal processes.

87.9    Sec. 43. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
87.10    Subd. 9e. Education requirements. (a) The commissioners of health, human
87.11services, and public safety shall cooperate in the development of a joint program for
87.12education of lead investigative agency investigators in the appropriate techniques for
87.13investigation of complaints of maltreatment. This program must be developed by July
87.141, 1996. The program must include but need not be limited to the following areas: (1)
87.15information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
87.16conclusions based on evidence; (5) interviewing skills, including specialized training to
87.17interview people with unique needs; (6) report writing; (7) coordination and referral
87.18to other necessary agencies such as law enforcement and judicial agencies; (8) human
87.19relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
87.20systems and the appropriate methods for interviewing relatives in the course of the
87.21assessment or investigation; (10) the protective social services that are available to protect
87.22alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
87.23which lead investigative agency investigators and law enforcement workers cooperate in
87.24conducting assessments and investigations in order to avoid duplication of efforts; and
87.25(12) data practices laws and procedures, including provisions for sharing data.
87.26(b) The commissioner of human services shall conduct an outreach campaign to
87.27promote the common entry point for reporting vulnerable adult maltreatment. This
87.28campaign shall use the Internet and other means of communication.
87.29(b) (c) The commissioners of health, human services, and public safety shall offer at
87.30least annual education to others on the requirements of this section, on how this section is
87.31implemented, and investigation techniques.
87.32(c) (d) The commissioner of human services, in coordination with the commissioner
87.33of public safety shall provide training for the common entry point staff as required in this
87.34subdivision and the program courses described in this subdivision, at least four times
87.35per year. At a minimum, the training shall be held twice annually in the seven-county
88.1metropolitan area and twice annually outside the seven-county metropolitan area. The
88.2commissioners shall give priority in the program areas cited in paragraph (a) to persons
88.3currently performing assessments and investigations pursuant to this section.
88.4(d) (e) The commissioner of public safety shall notify in writing law enforcement
88.5personnel of any new requirements under this section. The commissioner of public
88.6safety shall conduct regional training for law enforcement personnel regarding their
88.7responsibility under this section.
88.8(e) (f) Each lead investigative agency investigator must complete the education
88.9program specified by this subdivision within the first 12 months of work as a lead
88.10investigative agency investigator.
88.11A lead investigative agency investigator employed when these requirements take
88.12effect must complete the program within the first year after training is available or as soon
88.13as training is available.
88.14All lead investigative agency investigators having responsibility for investigation
88.15duties under this section must receive a minimum of eight hours of continuing education
88.16or in-service training each year specific to their duties under this section.

88.17    Sec. 44. FEDERAL APPROVAL.
88.18This article is contingent on federal approval.

88.19    Sec. 45. REPEALER.
88.20(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
88.213, 4, 5, 7, 8, 9, 10, 11, and 12, are repealed.
88.22(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
88.23repealed effective October 1, 2013.

88.24ARTICLE 3

88.25SAFE AND HEALTHY DEVELOPMENT OF CHILDREN,
88.26YOUTH, AND FAMILIES

88.27    Section 1. Minnesota Statutes 2012, section 119B.011, is amended by adding a
88.28subdivision to read:
88.29    Subd. 19b. Student parent. "Student parent" means a person who is:
88.30(1) under 21 years of age and has a child;
88.31(2) pursuing a high school or general equivalency diploma;
88.32(3) residing within a county that has a basic sliding fee waiting list under section
88.33119B.03, subdivision 4; and
88.34(4) not an MFIP participant.
89.1EFFECTIVE DATE.This section is effective November 11, 2013.

89.2    Sec. 2. Minnesota Statutes 2012, section 119B.02, is amended by adding a subdivision
89.3to read:
89.4    Subd. 7. Child care market rate survey. Biennially, the commissioner shall survey
89.5prices charged by child care providers in Minnesota to determine the 75th percentile for
89.6like-care arrangements in county price clusters.
89.7EFFECTIVE DATE.This section is effective February 3, 2014.

89.8    Sec. 3. Minnesota Statutes 2012, section 119B.025, subdivision 1, is amended to read:
89.9    Subdivision 1. Factors which must be verified. (a) The county shall verify the
89.10following at all initial child care applications using the universal application:
89.11(1) identity of adults;
89.12(2) presence of the minor child in the home, if questionable;
89.13(3) relationship of minor child to the parent, stepparent, legal guardian, eligible
89.14relative caretaker, or the spouses of any of the foregoing;
89.15(4) age;
89.16(5) immigration status, if related to eligibility;
89.17(6) Social Security number, if given;
89.18(7) income;
89.19(8) spousal support and child support payments made to persons outside the
89.20household;
89.21(9) residence; and
89.22(10) inconsistent information, if related to eligibility.
89.23(b) If a family did not use the universal application or child care addendum to apply
89.24for child care assistance, the family must complete the universal application or child care
89.25addendum at its next eligibility redetermination and the county must verify the factors
89.26listed in paragraph (a) as part of that redetermination. Once a family has completed a
89.27universal application or child care addendum, the county shall use the redetermination
89.28form described in paragraph (c) for that family's subsequent redeterminations. Eligibility
89.29must be redetermined at least every six months. A family is considered to have met the
89.30eligibility redetermination requirement if a complete redetermination form and all required
89.31verifications are received within 30 days after the date the form was due. Assistance shall
89.32be payable retroactively from the redetermination due date. For a family where at least
89.33one parent is under the age of 21, does not have a high school or general equivalency
89.34diploma, and is a student in a school district or another similar program that provides or
90.1arranges for child care, as well as parenting, social services, career and employment
90.2supports, and academic support to achieve high school graduation, the redetermination of
90.3eligibility shall be deferred beyond six months, but not to exceed 12 months, to the end of
90.4the student's school year. If a family reports a change in an eligibility factor before the
90.5family's next regularly scheduled redetermination, the county must recalculate eligibility
90.6without requiring verification of any eligibility factor that did not change.
90.7(c) The commissioner shall develop a redetermination form to redetermine eligibility
90.8and a change report form to report changes that minimize paperwork for the county and
90.9the participant.
90.10EFFECTIVE DATE.This section is effective August 4, 2014.

90.11    Sec. 4. Minnesota Statutes 2012, section 119B.03, subdivision 4, is amended to read:
90.12    Subd. 4. Funding priority. (a) First priority for child care assistance under the
90.13basic sliding fee program must be given to eligible non-MFIP families who do not have a
90.14high school or general equivalency diploma or who need remedial and basic skill courses
90.15in order to pursue employment or to pursue education leading to employment and who
90.16need child care assistance to participate in the education program. This includes student
90.17parents as defined under section 119B.011, subdivision 19b. Within this priority, the
90.18following subpriorities must be used:
90.19(1) child care needs of minor parents;
90.20(2) child care needs of parents under 21 years of age; and
90.21(3) child care needs of other parents within the priority group described in this
90.22paragraph.
90.23(b) Second priority must be given to parents who have completed their MFIP or
90.24DWP transition year, or parents who are no longer receiving or eligible for diversionary
90.25work program supports.
90.26(c) Third priority must be given to families who are eligible for portable basic sliding
90.27fee assistance through the portability pool under subdivision 9.
90.28(d) Fourth priority must be given to families in which at least one parent is a veteran
90.29as defined under section 197.447.
90.30(e) Families under paragraph (b) must be added to the basic sliding fee waiting list
90.31on the date they begin the transition year under section 119B.011, subdivision 20, and
90.32must be moved into the basic sliding fee program as soon as possible after they complete
90.33their transition year.
90.34EFFECTIVE DATE.This section is effective November 11, 2013.

91.1    Sec. 5. Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:
91.2    Subdivision 1. Eligible participants. Families eligible for child care assistance
91.3under the MFIP child care program are:
91.4    (1) MFIP participants who are employed or in job search and meet the requirements
91.5of section 119B.10;
91.6    (2) persons who are members of transition year families under section 119B.011,
91.7subdivision 20 , and meet the requirements of section 119B.10;
91.8    (3) families who are participating in employment orientation or job search, or
91.9other employment or training activities that are included in an approved employability
91.10development plan under section 256J.95;
91.11    (4) MFIP families who are participating in work job search, job support,
91.12employment, or training activities as required in their employment plan, or in appeals,
91.13hearings, assessments, or orientations according to chapter 256J;
91.14    (5) MFIP families who are participating in social services activities under chapter
91.15256J as required in their employment plan approved according to chapter 256J;
91.16    (6) families who are participating in services or activities that are included in an
91.17approved family stabilization plan under section 256J.575;
91.18    (7) families who are participating in programs as required in tribal contracts under
91.19section 119B.02, subdivision 2, or 256.01, subdivision 2; and
91.20    (8) families who are participating in the transition year extension under section
91.21119B.011, subdivision 20a; and
91.22(9) student parents as defined under section 119B.011, subdivision 19b.
91.23EFFECTIVE DATE.This section is effective November 11, 2013.

91.24    Sec. 6. Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:
91.25    Subdivision 1. Subsidy restrictions. (a) Beginning October 31, 2011 February 3,
91.262014, the maximum rate paid for child care assistance in any county or multicounty region
91.27 county price cluster under the child care fund shall be the rate for like-care arrangements in
91.28the county effective July 1, 2006, decreased by 2.5 percent greater of the 25th percentile of
91.29the 2011 child care provider rate survey or the maximum rate effective November 28, 2011.
91.30The commissioner may: (1) assign a county with no reported provider prices to a similar
91.31price cluster; and (2) consider county level access when determining final price clusters.
91.32    (b) Biennially, beginning in 2012, the commissioner shall survey rates charged
91.33by child care providers in Minnesota to determine the 75th percentile for like-care
91.34arrangements in counties. When the commissioner determines that, using the
91.35commissioner's established protocol, the number of providers responding to the survey is
92.1too small to determine the 75th percentile rate for like-care arrangements in a county or
92.2multicounty region, the commissioner may establish the 75th percentile maximum rate
92.3based on like-care arrangements in a county, region, or category that the commissioner
92.4deems to be similar.
92.5    (c) (b) A rate which includes a special needs rate paid under subdivision 3 or under a
92.6school readiness service agreement paid under section 119B.231, may be in excess of the
92.7maximum rate allowed under this subdivision.
92.8    (d) (c) The department shall monitor the effect of this paragraph on provider rates.
92.9The county shall pay the provider's full charges for every child in care up to the maximum
92.10established. The commissioner shall determine the maximum rate for each type of care
92.11on an hourly, full-day, and weekly basis, including special needs and disability care. The
92.12maximum payment to a provider for one day of care must not exceed the daily rate. The
92.13maximum payment to a provider for one week of care must not exceed the weekly rate.
92.14(e) (d) Child care providers receiving reimbursement under this chapter must not
92.15be paid activity fees or an additional amount above the maximum rates for care provided
92.16during nonstandard hours for families receiving assistance.
92.17    (f) (e) When the provider charge is greater than the maximum provider rate allowed,
92.18the parent is responsible for payment of the difference in the rates in addition to any
92.19family co-payment fee.
92.20    (g) (f) All maximum provider rates changes shall be implemented on the Monday
92.21following the effective date of the maximum provider rate.
92.22    (g) Notwithstanding Minnesota Rules, part 3400.0130, subpart 7, maximum
92.23registration fees in effect on January 1, 2013, shall remain in effect.

92.24    Sec. 7. Minnesota Statutes 2012, section 119B.13, subdivision 1a, is amended to read:
92.25    Subd. 1a. Legal nonlicensed family child care provider rates. (a) Legal
92.26nonlicensed family child care providers receiving reimbursement under this chapter must
92.27be paid on an hourly basis for care provided to families receiving assistance.
92.28(b) The maximum rate paid to legal nonlicensed family child care providers must be
92.2968 percent of the county maximum hourly rate for licensed family child care providers. In
92.30counties or county price clusters where the maximum hourly rate for licensed family child
92.31care providers is higher than the maximum weekly rate for those providers divided by 50,
92.32the maximum hourly rate that may be paid to legal nonlicensed family child care providers
92.33is the rate equal to the maximum weekly rate for licensed family child care providers
92.34divided by 50 and then multiplied by 0.68. The maximum payment to a provider for one
93.1day of care must not exceed the maximum hourly rate times ten. The maximum payment
93.2to a provider for one week of care must not exceed the maximum hourly rate times 50.
93.3(c) A rate which includes a special needs rate paid under subdivision 3 may be in
93.4excess of the maximum rate allowed under this subdivision.
93.5(d) Legal nonlicensed family child care providers receiving reimbursement under
93.6this chapter may not be paid registration fees for families receiving assistance.
93.7EFFECTIVE DATE.This section is effective February 3, 2014.

93.8    Sec. 8. Minnesota Statutes 2012, section 119B.13, subdivision 3a, is amended to read:
93.9    Subd. 3a. Provider rate differential for accreditation. A family child care
93.10provider or child care center shall be paid a 15 percent differential above the maximum
93.11rate established in subdivision 1, up to the actual provider rate, if the provider or center
93.12holds a current early childhood development credential or is accredited. For a family
93.13child care provider, early childhood development credential and accreditation includes
93.14an individual who has earned a child development associate degree, a child development
93.15associate credential, a diploma in child development from a Minnesota state technical
93.16college, or a bachelor's or post baccalaureate degree in early childhood education from
93.17an accredited college or university, or who is accredited by the National Association for
93.18Family Child Care or the Competency Based Training and Assessment Program. For a
93.19child care center, accreditation includes accreditation that meets the following criteria:
93.20the accrediting organization must demonstrate the use of standards that promote the
93.21physical, social, emotional, and cognitive development of children. The accreditation
93.22standards shall include, but are not limited to, positive interactions between adults and
93.23children, age-appropriate learning activities, a system of tracking children's learning,
93.24use of assessment to meet children's needs, specific qualifications for staff, a learning
93.25environment that supports developmentally appropriate experiences for children, health
93.26and safety requirements, and family engagement strategies. The commissioner of human
93.27services, in conjunction with the commissioners of education and health, will develop an
93.28application and approval process based on the criteria in this section and any additional
93.29criteria. The process developed by the commissioner of human services must address
93.30periodic reassessment of approved accreditations. The commissioner of human services
93.31must report the criteria developed, the application, approval, and reassessment processes,
93.32and any additional recommendations by February 15, 2013, to the chairs and ranking
93.33minority members of the legislative committees having jurisdiction over early childhood
93.34issues. Based on an application process developed by the commissioner in conjunction
93.35with the commissioners of education and health, the Department of Human Services must
94.1accept applications from accrediting organizations beginning on July 1, 2013, and on an
94.2annual basis thereafter. The provider rate differential shall be paid to centers holding an
94.3accreditation from an approved accrediting organization beginning on a billing cycle to be
94.4determined by the commissioner, no later than the last Monday in February of a calendar
94.5year. The commissioner shall annually publish a list of approved accrediting organizations.
94.6An approved accreditation must be reassessed by the commissioner every two years. If an
94.7approved accrediting organization is determined to no longer meet the approval criteria, the
94.8organization and centers being paid the differential under that accreditation must be given
94.9a 90-day notice by the commissioner and the differential payment must end after a 15-day
94.10notice to affected families and centers as directed in Minnesota Rules, part 3400.0185,
94.11subparts 3 and 4. The following accreditations shall be recognized for the provider rate
94.12differential until an approval process is implemented: the National Association for the
94.13Education of Young Children, the Council on Accreditation, the National Early Childhood
94.14Program Accreditation, the National School-Age Care Association, or the National Head
94.15Start Association Program of Excellence. For Montessori programs, accreditation includes
94.16the American Montessori Society, Association of Montessori International-USA, or the
94.17National Center for Montessori Education.

94.18    Sec. 9. Minnesota Statutes 2012, section 119B.13, is amended by adding a subdivision
94.19to read:
94.20    Subd. 3b. Provider rate differential for Parent Aware. A family child care
94.21provider or child care center shall be paid a 15 percent differential if they hold a three-star
94.22Parent Aware rating or a 20 percent differential if they hold a four-star Parent Aware
94.23rating. A 15 percent or 20 percent rate differential must be paid above the maximum rate
94.24established in subdivision 1, up to the actual provider rate.
94.25EFFECTIVE DATE.This section is effective March 3, 2014.

94.26    Sec. 10. Minnesota Statutes 2012, section 119B.13, is amended by adding a subdivision
94.27to read:
94.28    Subd. 3c. Weekly rate paid for children attending high-quality care. A licensed
94.29child care provider or license-exempt center may be paid up to the applicable weekly
94.30maximum rate, not to exceed the provider's actual charge, when the following conditions
94.31are met:
94.32(1) the child is age birth to five years, but not yet in kindergarten;
94.33(2) the child attends a child care provider that qualifies for the rate differential
94.34identified in subdivision 3a or 3b; and
95.1(3) the applicant's activities qualify for at least 30 hours of care per week under
95.2sections 119B.03, 119B.05, 119B.10, and Minnesota Rules, chapter 3400.
95.3EFFECTIVE DATE.This section is effective August 4, 2014.

95.4    Sec. 11. Minnesota Statutes 2012, section 119B.13, subdivision 6, is amended to read:
95.5    Subd. 6. Provider payments. (a) The provider shall bill for services provided
95.6within ten days of the end of the service period. If bills are submitted within ten days of
95.7the end of the service period, payments under the child care fund shall be made within 30
95.8days of receiving a bill from the provider. Counties or the state may establish policies that
95.9make payments on a more frequent basis.
95.10(b) If a provider has received an authorization of care and been issued a billing form
95.11for an eligible family, the bill must be submitted within 60 days of the last date of service on
95.12the bill. A bill submitted more than 60 days after the last date of service must be paid if the
95.13county determines that the provider has shown good cause why the bill was not submitted
95.14within 60 days. Good cause must be defined in the county's child care fund plan under
95.15section 119B.08, subdivision 3, and the definition of good cause must include county error.
95.16Any bill submitted more than a year after the last date of service on the bill must not be paid.
95.17(c) If a provider provided care for a time period without receiving an authorization
95.18of care and a billing form for an eligible family, payment of child care assistance may only
95.19be made retroactively for a maximum of six months from the date the provider is issued
95.20an authorization of care and billing form.
95.21(d) A county may refuse to issue a child care authorization to a licensed or legal
95.22nonlicensed provider, revoke an existing child care authorization to a licensed or legal
95.23nonlicensed provider, stop payment issued to a licensed or legal nonlicensed provider, or
95.24refuse to pay a bill submitted by a licensed or legal nonlicensed provider if:
95.25(1) the provider admits to intentionally giving the county materially false information
95.26on the provider's billing forms;
95.27(2) a county finds by a preponderance of the evidence that the provider intentionally
95.28gave the county materially false information on the provider's billing forms;
95.29(3) the provider is in violation of child care assistance program rules, until the
95.30agency determines those violations have been corrected;
95.31    (4) the provider is operating after receipt of an order of suspension or an order
95.32of revocation of the provider's license, or the provider has been issued an order citing
95.33violations of licensing standards that affect the health and safety of children in care due to
95.34the nature, chronicity, or severity of the licensing violations, until the licensing agency
95.35determines those violations have been corrected;
96.1(5) the provider submits false attendance reports or refuses to provide documentation
96.2of the child's attendance upon request; or
96.3(6) the provider gives false child care price information.
96.4The county may withhold the provider's authorization or payment for a period of
96.5time not to exceed three months beyond the time the condition has been corrected.
96.6(e) A county's payment policies must be included in the county's child care plan
96.7under section 119B.08, subdivision 3. If payments are made by the state, in addition to
96.8being in compliance with this subdivision, the payments must be made in compliance
96.9with section 16A.124.
96.10EFFECTIVE DATE.This section is effective February 3, 2014.

96.11    Sec. 12. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
96.12    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
96.13must not be reimbursed for more than ten 25 full-day absent days per child, excluding
96.14holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal
96.15nonlicensed family child care providers must not be reimbursed for absent days. If a child
96.16attends for part of the time authorized to be in care in a day, but is absent for part of the
96.17time authorized to be in care in that same day, the absent time must be reimbursed but
96.18the time must not count toward the ten absent day days limit. Child care providers must
96.19only be reimbursed for absent days if the provider has a written policy for child absences
96.20and charges all other families in care for similar absences.
96.21(b) Notwithstanding paragraph (a), children with documented medical conditions
96.22that cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
96.23full-day absent days limit. Absences due to a documented medical condition of a parent
96.24or sibling who lives in the same residence as the child receiving child care assistance
96.25do not count against the absent days limit in a fiscal year. Documentation of medical
96.26conditions must be on the forms and submitted according to the timelines established by
96.27the commissioner. A public health nurse or school nurse may verify the illness in lieu of
96.28a medical practitioner. If a provider sends a child home early due to a medical reason,
96.29including, but not limited to, fever or contagious illness, the child care center director or
96.30lead teacher may verify the illness in lieu of a medical practitioner.
96.31(b) (c) Notwithstanding paragraph (a), children in families may exceed the ten absent
96.32days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school
96.33or general equivalency diploma; and (3) is a student in a school district or another similar
96.34program that provides or arranges for child care, parenting support, social services, career
96.35and employment supports, and academic support to achieve high school graduation, upon
97.1request of the program and approval of the county. If a child attends part of an authorized
97.2day, payment to the provider must be for the full amount of care authorized for that day.
97.3    (c) (d) Child care providers must be reimbursed for up to ten federal or state holidays
97.4or designated holidays per year when the provider charges all families for these days and the
97.5holiday or designated holiday falls on a day when the child is authorized to be in attendance.
97.6Parents may substitute other cultural or religious holidays for the ten recognized state and
97.7federal holidays. Holidays do not count toward the ten absent day days limit.
97.8    (d) (e) A family or child care provider must not be assessed an overpayment for an
97.9absent day payment unless (1) there was an error in the amount of care authorized for the
97.10family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
97.11the family or provider did not timely report a change as required under law.
97.12    (e) (f) The provider and family shall receive notification of the number of absent
97.13days used upon initial provider authorization for a family and ongoing notification of the
97.14number of absent days used as of the date of the notification.
97.15(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent
97.16days per child, excluding holidays, in a fiscal year; and ten consecutive full-day absent days.
97.17EFFECTIVE DATE.This section is effective February 1, 2014.

97.18    Sec. 13. Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:
97.19    Subd. 2a. Immediate suspension expedited hearing. (a) Within five working days
97.20of receipt of the license holder's timely appeal, the commissioner shall request assignment
97.21of an administrative law judge. The request must include a proposed date, time, and place
97.22of a hearing. A hearing must be conducted by an administrative law judge within 30
97.23calendar days of the request for assignment, unless an extension is requested by either
97.24party and granted by the administrative law judge for good cause. The commissioner shall
97.25issue a notice of hearing by certified mail or personal service at least ten working days
97.26before the hearing. The scope of the hearing shall be limited solely to the issue of whether
97.27the temporary immediate suspension should remain in effect pending the commissioner's
97.28final order under section 245A.08, regarding a licensing sanction issued under subdivision
97.293 following the immediate suspension. The burden of proof in expedited hearings under
97.30this subdivision shall be limited to the commissioner's demonstration that reasonable
97.31cause exists to believe that the license holder's actions or failure to comply with applicable
97.32law or rule poses, or if the actions of other individuals or conditions in the program
97.33poses an imminent risk of harm to the health, safety, or rights of persons served by the
97.34program. "Reasonable cause" means there exist specific articulable facts or circumstances
97.35which provide the commissioner with a reasonable suspicion that there is an imminent
98.1risk of harm to the health, safety, or rights of persons served by the program. When the
98.2commissioner has determined there is reasonable cause to order the temporary immediate
98.3suspension of a license based on a violation of safe sleep requirements, as defined in
98.4section 245A.1435, the commissioner is not required to demonstrate that an infant died or
98.5was injured as a result of the safe sleep violations.
98.6    (b) The administrative law judge shall issue findings of fact, conclusions, and a
98.7recommendation within ten working days from the date of hearing. The parties shall have
98.8ten calendar days to submit exceptions to the administrative law judge's report. The
98.9record shall close at the end of the ten-day period for submission of exceptions. The
98.10commissioner's final order shall be issued within ten working days from the close of the
98.11record. Within 90 calendar days after a final order affirming an immediate suspension, the
98.12commissioner shall make a determination regarding whether a final licensing sanction
98.13shall be issued under subdivision 3. The license holder shall continue to be prohibited
98.14from operation of the program during this 90-day period.
98.15    (c) When the final order under paragraph (b) affirms an immediate suspension, and a
98.16final licensing sanction is issued under subdivision 3 and the license holder appeals that
98.17sanction, the license holder continues to be prohibited from operation of the program
98.18pending a final commissioner's order under section 245A.08, subdivision 5, regarding the
98.19final licensing sanction.

98.20    Sec. 14. Minnesota Statutes 2012, section 245A.1435, is amended to read:
98.21245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT
98.22DEATH SYNDROME IN LICENSED PROGRAMS.
98.23    (a) When a license holder is placing an infant to sleep, the license holder must
98.24place the infant on the infant's back, unless the license holder has documentation from
98.25the infant's parent physician directing an alternative sleeping position for the infant. The
98.26parent physician directive must be on a form approved by the commissioner and must
98.27include a statement that the parent or legal guardian has read the information provided by
98.28the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance
98.29of placing an infant or child on its back to sleep to reduce the risk of SIDS. remain on file
98.30at the licensed location. An infant who independently rolls onto its stomach after being
98.31placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant
98.32is at least six months of age or the license holder has a signed statement from the parent
98.33indicating that the infant regularly rolls over at home.
98.34(b) The license holder must place the infant in a crib directly on a firm mattress with
98.35a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be
99.1dislodged by pulling on the corner of the sheet. The license holder must not place pillows,
99.2quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib
99.3with the infant The license holder must place the infant in a crib directly on a firm mattress
99.4with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress,
99.5and overlaps the underside of the mattress so it cannot be dislodged by pulling on the
99.6corner of the sheet with reasonable effort. The license holder must not place anything in
99.7the crib with the infant except for the infant's pacifier, as defined in Code of Federal
99.8Regulations, title 16, part 1511. The requirements of this section apply to license holders
99.9serving infants up to and including 12 months younger than one year of age. Licensed
99.10child care providers must meet the crib requirements under section 245A.146.
99.11(c) If an infant falls asleep before being placed in a crib, the license holder must
99.12move the infant to a crib as soon as practicable, and must keep the infant within sight of
99.13the license holder until the infant is placed in a crib. When an infant falls asleep while
99.14being held, the license holder must consider the supervision needs of other children in
99.15care when determining how long to hold the infant before placing the infant in a crib to
99.16sleep. The sleeping infant must not be in a position where the airway may be blocked or
99.17with anything covering the infant's face.
99.18(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended
99.19for an infant of any age and is prohibited for any infant who has begun to roll over
99.20independently. However, with the written consent of a parent or guardian according to this
99.21paragraph, a license holder may place the infant who has not yet begun to roll over on its
99.22own down to sleep in a one-piece sleeper equipped with an attached system that fastens
99.23securely only across the upper torso, with no constriction of the hips or legs, to create a
99.24swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter,
99.25the license holder must obtain informed written consent for the use of swaddling from the
99.26parent or guardian of the infant on a form provided by the commissioner and prepared in
99.27partnership with the Minnesota Sudden Infant Death Center.

99.28    Sec. 15. Minnesota Statutes 2012, section 245A.144, is amended to read:
99.29245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
99.30DEATH AND SHAKEN BABY SYNDROME ABUSIVE HEAD TRAUMA FOR
99.31CHILD FOSTER CARE PROVIDERS.
99.32    (a) Licensed child foster care providers that care for infants or children through five
99.33years of age must document that before staff persons and caregivers assist in the care
99.34of infants or children through five years of age, they are instructed on the standards in
99.35section 245A.1435 and receive training on reducing the risk of sudden unexpected infant
100.1death syndrome and shaken baby syndrome for abusive head trauma from shaking infants
100.2and young children. This section does not apply to emergency relative placement under
100.3section 245A.035. The training on reducing the risk of sudden unexpected infant death
100.4syndrome and shaken baby syndrome abusive head trauma may be provided as:
100.5    (1) orientation training to child foster care providers, who care for infants or children
100.6through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
100.7    (2) in-service training to child foster care providers, who care for infants or children
100.8through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
100.9    (b) Training required under this section must be at least one hour in length and must
100.10be completed at least once every five years. At a minimum, the training must address
100.11the risk factors related to sudden unexpected infant death syndrome and shaken baby
100.12syndrome abusive head trauma, means of reducing the risk of sudden unexpected infant
100.13death syndrome and shaken baby syndrome abusive head trauma, and license holder
100.14communication with parents regarding reducing the risk of sudden unexpected infant
100.15death syndrome and shaken baby syndrome abusive head trauma.
100.16    (c) Training for child foster care providers must be approved by the county or
100.17private licensing agency that is responsible for monitoring the child foster care provider
100.18under section 245A.16. The approved training fulfills, in part, training required under
100.19Minnesota Rules, part 2960.3070.

100.20    Sec. 16. Minnesota Statutes 2012, section 245A.1444, is amended to read:
100.21245A.1444 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
100.22DEATH SYNDROME AND SHAKEN BABY SYNDROME ABUSIVE HEAD
100.23TRAUMA BY OTHER PROGRAMS.
100.24    A licensed chemical dependency treatment program that serves clients with infants
100.25or children through five years of age, who sleep at the program and a licensed children's
100.26residential facility that serves infants or children through five years of age, must document
100.27that before program staff persons or volunteers assist in the care of infants or children
100.28through five years of age, they are instructed on the standards in section 245A.1435 and
100.29receive training on reducing the risk of sudden unexpected infant death syndrome and
100.30shaken baby syndrome abusive head trauma from shaking infants and young children. The
100.31training conducted under this section may be used to fulfill training requirements under
100.32Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.
100.33    This section does not apply to child care centers or family child care programs
100.34governed by sections 245A.40 and 245A.50.

101.1    Sec. 17. [245A.1446] FAMILY CHILD CARE DIAPERING AREA
101.2DISINFECTION.
101.3Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may
101.4disinfect the diaper changing surface with chlorine bleach in a manner consistent with label
101.5directions for disinfection or with a surface disinfectant that meets the following criteria:
101.6(1) the manufacturer's label or instructions state that the product is registered with
101.7the United States Environmental Protection Agency;
101.8(2) the manufacturer's label or instructions state that the disinfectant is effective
101.9against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa;
101.10(3) the manufacturer's label or instructions state that the disinfectant is effective with
101.11a ten minute or less contact time;
101.12(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing
101.13and use;
101.14(5) the disinfectant is used only in accordance with the manufacturer's directions; and
101.15(6) the product does not include triclosan or derivatives of triclosan.

101.16    Sec. 18. [245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION
101.17REQUIREMENTS.
101.18    Subdivision 1. In-person checks on infants. (a) License holders that serve infants
101.19are encouraged to monitor sleeping infants by conducting in-person checks on each infant
101.20in their care every 30 minutes.
101.21(b) Upon enrollment of an infant in a family child care program, the license holder is
101.22encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during
101.23the first four months of care.
101.24(c) When an infant has an upper respiratory infection, the license holder is
101.25encouraged to conduct in-person checks on the sleeping infant every 15 minutes
101.26throughout the hours of sleep.
101.27    Subd. 2. Use of audio or visual monitoring devices. In addition to conducting
101.28the in-person checks encouraged under subdivision 1, license holders serving infants are
101.29encouraged to use and maintain an audio or visual monitoring device to monitor each
101.30sleeping infant in care during all hours of sleep.

101.31    Sec. 19. [245A.152] CHILD CARE LICENSE HOLDER INSURANCE.
101.32(a) A license holder must provide a written notice to all parents or guardians of all
101.33children to be accepted for care prior to admission stating whether the license holder has
102.1liability insurance. This notice may be incorporated into and provided on the admission
102.2form used by the license holder.
102.3(b) If the license holder has liability insurance:
102.4(1) the license holder shall inform parents in writing that a current certificate of
102.5coverage for insurance is available for inspection to all parents or guardians of children
102.6receiving services and to all parents seeking services from the family child care program;
102.7(2) the notice must provide the parent or guardian with the date of expiration or
102.8next renewal of the policy; and
102.9(3) upon the expiration date of the policy, the license holder must provide a new
102.10written notice indicating whether the insurance policy has lapsed or whether the license
102.11holder has renewed the policy.
102.12If the policy was renewed, the license holder must provide the new expiration date of the
102.13policy in writing to the parents or guardians.
102.14(c) If the license holder does not have liability insurance, the license holder must
102.15provide an annual notice, on a form developed and made available by the commissioner,
102.16to the parents or guardians of children in care indicating that the license holder does not
102.17carry liability insurance.
102.18(d) The license holder must notify all parents and guardians in writing immediately
102.19of any change in insurance status.
102.20(e) The license holder must make available upon request the certificate of liability
102.21insurance to the parents of children in care, to the commissioner, and to county licensing
102.22agents.
102.23(f) The license holder must document, with the signature of the parent or guardian,
102.24that the parent or guardian received the notices required by this section.

102.25    Sec. 20. Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:
102.26    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
102.27 abusive head trauma training. (a) License holders must document that before staff
102.28persons and volunteers care for infants, they are instructed on the standards in section
102.29245A.1435 and receive training on reducing the risk of sudden unexpected infant death
102.30syndrome. In addition, license holders must document that before staff persons care for
102.31infants or children under school age, they receive training on the risk of shaken baby
102.32syndrome abusive head trauma from shaking infants and young children. The training
102.33in this subdivision may be provided as orientation training under subdivision 1 and
102.34in-service training under subdivision 7.
103.1    (b) Sudden unexpected infant death syndrome reduction training required under
103.2this subdivision must be at least one-half hour in length and must be completed at least
103.3once every five years year. At a minimum, the training must address the risk factors
103.4related to sudden unexpected infant death syndrome, means of reducing the risk of sudden
103.5unexpected infant death syndrome in child care, and license holder communication with
103.6parents regarding reducing the risk of sudden unexpected infant death syndrome.
103.7    (c) Shaken baby syndrome Abusive head trauma training under this subdivision
103.8must be at least one-half hour in length and must be completed at least once every five
103.9years year. At a minimum, the training must address the risk factors related to shaken
103.10baby syndrome for shaking infants and young children, means to reduce the risk of shaken
103.11baby syndrome abusive head trauma in child care, and license holder communication with
103.12parents regarding reducing the risk of shaken baby syndrome abusive head trauma.
103.13(d) The commissioner shall make available for viewing a video presentation on the
103.14dangers associated with shaking infants and young children. The video presentation must
103.15be part of the orientation and annual in-service training of licensed child care center
103.16staff persons caring for children under school age. The commissioner shall provide to
103.17child care providers and interested individuals, at cost, copies of a video approved by the
103.18commissioner of health under section 144.574 on the dangers associated with shaking
103.19infants and young children.

103.20    Sec. 21. Minnesota Statutes 2012, section 245A.50, is amended to read:
103.21245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.
103.22    Subdivision 1. Initial training. (a) License holders, caregivers, and substitutes must
103.23comply with the training requirements in this section.
103.24    (b) Helpers who assist with care on a regular basis must complete six hours of
103.25training within one year after the date of initial employment.
103.26    Subd. 2. Child growth and development and behavior guidance training. (a) For
103.27purposes of family and group family child care, the license holder and each adult caregiver
103.28who provides care in the licensed setting for more than 30 days in any 12-month period
103.29shall complete and document at least two four hours of child growth and development
103.30and behavior guidance training within the first year of prior to initial licensure, and before
103.31caring for children. For purposes of this subdivision, "child growth and development
103.32training" means training in understanding how children acquire language and develop
103.33physically, cognitively, emotionally, and socially. "Behavior guidance training" means
103.34training in the understanding of the functions of child behavior and strategies for managing
103.35challenging situations. Child growth and development and behavior guidance training
104.1must be repeated annually. Training curriculum shall be developed or approved by the
104.2commissioner of human services by January 1, 2014.
104.3    (b) Notwithstanding paragraph (a), individuals are exempt from this requirement if
104.4they:
104.5    (1) have taken a three-credit course on early childhood development within the
104.6past five years;
104.7    (2) have received a baccalaureate or master's degree in early childhood education or
104.8school-age child care within the past five years;
104.9    (3) are licensed in Minnesota as a prekindergarten teacher, an early childhood
104.10educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early
104.11childhood special education teacher, or an elementary teacher with a kindergarten
104.12endorsement; or
104.13    (4) have received a baccalaureate degree with a Montessori certificate within the
104.14past five years.
104.15    Subd. 3. First aid. (a) When children are present in a family child care home
104.16governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person
104.17must be present in the home who has been trained in first aid. The first aid training must
104.18have been provided by an individual approved to provide first aid instruction. First aid
104.19training may be less than eight hours and persons qualified to provide first aid training
104.20include individuals approved as first aid instructors. First aid training must be repeated
104.21every two years.
104.22    (b) A family child care provider is exempt from the first aid training requirements
104.23under this subdivision related to any substitute caregiver who provides less than 30 hours
104.24of care during any 12-month period.
104.25    (c) Video training reviewed and approved by the county licensing agency satisfies
104.26the training requirement of this subdivision.
104.27    Subd. 4. Cardiopulmonary resuscitation. (a) When children are present in a family
104.28child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least
104.29one staff person must be present in the home who has been trained in cardiopulmonary
104.30resuscitation (CPR) and in the treatment of obstructed airways that includes CPR
104.31techniques for infants and children. The CPR training must have been provided by an
104.32individual approved to provide CPR instruction, must be repeated at least once every three
104.33 two years, and must be documented in the staff person's records.
104.34    (b) A family child care provider is exempt from the CPR training requirement in
104.35this subdivision related to any substitute caregiver who provides less than 30 hours of
104.36care during any 12-month period.
105.1    (c) Video training reviewed and approved by the county licensing agency satisfies
105.2the training requirement of this subdivision. Persons providing CPR training must use
105.3CPR training that has been developed:
105.4    (1) by the American Heart Association or the American Red Cross and incorporates
105.5psychomotor skills to support the instruction; or
105.6    (2) using nationally recognized, evidence-based guidelines for CPR training and
105.7incorporates psychomotor skills to support the instruction.
105.8    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
105.9 abusive head trauma training. (a) License holders must document that before staff
105.10persons, caregivers, and helpers assist in the care of infants, they are instructed on the
105.11standards in section 245A.1435 and receive training on reducing the risk of sudden
105.12unexpected infant death syndrome. In addition, license holders must document that before
105.13staff persons, caregivers, and helpers assist in the care of infants and children under
105.14school age, they receive training on reducing the risk of shaken baby syndrome abusive
105.15head trauma from shaking infants and young children. The training in this subdivision
105.16may be provided as initial training under subdivision 1 or ongoing annual training under
105.17subdivision 7.
105.18    (b) Sudden unexpected infant death syndrome reduction training required under this
105.19subdivision must be at least one-half hour in length and must be completed in person
105.20 at least once every five years two years. On the years when the license holder is not
105.21receiving the in-person training on sudden unexpected infant death reduction, the license
105.22holder must receive sudden unexpected infant death reduction training through a video
105.23of no more than one hour in length developed or approved by the commissioner. At a
105.24minimum, the training must address the risk factors related to sudden unexpected infant
105.25death syndrome, means of reducing the risk of sudden unexpected infant death syndrome
105.26 in child care, and license holder communication with parents regarding reducing the risk
105.27of sudden unexpected infant death syndrome.
105.28    (c) Shaken baby syndrome Abusive head trauma training required under this
105.29subdivision must be at least one-half hour in length and must be completed at least once
105.30every five years year. At a minimum, the training must address the risk factors related
105.31to shaken baby syndrome shaking infants and young children, means of reducing the
105.32risk of shaken baby syndrome abusive head trauma in child care, and license holder
105.33communication with parents regarding reducing the risk of shaken baby syndrome abusive
105.34head trauma.
105.35(d) Training for family and group family child care providers must be developed
105.36by the commissioner in conjunction with the Minnesota Sudden Infant Death Center
106.1and approved by the county licensing agency by the Minnesota Center for Professional
106.2Development.
106.3    (e) The commissioner shall make available for viewing by all licensed child care
106.4providers a video presentation on the dangers associated with shaking infants and young
106.5children. The video presentation shall be part of the initial and ongoing annual training of
106.6licensed child care providers, caregivers, and helpers caring for children under school age.
106.7The commissioner shall provide to child care providers and interested individuals, at cost,
106.8copies of a video approved by the commissioner of health under section 144.574 on the
106.9dangers associated with shaking infants and young children.
106.10    Subd. 6. Child passenger restraint systems; training requirement. (a) A license
106.11holder must comply with all seat belt and child passenger restraint system requirements
106.12under section 169.685.
106.13    (b) Family and group family child care programs licensed by the Department of
106.14Human Services that serve a child or children under nine years of age must document
106.15training that fulfills the requirements in this subdivision.
106.16    (1) Before a license holder, staff person, caregiver, or helper transports a child or
106.17children under age nine in a motor vehicle, the person placing the child or children in a
106.18passenger restraint must satisfactorily complete training on the proper use and installation
106.19of child restraint systems in motor vehicles. Training completed under this subdivision may
106.20be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.
106.21    (2) Training required under this subdivision must be at least one hour in length,
106.22completed at initial training, and repeated at least once every five years. At a minimum,
106.23the training must address the proper use of child restraint systems based on the child's
106.24size, weight, and age, and the proper installation of a car seat or booster seat in the motor
106.25vehicle used by the license holder to transport the child or children.
106.26    (3) Training under this subdivision must be provided by individuals who are certified
106.27and approved by the Department of Public Safety, Office of Traffic Safety. License holders
106.28may obtain a list of certified and approved trainers through the Department of Public
106.29Safety Web site or by contacting the agency.
106.30    (c) Child care providers that only transport school-age children as defined in section
106.31245A.02, subdivision 19 , paragraph (f), in child care buses as defined in section 169.448,
106.32subdivision 1, paragraph (e), are exempt from this subdivision.
106.33    Subd. 7. Training requirements for family and group family child care. For
106.34purposes of family and group family child care, the license holder and each primary
106.35caregiver must complete eight 16 hours of ongoing training each year. For purposes
106.36of this subdivision, a primary caregiver is an adult caregiver who provides services in
107.1the licensed setting for more than 30 days in any 12-month period. Repeat of topical
107.2training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training
107.3requirement. Additional ongoing training subjects to meet the annual 16-hour training
107.4requirement must be selected from the following areas:
107.5    (1) "child growth and development training" has the meaning given in under
107.6 subdivision 2, paragraph (a);
107.7    (2) "learning environment and curriculum" includes, including training in
107.8establishing an environment and providing activities that provide learning experiences to
107.9meet each child's needs, capabilities, and interests;
107.10    (3) "assessment and planning for individual needs" includes, including training in
107.11observing and assessing what children know and can do in order to provide curriculum
107.12and instruction that addresses their developmental and learning needs, including children
107.13with special needs and bilingual children or children for whom English is not their
107.14primary language;
107.15    (4) "interactions with children" includes, including training in establishing
107.16supportive relationships with children, guiding them as individuals and as part of a group;
107.17    (5) "families and communities" includes, including training in working
107.18collaboratively with families and agencies or organizations to meet children's needs and to
107.19encourage the community's involvement;
107.20    (6) "health, safety, and nutrition" includes, including training in establishing and
107.21maintaining an environment that ensures children's health, safety, and nourishment,
107.22including child abuse, maltreatment, prevention, and reporting; home and fire safety; child
107.23injury prevention; communicable disease prevention and control; first aid; and CPR; and
107.24    (7) "program planning and evaluation" includes, including training in establishing,
107.25implementing, evaluating, and enhancing program operations.; and
107.26(8) behavior guidance, including training in the understanding of the functions of
107.27child behavior and strategies for managing behavior.
107.28    Subd. 8. Other required training requirements. (a) The training required of
107.29family and group family child care providers and staff must include training in the cultural
107.30dynamics of early childhood development and child care. The cultural dynamics and
107.31disabilities training and skills development of child care providers must be designed to
107.32achieve outcomes for providers of child care that include, but are not limited to:
107.33    (1) an understanding and support of the importance of culture and differences in
107.34ability in children's identity development;
107.35    (2) understanding the importance of awareness of cultural differences and
107.36similarities in working with children and their families;
108.1    (3) understanding and support of the needs of families and children with differences
108.2in ability;
108.3    (4) developing skills to help children develop unbiased attitudes about cultural
108.4differences and differences in ability;
108.5    (5) developing skills in culturally appropriate caregiving; and
108.6    (6) developing skills in appropriate caregiving for children of different abilities.
108.7    The commissioner shall approve the curriculum for cultural dynamics and disability
108.8training.
108.9    (b) The provider must meet the training requirement in section 245A.14, subdivision
108.1011 , paragraph (a), clause (4), to be eligible to allow a child cared for at the family child
108.11care or group family child care home to use the swimming pool located at the home.
108.12    Subd. 9. Supervising for safety; training requirement. Effective July 1, 2014,
108.13all family child care license holders and each adult caregiver who provides care in the
108.14licensed family child care home for more than 30 days in any 12-month period shall
108.15complete and document at least six hours of approved training on supervising for safety
108.16prior to initial licensure, and before caring for children. At least two hours of training
108.17on supervising for safety must be repeated annually. For purposes of this subdivision,
108.18"supervising for safety" includes supervision basics, supervision outdoors, equipment and
108.19materials, illness, injuries, and disaster preparedness. The commissioner shall develop
108.20the supervising for safety curriculum by January 1, 2014.
108.21    Subd. 10. Approved training. County licensing staff must accept training approved
108.22by the Minnesota Center for Professional Development, including:
108.23(1) face-to-face or classroom training;
108.24(2) online training; and
108.25(3) relationship-based professional development, such as mentoring, coaching,
108.26and consulting.
108.27    Subd. 11. Provider training. New and increased training requirements under this
108.28section must not be imposed on providers until the commissioner establishes statewide
108.29accessibility to the required provider training.

108.30    Sec. 22. Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:
108.31    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
108.32child, including a child determined eligible for medical assistance without consideration of
108.33parental income, must contribute to the cost of services used by making monthly payments
108.34on a sliding scale based on income, unless the child is married or has been married, parental
108.35rights have been terminated, or the child's adoption is subsidized according to section
109.1259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial
109.2or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
109.3mitigating, rehabilitation, maintenance, and personal care services as defined in United
109.4States Code, title 26, section 213, needed by the child with a chronic illness or disability.
109.5    (b) For households with adjusted gross income equal to or greater than 100 275
109.6 percent of federal poverty guidelines, the parental contribution shall be computed by
109.7applying the following schedule of rates to the adjusted gross income of the natural or
109.8adoptive parents:
109.9    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
109.10poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
109.11contribution is $4 per month;
109.12    (2) (1) if the adjusted gross income is equal to or greater than 175 275 percent
109.13of federal poverty guidelines and less than or equal to 545 percent of federal poverty
109.14guidelines, the parental contribution shall be determined using a sliding fee scale
109.15established by the commissioner of human services which begins at one 2.76 percent of
109.16adjusted gross income at 175 275 percent of federal poverty guidelines and increases to
109.177.5 percent of adjusted gross income for those with adjusted gross income up to 545
109.18percent of federal poverty guidelines;
109.19    (3) (2) if the adjusted gross income is greater than 545 percent of federal poverty
109.20guidelines and less than 675 percent of federal poverty guidelines, the parental
109.21contribution shall be 7.5 percent of adjusted gross income;
109.22    (4) (3) if the adjusted gross income is equal to or greater than 675 percent of federal
109.23poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
109.24contribution shall be determined using a sliding fee scale established by the commissioner
109.25of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
109.26federal poverty guidelines and increases to ten percent of adjusted gross income for those
109.27with adjusted gross income up to 975 percent of federal poverty guidelines; and
109.28    (5) (4) if the adjusted gross income is equal to or greater than 975 percent of federal
109.29poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.
109.30    If the child lives with the parent, the annual adjusted gross income is reduced by
109.31$2,400 prior to calculating the parental contribution. If the child resides in an institution
109.32specified in section 256B.35, the parent is responsible for the personal needs allowance
109.33specified under that section in addition to the parental contribution determined under this
109.34section. The parental contribution is reduced by any amount required to be paid directly to
109.35the child pursuant to a court order, but only if actually paid.
110.1    (c) The household size to be used in determining the amount of contribution under
110.2paragraph (b) includes natural and adoptive parents and their dependents, including the
110.3child receiving services. Adjustments in the contribution amount due to annual changes
110.4in the federal poverty guidelines shall be implemented on the first day of July following
110.5publication of the changes.
110.6    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
110.7natural or adoptive parents determined according to the previous year's federal tax form,
110.8except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
110.9have been used to purchase a home shall not be counted as income.
110.10    (e) The contribution shall be explained in writing to the parents at the time eligibility
110.11for services is being determined. The contribution shall be made on a monthly basis
110.12effective with the first month in which the child receives services. Annually upon
110.13redetermination or at termination of eligibility, if the contribution exceeded the cost of
110.14services provided, the local agency or the state shall reimburse that excess amount to
110.15the parents, either by direct reimbursement if the parent is no longer required to pay a
110.16contribution, or by a reduction in or waiver of parental fees until the excess amount is
110.17exhausted. All reimbursements must include a notice that the amount reimbursed may be
110.18taxable income if the parent paid for the parent's fees through an employer's health care
110.19flexible spending account under the Internal Revenue Code, section 125, and that the
110.20parent is responsible for paying the taxes owed on the amount reimbursed.
110.21    (f) The monthly contribution amount must be reviewed at least every 12 months;
110.22when there is a change in household size; and when there is a loss of or gain in income
110.23from one month to another in excess of ten percent. The local agency shall mail a written
110.24notice 30 days in advance of the effective date of a change in the contribution amount.
110.25A decrease in the contribution amount is effective in the month that the parent verifies a
110.26reduction in income or change in household size.
110.27    (g) Parents of a minor child who do not live with each other shall each pay the
110.28contribution required under paragraph (a). An amount equal to the annual court-ordered
110.29child support payment actually paid on behalf of the child receiving services shall be
110.30deducted from the adjusted gross income of the parent making the payment prior to
110.31calculating the parental contribution under paragraph (b).
110.32    (h) The contribution under paragraph (b) shall be increased by an additional five
110.33percent if the local agency determines that insurance coverage is available but not
110.34obtained for the child. For purposes of this section, "available" means the insurance is a
110.35benefit of employment for a family member at an annual cost of no more than five percent
110.36of the family's annual income. For purposes of this section, "insurance" means health
111.1and accident insurance coverage, enrollment in a nonprofit health service plan, health
111.2maintenance organization, self-insured plan, or preferred provider organization.
111.3    Parents who have more than one child receiving services shall not be required
111.4to pay more than the amount for the child with the highest expenditures. There shall
111.5be no resource contribution from the parents. The parent shall not be required to pay
111.6a contribution in excess of the cost of the services provided to the child, not counting
111.7payments made to school districts for education-related services. Notice of an increase in
111.8fee payment must be given at least 30 days before the increased fee is due.
111.9    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
111.10in the 12 months prior to July 1:
111.11    (1) the parent applied for insurance for the child;
111.12    (2) the insurer denied insurance;
111.13    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
111.14a complaint or appeal, in writing, to the commissioner of health or the commissioner of
111.15commerce, or litigated the complaint or appeal; and
111.16    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
111.17    For purposes of this section, "insurance" has the meaning given in paragraph (h).
111.18    A parent who has requested a reduction in the contribution amount under this
111.19paragraph shall submit proof in the form and manner prescribed by the commissioner or
111.20county agency, including, but not limited to, the insurer's denial of insurance, the written
111.21letter or complaint of the parents, court documents, and the written response of the insurer
111.22approving insurance. The determinations of the commissioner or county agency under this
111.23paragraph are not rules subject to chapter 14.
111.24(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
111.252015, the parental contribution shall be computed by applying the following contribution
111.26schedule to the adjusted gross income of the natural or adoptive parents:
111.27(1) if the adjusted gross income is equal to or greater than 100 percent of federal
111.28poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
111.29contribution is $4 per month;
111.30(2) if the adjusted gross income is equal to or greater than 175 percent of federal
111.31poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
111.32the parental contribution shall be determined using a sliding fee scale established by the
111.33commissioner of human services which begins at one percent of adjusted gross income
111.34at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
111.35gross income for those with adjusted gross income up to 525 percent of federal poverty
111.36guidelines;
112.1(3) if the adjusted gross income is greater than 525 percent of federal poverty
112.2guidelines and less than 675 percent of federal poverty guidelines, the parental
112.3contribution shall be 9.5 percent of adjusted gross income;
112.4(4) if the adjusted gross income is equal to or greater than 675 percent of federal
112.5poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
112.6contribution shall be determined using a sliding fee scale established by the commissioner
112.7of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
112.8federal poverty guidelines and increases to 12 percent of adjusted gross income for those
112.9with adjusted gross income up to 900 percent of federal poverty guidelines; and
112.10(5) if the adjusted gross income is equal to or greater than 900 percent of federal
112.11poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
112.12income. If the child lives with the parent, the annual adjusted gross income is reduced by
112.13$2,400 prior to calculating the parental contribution. If the child resides in an institution
112.14specified in section 256B.35, the parent is responsible for the personal needs allowance
112.15specified under that section in addition to the parental contribution determined under this
112.16section. The parental contribution is reduced by any amount required to be paid directly to
112.17the child pursuant to a court order, but only if actually paid.
112.18EFFECTIVE DATE.Paragraph (b) is effective January 1, 2014. Paragraph (j)
112.19is effective July 1, 2013.

112.20    Sec. 23. Minnesota Statutes 2012, section 256.98, subdivision 8, is amended to read:
112.21    Subd. 8. Disqualification from program. (a) Any person found to be guilty of
112.22wrongfully obtaining assistance by a federal or state court or by an administrative hearing
112.23determination, or waiver thereof, through a disqualification consent agreement, or as part
112.24of any approved diversion plan under section 401.065, or any court-ordered stay which
112.25carries with it any probationary or other conditions, in the Minnesota family investment
112.26program and any affiliated program to include the diversionary work program and the
112.27work participation cash benefit program, the food stamp or food support program, the
112.28general assistance program, the group residential housing program, or the Minnesota
112.29supplemental aid program shall be disqualified from that program. In addition, any person
112.30disqualified from the Minnesota family investment program shall also be disqualified from
112.31the food stamp or food support program. The needs of that individual shall not be taken
112.32into consideration in determining the grant level for that assistance unit:
112.33(1) for one year after the first offense;
112.34(2) for two years after the second offense; and
112.35(3) permanently after the third or subsequent offense.
113.1The period of program disqualification shall begin on the date stipulated on the
113.2advance notice of disqualification without possibility of postponement for administrative
113.3stay or administrative hearing and shall continue through completion unless and until the
113.4findings upon which the sanctions were imposed are reversed by a court of competent
113.5jurisdiction. The period for which sanctions are imposed is not subject to review. The
113.6sanctions provided under this subdivision are in addition to, and not in substitution
113.7for, any other sanctions that may be provided for by law for the offense involved. A
113.8disqualification established through hearing or waiver shall result in the disqualification
113.9period beginning immediately unless the person has become otherwise ineligible for
113.10assistance. If the person is ineligible for assistance, the disqualification period begins
113.11when the person again meets the eligibility criteria of the program from which they were
113.12disqualified and makes application for that program.
113.13(b) A family receiving assistance through child care assistance programs under
113.14chapter 119B with a family member who is found to be guilty of wrongfully obtaining child
113.15care assistance by a federal court, state court, or an administrative hearing determination
113.16or waiver, through a disqualification consent agreement, as part of an approved diversion
113.17plan under section 401.065, or a court-ordered stay with probationary or other conditions,
113.18is disqualified from child care assistance programs. The disqualifications must be for
113.19periods of three months, six months, and one year and two years for the first, and
113.20 second, and third offenses, respectively. Subsequent violations must result in permanent
113.21disqualification. During the disqualification period, disqualification from any child care
113.22program must extend to all child care programs and must be immediately applied.
113.23(c) A provider caring for children receiving assistance through child care assistance
113.24programs under chapter 119B is disqualified from receiving payment for child care
113.25services from the child care assistance program under chapter 119B when the provider is
113.26found to have wrongfully obtained child care assistance by a federal court, state court,
113.27or an administrative hearing determination or waiver under section 256.046, through
113.28a disqualification consent agreement, as part of an approved diversion plan under
113.29section 401.065, or a court-ordered stay with probationary or other conditions. The
113.30disqualification must be for a period of one year for the first offense and two years for
113.31the second offense. Any subsequent violation must result in permanent disqualification.
113.32The disqualification period must be imposed immediately after a determination is made
113.33under this paragraph. During the disqualification period, the provider is disqualified from
113.34receiving payment from any child care program under chapter 119B.
113.35(d) Any person found to be guilty of wrongfully obtaining general assistance
113.36medical care, MinnesotaCare for adults without children, and upon federal approval, all
114.1categories of medical assistance and remaining categories of MinnesotaCare, except
114.2for children through age 18, by a federal or state court or by an administrative hearing
114.3determination, or waiver thereof, through a disqualification consent agreement, or as part
114.4of any approved diversion plan under section 401.065, or any court-ordered stay which
114.5carries with it any probationary or other conditions, is disqualified from that program. The
114.6period of disqualification is one year after the first offense, two years after the second
114.7offense, and permanently after the third or subsequent offense. The period of program
114.8disqualification shall begin on the date stipulated on the advance notice of disqualification
114.9without possibility of postponement for administrative stay or administrative hearing
114.10and shall continue through completion unless and until the findings upon which the
114.11sanctions were imposed are reversed by a court of competent jurisdiction. The period for
114.12which sanctions are imposed is not subject to review. The sanctions provided under this
114.13subdivision are in addition to, and not in substitution for, any other sanctions that may be
114.14provided for by law for the offense involved.
114.15EFFECTIVE DATE.This section is effective February 3, 2014.

114.16    Sec. 24. Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:
114.17    Subd. 24. Disregard. "Disregard" means earned income that is not counted when
114.18determining initial eligibility in the initial income test in section 256J.21, subdivision 3,
114.19 or income that is not counted when determining ongoing eligibility and calculating the
114.20amount of the assistance payment for participants. The commissioner shall determine
114.21the amount of the disregard according to section 256J.24, subdivision 10 for ongoing
114.22eligibility shall be 50 percent of gross earned income.
114.23EFFECTIVE DATE.This section is effective October 1, 2014, or upon approval
114.24from the United States Department of Agriculture, whichever is later.

114.25    Sec. 25. Minnesota Statutes 2012, section 256J.21, subdivision 2, is amended to read:
114.26    Subd. 2. Income exclusions. The following must be excluded in determining a
114.27family's available income:
114.28    (1) payments for basic care, difficulty of care, and clothing allowances received for
114.29providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
114.30to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used
114.31for care and maintenance of a third-party beneficiary who is not a household member;
114.32    (2) reimbursements for employment training received through the Workforce
114.33Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
115.1    (3) reimbursement for out-of-pocket expenses incurred while performing volunteer
115.2services, jury duty, employment, or informal carpooling arrangements directly related to
115.3employment;
115.4    (4) all educational assistance, except the county agency must count graduate student
115.5teaching assistantships, fellowships, and other similar paid work as earned income and,
115.6after allowing deductions for any unmet and necessary educational expenses, shall
115.7count scholarships or grants awarded to graduate students that do not require teaching
115.8or research as unearned income;
115.9    (5) loans, regardless of purpose, from public or private lending institutions,
115.10governmental lending institutions, or governmental agencies;
115.11    (6) loans from private individuals, regardless of purpose, provided an applicant or
115.12participant documents that the lender expects repayment;
115.13    (7)(i) state income tax refunds; and
115.14    (ii) federal income tax refunds;
115.15    (8)(i) federal earned income credits;
115.16    (ii) Minnesota working family credits;
115.17    (iii) state homeowners and renters credits under chapter 290A; and
115.18    (iv) federal or state tax rebates;
115.19    (9) funds received for reimbursement, replacement, or rebate of personal or real
115.20property when these payments are made by public agencies, awarded by a court, solicited
115.21through public appeal, or made as a grant by a federal agency, state or local government,
115.22or disaster assistance organizations, subsequent to a presidential declaration of disaster;
115.23    (10) the portion of an insurance settlement that is used to pay medical, funeral, and
115.24burial expenses, or to repair or replace insured property;
115.25    (11) reimbursements for medical expenses that cannot be paid by medical assistance;
115.26    (12) payments by a vocational rehabilitation program administered by the state
115.27under chapter 268A, except those payments that are for current living expenses;
115.28    (13) in-kind income, including any payments directly made by a third party to a
115.29provider of goods and services;
115.30    (14) assistance payments to correct underpayments, but only for the month in which
115.31the payment is received;
115.32    (15) payments for short-term emergency needs under section 256J.626, subdivision 2;
115.33    (16) funeral and cemetery payments as provided by section 256.935;
115.34    (17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
115.35a calendar month;
116.1    (18) any form of energy assistance payment made through Public Law 97-35,
116.2Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
116.3providers by other public and private agencies, and any form of credit or rebate payment
116.4issued by energy providers;
116.5    (19) Supplemental Security Income (SSI), including retroactive SSI payments and
116.6other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
116.7    (20) Minnesota supplemental aid, including retroactive payments;
116.8    (21) proceeds from the sale of real or personal property;
116.9    (22) state adoption assistance payments under section 259.67, and up to an equal
116.10amount of county adoption assistance payments;
116.11    (23) state-funded family subsidy program payments made under section 252.32 to
116.12help families care for children with developmental disabilities, consumer support grant
116.13funds under section 256.476, and resources and services for a disabled household member
116.14under one of the home and community-based waiver services programs under chapter 256B;
116.15    (24) interest payments and dividends from property that is not excluded from and
116.16that does not exceed the asset limit;
116.17    (25) rent rebates;
116.18    (26) income earned by a minor caregiver, minor child through age 6, or a minor
116.19child who is at least a half-time student in an approved elementary or secondary education
116.20program;
116.21    (27) income earned by a caregiver under age 20 who is at least a half-time student in
116.22an approved elementary or secondary education program;
116.23    (28) MFIP child care payments under section 119B.05;
116.24    (29) all other payments made through MFIP to support a caregiver's pursuit of
116.25greater economic stability;
116.26    (30) income a participant receives related to shared living expenses;
116.27    (31) reverse mortgages;
116.28    (32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
116.2942, chapter 13A, sections 1771 to 1790;
116.30    (33) benefits provided by the women, infants, and children (WIC) nutrition program,
116.31United States Code, title 42, chapter 13A, section 1786;
116.32    (34) benefits from the National School Lunch Act, United States Code, title 42,
116.33chapter 13, sections 1751 to 1769e;
116.34    (35) relocation assistance for displaced persons under the Uniform Relocation
116.35Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
117.142, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
117.2Code, title 12, chapter 13, sections 1701 to 1750jj;
117.3    (36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
117.412, part 2, sections 2271 to 2322;
117.5    (37) war reparations payments to Japanese Americans and Aleuts under United
117.6States Code, title 50, sections 1989 to 1989d;
117.7    (38) payments to veterans or their dependents as a result of legal settlements
117.8regarding Agent Orange or other chemical exposure under Public Law 101-239, section
117.910405, paragraph (a)(2)(E);
117.10    (39) income that is otherwise specifically excluded from MFIP consideration in
117.11federal law, state law, or federal regulation;
117.12    (40) security and utility deposit refunds;
117.13    (41) American Indian tribal land settlements excluded under Public Laws 98-123,
117.1498-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
117.15Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
117.16under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
117.17    (42) all income of the minor parent's parents and stepparents when determining the
117.18grant for the minor parent in households that include a minor parent living with parents or
117.19stepparents on MFIP with other children;
117.20    (43) income of the minor parent's parents and stepparents equal to 200 percent of the
117.21federal poverty guideline for a family size not including the minor parent and the minor
117.22parent's child in households that include a minor parent living with parents or stepparents
117.23not on MFIP when determining the grant for the minor parent. The remainder of income is
117.24deemed as specified in section 256J.37, subdivision 1b;
117.25    (44) payments made to children eligible for relative custody assistance under section
117.26257.85 ;
117.27    (45) vendor payments for goods and services made on behalf of a client unless the
117.28client has the option of receiving the payment in cash;
117.29    (46) the principal portion of a contract for deed payment; and
117.30    (47) cash payments to individuals enrolled for full-time service as a volunteer under
117.31AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
117.32National, and AmeriCorps NCCC; and
117.33    (48) housing assistance grants under section 256J.35, paragraph (a).

117.34    Sec. 26. Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:
118.1    Subd. 3. Initial income test. The county agency shall determine initial eligibility
118.2by considering all earned and unearned income that is not excluded under subdivision 2.
118.3To be eligible for MFIP, the assistance unit's countable income minus the disregards in
118.4paragraphs (a) and (b) must be below the transitional standard of assistance family wage
118.5level according to section 256J.24 for that size assistance unit.
118.6(a) The initial eligibility determination must disregard the following items:
118.7(1) the employment disregard is 18 percent of the gross earned income whether or
118.8not the member is working full time or part time;
118.9(2) dependent care costs must be deducted from gross earned income for the actual
118.10amount paid for dependent care up to a maximum of $200 per month for each child less
118.11than two years of age, and $175 per month for each child two years of age and older under
118.12this chapter and chapter 119B;
118.13(3) all payments made according to a court order for spousal support or the support
118.14of children not living in the assistance unit's household shall be disregarded from the
118.15income of the person with the legal obligation to pay support, provided that, if there has
118.16been a change in the financial circumstances of the person with the legal obligation to pay
118.17support since the support order was entered, the person with the legal obligation to pay
118.18support has petitioned for a modification of the support order; and
118.19(4) an allocation for the unmet need of an ineligible spouse or an ineligible child
118.20under the age of 21 for whom the caregiver is financially responsible and who lives with
118.21the caregiver according to section 256J.36.
118.22(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant
118.23units when at least one member has received MFIP in this state within four months of
118.24the most recent application for MFIP, apply the disregard as defined in section 256J.08,
118.25subdivision 24 , for all unit members.
118.26After initial eligibility is established, the assistance payment calculation is based on
118.27the monthly income test.
118.28EFFECTIVE DATE.This section is effective October 1, 2014, or upon approval
118.29from the United States Department of Agriculture, whichever is later.

118.30    Sec. 27. Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:
118.31    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
118.32on the number of persons in the assistance unit eligible for both food and cash assistance
118.33unless the restrictions in subdivision 6 on the birth of a child apply. The amount of the
118.34transitional standard is published annually by the Department of Human Services.
119.1EFFECTIVE DATE.This section is effective January 1, 2015.

119.2    Sec. 28. Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:
119.3    Subd. 7. Family wage level. The family wage level is 110 percent of the transitional
119.4standard under subdivision 5 or 6, when applicable, and is the standard used when there is
119.5earned income in the assistance unit. As specified in section 256J.21. If there is earned
119.6income in the assistance unit, earned income is subtracted from the family wage level to
119.7determine the amount of the assistance payment, as specified in section 256J.21. The
119.8assistance payment may not exceed the transitional standard under subdivision 5 or 6,
119.9or the shared household standard under subdivision 9, whichever is applicable, for the
119.10assistance unit.
119.11EFFECTIVE DATE.This section is effective October 1, 2014, or upon approval
119.12from the United States Department of Agriculture, whichever is later.

119.13    Sec. 29. Minnesota Statutes 2012, section 256J.35, is amended to read:
119.14256J.35 AMOUNT OF ASSISTANCE PAYMENT.
119.15Except as provided in paragraphs (a) to (c), the amount of an assistance payment is
119.16equal to the difference between the MFIP standard of need or the Minnesota family wage
119.17level in section 256J.24 and countable income.
119.18(a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing
119.19assistance grant of $110 per month, unless:
119.20(1) the housing assistance unit is currently receiving public and assisted rental
119.21subsidies provided through the Department of Housing and Urban Development (HUD)
119.22and is subject to section 256J.37, subdivision 3a; or
119.23(2) the assistance unit is a child-only case under section 256J.88.
119.24(a) (b) When MFIP eligibility exists for the month of application, the amount of
119.25the assistance payment for the month of application must be prorated from the date of
119.26application or the date all other eligibility factors are met for that applicant, whichever is
119.27later. This provision applies when an applicant loses at least one day of MFIP eligibility.
119.28(b) (c) MFIP overpayments to an assistance unit must be recouped according to
119.29section 256J.38, subdivision 4.
119.30(c) (d) An initial assistance payment must not be made to an applicant who is not
119.31eligible on the date payment is made.

119.32    Sec. 30. Minnesota Statutes 2012, section 256J.621, is amended to read:
120.1256J.621 WORK PARTICIPATION CASH BENEFITS.
120.2    Subdivision 1. Program characteristics. (a) Effective October 1, 2009, upon
120.3exiting the diversionary work program (DWP) or upon terminating the Minnesota family
120.4investment program with earnings, a participant who is employed may be eligible for work
120.5participation cash benefits of $25 per month to assist in meeting the family's basic needs
120.6as the participant continues to move toward self-sufficiency.
120.7    (b) To be eligible for work participation cash benefits, the participant shall not
120.8receive MFIP or diversionary work program assistance during the month and the
120.9participant or participants must meet the following work requirements:
120.10    (1) if the participant is a single caregiver and has a child under six years of age, the
120.11participant must be employed at least 87 hours per month;
120.12    (2) if the participant is a single caregiver and does not have a child under six years of
120.13age, the participant must be employed at least 130 hours per month; or
120.14    (3) if the household is a two-parent family, at least one of the parents must be
120.15employed 130 hours per month.
120.16    Whenever a participant exits the diversionary work program or is terminated from
120.17MFIP and meets the other criteria in this section, work participation cash benefits are
120.18available for up to 24 consecutive months.
120.19    (c) Expenditures on the program are maintenance of effort state funds under
120.20a separate state program for participants under paragraph (b), clauses (1) and (2).
120.21Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
120.22funds. Months in which a participant receives work participation cash benefits under this
120.23section do not count toward the participant's MFIP 60-month time limit.
120.24    Subd. 2. Program suspension. (a) Effective December 1, 2014, the work
120.25participation cash benefits program shall be suspended.
120.26(b) The commissioner of human services may reinstate the work participation cash
120.27benefits program if the United States Department of Human Services determines that the
120.28state of Minnesota did not meet the federal TANF work participation rate and sends a
120.29notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I
120.30of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation
120.31Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005.
120.32(c) The commissioner shall notify the chairs and ranking minority members of the
120.33legislative committees with jurisdiction over human services policy and finance of the
120.34potential penalty and the commissioner's plans to reinstate the work participation cash
120.35benefit program within 30 days of the date the commissioner receives notification that
120.36the state failed to meet the federal work participation rate.

121.1    Sec. 31. Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:
121.2    Subd. 7. Performance base funds. (a) For the purpose of this section, the following
121.3terms have the meanings given.
121.4(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
121.5TANF and separate state program caseload has fallen relative to federal fiscal year 2005
121.6based on caseload data from October 1 to September 30.
121.7(2) "TANF participation rate target" means a 50 percent participation rate reduced by
121.8the CRC for the previous year.
121.9(b) (a) For calendar year 2010 2016 and yearly thereafter, each county and tribe will
121.10 must be allocated 95 100 percent of their initial calendar year allocation. Allocations for
121.11counties and tribes will must be allocated additional funds adjusted based on performance
121.12as follows:
121.13    (1) a county or tribe that achieves the TANF participation rate target or a five
121.14percentage point improvement over the previous year's TANF participation rate under
121.15section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for
121.16the most recent year for which the measurements are available, will receive an additional
121.17allocation equal to 2.5 percent of its initial allocation;
121.18    (2) (1) a county or tribe that performs within or above its range of expected
121.19performance on the annualized three-year self-support index under section 256J.751,
121.20subdivision 2 , clause (6), will must receive an additional allocation equal to 2.5 percent of
121.21its initial allocation; and
121.22    (3) a county or tribe that does not achieve the TANF participation rate target or
121.23a five percentage point improvement over the previous year's TANF participation rate
121.24under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive
121.25months for the most recent year for which the measurements are available, will not
121.26receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
121.27improvement plan with the commissioner; or
121.28    (4) (2) a county or tribe that does not perform within or above performs below its
121.29range of expected performance on the annualized three-year self-support index under
121.30section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal
121.31to 2.5 percent of its initial allocation until after negotiating for two consecutive years must
121.32negotiate a multiyear improvement plan with the commissioner. If no improvement is
121.33shown by the end of the multiyear plan, the county's or tribe's allocation must be decreased
121.34by 2.5 percent. The decrease must remain in effect until the county or tribe performs
121.35within or above its range of expected performance.
122.1    (c) (b) For calendar year 2009 2016 and yearly thereafter, performance-based funds
122.2for a federally approved tribal TANF program in which the state and tribe have in place a
122.3contract under section 256.01, addressing consolidated funding, will must be allocated
122.4as follows:
122.5    (1) a tribe that achieves the participation rate approved in its federal TANF plan
122.6using the average of 12 consecutive months for the most recent year for which the
122.7measurements are available, will receive an additional allocation equal to 2.5 percent of
122.8its initial allocation; and
122.9    (2) (1) a tribe that performs within or above its range of expected performance on the
122.10annualized three-year self-support index under section 256J.751, subdivision 2, clause (6),
122.11will must receive an additional allocation equal to 2.5 percent of its initial allocation; or
122.12    (3) a tribe that does not achieve the participation rate approved in its federal TANF
122.13plan using the average of 12 consecutive months for the most recent year for which the
122.14measurements are available, will not receive an additional allocation equal to 2.5 percent
122.15of its initial allocation until after negotiating a multiyear improvement plan with the
122.16commissioner; or
122.17    (4) (2) a tribe that does not perform within or above performs below its range of
122.18expected performance on the annualized three-year self-support index under section
122.19256J.751, subdivision 2 , clause (6), will not receive an additional allocation equal to
122.202.5 percent until after negotiating for two consecutive years must negotiate a multiyear
122.21improvement plan with the commissioner. If no improvement is shown by the end of the
122.22multiyear plan, the tribe's allocation must be decreased by 2.5 percent. The decrease must
122.23remain in effect until the tribe performs within or above its range of expected performance.
122.24    (d) (c) Funds remaining unallocated after the performance-based allocations
122.25in paragraph (b) (a) are available to the commissioner for innovation projects under
122.26subdivision 5.
122.27     (1) (d) If available funds are insufficient to meet county and tribal allocations under
122.28paragraph paragraphs (a) and (b), the commissioner may make available for allocation
122.29funds that are unobligated and available from the innovation projects through the end of
122.30the current biennium shall proportionally prorate funds to counties and tribes that qualify
122.31for a bonus under paragraphs (a), clause (1), and (b), clause (2).
122.32    (2) If after the application of clause (1) funds remain insufficient to meet county and
122.33tribal allocations under paragraph (b), the commissioner must proportionally reduce the
122.34allocation of each county and tribe with respect to their maximum allocation available
122.35under paragraph (b).

123.1    Sec. 32. [256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM
123.2FEDERAL RULES AND REGULATIONS.
123.3    Subdivision 1. Duties of the commissioner. The commissioner of human services
123.4may pursue TANF demonstration projects or waivers of TANF requirements from the
123.5United States Department of Health and Human Services as needed to allow the state to
123.6build a more results-oriented Minnesota Family Investment Program to better meet the
123.7needs of Minnesota families.
123.8    Subd. 2. Purpose. The purpose of the TANF demonstration projects or waivers is to:
123.9(1) replace the federal TANF process measure and its complex administrative
123.10requirements with state-developed outcomes measures that track adult employment and
123.11exits from MFIP cash assistance;
123.12(2) simplify programmatic and administrative requirements; and
123.13(3) make other policy or programmatic changes that improve the performance of the
123.14program and the outcomes for participants.
123.15    Subd. 3. Report to legislature. The commissioner shall report to the members of
123.16the legislative committees having jurisdiction over human services issues by March 1,
123.172014, regarding the progress of this waiver or demonstration project.
123.18EFFECTIVE DATE.This section is effective the day following final enactment.

123.19    Sec. 33. Minnesota Statutes 2012, section 256K.45, is amended to read:
123.20256K.45 RUNAWAY AND HOMELESS YOUTH ACT.
123.21    Subdivision 1. Grant program established. The commissioner of human services
123.22shall establish a Homeless Youth Act fund and award grants to providers who are
123.23committed to serving homeless youth and youth at risk of homelessness, to provide
123.24street and community outreach and drop-in programs, emergency shelter programs,
123.25and integrated supportive housing and transitional living programs, consistent with the
123.26program descriptions in this act to reduce the incidence of homelessness among youth.
123.27    Subdivision 1. Subd. 1a. Definitions. (a) The definitions in this subdivision apply
123.28to this section.
123.29(b) "Commissioner" means the commissioner of human services.
123.30(c) "Homeless youth" means a person 21 years of age or younger who is
123.31unaccompanied by a parent or guardian and is without shelter where appropriate care and
123.32supervision are available, whose parent or legal guardian is unable or unwilling to provide
123.33shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
123.34following are not fixed, regular, or adequate nighttime residences:
124.1(1) a supervised publicly or privately operated shelter designed to provide temporary
124.2living accommodations;
124.3(2) an institution or a publicly or privately operated shelter designed to provide
124.4temporary living accommodations;
124.5(3) transitional housing;
124.6(4) a temporary placement with a peer, friend, or family member that has not offered
124.7permanent residence, a residential lease, or temporary lodging for more than 30 days; or
124.8(5) a public or private place not designed for, nor ordinarily used as, a regular
124.9sleeping accommodation for human beings.
124.10Homeless youth does not include persons incarcerated or otherwise detained under
124.11federal or state law.
124.12(d) "Youth at risk of homelessness" means a person 21 years of age or younger
124.13whose status or circumstances indicate a significant danger of experiencing homelessness
124.14in the near future. Status or circumstances that indicate a significant danger may include:
124.15(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
124.16youth whose parents or primary caregivers are or were previously homeless; (4) youth
124.17who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
124.18with parents due to chemical or alcohol dependency, mental health disabilities, or other
124.19disabilities; and (6) runaways.
124.20(e) "Runaway" means an unmarried child under the age of 18 years who is absent
124.21from the home of a parent or guardian or other lawful placement without the consent of
124.22the parent, guardian, or lawful custodian.
124.23    Subd. 2. Homeless and runaway youth report. The commissioner shall develop a
124.24 report for homeless youth, youth at risk of homelessness, and runaways. The report shall
124.25include coordination of services as defined under subdivisions 3 to 5 prepare a biennial
124.26report, beginning in February 2015, which provides meaningful information to the
124.27legislative committees having jurisdiction over the issue of homeless youth, that includes,
124.28but is not limited to: (1) a list of the areas of the state with the greatest need for services
124.29and housing for homeless youth, and the level and nature of the needs identified; (2) details
124.30about grants made; (3) the distribution of funds throughout the state based on population
124.31need; (4) follow-up information, if available, on the status of homeless youth and whether
124.32they have stable housing two years after services are provided; and (5) any other outcomes
124.33for populations served to determine the effectiveness of the programs and use of funding.
124.34    Subd. 3. Street and community outreach and drop-in program. Youth drop-in
124.35centers must provide walk-in access to crisis intervention and ongoing supportive services
124.36including one-to-one case management services on a self-referral basis. Street and
125.1community outreach programs must locate, contact, and provide information, referrals,
125.2and services to homeless youth, youth at risk of homelessness, and runaways. Information,
125.3referrals, and services provided may include, but are not limited to:
125.4(1) family reunification services;
125.5(2) conflict resolution or mediation counseling;
125.6(3) assistance in obtaining temporary emergency shelter;
125.7(4) assistance in obtaining food, clothing, medical care, or mental health counseling;
125.8(5) counseling regarding violence, prostitution sexual exploitation, substance abuse,
125.9sexually transmitted diseases, and pregnancy;
125.10(6) referrals to other agencies that provide support services to homeless youth,
125.11youth at risk of homelessness, and runaways;
125.12(7) assistance with education, employment, and independent living skills;
125.13(8) aftercare services;
125.14(9) specialized services for highly vulnerable runaways and homeless youth,
125.15including teen parents, emotionally disturbed and mentally ill youth, and sexually
125.16exploited youth; and
125.17(10) homelessness prevention.
125.18    Subd. 4. Emergency shelter program. (a) Emergency shelter programs must
125.19provide homeless youth and runaways with referral and walk-in access to emergency,
125.20short-term residential care. The program shall provide homeless youth and runaways with
125.21safe, dignified shelter, including private shower facilities, beds, and at least one meal each
125.22day; and shall assist a runaway and homeless youth with reunification with the family or
125.23legal guardian when required or appropriate.
125.24(b) The services provided at emergency shelters may include, but are not limited to:
125.25(1) family reunification services;
125.26(2) individual, family, and group counseling;
125.27(3) assistance obtaining clothing;
125.28(4) access to medical and dental care and mental health counseling;
125.29(5) education and employment services;
125.30(6) recreational activities;
125.31(7) advocacy and referral services;
125.32(8) independent living skills training;
125.33(9) aftercare and follow-up services;
125.34(10) transportation; and
125.35(11) homelessness prevention.
126.1    Subd. 5. Supportive housing and transitional living programs. Transitional
126.2living programs must help homeless youth and youth at risk of homelessness to find and
126.3maintain safe, dignified housing. The program may also provide rental assistance and
126.4related supportive services, or refer youth to other organizations or agencies that provide
126.5such services. Services provided may include, but are not limited to:
126.6(1) educational assessment and referrals to educational programs;
126.7(2) career planning, employment, work skill training, and independent living skills
126.8training;
126.9(3) job placement;
126.10(4) budgeting and money management;
126.11(5) assistance in securing housing appropriate to needs and income;
126.12(6) counseling regarding violence, prostitution sexual exploitation, substance abuse,
126.13sexually transmitted diseases, and pregnancy;
126.14(7) referral for medical services or chemical dependency treatment;
126.15(8) parenting skills;
126.16(9) self-sufficiency support services or life skill training;
126.17(10) aftercare and follow-up services; and
126.18(11) homelessness prevention.
126.19    Subd. 6. Funding. Any Funds appropriated for this section may be expended on
126.20programs described under subdivisions 3 to 5, technical assistance, and capacity building.
126.21Up to four percent of funds appropriated may be used for the purpose of monitoring and
126.22evaluating runaway and homeless youth programs receiving funding under this section.
126.23Funding shall be directed to meet the greatest need, with a significant share of the funding
126.24focused on homeless youth providers in greater Minnesota to meet the greatest need
126.25on a statewide basis.

126.26    Sec. 34. Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:
126.27    Subdivision 1. Formula. The commissioner shall allocate state funds appropriated
126.28under this chapter to each county board on a calendar year basis in an amount determined
126.29according to the formula in paragraphs (a) to (e).
126.30(a) For calendar years 2011 and 2012, the commissioner shall allocate available
126.31funds to each county in proportion to that county's share in calendar year 2010.
126.32(b) For calendar year 2013 and each calendar year thereafter, the commissioner shall
126.33allocate available funds to each county as follows:
126.34(1) 75 percent must be distributed on the basis of the county share in calendar year
126.352012;
127.1(2) five percent must be distributed on the basis of the number of persons residing in
127.2the county as determined by the most recent data of the state demographer;
127.3(3) ten percent must be distributed on the basis of the number of vulnerable children
127.4that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in
127.5the county as determined by the most recent data of the commissioner; and
127.6(4) ten percent must be distributed on the basis of the number of vulnerable adults
127.7that are subjects of reports under section 626.557 in the county as determined by the most
127.8recent data of the commissioner.
127.9(c) For calendar year 2014, the commissioner shall allocate available funds to each
127.10county as follows:
127.11(1) 50 percent must be distributed on the basis of the county share in calendar year
127.122012;
127.13(2) Ten percent must be distributed on the basis of the number of persons residing in
127.14the county as determined by the most recent data of the state demographer;
127.15(3) 20 percent must be distributed on the basis of the number of vulnerable children
127.16that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
127.17county as determined by the most recent data of the commissioner; and
127.18(4) 20 percent must be distributed on the basis of the number of vulnerable adults
127.19that are subjects of reports under section 626.557 in the county as determined by the
127.20most recent data of the commissioner The commissioner is precluded from changing the
127.21formula under this subdivision or recommending a change to the legislature without
127.22public review and input.
127.23(d) For calendar year 2015, the commissioner shall allocate available funds to each
127.24county as follows:
127.25(1) 25 percent must be distributed on the basis of the county share in calendar year
127.262012;
127.27(2) 15 percent must be distributed on the basis of the number of persons residing in
127.28the county as determined by the most recent data of the state demographer;
127.29(3) 30 percent must be distributed on the basis of the number of vulnerable children
127.30that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
127.31county as determined by the most recent data of the commissioner; and
127.32(4) 30 percent must be distributed on the basis of the number of vulnerable adults
127.33that are subjects of reports under section 626.557 in the county as determined by the most
127.34recent data of the commissioner.
127.35(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall
127.36allocate available funds to each county as follows:
128.1(1) 20 percent must be distributed on the basis of the number of persons residing in
128.2the county as determined by the most recent data of the state demographer;
128.3(2) 40 percent must be distributed on the basis of the number of vulnerable children
128.4that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
128.5county as determined by the most recent data of the commissioner; and
128.6(3) 40 percent must be distributed on the basis of the number of vulnerable adults
128.7that are subjects of reports under section 626.557 in the county as determined by the most
128.8recent data of the commissioner.

128.9    Sec. 35. Minnesota Statutes 2012, section 257.0755, subdivision 1, is amended to read:
128.10    Subdivision 1. Creation. One Each ombudsperson shall operate independently from
128.11but in collaboration with each of the following groups the community-specific board that
128.12appointed the ombudsperson under section 257.0768: the Indian Affairs Council, the
128.13Council on Affairs of Chicano/Latino people, the Council on Black Minnesotans, and
128.14the Council on Asian-Pacific Minnesotans.

128.15    Sec. 36. Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:
128.16    Subd. 4. Reimbursement for special nonmedical expenses. (a) Reimbursement
128.17for special nonmedical expenses is available to children, except those eligible for adoption
128.18assistance based on being an at-risk child.
128.19(b) Reimbursements under this paragraph shall be made only after the adoptive
128.20parent documents that the requested service was denied by the local social service agency,
128.21community agencies, the local school district, the local public health department, the
128.22parent's insurance provider, or the child's program. The denial must be for an eligible
128.23service or qualified item under the program requirements of the applicable agency or
128.24organization.
128.25(c) Reimbursements must be previously authorized, adhere to the requirements and
128.26procedures prescribed by the commissioner, and be limited to:
128.27(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a
128.28documented disability that requires special instruction for and services by the child care
128.29provider. Child care reimbursements may be made if all available adult caregivers are
128.30employed, unemployed due to a disability as defined in section 259A.01, subdivision 14,
128.31 or attending educational or vocational training programs. Documentation from a qualified
128.32expert that is dated within the last 12 months must be provided to verify the disability. If a
128.33parent is attending an educational or vocational training program, child care reimbursement
128.34is limited to no more than the time necessary to complete the credit requirements for an
129.1associate or baccalaureate degree as determined by the educational institution. Child
129.2care reimbursement is not limited for an adoptive parent completing basic or remedial
129.3education programs needed to prepare for postsecondary education or employment;
129.4(2) respite care provided for the relief of the child's parent up to 504 hours of respite
129.5care annually;
129.6(3) camping up to 14 days per state fiscal year for a child to attend a special needs
129.7camp. The camp must be accredited by the American Camp Association as a special needs
129.8camp in order to be eligible for camp reimbursement;
129.9(4) postadoption counseling to promote the child's integration into the adoptive
129.10family that is provided by the placing agency during the first year following the date of the
129.11adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;
129.12(5) family counseling that is required to meet the child's special needs.
129.13Reimbursement is limited to the prorated portion of the counseling fees allotted to the
129.14family when the adoptive parent's health insurance or Medicaid pays for the child's
129.15counseling but does not cover counseling for the rest of the family members;
129.16(6) home modifications to accommodate the child's special needs upon which
129.17eligibility for adoption assistance was approved. Reimbursement is limited to once every
129.18five years per child;
129.19(7) vehicle modifications to accommodate the child's special needs upon which
129.20eligibility for adoption assistance was approved. Reimbursement is limited to once every
129.21five years per family; and
129.22(8) burial expenses up to $1,000, if the special needs, upon which eligibility for
129.23adoption assistance was approved, resulted in the death of the child.
129.24(d) The adoptive parent shall submit statements for expenses incurred between July
129.251 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days
129.26after the end of the fiscal year in order for reimbursement to occur.

129.27    Sec. 37. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:
129.28    Subd. 6. Delinquent child. (a) Except as otherwise provided in paragraphs (b)
129.29and (c), "delinquent child" means a child:
129.30(1) who has violated any state or local law, except as provided in section 260B.225,
129.31subdivision 1 , and except for juvenile offenders as described in subdivisions 16 to 18;
129.32(2) who has violated a federal law or a law of another state and whose case has been
129.33referred to the juvenile court if the violation would be an act of delinquency if committed
129.34in this state or a crime or offense if committed by an adult;
130.1(3) who has escaped from confinement to a state juvenile correctional facility after
130.2being committed to the custody of the commissioner of corrections; or
130.3(4) who has escaped from confinement to a local juvenile correctional facility after
130.4being committed to the facility by the court.
130.5(b) The term delinquent child does not include a child alleged to have committed
130.6murder in the first degree after becoming 16 years of age, but the term delinquent child
130.7does include a child alleged to have committed attempted murder in the first degree.
130.8(c) The term delinquent child does not include a child under the age of 16 years
130.9 alleged to have engaged in conduct which would, if committed by an adult, violate any
130.10federal, state, or local law relating to being hired, offering to be hired, or agreeing to be
130.11hired by another individual to engage in sexual penetration or sexual conduct.
130.12EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
130.13offenses committed on or after that date.

130.14    Sec. 38. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:
130.15    Subd. 16. Juvenile petty offender; juvenile petty offense. (a) "Juvenile petty
130.16offense" includes a juvenile alcohol offense, a juvenile controlled substance offense,
130.17a violation of section 609.685, or a violation of a local ordinance, which by its terms
130.18prohibits conduct by a child under the age of 18 years which would be lawful conduct if
130.19committed by an adult.
130.20(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also
130.21includes an offense that would be a misdemeanor if committed by an adult.
130.22(c) "Juvenile petty offense" does not include any of the following:
130.23(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242,
130.24609.324 , subdivision 2 or 3, 609.5632, 609.576, 609.66, 609.746, 609.748, 609.79,
130.25or 617.23;
130.26(2) a major traffic offense or an adult court traffic offense, as described in section
130.27260B.225 ;
130.28(3) a misdemeanor-level offense committed by a child whom the juvenile court
130.29previously has found to have committed a misdemeanor, gross misdemeanor, or felony
130.30offense; or
130.31(4) a misdemeanor-level offense committed by a child whom the juvenile court
130.32has found to have committed a misdemeanor-level juvenile petty offense on two or
130.33more prior occasions, unless the county attorney designates the child on the petition
130.34as a juvenile petty offender notwithstanding this prior record. As used in this clause,
131.1"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that
131.2would have been a juvenile petty offense if it had been committed on or after July 1, 1995.
131.3(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The
131.4term juvenile petty offender does not include a child under the age of 16 years alleged
131.5to have violated any law relating to being hired, offering to be hired, or agreeing to be
131.6hired by another individual to engage in sexual penetration or sexual conduct which, if
131.7committed by an adult, would be a misdemeanor.
131.8EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
131.9offenses committed on or after that date.

131.10    Sec. 39. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:
131.11    Subd. 6. Child in need of protection or services. "Child in need of protection or
131.12services" means a child who is in need of protection or services because the child:
131.13    (1) is abandoned or without parent, guardian, or custodian;
131.14    (2)(i) has been a victim of physical or sexual abuse as defined in section 626.556,
131.15subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in
131.16subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
131.17would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or
131.18child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment
131.19as defined in subdivision 15;
131.20    (3) is without necessary food, clothing, shelter, education, or other required care
131.21for the child's physical or mental health or morals because the child's parent, guardian,
131.22or custodian is unable or unwilling to provide that care;
131.23    (4) is without the special care made necessary by a physical, mental, or emotional
131.24condition because the child's parent, guardian, or custodian is unable or unwilling to
131.25provide that care;
131.26    (5) is medically neglected, which includes, but is not limited to, the withholding of
131.27medically indicated treatment from a disabled infant with a life-threatening condition. The
131.28term "withholding of medically indicated treatment" means the failure to respond to the
131.29infant's life-threatening conditions by providing treatment, including appropriate nutrition,
131.30hydration, and medication which, in the treating physician's or physicians' reasonable
131.31medical judgment, will be most likely to be effective in ameliorating or correcting all
131.32conditions, except that the term does not include the failure to provide treatment other
131.33than appropriate nutrition, hydration, or medication to an infant when, in the treating
131.34physician's or physicians' reasonable medical judgment:
131.35    (i) the infant is chronically and irreversibly comatose;
132.1    (ii) the provision of the treatment would merely prolong dying, not be effective in
132.2ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
132.3futile in terms of the survival of the infant; or
132.4    (iii) the provision of the treatment would be virtually futile in terms of the survival
132.5of the infant and the treatment itself under the circumstances would be inhumane;
132.6    (6) is one whose parent, guardian, or other custodian for good cause desires to be
132.7relieved of the child's care and custody, including a child who entered foster care under a
132.8voluntary placement agreement between the parent and the responsible social services
132.9agency under section 260C.227;
132.10    (7) has been placed for adoption or care in violation of law;
132.11    (8) is without proper parental care because of the emotional, mental, or physical
132.12disability, or state of immaturity of the child's parent, guardian, or other custodian;
132.13    (9) is one whose behavior, condition, or environment is such as to be injurious or
132.14dangerous to the child or others. An injurious or dangerous environment may include, but
132.15is not limited to, the exposure of a child to criminal activity in the child's home;
132.16    (10) is experiencing growth delays, which may be referred to as failure to thrive, that
132.17have been diagnosed by a physician and are due to parental neglect;
132.18    (11) has engaged in prostitution as defined in section 609.321, subdivision 9 is a
132.19sexually exploited youth;
132.20    (12) has committed a delinquent act or a juvenile petty offense before becoming
132.21ten years old;
132.22    (13) is a runaway;
132.23    (14) is a habitual truant;
132.24    (15) has been found incompetent to proceed or has been found not guilty by reason
132.25of mental illness or mental deficiency in connection with a delinquency proceeding, a
132.26certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
132.27proceeding involving a juvenile petty offense; or
132.28(16) has a parent whose parental rights to one or more other children were
132.29involuntarily terminated or whose custodial rights to another child have been involuntarily
132.30transferred to a relative and there is a case plan prepared by the responsible social services
132.31agency documenting a compelling reason why filing the termination of parental rights
132.32petition under section 260C.301, subdivision 3, is not in the best interests of the child; or.
132.33(17) is a sexually exploited youth.
132.34EFFECTIVE DATE.This section is effective August 1, 2014.

132.35    Sec. 40. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:
133.1    Subd. 31. Sexually exploited youth. "Sexually exploited youth" means an
133.2individual who:
133.3(1) is alleged to have engaged in conduct which would, if committed by an adult,
133.4violate any federal, state, or local law relating to being hired, offering to be hired, or
133.5agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;
133.6(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
133.7609.3451 , 609.3453, 609.352, 617.246, or 617.247;
133.8(3) is a victim of a crime described in United States Code, title 18, section 2260;
133.92421; 2422; 2423; 2425; 2425A; or 2256; or
133.10(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.
133.11EFFECTIVE DATE.This section is effective the day following final enactment.

133.12    Sec. 41. Minnesota Statutes 2012, section 518A.60, is amended to read:
133.13518A.60 COLLECTION; ARREARS ONLY.
133.14(a) Remedies available for the collection and enforcement of support in this chapter
133.15and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
133.16for whom support is owed are emancipated and the obligor owes past support or has an
133.17accumulated arrearage as of the date of the youngest child's emancipation. Child support
133.18arrearages under this section include arrearages for child support, medical support, child
133.19care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
133.20section 518A.41, subdivision 1, paragraph (h).
133.21(b) This section applies retroactively to any support arrearage that accrued on or
133.22before June 3, 1997, and to all arrearages accruing after June 3, 1997.
133.23(c) Past support or pregnancy and confinement expenses ordered for which the
133.24obligor has specific court ordered terms for repayment may not be enforced using
133.25drivers' and occupational or professional license suspension, credit bureau reporting, and
133.26additional income withholding under section 518A.53, subdivision 10, paragraph (a),
133.27unless the obligor fails to comply with the terms of the court order for repayment.
133.28(d) If an arrearage exists at the time a support order would otherwise terminate
133.29and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
133.30arrearage shall be repaid in an amount equal to the current support order until all arrears
133.31have been paid in full, absent a court order to the contrary.
133.32(e) If an arrearage exists according to a support order which fails to establish a
133.33monthly support obligation in a specific dollar amount, the public authority, if it provides
133.34child support services, or the obligee, may establish a payment agreement which shall
134.1equal what the obligor would pay for current support after application of section 518A.34,
134.2plus an additional 20 percent of the current support obligation, until all arrears have been
134.3paid in full. If the obligor fails to enter into or comply with a payment agreement, the
134.4public authority, if it provides child support services, or the obligee, may move the district
134.5court or child support magistrate, if section 484.702 applies, for an order establishing
134.6repayment terms.
134.7(f) If there is no longer a current support order because all of the children of the
134.8order are emancipated, the public authority may discontinue child support services and
134.9close its case under title IV-D of the Social Security Act if:
134.10(1) the arrearage is under $500; or
134.11(2) the arrearage is considered unenforceable by the public authority because there
134.12have been no collections for three years, and all administrative and legal remedies have
134.13been attempted or are determined by the public authority to be ineffective because the
134.14obligor is unable to pay, the obligor has no known income or assets, and there is no
134.15reasonable prospect that the obligor will be able to pay in the foreseeable future.
134.16    (g) At least 60 calendar days before the discontinuation of services under paragraph
134.17(f), the public authority must mail a written notice to the obligee and obligor at the
134.18obligee's and obligor's last known addresses that the public authority intends to close the
134.19child support enforcement case and explaining each party's rights. Seven calendar days
134.20after the first notice is mailed, the public authority must mail a second notice under this
134.21paragraph to the obligee.
134.22    (h) The case must be kept open if the obligee responds before case closure and
134.23provides information that could reasonably lead to collection of arrears. If the case is
134.24closed, the obligee may later request that the case be reopened by completing a new
134.25application for services, if there is a change in circumstances that could reasonably lead to
134.26the collection of arrears.

134.27    Sec. 42. Laws 1998, chapter 407, article 6, section 116, is amended to read:
134.28    Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
134.29    The commissioner of human services shall request and receive approval from the
134.30legislature before adjusting the payment to not subsidize retailers for electronic benefit
134.31transfer transaction costs Supplemental Nutrition Assistance Program transactions.
134.32EFFECTIVE DATE.This section is effective 30 days after the commissioner
134.33notifies retailers of the termination of their agreement with the state. The commissioner of
134.34human services must notify the revisor of statutes of that date.

135.1    Sec. 43. Laws 2011, First Special Session chapter 9, article 1, section 3, the effective
135.2date, is amended to read:
135.3EFFECTIVE DATE.This section is effective January 1, 2013 July 1, 2014.
135.4EFFECTIVE DATE.This section is effective retroactively from January 1, 2013.

135.5    Sec. 44. DIRECTION TO COMMISSIONERS; INCOME AND ASSET
135.6EXCLUSION.
135.7(a) The commissioner of human services shall not count conditional cash transfers
135.8made to families participating in a family independence demonstration as income or
135.9assets for purposes of determining or redetermining eligibility for child care assistance
135.10programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota
135.11Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I;
135.12the Minnesota family investment program, work benefit program, or diversionary work
135.13program under Minnesota Statutes, chapter 256J, during the duration of the demonstration.
135.14(b) The commissioner of human services shall not count conditional cash transfers
135.15made to families participating in a family independence demonstration as income or assets
135.16for purposes of determining or redetermining eligibility for medical assistance under
135.17Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter
135.18256L, except that for enrollees subject to a modified adjusted gross income calculation to
135.19determine eligibility, the conditional cash transfer payments shall be counted as income if
135.20they are included on the enrollee's federal tax return as income, or if the payments can be
135.21taken into account in the month of receipt as a lump sum payment.
135.22(c) The commissioner of the Minnesota Housing Finance Agency shall not count
135.23conditional cash transfers made to families participating in a family independence
135.24demonstration as income or assets for purposes of determining or redetermining eligibility
135.25for housing assistance programs under Minnesota Statutes, section 462A.201, during
135.26the duration of the demonstration.
135.27(d) For the purposes of this section:
135.28(1) "conditional cash transfer" means a payment made to a participant in a family
135.29independence demonstration by a sponsoring organization to incent, support, or facilitate
135.30participation; and
135.31(2) "family independence demonstration" means an initiative sponsored or
135.32cosponsored by a governmental or nongovernmental organization, the goal of which is
135.33to facilitate individualized goal-setting and peer support for cohorts of no more than 12
136.1families each toward the development of financial and nonfinancial assets that enable the
136.2participating families to achieve financial independence.
136.3(e) The citizens league shall provide a report to the legislative committees having
136.4jurisdiction over human services issues by July 1, 2016, informing the legislature on the
136.5progress and outcomes of the demonstration under this section.

136.6    Sec. 45. REDUCTION OF YOUTH HOMELESSNESS.
136.7(a) The Minnesota Interagency Council on Homelessness established under the
136.8authority of Minnesota Statutes, section 462A.29, as it updates its statewide plan to
136.9prevent and end homelessness, shall make recommendations on strategies to reduce the
136.10number of youth experiencing homelessness and to prevent homelessness for youth who
136.11are at risk of becoming homeless.
136.12(b) Recommended strategies must take into consideration, to the extent feasible,
136.13issues that contribute to or reduce youth homelessness including, but not limited to, mental
136.14health, chemical dependency, trafficking of youth for sex or other purposes, exiting foster
136.15care, and involvement in gangs. The recommended strategies must include supportive
136.16services as outlined in Minnesota Statutes, section 256K.45, subdivision 5.
136.17(c) The council shall provide an update on the status of its work by December 1,
136.182014, to the legislative committees with jurisdiction over housing, homelessness, and
136.19matters pertaining to youth. If the council determines legislative action is required to
136.20implement recommended strategies, the council shall submit proposals to the legislature at
136.21the earliest possible opportunity.

136.22    Sec. 46. HOUSING ASSISTANCE GRANTS; FORECASTED PROGRAM.
136.23Beginning July 1, 2015, housing assistance grants under Minnesota Statutes, section
136.24256J.35, paragraph (a), must be a forecasted program and the commissioner, with the
136.25approval of the commissioner of management and budget, may transfer unencumbered
136.26appropriation balances within fiscal years of each biennium with other forecasted
136.27programs of the Department of Human Services. The commissioner shall inform the
136.28chairs and ranking minority members of the senate Health and Human Services Finance
136.29Division and the house of representatives Health and Human Services Finance committee
136.30quarterly about transfers made under this provision.

136.31    Sec. 47. PLAN FOR GROUP RESIDENTIAL HOUSING SPECIALTY RATE
136.32AND BANKED BEDS.
137.1The commissioner of human services, in consultation with and cooperation of the
137.2counties, shall review the statewide number and status of group residential housing beds
137.3with rates in excess of the MSA equivalent rate, including banked supplemental service
137.4rate beds. The commissioner shall study the type and amount of supplemental services
137.5delivered or planned for development, and develop a plan for rate setting criteria and
137.6an efficient use of these beds. The commissioner shall review the performance of all
137.7programs that receive supplemental service rates. The plan must require that all beds
137.8receiving supplemental service rates address critical service needs and must establish
137.9quality performance requirements for beds receiving supplemental service rates. The
137.10commissioner shall present the written plan no later than February 1, 2014, to the chairs
137.11and ranking minority members of the house of representatives and senate finance and
137.12policy committees and divisions with jurisdiction over the Department of Human Services.

137.13    Sec. 48. REPEALER.
137.14(a) Minnesota Statutes 2012, section 256J.24, is repealed January 1, 2015.
137.15(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following
137.16final enactment.

137.17ARTICLE 4

137.18STRENGTHENING CHEMICAL AND MENTAL HEALTH SERVICES

137.19    Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:
137.20    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the brain
137.21or a clinically significant disorder of thought, mood, perception, orientation, memory, or
137.22behavior that is detailed in a diagnostic codes list published by the commissioner, and that
137.23seriously limits a person's capacity to function in primary aspects of daily living such as
137.24personal relations, living arrangements, work, and recreation.
137.25    (b) An "adult with acute mental illness" means an adult who has a mental illness that
137.26is serious enough to require prompt intervention.
137.27    (c) For purposes of case management and community support services, a "person
137.28with serious and persistent mental illness" means an adult who has a mental illness and
137.29meets at least one of the following criteria:
137.30    (1) the adult has undergone two or more episodes of inpatient care for a mental
137.31illness within the preceding 24 months;
137.32    (2) the adult has experienced a continuous psychiatric hospitalization or residential
137.33treatment exceeding six months' duration within the preceding 12 months;
138.1    (3) the adult has been treated by a crisis team two or more times within the preceding
138.224 months;
138.3    (4) the adult:
138.4    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression,
138.5schizoaffective disorder, or borderline personality disorder;
138.6    (ii) indicates a significant impairment in functioning; and
138.7    (iii) has a written opinion from a mental health professional, in the last three years,
138.8stating that the adult is reasonably likely to have future episodes requiring inpatient or
138.9residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
138.10management or community support services are provided;
138.11    (5) the adult has, in the last three years, been committed by a court as a person who is
138.12mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or
138.13    (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period
138.14has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and
138.15(ii) has a written opinion from a mental health professional, in the last three years, stating
138.16that the adult is reasonably likely to have future episodes requiring inpatient or residential
138.17treatment, of a frequency described in clause (1) or (2), unless ongoing case management
138.18or community support services are provided; or
138.19    (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is
138.20age 21 or younger.

138.21    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
138.22    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
138.23the exception of the placement of a Minnesota specialty treatment facility as defined in
138.24paragraph (c), must be developed under the direction of the county board, or multiple
138.25county boards acting jointly, as the local mental health authority. The planning process
138.26for each pilot shall include, but not be limited to, mental health consumers, families,
138.27advocates, local mental health advisory councils, local and state providers, representatives
138.28of state and local public employee bargaining units, and the department of human services.
138.29As part of the planning process, the county board or boards shall designate a managing
138.30entity responsible for receipt of funds and management of the pilot project.
138.31(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
138.32request for proposal for regions in which a need has been identified for services.
138.33(c) For purposes of this section, "Minnesota specialty treatment facility" is defined
138.34as an intensive rehabilitative mental health service under section 256B.0622, subdivision
138.352, paragraph (b).

139.1    Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
139.2    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
139.3commissioner shall facilitate integration of funds or other resources as needed and
139.4requested by each project. These resources may include:
139.5(1) residential services funds administered under Minnesota Rules, parts 9535.2000
139.6to 9535.3000, in an amount to be determined by mutual agreement between the project's
139.7managing entity and the commissioner of human services after an examination of the
139.8county's historical utilization of facilities located both within and outside of the county
139.9and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
139.10(2) community support services funds administered under Minnesota Rules, parts
139.119535.1700 to 9535.1760;
139.12(3) other mental health special project funds;
139.13(4) medical assistance, general assistance medical care, MinnesotaCare and group
139.14residential housing if requested by the project's managing entity, and if the commissioner
139.15determines this would be consistent with the state's overall health care reform efforts; and
139.16(5) regional treatment center resources consistent with section 246.0136, subdivision
139.171 .; and
139.18(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
139.19participate in mental health specialty treatment services, awarded to providers through
139.20a request for proposal process.
139.21(b) The commissioner shall consider the following criteria in awarding start-up and
139.22implementation grants for the pilot projects:
139.23(1) the ability of the proposed projects to accomplish the objectives described in
139.24subdivision 2;
139.25(2) the size of the target population to be served; and
139.26(3) geographical distribution.
139.27(c) The commissioner shall review overall status of the projects initiatives at least
139.28every two years and recommend any legislative changes needed by January 15 of each
139.29odd-numbered year.
139.30(d) The commissioner may waive administrative rule requirements which are
139.31incompatible with the implementation of the pilot project.
139.32(e) The commissioner may exempt the participating counties from fiscal sanctions
139.33for noncompliance with requirements in laws and rules which are incompatible with the
139.34implementation of the pilot project.
139.35(f) The commissioner may award grants to an entity designated by a county board or
139.36group of county boards to pay for start-up and implementation costs of the pilot project.

140.1    Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
140.2    Subd. 2. General provisions. (a) In the design and implementation of reforms to
140.3the mental health system, the commissioner shall:
140.4    (1) consult with consumers, families, counties, tribes, advocates, providers, and
140.5other stakeholders;
140.6    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
140.7January 15, 2008, recommendations for legislation to update the role of counties and to
140.8clarify the case management roles, functions, and decision-making authority of health
140.9plans and counties, and to clarify county retention of the responsibility for the delivery of
140.10social services as required under subdivision 3, paragraph (a);
140.11    (3) withhold implementation of any recommended changes in case management
140.12roles, functions, and decision-making authority until after the release of the report due
140.13January 15, 2008;
140.14    (4) ensure continuity of care for persons affected by these reforms including
140.15ensuring client choice of provider by requiring broad provider networks and developing
140.16mechanisms to facilitate a smooth transition of service responsibilities;
140.17    (5) provide accountability for the efficient and effective use of public and private
140.18resources in achieving positive outcomes for consumers;
140.19    (6) ensure client access to applicable protections and appeals; and
140.20    (7) make budget transfers necessary to implement the reallocation of services and
140.21client responsibilities between counties and health care programs that do not increase the
140.22state and county costs and efficiently allocate state funds.
140.23    (b) When making transfers under paragraph (a) necessary to implement movement
140.24of responsibility for clients and services between counties and health care programs,
140.25the commissioner, in consultation with counties, shall ensure that any transfer of state
140.26grants to health care programs, including the value of case management transfer grants
140.27under section 256B.0625, subdivision 20, does not exceed the value of the services being
140.28transferred for the latest 12-month period for which data is available. The commissioner
140.29may make quarterly adjustments based on the availability of additional data during the
140.30first four quarters after the transfers first occur. If case management transfer grants under
140.31section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
140.32to repeal, exceeds the value of the services being transferred, the difference becomes an
140.33ongoing part of each county's adult and children's mental health grants under sections
140.34245.4661 , 245.4889, and 256E.12.
140.35    (c) This appropriation is not authorized to be expended after December 31, 2010,
140.36unless approved by the legislature.

141.1    Sec. 5. Minnesota Statutes 2012, section 245.4871, subdivision 26, is amended to read:
141.2    Subd. 26. Mental health practitioner. "Mental health practitioner" means a person
141.3providing services to children with emotional disturbances. A mental health practitioner
141.4must have training and experience in working with children. A mental health practitioner
141.5must be qualified in at least one of the following ways:
141.6(1) holds a bachelor's degree in one of the behavioral sciences or related fields from
141.7an accredited college or university and:
141.8(i) has at least 2,000 hours of supervised experience in the delivery of mental health
141.9services to children with emotional disturbances; or
141.10(ii) is fluent in the non-English language of the ethnic group to which at least 50
141.11percent of the practitioner's clients belong, completes 40 hours of training in the delivery
141.12of services to children with emotional disturbances, and receives clinical supervision from
141.13a mental health professional at least once a week until the requirement of 2,000 hours
141.14of supervised experience is met;
141.15(2) has at least 6,000 hours of supervised experience in the delivery of mental
141.16health services to children with emotional disturbances; hours worked as a mental health
141.17behavioral aide I or II under section 256B.0943, subdivision 7, may be included in the
141.186,000 hours of experience;
141.19(3) is a graduate student in one of the behavioral sciences or related fields and is
141.20formally assigned by an accredited college or university to an agency or facility for
141.21clinical training; or
141.22(4) holds a master's or other graduate degree in one of the behavioral sciences or
141.23related fields from an accredited college or university and has less than 4,000 hours
141.24post-master's experience in the treatment of emotional disturbance.

141.25    Sec. 6. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:
141.26    Subd. 8. Transition services. The county board may continue to provide mental
141.27health services as defined in sections 245.487 to 245.4889 to persons over 18 years of
141.28age, but under 21 years of age, if the person was receiving case management or family
141.29community support services prior to age 18, and if one of the following conditions is met:
141.30(1) the person is receiving special education services through the local school
141.31district; or
141.32(2) it is in the best interest of the person to continue services defined in sections
141.33245.487 to 245.4889; or
141.34(3) the person is requesting services and the services are medically necessary.

142.1    Sec. 7. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:
142.2    Subdivision 1. Availability of case management services. (a) The county board
142.3shall provide case management services for each child with severe emotional disturbance
142.4who is a resident of the county and the child's family who request or consent to the services.
142.5Case management services may be continued must be offered to be provided for a child with
142.6a serious emotional disturbance who is over the age of 18 consistent with section 245.4875,
142.7subdivision 8 , or the child's legal representative, provided the child's service needs can be
142.8met within the children's service system. Before discontinuing case management services
142.9under this subdivision for children between the ages of 17 and 21, a transition plan
142.10must be developed. The transition plan must be developed with the child and, with the
142.11consent of a child age 18 or over, the child's parent, guardian, or legal representative. The
142.12transition plan should include plans for health insurance, housing, education, employment,
142.13and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case
142.14manager must meet the requirements in section 245.4871, subdivision 4.
142.15(b) Except as permitted by law and the commissioner under demonstration projects,
142.16case management services provided to children with severe emotional disturbance eligible
142.17for medical assistance must be billed to the medical assistance program under sections
142.18256B.02, subdivision 8 , and 256B.0625.
142.19(c) Case management services are eligible for reimbursement under the medical
142.20assistance program. Costs of mentoring, supervision, and continuing education may be
142.21included in the reimbursement rate methodology used for case management services under
142.22the medical assistance program.

142.23    Sec. 8. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
142.24    Subd. 8. State-operated services account. (a) The state-operated services account is
142.25established in the special revenue fund. Revenue generated by new state-operated services
142.26listed under this section established after July 1, 2010, that are not enterprise activities must
142.27be deposited into the state-operated services account, unless otherwise specified in law:
142.28(1) intensive residential treatment services;
142.29(2) foster care services; and
142.30(3) psychiatric extensive recovery treatment services.
142.31(b) Funds deposited in the state-operated services account are available to the
142.32commissioner of human services for the purposes of:
142.33(1) providing services needed to transition individuals from institutional settings
142.34within state-operated services to the community when those services have no other
142.35adequate funding source;
143.1(2) grants to providers participating in mental health specialty treatment services
143.2under section 245.4661; and
143.3(3) to fund the operation of the Intensive Residential Treatment Service program in
143.4Willmar.

143.5    Sec. 9. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
143.6to read:
143.7    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
143.8to the account in subdivision 8 for noncovered allowable costs of a provider certified and
143.9licensed under section 256B.0622 and operating under section 246.014.

143.10    Sec. 10. Minnesota Statutes 2012, section 246.54, is amended to read:
143.11246.54 LIABILITY OF COUNTY; REIMBURSEMENT.
143.12    Subdivision 1. County portion for cost of care. (a) Except for chemical
143.13dependency services provided under sections 254B.01 to 254B.09, the client's county
143.14shall pay to the state of Minnesota a portion of the cost of care provided in a regional
143.15treatment center or a state nursing facility to a client legally settled in that county. A
143.16county's payment shall be made from the county's own sources of revenue and payments
143.17shall equal a percentage of the cost of care, as determined by the commissioner, for each
143.18day, or the portion thereof, that the client spends at a regional treatment center or a state
143.19nursing facility according to the following schedule:
143.20    (1) zero percent for the first 30 days;
143.21    (2) 20 percent for days 31 to 60; and
143.22    (3) 50 75 percent for any days over 60.
143.23    (b) The increase in the county portion for cost of care under paragraph (a), clause
143.24(3), shall be imposed when the treatment facility has determined that it is clinically
143.25appropriate for the client to be discharged.
143.26    (c) If payments received by the state under sections 246.50 to 246.53 exceed 80
143.27percent of the cost of care for days 31 to 60, or 50 25 percent for days over 60, the county
143.28shall be responsible for paying the state only the remaining amount. The county shall
143.29not be entitled to reimbursement from the client, the client's estate, or from the client's
143.30relatives, except as provided in section 246.53.
143.31    Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
143.32Minnesota Security Hospital or the Minnesota extended treatment options program. For
143.33services at these facilities the Minnesota Security Hospital, a county's payment shall be
143.34made from the county's own sources of revenue and payments shall be paid as follows:.
144.1Excluding the state-operated forensic transition service, payments to the state from the
144.2county shall equal ten percent of the cost of care, as determined by the commissioner, for
144.3each day, or the portion thereof, that the client spends at the facility. For the state-operated
144.4forensic transition service, payments to the state from the county shall equal 50 percent of
144.5the cost of care, as determined by the commissioner, for each day, or the portion thereof,
144.6that the client spends in the program. If payments received by the state under sections
144.7246.50 to 246.53 for services provided at the Minnesota Security Hospital, excluding the
144.8state-operated forensic transition service, exceed 90 percent of the cost of care, the county
144.9shall be responsible for paying the state only the remaining amount. If payments received
144.10by the state under sections 246.50 to 246.53 for the state-operated forensic transition service
144.11exceed 50 percent of the cost of care, the county shall be responsible for paying the state
144.12only the remaining amount. The county shall not be entitled to reimbursement from the
144.13client, the client's estate, or from the client's relatives, except as provided in section 246.53.
144.14    (b) Regardless of the facility to which the client is committed, subdivision 1 does
144.15not apply to the following individuals:
144.16    (1) clients who are committed as mentally ill and dangerous under section 253B.02,
144.17subdivision 17;
144.18    (2) (1) clients who are committed as sexual psychopathic personalities under section
144.19253B.02, subdivision 18b ; and
144.20    (3) (2) clients who are committed as sexually dangerous persons under section
144.21253B.02 , subdivision 18c.
144.22    For each of the individuals in clauses (1) to (3), the payment by the county to the state
144.23shall equal ten percent of the cost of care for each day as determined by the commissioner.

144.24    Sec. 11. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:
144.25    Subdivision 1. Administrative requirements. (a) When a person is committed,
144.26the court shall issue a warrant or an order committing the patient to the custody of the
144.27head of the treatment facility. The warrant or order shall state that the patient meets the
144.28statutory criteria for civil commitment.
144.29(b) The commissioner shall prioritize patients being admitted from jail or a
144.30correctional institution who are:
144.31(1) ordered confined in a state hospital for an examination under Minnesota Rules of
144.32Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
144.33(2) under civil commitment for competency treatment and continuing supervision
144.34under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
145.1(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
145.2Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
145.3detained in a state hospital or other facility pending completion of the civil commitment
145.4proceedings; or
145.5(4) committed under this chapter to the commissioner after dismissal of the patient's
145.6criminal charges.
145.7Patients described in this paragraph must be admitted to a service operated by the
145.8commissioner within 48 hours. The commitment must be ordered by the court as provided
145.9in section 253B.09, subdivision 1, paragraph (c).
145.10(c) Upon the arrival of a patient at the designated treatment facility, the head of the
145.11facility shall retain the duplicate of the warrant and endorse receipt upon the original
145.12warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment
145.13must be filed in the court of commitment. After arrival, the patient shall be under the
145.14control and custody of the head of the treatment facility.
145.15(d) Copies of the petition for commitment, the court's findings of fact and
145.16conclusions of law, the court order committing the patient, the report of the examiners,
145.17and the prepetition report shall be provided promptly to the treatment facility.

145.18    Sec. 12. Minnesota Statutes 2012, section 254B.13, is amended to read:
145.19254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
145.20    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
145.21approve and implement navigator pilot projects developed under the planning process
145.22required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
145.23enhance coordination of the delivery of chemical health services required under section
145.24254B.03 .
145.25    Subd. 2. Program design and implementation. (a) The commissioner and
145.26counties participating in the navigator pilot projects shall continue to work in partnership
145.27to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
145.2879, article 7, section 26.
145.29(b) The commissioner and counties participating in the navigator pilot projects shall
145.30complete the planning phase by June 30, 2010, and, if approved by the commissioner for
145.31implementation, enter into agreements governing the operation of the navigator pilot
145.32projects with implementation scheduled no earlier than July 1, 2010.
145.33    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
145.34participation in a navigator pilot program, an individual must:
145.35(1) be a resident of a county with an approved navigator program;
146.1(2) be eligible for consolidated chemical dependency treatment fund services;
146.2(3) be a voluntary participant in the navigator program;
146.3(4) satisfy one of the following items:
146.4(i) have at least one severity rating of three or above in dimension four, five, or six in
146.5a comprehensive assessment under Minnesota Rules, part 9530.6422; or
146.6(ii) have at least one severity rating of two or above in dimension four, five, or six in
146.7a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
146.8participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
146.99530.6505, or be within 60 days following discharge after participation in a Rule 31
146.10treatment program; and
146.11(5) have had at least two treatment episodes in the past two years, not limited
146.12to episodes reimbursed by the consolidated chemical dependency treatment funds. An
146.13admission to an emergency room, a detoxification program, or a hospital may be substituted
146.14for one treatment episode if it resulted from the individual's substance use disorder.
146.15(b) New eligibility criteria may be added as mutually agreed upon by the
146.16commissioner and participating navigator programs.
146.17    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
146.18projects under this section and report the results of the evaluation to the chairs and
146.19ranking minority members of the legislative committees with jurisdiction over chemical
146.20health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
146.21based on outcome evaluation criteria negotiated with the navigator pilot projects prior
146.22to implementation.
146.23    Subd. 4. Notice of navigator pilot project discontinuation. Each county's
146.24participation in the navigator pilot project may be discontinued for any reason by the county
146.25or the commissioner of human services after 30 days' written notice to the other party.
146.26Any unspent funds held for the exiting county's pro rata share in the special revenue fund
146.27under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
146.28chemical dependency treatment fund following discontinuation of the pilot project.
146.29    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
146.30this chapter, the commissioner may authorize navigator pilot projects to use chemical
146.31dependency treatment funds to pay for nontreatment navigator pilot services:
146.32(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
146.33(a); and
146.34(2) by vendors in addition to those authorized under section 254B.05 when not
146.35providing chemical dependency treatment services.
147.1(b) For purposes of this section, "nontreatment navigator pilot services" include
147.2navigator services, peer support, family engagement and support, housing support, rent
147.3subsidies, supported employment, and independent living skills.
147.4(c) State expenditures for chemical dependency services and nontreatment navigator
147.5pilot services provided by or through the navigator pilot projects must not be greater than
147.6the chemical dependency treatment fund expected share of forecasted expenditures in the
147.7absence of the navigator pilot projects. The commissioner may restructure the schedule of
147.8payments between the state and participating counties under the local agency share and
147.9division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
147.10facilitate the operation of the navigator pilot projects.
147.11(d) To the extent that state fiscal year expenditures within a pilot project are less
147.12than the expected share of forecasted expenditures in the absence of the pilot projects,
147.13the commissioner shall deposit the unexpended funds in a separate account within the
147.14consolidated chemical dependency treatment fund, and make these funds available for
147.15expenditure by the pilot projects the following year. To the extent that treatment and
147.16nontreatment pilot services expenditures within the pilot project exceed the amount
147.17expected in the absence of the pilot projects, the pilot project county or counties are
147.18responsible for the portion of nontreatment pilot services expenditures in excess of the
147.19otherwise expected share of forecasted expenditures.
147.20(e) (d) The commissioner may waive administrative rule requirements that are
147.21incompatible with the implementation of the navigator pilot project, except that any
147.22chemical dependency treatment funded under this section must continue to be provided
147.23by a licensed treatment provider.
147.24(f) (e) The commissioner shall not approve or enter into any agreement related to
147.25navigator pilot projects authorized under this section that puts current or future federal
147.26funding at risk.
147.27(f) The commissioner shall provide participating navigator pilot projects with
147.28transactional data, reports, provider data, and other data generated by county activity to
147.29assess and measure outcomes. This information must be transmitted or made available in
147.30an acceptable form to participating navigator pilot projects at least once every six months
147.31or within a reasonable time following the commissioner's receipt of information from the
147.32counties needed to comply with this paragraph.
147.33    Subd. 6. Duties of county board. The county board, or other county entity that
147.34is approved to administer a navigator pilot project, shall:
147.35(1) administer the navigator pilot project in a manner consistent with the objectives
147.36described in subdivision 2 and the planning process in subdivision 5;
148.1(2) ensure that no one is denied chemical dependency treatment services for which
148.2they would otherwise be eligible under section 254A.03, subdivision 3; and
148.3(3) provide the commissioner with timely and pertinent information as negotiated in
148.4agreements governing operation of the navigator pilot projects.
148.5    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
148.6program under subdivision 2a is excluded from mandatory enrollment in managed care
148.7until these services are included in the health plan's benefit set.
148.8    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
148.9projects implemented pursuant to subdivision 1 are authorized to continue operation after
148.10July 1, 2013, under existing agreements governing operation of the pilot projects.
148.11EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
148.12August 1, 2013. Subdivision 7 is effective July 1, 2013.

148.13    Sec. 13. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL
148.14HEALTH CARE.
148.15    Subdivision 1. Authorization for continuum of care pilot projects. The
148.16commissioner shall establish chemical dependency continuum of care pilot projects to
148.17begin implementing the measures developed with stakeholder input and identified in the
148.18report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot
148.19projects are intended to improve the effectiveness and efficiency of the service continuum
148.20for chemically dependent individuals in Minnesota while reducing duplication of efforts
148.21and promoting scientifically supported practices.
148.22    Subd. 2. Program implementation. (a) The commissioner, in coordination with
148.23representatives of the Minnesota Association of County Social Service Administrators
148.24and the Minnesota Inter-County Association, shall develop a process for identifying and
148.25selecting interested counties and providers for participation in the continuum of care pilot
148.26projects. There shall be three pilot projects; one representing the northern region, one for
148.27the metro region, and one for the southern region. The selection process of counties and
148.28providers must include consideration of population size, geographic distribution, cultural
148.29and racial demographics, and provider accessibility. The commissioner shall identify
148.30counties and providers that are selected for participation in the continuum of care pilot
148.31projects no later than September 30, 2013.
148.32(b) The commissioner and entities participating in the continuum of care pilot
148.33projects shall enter into agreements governing the operation of the continuum of care pilot
148.34projects. The agreements shall identify pilot project outcomes and include timelines for
148.35implementation and beginning operation of the pilot projects.
149.1(c) Entities that are currently participating in the navigator pilot project are
149.2eligible to participate in the continuum of care pilot project subsequent to or instead of
149.3participating in the navigator pilot project.
149.4(d) The commissioner may waive administrative rule requirements that are
149.5incompatible with implementation of the continuum of care pilot projects.
149.6(e) Notwithstanding section 254A.19, the commissioner may designate noncounty
149.7entities to complete chemical use assessments and placement authorizations required
149.8under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section
149.9254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the
149.10discretion of the commissioner.
149.11    Subd. 3. Program design. (a) The operation of the pilot projects shall include:
149.12(1) new services that are responsive to the chronic nature of substance use disorder;
149.13(2) telehealth services, when appropriate to address barriers to services;
149.14(3) services that assure integration with the mental health delivery system when
149.15appropriate;
149.16(4) services that address the needs of diverse populations; and
149.17(5) an assessment and access process that permits clients to present directly to a
149.18service provider for a substance use disorder assessment and authorization of services.
149.19(b) Prior to implementation of the continuum of care pilot projects, a utilization
149.20review process must be developed and agreed to by the commissioner, participating
149.21counties, and providers. The utilization review process shall be described in the
149.22agreements governing operation of the continuum of care pilot projects.
149.23    Subd. 4. Notice of project discontinuation. Each entity's participation in the
149.24continuum of care pilot project may be discontinued for any reason by the county or the
149.25commissioner after 30 days' written notice to the entity.
149.26    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
149.27chapter, the commissioner may authorize chemical dependency treatment funds to pay for
149.28nontreatment services arranged by continuum of care pilot projects. Individuals who are
149.29currently accessing Rule 31 treatment services are eligible for concurrent participation in
149.30the continuum of care pilot projects.
149.31(b) County expenditures for continuum of care pilot project services shall not
149.32be greater than their expected share of forecasted expenditures in the absence of the
149.33continuum of care pilot projects.
149.34    Subd. 6. Managed care. An individual who is eligible for the continuum of care
149.35pilot project is excluded from mandatory enrollment in managed care unless these services
149.36are included in the health plan's benefit set.
150.1EFFECTIVE DATE.This section is effective August 1, 2013.

150.2    Sec. 14. [256.478] HOME AND COMMUNITY-BASED SERVICES
150.3TRANSITIONS GRANTS.
150.4(a) The commissioner shall make available home and community-based services
150.5transition grants to serve individuals who do not meet eligibility criteria for the medical
150.6assistance program under section 256B.056 or 256B.057, but who otherwise meet the
150.7criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24.
150.8(b) For the purposes of this section, the commissioner has the authority to transfer
150.9funds between the medical assistance account and the home and community-based
150.10services transitions grants account.
150.11EFFECTIVE DATE.This section is effective July 1, 2013.

150.12    Sec. 15. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER
150.13SPECIALIST.
150.14    Subdivision 1. Scope. Medical assistance covers mental health certified family peer
150.15specialists services, as established in subdivision 2, subject to federal approval, if provided
150.16to recipients who have an emotional disturbance or severe emotional disturbance under
150.17chapter 245, and are provided by a certified family peer specialist who has completed the
150.18training under subdivision 5. A family peer specialist cannot provide services to the
150.19peer specialist's family.
150.20    Subd. 2. Establishment. The commissioner of human services shall establish a
150.21certified family peer specialists program model which:
150.22(1) provides nonclinical family peer support counseling, building on the strengths
150.23of families and helping them achieve desired outcomes;
150.24(2) collaborates with others providing care or support to the family;
150.25(3) provides nonadversarial advocacy;
150.26(4) promotes the individual family culture in the treatment milieu;
150.27(5) links parents to other parents in the community;
150.28(6) offers support and encouragement;
150.29(7) assists parents in developing coping mechanisms and problem-solving skills;
150.30(8) promotes resiliency, self-advocacy, development of natural supports, and
150.31maintenance of skills learned in other support services;
150.32(9) establishes and provides peer led parent support groups; and
151.1(10) increases the child's ability to function better within the child's home, school,
151.2and community by educating parents on community resources, assisting with problem
151.3solving, and educating parents on mental illnesses.
151.4    Subd. 3. Eligibility. Family peer support services may be located in inpatient
151.5hospitalization, partial hospitalization, residential treatment, treatment foster care, day
151.6treatment, children's therapeutic services and supports, or crisis services.
151.7    Subd. 4. Peer support specialist program providers. The commissioner shall
151.8develop a process to certify family peer support specialist programs, in accordance with
151.9the federal guidelines, in order for the program to bill for reimbursable services. Family
151.10peer support programs must operate within an existing mental health community provider
151.11or center.
151.12    Subd. 5. Certified family peer specialist training and certification. The
151.13commissioner shall develop a training and certification process for certified family peer
151.14specialists who must be at least 21 years of age and have a high school diploma or its
151.15equivalent. The candidates must have raised or are currently raising a child with a mental
151.16illness, have had experience navigating the children's mental health system, and must
151.17demonstrate leadership and advocacy skills and a strong dedication to family-driven and
151.18family-focused services. The training curriculum must teach participating family peer
151.19specialists specific skills relevant to providing peer support to other parents. In addition
151.20to initial training and certification, the commissioner shall develop ongoing continuing
151.21educational workshops on pertinent issues related to family peer support counseling.

151.22    Sec. 16. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
151.23    Subd. 2. Definitions. For purposes of this section, the following terms have the
151.24meanings given them.
151.25(a) "Adult rehabilitative mental health services" means mental health services
151.26which are rehabilitative and enable the recipient to develop and enhance psychiatric
151.27stability, social competencies, personal and emotional adjustment, and independent living,
151.28parenting skills, and community skills, when these abilities are impaired by the symptoms
151.29of mental illness. Adult rehabilitative mental health services are also appropriate when
151.30provided to enable a recipient to retain stability and functioning, if the recipient would
151.31be at risk of significant functional decompensation or more restrictive service settings
151.32without these services.
151.33(1) Adult rehabilitative mental health services instruct, assist, and support the
151.34recipient in areas such as: interpersonal communication skills, community resource
151.35utilization and integration skills, crisis assistance, relapse prevention skills, health care
152.1directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
152.2and nutrition skills, transportation skills, medication education and monitoring, mental
152.3illness symptom management skills, household management skills, employment-related
152.4skills, parenting skills, and transition to community living services.
152.5(2) These services shall be provided to the recipient on a one-to-one basis in the
152.6recipient's home or another community setting or in groups.
152.7(b) "Medication education services" means services provided individually or in
152.8groups which focus on educating the recipient about mental illness and symptoms; the role
152.9and effects of medications in treating symptoms of mental illness; and the side effects of
152.10medications. Medication education is coordinated with medication management services
152.11and does not duplicate it. Medication education services are provided by physicians,
152.12pharmacists, physician's assistants, or registered nurses.
152.13(c) "Transition to community living services" means services which maintain
152.14continuity of contact between the rehabilitation services provider and the recipient and
152.15which facilitate discharge from a hospital, residential treatment program under Minnesota
152.16Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
152.17living services are not intended to provide other areas of adult rehabilitative mental health
152.18services.

152.19    Sec. 17. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to
152.20read:
152.21    Subd. 48. Psychiatric consultation to primary care practitioners. Effective
152.22January 1, 2006, Medical assistance covers consultation provided by a psychiatrist, a
152.23psychologist, or an advanced practice registered nurse certified in psychiatric mental
152.24health via telephone, e-mail, facsimile, or other means of communication to primary care
152.25practitioners, including pediatricians. The need for consultation and the receipt of the
152.26consultation must be documented in the patient record maintained by the primary care
152.27practitioner. If the patient consents, and subject to federal limitations and data privacy
152.28provisions, the consultation may be provided without the patient present.

152.29    Sec. 18. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to
152.30read:
152.31    Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
152.32community-based service coordination that is performed through a hospital emergency
152.33department as an eligible procedure under a state healthcare program for a frequent user.
152.34A frequent user is defined as an individual who has frequented the hospital emergency
153.1department for services three or more times in the previous four consecutive months.
153.2In-reach community-based service coordination includes navigating services to address a
153.3client's mental health, chemical health, social, economic, and housing needs, or any other
153.4activity targeted at reducing the incidence of emergency room and other nonmedically
153.5necessary health care utilization.
153.6(2) Medical assistance covers in-reach community-based service coordination that
153.7is performed through a hospital emergency department or inpatient psychiatric unit
153.8for a child or young adult up to age 21 with a serious emotional disturbance who has
153.9frequented the hospital emergency room two or more times in the previous consecutive
153.10three months or been admitted to an inpatient psychiatric unit two or more times in the
153.11previous consecutive four months, or is being discharged to a shelter.
153.12    (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
153.13days posthospital discharge based upon the specific identified emergency department visit
153.14or inpatient admitting event. In-reach community-based service coordination shall seek to
153.15connect frequent users with existing covered services available to them, including, but not
153.16limited to, targeted case management, waiver case management, or care coordination in a
153.17health care home. For children and young adults with a serious emotional disturbance,
153.18in-reach community-based service coordination includes navigating and arranging for
153.19community-based services prior to discharge to address a client's mental health, chemical
153.20health, social, educational, family support and housing needs, or any other activity targeted
153.21at reducing multiple incidents of emergency room use, inpatient readmissions, and other
153.22nonmedically necessary health care utilization. In-reach services shall seek to connect
153.23them with existing covered services, including targeted case management, waiver case
153.24management, care coordination in a health care home, children's therapeutic services and
153.25supports, crisis services, and respite care. Eligible in-reach service coordinators must hold
153.26a minimum of a bachelor's degree in social work, public health, corrections, or a related
153.27field. The commissioner shall submit any necessary application for waivers to the Centers
153.28for Medicare and Medicaid Services to implement this subdivision.
153.29    (c)(1) For the purposes of this subdivision, "in-reach community-based service
153.30coordination" means the practice of a community-based worker with training, knowledge,
153.31skills, and ability to access a continuum of services, including housing, transportation,
153.32chemical and mental health treatment, employment, education, and peer support services,
153.33by working with an organization's staff to transition an individual back into the individual's
153.34living environment. In-reach community-based service coordination includes working
153.35with the individual during their discharge and for up to a defined amount of time in the
153.36individual's living environment, reducing the individual's need for readmittance.
154.1    (2) Hospitals utilizing in-reach service coordinators shall report annually to the
154.2commissioner on the number of adults, children, and adolescents served; the postdischarge
154.3services which they accessed; and emergency department/psychiatric hospitalization
154.4readmissions. The commissioner shall ensure that services and payments provided under
154.5in-reach care coordination do not duplicate services or payments provided under section
154.6256B.0753, 256B.0755, or 256B.0625, subdivision 20.

154.7    Sec. 19. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
154.8subdivision to read:
154.9    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
154.10federal approval, whichever is later, medical assistance covers family psychoeducation
154.11services provided to a child up to age 21 with a diagnosed mental health condition when
154.12identified in the child's individual treatment plan and provided by a licensed mental health
154.13professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
154.14clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
154.15has determined it medically necessary to involve family members in the child's care. For
154.16the purposes of this subdivision, "family psychoeducation services" means information
154.17or demonstration provided to an individual or family as part of an individual, family,
154.18multifamily group, or peer group session to explain, educate, and support the child and
154.19family in understanding a child's symptoms of mental illness, the impact on the child's
154.20development, and needed components of treatment and skill development so that the
154.21individual, family, or group can help the child to prevent relapse, prevent the acquisition
154.22of comorbid disorders, and achieve optimal mental health and long-term resilience.

154.23    Sec. 20. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
154.24subdivision to read:
154.25    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
154.26federal approval, whichever is later, medical assistance covers clinical care consultation
154.27for a person up to age 21 who is diagnosed with a complex mental health condition or a
154.28mental health condition that co-occurs with other complex and chronic conditions, when
154.29described in the person's individual treatment plan and provided by a licensed mental health
154.30professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a clinical
154.31trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the purposes
154.32of this subdivision, "clinical care consultation" means communication from a treating
154.33mental health professional to other providers or educators not under the clinical supervision
154.34of the treating mental health professional who are working with the same client to inform,
155.1inquire, and instruct regarding the client's symptoms; strategies for effective engagement,
155.2care, and intervention needs; and treatment expectations across service settings; and to
155.3direct and coordinate clinical service components provided to the client and family.

155.4    Sec. 21. Minnesota Statutes 2012, section 256B.092, is amended by adding a
155.5subdivision to read:
155.6    Subd. 13. Waiver allocations for transition populations. (a) The commissioner
155.7shall make available additional waiver allocations and additional necessary resources
155.8to assure timely discharges from the Anoka Metro Regional Treatment Center and the
155.9Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
155.10(1) are otherwise eligible for the developmental disabilities waiver under this section;
155.11(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
155.12the Minnesota Security Hospital;
155.13(3) whose discharge would be significantly delayed without the available waiver
155.14allocation; and
155.15(4) who have met treatment objectives and no longer meet hospital level of care.
155.16(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
155.17requirements of the federal approved waiver plan.
155.18(c) Any corporate foster care home developed under this subdivision must be
155.19considered an exception under section 245A.03, subdivision 7, paragraph (a).
155.20EFFECTIVE DATE.This section is effective July 1, 2013.

155.21    Sec. 22. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
155.22    Subdivision 1. Definitions. For purposes of this section, the following terms have
155.23the meanings given them.
155.24(a) "Children's therapeutic services and supports" means the flexible package of
155.25mental health services for children who require varying therapeutic and rehabilitative
155.26levels of intervention. The services are time-limited interventions that are delivered using
155.27various treatment modalities and combinations of services designed to reach treatment
155.28outcomes identified in the individual treatment plan.
155.29(b) "Clinical supervision" means the overall responsibility of the mental health
155.30professional for the control and direction of individualized treatment planning, service
155.31delivery, and treatment review for each client. A mental health professional who is an
155.32enrolled Minnesota health care program provider accepts full professional responsibility
155.33for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
155.34and oversees or directs the supervisee's work.
156.1(c) "County board" means the county board of commissioners or board established
156.2under sections 402.01 to 402.10 or 471.59.
156.3(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
156.4(e) "Culturally competent provider" means a provider who understands and can
156.5utilize to a client's benefit the client's culture when providing services to the client. A
156.6provider may be culturally competent because the provider is of the same cultural or
156.7ethnic group as the client or the provider has developed the knowledge and skills through
156.8training and experience to provide services to culturally diverse clients.
156.9(f) "Day treatment program" for children means a site-based structured program
156.10consisting of group psychotherapy for more than three individuals and other intensive
156.11therapeutic services provided by a multidisciplinary team, under the clinical supervision
156.12of a mental health professional.
156.13(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
156.1411 .
156.15(h) "Direct service time" means the time that a mental health professional, mental
156.16health practitioner, or mental health behavioral aide spends face-to-face with a client
156.17and the client's family. Direct service time includes time in which the provider obtains
156.18a client's history or provides service components of children's therapeutic services and
156.19supports. Direct service time does not include time doing work before and after providing
156.20direct services, including scheduling, maintaining clinical records, consulting with others
156.21about the client's mental health status, preparing reports, receiving clinical supervision,
156.22and revising the client's individual treatment plan.
156.23(i) "Direction of mental health behavioral aide" means the activities of a mental
156.24health professional or mental health practitioner in guiding the mental health behavioral
156.25aide in providing services to a client. The direction of a mental health behavioral aide
156.26must be based on the client's individualized treatment plan and meet the requirements in
156.27subdivision 6, paragraph (b), clause (5).
156.28(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
156.2915 . For persons at least age 18 but under age 21, mental illness has the meaning given in
156.30section 245.462, subdivision 20, paragraph (a).
156.31(k) "Individual behavioral plan" means a plan of intervention, treatment, and
156.32services for a child written by a mental health professional or mental health practitioner,
156.33under the clinical supervision of a mental health professional, to guide the work of the
156.34mental health behavioral aide.
156.35(l) "Individual treatment plan" has the meaning given in section 245.4871,
156.36subdivision 21 .
157.1(m) "Mental health behavioral aide services" means medically necessary one-on-one
157.2activities performed by a trained paraprofessional to assist a child retain or generalize
157.3psychosocial skills as taught by a mental health professional or mental health practitioner
157.4and as described in the child's individual treatment plan and individual behavior plan.
157.5Activities involve working directly with the child or child's family as provided in
157.6subdivision 9, paragraph (b), clause (4).
157.7(n) "Mental health professional" means an individual as defined in section 245.4871,
157.8subdivision 27 , clauses (1) to (6), or tribal vendor as defined in section 256B.02,
157.9subdivision 7 , paragraph (b).
157.10    (o) "Mental health service plan development" includes:
157.11    (1) the development, review, and revision of a child's individual treatment plan,
157.12as provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of
157.13the client or client's parents, primary caregiver, or other person authorized to consent to
157.14mental health services for the client, and including arrangement of treatment and support
157.15activities specified in the individual treatment plan; and
157.16    (2) administering standardized outcome measurement instruments, determined
157.17and updated by the commissioner, as periodically needed to evaluate the effectiveness
157.18of treatment for children receiving clinical services and reporting outcome measures,
157.19as required by the commissioner.
157.20(o) (p) "Preschool program" means a day program licensed under Minnesota Rules,
157.21parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
157.22supports provider to provide a structured treatment program to a child who is at least 33
157.23months old but who has not yet attended the first day of kindergarten.
157.24(p) (q) "Skills training" means individual, family, or group training, delivered
157.25by or under the direction of a mental health professional, designed to facilitate the
157.26acquisition of psychosocial skills that are medically necessary to rehabilitate the child
157.27to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
157.28illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
157.29or maladaptive skills acquired over the course of a psychiatric illness. Skills training
157.30is subject to the following requirements:
157.31(1) a mental health professional or a mental health practitioner must provide skills
157.32training;
157.33(2) the child must always be present during skills training; however, a brief absence
157.34of the child for no more than ten percent of the session unit may be allowed to redirect or
157.35instruct family members;
158.1(3) skills training delivered to children or their families must be targeted to the
158.2specific deficits or maladaptations of the child's mental health disorder and must be
158.3prescribed in the child's individual treatment plan;
158.4(4) skills training delivered to the child's family must teach skills needed by parents
158.5to enhance the child's skill development and to help the child use in daily life the skills
158.6previously taught by a mental health professional or mental health practitioner and to
158.7develop or maintain a home environment that supports the child's progressive use skills;
158.8(5) group skills training may be provided to multiple recipients who, because of the
158.9nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
158.10interaction in a group setting, which must be staffed as follows:
158.11(i) one mental health professional or one mental health practitioner under supervision
158.12of a licensed mental health professional must work with a group of four to eight clients; or
158.13(ii) two mental health professionals or two mental health practitioners under
158.14supervision of a licensed mental health professional, or one professional plus one
158.15practitioner must work with a group of nine to 12 clients.

158.16    Sec. 23. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
158.17    Subd. 2. Covered service components of children's therapeutic services and
158.18supports. (a) Subject to federal approval, medical assistance covers medically necessary
158.19children's therapeutic services and supports as defined in this section that an eligible
158.20provider entity certified under subdivision 4 provides to a client eligible under subdivision
158.213.
158.22(b) The service components of children's therapeutic services and supports are:
158.23(1) individual, family, and group psychotherapy;
158.24(2) individual, family, or group skills training provided by a mental health
158.25professional or mental health practitioner;
158.26(3) crisis assistance;
158.27(4) mental health behavioral aide services; and
158.28(5) direction of a mental health behavioral aide.;
158.29(6) mental health service plan development;
158.30(7) clinical care consultation under section 256B.0625, subdivision 62;
158.31(8) family psychoeducation under section 256B.0625, subdivision 61; and
158.32(9) services provided by a family peer specialist under section 256B.0616.
158.33(c) Service components in paragraph (b) may be combined to constitute therapeutic
158.34programs, including day treatment programs and therapeutic preschool programs.

159.1    Sec. 24. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:
159.2    Subd. 7. Qualifications of individual and team providers. (a) An individual
159.3or team provider working within the scope of the provider's practice or qualifications
159.4may provide service components of children's therapeutic services and supports that are
159.5identified as medically necessary in a client's individual treatment plan.
159.6(b) An individual provider must be qualified as:
159.7(1) a mental health professional as defined in subdivision 1, paragraph (n); or
159.8(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The
159.9mental health practitioner must work under the clinical supervision of a mental health
159.10professional; or
159.11(3) a mental health behavioral aide working under the clinical supervision of a
159.12mental health professional to implement the rehabilitative mental health services identified
159.13in the client's individual treatment plan and individual behavior plan.
159.14(A) A level I mental health behavioral aide must:
159.15(i) be at least 18 years old;
159.16(ii) have a high school diploma or general equivalency diploma (GED) or two years
159.17of experience as a primary caregiver to a child with severe emotional disturbance within
159.18the previous ten years; and
159.19(iii) meet preservice and continuing education requirements under subdivision 8.
159.20(B) A level II mental health behavioral aide must:
159.21(i) be at least 18 years old;
159.22(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
159.23clinical services in the treatment of mental illness concerning children or adolescents or
159.24complete a certificate program established under subdivision 8a; and
159.25(iii) meet preservice and continuing education requirements in subdivision 8.
159.26(c) A preschool program multidisciplinary team must include at least one mental
159.27health professional and one or more of the following individuals under the clinical
159.28supervision of a mental health professional:
159.29(i) a mental health practitioner; or
159.30(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
159.31qualifications and training standards of a level I mental health behavioral aide.
159.32(d) A day treatment multidisciplinary team must include at least one mental health
159.33professional and one mental health practitioner.

159.34    Sec. 25. Minnesota Statutes 2012, section 256B.0943, is amended by adding a
159.35subdivision to read:
160.1    Subd. 8a. Level II mental health behavioral aide. The commissioner of human
160.2services, in collaboration with children's mental health providers and the Board of Trustees
160.3of the Minnesota State Colleges and Universities, shall develop a certificate program
160.4for level II mental health behavioral aides.

160.5    Sec. 26. Minnesota Statutes 2012, section 256B.0946, is amended to read:
160.6256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
160.7    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
160.8 upon enactment and subject to federal approval, medical assistance covers medically
160.9necessary intensive treatment services described under paragraph (b) that are provided
160.10by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
160.11who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
160.12to 2960.3340.
160.13(b) Intensive treatment services to children with severe emotional disturbance mental
160.14illness residing in treatment foster care family settings must meet the relevant standards
160.15for mental health services under sections 245.487 to 245.4889. In addition, that comprise
160.16 specific required service components provided in clauses (1) to (5), are reimbursed by
160.17medical assistance must when they meet the following standards:
160.18(1) case management service component must meet the standards in Minnesota
160.19Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
160.20(1) psychotherapy provided by a mental health professional as defined in Minnesota
160.21Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
160.22Rules, part 9505.0371, subpart 5, item C;
160.23(2) psychotherapy, crisis assistance, and skills training components must meet the
160.24 provided according to standards for children's therapeutic services and supports in section
160.25256B.0943 ; and
160.26(3) individual family, and group psychoeducation services under supervision of,
160.27defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
160.28clinical trainee;
160.29(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
160.30health professional or a clinical trainee; and
160.31(5) service delivery payment requirements as provided under subdivision 4.
160.32    Subd. 1a. Definitions. For the purposes of this section, the following terms have
160.33the meanings given them.
160.34(a) "Clinical care consultation" means communication from a treating clinician to
160.35other providers working with the same client to inform, inquire, and instruct regarding
161.1the client's symptoms, strategies for effective engagement, care and intervention needs,
161.2and treatment expectations across service settings, including but not limited to the client's
161.3school, social services, day care, probation, home, primary care, medication prescribers,
161.4disabilities services, and other mental health providers and to direct and coordinate clinical
161.5service components provided to the client and family.
161.6(b) "Clinical supervision" means the documented time a clinical supervisor and
161.7supervisee spend together to discuss the supervisee's work, to review individual client
161.8cases, and for the supervisee's professional development. It includes the documented
161.9oversight and supervision responsibility for planning, implementation, and evaluation of
161.10services for a client's mental health treatment.
161.11(c) "Clinical supervisor" means the mental health professional who is responsible
161.12for clinical supervision.
161.13(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
161.14subpart 5, item C;
161.15(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
161.16including the development of a plan that addresses prevention and intervention strategies
161.17to be used in a potential crisis, but does not include actual crisis intervention.
161.18(f) "Culturally appropriate" means providing mental health services in a manner that
161.19incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
161.20subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
161.21strengths and resources to promote overall wellness.
161.22(g) "Culture" means the distinct ways of living and understanding the world that
161.23are used by a group of people and are transmitted from one generation to another or
161.24adopted by an individual.
161.25(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
161.269505.0370, subpart 11.
161.27(i) "Family" means a person who is identified by the client or the client's parent or
161.28guardian as being important to the client's mental health treatment. Family may include,
161.29but is not limited to, parents, foster parents, children, spouse, committed partners, former
161.30spouses, persons related by blood or adoption, persons who are a part of the client's
161.31permanency plan, or persons who are presently residing together as a family unit.
161.32(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
161.33(k) "Foster family setting" means the foster home in which the license holder resides.
161.34(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
161.359505.0370, subpart 15.
162.1(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
162.29505.0370, subpart 17.
162.3(n) "Mental health professional" has the meaning given in Minnesota Rules, part
162.49505.0370, subpart 18.
162.5(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
162.6subpart 20.
162.7(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
162.8(q) "Psychoeducation services" means information or demonstration provided to
162.9an individual, family, or group to explain, educate, and support the individual, family, or
162.10group in understanding a child's symptoms of mental illness, the impact on the child's
162.11development, and needed components of treatment and skill development so that the
162.12individual, family, or group can help the child to prevent relapse, prevent the acquisition
162.13of comorbid disorders, and achieve optimal mental health and long-term resilience.
162.14(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
162.15subpart 27.
162.16(s) "Team consultation and treatment planning" means the coordination of treatment
162.17plans and consultation among providers in a group concerning the treatment needs of the
162.18child, including disseminating the child's treatment service schedule to all members of the
162.19service team. Team members must include all mental health professionals working with
162.20the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
162.21and at least two of the following: an individualized education program case manager;
162.22probation agent; children's mental health case manager; child welfare worker, including
162.23adoption or guardianship worker; primary care provider; foster parent; and any other
162.24member of the child's service team.
162.25    Subd. 2. Determination of client eligibility. A client's eligibility to receive
162.26treatment foster care under this section shall be determined by An eligible recipient is an
162.27individual, from birth through age 20, who is currently placed in a foster home licensed
162.28under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
162.29assessment, and an evaluation of level of care needed, and development of an individual
162.30treatment plan, as defined in paragraphs (a) to (c) and (b).
162.31(a) The diagnostic assessment must:
162.32(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
162.33conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
162.34worker that is mental health professional or a clinical trainee;
162.35(2) determine whether or not a child meets the criteria for mental illness, as defined
162.36in Minnesota Rules, part 9505.0370, subpart 20;
163.1(3) document that intensive treatment services are medically necessary within a
163.2foster family setting to ameliorate identified symptoms and functional impairments;
163.3(4) be performed within 180 days prior to before the start of service; and
163.4(2) include current diagnoses on all five axes of the client's current mental health
163.5status;
163.6(3) determine whether or not a child meets the criteria for severe emotional
163.7disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
163.8in section 245.462, subdivision 20; and
163.9(4) be completed annually until age 18. For individuals between age 18 and 21,
163.10unless a client's mental health condition has changed markedly since the client's most
163.11recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
163.12"updating" means a written summary, including current diagnoses on all five axes, by a
163.13mental health professional of the client's current mental status and service needs.
163.14(5) be completed as either a standard or extended diagnostic assessment annually to
163.15determine continued eligibility for the service.
163.16(b) The evaluation of level of care must be conducted by the placing county with
163.17an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
163.18described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
163.19 approved by the commissioner of human services and not subject to the rulemaking
163.20process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
163.21evaluation demonstrates that the child requires intensive intervention without 24-hour
163.22medical monitoring. The commissioner shall update the list of approved level of care
163.23instruments tools annually and publish on the department's Web site.
163.24(c) The individual treatment plan must be:
163.25(1) based on the information in the client's diagnostic assessment;
163.26(2) developed through a child-centered, family driven planning process that identifies
163.27service needs and individualized, planned, and culturally appropriate interventions that
163.28contain specific measurable treatment goals and objectives for the client and treatment
163.29strategies for the client's family and foster family;
163.30(3) reviewed at least once every 90 days and revised; and
163.31(4) signed by the client or, if appropriate, by the client's parent or other person
163.32authorized by statute to consent to mental health services for the client.
163.33    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
163.34intensive children's mental health services in a foster family setting must be certified
163.35by the state and have a service provision contract with a county board or a reservation
164.1tribal council and must be able to demonstrate the ability to provide all of the services
164.2required in this section.
164.3(b) For purposes of this section, a provider agency must have an individual
164.4placement agreement for each recipient and must be a licensed child placing agency, under
164.5Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
164.6(1) a county county-operated entity certified by the state;
164.7(2) an Indian Health Services facility operated by a tribe or tribal organization under
164.8funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
164.9Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
164.10(3) a noncounty entity under contract with a county board.
164.11(c) Certified providers that do not meet the service delivery standards required in
164.12this section shall be subject to a decertification process.
164.13(d) For the purposes of this section, all services delivered to a client must be
164.14provided by a mental health professional or a clinical trainee.
164.15    Subd. 4. Eligible provider responsibilities Service delivery payment
164.16requirements. (a) To be an eligible provider for payment under this section, a provider
164.17must develop and practice written policies and procedures for treatment foster care services
164.18 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
164.19(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
164.20(b) In delivering services under this section, a treatment foster care provider must
164.21ensure that staff caseload size reasonably enables the provider to play an active role in
164.22service planning, monitoring, delivering, and reviewing for discharge planning to meet
164.23the needs of the client, the client's foster family, and the birth family, as specified in each
164.24client's individual treatment plan.
164.25(b) A qualified clinical supervisor, as defined in and performing in compliance with
164.26Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
164.27provision of services described in this section.
164.28(c) Each client receiving treatment services must receive an extended diagnostic
164.29assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
164.3030 days of enrollment in this service unless the client has a previous extended diagnostic
164.31assessment that the client, parent, and mental health professional agree still accurately
164.32describes the client's current mental health functioning.
164.33(d) Each previous and current mental health, school, and physical health treatment
164.34provider must be contacted to request documentation of treatment and assessments that
164.35the eligible client has received. This information must be reviewed and incorporated into
164.36the diagnostic assessment and team consultation and treatment planning review process.
165.1(e) Each client receiving treatment must be assessed for a trauma history, and
165.2the client's treatment plan must document how the results of the assessment will be
165.3incorporated into treatment.
165.4(f) Each client receiving treatment services must have an individual treatment plan
165.5that is reviewed, evaluated, and signed every 90 days using the team consultation and
165.6treatment planning process, as defined in subdivision 1a, paragraph (s).
165.7(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
165.8in accordance with the client's individual treatment plan.
165.9(h) Each client must have a crisis assistance plan within ten days of initiating
165.10services and must have access to clinical phone support 24 hours per day, seven days per
165.11week, during the course of treatment. The crisis plan must demonstrate coordination with
165.12the local or regional mobile crisis intervention team.
165.13(i) Services must be delivered and documented at least three days per week, equaling
165.14at least six hours of treatment per week, unless reduced units of service are specified on
165.15the treatment plan as part of transition or on a discharge plan to another service or level of
165.16care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
165.17(j) Location of service delivery must be in the client's home, day care setting,
165.18school, or other community-based setting that is specified on the client's individualized
165.19treatment plan.
165.20(k) Treatment must be developmentally and culturally appropriate for the client.
165.21(l) Services must be delivered in continual collaboration and consultation with the
165.22client's medical providers and, in particular, with prescribers of psychotropic medications,
165.23including those prescribed on an off-label basis. Members of the service team must be
165.24aware of the medication regimen and potential side effects.
165.25(m) Parents, siblings, foster parents, and members of the child's permanency plan
165.26must be involved in treatment and service delivery unless otherwise noted in the treatment
165.27plan.
165.28(n) Transition planning for the child must be conducted starting with the first
165.29treatment plan and must be addressed throughout treatment to support the child's
165.30permanency plan and postdischarge mental health service needs.
165.31    Subd. 5. Service authorization. The commissioner will administer authorizations
165.32for services under this section in compliance with section 256B.0625, subdivision 25.
165.33    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
165.34under this section and are not eligible for medical assistance payment as components of
165.35intensive treatment in foster care services, but may be billed separately:
166.1(1) treatment foster care services provided in violation of medical assistance policy
166.2in Minnesota Rules, part 9505.0220;
166.3(2) service components of children's therapeutic services and supports
166.4simultaneously provided by more than one treatment foster care provider;
166.5(3) home and community-based waiver services; and
166.6(4) treatment foster care services provided to a child without a level of care
166.7determination according to section 245.4885, subdivision 1.
166.8(1) inpatient psychiatric hospital treatment;
166.9(2) mental health targeted case management;
166.10(3) partial hospitalization;
166.11(4) medication management;
166.12(5) children's mental health day treatment services;
166.13(6) crisis response services under section 256B.0944; and
166.14(7) transportation.
166.15(b) Children receiving intensive treatment in foster care services are not eligible for
166.16medical assistance reimbursement for the following services while receiving intensive
166.17treatment in foster care:
166.18(1) mental health case management services under section 256B.0625, subdivision
166.1920 ; and
166.20(2) (1) psychotherapy and skill skills training components of children's therapeutic
166.21services and supports under section 256B.0625, subdivision 35b.;
166.22(2) mental health behavioral aide services as defined in section 256B.0943,
166.23subdivision 1, paragraph (m);
166.24(3) home and community-based waiver services;
166.25(4) mental health residential treatment; and
166.26(5) room and board costs as defined in section 256I.03, subdivision 6.
166.27    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
166.28establish a single daily per-client encounter rate for intensive treatment in foster care
166.29services. The rate must be constructed to cover only eligible services delivered to an
166.30eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

166.31    Sec. 27. Minnesota Statutes 2012, section 256B.49, is amended by adding a
166.32subdivision to read:
166.33    Subd. 24. Waiver allocations for transition populations. (a) The commissioner
166.34shall make available additional waiver allocations and additional necessary resources
167.1to assure timely discharges from the Anoka Metro Regional Treatment Center and the
167.2Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
167.3(1) are otherwise eligible for the brain injury, community alternatives for disabled
167.4individuals, or community alternative care waivers under this section;
167.5(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
167.6the Minnesota Security Hospital;
167.7(3) whose discharge would be significantly delayed without the available waiver
167.8allocation; and
167.9(4) who have met treatment objectives and no longer meet hospital level of care.
167.10(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
167.11requirements of the federal approved waiver plan.
167.12(c) Any corporate foster care home developed under this subdivision must be
167.13considered an exception under section 245A.03, subdivision 7, paragraph (a).
167.14EFFECTIVE DATE.This section is effective July 1, 2013.

167.15    Sec. 28. Minnesota Statutes 2012, section 256B.761, is amended to read:
167.16256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
167.17(a) Effective for services rendered on or after July 1, 2001, payment for medication
167.18management provided to psychiatric patients, outpatient mental health services, day
167.19treatment services, home-based mental health services, and family community support
167.20services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
167.2150th percentile of 1999 charges.
167.22(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
167.23services provided by an entity that operates: (1) a Medicare-certified comprehensive
167.24outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
167.251993, with at least 33 percent of the clients receiving rehabilitation services in the most
167.26recent calendar year who are medical assistance recipients, will be increased by 38 percent,
167.27when those services are provided within the comprehensive outpatient rehabilitation
167.28facility and provided to residents of nursing facilities owned by the entity.
167.29(c) The commissioner shall establish three levels of payment for mental health
167.30diagnostic assessment, based on three levels of complexity. The aggregate payment under
167.31the tiered rates must not exceed the projected aggregate payments for mental health
167.32diagnostic assessment under the previous single rate. The new rate structure is effective
167.33January 1, 2011, or upon federal approval, whichever is later.
168.1(d) In addition to rate increases otherwise provided, the commissioner may
168.2restructure coverage policy and rates to improve access to adult rehabilitative mental
168.3health services under section 256B.0623 and related mental health support services under
168.4section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
168.52016, the projected state share of increased costs due to this paragraph is transferred
168.6from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
168.7fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
168.8made to managed care plans and county-based purchasing plans under sections 256B.69,
168.9256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

168.10    Sec. 29. CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.
168.11The commissioner of human services shall, in consultation with children's mental
168.12health community providers, hospitals providing care to children, children's mental health
168.13advocates, and other interested parties, develop recommendations and legislation, if
168.14necessary, for the state-operated child and adolescent behavioral health services facility
168.15to ensure that:
168.16(1) the facility and the services provided meet the needs of children with serious
168.17emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD,
168.18serious emotional disturbance co-occurring with a developmental disability, borderline
168.19personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries,
168.20violent tendencies, and complex medical issues;
168.21(2) qualified personnel and staff can be recruited who have specific expertise and
168.22training to treat the children in the facility; and
168.23(3) the treatment provided at the facility is high-quality, effective treatment.

168.24    Sec. 30. PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND
168.25CHILDREN'S MENTAL HEALTH SERVICES.
168.26(a) To assess the efficiency and other operational issues in the management of the
168.27health care delivery system, the commissioner of human services shall initiate a provider
168.28survey. The pilot survey shall consist of an electronic survey of providers of pediatric
168.29home health care services and children's mental health services to identify and measure
168.30issues that arise in dealing with the management of medical assistance. To the maximum
168.31degree possible, existing technology shall be used and interns sought to analyze the results.
168.32(b) The survey questions must focus on seven key business functions provided
168.33by medical assistance contractors: provider inquiries; provider outreach and education;
168.34claims processing; appeals; provider enrollment; medical review; and provider audit and
169.1reimbursement. The commissioner must consider the results of the survey in evaluating
169.2and renewing managed care and fee-for-service management contracts.
169.3(c) The commissioner shall report by January 15, 2014, the results of the survey to
169.4the chairs of the health and human services policy and finance committees and shall
169.5make recommendations on the value of implementing an annual survey with a rotating
169.6list of provider groups as a component of the continuous quality improvement system for
169.7medical assistance.

169.8    Sec. 31. MENTALLY ILL AND DANGEROUS COMMITMENTS
169.9STAKEHOLDERS GROUP.
169.10(a) The commissioner of human services, in consultation with the state court
169.11administrator, shall convene a stakeholder group to develop recommendations for the
169.12legislature that address issues raised in the February 2013 Office of the Legislative
169.13Auditor report on State-Operated Services for persons committed to the commissioner as
169.14mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must
169.15include representatives from the Department of Human Services, county human services,
169.16county attorneys, commitment defense attorneys, the ombudsman for mental health and
169.17developmental disabilities, the federal protection and advocacy system, and consumers
169.18and advocates for persons with mental illnesses.
169.19(b) The stakeholder group shall provide recommendations in the following areas:
169.20(1) the role of the special review board, including the scope of authority of the
169.21special review board and the authority of the commissioner to accept or reject special
169.22review board recommendations;
169.23(2) review of special review board decisions by the district court;
169.24(3) annual district court review of commitment, scope of court authority, and
169.25appropriate review criteria;
169.26(4) options, including annual court hearing and review, as alternatives to
169.27indeterminate commitment under Minnesota Statutes, section 253B.18; and
169.28(5) extension of the right to petition the court under Minnesota Statutes,
169.29section 253B.17, to those committed under Minnesota Statutes, section 253B.18.
169.30The commissioner of human services and the state court administrator shall provide
169.31relevant data for the group's consideration in developing these recommendations,
169.32including numbers of proceedings in each category and costs associated with court and
169.33administrative proceedings under Minnesota Statutes, section 253B.18.
169.34(c) By January 15, 2014, the commissioner of human services shall submit the
169.35recommendations of the stakeholder group to the chairs and ranking minority members
170.1of the committees of the legislature with jurisdiction over civil commitment and human
170.2services issues.

170.3    Sec. 32. STATE ASSISTANCE TO COUNTIES; TRANSITIONS FOR HIGH
170.4NEEDS POPULATIONS.
170.5(a) Effective immediately, the commissioner of human services shall work with
170.6counties that request assistance to assure timely discharge from Anoka Metro Regional
170.7Treatment Center and the Minnesota Security Hospital for individuals who are ready
170.8for discharge but for whom the county may not have provider resources or appropriate
170.9placement available. Special consideration must be given to uninsured individuals who are
170.10not eligible for medical assistance and who may need continued treatment, and individuals
170.11with complex needs and other factors that hinder county efforts to place the individual in a
170.12safe, affordable setting.
170.13(b) The commissioner shall assure that, given Olmstead court directives and the
170.14role family and friends play in treatment progress, metropolitan area residents are asked
170.15whether they wished to be placed in an Intensive Residential Treatment Service program
170.16at Willmar or Cambridge or to be placed in a location more accessible to family, friends,
170.17and health providers.

170.18ARTICLE 5

170.19DEPARTMENT OF HUMAN SERVICES PROGRAM INTEGRITY

170.20    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
170.21subdivision to read:
170.22    Subd. 7b. Child care provider and recipient fraud investigations. Data related
170.23to child care fraud and recipient fraud investigations are governed by section 245E.01,
170.24subdivision 15.

170.25    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
170.26    Subd. 7. Use of data. (a) Except as otherwise provided in subdivision 7a or sections
170.27244.052 and 299C.093, the data provided under this section is private data on individuals
170.28under section 13.02, subdivision 12.
170.29(b) The data may be used only for by law enforcement and corrections agencies for
170.30 law enforcement and corrections purposes.
170.31(c) The commissioner of human services is authorized to have access to the data for:
171.1(1) state-operated services, as defined in section 246.014, are also authorized to
171.2have access to the data for the purposes described in section 246.13, subdivision 2,
171.3paragraph (b); and
171.4(2) purposes of completing background studies under chapter 245C.

171.5    Sec. 3. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision
171.6to read:
171.7    Subd. 4a. Agency background studies. (a) The commissioner shall develop and
171.8implement an electronic process for the regular transfer of new criminal case information
171.9that is added to the Minnesota court information system. The commissioner's system
171.10must include for review only information that relates to individuals who have been the
171.11subject of a background study under this chapter that remain affiliated with the agency
171.12that initiated the background study. For purposes of this paragraph, an individual remains
171.13affiliated with an agency that initiated the background study until the agency informs the
171.14commissioner that the individual is no longer affiliated. When any individual no longer
171.15affiliated according to this paragraph returns to a position requiring a background study
171.16under this chapter, the agency with whom the individual is again affiliated shall initiate
171.17a new background study regardless of the length of time the individual was no longer
171.18affiliated with the agency.
171.19(b) The commissioner shall develop and implement an online system for agencies that
171.20initiate background studies under this chapter to access and maintain records of background
171.21studies initiated by that agency. The system must show all active background study subjects
171.22affiliated with that agency and the status of each individual's background study. Each
171.23agency that initiates background studies must use this system to notify the commissioner
171.24of discontinued affiliation for purposes of the processes required under paragraph (a).

171.25    Sec. 4. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
171.26    Subdivision 1. Background studies conducted by Department of Human
171.27Services. (a) For a background study conducted by the Department of Human Services,
171.28the commissioner shall review:
171.29    (1) information related to names of substantiated perpetrators of maltreatment of
171.30vulnerable adults that has been received by the commissioner as required under section
171.31626.557, subdivision 9c , paragraph (j);
171.32    (2) the commissioner's records relating to the maltreatment of minors in licensed
171.33programs, and from findings of maltreatment of minors as indicated through the social
171.34service information system;
172.1    (3) information from juvenile courts as required in subdivision 4 for individuals
172.2listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
172.3    (4) information from the Bureau of Criminal Apprehension, including information
172.4regarding a background study subject's registration in Minnesota as a predatory offender
172.5under section 243.166;
172.6    (5) except as provided in clause (6), information from the national crime information
172.7system when the commissioner has reasonable cause as defined under section 245C.05,
172.8subdivision 5; and
172.9    (6) for a background study related to a child foster care application for licensure or
172.10adoptions, the commissioner shall also review:
172.11    (i) information from the child abuse and neglect registry for any state in which the
172.12background study subject has resided for the past five years; and
172.13    (ii) information from national crime information databases, when the background
172.14study subject is 18 years of age or older.
172.15    (b) Notwithstanding expungement by a court, the commissioner may consider
172.16information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
172.17received notice of the petition for expungement and the court order for expungement is
172.18directed specifically to the commissioner.
172.19    (c) The commissioner shall also review criminal case information received according
172.20to section 245C.04, subdivision 4a, from the Minnesota court information system that
172.21relates to individuals who have already been studied under this chapter and who remain
172.22affiliated with the agency that initiated the background study.

172.23    Sec. 5. [245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD
172.24INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM.
172.25    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in this
172.26subdivision have the meanings given them.
172.27(b) "Applicant" has the meaning given in section 119B.011, subdivision 2.
172.28(c) "Child care assistance program" means any of the assistance programs under
172.29chapter 119B.
172.30(d) "Commissioner" means the commissioner of human services.
172.31(e) "Controlling individual" has the meaning given in section 245A.02, subdivision
172.325a.
172.33(f) "County" means a local county child care assistance program staff or
172.34subcontracted staff, or a county investigator acting on behalf of the commissioner.
172.35(g) "Department" means the Department of Human Services.
173.1(h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or
173.2omissions that result in fraud and abuse or error against the Department of Human Services.
173.3(i) "Identify" means to furnish the full name, current or last known address, phone
173.4number, and e-mail address of the individual or business entity.
173.5(j) "License holder" has the meaning given in section 245A.02, subdivision 9.
173.6(k) "Mail" means the use of any mail service with proof of delivery and receipt.
173.7(l) "Provider" means either a provider as defined in section 119B.011, subdivision
173.819, or a legal unlicensed provider as defined in section 119B.011, subdivision 16.
173.9(m) "Recipient" means a family receiving assistance as defined under section
173.10119B.011, subdivision 13.
173.11(n) "Terminate" means revocation of participation in the child care assistance
173.12program.
173.13    Subd. 2. Investigating provider or recipient financial misconduct. The
173.14department shall investigate alleged or suspected financial misconduct by providers and
173.15errors related to payments issued by the child care assistance program under this chapter.
173.16Recipients, employees, and staff may be investigated when the evidence shows that their
173.17conduct is related to the financial misconduct of a provider, license holder, or controlling
173.18individual.
173.19    Subd. 3. Scope of investigations. (a) The department may contact any person,
173.20agency, organization, or other entity that is necessary to an investigation.
173.21(b) The department may examine or interview any individual, document, or piece of
173.22evidence that may lead to information that is relevant to child care assistance program
173.23benefits, payments, and child care provider authorizations. This includes, but is not
173.24limited to:
173.25(1) child care assistance program payments;
173.26(2) services provided by the program or related to child care assistance program
173.27recipients;
173.28(3) services provided to a provider;
173.29(4) provider financial records of any type;
173.30(5) daily attendance records of the children receiving services from the provider;
173.31(6) billings; and
173.32(7) verification of the credentials of a license holder, controlling individual,
173.33employee, staff person, contractor, subcontractor, and entities under contract with the
173.34provider to provide services or maintain service and the provider's financial records
173.35related to those services.
174.1    Subd. 4. Determination of investigation. After completing its investigation, the
174.2department shall issue one of the following determinations:
174.3(1) no violation of child care assistance requirements occurred;
174.4(2) there is insufficient evidence to show that a violation of child care assistance
174.5requirements occurred;
174.6(3) a preponderance of evidence shows a violation of child care assistance program
174.7law, rule, or policy; or
174.8(4) there exists a credible allegation of fraud.
174.9    Subd. 5. Actions or administrative sanctions. (a) After completing the
174.10determination under subdivision 4, the department may take one or more of the actions
174.11or sanctions specified in this subdivision.
174.12(b) The department may take the following actions:
174.13(1) refer the investigation to law enforcement or a county attorney for possible
174.14criminal prosecution;
174.15(2) refer relevant information to the department's licensing division, the child care
174.16assistance program, the Department of Education, the federal child and adult care food
174.17program, or appropriate child or adult protection agency;
174.18(3) enter into a settlement agreement with a provider, license holder, controlling
174.19individual, or recipient; or
174.20(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction
174.21for possible civil action under the Minnesota False Claims Act, chapter 15C.
174.22(c) In addition to section 256.98, the department may impose sanctions by:
174.23(1) pursuing administrative disqualification through hearings or waivers;
174.24(2) establishing and seeking monetary recovery or recoupment; or
174.25(3) issuing an order of corrective action that states the practices that are violations of
174.26child care assistance program policies, laws, or regulations, and that they must be corrected.
174.27    Subd. 6. Duty to provide access. (a) A provider, license holder, controlling
174.28individual, employee, staff person, or recipient has an affirmative duty to provide access
174.29upon request to information specified under subdivision 8 or the program facility.
174.30(b) Failure to provide access may result in denial or termination of authorizations for
174.31or payments to a recipient, provider, license holder, or controlling individual in the child
174.32care assistance program.
174.33(c) When a provider fails to provide access, a 15-day notice of denial or termination
174.34must be issued to the provider, which prohibits the provider from participating in the child
174.35care assistance program. Notice must be sent to recipients whose children are under the
174.36provider's care pursuant to Minnesota Rules, part 3400.0185.
175.1(d) If the provider continues to fail to provide access at the expiration of the 15-day
175.2notice period, child care assistance program payments to the provider must be denied
175.3beginning the 16th day following notice of the initial failure or refusal to provide access.
175.4The department may rescind the denial based upon good cause if the provider submits in
175.5writing a good cause basis for having failed or refused to provide access. The writing must
175.6be postmarked no later than the 15th day following the provider's notice of initial failure
175.7to provide access. Additionally, the provider, license holder, or controlling individual
175.8must immediately provide complete, ongoing access to the department. Repeated failures
175.9to provide access must, after the initial failure or for any subsequent failure, result in
175.10termination from participation in the child care assistance program.
175.11(e) The department, at its own expense, may photocopy or otherwise duplicate
175.12records referenced in subdivision 8. Photocopying must be done on the provider's
175.13premises on the day of the request or other mutually agreeable time, unless removal of
175.14records is specifically permitted by the provider. If requested, a provider, license holder,
175.15or controlling individual, or a designee, must assist the investigator in duplicating any
175.16record, including a hard copy or electronically stored data, on the day of the request.
175.17(f) A provider, license holder, controlling individual, employee, or staff person must
175.18grant the department access during the department's normal business hours, and any hours
175.19that the program is operated, to examine the provider's program or the records listed in
175.20subdivision 8. A provider shall make records available at the provider's place of business
175.21on the day for which access is requested, unless the provider and the department both agree
175.22otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday
175.23through Friday, excluding state holidays as defined in section 645.44, subdivision 5.
175.24    Subd. 7. Honest and truthful statements. It shall be unlawful for a provider,
175.25license holder, controlling individual, or recipient to:
175.26(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact;
175.27(2) make any materially false, fictitious, or fraudulent statement or representation; or
175.28(3) make or use any false writing or document knowing the same to contain any
175.29materially false, fictitious, or fraudulent statement or entry related to any child care
175.30assistance program services that the provider, license holder, or controlling individual
175.31supplies or in relation to any child care assistance payments received by a provider, license
175.32holder, or controlling individual or to any fraud investigator or law enforcement officer
175.33conducting a financial misconduct investigation.
175.34    Subd. 8. Record retention. (a) The following records must be maintained,
175.35controlled, and made immediately accessible to license holders, providers, and controlling
175.36individuals. The records must be organized and labeled to correspond to categories that
176.1make them easy to identify so that they can be made available immediately upon request
176.2to an investigator acting on behalf of the commissioner at the provider's place of business:
176.3(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting
176.4records;
176.5(2) daily attendance records required by and that comply with section 119B.125,
176.6subdivision 6;
176.7(3) billing transmittal forms requesting payments from the child care assistance
176.8program and billing adjustments related to child care assistance program payments;
176.9(4) records identifying all persons, corporations, partnerships, and entities with an
176.10ownership or controlling interest in the provider's child care business;
176.11(5) employee records identifying those persons currently employed by the provider's
176.12child care business or who have been employed by the business at any time within the
176.13previous five years. The records must include each employee's name, hourly and annual
176.14salary, qualifications, position description, job title, and dates of employment. In addition,
176.15employee records that must be made available include the employee's time sheets, current
176.16home address of the employee or last known address of any former employee, and
176.17documentation of background studies required under chapter 119B or 245C;
176.18(6) records related to transportation of children in care, including but not limited to:
176.19(i) the dates and times that transportation is provided to children for transportation to
176.20and from the provider's business location for any purpose. For transportation related to
176.21field trips or locations away from the provider's business location, the names and addresses
176.22of those field trips and locations must also be provided;
176.23(ii) the name, business address, phone number, and Web site address, if any, of the
176.24transportation service utilized; and
176.25(iii) all billing or transportation records related to the transportation.
176.26(b) A provider, license holder, or controlling individual must retain all records in
176.27paragraph (a) for at least six years after the last date of service. Microfilm or electronically
176.28stored records satisfy the record keeping requirements of this subdivision.
176.29(c) A provider, license holder, or controlling individual who withdraws or is
176.30terminated from the child care assistance program must retain the records required under
176.31this subdivision and make them available to the department on demand.
176.32(d) If the ownership of a provider changes, the transferor, unless otherwise provided
176.33by law or by written agreement with the transferee, is responsible for maintaining,
176.34preserving, and upon request from the department, making available the records related to
176.35the provider that were generated before the date of the transfer. Any written agreement
176.36affecting this provision must be held in the possession of the transferor and transferee.
177.1The written agreement must be provided to the department or county immediately upon
177.2request, and the written agreement must be retained by the transferor and transferee for six
177.3years after the agreement is fully executed.
177.4(e) In the event of an appealed case, the provider must retain all records required in
177.5this subdivision for the duration of the appeal or six years, whichever is longer.
177.6(f) A provider's use of electronic record keeping or electronic signatures is governed
177.7by chapter 325L.
177.8    Subd. 9. Factors regarding imposition of administrative sanctions. (a) The
177.9department shall consider the following factors in determining the administrative sanctions
177.10to be imposed:
177.11(1) nature and extent of financial misconduct;
177.12(2) history of financial misconduct;
177.13(3) actions taken or recommended by other state agencies, other divisions of the
177.14department, and court and administrative decisions;
177.15(4) prior imposition of sanctions;
177.16(5) size and type of provider;
177.17(6) information obtained through an investigation from any source;
177.18(7) convictions or pending criminal charges; and
177.19(8) any other information relevant to the acts or omissions related to the financial
177.20misconduct.
177.21(b) Any single factor under paragraph (a) may be determinative of the department's
177.22decision of whether and what sanctions are imposed.
177.23    Subd. 10. Written notice of department sanction. (a) The department shall give
177.24notice in writing to a person of an administrative sanction that is to be imposed. The notice
177.25shall be sent by mail as defined in subdivision 1, paragraph (k).
177.26(b) The notice shall state:
177.27(1) the factual basis for the department's determination;
177.28(2) the sanction the department intends to take;
177.29(3) the dollar amount of the monetary recovery or recoupment, if any;
177.30(4) how the dollar amount was computed;
177.31(5) the right to dispute the department's determination and to provide evidence;
177.32(6) the right to appeal the department's proposed sanction; and
177.33(7) the option to meet informally with department staff, and to bring additional
177.34documentation or information, to resolve the issues.
177.35(c) In cases of determinations resulting in denial or termination of payments, in
177.36addition to the requirements of paragraph (b), the notice must state:
178.1(1) the length of the denial or termination;
178.2(2) the requirements and procedures for reinstatement; and
178.3(3) the provider's right to submit documents and written arguments against the
178.4denial or termination of payments for review by the department before the effective date
178.5of denial or termination.
178.6(d) The submission of documents and written argument for review by the department
178.7under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the
178.8deadline for filing an appeal.
178.9(e) Unless timely appealed, the effective date of the proposed sanction shall be 30
178.10days after the license holder's, provider's, controlling individual's, or recipient's receipt of
178.11the notice. If a timely appeal is made, the proposed sanction shall be delayed pending
178.12the final outcome of the appeal. Implementation of a proposed sanction following the
178.13resolution of a timely appeal may be postponed if, in the opinion of the department, the
178.14delay of sanction is necessary to protect the health or safety of children in care. The
178.15department may consider the economic hardship of a person in implementing the proposed
178.16sanction, but economic hardship shall not be a determinative factor in implementing the
178.17proposed sanction.
178.18(f) Requests for an informal meeting to attempt to resolve issues and requests
178.19for appeals must be sent or delivered to the department's Office of Inspector General,
178.20Financial Fraud and Abuse Division.
178.21    Subd. 11. Appeal of department sanction under this section. (a) If the department
178.22does not pursue a criminal action against a provider, license holder, controlling individual,
178.23or recipient for financial misconduct, but the department imposes an administrative
178.24sanction under subdivision 5, paragraph (c), any individual or entity against whom the
178.25sanction was imposed may appeal the department's administrative sanction under this
178.26section pursuant to section 119B.16 or 256.045 with the additional requirements in clauses
178.27(1) to (4). An appeal must specify:
178.28(1) each disputed item, the reason for the dispute, and an estimate of the dollar
178.29amount involved for each disputed item, if appropriate;
178.30(2) the computation that is believed to be correct, if appropriate;
178.31(3) the authority in the statute or rule relied upon for each disputed item; and
178.32(4) the name, address, and phone number of the person at the provider's place of
178.33business with whom contact may be made regarding the appeal.
178.34(b) An appeal is considered timely only if postmarked or received by the department's
178.35Appeals Division within 30 days after receiving a notice of department sanction.
179.1(c) Before the appeal hearing, the department may deny or terminate authorizations
179.2or payment to the entity or individual if the department determines that the action is
179.3necessary to protect the public welfare or the interests of the child care assistance program.
179.4    Subd. 12. Consolidated hearings with licensing sanction. If a financial
179.5misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing
179.6sanction exists for which there is an appeal hearing right and the sanction is timely
179.7appealed, and the overpayment recovery action and licensing sanction involve the same
179.8set of facts, the overpayment recovery action and licensing sanction must be consolidated
179.9in the contested case hearing related to the licensing sanction.
179.10    Subd. 13. Grounds for and methods of monetary recovery. (a) The department
179.11may obtain monetary recovery from a provider who has been improperly paid by the
179.12child care assistance program, regardless of whether the error was intentional or county
179.13error. The department does not need to establish a pattern as a precondition of monetary
179.14recovery of erroneous or false billing claims, duplicate billing claims, or billing claims
179.15based on false statements or financial misconduct.
179.16(b) The department shall obtain monetary recovery from providers by the following
179.17means:
179.18(1) permitting voluntary repayment of money, either in lump-sum payment or
179.19installment payments;
179.20(2) using any legal collection process;
179.21(3) deducting or withholding program payments; or
179.22(4) utilizing the means set forth in chapter 16D.
179.23    Subd. 14. Reporting of suspected fraudulent activity. (a) A person who, in
179.24good faith, makes a report of or testifies in any action or proceeding in which financial
179.25misconduct is alleged, and who is not involved in, has not participated in, or has not aided
179.26and abetted, conspired, or colluded in the financial misconduct, shall have immunity from
179.27any liability, civil or criminal, that results by reason of the person's report or testimony.
179.28For the purpose of any proceeding, the good faith of any person reporting or testifying
179.29under this provision shall be presumed.
179.30(b) If a person that is or has been involved in, participated in, aided and abetted,
179.31conspired, or colluded in the financial misconduct reports the financial misconduct,
179.32the department may consider that person's report and assistance in investigating the
179.33misconduct as a mitigating factor in the department's pursuit of civil, criminal, or
179.34administrative remedies.
180.1    Subd. 15. Data privacy. Data of any kind obtained or created in relation to a provider
180.2or recipient investigation under this section is defined, classified, and protected the same as
180.3all other data under section 13.46, and this data has the same classification as licensing data.
180.4    Subd. 16. Monetary recovery; random sample extrapolation. The department is
180.5authorized to calculate the amount of monetary recovery from a provider, license holder, or
180.6controlling individual based upon extrapolation from a statistical random sample of claims
180.7submitted by the provider, license holder, or controlling individual and paid by the child
180.8care assistance program. The department's random sample extrapolation shall constitute a
180.9rebuttable presumption of the accuracy of the calculation of monetary recovery. If the
180.10presumption is not rebutted by the provider, license holder, or controlling individual in the
180.11appeal process, the department shall use the extrapolation as the monetary recovery figure.
180.12The department may use sampling and extrapolation to calculate the amount of monetary
180.13recovery if the claims to be reviewed represent services to 50 or more children in care.
180.14    Subd. 17. Effect of department's monetary penalty determination. Unless a
180.15timely and proper appeal is received by the department, the department's administrative
180.16determination or sanction shall be considered a final department determination.
180.17    Subd. 18. Office of Inspector General recoveries. Overpayment recoveries
180.18resulting from child care provider fraud investigations initiated by the department's Office
180.19of Inspector General's fraud investigations staff are excluded from the county recovery
180.20provision in section 119B.11, subdivision 3.

180.21    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
180.22    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
180.23Medicare and Medicaid Services determines that a provider is designated "high-risk," the
180.24commissioner may withhold payment from providers within that category upon initial
180.25enrollment for a 90-day period. The withholding for each provider must begin on the date
180.26of the first submission of a claim.
180.27(b) An enrolled provider that is also licensed by the commissioner under chapter
180.28245A must designate an individual as the entity's compliance officer. The compliance
180.29officer must:
180.30(1) develop policies and procedures to assure adherence to medical assistance laws
180.31and regulations and to prevent inappropriate claims submissions;
180.32(2) train the employees of the provider entity, and any agents or subcontractors of
180.33the provider entity including billers, on the policies and procedures under clause (1);
180.34(3) respond to allegations of improper conduct related to the provision or billing of
180.35medical assistance services, and implement action to remediate any resulting problems;
181.1(4) use evaluation techniques to monitor compliance with medical assistance laws
181.2and regulations;
181.3(5) promptly report to the commissioner any identified violations of medical
181.4assistance laws or regulations; and
181.5    (6) within 60 days of discovery by the provider of a medical assistance
181.6reimbursement overpayment, report the overpayment to the commissioner and make
181.7arrangements with the commissioner for the commissioner's recovery of the overpayment.
181.8The commissioner may require, as a condition of enrollment in medical assistance, that a
181.9provider within a particular industry sector or category establish a compliance program that
181.10contains the core elements established by the Centers for Medicare and Medicaid Services.
181.11(c) The commissioner may revoke the enrollment of an ordering or rendering
181.12provider for a period of not more than one year, if the provider fails to maintain and, upon
181.13request from the commissioner, provide access to documentation relating to written orders
181.14or requests for payment for durable medical equipment, certifications for home health
181.15services, or referrals for other items or services written or ordered by such provider, when
181.16the commissioner has identified a pattern of a lack of documentation. A pattern means a
181.17failure to maintain documentation or provide access to documentation on more than one
181.18occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a
181.19provider under the provisions of section 256B.064.
181.20(d) The commissioner shall terminate or deny the enrollment of any individual or
181.21entity if the individual or entity has been terminated from participation in Medicare or
181.22under the Medicaid program or Children's Health Insurance Program of any other state.
181.23(e) As a condition of enrollment in medical assistance, the commissioner shall
181.24require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
181.25and Medicaid Services or the Minnesota Department of Human Services commissioner
181.26 permit the Centers for Medicare and Medicaid Services, its agents, or its designated
181.27contractors and the state agency, its agents, or its designated contractors to conduct
181.28unannounced on-site inspections of any provider location. The commissioner shall publish
181.29in the Minnesota Health Care Program Provider Manual a list of provider types designated
181.30"limited," "moderate," or "high-risk," based on the criteria and standards used to designate
181.31Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and
181.32criteria are not subject to the requirements of chapter 14. The commissioner's designations
181.33are not subject to administrative appeal.
181.34(f) As a condition of enrollment in medical assistance, the commissioner shall
181.35require that a high-risk provider, or a person with a direct or indirect ownership interest in
181.36the provider of five percent or higher, consent to criminal background checks, including
182.1fingerprinting, when required to do so under state law or by a determination by the
182.2commissioner or the Centers for Medicare and Medicaid Services that a provider is
182.3designated high-risk for fraud, waste, or abuse.
182.4(g)(1) Upon initial enrollment, reenrollment, and revalidation, all durable medical
182.5equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers operating in
182.6Minnesota and receiving Medicaid funds, must purchase a surety bond that is annually
182.7renewed and designates the Minnesota Department of Human Services as the obligee, and
182.8must be submitted in a form approved by the commissioner.
182.9(2) At the time of initial enrollment or reenrollment, the provider agency must
182.10purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue
182.11in the previous calendar year is up to and including $300,000, the provider agency must
182.12purchase a performance bond of $50,000. If a revalidating provider's Medicaid revenue
182.13in the previous calendar year is over $300,000, the provider agency must purchase a
182.14performance bond of $100,000. The performance bond must allow for recovery of costs
182.15and fees in pursuing a claim on the bond.
182.16(h) The Department of Human Services may require a provider to purchase a
182.17performance surety bond as a condition of initial enrollment, reenrollment, reinstatement,
182.18or continued enrollment if: (1) the provider fails to demonstrate financial viability, (2) the
182.19department determines there is significant evidence of or potential for fraud and abuse by
182.20the provider, or (3) the provider or category of providers is designated high-risk pursuant
182.21to paragraph (a) and as per Code of Federal Regulations, title 42, section 455.450. The
182.22performance bond must be in an amount of $100,000 or ten percent of the provider's
182.23payments from Medicaid during the immediately preceding 12 months, whichever is
182.24greater. The performance bond must name the Department of Human Services as an
182.25obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.
182.26EFFECTIVE DATE.This section is effective the day following final enactment.

182.27    Sec. 7. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
182.28to read:
182.29    Subd. 22. Application fee. (a) The commissioner must collect and retain federally
182.30required nonrefundable application fees to pay for provider screening activities in
182.31accordance with Code of Federal Regulations, title 42, section 455, subpart E. The
182.32enrollment application must be made under the procedures specified by the commissioner,
182.33in the form specified by the commissioner, and accompanied by an application fee
182.34described in paragraph (b), or a request for a hardship exception as described in the
182.35specified procedures. Application fees must be deposited in the provider screening account
183.1in the special revenue fund. Amounts in the provider screening account are appropriated
183.2to the commissioner for costs associated with the provider screening activities required
183.3in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner
183.4shall conduct screening activities as required by Code of Federal Regulations, title 42,
183.5section 455, subpart E, and as otherwise provided by law, to include database checks,
183.6unannounced pre- and postenrollment site visits, fingerprinting, and criminal background
183.7studies. The commissioner must revalidate all providers under this subdivision at least
183.8once every five years.
183.9(b) The application fee under this subdivision is $532 for the calendar year 2013.
183.10For calendar year 2014 and subsequent years, the fee:
183.11(1) is adjusted by the percentage change to the consumer price index for all urban
183.12consumers, United States city average, for the 12-month period ending with June of the
183.13previous year. The resulting fee must be announced in the Federal Register;
183.14(2) is effective from January 1 to December 31 of a calendar year;
183.15(3) is required on the submission of an initial application, an application to establish
183.16a new practice location, an application for re-enrollment when the provider is not enrolled
183.17at the time of application of re-enrollment, or at revalidation when required by federal
183.18regulation; and
183.19(4) must be in the amount in effect for the calendar year during which the application
183.20for enrollment, new practice location, or re-enrollment is being submitted.
183.21(c) The application fee under this subdivision cannot be charged to:
183.22(1) providers who are enrolled in Medicare or who provide documentation of
183.23payment of the fee to, and enrollment with, another state, unless the commissioner is
183.24required to rescreen the provider;
183.25(2) providers who are enrolled but are required to submit new applications for
183.26purposes of reenrollment;
183.27(3) a provider who enrolls as an individual; and
183.28(4) group practices and clinics that bill on behalf of individually enrolled providers
183.29within the practice who have reassigned their billing privileges to the group practice
183.30or clinic.
183.31EFFECTIVE DATE.This section is effective the day following final enactment.

183.32    Sec. 8. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
183.33    Subd. 1a. Grounds for sanctions against vendors. The commissioner may
183.34impose sanctions against a vendor of medical care for any of the following: (1) fraud,
183.35theft, or abuse in connection with the provision of medical care to recipients of public
184.1assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
184.2not medically necessary; (3) a pattern of making false statements of material facts for
184.3the purpose of obtaining greater compensation than that to which the vendor is legally
184.4entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
184.5agency access during regular business hours to examine all records necessary to disclose
184.6the extent of services provided to program recipients and appropriateness of claims for
184.7payment; (6) failure to repay an overpayment or a fine finally established under this
184.8section; and (7) failure to correct errors in the maintenance of health service or financial
184.9records for which a fine was imposed or after issuance of a warning by the commissioner;
184.10and (8) any reason for which a vendor could be excluded from participation in the
184.11Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
184.12The determination of services not medically necessary may be made by the commissioner
184.13in consultation with a peer advisory task force appointed by the commissioner on the
184.14recommendation of appropriate professional organizations. The task force expires as
184.15provided in section 15.059, subdivision 5.

184.16    Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
184.17    Subd. 1b. Sanctions available. The commissioner may impose the following
184.18sanctions for the conduct described in subdivision 1a: suspension or withholding of
184.19payments to a vendor and suspending or terminating participation in the program, or
184.20imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
184.21this section, the commissioner shall consider the nature, chronicity, or severity of the
184.22conduct and the effect of the conduct on the health and safety of persons served by the
184.23vendor. Regardless of imposition of sanctions, the commissioner may make a referral
184.24to the appropriate state licensing board.

184.25    Sec. 10. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
184.26    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
184.27shall determine any monetary amounts to be recovered and sanctions to be imposed upon
184.28a vendor of medical care under this section. Except as provided in paragraphs (b) and
184.29(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
184.30without prior notice and an opportunity for a hearing, according to chapter 14, on the
184.31commissioner's proposed action, provided that the commissioner may suspend or reduce
184.32payment to a vendor of medical care, except a nursing home or convalescent care facility,
184.33after notice and prior to the hearing if in the commissioner's opinion that action is
184.34necessary to protect the public welfare and the interests of the program.
185.1(b) Except when the commissioner finds good cause not to suspend payments under
185.2Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
185.3withhold or reduce payments to a vendor of medical care without providing advance
185.4notice of such withholding or reduction if either of the following occurs:
185.5(1) the vendor is convicted of a crime involving the conduct described in subdivision
185.61a; or
185.7(2) the commissioner determines there is a credible allegation of fraud for which an
185.8investigation is pending under the program. A credible allegation of fraud is an allegation
185.9which has been verified by the state, from any source, including but not limited to:
185.10(i) fraud hotline complaints;
185.11(ii) claims data mining; and
185.12(iii) patterns identified through provider audits, civil false claims cases, and law
185.13enforcement investigations.
185.14Allegations are considered to be credible when they have an indicia of reliability
185.15and the state agency has reviewed all allegations, facts, and evidence carefully and acts
185.16judiciously on a case-by-case basis.
185.17(c) The commissioner must send notice of the withholding or reduction of payments
185.18under paragraph (b) within five days of taking such action unless requested in writing by a
185.19law enforcement agency to temporarily withhold the notice. The notice must:
185.20(1) state that payments are being withheld according to paragraph (b);
185.21(2) set forth the general allegations as to the nature of the withholding action, but
185.22need not disclose any specific information concerning an ongoing investigation;
185.23(3) except in the case of a conviction for conduct described in subdivision 1a, state
185.24that the withholding is for a temporary period and cite the circumstances under which
185.25withholding will be terminated;
185.26(4) identify the types of claims to which the withholding applies; and
185.27(5) inform the vendor of the right to submit written evidence for consideration by
185.28the commissioner.
185.29The withholding or reduction of payments will not continue after the commissioner
185.30determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
185.31relating to the alleged fraud are completed, unless the commissioner has sent notice of
185.32intention to impose monetary recovery or sanctions under paragraph (a).
185.33(d) The commissioner shall suspend or terminate a vendor's participation in the
185.34program without providing advance notice and an opportunity for a hearing when the
185.35suspension or termination is required because of the vendor's exclusion from participation
186.1in Medicare. Within five days of taking such action, the commissioner must send notice of
186.2the suspension or termination. The notice must:
186.3(1) state that suspension or termination is the result of the vendor's exclusion from
186.4Medicare;
186.5(2) identify the effective date of the suspension or termination; and
186.6(3) inform the vendor of the need to be reinstated to Medicare before reapplying
186.7for participation in the program.
186.8(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
186.9sanction is to be imposed, a vendor may request a contested case, as defined in section
186.1014.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
186.11appeal request must be received by the commissioner no later than 30 days after the date
186.12the notification of monetary recovery or sanction was mailed to the vendor. The appeal
186.13request must specify:
186.14(1) each disputed item, the reason for the dispute, and an estimate of the dollar
186.15amount involved for each disputed item;
186.16(2) the computation that the vendor believes is correct;
186.17(3) the authority in statute or rule upon which the vendor relies for each disputed item;
186.18(4) the name and address of the person or entity with whom contacts may be made
186.19regarding the appeal; and
186.20(5) other information required by the commissioner.
186.21(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
186.22services according to standards in this chapter and Minnesota Rules, chapter 9505. The
186.23commissioner may assess fines if specific required components of documentation are
186.24missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
186.25on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less.
186.26(g) The vendor shall pay the fine assessed on or before the payment date specified. If
186.27the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
186.28recover the amount of the fine. A timely appeal shall stay payment of the fine until the
186.29commissioner issues a final order.

186.30    Sec. 11. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to
186.31read:
186.32    Subd. 21. Requirements for initial provider enrollment of personal care
186.33assistance provider agencies. (a) All personal care assistance provider agencies must
186.34provide, at the time of enrollment, reenrollment, and revalidation as a personal care
187.1assistance provider agency in a format determined by the commissioner, information and
187.2documentation that includes, but is not limited to, the following:
187.3    (1) the personal care assistance provider agency's current contact information
187.4including address, telephone number, and e-mail address;
187.5    (2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
187.6provider's payments from Medicaid in the previous year, whichever is less;
187.7    (2) proof of surety bond coverage. Upon new enrollment, or if the provider's
187.8Medicaid revenue in the previous calendar year is up to and including $300,000,
187.9the provider agency must purchase a performance bond of $50,000. If the Medicaid
187.10revenue in the previous year is over $300,000, the provider agency must purchase a
187.11performance bond of $100,000. The performance bond must be in a form approved by the
187.12commissioner, must be renewed annually, and must allow for recovery of costs and fees
187.13in pursuing a claim on the bond;
187.14    (3) proof of fidelity bond coverage in the amount of $20,000;
187.15    (4) proof of workers' compensation insurance coverage;
187.16    (5) proof of liability insurance;
187.17    (6) a description of the personal care assistance provider agency's organization
187.18identifying the names of all owners, managing employees, staff, board of directors, and
187.19the affiliations of the directors, owners, or staff to other service providers;
187.20    (7) a copy of the personal care assistance provider agency's written policies and
187.21procedures including: hiring of employees; training requirements; service delivery;
187.22and employee and consumer safety including process for notification and resolution
187.23of consumer grievances, identification and prevention of communicable diseases, and
187.24employee misconduct;
187.25    (8) copies of all other forms the personal care assistance provider agency uses in
187.26the course of daily business including, but not limited to:
187.27    (i) a copy of the personal care assistance provider agency's time sheet if the time
187.28sheet varies from the standard time sheet for personal care assistance services approved
187.29by the commissioner, and a letter requesting approval of the personal care assistance
187.30provider agency's nonstandard time sheet;
187.31    (ii) the personal care assistance provider agency's template for the personal care
187.32assistance care plan; and
187.33    (iii) the personal care assistance provider agency's template for the written
187.34agreement in subdivision 20 for recipients using the personal care assistance choice
187.35option, if applicable;
188.1    (9) a list of all training and classes that the personal care assistance provider agency
188.2requires of its staff providing personal care assistance services;
188.3    (10) documentation that the personal care assistance provider agency and staff have
188.4successfully completed all the training required by this section;
188.5    (11) documentation of the agency's marketing practices;
188.6    (12) disclosure of ownership, leasing, or management of all residential properties
188.7that is used or could be used for providing home care services;
188.8    (13) documentation that the agency will use the following percentages of revenue
188.9generated from the medical assistance rate paid for personal care assistance services
188.10for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
188.11personal care assistance choice option and 72.5 percent of revenue from other personal
188.12care assistance providers. The revenue generated by the qualified professional and the
188.13reasonable costs associated with the qualified professional shall not be used in making
188.14this calculation; and
188.15    (14) effective May 15, 2010, documentation that the agency does not burden
188.16recipients' free exercise of their right to choose service providers by requiring personal
188.17care assistants to sign an agreement not to work with any particular personal care
188.18assistance recipient or for another personal care assistance provider agency after leaving
188.19the agency and that the agency is not taking action on any such agreements or requirements
188.20regardless of the date signed.
188.21    (b) Personal care assistance provider agencies shall provide the information specified
188.22in paragraph (a) to the commissioner at the time the personal care assistance provider
188.23agency enrolls as a vendor or upon request from the commissioner. The commissioner
188.24shall collect the information specified in paragraph (a) from all personal care assistance
188.25providers beginning July 1, 2009.
188.26    (c) All personal care assistance provider agencies shall require all employees in
188.27management and supervisory positions and owners of the agency who are active in the
188.28day-to-day management and operations of the agency to complete mandatory training
188.29as determined by the commissioner before enrollment of the agency as a provider.
188.30Employees in management and supervisory positions and owners who are active in
188.31the day-to-day operations of an agency who have completed the required training as
188.32an employee with a personal care assistance provider agency do not need to repeat
188.33the required training if they are hired by another agency, if they have completed the
188.34training within the past three years. By September 1, 2010, the required training must
188.35be available with meaningful access according to title VI of the Civil Rights Act and
188.36federal regulations adopted under that law or any guidance from the United States Health
189.1and Human Services Department. The required training must be available online or by
189.2electronic remote connection. The required training must provide for competency testing.
189.3Personal care assistance provider agency billing staff shall complete training about
189.4personal care assistance program financial management. This training is effective July 1,
189.52009. Any personal care assistance provider agency enrolled before that date shall, if it
189.6has not already, complete the provider training within 18 months of July 1, 2009. Any new
189.7owners or employees in management and supervisory positions involved in the day-to-day
189.8operations are required to complete mandatory training as a requisite of working for the
189.9agency. Personal care assistance provider agencies certified for participation in Medicare
189.10as home health agencies are exempt from the training required in this subdivision. When
189.11available, Medicare-certified home health agency owners, supervisors, or managers must
189.12successfully complete the competency test.
189.13EFFECTIVE DATE.This section is effective the day following final enactment.

189.14    Sec. 12. Minnesota Statutes 2012, section 299C.093, is amended to read:
189.15299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.
189.16The superintendent of the Bureau of Criminal Apprehension shall maintain a
189.17computerized data system relating to individuals required to register as predatory offenders
189.18under section 243.166. To the degree feasible, the system must include the data required
189.19to be provided under section 243.166, subdivisions 4 and 4a, and indicate the time period
189.20that the person is required to register. The superintendent shall maintain this data in a
189.21manner that ensures that it is readily available to law enforcement agencies. This data is
189.22private data on individuals under section 13.02, subdivision 12, but may be used for law
189.23enforcement and corrections purposes. The commissioner of human services has access
189.24to the data for state-operated services, as defined in section 246.014, are also authorized
189.25to have access to the data for the purposes described in section 246.13, subdivision 2,
189.26paragraph (b), and for purposes of conducting background studies under chapter 245C.

189.27    Sec. 13. Minnesota Statutes 2012, section 402A.10, is amended to read:
189.28402A.10 DEFINITIONS.
189.29    Subdivision 1. Terms defined. For the purposes of this chapter, the terms defined
189.30in this section have the meanings given.
189.31    Subd. 1a. Balanced set of program measures. A "balanced set of program
189.32measures" is a set of measures that, together, adequately quantify achievement toward a
189.33particular program's outcome. As directed by section 402A.16, the Human Services
190.1Performance Council must recommend to the commissioner when a particular program
190.2has a balanced set of program measures.
190.3    Subd. 2. Commissioner. "Commissioner" means the commissioner of human
190.4services.
190.5    Subd. 3. Council. "Council" means the State-County Results, Accountability, and
190.6Service Delivery Redesign Council established in section 402A.20.
190.7    Subd. 4. Essential human services or essential services. "Essential human
190.8services" or "essential services" means assistance and services to recipients or potential
190.9recipients of public welfare and other services delivered by counties or tribes that are
190.10mandated in federal and state law that are to be available in all counties of the state.
190.11    Subd. 4a. Essential human services program. An "essential human services
190.12program" for the purposes of remedies under section 402A.18 means the following
190.13programs:
190.14(1) child welfare, including protection, truancy, minor parent, guardianship, and
190.15adoption;
190.16(2) children's mental health;
190.17(3) children's disability services;
190.18(4) public assistance eligibility, including measures related to processing timelines
190.19across information services programs;
190.20(5) MFIP;
190.21(6) child support;
190.22(7) chemical dependency;
190.23(8) adult disability;
190.24(9) adult mental health;
190.25(10) adult services such as long-term care; and
190.26(11) adult protection.
190.27    Subd. 4b. Measure. A "measure" means a quantitative indicator of a performance
190.28outcome.
190.29    Subd. 4c. Performance improvement plan. A "performance improvement plan"
190.30means a plan developed by a county or service delivery authority that describes steps the
190.31county or service delivery authority must take to improve performance on a specific
190.32measure or set of measures. The performance improvement plan must be negotiated
190.33with and approved by the commissioner. The performance improvement plan must
190.34require a specific numerical improvement in the measure or measures on which the plan
190.35is based and may include specific programmatic best practices or specific performance
190.36management practices that the county must implement.
191.1    Subd. 4d. Performance management system for human services. A "performance
191.2management system for human services" means a process by which performance data for
191.3essential human services is collected from counties or service delivery authorities and used
191.4to inform a variety of stakeholders and to improve performance over time.
191.5    Subd. 5. Service delivery authority. "Service delivery authority" means a single
191.6county, or consortium of counties operating by execution of a joint powers agreement
191.7under section 471.59 or other contractual agreement, that has voluntarily chosen by
191.8resolution of the county board of commissioners to participate in the redesign under this
191.9chapter or has been assigned by the commissioner pursuant to section 402A.18. A service
191.10delivery authority includes an Indian tribe or group of tribes that have voluntarily chosen
191.11by resolution of tribal government to participate in redesign under this chapter.
191.12    Subd. 6. Steering committee. "Steering committee" means the Steering Committee
191.13on Performance and Outcome Reforms.

191.14    Sec. 14. [402A.12] ESTABLISHMENT OF A PERFORMANCE MANAGEMENT
191.15SYSTEM FOR HUMAN SERVICES.
191.16By January 1, 2014, the commissioner shall implement a performance management
191.17system for essential human services as described in sections 402A.15 to 402A.18 that
191.18includes initial performance measures and standards consistent with the recommendations
191.19of the Steering Committee on Performance and Outcome Reforms in the December 2012
191.20report to the legislature.

191.21    Sec. 15. [402A.16] HUMAN SERVICES PERFORMANCE COUNCIL.
191.22    Subdivision 1. Establishment. By October 1, 2013, the commissioner shall convene
191.23a Human Services Performance Council to advise the commissioner on the implementation
191.24and operation of the performance management system for human services.
191.25    Subd. 2. Duties. The Human Services Performance Council shall:
191.26(1) hold meetings at least quarterly that are in compliance with Minnesota's Open
191.27Meeting Law under chapter 13D;
191.28(2) annually review the annual performance data submitted by counties or service
191.29delivery authorities;
191.30(3) review and advise the commissioner on department procedures related to the
191.31implementation of the performance management system and system process requirements
191.32and on barriers to process improvement in human services delivery;
191.33(4) advise the commissioner on the training and technical assistance needs of county
191.34or service delivery authority and department personnel;
192.1(5) review instances in which a county or service delivery authority has not made
192.2adequate progress on a performance improvement plan and make recommendations to
192.3the commissioner under section 402A.18;
192.4(6) consider appeals from counties or service delivery authorities that are in the
192.5remedies process and make recommendations to the commissioner on resolving the issue;
192.6(7) convene working groups to update and develop outcomes, measures, and
192.7performance standards for the performance management system and, on an annual basis,
192.8present these recommendations to the commissioner, including recommendations on when
192.9a particular essential human service program has a balanced set of program measures
192.10in place;
192.11(8) make recommendations on human services administrative rules or statutes that
192.12could be repealed in order to improve service delivery;
192.13(9) provide information to stakeholders on the council's role and regularly collect
192.14stakeholder input on performance management system performance; and
192.15(10) submit an annual report to the legislature and the commissioner, which
192.16includes a comprehensive report on the performance of individual counties or service
192.17delivery authorities as it relates to system measures; a list of counties or service delivery
192.18authorities that have been required to create performance improvement plans and the areas
192.19identified for improvement as part of the remedies process; a summary of performance
192.20improvement training and technical assistance activities offered to the county personnel
192.21by the department; recommendations on administrative rules or state statutes that could be
192.22repealed in order to improve service delivery; recommendations for system improvements,
192.23including updates to system outcomes, measures, and standards; and a response from
192.24the commissioner.
192.25    Subd. 3. Membership. (a) Human Services Performance Council membership shall
192.26be equally balanced among the following five stakeholder groups: the Association of
192.27Minnesota Counties, the Minnesota Association of County Social Service Administrators,
192.28the Department of Human Services, tribes and communities of color, and service providers
192.29and advocates for persons receiving human services. The Association of Minnesota
192.30Counties and the Minnesota Association of County Social Service Administrators shall
192.31appoint their own respective representatives. The commissioner of human services shall
192.32appoint representatives of the Department of Human Services, tribes and communities of
192.33color, and social services providers and advocates. Minimum council membership shall
192.34be 15 members, with at least three representatives from each stakeholder group, and
192.35maximum council membership shall be 20 members, with four representatives from
192.36each stakeholder group.
193.1(b) Notwithstanding section 15.059, Human Services Performance Council members
193.2shall be appointed for a minimum of two years, but may serve longer terms at the
193.3discretion of their appointing authority.
193.4(c) Notwithstanding section 15.059, members of the council shall receive no
193.5compensation for their services.
193.6(d) A commissioner's representative and a county representative from either the
193.7Association of Minnesota Counties or the Minnesota Association of County Social Service
193.8Administrators shall serve as Human Services Performance Council cochairs.
193.9    Subd. 4. Commissioner duties. The commissioner shall:
193.10(1) implement and maintain the performance management system for human services;
193.11(2) establish and regularly update the system's outcomes, measures, and standards,
193.12including the minimum performance standard for each performance measure;
193.13(3) determine when a particular program has a balanced set of measures;
193.14(4) receive reports from counties or service delivery authorities at least annually on
193.15their performance against system measures, provide counties with data needed to assess
193.16performance and monitor progress, and provide timely feedback to counties or service
193.17delivery authorities on their performance;
193.18(5) implement and monitor the remedies process in section 402A.18;
193.19(6) report to the Human Services Performance Council on county or service delivery
193.20authority performance on a semiannual basis;
193.21(7) provide general training and technical assistance to counties or service delivery
193.22authorities on topics related to performance measurement and performance improvement;
193.23(8) provide targeted training and technical assistance to counties or service delivery
193.24authorities that supports their performance improvement plans; and
193.25(9) provide staff support for the Human Services Performance Council.
193.26    Subd. 5. County or service delivery authority duties. The counties or service
193.27delivery authorities shall:
193.28(1) report performance data to meet performance management system requirements;
193.29and
193.30(2) provide training to personnel on basic principles of performance measurement
193.31and improvement and participate in training provided by the department.

193.32    Sec. 16. Minnesota Statutes 2012, section 402A.18, is amended to read:
193.33402A.18 COMMISSIONER POWER TO REMEDY FAILURE TO MEET
193.34PERFORMANCE OUTCOMES.
194.1    Subdivision 1. Underperforming county; specific service. If the commissioner
194.2determines that a county or service delivery authority is deficient in achieving minimum
194.3performance outcomes standards for a specific essential service human services program,
194.4the commissioner may impose the following remedies and adjust state and federal
194.5program allocations accordingly:
194.6(1) voluntary incorporation of the administration and operation of the specific
194.7essential service human services program with an existing service delivery authority or
194.8another county. A service delivery authority or county incorporating an underperforming
194.9county shall not be financially liable for the costs associated with remedying performance
194.10outcome deficiencies;
194.11(2) mandatory incorporation of the administration and operation of the specific
194.12essential service human services program with an existing service delivery authority or
194.13another county. A service delivery authority or county incorporating an underperforming
194.14county shall not be financially liable for the costs associated with remedying performance
194.15outcome deficiencies; or
194.16(3) transfer of authority for program administration and operation of the specific
194.17essential service human services program to the commissioner.
194.18    Subd. 2. Underperforming county; more than one-half of services. If the
194.19commissioner determines that a county or service delivery authority is deficient in
194.20achieving minimum performance outcomes standards for more than one-half of the defined
194.21essential human services programs, the commissioner may impose the following remedies:
194.22(1) voluntary incorporation of the administration and operation of essential human
194.23services programs with an existing service delivery authority or another county. A
194.24service delivery authority or county incorporating an underperforming county shall
194.25not be financially liable for the costs associated with remedying performance outcome
194.26deficiencies;
194.27(2) mandatory incorporation of the administration and operation of essential human
194.28services programs with an existing service delivery authority or another county. A
194.29service delivery authority or county incorporating an underperforming county shall
194.30not be financially liable for the costs associated with remedying performance outcome
194.31deficiencies; or
194.32(3) transfer of authority for program administration and operation of essential human
194.33services programs to the commissioner.
194.34    Subd. 2a. Financial responsibility of underperforming county. A county subject
194.35to remedies under subdivision 1 or 2 shall provide to the entity assuming administration
195.1of the essential service or essential human services program or programs the amount of
195.2nonfederal and nonstate funding needed to remedy performance outcome deficiencies.
195.3    Subd. 3. Conditions prior to imposing remedies. Before the commissioner may
195.4impose the remedies authorized under this section, the following conditions must be met:
195.5(1) the county or service delivery authority determined by the commissioner
195.6to be deficient in achieving minimum performance outcomes has the opportunity, in
195.7coordination with the council, to develop a program outcome improvement plan. The
195.8program outcome improvement plan must be developed no later than six months from the
195.9date of the deficiency determination; and
195.10(2) the council has conducted an assessment of the program outcome improvement
195.11plan to determine if the county or service delivery authority has made satisfactory progress
195.12toward performance outcomes and has made a recommendation about remedies to the
195.13commissioner. The assessment and recommendation must be made to the commissioner
195.14within 12 months from the date of the deficiency determination. (a) The commissioner
195.15shall notify a county or service delivery authority that it must submit a performance
195.16improvement plan if:
195.17(1) the county or service delivery authority does not meet the minimum performance
195.18standard for a measure; or
195.19(2) the county or service delivery authority does not meet the minimum performance
195.20standard for one or more racial or ethnic subgroup for which there is a statistically valid
195.21population size for three or more measures, even if the county or service delivery authority
195.22met the standard for the overall population.
195.23The commissioner must approve the performance improvement plan. The county or
195.24service delivery authority may negotiate the terms of the performance improvement plan
195.25with the commissioner.
195.26(b) When the department determines that a county or service delivery authority does
195.27not meet the minimum performance standard for a given measure, the commissioner
195.28must advise the county or service delivery authority that fiscal penalties may result if the
195.29performance does not improve. The department must offer technical assistance to the
195.30county or service delivery authority. Within 30 days of the initial advisement from the
195.31department, the county or service delivery authority may claim and the department may
195.32approve an extenuating circumstance that relieves the county or service delivery authority
195.33of any further remedy. If a county or service delivery authority has a small number of
195.34participants in an essential human services program such that reliable measurement is
195.35not possible, the commissioner may approve extenuating circumstances or may average
195.36performance over three years.
196.1(c) If there are no extenuating circumstances, the county or service delivery authority
196.2must submit a performance improvement plan to the commissioner within 60 days of the
196.3initial advisement from the department. The term of the performance improvement plan
196.4must be two years, starting with the date the plan is approved by the commissioner. This
196.5plan must include a target level for improvement for each measure that did not meet
196.6the minimum performance standard. The commissioner must approve the performance
196.7improvement plan within 60 days of submittal.
196.8(d) The department must monitor the performance improvement plan for two
196.9years. After two years, if the county or service delivery authority meets the minimum
196.10performance standard, there is no further remedy. If the county or service delivery
196.11authority fails to meet the minimum performance standard, but meets the improvement
196.12target in the performance improvement plan, the county or service delivery authority shall
196.13modify the performance improvement plan for further improvement and the department
196.14shall continue to monitor the plan.
196.15(e) If, after two years of monitoring, the county or service delivery authority fails to
196.16meet both the minimum performance standard and the improvement target identified in
196.17the performance improvement plan, the next step of the remedies process shall be invoked
196.18by the commissioner. This phase of the remedies process may include:
196.19(1) fiscal penalties for the county or service delivery authority that do not exceed
196.20one percent of the county's human services expenditures and that are negotiated in the
196.21performance improvement plan, based on what is needed to improve outcomes. Counties
196.22or service delivery authorities must reinvest the amount of the fiscal penalty into the
196.23essential human services program that was underperforming. A county or service delivery
196.24authority shall not be required to pay more than three fiscal penalties in a year; and
196.25(2) the department's provision of technical assistance to the county or service
196.26delivery authority that is targeted to address the specific performance issues.
196.27The commissioner shall continue monitoring the performance improvement plan for a
196.28third year.
196.29(f) If, after the third year of monitoring, the county or service delivery authority
196.30meets the minimum performance standard, there is no further remedy. If the county or
196.31service delivery authority fails to meet the minimum performance standard, but meets the
196.32improvement target for the performance improvement plan, the county or service delivery
196.33authority shall modify the performance improvement plan for further improvement and
196.34the department shall continue to monitor the plan.
196.35(g) If, after the third year of monitoring, the county or service delivery authority fails
196.36to meet the minimum performance standard and the improvement target identified in the
197.1performance improvement plan, the Human Services Performance Council shall review
197.2the situation and recommend a course of action to the commissioner.
197.3(h) If the commissioner has determined that a program has a balanced set of program
197.4measures and a county or service delivery authority is subject to fiscal penalties for more
197.5than one-half of the measures for that program, the commissioner may apply further
197.6remedies as described in subdivisions 1 and 2.

197.7    Sec. 17. INSTRUCTIONS TO THE COMMISSIONER.
197.8    In collaboration with labor organizations, the commissioner of human services shall
197.9develop clear and consistent standards for state-operated services programs to:
197.10    (1) address direct service staffing shortages;
197.11    (2) identify and help resolve workplace safety issues; and
197.12    (3) elevate the use and visibility of performance measures and objectives related to
197.13overtime use.

197.14ARTICLE 6

197.15HEALTH CARE

197.16    Section 1. Minnesota Statutes 2012, section 245.03, subdivision 1, is amended to read:
197.17    Subdivision 1. Establishment. There is created a Department of Human Services.
197.18A commissioner of human services shall be appointed by the governor under the
197.19provisions of section 15.06. The commissioner shall be selected on the basis of ability and
197.20experience in welfare and without regard to political affiliations. The commissioner shall
197.21 may appoint a up to two deputy commissioner commissioners.

197.22    Sec. 2. Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:
197.23    Subd. 3. Surcharge on HMOs and community integrated service networks. (a)
197.24Effective October 1, 1992, each health maintenance organization with a certificate of
197.25authority issued by the commissioner of health under chapter 62D and each community
197.26integrated service network licensed by the commissioner under chapter 62N shall pay to
197.27the commissioner of human services a surcharge equal to six-tenths of one percent of the
197.28total premium revenues of the health maintenance organization or community integrated
197.29service network as reported to the commissioner of health according to the schedule in
197.30subdivision 4.
197.31(b) For purposes of this subdivision, total premium revenue means:
197.32(1) premium revenue recognized on a prepaid basis from individuals and groups
197.33for provision of a specified range of health services over a defined period of time which
198.1is normally one month, excluding premiums paid to a health maintenance organization
198.2or community integrated service network from the Federal Employees Health Benefit
198.3Program;
198.4(2) premiums from Medicare wraparound subscribers for health benefits which
198.5supplement Medicare coverage;
198.6(3) Medicare revenue, as a result of an arrangement between a health maintenance
198.7organization or a community integrated service network and the Centers for Medicare
198.8and Medicaid Services of the federal Department of Health and Human Services, for
198.9services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
198.10from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
198.11Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
198.121395w-24, respectively, as they may be amended from time to time; and
198.13(4) medical assistance revenue, as a result of an arrangement between a health
198.14maintenance organization or community integrated service network and a Medicaid state
198.15agency, for services to a medical assistance beneficiary.
198.16If advance payments are made under clause (1) or (2) to the health maintenance
198.17organization or community integrated service network for more than one reporting period,
198.18the portion of the payment that has not yet been earned must be treated as a liability.
198.19(c) When a health maintenance organization or community integrated service
198.20network merges or consolidates with or is acquired by another health maintenance
198.21organization or community integrated service network, the surviving corporation or the
198.22new corporation shall be responsible for the annual surcharge originally imposed on
198.23each of the entities or corporations subject to the merger, consolidation, or acquisition,
198.24regardless of whether one of the entities or corporations does not retain a certificate of
198.25authority under chapter 62D or a license under chapter 62N.
198.26(d) Effective July 1 June 15 of each year, the surviving corporation's or the new
198.27corporation's surcharge shall be based on the revenues earned in the second previous
198.28calendar year by all of the entities or corporations subject to the merger, consolidation,
198.29or acquisition regardless of whether one of the entities or corporations does not retain a
198.30certificate of authority under chapter 62D or a license under chapter 62N until the total
198.31premium revenues of the surviving corporation include the total premium revenues of all
198.32the merged entities as reported to the commissioner of health.
198.33(e) When a health maintenance organization or community integrated service
198.34network, which is subject to liability for the surcharge under this chapter, transfers,
198.35assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
199.1for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
199.2of the health maintenance organization or community integrated service network.
199.3(f) In the event a health maintenance organization or community integrated service
199.4network converts its licensure to a different type of entity subject to liability for the
199.5surcharge under this chapter, but survives in the same or substantially similar form, the
199.6surviving entity remains liable for the surcharge regardless of whether one of the entities
199.7or corporations does not retain a certificate of authority under chapter 62D or a license
199.8under chapter 62N.
199.9(g) The surcharge assessed to a health maintenance organization or community
199.10integrated service network ends when the entity ceases providing services for premiums
199.11and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

199.12    Sec. 3. Minnesota Statutes 2012, section 256.9657, subdivision 4, is amended to read:
199.13    Subd. 4. Payments into the account. (a) Payments to the commissioner under
199.14subdivisions subdivision 1 to 3 must be paid in monthly installments due on the 15th of
199.15the month beginning October 15, 1992. The monthly payment must be equal to the annual
199.16surcharge divided by 12. Payments to the commissioner under subdivisions 2 and 3 for
199.17fiscal year 1993 must be based on calendar year 1990 revenues. Effective July 1 of each
199.18year, beginning in 1993, payments under subdivisions 2 and 3 must be based on revenues
199.19earned in the second previous calendar year.
199.20(b) Effective October 15, 2014, payment to the commissioner under subdivision 2
199.21must be paid in nine monthly installments due on the 15th of the month beginning October
199.2215, 2014, through June 15 of the following year. The monthly payment must be equal
199.23to the annual surcharge divided by nine.
199.24(b) (c) Effective October 1, 1995 2014, and each October 1 thereafter, the payments
199.25in subdivisions subdivision 2 and 3 must be based on revenues earned in the previous
199.26calendar year.
199.27(c) (d) If the commissioner of health does not provide by August 15 of any year data
199.28needed to update the base year for the hospital and or April 15 of any year data needed to
199.29update the base year for the health maintenance organization surcharges, the commissioner
199.30of human services may estimate base year revenue and use that estimate for the purposes
199.31of this section until actual data is provided by the commissioner of health.
199.32(d) (e) Payments to the commissioner under subdivision 3a must be paid in monthly
199.33installments due on the 15th of the month beginning July 15, 2003. The monthly payment
199.34must be equal to the annual surcharge divided by 12.
200.1(f) Payments due in July through September 2014 under subdivision 3 for revenue
200.2earned in calendar year 2012 shall be paid in a lump sum on June 15, 2014. On June
200.315, 2014, each health maintenance organization and community-integrated service
200.4network shall pay all payments under subdivision 3 in a lump sum for revenue earned in
200.5calendar year 2013. Effective June 15, 2015, and each June 15 thereafter, the payments in
200.6subdivision 3 shall be based on revenues earned in the previous calendar year and paid
200.7in a lump sum on June 15 of each year.

200.8    Sec. 4. Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:
200.9    Subd. 29. Reimbursement for the fee increase for the early hearing detection
200.10and intervention program. (a) For admissions occurring on or after July 1, 2010,
200.11payment rates shall be adjusted to include the increase to the fee that is effective on July 1,
200.122010, for the early hearing detection and intervention program recipients under section
200.13144.125, subdivision 1 , that is paid by the hospital for public program recipients. This
200.14payment increase shall be in effect until the increase is fully recognized in the base year
200.15cost under subdivision 2b. This payment shall be included in payments to contracted
200.16managed care organizations.
200.17    (b) For admissions occurring on or after July 1, 2013, payment rates shall be adjusted
200.18to include the increase to the fee that is effective July 1, 2013, for the early hearing
200.19detection and intervention program under section 144.125, subdivision 1, paragraph (d),
200.20that is paid by the hospital for medical assistance and MinnesotaCare program enrollees.
200.21This payment increase shall be in effect until the increase is fully recognized in the
200.22base-year cost under subdivision 2b. This payment shall be included in payments to
200.23managed care plans and county-based purchasing plans.

200.24    Sec. 5. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
200.25to read:
200.26    Subd. 22. Medical assistance costs for certain inmates. The commissioner shall
200.27execute an interagency agreement with the commissioner of corrections to recover the
200.28state cost attributable to medical assistance eligibility for inmates of public institutions
200.29admitted to a medical institution on an inpatient basis. The annual amount to be transferred
200.30from the Department of Corrections under the agreement must include all eligible state
200.31medical assistance costs, including administrative costs incurred by the Department of
200.32Human Services, attributable to inmates under state and county jurisdiction admitted to
200.33medical institutions on an inpatient basis that are related to the implementation of section
200.34256B.055, subdivision 14, paragraph (c).

201.1    Sec. 6. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:
201.2    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
201.3inmate of a correctional facility who is conditionally released as authorized under section
201.4241.26 , 244.065, or 631.425, if the individual does not require the security of a public
201.5detention facility and is housed in a halfway house or community correction center, or
201.6under house arrest and monitored by electronic surveillance in a residence approved
201.7by the commissioner of corrections, and if the individual meets the other eligibility
201.8requirements of this chapter.
201.9    (b) An individual who is enrolled in medical assistance, and who is charged with a
201.10crime and incarcerated for less than 12 months shall be suspended from eligibility at the
201.11time of incarceration until the individual is released. Upon release, medical assistance
201.12eligibility is reinstated without reapplication using a reinstatement process and form, if the
201.13individual is otherwise eligible.
201.14    (c) An individual, regardless of age, who is considered an inmate of a public
201.15institution as defined in Code of Federal Regulations, title 42, section 435.1010, and
201.16who meets the eligibility requirements in section 256B.056, is not eligible for medical
201.17assistance, except for covered services received while an inpatient in a medical institution
201.18as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues,
201.19including costs, related to the inpatient treatment of an inmate are the responsibility of the
201.20entity with jurisdiction over the inmate.
201.21EFFECTIVE DATE.This section is effective January 1, 2014.

201.22    Sec. 7. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
201.23    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
201.24to citizens of the United States, qualified noncitizens as defined in this subdivision, and
201.25other persons residing lawfully in the United States. Citizens or nationals of the United
201.26States must cooperate in obtaining satisfactory documentary evidence of citizenship or
201.27nationality according to the requirements of the federal Deficit Reduction Act of 2005,
201.28Public Law 109-171.
201.29(b) "Qualified noncitizen" means a person who meets one of the following
201.30immigration criteria:
201.31(1) admitted for lawful permanent residence according to United States Code, title 8;
201.32(2) admitted to the United States as a refugee according to United States Code,
201.33title 8, section 1157;
201.34(3) granted asylum according to United States Code, title 8, section 1158;
202.1(4) granted withholding of deportation according to United States Code, title 8,
202.2section 1253(h);
202.3(5) paroled for a period of at least one year according to United States Code, title 8,
202.4section 1182(d)(5);
202.5(6) granted conditional entrant status according to United States Code, title 8,
202.6section 1153(a)(7);
202.7(7) determined to be a battered noncitizen by the United States Attorney General
202.8according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
202.9title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
202.10(8) is a child of a noncitizen determined to be a battered noncitizen by the United
202.11States Attorney General according to the Illegal Immigration Reform and Immigrant
202.12Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
202.13Public Law 104-200; or
202.14(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
202.15Law 96-422, the Refugee Education Assistance Act of 1980.
202.16(c) All qualified noncitizens who were residing in the United States before August
202.1722, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
202.18medical assistance with federal financial participation.
202.19(d) Beginning December 1, 1996, qualified noncitizens who entered the United
202.20States on or after August 22, 1996, and who otherwise meet the eligibility requirements
202.21of this chapter are eligible for medical assistance with federal participation for five years
202.22if they meet one of the following criteria:
202.23(1) refugees admitted to the United States according to United States Code, title 8,
202.24section 1157;
202.25(2) persons granted asylum according to United States Code, title 8, section 1158;
202.26(3) persons granted withholding of deportation according to United States Code,
202.27title 8, section 1253(h);
202.28(4) veterans of the United States armed forces with an honorable discharge for
202.29a reason other than noncitizen status, their spouses and unmarried minor dependent
202.30children; or
202.31(5) persons on active duty in the United States armed forces, other than for training,
202.32their spouses and unmarried minor dependent children.
202.33 Beginning July 1, 2010, children and pregnant women who are noncitizens
202.34described in paragraph (b) or who are lawfully present in the United States as defined
202.35in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
202.36eligibility requirements of this chapter, are eligible for medical assistance with federal
203.1financial participation as provided by the federal Children's Health Insurance Program
203.2Reauthorization Act of 2009, Public Law 111-3.
203.3(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
203.4are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
203.5subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
203.6Code, title 8, section 1101(a)(15).
203.7(f) Payment shall also be made for care and services that are furnished to noncitizens,
203.8regardless of immigration status, who otherwise meet the eligibility requirements of
203.9this chapter, if such care and services are necessary for the treatment of an emergency
203.10medical condition.
203.11(g) For purposes of this subdivision, the term "emergency medical condition" means
203.12a medical condition that meets the requirements of United States Code, title 42, section
203.131396b(v).
203.14(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
203.15of an emergency medical condition are limited to the following:
203.16(i) services delivered in an emergency room or by an ambulance service licensed
203.17under chapter 144E that are directly related to the treatment of an emergency medical
203.18condition;
203.19(ii) services delivered in an inpatient hospital setting following admission from an
203.20emergency room or clinic for an acute emergency condition; and
203.21(iii) follow-up services that are directly related to the original service provided
203.22to treat the emergency medical condition and are covered by the global payment made
203.23to the provider.
203.24    (2) Services for the treatment of emergency medical conditions do not include:
203.25(i) services delivered in an emergency room or inpatient setting to treat a
203.26nonemergency condition;
203.27(ii) organ transplants, stem cell transplants, and related care;
203.28(iii) services for routine prenatal care;
203.29(iv) continuing care, including long-term care, nursing facility services, home health
203.30care, adult day care, day training, or supportive living services;
203.31(v) elective surgery;
203.32(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
203.33part of an emergency room visit;
203.34(vii) preventative health care and family planning services;
203.35(viii) dialysis;
203.36(ix) chemotherapy or therapeutic radiation services;
204.1(x) (viii) rehabilitation services;
204.2(xi) (ix) physical, occupational, or speech therapy;
204.3(xii) (x) transportation services;
204.4(xiii) (xi) case management;
204.5(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
204.6(xv) (xiii) dental services;
204.7(xvi) (xiv) hospice care;
204.8(xvii) (xv) audiology services and hearing aids;
204.9(xviii) (xvi) podiatry services;
204.10(xix) (xvii) chiropractic services;
204.11(xx) (xviii) immunizations;
204.12(xxi) (xix) vision services and eyeglasses;
204.13(xxii) (xx) waiver services;
204.14(xxiii) (xxi) individualized education programs; or
204.15(xxiv) (xxii) chemical dependency treatment.
204.16(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
204.17nonimmigrants, or lawfully present in the United States as defined in Code of Federal
204.18Regulations, title 8, section 103.12, are not covered by a group health plan or health
204.19insurance coverage according to Code of Federal Regulations, title 42, section 457.310,
204.20and who otherwise meet the eligibility requirements of this chapter, are eligible for
204.21medical assistance through the period of pregnancy, including labor and delivery, and 60
204.22days postpartum, to the extent federal funds are available under title XXI of the Social
204.23Security Act, and the state children's health insurance program.
204.24(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
204.25services from a nonprofit center established to serve victims of torture and are otherwise
204.26ineligible for medical assistance under this chapter are eligible for medical assistance
204.27without federal financial participation. These individuals are eligible only for the period
204.28during which they are receiving services from the center. Individuals eligible under this
204.29paragraph shall not be required to participate in prepaid medical assistance.
204.30(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
204.31emergency medical conditions under paragraph (f) except where coverage is prohibited
204.32under federal law:
204.33(1) dialysis services provided in a hospital or freestanding dialysis facility; and
204.34(2) surgery and the administration of chemotherapy, radiation, and related services
204.35necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission
204.36and requires surgery, chemotherapy, or radiation treatment.
205.1(l) Effective July 1, 2013, recipients of emergency medical assistance under this
205.2subdivision are eligible for coverage of the elderly waiver services provided under section
205.3256B.0915, and coverage of rehabilitative services provided in a nursing facility. The
205.4age limit for elderly waiver services does not apply. In order to qualify for coverage, a
205.5recipient of emergency medical assistance is subject to the assessment and reassessment
205.6requirements of section 256B.0911. Initial and continued enrollment under this paragraph
205.7is subject to the limits of available funding.
205.8EFFECTIVE DATE.This section is effective July 1, 2013.

205.9    Sec. 8. Minnesota Statutes 2012, section 256B.0625, subdivision 9, is amended to read:
205.10    Subd. 9. Dental services. (a) Medical assistance covers dental services.
205.11(b) Medical assistance dental coverage for nonpregnant adults is limited to the
205.12following services:
205.13(1) comprehensive exams, limited to once every five years;
205.14(2) periodic exams, limited to one per year;
205.15(3) limited exams;
205.16(4) bitewing x-rays, limited to one per year;
205.17(5) periapical x-rays;
205.18(6) panoramic x-rays, limited to one every five years except (1) when medically
205.19necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma
205.20or (2) once every two years for patients who cannot cooperate for intraoral film due to
205.21a developmental disability or medical condition that does not allow for intraoral film
205.22placement;
205.23(7) prophylaxis, limited to one per year;
205.24(8) application of fluoride varnish, limited to one per year;
205.25(9) posterior fillings, all at the amalgam rate;
205.26(10) anterior fillings;
205.27(11) endodontics, limited to root canals on the anterior and premolars only;
205.28(12) removable prostheses, each dental arch limited to one every six years;
205.29(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
205.30abscesses;
205.31(14) palliative treatment and sedative fillings for relief of pain; and
205.32(15) full-mouth debridement, limited to one every five years.
205.33(c) In addition to the services specified in paragraph (b), medical assistance
205.34covers the following services for adults, if provided in an outpatient hospital setting or
205.35freestanding ambulatory surgical center as part of outpatient dental surgery:
206.1(1) periodontics, limited to periodontal scaling and root planing once every two years;
206.2(2) general anesthesia; and
206.3(3) full-mouth survey once every five years.
206.4(d) Medical assistance covers medically necessary dental services for children and
206.5pregnant women. The following guidelines apply:
206.6(1) posterior fillings are paid at the amalgam rate;
206.7(2) application of sealants are covered once every five years per permanent molar for
206.8children only;
206.9(3) application of fluoride varnish is covered once every six months; and
206.10(4) orthodontia is eligible for coverage for children only.
206.11(e) In addition to the services specified in paragraphs (b) and (c), medical assistance
206.12covers the following services for adults:
206.13(1) house calls or extended care facility calls for on-site delivery of covered services;
206.14(2) behavioral management when additional staff time is required to accommodate
206.15behavioral challenges and sedation is not used;
206.16(3) oral or IV sedation, if the covered dental service cannot be performed safely
206.17without it or would otherwise require the service to be performed under general anesthesia
206.18in a hospital or surgical center; and
206.19(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
206.20no more than four times per year.

206.21    Sec. 9. Minnesota Statutes 2012, section 256B.0625, subdivision 13, is amended to read:
206.22    Subd. 13. Drugs. (a) Medical assistance covers drugs, except for fertility drugs
206.23when specifically used to enhance fertility, if prescribed by a licensed practitioner and
206.24dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance
206.25program as a dispensing physician, or by a physician, physician assistant, or a nurse
206.26practitioner employed by or under contract with a community health board as defined in
206.27section 145A.02, subdivision 5, for the purposes of communicable disease control.
206.28(b) The dispensed quantity of a prescription drug must not exceed a 34-day supply,
206.29unless authorized by the commissioner.
206.30(c) For the purpose of this subdivision and subdivision 13d, an "active
206.31pharmaceutical ingredient" is defined as a substance that is represented for use in a drug
206.32and when used in the manufacturing, processing, or packaging of a drug becomes an
206.33active ingredient of the drug product. An "excipient" is defined as an inert substance
206.34used as a diluent or vehicle for a drug. The commissioner shall establish a list of active
206.35pharmaceutical ingredients and excipients which are included in the medical assistance
207.1formulary. Medical assistance covers selected active pharmaceutical ingredients and
207.2excipients used in compounded prescriptions when the compounded combination is
207.3specifically approved by the commissioner or when a commercially available product:
207.4(1) is not a therapeutic option for the patient;
207.5(2) does not exist in the same combination of active ingredients in the same strengths
207.6as the compounded prescription; and
207.7(3) cannot be used in place of the active pharmaceutical ingredient in the
207.8compounded prescription.
207.9(d) Medical assistance covers the following over-the-counter drugs when prescribed
207.10by a licensed practitioner or by a licensed pharmacist who meets standards established by
207.11the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen,
207.12family planning products, aspirin, insulin, products for the treatment of lice, vitamins for
207.13adults with documented vitamin deficiencies, vitamins for children under the age of seven
207.14and pregnant or nursing women, and any other over-the-counter drug identified by the
207.15commissioner, in consultation with the formulary committee, as necessary, appropriate,
207.16and cost-effective for the treatment of certain specified chronic diseases, conditions,
207.17or disorders, and this determination shall not be subject to the requirements of chapter
207.1814. A pharmacist may prescribe over-the-counter medications as provided under this
207.19paragraph for purposes of receiving reimbursement under Medicaid. When prescribing
207.20over-the-counter drugs under this paragraph, licensed pharmacists must consult with
207.21the recipient to determine necessity, provide drug counseling, review drug therapy
207.22for potential adverse interactions, and make referrals as needed to other health care
207.23professionals. Over-the-counter medications must be dispensed in a quantity that is the
207.24lower of: (1) the number of dosage units contained in the manufacturer's original package;
207.25and (2) the number of dosage units required to complete the patient's course of therapy.
207.26(e) Effective January 1, 2006, medical assistance shall not cover drugs that
207.27are coverable under Medicare Part D as defined in the Medicare Prescription Drug,
207.28Improvement, and Modernization Act of 2003, Public Law 108-173, section 1860D-2(e),
207.29for individuals eligible for drug coverage as defined in the Medicare Prescription
207.30Drug, Improvement, and Modernization Act of 2003, Public Law 108-173, section
207.311860D-1(a)(3)(A). For these individuals, medical assistance may cover drugs from the
207.32drug classes listed in United States Code, title 42, section 1396r-8(d)(2), subject to this
207.33subdivision and subdivisions 13a to 13g, except that drugs listed in United States Code,
207.34title 42, section 1396r-8(d)(2)(E), shall not be covered.
207.35(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
207.36Program and dispensed by 340B covered entities and ambulatory pharmacies under
208.1common ownership of the 340B covered entity. Medical assistance does not cover drugs
208.2acquired through the federal 340B Drug Pricing Program and dispensed by 340B contract
208.3pharmacies.

208.4    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to
208.5read:
208.6    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
208.7shall be the lower of the actual acquisition costs of the drugs or the maximum allowable
208.8cost by the commissioner plus the fixed dispensing fee; or the usual and customary price
208.9charged to the public. The amount of payment basis must be reduced to reflect all discount
208.10amounts applied to the charge by any provider/insurer agreement or contract for submitted
208.11charges to medical assistance programs. The net submitted charge may not be greater
208.12than the patient liability for the service. The pharmacy dispensing fee shall be $3.65,
208.13except that the dispensing fee for intravenous solutions which must be compounded by
208.14the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and
208.15$30 per bag for total parenteral nutritional products dispensed in one liter quantities,
208.16or $44 per bag for total parenteral nutritional products dispensed in quantities greater
208.17than one liter. Actual acquisition cost includes quantity and other special discounts
208.18except time and cash discounts. The actual acquisition cost of a drug shall be estimated
208.19by the commissioner at wholesale acquisition cost plus four percent for independently
208.20owned pharmacies located in a designated rural area within Minnesota, and at wholesale
208.21acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently
208.22owned" if it is one of four or fewer pharmacies under the same ownership nationally. A
208.23"designated rural area" means an area defined as a small rural area or isolated rural area
208.24according to the four-category classification of the Rural Urban Commuting Area system
208.25developed for the United States Health Resources and Services Administration. Effective
208.26January 1, 2014, the actual acquisition cost of a drug acquired through the federal 340B
208.27Drug Pricing Program shall be estimated by the commissioner at wholesale acquisition
208.28cost minus 40 percent. Wholesale acquisition cost is defined as the manufacturer's list
208.29price for a drug or biological to wholesalers or direct purchasers in the United States, not
208.30including prompt pay or other discounts, rebates, or reductions in price, for the most
208.31recent month for which information is available, as reported in wholesale price guides or
208.32other publications of drug or biological pricing data. The maximum allowable cost of a
208.33multisource drug may be set by the commissioner and it shall be comparable to, but no
208.34higher than, the maximum amount paid by other third-party payors in this state who have
209.1maximum allowable cost programs. Establishment of the amount of payment for drugs
209.2shall not be subject to the requirements of the Administrative Procedure Act.
209.3    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
209.4to pharmacists for legend drug prescriptions dispensed to residents of long-term care
209.5facilities when a unit dose blister card system, approved by the department, is used. Under
209.6this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The
209.7National Drug Code (NDC) from the drug container used to fill the blister card must be
209.8identified on the claim to the department. The unit dose blister card containing the drug
209.9must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that
209.10govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will
209.11be required to credit the department for the actual acquisition cost of all unused drugs that
209.12are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in
209.13a quantity that is less than a 30-day supply.
209.14    (c) Whenever a maximum allowable cost has been set for a multisource drug,
209.15payment shall be the lower of the usual and customary price charged to the public or the
209.16maximum allowable cost established by the commissioner unless prior authorization
209.17for the brand name product has been granted according to the criteria established by
209.18the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the
209.19prescriber has indicated "dispense as written" on the prescription in a manner consistent
209.20with section 151.21, subdivision 2.
209.21    (d) The basis for determining the amount of payment for drugs administered in an
209.22outpatient setting shall be the lower of the usual and customary cost submitted by the
209.23provider or, 106 percent of the average sales price as determined by the United States
209.24Department of Health and Human Services pursuant to title XVIII, section 1847a of the
209.25federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
209.26set by the commissioner. If average sales price is unavailable, the amount of payment
209.27must be lower of the usual and customary cost submitted by the provider or, the wholesale
209.28acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the
209.29commissioner. Effective January 1, 2014, the commissioner shall discount the payment
209.30rate for drugs obtained through the federal 340B Drug Pricing Program by 20 percent. The
209.31payment for drugs administered in an outpatient setting shall be made to the administering
209.32facility or practitioner. A retail or specialty pharmacy dispensing a drug for administration
209.33in an outpatient setting is not eligible for direct reimbursement.
209.34    (e) The commissioner may negotiate lower reimbursement rates for specialty
209.35pharmacy products than the rates specified in paragraph (a). The commissioner may
209.36require individuals enrolled in the health care programs administered by the department
210.1to obtain specialty pharmacy products from providers with whom the commissioner has
210.2negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
210.3used by a small number of recipients or recipients with complex and chronic diseases
210.4that require expensive and challenging drug regimens. Examples of these conditions
210.5include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
210.6C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
210.7of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
210.8biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
210.9that require complex care. The commissioner shall consult with the formulary committee
210.10to develop a list of specialty pharmacy products subject to this paragraph. In consulting
210.11with the formulary committee in developing this list, the commissioner shall take into
210.12consideration the population served by specialty pharmacy products, the current delivery
210.13system and standard of care in the state, and access to care issues. The commissioner shall
210.14have the discretion to adjust the reimbursement rate to prevent access to care issues.
210.15(f) Home infusion therapy services provided by home infusion therapy pharmacies
210.16must be paid at rates according to subdivision 8d.
210.17EFFECTIVE DATE.This section is effective July 1, 2013.

210.18    Sec. 11. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
210.19subdivision to read:
210.20    Subd. 28b. Doula services. Medical assistance covers doula services provided by a
210.21certified doula as defined in section 148.995, subdivision 2, of the mother's choice. For
210.22purposes of this section, "doula services" means childbirth education and support services,
210.23including emotional and physical support provided during pregnancy, labor, birth, and
210.24postpartum.
210.25EFFECTIVE DATE.This section is effective July 1, 2014, or upon federal
210.26approval, whichever is later, and applies to services provided on or after the effective date.

210.27    Sec. 12. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to
210.28read:
210.29    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
210.30supplies and equipment. Separate payment outside of the facility's payment rate shall
210.31be made for wheelchairs and wheelchair accessories for recipients who are residents
210.32of intermediate care facilities for the developmentally disabled. Reimbursement for
210.33wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
211.1conditions and limitations as coverage for recipients who do not reside in institutions. A
211.2wheelchair purchased outside of the facility's payment rate is the property of the recipient.
211.3The commissioner may set reimbursement rates for specified categories of medical
211.4supplies at levels below the Medicare payment rate.
211.5(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
211.6must enroll as a Medicare provider.
211.7(c) When necessary to ensure access to durable medical equipment, prosthetics,
211.8orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
211.9enrollment requirement if:
211.10(1) the vendor supplies only one type of durable medical equipment, prosthetic,
211.11orthotic, or medical supply;
211.12(2) the vendor serves ten or fewer medical assistance recipients per year;
211.13(3) the commissioner finds that other vendors are not available to provide same or
211.14similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
211.15(4) the vendor complies with all screening requirements in this chapter and Code of
211.16Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
211.17the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
211.18and Medicaid Services approved national accreditation organization as complying with
211.19the Medicare program's supplier and quality standards and the vendor serves primarily
211.20pediatric patients.
211.21(d) Durable medical equipment means a device or equipment that:
211.22(1) can withstand repeated use;
211.23(2) is generally not useful in the absence of an illness, injury, or disability; and
211.24(3) is provided to correct or accommodate a physiological disorder or physical
211.25condition or is generally used primarily for a medical purpose.
211.26(e) Electronic tablets may be considered durable medical equipment if the electronic
211.27tablet will be used as an augmentative and alternative communication system as defined
211.28under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
211.29must be locked in order to prevent use not related to communication.

211.30    Sec. 13. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
211.31subdivision to read:
211.32    Subd. 31b. Preferred diabetic testing supply program. (a) The commissioner
211.33shall implement a point-of-sale preferred diabetic testing supply program by January 1,
211.342014. Medical assistance coverage for diabetic testing supplies shall conform to the
211.35limitations established under the program. The commissioner may enter into a contract
212.1with a vendor for the purpose of participating in a preferred diabetic testing supply list and
212.2supplemental rebate program. The commissioner shall ensure that any contract meets all
212.3federal requirements and maximizes federal financial participation. The commissioner
212.4shall maintain an accurate and up-to-date list on the department's Web site.
212.5(b) The commissioner may add to, delete from, and otherwise modify the preferred
212.6diabetic testing supply program drug list after consulting with the Drug Formulary
212.7Committee and appropriate medical specialists and providing public notice and the
212.8opportunity for public comment.
212.9(c) The commissioner shall adopt and administer the preferred diabetic testing
212.10supply program as part of the administration of the diabetic testing supply rebate program.
212.11Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply
212.12list may be subject to prior authorization.
212.13(d) All claims for diabetic testing supplies in categories on the preferred diabetic
212.14testing supply list must be submitted by enrolled pharmacy providers using the most
212.15current National Council of Prescription Drug Plans electronic claims standard.
212.16(e) For purposes of this subdivision, "preferred diabetic testing supply list" means a
212.17list of diabetic testing supplies selected by the commissioner, for which prior authorization
212.18is not required.
212.19(f) The commissioner shall seek any federal waivers or approvals necessary to
212.20implement this subdivision.

212.21    Sec. 14. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to
212.22read:
212.23    Subd. 39. Childhood immunizations. Providers who administer pediatric vaccines
212.24within the scope of their licensure, and who are enrolled as a medical assistance provider,
212.25must enroll in the pediatric vaccine administration program established by section 13631
212.26of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an
212.27$8.50 fee per dose for administration of the vaccine to children eligible for medical
212.28assistance. Medical assistance does not pay for vaccines that are available at no cost from
212.29the pediatric vaccine administration program.

212.30    Sec. 15. Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to
212.31read:
212.32    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
212.33Medical assistance covers early and periodic screening, diagnosis, and treatment services
212.34(EPSDT). The payment amount for a complete EPSDT screening shall not include charges
213.1for vaccines that are available at no cost to the provider and shall not exceed the rate
213.2established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

213.3    Sec. 16. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
213.4subdivision to read:
213.5    Subd. 61. Payment for multiple services provided on the same day. The
213.6commissioner shall not prohibit payment, including supplemental payments, for mental
213.7health services or dental services provided to a patient by a clinic or health care
213.8professional solely because the mental health or dental services were provided on the same
213.9day as other covered health services furnished by the same provider.

213.10    Sec. 17. Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:
213.11    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
213.12assistance benefit plan shall include the following cost-sharing for all recipients, effective
213.13for services provided on or after September 1, 2011:
213.14    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
213.15of this subdivision, a visit means an episode of service which is required because of
213.16a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
213.17ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
213.18midwife, advanced practice nurse, audiologist, optician, or optometrist;
213.19    (2) $3.50 for nonemergency visits to a hospital-based emergency room, except that
213.20this co-payment shall be increased to $20 upon federal approval;
213.21    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
213.22subject to a $12 per month maximum for prescription drug co-payments. No co-payments
213.23shall apply to antipsychotic drugs when used for the treatment of mental illness;
213.24(4) effective January 1, 2012, a family deductible equal to the maximum amount
213.25allowed under Code of Federal Regulations, title 42, part 447.54; and
213.26    (5) for individuals identified by the commissioner with income at or below 100
213.27percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
213.28percent of family income. For purposes of this paragraph, family income is the total
213.29earned and unearned income of the individual and the individual's spouse, if the spouse is
213.30enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
213.31    (b) Recipients of medical assistance are responsible for all co-payments and
213.32deductibles in this subdivision.
213.33(c) Notwithstanding paragraph (b), the commissioner, through the contracting
213.34process under sections 256B.69 and 256B.692, may allow managed care plans and
214.1county-based purchasing plans to waive the family deductible under paragraph (a),
214.2clause (4). The value of the family deductible shall not be included in the capitation
214.3payment to managed care plans and county-based purchasing plans. Managed care plans
214.4and county-based purchasing plans shall certify annually to the commissioner the dollar
214.5value of the family deductible.
214.6(d) Notwithstanding paragraph (b), the commissioner may waive the collection of
214.7the family deductible described under paragraph (a), clause (4), from individuals and
214.8allow long-term care and waivered service providers to assume responsibility for payment.
214.9(e) Notwithstanding paragraph (b), the commissioner, through the contracting
214.10process under section 256B.0756 shall allow the pilot program in Hennepin County to
214.11waive co-payments. The value of the co-payments shall not be included in the capitation
214.12payment amount to the integrated health care delivery networks under the pilot program.

214.13    Sec. 18. Minnesota Statutes 2012, section 256B.0756, is amended to read:
214.14256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.
214.15(a) The commissioner, upon federal approval of a new waiver request or amendment
214.16of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey
214.17County, or both, to test alternative and innovative integrated health care delivery networks.
214.18(b) Individuals eligible for the pilot program shall be individuals who are eligible for
214.19medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin
214.20County or Ramsey County. The commissioner may identify individuals to be enrolled in
214.21the Hennepin County pilot program based on zip code in Hennepin County or whether the
214.22individuals would benefit from an integrated health care delivery network.
214.23(c) Individuals enrolled in the pilot program shall be enrolled in an integrated
214.24health care delivery network in their county of residence. The integrated health care
214.25delivery network in Hennepin County shall be a network, such as an accountable care
214.26organization or a community-based collaborative care network, created by or including
214.27Hennepin County Medical Center. The integrated health care delivery network in Ramsey
214.28County shall be a network, such as an accountable care organization or community-based
214.29collaborative care network, created by or including Regions Hospital.
214.30(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for
214.31Hennepin County and 3,500 enrollees for Ramsey County.
214.32(e) (d) In developing a payment system for the pilot programs, the commissioner
214.33shall establish a total cost of care for the recipients enrolled in the pilot programs that
214.34equals the cost of care that would otherwise be spent for these enrollees in the prepaid
214.35medical assistance program.
215.1(f) Counties may transfer funds necessary to support the nonfederal share of
215.2payments for integrated health care delivery networks in their county. Such transfers per
215.3county shall not exceed 15 percent of the expected expenses for county enrollees.
215.4(g) (e) The commissioner shall apply to the federal government for, or as appropriate,
215.5cooperate with counties, providers, or other entities that are applying for any applicable
215.6grant or demonstration under the Patient Protection and Affordable Health Care Act, Public
215.7Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law
215.8111-152, that would further the purposes of or assist in the creation of an integrated health
215.9care delivery network for the purposes of this subdivision, including, but not limited to, a
215.10global payment demonstration or the community-based collaborative care network grants.

215.11    Sec. 19. Minnesota Statutes 2012, section 256B.196, subdivision 2, is amended to read:
215.12    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
215.13subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
215.14services upper payment limit for nonstate government hospitals. The commissioner shall
215.15then determine the amount of a supplemental payment to Hennepin County Medical
215.16Center and Regions Hospital for these services that would increase medical assistance
215.17spending in this category to the aggregate upper payment limit for all nonstate government
215.18hospitals in Minnesota. In making this determination, the commissioner shall allot the
215.19available increases between Hennepin County Medical Center and Regions Hospital
215.20based on the ratio of medical assistance fee-for-service outpatient hospital payments to
215.21the two facilities. The commissioner shall adjust this allotment as necessary based on
215.22federal approvals, the amount of intergovernmental transfers received from Hennepin and
215.23Ramsey Counties, and other factors, in order to maximize the additional total payments.
215.24The commissioner shall inform Hennepin County and Ramsey County of the periodic
215.25intergovernmental transfers necessary to match federal Medicaid payments available
215.26under this subdivision in order to make supplementary medical assistance payments to
215.27Hennepin County Medical Center and Regions Hospital equal to an amount that when
215.28combined with existing medical assistance payments to nonstate governmental hospitals
215.29would increase total payments to hospitals in this category for outpatient services to
215.30the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
215.31receipt of these periodic transfers, the commissioner shall make supplementary payments
215.32to Hennepin County Medical Center and Regions Hospital.
215.33    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall
215.34determine an upper payment limit for physicians and other billing professionals affiliated
215.35with Hennepin County Medical Center and with Regions Hospital. The upper payment
216.1limit shall be based on the average commercial rate or be determined using another method
216.2acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
216.3inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
216.4necessary to match the federal Medicaid payments available under this subdivision in order
216.5to make supplementary payments to physicians and other billing professionals affiliated
216.6with Hennepin County Medical Center and to make supplementary payments to physicians
216.7and other billing professionals affiliated with Regions Hospital through HealthPartners
216.8Medical Group equal to the difference between the established medical assistance
216.9payment for physician and other billing professional services and the upper payment limit.
216.10Upon receipt of these periodic transfers, the commissioner shall make supplementary
216.11payments to physicians and other billing professionals affiliated with Hennepin County
216.12Medical Center and shall make supplementary payments to physicians and other billing
216.13professionals affiliated with Regions Hospital through HealthPartners Medical Group.
216.14    (c) Beginning January 1, 2010, Hennepin County and Ramsey County may make
216.15monthly voluntary intergovernmental transfers to the commissioner in amounts not to
216.16exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from
216.17Ramsey County. The commissioner shall increase the medical assistance capitation
216.18payments to any licensed health plan under contract with the medical assistance program
216.19that agrees to make enhanced payments to Hennepin County Medical Center or Regions
216.20Hospital. The increase shall be in an amount equal to the annual value of the monthly
216.21transfers plus federal financial participation, with each health plan receiving its pro rata
216.22share of the increase based on the pro rata share of medical assistance admissions to
216.23Hennepin County Medical Center and Regions Hospital by those plans. Upon the request
216.24of the commissioner, health plans shall submit individual-level cost data for verification
216.25purposes. The commissioner may ratably reduce these payments on a pro rata basis in
216.26order to satisfy federal requirements for actuarial soundness. If payments are reduced,
216.27transfers shall be reduced accordingly. Any licensed health plan that receives increased
216.28medical assistance capitation payments under the intergovernmental transfer described in
216.29this paragraph shall increase its medical assistance payments to Hennepin County Medical
216.30Center and Regions Hospital by the same amount as the increased payments received in
216.31the capitation payment described in this paragraph.
216.32    (d) For the purposes of this subdivision and subdivision 3, the commissioner shall
216.33determine an upper payment limit for ambulance services affiliated with Hennepin County
216.34Medical Center and the city of St. Paul. The upper payment limit shall be based on
216.35the average commercial rate or be determined using another method acceptable to the
216.36Centers for Medicare and Medicaid Services. The commissioner shall inform Hennepin
217.1County and the city of St. Paul of the periodic intergovernmental transfers necessary to
217.2match the federal Medicaid payments available under this subdivision in order to make
217.3supplementary payments to Hennepin County Medical Center and the city of St. Paul
217.4equal to the difference between the established medical assistance payment for ambulance
217.5services and the upper payment limit. Upon receipt of these periodic transfers, the
217.6commissioner shall make supplementary payments to Hennepin County Medical Center
217.7and the city of St. Paul.
217.8    (e) The commissioner shall inform the transferring governmental entities on an
217.9ongoing basis of the need for any changes needed in the intergovernmental transfers in
217.10order to continue the payments under paragraphs (a) to (c) (d), at their maximum level,
217.11including increases in upper payment limits, changes in the federal Medicaid match, and
217.12other factors.
217.13    (e) (f) The payments in paragraphs (a) to (c) (d) shall be implemented independently
217.14of each other, subject to federal approval and to the receipt of transfers under subdivision 3.

217.15    Sec. 20. Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:
217.16    Subd. 5c. Medical education and research fund. (a) The commissioner of human
217.17services shall transfer each year to the medical education and research fund established
217.18under section 62J.692, an amount specified in this subdivision. The commissioner shall
217.19calculate the following:
217.20(1) an amount equal to the reduction in the prepaid medical assistance payments as
217.21specified in this clause. Until January 1, 2002, the county medical assistance capitation
217.22base rate prior to plan specific adjustments and after the regional rate adjustments under
217.23subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
217.24metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
217.25January 1, 2002, the county medical assistance capitation base rate prior to plan specific
217.26adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
217.27metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
217.28facility and elderly waiver payments and demonstration project payments operating
217.29under subdivision 23 are excluded from this reduction. The amount calculated under
217.30this clause shall not be adjusted for periods already paid due to subsequent changes to
217.31the capitation payments;
217.32(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
217.33section;
217.34(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
217.35paid under this section; and
218.1(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
218.2under this section.
218.3(b) This subdivision shall be effective upon approval of a federal waiver which
218.4allows federal financial participation in the medical education and research fund. The
218.5amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount
218.6transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under
218.7paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally
218.8reduce the amount specified under paragraph (a), clause (1).
218.9(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner
218.10shall transfer $21,714,000 each fiscal year to the medical education and research fund.
218.11(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
218.12transfer under paragraph (c), the commissioner shall transfer to the medical education
218.13research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 $49,552,000 in
218.14fiscal year 2014 and thereafter.

218.15    Sec. 21. Minnesota Statutes 2012, section 256B.69, subdivision 5i, is amended to read:
218.16    Subd. 5i. Administrative expenses. (a) Managed care plan and county-based
218.17purchasing plan administrative costs for a prepaid health plan provided under this section
218.18or section 256B.692 must not exceed by more than five percent that prepaid health plan's
218.19or county-based purchasing plan's actual calculated administrative spending for the
218.20previous calendar year as a percentage of total revenue. The penalty for exceeding this
218.21limit must be the amount of administrative spending in excess of 105 percent of the actual
218.22calculated amount. The commissioner may waive this penalty if the excess administrative
218.23spending is the result of unexpected shifts in enrollment or member needs or new program
218.24requirements.
218.25    (b) Expenses listed under section 62D.12, subdivision 9a, clause (4), are not
218.26allowable administrative expenses for rate-setting purposes under this section, unless
218.27approved by the commissioner. The following expenses are not allowable administrative
218.28expenses for rate-setting purposes under this section:
218.29    (1) charitable contributions made by the managed care plan or the county-based
218.30purchasing plan;
218.31    (2) any portion of an individual's compensation in excess of $200,000 paid by the
218.32managed care plan or county-based purchasing plan;
218.33    (3) any penalties or fines assessed against the managed care plan or county-based
218.34purchasing plan; and
219.1    (4) any indirect marketing or advertising expenses of the managed care plan or
219.2county-based purchasing plan.
219.3For the purposes of this subdivision, compensation includes salaries, bonuses and
219.4incentives, other reportable compensation on an IRS 990 form, retirement and other
219.5deferred compensation, and nontaxable benefits.

219.6    Sec. 22. Minnesota Statutes 2012, section 256B.69, subdivision 9c, is amended to read:
219.7    Subd. 9c. Managed care financial reporting. (a) The commissioner shall collect
219.8detailed data regarding financials, provider payments, provider rate methodologies, and
219.9other data as determined by the commissioner and managed care and county-based
219.10purchasing plans that are required to be submitted under this section. The commissioner,
219.11in consultation with the commissioners of health and commerce, and in consultation
219.12with managed care plans and county-based purchasing plans, shall set uniform criteria,
219.13definitions, and standards for the data to be submitted, and shall require managed care and
219.14county-based purchasing plans to comply with these criteria, definitions, and standards
219.15when submitting data under this section. In carrying out the responsibilities of this
219.16subdivision, the commissioner shall ensure that the data collection is implemented in an
219.17integrated and coordinated manner that avoids unnecessary duplication of effort. To the
219.18extent possible, the commissioner shall use existing data sources and streamline data
219.19collection in order to reduce public and private sector administrative costs. Nothing in
219.20this subdivision shall allow release of information that is nonpublic data pursuant to
219.21section 13.02.
219.22(b) Effective January 1, 2014, each managed care and county-based purchasing plan
219.23must annually quarterly provide to the commissioner the following information on state
219.24public programs, in the form and manner specified by the commissioner, according to
219.25guidelines developed by the commissioner in consultation with managed care plans and
219.26county-based purchasing plans under contract:
219.27(1) an income statement by program;
219.28(2) financial statement footnotes;
219.29(3) quarterly profitability by program and population group;
219.30(4) a medical liability summary by program and population group;
219.31(5) received but unpaid claims report by program;
219.32(6) services versus payment lags by program for hospital services, outpatient
219.33services, physician services, other medical services, and pharmaceutical benefits;
220.1(7) utilization reports that summarize utilization and unit cost information by
220.2program for hospitalization services, outpatient services, physician services, and other
220.3medical services;
220.4(8) pharmaceutical statistics by program and population group for measures of price
220.5and utilization of pharmaceutical services;
220.6(9) subcapitation expenses by population group;
220.7(10) third-party payments by program;
220.8(11) all new, active, and closed subrogation cases by program;
220.9(12) all new, active, and closed fraud and abuse cases by program;
220.10(13) medical loss ratios by program;
220.11(1) (14) administrative expenses by category and subcategory consistent with
220.12administrative expense reporting by program that reconcile to other state and federal
220.13regulatory agencies, by program;
220.14(2) (15) revenues by program, including investment income;
220.15(3) (16) nonadministrative service payments, provider payments, and reimbursement
220.16rates by provider type or service category, by program, paid by the managed care plan
220.17under this section or the county-based purchasing plan under section 256B.692 to
220.18providers and vendors for administrative services under contract with the plan, including
220.19but not limited to:
220.20(i) individual-level provider payment and reimbursement rate data;
220.21(ii) provider reimbursement rate methodologies by provider type, by program,
220.22including a description of alternative payment arrangements and payments outside the
220.23claims process;
220.24(iii) data on implementation of legislatively mandated provider rate changes; and
220.25(iv) individual-level provider payment and reimbursement rate data and plan-specific
220.26provider reimbursement rate methodologies by provider type, by program, including
220.27alternative payment arrangements and payments outside the claims process, provided to
220.28the commissioner under this subdivision are nonpublic data as defined in section 13.02;
220.29(4) (17) data on the amount of reinsurance or transfer of risk by program; and
220.30(5) (18) contribution to reserve, by program.
220.31(c) In the event a report is published or released based on data provided under
220.32this subdivision, the commissioner shall provide the report to managed care plans and
220.33county-based purchasing plans 30 15 days prior to the publication or release of the report.
220.34Managed care plans and county-based purchasing plans shall have 30 15 days to review
220.35the report and provide comment to the commissioner.
221.1The quarterly reports shall be submitted to the commissioner no later than 60 days after the
221.2end of the previous quarter, except the fourth-quarter report, which shall be submitted by
221.3April 1 of each year. The fourth-quarter report shall include audited financial statements,
221.4parent company audited financial statements, an income statement reconciliation report,
221.5and any other documentation necessary to reconcile the detailed reports to the audited
221.6financial statements.

221.7    Sec. 23. Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:
221.8    Subd. 31. Payment reduction. (a) Beginning September 1, 2011, the commissioner
221.9shall reduce payments and limit future rate increases paid to managed care plans and
221.10county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved
221.11on a statewide aggregate basis by program. The commissioner may use competitive
221.12bidding, payment reductions, or other reductions to achieve the reductions and limits
221.13in this subdivision.
221.14(b) Beginning September 1, 2011, the commissioner shall reduce payments to
221.15managed care plans and county-based purchasing plans as follows:
221.16(1) 2.0 percent for medical assistance elderly basic care. This shall not apply
221.17to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
221.18services;
221.19(2) 2.82 percent for medical assistance families and children;
221.20(3) 10.1 percent for medical assistance adults without children; and
221.21(4) 6.0 percent for MinnesotaCare families and children.
221.22(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed
221.23care plans and county-based purchasing plans for calendar year 2012 to a percentage of
221.24the rates in effect on August 31, 2011, as follows:
221.25(1) 98 percent for medical assistance elderly basic care. This shall not apply to
221.26Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
221.27services;
221.28(2) 97.18 percent for medical assistance families and children;
221.29(3) 89.9 percent for medical assistance adults without children; and
221.30(4) 94 percent for MinnesotaCare families and children.
221.31(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit
221.32the maximum annual trend increases to rates paid to managed care plans and county-based
221.33purchasing plans as follows:
222.1(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
222.2to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
222.3services;
222.4(2) 5.0 percent for medical assistance special needs basic care;
222.5(3) 2.0 percent for medical assistance families and children;
222.6(4) 3.0 percent for medical assistance adults without children;
222.7(5) 3.0 percent for MinnesotaCare families and children; and
222.8(6) 3.0 percent for MinnesotaCare adults without children.
222.9(e) The commissioner may limit trend increases to less than the maximum.
222.10Beginning July 1, 2014, the commissioner shall limit the maximum annual trend increases
222.11to rates paid to managed care plans and county-based purchasing plans as follows for
222.12calendar years 2014 and 2015:
222.13(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
222.14to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
222.15services;
222.16(2) 5.0 percent for medical assistance special needs basic care;
222.17(3) 2.0 percent for medical assistance families and children;
222.18(4) 3.0 percent for medical assistance adults without children;
222.19(5) 3.0 percent for MinnesotaCare families and children; and
222.20(6) 4.0 percent for MinnesotaCare adults without children.
222.21The commissioner may limit trend increases to less than the maximum. For calendar
222.22year 2014, the commissioner shall reduce the maximum aggregate trend increases by
222.23$47,000,000 in state and federal funds to account for the reductions in administrative
222.24expenses in subdivision 5i.

222.25    Sec. 24. Minnesota Statutes 2012, section 256B.69, is amended by adding a
222.26subdivision to read:
222.27    Subd. 35. Supplemental recovery program. The commissioner shall conduct a
222.28supplemental recovery program for third-party liabilities not recovered by managed care
222.29plans and county-based purchasing plans for state public health programs. Any third-party
222.30liability identified and recovered by the commissioner more than six months after the date
222.31a managed care plan or county-based purchasing plan receives a health care claim shall
222.32be retained by the commissioner and deposited in the general fund. The commissioner
222.33shall establish a mechanism for managed care plans and county-based purchasing plans to
222.34coordinate third-party liability collections efforts with the commissioner to ensure there
223.1is no duplication of efforts. The coordination mechanism must be consistent with the
223.2reporting requirements in subdivision 9c.

223.3    Sec. 25. Minnesota Statutes 2012, section 256B.76, subdivision 1, is amended to read:
223.4    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
223.5or after October 1, 1992, the commissioner shall make payments for physician services
223.6as follows:
223.7    (1) payment for level one Centers for Medicare and Medicaid Services' common
223.8procedural coding system codes titled "office and other outpatient services," "preventive
223.9medicine new and established patient," "delivery, antepartum, and postpartum care,"
223.10"critical care," cesarean delivery and pharmacologic management provided to psychiatric
223.11patients, and level three codes for enhanced services for prenatal high risk, shall be paid
223.12at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
223.1330, 1992. If the rate on any procedure code within these categories is different than the
223.14rate that would have been paid under the methodology in section 256B.74, subdivision 2,
223.15then the larger rate shall be paid;
223.16    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
223.17or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
223.18    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
223.19percentile of 1989, less the percent in aggregate necessary to equal the above increases
223.20except that payment rates for home health agency services shall be the rates in effect
223.21on September 30, 1992.
223.22    (b) Effective for services rendered on or after January 1, 2000, payment rates for
223.23physician and professional services shall be increased by three percent over the rates
223.24in effect on December 31, 1999, except for home health agency and family planning
223.25agency services. The increases in this paragraph shall be implemented January 1, 2000,
223.26for managed care.
223.27(c) Effective for services rendered on or after July 1, 2009, payment rates for
223.28physician and professional services shall be reduced by five percent, except that for the
223.29period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
223.30for the medical assistance and general assistance medical care programs, over the rates in
223.31effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
223.32to office or other outpatient visits, preventive medicine visits and family planning visits
223.33billed by physicians, advanced practice nurses, or physician assistants in a family planning
223.34agency or in one of the following primary care practices: general practice, general internal
223.35medicine, general pediatrics, general geriatrics, and family medicine. This reduction
224.1and the reductions in paragraph (d) do not apply to federally qualified health centers,
224.2rural health centers, and Indian health services. Effective October 1, 2009, payments
224.3made to managed care plans and county-based purchasing plans under sections 256B.69,
224.4256B.692 , and 256L.12 shall reflect the payment reduction described in this paragraph.
224.5(d) Effective for services rendered on or after July 1, 2010, payment rates for
224.6physician and professional services shall be reduced an additional seven percent over
224.7the five percent reduction in rates described in paragraph (c). This additional reduction
224.8does not apply to physical therapy services, occupational therapy services, and speech
224.9pathology and related services provided on or after July 1, 2010. This additional reduction
224.10does not apply to physician services billed by a psychiatrist or an advanced practice nurse
224.11with a specialty in mental health. Effective October 1, 2010, payments made to managed
224.12care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
224.13256L.12 shall reflect the payment reduction described in this paragraph.
224.14(e) Effective for services rendered on or after September 1, 2011, through June 30,
224.152013, payment rates for physician and professional services shall be reduced three percent
224.16from the rates in effect on August 31, 2011. This reduction does not apply to physical
224.17therapy services, occupational therapy services, and speech pathology and related services.
224.18(f) Effective for services rendered on or after September 1, 2014, payment rates for
224.19physician and professional services, including physical therapy, occupational therapy,
224.20speech pathology, and mental health services shall be increased by five percent from the
224.21rates in effect on August 31, 2014. In calculating this rate increase, the commissioner
224.22shall not include in the base rate for August 31, 2014, the rate increase provided under
224.23section 256B.76, subdivision 7. This increase does not apply to federally qualified health
224.24centers, rural health centers, and Indian health services. Payments made to managed
224.25care plans and county-based purchasing plans shall not be adjusted to reflect payments
224.26under this paragraph.

224.27    Sec. 26. Minnesota Statutes 2012, section 256B.76, subdivision 2, is amended to read:
224.28    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
224.29October 1, 1992, the commissioner shall make payments for dental services as follows:
224.30    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
224.31percent above the rate in effect on June 30, 1992; and
224.32    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
224.33percentile of 1989, less the percent in aggregate necessary to equal the above increases.
224.34    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
224.35shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
225.1    (c) Effective for services rendered on or after January 1, 2000, payment rates for
225.2dental services shall be increased by three percent over the rates in effect on December
225.331, 1999.
225.4    (d) Effective for services provided on or after January 1, 2002, payment for
225.5diagnostic examinations and dental x-rays provided to children under age 21 shall be the
225.6lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
225.7    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
225.82000, for managed care.
225.9(f) Effective for dental services rendered on or after October 1, 2010, by a
225.10state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
225.11on the Medicare principles of reimbursement. This payment shall be effective for services
225.12rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
225.13county-based purchasing plans.
225.14(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
225.15in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
225.16year, a supplemental state payment equal to the difference between the total payments
225.17in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
225.18services for the operation of the dental clinics.
225.19(h) If the cost-based payment system for state-operated dental clinics described in
225.20paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
225.21designated as critical access dental providers under subdivision 4, paragraph (b), and shall
225.22receive the critical access dental reimbursement rate as described under subdivision 4,
225.23paragraph (a).
225.24(i) Effective for services rendered on or after September 1, 2011, through June 30,
225.252013, payment rates for dental services shall be reduced by three percent. This reduction
225.26does not apply to state-operated dental clinics in paragraph (f).
225.27(j) Effective for services rendered on or after January 1, 2014, payment rates for
225.28dental services shall be increased by five percent from the rates in effect on December
225.2931, 2013. This increase does not apply to state-operated dental clinics in paragraph (f),
225.30federally qualified health centers, rural health centers, and Indian health services. Effective
225.31January 1, 2014, payments made to managed care plans and county-based purchasing
225.32plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase
225.33described in this paragraph.

225.34    Sec. 27. Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:
226.1    Subd. 4. Critical access dental providers. (a) Effective for dental services rendered
226.2on or after January 1, 2002, the commissioner shall increase reimbursements to dentists
226.3and dental clinics deemed by the commissioner to be critical access dental providers.
226.4For dental services rendered on or after July 1, 2007, the commissioner shall increase
226.5reimbursement by 30 35 percent above the reimbursement rate that would otherwise be
226.6paid to the critical access dental provider. The commissioner shall pay the managed
226.7care plans and county-based purchasing plans in amounts sufficient to reflect increased
226.8reimbursements to critical access dental providers as approved by the commissioner.
226.9(b) The commissioner shall designate the following dentists and dental clinics as
226.10critical access dental providers:
226.11    (1) nonprofit community clinics that:
226.12(i) have nonprofit status in accordance with chapter 317A;
226.13(ii) have tax exempt status in accordance with the Internal Revenue Code, section
226.14501(c)(3);
226.15(iii) are established to provide oral health services to patients who are low income,
226.16uninsured, have special needs, and are underserved;
226.17(iv) have professional staff familiar with the cultural background of the clinic's
226.18patients;
226.19(v) charge for services on a sliding fee scale designed to provide assistance to
226.20low-income patients based on current poverty income guidelines and family size;
226.21(vi) do not restrict access or services because of a patient's financial limitations
226.22or public assistance status; and
226.23(vii) have free care available as needed;
226.24    (2) federally qualified health centers, rural health clinics, and public health clinics;
226.25    (3) city or county owned and operated hospital-based dental clinics;
226.26(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
226.27accordance with chapter 317A with more than 10,000 patient encounters per year with
226.28patients who are uninsured or covered by medical assistance, general assistance medical
226.29care, or MinnesotaCare; and
226.30(5) a dental clinic owned and operated by the University of Minnesota or the
226.31Minnesota State Colleges and Universities system.; and
226.32(6) private practicing dentists if:
226.33(i) the dentist's office is located within a health professional shortage area as defined
226.34under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
226.35section 254E;
227.1(ii) more than 50 percent of the dentist's patient encounters per year are with patients
227.2who are uninsured or covered by medical assistance or MinnesotaCare;
227.3(iii) the dentist does not restrict access or services because of a patient's financial
227.4limitations or public assistance status; and
227.5(iv) the level of service provided by the dentist is critical to maintaining adequate
227.6levels of patient access within the service area in which the dentist operates.
227.7    (c) The commissioner may designate a dentist or dental clinic as a critical access
227.8dental provider if the dentist or dental clinic is willing to provide care to patients covered
227.9by medical assistance, general assistance medical care, or MinnesotaCare at a level which
227.10significantly increases access to dental care in the service area.
227.11(d) (c) A designated critical access clinic shall receive the reimbursement rate
227.12specified in paragraph (a) for dental services provided off site at a private dental office if
227.13the following requirements are met:
227.14(1) the designated critical access dental clinic is located within a health professional
227.15shortage area as defined under Code of Federal Regulations, title 42, part 5, and United
227.16States Code, title 42, section 254E, and is located outside the seven-county metropolitan
227.17area;
227.18(2) the designated critical access dental clinic is not able to provide the service
227.19and refers the patient to the off-site dentist;
227.20(3) the service, if provided at the critical access dental clinic, would be reimbursed
227.21at the critical access reimbursement rate;
227.22(4) the dentist and allied dental professionals providing the services off site are
227.23licensed and in good standing under chapter 150A;
227.24(5) the dentist providing the services is enrolled as a medical assistance provider;
227.25(6) the critical access dental clinic submits the claim for services provided off site
227.26and receives the payment for the services; and
227.27(7) the critical access dental clinic maintains dental records for each claim submitted
227.28under this paragraph, including the name of the dentist, the off-site location, and the
227.29license number of the dentist and allied dental professionals providing the services.

227.30    Sec. 28. Minnesota Statutes 2012, section 256B.76, is amended by adding a
227.31subdivision to read:
227.32    Subd. 7. Payment for certain primary care services and immunization
227.33administration. Payment for certain primary care services and immunization
227.34administration services rendered on or after January 1, 2013, through December 31, 2014,
227.35shall be made in accordance with section 1902(a)(13) of the Social Security Act.

228.1    Sec. 29. Minnesota Statutes 2012, section 256B.764, is amended to read:
228.2256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
228.3    (a) Effective for services rendered on or after July 1, 2007, payment rates for family
228.4planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
228.5when these services are provided by a community clinic as defined in section 145.9268,
228.6subdivision 1.
228.7    (b) Effective for services rendered on or after July 1, 2013, payment rates for
228.8family planning services shall be increased by 20 percent over the rates in effect June
228.930, 2013, when these services are provided by a community clinic as defined in section
228.10145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care
228.11and county-based purchasing plans to reflect this increase, and shall require plans to pass
228.12on the full amount of the rate increase to eligible community clinics, in the form of higher
228.13payment rates for family planning services.

228.14    Sec. 30. Minnesota Statutes 2012, section 256B.766, is amended to read:
228.15256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
228.16(a) Effective for services provided on or after July 1, 2009, total payments for basic
228.17care services, shall be reduced by three percent, except that for the period July 1, 2009,
228.18through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
228.19assistance and general assistance medical care programs, prior to third-party liability and
228.20spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
228.21therapy services, occupational therapy services, and speech-language pathology and
228.22related services as basic care services. The reduction in this paragraph shall apply to
228.23physical therapy services, occupational therapy services, and speech-language pathology
228.24and related services provided on or after July 1, 2010.
228.25(b) Payments made to managed care plans and county-based purchasing plans shall
228.26be reduced for services provided on or after October 1, 2009, to reflect the reduction
228.27effective July 1, 2009, and payments made to the plans shall be reduced effective October
228.281, 2010, to reflect the reduction effective July 1, 2010.
228.29(c) Effective for services provided on or after September 1, 2011, through June 30,
228.302013, total payments for outpatient hospital facility fees shall be reduced by five percent
228.31from the rates in effect on August 31, 2011.
228.32(d) Effective for services provided on or after September 1, 2011, through June
228.3330, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
228.34and durable medical equipment not subject to a volume purchase contract, prosthetics
228.35and orthotics, renal dialysis services, laboratory services, public health nursing services,
229.1physical therapy services, occupational therapy services, speech therapy services,
229.2eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
229.3purchase contract, and anesthesia services, and hospice services shall be reduced by three
229.4percent from the rates in effect on August 31, 2011.
229.5(e) Effective for services provided on or after September 1, 2014, payments for
229.6ambulatory surgery centers facility fees, medical supplies and durable medical equipment
229.7not subject to a volume purchase contract, prosthetics and orthotics, hospice services, renal
229.8dialysis services, laboratory services, public health nursing services, eyeglasses not subject
229.9to a volume purchase contract, and hearing aids not subject to a volume purchase contract
229.10shall be increased by three percent and payments for outpatient hospital facility fees shall
229.11be increased by three percent. Payments made to managed care plans and county-based
229.12purchasing plans shall not be adjusted to reflect payments under this paragraph.
229.13(e) (f) This section does not apply to physician and professional services, inpatient
229.14hospital services, family planning services, mental health services, dental services,
229.15prescription drugs, medical transportation, federally qualified health centers, rural health
229.16centers, Indian health services, and Medicare cost-sharing.

229.17    Sec. 31. Minnesota Statutes 2012, section 256B.767, is amended to read:
229.18256B.767 MEDICARE PAYMENT LIMIT.
229.19(a) Effective for services rendered on or after July 1, 2010, fee-for-service payment
229.20rates for physician and professional services under section 256B.76, subdivision 1, and
229.21basic care services subject to the rate reduction specified in section 256B.766, shall not
229.22exceed the Medicare payment rate for the applicable service, as adjusted for any changes
229.23in Medicare payment rates after July 1, 2010. The commissioner shall implement this
229.24section after any other rate adjustment that is effective July 1, 2010, and shall reduce rates
229.25under this section by first reducing or eliminating provider rate add-ons.
229.26(b) This section does not apply to services provided by advanced practice certified
229.27nurse midwives licensed under chapter 148 or traditional midwives licensed under chapter
229.28147D. Notwithstanding this exemption, medical assistance fee-for-service payment rates
229.29for advanced practice certified nurse midwives and licensed traditional midwives shall
229.30equal and shall not exceed the medical assistance payment rate to physicians for the
229.31applicable service.
229.32(c) This section does not apply to mental health services or physician services billed
229.33by a psychiatrist or an advanced practice registered nurse with a specialty in mental health.
229.34(d) Effective for durable medical equipment, prosthetics, orthotics, or supplies
229.35provided on or after July 1, 2013, through June 30, 2014, the payment rate for items
230.1that are subject to the rates established under Medicare's National Competitive Bidding
230.2Program shall be equal to the rate that applies to the same item when not subject to the
230.3rate established under Medicare's National Competitive Bidding Program. This paragraph
230.4does not apply to mail order diabetic supplies and does not apply to items provided to
230.5dually eligible recipients when Medicare is the primary payer of the item.

230.6    Sec. 32. Laws 2013, chapter 1, section 6, is amended to read:
230.7    Sec. 6. TRANSFER.
230.8(a) The commissioner of management and budget shall transfer from the health care
230.9access fund to the general fund up to $21,319,000 in fiscal year 2014; up to $42,314,000
230.10in fiscal year 2015; up to $56,147,000 in fiscal year 2016; and up to $64,683,000 in fiscal
230.11year 2017.
230.12(b) The commissioner of human services shall determine the difference between the
230.13actual or forecasted cost to the medical assistance program of adding 19- and 20-year-olds
230.14and parents and relative caretaker populations with income between 100 and 138 percent of
230.15the federal poverty guidelines and the cost of adding those populations that was estimated
230.16during the 2013 legislative session based on the data from the February 2013 forecast.
230.17(c) For each fiscal year from 2014 to 2017, the commissioner of human services
230.18shall certify and report to the commissioner of management and budget the actual
230.19or forecasted cost difference of adding 19- and 20-year-olds and parents and relative
230.20caretaker populations with income between 100 and 138 percent of the federal poverty
230.21guidelines, as determined under paragraph (b), to the commissioner of management and
230.22budget at least four weeks prior to the release of a forecast under Minnesota Statutes,
230.23section 16A.103, of each fiscal year.
230.24(d) No later than three weeks before the release of the forecast under Minnesota
230.25Statutes, section 16A.103, the commissioner of management and budget shall reduce the
230.26health care access fund transfer in paragraph (a), by the cumulative differences in costs
230.27reported by the commissioner of human services under paragraph (c). If, for any fiscal
230.28year, the amount of the cumulative cost differences determined under paragraph (b) is
230.29positive, no change is made to the appropriation. If, for any fiscal year, the amount of the
230.30cumulative cost differences determined under paragraph (b) is less than the amount of the
230.31original appropriation, the appropriation for that year must be zero.

230.32    Sec. 33. REQUEST FOR INFORMATION; EMERGENCY MEDICAL
230.33ASSISTANCE AND THE UNINSURED STUDY.
231.1(a) The commissioner of human services, in consultation with safety net hospitals,
231.2nonprofit health care coverage programs, nonprofit community clinics, counties, and other
231.3interested parties, shall identify alternatives and make recommendations for providing
231.4coordinated and cost-effective health care and coverage to individuals who:
231.5(1) meet eligibility standards for emergency medical assistance; or
231.6(2) are uninsured and ineligible for other state public health care programs, have
231.7incomes below 400 percent of the federal poverty level, and are ineligible for premium
231.8credits through the Minnesota Insurance Marketplace as defined under Minnesota Statutes,
231.9section 62V.02.
231.10(b) The commissioner of human services shall issue a request for information
231.11to help identify options for coverage of medically necessary services not eligible for
231.12federal financial participation for emergency medical assistance recipients and medically
231.13necessary services for individuals who are uninsured and ineligible for other state public
231.14health care programs or coverage through the Minnesota Insurance Marketplace. The
231.15request for information shall provide:
231.16(1) the identification of services, including community-based medical, dental, and
231.17behavioral health services, necessary to reduce emergency department and inpatient
231.18hospital utilization for these recipients;
231.19(2) delivery system options, including for each option how the system would be
231.20organized to promote care coordination and cost-effectiveness, and how the system would
231.21be available statewide;
231.22(3) funding options and payment mechanisms to encourage providers to manage
231.23the delivery of care to these populations at a lower cost of care and with better patient
231.24outcomes than the current system;
231.25(4) how the funding and delivery of services will be coordinated with the services
231.26covered under emergency medical assistance;
231.27(5) options for administration of eligibility determination and service delivery; and
231.28(6) evaluation methods to measure cost-effectiveness and health outcomes that take
231.29into consideration the social determinants of health care for recipients participating in
231.30this alternative coverage option.
231.31(c) The commissioner shall issue a request for information by August 1, 2013, and
231.32respondents to the request must submit information to the commissioner by October
231.331, 2013.
231.34(d) The commissioner shall incorporate the information obtained through the request
231.35for information described in paragraph (b) and information collected by the commissioner
232.1of health and other relevant sources related to the uninsured in this state when developing
232.2recommendations.
232.3(e) The commissioner shall submit recommendations to the chairs and ranking
232.4minority members of the legislative committees and divisions with jurisdiction over health
232.5and human services and finance by January 15, 2014.
232.6EFFECTIVE DATE.This section is effective the day following final enactment.

232.7    Sec. 34. REQUEST FOR INFORMATION; EMERGENCY MEDICAL
232.8ASSISTANCE.
232.9(a) The commissioner of human services shall issue a request for information (RFI)
232.10to identify and develop options for a program to provide emergency medical assistance
232.11recipients with coverage for medically necessary services not eligible for federal financial
232.12participation. The RFI must focus on providing coverage for nonemergent services
232.13for recipients who have two or more chronic conditions and have had two or more
232.14hospitalizations covered by emergency medical assistance in a one-year period.
232.15(b) The RFI must be issued by August 1, 2013, and require respondents to submit
232.16information to the commissioner by November 1, 2013. The RFI must request information
232.17on:
232.18(1) services necessary to reduce emergency department and inpatient hospital use for
232.19emergency medical assistance recipients;
232.20(2) methods of service delivery that promote efficiency and cost-effectiveness, and
232.21provide statewide access;
232.22(3) funding options for the services to be covered under the program;
232.23(4) coordination of service delivery and funding with services covered under
232.24emergency medical assistance;
232.25(5) options for program administration; and
232.26(6) methods to evaluate the program, including evaluation of cost-effectiveness and
232.27health outcomes for those emergency medical assistance recipients eligible for coverage
232.28of additional services under the program.
232.29(c) The commissioner shall make information submitted in response to the RFI
232.30available on the agency Web site. The commissioner, based on the responses to the RFI,
232.31shall submit recommendations on providing emergency medical assistance recipients
232.32with coverage for nonemergent services, as described in paragraph (a), to the chairs and
232.33ranking minority members of the legislative committees with jurisdiction over health and
232.34human services policy and finance by January 15, 2014.

233.1    Sec. 35. DENTAL ACCESS AND REIMBURSEMENT REPORT.
233.2    Subdivision 1. Study. (a) The commissioner of human services shall study
233.3the current oral health and dental services delivery system for state public health
233.4care programs to improve access and ensure cost-effective delivery of services. The
233.5commissioner shall make recommendations on modifying the delivery of services and
233.6reimbursement methods, including modifications to the critical access dental provider
233.7payments under Minnesota Statutes, section 256B.76, subdivision 4.
233.8(b) The commissioner shall consult with dental providers enrolled in Minnesota
233.9health care programs, including providers who serve substantial numbers of low-income
233.10and uninsured patients and are currently receiving enhanced critical access dental provider
233.11payments.
233.12    Subd. 2. Service delivery and reimbursement methods. The recommendations
233.13must address:
233.14(1) targeting state funding and critical access dental payments to improve access
233.15to oral health services for individuals enrolled in Minnesota health care programs who
233.16are not receiving timely and appropriate dental services;
233.17(2) encouraging the use of cost-effective service delivery methods, workforce
233.18innovations, and the delivery of preventive services, including, but not limited to, dental
233.19sealants that will reduce dental disease and future costs of treatment;
233.20(3) improving access in all geographic areas of the state;
233.21(4) encouraging the use of tele-dentistry and mobile dental equipment to serve
233.22underserved patients and communities;
233.23(5) evaluating the use of a single administrator delivery model;
233.24(6) compensating providers for the added costs to providers of serving low-income
233.25and underserved patients and populations who experience the greatest oral health
233.26disparities in terms of incidence of oral health disease and access to and utilization of
233.27needed oral health services;
233.28(7) encouraging coordination of oral health care with other health care services;
233.29(8) preventing overtreatment, fraud, and abuse; and
233.30(9) reducing administrative costs for the state and for dental providers.
233.31    Subd. 3. Report. The commissioner shall submit a report on the recommendations to
233.32the chairs and ranking minority members of the of the legislative committees and divisions
233.33with jurisdiction over health and human services policy and finance by December 15, 2013.

234.1ARTICLE 7

234.2CONTINUING CARE

234.3    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 6, is amended to read:
234.4    Subd. 6. Penalties for late or nonsubmission. (a) A facility that fails to complete
234.5or submit an assessment for a RUG-III or RUG-IV classification within seven days of the
234.6time requirements in subdivisions 4 and 5 is subject to a reduced rate for that resident.
234.7The reduced rate shall be the lowest rate for that facility. The reduced rate is effective on
234.8the day of admission for new admission assessments or on the day that the assessment
234.9was due for all other assessments and continues in effect until the first day of the month
234.10following the date of submission of the resident's assessment.
234.11    (b) If loss of revenue due to penalties incurred by a facility for any period of 92 days
234.12are equal to or greater than 1.0 percent of the total operating costs on the facility's most
234.13recent annual statistical and cost report, a facility may apply to the commissioner of
234.14human services for a reduction in the total penalty amount. The commissioner of human
234.15services, in consultation with the commissioner of health, may, at the sole discretion of
234.16the commissioner of human services, limit the penalty for residents covered by medical
234.17assistance to 15 days.

234.18    Sec. 2. Minnesota Statutes 2012, section 144A.071, subdivision 4b, is amended to read:
234.19    Subd. 4b. Licensed beds on layaway status. A licensed and certified nursing
234.20facility may lay away, upon prior written notice to the commissioner of health, licensed
234.21and certified beds. A nursing facility may not discharge a resident in order to lay away
234.22a bed. Notice to the commissioner shall be given 60 days prior to the effective date of
234.23the layaway. Beds on layaway shall have the same status as voluntarily delicensed and
234.24decertified beds and shall not be subject to license fees and license surcharge fees. In
234.25addition, beds on layaway may be removed from layaway at any time on or after one year
234.26 six months after the effective date of layaway in the facility of origin, with a 60-day notice
234.27to the commissioner. A nursing facility that removes beds from layaway may not place
234.28beds on layaway status for one year six months after the effective date of the removal from
234.29layaway. The commissioner may approve the immediate removal of beds from layaway if
234.30necessary to provide access to those nursing home beds to residents relocated from other
234.31nursing homes due to emergency situations or closure. In the event approval is granted,
234.32the one-year six-month restriction on placing beds on layaway after a removal of beds
234.33from layaway shall not apply. Beds may remain on layaway for up to ten years. The
234.34commissioner may approve placing and removing beds on layaway at any time during
234.35renovation or construction related to a moratorium project approved under this section
235.1or section 144A.073. Nursing facilities are not required to comply with any licensure or
235.2certification requirements for beds on layaway status.

235.3    Sec. 3. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
235.4    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
235.5initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
235.62960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
235.79555.6265, under this chapter for a physical location that will not be the primary residence
235.8of the license holder for the entire period of licensure. If a license is issued during this
235.9moratorium, and the license holder changes the license holder's primary residence away
235.10from the physical location of the foster care license, the commissioner shall revoke the
235.11license according to section 245A.07. Exceptions to the moratorium include:
235.12(1) foster care settings that are required to be registered under chapter 144D;
235.13(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
235.14and determined to be needed by the commissioner under paragraph (b);
235.15(3) new foster care licenses determined to be needed by the commissioner under
235.16paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center,
235.17or; restructuring of state-operated services that limits the capacity of state-operated
235.18facilities; or, allowing movement to the community for people who no longer require the
235.19level of care provided in state-operated facilities as provided under section 256B.092,
235.20subdivision 13, or 256B.49, subdivision 24;
235.21(4) new foster care licenses determined to be needed by the commissioner under
235.22paragraph (b) for persons requiring hospital level care; or
235.23(5) new foster care licenses determined to be needed by the commissioner for the
235.24transition of people from personal care assistance to the home and community-based
235.25services.
235.26(b) The commissioner shall determine the need for newly licensed foster care homes
235.27as defined under this subdivision. As part of the determination, the commissioner shall
235.28consider the availability of foster care capacity in the area in which the licensee seeks to
235.29operate, and the recommendation of the local county board. The determination by the
235.30commissioner must be final. A determination of need is not required for a change in
235.31ownership at the same address.
235.32(c) The commissioner shall study the effects of the license moratorium under this
235.33subdivision and shall report back to the legislature by January 15, 2011. This study shall
235.34include, but is not limited to the following:
236.1(1) the overall capacity and utilization of foster care beds where the physical location
236.2is not the primary residence of the license holder prior to and after implementation
236.3of the moratorium;
236.4(2) the overall capacity and utilization of foster care beds where the physical
236.5location is the primary residence of the license holder prior to and after implementation
236.6of the moratorium; and
236.7(3) the number of licensed and occupied ICF/MR beds prior to and after
236.8implementation of the moratorium.
236.9(d) (c) When a foster care recipient moves out of a foster home that is not the primary
236.10residence of the license holder according to section 256B.49, subdivision 15, paragraph
236.11(f), the county shall immediately inform the Department of Human Services Licensing
236.12Division. The department shall decrease the statewide licensed capacity for foster care
236.13settings where the physical location is not the primary residence of the license holder, if
236.14the voluntary changes described in paragraph (f) (e) are not sufficient to meet the savings
236.15required by reductions in licensed bed capacity under Laws 2011, First Special Session
236.16chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term
236.17care residential services capacity within budgetary limits. Implementation of the statewide
236.18licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense
236.19up to 128 beds by June 30, 2014, using the needs determination process. Under this
236.20paragraph, the commissioner has the authority to reduce unused licensed capacity of a
236.21current foster care program to accomplish the consolidation or closure of settings. Under
236.22this paragraph, the commissioner has the authority to manage statewide capacity, including
236.23adjusting the capacity available to each county and adjusting statewide available capacity,
236.24to meet the statewide needs identified through the process in paragraph (e). A decreased
236.25licensed capacity according to this paragraph is not subject to appeal under this chapter.
236.26(e) (d) Residential settings that would otherwise be subject to the decreased license
236.27capacity established in paragraph (d) (c) shall be exempt under the following circumstances:
236.28(1) until August 1, 2013, the license holder's beds occupied by residents whose
236.29primary diagnosis is mental illness and the license holder is:
236.30(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
236.31health services (ARMHS) as defined in section 256B.0623;
236.32(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
236.339520.0870;
236.34(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
236.359520.0870; or
237.1(iv) a provider of intensive residential treatment services (IRTS) licensed under
237.2Minnesota Rules, parts 9520.0500 to 9520.0670; or
237.3(2) the license holder's beds occupied by residents whose primary diagnosis is
237.4mental illness and the license holder is certified under the requirements in subdivision 6a.
237.5(f) (e) A resource need determination process, managed at the state level, using the
237.6available reports required by section 144A.351, and other data and information shall
237.7be used to determine where the reduced capacity required under paragraph (d) (c) will
237.8be implemented. The commissioner shall consult with the stakeholders described in
237.9section 144A.351, and employ a variety of methods to improve the state's capacity to
237.10meet long-term care service needs within budgetary limits, including seeking proposals
237.11from service providers or lead agencies to change service type, capacity, or location to
237.12improve services, increase the independence of residents, and better meet needs identified
237.13by the long-term care services reports and statewide data and information. By February
237.141 of each, 2013, and August 1, 2014, and each following year, the commissioner shall
237.15provide information and data on the overall capacity of licensed long-term care services,
237.16actions taken under this subdivision to manage statewide long-term care services and
237.17supports resources, and any recommendations for change to the legislative committees
237.18with jurisdiction over health and human services budget.
237.19    (g) (f) At the time of application and reapplication for licensure, the applicant and the
237.20license holder that are subject to the moratorium or an exclusion established in paragraph
237.21(a) are required to inform the commissioner whether the physical location where the foster
237.22care will be provided is or will be the primary residence of the license holder for the entire
237.23period of licensure. If the primary residence of the applicant or license holder changes, the
237.24applicant or license holder must notify the commissioner immediately. The commissioner
237.25shall print on the foster care license certificate whether or not the physical location is the
237.26primary residence of the license holder.
237.27    (h) (g) License holders of foster care homes identified under paragraph (g) (f) that
237.28are not the primary residence of the license holder and that also provide services in the
237.29foster care home that are covered by a federally approved home and community-based
237.30services waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must
237.31inform the human services licensing division that the license holder provides or intends to
237.32provide these waiver-funded services. These license holders must be considered registered
237.33under section 256B.092, subdivision 11, paragraph (c), and this registration status must
237.34be identified on their license certificates.

238.1    Sec. 4. Minnesota Statutes 2012, section 252.291, is amended by adding a subdivision
238.2to read:
238.3    Subd. 2b. Nicollet County facility project. The commissioner of health shall
238.4certify one additional bed in an intermediate care facility for persons with developmental
238.5disabilities in Nicollet County.

238.6    Sec. 5. Minnesota Statutes 2012, section 256.9657, subdivision 3a, is amended to read:
238.7    Subd. 3a. ICF/MR ICF/DD license surcharge. (a) Effective July 1, 2003, each
238.8non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay
238.9to the commissioner an annual surcharge according to the schedule in subdivision 4,
238.10paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of
238.11licensed beds is reduced, the surcharge shall be based on the number of remaining licensed
238.12beds the second month following the receipt of timely notice by the commissioner of
238.13human services that beds have been delicensed. The facility must notify the commissioner
238.14of health in writing when beds are delicensed. The commissioner of health must notify
238.15the commissioner of human services within ten working days after receiving written
238.16notification. If the notification is received by the commissioner of human services by
238.17the 15th of the month, the invoice for the second following month must be reduced to
238.18recognize the delicensing of beds. The commissioner may reduce, and may subsequently
238.19restore, the surcharge under this subdivision based on the commissioner's determination of
238.20a permissible surcharge.
238.21(b) Effective July 1, 2013, the surcharge under paragraph (a) is increased to$3,679
238.22per licensed bed.
238.23EFFECTIVE DATE.This section is effective July 1, 2013.

238.24    Sec. 6. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to read:
238.25    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
238.26waivered services to an individual elderly waiver client except for individuals described in
238.27paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility
238.28rate of the case mix resident class to which the elderly waiver client would be assigned
238.29under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance
238.30needs allowance as described in subdivision 1d, paragraph (a), until the first day of the
238.31state fiscal year in which the resident assessment system as described in section 256B.438
238.32for nursing home rate determination is implemented. Effective on the first day of the state
238.33fiscal year in which the resident assessment system as described in section 256B.438 for
238.34nursing home rate determination is implemented and the first day of each subsequent state
239.1fiscal year, the monthly limit for the cost of waivered services to an individual elderly
239.2waiver client shall be the rate of the case mix resident class to which the waiver client
239.3would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on
239.4the last day of the previous state fiscal year, adjusted by any legislatively adopted home
239.5and community-based services percentage rate adjustment.
239.6    (b) The monthly limit for the cost of waivered services to an individual elderly
239.7waiver client assigned to a case mix classification A under paragraph (a) with:
239.8(1) no dependencies in activities of daily living; or
239.9(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
239.10when the dependency score in eating is three or greater as determined by an assessment
239.11performed under section 256B.0911 shall be $1,750 per month effective on July 1, 2011,
239.12for all new participants enrolled in the program on or after July 1, 2011. This monthly
239.13limit shall be applied to all other participants who meet this criteria at reassessment. This
239.14monthly limit shall be increased annually as described in paragraph (a).
239.15(c) If extended medical supplies and equipment or environmental modifications are
239.16or will be purchased for an elderly waiver client, the costs may be prorated for up to
239.1712 consecutive months beginning with the month of purchase. If the monthly cost of a
239.18recipient's waivered services exceeds the monthly limit established in paragraph (a) or
239.19(b), the annual cost of all waivered services shall be determined. In this event, the annual
239.20cost of all waivered services shall not exceed 12 times the monthly limit of waivered
239.21services as described in paragraph (a) or (b).
239.22(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
239.23any necessary home care services described in section 256B.0651, subdivision 2, for
239.24individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
239.25subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
239.26amount established for home care services as described in section 256B.0652, subdivision
239.277, and the annual average contracted amount established by the commissioner for nursing
239.28facility services for ventilator-dependent individuals. This monthly limit shall be increased
239.29annually as described in paragraph (a).

239.30    Sec. 7. Minnesota Statutes 2012, section 256B.0915, is amended by adding a
239.31subdivision to read:
239.32    Subd. 3j. Individual community living support. Upon federal approval, there
239.33is established a new service called individual community living support (ICLS) that is
239.34available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor
239.35have any interest in the recipient's housing. ICLS must be delivered in a single-family
240.1home or apartment where the service recipient or their family owns or rents, as
240.2demonstrated by a lease agreement, and maintains control over the individual unit. Case
240.3managers or care coordinators must develop individual ICLS plans in consultation with
240.4the client using a tool developed by the commissioner. The commissioner shall establish
240.5payment rates and mechanisms to align payments with the type and amount of service
240.6provided, assure statewide uniformity for payment rates, and assure cost-effectiveness.
240.7Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and
240.8Human Services to avoid conflict with provider regulatory standards pursuant to section
240.9144A.43 and chapter 245D.

240.10    Sec. 8. Minnesota Statutes 2012, section 256B.0916, is amended by adding a
240.11subdivision to read:
240.12    Subd. 11. Excess spending. County and tribal agencies are responsible for spending
240.13in excess of the allocation made by the commissioner. In the event a county or tribal
240.14agency spends in excess of the allocation made by the commissioner for a given allocation
240.15period, they must submit a corrective action plan to the commissioner. The plan must state
240.16the actions the agency will take to correct their overspending for the year following the
240.17period when the overspending occurred. Failure to correct overspending shall result in
240.18recoupment of spending in excess of the allocation. Nothing in this subdivision shall be
240.19construed as reducing the county's responsibility to offer and make available feasible
240.20home and community-based options to eligible waiver recipients within the resources
240.21allocated to them for that purpose.

240.22    Sec. 9. Minnesota Statutes 2012, section 256B.092, subdivision 7, is amended to read:
240.23    Subd. 7. Screening teams. (a) For persons with developmental disabilities, screening
240.24teams shall be established which shall evaluate the need for the level of care provided
240.25by residential-based habilitation services, residential services, training and habilitation
240.26services, and nursing facility services. The evaluation shall address whether home and
240.27community-based services are appropriate for persons who are at risk of placement in an
240.28intermediate care facility for persons with developmental disabilities, or for whom there is
240.29reasonable indication that they might require this level of care. The screening team shall
240.30make an evaluation of need within 60 working days of a request for service by a person
240.31with a developmental disability, and within five working days of an emergency admission
240.32of a person to an intermediate care facility for persons with developmental disabilities.
240.33(b) The screening team shall consist of the case manager for persons with
240.34developmental disabilities, the person, the person's legal guardian or conservator, or the
241.1parent if the person is a minor, and a qualified developmental disability professional, as
241.2defined in Code of Federal Regulations, title 42, section 483.430, as amended through
241.3June 3, 1988. The case manager may also act as the qualified developmental disability
241.4professional if the case manager meets the federal definition.
241.5(c) County social service agencies may contract with a public or private agency
241.6or individual who is not a service provider for the person for the public guardianship
241.7representation required by the screening or individual service planning process. The
241.8contract shall be limited to public guardianship representation for the screening and
241.9individual service planning activities. The contract shall require compliance with the
241.10commissioner's instructions and may be for paid or voluntary services.
241.11(d) For persons determined to have overriding health care needs and are
241.12seeking admission to a nursing facility or an ICF/MR, or seeking access to home and
241.13community-based waivered services, a registered nurse must be designated as either the
241.14case manager or the qualified developmental disability professional.
241.15(e) For persons under the jurisdiction of a correctional agency, the case manager
241.16must consult with the corrections administrator regarding additional health, safety, and
241.17supervision needs.
241.18(f) The case manager, with the concurrence of the person, the person's legal guardian
241.19or conservator, or the parent if the person is a minor, may invite other individuals to
241.20attend meetings of the screening team. With the permission of the person being screened
241.21or the person's designated legal representative, the person's current provider of services
241.22may submit a written report outlining their recommendations regarding the person's care
241.23needs prepared by a direct service employee with at least 20 hours of service to that client.
241.24The screening team must notify the provider of the date by which this information is to
241.25be submitted. This information must be provided to the screening team and the person
241.26or the person's legal representative and must be considered prior to the finalization of
241.27the screening.
241.28(g) Upon federal approval, if during an assessment or reassessment the recipient
241.29is determined to be able to have the recipient's needs met through alternative services
241.30in a less restrictive setting, the case manager shall help the recipient develop a plan to
241.31transition to an appropriate less restrictive setting.
241.32(g) (h) No member of the screening team shall have any direct or indirect service
241.33provider interest in the case.
241.34(h) (i) Nothing in this section shall be construed as requiring the screening team
241.35meeting to be separate from the service planning meeting.
241.36EFFECTIVE DATE.This section is effective January 1, 2014.

242.1    Sec. 10. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
242.2    Subd. 11. Residential support services. (a) Upon federal approval, there is
242.3established a new service called residential support that is available on the community
242.4alternative care, community alternatives for disabled individuals, developmental
242.5disabilities, and brain injury waivers. Existing waiver service descriptions must be
242.6modified to the extent necessary to ensure there is no duplication between other services.
242.7Residential support services must be provided by vendors licensed as a community
242.8residential setting as defined in section 245A.11, subdivision 8.
242.9    (b) Residential support services must meet the following criteria:
242.10    (1) providers of residential support services must own or control the residential site;
242.11    (2) the residential site must not be the primary residence of the license holder;
242.12    (3) the residential site must have a designated program supervisor responsible for
242.13program oversight, development, and implementation of policies and procedures;
242.14    (4) the provider of residential support services must provide supervision, training,
242.15and assistance as described in the person's coordinated service and support plan; and
242.16    (5) the provider of residential support services must meet the requirements of
242.17licensure and additional requirements of the person's coordinated service and support plan.
242.18    (c) Providers of residential support services that meet the definition in paragraph
242.19(a) must be registered using a process determined by the commissioner beginning July
242.201, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts
242.212960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts
242.229555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision
242.237 , paragraph (g) (f), are considered registered under this section.

242.24    Sec. 11. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:
242.25    Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
242.26establish statewide priorities for individuals on the waiting list for developmental
242.27disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
242.28include, but are not limited to, individuals who continue to have a need for waiver services
242.29after they have maximized the use of state plan services and other funding resources,
242.30including natural supports, prior to accessing waiver services, and who meet at least one
242.31of the following criteria:
242.32(1) no longer require the intensity of services provided where they are currently
242.33living; or
242.34(2) make a request to move from an institutional setting.
243.1(b) After the priorities in paragraph (a) are met, priority must also be given to
243.2individuals who meet at least one of the following criteria:
243.3(1) have unstable living situations due to the age, incapacity, or sudden loss of
243.4the primary caregivers;
243.5(2) are moving from an institution due to bed closures;
243.6(3) experience a sudden closure of their current living arrangement;
243.7(4) require protection from confirmed abuse, neglect, or exploitation;
243.8(5) experience a sudden change in need that can no longer be met through state plan
243.9services or other funding resources alone; or
243.10(6) meet other priorities established by the department.
243.11(b) (c) When allocating resources to lead agencies, the commissioner must take into
243.12consideration the number of individuals waiting who meet statewide priorities and the
243.13lead agencies' current use of waiver funds and existing service options. The commissioner
243.14has the authority to transfer funds between counties, groups of counties, and tribes to
243.15accommodate statewide priorities and resource needs while accounting for a necessary
243.16base level reserve amount for each county, group of counties, and tribe.
243.17(c) The commissioner shall evaluate the impact of the use of statewide priorities and
243.18provide recommendations to the legislature on whether to continue the use of statewide
243.19priorities in the November 1, 2011, annual report required by the commissioner in sections
243.20256B.0916, subdivision 7, and 256B.49, subdivision 21.

243.21    Sec. 12. Minnesota Statutes 2012, section 256B.092, is amended by adding a
243.22subdivision to read:
243.23    Subd. 14. Reduce avoidable behavioral crisis emergency room admissions,
243.24psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons
243.25receiving home and community-based services authorized under this section who have
243.26had two or more admissions within a calendar year to an emergency room, psychiatric
243.27unit, or institution must receive consultation from a mental health professional as defined
243.28in section 245.462, subdivision 18, or a behavioral professional as defined in the home
243.29and community-based services state plan within 30 days of discharge. The mental health
243.30professional or behavioral professional must:
243.31(1) conduct a functional assessment of the crisis incident as defined in section
243.32245D.02, subdivision 11, which led to the hospitalization with the goal of developing
243.33proactive strategies as well as necessary reactive strategies to reduce the likelihood of
243.34future avoidable hospitalizations due to a behavioral crisis;
244.1(2) use the results of the functional assessment to amend the coordinated service and
244.2support plan set forth in section 245D.02, subdivision 4b, to address the potential need
244.3for additional staff training, increased staffing, access to crisis mobility services, mental
244.4health services, use of technology, and crisis stabilization services in section 256B.0624,
244.5subdivision 7; and
244.6(3) identify the need for additional consultation, testing, and mental health crisis
244.7intervention team services as defined in section 245D.02, subdivision 20, psychotropic
244.8medication use and monitoring under section 245D.051, and the frequency and duration
244.9of ongoing consultation.
244.10(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
244.11the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

244.12    Sec. 13. [256B.0922] ESSENTIAL COMMUNITY SUPPORTS.
244.13    Subdivision 1. Essential community supports. (a) The purpose of the essential
244.14community supports program is to provide targeted services to persons age 65 and older
244.15who need essential community support, but whose needs do not meet the level of care
244.16required for nursing facility placement under section 144.0724, subdivision 11.
244.17(b) Essential community supports are available not to exceed $400 per person per
244.18month. Essential community supports may be used as authorized within an authorization
244.19period not to exceed 12 months. Services must be available to a person who:
244.20(1) is age 65 or older;
244.21(2) is not eligible for medical assistance;
244.22(3) has received a community assessment under section 256B.0911, subdivision 3a
244.23or 3b, and does not require the level of care provided in a nursing facility;
244.24(4) meets the financial eligibility criteria for the alternative care program under
244.25section 256B.0913, subdivision 4;
244.26(5) has a community support plan; and
244.27(6) has been determined by a community assessment under section 256B.0911,
244.28subdivision 3a or 3b, to be a person who would require provision of at least one of the
244.29following services, as defined in the approved elderly waiver plan, in order to maintain
244.30their community residence:
244.31(i) caregiver support;
244.32(ii) homemaker support;
244.33(iii) chores;
244.34(iv) a personal emergency response device or system;
244.35(v) home-delivered meals; or
245.1(vi) community living assistance as defined by the commissioner.
245.2(c) The person receiving any of the essential community supports in this subdivision
245.3must also receive service coordination, not to exceed $600 in a 12-month authorization
245.4period, as part of their community support plan.
245.5(d) A person who has been determined to be eligible for essential community
245.6supports must be reassessed at least annually and continue to meet the criteria in paragraph
245.7(b) to remain eligible for essential community supports.
245.8(e) The commissioner is authorized to use federal matching funds for essential
245.9community supports as necessary and to meet demand for essential community supports
245.10as outlined in subdivision 2, and that amount of federal funds is appropriated to the
245.11commissioner for this purpose.
245.12    Subd. 2. Essential community supports for people in transition. (a) Essential
245.13community supports under subdivision 1 are also available to an individual who:
245.14(1) is receiving nursing facility services or home and community-based long-term
245.15services and supports under section 256B.0915 or 256B.49 on the effective date of
245.16implementation of the revised nursing facility level of care under section 144.0724,
245.17subdivision 11;
245.18(2) meets one of the following criteria:
245.19(i) due to the implementation of the revised nursing facility level of care, loses
245.20eligibility for continuing medical assistance payment of nursing facility services at the
245.21first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or
245.22after the effective date of the revised nursing facility level of care criteria under section
245.23144.0724, subdivision 11; or
245.24(ii) due to the implementation of the revised nursing facility level of care, loses
245.25eligibility for continuing medical assistance payment of home and community-based
245.26long-term services and supports under section 256B.0915 or 256B.49 at the first
245.27reassessment required under those sections that occurs on or after the effective date of
245.28implementation of the revised nursing facility level of care under section 144.0724,
245.29subdivision 11;
245.30(3) is not eligible for personal care attendant services; and
245.31(4) has an assessed need for one or more of the supportive services offered under
245.32essential community supports under subdivision 1, paragraph (b), clause (6).
245.33Individuals eligible under this paragraph includes individuals who continue to be
245.34eligible for medical assistance state plan benefits and those who are not or are no longer
245.35financially eligible for medical assistance.
246.1(b) Additional onetime case management is available for participants under
246.2paragraph (a), not to exceed $600 per person to be used within one authorization period
246.3not to exceed 12 months. This service is provided in addition to the essential community
246.4supports benefit described under subdivision 1, paragraph (b).
246.5EFFECTIVE DATE.This section is effective January 1, 2014.

246.6    Sec. 14. [256B.0949] AUTISM EARLY INTENSIVE INTERVENTION BENEFIT.
246.7    Subdivision 1. Purpose. This section creates a new benefit to provide early
246.8intensive intervention to a child with an autism spectrum disorder diagnosis. This benefit
246.9must provide coverage for diagnosis, multidisciplinary assessment, ongoing progress
246.10evaluation, and medically necessary treatment of autism spectrum disorder.
246.11    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
246.12this subdivision have the meanings given.
246.13    (b) "Autism spectrum disorder diagnosis" is defined by diagnostic code 299 in the
246.14current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
246.15    (c) "Child" means a person under the age of 18.
246.16    (d) "Commissioner" means the commissioner of human services, unless otherwise
246.17specified.
246.18    (e) "Early intensive intervention benefit" means autism treatment options based in
246.19behavioral and developmental science, which may include modalities such as applied
246.20behavior analysis, developmental treatment approaches, and naturalistic and parent
246.21training models.
246.22    (f) "Generalizable goals" means results or gains that are observed during a variety
246.23of activities with different people, such as providers, family members, other adults, and
246.24children, and in different environments including, but not limited to, clinics, homes,
246.25schools, and the community.
246.26    (g) "Mental health professional" has the meaning given in section 245.4871,
246.27subdivision 27, clauses (1) to (6).
246.28    Subd. 3. Initial eligibility. This benefit is available to a child enrolled in medical
246.29assistance who:
246.30    (1) has an autism spectrum disorder diagnosis;
246.31    (2) has had a diagnostic assessment described in subdivision 5, which recommends
246.32early intensive intervention services; and
246.33    (3) meets the criteria for medically necessary autism early intensive intervention
246.34services.
246.35    Subd. 4. Diagnosis. (a) A diagnosis must:
247.1    (1) be based upon current DSM criteria including direct observations of the child
247.2and reports from parents or primary caregivers; and
247.3    (2) be completed by both a licensed physician or advanced practice registered nurse
247.4and a mental health professional.
247.5    (b) Additional diagnostic assessment information may be considered including from
247.6special education evaluations and licensed school personnel, and from professionals
247.7licensed in the fields of medicine, speech and language, psychology, occupational therapy,
247.8and physical therapy.
247.9(c) If the commissioner determines there are access problems or delays in diagnosis
247.10for a geographic area due to the lack of qualified professionals, the commissioner shall
247.11waive the requirement in paragraph (a), clause (2), for two professionals and allow a
247.12diagnosis to be made by one professional for that geographic area. This exception must be
247.13limited to a specific period of time until, with stakeholder input as described in subdivision
247.148, there is a determination of an adequate number of professionals available to require two
247.15professionals for each diagnosis.
247.16    Subd. 5. Diagnostic assessment. The following information and assessments must
247.17be performed, reviewed, and relied upon for the eligibility determination, treatment and
247.18services recommendations, and treatment plan development for the child:
247.19    (1) an assessment of the child's developmental skills, functional behavior, needs, and
247.20capacities based on direct observation of the child which must be administered by a licensed
247.21mental health professional and may also include observations from family members,
247.22school personnel, child care providers, or other caregivers, as well as any medical or
247.23assessment information from other licensed professionals such as the child's physician,
247.24rehabilitation therapists, licensed school personnel, or mental health professionals; and
247.25    (2) an assessment of parental or caregiver capacity to participate in therapy including
247.26the type and level of parental or caregiver involvement and training recommended.
247.27    Subd. 6. Treatment plan. (a) Each child's treatment plan must be:
247.28    (1) based on the diagnostic assessment information specified in subdivisions 4 and 5;
247.29    (2) coordinated with medically necessary occupational, physical, and speech and
247.30language therapies, special education, and other services the child and family are receiving;
247.31    (3) family-centered;
247.32    (4) culturally sensitive; and
247.33    (5) individualized based on the child's developmental status and the child's and
247.34family's identified needs.
247.35    (b) The treatment plan must specify the:
248.1    (1) child's goals which are developmentally appropriate, functional, and
248.2generalizable;
248.3    (2) treatment modality;
248.4    (3) treatment intensity;
248.5    (4) setting; and
248.6    (5) level and type of parental or caregiver involvement.
248.7    (c) The treatment must be supervised by a professional with expertise and training in
248.8autism and child development who is a licensed physician, advanced practice registered
248.9nurse, or mental health professional.
248.10    (d) The treatment plan must be submitted to the commissioner for approval in a
248.11manner determined by the commissioner for this purpose.
248.12    (e) Services authorized must be consistent with the child's approved treatment plan.
248.13Services included in the treatment plan must meet all applicable requirements for
248.14medical necessity and coverage.
248.15    Subd. 7. Ongoing eligibility. (a) An independent progress evaluation conducted
248.16by a licensed mental health professional with expertise and training in autism spectrum
248.17disorder and child development must be completed after each six months of treatment,
248.18or more frequently as determined by the commissioner, to determine if progress is being
248.19made toward achieving generalizable goals and meeting functional goals contained in
248.20the treatment plan.
248.21    (b) The progress evaluation must include:
248.22    (1) the treating provider's report;
248.23    (2) parental or caregiver input;
248.24    (3) an independent observation of the child which can be performed by the child's
248.25licensed special education staff;
248.26    (4) any treatment plan modifications; and
248.27    (5) recommendations for continued treatment services.
248.28    (c) Progress evaluations must be submitted to the commissioner in a manner
248.29determined by the commissioner for this purpose.
248.30    (d) A child who continues to achieve generalizable goals and treatment goals as
248.31specified in the treatment plan is eligible to continue receiving this benefit.
248.32    (e) A child's treatment shall continue during the progress evaluation using the
248.33process determined under subdivision 8, clause (8). Treatment may continue during an
248.34appeal pursuant to section 256.045.
248.35    Subd. 8. Refining the benefit with stakeholders. The commissioner must develop
248.36the implementation details of the benefit in consultation with stakeholders and consider
249.1recommendations from the Health Services Advisory Council, the Department of Human
249.2Services Autism Spectrum Disorder Advisory Council, the Legislative Autism Spectrum
249.3Disorder Task Force, and the Interagency Task Force of the Departments of Health,
249.4Education, and Human Services. The commissioner must release these details for a 30-day
249.5public comment period prior to submission to the federal government for approval. The
249.6implementation details must include, but are not limited to, the following components:
249.7    (1) a definition of the qualifications, standards, and roles of the treatment team,
249.8including recommendations after stakeholder consultation on whether board-certified
249.9behavior analysts and other types of professionals trained in autism spectrum disorder and
249.10child development should be added as mental health or other professionals for treatment
249.11supervision or other functions under medical assistance;
249.12    (2) development of initial, uniform parameters for comprehensive multidisciplinary
249.13diagnostic assessment information and progress evaluation standards;
249.14    (3) the design of an effective and consistent process for assessing parent and
249.15caregiver capacity to participate in the child's early intervention treatment and methods of
249.16involving the parents and caregivers in the treatment of the child;
249.17    (4) formulation of a collaborative process in which professionals have opportunities
249.18to collectively inform a comprehensive, multidisciplinary diagnostic assessment and
249.19progress evaluation processes and standards to support quality improvement of early
249.20intensive intervention services;
249.21    (5) coordination of this benefit and its interaction with other services provided by the
249.22Departments of Human Services, Health, and Education;
249.23    (6) evaluation, on an ongoing basis, of research regarding the program and treatment
249.24modalities provided to children under this benefit;
249.25    (7) determination of the availability of licensed physicians, nurse practitioners,
249.26and mental health professionals with expertise and training in autism spectrum disorder
249.27throughout the state to assess whether there are sufficient professionals to require
249.28involvement of both a physician or nurse practitioner and a mental health professional to
249.29provide access and prevent delay in the diagnosis and treatment of young children, so as to
249.30implement subdivision 4, and to ensure treatment is effective, timely, and accessible; and
249.31(8) development of the process for the progress evaluation that will be used to
249.32determine the ongoing eligibility, including necessary documentation, timelines, and
249.33responsibilities of all parties.
249.34    Subd. 9. Revision of treatment options. (a) The commissioner may revise covered
249.35treatment options as needed based on outcome data and other evidence.
250.1    (b) Before the changes become effective, the commissioner must provide public
250.2notice of the changes, the reasons for the change, and a 30-day public comment period
250.3to those who request notice through an electronic list accessible to the public on the
250.4department's Web site.
250.5    Subd. 10. Coordination between agencies. The commissioners of human services
250.6and education must develop the capacity to coordinate services and information including
250.7diagnostic, functional, developmental, medical, and educational assessments; service
250.8delivery; and progress evaluations across health and education sectors.
250.9    Subd. 11. Federal approval of the autism benefit. The provisions of subdivision 9
250.10shall apply to state plan services under Title XIX of the Social Security Act when federal
250.11approval is granted under a 1915(i) waiver or other authority which allows children
250.12eligible for medical assistance through the TEFRA option under section 256B.055,
250.13subdivision 12, to qualify and includes children eligible for medical assistance in families
250.14over 150 percent of the federal poverty guidelines.
250.15EFFECTIVE DATE.Subdivisions 1 to 7 and 9, are effective upon federal approval
250.16consistent with subdivision 11, but no earlier than March 1, 2014. Subdivisions 8, 10,
250.17and 11 are effective July 1, 2013.

250.18    Sec. 15. Minnesota Statutes 2012, section 256B.095, is amended to read:
250.19256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
250.20    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
250.21disabilities, which includes an alternative quality assurance licensing system for programs,
250.22is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
250.23Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
250.24services provided to persons with developmental disabilities. A county, at its option, may
250.25choose to have all programs for persons with developmental disabilities located within
250.26the county licensed under chapter 245A using standards determined under the alternative
250.27quality assurance licensing system or may continue regulation of these programs under the
250.28licensing system operated by the commissioner. The project expires on June 30, 2014.
250.29    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
250.30participate in the quality assurance system established under paragraph (a). The
250.31commission established under section 256B.0951 may, at its option, allow additional
250.32counties to participate in the system.
250.33    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
250.34may establish a quality assurance system under this section. A new system established
251.1under this section shall have the same rights and duties as the system established
251.2under paragraph (a). A new system shall be governed by a commission under section
251.3256B.0951 . The commissioner shall appoint the initial commission members based
251.4on recommendations from advocates, families, service providers, and counties in the
251.5geographic area included in the new system. Counties that choose to participate in a
251.6new system shall have the duties assigned under section 256B.0952. The new system
251.7shall establish a quality assurance process under section 256B.0953. The provisions of
251.8section 256B.0954 shall apply to a new system established under this paragraph. The
251.9commissioner shall delegate authority to a new system established under this paragraph
251.10according to section 256B.0955.
251.11    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
251.12programs for persons with disabilities and older adults.
251.13(e) Effective July 1, 2013, a provider of service located in a county listed in
251.14paragraph (a) that is a non-opted-in county may opt in to the quality assurance system
251.15provided the county where services are provided indicates its agreement with a county
251.16with a delegation agreement with the Department of Human Services.
251.17EFFECTIVE DATE.This section is effective July 1, 2013.

251.18    Sec. 16. Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:
251.19    Subdivision 1. Membership. The Quality Assurance Commission is established.
251.20The commission consists of at least 14 but not more than 21 members as follows: at
251.21least three but not more than five members representing advocacy organizations; at
251.22least three but not more than five members representing consumers, families, and their
251.23legal representatives; at least three but not more than five members representing service
251.24providers; at least three but not more than five members representing counties; and the
251.25commissioner of human services or the commissioner's designee. The first commission
251.26shall establish membership guidelines for the transition and recruitment of membership for
251.27the commission's ongoing existence. Members of the commission who do not receive a
251.28salary or wages from an employer for time spent on commission duties may receive a per
251.29diem payment when performing commission duties and functions. All members may be
251.30reimbursed for expenses related to commission activities. Notwithstanding the provisions
251.31of section 15.059, subdivision 5, the commission expires on June 30, 2014.

251.32    Sec. 17. Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:
251.33    Subd. 4. Commission's authority to recommend variances of licensing
251.34standards. The commission may recommend to the commissioners of human services
252.1and health variances from the standards governing licensure of programs for persons with
252.2developmental disabilities in order to improve the quality of services by implementing
252.3an alternative developmental disabilities licensing system if the commission determines
252.4that the alternative licensing system does not adversely affect the health or safety of
252.5persons being served by the licensed program nor compromise the qualifications of staff
252.6to provide services.

252.7    Sec. 18. Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:
252.8    Subdivision 1. Notification. Counties or providers shall give notice to the
252.9commission and commissioners of human services and health of intent to join the
252.10alternative quality assurance licensing system. A county or provider choosing to participate
252.11in the alternative quality assurance licensing system commits to participate for three years.

252.12    Sec. 19. Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:
252.13    Subd. 5. Quality assurance teams. Quality assurance teams shall be comprised
252.14of county staff; providers; consumers, families, and their legal representatives; members
252.15of advocacy organizations; and other involved community members. Team members
252.16must satisfactorily complete the training program approved by the commission and must
252.17demonstrate performance-based competency. Team members are not considered to be
252.18county employees for purposes of workers' compensation, unemployment insurance, or
252.19state retirement laws solely on the basis of participation on a quality assurance team. The
252.20county may pay A per diem may be paid to team members for time spent on alternative
252.21quality assurance process matters. All team members may be reimbursed for expenses
252.22related to their participation in the alternative process.

252.23    Sec. 20. Minnesota Statutes 2012, section 256B.0955, is amended to read:
252.24256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.
252.25(a) Effective July 1, 1998, the commissioner of human services shall delegate
252.26authority to perform licensing functions and activities, in accordance with section
252.27245A.16 , to counties participating in the alternative quality assurance licensing system.
252.28The commissioner shall not license or reimburse a facility, program, or service for persons
252.29with developmental disabilities in a county that participates in the alternative quality
252.30assurance licensing system if the commissioner has received from the appropriate county
252.31notification that the facility, program, or service has been reviewed by a quality assurance
252.32team and has failed to qualify for licensure.
253.1(b) The commissioner may conduct random licensing inspections based on outcomes
253.2adopted under section 256B.0951 at facilities, programs, and services governed by the
253.3alternative quality assurance licensing system. The role of such random inspections shall
253.4be to verify that the alternative quality assurance licensing system protects the safety
253.5and well-being of consumers and maintains the availability of high-quality services for
253.6persons with developmental disabilities.
253.7EFFECTIVE DATE.This section is effective July 1, 2013.

253.8    Sec. 21. Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:
253.9    Subdivision 1. Scope. (a) In order to improve the quality of services provided to
253.10Minnesotans with disabilities and to meet the requirements of the federally approved home
253.11and community-based waivers under section 1915c of the Social Security Act, a State
253.12Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving
253.13disability services is enacted. This system is a partnership between the Department of
253.14Human Services and the State Quality Council established under subdivision 3.
253.15    (b) This system is a result of the recommendations from the Department of Human
253.16Services' licensing and alternative quality assurance study mandated under Laws 2005,
253.17First Special Session chapter 4, article 7, section 57, and presented to the legislature
253.18in February 2007.
253.19    (c) The disability services eligible under this section include:
253.20    (1) the home and community-based services waiver programs for persons with
253.21developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
253.22including brain injuries and services for those who qualify for nursing facility level of care
253.23or hospital facility level of care and any other services licensed under chapter 245D;
253.24    (2) home care services under section 256B.0651;
253.25    (3) family support grants under section 252.32;
253.26    (4) consumer support grants under section 256.476;
253.27    (5) semi-independent living services under section 252.275; and
253.28    (6) services provided through an intermediate care facility for the developmentally
253.29disabled.
253.30    (d) For purposes of this section, the following definitions apply:
253.31    (1) "commissioner" means the commissioner of human services;
253.32    (2) "council" means the State Quality Council under subdivision 3;
253.33    (3) "Quality Assurance Commission" means the commission under section
253.34256B.0951 ; and
254.1    (4) "system" means the State Quality Assurance, Quality Improvement and
254.2Licensing System under this section.

254.3    Sec. 22. Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:
254.4    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
254.5Council which must define regional quality councils, and carry out a community-based,
254.6person-directed quality review component, and a comprehensive system for effective
254.7incident reporting, investigation, analysis, and follow-up.
254.8    (b) By August 1, 2011, the commissioner of human services shall appoint the
254.9members of the initial State Quality Council. Members shall include representatives
254.10from the following groups:
254.11    (1) disability service recipients and their family members;
254.12    (2) during the first two four years of the State Quality Council, there must be at least
254.13three members from the Region 10 stakeholders. As regional quality councils are formed
254.14under subdivision 4, each regional quality council shall appoint one member;
254.15    (3) disability service providers;
254.16    (4) disability advocacy groups; and
254.17    (5) county human services agencies and staff from the Department of Human
254.18Services and Ombudsman for Mental Health and Developmental Disabilities.
254.19    (c) Members of the council who do not receive a salary or wages from an employer
254.20for time spent on council duties may receive a per diem payment when performing council
254.21duties and functions.
254.22    (d) The State Quality Council shall:
254.23    (1) assist the Department of Human Services in fulfilling federally mandated
254.24obligations by monitoring disability service quality and quality assurance and
254.25improvement practices in Minnesota;
254.26    (2) establish state quality improvement priorities with methods for achieving results
254.27and provide an annual report to the legislative committees with jurisdiction over policy
254.28and funding of disability services on the outcomes, improvement priorities, and activities
254.29undertaken by the commission during the previous state fiscal year;
254.30(3) identify issues pertaining to financial and personal risk that impede Minnesotans
254.31with disabilities from optimizing choice of community-based services; and
254.32(4) recommend to the chairs and ranking minority members of the legislative
254.33committees with jurisdiction over human services and civil law by January 15, 2013
254.34 2014, statutory and rule changes related to the findings under clause (3) that promote
255.1individualized service and housing choices balanced with appropriate individualized
255.2protection.
255.3    (e) The State Quality Council, in partnership with the commissioner, shall:
255.4    (1) approve and direct implementation of the community-based, person-directed
255.5system established in this section;
255.6    (2) recommend an appropriate method of funding this system, and determine the
255.7feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
255.8    (3) approve measurable outcomes in the areas of health and safety, consumer
255.9evaluation, education and training, providers, and systems;
255.10    (4) establish variable licensure periods not to exceed three years based on outcomes
255.11achieved; and
255.12    (5) in cooperation with the Quality Assurance Commission, design a transition plan
255.13for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
255.14    (f) The State Quality Council shall notify the commissioner of human services that a
255.15facility, program, or service has been reviewed by quality assurance team members under
255.16subdivision 4, paragraph (b), clause (13), and qualifies for a license.
255.17    (g) The State Quality Council, in partnership with the commissioner, shall establish
255.18an ongoing review process for the system. The review shall take into account the
255.19comprehensive nature of the system which is designed to evaluate the broad spectrum of
255.20licensed and unlicensed entities that provide services to persons with disabilities. The
255.21review shall address efficiencies and effectiveness of the system.
255.22    (h) The State Quality Council may recommend to the commissioner certain
255.23variances from the standards governing licensure of programs for persons with disabilities
255.24in order to improve the quality of services so long as the recommended variances do
255.25not adversely affect the health or safety of persons being served or compromise the
255.26qualifications of staff to provide services.
255.27    (i) The safety standards, rights, or procedural protections referenced under
255.28subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
255.29recommendations to the commissioner or to the legislature in the report required under
255.30paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
255.31procedural protections referenced under subdivision 2, paragraph (c).
255.32    (j) The State Quality Council may hire staff to perform the duties assigned in this
255.33subdivision.

255.34    Sec. 23. Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:
256.1    Subd. 44. Property rate increase increases for a facility in Bloomington effective
256.2November 1, 2010 certain nursing facilities. (a) Notwithstanding any other law to the
256.3contrary, money available for moratorium projects under section 144A.073, subdivision
256.411 , shall be used, effective November 1, 2010, to fund an approved moratorium exception
256.5project for a nursing facility in Bloomington licensed for 137 beds as of November 1,
256.62010, up to a total property rate adjustment of $19.33.
256.7(b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110
256.8beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow
256.9$1,129,463 of a completed construction project to increase the property payment rate.
256.10Notwithstanding any other law to the contrary, money available under section 144A.073,
256.11subdivision 11, after the completion of the moratorium exception approval process in 2013
256.12under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the
256.13medical assistance budget for the increase in the replacement-cost-new limit.
256.14(c) Effective July 1, 2012, any nursing facility in Dakota County licensed for
256.1561 beds shall have their replacement-cost-new limit under subdivision 17e adjusted to
256.16allow $1,407,624 of a completed construction project to increase their property payment
256.17rate. Effective September 1, 2013, or later, their replacement-cost-new limit under
256.18subdivision 17e shall be adjusted to allow $1,244,599 of a completed construction project
256.19to increase the property payment rate. Notwithstanding any other law to the contrary,
256.20money available under section 144A.073, subdivision 11, after the completion of the
256.21moratorium exception approval process in 2013 under section 144A.073, subdivision 3,
256.22shall be used to reduce the fiscal impact to the medical assistance budget for the increase
256.23in the replacement-cost-new limit.
256.24    (d) Effective July 1, 2013, or later, any boarding care facility in Hennepin
256.25County licensed for 101 beds shall be allowed to receive a property rate adjustment
256.26for a construction project that takes action to come into compliance with Minnesota
256.27Department of Labor and Industry elevator upgrade requirements, with costs below the
256.28minimum threshold under subdivision 16. Only costs related to the construction project
256.29that brings the facility into compliance with the elevator requirements shall be allowed.
256.30Notwithstanding any other law to the contrary, money available under section 144A.073,
256.31subdivision 11, after the completion of the moratorium exception approval process in
256.322013 under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to
256.33the medical assistance program.
256.34EFFECTIVE DATE.Paragraph (b) is effective retroactively from June 1, 2012.
256.35Paragraph (c) is effective retroactively from July 1, 2012.

257.1    Sec. 24. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:
257.2    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
257.3have their payment rates determined under this section rather than section 256B.431, the
257.4commissioner shall establish a rate under this subdivision. The nursing facility must enter
257.5into a written contract with the commissioner.
257.6    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
257.7contract under this section is the payment rate the facility would have received under
257.8section 256B.431.
257.9    (c) A nursing facility's case mix payment rates for the second and subsequent years
257.10of a facility's contract under this section are the previous rate year's contract payment
257.11rates plus an inflation adjustment and, for facilities reimbursed under this section or
257.12section 256B.431, an adjustment to include the cost of any increase in Health Department
257.13licensing fees for the facility taking effect on or after July 1, 2001. The index for the
257.14inflation adjustment must be based on the change in the Consumer Price Index-All Items
257.15(United States City average) (CPI-U) forecasted by the commissioner of management and
257.16budget's national economic consultant, as forecasted in the fourth quarter of the calendar
257.17year preceding the rate year. The inflation adjustment must be based on the 12-month
257.18period from the midpoint of the previous rate year to the midpoint of the rate year for
257.19which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
257.202000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
257.21July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall
257.22apply only to the property-related payment rate. For the rate years beginning on October
257.231, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and
257.24October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning
257.25in 2005, adjustment to the property payment rate under this section and section 256B.431
257.26shall be effective on October 1. In determining the amount of the property-related payment
257.27rate adjustment under this paragraph, the commissioner shall determine the proportion of
257.28the facility's rates that are property-related based on the facility's most recent cost report.
257.29    (d) The commissioner shall develop additional incentive-based payments of up to
257.30five percent above a facility's operating payment rate for achieving outcomes specified
257.31in a contract. The commissioner may solicit contract amendments and implement those
257.32which, on a competitive basis, best meet the state's policy objectives. The commissioner
257.33shall limit the amount of any incentive payment and the number of contract amendments
257.34under this paragraph to operate the incentive payments within funds appropriated for this
257.35purpose. The contract amendments may specify various levels of payment for various
257.36levels of performance. Incentive payments to facilities under this paragraph may be in the
258.1form of time-limited rate adjustments or onetime supplemental payments. In establishing
258.2the specified outcomes and related criteria, the commissioner shall consider the following
258.3state policy objectives:
258.4    (1) successful diversion or discharge of residents to the residents' prior home or other
258.5community-based alternatives;
258.6    (2) adoption of new technology to improve quality or efficiency;
258.7    (3) improved quality as measured in the Nursing Home Report Card;
258.8    (4) reduced acute care costs; and
258.9    (5) any additional outcomes proposed by a nursing facility that the commissioner
258.10finds desirable.
258.11    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
258.12take action to come into compliance with existing or pending requirements of the life
258.13safety code provisions or federal regulations governing sprinkler systems must receive
258.14reimbursement for the costs associated with compliance if all of the following conditions
258.15are met:
258.16    (1) the expenses associated with compliance occurred on or after January 1, 2005,
258.17and before December 31, 2008;
258.18    (2) the costs were not otherwise reimbursed under subdivision 4f or section
258.19144A.071 or 144A.073; and
258.20    (3) the total allowable costs reported under this paragraph are less than the minimum
258.21threshold established under section 256B.431, subdivision 15, paragraph (e), and
258.22subdivision 16.
258.23The commissioner shall use money appropriated for this purpose to provide to qualifying
258.24nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
258.252008. Nursing facilities that have spent money or anticipate the need to spend money
258.26to satisfy the most recent life safety code requirements by (1) installing a sprinkler
258.27system or (2) replacing all or portions of an existing sprinkler system may submit to the
258.28commissioner by June 30, 2007, on a form provided by the commissioner the actual
258.29costs of a completed project or the estimated costs, based on a project bid, of a planned
258.30project. The commissioner shall calculate a rate adjustment equal to the allowable
258.31costs of the project divided by the resident days reported for the report year ending
258.32September 30, 2006. If the costs from all projects exceed the appropriation for this
258.33purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
258.34qualifying facilities by reducing the rate adjustment determined for each facility by an
258.35equal percentage. Facilities that used estimated costs when requesting the rate adjustment
258.36shall report to the commissioner by January 31, 2009, on the use of this money on a
259.1form provided by the commissioner. If the nursing facility fails to provide the report, the
259.2commissioner shall recoup the money paid to the facility for this purpose. If the facility
259.3reports expenditures allowable under this subdivision that are less than the amount received
259.4in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

259.5    Sec. 25. Minnesota Statutes 2012, section 256B.434, is amended by adding a
259.6subdivision to read:
259.7    Subd. 19a. Nursing facility rate adjustments beginning September 1, 2013. A
259.8total of a five percent average rate adjustment shall be provided as described under this
259.9subdivision and under section 256B.441, subdivision 46b.
259.10(a) Beginning September 1, 2013, the commissioner shall make available to each
259.11nursing facility reimbursed under this section a 3.75 percent operating payment rate
259.12increase, in accordance with paragraphs (b) to (g).
259.13(b) Seventy-five percent of the money resulting from the rate adjustment under
259.14paragraph (a) must be used for increases in compensation-related costs for employees
259.15directly employed by the nursing facility on or after the effective date of the rate
259.16adjustment, except:
259.17(1) the administrator;
259.18(2) persons employed in the central office of a corporation that has an ownership
259.19interest in the nursing facility or exercises control over the nursing facility; and
259.20(3) persons paid by the nursing facility under a management contract.
259.21(c) The commissioner shall allow as compensation-related costs all costs for:
259.22(1) wage and salary increases effective after May 25, 2013;
259.23(2) the employer's share of FICA taxes, Medicare taxes, state and federal
259.24unemployment taxes, and workers' compensation;
259.25(3) the employer's share of health and dental insurance, life insurance, disability
259.26insurance, long-term care insurance, uniform allowance, and pensions; and
259.27(4) other benefits provided and workforce needs, including the recruiting and
259.28training of employees, subject to the approval of the commissioner.
259.29(d) The portion of the rate adjustment under paragraph (a) that is not subject to the
259.30requirements of paragraph (b) shall be provided to nursing facilities effective September 1,
259.312013. Nursing facilities may apply for the portion of the rate adjustment under paragraph
259.32(a) that is subject to the requirements in paragraph (b). The application must be submitted
259.33to the commissioner within six months of the effective date of the rate adjustment, and
259.34the nursing facility must provide additional information required by the commissioner
259.35within nine months of the effective date of the rate adjustment. The commissioner must
260.1respond to all applications within three weeks of receipt. The commissioner may waive
260.2the deadlines in this paragraph under extraordinary circumstances, to be determined at the
260.3sole discretion of the commissioner. The application must contain:
260.4(1) an estimate of the amounts of money that must be used as specified in paragraph
260.5(b);
260.6(2) a detailed distribution plan specifying the allowable compensation-related
260.7increases the nursing facility will implement to use the funds available in clause (1);
260.8(3) a description of how the nursing facility will notify eligible employees of
260.9the contents of the approved application, which must provide for giving each eligible
260.10employee a copy of the approved application, excluding the information required in clause
260.11(1), or posting a copy of the approved application, excluding the information required in
260.12clause (1), for a period of at least six weeks in an area of the nursing facility to which all
260.13eligible employees have access; and
260.14(4) instructions for employees who believe they have not received the
260.15compensation-related increases specified in clause (2), as approved by the commissioner,
260.16and which must include a mailing address, e-mail address, and the telephone number
260.17that may be used by the employee to contact the commissioner or the commissioner's
260.18representative.
260.19(e) The commissioner shall ensure that cost increases in distribution plans under
260.20paragraph (d), clause (2), that may be included in approved applications, comply with the
260.21following requirements:
260.22(1) a portion of the costs resulting from tenure-related wage or salary increases
260.23may be considered to be allowable wage increases, according to formulas that the
260.24commissioner shall provide, where employee retention is above the average statewide
260.25rate of retention of direct-care employees;
260.26(2) the annualized amount of increases in costs for the employer's share of health
260.27and dental insurance, life insurance, disability insurance, and workers' compensation
260.28shall be allowable compensation-related increases if they are effective on or after April
260.291, 2013, and prior to April 1, 2014; and
260.30(3) for nursing facilities in which employees are represented by an exclusive
260.31bargaining representative, the commissioner shall approve the application only upon
260.32receipt of a letter of acceptance of the distribution plan, in regard to members of the
260.33bargaining unit, signed by the exclusive bargaining agent, and dated after May 25, 2013.
260.34Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of
260.35this provision as having been met in regard to the members of the bargaining unit.
261.1(f) The commissioner shall review applications received under paragraph (d) and
261.2shall provide the portion of the rate adjustment under paragraph (b) if the requirements
261.3of this statute have been met. The rate adjustment shall be effective September 1, 2013.
261.4Notwithstanding paragraph (a), if the approved application distributes less money than is
261.5available, the amount of the rate adjustment shall be reduced so that the amount of money
261.6made available is equal to the amount to be distributed.
261.7(g) The increase in this subdivision shall be applied as a percentage to operating
261.8payment rates in effect on August 31, 2013. For each facility, the commissioner shall
261.9determine the operating payment rate, not including any rate components resulting from
261.10equitable cost-sharing for publicly owned nursing facility program participation under
261.11section 256B.441, subdivision 55a, critical access nursing facility program participation
261.12under section 256B.441, subdivision 63, or performance-based incentive payment
261.13program participation under subdivision 4, paragraph (d), for a RUG class with a weight
261.14of 1.00 in effect on August 31, 2013.

261.15    Sec. 26. Minnesota Statutes 2012, section 256B.434, is amended by adding a
261.16subdivision to read:
261.17    Subd. 19b. Nursing facility rate adjustments beginning October 1, 2015. A
261.18total of a 3.2 percent average rate adjustment shall be provided as described under this
261.19subdivision and under section 256B.441, subdivision 46c.
261.20(a) Beginning October 1, 2015, the commissioner shall make available to each
261.21nursing facility reimbursed under this section a 2.4 percent operating payment rate
261.22increase, in accordance with paragraphs (b) to (g).
261.23(b) Seventy-five percent of the money resulting from the rate adjustment under
261.24paragraph (a) must be used for increases in compensation-related costs for employees
261.25directly employed by the nursing facility on or after the effective date of the rate
261.26adjustment, except:
261.27(1) the administrator;
261.28(2) persons employed in the central office of a corporation that has an ownership
261.29interest in the nursing facility or exercises control over the nursing facility; and
261.30(3) persons paid by the nursing facility under a management contract.
261.31(c) The commissioner shall allow as compensation-related costs all costs for:
261.32(1) wage and salary increases effective after May 25, 2015;
261.33(2) the employer's share of FICA taxes, Medicare taxes, state and federal
261.34unemployment taxes, and workers' compensation;
262.1(3) the employer's share of health and dental insurance, life insurance, disability
262.2insurance, long-term care insurance, uniform allowance, and pensions; and
262.3(4) other benefits provided and workforce needs, including the recruiting and
262.4training of employees, subject to the approval of the commissioner.
262.5(d) The portion of the rate adjustment under paragraph (a) that is not subject to the
262.6requirements of paragraph (b) shall be provided to nursing facilities effective October 1,
262.72015. Nursing facilities may apply for the portion of the rate adjustment under paragraph
262.8(a) that is subject to the requirements in paragraph (b). The application must be submitted
262.9to the commissioner within six months of the effective date of the rate adjustment, and
262.10the nursing facility must provide additional information required by the commissioner
262.11within nine months of the effective date of the rate adjustment. The commissioner must
262.12respond to all applications within three weeks of receipt. The commissioner may waive
262.13the deadlines in this paragraph under extraordinary circumstances, to be determined at the
262.14sole discretion of the commissioner. The application must contain:
262.15(1) an estimate of the amounts of money that must be used as specified in paragraph
262.16(b);
262.17(2) a detailed distribution plan specifying the allowable compensation-related
262.18increases the nursing facility will implement to use the funds available in clause (1);
262.19(3) a description of how the nursing facility will notify eligible employees of
262.20the contents of the approved application, which must provide for giving each eligible
262.21employee a copy of the approved application, excluding the information required in clause
262.22(1), or posting a copy of the approved application, excluding the information required in
262.23clause (1), for a period of at least six weeks in an area of the nursing facility to which all
262.24eligible employees have access; and
262.25(4) instructions for employees who believe they have not received the
262.26compensation-related increases specified in clause (2), as approved by the commissioner,
262.27and which must include a mailing address, e-mail address, and the telephone number
262.28that may be used by the employee to contact the commissioner or the commissioner's
262.29representative.
262.30(e) The commissioner shall ensure that cost increases in distribution plans under
262.31paragraph (d), clause (2), that may be included in approved applications, comply with the
262.32following requirements:
262.33(1) a portion of the costs resulting from tenure-related wage or salary increases
262.34may be considered to be allowable wage increases, according to formulas that the
262.35commissioner shall provide, where employee retention is above the average statewide
262.36rate of retention of direct-care employees;
263.1(2) the annualized amount of increases in costs for the employer's share of health
263.2and dental insurance, life insurance, disability insurance, and workers' compensation
263.3shall be allowable compensation-related increases if they are effective on or after April
263.41, 2015, and prior to April 1, 2016; and
263.5(3) for nursing facilities in which employees are represented by an exclusive
263.6bargaining representative, the commissioner shall approve the application only upon
263.7receipt of a letter of acceptance of the distribution plan, in regard to members of the
263.8bargaining unit, signed by the exclusive bargaining agent and dated after May 25, 2015.
263.9Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of
263.10this provision as having been met in regard to the members of the bargaining unit.
263.11(f) The commissioner shall review applications received under paragraph (d) and
263.12shall provide the portion of the rate adjustment under paragraph (b) if the requirements
263.13of this statute have been met. The rate adjustment shall be effective October 1, 2015.
263.14Notwithstanding paragraph (a), if the approved application distributes less money than is
263.15available, the amount of the rate adjustment shall be reduced so that the amount of money
263.16made available is equal to the amount to be distributed.
263.17(g) The increase in this subdivision shall be applied as a percentage to operating
263.18payment rates in effect on September 30, 2015. For each facility, the commissioner shall
263.19determine the operating payment rate, not including any rate components resulting from
263.20equitable cost-sharing for publicly owned nursing facility program participation under
263.21section 256B.441, subdivision 55a, critical access nursing facility program participation
263.22under section 256B.441, subdivision 63, or performance-based incentive payment
263.23program participation under subdivision 4, paragraph (d), for a RUG class with a weight
263.24of 1.00 in effect on September 30, 2015.

263.25    Sec. 27. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:
263.26    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
263.27services shall calculate the amount of the planned closure rate adjustment available under
263.28subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
263.29(1) the amount available is the net reduction of nursing facility beds multiplied
263.30by $2,080;
263.31(2) the total number of beds in the nursing facility or facilities receiving the planned
263.32closure rate adjustment must be identified;
263.33(3) capacity days are determined by multiplying the number determined under
263.34clause (2) by 365; and
264.1(4) the planned closure rate adjustment is the amount available in clause (1), divided
264.2by capacity days determined under clause (3).
264.3(b) A planned closure rate adjustment under this section is effective on the first day
264.4of the month following completion of closure of the facility designated for closure in
264.5the application and becomes part of the nursing facility's total operating external fixed
264.6 payment rate.
264.7(c) Applicants may use the planned closure rate adjustment to allow for a property
264.8payment for a new nursing facility or an addition to an existing nursing facility or as an
264.9operating payment rate adjustment. Applications approved under this subdivision are
264.10exempt from other requirements for moratorium exceptions under section 144A.073,
264.11subdivisions 2 and 3.
264.12(d) (c) Upon the request of a closing facility, the commissioner must allow the
264.13facility a closure rate adjustment as provided under section 144A.161, subdivision 10.
264.14(e) (d) A facility that has received a planned closure rate adjustment may reassign it
264.15to another facility that is under the same ownership at any time within three years of its
264.16effective date. The amount of the adjustment shall be computed according to paragraph (a).
264.17(f) (e) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
264.18the commissioner shall recalculate planned closure rate adjustments for facilities that
264.19delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
264.20bed dollar amount. The recalculated planned closure rate adjustment shall be effective
264.21from the date the per bed dollar amount is increased.
264.22(g) (f) For planned closures approved after June 30, 2009, the commissioner of
264.23human services shall calculate the amount of the planned closure rate adjustment available
264.24under subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
264.25(h) Beginning (g) Between July 16, 2011, and June 30, 2013, the commissioner shall
264.26no longer not accept applications for planned closure rate adjustments under subdivision 3.

264.27    Sec. 28. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
264.28    Subdivision 1. Development and implementation of quality profiles. (a) The
264.29commissioner of human services, in cooperation with the commissioner of health,
264.30shall develop and implement a quality profile system profiles for nursing facilities and,
264.31beginning not later than July 1, 2004, other providers of long-term care services 2014, for
264.32home and community-based services providers, except when the quality profile system
264.33would duplicate requirements under section 256B.5011, 256B.5012, or 256B.5013. For
264.34purposes of this section, home and community-based services providers are defined as
264.35providers of home and community-based services under sections 256B.0913, 256B.0915,
265.1256B.092, and 256B.49, and intermediate care facilities for persons with developmental
265.2disabilities providers under section 256B.5013. To the extent possible, quality profiles
265.3must be developed for providers of services to older adults and people with disabilities,
265.4regardless of payor source, for the purposes of providing information to consumers. The
265.5system quality profiles must be developed and implemented to the extent possible without
265.6the collection of significant amounts of new data. To the extent possible, the system
265.7 using existing data sets maintained by the commissioners of health and human services
265.8to the extent possible. The profiles must incorporate or be coordinated with information
265.9on quality maintained by area agencies on aging, long-term care trade associations, the
265.10ombudsman offices, counties, tribes, health plans, and other entities and the long-term
265.11care database maintained under section 256.975, subdivision 7. The system profiles must
265.12be designed to provide information on quality to:
265.13(1) consumers and their families to facilitate informed choices of service providers;
265.14(2) providers to enable them to measure the results of their quality improvement
265.15efforts and compare quality achievements with other service providers; and
265.16(3) public and private purchasers of long-term care services to enable them to
265.17purchase high-quality care.
265.18(b) The system profiles must be developed in consultation with the long-term care
265.19task force, area agencies on aging, and representatives of consumers, providers, and labor
265.20unions. Within the limits of available appropriations, the commissioners may employ
265.21consultants to assist with this project.

265.22    Sec. 29. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
265.23    Subd. 2. Quality measurement tools for nursing facilities. The commissioners
265.24shall identify and apply existing quality measurement tools to:
265.25(1) emphasize quality of care and its relationship to quality of life; and
265.26(2) address the needs of various users of long-term care services, including, but not
265.27limited to, short-stay residents, persons with behavioral problems, persons with dementia,
265.28and persons who are members of minority groups.
265.29    The tools must be identified and applied, to the extent possible, without requiring
265.30providers to supply information beyond current state and federal requirements.

265.31    Sec. 30. Minnesota Statutes 2012, section 256B.439, is amended by adding a
265.32subdivision to read:
265.33    Subd. 2a. Quality measurement tools for home and community-based services.
265.34 (a) The commissioners shall identify and apply quality measurement tools to:
266.1(1) emphasize service quality and its relationship to quality of life; and
266.2(2) address the needs of various users of home and community-based services.
266.3(b) The tools must include, but not be limited to, surveys of consumers of home
266.4and community-based services. The tools must be identified and applied, to the extent
266.5possible, without requiring providers to supply information beyond state and federal
266.6requirements, for purposes of this subdivision.

266.7    Sec. 31. Minnesota Statutes 2012, section 256B.439, is amended by adding a
266.8subdivision to read:
266.9    Subd. 3a. Consumer surveys for home and community-based services.
266.10 Following identification of the quality measurement tool, and within the limits of the
266.11appropriation, the commissioner shall conduct surveys of home and community-based
266.12services consumers to develop quality profiles of providers. To the extent possible, surveys
266.13must be conducted face-to-face by state employees or contractors. At the discretion of
266.14the commissioner, surveys may be conducted by an alternative method. Surveys must be
266.15conducted periodically to update quality profiles of individual service providers.

266.16    Sec. 32. Minnesota Statutes 2012, section 256B.439, is amended by adding a
266.17subdivision to read:
266.18    Subd. 5. Implementation of home and community-based services
266.19performance-based incentive payment program. By April 1, 2014, the commissioner
266.20shall develop incentive-based grants for home and community-based services providers
266.21for achieving outcomes specified in a contract. The commissioner may solicit proposals
266.22from home and community-based services providers and implement those that, on
266.23a competitive basis, best meet the state's policy objectives. The commissioner shall
266.24determine the types of home and community-based services providers that will participate
266.25in the program. The determination of participating provider types may be revised annually
266.26by the commissioner. The commissioner shall limit the amount of any incentive-based
266.27grants and the number of grants under this subdivision to operate the incentive payments
266.28within funds appropriated for this purpose. The grant agreements may specify various
266.29levels of payment for various levels of performance. In establishing the specified outcomes
266.30and related criteria, the commissioner shall consider the following state policy objectives:
266.31(1) provide more efficient, higher quality services;
266.32(2) encourage home and community-based services providers to innovate;
266.33(3) equip home and community-based services providers with organizational tools
266.34and expertise to improve their quality;
267.1(4) incentivize home and community-based services providers to invest in better
267.2services; and
267.3(5) disseminate successful performance improvement strategies statewide.

267.4    Sec. 33. Minnesota Statutes 2012, section 256B.439, is amended by adding a
267.5subdivision to read:
267.6    Subd. 6. Calculation of home and community-based services quality score.
267.7 (a) The commissioner shall determine a quality score for each participating home and
267.8community-based services provider using quality measures established in subdivisions
267.91 and 2a, according to methods determined by the commissioner in consultation
267.10with stakeholders and experts. These methods shall be exempt from the rulemaking
267.11requirements under chapter 14.
267.12(b) For each quality measure, a score shall be determined with a maximum number
267.13of points available and number of points assigned as determined by the commissioner
267.14using the methodology established according to this subdivision. The determination of
267.15the quality measures to be used and the methods of calculating scores may be revised
267.16annually be the commissioner.

267.17    Sec. 34. Minnesota Statutes 2012, section 256B.439, is amended by adding a
267.18subdivision to read:
267.19    Subd. 7. Calculation of home and community-based services quality add-on.
267.20 Effective July 1, 2015, the commissioner shall determine the quality add-on payment
267.21for participating home and community-based services providers. The payment rate for
267.22the quality add-on shall be a variable amount based on each provider's quality score as
267.23determined in subdivisions 1 and 2a. The commissioner shall limit the types of home and
267.24community-based services providers that may receive the quality add-on and the amount
267.25of the quality add-on payments to operate the quality add-on within funds appropriated for
267.26this purpose and based on the availability of the quality measures.

267.27    Sec. 35. Minnesota Statutes 2012, section 256B.441, subdivision 44, is amended to read:
267.28    Subd. 44. Calculation of a quality score. (a) The commissioner shall determine
267.29a quality score for each nursing facility using quality measures established in section
267.30256B.439 , according to methods determined by the commissioner in consultation
267.31with stakeholders and experts. These methods shall be exempt from the rulemaking
267.32requirements under chapter 14.
268.1(b) For each quality measure, a score shall be determined with a maximum number
268.2of points available and number of points assigned as determined by the commissioner
268.3using the methodology established according to this subdivision. The scores determined
268.4for all quality measures shall be totaled. The determination of the quality measures to be
268.5used and the methods of calculating scores may be revised annually by the commissioner.
268.6(c) For the initial rate year under the new payment system, the quality measures
268.7shall include:
268.8(1) staff turnover;
268.9(2) staff retention;
268.10(3) use of pool staff;
268.11(4) quality indicators from the minimum data set; and
268.12(5) survey deficiencies.
268.13(d) For rate years beginning after October 1, 2006, when making revisions to the
268.14quality measures or method for calculating scores, the commissioner shall publish the
268.15methodology in the State Register at least 15 months prior to the start of the rate year for
268.16which the revised methodology is to be used for rate-setting purposes. The quality score
268.17used to determine payment rates shall be established for a rate year using data submitted
268.18in the statistical and cost report from the associated reporting year, and using data from
268.19other sources related to a period beginning no more than six months prior to the associated
268.20reporting year Beginning July 1, 2013, the quality score shall be a value between zero and
268.21100, using data as provided in the Minnesota nursing home report card, with 50 percent
268.22derived from the Minnesota quality indicators score, 40 percent derived from the resident
268.23quality of life score, and ten percent derived from the state inspection results score.
268.24(e) The commissioner, in cooperation with the commissioner of health, may adjust
268.25the formula in paragraph (d), or the methodology for computing the total quality score,
268.26effective July 1 of any year beginning in 2014, with five months advance public notice.
268.27In changing the formula, the commissioner shall consider quality measure priorities
268.28registered by report card users, advise of stakeholders, and available research.

268.29    Sec. 36. Minnesota Statutes 2012, section 256B.441, is amended by adding a
268.30subdivision to read:
268.31    Subd. 46b. Calculation of quality add-on, with an average value of 1.25 percent,
268.32effective September 1, 2013. (a) The commissioner shall determine quality add-ons to
268.33the operating payment rates for each facility. The increase in this subdivision shall be
268.34applied as a percentage to operating payment rates in effect on August 31, 2013. For each
268.35facility, the commissioner shall determine the operating payment rate, not including any
269.1rate components resulting from equitable cost-sharing for publicly owned nursing facility
269.2program participation under subdivision 55a, critical access nursing facility program
269.3participation under subdivision 63, or performance-based incentive payment program
269.4participation under section 256B.434, subdivision 4, paragraph (d), for a RUG class with a
269.5weight of 1.00 in effect on August 31, 2013.
269.6(b) For each facility, the commissioner shall compute a quality factor by subtracting
269.740 from the most recent quality score computed under subdivision 44, and then dividing
269.8by 60. If the quality factor is less than zero, the commissioner shall use the value zero.
269.9(c) The quality add-ons shall be the operating payment rates determined in paragraph
269.10(a), multiplied by the quality factor determined in paragraph (b), and then multiplied by
269.113.2 percent. The commissioner shall implement the quality add-ons effective September
269.121, 2013.

269.13    Sec. 37. Minnesota Statutes 2012, section 256B.441, is amended by adding a
269.14subdivision to read:
269.15    Subd. 46c. Quality improvement incentive system beginning October 1, 2015.
269.16 The commissioner shall develop a quality improvement incentive program in consultation
269.17with stakeholders. The annual funding pool available for quality improvement incentive
269.18payments shall be equal to 0.8 percent of all operating payments, not including any rate
269.19components resulting from equitable cost-sharing for publicly owned nursing facility
269.20program participation under subdivision 55a, critical access nursing facility program
269.21participation under subdivision 63, or performance-based incentive payment program
269.22participation under section 256B.434, subdivision 4, paragraph (d). Beginning October 1,
269.232015, annual rate adjustments provided under this subdivision shall be effective for one
269.24year, starting October 1 and ending the following September 30.

269.25    Sec. 38. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:
269.26    Subd. 11a. Waivered services statewide priorities. (a) The commissioner shall
269.27establish statewide priorities for individuals on the waiting list for community alternative
269.28care, community alternatives for disabled individuals, and brain injury waiver services,
269.29as of January 1, 2010. The statewide priorities must include, but are not limited to,
269.30individuals who continue to have a need for waiver services after they have maximized the
269.31use of state plan services and other funding resources, including natural supports, prior to
269.32accessing waiver services, and who meet at least one of the following criteria:
269.33(1) no longer require the intensity of services provided where they are currently
269.34living; or
270.1(2) make a request to move from an institutional setting.
270.2(b) After the priorities in paragraph (a) are met, priority must also be given to
270.3individuals who meet at least one of the following criteria:
270.4(1) have unstable living situations due to the age, incapacity, or sudden loss of
270.5the primary caregivers;
270.6(2) are moving from an institution due to bed closures;
270.7(3) experience a sudden closure of their current living arrangement;
270.8(4) require protection from confirmed abuse, neglect, or exploitation;
270.9(5) experience a sudden change in need that can no longer be met through state plan
270.10services or other funding resources alone; or
270.11(6) meet other priorities established by the department.
270.12(b) (c) When allocating resources to lead agencies, the commissioner must take into
270.13consideration the number of individuals waiting who meet statewide priorities and the
270.14lead agencies' current use of waiver funds and existing service options. The commissioner
270.15has the authority to transfer funds between counties, groups of counties, and tribes to
270.16accommodate statewide priorities and resource needs while accounting for a necessary
270.17base level reserve amount for each county, group of counties, and tribe.
270.18(c) The commissioner shall evaluate the impact of the use of statewide priorities and
270.19provide recommendations to the legislature on whether to continue the use of statewide
270.20priorities in the November 1, 2011, annual report required by the commissioner in sections
270.21256B.0916, subdivision 7, and 256B.49, subdivision 21.

270.22    Sec. 39. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
270.23    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
270.24shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
270.25With the permission of the recipient or the recipient's designated legal representative,
270.26the recipient's current provider of services may submit a written report outlining their
270.27recommendations regarding the recipient's care needs prepared by a direct service
270.28employee with at least 20 hours of service to that client. The person conducting the
270.29assessment or reassessment must notify the provider of the date by which this information
270.30is to be submitted. This information shall be provided to the person conducting the
270.31assessment and the person or the person's legal representative and must be considered
270.32prior to the finalization of the assessment or reassessment.
270.33(b) There must be a determination that the client requires a hospital level of care or a
270.34nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
271.1(d), at initial and subsequent assessments to initiate and maintain participation in the
271.2waiver program.
271.3(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
271.4appropriate to determine nursing facility level of care for purposes of medical assistance
271.5payment for nursing facility services, only face-to-face assessments conducted according
271.6to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
271.7determination or a nursing facility level of care determination must be accepted for
271.8purposes of initial and ongoing access to waiver services payment.
271.9(d) Recipients who are found eligible for home and community-based services under
271.10this section before their 65th birthday may remain eligible for these services after their
271.1165th birthday if they continue to meet all other eligibility factors.
271.12(e) The commissioner shall develop criteria to identify recipients whose level of
271.13functioning is reasonably expected to improve and reassess these recipients to establish
271.14a baseline assessment. Recipients who meet these criteria must have a comprehensive
271.15transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
271.16reassessed every six months until there has been no significant change in the recipient's
271.17functioning for at least 12 months. After there has been no significant change in the
271.18recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
271.19informal support systems, and need for services shall be conducted at least every 12
271.20months and at other times when there has been a significant change in the recipient's
271.21functioning. Counties, case managers, and service providers are responsible for
271.22conducting these reassessments and shall complete the reassessments out of existing funds.

271.23    Sec. 40. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:
271.24    Subd. 15. Coordinated service and support plan; comprehensive transitional
271.25service plan; maintenance service plan. (a) Each recipient of home and community-based
271.26waivered services shall be provided a copy of the written coordinated service and support
271.27plan which meets the requirements in section 256B.092, subdivision 1b.
271.28(b) In developing the comprehensive transitional service plan, the individual
271.29receiving services, the case manager, and the guardian, if applicable, will identify the
271.30transitional service plan fundamental service outcome and anticipated timeline to achieve
271.31this outcome. Within the first 20 days following a recipient's request for an assessment or
271.32reassessment, the transitional service planning team must be identified. A team leader must
271.33be identified who will be responsible for assigning responsibility and communicating with
271.34team members to ensure implementation of the transition plan and ongoing assessment and
272.1communication process. The team leader should be an individual, such as the case manager
272.2or guardian, who has the opportunity to follow the recipient to the next level of service.
272.3Within ten days following an assessment, a comprehensive transitional service plan
272.4must be developed incorporating elements of a comprehensive functional assessment and
272.5including short-term measurable outcomes and timelines for achievement of and reporting
272.6on these outcomes. Functional milestones must also be identified and reported according
272.7to the timelines agreed upon by the transitional service planning team. In addition, the
272.8comprehensive transitional service plan must identify additional supports that may assist
272.9in the achievement of the fundamental service outcome such as the development of greater
272.10natural community support, increased collaboration among agencies, and technological
272.11supports.
272.12The timelines for reporting on functional milestones will prompt a reassessment of
272.13services provided, the units of services, rates, and appropriate service providers. It is
272.14the responsibility of the transitional service planning team leader to review functional
272.15milestone reporting to determine if the milestones are consistent with observable skills
272.16and that milestone achievement prompts any needed changes to the comprehensive
272.17transitional service plan.
272.18For those whose fundamental transitional service outcome involves the need to
272.19procure housing, a plan for the recipient to seek the resources necessary to secure the least
272.20restrictive housing possible should be incorporated into the plan, including employment
272.21and public supports such as housing access and shelter needy funding.
272.22(c) Counties and other agencies responsible for funding community placement and
272.23ongoing community supportive services are responsible for the implementation of the
272.24comprehensive transitional service plans. Oversight responsibilities include both ensuring
272.25effective transitional service delivery and efficient utilization of funding resources.
272.26(d) Following one year of transitional services, the transitional services planning team
272.27will make a determination as to whether or not the individual receiving services requires
272.28the current level of continuous and consistent support in order to maintain the recipient's
272.29current level of functioning. Recipients who are determined to have not had a significant
272.30change in functioning for 12 months must move from a transitional to a maintenance
272.31service plan. Recipients on a maintenance service plan must be reassessed to determine if
272.32the recipient would benefit from a transitional service plan at least every 12 months and at
272.33other times when there has been a significant change in the recipient's functioning. This
272.34assessment should consider any changes to technological or natural community supports.
272.35(e) When a county is evaluating denials, reductions, or terminations of home and
272.36community-based services under section 256B.49 for an individual, the case manager
273.1shall offer to meet with the individual or the individual's guardian in order to discuss
273.2the prioritization of service needs within the coordinated service and support plan,
273.3comprehensive transitional service plan, or maintenance service plan. The reduction in
273.4the authorized services for an individual due to changes in funding for waivered services
273.5may not exceed the amount needed to ensure medically necessary services to meet the
273.6individual's health, safety, and welfare.
273.7(f) At the time of reassessment, local agency case managers shall assess each recipient
273.8of community alternatives for disabled individuals or brain injury waivered services
273.9currently residing in a licensed adult foster home that is not the primary residence of the
273.10license holder, or in which the license holder is not the primary caregiver, to determine if
273.11that recipient could appropriately be served in a community-living setting. If appropriate
273.12for the recipient, the case manager shall offer the recipient, through a person-centered
273.13planning process, the option to receive alternative housing and service options. In the
273.14event that the recipient chooses to transfer from the adult foster home, the vacated bed
273.15shall not be filled with another recipient of waiver services and group residential housing
273.16and the licensed capacity shall be reduced accordingly, unless the savings required by the
273.17licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7,
273.18sections 1 and 40, paragraph (f), for foster care settings where the physical location is not
273.19the primary residence of the license holder are met through voluntary changes described
273.20in section 245A.03, subdivision 7, paragraph (f) (e), or as provided under paragraph (a),
273.21clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers,
273.22the county agency, with the assistance of the department, shall facilitate a consolidation of
273.23settings or closure. This reassessment process shall be completed by July 1, 2013.

273.24    Sec. 41. Minnesota Statutes 2012, section 256B.49, is amended by adding a
273.25subdivision to read:
273.26    Subd. 25. Reduce avoidable behavioral crisis emergency room admissions,
273.27psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons
273.28receiving home and community-based services authorized under this section who have
273.29two or more admissions within a calendar year to an emergency room, psychiatric unit,
273.30or institution must receive consultation from a mental health professional as defined in
273.31section 245.462, subdivision 18, or a behavioral professional as defined in the home and
273.32community-based services state plan within 30 days of discharge. The mental health
273.33professional or behavioral professional must:
273.34(1) conduct a functional assessment of the crisis incident as defined in section
273.35245D.02, subdivision 11, which led to the hospitalization with the goal of developing
274.1proactive strategies as well as necessary reactive strategies to reduce the likelihood of
274.2future avoidable hospitalizations due to a behavioral crisis;
274.3(2) use the results of the functional assessment to amend the coordinated service and
274.4support plan in section 245D.02, subdivision 4b, to address the potential need for additional
274.5staff training, increased staffing, access to crisis mobility services, mental health services,
274.6use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
274.7(3) identify the need for additional consultation, testing, mental health crisis
274.8intervention team services as defined in section 245D.02, subdivision 20, psychotropic
274.9medication use and monitoring under section 245D.051, and the frequency and duration
274.10of ongoing consultation.
274.11(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
274.12the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

274.13    Sec. 42. Minnesota Statutes 2012, section 256B.49, is amended by adding a
274.14subdivision to read:
274.15    Subd. 26. Excess allocations. County and tribal agencies will be responsible for
274.16authorizations in excess of the allocation made by the commissioner. In the event a county
274.17or tribal agency authorizes in excess of the allocation made by the commissioner for a
274.18given allocation period, the county or tribal agency must submit a corrective action plan to
274.19the commissioner. The plan must state the actions the agency will take to correct their
274.20overspending for the year following the period when the overspending occurred. Failure
274.21to correct overauthorizations shall result in recoupment of authorizations in excess of
274.22the allocation. Nothing in this subdivision shall be construed as reducing the county's
274.23responsibility to offer and make available feasible home and community-based options to
274.24eligible waiver recipients within the resources allocated to them for that purpose.

274.25    Sec. 43. Minnesota Statutes 2012, section 256B.492, is amended to read:
274.26256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
274.27WITH DISABILITIES.
274.28(a) Individuals receiving services under a home and community-based waiver under
274.29section 256B.092 or 256B.49 may receive services in the following settings:
274.30(1) an individual's own home or family home;
274.31(2) a licensed adult foster care setting of up to five people; and
274.32(3) community living settings as defined in section 256B.49, subdivision 23, where
274.33individuals with disabilities may reside in all of the units in a building of four or fewer
274.34units, and no more than the greater of four or 25 percent of the units in a multifamily
275.1building of more than four units, unless required by the Housing Opportunities for Persons
275.2with AIDS Program.
275.3(b) The settings in paragraph (a) must not:
275.4(1) be located in a building that is a publicly or privately operated facility that
275.5provides institutional treatment or custodial care;
275.6(2) be located in a building on the grounds of or adjacent to a public or private
275.7institution;
275.8(3) be a housing complex designed expressly around an individual's diagnosis or
275.9disability, unless required by the Housing Opportunities for Persons with AIDS Program;
275.10(4) be segregated based on a disability, either physically or because of setting
275.11characteristics, from the larger community; and
275.12(5) have the qualities of an institution which include, but are not limited to:
275.13regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
275.14agreed to and documented in the person's individual service plan shall not result in a
275.15residence having the qualities of an institution as long as the restrictions for the person are
275.16not imposed upon others in the same residence and are the least restrictive alternative,
275.17imposed for the shortest possible time to meet the person's needs.
275.18(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
275.19individuals receive services under a home and community-based waiver as of July 1,
275.202012, and the setting does not meet the criteria of this section.
275.21(d) Notwithstanding paragraph (c), a program in Hennepin County established as
275.22part of a Hennepin County demonstration project is qualified for the exception allowed
275.23under paragraph (c).
275.24(e) The commissioner shall submit an amendment to the waiver plan no later than
275.25December 31, 2012.

275.26    Sec. 44. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:
275.27    Subd. 2. Planned closure process needs determination. The commissioner shall
275.28announce and implement a program for planned closure of adult foster care homes. Planned
275.29closure shall be the preferred method for achieving necessary budgetary savings required by
275.30the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph (d)
275.31 (c). If additional closures are required to achieve the necessary savings, the commissioner
275.32shall use the process and priorities in section 245A.03, subdivision 7, paragraph (d) (c).

275.33    Sec. 45. Minnesota Statutes 2012, section 256B.501, is amended by adding a
275.34subdivision to read:
276.1    Subd. 14. Rate adjustment for ICF/DD in Cottonwood County. The
276.2commissioner of health shall decertify three beds in an intermediate care facility for
276.3persons with developmental disabilities with 21 certified beds located in Cottonwood
276.4County. The total payment rate shall be $282.62 per bed, per day.

276.5    Sec. 46. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
276.6subdivision to read:
276.7    Subd. 14. Rate increase effective June 1, 2013. For rate periods beginning on or
276.8after June 1, 2013, the commissioner shall increase the total operating payment rate for
276.9each facility reimbursed under this section by $7.81 per day. The increase shall not be
276.10subject to any annual percentage increase.
276.11EFFECTIVE DATE.This section is effective June 1, 2013.

276.12    Sec. 47. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
276.13subdivision to read:
276.14    Subd. 15. ICF/DD rate increases effective April 1, 2014. (a) Notwithstanding
276.15subdivision 12, for each facility reimbursed under this section, for the rate period
276.16beginning April 1, 2014, the commissioner shall increase operating payments equal to one
276.17percent of the operating payment rates in effect on March 31, 2014.
276.18(b) For each facility, the commissioner shall apply the rate increase based on
276.19occupied beds, using the percentage specified in this subdivision multiplied by the total
276.20payment rate, including the variable rate, but excluding the property-related payment
276.21rate in effect on the preceding date. The total rate increase shall include the adjustment
276.22provided in section 256B.501, subdivision 12.

276.23    Sec. 48. Minnesota Statutes 2012, section 256B.69, is amended by adding a
276.24subdivision to read:
276.25    Subd. 32a. Initiatives to improve early screening, diagnosis, and treatment of
276.26children with autism spectrum disorder and other developmental conditions. (a) The
276.27commissioner shall require managed care plans and county-based purchasing plans, as
276.28a condition of contract, to implement strategies that facilitate access for young children
276.29between the ages of one and three years to periodic developmental and social-emotional
276.30screenings, as recommended by the Minnesota Interagency Developmental Screening
276.31Task Force, and that those children who do not meet milestones are provided access to
276.32appropriate evaluation and assessment, including treatment recommendations, expected to
276.33improve the child's functioning, with the goal of meeting milestones by age five.
277.1    (b) The following information from encounter data provided to the commissioner
277.2shall be reported on the department's public Web site for each managed care plan and
277.3county-based purchasing plan annually by July 31 of each year beginning in 2014:
277.4    (1) the number of children who received a diagnostic assessment;
277.5    (2) the total number of children ages one to six with a diagnosis of autism spectrum
277.6disorder who received treatments;
277.7    (3) the number of children identified under clause (2) reported by each 12-month age
277.8group beginning with age one and ending with age six; and
277.9    (4) the types of treatments provided to children identified under clause (2) listed by
277.10billing code, including the number of units billed for each child.
277.11    (c) The managed care plans and county-based purchasing plans shall also report on
277.12any barriers to providing screening, diagnosis, and treatment of young children between
277.13the ages of one and three years, any strategies implemented to address those barriers,
277.14and make recommendations on how to measure and report on the effectiveness of the
277.15strategies implemented to facilitate access for young children to provide developmental
277.16and social-emotional screening, diagnosis, and treatment as described in paragraph (a).

277.17    Sec. 49. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
277.18    Subdivision 1. Basis and scope. (a) Upon federal approval, the commissioner
277.19shall establish a medical assistance state plan option for the provision of home and
277.20community-based personal assistance service and supports called "community first
277.21services and supports (CFSS)."
277.22(b) CFSS is a participant-controlled method of selecting and providing services
277.23and supports that allows the participant maximum control of the services and supports.
277.24Participants may choose the degree to which they direct and manage their supports by
277.25choosing to have a significant and meaningful role in the management of services and
277.26supports including by directly employing support workers with the necessary supports
277.27to perform that function.
277.28(c) CFSS is available statewide to eligible individuals to assist with accomplishing
277.29activities of daily living (ADLs), instrumental activities of daily living (IADLs), and
277.30health-related procedures and tasks through hands-on assistance to accomplish the task
277.31or constant supervision and cueing to accomplish the task; and to assist with acquiring,
277.32maintaining, and enhancing the skills necessary to accomplish ADLs, IADLs, and
277.33health-related procedures and tasks. CFSS allows payment for certain supports and goods
277.34such as environmental modifications and technology that are intended to replace or
277.35decrease the need for human assistance.
278.1(d) Upon federal approval, CFSS will replace the personal care assistance program
278.2under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
278.3    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
278.4this subdivision have the meanings given.
278.5(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming,
278.6dressing, bathing, mobility, positioning, and transferring.
278.7(c) "Agency-provider model" means a method of CFSS under which a qualified
278.8agency provides services and supports through the agency's own employees and policies.
278.9The agency must allow the participant to have a significant role in the selection and
278.10dismissal of support workers of their choice for the delivery of their specific services
278.11and supports.
278.12(d) "Behavior" means a description of a need for services and supports used to
278.13determine the home care rating and additional service units. The presence of Level I
278.14behavior is used to determine the home care rating. "Level I behavior" means physical
278.15aggression towards self or others or destruction of property that requires the immediate
278.16response of another person. If qualified for a home care rating as described in subdivision
278.178, additional service units can be added as described in subdivision 8, paragraph (f), for
278.18the following behaviors:
278.19(1) Level I behavior;
278.20(2) increased vulnerability due to cognitive deficits or socially inappropriate
278.21behavior; or
278.22(3) increased need for assistance for recipients who are verbally aggressive or
278.23resistive to care so that time needed to perform activities of daily living is increased.
278.24(e) "Complex health-related needs" means an intervention listed in clauses (1) to
278.25(8) that has been ordered by a physician, and is specified in a community support plan,
278.26including:
278.27(1) tube feedings requiring:
278.28(i) a gastrojejunostomy tube; or
278.29(ii) continuous tube feeding lasting longer than 12 hours per day;
278.30(2) wounds described as:
278.31(i) stage III or stage IV;
278.32(ii) multiple wounds;
278.33(iii) requiring sterile or clean dressing changes or a wound vac; or
278.34(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require
278.35specialized care;
278.36(3) parenteral therapy described as:
279.1(i) IV therapy more than two times per week lasting longer than four hours for
279.2each treatment; or
279.3(ii) total parenteral nutrition (TPN) daily;
279.4(4) respiratory interventions, including:
279.5(i) oxygen required more than eight hours per day;
279.6(ii) respiratory vest more than one time per day;
279.7(iii) bronchial drainage treatments more than two times per day;
279.8(iv) sterile or clean suctioning more than six times per day;
279.9(v) dependence on another to apply respiratory ventilation augmentation devices
279.10such as BiPAP and CPAP; and
279.11(vi) ventilator dependence under section 256B.0652;
279.12(5) insertion and maintenance of catheter, including:
279.13(i) sterile catheter changes more than one time per month;
279.14(ii) clean intermittent catheterization, and including self-catheterization more than
279.15six times per day; or
279.16(iii) bladder irrigations;
279.17(6) bowel program more than two times per week requiring more than 30 minutes to
279.18perform each time;
279.19(7) neurological intervention, including:
279.20(i) seizures more than two times per week and requiring significant physical
279.21assistance to maintain safety; or
279.22(ii) swallowing disorders diagnosed by a physician and requiring specialized
279.23assistance from another on a daily basis; and
279.24(8) other congenital or acquired diseases creating a need for significantly increased
279.25direct hands-on assistance and interventions in six to eight activities of daily living.
279.26(f) "Community first services and supports" or "CFSS" means the assistance and
279.27supports program under this section needed for accomplishing activities of daily living,
279.28instrumental activities of daily living, and health-related tasks through hands-on assistance
279.29to accomplish the task or constant supervision and cueing to accomplish the task, or the
279.30purchase of goods as defined in subdivision 7, paragraph (a), clause (3), that replace
279.31the need for human assistance.
279.32(g) "Community first services and supports service delivery plan" or "service delivery
279.33plan" means a written summary of the services and supports, that is based on the community
279.34support plan identified in section 256B.0911 and coordinated services and support plan
279.35and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined
279.36by the participant to meet the assessed needs, using a person-centered planning process.
280.1(h) "Critical activities of daily living" means transferring, mobility, eating, and
280.2toileting.
280.3(i) "Dependency" in activities of daily living means a person requires hands-on
280.4assistance or constant supervision and cueing to accomplish one or more of the activities
280.5of daily living every day or on the days during the week that the activity is performed;
280.6however, a child may not be found to be dependent in an activity of daily living if,
280.7because of the child's age, an adult would either perform the activity for the child or assist
280.8the child with the activity and the assistance needed is the assistance appropriate for
280.9a typical child of the same age.
280.10(j) "Extended CFSS" means CFSS services and supports under the agency–provider
280.11model included in a service plan through one of the home and community-based services
280.12waivers authorized under sections 256B.0915; 256B.092, subdivision 5; and 256B.49,
280.13which exceed the amount, duration, and frequency of the state plan CFSS services for
280.14participants.
280.15(k) "Financial management services contractor or vendor" means a qualified
280.16organization having a written contract with the department to provide services necessary to
280.17use the budget model under subdivision 13, that include but are not limited to: participant
280.18education and technical assistance; CFSS service delivery planning and budgeting; billing,
280.19making payments, and monitoring of spending; and assisting the participant in fulfilling
280.20employer-related requirements in accordance with Section 3504 of the IRS code and
280.21the IRS Revenue Procedure 70-6.
280.22(l) "Budget model" means a service delivery method of CFSS that allows the use of
280.23an individualized CFSS service delivery plan and service budget and provides assistance
280.24from the financial management services contractor to facilitate participant employment of
280.25support workers and the acquisition of supports and goods.
280.26(m) "Health-related procedures and tasks" means procedures and tasks related to
280.27the specific needs of an individual that can be delegated or assigned by a state-licensed
280.28healthcare or mental health professional and performed by a support worker.
280.29(n) "Instrumental activities of daily living" means activities related to living
280.30independently in the community, including but not limited to: meal planning, preparation,
280.31and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning;
280.32assistance with medications; managing finances; communicating needs and preferences
280.33during activities; arranging supports; and assistance with traveling around and
280.34participating in the community.
280.35(o) "Legal representative" means parent of a minor, a court-appointed guardian, or
280.36another representative with legal authority to make decisions about services and supports
281.1for the participant. Other representatives with legal authority to make decisions include
281.2but are not limited to a health care agent or an attorney-in-fact authorized through a health
281.3care directive or power of attorney.
281.4(p) "Medication assistance" means providing verbal or visual reminders to take
281.5regularly scheduled medication, and includes any of the following supports listed in clauses
281.6(1) to (3) and other types of assistance, except that a support worker may not determine
281.7medication dose or time for medication or inject medications into veins, muscles, or skin:
281.8(1) under the direction of the participant or the participant's representative, bringing
281.9medications to the participant including medications given through a nebulizer, opening a
281.10container of previously set-up medications, emptying the container into the participant's
281.11hand, opening and giving the medication in the original container to the participant, or
281.12bringing to the participant liquids or food to accompany the medication;
281.13(2) organizing medications as directed by the participant or the participant's
281.14representative; and
281.15(3) providing verbal or visual reminders to perform regularly scheduled medications.
281.16(q) "Participant's representative" means a parent, family member, advocate, or
281.17other adult authorized by the participant to serve as a representative in connection with
281.18the provision of CFSS. This authorization must be in writing or by another method
281.19that clearly indicates the participant's free choice. The participant's representative must
281.20have no financial interest in the provision of any services included in the participant's
281.21service delivery plan and must be capable of providing the support necessary to assist
281.22the participant in the use of CFSS. If through the assessment process described in
281.23subdivision 5 a participant is determined to be in need of a participant's representative, one
281.24must be selected. If the participant is unable to assist in the selection of a participant's
281.25representative, the legal representative shall appoint one. Two persons may be designated
281.26as a participant's representative for reasons such as divided households and court-ordered
281.27custodies. Duties of a participant's representatives may include:
281.28(1) being available while care is provided in a method agreed upon by the participant
281.29or the participant's legal representative and documented in the participant's CFSS service
281.30delivery plan;
281.31(2) monitoring CFSS services to ensure the participant's CFSS service delivery
281.32plan is being followed; and
281.33(3) reviewing and signing CFSS time sheets after services are provided to provide
281.34verification of the CFSS services.
281.35(r) "Person-centered planning process" means a process that is directed by the
281.36participant to plan for services and supports. The person-centered planning process must:
282.1(1) include people chosen by the participant;
282.2(2) provide necessary information and support to ensure that the participant directs
282.3the process to the maximum extent possible, and is enabled to make informed choices
282.4and decisions;
282.5(3) be timely and occur at time and locations of convenience to the participant;
282.6(4) reflect cultural considerations of the participant;
282.7(5) include strategies for solving conflict or disagreement within the process,
282.8including clear conflict-of-interest guidelines for all planning;
282.9(6) provide the participant choices of the services and supports they receive and the
282.10staff providing those services and supports;
282.11(7) include a method for the participant to request updates to the plan; and
282.12(8) record the alternative home and community-based settings that were considered
282.13by the participant.
282.14(s) "Shared services" means the provision of CFSS services by the same CFSS
282.15support worker to two or three participants who voluntarily enter into an agreement to
282.16receive services at the same time and in the same setting by the same provider.
282.17(t) "Support specialist" means a professional with the skills and ability to assist the
282.18participant using either the agency provider model under subdivision 11 or the flexible
282.19spending model under subdivision 13, in services including but not limited to assistance
282.20regarding:
282.21(1) the development, implementation, and evaluation of the CFSS service delivery
282.22plan under subdivision 6;
282.23(2) recruitment, training, or supervision, including supervision of health-related tasks
282.24or behavioral supports appropriately delegated or assigned by a health care professional,
282.25and evaluation of support workers; and
282.26(3) facilitating the use of informal and community supports, goods, or resources.
282.27(u) "Support worker" means an employee of the agency provider or of the participant
282.28who has direct contact with the participant and provides services as specified within the
282.29participant's service delivery plan.
282.30(v) "Wages and benefits" means the hourly wages and salaries, the employer's
282.31share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
282.32compensation, mileage reimbursement, health and dental insurance, life insurance,
282.33disability insurance, long-term care insurance, uniform allowance, contributions to
282.34employee retirement accounts, or other forms of employee compensation and benefits.
282.35    Subd. 3. Eligibility. (a) CFSS is available to a person who meets one of the
282.36following:
283.1(1) is a recipient of medical assistance as determined under section 256B.055,
283.2256B.056, or 256B.057, subdivisions 5 and 9;
283.3(2) is a recipient of the alternative care program under section 256B.0913;
283.4(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093,
283.5or 256B.49; or
283.6(4) has medical services identified in a participant's individualized education
283.7program and is eligible for services as determined in section 256B.0625, subdivision 26.
283.8(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
283.9meet all of the following:
283.10(1) require assistance and be determined dependent in one activity of daily living or
283.11Level I behavior based on assessment under section 256B.0911;
283.12(2) is not a recipient under the family support grant under section 252.32;
283.13(3) lives in the person's own apartment or home including a family foster care setting
283.14licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a
283.15noncertified boarding care or boarding and lodging establishments under chapter 157.
283.16    Subd. 4. Eligibility for other services. Selection of CFSS by a participant must not
283.17restrict access to other medically necessary care and services furnished under the state
283.18plan medical assistance benefit or other services available through alternative care.
283.19    Subd. 5. Assessment requirements. (a) The assessment of functional need must:
283.20(1) be conducted by a certified assessor according to the criteria established in
283.21section 256B.0911, subdivision 3a;
283.22(2) be conducted face-to-face, initially and at least annually thereafter, or when there
283.23is a significant change in the participant's condition or a change in the need for services
283.24and supports; and
283.25(3) be completed using the format established by the commissioner.
283.26(b) A participant who is residing in a facility may be assessed and choose CFSS for
283.27the purpose of using CFSS to return to the community as described in subdivisions 3
283.28and 7, paragraph (a), clause (5).
283.29(c) The results of the assessment and any recommendations and authorizations for
283.30CFSS must be determined and communicated in writing by the lead agency's certified
283.31assessor as defined in section 256B.0911 to the participant and the agency-provider or
283.32financial management services provider chosen by the participant within 40 calendar days
283.33and must include the participant's right to appeal under section 256.045, subdivision 3.
283.34(d) The lead agency assessor may request a temporary authorization for CFSS
283.35services. Authorization for a temporary level of CFSS services is limited to the time
284.1specified by the commissioner, but shall not exceed 45 days. The level of services
284.2authorized under this provision shall have no bearing on a future authorization.
284.3    Subd. 6. Community first services and support service delivery plan. (a) The
284.4CFSS service delivery plan must be developed, implemented, and evaluated through a
284.5person-centered planning process by the participant, or the participant's representative
284.6or legal representative who may be assisted by a support specialist. The CFSS service
284.7delivery plan must reflect the services and supports that are important to the participant
284.8and for the participant to meet the needs assessed by the certified assessor and identified in
284.9the community support plan under section 256B.0911, subdivision 3, or the coordinated
284.10services and support plan identified in section 256B.0915, subdivision 6, if applicable. The
284.11CFSS service delivery plan must be reviewed by the participant and the agency-provider
284.12or financial management services contractor at least annually upon reassessment, or
284.13when there is a significant change in the participant's condition, or a change in the need
284.14for services and supports.
284.15(b) The commissioner shall establish the format and criteria for the CFSS service
284.16delivery plan.
284.17(c) The CFSS service delivery plan must be person-centered and:
284.18(1) specify the agency-provider or financial management services contractor selected
284.19by the participant;
284.20(2) reflect the setting in which the participant resides that is chosen by the participant;
284.21(3) reflect the participant's strengths and preferences;
284.22(4) include the means to address the clinical and support needs as identified through
284.23an assessment of functional needs;
284.24(5) include individually identified goals and desired outcomes;
284.25(6) reflect the services and supports, paid and unpaid, that will assist the participant
284.26to achieve identified goals, and the providers of those services and supports, including
284.27natural supports;
284.28(7) identify the amount and frequency of face-to-face supports and amount and
284.29frequency of remote supports and technology that will be used;
284.30(8) identify risk factors and measures in place to minimize them, including
284.31individualized backup plans;
284.32(9) be understandable to the participant and the individuals providing support;
284.33(10) identify the individual or entity responsible for monitoring the plan;
284.34(11) be finalized and agreed to in writing by the participant and signed by all
284.35individuals and providers responsible for its implementation;
284.36(12) be distributed to the participant and other people involved in the plan; and
285.1(13) prevent the provision of unnecessary or inappropriate care.
285.2(d) The total units of agency-provider services or the budget allocation amount for
285.3the budget model include both annual totals and a monthly average amount that cover
285.4the number of months of the service authorization. The amount used each month may
285.5vary, but additional funds must not be provided above the annual service authorization
285.6amount unless a change in condition is assessed and authorized by the certified assessor
285.7and documented in the community support plan, coordinated services and supports plan,
285.8and service delivery plan.
285.9    Subd. 7. Community first services and supports; covered services. Within the
285.10service unit authorization or budget allocation, services and supports covered under
285.11CFSS include:
285.12(1) assistance to accomplish activities of daily living (ADLs), instrumental activities
285.13of daily living (IADLs), and health-related procedures and tasks through hands-on
285.14assistance to accomplish the task or constant supervision and cueing to accomplish the task;
285.15(2) assistance to acquire, maintain, or enhance the skills necessary for the participant
285.16to accomplish activities of daily living, instrumental activities of daily living, or
285.17health-related tasks;
285.18(3) expenditures for items, services, supports, environmental modifications, or
285.19goods, including assistive technology. These expenditures must:
285.20(i) relate to a need identified in a participant's CFSS service delivery plan;
285.21(ii) increase independence or substitute for human assistance to the extent that
285.22expenditures would otherwise be made for human assistance for the participant's assessed
285.23needs;
285.24(4) observation and redirection for behavior or symptoms where there is a need for
285.25assistance. An assessment of behaviors must meet the criteria in this clause. A recipient
285.26qualifies as having a need for assistance due to behaviors if the recipient's behavior requires
285.27assistance at least four times per week and shows one or more of the following behaviors:
285.28(i) physical aggression towards self or others, or destruction of property that requires
285.29the immediate response of another person;
285.30(ii) increased vulnerability due to cognitive deficits or socially inappropriate
285.31behavior; or
285.32(iii) increased need for assistance for recipients who are verbally aggressive or
285.33resistive to care so that time needed to perform activities of daily living is increased;
285.34(5) back-up systems or mechanisms, such as the use of pagers or other electronic
285.35devices, to ensure continuity of the participant's services and supports;
285.36(6) transition costs, including:
286.1(i) deposits for rent and utilities;
286.2(ii) first month's rent and utilities;
286.3(iii) bedding;
286.4(iv) basic kitchen supplies;
286.5(v) other necessities, to the extent that these necessities are not otherwise covered
286.6under any other funding that the participant is eligible to receive; and
286.7(vi) other required necessities for an individual to make the transition from a nursing
286.8facility, institution for mental diseases, or intermediate care facility for persons with
286.9developmental disabilities to a community-based home setting where the participant
286.10resides; and
286.11(7) services by a support specialist defined under subdivision 2 that are chosen
286.12by the participant.
286.13    Subd. 8. Determination of CFSS service methodology. (a) All community first
286.14services and supports must be authorized by the commissioner or the commissioner's
286.15designee before services begin, except for the assessments established in section
286.16256B.0911. The authorization for CFSS must be completed as soon as possible following
286.17an assessment but no later than 40 calendar days from the date of the assessment.
286.18(b) The amount of CFSS authorized must be based on the recipient's home care
286.19rating described in subdivision 8, paragraphs (d) and (e), and any additional service units
286.20for which the person qualifies as described in subdivision 8, paragraph (f).
286.21(c) The home care rating shall be determined by the commissioner or the
286.22commissioner's designee based on information submitted to the commissioner identifying
286.23the following for a recipient:
286.24(1) the total number of dependencies of activities of daily living as defined in
286.25subdivision 2, paragraph (b);
286.26(2) the presence of complex health-related needs as defined in subdivision 2,
286.27paragraph (e); and
286.28(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d),
286.29clause (1).
286.30(d) The methodology to determine the total service units for CFSS for each home
286.31care rating is based on the median paid units per day for each home care rating from
286.32fiscal year 2007 data for the PCA program.
286.33(e) Each home care rating is designated by the letters P through Z and EN and has
286.34the following base number of service units assigned:
286.35(i) P home care rating requires Level 1 behavior or one to three dependencies in
286.36ADLs and qualifies one for five service units;
287.1(ii) Q home care rating requires Level 1 behavior and one to three dependencies in
287.2ADLs and qualifies one for six service units;
287.3(iii) R home care rating requires a complex health-related need and one to three
287.4dependencies in ADLs and qualifies one for seven service units;
287.5(iv) S home care rating requires four to six dependencies in ADLs and qualifies
287.6one for ten service units;
287.7(v) T home care rating requires four to six dependencies in ADLs and Level 1
287.8behavior and qualifies one for 11 service units;
287.9(vi) U home care rating requires four to six dependencies in ADLs and a complex
287.10health need and qualifies one for 14 service units;
287.11(vii) V home care rating requires seven to eight dependencies in ADLs and qualifies
287.12one for 17 service units;
287.13(viii) W home care rating requires seven to eight dependencies in ADLs and Level 1
287.14behavior and qualifies one for 20 service units;
287.15(ix) Z home care rating requires seven to eight dependencies in ADLs and a complex
287.16health related need and qualifies one for 30 service units; and
287.17(x) EN home care rating includes ventilator dependency as defined in section
287.18256B.0651, subdivision 1, paragraph (g). Recipients who meet the definition of
287.19ventilator-dependent and the EN home care rating and utilize a combination of CFSS
287.20and other home care services are limited to a total of 96 service units per day for those
287.21services in combination. Additional units may be authorized when a recipient's assessment
287.22indicates a need for two staff to perform activities. Additional time is limited to 16 service
287.23units per day.
287.24(f) Additional service units are provided through the assessment and identification of
287.25the following:
287.26(1) 30 additional minutes per day for a dependency in each critical activity of daily
287.27living as defined in subdivision 2, paragraph (h);
287.28(2) 30 additional minutes per day for each complex health-related function as
287.29defined in subdivision 2, paragraph (e); and
287.30(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2,
287.31paragraph (d).
287.32    Subd. 9. Noncovered services. (a) Services or supports that are not eligible for
287.33payment under this section include those that:
287.34(1) are not authorized by the certified assessor or included in the written service
287.35delivery plan;
288.1(2) are provided prior to the authorization of services and the approval of the written
288.2CFSS service delivery plan;
288.3(3) are duplicative of other paid services in the written service delivery plan;
288.4(4) supplant natural unpaid supports that appropriately meet a need in the service
288.5plan, are provided voluntarily to the participant and are selected by the participant in lieu
288.6of other services and supports;
288.7(5) are not effective means to meet the participant's needs; and
288.8(6) are available through other funding sources, including, but not limited to, funding
288.9through Title IV-E of the Social Security Act.
288.10(b) Additional services, goods, or supports that are not covered include:
288.11(1) those that are not for the direct benefit of the participant, except that services for
288.12caregivers such as training to improve the ability to provide CFSS are considered to directly
288.13benefit the participant if chosen by the participant and approved in the support plan;
288.14(2) any fees incurred by the participant, such as Minnesota health care programs fees
288.15and co-pays, legal fees, or costs related to advocate agencies;
288.16(3) insurance, except for insurance costs related to employee coverage;
288.17(4) room and board costs for the participant with the exception of allowable
288.18transition costs in subdivision 7, clause (6);
288.19(5) services, supports, or goods that are not related to the assessed needs;
288.20(6) special education and related services provided under the Individuals with
288.21Disabilities Education Act and vocational rehabilitation services provided under the
288.22Rehabilitation Act of 1973;
288.23(7) assistive technology devices and assistive technology services other than those
288.24for back-up systems or mechanisms to ensure continuity of service and supports listed in
288.25subdivision 7;
288.26(8) medical supplies and equipment;
288.27(9) environmental modifications, except as specified in subdivision 7;
288.28(10) expenses for travel, lodging, or meals related to training the participant, the
288.29participant's representative, legal representative, or paid or unpaid caregivers that exceed
288.30$500 in a 12-month period;
288.31(11) experimental treatments;
288.32(12) any service or good covered by other medical assistance state plan services,
288.33including prescription and over-the-counter medications, compounds, and solutions and
288.34related fees, including premiums and co-payments;
288.35(13) membership dues or costs, except when the service is necessary and appropriate
288.36to treat a physical condition or to improve or maintain the participant's physical condition.
289.1The condition must be identified in the participant's CFSS plan and monitored by a
289.2physician enrolled in a Minnesota health care program;
289.3(14) vacation expenses other than the cost of direct services;
289.4(15) vehicle maintenance or modifications not related to the disability, health
289.5condition, or physical need; and
289.6(16) tickets and related costs to attend sporting or other recreational or entertainment
289.7events.
289.8    Subd. 10. Provider qualifications and general requirements. Agency-providers
289.9delivering services under the agency-provider model under subdivision 11 or financial
289.10management service (FMS) contractors under subdivision 13 shall:
289.11(1) enroll as a medical assistance Minnesota health care programs provider and meet
289.12all applicable provider standards;
289.13(2) comply with medical assistance provider enrollment requirements;
289.14(3) demonstrate compliance with law and policies of CFSS as determined by the
289.15commissioner;
289.16(4) comply with background study requirements under chapter 245C;
289.17(5) verify and maintain records of all services and expenditures by the participant,
289.18including hours worked by support workers and support specialists;
289.19(6) not engage in any agency-initiated direct contact or marketing in person, by
289.20telephone, or other electronic means to potential participants, guardians, family member,
289.21or participants' representatives;
289.22(7) pay support workers and support specialists based upon actual hours of services
289.23provided;
289.24(8) withhold and pay all applicable federal and state payroll taxes;
289.25(9) make arrangements and pay unemployment insurance, taxes, workers'
289.26compensation, liability insurance, and other benefits, if any;
289.27(10) enter into a written agreement with the participant, participant's representative,
289.28or legal representative that assigns roles and responsibilities to be performed before
289.29services, supports, or goods are provided using a format established by the commissioner;
289.30(11) report maltreatment as required under sections 626.556 and 626.557; and
289.31(12) provide the participant with a copy of the service-related rights under
289.32subdivision 19 at the start of services and supports.
289.33    Subd. 11. Agency-provider model. (a) The agency-provider model is limited to
289.34the services provided by support workers and support specialists who are employed by
289.35an agency-provider that is licensed according to chapter 245A or meets other criteria
289.36established by the commissioner, including required training.
290.1(b) The agency-provider shall allow the participant to have a significant role in the
290.2selection and dismissal of the support workers for the delivery of the services and supports
290.3specified in the participant's service delivery plan.
290.4(c) A participant may use authorized units of CFSS services as needed within a
290.5service authorization that is not greater than 12 months. Using authorized units in a
290.6flexible manner in either the agency-provider model or the budget model does not increase
290.7the total amount of services and supports authorized for a participant or included in the
290.8participant's service delivery plan.
290.9(d) A participant may share CFSS services. Two or three CFSS participants may
290.10share services at the same time provided by the same support worker.
290.11(e) The agency-provider must use a minimum of 72.5 percent of the revenue
290.12generated by the medical assistance payment for CFSS for support worker wages and
290.13benefits. The agency-provider must document how this requirement is being met. The
290.14revenue generated by the support specialist and the reasonable costs associated with the
290.15support specialist must not be used in making this calculation.
290.16(f) The agency-provider model must be used by individuals who have been restricted
290.17by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160
290.18to 9505.2245.
290.19    Subd. 12. Requirements for enrollment of CFSS provider agencies. (a) All CFSS
290.20provider agencies must provide, at the time of enrollment, reenrollment, and revalidation
290.21as a CFSS provider agency in a format determined by the commissioner, information and
290.22documentation that includes, but is not limited to, the following:
290.23(1) the CFSS provider agency's current contact information including address,
290.24telephone number, and e-mail address;
290.25(2) proof of surety bond coverage. Upon new enrollment, or if the provider agency's
290.26Medicaid revenue in the previous calendar year is less than or equal to $300,000, the
290.27provider agency must purchase a performance bond of $50,000. If the provider agency's
290.28Medicaid revenue in the previous calendar year is greater than $300,000, the provider
290.29agency must purchase a performance bond of $100,000. The performance bond must be
290.30in a form approved by the commissioner, must be renewed annually, and must allow for
290.31recovery of costs and fees in pursuing a claim on the bond;
290.32(3) proof of fidelity bond coverage in the amount of $20,000;
290.33(4) proof of workers' compensation insurance coverage;
290.34(5) proof of liability insurance;
291.1(6) a description of the CFSS provider agency's organization identifying the names
291.2or all owners, managing employees, staff, board of directors, and the affiliations of the
291.3directors, owners, or staff to other service providers;
291.4(7) a copy of the CFSS provider agency's written policies and procedures including:
291.5hiring of employees; training requirements; service delivery; and employee and consumer
291.6safety including process for notification and resolution of consumer grievances,
291.7identification and prevention of communicable diseases, and employee misconduct;
291.8(8) copies of all other forms the CFSS provider agency uses in the course of daily
291.9business including, but not limited to:
291.10(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from
291.11the standard time sheet for CFSS services approved by the commissioner, and a letter
291.12requesting approval of the CFSS provider agency's nonstandard time sheet; and
291.13(ii) the CFSS provider agency's template for the CFSS care plan;
291.14(9) a list of all training and classes that the CFSS provider agency requires of its
291.15staff providing CFSS services;
291.16(10) documentation that the CFSS provider agency and staff have successfully
291.17completed all the training required by this section;
291.18(11) documentation of the agency's marketing practices;
291.19(12) disclosure of ownership, leasing, or management of all residential properties
291.20that are used or could be used for providing home care services;
291.21(13) documentation that the agency will use at least the following percentages of
291.22revenue generated from the medical assistance rate paid for CFSS services for employee
291.23personal care assistant wages and benefits: 72.5 percent of revenue from CFSS providers.
291.24The revenue generated by the support specialist and the reasonable costs associated with
291.25the support specialist shall not be used in making this calculation; and
291.26(14) documentation that the agency does not burden recipients' free exercise of their
291.27right to choose service providers by requiring personal care assistants to sign an agreement
291.28not to work with any particular CFSS recipient or for another CFSS provider agency after
291.29leaving the agency and that the agency is not taking action on any such agreements or
291.30requirements regardless of the date signed.
291.31(b) CFSS provider agencies shall provide to the commissioner the information
291.32specified in paragraph (a).
291.33(c) All CFSS provider agencies shall require all employees in management and
291.34supervisory positions and owners of the agency who are active in the day-to-day
291.35management and operations of the agency to complete mandatory training as determined
291.36by the commissioner. Employees in management and supervisory positions and owners
292.1who are active in the day-to-day operations of an agency who have completed the required
292.2training as an employee with a CFSS provider agency do not need to repeat the required
292.3training if they are hired by another agency, if they have completed the training within
292.4the past three years. CFSS provider agency billing staff shall complete training about
292.5CFSS program financial management. Any new owners or employees in management
292.6and supervisory positions involved in the day-to-day operations are required to complete
292.7mandatory training as a requisite of working for the agency. CFSS provider agencies
292.8certified for participation in Medicare as home health agencies are exempt from the
292.9training required in this subdivision.
292.10    Subd. 13. Budget model. (a) Under the budget model participants can exercise
292.11more responsibility and control over the services and supports described and budgeted
292.12within the CFSS service delivery plan. Under this model, participants may use their
292.13budget allocation to:
292.14(1) directly employ support workers;
292.15(2) obtain supports and goods as defined in subdivision 7; and
292.16(3) choose a range of support assistance services from the financial management
292.17services (FMS) contractor related to:
292.18(i) assistance in managing the budget to meet the service delivery plan needs,
292.19consistent with federal and state laws and regulations;
292.20(ii) the employment, training, supervision, and evaluation of workers by the
292.21participant;
292.22(iii) acquisition and payment for supports and goods; and
292.23(iv) evaluation of individual service outcomes as needed for the scope of the
292.24participant's degree of control and responsibility.
292.25(b) Participants who are unable to fulfill any of the functions listed in paragraph (a)
292.26may authorize a legal representative or participant's representative to do so on their behalf.
292.27(c) The FMS contractor shall not provide CFSS services and supports under the
292.28agency-provider service model. The FMS contractor shall provide service functions as
292.29determined by the commissioner that include but are not limited to:
292.30(1) information and consultation about CFSS;
292.31(2) assistance with the development of the service delivery plan and budget model
292.32as requested by the participant;
292.33(3) billing and making payments for budget model expenditures;
292.34(4) assisting participants in fulfilling employer-related requirements according to
292.35Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,
293.1regulation 137036-08, which includes assistance with filing and paying payroll taxes, and
293.2obtaining worker compensation coverage;
293.3(5) data recording and reporting of participant spending; and
293.4(6) other duties established in the contract with the department, including with
293.5respect to providing assistance to the participant, participant's representative, or legal
293.6representative in performing their employer responsibilities regarding support workers.
293.7The support worker shall not be considered the employee of the financial management
293.8services contractor.
293.9(d) A participant who requests to purchase goods and supports along with support
293.10worker services under the agency-provider model must use the budget model with
293.11a service delivery plan that specifies the amount of services to be authorized to the
293.12agency-provider and the expenditures to be paid by the FMS contractor.
293.13(e) The FMS contractor shall:
293.14(1) not limit or restrict the participant's choice of service or support providers or
293.15service delivery models consistent with any applicable state and federal requirements;
293.16(2) provide the participant and the targeted case manager, if applicable, with a
293.17monthly written summary of the spending for services and supports that were billed
293.18against the spending budget;
293.19(3) be knowledgeable of state and federal employment regulations, including those
293.20under the Fair Labor Standards Act of 1938, and comply with the requirements under the
293.21Internal Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer
293.22Tax Liability for vendor or fiscal employer agent, and any requirements necessary to
293.23process employer and employee deductions, provide appropriate and timely submission of
293.24employer tax liabilities, and maintain documentation to support medical assistance claims;
293.25(4) have current and adequate liability insurance and bonding and sufficient cash
293.26flow as determined by the commissioner and have on staff or under contract a certified
293.27public accountant or an individual with a baccalaureate degree in accounting;
293.28(5) assume fiscal accountability for state funds designated for the program; and
293.29(6) maintain documentation of receipts, invoices, and bills to track all services and
293.30supports expenditures for any goods purchased and maintain time records of support
293.31workers. The documentation and time records must be maintained for a minimum of
293.32five years from the claim date and be available for audit or review upon request by the
293.33commissioner. Claims submitted by the FMS contractor to the commissioner for payment
293.34must correspond with services, amounts, and time periods as authorized in the participant's
293.35spending budget and service plan.
293.36(f) The commissioner of human services shall:
294.1(1) establish rates and payment methodology for the FMS contractor;
294.2(2) identify a process to ensure quality and performance standards for the FMS
294.3contractor and ensure statewide access to FMS contractors; and
294.4(3) establish a uniform protocol for delivering and administering CFSS services
294.5to be used by eligible FMS contractors.
294.6(g) The commissioner of human services shall disenroll or exclude participants from
294.7the budget model and transfer them to the agency-provider model under the following
294.8circumstances that include but are not limited to:
294.9(1) when a participant has been restricted by the Minnesota restricted recipient
294.10program, the participant may be excluded for a specified time period under Minnesota
294.11Rules, parts 9505.2160 to 9505.2245;
294.12(2) when a participant exits the budget model during the participant's service plan
294.13year. Upon transfer, the participant shall not access the budget model for the remainder of
294.14that service plan year; or
294.15(3) when the department determines that the participant or participant's representative
294.16or legal representative cannot manage participant responsibilities under the budget model.
294.17The commissioner must develop policies for determining if a participant is unable to
294.18manage responsibilities under a budget model.
294.19(h) A participant may appeal under section 256.045, subdivision 3, in writing to the
294.20department to contest the department's decision under paragraph (c), clause (3), to remove
294.21or exclude the participant from the budget model.
294.22    Subd. 14. Participant's responsibilities under budget model. (a) A participant
294.23using the budget model must use an FMS contractor or vendor that is under contract with
294.24the department. Upon a determination of eligibility and completion of the assessment and
294.25community support plan, the participant shall choose a FMS contractor from a list of
294.26eligible vendors maintained by the department.
294.27(b) When the participant, participant's representative, or legal representative
294.28chooses to be the employer of the support worker, they are responsible for the hiring and
294.29supervision of the support worker, including, but not limited to, recruiting, interviewing,
294.30training, scheduling, and discharging the support worker consistent with federal and
294.31state laws and regulations.
294.32(c) In addition to the employer responsibilities in paragraph (b), the participant,
294.33participant's representative, or legal representative is responsible for:
294.34(1) tracking the services provided and all expenditures for goods or other supports;
295.1(2) preparing and submitting time sheets, signed by both the participant and support
295.2worker, to the FMS contractor on a regular basis and in a timely manner according to
295.3the FMS contractor's procedures;
295.4(3) notifying the FMS contractor within ten days of any changes in circumstances
295.5affecting the CFSS service plan or in the participant's place of residence including, but
295.6not limited to, any hospitalization of the participant or change in the participant's address,
295.7telephone number, or employment;
295.8(4) notifying the FMS contractor of any changes in the employment status of each
295.9participant support worker; and
295.10(5) reporting any problems resulting from the quality of services rendered by the
295.11support worker to the FMS contractor. If the participant is unable to resolve any problems
295.12resulting from the quality of service rendered by the support worker with the assistance of
295.13the FMS contractor, the participant shall report the situation to the department.
295.14    Subd. 15. Documentation of support services provided. (a) Support services
295.15provided to a participant by a support worker employed by either an agency-provider
295.16or the participant acting as the employer must be documented daily by each support
295.17worker, on a time sheet form approved by the commissioner. All documentation may be
295.18Web-based, electronic, or paper documentation. The completed form must be submitted
295.19on a monthly basis to the provider or the participant and the FMS contractor selected by
295.20the participant to provide assistance with meeting the participant's employer obligations
295.21and kept in the recipient's health record.
295.22(b) The activity documentation must correspond to the written service delivery plan
295.23and be reviewed by the agency provider or the participant and the FMS contractor when
295.24the participant is acting as the employer of the support worker.
295.25(c) The time sheet must be on a form approved by the commissioner documenting
295.26time the support worker provides services in the home. The following criteria must be
295.27included in the time sheet:
295.28(1) full name of the support worker and individual provider number;
295.29(2) provider name and telephone numbers, if an agency-provider is responsible for
295.30delivery services under the written service plan;
295.31(3) full name of the participant;
295.32(4) consecutive dates, including month, day, and year, and arrival and departure
295.33times with a.m. or p.m. notations;
295.34(5) signatures of the participant or the participant's representative;
295.35(6) personal signature of the support worker;
295.36(7) any shared care provided, if applicable;
296.1(8) a statement that it is a federal crime to provide false information on CFSS
296.2billings for medical assistance payments; and
296.3(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
296.4    Subd. 16. Support workers requirements. (a) Support workers shall:
296.5(1) enroll with the department as a support worker after a background study under
296.6chapter 245C has been completed and the support worker has received a notice from the
296.7commissioner that:
296.8(i) the support worker is not disqualified under section 245C.14; or
296.9(ii) is disqualified, but the support worker has received a set-aside of the
296.10disqualification under section 245C.22;
296.11(2) have the ability to effectively communicate with the participant or the
296.12participant's representative;
296.13(3) have the skills and ability to provide the services and supports according to the
296.14person's CFSS service delivery plan and respond appropriately to the participant's needs;
296.15(4) not be a participant of CFSS, unless the support services provided by the support
296.16worker differ from those provided to the support worker;
296.17(5) complete the basic standardized training as determined by the commissioner
296.18before completing enrollment. The training must be available in languages other than
296.19English and to those who need accommodations due to disabilities. Support worker
296.20training must include successful completion of the following training components: basic
296.21first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles
296.22and responsibilities of support workers including information about basic body mechanics,
296.23emergency preparedness, orientation to positive behavioral practices, orientation to
296.24responding to a mental health crisis, fraud issues, time cards and documentation, and an
296.25overview of person-centered planning and self-direction. Upon completion of the training
296.26components, the support worker must pass the certification test to provide assistance
296.27to participants;
296.28(6) complete training and orientation on the participant's individual needs; and
296.29(7) maintain the privacy and confidentiality of the participant, and not independently
296.30determine the medication dose or time for medications for the participant.
296.31(b) The commissioner may deny or terminate a support worker's provider enrollment
296.32and provider number if the support worker:
296.33(1) lacks the skills, knowledge, or ability to adequately or safely perform the
296.34required work;
296.35(2) fails to provide the authorized services required by the participant employer;
297.1(3) has been intoxicated by alcohol or drugs while providing authorized services to
297.2the participant or while in the participant's home;
297.3(4) has manufactured or distributed drugs while providing authorized services to the
297.4participant or while in the participant's home; or
297.5(5) has been excluded as a provider by the commissioner of human services, or the
297.6United States Department of Health and Human Services, Office of Inspector General,
297.7from participation in Medicaid, Medicare, or any other federal health care program.
297.8(c) A support worker may appeal in writing to the commissioner to contest the
297.9decision to terminate the support worker's provider enrollment and provider number.
297.10    Subd. 17. Support specialist requirements and payments. The commissioner
297.11shall develop qualifications, scope of functions, and payment rates and service limits for a
297.12support specialist that may provide additional or specialized assistance necessary to plan,
297.13implement, arrange, augment, or evaluate services and supports.
297.14    Subd. 18. Service unit and budget allocation requirements and limits. (a) For the
297.15agency-provider model, services will be authorized in units of service. The total service
297.16unit amount must be established based upon the assessed need for CFSS services, and must
297.17not exceed the maximum number of units available as determined under subdivision 8.
297.18(b) For the budget model, the budget allocation allowed for services and supports
297.19is established by multiplying the number of units authorized under subdivision 8 by the
297.20payment rate established by the commissioner.
297.21    Subd. 19. Support system. (a) The commissioner shall provide information,
297.22consultation, training, and assistance to ensure the participant is able to manage the
297.23services and supports and budgets, if applicable. This support shall include individual
297.24consultation on how to select and employ workers, manage responsibilities under CFSS,
297.25and evaluate personal outcomes.
297.26(b) The commissioner shall provide assistance with the development of risk
297.27management agreements.
297.28    Subd. 20. Service-related rights. (a) Participants must be provided with adequate
297.29information, counseling, training, and assistance, as needed, to ensure that the participant
297.30is able to choose and manage services, models, and budgets. This support shall include
297.31information regarding:
297.32(1) person-centered planning;
297.33(2) the range and scope of individual choices;
297.34(3) the process for changing plans, services and budgets;
297.35(4) the grievance process;
297.36(5) individual rights;
298.1(6) identifying and assessing appropriate services;
298.2(7) risks and responsibilities; and
298.3(8) risk management.
298.4(b) The commissioner must ensure that the participant has a copy of the most recent
298.5community support plan and service delivery plan.
298.6(c) A participant who appeals a reduction in previously authorized CFSS services
298.7may continue previously authorized services pending an appeal in accordance with section
298.8256.045.
298.9(d) If the units of service or budget allocation for CFSS are reduced, denied, or
298.10terminated, the commissioner must provide notice of the reasons for the reduction in the
298.11participant's notice of denial, termination, or reduction.
298.12(e) If all or part of a service delivery plan is denied approval, the commissioner must
298.13provide a notice that describes the basis of the denial.
298.14    Subd. 21. Development and Implementation Council. The commissioner
298.15shall establish a Development and Implementation Council of which the majority of
298.16members are individuals with disabilities, elderly individuals, and their representatives.
298.17The commissioner shall consult and collaborate with the council when developing and
298.18implementing this section for at least the first five years of operation. The commissioner,
298.19in consultation with the council, shall provide recommendations on how to improve the
298.20quality and integrity of CFSS, reduce the paper documentation required in subdivisions
298.2110, 12, and 15, make use of electronic means of documentation and online reporting in
298.22order to reduce administrative costs and improve training to the legislative chairs of the
298.23health and human services policy and finance committees by February 1, 2014.
298.24    Subd. 22. Quality assurance and risk management system. (a) The commissioner
298.25shall establish quality assurance and risk management measures for use in developing and
298.26implementing CFSS, including those that (1) recognize the roles and responsibilities of
298.27those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and
298.28budgets based upon a recipient's resources and capabilities. Risk management measures
298.29must include background studies, and backup and emergency plans, including disaster
298.30planning.
298.31(b) The commissioner shall provide ongoing technical assistance and resource and
298.32educational materials for CFSS participants.
298.33(c) Performance assessment measures, such as a participant's satisfaction with the
298.34services and supports, and ongoing monitoring of health and well-being shall be identified
298.35in consultation with the council established in subdivision 21.
299.1(d) Data reporting requirements will be developed in consultation with the council
299.2established in subdivision 21.
299.3    Subd. 23. Commissioner's access. When the commissioner is investigating a
299.4possible overpayment of Medicaid funds, the commissioner must be given immediate
299.5access without prior notice to the agency provider or FMS contractor's office during
299.6regular business hours and to documentation and records related to services provided and
299.7submission of claims for services provided. Denying the commissioner access to records
299.8is cause for immediate suspension of payment and terminating the agency provider's
299.9enrollment according to section 256B.064 or terminating the FMS contract.
299.10    Subd. 24. CFSS agency-providers; background studies. CFSS agency-providers
299.11enrolled to provide personal care assistance services under the medical assistance program
299.12shall comply with the following:
299.13(1) owners who have a five percent interest or more and all managing employees
299.14are subject to a background study as provided in chapter 245C. This applies to currently
299.15enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS
299.16agency-provider. "Managing employee" has the same meaning as Code of Federal
299.17Regulations, title 42, section 455. An organization is barred from enrollment if:
299.18(i) the organization has not initiated background studies on owners managing
299.19employees; or
299.20(ii) the organization has initiated background studies on owners and managing
299.21employees, but the commissioner has sent the organization a notice that an owner or
299.22managing employee of the organization has been disqualified under section 245C.14, and
299.23the owner or managing employee has not received a set-aside of the disqualification
299.24under section 245C.22;
299.25(2) a background study must be initiated and completed for all support specialists; and
299.26(3) a background study must be initiated and completed for all support workers.
299.27    Subd. 25. Commissioner recommendations required. In consultation with
299.28the Development and Implementation Council described in subdivision 21 and other
299.29stakeholders, the commissioner shall develop recommendations for revisions to
299.30subdivisions 12, 15, and 16, that promote self-direction in the following areas:
299.31(1) CFSS provider and support worker enrollment, qualification, and disqualification
299.32criteria;
299.33(2) documentation requirements that are consistent with state and federal
299.34requirements; and
299.35(3) provisions to maintain program integrity and assure fiscal accountability for
299.36goods and services purchased through CFSS.
300.1The recommendations shall be provided to the chairs and ranking minority members
300.2of the legislative committees and divisions with jurisdiction over health and human
300.3services policy and finance by November 15, 2013.
300.4EFFECTIVE DATE.This section is effective upon federal approval but no earlier
300.5than April 1, 2014. The service will begin 90 days after federal approval or April 1,
300.62014, whichever is later. The commissioner of human services shall notify the revisor of
300.7statutes when this occurs.

300.8    Sec. 50. Minnesota Statutes 2012, section 256D.44, subdivision 5, is amended to read:
300.9    Subd. 5. Special needs. In addition to the state standards of assistance established in
300.10subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
300.11Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
300.12center, or a group residential housing facility.
300.13    (a) The county agency shall pay a monthly allowance for medically prescribed
300.14diets if the cost of those additional dietary needs cannot be met through some other
300.15maintenance benefit. The need for special diets or dietary items must be prescribed by
300.16a licensed physician. Costs for special diets shall be determined as percentages of the
300.17allotment for a one-person household under the thrifty food plan as defined by the United
300.18States Department of Agriculture. The types of diets and the percentages of the thrifty
300.19food plan that are covered are as follows:
300.20    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
300.21    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
300.22of thrifty food plan;
300.23    (3) controlled protein diet, less than 40 grams and requires special products, 125
300.24percent of thrifty food plan;
300.25    (4) low cholesterol diet, 25 percent of thrifty food plan;
300.26    (5) high residue diet, 20 percent of thrifty food plan;
300.27    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
300.28    (7) gluten-free diet, 25 percent of thrifty food plan;
300.29    (8) lactose-free diet, 25 percent of thrifty food plan;
300.30    (9) antidumping diet, 15 percent of thrifty food plan;
300.31    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
300.32    (11) ketogenic diet, 25 percent of thrifty food plan.
300.33    (b) Payment for nonrecurring special needs must be allowed for necessary home
300.34repairs or necessary repairs or replacement of household furniture and appliances using
301.1the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
301.2as long as other funding sources are not available.
301.3    (c) A fee for guardian or conservator service is allowed at a reasonable rate
301.4negotiated by the county or approved by the court. This rate shall not exceed five percent
301.5of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
301.6guardian or conservator is a member of the county agency staff, no fee is allowed.
301.7    (d) The county agency shall continue to pay a monthly allowance of $68 for
301.8restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
301.91990, and who eats two or more meals in a restaurant daily. The allowance must continue
301.10until the person has not received Minnesota supplemental aid for one full calendar month
301.11or until the person's living arrangement changes and the person no longer meets the criteria
301.12for the restaurant meal allowance, whichever occurs first.
301.13    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
301.14is allowed for representative payee services provided by an agency that meets the
301.15requirements under SSI regulations to charge a fee for representative payee services. This
301.16special need is available to all recipients of Minnesota supplemental aid regardless of
301.17their living arrangement.
301.18    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
301.19maximum allotment authorized by the federal Food Stamp Program for a single individual
301.20which is in effect on the first day of July of each year will be added to the standards of
301.21assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
301.22as shelter needy and are: (i) relocating from an institution, or an adult mental health
301.23residential treatment program under section 256B.0622; (ii) eligible for the self-directed
301.24supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
301.25community-based waiver recipients living in their own home or rented or leased apartment
301.26which is not owned, operated, or controlled by a provider of service not related by blood
301.27or marriage, unless allowed under paragraph (g).
301.28    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
301.29shelter needy benefit under this paragraph is considered a household of one. An eligible
301.30individual who receives this benefit prior to age 65 may continue to receive the benefit
301.31after the age of 65.
301.32    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
301.33exceed 40 percent of the assistance unit's gross income before the application of this
301.34special needs standard. "Gross income" for the purposes of this section is the applicant's or
301.35recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
301.36in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
302.1state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
302.2considered shelter needy for purposes of this paragraph.
302.3(g) Notwithstanding this subdivision, to access housing and services as provided
302.4in paragraph (f), the recipient may choose housing that may be owned, operated, or
302.5controlled by the recipient's service provider. In a multifamily building of more than four
302.6units, the maximum number of units that may be used by recipients of this program shall
302.7be the greater of four units or 25 percent of the units in the building, unless required by the
302.8Housing Opportunities for Persons with AIDS Program. In multifamily buildings of four
302.9or fewer units, all of the units may be used by recipients of this program. When housing is
302.10controlled by the service provider, the individual may choose the individual's own service
302.11provider as provided in section 256B.49, subdivision 23, clause (3). When the housing is
302.12controlled by the service provider, the service provider shall implement a plan with the
302.13recipient to transition the lease to the recipient's name. Within two years of signing the
302.14initial lease, the service provider shall transfer the lease entered into under this subdivision
302.15to the recipient. In the event the landlord denies this transfer, the commissioner may
302.16approve an exception within sufficient time to ensure the continued occupancy by the
302.17recipient. This paragraph expires June 30, 2016.

302.18    Sec. 51. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
302.193, as amended by Laws 2012, chapter 247, article 4, section 43, is amended to read:

302.20

Subd. 3.Forecasted Programs

302.21The amounts that may be spent from this
302.22appropriation for each purpose are as follows:

302.23

(a) MFIP/DWP Grants

302.24	Appropriations by Fund
302.25	General	84,680,000	91,978,000
302.26	Federal TANF	84,425,000	75,417,000

302.27

(b) MFIP Child Care Assistance Grants

55,456,000

30,923,000

302.28

(c) General Assistance Grants

49,192,000

46,938,000

302.29General Assistance Standard. The
302.30commissioner shall set the monthly standard
302.31of assistance for general assistance units
302.32consisting of an adult recipient who is
302.33childless and unmarried or living apart
303.1from parents or a legal guardian at $203.
303.2The commissioner may reduce this amount
303.3according to Laws 1997, chapter 85, article
303.43, section 54.
303.5Emergency General Assistance. The
303.6amount appropriated for emergency general
303.7assistance funds is limited to no more than
303.8$6,689,812 in fiscal year 2012 and $6,729,812
303.9in fiscal year 2013. Funds to counties shall
303.10be allocated by the commissioner using the
303.11allocation method specified in Minnesota
303.12Statutes, section 256D.06.

303.13

(d) Minnesota Supplemental Aid Grants

38,095,000

39,120,000

303.14

(e) Group Residential Housing Grants

121,080,000

129,238,000

303.15

(f) MinnesotaCare Grants

295,046,000

317,272,000

303.16This appropriation is from the health care
303.17access fund.

303.18

(g) Medical Assistance Grants

4,501,582,000

4,437,282,000

303.19Managed Care Incentive Payments. The
303.20commissioner shall not make managed care
303.21incentive payments for expanding preventive
303.22services during fiscal years beginning July 1,
303.232011, and July 1, 2012.
303.24Reduction of Rates for Congregate
303.25Living for Individuals with Lower Needs.
303.26Beginning October 1, 2011, lead agencies
303.27must reduce rates in effect on January 1, 2011,
303.28by ten percent for individuals with lower
303.29needs living in foster care settings where the
303.30license holder does not share the residence
303.31with recipients on the CADI and DD waivers
303.32and customized living settings for CADI.
303.33Lead agencies shall consult with providers to
303.34review individual service plans and identify
304.1changes or modifications to reduce the
304.2utilization of services while maintaining the
304.3health and safety of the individual receiving
304.4services. Lead agencies must adjust contracts
304.5within 60 days of the effective date. If
304.6federal waiver approval is obtained under
304.7the long-term care realignment waiver
304.8application submitted on February 13,
304.92012, and federal financial participation is
304.10authorized for the alternative care program,
304.11the commissioner shall adjust this payment
304.12rate reduction from ten to five percent for
304.13services rendered on or after July 1, 2012, or
304.14the first day of the month following federal
304.15approval, whichever is later. Effective
304.16August 1, 2013, this provision does not apply
304.17to individuals whose primary diagnosis is
304.18mental illness and who are living in foster
304.19care settings where the license holder is
304.20also (1) a provider of assertive community
304.21treatment (ACT) or adult rehabilitative
304.22mental health services (ARMHS) as defined
304.23in Minnesota Statutes, section 256B.0623;
304.24(2) a mental health center or mental health
304.25clinic certified under Minnesota Rules, parts
304.269520.0750 to 9520.0870; or (3) a provider
304.27of intensive residential treatment services
304.28(IRTS) licensed under Minnesota Rules,
304.29parts 9520.0500 to 9520.0670.
304.30Reduction of Lead Agency Waiver
304.31Allocations to Implement Rate Reductions
304.32for Congregate Living for Individuals
304.33with Lower Needs. Beginning October 1,
304.342011, the commissioner shall reduce lead
304.35agency waiver allocations to implement the
304.36reduction of rates for individuals with lower
305.1needs living in foster care settings where the
305.2license holder does not share the residence
305.3with recipients on the CADI and DD waivers
305.4and customized living settings for CADI.
305.5Reduce customized living and 24-hour
305.6customized living component rates.
305.7Effective July 1, 2011, the commissioner
305.8shall reduce elderly waiver customized living
305.9and 24-hour customized living component
305.10service spending by five percent through
305.11reductions in component rates and service
305.12rate limits. The commissioner shall adjust
305.13the elderly waiver capitation payment
305.14rates for managed care organizations paid
305.15under Minnesota Statutes, section 256B.69,
305.16subdivisions 6a and 23, to reflect reductions
305.17in component spending for customized living
305.18services and 24-hour customized living
305.19services under Minnesota Statutes, section
305.20256B.0915, subdivisions 3e and 3h, for the
305.21contract period beginning January 1, 2012.
305.22To implement the reduction specified in
305.23this provision, capitation rates paid by the
305.24commissioner to managed care organizations
305.25under Minnesota Statutes, section 256B.69,
305.26shall reflect a ten percent reduction for the
305.27specified services for the period January 1,
305.282012, to June 30, 2012, and a five percent
305.29reduction for those services on or after July
305.301, 2012.
305.31Limit Growth in the Developmental
305.32Disability Waiver. The commissioner
305.33shall limit growth in the developmental
305.34disability waiver to six diversion allocations
305.35per month beginning July 1, 2011, through
305.36June 30, 2013, and 15 diversion allocations
306.1per month beginning July 1, 2013, through
306.2June 30, 2015. Waiver allocations shall
306.3be targeted to individuals who meet the
306.4priorities for accessing waiver services
306.5identified in Minnesota Statutes, 256B.092,
306.6subdivision 12 . The limits do not include
306.7conversions from intermediate care facilities
306.8for persons with developmental disabilities.
306.9Notwithstanding any contrary provisions in
306.10this article, this paragraph expires June 30,
306.112015.
306.12Limit Growth in the Community
306.13Alternatives for Disabled Individuals
306.14Waiver. The commissioner shall limit
306.15growth in the community alternatives for
306.16disabled individuals waiver to 60 allocations
306.17per month beginning July 1, 2011, through
306.18June 30, 2013, and 85 allocations per
306.19month beginning July 1, 2013, through
306.20June 30, 2015. Waiver allocations must
306.21be targeted to individuals who meet the
306.22priorities for accessing waiver services
306.23identified in Minnesota Statutes, section
306.24256B.49, subdivision 11a . The limits include
306.25conversions and diversions, unless the
306.26commissioner has approved a plan to convert
306.27funding due to the closure or downsizing
306.28of a residential facility or nursing facility
306.29to serve directly affected individuals on
306.30the community alternatives for disabled
306.31individuals waiver. Notwithstanding any
306.32contrary provisions in this article, this
306.33paragraph expires June 30, 2015.
306.34Personal Care Assistance Relative
306.35Care. The commissioner shall adjust the
306.36capitation payment rates for managed care
307.1organizations paid under Minnesota Statutes,
307.2section 256B.69, to reflect the rate reductions
307.3for personal care assistance provided by
307.4a relative pursuant to Minnesota Statutes,
307.5section 256B.0659, subdivision 11. This rate
307.6reduction is effective July 1, 2013.

307.7

(h) Alternative Care Grants

46,421,000

46,035,000

307.8Alternative Care Transfer. Any money
307.9allocated to the alternative care program that
307.10is not spent for the purposes indicated does
307.11not cancel but shall be transferred to the
307.12medical assistance account.

307.13

(i) Chemical Dependency Entitlement Grants

94,675,000

93,298,000

307.14EFFECTIVE DATE.This section is effective August 1, 2013.

307.15    Sec. 52. Laws 2012, chapter 247, article 6, section 4, is amended to read:

307.16 307.17

Sec. 4. BOARD OF NURSING HOME ADMINISTRATORS

$

-0-

$

10,000

307.18Administrative Services Unit. This
307.19appropriation is to provide a grant to the
307.20Minnesota Ambulance Association to
307.21coordinate and prepare an assessment of
307.22the extent and costs of uncompensated care
307.23as a direct result of emergency responses
307.24on interstate highways in Minnesota.
307.25The study will collect appropriate
307.26information from medical response units
307.27and ambulance services regulated under
307.28Minnesota Statutes, chapter 144E, and to
307.29the extent possible, firefighting agencies.
307.30In preparing the assessment, the Minnesota
307.31Ambulance Association shall consult with
307.32its membership, the Minnesota Fire Chiefs
307.33Association, the Office of the State Fire
308.1Marshal, and the Emergency Medical
308.2Services Regulatory Board. The findings
308.3of the assessment will be reported to the
308.4chairs and ranking minority members of the
308.5legislative committees with jurisdiction over
308.6health and public safety by January 1, 2013.
308.7 This is a onetime appropriation.

308.8    Sec. 53. RECOMMENDATIONS FOR CONCENTRATION LIMITS ON HOME
308.9AND COMMUNITY-BASED SETTINGS.
308.10The commissioner of human services shall consult with the Minnesota Olmstead
308.11subcabinet, advocates, providers, and city representatives to develop recommendations
308.12on concentration limits on home and community-based settings, as defined in
308.13Minnesota Statutes, section 256B.492, as well as any other exceptions to the definition.
308.14The recommendations must be consistent with Minnesota's Olmstead plan. The
308.15recommendations and proposed legislation must be submitted to the chairs and ranking
308.16minority members of the legislative committees with jurisdiction over health and human
308.17services policy and finance by February 1, 2014.

308.18    Sec. 54. TRAINING OF AUTISM SERVICE PROVIDERS.
308.19    The commissioners of health and human services shall ensure that the departments'
308.20autism-related service providers receive training in culturally appropriate approaches to
308.21serving the Somali, Latino, Hmong, and Indigenous American Indian communities, and
308.22other cultural groups experiencing a disproportionate incidence of autism.

308.23    Sec. 55. DIRECTION TO COMMISSIONER; SPOUSAL DISREGARD.
308.24    The commissioner of human services shall request authority, in whatever form is
308.25necessary, from the federal Centers for Medicare and Medicaid Services to allow persons
308.26under age 65 participating in the home and community-based services waivers to continue
308.27to use the disregard of the nonassisted spouse's income and assets instead of the spousal
308.28impoverishment provisions under the federal Patient Protection and Affordable Care Act,
308.29Public Law 111-148, section 2404, as amended by the federal Health Care and Education
308.30Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations
308.31or guidance issued under, those acts.

308.32    Sec. 56. DIRECTION TO COMMISSIONER; ABA.
309.1    By January 1, 2014, the commissioner of human services shall apply to the federal
309.2Centers for Medicare and Medicaid Services for a waiver or other authority to provide
309.3applied behavioral analysis services to children with autism spectrum disorder and related
309.4conditions under the medical assistance program.
309.5EFFECTIVE DATE.This section is effective the day following final enactment.

309.6    Sec. 57. RECOMMENDATIONS ON RAISING THE ASSET LIMITS FOR
309.7SENIORS AND PERSONS WITH DISABILITIES.
309.8    The commissioner of human services shall consult with interested stakeholders to
309.9develop recommendations and a request for a federal 1115 demonstration waiver in order
309.10to increase the asset limit for individuals eligible for medical assistance due to disability
309.11or age who are not residing in a nursing facility, intermediate care facility for persons
309.12with developmental disabilities, or other institution whose costs for room and board are
309.13covered by medical assistance or state funds. The recommendations must be provided to
309.14the legislative committees and divisions with jurisdiction over health and human services
309.15policy and finance by February 1, 2014.

309.16    Sec. 58. NURSING HOME LEVEL OF CARE REPORT.
309.17    (a) The commissioner of human services shall report on the impact of the
309.18modification to the nursing facility level of care to be implemented January 1, 2014,
309.19including the following:
309.20    (1) the number of individuals who lose eligibility for home and community-based
309.21services waivers under Minnesota Statutes, sections 256B.0915 and 256B.49, and
309.22alternative care under Minnesota Statutes, section 256B.0913;
309.23    (2) the number of individuals who lose eligibility for medical assistance; and
309.24    (3) for individuals reported under clauses (1) and (2), and to the extent possible:
309.25    (i) their living situation before and after nursing facility level of care implementation;
309.26and
309.27    (ii) the programs or services they received before and after nursing facility level of
309.28care implementation, including, but not limited to, personal care assistant services and
309.29essential community supports.
309.30    (b) The commissioner of human services shall report to the chairs and ranking
309.31minority members of the legislative committees and divisions with jurisdiction over health
309.32and human services policy and finance with the information required under paragraph
309.33(a). A preliminary report shall be submitted on October 1, 2014, and a final report shall
309.34be submitted February 15, 2015.

310.1    Sec. 59. ASSISTIVE TECHNOLOGY EQUIPMENT FOR HOME AND
310.2COMMUNITY-BASED SERVICES WAIVERS FUNDING DEVELOPMENT.
310.3(a) For the purposes of this section, "assistive technology equipment" includes
310.4computer tablets, passive sensors, and other forms of technology allowing increased
310.5safety and independence, and used by those receiving services through a home and
310.6community-based services waiver under Minnesota Statutes, sections 256B.0915,
310.7256B.092, and 256B.49.
310.8(b) The commissioner of human services shall develop recommendations for
310.9assistive technology equipment funding to enable individuals receiving services identified
310.10in paragraph (a) to live in the least restrictive setting possible. In developing the funding,
310.11the commissioner shall examine funding for the following:
310.12(1) an assessment process to match the appropriate assistive technology equipment
310.13with the waiver recipient, including when the recipient's condition changes or progresses;
310.14(2) the use of monitoring services, if applicable, to the assistive technology
310.15equipment identified in clause (1);
310.16(3) the leasing of assistive technology equipment as a possible alternative to
310.17purchasing the equipment; and
310.18(4) ongoing support services, such as technological support.
310.19(c) The commissioner shall provide the chairs and ranking minority members of the
310.20legislative committees and divisions with jurisdiction over health and human services
310.21policy and finance a recommendation for implementing an assistive technology equipment
310.22program as developed in paragraph (b) by February 1, 2014.

310.23    Sec. 60. PROVIDER RATE AND GRANT INCREASE EFFECTIVE APRIL
310.241, 2014.
310.25(a) The commissioner of human services shall increase reimbursement rates, grants,
310.26allocations, individual limits, and rate limits, as applicable, by one percent for the rate
310.27period beginning April 1, 2014, for services rendered on or after those dates. County or
310.28tribal contracts for services specified in this section must be amended to pass through
310.29these rate increases within 60 days of the effective date.
310.30(b) The rate changes described in this section must be provided to:
310.31(1) home and community-based waivered services for persons with developmental
310.32disabilities or related conditions, including consumer-directed community supports, under
310.33Minnesota Statutes, section 256B.501;
311.1(2) waivered services under community alternatives for disabled individuals,
311.2including consumer-directed community supports, under Minnesota Statutes, section
311.3256B.49;
311.4(3) community alternative care waivered services, including consumer-directed
311.5community supports, under Minnesota Statutes, section 256B.49;
311.6(4) brain injury waivered services, including consumer-directed community
311.7supports, under Minnesota Statutes, section 256B.49;
311.8(5) home and community-based waivered services for the elderly under Minnesota
311.9Statutes, section 256B.0915;
311.10(6) nursing services and home health services under Minnesota Statutes, section
311.11256B.0625, subdivision 6a;
311.12(7) personal care services and qualified professional supervision of personal care
311.13services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
311.14(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
311.15subdivision 7;
311.16(9) day training and habilitation services for adults with developmental disabilities
311.17or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
311.18additional cost of rate adjustments on day training and habilitation services, provided as a
311.19social service, formerly funded under Minnesota Statutes 2010, chapter 256M;
311.20(10) alternative care services under Minnesota Statutes, section 256B.0913;
311.21(11) living skills training programs for persons with intractable epilepsy who need
311.22assistance in the transition to independent living under Laws 1988, chapter 689;
311.23(12) semi-independent living services (SILS) under Minnesota Statutes, section
311.24252.275, including SILS funding under county social services grants formerly funded
311.25under Minnesota Statutes, chapter 256M;
311.26(13) consumer support grants under Minnesota Statutes, section 256.476;
311.27(14) family support grants under Minnesota Statutes, section 252.32;
311.28(15) housing access grants under Minnesota Statutes, sections 256B.0658 and
311.29256B.0917, subdivision 14;
311.30(16) self-advocacy grants under Laws 2009, chapter 101;
311.31(17) technology grants under Laws 2009, chapter 79;
311.32(18) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
311.33and 256B.0928; and
311.34(19) community support services for deaf and hard-of-hearing adults with mental
311.35illness who use or wish to use sign language as their primary means of communication
311.36under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
312.1grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9;
312.2and Laws 1997, First Special Session chapter 5, section 20.
312.3(c) A managed care plan receiving state payments for the services in this section
312.4must include these increases in their payments to providers. To implement the rate increase
312.5in this section, capitation rates paid by the commissioner to managed care organizations
312.6under Minnesota Statutes, section 256B.69, shall reflect a one percent increase for the
312.7specified services for the period beginning April 1, 2014.
312.8(d) Counties shall increase the budget for each recipient of consumer-directed
312.9community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).

312.10    Sec. 61. SAFETY NET FOR HOME AND COMMUNITY-BASED SERVICES
312.11WAIVERS.
312.12The commissioner of human services shall submit a request by December 31, 2013,
312.13to the federal government to amend the home and community-based services waivers for
312.14individuals with disabilities authorized under Minnesota Statutes, section 256B.49, to
312.15modify the financial management of the home and community-based services waivers
312.16to provide a state-administered safety net when costs for an individual increase above
312.17an identified threshold. The implementation of the safety net may result in a decreased
312.18allocation for individual counties, tribes, or collaboratives of counties or tribes, but must
312.19not result in a net decreased statewide allocation.

312.20    Sec. 62. SHARED LIVING MODEL.
312.21The commissioner of human services shall develop and promote a shared living model
312.22option for individuals receiving services through the home and community-based services
312.23waivers for individuals with disabilities, authorized under Minnesota Statutes, section
312.24256B.092 or 256B.49, as an option for individuals who require 24-hour assistance. The
312.25option must be a companion model with a limit of one or two individuals receiving support
312.26in the home, planned respite for the caregiver, and the availability of intensive training
312.27and support on the needs of the individual or individuals. Any necessary amendments to
312.28implement the model must be submitted to the federal government by December 31, 2013.

312.29    Sec. 63. MONEY FOLLOWS THE PERSON GRANT.
312.30The commissioner of human services shall submit to the federal government all
312.31necessary waiver amendments to implement the Money Follows the Person federal grant
312.32by December 31, 2013.

313.1    Sec. 64. REPEALER.
313.2Minnesota Statutes 2012, sections 256B.0917, subdivision 14; 256B.096,
313.3subdivisions 1, 2, 3, and 4; 256B.14, subdivision 3a; and 256B.5012, subdivision 13, and
313.4Laws 2011, First Special Session chapter 9, article 7, section 54, as amended by Laws 2012,
313.5chapter 247, article 4, section 42, and Laws 2012, chapter 298, section 3, are repealed.

313.6ARTICLE 8

313.7WAIVER PROVIDER STANDARDS

313.8    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
313.9subdivision to read:
313.10    Subd. 7c. Human services license holders. Section 245D.095, subdivision 3,
313.11requires certain license holders to protect service recipient records in accordance with
313.12specified provisions of this chapter.

313.13    Sec. 2. Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:
313.14    Subd. 7. Health care facility. "Health care facility" means a hospital or other entity
313.15licensed under sections 144.50 to 144.58, a nursing home licensed to serve adults under
313.16section 144A.02, a home care provider licensed under sections 144A.43 to 144A.47,
313.17an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts
313.189555.5105 to 9555.6265, a community residential setting licensed under chapter 245D, or
313.19a hospice provider licensed under sections 144A.75 to 144A.755.

313.20    Sec. 3. Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:
313.21    Subd. 4b. Health care facility; notice of status. (a) For the purposes of this
313.22subdivision, "health care facility" means a facility:
313.23(1) licensed by the commissioner of health as a hospital, boarding care home or
313.24supervised living facility under sections 144.50 to 144.58, or a nursing home under
313.25chapter 144A;
313.26(2) registered by the commissioner of health as a housing with services establishment
313.27as defined in section 144D.01; or
313.28(3) licensed by the commissioner of human services as a residential facility under
313.29chapter 245A to provide adult foster care, adult mental health treatment, chemical
313.30dependency treatment to adults, or residential services to persons with developmental
313.31 disabilities.
313.32(b) Prior to admission to a health care facility, a person required to register under
313.33this section shall disclose to:
314.1(1) the health care facility employee processing the admission the person's status
314.2as a registered predatory offender under this section; and
314.3(2) the person's corrections agent, or if the person does not have an assigned
314.4corrections agent, the law enforcement authority with whom the person is currently
314.5required to register, that inpatient admission will occur.
314.6(c) A law enforcement authority or corrections agent who receives notice under
314.7paragraph (b) or who knows that a person required to register under this section is
314.8planning to be admitted and receive, or has been admitted and is receiving health care
314.9at a health care facility shall notify the administrator of the facility and deliver a fact
314.10sheet to the administrator containing the following information: (1) name and physical
314.11description of the offender; (2) the offender's conviction history, including the dates of
314.12conviction; (3) the risk level classification assigned to the offender under section 244.052,
314.13if any; and (4) the profile of likely victims.
314.14(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care
314.15facility receives a fact sheet under paragraph (c) that includes a risk level classification for
314.16the offender, and if the facility admits the offender, the facility shall distribute the fact
314.17sheet to all residents at the facility. If the facility determines that distribution to a resident
314.18is not appropriate given the resident's medical, emotional, or mental status, the facility
314.19shall distribute the fact sheet to the patient's next of kin or emergency contact.

314.20    Sec. 4. [245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY
314.21MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
314.22    Subdivision 1. Rules. The commissioner of human services shall, within 24 months
314.23of enactment of this section, adopt rules governing the use of positive support strategies,
314.24safety interventions, and emergency use of manual restraint in facilities and services
314.25licensed under chapter 245D.
314.26    Subd. 2. Data collection. (a) The commissioner shall, with stakeholder input,
314.27develop data collection elements specific to incidents of emergency use of manual restraint
314.28and positive support transition plans for persons receiving services from providers
314.29governed under chapter 245D effective January 1, 2014. Providers shall report the data in
314.30a format and at a frequency determined by the commissioner of human services. Providers
314.31shall submit the data to the commissioner and the Office of the Ombudsman for Mental
314.32Health and Developmental Disabilities.
314.33(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts
314.349525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures
314.35identified in Minnesota Rules, part 9525.2740, in a format and at a frequency determined
315.1by the commissioner. Providers shall submit the data to the commissioner and the Office
315.2of the Ombudsman for Mental Health and Developmental Disabilities.

315.3    Sec. 5. Minnesota Statutes 2012, section 245.91, is amended by adding a subdivision
315.4to read:
315.5    Subd. 3a. Emergency use of manual restraint. "Emergency use of manual
315.6restraint" has the meaning given in section 245D.02, subdivision 8a, and applies to
315.7services licensed under chapter 245D.

315.8    Sec. 6. Minnesota Statutes 2012, section 245.94, subdivision 2, is amended to read:
315.9    Subd. 2. Matters appropriate for review. (a) In selecting matters for review by the
315.10office, the ombudsman shall give particular attention to unusual deaths or injuries of a
315.11client or reports of emergency use of manual restraint as identified in section 245D.061,
315.12served by an agency, facility, or program, or actions of an agency, facility, or program that:
315.13(1) may be contrary to law or rule;
315.14(2) may be unreasonable, unfair, oppressive, or inconsistent with a policy or order of
315.15an agency, facility, or program;
315.16(3) may be mistaken in law or arbitrary in the ascertainment of facts;
315.17(4) may be unclear or inadequately explained, when reasons should have been
315.18revealed;
315.19(5) may result in abuse or neglect of a person receiving treatment;
315.20(6) may disregard the rights of a client or other individual served by an agency
315.21or facility;
315.22(7) may impede or promote independence, community integration, and productivity
315.23for clients; or
315.24(8) may impede or improve the monitoring or evaluation of services provided to
315.25clients.
315.26(b) The ombudsman shall, in selecting matters for review and in the course of the
315.27review, avoid duplicating other investigations or regulatory efforts.

315.28    Sec. 7. Minnesota Statutes 2012, section 245.94, subdivision 2a, is amended to read:
315.29    Subd. 2a. Mandatory reporting. Within 24 hours after a client suffers death or
315.30serious injury, the agency, facility, or program director shall notify the ombudsman of the
315.31death or serious injury. The emergency use of manual restraint must be reported to the
315.32ombudsman as required under section 245D.061, subdivision 10. The ombudsman is
316.1authorized to receive identifying information about a deceased client according to Code of
316.2Federal Regulations, title 42, section 2.15, paragraph (b).

316.3    Sec. 8. Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:
316.4    Subd. 10. Nonresidential program. "Nonresidential program" means care,
316.5supervision, rehabilitation, training or habilitation of a person provided outside the
316.6person's own home and provided for fewer than 24 hours a day, including adult day
316.7care programs; and chemical dependency or chemical abuse programs that are located
316.8in a nursing home or hospital and receive public funds for providing chemical abuse or
316.9chemical dependency treatment services under chapter 254B. Nonresidential programs
316.10include home and community-based services and semi-independent living services for
316.11persons with developmental disabilities or persons age 65 and older that are provided in
316.12or outside of a person's own home under chapter 245D.

316.13    Sec. 9. Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:
316.14    Subd. 14. Residential program. "Residential program" means a program
316.15that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training,
316.16education, habilitation, or treatment outside a person's own home, including a program
316.17in an intermediate care facility for four or more persons with developmental disabilities;
316.18and chemical dependency or chemical abuse programs that are located in a hospital
316.19or nursing home and receive public funds for providing chemical abuse or chemical
316.20dependency treatment services under chapter 254B. Residential programs include home
316.21and community-based services for persons with developmental disabilities or persons age
316.2265 and older that are provided in or outside of a person's own home under chapter 245D.

316.23    Sec. 10. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
316.24    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial
316.25license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,
316.26or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under
316.27this chapter for a physical location that will not be the primary residence of the license
316.28holder for the entire period of licensure. If a license is issued during this moratorium, and
316.29the license holder changes the license holder's primary residence away from the physical
316.30location of the foster care license, the commissioner shall revoke the license according
316.31to section 245A.07. The commissioner shall not issue an initial license for a community
316.32residential setting licensed under chapter 245D. Exceptions to the moratorium include:
316.33(1) foster care settings that are required to be registered under chapter 144D;
317.1(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
317.2community residential setting licenses replacing adult foster care licenses in existence on
317.3December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
317.4(3) new foster care licenses or community residential setting licenses determined to
317.5be needed by the commissioner under paragraph (b) for the closure of a nursing facility,
317.6ICF/MR, or regional treatment center, or restructuring of state-operated services that
317.7limits the capacity of state-operated facilities;
317.8(4) new foster care licenses or community residential setting licenses determined
317.9to be needed by the commissioner under paragraph (b) for persons requiring hospital
317.10level care; or
317.11(5) new foster care licenses or community residential setting licenses determined to
317.12be needed by the commissioner for the transition of people from personal care assistance
317.13to the home and community-based services.
317.14(b) The commissioner shall determine the need for newly licensed foster care
317.15homes or community residential settings as defined under this subdivision. As part of the
317.16determination, the commissioner shall consider the availability of foster care capacity in
317.17the area in which the licensee seeks to operate, and the recommendation of the local
317.18county board. The determination by the commissioner must be final. A determination of
317.19need is not required for a change in ownership at the same address.
317.20(c) The commissioner shall study the effects of the license moratorium under this
317.21subdivision and shall report back to the legislature by January 15, 2011. This study shall
317.22include, but is not limited to the following:
317.23(1) the overall capacity and utilization of foster care beds where the physical location
317.24is not the primary residence of the license holder prior to and after implementation
317.25of the moratorium;
317.26(2) the overall capacity and utilization of foster care beds where the physical
317.27location is the primary residence of the license holder prior to and after implementation
317.28of the moratorium; and
317.29(3) the number of licensed and occupied ICF/MR beds prior to and after
317.30implementation of the moratorium.
317.31(d) When a foster care recipient an adult resident served by the program moves out
317.32of a foster home that is not the primary residence of the license holder according to section
317.33256B.49, subdivision 15 , paragraph (f), or the adult community residential setting, the
317.34county shall immediately inform the Department of Human Services Licensing Division.
317.35The department shall decrease the statewide licensed capacity for adult foster care settings
317.36where the physical location is not the primary residence of the license holder, or for adult
318.1community residential settings, if the voluntary changes described in paragraph (f) are
318.2not sufficient to meet the savings required by reductions in licensed bed capacity under
318.3Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
318.4and maintain statewide long-term care residential services capacity within budgetary
318.5limits. Implementation of the statewide licensed capacity reduction shall begin on July
318.61, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the
318.7needs determination process. Under this paragraph, the commissioner has the authority
318.8to reduce unused licensed capacity of a current foster care program, or the community
318.9residential settings, to accomplish the consolidation or closure of settings. A decreased
318.10licensed capacity according to this paragraph is not subject to appeal under this chapter.
318.11(e) Residential settings that would otherwise be subject to the decreased license
318.12capacity established in paragraph (d) shall be exempt under the following circumstances:
318.13(1) until August 1, 2013, the license holder's beds occupied by residents whose
318.14primary diagnosis is mental illness and the license holder is:
318.15(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
318.16health services (ARMHS) as defined in section 256B.0623;
318.17(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
318.189520.0870;
318.19(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
318.209520.0870; or
318.21(iv) a provider of intensive residential treatment services (IRTS) licensed under
318.22Minnesota Rules, parts 9520.0500 to 9520.0670; or
318.23(2) the license holder is certified under the requirements in subdivision 6a or section
318.24245D.33.
318.25(f) A resource need determination process, managed at the state level, using the
318.26available reports required by section 144A.351, and other data and information shall
318.27be used to determine where the reduced capacity required under paragraph (d) will be
318.28implemented. The commissioner shall consult with the stakeholders described in section
318.29144A.351 , and employ a variety of methods to improve the state's capacity to meet
318.30long-term care service needs within budgetary limits, including seeking proposals from
318.31service providers or lead agencies to change service type, capacity, or location to improve
318.32services, increase the independence of residents, and better meet needs identified by the
318.33long-term care services reports and statewide data and information. By February 1 of each
318.34year, the commissioner shall provide information and data on the overall capacity of
318.35licensed long-term care services, actions taken under this subdivision to manage statewide
319.1long-term care services and supports resources, and any recommendations for change to
319.2the legislative committees with jurisdiction over health and human services budget.
319.3    (g) At the time of application and reapplication for licensure, the applicant and the
319.4license holder that are subject to the moratorium or an exclusion established in paragraph
319.5(a) are required to inform the commissioner whether the physical location where the foster
319.6care will be provided is or will be the primary residence of the license holder for the entire
319.7period of licensure. If the primary residence of the applicant or license holder changes, the
319.8applicant or license holder must notify the commissioner immediately. The commissioner
319.9shall print on the foster care license certificate whether or not the physical location is the
319.10primary residence of the license holder.
319.11    (h) License holders of foster care homes identified under paragraph (g) that are not
319.12the primary residence of the license holder and that also provide services in the foster care
319.13home that are covered by a federally approved home and community-based services
319.14waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the
319.15human services licensing division that the license holder provides or intends to provide
319.16these waiver-funded services. These license holders must be considered registered under
319.17section 256B.092, subdivision 11, paragraph (c), and this registration status must be
319.18identified on their license certificates.

319.19    Sec. 11. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:
319.20    Subd. 8. Excluded providers seeking licensure. Nothing in this section shall
319.21prohibit a program that is excluded from licensure under subdivision 2, paragraph
319.22(a), clause (28) (26), from seeking licensure. The commissioner shall ensure that any
319.23application received from such an excluded provider is processed in the same manner as
319.24all other applications for child care center licensure.

319.25    Sec. 12. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:
319.26    Subd. 9. Permitted services by an individual who is related. Notwithstanding
319.27subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a
319.28person receiving supported living services may provide licensed services to that person if:
319.29(1) the person who receives supported living services received these services in a
319.30residential site on July 1, 2005;
319.31(2) the services under clause (1) were provided in a corporate foster care setting for
319.32adults and were funded by the developmental disabilities home and community-based
319.33services waiver defined in section 256B.092;
320.1(3) the individual who is related obtains and maintains both a license under chapter
320.2245B or successor licensing requirements for the provision of supported living services
320.3and an adult foster care license under Minnesota Rules, parts 9555.5105 to 9555.6265; and
320.4(4) the individual who is related is not the guardian of the person receiving supported
320.5living services.

320.6    Sec. 13. Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:
320.7    Subd. 3. Implementation. (a) The commissioner shall implement the
320.8responsibilities of this chapter according to the timelines in paragraphs (b) and (c)
320.9only within the limits of available appropriations or other administrative cost recovery
320.10methodology.
320.11(b) The licensure of home and community-based services according to this section
320.12shall be implemented January 1, 2014. License applications shall be received and
320.13processed on a phased-in schedule as determined by the commissioner beginning July
320.141, 2013. Licenses will be issued thereafter upon the commissioner's determination that
320.15the application is complete according to section 245A.04.
320.16(c) Within the limits of available appropriations or other administrative cost recovery
320.17methodology, implementation of compliance monitoring must be phased in after January
320.181, 2014.
320.19(1) Applicants who do not currently hold a license issued under this chapter 245B
320.20 must receive an initial compliance monitoring visit after 12 months of the effective date of
320.21the initial license for the purpose of providing technical assistance on how to achieve and
320.22maintain compliance with the applicable law or rules governing the provision of home and
320.23community-based services under chapter 245D. If during the review the commissioner
320.24finds that the license holder has failed to achieve compliance with an applicable law or
320.25rule and this failure does not imminently endanger the health, safety, or rights of the
320.26persons served by the program, the commissioner may issue a licensing review report with
320.27recommendations for achieving and maintaining compliance.
320.28(2) Applicants who do currently hold a license issued under this chapter must receive
320.29a compliance monitoring visit after 24 months of the effective date of the initial license.
320.30(d) Nothing in this subdivision shall be construed to limit the commissioner's
320.31authority to suspend or revoke a license or issue a fine at any time under section 245A.07,
320.32or make issue correction orders and make a license conditional for failure to comply with
320.33applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity
320.34of the violation of law or rule and the effect of the violation on the health, safety, or
320.35rights of persons served by the program.

321.1    Sec. 14. Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:
321.2    Subd. 2a. Consolidated contested case hearings. (a) When a denial of a license
321.3under section 245A.05 or a licensing sanction under section 245A.07, subdivision 3, is
321.4based on a disqualification for which reconsideration was requested and which was not
321.5set aside under section 245C.22, the scope of the contested case hearing shall include the
321.6disqualification and the licensing sanction or denial of a license, unless otherwise specified
321.7in this subdivision. When the licensing sanction or denial of a license is based on a
321.8determination of maltreatment under section 626.556 or 626.557, or a disqualification for
321.9serious or recurring maltreatment which was not set aside, the scope of the contested case
321.10hearing shall include the maltreatment determination, disqualification, and the licensing
321.11sanction or denial of a license, unless otherwise specified in this subdivision. In such
321.12cases, a fair hearing under section 256.045 shall not be conducted as provided for in
321.13sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.
321.14    (b) Except for family child care and child foster care, reconsideration of a
321.15maltreatment determination under sections 626.556, subdivision 10i, and 626.557,
321.16subdivision 9d, and reconsideration of a disqualification under section 245C.22, shall
321.17not be conducted when:
321.18    (1) a denial of a license under section 245A.05, or a licensing sanction under section
321.19245A.07 , is based on a determination that the license holder is responsible for maltreatment
321.20or the disqualification of a license holder is based on serious or recurring maltreatment;
321.21    (2) the denial of a license or licensing sanction is issued at the same time as the
321.22maltreatment determination or disqualification; and
321.23    (3) the license holder appeals the maltreatment determination or disqualification,
321.24and denial of a license or licensing sanction. In these cases, a fair hearing shall not be
321.25conducted under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision
321.269d. The scope of the contested case hearing must include the maltreatment determination,
321.27disqualification, and denial of a license or licensing sanction.
321.28    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
321.29determination or disqualification, but does not appeal the denial of a license or a licensing
321.30sanction, reconsideration of the maltreatment determination shall be conducted under
321.31sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
321.32disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
321.33shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
321.34626.557, subdivision 9d .
321.35    (c) In consolidated contested case hearings regarding sanctions issued in family child
321.36care, child foster care, family adult day services, and adult foster care, and community
322.1residential settings, the county attorney shall defend the commissioner's orders in
322.2accordance with section 245A.16, subdivision 4.
322.3    (d) The commissioner's final order under subdivision 5 is the final agency action
322.4on the issue of maltreatment and disqualification, including for purposes of subsequent
322.5background studies under chapter 245C and is the only administrative appeal of the final
322.6agency determination, specifically, including a challenge to the accuracy and completeness
322.7of data under section 13.04.
322.8    (e) When consolidated hearings under this subdivision involve a licensing sanction
322.9based on a previous maltreatment determination for which the commissioner has issued
322.10a final order in an appeal of that determination under section 256.045, or the individual
322.11failed to exercise the right to appeal the previous maltreatment determination under
322.12section 626.556, subdivision 10i, or 626.557, subdivision 9d, the commissioner's order is
322.13conclusive on the issue of maltreatment. In such cases, the scope of the administrative
322.14law judge's review shall be limited to the disqualification and the licensing sanction or
322.15denial of a license. In the case of a denial of a license or a licensing sanction issued to
322.16a facility based on a maltreatment determination regarding an individual who is not the
322.17license holder or a household member, the scope of the administrative law judge's review
322.18includes the maltreatment determination.
322.19    (f) The hearings of all parties may be consolidated into a single contested case
322.20hearing upon consent of all parties and the administrative law judge, if:
322.21    (1) a maltreatment determination or disqualification, which was not set aside under
322.22section 245C.22, is the basis for a denial of a license under section 245A.05 or a licensing
322.23sanction under section 245A.07;
322.24    (2) the disqualified subject is an individual other than the license holder and upon
322.25whom a background study must be conducted under section 245C.03; and
322.26    (3) the individual has a hearing right under section 245C.27.
322.27    (g) When a denial of a license under section 245A.05 or a licensing sanction under
322.28section 245A.07 is based on a disqualification for which reconsideration was requested
322.29and was not set aside under section 245C.22, and the individual otherwise has no hearing
322.30right under section 245C.27, the scope of the administrative law judge's review shall
322.31include the denial or sanction and a determination whether the disqualification should
322.32be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In
322.33determining whether the disqualification should be set aside, the administrative law judge
322.34shall consider the factors under section 245C.22, subdivision 4, to determine whether the
322.35individual poses a risk of harm to any person receiving services from the license holder.
323.1    (h) Notwithstanding section 245C.30, subdivision 5, when a licensing sanction
323.2under section 245A.07 is based on the termination of a variance under section 245C.30,
323.3subdivision 4 , the scope of the administrative law judge's review shall include the sanction
323.4and a determination whether the disqualification should be set aside, unless section
323.5245C.24 prohibits the set-aside of the disqualification. In determining whether the
323.6disqualification should be set aside, the administrative law judge shall consider the factors
323.7under section 245C.22, subdivision 4, to determine whether the individual poses a risk of
323.8harm to any person receiving services from the license holder.

323.9    Sec. 15. Minnesota Statutes 2012, section 245A.10, is amended to read:
323.10245A.10 FEES.
323.11    Subdivision 1. Application or license fee required, programs exempt from fee.
323.12(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
323.13of applications and inspection of programs which are licensed under this chapter.
323.14(b) Except as provided under subdivision 2, no application or license fee shall be
323.15charged for child foster care, adult foster care, or family and group family child care, or
323.16a community residential setting.
323.17    Subd. 2. County fees for background studies and licensing inspections. (a) For
323.18purposes of family and group family child care licensing under this chapter, a county
323.19agency may charge a fee to an applicant or license holder to recover the actual cost of
323.20background studies, but in any case not to exceed $100 annually. A county agency may
323.21also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
323.22license or $100 for a two-year license.
323.23    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
323.24applicant for authorization to recover the actual cost of background studies completed
323.25under section 119B.125, but in any case not to exceed $100 annually.
323.26    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
323.27    (1) in cases of financial hardship;
323.28    (2) if the county has a shortage of providers in the county's area;
323.29    (3) for new providers; or
323.30    (4) for providers who have attained at least 16 hours of training before seeking
323.31initial licensure.
323.32    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
323.33an installment basis for up to one year. If the provider is receiving child care assistance
323.34payments from the state, the provider may have the fees under paragraph (a) or (b)
324.1deducted from the child care assistance payments for up to one year and the state shall
324.2reimburse the county for the county fees collected in this manner.
324.3    (e) For purposes of adult foster care and child foster care licensing, and licensing
324.4the physical plant of a community residential setting, under this chapter, a county agency
324.5may charge a fee to a corporate applicant or corporate license holder to recover the actual
324.6cost of licensing inspections, not to exceed $500 annually.
324.7    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
324.8following circumstances:
324.9(1) in cases of financial hardship;
324.10(2) if the county has a shortage of providers in the county's area; or
324.11(3) for new providers.
324.12    Subd. 3. Application fee for initial license or certification. (a) For fees required
324.13under subdivision 1, an applicant for an initial license or certification issued by the
324.14commissioner shall submit a $500 application fee with each new application required
324.15under this subdivision. An applicant for an initial day services facility license under
324.16chapter 245D shall submit a $250 application fee with each new application. The
324.17application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license
324.18or certification fee that expires on December 31. The commissioner shall not process an
324.19application until the application fee is paid.
324.20(b) Except as provided in clauses (1) to (4) (3), an applicant shall apply for a license
324.21to provide services at a specific location.
324.22(1) For a license to provide residential-based habilitation services to persons with
324.23developmental disabilities under chapter 245B, an applicant shall submit an application
324.24for each county in which the services will be provided. Upon licensure, the license
324.25holder may provide services to persons in that county plus no more than three persons
324.26at any one time in each of up to ten additional counties. A license holder in one county
324.27may not provide services under the home and community-based waiver for persons with
324.28developmental disabilities to more than three people in a second county without holding
324.29a separate license for that second county. Applicants or licensees providing services
324.30under this clause to not more than three persons remain subject to the inspection fees
324.31established in section 245A.10, subdivision 2, for each location. The license issued by
324.32the commissioner must state the name of each additional county where services are being
324.33provided to persons with developmental disabilities. A license holder must notify the
324.34commissioner before making any changes that would alter the license information listed
324.35under section 245A.04, subdivision 7, paragraph (a), including any additional counties
324.36where persons with developmental disabilities are being served. For a license to provide
325.1home and community-based services to persons with disabilities or age 65 and older under
325.2chapter 245D, an applicant shall submit an application to provide services statewide.
325.3Notwithstanding paragraph (a), applications received by the commissioner between July 1,
325.42013, and December 31, 2013, for licensure of services provided under chapter 245D must
325.5include an application fee that is equal to the annual license renewal fee under subdivision
325.64, paragraph (b), or $500, whichever is less. Applications received by the commissioner
325.7after January 1, 2014, must include the application fee required under paragraph (a).
325.8Applicants who meet the modified application criteria identified in section 245A.042,
325.9subdivision 2, are exempt from paying an application fee.
325.10(2) For a license to provide supported employment, crisis respite, or
325.11semi-independent living services to persons with developmental disabilities under chapter
325.12245B, an applicant shall submit a single application to provide services statewide.
325.13(3) For a license to provide independent living assistance for youth under section
325.14245A.22 , an applicant shall submit a single application to provide services statewide.
325.15(4) (3) For a license for a private agency to provide foster care or adoption services
325.16under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
325.17application to provide services statewide.
325.18(c) The initial application fee charged under this subdivision does not include the
325.19temporary license surcharge under section 16E.22.
325.20    Subd. 4. License or certification fee for certain programs. (a) Child care centers
325.21shall pay an annual nonrefundable license fee based on the following schedule:

325.22 325.23		Licensed Capacity	Child Care Center License Fee
325.24		1 to 24 persons	$200
325.25		25 to 49 persons	$300
325.26		50 to 74 persons	$400
325.27		75 to 99 persons	$500
325.28		100 to 124 persons	$600
325.29		125 to 149 persons	$700
325.30		150 to 174 persons	$800
325.31		175 to 199 persons	$900
325.32		200 to 224 persons	$1,000
325.33		225 or more persons	$1,100

325.34    (b) A day training and habilitation program serving persons with developmental
325.35disabilities or related conditions shall pay an annual nonrefundable license fee based on
325.36the following schedule:

325.37		Licensed Capacity	License Fee
325.38		1 to 24 persons	$800
326.1		25 to 49 persons	$1,000
326.2		50 to 74 persons	$1,200
326.3		75 to 99 persons	$1,400
326.4		100 to 124 persons	$1,600
326.5		125 to 149 persons	$1,800
326.6		150 or more persons	$2,000

326.7Except as provided in paragraph (c), when a day training and habilitation program
326.8serves more than 50 percent of the same persons in two or more locations in a community,
326.9the day training and habilitation program shall pay a license fee based on the licensed
326.10capacity of the largest facility and the other facility or facilities shall be charged a license
326.11fee based on a licensed capacity of a residential program serving one to 24 persons.
326.12    (c) When a day training and habilitation program serving persons with developmental
326.13disabilities or related conditions seeks a single license allowed under section 245B.07,
326.14subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
326.15capacity for each location.
326.16(d) A program licensed to provide supported employment services to persons
326.17with developmental disabilities under chapter 245B shall pay an annual nonrefundable
326.18license fee of $650.
326.19(e) A program licensed to provide crisis respite services to persons with
326.20developmental disabilities under chapter 245B shall pay an annual nonrefundable license
326.21fee of $700.
326.22(f) A program licensed to provide semi-independent living services to persons
326.23with developmental disabilities under chapter 245B shall pay an annual nonrefundable
326.24license fee of $700.
326.25(g) A program licensed to provide residential-based habilitation services under the
326.26home and community-based waiver for persons with developmental disabilities shall pay
326.27an annual license fee that includes a base rate of $690 plus $60 times the number of clients
326.28served on the first day of July of the current license year.
326.29(h) A residential program certified by the Department of Health as an intermediate
326.30care facility for persons with developmental disabilities (ICF/MR) and a noncertified
326.31residential program licensed to provide health or rehabilitative services for persons
326.32with developmental disabilities shall pay an annual nonrefundable license fee based on
326.33the following schedule:

326.34		Licensed Capacity	License Fee
326.35		1 to 24 persons	$535
326.36		25 to 49 persons	$735
326.37		50 or more persons	$935

327.1(b)(1) A program licensed to provide one or more of the home and community-based
327.2services and supports identified under chapter 245D to persons with disabilities or age
327.365 and older, shall pay an annual nonrefundable license fee based on revenues derived
327.4from the provision of services that would require licensure under chapter 245D during the
327.5calendar year immediately preceding the year in which the license fee is paid, according to
327.6the following schedule:

327.7	License Holder Annual Revenue	License Fee
327.8	less than or equal to $10,000	$200
327.9 327.10	greater than $10,000 but less than or equal to $25,000	$300
327.11 327.12	greater than $25,000 but less than or equal to $50,000	$400
327.13 327.14	greater than $50,000 but less than or equal to $100,000	$500
327.15 327.16	greater than $100,000 but less than or equal to $150,000	$600
327.17 327.18	greater than $150,000 but less than or equal to $200,000	$800
327.19 327.20	greater than $200,000 but less than or equal to $250,000	$1,000
327.21 327.22	greater than $250,000 but less than or equal to $300,000	$1,200
327.23 327.24	greater than $300,000 but less than or equal to $350,000	$1,400
327.25 327.26	greater than $350,000 but less than or equal to $400,000	$1,600
327.27 327.28	greater than $400,000 but less than or equal to $450,000	$1,800
327.29 327.30	greater than $450,000 but less than or equal to $500,000	$2,000
327.31 327.32	greater than $500,000 but less than or equal to $600,000	$2,250
327.33 327.34	greater than $600,000 but less than or equal to $700,000	$2,500
327.35 327.36	greater than $700,000 but less than or equal to $800,000	$2,750
327.37 327.38	greater than $800,000 but less than or equal to $900,000	$3,000
327.39 327.40	greater than $900,000 but less than or equal to $1,000,000	$3,250
327.41 327.42	greater than $1,000,000 but less than or equal to $1,250,000	$3,500
327.43 327.44	greater than $1,250,000 but less than or equal to $1,500,000	$3,750
327.45 327.46	greater than $1,500,000 but less than or equal to $1,750,000	$4,000
328.1 328.2	greater than $1,750,000 but less than or equal to $2,000,000	$4,250
328.3 328.4	greater than $2,000,000 but less than or equal to $2,500,000	$4,500
328.5 328.6	greater than $2,500,000 but less than or equal to $3,000,000	$4,750
328.7 328.8	greater than $3,000,000 but less than or equal to $3,500,000	$5,000
328.9 328.10	greater than $3,500,000 but less than or equal to $4,000,000	$5,500
328.11 328.12	greater than $4,000,000 but less than or equal to $4,500,000	$6,000
328.13 328.14	greater than $4,500,000 but less than or equal to $5,000,000	$6,500
328.15 328.16	greater than $5,000,000 but less than or equal to $7,500,000	$7,000
328.17 328.18	greater than $7,500,000 but less than or equal to $10,000,000	$8,500
328.19 328.20	greater than $10,000,000 but less than or equal to $12,500,000	$10,000
328.21 328.22	greater than $12,500,000 but less than or equal to $15,000,000	$14,000
328.23	greater than $15,000,000	$18,000

328.24(2) If requested, the license holder shall provide the commissioner information to
328.25verify the license holder's annual revenues or other information as needed, including
328.26copies of documents submitted to the Department of Revenue.
328.27(3) At each annual renewal, a license holder may elect to pay the highest renewal
328.28fee, and not provide annual revenue information to the commissioner.
328.29(4) A license holder that knowingly provides the commissioner incorrect revenue
328.30amounts for the purpose of paying a lower license fee shall be subject to a civil penalty in
328.31the amount of double the fee the provider should have paid.
328.32(5) Notwithstanding clause (1), a license holder providing services under one or
328.33more licenses under chapter 245B that are in effect on May 15, 2013, shall pay an annual
328.34license fee for calendar years 2014, 2015, and 2016, equal to the total license fees paid
328.35by the license holder for all licenses held under chapter 245B for calendar year 2013.
328.36For calendar year 2017 and thereafter, the license holder shall pay an annual license fee
328.37according to clause (1).
328.38(i) (c) A chemical dependency treatment program licensed under Minnesota Rules,
328.39parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an
328.40annual nonrefundable license fee based on the following schedule:

328.41		Licensed Capacity	License Fee
328.42		1 to 24 persons	$600
329.1		25 to 49 persons	$800
329.2		50 to 74 persons	$1,000
329.3		75 to 99 persons	$1,200
329.4		100 or more persons	$1,400

329.5(j) (d) A chemical dependency program licensed under Minnesota Rules, parts
329.69530.6510 to 9530.6590, to provide detoxification services shall pay an annual
329.7nonrefundable license fee based on the following schedule:

329.8		Licensed Capacity	License Fee
329.9		1 to 24 persons	$760
329.10		25 to 49 persons	$960
329.11		50 or more persons	$1,160

329.12(k) (e) Except for child foster care, a residential facility licensed under Minnesota
329.13Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
329.14based on the following schedule:

329.15		Licensed Capacity	License Fee
329.16		1 to 24 persons	$1,000
329.17		25 to 49 persons	$1,100
329.18		50 to 74 persons	$1,200
329.19		75 to 99 persons	$1,300
329.20		100 or more persons	$1,400

329.21(l) (f) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
329.229520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
329.23fee based on the following schedule:

329.24		Licensed Capacity	License Fee
329.25		1 to 24 persons	$2,525
329.26		25 or more persons	$2,725

329.27(m) (g) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
329.289570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
329.29license fee based on the following schedule:

329.30		Licensed Capacity	License Fee
329.31		1 to 24 persons	$450
329.32		25 to 49 persons	$650
329.33		50 to 74 persons	$850
329.34		75 to 99 persons	$1,050
329.35		100 or more persons	$1,250

329.36(n) (h) A program licensed to provide independent living assistance for youth under
329.37section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
330.1(o) (i) A private agency licensed to provide foster care and adoption services under
330.2Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
330.3license fee of $875.
330.4(p) (j) A program licensed as an adult day care center licensed under Minnesota
330.5Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based
330.6on the following schedule:

330.7		Licensed Capacity	License Fee
330.8		1 to 24 persons	$500
330.9		25 to 49 persons	$700
330.10		50 to 74 persons	$900
330.11		75 to 99 persons	$1,100
330.12		100 or more persons	$1,300

330.13(q) (k) A program licensed to provide treatment services to persons with sexual
330.14psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
330.159515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
330.16(r) (l) A mental health center or mental health clinic requesting certification for
330.17purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
330.18parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
330.19mental health center or mental health clinic provides services at a primary location with
330.20satellite facilities, the satellite facilities shall be certified with the primary location without
330.21an additional charge.
330.22    Subd. 6. License not issued until license or certification fee is paid. The
330.23commissioner shall not issue a license or certification until the license or certification fee
330.24is paid. The commissioner shall send a bill for the license or certification fee to the billing
330.25address identified by the license holder. If the license holder does not submit the license or
330.26certification fee payment by the due date, the commissioner shall send the license holder
330.27a past due notice. If the license holder fails to pay the license or certification fee by the
330.28due date on the past due notice, the commissioner shall send a final notice to the license
330.29holder informing the license holder that the program license will expire on December 31
330.30unless the license fee is paid before December 31. If a license expires, the program is no
330.31longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2,
330.32must not operate after the expiration date. After a license expires, if the former license
330.33holder wishes to provide licensed services, the former license holder must submit a new
330.34license application and application fee under subdivision 3.
330.35    Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding
330.36section 16A.1285, subdivision 2, related to activities for which the commissioner charges
330.37a fee, the commissioner must plan to fully recover direct expenditures for licensing
331.1activities under this chapter over a five-year period. The commissioner may have
331.2anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
331.3revenues accumulated in previous bienniums.
331.4    Subd. 8. Deposit of license fees. A human services licensing account is created in
331.5the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
331.6be deposited in the human services licensing account and are annually appropriated to the
331.7commissioner for licensing activities authorized under this chapter.
331.8EFFECTIVE DATE.This section is effective July 1, 2013.

331.9    Sec. 16. Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:
331.10    Subd. 2a. Adult foster care and community residential setting license capacity.
331.11(a) The commissioner shall issue adult foster care and community residential setting
331.12 licenses with a maximum licensed capacity of four beds, including nonstaff roomers and
331.13boarders, except that the commissioner may issue a license with a capacity of five beds,
331.14including roomers and boarders, according to paragraphs (b) to (f).
331.15(b) An adult foster care The license holder may have a maximum license capacity
331.16of five if all persons in care are age 55 or over and do not have a serious and persistent
331.17mental illness or a developmental disability.
331.18(c) The commissioner may grant variances to paragraph (b) to allow a foster care
331.19provider facility with a licensed capacity of five persons to admit an individual under the
331.20age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of
331.21the variance is recommended by the county in which the licensed foster care provider
331.22 facility is located.
331.23(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
331.24bed for emergency crisis services for a person with serious and persistent mental illness
331.25or a developmental disability, regardless of age, if the variance complies with section
331.26245A.04, subdivision 9 , and approval of the variance is recommended by the county in
331.27which the licensed foster care provider facility is located.
331.28(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a
331.29fifth bed for respite services, as defined in section 245A.02, for persons with disabilities,
331.30regardless of age, if the variance complies with sections 245A.03, subdivision 7, and
331.31245A.04, subdivision 9 , and approval of the variance is recommended by the county in
331.32which the licensed foster care provider facility is licensed located. Respite care may be
331.33provided under the following conditions:
331.34(1) staffing ratios cannot be reduced below the approved level for the individuals
331.35being served in the home on a permanent basis;
332.1(2) no more than two different individuals can be accepted for respite services in
332.2any calendar month and the total respite days may not exceed 120 days per program in
332.3any calendar year;
332.4(3) the person receiving respite services must have his or her own bedroom, which
332.5could be used for alternative purposes when not used as a respite bedroom, and cannot be
332.6the room of another person who lives in the foster care home facility; and
332.7(4) individuals living in the foster care home facility must be notified when the
332.8variance is approved. The provider must give 60 days' notice in writing to the residents
332.9and their legal representatives prior to accepting the first respite placement. Notice must
332.10be given to residents at least two days prior to service initiation, or as soon as the license
332.11holder is able if they receive notice of the need for respite less than two days prior to
332.12initiation, each time a respite client will be served, unless the requirement for this notice is
332.13waived by the resident or legal guardian.
332.14(f) The commissioner may issue an adult foster care or community residential setting
332.15 license with a capacity of five adults if the fifth bed does not increase the overall statewide
332.16capacity of licensed adult foster care or community residential setting beds in homes that
332.17are not the primary residence of the license holder, as identified in a plan submitted to the
332.18commissioner by the county, when the capacity is recommended by the county licensing
332.19agency of the county in which the facility is located and if the recommendation verifies that:
332.20(1) the facility meets the physical environment requirements in the adult foster
332.21care licensing rule;
332.22(2) the five-bed living arrangement is specified for each resident in the resident's:
332.23(i) individualized plan of care;
332.24(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
332.25(iii) individual resident placement agreement under Minnesota Rules, part
332.269555.5105, subpart 19, if required;
332.27(3) the license holder obtains written and signed informed consent from each
332.28resident or resident's legal representative documenting the resident's informed choice
332.29to remain living in the home and that the resident's refusal to consent would not have
332.30resulted in service termination; and
332.31(4) the facility was licensed for adult foster care before March 1, 2011.
332.32(g) The commissioner shall not issue a new adult foster care license under paragraph
332.33(f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care
332.34license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five
332.35adults if the license holder continues to comply with the requirements in paragraph (f).

333.1    Sec. 17. Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:
333.2    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The
333.3commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
333.4requiring a caregiver to be present in an adult foster care home during normal sleeping
333.5hours to allow for alternative methods of overnight supervision. The commissioner may
333.6grant the variance if the local county licensing agency recommends the variance and the
333.7county recommendation includes documentation verifying that:
333.8    (1) the county has approved the license holder's plan for alternative methods of
333.9providing overnight supervision and determined the plan protects the residents' health,
333.10safety, and rights;
333.11    (2) the license holder has obtained written and signed informed consent from
333.12each resident or each resident's legal representative documenting the resident's or legal
333.13representative's agreement with the alternative method of overnight supervision; and
333.14    (3) the alternative method of providing overnight supervision, which may include
333.15the use of technology, is specified for each resident in the resident's: (i) individualized
333.16plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
333.17required; or (iii) individual resident placement agreement under Minnesota Rules, part
333.189555.5105, subpart 19, if required.
333.19    (b) To be eligible for a variance under paragraph (a), the adult foster care license
333.20holder must not have had a conditional license issued under section 245A.06, or any
333.21other licensing sanction issued under section 245A.07 during the prior 24 months based
333.22on failure to provide adequate supervision, health care services, or resident safety in
333.23the adult foster care home.
333.24    (c) A license holder requesting a variance under this subdivision to utilize
333.25technology as a component of a plan for alternative overnight supervision may request
333.26the commissioner's review in the absence of a county recommendation. Upon receipt of
333.27such a request from a license holder, the commissioner shall review the variance request
333.28with the county.
333.29(d) A variance granted by the commissioner according to this subdivision before
333.30January 1, 2014, to a license holder for an adult foster care home must transfer with the
333.31license when the license converts to a community residential setting license under chapter
333.32245D. The terms and conditions of the variance remain in effect as approved at the time
333.33the variance was granted.

333.34    Sec. 18. Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:
334.1    Subd. 7a. Alternate overnight supervision technology; adult foster care license
334.2 and community residential setting licenses. (a) The commissioner may grant an
334.3applicant or license holder an adult foster care or community residential setting license
334.4for a residence that does not have a caregiver in the residence during normal sleeping
334.5hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, or section
334.6245D.02, subdivision 33b, but uses monitoring technology to alert the license holder
334.7when an incident occurs that may jeopardize the health, safety, or rights of a foster
334.8care recipient. The applicant or license holder must comply with all other requirements
334.9under Minnesota Rules, parts 9555.5105 to 9555.6265, or applicable requirements under
334.10chapter 245D, and the requirements under this subdivision. The license printed by the
334.11commissioner must state in bold and large font:
334.12    (1) that the facility is under electronic monitoring; and
334.13    (2) the telephone number of the county's common entry point for making reports of
334.14suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
334.15(b) Applications for a license under this section must be submitted directly to
334.16the Department of Human Services licensing division. The licensing division must
334.17immediately notify the host county and lead county contract agency and the host county
334.18licensing agency. The licensing division must collaborate with the county licensing
334.19agency in the review of the application and the licensing of the program.
334.20    (c) Before a license is issued by the commissioner, and for the duration of the
334.21license, the applicant or license holder must establish, maintain, and document the
334.22implementation of written policies and procedures addressing the requirements in
334.23paragraphs (d) through (f).
334.24    (d) The applicant or license holder must have policies and procedures that:
334.25    (1) establish characteristics of target populations that will be admitted into the home,
334.26and characteristics of populations that will not be accepted into the home;
334.27    (2) explain the discharge process when a foster care recipient resident served by the
334.28program requires overnight supervision or other services that cannot be provided by the
334.29license holder due to the limited hours that the license holder is on site;
334.30    (3) describe the types of events to which the program will respond with a physical
334.31presence when those events occur in the home during time when staff are not on site, and
334.32how the license holder's response plan meets the requirements in paragraph (e), clause
334.33(1) or (2);
334.34    (4) establish a process for documenting a review of the implementation and
334.35effectiveness of the response protocol for the response required under paragraph (e),
334.36clause (1) or (2). The documentation must include:
335.1    (i) a description of the triggering incident;
335.2    (ii) the date and time of the triggering incident;
335.3    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
335.4    (iv) whether the response met the resident's needs;
335.5    (v) whether the existing policies and response protocols were followed; and
335.6    (vi) whether the existing policies and protocols are adequate or need modification.
335.7    When no physical presence response is completed for a three-month period, the
335.8license holder's written policies and procedures must require a physical presence response
335.9drill to be conducted for which the effectiveness of the response protocol under paragraph
335.10(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
335.11    (5) establish that emergency and nonemergency phone numbers are posted in a
335.12prominent location in a common area of the home where they can be easily observed by a
335.13person responding to an incident who is not otherwise affiliated with the home.
335.14    (e) The license holder must document and include in the license application which
335.15response alternative under clause (1) or (2) is in place for responding to situations that
335.16present a serious risk to the health, safety, or rights of people receiving foster care services
335.17in the home residents served by the program:
335.18    (1) response alternative (1) requires only the technology to provide an electronic
335.19notification or alert to the license holder that an event is underway that requires a response.
335.20Under this alternative, no more than ten minutes will pass before the license holder will be
335.21physically present on site to respond to the situation; or
335.22    (2) response alternative (2) requires the electronic notification and alert system under
335.23alternative (1), but more than ten minutes may pass before the license holder is present on
335.24site to respond to the situation. Under alternative (2), all of the following conditions are met:
335.25    (i) the license holder has a written description of the interactive technological
335.26applications that will assist the license holder in communicating with and assessing the
335.27needs related to the care, health, and safety of the foster care recipients. This interactive
335.28technology must permit the license holder to remotely assess the well being of the foster
335.29care recipient resident served by the program without requiring the initiation of the
335.30foster care recipient. Requiring the foster care recipient to initiate a telephone call does
335.31not meet this requirement;
335.32(ii) the license holder documents how the remote license holder is qualified and
335.33capable of meeting the needs of the foster care recipients and assessing foster care
335.34recipients' needs under item (i) during the absence of the license holder on site;
335.35(iii) the license holder maintains written procedures to dispatch emergency response
335.36personnel to the site in the event of an identified emergency; and
336.1    (iv) each foster care recipient's resident's individualized plan of care, individual
336.2service plan coordinated service and support plan under section sections 256B.0913,
336.3subdivision 8; 256B.0915, subdivision 6; 256B.092, subdivision 1b; and 256B.49,
336.4subdivision 15, if required, or individual resident placement agreement under Minnesota
336.5Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time,
336.6which may be greater than ten minutes, for the license holder to be on site for that foster
336.7care recipient resident.
336.8    (f) Each foster care recipient's resident's placement agreement, individual service
336.9agreement, and plan must clearly state that the adult foster care or community residential
336.10setting license category is a program without the presence of a caregiver in the residence
336.11during normal sleeping hours; the protocols in place for responding to situations that
336.12present a serious risk to the health, safety, or rights of foster care recipients residents
336.13served by the program under paragraph (e), clause (1) or (2); and a signed informed
336.14consent from each foster care recipient resident served by the program or the person's
336.15legal representative documenting the person's or legal representative's agreement with
336.16placement in the program. If electronic monitoring technology is used in the home, the
336.17informed consent form must also explain the following:
336.18    (1) how any electronic monitoring is incorporated into the alternative supervision
336.19system;
336.20    (2) the backup system for any electronic monitoring in times of electrical outages or
336.21other equipment malfunctions;
336.22    (3) how the caregivers or direct support staff are trained on the use of the technology;
336.23    (4) the event types and license holder response times established under paragraph (e);
336.24    (5) how the license holder protects the foster care recipient's each resident's privacy
336.25related to electronic monitoring and related to any electronically recorded data generated
336.26by the monitoring system. A foster care recipient resident served by the program may
336.27not be removed from a program under this subdivision for failure to consent to electronic
336.28monitoring. The consent form must explain where and how the electronically recorded
336.29data is stored, with whom it will be shared, and how long it is retained; and
336.30    (6) the risks and benefits of the alternative overnight supervision system.
336.31    The written explanations under clauses (1) to (6) may be accomplished through
336.32cross-references to other policies and procedures as long as they are explained to the
336.33person giving consent, and the person giving consent is offered a copy.
336.34(g) Nothing in this section requires the applicant or license holder to develop or
336.35maintain separate or duplicative policies, procedures, documentation, consent forms, or
337.1individual plans that may be required for other licensing standards, if the requirements of
337.2this section are incorporated into those documents.
337.3(h) The commissioner may grant variances to the requirements of this section
337.4according to section 245A.04, subdivision 9.
337.5(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
337.6under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
337.7contractors affiliated with the license holder.
337.8(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
337.9remotely determine what action the license holder needs to take to protect the well-being
337.10of the foster care recipient.
337.11(k) The commissioner shall evaluate license applications using the requirements
337.12in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
337.13including a checklist of criteria needed for approval.
337.14(l) To be eligible for a license under paragraph (a), the adult foster care or community
337.15residential setting license holder must not have had a conditional license issued under
337.16section 245A.06 or any licensing sanction under section 245A.07 during the prior 24
337.17months based on failure to provide adequate supervision, health care services, or resident
337.18safety in the adult foster care home or community residential setting.
337.19(m) The commissioner shall review an application for an alternative overnight
337.20supervision license within 60 days of receipt of the application. When the commissioner
337.21receives an application that is incomplete because the applicant failed to submit required
337.22documents or that is substantially deficient because the documents submitted do not meet
337.23licensing requirements, the commissioner shall provide the applicant written notice
337.24that the application is incomplete or substantially deficient. In the written notice to the
337.25applicant, the commissioner shall identify documents that are missing or deficient and
337.26give the applicant 45 days to resubmit a second application that is substantially complete.
337.27An applicant's failure to submit a substantially complete application after receiving
337.28notice from the commissioner is a basis for license denial under section 245A.05. The
337.29commissioner shall complete subsequent review within 30 days.
337.30(n) Once the application is considered complete under paragraph (m), the
337.31commissioner will approve or deny an application for an alternative overnight supervision
337.32license within 60 days.
337.33(o) For the purposes of this subdivision, "supervision" means:
337.34(1) oversight by a caregiver or direct support staff as specified in the individual
337.35resident's place agreement or coordinated service and support plan and awareness of the
337.36resident's needs and activities; and
338.1(2) the presence of a caregiver or direct support staff in a residence during normal
338.2sleeping hours, unless a determination has been made and documented in the individual's
338.3 coordinated service and support plan that the individual does not require the presence of a
338.4caregiver or direct support staff during normal sleeping hours.

338.5    Sec. 19. Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:
338.6    Subd. 7b. Adult foster care data privacy and security. (a) An adult foster care
338.7 or community residential setting license holder who creates, collects, records, maintains,
338.8stores, or discloses any individually identifiable recipient data, whether in an electronic
338.9or any other format, must comply with the privacy and security provisions of applicable
338.10privacy laws and regulations, including:
338.11(1) the federal Health Insurance Portability and Accountability Act of 1996
338.12(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
338.13title 45, part 160, and subparts A and E of part 164; and
338.14(2) the Minnesota Government Data Practices Act as codified in chapter 13.
338.15(b) For purposes of licensure, the license holder shall be monitored for compliance
338.16with the following data privacy and security provisions:
338.17(1) the license holder must control access to data on foster care recipients residents
338.18served by the program according to the definitions of public and private data on individuals
338.19under section 13.02; classification of the data on individuals as private under section
338.2013.46, subdivision 2 ; and control over the collection, storage, use, access, protection,
338.21and contracting related to data according to section 13.05, in which the license holder is
338.22assigned the duties of a government entity;
338.23(2) the license holder must provide each foster care recipient resident served by
338.24the program with a notice that meets the requirements under section 13.04, in which
338.25the license holder is assigned the duties of the government entity, and that meets the
338.26requirements of Code of Federal Regulations, title 45, part 164.52. The notice shall
338.27describe the purpose for collection of the data, and to whom and why it may be disclosed
338.28pursuant to law. The notice must inform the recipient individual that the license holder
338.29uses electronic monitoring and, if applicable, that recording technology is used;
338.30(3) the license holder must not install monitoring cameras in bathrooms;
338.31(4) electronic monitoring cameras must not be concealed from the foster care
338.32recipients residents served by the program; and
338.33(5) electronic video and audio recordings of foster care recipients residents served
338.34by the program shall be stored by the license holder for five days unless: (i) a foster care
338.35recipient resident served by the program or legal representative requests that the recording
339.1be held longer based on a specific report of alleged maltreatment; or (ii) the recording
339.2captures an incident or event of alleged maltreatment under section 626.556 or 626.557 or
339.3a crime under chapter 609. When requested by a recipient resident served by the program
339.4 or when a recording captures an incident or event of alleged maltreatment or a crime, the
339.5license holder must maintain the recording in a secured area for no longer than 30 days
339.6to give the investigating agency an opportunity to make a copy of the recording. The
339.7investigating agency will maintain the electronic video or audio recordings as required in
339.8section 626.557, subdivision 12b.
339.9(c) The commissioner shall develop, and make available to license holders and
339.10county licensing workers, a checklist of the data privacy provisions to be monitored
339.11for purposes of licensure.

339.12    Sec. 20. Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:
339.13    Subd. 8. Community residential setting license. (a) The commissioner shall
339.14establish provider standards for residential support services that integrate service standards
339.15and the residential setting under one license. The commissioner shall propose statutory
339.16language and an implementation plan for licensing requirements for residential support
339.17services to the legislature by January 15, 2012, as a component of the quality outcome
339.18standards recommendations required by Laws 2010, chapter 352, article 1, section 24.
339.19(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
339.20for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105
339.21to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340;
339.22and meeting the provisions of section 256B.092, subdivision 11, paragraph (b) section
339.23245D.02, subdivision 4a, must be required to obtain a community residential setting license.

339.24    Sec. 21. Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:
339.25    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
339.26private agencies that have been designated or licensed by the commissioner to perform
339.27licensing functions and activities under section 245A.04 and background studies for family
339.28child care under chapter 245C; to recommend denial of applicants under section 245A.05;
339.29to issue correction orders, to issue variances, and recommend a conditional license under
339.30section 245A.06, or to recommend suspending or revoking a license or issuing a fine under
339.31section 245A.07, shall comply with rules and directives of the commissioner governing
339.32those functions and with this section. The following variances are excluded from the
339.33delegation of variance authority and may be issued only by the commissioner:
340.1    (1) dual licensure of family child care and child foster care, dual licensure of child
340.2and adult foster care, and adult foster care and family child care;
340.3    (2) adult foster care maximum capacity;
340.4    (3) adult foster care minimum age requirement;
340.5    (4) child foster care maximum age requirement;
340.6    (5) variances regarding disqualified individuals except that county agencies may
340.7issue variances under section 245C.30 regarding disqualified individuals when the county
340.8is responsible for conducting a consolidated reconsideration according to sections 245C.25
340.9and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
340.10and a disqualification based on serious or recurring maltreatment; and
340.11    (6) the required presence of a caregiver in the adult foster care residence during
340.12normal sleeping hours; and
340.13    (7) variances for community residential setting licenses under chapter 245D.
340.14Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency
340.15must not grant a license holder a variance to exceed the maximum allowable family child
340.16care license capacity of 14 children.
340.17    (b) County agencies must report information about disqualification reconsiderations
340.18under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances
340.19granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
340.20prescribed by the commissioner.
340.21    (c) For family day care programs, the commissioner may authorize licensing reviews
340.22every two years after a licensee has had at least one annual review.
340.23    (d) For family adult day services programs, the commissioner may authorize
340.24licensing reviews every two years after a licensee has had at least one annual review.
340.25    (e) A license issued under this section may be issued for up to two years.
340.26(f) During implementation of chapter 245D, the commissioner shall consider:
340.27(1) the role of counties in quality assurance;
340.28(2) the duties of county licensing staff; and
340.29(3) the possible use of joint powers agreements, according to section 471.59, with
340.30counties through which some licensing duties under chapter 245D may be delegated by
340.31the commissioner to the counties.
340.32Any consideration related to this paragraph must meet all of the requirements of the
340.33corrective action plan ordered by the federal Centers for Medicare and Medicaid Services.

340.34    Sec. 22. Minnesota Statutes 2012, section 245D.02, is amended to read:
340.35245D.02 DEFINITIONS.
341.1    Subdivision 1. Scope. The terms used in this chapter have the meanings given
341.2them in this section.
341.3    Subd. 2. Annual and annually. "Annual" and "annually" have the meaning given
341.4in section 245A.02, subdivision 2b.
341.5    Subd. 2a. Authorized representative. "Authorized representative" means a parent,
341.6family member, advocate, or other adult authorized by the person or the person's legal
341.7representative, to serve as a representative in connection with the provision of services
341.8licensed under this chapter. This authorization must be in writing or by another method
341.9that clearly indicates the person's free choice. The authorized representative must have no
341.10financial interest in the provision of any services included in the person's service delivery
341.11plan and must be capable of providing the support necessary to assist the person in the use
341.12of home and community-based services licensed under this chapter.
341.13    Subd. 2b. Aversive procedure. "Aversive procedure" means the application of
341.14an aversive stimulus contingent upon the occurrence of a behavior for the purposes of
341.15reducing or eliminating the behavior.
341.16    Subd. 2c. Aversive stimulus. "Aversive stimulus" means an object, event, or
341.17situation that is presented immediately following a behavior in an attempt to suppress the
341.18behavior. Typically, an aversive stimulus is unpleasant and penalizes or confines.
341.19    Subd. 3. Case manager. "Case manager" means the individual designated
341.20to provide waiver case management services, care coordination, or long-term care
341.21consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
341.22or successor provisions.
341.23    Subd. 3a. Certification. "Certification" means the commissioner's written
341.24authorization for a license holder to provide specialized services based on certification
341.25standards in section 245D.33. The term certification and its derivatives have the same
341.26meaning and may be substituted for the term licensure and its derivatives in this chapter
341.27and chapter 245A.
341.28    Subd. 3b. Chemical restraint. "Chemical restraint" means the administration of
341.29a drug or medication to control the person's behavior or restrict the person's freedom
341.30of movement and is not a standard treatment or dosage for the person's medical or
341.31psychological condition.
341.32    Subd. 4. Commissioner. "Commissioner" means the commissioner of the
341.33Department of Human Services or the commissioner's designated representative.
341.34    Subd. 4a. Community residential setting. "Community residential setting" means
341.35a residential program as identified in section 245A.11, subdivision 8, where residential
341.36supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause
342.1(3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant
342.2of the facility licensed according to this chapter, and the license holder does not reside
342.3in the facility.
342.4    Subd. 4b. Coordinated service and support plan. "Coordinated service and support
342.5plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision
342.66; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions.
342.7    Subd. 4c. Coordinated service and support plan addendum. "Coordinated
342.8service and support plan addendum" means the documentation that this chapter requires
342.9of the license holder for each person receiving services.
342.10    Subd. 4d. Corporate foster care. "Corporate foster care" means a child foster
342.11residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340,
342.12or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to
342.139555.6265, where the license holder does not live in the home.
342.14    Subd. 4e. Cultural competence or culturally competent. "Cultural competence"
342.15or "culturally competent" means the ability and the will to respond to the unique needs of
342.16a person that arise from the person's culture and the ability to use the person's culture as a
342.17resource or tool to assist with the intervention and help meet the person's needs.
342.18    Subd. 4f. Day services facility. "Day services facility" means a facility licensed
342.19according to this chapter at which persons receive day services licensed under this chapter
342.20from the license holder's direct support staff for a cumulative total of more than 30 days
342.21within any 12-month period and the license holder is the owner, lessor, or tenant of the
342.22facility.
342.23    Subd. 5. Department. "Department" means the Department of Human Services.
342.24    Subd. 5a. Deprivation procedure. "Deprivation procedure" means the removal of a
342.25positive reinforcer following a response resulting in, or intended to result in, a decrease in
342.26the frequency, duration, or intensity of that response. Oftentimes the positive reinforcer
342.27available is goods, services, or activities to which the person is normally entitled. The
342.28removal is often in the form of a delay or postponement of the positive reinforcer.
342.29    Subd. 6. Direct contact. "Direct contact" has the meaning given in section 245C.02,
342.30subdivision 11 , and is used interchangeably with the term "direct support service."
342.31    Subd. 6a. Direct support staff or staff. "Direct support staff" or "staff" means
342.32employees of the license holder who have direct contact with persons served by the
342.33program and includes temporary staff or subcontractors, regardless of employer, providing
342.34program services for hire under the control of the license holder who have direct contact
342.35with persons served by the program.
342.36    Subd. 7. Drug. "Drug" has the meaning given in section 151.01, subdivision 5.
343.1    Subd. 8. Emergency. "Emergency" means any event that affects the ordinary
343.2daily operation of the program including, but not limited to, fires, severe weather, natural
343.3disasters, power failures, or other events that threaten the immediate health and safety of
343.4a person receiving services and that require calling 911, emergency evacuation, moving
343.5to an emergency shelter, or temporary closure or relocation of the program to another
343.6facility or service site for more than 24 hours.
343.7    Subd. 8a. Emergency use of manual restraint. "Emergency use of manual
343.8restraint" means using a manual restraint when a person poses an imminent risk of
343.9physical harm to self or others and is the least restrictive intervention that would achieve
343.10safety. Property damage, verbal aggression, or a person's refusal to receive or participate
343.11in treatment or programming on their own, do not constitute an emergency.
343.12    Subd. 8b. Expanded support team. "Expanded support team" means the members
343.13of the support team defined in subdivision 46, and a licensed health or mental health
343.14professional or other licensed, certified, or qualified professionals or consultants working
343.15with the person and included in the team at the request of the person or the person's legal
343.16representative.
343.17    Subd. 8c. Family foster care. "Family foster care" means a child foster family
343.18setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult
343.19foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265,
343.20where the license holder lives in the home.
343.21    Subd. 9. Health services. "Health services" means any service or treatment
343.22consistent with the physical and mental health needs of the person, such as medication
343.23administration and monitoring, medical, dental, nutritional, health monitoring, wellness
343.24education, and exercise.
343.25    Subd. 10. Home and community-based services. "Home and community-based
343.26services" means the services subject to the provisions of this chapter identified in section
343.27245D.03, subdivision 1, and as defined in:
343.28(1) the federal federally approved waiver plans governed by United States Code,
343.29title 42, sections 1396 et seq., or the state's alternative care program according to section
343.30256B.0913, including the waivers for persons with disabilities under section 256B.49,
343.31subdivision 11, including the brain injury (BI) waiver, plan; the community alternative
343.32care (CAC) waiver, plan; the community alternatives for disabled individuals (CADI)
343.33waiver, plan; the developmental disability (DD) waiver, plan under section 256B.092,
343.34subdivision 5; the elderly waiver (EW), and plan under section 256B.0915, subdivision 1;
343.35or successor plans respective to each waiver; or
343.36(2) the alternative care (AC) program under section 256B.0913.
344.1    Subd. 11. Incident. "Incident" means an occurrence that affects the which involves
344.2a person and requires the program to make a response that is not a part of the program's
344.3 ordinary provision of services to a that person, and includes any of the following:
344.4(1) serious injury of a person as determined by section 245.91, subdivision 6;
344.5(2) a person's death;
344.6(3) any medical emergency, unexpected serious illness, or significant unexpected
344.7change in an illness or medical condition, or the mental health status of a person that
344.8requires calling the program to call 911 or a mental health crisis intervention team,
344.9physician treatment, or hospitalization;
344.10(4) any mental health crisis that requires the program to call 911 or a mental health
344.11crisis intervention team;
344.12(5) an act or situation involving a person that requires the program to call 911,
344.13law enforcement, or the fire department;
344.14(4) (6) a person's unauthorized or unexplained absence from a program;
344.15(5) (7) physical aggression conduct by a person receiving services against another
344.16person receiving services that causes physical pain, injury, or persistent emotional distress,
344.17including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting,
344.18pushing, and spitting;:
344.19(i) is so severe, pervasive, or objectively offensive that it substantially interferes with
344.20a person's opportunities to participate in or receive service or support;
344.21(ii) places the person in actual and reasonable fear of harm;
344.22(iii) places the person in actual and reasonable fear of damage to property of the
344.23person; or
344.24(iv) substantially disrupts the orderly operation of the program;
344.25(6) (8) any sexual activity between persons receiving services involving force or
344.26coercion as defined under section 609.341, subdivisions 3 and 14; or
344.27(9) any emergency use of manual restraint as identified in section 245D.061; or
344.28(7) (10) a report of alleged or suspected child or vulnerable adult maltreatment
344.29under section 626.556 or 626.557.
344.30    Subd. 11a. Intermediate care facility for persons with developmental disabilities
344.31or ICF/DD. "Intermediate care facility for persons with developmental disabilities" or
344.32"ICF/DD" means a residential program licensed to serve four or more persons with
344.33developmental disabilities under section 252.28 and chapter 245A and licensed as a
344.34supervised living facility under chapter 144, which together are certified by the Department
344.35of Health as an intermediate care facility for persons with developmental disabilities.
345.1    Subd. 11b. Least restrictive alternative. "Least restrictive alternative" means
345.2the alternative method for providing supports and services that is the least intrusive and
345.3most normalized given the level of supervision and protection required for the person.
345.4This level of supervision and protection allows risk taking to the extent that there is no
345.5reasonable likelihood that serious harm will happen to the person or others.
345.6    Subd. 12. Legal representative. "Legal representative" means the parent of a
345.7person who is under 18 years of age, a court-appointed guardian, or other representative
345.8with legal authority to make decisions about services for a person. Other representatives
345.9with legal authority to make decisions include but are not limited to a health care agent or
345.10an attorney-in-fact authorized through a health care directive or power of attorney.
345.11    Subd. 13. License. "License" has the meaning given in section 245A.02,
345.12subdivision 8 .
345.13    Subd. 14. Licensed health professional. "Licensed health professional" means a
345.14person licensed in Minnesota to practice those professions described in section 214.01,
345.15subdivision 2 .
345.16    Subd. 15. License holder. "License holder" has the meaning given in section
345.17245A.02, subdivision 9 .
345.18    Subd. 15a. Manual restraint. "Manual restraint" means physical intervention
345.19intended to hold a person immobile or limit a person's voluntary movement by using body
345.20contact as the only source of physical restraint.
345.21    Subd. 15b. Mechanical restraint. Except for devices worn by the person that
345.22trigger electronic alarms to warn staff that a person is leaving a room or area, which
345.23do not, in and of themselves, restrict freedom of movement, or the use of adaptive aids
345.24or equipment or orthotic devices ordered by a health care professional used to treat or
345.25manage a medical condition, "mechanical restraint" means the use of devices, materials,
345.26or equipment attached or adjacent to the person's body, or the use of practices that are
345.27intended to restrict freedom of movement or normal access to one's body or body parts,
345.28or limits a person's voluntary movement or holds a person immobile as an intervention
345.29precipitated by a person's behavior. The term applies to the use of mechanical restraint
345.30used to prevent injury with persons who engage in self-injurious behaviors, such as
345.31head-banging, gouging, or other actions resulting in tissue damage that have caused or
345.32could cause medical problems resulting from the self-injury.
345.33    Subd. 16. Medication. "Medication" means a prescription drug or over-the-counter
345.34drug. For purposes of this chapter, "medication" includes dietary supplements.
345.35    Subd. 17. Medication administration. "Medication administration" means
345.36performing the following set of tasks to ensure a person takes both prescription and
346.1over-the-counter medications and treatments according to orders issued by appropriately
346.2licensed professionals, and includes the following:
346.3(1) checking the person's medication record;
346.4(2) preparing the medication for administration;
346.5(3) administering the medication to the person;
346.6(4) documenting the administration of the medication or the reason for not
346.7administering the medication; and
346.8(5) reporting to the prescriber or a nurse any concerns about the medication,
346.9including side effects, adverse reactions, effectiveness, or the person's refusal to take the
346.10medication or the person's self-administration of the medication.
346.11    Subd. 18. Medication assistance. "Medication assistance" means providing verbal
346.12or visual reminders to take regularly scheduled medication, which includes either of
346.13the following:
346.14(1) bringing to the person and opening a container of previously set up medications
346.15and emptying the container into the person's hand or opening and giving the medications
346.16in the original container to the person, or bringing to the person liquids or food to
346.17accompany the medication; or
346.18(2) providing verbal or visual reminders to perform regularly scheduled treatments
346.19and exercises.
346.20    Subd. 19. Medication management. "Medication management" means the
346.21provision of any of the following:
346.22(1) medication-related services to a person;
346.23(2) medication setup;
346.24(3) medication administration;
346.25(4) medication storage and security;
346.26(5) medication documentation and charting;
346.27(6) verification and monitoring of effectiveness of systems to ensure safe medication
346.28handling and administration;
346.29(7) coordination of medication refills;
346.30(8) handling changes to prescriptions and implementation of those changes;
346.31(9) communicating with the pharmacy; or
346.32(10) coordination and communication with prescriber.
346.33For the purposes of this chapter, medication management does not mean "medication
346.34therapy management services" as identified in section 256B.0625, subdivision 13h.
346.35    Subd. 20. Mental health crisis intervention team. "Mental health crisis
346.36intervention team" means a mental health crisis response providers provider as identified
347.1in section 256B.0624, subdivision 2, paragraph (d), for adults, and in section 256B.0944,
347.2subdivision 1 , paragraph (d), for children.
347.3    Subd. 20a. Most integrated setting. "Most integrated setting" means a setting that
347.4enables individuals with disabilities to interact with nondisabled persons to the fullest
347.5extent possible.
347.6    Subd. 21. Over-the-counter drug. "Over-the-counter drug" means a drug that
347.7is not required by federal law to bear the statement "Caution: Federal law prohibits
347.8dispensing without prescription."
347.9    Subd. 21a. Outcome. "Outcome" means the behavior, action, or status attained by
347.10the person that can be observed, measured, and determined reliable and valid.
347.11    Subd. 22. Person. "Person" has the meaning given in section 245A.02, subdivision
347.1211 .
347.13    Subd. 23. Person with a disability. "Person with a disability" means a person
347.14determined to have a disability by the commissioner's state medical review team as
347.15identified in section 256B.055, subdivision 7, the Social Security Administration, or
347.16the person is determined to have a developmental disability as defined in Minnesota
347.17Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section
347.18252.27, subdivision 1a .
347.19    Subd. 23a. Physician. "Physician" means a person who is licensed under chapter
347.20147.
347.21    Subd. 23b. Positive support transition plan. "Positive support transition plan"
347.22means the plan required in section 245D.06, subdivision 5, paragraph (b), to be developed
347.23by the expanded support team to implement positive support strategies to:
347.24(1) eliminate the use of prohibited procedures as identified in section 245D.06,
347.25subdivision 5, paragraph (a);
347.26(2) avoid the emergency use of manual restraint as identified in section 245D.061; and
347.27(3) prevent the person from physically harming self or others.
347.28    Subd. 24. Prescriber. "Prescriber" means a licensed practitioner as defined in
347.29section 151.01, subdivision 23, person who is authorized under section 148.235; 151.01,
347.30subdivision 23; or 151.37 to prescribe drugs. For the purposes of this chapter, the term
347.31"prescriber" is used interchangeably with "physician."
347.32    Subd. 25. Prescription drug. "Prescription drug" has the meaning given in section
347.33151.01, subdivision 17 16 .
347.34    Subd. 26. Program. "Program" means either the nonresidential or residential
347.35program as defined in section 245A.02, subdivisions 10 and 14.
348.1    Subd. 27. Psychotropic medication. "Psychotropic medication" means any
348.2medication prescribed to treat the symptoms of mental illness that affect thought processes,
348.3mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic
348.4(neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and
348.5stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder.
348.6Other miscellaneous medications are considered to be a psychotropic medication when
348.7they are specifically prescribed to treat a mental illness or to control or alter behavior.
348.8    Subd. 28. Restraint. "Restraint" means physical or mechanical manual restraint
348.9as defined in subdivision 15a or mechanical restraint as defined in subdivision 15b, or
348.10any other form of restraint that results in limiting of the free and normal movement of
348.11body or limbs.
348.12    Subd. 29. Seclusion. "Seclusion" means separating a person from others in a way
348.13that prevents social contact and prevents the person from leaving the situation if he or she
348.14chooses the placement of a person alone in a room from which exit is prohibited by a staff
348.15person or a mechanism such as a lock, a device, or an object positioned to hold the door
348.16closed or otherwise prevent the person from leaving the room.
348.17    Subd. 29a. Self-determination. "Self-determination" means the person makes
348.18decisions independently, plans for the person's own future, determines how money is spent
348.19for the person's supports, and takes responsibility for making these decisions. If a person
348.20has a legal representative, the legal representative's decision-making authority is limited to
348.21the scope of authority granted by the court or allowed in the document authorizing the
348.22legal representative to act.
348.23    Subd. 29b. Semi-independent living services. "Semi-independent living services"
348.24has the meaning given in section 252.275.
348.25    Subd. 30. Service. "Service" means care, training, supervision, counseling,
348.26consultation, or medication assistance assigned to the license holder in the coordinated
348.27service and support plan.
348.28    Subd. 31. Service plan. "Service plan" means the individual service plan or
348.29individual care plan identified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
348.30or successor provisions, and includes any support plans or service needs identified as
348.31a result of long-term care consultation, or a support team meeting that includes the
348.32participation of the person, the person's legal representative, and case manager, or assigned
348.33to a license holder through an authorized service agreement.
348.34    Subd. 32. Service site. "Service site" means the location where the service is
348.35provided to the person, including, but not limited to, a facility licensed according to
349.1chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's
349.2own home; or a community-based location.
349.3    Subd. 33. Staff. "Staff" means an employee who will have direct contact with a
349.4person served by the facility, agency, or program.
349.5    Subd. 33a. Supervised living facility. "Supervised living facility" has the meaning
349.6given in Minnesota Rules, part 4665.0100, subpart 10.
349.7    Subd. 33b. Supervision. (a) "Supervision" means:
349.8(1) oversight by direct support staff as specified in the person's coordinated service
349.9and support plan or coordinated service and support plan addendum and awareness of
349.10the person's needs and activities;
349.11(2) responding to situations that present a serious risk to the health, safety, or rights
349.12of the person while services are being provided; and
349.13(3) the presence of direct support staff at a service site while services are being
349.14provided, unless a determination has been made and documented in the person's coordinated
349.15service and support plan or coordinated service and support plan addendum that the person
349.16does not require the presence of direct support staff while services are being provided.
349.17(b) For the purposes of this definition, "while services are being provided," means
349.18any period of time during which the license holder will seek reimbursement for services.
349.19    Subd. 34. Support team. "Support team" means the service planning team
349.20identified in section 256B.49, subdivision 15, or the interdisciplinary team identified in
349.21Minnesota Rules, part 9525.0004, subpart 14.
349.22    Subd. 34a. Time out. "Time out" means removing a person involuntarily from an
349.23ongoing activity to a room, either locked or unlocked, or otherwise separating a person
349.24from others in a way that prevents social contact and prevents the person from leaving
349.25the situation if the person chooses. For the purpose of chapter 245D, "time out" does
349.26not mean voluntary removal or self-removal for the purpose of calming, prevention of
349.27escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out"
349.28does not include a person voluntarily moving from an ongoing activity to an unlocked
349.29room or otherwise separating from a situation or social contact with others if the person
349.30chooses. For the purposes of this definition, "voluntarily" means without being forced,
349.31compelled, or coerced.
349.32    Subd. 35. Unit of government. "Unit of government" means every city, county,
349.33town, school district, other political subdivisions of the state, and any agency of the state
349.34or the United States, and includes any instrumentality of a unit of government.
350.1    Subd. 35a. Treatment. "Treatment" means the provision of care, other than
350.2medications, ordered or prescribed by a licensed health or mental health professional,
350.3provided to a person to cure, rehabilitate, or ease symptoms.
350.4    Subd. 36. Volunteer. "Volunteer" means an individual who, under the direction of the
350.5license holder, provides direct services without pay to a person served by the license holder.
350.6EFFECTIVE DATE.This section is effective January 1, 2014.

350.7    Sec. 23. Minnesota Statutes 2012, section 245D.03, is amended to read:
350.8245D.03 APPLICABILITY AND EFFECT.
350.9    Subdivision 1. Applicability. (a) The commissioner shall regulate the provision of
350.10home and community-based services to persons with disabilities and persons age 65 and
350.11older pursuant to this chapter. The licensing standards in this chapter govern the provision
350.12of the following basic support services: and intensive support services.
350.13(1) housing access coordination as defined under the current BI, CADI, and DD
350.14waiver plans or successor plans;
350.15(2) respite services as defined under the current CADI, BI, CAC, DD, and EW
350.16waiver plans or successor plans when the provider is an individual who is not an employee
350.17of a residential or nonresidential program licensed by the Department of Human Services
350.18or the Department of Health that is otherwise providing the respite service;
350.19(3) behavioral programming as defined under the current BI and CADI waiver
350.20plans or successor plans;
350.21(4) specialist services as defined under the current DD waiver plan or successor plans;
350.22(5) companion services as defined under the current BI, CADI, and EW waiver
350.23plans or successor plans, excluding companion services provided under the Corporation
350.24for National and Community Services Senior Companion Program established under the
350.25Domestic Volunteer Service Act of 1973, Public Law 98-288;
350.26(6) personal support as defined under the current DD waiver plan or successor plans;
350.27(7) 24-hour emergency assistance, on-call and personal emergency response as
350.28defined under the current CADI and DD waiver plans or successor plans;
350.29(8) night supervision services as defined under the current BI waiver plan or
350.30successor plans;
350.31(9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW
350.32waiver plans or successor plans, excluding providers licensed by the Department of Health
350.33under chapter 144A and those providers providing cleaning services only;
351.1(10) independent living skills training as defined under the current BI and CADI
351.2waiver plans or successor plans;
351.3(11) prevocational services as defined under the current BI and CADI waiver plans
351.4or successor plans;
351.5(12) structured day services as defined under the current BI waiver plan or successor
351.6plans; or
351.7(13) supported employment as defined under the current BI and CADI waiver plans
351.8or successor plans.
351.9(b) Basic support services provide the level of assistance, supervision, and care that
351.10is necessary to ensure the health and safety of the person and do not include services that
351.11are specifically directed toward the training, treatment, habilitation, or rehabilitation of
351.12the person. Basic support services include:
351.13(1) in-home and out-of-home respite care services as defined in section 245A.02,
351.14subdivision 15, and under the brain injury, community alternative care, community
351.15alternatives for disabled individuals, developmental disability, and elderly waiver plans;
351.16(2) companion services as defined under the brain injury, community alternatives for
351.17disabled individuals, and elderly waiver plans, excluding companion services provided
351.18under the Corporation for National and Community Services Senior Companion Program
351.19established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
351.20(3) personal support as defined under the developmental disability waiver plan;
351.21(4) 24-hour emergency assistance, personal emergency response as defined under the
351.22community alternatives for disabled individuals and developmental disability waiver plans;
351.23(5) night supervision services as defined under the brain injury waiver plan; and
351.24(6) homemaker services as defined under the community alternatives for disabled
351.25individuals, brain injury, community alternative care, developmental disability, and elderly
351.26waiver plans, excluding providers licensed by the Department of Health under chapter
351.27144A and those providers providing cleaning services only.
351.28(c) Intensive support services provide assistance, supervision, and care that is
351.29necessary to ensure the health and safety of the person and services specifically directed
351.30toward the training, habilitation, or rehabilitation of the person. Intensive support services
351.31include:
351.32(1) intervention services, including:
351.33(i) behavioral support services as defined under the brain injury and community
351.34alternatives for disabled individuals waiver plans;
351.35(ii) in-home or out-of-home crisis respite services as defined under the developmental
351.36disability waiver plan; and
352.1(iii) specialist services as defined under the current developmental disability waiver
352.2plan;
352.3(2) in-home support services, including:
352.4(i) in-home family support and supported living services as defined under the
352.5developmental disability waiver plan;
352.6(ii) independent living services training as defined under the brain injury and
352.7community alternatives for disabled individuals waiver plans; and
352.8(iii) semi-independent living services;
352.9(3) residential supports and services, including:
352.10(i) supported living services as defined under the developmental disability waiver
352.11plan provided in a family or corporate child foster care residence, a family adult foster
352.12care residence, a community residential setting, or a supervised living facility;
352.13(ii) foster care services as defined in the brain injury, community alternative care,
352.14and community alternatives for disabled individuals waiver plans provided in a family or
352.15corporate child foster care residence, a family adult foster care residence, or a community
352.16residential setting; and
352.17(iii) residential services provided in a supervised living facility that is certified by
352.18the Department of Health as an ICF/DD;
352.19(4) day services, including:
352.20(i) structured day services as defined under the brain injury waiver plan;
352.21(ii) day training and habilitation services under sections 252.40 to 252.46, and as
352.22defined under the developmental disability waiver plan; and
352.23(iii) prevocational services as defined under the brain injury and community
352.24alternatives for disabled individuals waiver plans; and
352.25(5) supported employment as defined under the brain injury, developmental
352.26disability, and community alternatives for disabled individuals waiver plans.
352.27    Subd. 2. Relationship to other standards governing home and community-based
352.28services. (a) A license holder governed by this chapter is also subject to the licensure
352.29requirements under chapter 245A.
352.30(b) A license holder concurrently providing child foster care services licensed
352.31according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed
352.32under this chapter is exempt from section 245D.04 as it applies to the person. A corporate
352.33or family child foster care site controlled by a license holder and providing services
352.34governed by this chapter is exempt from compliance with section 245D.04. This exemption
352.35applies to foster care homes where at least one resident is receiving residential supports
353.1and services licensed according to this chapter. This chapter does not apply to corporate or
353.2family child foster care homes that do not provide services licensed under this chapter.
353.3(c) A family adult foster care site controlled by a license holder and providing
353.4services governed by this chapter is exempt from compliance with Minnesota Rules,
353.5parts 9555.6185; 9555.6225; 9555.6245; 9555.6255; and 9555.6265. These exemptions
353.6apply to family adult foster care homes where at least one resident is receiving residential
353.7supports and services licensed according to this chapter. This chapter does not apply to
353.8family adult foster care homes that do not provide services licensed under this chapter.
353.9(d) A license holder providing services licensed according to this chapter in a
353.10supervised living facility is exempt from compliance with sections 245D.04; 245D.05,
353.11subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
353.12(e) A license holder providing residential services to persons in an ICF/DD is exempt
353.13from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision
353.142, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09,
353.15subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
353.16(c) (f) A license holder concurrently providing home care homemaker services
353.17registered licensed according to sections 144A.43 to 144A.49 to the same person receiving
353.18home management services licensed under this chapter and registered according to chapter
353.19144A is exempt from compliance with section 245D.04 as it applies to the person.
353.20(d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt
353.21from compliance with sections 245A.65, subdivision 2, paragraph (a), and 626.557,
353.22subdivision 14 , paragraph (b).
353.23(e) Notwithstanding section 245D.06, subdivision 5, a license holder providing
353.24structured day, prevocational, or supported employment services under this chapter
353.25and day training and habilitation or supported employment services licensed under
353.26chapter 245B within the same program is exempt from compliance with this chapter
353.27when the license holder notifies the commissioner in writing that the requirements under
353.28chapter 245B will be met for all persons receiving these services from the program. For
353.29the purposes of this paragraph, if the license holder has obtained approval from the
353.30commissioner for an alternative inspection status according to section 245B.031, that
353.31approval will apply to all persons receiving services in the program.
353.32(g) Nothing in this chapter prohibits a license holder from concurrently serving
353.33persons without disabilities or people who are or are not age 65 and older, provided this
353.34chapter's standards are met as well as other relevant standards.
354.1(h) The documentation required under sections 245D.07 and 245D.071 must meet
354.2the individual program plan requirements identified in section 256B.092 or successor
354.3provisions.
354.4    Subd. 3. Variance. If the conditions in section 245A.04, subdivision 9, are met,
354.5the commissioner may grant a variance to any of the requirements in this chapter, except
354.6sections 245D.04, and 245D.10, subdivision 4, paragraph (b) 245D.06, subdivision 4,
354.7paragraph (b), and 245D.061, subdivision 3, or provisions governing data practices and
354.8information rights of persons.
354.9    Subd. 4. License holders with multiple 245D licenses. (a) When a person changes
354.10service from one license to a different license held by the same license holder, the license
354.11holder is exempt from the requirements in section 245D.10, subdivision 4, paragraph (b).
354.12(b) When a staff person begins providing direct service under one or more licenses
354.13held by the same license holder, other than the license for which staff orientation was
354.14initially provided according to section 245D.09, subdivision 4, the license holder is
354.15exempt from those staff orientation requirements, except the staff person must review each
354.16person's service plan and medication administration procedures in accordance with section
354.17245D.09, subdivision 4, paragraph (c), if not previously reviewed by the staff person.
354.18    Subd. 5. Program certification. An applicant or a license holder may apply for
354.19program certification as identified in section 245D.33.
354.20EFFECTIVE DATE.This section is effective January 1, 2014.

354.21    Sec. 24. Minnesota Statutes 2012, section 245D.04, is amended to read:
354.22245D.04 SERVICE RECIPIENT RIGHTS.
354.23    Subdivision 1. License holder responsibility for individual rights of persons
354.24served by the program. The license holder must:
354.25(1) provide each person or each person's legal representative with a written notice
354.26that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of
354.27those rights within five working days of service initiation and annually thereafter;
354.28(2) make reasonable accommodations to provide this information in other formats
354.29or languages as needed to facilitate understanding of the rights by the person and the
354.30person's legal representative, if any;
354.31(3) maintain documentation of the person's or the person's legal representative's
354.32receipt of a copy and an explanation of the rights; and
354.33(4) ensure the exercise and protection of the person's rights in the services provided
354.34by the license holder and as authorized in the coordinated service and support plan.
355.1    Subd. 2. Service-related rights. A person's service-related rights include the right to:
355.2(1) participate in the development and evaluation of the services provided to the
355.3person;
355.4(2) have services and supports identified in the coordinated service and support plan
355.5and the coordinated service and support plan addendum provided in a manner that respects
355.6and takes into consideration the person's preferences according to the requirements in
355.7sections 245D.07 and 245D.071;
355.8(3) refuse or terminate services and be informed of the consequences of refusing
355.9or terminating services;
355.10(4) know, in advance, limits to the services available from the license holder,
355.11including the license holder's knowledge, skill, and ability to meet the person's service
355.12and support needs;
355.13(5) know conditions and terms governing the provision of services, including the
355.14license holder's admission criteria and policies and procedures related to temporary
355.15service suspension and service termination;
355.16(6) a coordinated transfer to ensure continuity of care when there will be a change
355.17in the provider;
355.18(7) know what the charges are for services, regardless of who will be paying for the
355.19services, and be notified of changes in those charges;
355.20(7) (8) know, in advance, whether services are covered by insurance, government
355.21funding, or other sources, and be told of any charges the person or other private party
355.22may have to pay; and
355.23(8) (9) receive services from an individual who is competent and trained, who has
355.24professional certification or licensure, as required, and who meets additional qualifications
355.25identified in the person's coordinated service and support plan. or coordinated service and
355.26support plan addendum.
355.27    Subd. 3. Protection-related rights. (a) A person's protection-related rights include
355.28the right to:
355.29(1) have personal, financial, service, health, and medical information kept private,
355.30and be advised of disclosure of this information by the license holder;
355.31(2) access records and recorded information about the person in accordance with
355.32applicable state and federal law, regulation, or rule;
355.33(3) be free from maltreatment;
355.34(4) be free from restraint, time out, or seclusion used for a purpose other than except
355.35for emergency use of manual restraint to protect the person from imminent danger to self
355.36or others according to the requirements in section 245D.06;
356.1(5) receive services in a clean and safe environment when the license holder is the
356.2owner, lessor, or tenant of the service site;
356.3(6) be treated with courtesy and respect and receive respectful treatment of the
356.4person's property;
356.5(7) reasonable observance of cultural and ethnic practice and religion;
356.6(8) be free from bias and harassment regarding race, gender, age, disability,
356.7spirituality, and sexual orientation;
356.8(9) be informed of and use the license holder's grievance policy and procedures,
356.9including knowing how to contact persons responsible for addressing problems and to
356.10appeal under section 256.045;
356.11(10) know the name, telephone number, and the Web site, e-mail, and street
356.12addresses of protection and advocacy services, including the appropriate state-appointed
356.13ombudsman, and a brief description of how to file a complaint with these offices;
356.14(11) assert these rights personally, or have them asserted by the person's family,
356.15authorized representative, or legal representative, without retaliation;
356.16(12) give or withhold written informed consent to participate in any research or
356.17experimental treatment;
356.18(13) associate with other persons of the person's choice;
356.19(14) personal privacy; and
356.20(15) engage in chosen activities.
356.21(b) For a person residing in a residential site licensed according to chapter 245A,
356.22or where the license holder is the owner, lessor, or tenant of the residential service site,
356.23protection-related rights also include the right to:
356.24(1) have daily, private access to and use of a non-coin-operated telephone for local
356.25calls and long-distance calls made collect or paid for by the person;
356.26(2) receive and send, without interference, uncensored, unopened mail or electronic
356.27correspondence or communication; and
356.28(3) have use of and free access to common areas in the residence; and
356.29(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious
356.30advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including
356.31privacy in the person's bedroom.
356.32(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a),
356.33clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure
356.34the health, safety, and well-being of the person. Any restriction of those rights must be
356.35documented in the person's coordinated service and support plan for the person and or
356.36coordinated service and support plan addendum. The restriction must be implemented
357.1in the least restrictive alternative manner necessary to protect the person and provide
357.2support to reduce or eliminate the need for the restriction in the most integrated setting
357.3and inclusive manner. The documentation must include the following information:
357.4(1) the justification for the restriction based on an assessment of the person's
357.5vulnerability related to exercising the right without restriction;
357.6(2) the objective measures set as conditions for ending the restriction;
357.7(3) a schedule for reviewing the need for the restriction based on the conditions for
357.8ending the restriction to occur, at a minimum, every three months for persons who do not
357.9have a legal representative and annually for persons who do have a legal representative
357.10 semiannually from the date of initial approval, at a minimum, or more frequently if
357.11requested by the person, the person's legal representative, if any, and case manager; and
357.12(4) signed and dated approval for the restriction from the person, or the person's
357.13legal representative, if any. A restriction may be implemented only when the required
357.14approval has been obtained. Approval may be withdrawn at any time. If approval is
357.15withdrawn, the right must be immediately and fully restored.
357.16EFFECTIVE DATE.This section is effective January 1, 2014.

357.17    Sec. 25. Minnesota Statutes 2012, section 245D.05, is amended to read:
357.18245D.05 HEALTH SERVICES.
357.19    Subdivision 1. Health needs. (a) The license holder is responsible for providing
357.20 meeting health services service needs assigned in the coordinated service and support plan
357.21and or the coordinated service and support plan addendum, consistent with the person's
357.22health needs. The license holder is responsible for promptly notifying the person or
357.23 the person's legal representative, if any, and the case manager of changes in a person's
357.24physical and mental health needs affecting assigned health services service needs assigned
357.25to the license holder in the coordinated service and support plan or the coordinated service
357.26and support plan addendum, when discovered by the license holder, unless the license
357.27holder has reason to know the change has already been reported. The license holder
357.28must document when the notice is provided.
357.29(b) When assigned in the service plan, If responsibility for meeting the person's
357.30health service needs has been assigned to the license holder in the coordinated service and
357.31support plan or the coordinated service and support plan addendum, the license holder is
357.32required to must maintain documentation on how the person's health needs will be met,
357.33including a description of the procedures the license holder will follow in order to:
358.1(1) provide medication administration, assistance or medication assistance, or
358.2medication management administration according to this chapter;
358.3(2) monitor health conditions according to written instructions from the person's
358.4physician or a licensed health professional;
358.5(3) assist with or coordinate medical, dental, and other health service appointments; or
358.6(4) use medical equipment, devices, or adaptive aides or technology safely and
358.7correctly according to written instructions from the person's physician or a licensed
358.8health professional.
358.9    Subd. 1a. Medication setup. For the purposes of this subdivision, "medication
358.10setup" means the arranging of medications according to instructions from the pharmacy,
358.11the prescriber, or a licensed nurse, for later administration when the license holder
358.12is assigned responsibility for medication assistance or medication administration in
358.13the coordinated service and support plan or the coordinated service and support plan
358.14addendum. A prescription label or the prescriber's written or electronically recorded order
358.15for the prescription is sufficient to constitute written instructions from the prescriber. The
358.16license holder must document in the person's medication administration record: dates
358.17of setup, name of medication, quantity of dose, times to be administered, and route of
358.18administration at time of setup; and, when the person will be away from home, to whom
358.19the medications were given.
358.20    Subd. 1b. Medication assistance. If responsibility for medication assistance
358.21is assigned to the license holder in the coordinated service and support plan or the
358.22coordinated service and support plan addendum, the license holder must ensure that
358.23the requirements of subdivision 2, paragraph (b), have been met when staff provides
358.24medication assistance to enable a person to self-administer medication or treatment when
358.25the person is capable of directing the person's own care, or when the person's legal
358.26representative is present and able to direct care for the person. For the purposes of this
358.27subdivision, "medication assistance" means any of the following:
358.28(1) bringing to the person and opening a container of previously set up medications,
358.29emptying the container into the person's hand, or opening and giving the medications in
358.30the original container to the person;
358.31(2) bringing to the person liquids or food to accompany the medication; or
358.32(3) providing reminders to take regularly scheduled medication or perform regularly
358.33scheduled treatments and exercises.
358.34    Subd. 2. Medication administration. (a) If responsibility for medication
358.35administration is assigned to the license holder in the coordinated service and support plan
358.36or the coordinated service and support plan addendum, the license holder must implement
359.1the following medication administration procedures to ensure a person takes medications
359.2and treatments as prescribed:
359.3(1) checking the person's medication record;
359.4(2) preparing the medication as necessary;
359.5(3) administering the medication or treatment to the person;
359.6(4) documenting the administration of the medication or treatment or the reason for
359.7not administering the medication or treatment; and
359.8(5) reporting to the prescriber or a nurse any concerns about the medication or
359.9treatment, including side effects, effectiveness, or a pattern of the person refusing to
359.10take the medication or treatment as prescribed. Adverse reactions must be immediately
359.11reported to the prescriber or a nurse.
359.12(b)(1) The license holder must ensure that the following criteria requirements in
359.13clauses (2) to (4) have been met before staff that is not a licensed health professional
359.14administers administering medication or treatment:.
359.15(1) (2) The license holder must obtain written authorization has been obtained from
359.16the person or the person's legal representative to administer medication or treatment
359.17orders; and must obtain reauthorization annually as needed. If the person or the person's
359.18legal representative refuses to authorize the license holder to administer medication, the
359.19medication must not be administered. The refusal to authorize medication administration
359.20must be reported to the prescriber as expediently as possible.
359.21(2) (3) The staff person has completed responsible for administering the medication
359.22or treatment must complete medication administration training according to section
359.23245D.09, subdivision 4 , paragraph 4a, paragraphs (a) and (c), clause (2); and, as applicable
359.24to the person, paragraph (d).
359.25(3) The medication or treatment will be administered under administration
359.26procedures established for the person in consultation with a licensed health professional.
359.27written instruction from the person's physician may constitute the medication
359.28administration procedures. A prescription label or the prescriber's order for the
359.29prescription is sufficient to constitute written instructions from the prescriber. A licensed
359.30health professional may delegate medication administration procedures.
359.31(4) For a license holder providing intensive support services, the medication or
359.32treatment must be administered according to the license holder's medication administration
359.33policy and procedures as required under section 245D.11, subdivision 2, clause (3).
359.34(b) (c) The license holder must ensure the following information is documented in
359.35the person's medication administration record:
360.1(1) the information on the current prescription label or the prescriber's current written
360.2or electronically recorded order or prescription that includes directions for the person's
360.3name, description of the medication or treatment to be provided, and the frequency and
360.4other information needed to safely and correctly administering administer the medication
360.5or treatment to ensure effectiveness;
360.6(2) information on any discomforts, risks, or other side effects that are reasonable to
360.7expect, and any contraindications to its use. This information must be readily available
360.8to all staff administering the medication;
360.9(3) the possible consequences if the medication or treatment is not taken or
360.10administered as directed;
360.11(4) instruction from the prescriber on when and to whom to report the following:
360.12(i) if the a dose of medication or treatment is not administered or treatment is not
360.13performed as prescribed, whether by error by the staff or the person or by refusal by
360.14the person; and
360.15(ii) the occurrence of possible adverse reactions to the medication or treatment;
360.16(5) notation of any occurrence of a dose of medication not being administered or
360.17treatment not performed as prescribed, whether by error by the staff or the person or by
360.18refusal by the person, or of adverse reactions, and when and to whom the report was
360.19made; and
360.20(6) notation of when a medication or treatment is started, administered, changed, or
360.21discontinued.
360.22(c) The license holder must ensure that the information maintained in the medication
360.23administration record is current and is regularly reviewed with the person or the person's
360.24legal representative and the staff administering the medication to identify medication
360.25administration issues or errors. At a minimum, the review must be conducted every three
360.26months or more often if requested by the person or the person's legal representative.
360.27Based on the review, the license holder must develop and implement a plan to correct
360.28medication administration issues or errors. If issues or concerns are identified related to
360.29the medication itself, the license holder must report those as required under subdivision 4.
360.30    Subd. 3. Medication assistance. The license holder must ensure that the
360.31requirements of subdivision 2, paragraph (a), have been met when staff provides assistance
360.32to enable a person to self-administer medication when the person is capable of directing
360.33the person's own care, or when the person's legal representative is present and able to
360.34direct care for the person.
360.35    Subd. 4. Reviewing and reporting medication and treatment issues. The
360.36following medication administration issues must be reported to the person or the person's
361.1legal representative and case manager as they occur or following timelines established
361.2in the person's service plan or as requested in writing by the person or the person's legal
361.3representative, or the case manager: (a) When assigned responsibility for medication
361.4administration, the license holder must ensure that the information maintained in
361.5the medication administration record is current and is regularly reviewed to identify
361.6medication administration errors. At a minimum, the review must be conducted every
361.7three months, or more frequently as directed in the coordinated service and support plan
361.8or coordinated service and support plan addendum or as requested by the person or the
361.9person's legal representative. Based on the review, the license holder must develop and
361.10implement a plan to correct patterns of medication administration errors when identified.
361.11(b) If assigned responsibility for medication assistance or medication administration,
361.12the license holder must report the following to the person's legal representative and case
361.13manager as they occur or as otherwise directed in the coordinated service and support plan
361.14or the coordinated service and support plan addendum:
361.15(1) any reports made to the person's physician or prescriber required under
361.16subdivision 2, paragraph (b) (c), clause (4);
361.17(2) a person's refusal or failure to take or receive medication or treatment as
361.18prescribed; or
361.19(3) concerns about a person's self-administration of medication or treatment.
361.20    Subd. 5. Injectable medications. Injectable medications may be administered
361.21according to a prescriber's order and written instructions when one of the following
361.22conditions has been met:
361.23(1) a registered nurse or licensed practical nurse will administer the subcutaneous or
361.24intramuscular injection;
361.25(2) a supervising registered nurse with a physician's order has delegated the
361.26administration of subcutaneous injectable medication to an unlicensed staff member
361.27and has provided the necessary training; or
361.28(3) there is an agreement signed by the license holder, the prescriber, and the
361.29person or the person's legal representative specifying what subcutaneous injections may
361.30be given, when, how, and that the prescriber must retain responsibility for the license
361.31holder's giving the injections. A copy of the agreement must be placed in the person's
361.32service recipient record.
361.33Only licensed health professionals are allowed to administer psychotropic
361.34medications by injection.
361.35EFFECTIVE DATE.This section is effective January 1, 2014.

362.1    Sec. 26. [245D.051] PSYCHOTROPIC MEDICATION USE AND
362.2MONITORING.
362.3    Subdivision 1. Conditions for psychotropic medication administration. (a)
362.4When a person is prescribed a psychotropic medication and the license holder is assigned
362.5responsibility for administration of the medication in the person's coordinated service
362.6and support plan or the coordinated service and support plan addendum, the license
362.7holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05,
362.8subdivision 2, are met.
362.9(b) Use of the medication must be included in the person's coordinated service and
362.10support plan or in the coordinated service and support plan addendum and based on a
362.11prescriber's current written or electronically recorded prescription.
362.12(c) The license holder must develop, implement, and maintain the following
362.13documentation in the person's coordinated service and support plan addendum according
362.14to the requirements in sections 245D.07 and 245D.071:
362.15(1) a description of the target symptoms that the psychotropic medication is to
362.16alleviate; and
362.17(2) documentation methods the license holder will use to monitor and measure
362.18changes in the target symptoms that are to be alleviated by the psychotropic medication if
362.19required by the prescriber. The license holder must collect and report on medication and
362.20symptom-related data as instructed by the prescriber. The license holder must provide
362.21the monitoring data to the expanded support team for review every three months, or as
362.22otherwise requested by the person or the person's legal representative.
362.23For the purposes of this section, "target symptom" refers to any perceptible
362.24diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic
362.25and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or
362.26successive editions that has been identified for alleviation.
362.27    Subd. 2. Refusal to authorize psychotropic medication. If the person or the
362.28person's legal representative refuses to authorize the administration of a psychotropic
362.29medication as ordered by the prescriber, the license holder must follow the requirement
362.30in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal
362.31to the prescriber, the license holder must follow any directives or orders given by the
362.32prescriber. A court order must be obtained to override the refusal. Refusal to authorize
362.33administration of a specific psychotropic medication is not grounds for service termination
362.34and does not constitute an emergency. A decision to terminate services must be reached in
362.35compliance with section 245D.10, subdivision 3.
362.36EFFECTIVE DATE.This section is effective January 1, 2014.

363.1    Sec. 27. Minnesota Statutes 2012, section 245D.06, is amended to read:
363.2245D.06 PROTECTION STANDARDS.
363.3    Subdivision 1. Incident response and reporting. (a) The license holder must
363.4respond to all incidents under section 245D.02, subdivision 11, that occur while providing
363.5services to protect the health and safety of and minimize risk of harm to the person.
363.6(b) The license holder must maintain information about and report incidents to the
363.7person's legal representative or designated emergency contact and case manager within 24
363.8hours of an incident occurring while services are being provided, or within 24 hours of
363.9discovery or receipt of information that an incident occurred, unless the license holder
363.10has reason to know that the incident has already been reported, or as otherwise directed
363.11in a person's coordinated service and support plan or coordinated service and support
363.12plan addendum. An incident of suspected or alleged maltreatment must be reported as
363.13required under paragraph (d), and an incident of serious injury or death must be reported
363.14as required under paragraph (e).
363.15(c) When the incident involves more than one person, the license holder must not
363.16disclose personally identifiable information about any other person when making the report
363.17to each person and case manager unless the license holder has the consent of the person.
363.18(d) Within 24 hours of reporting maltreatment as required under section 626.556
363.19or 626.557, the license holder must inform the case manager of the report unless there is
363.20reason to believe that the case manager is involved in the suspected maltreatment. The
363.21license holder must disclose the nature of the activity or occurrence reported and the
363.22agency that received the report.
363.23(e) The license holder must report the death or serious injury of the person to the legal
363.24representative, if any, and case manager, as required in paragraph (b) and to the Department
363.25of Human Services Licensing Division, and the Office of Ombudsman for Mental Health
363.26and Developmental Disabilities as required under section 245.94, subdivision 2a, within
363.2724 hours of the death, or receipt of information that the death occurred, unless the license
363.28holder has reason to know that the death has already been reported.
363.29(f) When a death or serious injury occurs in a facility certified as an intermediate
363.30care facility for persons with developmental disabilities, the death or serious injury must
363.31be reported to the Department of Health, Office of Health Facility Complaints, and the
363.32Office of Ombudsman for Mental Health and Developmental Disabilities, as required
363.33under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
363.34know that the death has already been reported.
363.35(f) (g) The license holder must conduct a an internal review of incident reports of
363.36deaths and serious injuries that occurred while services were being provided and that
364.1were not reported by the program as alleged or suspected maltreatment, for identification
364.2of incident patterns, and implementation of corrective action as necessary to reduce
364.3occurrences. The review must include an evaluation of whether related policies and
364.4procedures were followed, whether the policies and procedures were adequate, whether
364.5there is a need for additional staff training, whether the reported event is similar to past
364.6events with the persons or the services involved, and whether there is a need for corrective
364.7action by the license holder to protect the health and safety of persons receiving services.
364.8Based on the results of this review, the license holder must develop, document, and
364.9implement a corrective action plan designed to correct current lapses and prevent future
364.10lapses in performance by staff or the license holder, if any.
364.11(h) The license holder must verbally report the emergency use of manual restraint of
364.12a person as required in paragraph (b), within 24 hours of the occurrence. The license holder
364.13must ensure the written report and internal review of all incident reports of the emergency
364.14use of manual restraints are completed according to the requirements in section 245D.061.
364.15    Subd. 2. Environment and safety. The license holder must:
364.16(1) ensure the following when the license holder is the owner, lessor, or tenant
364.17of the service site:
364.18(i) the service site is a safe and hazard-free environment;
364.19(ii) doors are locked or that toxic substances or dangerous items normally accessible
364.20 are inaccessible to persons served by the program are stored in locked cabinets, drawers, or
364.21containers only to protect the safety of a person receiving services and not as a substitute
364.22for staff supervision or interactions with a person who is receiving services. If doors are
364.23locked or toxic substances or dangerous items normally accessible to persons served by the
364.24program are stored in locked cabinets, drawers, or containers are made inaccessible, the
364.25license holder must justify and document how this determination was made in consultation
364.26with the person or person's legal representative, and how access will otherwise be provided
364.27to the person and all other affected persons receiving services; and document an assessment
364.28of the physical plant, its environment, and its population identifying the risk factors which
364.29require toxic substances or dangerous items to be inaccessible and a statement of specific
364.30measures to be taken to minimize the safety risk to persons receiving services;
364.31(iii) doors are locked from the inside to prevent a person from exiting only when
364.32necessary to protect the safety of a person receiving services and not as a substitute for
364.33staff supervision or interactions with the person. If doors are locked from the inside, the
364.34license holder must document an assessment of the physical plant, the environment and
364.35the population served, identifying the risk factors which require the use of locked doors,
365.1and a statement of specific measures to be taken to minimize the safety risk to persons
365.2receiving services at the service site; and
365.3(iii) (iv) a staff person is available on at the service site who is trained in basic first
365.4aid and, when required in a person's coordinated service and support plan or coordinated
365.5service and support plan addendum, cardiopulmonary resuscitation, "CPR," whenever
365.6persons are present and staff are required to be at the site to provide direct service. The
365.7CPR training must include in-person instruction, hands-on practice, and an observed skills
365.8assessment under the direct supervision of a CPR instructor;
365.9(2) maintain equipment, vehicles, supplies, and materials owned or leased by the
365.10license holder in good condition when used to provide services;
365.11(3) follow procedures to ensure safe transportation, handling, and transfers of the
365.12person and any equipment used by the person, when the license holder is responsible for
365.13transportation of a person or a person's equipment;
365.14(4) be prepared for emergencies and follow emergency response procedures to
365.15ensure the person's safety in an emergency; and
365.16(5) follow universal precautions and sanitary practices, including hand washing, for
365.17infection prevention and control, and to prevent communicable diseases.
365.18    Subd. 3. Compliance with fire and safety codes. When services are provided at a
365.19 service site licensed according to chapter 245A or where the license holder is the owner,
365.20lessor, or tenant of the service site, the license holder must document compliance with
365.21applicable building codes, fire and safety codes, health rules, and zoning ordinances, or
365.22document that an appropriate waiver has been granted.
365.23    Subd. 4. Funds and property. (a) Whenever the license holder assists a person
365.24with the safekeeping of funds or other property according to section 245A.04, subdivision
365.2513 , the license holder must have obtain written authorization to do so from the person or
365.26the person's legal representative and the case manager. Authorization must be obtained
365.27within five working days of service initiation and renewed annually thereafter. At the time
365.28initial authorization is obtained, the license holder must survey, document, and implement
365.29the preferences of the person or the person's legal representative and the case manager
365.30for frequency of receiving a statement that itemizes receipts and disbursements of funds
365.31or other property. The license holder must document changes to these preferences when
365.32they are requested.
365.33(b) A license holder or staff person may not accept powers-of-attorney from a
365.34person receiving services from the license holder for any purpose, and may not accept an
365.35appointment as guardian or conservator of a person receiving services from the license
365.36holder. This does not apply to license holders that are Minnesota counties or other
366.1units of government or to staff persons employed by license holders who were acting
366.2as power-of-attorney, guardian, or conservator attorney-in-fact for specific individuals
366.3prior to April 23, 2012 implementation of this chapter. The license holder must maintain
366.4documentation of the power-of-attorney, guardianship, or conservatorship in the service
366.5recipient record.
366.6(c) Upon the transfer or death of a person, any funds or other property of the person
366.7must be surrendered to the person or the person's legal representative, or given to the
366.8executor or administrator of the estate in exchange for an itemized receipt.
366.9    Subd. 5. Prohibitions Prohibited procedures. (a) The license holder is prohibited
366.10from using psychotropic medication chemical restraints, mechanical restraints, manual
366.11restraints, time out, seclusion, or any other aversive or deprivation procedure, as a
366.12substitute for adequate staffing, for a behavioral or therapeutic program to reduce or
366.13eliminate behavior, as punishment, or for staff convenience, or for any reason other than
366.14as prescribed.
366.15(b) The license holder is prohibited from using restraints or seclusion under any
366.16circumstance, unless the commissioner has approved a variance request from the license
366.17holder that allows for the emergency use of restraints and seclusion according to terms
366.18and conditions approved in the variance. Applicants and license holders who have
366.19reason to believe they may be serving an individual who will need emergency use of
366.20restraints or seclusion may request a variance on the application or reapplication, and
366.21the commissioner shall automatically review the request for a variance as part of the
366.22application or reapplication process. License holders may also request the variance any
366.23time after issuance of a license. In the event a license holder uses restraint or seclusion for
366.24any reason without first obtaining a variance as required, the license holder must report
366.25the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the
366.26occurrence and request the required variance.
366.27    Subd. 6. Restricted procedures. The following procedures are allowed when the
366.28procedures are implemented in compliance with the standards governing their use as
366.29identified in clauses (1) to (3). Allowed but restricted procedures include:
366.30(1) permitted actions and procedures subject to the requirements in subdivision 7;
366.31(2) procedures identified in a positive support transition plan subject to the
366.32requirements in subdivision 8; or
366.33(3) emergency use of manual restraint subject to the requirements in section
366.34245D.061.
366.35For purposes of this chapter, this section supersedes the requirements identified in
366.36Minnesota Rules, part 9525.2740.
367.1    Subd. 7. Permitted actions and procedures. (a) Use of the instructional techniques
367.2and intervention procedures as identified in paragraphs (b) and (c), is permitted when used
367.3on an intermittent or continuous basis. When used on a continuous basis, it must be
367.4addressed in a person's coordinated service and support plan addendum as identified in
367.5sections 245D.07 and 245D.071. For purposes of this chapter, the requirements of this
367.6subdivision supersede the requirements identified in Minnesota Rules, part 9525.2720.
367.7(b) Physical contact or instructional techniques must use the least restrictive
367.8alternative possible to meet the needs of the person and may be used:
367.9(1) to calm or comfort a person by holding that person with no resistance from
367.10that person;
367.11(2) to protect a person known to be at risk or injury due to frequent falls as a result
367.12of a medical condition;
367.13(3) to facilitate the person's completion of a task or response when the person does
367.14not resist or the person's resistance is minimal in intensity and duration; or
367.15(4) to briefly block or redirect a person's limbs or body without holding the person
367.16or limiting the person's movement to interrupt the person's behavior that may result in
367.17injury to self or others.
367.18(c) Restraint may be used as an intervention procedure to:
367.19(1) allow a licensed health care professional to safely conduct a medical examination
367.20or to provide medical treatment ordered by a licensed health care professional to a person
367.21necessary to promote healing or recovery from an acute, meaning short-term, medical
367.22condition;
367.23(2) assist in the safe evacuation or redirection of a person in the event of an
367.24emergency and the person is at imminent risk of harm.
367.25Any use of manual restraint as allowed in this paragraph must comply with the restrictions
367.26identified in section 245D.061, subdivision 3; or
367.27(3) to position a person with physical disabilities in a manner specified in the
367.28person's coordinated service and support plan addendum.
367.29(d) Use of adaptive aids or equipment, orthotic devices, or other medical equipment
367.30ordered by a licensed health professional to treat a diagnosed medical condition do not in
367.31and of themselves constitute the use of mechanical restraint.
367.32    Subd. 8. Positive support transition plan. License holders must develop a positive
367.33support transition plan on the forms and in the manner prescribed by the commissioner for
367.34a person who requires intervention in order to maintain safety when it is known that the
367.35person's behavior poses an immediate risk of physical harm to self or others. The positive
367.36support transition plan forms and instructions will supersede the requirements in Minnesota
368.1Rules, parts 9525.2750; 9525.2760; and 9525.2780. The positive support transition plan
368.2must phase out any existing plans for the emergency or programmatic use of aversive or
368.3deprivation procedures prohibited under this chapter within the following timelines:
368.4(1) for persons receiving services from the license holder before January 1, 2014,
368.5the plan must be developed and implemented by February 1, 2014, and phased out no
368.6later than December 31, 2014; and
368.7(2) for persons admitted to the program on or after January 1, 2014, the plan must be
368.8developed and implemented within 30 calendar days of service initiation and phased out
368.9no later than 11 months from the date of plan implementation.
368.10EFFECTIVE DATE.This section is effective January 1, 2014.

368.11    Sec. 28. [245D.061] EMERGENCY USE OF MANUAL RESTRAINTS.
368.12    Subdivision 1. Standards for emergency use of manual restraints. The license
368.13holder must ensure that emergency use of manual restraints complies with the requirements
368.14of this chapter and the license holder's policy and procedures as required under subdivision
368.1510. For the purposes of persons receiving services governed by this chapter, this section
368.16supersedes the requirements identified in Minnesota Rules, part 9525.2770.
368.17    Subd. 2. Conditions for emergency use of manual restraint. Emergency use of
368.18manual restraint must meet the following conditions:
368.19(1) immediate intervention must be needed to protect the person or others from
368.20imminent risk of physical harm; and
368.21(2) the type of manual restraint used must be the least restrictive intervention to
368.22eliminate the immediate risk of harm and effectively achieve safety. The manual restraint
368.23must end when the threat of harm ends.
368.24    Subd. 3. Restrictions when implementing emergency use of manual restraint.
368.25(a) Emergency use of manual restraint procedures must not:
368.26(1) be implemented with a child in a manner that constitutes sexual abuse, neglect,
368.27physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
368.28(2) be implemented with an adult in a manner that constitutes abuse or neglect as
368.29defined in section 626.5572, subdivisions 2 and 17;
368.30(3) be implemented in a manner that violates a person's rights and protections
368.31identified in section 245D.04;
368.32(4) restrict a person's normal access to a nutritious diet, drinking water, adequate
368.33ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping
368.34conditions, or necessary clothing, or to any protection required by state licensing standards
368.35and federal regulations governing the program;
369.1(5) deny the person visitation or ordinary contact with legal counsel, a legal
369.2representative, or next of kin;
369.3(6) be used as a substitute for adequate staffing, for the convenience of staff, as
369.4punishment, or as a consequence if the person refuses to participate in the treatment
369.5or services provided by the program; or
369.6(7) use prone restraint. For the purposes of this section, "prone restraint" means use
369.7of manual restraint that places a person in a face-down position. This does not include
369.8brief physical holding of a person who, during an emergency use of manual restraint, rolls
369.9into a prone position, and the person is restored to a standing, sitting, or side-lying position
369.10as quickly as possible. Applying back or chest pressure while a person is in the prone or
369.11supine position or face-up is prohibited.
369.12    Subd. 4. Monitoring emergency use of manual restraint. The license holder shall
369.13monitor a person's health and safety during an emergency use of a manual restraint. Staff
369.14monitoring the procedure must not be the staff implementing the procedure when possible.
369.15The license holder shall complete a monitoring form, approved by the commissioner, for
369.16each incident involving the emergency use of a manual restraint.
369.17    Subd. 5. Reporting emergency use of manual restraint incident. (a) Within
369.18three calendar days after an emergency use of a manual restraint, the staff person who
369.19implemented the emergency use must report in writing to the designated coordinator the
369.20following information about the emergency use:
369.21(1) the staff and persons receiving services who were involved in the incident
369.22leading up to the emergency use of manual restraint;
369.23(2) a description of the physical and social environment, including who was present
369.24before and during the incident leading up to the emergency use of manual restraint;
369.25(3) a description of what less restrictive alternative measures were attempted to
369.26de-escalate the incident and maintain safety before the manual restraint was implemented
369.27that identifies when, how, and how long the alternative measures were attempted before
369.28manual restraint was implemented;
369.29(4) a description of the mental, physical, and emotional condition of the person who
369.30was restrained, and other persons involved in the incident leading up to, during, and
369.31following the manual restraint;
369.32(5) whether there was any injury to the person who was restrained or other persons
369.33involved in the incident, including staff, before or as a result of the use of manual restraint;
369.34(6) whether there was a debriefing with the staff, and, if not contraindicated, with
369.35the person who was restrained and other persons who were involved in or who witnessed
369.36the restraint, following the incident and the outcome of the debriefing. If the debriefing
370.1was not conducted at the time the incident report was made, the report should identify
370.2whether a debriefing is planned; and
370.3(7) a copy of the report must be maintained in the person's service recipient record.
370.4(b) Each single incident of emergency use of manual restraint must be reported
370.5separately. For the purposes of this subdivision, an incident of emergency use of manual
370.6restraint is a single incident when the following conditions have been met:
370.7(1) after implementing the manual restraint, staff attempt to release the person at the
370.8moment staff believe the person's conduct no longer poses an imminent risk of physical
370.9harm to self or others and less restrictive strategies can be implemented to maintain safety;
370.10(2) upon the attempt to release the restraint, the person's behavior immediately
370.11re-escalates; and
370.12(3) staff must immediately reimplement the restraint in order to maintain safety.
370.13    Subd. 6. Internal review of emergency use of manual restraint. (a) Within five
370.14working days of the emergency use of manual restraint, the license holder must complete
370.15and document an internal review of each report of emergency use of manual restraint. The
370.16review must include an evaluation of whether:
370.17(1) the person's service and support strategies developed according to sections
370.18245D.07 and 245D.071 need to be revised;
370.19(2) related policies and procedures were followed;
370.20(3) the policies and procedures were adequate;
370.21(4) there is a need for additional staff training;
370.22(5) the reported event is similar to past events with the persons, staff, or the services
370.23involved; and
370.24(6) there is a need for corrective action by the license holder to protect the health
370.25and safety of persons.
370.26(b) Based on the results of the internal review, the license holder must develop,
370.27document, and implement a corrective action plan for the program designed to correct
370.28current lapses and prevent future lapses in performance by individuals or the license
370.29holder, if any. The corrective action plan, if any, must be implemented within 30 days of
370.30the internal review being completed.
370.31(c) The license holder must maintain a copy of the internal review and the corrective
370.32action plan, if any, in the person's service recipient record.
370.33    Subd. 7. Expanded support team review. (a) Within five working days after the
370.34completion of the internal review required in subdivision 8, the license holder must consult
370.35with the expanded support team following the emergency use of manual restraint to:
371.1(1) discuss the incident reported in subdivision 7, to define the antecedent or event
371.2that gave rise to the behavior resulting in the manual restraint and identify the perceived
371.3function the behavior served; and
371.4(2) determine whether the person's coordinated service and support plan addendum
371.5needs to be revised according to sections 245D.07 and 245D.071 to positively and
371.6effectively help the person maintain stability and to reduce or eliminate future occurrences
371.7requiring emergency use of manual restraint.
371.8(b) The license holder must maintain a written summary of the expanded support
371.9team's discussion and decisions required in paragraph (a) in the person's service recipient
371.10record.
371.11    Subd. 8. External review and reporting. Within five working days of the expanded
371.12support team review, the license holder must submit the following to the Department of
371.13Human Services, and the Office of the Ombudsman for Mental Health and Developmental
371.14Disabilities, as required under section 245.94, subdivision 2a:
371.15(1) the report required under subdivision 7;
371.16(2) the internal review and the corrective action plan required under subdivision 8; and
371.17(3) the summary of the expanded support team review required under subdivision 9.
371.18    Subd. 9. Emergency use of manual restraints policy and procedures. The license
371.19holder must develop, document, and implement a policy and procedures that promote
371.20service recipient rights and protect health and safety during the emergency use of manual
371.21restraints. The policy and procedures must comply with the requirements of this section
371.22and must specify the following:
371.23(1) a description of the positive support strategies and techniques staff must use to
371.24attempt to de-escalate a person's behavior before it poses an imminent risk of physical
371.25harm to self or others;
371.26(2) a description of the types of manual restraints the license holder allows staff to
371.27use on an emergency basis, if any. If the license holder will not allow the emergency use
371.28of manual restraint, the policy and procedure must identify the alternative measures the
371.29license holder will require staff to use when a person's conduct poses an imminent risk of
371.30physical harm to self or others and less restrictive strategies would not achieve safety;
371.31(3) instructions for safe and correct implementation of the allowed manual restraint
371.32procedures;
371.33(4) the training that staff must complete and the timelines for completion, before they
371.34may implement an emergency use of manual restraint. In addition to the training on this
371.35policy and procedure and the orientation and annual training required in section 245D.09,
372.1subdivision 4, the training for emergency use of manual restraint must incorporate the
372.2following subjects:
372.3(i) alternatives to manual restraint procedures, including techniques to identify
372.4events and environmental factors that may escalate conduct that poses an imminent risk of
372.5physical harm to self or others;
372.6(ii) de-escalation methods, positive support strategies, and how to avoid power
372.7struggles;
372.8(iii) simulated experiences of administering and receiving manual restraint
372.9procedures allowed by the license holder on an emergency basis;
372.10(iv) how to properly identify thresholds for implementing and ceasing restrictive
372.11procedures;
372.12(v) how to recognize, monitor, and respond to the person's physical signs of distress,
372.13including positional asphyxia;
372.14(vi) the physiological and psychological impact on the person and the staff when
372.15restrictive procedures are used;
372.16(vii) the communicative intent of behaviors; and
372.17(viii) relationship building;
372.18(5) the procedures and forms to be used to monitor the emergency use of manual
372.19restraints, including what must be monitored and the frequency of monitoring per
372.20each incident of emergency use of manual restraint, and the person or position who is
372.21responsible for monitoring the use;
372.22(6) the instructions, forms, and timelines required for completing and submitting an
372.23incident report by the person or persons who implemented the manual restraint; and
372.24(7) the procedures and timelines for conducting the internal review and the expanded
372.25support team review, and the person or position responsible for completing the reviews
372.26and for ensuring that corrective action is taken or the person's coordinated service and
372.27support plan addendum is revised, when determined necessary.
372.28EFFECTIVE DATE.This section is effective January 1, 2014.

372.29    Sec. 29. Minnesota Statutes 2012, section 245D.07, is amended to read:
372.30245D.07 SERVICE NEEDS PLANNING AND DELIVERY.
372.31    Subdivision 1. Provision of services. The license holder must provide services as
372.32specified assigned in the coordinated service and support plan and assigned to the license
372.33holder. The provision of services must comply with the requirements of this chapter and
372.34the federal waiver plans.
373.1    Subd. 1a. Person-centered planning and service delivery. (a) The license holder
373.2must provide services in response to the person's identified needs, interests, preferences,
373.3and desired outcomes as specified in the coordinated service and support plan and the
373.4coordinated service and support plan addendum, and in compliance with the requirements
373.5of this chapter. License holders providing intensive support services must also provide
373.6outcome-based services according to the requirements in section 245D.071.
373.7(b) Services must be provided in a manner that supports the person's preferences,
373.8daily needs, and activities and accomplishment of the person's personal goals and service
373.9outcomes, consistent with the principles of:
373.10(1) person-centered service planning and delivery that:
373.11(i) identifies and supports what is important to the person as well as what is
373.12important for the person, including preferences for when, how, and by whom direct
373.13support service is provided;
373.14(ii) uses that information to identify outcomes the person desires; and
373.15(iii) respects each person's history, dignity, and cultural background;
373.16(2) self-determination that supports and provides:
373.17(i) opportunities for the development and exercise of functional and age-appropriate
373.18skills, decision making and choice, personal advocacy, and communication; and
373.19(ii) the affirmation and protection of each person's civil and legal rights; and
373.20(3) providing the most integrated setting and inclusive service delivery that supports,
373.21promotes, and allows:
373.22(i) inclusion and participation in the person's community as desired by the person
373.23in a manner that enables the person to interact with nondisabled persons to the fullest
373.24extent possible and supports the person in developing and maintaining a role as a valued
373.25community member;
373.26(ii) opportunities for self-sufficiency as well as developing and maintaining social
373.27relationships and natural supports; and
373.28(iii) a balance between risk and opportunity, meaning the least restrictive supports or
373.29interventions necessary are provided in the most integrated settings in the most inclusive
373.30manner possible to support the person to engage in activities of the person's own choosing
373.31that may otherwise present a risk to the person's health, safety, or rights.
373.32    Subd. 2. Service planning requirements for basic support services. (a) License
373.33holders providing basic support services must meet the requirements of this subdivision.
373.34(b) Within 15 days of service initiation the license holder must complete a
373.35preliminary coordinated service and support plan addendum based on the coordinated
373.36service and support plan.
374.1(c) Within 60 days of service initiation the license holder must review and revise as
374.2needed the preliminary coordinated service and support plan addendum to document the
374.3services that will be provided including how, when, and by whom services will be provided,
374.4and the person responsible for overseeing the delivery and coordination of services.
374.5(d) The license holder must participate in service planning and support team
374.6meetings related to for the person following stated timelines established in the person's
374.7 coordinated service and support plan or as requested by the support team, the person, or
374.8the person's legal representative, the support team or the expanded support team.
374.9    Subd. 3. Reports. The license holder must provide written reports regarding the
374.10person's progress or status as requested by the person, the person's legal representative, the
374.11case manager, or the team.
374.12EFFECTIVE DATE.This section is effective January 1, 2014.

374.13    Sec. 30. [245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE
374.14SUPPORT SERVICES.
374.15    Subdivision 1. Requirements for intensive support services. A license holder
374.16providing intensive support services identified in section 245D.03, subdivision 1,
374.17paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1
374.18and 3, and this section.
374.19    Subd. 2. Abuse prevention. Prior to or upon initiating services, the license holder
374.20must develop, document, and implement an abuse prevention plan according to section
374.21245A.65, subdivision 2.
374.22    Subd. 3. Assessment and initial service planning. (a) Within 15 days of service
374.23initiation the license holder must complete a preliminary coordinated service and support
374.24plan addendum based on the coordinated service and support plan.
374.25(b) Within 45 days of service initiation the license holder must meet with the person,
374.26the person's legal representative, the case manager, and other members of the support team
374.27or expanded support team to assess and determine the following based on the person's
374.28coordinated service and support plan and the requirements in subdivision 4 and section
374.29245D.07, subdivision 1a:
374.30(1) the scope of the services to be provided to support the person's daily needs
374.31and activities;
374.32(2) the person's desired outcomes and the supports necessary to accomplish the
374.33person's desired outcomes;
374.34(3) the person's preferences for how services and supports are provided;
375.1(4) whether the current service setting is the most integrated setting available and
375.2appropriate for the person; and
375.3(5) how services must be coordinated across other providers licensed under this
375.4chapter serving the same person to ensure continuity of care for the person.
375.5(c) Within the scope of services, the license holder must, at a minimum, assess
375.6the following areas:
375.7(1) the person's ability to self-manage health and medical needs to maintain or
375.8improve physical, mental, and emotional well-being, including, when applicable, allergies,
375.9seizures, choking, special dietary needs, chronic medical conditions, self-administration
375.10of medication or treatment orders, preventative screening, and medical and dental
375.11appointments;
375.12(2) the person's ability to self-manage personal safety to avoid injury or accident in
375.13the service setting, including, when applicable, risk of falling, mobility, regulating water
375.14temperature, community survival skills, water safety skills, and sensory disabilities; and
375.15(3) the person's ability to self-manage symptoms or behavior that may otherwise
375.16result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to
375.17(7), suspension or termination of services by the license holder, or other symptoms
375.18or behaviors that may jeopardize the health and safety of the person or others. The
375.19assessments must produce information about the person that is descriptive of the person's
375.20overall strengths, functional skills and abilities, and behaviors or symptoms.
375.21    Subd. 4. Service outcomes and supports. (a) Within ten working days of the
375.2245-day meeting, the license holder must develop and document the service outcomes and
375.23supports based on the assessments completed under subdivision 3 and the requirements
375.24in section 245D.07, subdivision 1a. The outcomes and supports must be included in the
375.25coordinated service and support plan addendum.
375.26(b) The license holder must document the supports and methods to be implemented
375.27to support the accomplishment of outcomes related to acquiring, retaining, or improving
375.28skills. The documentation must include:
375.29(1) the methods or actions that will be used to support the person and to accomplish
375.30the service outcomes, including information about:
375.31(i) any changes or modifications to the physical and social environments necessary
375.32when the service supports are provided;
375.33(ii) any equipment and materials required; and
375.34(iii) techniques that are consistent with the person's communication mode and
375.35learning style;
376.1(2) the measurable and observable criteria for identifying when the desired outcome
376.2has been achieved and how data will be collected;
376.3(3) the projected starting date for implementing the supports and methods and
376.4the date by which progress towards accomplishing the outcomes will be reviewed and
376.5evaluated; and
376.6(4) the names of the staff or position responsible for implementing the supports
376.7and methods.
376.8(c) Within 20 working days of the 45-day meeting, the license holder must obtain
376.9dated signatures from the person or the person's legal representative and case manager
376.10to document completion and approval of the assessment and coordinated service and
376.11support plan addendum.
376.12    Subd. 5. Progress reviews. (a) The license holder must give the person or the
376.13person's legal representative and case manager an opportunity to participate in the ongoing
376.14review and development of the methods used to support the person and accomplish
376.15outcomes identified in subdivisions 3 and 4. The license holder, in coordination with
376.16the person's support team or expanded support team, must meet with the person, the
376.17person's legal representative, and the case manager, and participate in progress review
376.18meetings following stated timelines established in the person's coordinated service and
376.19support plan or coordinated service and support plan addendum or within 30 days of a
376.20written request by the person, the person's legal representative, or the case manager,
376.21at a minimum of once per year.
376.22(b) The license holder must summarize the person's progress toward achieving the
376.23identified outcomes and make recommendations and identify the rationale for changing,
376.24continuing, or discontinuing implementation of supports and methods identified in
376.25subdivision 4 in a written report sent to the person or the person's legal representative
376.26and case manager five working days prior to the review meeting, unless the person, the
376.27person's legal representative, or the case manager requests to receive the report at the
376.28time of the meeting.
376.29(c) Within ten working days of the progress review meeting, the license holder
376.30must obtain dated signatures from the person or the person's legal representative and
376.31the case manager to document approval of any changes to the coordinated service and
376.32support plan addendum.
376.33EFFECTIVE DATE.This section is effective January 1, 2014.

376.34    Sec. 31. [245D.081] PROGRAM COORDINATION, EVALUATION, AND
376.35OVERSIGHT.
377.1    Subdivision 1. Program coordination and evaluation. (a) The license holder
377.2is responsible for:
377.3(1) coordination of service delivery and evaluation for each person served by the
377.4program as identified in subdivision 2; and
377.5(2) program management and oversight that includes evaluation of the program
377.6quality and program improvement for services provided by the license holder as identified
377.7in subdivision 3.
377.8(b) The same person may perform the functions in paragraph (a) if the work and
377.9education qualifications are met in subdivisions 2 and 3.
377.10    Subd. 2. Coordination and evaluation of individual service delivery. (a) Delivery
377.11and evaluation of services provided by the license holder must be coordinated by a
377.12designated staff person. The designated coordinator must provide supervision, support,
377.13and evaluation of activities that include:
377.14(1) oversight of the license holder's responsibilities assigned in the person's
377.15coordinated service and support plan and the coordinated service and support plan
377.16addendum;
377.17(2) taking the action necessary to facilitate the accomplishment of the outcomes
377.18according to the requirements in section 245D.07;
377.19(3) instruction and assistance to direct support staff implementing the coordinated
377.20service and support plan and the service outcomes, including direct observation of service
377.21delivery sufficient to assess staff competency; and
377.22(4) evaluation of the effectiveness of service delivery, methodologies, and progress on
377.23the person's outcomes based on the measurable and observable criteria for identifying when
377.24the desired outcome has been achieved according to the requirements in section 245D.07.
377.25(b) The license holder must ensure that the designated coordinator is competent to
377.26perform the required duties identified in paragraph (a) through education and training in
377.27human services and disability-related fields, and work experience in providing direct care
377.28services and supports to persons with disabilities. The designated coordinator must have
377.29the skills and ability necessary to develop effective plans and to design and use data
377.30systems to measure effectiveness of services and supports. The license holder must verify
377.31and document competence according to the requirements in section 245D.09, subdivision
377.323. The designated coordinator must minimally have:
377.33(1) a baccalaureate degree in a field related to human services, and one year of
377.34full-time work experience providing direct care services to persons with disabilities or
377.35persons age 65 and older;
378.1(2) an associate degree in a field related to human services, and two years of
378.2full-time work experience providing direct care services to persons with disabilities or
378.3persons age 65 and older;
378.4(3) a diploma in a field related to human services from an accredited postsecondary
378.5institution and three years of full-time work experience providing direct care services to
378.6persons with disabilities or persons age 65 and older; or
378.7(4) a minimum of 50 hours of education and training related to human services
378.8and disabilities; and
378.9(5) four years of full-time work experience providing direct care services to persons
378.10with disabilities or persons age 65 and older under the supervision of a staff person who
378.11meets the qualifications identified in clauses (1) to (3).
378.12    Subd. 3. Program management and oversight. (a) The license holder must
378.13designate a managerial staff person or persons to provide program management and
378.14oversight of the services provided by the license holder. The designated manager is
378.15responsible for the following:
378.16(1) maintaining a current understanding of the licensing requirements sufficient to
378.17ensure compliance throughout the program as identified in section 245A.04, subdivision
378.181, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21,
378.19paragraph (b);
378.20(2) ensuring the duties of the designated coordinator are fulfilled according to the
378.21requirements in subdivision 2;
378.22(3) ensuring the program implements corrective action identified as necessary
378.23by the program following review of incident and emergency reports according to the
378.24requirements in section 245D.11, subdivision 2, clause (7). An internal review of
378.25incident reports of alleged or suspected maltreatment must be conducted according to the
378.26requirements in section 245A.65, subdivision 1, paragraph (b);
378.27(4) evaluation of satisfaction of persons served by the program, the person's legal
378.28representative, if any, and the case manager, with the service delivery and progress
378.29towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and
378.30ensuring and protecting each person's rights as identified in section 245D.04;
378.31(5) ensuring staff competency requirements are met according to the requirements in
378.32section 245D.09, subdivision 3, and ensuring staff orientation and training is provided
378.33according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
378.34(6) ensuring corrective action is taken when ordered by the commissioner and that
378.35the terms and condition of the license and any variances are met; and
379.1(7) evaluating the information identified in clauses (1) to (6) to develop, document,
379.2and implement ongoing program improvements.
379.3(b) The designated manager must be competent to perform the duties as required and
379.4must minimally meet the education and training requirements identified in subdivision
379.52, paragraph (b), and have a minimum of three years of supervisory level experience in
379.6a program providing direct support services to persons with disabilities or persons age
379.765 and older.
379.8EFFECTIVE DATE.This section is effective January 1, 2014.

379.9    Sec. 32. Minnesota Statutes 2012, section 245D.09, is amended to read:
379.10245D.09 STAFFING STANDARDS.
379.11    Subdivision 1. Staffing requirements. The license holder must provide the level of
379.12 direct service support staff sufficient supervision, assistance, and training necessary:
379.13(1) to ensure the health, safety, and protection of rights of each person; and
379.14(2) to be able to implement the responsibilities assigned to the license holder in each
379.15person's coordinated service and support plan or identified in the coordinated service and
379.16support plan addendum, according to the requirements of this chapter.
379.17    Subd. 2. Supervision of staff having direct contact. Except for a license holder
379.18who is the sole direct service support staff, the license holder must provide adequate
379.19supervision of staff providing direct service support to ensure the health, safety, and
379.20protection of rights of each person and implementation of the responsibilities assigned to
379.21the license holder in each person's service plan coordinated service and support plan or
379.22coordinated service and support plan addendum.
379.23    Subd. 3. Staff qualifications. (a) The license holder must ensure that staff is
379.24 providing direct support, or staff who have responsibilities related to supervising or
379.25managing the provision of direct support service, are competent as demonstrated through
379.26 skills and knowledge training, experience, and education to meet the person's needs
379.27and additional requirements as written in the coordinated service and support plan or
379.28coordinated service and support plan addendum, or when otherwise required by the case
379.29manager or the federal waiver plan. The license holder must verify and maintain evidence
379.30of staff competency, including documentation of:
379.31(1) education and experience qualifications relevant to the job responsibilities
379.32assigned to the staff and the needs of the general population of persons served by the
379.33program, including a valid degree and transcript, or a current license, registration, or
379.34certification, when a degree or licensure, registration, or certification is required by this
380.1chapter or in the coordinated service and support plan or coordinated service and support
380.2plan addendum;
380.3(2) completion of required demonstrated competency in the orientation and training
380.4 areas required under this chapter, including and when applicable, completion of continuing
380.5education required to maintain professional licensure, registration, or certification
380.6requirements. Competency in these areas is determined by the license holder through
380.7knowledge testing and observed skill assessment conducted by the trainer or instructor; and
380.8(3) except for a license holder who is the sole direct service support staff, periodic
380.9 performance evaluations completed by the license holder of the direct service support staff
380.10person's ability to perform the job functions based on direct observation.
380.11(b) Staff under 18 years of age may not perform overnight duties or administer
380.12medication.
380.13    Subd. 4. Orientation to program requirements. (a) Except for a license holder
380.14who does not supervise any direct service support staff, within 90 days of hiring direct
380.15service staff 60 days of hire, unless stated otherwise, the license holder must provide
380.16and ensure completion of 30 hours of orientation for direct support staff that combines
380.17supervised on-the-job training with review of and instruction on in the following areas:
380.18(1) the job description and how to complete specific job functions, including:
380.19(i) responding to and reporting incidents as required under section 245D.06,
380.20subdivision 1; and
380.21(ii) following safety practices established by the license holder and as required in
380.22section 245D.06, subdivision 2;
380.23(2) the license holder's current policies and procedures required under this chapter,
380.24including their location and access, and staff responsibilities related to implementation
380.25of those policies and procedures;
380.26(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the
380.27federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff
380.28responsibilities related to complying with data privacy practices;
380.29(4) the service recipient rights under section 245D.04, and staff responsibilities
380.30related to ensuring the exercise and protection of those rights according to the requirements
380.31in section 245D.04;
380.32(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment
380.33reporting and service planning for children and vulnerable adults, and staff responsibilities
380.34related to protecting persons from maltreatment and reporting maltreatment. This
380.35orientation must be provided within 72 hours of first providing direct contact services and
380.36annually thereafter according to section 245A.65, subdivision 3;
381.1(6) what constitutes use of restraints, seclusion, and psychotropic medications,
381.2and staff responsibilities related to the prohibitions of their use the principles of
381.3person-centered service planning and delivery as identified in section 245D.07, subdivision
381.41a, and how they apply to direct support service provided by the staff person; and
381.5(7) other topics as determined necessary in the person's coordinated service and
381.6support plan by the case manager or other areas identified by the license holder.
381.7(b) License holders who provide direct service themselves must complete the
381.8orientation required in paragraph (a), clauses (3) to (7).
381.9    Subd. 4a. Orientation to individual service recipient needs. (c) (a) Before
381.10providing having unsupervised direct service to contact with a person served by the
381.11program, or for whom the staff person has not previously provided direct service support,
381.12or any time the plans or procedures identified in clauses (1) and (2) paragraphs (b) to
381.13(f) are revised, the staff person must review and receive instruction on the following
381.14as it relates requirements in paragraphs (b) to (f) as they relate to the staff person's job
381.15functions for that person:.
381.16(b) Training and competency evaluations must include the following:
381.17(1) appropriate and safe techniques in personal hygiene and grooming, including
381.18hair care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities of
381.19daily living (ADLs) as defined under section 256B.0659, subdivision 1;
381.20(2) an understanding of what constitutes a healthy diet according to data from the
381.21Centers for Disease Control and Prevention and the skills necessary to prepare that diet;
381.22(3) skills necessary to provide appropriate support in instrumental activities of daily
381.23living (IADLs) as defined under section 256B.0659, subdivision 1; and
381.24(4) demonstrated competence in providing first aid.
381.25(1) (c) The staff person must review and receive instruction on the person's
381.26 coordinated service and support plan or coordinated service and support plan addendum as
381.27it relates to the responsibilities assigned to the license holder, and when applicable, the
381.28person's individual abuse prevention plan according to section 245A.65, to achieve and
381.29demonstrate an understanding of the person as a unique individual, and how to implement
381.30those plans; and.
381.31(2) (d) The staff person must review and receive instruction on medication
381.32administration procedures established for the person when medication administration is
381.33 assigned to the license holder according to section 245D.05, subdivision 1, paragraph
381.34(b). Unlicensed staff may administer medications only after successful completion of a
381.35medication administration training, from a training curriculum developed by a registered
381.36nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse
382.1practitioner, physician's assistant, or physician incorporating. The training curriculum
382.2must incorporate an observed skill assessment conducted by the trainer to ensure staff
382.3demonstrate the ability to safely and correctly follow medication procedures.
382.4Medication administration must be taught by a registered nurse, clinical nurse
382.5specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of
382.6service initiation or any time thereafter, the person has or develops a health care condition
382.7that affects the service options available to the person because the condition requires:
382.8(i) (1) specialized or intensive medical or nursing supervision; and
382.9(ii) (2) nonmedical service providers to adapt their services to accommodate the
382.10health and safety needs of the person; and.
382.11(iii) necessary training in order to meet the health service needs of the person as
382.12determined by the person's physician.
382.13(e) The staff person must review and receive instruction on the safe and correct
382.14operation of medical equipment used by the person to sustain life, including but not
382.15limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided
382.16by a licensed health care professional or a manufacturer's representative and incorporate
382.17an observed skill assessment to ensure staff demonstrate the ability to safely and correctly
382.18operate the equipment according to the treatment orders and the manufacturer's instructions.
382.19(f) The staff person must review and receive instruction on what constitutes use of
382.20restraints, time out, and seclusion, including chemical restraint, and staff responsibilities
382.21related to the prohibitions of their use according to the requirements in section 245D.06,
382.22subdivision 5, why such procedures are not effective for reducing or eliminating symptoms
382.23or undesired behavior and why they are not safe, and the safe and correct use of manual
382.24restraint on an emergency basis according to the requirements in section 245D.061.
382.25(g) In the event of an emergency service initiation, the license holder must ensure
382.26the training required in this subdivision occurs within 72 hours of the direct support staff
382.27person first having unsupervised contact with the person receiving services. The license
382.28holder must document the reason for the unplanned or emergency service initiation and
382.29maintain the documentation in the person's service recipient record.
382.30(h) License holders who provide direct support services themselves must complete
382.31the orientation required in subdivision 4, clauses (3) to (7).
382.32    Subd. 5. Annual training. (a) A license holder must provide annual training
382.33to direct service support staff on the topics identified in subdivision 4, paragraph (a),
382.34 clauses (3) to (6) (7), and subdivision 4a. A license holder must provide a minimum of 24
382.35hours of annual training to direct service staff with fewer than five years of documented
382.36experience and 12 hours of annual training to direct service staff with five or more years
383.1of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a)
383.2to (h). Training on relevant topics received from sources other than the license holder
383.3may count toward training requirements.
383.4(b) A license holder providing behavioral programming, specialist services, personal
383.5support, 24-hour emergency assistance, night supervision, independent living skills,
383.6structured day, prevocational, or supported employment services must provide a minimum
383.7of eight hours of annual training to direct service staff that addresses:
383.8(1) topics related to the general health, safety, and service needs of the population
383.9served by the license holder; and
383.10(2) other areas identified by the license holder or in the person's current service plan.
383.11Training on relevant topics received from sources other than the license holder
383.12may count toward training requirements.
383.13(c) When the license holder is the owner, lessor, or tenant of the service site and
383.14whenever a person receiving services is present at the site, the license holder must have
383.15a staff person available on site who is trained in basic first aid and, when required in a
383.16person's service plan, cardiopulmonary resuscitation.
383.17    Subd. 5a. Alternative sources of training. Orientation or training received by the
383.18staff person from sources other than the license holder in the same subjects as identified
383.19in subdivision 4 may count toward the orientation and annual training requirements if
383.20received in the 12-month period before the staff person's date of hire. The license holder
383.21must maintain documentation of the training received from other sources and of each staff
383.22person's competency in the required area according to the requirements in subdivision 3.
383.23    Subd. 6. Subcontractors and temporary staff. If the license holder uses a
383.24subcontractor or temporary staff to perform services licensed under this chapter on the
383.25license holder's behalf, the license holder must ensure that the subcontractor or temporary
383.26staff meets and maintains compliance with all requirements under this chapter that apply
383.27to the services to be provided, including training, orientation, and supervision necessary
383.28to fulfill their responsibilities. The license holder must ensure that a background study
383.29has been completed according to the requirements in sections 245C.03, subdivision 1,
383.30and 245C.04. Subcontractors and temporary staff hired by the license holder must meet
383.31the Minnesota licensing requirements applicable to the disciplines in which they are
383.32providing services. The license holder must maintain documentation that the applicable
383.33requirements have been met.
383.34    Subd. 7. Volunteers. The license holder must ensure that volunteers who provide
383.35direct support services to persons served by the program receive the training, orientation,
383.36and supervision necessary to fulfill their responsibilities. The license holder must ensure
384.1that a background study has been completed according to the requirements in sections
384.2245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation
384.3that the applicable requirements have been met.
384.4    Subd. 8. Staff orientation and training plan. The license holder must develop
384.5a staff orientation and training plan documenting when and how compliance with
384.6subdivisions 4, 4a, and 5 will be met.
384.7EFFECTIVE DATE.This section is effective January 1, 2014.

384.8    Sec. 33. [245D.091] INTERVENTION SERVICES.
384.9    Subdivision 1. Licensure requirements. An individual meeting the staff
384.10qualification requirements of this section who is an employee of a program licensed
384.11according to this chapter and providing behavioral support services, specialist services,
384.12or crisis respite services is not required to hold a separate license under this chapter.
384.13An individual meeting the staff qualifications of this section who is not providing these
384.14services as an employee of a program licensed according to this chapter must obtain a
384.15license according to this chapter.
384.16    Subd. 2. Behavior professional qualifications. A behavior professional, as defined
384.17in the brain injury and community alternatives for disabled individuals waiver plans or
384.18successor plans, must have competencies in areas related to:
384.19(1) ethical considerations;
384.20(2) functional assessment;
384.21(3) functional analysis;
384.22(4) measurement of behavior and interpretation of data;
384.23(5) selecting intervention outcomes and strategies;
384.24(6) behavior reduction and elimination strategies that promote least restrictive
384.25approved alternatives;
384.26(7) data collection;
384.27(8) staff and caregiver training;
384.28(9) support plan monitoring;
384.29(10) co-occurring mental disorders or neuro-cognitive disorder;
384.30(11) demonstrated expertise with populations being served; and
384.31(12) must be a:
384.32(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the
384.33Board of Psychology competencies in the above identified areas;
384.34(ii) clinical social worker licensed as an independent clinical social worker under
384.35chapter 148D, or a person with a master's degree in social work from an accredited college
385.1or university, with at least 4,000 hours of post-master's supervised experience in the
385.2delivery of clinical services in the areas identified in clauses (1) to (11);
385.3(iii) physician licensed under chapter 147 and certified by the American Board
385.4of Psychiatry and Neurology or eligible for board certification in psychiatry with
385.5competencies in the areas identified in clauses (1) to (11);
385.6(iv) licensed professional clinical counselor licensed under sections 148B.29 to
385.7148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery
385.8of clinical services who has demonstrated competencies in the areas identified in clauses
385.9(1) to (11);
385.10(v) person with a master's degree from an accredited college or university in one
385.11of the behavioral sciences or related fields, with at least 4,000 hours of post-master's
385.12supervised experience in the delivery of clinical services with demonstrated competencies
385.13in the areas identified in clauses (1) to (11); or
385.14(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is
385.15certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
385.16mental health nursing by a national nurse certification organization, or who has a master's
385.17degree in nursing or one of the behavioral sciences or related fields from an accredited
385.18college or university or its equivalent, with at least 4,000 hours of post-master's supervised
385.19experience in the delivery of clinical services.
385.20    Subd. 3. Behavior analyst qualifications. (a) A behavior analyst, as defined in
385.21the brain injury and community alternatives for disabled individuals waiver plans or
385.22successor plans, must:
385.23(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
385.24discipline; or
385.25(2) meet the qualifications of a mental health practitioner as defined in section
385.26245.462, subdivision 17.
385.27(b) In addition, a behavior analyst must:
385.28(1) have four years of supervised experience working with individuals who exhibit
385.29challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder;
385.30(2) have received ten hours of instruction in functional assessment and functional
385.31analysis;
385.32(3) have received 20 hours of instruction in the understanding of the function of
385.33behavior;
385.34(4) have received ten hours of instruction on design of positive practices behavior
385.35support strategies;
386.1(5) have received 20 hours of instruction on the use of behavior reduction approved
386.2strategies used only in combination with behavior positive practices strategies;
386.3(6) be determined by a behavior professional to have the training and prerequisite
386.4skills required to provide positive practice strategies as well as behavior reduction
386.5approved and permitted intervention to the person who receives behavioral support; and
386.6(7) be under the direct supervision of a behavior professional.
386.7    Subd. 4. Behavior specialist qualifications. (a) A behavior specialist, as defined
386.8in the brain injury and community alternatives for disabled individuals waiver plans or
386.9successor plans, must meet the following qualifications:
386.10(1) have an associate's degree in a social services discipline; or
386.11(2) have two years of supervised experience working with individuals who exhibit
386.12challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder.
386.13(b) In addition, a behavior specialist must:
386.14(1) have received a minimum of four hours of training in functional assessment;
386.15(2) have received 20 hours of instruction in the understanding of the function of
386.16behavior;
386.17(3) have received ten hours of instruction on design of positive practices behavioral
386.18support strategies;
386.19(4) be determined by a behavior professional to have the training and prerequisite
386.20skills required to provide positive practices strategies as well as behavior reduction
386.21approved intervention to the person who receives behavioral support; and
386.22(5) be under the direct supervision of a behavior professional.
386.23    Subd. 5. Specialist services qualifications. An individual providing specialist
386.24services, as defined in the developmental disabilities waiver plan or successor plan, must
386.25have:
386.26(1) the specific experience and skills required of the specialist to meet the needs of
386.27the person identified by the person's service planning team; and
386.28(2) the qualifications of the specialist identified in the person's coordinated service
386.29and support plan.
386.30EFFECTIVE DATE.This section is effective January 1, 2014.

386.31    Sec. 34. [245D.095] RECORD REQUIREMENTS.
386.32    Subdivision 1. Record-keeping systems. The license holder must ensure that the
386.33content and format of service recipient, personnel, and program records are uniform and
386.34legible according to the requirements of this chapter.
387.1    Subd. 2. Admission and discharge register. The license holder must keep a written
387.2or electronic register, listing in chronological order the dates and names of all persons
387.3served by the program who have been admitted, discharged, or transferred, including
387.4service terminations initiated by the license holder and deaths.
387.5    Subd. 3. Service recipient record. (a) The license holder must maintain a record of
387.6current services provided to each person on the premises where the services are provided
387.7or coordinated. When the services are provided in a licensed facility, the records must
387.8be maintained at the facility, otherwise the records must be maintained at the license
387.9holder's program office. The license holder must protect service recipient records against
387.10loss, tampering, or unauthorized disclosure according to the requirements in sections
387.1113.01 to 13.10 and 13.46.
387.12(b) The license holder must maintain the following information for each person:
387.13(1) an admission form signed by the person or the person's legal representative
387.14that includes:
387.15(i) identifying information, including the person's name, date of birth, address,
387.16and telephone number; and
387.17(ii) the name, address, and telephone number of the person's legal representative, if
387.18any, and a primary emergency contact, the case manager, and family members or others as
387.19identified by the person or case manager;
387.20(2) service information, including service initiation information, verification of the
387.21person's eligibility for services, documentation verifying that services have been provided
387.22as identified in the coordinated service and support plan or coordinated service and support
387.23plan addendum according to paragraph (a), and date of admission or readmission;
387.24(3) health information, including medical history, special dietary needs, and
387.25allergies, and when the license holder is assigned responsibility for meeting the person's
387.26health service needs according to section 245D.05:
387.27(i) current orders for medication, treatments, or medical equipment and a signed
387.28authorization from the person or the person's legal representative to administer or assist in
387.29administering the medication or treatments, if applicable;
387.30(ii) a signed statement authorizing the license holder to act in a medical emergency
387.31when the person's legal representative, if any, cannot be reached or is delayed in arriving;
387.32(iii) medication administration procedures;
387.33(iv) a medication administration record documenting the implementation of the
387.34medication administration procedures, and the medication administration record reviews,
387.35including any agreements for administration of injectable medications by the license
387.36holder according to the requirements in section 245D.05; and
388.1(v) a medical appointment schedule when the license holder is assigned
388.2responsibility for assisting with medical appointments;
388.3(4) the person's current coordinated service and support plan or that portion of the
388.4plan assigned to the license holder;
388.5(5) copies of the individual abuse prevention plan and assessments as required under
388.6section 245D.071, subdivisions 2 and 3;
388.7(6) a record of other service providers serving the person when the person's
388.8coordinated service and support plan or coordinated service and support plan addendum
388.9identifies the need for coordination between the service providers, that includes a contact
388.10person and telephone numbers, services being provided, and names of staff responsible for
388.11coordination;
388.12(7) documentation of orientation to service recipient rights according to section
388.13245D.04, subdivision 1, and maltreatment reporting policies and procedures according to
388.14section 245A.65, subdivision 1, paragraph (c);
388.15(8) copies of authorizations to handle a person's funds, according to section 245D.06,
388.16subdivision 4, paragraph (a);
388.17(9) documentation of complaints received and grievance resolution;
388.18(10) incident reports involving the person, required under section 245D.06,
388.19subdivision 1;
388.20(11) copies of written reports regarding the person's status when requested according
388.21to section 245D.07, subdivision 3, progress review reports as required under section
388.22245D.071, subdivision 5, progress or daily log notes that are recorded by the program,
388.23and reports received from other agencies involved in providing services or care to the
388.24person; and
388.25(12) discharge summary, including service termination notice and related
388.26documentation, when applicable.
388.27    Subd. 4. Access to service recipient records. The license holder must ensure that
388.28the following people have access to the information in subdivision 1 in accordance with
388.29applicable state and federal laws, regulations, or rules:
388.30(1) the person, the person's legal representative, and anyone properly authorized
388.31by the person;
388.32(2) the person's case manager;
388.33(3) staff providing services to the person unless the information is not relevant to
388.34carrying out the coordinated service and support plan or coordinated service and support
388.35plan addendum; and
389.1(4) the county child or adult foster care licensor, when services are also licensed as
389.2child or adult foster care.
389.3    Subd. 5. Personnel records. (a) The license holder must maintain a personnel
389.4record of each employee to document and verify staff qualifications, orientation, and
389.5training. The personnel record must include:
389.6(1) the employee's date of hire, completed application, an acknowledgement signed
389.7by the employee that job duties were reviewed with the employee and the employee
389.8understands those duties, and documentation that the employee meets the position
389.9requirements as determined by the license holder;
389.10 (2) documentation of staff qualifications, orientation, training, and performance
389.11evaluations as required under section 245D.09, subdivisions 3 to 5, including the date
389.12the training was completed, the number of hours per subject area, and the name of the
389.13trainer or instructor; and
389.14(3) a completed background study as required under chapter 245C.
389.15(b) For employees hired after January 1, 2014, the license holder must maintain
389.16documentation in the personnel record or elsewhere, sufficient to determine the date of the
389.17employee's first supervised direct contact with a person served by the program, and the
389.18date of first unsupervised direct contact with a person served by the program.
389.19EFFECTIVE DATE.This section is effective January 1, 2014.

389.20    Sec. 35. Minnesota Statutes 2012, section 245D.10, is amended to read:
389.21245D.10 POLICIES AND PROCEDURES.
389.22    Subdivision 1. Policy and procedure requirements. The A license holder
389.23 providing either basic or intensive supports and services must establish, enforce, and
389.24maintain policies and procedures as required in this chapter, chapter 245A, and other
389.25applicable state and federal laws and regulations governing the provision of home and
389.26community-based services licensed according to this chapter.
389.27    Subd. 2. Grievances. The license holder must establish policies and procedures
389.28that provide promote service recipient rights by providing a simple complaint process for
389.29persons served by the program and their authorized representatives to bring a grievance that:
389.30(1) provides staff assistance with the complaint process when requested, and the
389.31addresses and telephone numbers of outside agencies to assist the person;
389.32(2) allows the person to bring the complaint to the highest level of authority in the
389.33program if the grievance cannot be resolved by other staff members, and that provides
389.34the name, address, and telephone number of that person;
390.1(3) requires the license holder to promptly respond to all complaints affecting a
390.2person's health and safety. For all other complaints, the license holder must provide an
390.3initial response within 14 calendar days of receipt of the complaint. All complaints must
390.4be resolved within 30 calendar days of receipt or the license holder must document the
390.5reason for the delay and a plan for resolution;
390.6(4) requires a complaint review that includes an evaluation of whether:
390.7(i) related policies and procedures were followed and adequate;
390.8(ii) there is a need for additional staff training;
390.9(iii) the complaint is similar to past complaints with the persons, staff, or services
390.10involved; and
390.11(iv) there is a need for corrective action by the license holder to protect the health
390.12and safety of persons receiving services;
390.13(5) based on the review in clause (4), requires the license holder to develop,
390.14document, and implement a corrective action plan designed to correct current lapses and
390.15prevent future lapses in performance by staff or the license holder, if any;
390.16(6) provides a written summary of the complaint and a notice of the complaint
390.17resolution to the person and case manager that:
390.18(i) identifies the nature of the complaint and the date it was received;
390.19(ii) includes the results of the complaint review;
390.20(iii) identifies the complaint resolution, including any corrective action; and
390.21(7) requires that the complaint summary and resolution notice be maintained in the
390.22service recipient record.
390.23    Subd. 3. Service suspension and service termination. (a) The license holder must
390.24establish policies and procedures for temporary service suspension and service termination
390.25that promote continuity of care and service coordination with the person and the case
390.26manager and with other licensed caregivers, if any, who also provide support to the person.
390.27(b) The policy must include the following requirements:
390.28(1) the license holder must notify the person or the person's legal representative and
390.29case manager in writing of the intended termination or temporary service suspension, and
390.30the person's right to seek a temporary order staying the termination of service according to
390.31the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
390.32(2) notice of the proposed termination of services, including those situations
390.33that began with a temporary service suspension, must be given at least 60 days before
390.34the proposed termination is to become effective when a license holder is providing
390.35independent living skills training, structured day, prevocational or supported employment
390.36services to the person intensive supports and services identified in section 245D.03,
391.1subdivision 1, paragraph (c), and 30 days prior to termination for all other services
391.2licensed under this chapter;
391.3(3) the license holder must provide information requested by the person or case
391.4manager when services are temporarily suspended or upon notice of termination;
391.5(4) prior to giving notice of service termination or temporary service suspension,
391.6the license holder must document actions taken to minimize or eliminate the need for
391.7service suspension or termination;
391.8(5) during the temporary service suspension or service termination notice period,
391.9the license holder will work with the appropriate county agency to develop reasonable
391.10alternatives to protect the person and others;
391.11(6) the license holder must maintain information about the service suspension or
391.12termination, including the written termination notice, in the service recipient record; and
391.13(7) the license holder must restrict temporary service suspension to situations in
391.14which the person's behavior causes immediate and serious danger to the health and safety
391.15of the person or others conduct poses an imminent risk of physical harm to self or others
391.16and less restrictive or positive support strategies would not achieve safety.
391.17    Subd. 4. Availability of current written policies and procedures. (a) The license
391.18holder must review and update, as needed, the written policies and procedures required
391.19under this chapter.
391.20(b)(1) The license holder must inform the person and case manager of the policies
391.21and procedures affecting a person's rights under section 245D.04, and provide copies of
391.22those policies and procedures, within five working days of service initiation.
391.23(2) If a license holder only provides basic services and supports, this includes the:
391.24(i) grievance policy and procedure required under subdivision 2; and
391.25(ii) service suspension and termination policy and procedure required under
391.26subdivision 3.
391.27(3) For all other license holders this includes the:
391.28(i) policies and procedures in clause (2);
391.29(ii) emergency use of manual restraints policy and procedure required under section
391.30245D.061, subdivision 10; and
391.31(iii) data privacy requirements under section 245D.11, subdivision 3.
391.32(c) The license holder must provide a written notice to all persons or their legal
391.33representatives and case managers at least 30 days before implementing any revised
391.34policies and procedures procedural revisions to policies affecting a person's service-related
391.35or protection-related rights under section 245D.04 and maltreatment reporting policies and
391.36procedures. The notice must explain the revision that was made and include a copy of the
392.1revised policy and procedure. The license holder must document the reason reasonable
392.2cause for not providing the notice at least 30 days before implementing the revisions.
392.3(d) Before implementing revisions to required policies and procedures, the license
392.4holder must inform all employees of the revisions and provide training on implementation
392.5of the revised policies and procedures.
392.6(e) The license holder must annually notify all persons, or their legal representatives,
392.7and case managers of any procedural revisions to policies required under this chapter,
392.8other than those in paragraph (c). Upon request, the license holder must provide the
392.9person, or the person's legal representative, and case manager with copies of the revised
392.10policies and procedures.
392.11EFFECTIVE DATE.This section is effective January 1, 2014.

392.12    Sec. 36. [245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT
392.13SERVICES.
392.14    Subdivision 1. Policy and procedure requirements. A license holder providing
392.15intensive support services as identified in section 245D.03, subdivision 1, paragraph (c),
392.16must establish, enforce, and maintain policies and procedures as required in this section.
392.17    Subd. 2. Health and safety. The license holder must establish policies and
392.18procedures that promote health and safety by ensuring:
392.19(1) use of universal precautions and sanitary practices in compliance with section
392.20245D.06, subdivision 2, clause (5);
392.21(2) if the license holder operates a residential program, health service coordination
392.22and care according to the requirements in section 245D.05, subdivision 1;
392.23(3) safe medication assistance and administration according to the requirements
392.24in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in
392.25consultation with a registered nurse, nurse practitioner, physician's assistant, or medical
392.26doctor and require completion of medication administration training according to the
392.27requirements in section 245D.09, subdivision 4a, paragraph (d). Medication assistance
392.28and administration includes, but is not limited to:
392.29(i) providing medication-related services for a person;
392.30(ii) medication setup;
392.31(iii) medication administration;
392.32(iv) medication storage and security;
392.33(v) medication documentation and charting;
392.34(vi) verification and monitoring of effectiveness of systems to ensure safe medication
392.35handling and administration;
393.1(vii) coordination of medication refills;
393.2(viii) handling changes to prescriptions and implementation of those changes;
393.3(ix) communicating with the pharmacy; and
393.4(x) coordination and communication with prescriber;
393.5(4) safe transportation, when the license holder is responsible for transportation of
393.6persons, with provisions for handling emergency situations according to the requirements
393.7in section 245D.06, subdivision 2, clauses (2) to (4);
393.8(5) a plan for ensuring the safety of persons served by the program in emergencies as
393.9defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies
393.10to the license holder. A license holder with a community residential setting or a day service
393.11facility license must ensure the policy and procedures comply with the requirements in
393.12section 245D.22, subdivision 4;
393.13(6) a plan for responding to all incidents as defined in section 245D.02, subdivision
393.1411; and reporting all incidents required to be reported according to section 245D.06,
393.15subdivision 1. The plan must:
393.16(i) provide the contact information of a source of emergency medical care and
393.17transportation; and
393.18(ii) require staff to first call 911 when the staff believes a medical emergency may be
393.19life threatening, or to call the mental health crisis intervention team when the person is
393.20experiencing a mental health crisis; and
393.21(7) a procedure for the review of incidents and emergencies to identify trends or
393.22patterns, and corrective action if needed. The license holder must establish and maintain
393.23a record-keeping system for the incident and emergency reports. Each incident and
393.24emergency report file must contain a written summary of the incident. The license holder
393.25must conduct a review of incident reports for identification of incident patterns, and
393.26implementation of corrective action as necessary to reduce occurrences. Each incident
393.27report must include:
393.28(i) the name of the person or persons involved in the incident. It is not necessary
393.29to identify all persons affected by or involved in an emergency unless the emergency
393.30resulted in an incident;
393.31(ii) the date, time, and location of the incident or emergency;
393.32(iii) a description of the incident or emergency;
393.33(iv) a description of the response to the incident or emergency and whether a person's
393.34coordinated service and support plan addendum or program policies and procedures were
393.35implemented as applicable;
394.1(v) the name of the staff person or persons who responded to the incident or
394.2emergency; and
394.3(vi) the determination of whether corrective action is necessary based on the results
394.4of the review.
394.5    Subd. 3. Data privacy. The license holder must establish policies and procedures that
394.6promote service recipient rights by ensuring data privacy according to the requirements in:
394.7(1) the Minnesota Government Data Practices Act, section 13.46, and all other
394.8applicable Minnesota laws and rules in handling all data related to the services provided;
394.9and
394.10(2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the
394.11extent that the license holder performs a function or activity involving the use of protected
394.12health information as defined under Code of Federal Regulations, title 45, section 164.501,
394.13including, but not limited to, providing health care services; health care claims processing
394.14or administration; data analysis, processing, or administration; utilization review; quality
394.15assurance; billing; benefit management; practice management; repricing; or as otherwise
394.16provided by Code of Federal Regulations, title 45, section 160.103. The license holder
394.17must comply with the Health Insurance Portability and Accountability Act of 1996 and
394.18its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164,
394.19and all applicable requirements.
394.20    Subd. 4. Admission criteria. The license holder must establish policies and
394.21procedures that promote continuity of care by ensuring that admission or service initiation
394.22criteria:
394.23(1) is consistent with the license holder's registration information identified in the
394.24requirements in section 245D.031, subdivision 2, and with the service-related rights
394.25identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8);
394.26(2) identifies the criteria to be applied in determining whether the license holder
394.27can develop services to meet the needs specified in the person's coordinated service and
394.28support plan;
394.29(3) requires a license holder providing services in a health care facility to comply
394.30with the requirements in section 243.166, subdivision 4b, to provide notification to
394.31residents when a registered predatory offender is admitted into the program or to a
394.32potential admission when the facility was already serving a registered predatory offender.
394.33For purposes of this clause, "health care facility" means a facility licensed by the
394.34commissioner as a residential facility under chapter 245A to provide adult foster care or
394.35residential services to persons with disabilities; and
395.1(4) requires that when a person or the person's legal representative requests services
395.2from the license holder, a refusal to admit the person must be based on an evaluation of
395.3the person's assessed needs and the license holder's lack of capacity to meet the needs of
395.4the person. The license holder must not refuse to admit a person based solely on the
395.5type of residential services the person is receiving, or solely on the person's severity of
395.6disability, orthopedic or neurological handicaps, sight or hearing impairments, lack of
395.7communication skills, physical disabilities, toilet habits, behavioral disorders, or past
395.8failure to make progress. Documentation of the basis for refusal must be provided to the
395.9person or the person's legal representative and case manager upon request.
395.10EFFECTIVE DATE.This section is effective January 1, 2014.

395.11    Sec. 37. [245D.21] FACILITY LICENSURE REQUIREMENTS AND
395.12APPLICATION PROCESS.
395.13    Subdivision 1. Community residential settings and day service facilities. For
395.14purposes of this section, "facility" means both a community residential setting and day
395.15service facility and the physical plant.
395.16    Subd. 2. Inspections and code compliance. (a) Physical plants must comply with
395.17applicable state and local fire, health, building, and zoning codes.
395.18(b)(1) The facility must be inspected by a fire marshal or their delegate within
395.1912 months before initial licensure to verify that it meets the applicable occupancy
395.20requirements as defined in the State Fire Code and that the facility complies with the fire
395.21safety standards for that occupancy code contained in the State Fire Code.
395.22(2) The fire marshal inspection of a community residential setting must verify the
395.23residence is a dwelling unit within a residential occupancy as defined in section 9.117 of
395.24the State Fire Code. A home safety checklist, approved by the commissioner, must be
395.25completed for a community residential setting by the license holder and the commissioner
395.26before the satellite license is reissued.
395.27(3) The facility shall be inspected according to the facility capacity specified on the
395.28initial application form.
395.29(4) If the commissioner has reasonable cause to believe that a potentially hazardous
395.30condition may be present or the licensed capacity is increased, the commissioner shall
395.31request a subsequent inspection and written report by a fire marshal to verify the absence
395.32of hazard.
395.33(5) Any condition cited by a fire marshal, building official, or health authority as
395.34hazardous or creating an immediate danger of fire or threat to health and safety must be
396.1corrected before a license is issued by the department, and for community residential
396.2settings, before a license is reissued.
396.3(c) The facility must maintain in a permanent file the reports of health, fire, and
396.4other safety inspections.
396.5(d) The facility's plumbing, ventilation, heating, cooling, lighting, and other
396.6fixtures and equipment, including elevators or food service, if provided, must conform to
396.7applicable health, sanitation, and safety codes and regulations.
396.8EFFECTIVE DATE.This section is effective January 1, 2014.

396.9    Sec. 38. [245D.22] FACILITY SANITATION AND HEALTH.
396.10    Subdivision 1. General maintenance. The license holder must maintain the interior
396.11and exterior of buildings, structures, or enclosures used by the facility, including walls,
396.12floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a
396.13sanitary and safe condition. The facility must be clean and free from accumulations of
396.14dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must
396.15correct building and equipment deterioration, safety hazards, and unsanitary conditions.
396.16    Subd. 2. Hazards and toxic substances. The license holder must ensure that
396.17service sites owned or leased by the license holder are free from hazards that would
396.18threaten the health or safety of a person receiving services by ensuring the requirements
396.19in paragraphs (a) to (g) are met.
396.20(a) Chemicals, detergents, and other hazardous or toxic substances must not be
396.21stored with food products or in any way that poses a hazard to persons receiving services.
396.22(b) The license holder must install handrails and nonslip surfaces on interior and
396.23exterior runways, stairways, and ramps according to the applicable building code.
396.24(c) If there are elevators in the facility, the license holder must have elevators
396.25inspected each year. The date of the inspection, any repairs needed, and the date the
396.26necessary repairs were made must be documented.
396.27(d) The license holder must keep stairways, ramps, and corridors free of obstructions.
396.28(e) Outside property must be free from debris and safety hazards. Exterior stairs and
396.29walkways must be kept free of ice and snow.
396.30(f) Heating, ventilation, air conditioning units, and other hot surfaces and moving
396.31parts of machinery must be shielded or enclosed.
396.32(g) Use of dangerous items or equipment by persons served by the program must be
396.33allowed in accordance with the person's coordinated service and support plan addendum
396.34or the program abuse prevention plan, if not addressed in the coordinated service and
396.35support plan addendum.
397.1    Subd. 3. Storage and disposal of medication. Schedule II controlled substances in
397.2the facility that are named in section 152.02, subdivision 3, must be stored in a locked
397.3storage area permitting access only by persons and staff authorized to administer the
397.4medication. This must be incorporated into the license holder's medication administration
397.5policy and procedures required under section 245D.11, subdivision 2, clause (3).
397.6Medications must be disposed of according to the Environmental Protection Agency
397.7recommendations.
397.8    Subd. 4. First aid must be available on site. (a) A staff person trained in first
397.9aid must be available on site and, when required in a person's coordinated service and
397.10support plan or coordinated service and support plan addendum, be able to provide
397.11cardiopulmonary resuscitation, whenever persons are present and staff are required to be
397.12at the site to provide direct service. The CPR training must include in-person instruction,
397.13hands-on practice, and an observed skills assessment under the direct supervision of a
397.14CPR instructor.
397.15(b) A facility must have first aid kits readily available for use by, and that meet
397.16the needs of, persons receiving services and staff. At a minimum, the first aid kit must
397.17be equipped with accessible first aid supplies including bandages, sterile compresses,
397.18scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap,
397.19adhesive tape, and first aid manual.
397.20    Subd. 5. Emergencies. (a) The license holder must have a written plan for
397.21responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the
397.22safety of persons served in the facility. The plan must include:
397.23(1) procedures for emergency evacuation and emergency sheltering, including:
397.24(i) how to report a fire or other emergency;
397.25(ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive
397.26procedures or equipment to assist with the safe evacuation of persons with physical or
397.27sensory disabilities; and
397.28(iii) instructions on closing off the fire area, using fire extinguishers, and activating
397.29and responding to alarm systems;
397.30(2) a floor plan that identifies:
397.31(i) the location of fire extinguishers;
397.32(ii) the location of audible or visual alarm systems, including but not limited to
397.33manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and
397.34sprinkler systems;
397.35(iii) the location of exits, primary and secondary evacuation routes, and accessible
397.36egress routes, if any; and
398.1(iv) the location of emergency shelter within the facility;
398.2(3) a site plan that identifies:
398.3(i) designated assembly points outside the facility;
398.4(ii) the locations of fire hydrants; and
398.5(iii) the routes of fire department access;
398.6(4) the responsibilities each staff person must assume in case of emergency;
398.7(5) procedures for conducting quarterly drills each year and recording the date of
398.8each drill in the file of emergency plans;
398.9(6) procedures for relocation or service suspension when services are interrupted
398.10for more than 24 hours;
398.11(7) for a community residential setting with three or more dwelling units, a floor
398.12plan that identifies the location of enclosed exit stairs; and
398.13(8) an emergency escape plan for each resident.
398.14(b) The license holder must:
398.15(1) maintain a log of quarterly fire drills on file in the facility;
398.16(2) provide an emergency response plan that is readily available to staff and persons
398.17receiving services;
398.18(3) inform each person of a designated area within the facility where the person
398.19should go for emergency shelter during severe weather and the designated assembly points
398.20outside the facility; and
398.21(4) maintain emergency contact information for persons served at the facility that
398.22can be readily accessed in an emergency.
398.23    Subd. 6. Emergency equipment. The facility must have a flashlight and a portable
398.24radio or television set that do not require electricity and can be used if a power failure
398.25occurs.
398.26    Subd. 7. Telephone and posted numbers. A facility must have a non-coin operated
398.27telephone that is readily accessible. A list of emergency numbers must be posted in a
398.28prominent location. When an area has a 911 number or a mental health crisis intervention
398.29team number, both numbers must be posted and the emergency number listed must be
398.30911. In areas of the state without a 911 number, the numbers listed must be those of the
398.31local fire department, police department, emergency transportation, and poison control
398.32center. The names and telephone numbers of each person's representative, physician, and
398.33dentist must be readily available.
398.34EFFECTIVE DATE.This section is effective January 1, 2014.

399.1    Sec. 39. [245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE
399.2LICENSURE REQUIREMENTS AND APPLICATION PROCESS.
399.3    Subdivision 1. Separate satellite license required for separate sites. (a) A license
399.4holder providing residential support services must obtain a separate satellite license for
399.5each community residential setting located at separate addresses when the community
399.6residential settings are to be operated by the same license holder. For purposes of this
399.7chapter, a community residential setting is a satellite of the home and community-based
399.8services license.
399.9(b) Community residential settings are permitted single-family use homes. After a
399.10license has been issued, the commissioner shall notify the local municipality where the
399.11residence is located of the approved license.
399.12    Subd. 2. Notification to local agency. The license holder must notify the local
399.13agency within 24 hours of the onset of changes in a residence resulting from construction,
399.14remodeling, or damages requiring repairs that require a building permit or may affect a
399.15licensing requirement in this chapter.
399.16    Subd. 3. Alternate overnight supervision. A license holder granted an alternate
399.17overnight supervision technology adult foster care license according to section 245A.11,
399.18subdivision 7a, that converts to a community residential setting satellite license according
399.19to this chapter, must retain that designation.
399.20EFFECTIVE DATE.This section is effective January 1, 2014.

399.21    Sec. 40. [245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL
399.22PLANT AND ENVIRONMENT.
399.23    Subdivision 1. Occupancy. The residence must meet the definition of a dwelling
399.24unit in a residential occupancy.
399.25    Subd. 2. Common area requirements. The living area must be provided with an
399.26adequate number of furnishings for the usual functions of daily living and social activities.
399.27The dining area must be furnished to accommodate meals shared by all persons living in
399.28the residence. These furnishings must be in good repair and functional to meet the daily
399.29needs of the persons living in the residence.
399.30    Subd. 3. Bedrooms. (a) People receiving services must mutually consent, in
399.31writing, to sharing a bedroom with one another. No more than two people receiving
399.32services may share one bedroom.
399.33(b) A single occupancy bedroom must have at least 80 square feet of floor space with
399.34a 7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor
399.35space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and
400.1other habitable rooms by floor to ceiling walls containing no openings except doorways
400.2and must not serve as a corridor to another room used in daily living.
400.3(c) A person's personal possessions and items for the person's own use are the only
400.4items permitted to be stored in a person's bedroom.
400.5(d) Unless otherwise documented through assessment as a safety concern for the
400.6person, each person must be provided with the following furnishings:
400.7(1) a separate bed of proper size and height for the convenience and comfort of the
400.8person, with a clean mattress in good repair;
400.9(2) clean bedding appropriate for the season for each person;
400.10(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal
400.11possessions and clothing; and
400.12(4) a mirror for grooming.
400.13(e) When possible, a person must be allowed to have items of furniture that the
400.14person personally owns in the bedroom, unless doing so would interfere with safety
400.15precautions, violate a building or fire code, or interfere with another person's use of the
400.16bedroom. A person may choose not to have a cabinet, dresser, shelves, or a mirror in the
400.17bedroom, as otherwise required under paragraph (d), clause (3) or (4). A person may
400.18choose to use a mattress other than an innerspring mattress and may choose not to have
400.19the mattress on a mattress frame or support. If a person chooses not to have a piece of
400.20required furniture, the license holder must document this choice and is not required to
400.21provide the item. If a person chooses to use a mattress other than an innerspring mattress
400.22or chooses not to have a mattress frame or support, the license holder must document this
400.23choice and allow the alternative desired by the person.
400.24(f) A person must be allowed to bring personal possessions into the bedroom
400.25and other designated storage space, if such space is available, in the residence. The
400.26person must be allowed to accumulate possessions to the extent the residence is able to
400.27accommodate them, unless doing so is contraindicated for the person's physical or mental
400.28health, would interfere with safety precautions or another person's use of the bedroom, or
400.29would violate a building or fire code. The license holder must allow for locked storage
400.30of personal items. Any restriction on the possession or locked storage of personal items,
400.31including requiring a person to use a lock provided by the license holder, must comply
400.32with section 245D.04, subdivision 3, paragraph (c), and allow the person to be present if
400.33and when the license holder opens the lock.
400.34EFFECTIVE DATE.This section is effective January 1, 2014.

401.1    Sec. 41. [245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND
401.2WATER.
401.3    Subdivision 1. Water. Potable water from privately owned wells must be tested
401.4annually by a Department of Health-certified laboratory for coliform bacteria and nitrate
401.5nitrogens to verify safety. The health authority may require retesting and corrective
401.6measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in
401.7the event of flooding or an incident which may put the well at risk of contamination. To
401.8prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.
401.9    Subd. 2. Food. Food served must meet any special dietary needs of a person as
401.10prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day
401.11must be served or made available to persons, and nutritious snacks must be available
401.12between meals.
401.13    Subd. 3. Food safety. Food must be obtained, handled, and properly stored to
401.14prevent contamination, spoilage, or a threat to the health of a person.
401.15EFFECTIVE DATE.This section is effective January 1, 2014.

401.16    Sec. 42. [245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION
401.17AND HEALTH.
401.18    Subdivision 1. Goods provided by the license holder. Individual clean bed linens
401.19appropriate for the season and the person's comfort, including towels and wash cloths,
401.20must be available for each person. Usual or customary goods for the operation of a
401.21residence which are communally used by all persons receiving services living in the
401.22residence must be provided by the license holder, including household items for meal
401.23preparation, cleaning supplies to maintain the cleanliness of the residence, window
401.24coverings on windows for privacy, toilet paper, and hand soap.
401.25    Subd. 2. Personal items. Personal health and hygiene items must be stored in a
401.26safe and sanitary manner.
401.27    Subd. 3. Pets and service animals. Pets and service animals housed within
401.28the residence must be immunized and maintained in good health as required by local
401.29ordinances and state law. The license holder must ensure that the person and the person's
401.30representative are notified before admission of the presence of pets in the residence.
401.31    Subd. 4. Smoking in the residence. License holders must comply with the
401.32requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when
401.33smoking is permitted in the residence.
401.34    Subd. 5. Weapons. Weapons and ammunition must be stored separately in locked
401.35areas that are inaccessible to a person receiving services. For purposes of this subdivision,
402.1"weapons" means firearms and other instruments or devices designed for and capable of
402.2producing bodily harm.
402.3EFFECTIVE DATE.This section is effective January 1, 2014.

402.4    Sec. 43. [245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE
402.5REQUIREMENTS AND APPLICATION PROCESS.
402.6Except for day service facilities on the same or adjoining lot, the license holder
402.7providing day services must apply for a separate license for each facility-based service
402.8site when the license holder is the owner, lessor, or tenant of the service site at which
402.9persons receive day services and the license holder's employees who provide day services
402.10are present for a cumulative total of more than 30 days within any 12-month period. For
402.11purposes of this chapter, a day services facility license is a satellite license of the day
402.12services program. A day services program may operate multiple licensed day service
402.13facilities in one or more counties in the state. For the purposes of this section, "adjoining
402.14lot" means day services facilities that are next door to or across the street from one another.
402.15EFFECTIVE DATE.This section is effective January 1, 2014.

402.16    Sec. 44. [245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND
402.17SPACE REQUIREMENTS.
402.18    Subdivision 1. Facility capacity and useable space requirements. (a) The facility
402.19capacity of each day service facility must be determined by the amount of primary space
402.20available, the scheduling of activities at other service sites, and the space requirements of
402.21all persons receiving services at the facility, not just the licensed services. The facility
402.22capacity must specify the maximum number of persons that may receive services on
402.23site at any one time.
402.24(b) When a facility is located in a multifunctional organization, the facility may
402.25share common space with the multifunctional organization if the required available
402.26primary space for use by persons receiving day services is maintained while the facility is
402.27operating. The license holder must comply at all times with all applicable fire and safety
402.28codes under section 245A.04, subdivision 2a, and adequate supervision requirements
402.29under section 245D.31 for all persons receiving day services.
402.30(c) A day services facility must have a minimum of 40 square feet of primary space
402.31available for each person receiving services who is present at the site at any one time.
402.32Primary space does not include:
403.1(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms,
403.2and kitchens;
403.3(2) floor areas beneath stationary equipment; or
403.4(3) any space occupied by persons associated with the multifunctional organization
403.5while persons receiving day services are using common space.
403.6    Subd. 2. Individual personal articles. Each person must be provided space in a
403.7closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own
403.8use while receiving services at the facility, unless doing so would interfere with safety
403.9precautions, another person's work space, or violate a building or fire code.
403.10EFFECTIVE DATE.This section is effective January 1, 2014.

403.11    Sec. 45. [245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY
403.12REQUIREMENTS.
403.13    Subdivision 1. Refrigeration. If the license holder provides refrigeration at service
403.14sites owned or leased by the license holder for storing perishable foods and perishable
403.15portions of bag lunches, whether the foods are supplied by the license holder or the
403.16persons receiving services, the refrigeration must have a temperature of 40 degrees
403.17Fahrenheit or less.
403.18    Subd. 2. Drinking water. Drinking water must be available to all persons
403.19receiving services. If a person is unable to request or obtain drinking water, it must be
403.20provided according to that person's individual needs. Drinking water must be provided in
403.21single-service containers or from drinking fountains accessible to all persons.
403.22    Subd. 3. Individuals who become ill during the day. There must be an area in
403.23which a person receiving services can rest if:
403.24(1) the person becomes ill during the day;
403.25(2) the person does not live in a licensed residential site;
403.26(3) the person requires supervision; and
403.27(4) there is not a caretaker immediately available. Supervision must be provided
403.28until the caretaker arrives to bring the person home.
403.29    Subd. 4. Safety procedures. The license holder must establish general written
403.30safety procedures that include criteria for selecting, training, and supervising persons who
403.31work with hazardous machinery, tools, or substances. Safety procedures specific to each
403.32person's activities must be explained and be available in writing to all staff members
403.33and persons receiving services.
403.34EFFECTIVE DATE.This section is effective January 1, 2014.

404.1    Sec. 46. [245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND
404.2FACILITY COVERAGE.
404.3    Subdivision 1. Scope. This section applies only to facility-based day services.
404.4    Subd. 2. Factors. (a) The number of direct support service staff members that a
404.5license holder must have on duty at the facility at a given time to meet the minimum
404.6staffing requirements established in this section varies according to:
404.7(1) the number of persons who are enrolled and receiving direct support services
404.8at that given time;
404.9(2) the staff ratio requirement established under subdivision 3 for each person who
404.10is present; and
404.11(3) whether the conditions described in subdivision 8 exist and warrant additional
404.12staffing beyond the number determined to be needed under subdivision 7.
404.13(b) The commissioner must consider the factors in paragraph (a) in determining a
404.14license holder's compliance with the staffing requirements and must further consider
404.15whether the staff ratio requirement established under subdivision 3 for each person
404.16receiving services accurately reflects the person's need for staff time.
404.17    Subd. 3. Staff ratio requirement for each person receiving services. The case
404.18manager, in consultation with the interdisciplinary team, must determine at least once each
404.19year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving
404.20services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio
404.21assigned each person and the documentation of how the ratio was arrived at must be kept
404.22in each person's individual service plan. Documentation must include an assessment of the
404.23person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard
404.24assessment form required by the commissioner.
404.25    Subd. 4. Person requiring staff ratio of one to four. A person must be assigned a
404.26staff ratio requirement of one to four if:
404.27(1) on a daily basis the person requires total care and monitoring or constant
404.28hand-over-hand physical guidance to successfully complete at least three of the following
404.29activities: toileting, communicating basic needs, eating, ambulating; or is not capable of
404.30taking appropriate action for self-preservation under emergency conditions; or
404.31(2) the person engages in conduct that poses an imminent risk of physical harm to
404.32self or others at a documented level of frequency, intensity, or duration requiring frequent
404.33daily ongoing intervention and monitoring as established in the person's coordinated
404.34service and support plan or coordinated service and support plan addendum.
404.35    Subd. 5. Person requiring staff ratio of one to eight. A person must be assigned a
404.36staff ratio requirement of one to eight if:
405.1(1) the person does not meet the requirements in subdivision 4; and
405.2(2) on a daily basis the person requires verbal prompts or spot checks and minimal
405.3or no physical assistance to successfully complete at least four of the following activities:
405.4toileting, communicating basic needs, eating, ambulating, or taking appropriate action for
405.5self-preservation under emergency conditions.
405.6    Subd. 6. Person requiring staff ratio of one to six. A person who does not have
405.7any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio
405.8requirement of one to six.
405.9    Subd. 7. Determining number of direct support service staff required. The
405.10minimum number of direct support service staff members required at any one time to
405.11meet the combined staff ratio requirements of the persons present at that time can be
405.12determined by the following steps:
405.13(1) assign to each person in attendance the three-digit decimal below that corresponds
405.14to the staff ratio requirement assigned to that person. A staff ratio requirement of one to
405.15four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio
405.16requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100;
405.17(2) add all of the three-digit decimals (one three-digit decimal for every person in
405.18attendance) assigned in clause (1);
405.19(3) when the sum in clause (2) falls between two whole numbers, round off the sum
405.20to the larger of the two whole numbers; and
405.21(4) the larger of the two whole numbers in clause (3) equals the number of direct
405.22support service staff members needed to meet the staff ratio requirements of the persons
405.23in attendance.
405.24    Subd. 8. Staff to be included in calculating minimum staffing requirement.
405.25Only staff providing direct support must be counted as staff members in calculating
405.26the staff-to-participant ratio. A volunteer may be counted as a direct support staff in
405.27calculating the staff-to-participant ratio if the volunteer meets the same standards and
405.28requirements as paid staff. No person receiving services must be counted as or be
405.29substituted for a staff member in calculating the staff-to-participant ratio.
405.30    Subd. 9. Conditions requiring additional direct support staff. The license holder
405.31must increase the number of direct support staff members present at any one time beyond
405.32the number arrived at in subdivision 4 if necessary when any one or combination of the
405.33following circumstances can be documented by the commissioner as existing:
405.34(1) the health and safety needs of the persons receiving services cannot be met by
405.35the number of staff members available under the staffing pattern in effect even though the
405.36number has been accurately calculated under subdivision 7; or
406.1(2) the person's conduct frequently presents an imminent risk of physical harm to
406.2self or others.
406.3    Subd. 10. Supervision requirements. (a) At no time must one direct support
406.4staff member be assigned responsibility for supervision and training of more than ten
406.5persons receiving supervision and training, except as otherwise stated in each person's risk
406.6management plan.
406.7(b) In the temporary absence of the director or a supervisor, a direct support staff
406.8member must be designated to supervise the center.
406.9    Subd. 11. Multifunctional programs. A multifunctional program may count other
406.10employees of the organization besides direct support staff of the day service facility in
406.11calculating the staff-to-participant ratio if the employee is assigned to the day services
406.12facility for a specified amount of time, during which the employee is not assigned to
406.13another organization or program.
406.14EFFECTIVE DATE.This section is effective January 1, 2014.

406.15    Sec. 47. [245D.32] ALTERNATIVE LICENSING INSPECTIONS.
406.16    Subdivision 1. Eligibility for an alternative licensing inspection. (a) A license
406.17holder providing services licensed under this chapter, with a qualifying accreditation and
406.18meeting the eligibility criteria in paragraphs (b) and (c), may request approval for an
406.19alternative licensing inspection when all services provided under the license holder's
406.20license are accredited. A license holder with a qualifying accreditation and meeting
406.21the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative
406.22licensing inspection for individual community residential settings or day services facilities
406.23licensed under this chapter.
406.24(b) In order to be eligible for an alternative licensing inspection, the program must
406.25have had at least one inspection by the commissioner following issuance of the initial
406.26license. For programs operating a day services facility, each facility must have had at least
406.27one on-site inspection by the commissioner following issuance of the initial license.
406.28(c) In order to be eligible for an alternative licensing inspection, the program must
406.29have been in substantial and consistent compliance at the time of the last licensing
406.30inspection and during the current licensing period. For purposes of this section,
406.31"substantial and consistent compliance" means:
406.32(1) the license holder's license was not made conditional, suspended, or revoked;
406.33(2) there have been no substantiated allegations of maltreatment against the license
406.34holder;
407.1(3) there were no program deficiencies identified that would jeopardize the health,
407.2safety, or rights of persons being served; and
407.3(4) the license holder maintained substantial compliance with the other requirements
407.4of chapters 245A and 245C and other applicable laws and rules.
407.5(d) For the purposes of this section, the license holder's license includes services
407.6licensed under this chapter that were previously licensed under chapter 245B until
407.7December 31, 2013.
407.8    Subd. 2. Qualifying accreditation. The commissioner must accept a three-year
407.9accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF)
407.10as a qualifying accreditation.
407.11    Subd. 3. Request for approval of an alternative inspection status. (a) A request
407.12for an alternative inspection must be made on the forms and in the manner prescribed
407.13by the commissioner. When submitting the request, the license holder must submit all
407.14documentation issued by the accrediting body verifying that the license holder has obtained
407.15and maintained the qualifying accreditation and has complied with recommendations
407.16or requirements from the accrediting body during the period of accreditation. Based
407.17on the request and the additional required materials, the commissioner may approve
407.18an alternative inspection status.
407.19(b) The commissioner must notify the license holder in writing that the request for
407.20an alternative inspection status has been approved. Approval must be granted until the
407.21end of the qualifying accreditation period.
407.22(c) The license holder must submit a written request for approval to be renewed
407.23one month before the end of the current approval period according to the requirements
407.24in paragraph (a). If the license holder does not submit a request to renew approval as
407.25required, the commissioner must conduct a licensing inspection.
407.26    Subd. 4. Programs approved for alternative licensing inspection; deemed
407.27compliance licensing requirements. (a) A license holder approved for alternative
407.28licensing inspection under this section is required to maintain compliance with all
407.29licensing standards according to this chapter.
407.30(b) A license holder approved for alternative licensing inspection under this section
407.31must be deemed to be in compliance with all the requirements of this chapter, and the
407.32commissioner must not perform routine licensing inspections.
407.33(c) Upon receipt of a complaint regarding the services of a license holder approved
407.34for alternative licensing inspection under this section, the commissioner must investigate
407.35the complaint and may take any action as provided under section 245A.06 or 245A.07.
408.1    Subd. 5. Investigations of alleged or suspected maltreatment. Nothing in this
408.2section changes the commissioner's responsibilities to investigate alleged or suspected
408.3maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557.
408.4    Subd. 6. Termination or denial of subsequent approval. Following approval of
408.5an alternative licensing inspection, the commissioner may terminate or deny subsequent
408.6approval of an alternative licensing inspection if the commissioner determines that:
408.7(1) the license holder has not maintained the qualifying accreditation;
408.8(2) the commissioner has substantiated maltreatment for which the license holder or
408.9facility is determined to be responsible during the qualifying accreditation period; or
408.10(3) during the qualifying accreditation period, the license holder has been issued
408.11an order for conditional license, fine, suspension, or license revocation that has not been
408.12reversed upon appeal.
408.13    Subd. 7. Appeals. The commissioner's decision that the conditions for approval for
408.14an alternative licensing inspection have not been met is final and not subject to appeal
408.15under the provisions of chapter 14.
408.16    Subd. 8. Commissioner's programs. Home and community-based services licensed
408.17under this chapter for which the commissioner is the license holder with a qualifying
408.18accreditation are excluded from being approved for an alternative licensing inspection.
408.19EFFECTIVE DATE.This section is effective January 1, 2014.

408.20    Sec. 48. [245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS.
408.21(a) The commissioner of human services shall issue a mental health certification
408.22for services licensed under this chapter when a license holder is determined to have met
408.23the requirements under paragraph (b). This certification is voluntary for license holders.
408.24The certification shall be printed on the license and identified on the commissioner's
408.25public Web site.
408.26(b) The requirements for certification are:
408.27(1) all staff have received at least seven hours of annual training covering all of
408.28the following topics:
408.29(i) mental health diagnoses;
408.30(ii) mental health crisis response and de-escalation techniques;
408.31(iii) recovery from mental illness;
408.32(iv) treatment options, including evidence-based practices;
408.33(v) medications and their side effects;
408.34(vi) co-occurring substance abuse and health conditions; and
408.35(vii) community resources;
409.1(2) a mental health professional, as defined in section 245.462, subdivision 18, or a
409.2mental health practitioner as defined in section 245.462, subdivision 17, is available
409.3for consultation and assistance;
409.4(3) there is a plan and protocol in place to address a mental health crisis; and
409.5(4) each person's individual service and support plan identifies who is providing
409.6clinical services and their contact information, and includes an individual crisis prevention
409.7and management plan developed with the person.
409.8(c) License holders seeking certification under this section must request this
409.9certification on forms and in the manner prescribed by the commissioner.
409.10(d) If the commissioner finds that the license holder has failed to comply with the
409.11certification requirements under paragraph (b), the commissioner may issue a correction
409.12order and an order of conditional license in accordance with section 245A.06 or may
409.13issue a sanction in accordance with section 245A.07, including and up to removal of
409.14the certification.
409.15(e) A denial of the certification or the removal of the certification based on a
409.16determination that the requirements under paragraph (b) have not been met is not subject to
409.17appeal. A license holder that has been denied a certification or that has had a certification
409.18removed may again request certification when the license holder is in compliance with the
409.19requirements of paragraph (b).
409.20EFFECTIVE DATE.This section is effective January 1, 2014.

409.21    Sec. 49. Minnesota Statutes 2012, section 256B.092, subdivision 1a, is amended to read:
409.22    Subd. 1a. Case management services. (a) Each recipient of a home and
409.23community-based waiver shall be provided case management services by qualified
409.24vendors as described in the federally approved waiver application.
409.25(b) Case management service activities provided to or arranged for a person include:
409.26(1) development of the coordinated service and support plan under subdivision 1b;
409.27(2) informing the individual or the individual's legal guardian or conservator, or
409.28parent if the person is a minor, of service options;
409.29(3) consulting with relevant medical experts or service providers;
409.30(4) assisting the person in the identification of potential providers;
409.31(5) assisting the person to access services and assisting in appeals under section
409.32256.045 ;
409.33(6) coordination of services, if coordination is not provided by another service
409.34provider;
410.1(7) evaluation and monitoring of the services identified in the coordinated service
410.2and support plan, which must incorporate at least one annual face-to-face visit by the case
410.3manager with each person; and
410.4(8) reviewing coordinated service and support plans and providing the lead agency
410.5with recommendations for service authorization based upon the individual's needs
410.6identified in the coordinated service and support plan.
410.7(c) Case management service activities that are provided to the person with a
410.8developmental disability shall be provided directly by county agencies or under contract.
410.9Case management services must be provided by a public or private agency that is enrolled
410.10as a medical assistance provider determined by the commissioner to meet all of the
410.11requirements in the approved federal waiver plans. Case management services must not
410.12be provided to a recipient by a private agency that has a financial interest in the provision
410.13of any other services included in the recipient's coordinated service and support plan. For
410.14purposes of this section, "private agency" means any agency that is not identified as a lead
410.15agency under section 256B.0911, subdivision 1a, paragraph (e).
410.16(d) Case managers are responsible for service provisions listed in paragraphs (a) and
410.17(b). Case managers shall collaborate with consumers, families, legal representatives, and
410.18relevant medical experts and service providers in the development and annual review of
410.19the coordinated service and support plan and habilitation plan.
410.20(e) For persons who need a positive support transition plan as required in chapter
410.21245D, the case manager shall participate in the development and ongoing evaluation
410.22of the plan with the expanded support team. At least quarterly, the case manager, in
410.23consultation with the expanded support team, shall evaluate the effectiveness of the plan
410.24based on progress evaluation data submitted by the licensed provider to the case manager.
410.25The evaluation must identify whether the plan has been developed and implemented in a
410.26manner to achieve the following within the required timelines:
410.27(1) phasing out the use of prohibited procedures;
410.28(2) acquisition of skills needed to eliminate the prohibited procedures within the
410.29plan's timeline; and
410.30(3) accomplishment of identified outcomes.
410.31If adequate progress is not being made, the case manager shall consult with the person's
410.32expanded support team to identify needed modifications and whether additional
410.33professional support is required to provide consultation.
410.34(e) (f) The Department of Human Services shall offer ongoing education in case
410.35management to case managers. Case managers shall receive no less than ten hours of case
410.36management education and disability-related training each year.
411.1EFFECTIVE DATE.This section is effective January 1, 2014.

411.2    Sec. 50. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
411.3    Subd. 11. Residential support services. (a) Upon federal approval, there is
411.4established a new service called residential support that is available on the community
411.5alternative care, community alternatives for disabled individuals, developmental
411.6disabilities, and brain injury waivers. Existing waiver service descriptions must be
411.7modified to the extent necessary to ensure there is no duplication between other services.
411.8Residential support services must be provided by vendors licensed as a community
411.9residential setting as defined in section 245A.11, subdivision 8, a foster care setting
411.10licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care
411.11setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
411.12    (b) Residential support services must meet the following criteria:
411.13    (1) providers of residential support services must own or control the residential site;
411.14    (2) the residential site must not be the primary residence of the license holder;
411.15    (3) (1) the residential site must have a designated program supervisor person
411.16 responsible for program management, oversight, development, and implementation of
411.17policies and procedures;
411.18    (4) (2) the provider of residential support services must provide supervision, training,
411.19and assistance as described in the person's coordinated service and support plan; and
411.20    (5) (3) the provider of residential support services must meet the requirements of
411.21licensure and additional requirements of the person's coordinated service and support plan.
411.22    (c) Providers of residential support services that meet the definition in paragraph (a)
411.23must be registered using a process determined by the commissioner beginning July 1, 2009
411.24 must be licensed according to chapter 245D. Providers licensed to provide child foster care
411.25under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under
411.26Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section
411.27245A.03, subdivision 7 , paragraph (g), are considered registered under this section.

411.28    Sec. 51. Minnesota Statutes 2012, section 256B.49, subdivision 13, is amended to read:
411.29    Subd. 13. Case management. (a) Each recipient of a home and community-based
411.30waiver shall be provided case management services by qualified vendors as described
411.31in the federally approved waiver application. The case management service activities
411.32provided must include:
411.33    (1) finalizing the written coordinated service and support plan within ten working
411.34days after the case manager receives the plan from the certified assessor;
412.1    (2) informing the recipient or the recipient's legal guardian or conservator of service
412.2options;
412.3    (3) assisting the recipient in the identification of potential service providers and
412.4available options for case management service and providers;
412.5    (4) assisting the recipient to access services and assisting with appeals under section
412.6256.045 ; and
412.7    (5) coordinating, evaluating, and monitoring of the services identified in the service
412.8plan.
412.9    (b) The case manager may delegate certain aspects of the case management service
412.10activities to another individual provided there is oversight by the case manager. The case
412.11manager may not delegate those aspects which require professional judgment including:
412.12(1) finalizing the coordinated service and support plan;
412.13(2) ongoing assessment and monitoring of the person's needs and adequacy of the
412.14approved coordinated service and support plan; and
412.15(3) adjustments to the coordinated service and support plan.
412.16(c) Case management services must be provided by a public or private agency that is
412.17enrolled as a medical assistance provider determined by the commissioner to meet all of
412.18the requirements in the approved federal waiver plans. Case management services must
412.19not be provided to a recipient by a private agency that has any financial interest in the
412.20provision of any other services included in the recipient's coordinated service and support
412.21plan. For purposes of this section, "private agency" means any agency that is not identified
412.22as a lead agency under section 256B.0911, subdivision 1a, paragraph (e).
412.23(d) For persons who need a positive support transition plan as required in chapter
412.24245D, the case manager shall participate in the development and ongoing evaluation
412.25of the plan with the expanded support team. At least quarterly, the case manager, in
412.26consultation with the expanded support team, shall evaluate the effectiveness of the plan
412.27based on progress evaluation data submitted by the licensed provider to the case manager.
412.28The evaluation must identify whether the plan has been developed and implemented in a
412.29manner to achieve the following within the required timelines:
412.30(1) phasing out the use of prohibited procedures;
412.31(2) acquisition of skills needed to eliminate the prohibited procedures within the
412.32plan's timeline; and
412.33(3) accomplishment of identified outcomes.
412.34If adequate progress is not being made, the case manager shall consult with the person's
412.35expanded support team to identify needed modifications and whether additional
412.36professional support is required to provide consultation.
413.1EFFECTIVE DATE.This section is effective January 1, 2014.

413.2    Sec. 52. Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:
413.3    Subdivision 1. Provider qualifications. (a) For the home and community-based
413.4waivers providing services to seniors and individuals with disabilities under sections
413.5256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
413.6(1) agreements with enrolled waiver service providers to ensure providers meet
413.7Minnesota health care program requirements;
413.8(2) regular reviews of provider qualifications, and including requests of proof of
413.9documentation; and
413.10(3) processes to gather the necessary information to determine provider qualifications.
413.11    (b) Beginning July 1, 2012, staff that provide direct contact, as defined in section
413.12245C.02, subdivision 11 , for services specified in the federally approved waiver plans
413.13must meet the requirements of chapter 245C prior to providing waiver services and as
413.14part of ongoing enrollment. Upon federal approval, this requirement must also apply to
413.15consumer-directed community supports.
413.16    (c) Beginning January 1, 2014, service owners and managerial officials overseeing
413.17the management or policies of services that provide direct contact as specified in the
413.18federally approved waiver plans must meet the requirements of chapter 245C prior to
413.19reenrollment or, for new providers, prior to initial enrollment if they have not already done
413.20so as a part of service licensure requirements.

413.21    Sec. 53. Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:
413.22    Subd. 7. Applicant and license holder training. An applicant or license holder
413.23for the home and community-based waivers providing services to seniors and individuals
413.24with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 that is
413.25not enrolled as a Minnesota health care program home and community-based services
413.26waiver provider at the time of application must ensure that at least one controlling
413.27individual completes a onetime training on the requirements for providing home and
413.28community-based services from a qualified source as determined by the commissioner,
413.29before a provider is enrolled or license is issued. Within six months of enrollment, a
413.30newly enrolled home and community-based waiver service provider must ensure that at
413.31least one controlling individual has completed training on waiver and related program
413.32billing. Exemptions to new waiver provider training requirements may be granted, as
413.33determined by the commissioner.

414.1    Sec. 54. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
414.2subdivision to read:
414.3    Subd. 8. Data on use of emergency use of manual restraint. Beginning July 1,
414.42013, facilities and services to be licensed under chapter 245D shall submit data regarding
414.5the use of emergency use of manual restraint as identified in section 245D.061 in a format
414.6and at a frequency identified by the commissioner.

414.7    Sec. 55. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
414.8subdivision to read:
414.9    Subd. 9. Definitions. (a) For the purposes of this section, the following terms
414.10have the meanings given them.
414.11(b) "Controlling individual" means a public body, governmental agency, business
414.12entity, officer, owner, or managerial official whose responsibilities include the direction of
414.13the management or policies of a program.
414.14(c) "Managerial official" means an individual who has decision-making authority
414.15related to the operation of the program and responsibility for the ongoing management of
414.16or direction of the policies, services, or employees of the program.
414.17(d) "Owner" means an individual who has direct or indirect ownership interest in
414.18a corporation or partnership, or business association enrolling with the Department of
414.19Human Services as a provider of waiver services.

414.20    Sec. 56. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
414.21subdivision to read:
414.22    Subd. 10. Enrollment requirements. All home and community-based waiver
414.23providers must provide, at the time of enrollment and within 30 days of a request, in a
414.24format determined by the commissioner, information and documentation that includes, but
414.25is not limited to, the following:
414.26(1) proof of surety bond coverage in the amount of $50,000 or ten percent of the
414.27provider's payments from Medicaid in the previous calendar year, whichever is greater;
414.28(2) proof of fidelity bond coverage in the amount of $20,000; and
414.29(3) proof of liability insurance.

414.30    Sec. 57. Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:
414.31    Subd. 9a. Evaluation and referral of reports made to common entry point unit.
414.32    The common entry point must screen the reports of alleged or suspected maltreatment for
414.33immediate risk and make all necessary referrals as follows:
415.1    (1) if the common entry point determines that there is an immediate need for
415.2adult protective services, the common entry point agency shall immediately notify the
415.3appropriate county agency;
415.4    (2) if the report contains suspected criminal activity against a vulnerable adult, the
415.5common entry point shall immediately notify the appropriate law enforcement agency;
415.6    (3) the common entry point shall refer all reports of alleged or suspected
415.7maltreatment to the appropriate lead investigative agency as soon as possible, but in any
415.8event no longer than two working days; and
415.9    (4) if the report involves services licensed by the Department of Human Services
415.10and subject to chapter 245D, the common entry point shall refer the report to the county as
415.11the lead agency according to clause (3), but shall also notify the Department of Human
415.12Services of the report; and
415.13    (5) (4) if the report contains information about a suspicious death, the common
415.14entry point shall immediately notify the appropriate law enforcement agencies, the local
415.15medical examiner, and the ombudsman for mental health and developmental disabilities
415.16established under section 245.92. Law enforcement agencies shall coordinate with the
415.17local medical examiner and the ombudsman as provided by law.

415.18    Sec. 58. Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:
415.19    Subd. 13. Lead investigative agency. "Lead investigative agency" is the primary
415.20administrative agency responsible for investigating reports made under section 626.557.
415.21(a) The Department of Health is the lead investigative agency for facilities or
415.22services licensed or required to be licensed as hospitals, home care providers, nursing
415.23homes, boarding care homes, hospice providers, residential facilities that are also federally
415.24certified as intermediate care facilities that serve people with developmental disabilities,
415.25or any other facility or service not listed in this subdivision that is licensed or required to
415.26be licensed by the Department of Health for the care of vulnerable adults. "Home care
415.27provider" has the meaning provided in section 144A.43, subdivision 4, and applies when
415.28care or services are delivered in the vulnerable adult's home, whether a private home or a
415.29housing with services establishment registered under chapter 144D, including those that
415.30offer assisted living services under chapter 144G.
415.31(b) Except as provided under paragraph (c), for services licensed according to chapter
415.32245D, The Department of Human Services is the lead investigative agency for facilities or
415.33services licensed or required to be licensed as adult day care, adult foster care, community
415.34residential settings, programs for people with developmental disabilities, family adult day
415.35services, mental health programs, mental health clinics, chemical dependency programs,
416.1the Minnesota sex offender program, or any other facility or service not listed in this
416.2subdivision that is licensed or required to be licensed by the Department of Human Services.
416.3(c) The county social service agency or its designee is the lead investigative agency
416.4for all other reports, including, but not limited to, reports involving vulnerable adults
416.5receiving services from a personal care provider organization under section 256B.0659,
416.6or receiving home and community-based services licensed by the Department of Human
416.7Services and subject to chapter 245D.

416.8    Sec. 59. REPORT ON TRANSFER OF VULNERABLE ADULT
416.9MALTREATMENT INVESTIGATION DUTIES.
416.10(a) The commissioner of human services shall provide a follow-up report on the
416.11collection of fees and actual licensing and maltreatment investigation costs resulting from
416.12the reform of the standards and oversight for home and community-based services as
416.13adopted and funded by the 2013 legislature.
416.14(b) The report must identify actual fees collected based on provider revenue,
416.15distinguish the amount of fees collected based on non-medical assistance revenue, and
416.16determine the impact of the non-medical assistance revenue on future licensing fees.
416.17(c) The report must recommend how maltreatment investigations, when conducted
416.18by the commissioner of human services, should be funded and at what amount. The
416.19recommendation must identify whether maltreatment investigation costs should be
416.20recovered through licensure fees, an appropriation from the general fund, provider
416.21fines for substantiated maltreatment, licensing fee surcharges related to substantiated
416.22maltreatment, or a combination of these sources.
416.23(d) The report must contain a cost comparison between similar maltreatment
416.24investigations completed by the Minnesota Department of Health and the Department of
416.25Human Services, and describe the method of funding for the investigations conducted by
416.26the Department of Health.
416.27(e) The report must make recommendations for changes that the commissioner
416.28determines are appropriate to reduce the costs of maltreatment investigations.
416.29(f) The commissioner must submit the report with draft legislation proposing
416.30alternative fees, if necessary, to the chairs and ranking minority members of the legislative
416.31committees with jurisdiction over health and human services policy and finance by July
416.321, 2015.

416.33    Sec. 60. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
416.34AND COMMUNITY-BASED SERVICES.
417.1(a) The Department of Health Compliance Monitoring Division and the Department
417.2of Human Services Licensing Division shall jointly develop an integrated licensing system
417.3for providers of both home care services subject to licensure under Minnesota Statutes,
417.4chapter 144A, and for home and community-based services subject to licensure under
417.5Minnesota Statutes, chapter 245D. The integrated licensing system shall:
417.6(1) require only one license of any provider of services under Minnesota Statutes,
417.7sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
417.8(2) promote quality services that recognize a person's individual needs and protect
417.9the person's health, safety, rights, and well-being;
417.10(3) promote provider accountability through application requirements, compliance
417.11inspections, investigations, and enforcement actions;
417.12(4) reference other applicable requirements in existing state and federal laws,
417.13including the federal Affordable Care Act;
417.14(5) establish internal procedures to facilitate ongoing communications between the
417.15agencies and with providers and services recipients about the regulatory activities;
417.16(6) create a link between the agency Web sites so that providers and the public can
417.17access the same information regardless of which Web site is accessed initially; and
417.18(7) collect data on identified outcome measures as necessary for the agencies to
417.19report to the Centers for Medicare and Medicaid Services.
417.20(b) The joint recommendations for legislative changes to implement the integrated
417.21licensing system are due to the legislature by February 15, 2014.
417.22(c) Before implementation of the integrated licensing system, providers licensed as
417.23home care providers under Minnesota Statutes, chapter 144A, may also provide home
417.24and community-based services subject to licensure under Minnesota Statutes, chapter
417.25245D, without obtaining a home and community-based services license under Minnesota
417.26Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
417.27apply to these providers:
417.28(1) the provider must comply with all requirements under Minnesota Statutes, chapter
417.29245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
417.30(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
417.31enforced by the Department of Health under the enforcement authority set forth in
417.32Minnesota Statutes, section 144A.475; and
417.33(3) the Department of Health will provide information to the Department of Human
417.34Services about each provider licensed under this section, including the provider's license
417.35application, licensing documents, inspections, information about complaints received, and
417.36investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

418.1    Sec. 61. REPEALER.
418.2(a) Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031;
418.3245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and
418.4245B.08, are repealed effective January 1, 2014.
418.5(b) Minnesota Statutes 2012, section 245D.08, is repealed.

418.6ARTICLE 9

418.7WAIVER PROVIDER STANDARDS TECHNICAL CHANGES

418.8    Section 1. Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:
418.9    Subd. 5. Specific purchases. The solicitation process described in this chapter is
418.10not required for acquisition of the following:
418.11(1) merchandise for resale purchased under policies determined by the commissioner;
418.12(2) farm and garden products which, as determined by the commissioner, may be
418.13purchased at the prevailing market price on the date of sale;
418.14(3) goods and services from the Minnesota correctional facilities;
418.15(4) goods and services from rehabilitation facilities and extended employment
418.16providers that are certified by the commissioner of employment and economic
418.17development, and day training and habilitation services licensed under sections 245B.01
418.18to 245B.08 chapter 245D;
418.19(5) goods and services for use by a community-based facility operated by the
418.20commissioner of human services;
418.21(6) goods purchased at auction or when submitting a sealed bid at auction provided
418.22that before authorizing such an action, the commissioner consult with the requesting
418.23agency to determine a fair and reasonable value for the goods considering factors
418.24including, but not limited to, costs associated with submitting a bid, travel, transportation,
418.25and storage. This fair and reasonable value must represent the limit of the state's bid;
418.26(7) utility services where no competition exists or where rates are fixed by law or
418.27ordinance; and
418.28(8) goods and services from Minnesota sex offender program facilities.
418.29EFFECTIVE DATE.This section is effective January 1, 2014.

418.30    Sec. 2. Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:
418.31    Subdivision 1. Service contracts. The commissioner of administration shall
418.32ensure that a portion of all contracts for janitorial services; document imaging;
418.33document shredding; and mailing, collating, and sorting services be awarded by the
418.34state to rehabilitation programs and extended employment providers that are certified
419.1by the commissioner of employment and economic development, and day training and
419.2habilitation services licensed under sections 245B.01 to 245B.08 chapter 245D. The
419.3amount of each contract awarded under this section may exceed the estimated fair market
419.4price as determined by the commissioner for the same goods and services by up to six
419.5percent. The aggregate value of the contracts awarded to eligible providers under this
419.6section in any given year must exceed 19 percent of the total value of all contracts for
419.7janitorial services; document imaging; document shredding; and mailing, collating, and
419.8sorting services entered into in the same year. For the 19 percent requirement to be
419.9applicable in any given year, the contract amounts proposed by eligible providers must be
419.10within six percent of the estimated fair market price for at least 19 percent of the contracts
419.11awarded for the corresponding service area.
419.12EFFECTIVE DATE.This section is effective January 1, 2014.

419.13    Sec. 3. Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:
419.14    Subd. 4. Housing with services establishment or establishment. (a) "Housing
419.15with services establishment" or "establishment" means:
419.16(1) an establishment providing sleeping accommodations to one or more adult
419.17residents, at least 80 percent of which are 55 years of age or older, and offering or
419.18providing, for a fee, one or more regularly scheduled health-related services or two or
419.19more regularly scheduled supportive services, whether offered or provided directly by the
419.20establishment or by another entity arranged for by the establishment; or
419.21(2) an establishment that registers under section 144D.025.
419.22(b) Housing with services establishment does not include:
419.23(1) a nursing home licensed under chapter 144A;
419.24(2) a hospital, certified boarding care home, or supervised living facility licensed
419.25under sections 144.50 to 144.56;
419.26(3) a board and lodging establishment licensed under chapter 157 and Minnesota
419.27Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660,
419.28or 9530.4100 to 9530.4450, or under chapter 245B 245D;
419.29(4) a board and lodging establishment which serves as a shelter for battered women
419.30or other similar purpose;
419.31(5) a family adult foster care home licensed by the Department of Human Services;
419.32(6) private homes in which the residents are related by kinship, law, or affinity with
419.33the providers of services;
420.1(7) residential settings for persons with developmental disabilities in which the
420.2services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable
420.3successor rules or laws;
420.4(8) a home-sharing arrangement such as when an elderly or disabled person or
420.5single-parent family makes lodging in a private residence available to another person
420.6in exchange for services or rent, or both;
420.7(9) a duly organized condominium, cooperative, common interest community, or
420.8owners' association of the foregoing where at least 80 percent of the units that comprise the
420.9condominium, cooperative, or common interest community are occupied by individuals
420.10who are the owners, members, or shareholders of the units; or
420.11(10) services for persons with developmental disabilities that are provided under
420.12a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until
420.13January 1, 1998, or under chapter 245B 245D.
420.14EFFECTIVE DATE.This section is effective January 1, 2014.

420.15    Sec. 4. Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:
420.16    Subdivision 1. Applicability. (a) The operating standards for special transportation
420.17service adopted under this section do not apply to special transportation provided by:
420.18(1) a common carrier operating on fixed routes and schedules;
420.19(2) a volunteer driver using a private automobile;
420.20(3) a school bus as defined in section 169.011, subdivision 71; or
420.21(4) an emergency ambulance regulated under chapter 144.
420.22(b) The operating standards adopted under this section only apply to providers
420.23of special transportation service who receive grants or other financial assistance from
420.24either the state or the federal government, or both, to provide or assist in providing that
420.25service; except that the operating standards adopted under this section do not apply
420.26to any nursing home licensed under section 144A.02, to any board and care facility
420.27licensed under section 144.50, or to any day training and habilitation services, day care,
420.28or group home facility licensed under sections 245A.01 to 245A.19 unless the facility or
420.29program provides transportation to nonresidents on a regular basis and the facility receives
420.30reimbursement, other than per diem payments, for that service under rules promulgated
420.31by the commissioner of human services.
420.32(c) Notwithstanding paragraph (b), the operating standards adopted under this
420.33section do not apply to any vendor of services licensed under chapter 245B 245D that
420.34provides transportation services to consumers or residents of other vendors licensed under
421.1chapter 245B 245D and transports 15 or fewer persons, including consumers or residents
421.2and the driver.
421.3EFFECTIVE DATE.This section is effective January 1, 2014.

421.4    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:
421.5    Subdivision 1. Scope. The terms used in this chapter and chapter 245B have the
421.6meanings given them in this section.
421.7EFFECTIVE DATE.This section is effective January 1, 2014.

421.8    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:
421.9    Subd. 9. License holder. "License holder" means an individual, corporation,
421.10partnership, voluntary association, or other organization that is legally responsible for the
421.11operation of the program, has been granted a license by the commissioner under this chapter
421.12or chapter 245B 245D and the rules of the commissioner, and is a controlling individual.
421.13EFFECTIVE DATE.This section is effective January 1, 2014.

421.14    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:
421.15    Subd. 9. Permitted services by an individual who is related. Notwithstanding
421.16subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a
421.17person receiving supported living services may provide licensed services to that person if:
421.18(1) the person who receives supported living services received these services in a
421.19residential site on July 1, 2005;
421.20(2) the services under clause (1) were provided in a corporate foster care setting for
421.21adults and were funded by the developmental disabilities home and community-based
421.22services waiver defined in section 256B.092;
421.23(3) the individual who is related obtains and maintains both a license under chapter
421.24245B 245D and an adult foster care license under Minnesota Rules, parts 9555.5105
421.25to 9555.6265; and
421.26(4) the individual who is related is not the guardian of the person receiving supported
421.27living services.
421.28EFFECTIVE DATE.This section is effective January 1, 2014.

421.29    Sec. 8. Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:
422.1    Subd. 13. Funds and property; other requirements. (a) A license holder must
422.2ensure that persons served by the program retain the use and availability of personal funds
422.3or property unless restrictions are justified in the person's individual plan. This subdivision
422.4does not apply to programs governed by the provisions in section 245B.07, subdivision 10.
422.5(b) The license holder must ensure separation of funds of persons served by the
422.6program from funds of the license holder, the program, or program staff.
422.7(c) Whenever the license holder assists a person served by the program with the
422.8safekeeping of funds or other property, the license holder must:
422.9(1) immediately document receipt and disbursement of the person's funds or other
422.10property at the time of receipt or disbursement, including the person's signature, or the
422.11signature of the conservator or payee; and
422.12(2) return to the person upon the person's request, funds and property in the license
422.13holder's possession subject to restrictions in the person's treatment plan, as soon as
422.14possible, but no later than three working days after the date of request.
422.15(d) License holders and program staff must not:
422.16(1) borrow money from a person served by the program;
422.17(2) purchase personal items from a person served by the program;
422.18(3) sell merchandise or personal services to a person served by the program;
422.19(4) require a person served by the program to purchase items for which the license
422.20holder is eligible for reimbursement; or
422.21(5) use funds of persons served by the program to purchase items for which the
422.22facility is already receiving public or private payments.
422.23EFFECTIVE DATE.This section is effective January 1, 2014.

422.24    Sec. 9. Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:
422.25    Subd. 3. License suspension, revocation, or fine. (a) The commissioner may
422.26suspend or revoke a license, or impose a fine if:
422.27(1) a license holder fails to comply fully with applicable laws or rules;
422.28(2) a license holder, a controlling individual, or an individual living in the household
422.29where the licensed services are provided or is otherwise subject to a background study has
422.30a disqualification which has not been set aside under section 245C.22;
422.31(3) a license holder knowingly withholds relevant information from or gives false
422.32or misleading information to the commissioner in connection with an application for
422.33a license, in connection with the background study status of an individual, during an
422.34investigation, or regarding compliance with applicable laws or rules; or
423.1(4) after July 1, 2012, and upon request by the commissioner, a license holder fails
423.2to submit the information required of an applicant under section 245A.04, subdivision 1,
423.3paragraph (f) or (g).
423.4A license holder who has had a license suspended, revoked, or has been ordered
423.5to pay a fine must be given notice of the action by certified mail or personal service. If
423.6mailed, the notice must be mailed to the address shown on the application or the last
423.7known address of the license holder. The notice must state the reasons the license was
423.8suspended, revoked, or a fine was ordered.
423.9    (b) If the license was suspended or revoked, the notice must inform the license
423.10holder of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
423.111400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
423.12a license. The appeal of an order suspending or revoking a license must be made in writing
423.13by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
423.14the commissioner within ten calendar days after the license holder receives notice that the
423.15license has been suspended or revoked. If a request is made by personal service, it must be
423.16received by the commissioner within ten calendar days after the license holder received
423.17the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits
423.18a timely appeal of an order suspending or revoking a license, the license holder may
423.19continue to operate the program as provided in section 245A.04, subdivision 7, paragraphs
423.20(g) and (h), until the commissioner issues a final order on the suspension or revocation.
423.21    (c)(1) If the license holder was ordered to pay a fine, the notice must inform the
423.22license holder of the responsibility for payment of fines and the right to a contested case
423.23hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal
423.24of an order to pay a fine must be made in writing by certified mail or personal service. If
423.25mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
423.26days after the license holder receives notice that the fine has been ordered. If a request is
423.27made by personal service, it must be received by the commissioner within ten calendar
423.28days after the license holder received the order.
423.29    (2) The license holder shall pay the fines assessed on or before the payment date
423.30specified. If the license holder fails to fully comply with the order, the commissioner
423.31may issue a second fine or suspend the license until the license holder complies. If the
423.32license holder receives state funds, the state, county, or municipal agencies or departments
423.33responsible for administering the funds shall withhold payments and recover any payments
423.34made while the license is suspended for failure to pay a fine. A timely appeal shall stay
423.35payment of the fine until the commissioner issues a final order.
424.1    (3) A license holder shall promptly notify the commissioner of human services,
424.2in writing, when a violation specified in the order to forfeit a fine is corrected. If upon
424.3reinspection the commissioner determines that a violation has not been corrected as
424.4indicated by the order to forfeit a fine, the commissioner may issue a second fine. The
424.5commissioner shall notify the license holder by certified mail or personal service that a
424.6second fine has been assessed. The license holder may appeal the second fine as provided
424.7under this subdivision.
424.8    (4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for
424.9each determination of maltreatment of a child under section 626.556 or the maltreatment
424.10of a vulnerable adult under section 626.557 for which the license holder is determined
424.11responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i),
424.12or 626.557, subdivision 9c, paragraph (c); the license holder shall forfeit $200 for each
424.13occurrence of a violation of law or rule governing matters of health, safety, or supervision,
424.14including but not limited to the provision of adequate staff-to-child or adult ratios, and
424.15failure to comply with background study requirements under chapter 245C; and the license
424.16holder shall forfeit $100 for each occurrence of a violation of law or rule other than
424.17those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence"
424.18means each violation identified in the commissioner's fine order. Fines assessed against a
424.19license holder that holds a license to provide the residential-based habilitation home and
424.20community-based services, as defined under identified in section 245B.02, subdivision
424.2120 245D.03, subdivision 1, and a community residential setting or day services facility
424.22license to provide foster care under chapter 245D where the services are provided, may be
424.23assessed against both licenses for the same occurrence, but the combined amount of the
424.24fines shall not exceed the amount specified in this clause for that occurrence.
424.25    (5) When a fine has been assessed, the license holder may not avoid payment by
424.26closing, selling, or otherwise transferring the licensed program to a third party. In such an
424.27event, the license holder will be personally liable for payment. In the case of a corporation,
424.28each controlling individual is personally and jointly liable for payment.
424.29(d) Except for background study violations involving the failure to comply with an
424.30order to immediately remove an individual or an order to provide continuous, direct
424.31supervision, the commissioner shall not issue a fine under paragraph (c) relating to a
424.32background study violation to a license holder who self-corrects a background study
424.33violation before the commissioner discovers the violation. A license holder who has
424.34previously exercised the provisions of this paragraph to avoid a fine for a background
424.35study violation may not avoid a fine for a subsequent background study violation unless at
425.1least 365 days have passed since the license holder self-corrected the earlier background
425.2study violation.
425.3EFFECTIVE DATE.This section is effective January 1, 2014.

425.4    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to
425.5read:
425.6    Subd. 19c. Personal care. Medical assistance covers personal care assistance
425.7services provided by an individual who is qualified to provide the services according to
425.8subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a
425.9plan, and supervised by a qualified professional.
425.10"Qualified professional" means a mental health professional as defined in section
425.11245.462, subdivision 18 , clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6);
425.12or a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker
425.13as defined in sections 148E.010 and 148E.055, or a qualified developmental disabilities
425.14specialist under section 245B.07, subdivision 4 designated coordinator under section
425.15245D.081, subdivision 2. The qualified professional shall perform the duties required in
425.16section 256B.0659.
425.17EFFECTIVE DATE.This section is effective January 1, 2014.

425.18    Sec. 11. Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:
425.19    Subd. 2. Contract provisions. (a) The service contract with each intermediate
425.20care facility must include provisions for:
425.21(1) modifying payments when significant changes occur in the needs of the
425.22consumers;
425.23(2) appropriate and necessary statistical information required by the commissioner;
425.24(3) annual aggregate facility financial information; and
425.25(4) additional requirements for intermediate care facilities not meeting the standards
425.26set forth in the service contract.
425.27(b) The commissioner of human services and the commissioner of health, in
425.28consultation with representatives from counties, advocacy organizations, and the provider
425.29community, shall review the consolidated standards under chapter 245B and the home and
425.30community-based services standards under chapter 245D and the supervised living facility
425.31rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota
425.32Rules, chapter 4665, may be waived by the commissioner of health for intermediate care
425.33facilities in order to enable facilities to implement the performance measures in their
426.1contract and provide quality services to residents without a duplication of or increase in
426.2regulatory requirements.
426.3EFFECTIVE DATE.This section is effective January 1, 2014.

426.4    Sec. 12. Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:
426.5    Subdivision 1. Agreement. Two or more governmental units, by agreement entered
426.6into through action of their governing bodies, may jointly or cooperatively exercise
426.7any power common to the contracting parties or any similar powers, including those
426.8which are the same except for the territorial limits within which they may be exercised.
426.9The agreement may provide for the exercise of such powers by one or more of the
426.10participating governmental units on behalf of the other participating units. The term
426.11"governmental unit" as used in this section includes every city, county, town, school
426.12district, independent nonprofit firefighting corporation, other political subdivision of
426.13this or another state, another state, federally recognized Indian tribe, the University
426.14of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under
426.15sections 144.50 to 144.56, rehabilitation facilities and extended employment providers
426.16that are certified by the commissioner of employment and economic development, day
426.17training and habilitation services licensed under sections 245B.01 to 245B.08, day and
426.18supported employment services licensed under chapter 245D, and any agency of the state
426.19of Minnesota or the United States, and includes any instrumentality of a governmental
426.20unit. For the purpose of this section, an instrumentality of a governmental unit means an
426.21instrumentality having independent policy-making and appropriating authority.
426.22EFFECTIVE DATE.This section is effective January 1, 2014.

426.23    Sec. 13. Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:
426.24    Subd. 2. Definitions. As used in this section, the following terms have the meanings
426.25given them unless the specific content indicates otherwise:
426.26    (a) "Family assessment" means a comprehensive assessment of child safety, risk
426.27of subsequent child maltreatment, and family strengths and needs that is applied to a
426.28child maltreatment report that does not allege substantial child endangerment. Family
426.29assessment does not include a determination as to whether child maltreatment occurred
426.30but does determine the need for services to address the safety of family members and the
426.31risk of subsequent maltreatment.
426.32    (b) "Investigation" means fact gathering related to the current safety of a child
426.33and the risk of subsequent maltreatment that determines whether child maltreatment
427.1occurred and whether child protective services are needed. An investigation must be used
427.2when reports involve substantial child endangerment, and for reports of maltreatment in
427.3facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
427.4144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
427.513, and 124D.10; or in a nonlicensed personal care provider association as defined in
427.6sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
427.7    (c) "Substantial child endangerment" means a person responsible for a child's care,
427.8and in the case of sexual abuse includes a person who has a significant relationship to the
427.9child as defined in section 609.341, or a person in a position of authority as defined in
427.10section 609.341, who by act or omission commits or attempts to commit an act against a
427.11child under their care that constitutes any of the following:
427.12    (1) egregious harm as defined in section 260C.007, subdivision 14;
427.13    (2) sexual abuse as defined in paragraph (d);
427.14    (3) abandonment under section 260C.301, subdivision 2;
427.15    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
427.16child's physical or mental health, including a growth delay, which may be referred to as
427.17failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
427.18    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
427.19609.195 ;
427.20    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
427.21    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
427.22609.223 ;
427.23    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
427.24    (9) criminal sexual conduct under sections 609.342 to 609.3451;
427.25    (10) solicitation of children to engage in sexual conduct under section 609.352;
427.26    (11) malicious punishment or neglect or endangerment of a child under section
427.27609.377 or 609.378;
427.28    (12) use of a minor in sexual performance under section 617.246; or
427.29    (13) parental behavior, status, or condition which mandates that the county attorney
427.30file a termination of parental rights petition under section 260C.301, subdivision 3,
427.31paragraph (a).
427.32    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
427.33child's care, by a person who has a significant relationship to the child, as defined in
427.34section 609.341, or by a person in a position of authority, as defined in section 609.341,
427.35subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
427.36conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
428.1609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
428.2in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
428.3abuse also includes any act which involves a minor which constitutes a violation of
428.4prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
428.5threatened sexual abuse which includes the status of a parent or household member
428.6who has committed a violation which requires registration as an offender under section
428.7243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
428.8243.166, subdivision 1b, paragraph (a) or (b).
428.9    (e) "Person responsible for the child's care" means (1) an individual functioning
428.10within the family unit and having responsibilities for the care of the child such as a
428.11parent, guardian, or other person having similar care responsibilities, or (2) an individual
428.12functioning outside the family unit and having responsibilities for the care of the child
428.13such as a teacher, school administrator, other school employees or agents, or other lawful
428.14custodian of a child having either full-time or short-term care responsibilities including,
428.15but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
428.16and coaching.
428.17    (f) "Neglect" means the commission or omission of any of the acts specified under
428.18clauses (1) to (9), other than by accidental means:
428.19    (1) failure by a person responsible for a child's care to supply a child with necessary
428.20food, clothing, shelter, health, medical, or other care required for the child's physical or
428.21mental health when reasonably able to do so;
428.22    (2) failure to protect a child from conditions or actions that seriously endanger the
428.23child's physical or mental health when reasonably able to do so, including a growth delay,
428.24which may be referred to as a failure to thrive, that has been diagnosed by a physician and
428.25is due to parental neglect;
428.26    (3) failure to provide for necessary supervision or child care arrangements
428.27appropriate for a child after considering factors as the child's age, mental ability, physical
428.28condition, length of absence, or environment, when the child is unable to care for the
428.29child's own basic needs or safety, or the basic needs or safety of another child in their care;
428.30    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
428.31260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's
428.32child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
428.33    (5) nothing in this section shall be construed to mean that a child is neglected solely
428.34because the child's parent, guardian, or other person responsible for the child's care in
428.35good faith selects and depends upon spiritual means or prayer for treatment or care of
428.36disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
429.1or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
429.2if a lack of medical care may cause serious danger to the child's health. This section does
429.3not impose upon persons, not otherwise legally responsible for providing a child with
429.4necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
429.5    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
429.6subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
429.7symptoms in the child at birth, results of a toxicology test performed on the mother at
429.8delivery or the child at birth, medical effects or developmental delays during the child's
429.9first year of life that medically indicate prenatal exposure to a controlled substance, or the
429.10presence of a fetal alcohol spectrum disorder;
429.11    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
429.12    (8) chronic and severe use of alcohol or a controlled substance by a parent or
429.13person responsible for the care of the child that adversely affects the child's basic needs
429.14and safety; or
429.15    (9) emotional harm from a pattern of behavior which contributes to impaired
429.16emotional functioning of the child which may be demonstrated by a substantial and
429.17observable effect in the child's behavior, emotional response, or cognition that is not
429.18within the normal range for the child's age and stage of development, with due regard to
429.19the child's culture.
429.20    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
429.21inflicted by a person responsible for the child's care on a child other than by accidental
429.22means, or any physical or mental injury that cannot reasonably be explained by the child's
429.23history of injuries, or any aversive or deprivation procedures, or regulated interventions,
429.24that have not been authorized under section 121A.67 or 245.825.
429.25    Abuse does not include reasonable and moderate physical discipline of a child
429.26administered by a parent or legal guardian which does not result in an injury. Abuse does
429.27not include the use of reasonable force by a teacher, principal, or school employee as
429.28allowed by section 121A.582. Actions which are not reasonable and moderate include,
429.29but are not limited to, any of the following that are done in anger or without regard to the
429.30safety of the child:
429.31    (1) throwing, kicking, burning, biting, or cutting a child;
429.32    (2) striking a child with a closed fist;
429.33    (3) shaking a child under age three;
429.34    (4) striking or other actions which result in any nonaccidental injury to a child
429.35under 18 months of age;
429.36    (5) unreasonable interference with a child's breathing;
430.1    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
430.2    (7) striking a child under age one on the face or head;
430.3    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
430.4substances which were not prescribed for the child by a practitioner, in order to control or
430.5punish the child; or other substances that substantially affect the child's behavior, motor
430.6coordination, or judgment or that results in sickness or internal injury, or subjects the
430.7child to medical procedures that would be unnecessary if the child were not exposed
430.8to the substances;
430.9    (9) unreasonable physical confinement or restraint not permitted under section
430.10609.379 , including but not limited to tying, caging, or chaining; or
430.11    (10) in a school facility or school zone, an act by a person responsible for the child's
430.12care that is a violation under section 121A.58.
430.13    (h) "Report" means any report received by the local welfare agency, police
430.14department, county sheriff, or agency responsible for assessing or investigating
430.15maltreatment pursuant to this section.
430.16    (i) "Facility" means:
430.17    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
430.18sanitarium, or other facility or institution required to be licensed under sections 144.50 to
430.19144.58 , 241.021, or 245A.01 to 245A.16, or chapter 245B 245D;
430.20    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
430.21124D.10 ; or
430.22    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
430.23subdivision 16, and 256B.0625, subdivision 19a.
430.24    (j) "Operator" means an operator or agency as defined in section 245A.02.
430.25    (k) "Commissioner" means the commissioner of human services.
430.26    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
430.27not limited to employee assistance counseling and the provision of guardian ad litem and
430.28parenting time expeditor services.
430.29    (m) "Mental injury" means an injury to the psychological capacity or emotional
430.30stability of a child as evidenced by an observable or substantial impairment in the child's
430.31ability to function within a normal range of performance and behavior with due regard to
430.32the child's culture.
430.33    (n) "Threatened injury" means a statement, overt act, condition, or status that
430.34represents a substantial risk of physical or sexual abuse or mental injury. Threatened
430.35injury includes, but is not limited to, exposing a child to a person responsible for the
430.36child's care, as defined in paragraph (e), clause (1), who has:
431.1    (1) subjected a child to, or failed to protect a child from, an overt act or condition
431.2that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
431.3similar law of another jurisdiction;
431.4    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
431.5(4), or a similar law of another jurisdiction;
431.6    (3) committed an act that has resulted in an involuntary termination of parental rights
431.7under section 260C.301, or a similar law of another jurisdiction; or
431.8    (4) committed an act that has resulted in the involuntary transfer of permanent
431.9legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
431.10260C.201, subdivision 11 , paragraph (d), clause (1), section 260C.515, subdivision 4, or a
431.11similar law of another jurisdiction.
431.12A child is the subject of a report of threatened injury when the responsible social
431.13services agency receives birth match data under paragraph (o) from the Department of
431.14Human Services.
431.15(o) Upon receiving data under section 144.225, subdivision 2b, contained in a
431.16birth record or recognition of parentage identifying a child who is subject to threatened
431.17injury under paragraph (n), the Department of Human Services shall send the data to the
431.18responsible social services agency. The data is known as "birth match" data. Unless the
431.19responsible social services agency has already begun an investigation or assessment of the
431.20report due to the birth of the child or execution of the recognition of parentage and the
431.21parent's previous history with child protection, the agency shall accept the birth match
431.22data as a report under this section. The agency may use either a family assessment or
431.23investigation to determine whether the child is safe. All of the provisions of this section
431.24apply. If the child is determined to be safe, the agency shall consult with the county
431.25attorney to determine the appropriateness of filing a petition alleging the child is in need
431.26of protection or services under section 260C.007, subdivision 6, clause (16), in order to
431.27deliver needed services. If the child is determined not to be safe, the agency and the county
431.28attorney shall take appropriate action as required under section 260C.301, subdivision 3.
431.29    (p) Persons who conduct assessments or investigations under this section shall take
431.30into account accepted child-rearing practices of the culture in which a child participates
431.31and accepted teacher discipline practices, which are not injurious to the child's health,
431.32welfare, and safety.
431.33    (q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
431.34occurrence or event which:
431.35    (1) is not likely to occur and could not have been prevented by exercise of due
431.36care; and
432.1    (2) if occurring while a child is receiving services from a facility, happens when the
432.2facility and the employee or person providing services in the facility are in compliance
432.3with the laws and rules relevant to the occurrence or event.
432.4(r) "Nonmaltreatment mistake" means:
432.5(1) at the time of the incident, the individual was performing duties identified in the
432.6center's child care program plan required under Minnesota Rules, part 9503.0045;
432.7(2) the individual has not been determined responsible for a similar incident that
432.8resulted in a finding of maltreatment for at least seven years;
432.9(3) the individual has not been determined to have committed a similar
432.10nonmaltreatment mistake under this paragraph for at least four years;
432.11(4) any injury to a child resulting from the incident, if treated, is treated only with
432.12remedies that are available over the counter, whether ordered by a medical professional or
432.13not; and
432.14(5) except for the period when the incident occurred, the facility and the individual
432.15providing services were both in compliance with all licensing requirements relevant to the
432.16incident.
432.17This definition only applies to child care centers licensed under Minnesota
432.18Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
432.19substantiated maltreatment by the individual, the commissioner of human services shall
432.20determine that a nonmaltreatment mistake was made by the individual.
432.21EFFECTIVE DATE.This section is effective January 1, 2014.

432.22    Sec. 14. Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:
432.23    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
432.24to believe a child is being neglected or physically or sexually abused, as defined in
432.25subdivision 2, or has been neglected or physically or sexually abused within the preceding
432.26three years, shall immediately report the information to the local welfare agency, agency
432.27responsible for assessing or investigating the report, police department, or the county
432.28sheriff if the person is:
432.29    (1) a professional or professional's delegate who is engaged in the practice of
432.30the healing arts, social services, hospital administration, psychological or psychiatric
432.31treatment, child care, education, correctional supervision, probation and correctional
432.32services, or law enforcement; or
432.33    (2) employed as a member of the clergy and received the information while
432.34engaged in ministerial duties, provided that a member of the clergy is not required by
433.1this subdivision to report information that is otherwise privileged under section 595.02,
433.2subdivision 1 , paragraph (c).
433.3    The police department or the county sheriff, upon receiving a report, shall
433.4immediately notify the local welfare agency or agency responsible for assessing or
433.5investigating the report, orally and in writing. The local welfare agency, or agency
433.6responsible for assessing or investigating the report, upon receiving a report, shall
433.7immediately notify the local police department or the county sheriff orally and in writing.
433.8The county sheriff and the head of every local welfare agency, agency responsible
433.9for assessing or investigating reports, and police department shall each designate a
433.10person within their agency, department, or office who is responsible for ensuring that
433.11the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
433.12this subdivision shall be construed to require more than one report from any institution,
433.13facility, school, or agency.
433.14    (b) Any person may voluntarily report to the local welfare agency, agency responsible
433.15for assessing or investigating the report, police department, or the county sheriff if the
433.16person knows, has reason to believe, or suspects a child is being or has been neglected or
433.17subjected to physical or sexual abuse. The police department or the county sheriff, upon
433.18receiving a report, shall immediately notify the local welfare agency or agency responsible
433.19for assessing or investigating the report, orally and in writing. The local welfare agency or
433.20agency responsible for assessing or investigating the report, upon receiving a report, shall
433.21immediately notify the local police department or the county sheriff orally and in writing.
433.22    (c) A person mandated to report physical or sexual child abuse or neglect occurring
433.23within a licensed facility shall report the information to the agency responsible for
433.24licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
433.25chapter 245B 245D; or a nonlicensed personal care provider organization as defined in
433.26sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections
433.27agency receiving a report may request the local welfare agency to provide assistance
433.28pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees
433.29perform work within a school facility, upon receiving a complaint of alleged maltreatment,
433.30shall provide information about the circumstances of the alleged maltreatment to the
433.31commissioner of education. Section 13.03, subdivision 4, applies to data received by the
433.32commissioner of education from a licensing entity.
433.33    (d) Any person mandated to report shall receive a summary of the disposition of
433.34any report made by that reporter, including whether the case has been opened for child
433.35protection or other services, or if a referral has been made to a community organization,
433.36unless release would be detrimental to the best interests of the child. Any person who is
434.1not mandated to report shall, upon request to the local welfare agency, receive a concise
434.2summary of the disposition of any report made by that reporter, unless release would be
434.3detrimental to the best interests of the child.
434.4    (e) For purposes of this section, "immediately" means as soon as possible but in
434.5no event longer than 24 hours.
434.6EFFECTIVE DATE.This section is effective January 1, 2014.

434.7    Sec. 15. Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:
434.8    Subd. 10d. Notification of neglect or abuse in facility. (a) When a report is
434.9received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while
434.10in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
434.11sanitarium, or other facility or institution required to be licensed according to sections
434.12144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B 245D, or a school as
434.13defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed
434.14personal care provider organization as defined in section 256B.04, subdivision 16, and
434.15256B.0625, subdivision 19a , the commissioner of the agency responsible for assessing
434.16or investigating the report or local welfare agency investigating the report shall provide
434.17the following information to the parent, guardian, or legal custodian of a child alleged to
434.18have been neglected, physically abused, sexually abused, or the victim of maltreatment
434.19of a child in the facility: the name of the facility; the fact that a report alleging neglect,
434.20physical abuse, sexual abuse, or maltreatment of a child in the facility has been received;
434.21the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child
434.22in the facility; that the agency is conducting an assessment or investigation; any protective
434.23or corrective measures being taken pending the outcome of the investigation; and that a
434.24written memorandum will be provided when the investigation is completed.
434.25(b) The commissioner of the agency responsible for assessing or investigating the
434.26report or local welfare agency may also provide the information in paragraph (a) to the
434.27parent, guardian, or legal custodian of any other child in the facility if the investigative
434.28agency knows or has reason to believe the alleged neglect, physical abuse, sexual
434.29abuse, or maltreatment of a child in the facility has occurred. In determining whether
434.30to exercise this authority, the commissioner of the agency responsible for assessing
434.31or investigating the report or local welfare agency shall consider the seriousness of the
434.32alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the
434.33number of children allegedly neglected, physically abused, sexually abused, or victims of
434.34maltreatment of a child in the facility; the number of alleged perpetrators; and the length
434.35of the investigation. The facility shall be notified whenever this discretion is exercised.
435.1(c) When the commissioner of the agency responsible for assessing or investigating
435.2the report or local welfare agency has completed its investigation, every parent, guardian,
435.3or legal custodian previously notified of the investigation by the commissioner or
435.4local welfare agency shall be provided with the following information in a written
435.5memorandum: the name of the facility investigated; the nature of the alleged neglect,
435.6physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's
435.7name; a summary of the investigation findings; a statement whether maltreatment was
435.8found; and the protective or corrective measures that are being or will be taken. The
435.9memorandum shall be written in a manner that protects the identity of the reporter and
435.10the child and shall not contain the name, or to the extent possible, reveal the identity of
435.11the alleged perpetrator or of those interviewed during the investigation. If maltreatment
435.12is determined to exist, the commissioner or local welfare agency shall also provide the
435.13written memorandum to the parent, guardian, or legal custodian of each child in the facility
435.14who had contact with the individual responsible for the maltreatment. When the facility is
435.15the responsible party for maltreatment, the commissioner or local welfare agency shall also
435.16provide the written memorandum to the parent, guardian, or legal custodian of each child
435.17who received services in the population of the facility where the maltreatment occurred.
435.18This notification must be provided to the parent, guardian, or legal custodian of each child
435.19receiving services from the time the maltreatment occurred until either the individual
435.20responsible for maltreatment is no longer in contact with a child or children in the facility
435.21or the conclusion of the investigation. In the case of maltreatment within a school facility,
435.22as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10, the commissioner
435.23of education need not provide notification to parents, guardians, or legal custodians of
435.24each child in the facility, but shall, within ten days after the investigation is completed,
435.25provide written notification to the parent, guardian, or legal custodian of any student
435.26alleged to have been maltreated. The commissioner of education may notify the parent,
435.27guardian, or legal custodian of any student involved as a witness to alleged maltreatment.
435.28EFFECTIVE DATE.This section is effective January 1, 2014.

435.29    Sec. 16. REPEALER.
435.30Minnesota Statutes 2012, section 256B.49, subdivision 16a, is repealed effective
435.31January 1, 2014.

435.32ARTICLE 10

435.33HEALTH-RELATED LICENSING BOARDS

435.34    Section 1. Minnesota Statutes 2012, section 148B.17, subdivision 2, is amended to read:
436.1    Subd. 2. Licensure and application fees. Nonrefundable licensure and application
436.2fees charged established by the board are as follows shall not exceed the following amounts:
436.3(1) application fee for national examination is $220 $110;
436.4(2) application fee for Licensed Marriage and Family Therapist (LMFT) state
436.5examination is $110;
436.6(3) initial LMFT license fee is prorated, but cannot exceed $125;
436.7(4) annual renewal fee for LMFT license is $125;
436.8(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
436.9 LMFT license renewal is $50;
436.10(6) application fee for LMFT licensure by reciprocity is $340 $220;
436.11(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
436.12license is $75;
436.13(8) annual renewal fee for LAMFT license is $75;
436.14(9) late fee for LAMFT renewal is $50 $25;
436.15(10) fee for reinstatement of license is $150; and
436.16(11) fee for emeritus status is $125.

436.17    Sec. 2. Minnesota Statutes 2012, section 151.19, subdivision 1, is amended to read:
436.18    Subdivision 1. Pharmacy registration licensure requirements. The board shall
436.19require and provide for the annual registration of every pharmacy now or hereafter doing
436.20business within this state. Upon the payment of any applicable fee specified in section
436.21151.065, the board shall issue a registration certificate in such form as it may prescribe to
436.22such persons as may be qualified by law to conduct a pharmacy. Such certificate shall
436.23be displayed in a conspicuous place in the pharmacy for which it is issued and expire on
436.24the 30th day of June following the date of issue. It shall be unlawful for any person to
436.25conduct a pharmacy unless such certificate has been issued to the person by the board. (a)
436.26No person shall operate a pharmacy without first obtaining a license from the board and
436.27paying any applicable fee specified in section 151.065. The license shall be displayed in a
436.28conspicuous place in the pharmacy for which it is issued and expires on June 30 following
436.29the date of issue. It is unlawful for any person to operate a pharmacy unless the license
436.30has been issued to the person by the board.
436.31    (b) Application for a pharmacy license under this section shall be made in a manner
436.32specified by the board.
436.33    (c) No license shall be issued or renewed for a pharmacy located within the state
436.34unless the applicant agrees to operate the pharmacy in a manner prescribed by federal and
436.35state law and according to rules adopted by the board. No license shall be issued for a
437.1pharmacy located outside of the state unless the applicant agrees to operate the pharmacy
437.2in a manner prescribed by federal law and, when dispensing medications for residents of
437.3this state, the laws of this state, and Minnesota Rules.
437.4    (d) No license shall be issued or renewed for a pharmacy that is required to be
437.5licensed or registered by the state in which it is physically located unless the applicant
437.6supplies the board with proof of such licensure or registration.
437.7    (e) The board shall require a separate license for each pharmacy located within
437.8the state and for each pharmacy located outside of the state at which any portion of the
437.9dispensing process occurs for drugs dispensed to residents of this state.
437.10    (f) The board shall not issue an initial or renewed license for a pharmacy unless the
437.11pharmacy passes an inspection conducted by an authorized representative of the board. In
437.12the case of a pharmacy located outside of the state, the board may require the applicant to
437.13pay the cost of the inspection, in addition to the license fee in section 151.065, unless the
437.14applicant furnishes the board with a report, issued by the appropriate regulatory agency of
437.15the state in which the facility is located, of an inspection that has occurred within the 24
437.16months immediately preceding receipt of the license application by the board. The board
437.17may deny licensure unless the applicant submits documentation satisfactory to the board
437.18that any deficiencies noted in an inspection report have been corrected.
437.19    (g) The board shall not issue an initial or renewed license for a pharmacy located
437.20outside of the state unless the applicant discloses and certifies:
437.21    (1) the location, names, and titles of all principal corporate officers and all
437.22pharmacists who are involved in dispensing drugs to residents of this state;
437.23    (2) that it maintains its records of drugs dispensed to residents of this state so that the
437.24records are readily retrievable from the records of other drugs dispensed;
437.25    (3) that it agrees to cooperate with, and provide information to, the board concerning
437.26matters related to dispensing drugs to residents of this state;
437.27    (4) that, during its regular hours of operation, but no less than six days per week, for
437.28a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
437.29communication between patients in this state and a pharmacist at the pharmacy who has
437.30access to the patients' records; the toll-free number must be disclosed on the label affixed
437.31to each container of drugs dispensed to residents of this state; and
437.32    (5) that, upon request of a resident of a long-term care facility located in this
437.33state, the resident's authorized representative, or a contract pharmacy or licensed health
437.34care facility acting on behalf of the resident, the pharmacy will dispense medications
437.35prescribed for the resident in unit-dose packaging or, alternatively, comply with section
437.36151.415, subdivision 5.

438.1    Sec. 3. Minnesota Statutes 2012, section 151.19, subdivision 3, is amended to read:
438.2    Subd. 3. Sale of federally restricted medical gases. The board shall require and
438.3provide for the annual registration of every person or establishment not licensed as a
438.4pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
438.5medical gases. Upon the payment of any applicable fee specified in section 151.065, the
438.6board shall issue a registration certificate in such form as it may prescribe to those persons
438.7or places that may be qualified to sell or distribute federally restricted medical gases. The
438.8certificate shall be displayed in a conspicuous place in the business for which it is issued
438.9and expire on the date set by the board. It is unlawful for a person to sell or distribute
438.10federally restricted medical gases unless a certificate has been issued to that person by the
438.11board. (a) A person or establishment not licensed as a pharmacy or a practitioner shall not
438.12engage in the retail sale or distribution of federally restricted medical gases without first
438.13obtaining a registration from the board and paying the applicable fee specified in section
438.14151.065. The registration shall be displayed in a conspicuous place in the business for
438.15which it is issued and expires on the date set by the board. It is unlawful for a person to
438.16sell or distribute federally restricted medical gases unless a certificate has been issued to
438.17that person by the board.
438.18    (b) Application for a medical gas distributor registration under this section shall be
438.19made in a manner specified by the board.
438.20    (c) No registration shall be issued or renewed for a medical gas distributor located
438.21within the state unless the applicant agrees to operate in a manner prescribed by federal
438.22and state law and according to the rules adopted by the board. No license shall be issued
438.23for a medical gas distributor located outside of the state unless the applicant agrees to
438.24operate in a manner prescribed by federal law and, when distributing medical gases for
438.25residents of this state, the laws of this state and Minnesota Rules.
438.26    (d) No registration shall be issued or renewed for a medical gas distributor that is
438.27required to be licensed or registered by the state in which it is physically located unless the
438.28applicant supplies the board with proof of the licensure or registration. The board may, by
438.29rule, establish standards for the registration of a medical gas distributor that is not required
438.30to be licensed or registered by the state in which it is physically located.
438.31    (e) The board shall require a separate registration for each medical gas distributor
438.32located within the state and for each facility located outside of the state from which
438.33medical gases are distributed to residents of this state.
438.34    (f) The board shall not issue an initial or renewed registration for a medical gas
438.35distributor unless the medical gas distributor passes an inspection conducted by an
438.36authorized representative of the board. In the case of a medical gas distributor located
439.1outside of the state, the board may require the applicant to pay the cost of the inspection,
439.2in addition to the license fee in section 151.065, unless the applicant furnishes the board
439.3with a report, issued by the appropriate regulatory agency of the state in which the facility
439.4is located, of an inspection that has occurred within the 24 months immediately preceding
439.5receipt of the license application by the board. The board may deny licensure unless the
439.6applicant submits documentation satisfactory to the board that any deficiencies noted in
439.7an inspection report have been corrected.

439.8    Sec. 4. [151.252] LICENSING OF DRUG MANUFACTURERS; FEES;
439.9PROHIBITIONS.
439.10    Subdivision 1. Requirements. (a) No person shall act as a drug manufacturer
439.11without first obtaining a license from the board and paying any applicable fee specified
439.12in section 151.065.
439.13    (b) Application for a drug manufacturer license under this section shall be made in a
439.14manner specified by the board.
439.15    (c) No license shall be issued or renewed for a drug manufacturer unless the
439.16applicant agrees to operate in a manner prescribed by federal and state law and according
439.17to Minnesota Rules.
439.18    (d) No license shall be issued or renewed for a drug manufacturer that is required
439.19to be registered pursuant to United State Code, title 21, section 360, unless the applicant
439.20supplies the board with proof of registration. The board may establish by rule the
439.21standards for licensure of drug manufacturers that are not required to be registered under
439.22United States Code, title 21, section 360.
439.23    (e) No license shall be issued or renewed for a drug manufacturer that is required to
439.24be licensed or registered by the state in which it is physically located unless the applicant
439.25supplies the board with proof of licensure or registration. The board may establish, by
439.26rule, standards for the licensure of a drug manufacturer that is not required to be licensed
439.27or registered by the state in which it is physically located.
439.28    (f) The board shall require a separate license for each facility located within the state
439.29at which drug manufacturing occurs and for each facility located outside of the state at
439.30which drugs that are shipped into the state are manufactured.
439.31    (g) The board shall not issue an initial or renewed license for a drug manufacturing
439.32facility unless the facility passes an inspection conducted by an authorized representative
439.33of the board. In the case of a drug manufacturing facility located outside of the state, the
439.34board may require the applicant to pay the cost of the inspection, in addition to the license
439.35fee in section 151.065, unless the applicant furnishes the board with a report, issued by the
440.1appropriate regulatory agency of the state in which the facility is located or by the United
440.2States Food and Drug Administration, of an inspection that has occurred within the 24
440.3months immediately preceding receipt of the license application by the board. The board
440.4may deny licensure unless the applicant submits documentation satisfactory to the board
440.5that any deficiencies noted in an inspection report have been corrected.
440.6    Subd. 2. Prohibition. It is unlawful for any person engaged in drug manufacturing
440.7to sell legend drugs to anyone located in this state except as provided in this chapter.
440.8    Subd. 3. Payment to practitioner; reporting. Unless prohibited by United States
440.9Code, title 42, section 1320a-7h, a drug manufacturer shall file with the board an annual
440.10report, in a form and on the date prescribed by the board, identifying all payments,
440.11honoraria, reimbursement, or other compensation authorized under section 151.461,
440.12clauses (4) and (5), paid to practitioners in Minnesota during the preceding calendar year.
440.13The report shall identify the nature and value of any payments totaling $100 or more to a
440.14particular practitioner during the year, and shall identify the practitioner. Reports filed
440.15under this subdivision are public data.

440.16    Sec. 5. Minnesota Statutes 2012, section 151.37, subdivision 4, is amended to read:
440.17    Subd. 4. Research. (a) Any qualified person may use legend drugs in the course
440.18of a bona fide research project, but cannot administer or dispense such drugs to human
440.19beings unless such drugs are prescribed, dispensed, and administered by a person lawfully
440.20authorized to do so.
440.21    (b) Drugs may be dispensed or distributed by a pharmacy licensed by the board for
440.22use by, or administration to, patients enrolled in a bona fide research study that is being
440.23conducted pursuant to either an investigational new drug application approved by the
440.24United States Food and Drug Administration or that has been approved by an institutional
440.25review board. For the purposes of this subdivision only:
440.26    (1) a prescription drug order is not required for a pharmacy to dispense a research
440.27drug, unless the study protocol requires the pharmacy to receive such an order;
440.28    (2) notwithstanding the prescription labeling requirements found in this chapter or
440.29the rules promulgated by the board, a research drug may be labeled as required by the
440.30study protocol; and
440.31    (3) dispensing and distribution of research drugs by pharmacies shall not be
440.32considered compounding, manufacturing, or wholesaling under this chapter.
440.33    (c) An entity that is under contract to a federal agency for the purpose of distributing
440.34drugs for bona fide research studies is exempt from the drug wholesaler licensing
440.35requirements of this chapter. Any other entity is exempt from the drug wholesaler
441.1licensing requirements of this chapter if the board finds that the entity is licensed or
441.2registered according to the laws of the state in which it is physically located and it is
441.3distributing drugs for use by, or administration to, patients enrolled in a bona fide research
441.4study that is being conducted pursuant to either an investigational new drug application
441.5approved by the United States Food and Drug Administration or that has been approved
441.6by an institutional review board.
441.7EFFECTIVE DATE.This section is effective the day following final enactment.

441.8    Sec. 6. Minnesota Statutes 2012, section 151.47, subdivision 1, is amended to read:
441.9    Subdivision 1. Requirements. (a) All wholesale drug distributors are subject to the
441.10requirements in paragraphs (a) to (f) of this subdivision.
441.11    (a) (b) No person or distribution outlet shall act as a wholesale drug distributor
441.12without first obtaining a license from the board and paying any applicable fee specified
441.13in section 151.065.
441.14    (c) Application for a wholesale drug distributor license under this section shall be
441.15made in a manner specified by the board.
441.16    (b) (d) No license shall be issued or renewed for a wholesale drug distributor to
441.17operate unless the applicant agrees to operate in a manner prescribed by federal and state
441.18law and according to the rules adopted by the board.
441.19    (c) The board may require a separate license for each facility directly or indirectly
441.20owned or operated by the same business entity within the state, or for a parent entity
441.21with divisions, subsidiaries, or affiliate companies within the state, when operations
441.22are conducted at more than one location and joint ownership and control exists among
441.23all the entities.
441.24    (e) No license may be issued or renewed for a drug wholesale distributor that is
441.25required to be licensed or registered by the state in which it is physically located unless
441.26the applicant supplies the board with proof of licensure or registration. The board may
441.27establish, by rule, standards for the licensure of a drug wholesale distributor that is not
441.28required to be licensed or registered by the state in which it is physically located.
441.29    (f) The board shall require a separate license for each drug wholesale distributor
441.30facility located within the state and for each drug wholesale distributor facility located
441.31outside of the state from which drugs are shipped into the state or to which drugs are
441.32reverse distributed.
441.33    (g) The board shall not issue an initial or renewed license for a drug wholesale
441.34distributor facility unless the facility passes an inspection conducted by an authorized
441.35representative of the board, or is accredited by an accreditation program approved by the
442.1board. In the case of a drug wholesale distributor facility located outside of the state, the
442.2board may require the applicant to pay the cost of the inspection, in addition to the license
442.3fee in section 151.065, unless the applicant furnishes the board with a report, issued by the
442.4appropriate regulatory agency of the state in which the facility is located, of an inspection
442.5that has occurred within the 24 months immediately preceding receipt of the license
442.6application by the board, or furnishes the board with proof of current accreditation. The
442.7board may deny licensure unless the applicant submits documentation satisfactory to the
442.8board that any deficiencies noted in an inspection report have been corrected.
442.9    (d) (h) As a condition for receiving and retaining a wholesale drug distributor license
442.10issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
442.11and will continuously maintain:
442.12    (1) adequate storage conditions and facilities;
442.13    (2) minimum liability and other insurance as may be required under any applicable
442.14federal or state law;
442.15    (3) a viable security system that includes an after hours central alarm, or comparable
442.16entry detection capability; restricted access to the premises; comprehensive employment
442.17applicant screening; and safeguards against all forms of employee theft;
442.18    (4) a system of records describing all wholesale drug distributor activities set forth
442.19in section 151.44 for at least the most recent two-year period, which shall be reasonably
442.20accessible as defined by board regulations in any inspection authorized by the board;
442.21    (5) principals and persons, including officers, directors, primary shareholders,
442.22and key management executives, who must at all times demonstrate and maintain their
442.23capability of conducting business in conformity with sound financial practices as well
442.24as state and federal law;
442.25    (6) complete, updated information, to be provided to the board as a condition for
442.26obtaining and retaining a license, about each wholesale drug distributor to be licensed,
442.27including all pertinent corporate licensee information, if applicable, or other ownership,
442.28principal, key personnel, and facilities information found to be necessary by the board;
442.29    (7) written policies and procedures that assure reasonable wholesale drug distributor
442.30preparation for, protection against, and handling of any facility security or operation
442.31problems, including, but not limited to, those caused by natural disaster or government
442.32emergency, inventory inaccuracies or product shipping and receiving, outdated product
442.33or other unauthorized product control, appropriate disposition of returned goods, and
442.34product recalls;
442.35    (8) sufficient inspection procedures for all incoming and outgoing product
442.36shipments; and
443.1    (9) operations in compliance with all federal requirements applicable to wholesale
443.2drug distribution.
443.3    (e) (i) An agent or employee of any licensed wholesale drug distributor need not
443.4seek licensure under this section.
443.5    (f) A wholesale drug distributor shall file with the board an annual report, in a
443.6form and on the date prescribed by the board, identifying all payments, honoraria,
443.7reimbursement or other compensation authorized under section 151.461, clauses (3) to
443.8(5), paid to practitioners in Minnesota during the preceding calendar year. The report
443.9shall identify the nature and value of any payments totaling $100 or more, to a particular
443.10practitioner during the year, and shall identify the practitioner. Reports filed under this
443.11provision are public data.

443.12    Sec. 7. Minnesota Statutes 2012, section 151.47, is amended by adding a subdivision
443.13to read:
443.14    Subd. 3. Prohibition. It is unlawful for any person engaged in wholesale drug
443.15distribution to sell drugs to a person located within the state or to receive drugs in reverse
443.16distribution from a person located within the state except as provided in this chapter.

443.17    Sec. 8. Minnesota Statutes 2012, section 151.49, is amended to read:
443.18151.49 LICENSE RENEWAL APPLICATION PROCEDURES.
443.19    Application blanks or notices for renewal of a license required by sections 151.42
443.20to 151.51 shall be mailed or otherwise provided to each licensee on or before the first
443.21day of the month prior to the month in which the license expires and, if application for
443.22renewal of the license with the required fee and supporting documents is not made before
443.23the expiration date, the existing license or renewal shall lapse and become null and void
443.24upon the date of expiration.

443.25    Sec. 9. [214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL
443.26BACKGROUND CHECKS.
443.27    Subdivision 1. Applications. (a) By January 1, 2018, each health-related licensing
443.28board, as defined in section 214.01, subdivision 2, shall require applicants for initial
443.29licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse
443.30in licensure, as defined by the individual health-related licensing boards, to submit to
443.31a criminal history records check of state data completed by the Bureau of Criminal
443.32Apprehension (BCA) and a national criminal history records check, including a search of
443.33the records of the Federal Bureau of Investigation (FBI).
444.1(b) An applicant must complete a criminal background check if more than one year
444.2has elapsed since the applicant last submitted a background check to the board.
444.3    Subd. 2. Investigations. If a health-related licensing board has reasonable cause
444.4to believe a licensee has been charged with or convicted of a crime in this or any other
444.5jurisdiction, the health-related licensing board may require the licensee to submit to a
444.6criminal history records check of state data completed by the BCA and a national criminal
444.7history records check, including a search of the records of the FBI.
444.8    Subd. 3. Consent form; fees; fingerprints. (a) In order to effectuate the federal
444.9and state level, fingerprint-based criminal background check, the applicant or licensee
444.10must submit a completed criminal history records check consent form and a full set of
444.11fingerprints to the respective health-related licensing board or a designee in the manner
444.12and form specified by the board.
444.13(b) The applicant or licensee is responsible for all fees associated with preparation of
444.14the fingerprints, the criminal records check consent form, and the criminal background
444.15check. The fees for the criminal records background check shall be set by the BCA and
444.16the FBI and are not refundable. The fees shall be submitted to the respective health-related
444.17licensing board by the applicant or licensee as prescribed by the respective board.
444.18    (c) All fees received by the health-related licensing boards under this subdivision
444.19shall be deposited in a dedicated account in the special revenue fund and are appropriated
444.20to the Board of Nursing Home Administrators for the administrative services unit to pay
444.21for the criminal background checks conducted by the Bureau of Criminal Apprehension
444.22and Federal Bureau of Investigation.
444.23    Subd. 4. Refusal to consent. (a) The health-related licensing boards shall not issue
444.24a license to any applicant who refuses to consent to a criminal background check or fails
444.25to submit fingerprints within 90 days after submission of an application for licensure. Any
444.26fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent
444.27to the criminal background check or fails to submit the required fingerprints.
444.28(b) The failure of a licensee to submit to a criminal background check as provided in
444.29subdivision 3 is grounds for disciplinary action by the respective health licensing board.
444.30    Subd. 5. Submission of fingerprints to the Bureau of Criminal Apprehension.
444.31The health-related licensing board or designee shall submit applicant or licensee
444.32fingerprints to the BCA. The BCA shall perform a check for state criminal justice
444.33information and shall forward the applicant's or licensee's fingerprints to the FBI to
444.34perform a check for national criminal justice information regarding the applicant or
444.35licensee. The BCA shall report to the board the results of the state and national criminal
444.36justice information checks.
445.1    Subd. 6. Alternatives to fingerprint-based criminal background checks. The
445.2health-related licensing board may require an alternative method of criminal history
445.3checks for an applicant or licensee who has submitted at least three sets of fingerprints in
445.4accordance with this section that have been unreadable by the BCA or the FBI.
445.5    Subd. 7. Opportunity to challenge accuracy of report. Prior to taking disciplinary
445.6action against an applicant or a licensee based on a criminal conviction, the health-related
445.7licensing board shall provide the applicant or the licensee an opportunity to complete or
445.8challenge the accuracy of the criminal history information reported to the board. The
445.9applicant or licensee shall have 30 calendar days following notice from the board of
445.10the intent to deny licensure or to take disciplinary action to request an opportunity to
445.11correct or complete the record prior to the board taking disciplinary action based on the
445.12information reported to the board. The board shall provide the applicant up to 180 days to
445.13challenge the accuracy or completeness of the report with the agency responsible for the
445.14record. This subdivision does not affect the right of the subject of the data to contest the
445.15accuracy or completeness under section 13.04, subdivision 4.
445.16    Subd. 8. Instructions to the board; plans. The health-related licensing boards, in
445.17collaboration with the commissioner of human services and the BCA, shall establish a
445.18plan for completing criminal background checks of all licensees who were licensed before
445.19the effective date requirement under subdivision 1. The plan must seek to minimize
445.20duplication of requirements for background checks of licensed health professionals. The
445.21plan for background checks of current licensees shall be developed no later than January
445.221, 2017, and may be contingent upon the implementation of a system by the BCA or FBI
445.23in which any new crimes that an applicant or licensee commits after an initial background
445.24check are flagged in the BCA's or FBI's database and reported back to the board. The plan
445.25shall include recommendations for any necessary statutory changes.

445.26    Sec. 10. Minnesota Statutes 2012, section 214.12, is amended by adding a subdivision
445.27to read:
445.28    Subd. 4. Parental depression. The health-related licensing boards that regulate
445.29professions that serve caregivers at risk of depression, or their children, including
445.30behavioral health and therapy, chiropractic, marriage and family therapy, medical practice,
445.31nursing, psychology, and social work, shall provide educational materials to licensees on
445.32the subject of parental depression and its potential effects on children if unaddressed,
445.33including how to:
445.34(1) screen mothers for depression;
445.35(2) identify children who are affected by their mother's depression; and
446.1(3) provide treatment or referral information on needed services.

446.2    Sec. 11. Minnesota Statutes 2012, section 214.40, subdivision 1, is amended to read:
446.3    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this
446.4section.
446.5(b) "Administrative services unit" means the administrative services unit for the
446.6health-related licensing boards.
446.7(c) "Charitable organization" means a charitable organization within the meaning of
446.8section 501(c)(3) of the Internal Revenue Code that has as a purpose the sponsorship or
446.9support of programs designed to improve the quality, awareness, and availability of health
446.10care services and that serves as a funding mechanism for providing those services.
446.11(d) "Health care facility or organization" means a health care facility licensed under
446.12chapter 144 or 144A, or a charitable organization.
446.13(e) "Health care provider" means a physician licensed under chapter 147, physician
446.14assistant registered licensed and practicing under chapter 147A, nurse licensed and
446.15registered to practice under chapter 148, or dentist or, dental hygienist, or dental therapist
446.16 licensed under chapter 150A, or an advanced dental therapist licensed and certified under
446.17chapter 150A.
446.18(f) "Health care services" means health promotion, health monitoring, health
446.19education, diagnosis, treatment, minor surgical procedures, the administration of local
446.20anesthesia for the stitching of wounds, and primary dental services, including preventive,
446.21diagnostic, restorative, and emergency treatment. Health care services do not include the
446.22administration of general anesthesia or surgical procedures other than minor surgical
446.23procedures.
446.24(g) "Medical professional liability insurance" means medical malpractice insurance
446.25as defined in section 62F.03.
446.26EFFECTIVE DATE.This section is effective the day following final enactment.

446.27    Sec. 12. INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO
446.28CRIMINAL BACKGROUND CHECKS.
446.29(a) If the Department of Health is not reviewed by the Sunset Advisory Commission
446.30according to the schedule in Minnesota Statutes, section 3D.21, the commissioner
446.31of health, as the regulator for occupational therapy practitioners, speech-language
446.32pathologists, audiologists, and hearing instrument dispensers, shall require applicants
446.33for licensure or renewal to submit to a criminal history records check as required under
447.1Minnesota Statutes, section 214.075, for other health-related licensed occupations
447.2regulated by the health-related licensing boards.
447.3(b) Any statutory changes necessary to include the commissioner of health to
447.4Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota
447.5Statutes, section 214.075, subdivision 8.

447.6    Sec. 13. REPEALER.
447.7Minnesota Statutes 2012, sections 151.19, subdivision 2; 151.25; 151.45; 151.47,
447.8subdivision 2; and 151.48, are repealed.

447.9ARTICLE 11

447.10HOME CARE PROVIDERS

447.11    Section 1. Minnesota Statutes 2012, section 13.381, subdivision 2, is amended to read:
447.12    Subd. 2. Health occupations data. (a) Health-related licensees and registrants.
447.13The collection, analysis, reporting, and use of data on individuals licensed or registered by
447.14the commissioner of health or health-related licensing boards are governed by sections
447.15144.051, subdivision 2 subdivisions 2 to 6 , and 144.052.
447.16(b) Health services personnel. Data collected by the commissioner of health for the
447.17database on health services personnel are classified under section 144.1485.

447.18    Sec. 2. Minnesota Statutes 2012, section 13.381, subdivision 10, is amended to read:
447.19    Subd. 10. Home care and hospice provider. Data regarding a home care provider
447.20under sections 144A.43 to 144A.47 are governed by section 144A.45. Data regarding
447.21home care provider background studies are governed by section 144A.476, subdivision 1.
447.22Data regarding a hospice provider under sections 144A.75 to 144A.755 are governed by
447.23sections 144A.752 and 144A.754.

447.24    Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
447.25to read:
447.26    Subd. 3. Data classification; private data. For providers regulated pursuant to
447.27sections 144A.43 to 144A.482, the following data collected, created, or maintained by
447.28the commissioner are classified as private data on individuals as defined in section 13.02,
447.29subdivision 12:
447.30(1) data submitted by or on behalf of applicants for licenses prior to issuance of
447.31the license;
448.1(2) the identity of complainants who have made reports concerning licensees or
448.2applicants unless the complainant consents to the disclosure;
448.3(3) the identity of individuals who provide information as part of surveys and
448.4investigations;
448.5(4) Social Security numbers; and
448.6(5) health record data.

448.7    Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
448.8to read:
448.9    Subd. 4. Data classification; public data. For providers regulated pursuant to
448.10sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
448.11commissioner are classified as public data as defined in section 13.02, subdivision 15:
448.12(1) all application data on licensees, license numbers, license status;
448.13(2) licensing information about licenses previously held under this chapter;
448.14(3) correction orders, including information about compliance with the order and
448.15whether the fine was paid;
448.16(4) final enforcement actions pursuant to chapter 14;
448.17(5) orders for hearing, findings of fact and conclusions of law; and
448.18(6) when the licensee and department agree to resolve the matter without a hearing,
448.19the agreement and specific reasons for the agreement are public data.

448.20    Sec. 5. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
448.21to read:
448.22    Subd. 5. Data classification; confidential data. For providers regulated pursuant to
448.23sections 144A.43 to 144A.482, the following data collected, created, or maintained by
448.24the Department of Health are classified as confidential data on individuals as defined in
448.25section 13.02, subdivision 3: active investigative data relating to the investigation of
448.26potential violations of law by a licensee including data from the survey process before the
448.27correction order is issued by the department.

448.28    Sec. 6. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
448.29to read:
448.30    Subd. 6. Release of private or confidential data. For providers regulated pursuant
448.31to sections 144A.43 to 144A.482, the department may release private or confidential data,
448.32except Social Security numbers, to the appropriate state, federal, or local agency and law
448.33enforcement office to enhance investigative or enforcement efforts or further a public
449.1health protective process. Types of offices include Adult Protective Services, Office of the
449.2Ombudsmen for Long-Term Care and Office of the Ombudsmen for Mental Health and
449.3Developmental Disabilities, the health licensing boards, Department of Human Services,
449.4county or city attorney's offices, police, and local or county public health offices.

449.5    Sec. 7. Minnesota Statutes 2012, section 144A.43, is amended to read:
449.6144A.43 DEFINITIONS.
449.7    Subdivision 1. Applicability. The definitions in this section apply to sections
449.8144.699, subdivision 2 , and 144A.43 to 144A.47 144A.482.
449.9    Subd. 1a. Agent. "Agent" means the person upon whom all notices and orders shall
449.10be served and who is authorized to accept service of notices and orders on behalf of
449.11the home care provider.
449.12    Subd. 1b. Applicant. "Applicant" means an individual, organization, association,
449.13corporation, unit of government, or other entity that applies for a temporary license,
449.14license, or renewal of the applicant's home care provider license under section 144A.472.
449.15    Subd. 1c. Client. "Client" means a person to whom home care services are provided.
449.16    Subd. 1d. Client record. "Client record" means all records that document
449.17information about the home care services provided to the client by the home care provider.
449.18    Subd. 1e. Client representative. "Client representative" means a person who,
449.19because of the client's needs, makes decisions about the client's care on behalf of the
449.20client. A client representative may be a guardian, health care agent, family member, or
449.21other agent of the client. Nothing in this section expands or diminishes the rights of
449.22persons to act on behalf of clients under other law.
449.23    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
449.24    Subd. 2a. Controlled substance. "Controlled substance" has the meaning given
449.25in section 152.01, subdivision 4.
449.26    Subd. 2b. Department. "Department" means the Minnesota Department of Health.
449.27    Subd. 2c. Dietary supplement. "Dietary supplement" means a product taken
449.28by mouth that contains a dietary ingredient intended to supplement the diet. Dietary
449.29ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and
449.30substances such as enzymes, organ tissue, glandulars, or metabolites.
449.31    Subd. 2d. Dietitian. "Dietitian" is a person licensed under sections 148.621 to
449.32148.633.
449.33    Subd. 2e. Dietetics or nutrition practice. "Dietetics or nutrition practice" is
449.34performed by a licensed dietitian or licensed nutritionist and includes the activities of
449.35assessment, setting priorities and objectives, providing nutrition counseling, developing
450.1and implementing nutrition care services, and evaluating and maintaining appropriate
450.2standards of quality of nutrition care under sections 148.621 to 148.633.
450.3    Subd. 3. Home care service. "Home care service" means any of the following
450.4services when delivered in a place of residence to the home of a person whose illness,
450.5disability, or physical condition creates a need for the service:
450.6(1) nursing services, including the services of a home health aide;
450.7(2) personal care services not included under sections 148.171 to 148.285;
450.8(3) physical therapy;
450.9(4) speech therapy;
450.10(5) respiratory therapy;
450.11(6) occupational therapy;
450.12(7) nutritional services;
450.13(8) home management services when provided to a person who is unable to perform
450.14these activities due to illness, disability, or physical condition. Home management
450.15services include at least two of the following services: housekeeping, meal preparation,
450.16and shopping;
450.17(9) medical social services;
450.18(10) the provision of medical supplies and equipment when accompanied by the
450.19provision of a home care service; and
450.20(11) other similar medical services and health-related support services identified by
450.21the commissioner in rule.
450.22"Home care service" does not include the following activities conducted by the
450.23commissioner of health or a board of health as defined in section 145A.02, subdivision 2:
450.24communicable disease investigations or testing; administering or monitoring a prescribed
450.25therapy necessary to control or prevent a communicable disease; or the monitoring
450.26of an individual's compliance with a health directive as defined in section 144.4172,
450.27subdivision 6 .
450.28(1) assistive tasks provided by unlicensed personnel;
450.29(2) services provided by a registered nurse or licensed practical nurse, physical
450.30therapist, respiratory therapist, occupational therapist, speech-language pathologist,
450.31dietitian or nutritionist, or social worker;
450.32(3) medication and treatment management services; or
450.33(4) the provision of durable medical equipment services when provided with any of
450.34the home care services listed in clauses (1) to (3).
450.35    Subd. 3a. Hands-on assistance. "Hands-on assistance" means physical help by
450.36another person without which the client is not able to perform the activity.
451.1    Subd. 3b. Home. "Home" means the client's temporary or permanent place of
451.2residence.
451.3    Subd. 4. Home care provider. "Home care provider" means an individual,
451.4organization, association, corporation, unit of government, or other entity that is regularly
451.5engaged in the delivery of at least one home care service, directly or by contractual
451.6arrangement, of home care services in a client's home for a fee and who has a valid current
451.7temporary license or license issued under sections 144A.43 to 144A.482. At least one
451.8home care service must be provided directly, although additional home care services may
451.9be provided by contractual arrangements. "Home care provider" does not include:
451.10(1) any home care or nursing services conducted by and for the adherents of any
451.11recognized church or religious denomination for the purpose of providing care and
451.12services for those who depend upon spiritual means, through prayer alone, for healing;
451.13(2) an individual who only provides services to a relative;
451.14(3) an individual not connected with a home care provider who provides assistance
451.15with home management services or personal care needs if the assistance is provided
451.16primarily as a contribution and not as a business;
451.17(4) an individual not connected with a home care provider who shares housing with
451.18and provides primarily housekeeping or homemaking services to an elderly or disabled
451.19person in return for free or reduced-cost housing;
451.20(5) an individual or agency providing home-delivered meal services;
451.21(6) an agency providing senior companion services and other older American
451.22volunteer programs established under the Domestic Volunteer Service Act of 1973,
451.23Public Law 98-288;
451.24(7) an employee of a nursing home licensed under this chapter or an employee of a
451.25boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
451.26emergency calls from individuals residing in a residential setting that is attached to or
451.27located on property contiguous to the nursing home or boarding care home;
451.28(8) a member of a professional corporation organized under chapter 319B that does
451.29not regularly offer or provide home care services as defined in subdivision 3;
451.30(9) the following organizations established to provide medical or surgical services
451.31that do not regularly offer or provide home care services as defined in subdivision 3:
451.32a business trust organized under sections 318.01 to 318.04, a nonprofit corporation
451.33organized under chapter 317A, a partnership organized under chapter 323, or any other
451.34entity determined by the commissioner;
452.1(10) an individual or agency that provides medical supplies or durable medical
452.2equipment, except when the provision of supplies or equipment is accompanied by a
452.3home care service;
452.4(11) an individual licensed under chapter 147; or
452.5(12) an individual who provides home care services to a person with a developmental
452.6disability who lives in a place of residence with a family, foster family, or primary caregiver.
452.7    Subd. 5. Medication reminder. "Medication reminder" means providing a verbal
452.8or visual reminder to a client to take medication. This includes bringing the medication
452.9to the client and providing liquids or nutrition to accompany medication that a client is
452.10self-administering.
452.11    Subd. 6. License. "License" means a basic or comprehensive home care license
452.12issued by the commissioner to a home care provider.
452.13    Subd. 7. Licensed health professional. "Licensed health professional" means a
452.14person, other than a registered nurse or licensed practical nurse, who provides home care
452.15services within the scope of practice of the person's health occupation license, registration,
452.16or certification as regulated and who is licensed by the appropriate Minnesota state board
452.17or agency.
452.18    Subd. 8. Licensee. "Licensee" means a home care provider that is licensed under
452.19this chapter.
452.20    Subd. 9. Managerial official. "Managerial official" means an administrator,
452.21director, officer, trustee, or employee of a home care provider, however designated, who
452.22has the authority to establish or control business policy.
452.23    Subd. 10. Medication. "Medication" means a prescription or over-the-counter drug.
452.24For purposes of this chapter only, medication includes dietary supplements.
452.25    Subd. 11. Medication administration. "Medication administration" means
452.26performing a set of tasks to ensure a client takes medications, and includes the following:
452.27(1) checking the client's medication record;
452.28(2) preparing the medication as necessary;
452.29(3) administering the medication to the client;
452.30(4) documenting the administration or reason for not administering the medication;
452.31and
452.32(5) reporting to a nurse any concerns about the medication, the client, or the client's
452.33refusal to take the medication.
452.34    Subd. 12. Medication management. "Medication management" means the
452.35provision of any of the following medication-related services to a client:
452.36(1) performing medication setup;
453.1(2) administering medication;
453.2(3) storing and securing medications;
453.3(4) documenting medication activities;
453.4(5) verifying and monitoring effectiveness of systems to ensure safe handling and
453.5administration;
453.6(6) coordinating refills;
453.7(7) handling and implementing changes to prescriptions;
453.8(8) communicating with the pharmacy about the client's medications; and
453.9(9) coordinating and communicating with the prescriber.
453.10    Subd. 13. Medication setup. "Medication setup" means arranging medications by a
453.11nurse, pharmacy, or authorized prescriber for later administration by the client or by
453.12comprehensive home care staff.
453.13    Subd. 14. Nurse. "Nurse" means a person who is licensed under sections 148.171 to
453.14148.285.
453.15    Subd. 15. Occupational therapist. "Occupational therapist" means a person who is
453.16licensed under sections 148.6401 to 148.6450.
453.17    Subd. 16. Over-the-counter drug. "Over-the-counter drug" means a drug that is
453.18not required by federal law to bear the symbol "Rx only."
453.19    Subd. 17. Owner. "Owner" means a proprietor, general partner, limited partner who
453.20has five percent or more equity interest in a limited partnership, a person who owns or
453.21controls voting stock in a corporation in an amount equal to or greater than five percent of
453.22the shares issued and outstanding, or a corporation that owns equity interest in a licensee
453.23or applicant for a license.
453.24    Subd. 18. Pharmacist. "Pharmacist" has the meaning given in section 151.01,
453.25subdivision 3.
453.26    Subd. 19. Physical therapist. "Physical therapist" means a person who is licensed
453.27under sections 148.65 to 148.78.
453.28    Subd. 20. Physician. "Physician" means a person who is licensed under chapter 147.
453.29    Subd. 21. Prescriber. "Prescriber" means a person who is authorized by sections
453.30148.235; 151.01, subdivision 23; and 151.37 to prescribe prescription drugs.
453.31    Subd. 22. Prescription. "Prescription" has the meaning given in section 151.01,
453.32subdivision 16.
453.33    Subd. 23. Regularly scheduled. "Regularly scheduled" means ordered or planned
453.34to be completed at predetermined times or according to a predetermined routine.
453.35    Subd. 24. Reminder. "Reminder" means providing a verbal or visual reminder
453.36to a client.
454.1    Subd. 25. Respiratory therapist. "Respiratory therapist" means a person who
454.2is licensed under chapter 147C.
454.3    Subd. 26. Revenues. "Revenues" means all money received by a licensee derived
454.4from the provision of home care services, including fees for services and appropriations
454.5of public money for home care services.
454.6    Subd. 27. Service plan. "Service plan" means the written plan between the client or
454.7client's representative and the temporary licensee or licensee about the services that will
454.8be provided to the client.
454.9    Subd. 28. Social worker. "Social worker" means a person who is licensed under
454.10chapter 148D or 148E.
454.11    Subd. 29. Speech-language pathologist. "Speech-language pathologist" has the
454.12meaning given in section 148.512.
454.13    Subd. 30. Standby assistance. "Standby assistance" means the presence of another
454.14person within arm's reach to minimize the risk of injury while performing daily activities
454.15through physical intervention or cuing.
454.16    Subd. 31. Substantial compliance. "Substantial compliance" means complying
454.17with the requirements in this chapter sufficiently to prevent unacceptable health or safety
454.18risks to the home care client.
454.19    Subd. 32. Survey. "Survey" means an inspection of a licensee or applicant for
454.20licensure for compliance with this chapter.
454.21    Subd. 33. Surveyor. "Surveyor" means a staff person of the department authorized
454.22to conduct surveys of home care providers and applicants.
454.23    Subd. 34. Temporary license. "Temporary license" means the initial basic or
454.24comprehensive home care license the department issues after approval of a complete
454.25written application and before the department completes the temporary license survey and
454.26determines that the temporary licensee is in substantial compliance.
454.27    Subd. 35. Treatment or therapy. "Treatment" or "therapy" means the provision
454.28of care, other than medications, ordered or prescribed by a licensed health professional
454.29provided to a client to cure, rehabilitate, or ease symptoms.
454.30    Subd. 36. Unit of government. "Unit of government" means every city, county,
454.31town, school district, other political subdivisions of the state, or agency of the state or
454.32federal government, which includes any instrumentality of a unit of government.
454.33    Subd. 37. Unlicensed personnel. "Unlicensed personnel" are individuals not
454.34otherwise licensed or certified by a governmental health board or agency who provide
454.35home care services in the client's home.
454.36    Subd. 38. Verbal. "Verbal" means oral and not in writing.

455.1    Sec. 8. Minnesota Statutes 2012, section 144A.44, is amended to read:
455.2144A.44 HOME CARE BILL OF RIGHTS.
455.3    Subdivision 1. Statement of rights. A person who receives home care services
455.4has these rights:
455.5(1) the right to receive written information about rights in advance of before
455.6receiving care or during the initial evaluation visit before the initiation of treatment
455.7 services, including what to do if rights are violated;
455.8(2) the right to receive care and services according to a suitable and up-to-date plan,
455.9and subject to accepted health care, medical or nursing standards, to take an active part
455.10in creating and changing the plan developing, modifying, and evaluating care the plan
455.11 and services;
455.12(3) the right to be told in advance of before receiving care about the services that will
455.13be provided, the disciplines that will furnish care the type and disciplines of staff who will
455.14be providing the services, the frequency of visits proposed to be furnished, other choices
455.15that are available for addressing home care needs, and the consequences of these choices
455.16including the potential consequences of refusing these services;
455.17(4) the right to be told in advance of any change recommended changes by the
455.18provider in the service plan of care and to take an active part in any change decisions
455.19about changes to the service plan;
455.20(5) the right to refuse services or treatment;
455.21(6) the right to know, in advance before receiving services or during the initial
455.22visit, any limits to the services available from a home care provider, and the provider's
455.23grounds for a termination of services;
455.24(7) the right to know in advance of receiving care whether the services are covered
455.25by health insurance, medical assistance, or other health programs, the charges for services
455.26that will not be covered by Medicare, and the charges that the individual may have to pay;
455.27(8) (7) the right to know be told before services are initiated what the provider
455.28charges are for the services, no matter who will be paying the bill; to what extent payment
455.29may be expected from health insurance, public programs, or other sources, if known; and
455.30what charges the client may be responsible for paying;
455.31(9) (8) the right to know that there may be other services available in the community,
455.32including other home care services and providers, and to know where to go for find
455.33 information about these services;
455.34(10) (9) the right to choose freely among available providers and to change providers
455.35after services have begun, within the limits of health insurance, long-term care insurance,
455.36medical assistance, or other health programs;
456.1(11) (10) the right to have personal, financial, and medical information kept private,
456.2and to be advised of the provider's policies and procedures regarding disclosure of such
456.3information;
456.4(12) (11) the right to be allowed access to the client's own records and written
456.5information from those records in accordance with sections 144.291 to 144.298;
456.6(13) (12) the right to be served by people who are properly trained and competent
456.7to perform their duties;
456.8(14) (13) the right to be treated with courtesy and respect, and to have the patient's
456.9 client's property treated with respect;
456.10(15) (14) the right to be free from physical and verbal abuse, neglect, financial
456.11exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and
456.12the Maltreatment of Minors Act;
456.13(16) (15) the right to reasonable, advance notice of changes in services or charges,
456.14including;
456.15(16) the right to know the provider's reason for termination of services;
456.16(17) the right to at least ten days' advance notice of the termination of a service by a
456.17provider, except in cases where:
456.18(i) the recipient of services client engages in conduct that significantly alters the
456.19conditions of employment as specified in the employment contract between terms of
456.20the service plan with the home care provider and the individual providing home care
456.21services, or creates;
456.22(ii) the client, person who lives with the client, or others create an abusive or unsafe
456.23work environment for the individual person providing home care services; or
456.24(ii) (iii) an emergency for the informal caregiver or a significant change in the
456.25recipient's client's condition has resulted in service needs that exceed the current service
456.26provider agreement plan and that cannot be safely met by the home care provider;
456.27(17) (18) the right to a coordinated transfer when there will be a change in the
456.28provider of services;
456.29(18) (19) the right to voice grievances regarding treatment or care that is complain
456.30about services that are provided, or fails to be, furnished, or regarding fail to be provided,
456.31and the lack of courtesy or respect to the patient client or the patient's client's property;
456.32(19) (20) the right to know how to contact an individual associated with the home
456.33care provider who is responsible for handling problems and to have the home care provider
456.34investigate and attempt to resolve the grievance or complaint;
456.35(20) (21) the right to know the name and address of the state or county agency to
456.36contact for additional information or assistance; and
457.1(21) (22) the right to assert these rights personally, or have them asserted by
457.2the patient's family or guardian when the patient has been judged incompetent, client's
457.3representative or by anyone on behalf of the client, without retaliation.
457.4    Subd. 2. Interpretation and enforcement of rights. These rights are established
457.5for the benefit of persons clients who receive home care services. "Home care services"
457.6means home care services as defined in section 144A.43, subdivision 3, and unlicensed
457.7personal care assistance services, including services covered by medical assistance under
457.8section 256B.0625, subdivision 19a. All home care providers, including those exempted
457.9under section 144A.471, must comply with this section. The commissioner shall enforce
457.10this section and the home care bill of rights requirement against home care providers
457.11exempt from licensure in the same manner as for licensees. A home care provider may
457.12not request or require a person client to surrender any of these rights as a condition of
457.13receiving services. A guardian or conservator or, when there is no guardian or conservator,
457.14a designated person, may seek to enforce these rights. This statement of rights does not
457.15replace or diminish other rights and liberties that may exist relative to persons clients
457.16 receiving home care services, persons providing home care services, or providers licensed
457.17under Laws 1987, chapter 378. A copy of these rights must be provided to an individual
457.18at the time home care services, including personal care assistance services, are initiated.
457.19The copy shall also contain the address and phone number of the Office of Health Facility
457.20Complaints and the Office of Ombudsman for Long-Term Care and a brief statement
457.21describing how to file a complaint with these offices. Information about how to contact
457.22the Office of Ombudsman for Long-Term Care shall be included in notices of change in
457.23client fees and in notices where home care providers initiate transfer or discontinuation of
457.24services sections 144A.43 to 144A.482.

457.25    Sec. 9. Minnesota Statutes 2012, section 144A.45, is amended to read:
457.26144A.45 REGULATION OF HOME CARE SERVICES.
457.27    Subdivision 1. Rules Regulations. The commissioner shall adopt rules for the
457.28regulation of regulate home care providers pursuant to sections 144A.43 to 144A.47
457.29 144A.482. The rules regulations shall include the following:
457.30    (1) provisions to assure, to the extent possible, the health, safety and, well-being,
457.31and appropriate treatment of persons who receive home care services while respecting
457.32a client's autonomy and choice;
457.33    (2) requirements that home care providers furnish the commissioner with specified
457.34information necessary to implement sections 144A.43 to 144A.47 144A.482;
458.1    (3) standards of training of home care provider personnel, which may vary according
458.2to the nature of the services provided or the health status of the consumer;
458.3(4) standards for provision of home care services;
458.4    (4) (5) standards for medication management which may vary according to the
458.5nature of the services provided, the setting in which the services are provided, or the
458.6status of the consumer. Medication management includes the central storage, handling,
458.7distribution, and administration of medications;
458.8    (5) (6) standards for supervision of home care services requiring supervision by a
458.9registered nurse or other appropriate health care professional which must occur on site
458.10at least every 62 days, or more frequently if indicated by a clinical assessment, and in
458.11accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a
458.12person performing home care aide tasks for a class B licensee providing paraprofessional
458.13services does not require nursing supervision;
458.14    (6) (7) standards for client evaluation or assessment which may vary according to
458.15the nature of the services provided or the status of the consumer;
458.16    (7) (8) requirements for the involvement of a consumer's physician client's health
458.17care provider, the documentation of physicians' health care providers' orders, if required,
458.18and the consumer's treatment client's service plan, and;
458.19(9) the maintenance of accurate, current clinical client records;
458.20    (8) (10) the establishment of different classes basic and comprehensive levels of
458.21licenses for different types of providers and different standards and requirements for
458.22different kinds of home care based on services provided; and
458.23    (9) operating procedures required to implement (11) provisions to enforce these
458.24regulations and the home care bill of rights.
458.25    Subd. 1a. Home care aide tasks. Notwithstanding the provisions of Minnesota
458.26Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
458.27toileting, transfers, and ambulation if the client is ambulatory and if the client has no
458.28serious acute illness or infectious disease.
458.29    Subd. 1b. Home health aide qualifications. Notwithstanding the provisions of
458.30Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks
458.31if the person maintains current registration as a nursing assistant on the Minnesota nursing
458.32assistant registry. Maintaining current registration on the Minnesota nursing assistant
458.33registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110,
458.34subpart 3.
458.35    Subd. 2. Regulatory functions. (a) The commissioner shall:
459.1(1) evaluate, monitor, and license, survey, and monitor without advance notice, home
459.2care providers in accordance with sections 144A.45 to 144A.47 144A.43 to 144A.482;
459.3(2) inspect the office and records of a provider during regular business hours without
459.4advance notice to the home care provider;
459.5(2) survey every temporary licensee within one year of the temporary license issuance
459.6date subject to the temporary licensee providing home care services to a client or clients;
459.7(3) survey all licensed home care providers on an interval that will promote the
459.8health and safety of clients;
459.9(3) (4) with the consent of the consumer client, visit the home where services are
459.10being provided;
459.11(4) (5) issue correction orders and assess civil penalties in accordance with section
459.12144.653, subdivisions 5 to 8 , for violations of sections 144A.43 to 144A.47 or the rules
459.13adopted under those sections 144A.482;
459.14(5) (6) take action as authorized in section 144A.46, subdivision 3 144A.475; and
459.15(6) (7) take other action reasonably required to accomplish the purposes of sections
459.16144A.43 to 144A.47 144A.482.
459.17(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the
459.18commissioner shall comply with the applicable requirements of section 144.122, the
459.19Government Data Practices Act, and the Administrative Procedure Act.
459.20    Subd. 4. Medicaid reimbursement. Notwithstanding the provisions of section
459.21256B.37 or state plan requirements to the contrary, certification by the federal Medicare
459.22program must not be a requirement of Medicaid payment for services delivered under
459.23section 144A.4605.
459.24    Subd. 5. Home care providers; services for Alzheimer's disease or related
459.25disorder. (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets
459.26or otherwise promotes services for persons with Alzheimer's disease or related disorders,
459.27the facility's direct care staff and their supervisors must be trained in dementia care.
459.28(b) Areas of required training include:
459.29(1) an explanation of Alzheimer's disease and related disorders;
459.30(2) assistance with activities of daily living;
459.31(3) problem solving with challenging behaviors; and
459.32(4) communication skills.
459.33(c) The licensee shall provide to consumers in written or electronic form a
459.34description of the training program, the categories of employees trained, the frequency
459.35of training, and the basic topics covered.

460.1    Sec. 10. [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.
460.2    Subdivision 1. License required. A home care provider may not open, operate,
460.3manage, conduct, maintain, or advertise itself as a home care provider or provide home
460.4care services in Minnesota without a temporary or current home care provider license
460.5issued by the commissioner of health.
460.6    Subd. 2. Determination of direct home care service. (a) "Direct home care
460.7service" means a home care service provided to a client by the home care provider or its
460.8employees, and not by contract. Factors that must be considered in determining whether
460.9an individual or a business entity provides at least one home care service directly include,
460.10but are not limited to, whether the individual or business entity:
460.11    (1) has the right to control, and does control, the types of services provided;
460.12(2) has the right to control, and does control, when and how the services are provided;
460.13    (3) establishes the charges;
460.14(4) collects fees from the clients or receives payment from third-party payers on
460.15the clients' behalf;
460.16(5) pays individuals providing services compensation on an hourly, weekly, or
460.17similar basis;
460.18(6) treats the individuals providing services as employees for the purposes of payroll
460.19taxes and workers' compensation insurance; and
460.20(7) holds itself out as a provider of home care services or acts in a manner that
460.21leads clients or potential clients to believe that it is a home care provider providing home
460.22care services.
460.23    (b) None of the factors listed in this subdivision is solely determinative.
460.24    Subd. 3. Determination of regularly engaged. (a) "Regularly engaged" means
460.25providing, or offering to provide, home care services as a regular part of a business. The
460.26following factors must be considered by the commissioner in determining whether an
460.27individual or a business entity is regularly engaged in providing home care services:
460.28    (1) whether the individual or business entity states or otherwise promotes that the
460.29individual or business entity provides home care services;
460.30    (2) whether persons receiving home care services constitute a substantial part of the
460.31individual's or the business entity's clientele; and
460.32(3) whether the home care services provided are other than occasional or incidental
460.33to the provision of services other than home care services.
460.34    (b) None of the factors listed in this subdivision is solely determinative.
460.35    Subd. 4. Penalties for operating without license. A person involved in the
460.36management, operation, or control of a home care provider that operates without an
461.1appropriate license is guilty of a misdemeanor. This section does not apply to a person
461.2who has no legal authority to affect or change decisions related to the management,
461.3operation, or control of a home care provider.
461.4    Subd. 5. Basic and comprehensive levels of licensure. An applicant seeking
461.5to become a home care provider must apply for either a basic or comprehensive home
461.6care license.
461.7    Subd. 6. Basic home care license provider. Home care services that can be
461.8provided with a basic home care license are assistive tasks provided by licensed or
461.9unlicensed personnel that include:
461.10(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting,
461.11and bathing;
461.12(2) providing standby assistance;
461.13(3) providing verbal or visual reminders to the client to take regularly scheduled
461.14medication, which includes bringing the client previously set-up medication, medication
461.15in original containers, or liquid or food to accompany the medication;
461.16(4) providing verbal or visual reminders to the client to perform regularly scheduled
461.17treatments and exercises;
461.18(5) preparing modified diets ordered by a licensed health professional; and
461.19(6) assisting with laundry, housekeeping, meal preparation, shopping, or other
461.20household chores and services if the provider is also providing at least one of the activities
461.21in clauses (1) to (5)
461.22    Subd. 7. Comprehensive home care license provider. Home care services that
461.23may be provided with a comprehensive home care license include any of the basic home
461.24care services listed in subdivision 6, and one or more of the following:
461.25(1) services of an advanced practice nurse, registered nurse, licensed practical
461.26nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
461.27pathologist, dietitian or nutritionist, or social worker;
461.28(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a
461.29licensed health professional within the person's scope of practice;
461.30(3) medication management services;
461.31(4) hands-on assistance with transfers and mobility;
461.32(5) assisting clients with eating when the clients have complicating eating problems
461.33as identified in the client record or through an assessment such as difficulty swallowing,
461.34recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
461.35instruments to be fed; or
461.36(6) providing other complex or specialty health care services.
462.1    Subd. 8. Exemptions from home care services licensure. (a) Except as otherwise
462.2provided in this chapter, home care services that are provided by the state, counties, or
462.3other units of government must be licensed under this chapter.
462.4(b) An exemption under this subdivision does not excuse the exempted individual or
462.5organization from complying with applicable provisions of the home care bill of rights
462.6in section 144A.44. The following individuals or organizations are exempt from the
462.7requirement to obtain a home care provider license:
462.8(1) an individual or organization that offers, provides, or arranges for personal care
462.9assistance services under the medical assistance program as authorized under sections
462.10256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;
462.11(2) a provider that is licensed by the commissioner of human services to provide
462.12semi-independent living services for persons with developmental disabilities under section
462.13252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
462.14(3) a provider that is licensed by the commissioner of human services to provide
462.15home and community-based services for persons with developmental disabilities under
462.16section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
462.17(4) an individual or organization that provides only home management services, if
462.18the individual or organization is registered under section 144A.482; or
462.19(5) an individual who is licensed in this state as a nurse, dietitian, social worker,
462.20occupational therapist, physical therapist, or speech-language pathologist who provides
462.21health care services in the home independently and not through any contractual or
462.22employment relationship with a home care provider or other organization.
462.23    Subd. 9. Exclusions from home care licensure. The following are excluded from
462.24home care licensure and are not required to provide the home care bill of rights:
462.25(1) an individual or business entity providing only coordination of home care that
462.26includes one or more of the following:
462.27(i) determination of whether a client needs home care services, or assisting a client
462.28in determining what services are needed;
462.29(ii) referral of clients to a home care provider;
462.30(iii) administration of payments for home care services; or
462.31(iv) administration of a health care home established under section 256B.0751;
462.32(2) an individual who is not an employee of a licensed home care provider if the
462.33individual:
462.34(i) only provides services as an independent contractor to one or more licensed
462.35home care providers;
462.36(ii) provides no services under direct agreements or contracts with clients; and
463.1(iii) is contractually bound to perform services in compliance with the contracting
463.2home care provider's policies and service plans;
463.3(3) a business that provides staff to home care providers, such as a temporary
463.4employment agency, if the business:
463.5(i) only provides staff under contract to licensed or exempt providers;
463.6(ii) provides no services under direct agreements with clients; and
463.7(iii) is contractually bound to perform services under the contracting home care
463.8provider's direction and supervision;
463.9(4) any home care services conducted by and for the adherents of any recognized
463.10church or religious denomination for its members through spiritual means, or by prayer
463.11for healing;
463.12(5) an individual who only provides home care services to a relative;
463.13(6) an individual not connected with a home care provider that provides assistance
463.14with basic home care needs if the assistance is provided primarily as a contribution and
463.15not as a business;
463.16(7) an individual not connected with a home care provider that shares housing with
463.17and provides primarily housekeeping or homemaking services to an elderly or disabled
463.18person in return for free or reduced-cost housing;
463.19(8) an individual or provider providing home-delivered meal services;
463.20(9) an individual providing senior companion services and other older American
463.21volunteer programs (OAVP) established under the Domestic Volunteer Service Act of
463.221973, United States Code, title 42, chapter 66;
463.23(10) an employee of a nursing home licensed under this chapter or an employee of a
463.24boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
463.25emergency calls from individuals residing in a residential setting that is attached to or
463.26located on property contiguous to the nursing home or boarding care home;
463.27(11) a member of a professional corporation organized under chapter 319B that
463.28does not regularly offer or provide home care services as defined in section 144A.43,
463.29subdivision 3;
463.30(12) the following organizations established to provide medical or surgical services
463.31that do not regularly offer or provide home care services as defined in section 144A.43,
463.32subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
463.33corporation organized under chapter 317A, a partnership organized under chapter 323, or
463.34any other entity determined by the commissioner;
464.1(13) an individual or agency that provides medical supplies or durable medical
464.2equipment, except when the provision of supplies or equipment is accompanied by a
464.3home care service;
464.4(14) a physician licensed under chapter 147;
464.5(15) an individual who provides home care services to a person with a developmental
464.6disability who lives in a place of residence with a family, foster family, or primary caregiver;
464.7(16) a business that only provides services that are primarily instructional and not
464.8medical services or health-related support services;
464.9(17) an individual who performs basic home care services for no more than 14 hours
464.10each calendar week to no more than one client;
464.11(18) an individual or business licensed as hospice as defined in sections 144A.75 to
464.12144A.755 who is not providing home care services independent of hospice service;
464.13(19) activities conducted by the commissioner of health or a board of health as
464.14defined in section 145A.02, subdivision 2, including communicable disease investigations
464.15or testing; or
464.16(20) administering or monitoring a prescribed therapy necessary to control or
464.17prevent a communicable disease, or the monitoring of an individual's compliance with a
464.18health directive as defined in section 144.4172, subdivision 6.

464.19    Sec. 11. [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION
464.20AND RENEWAL.
464.21    Subdivision 1. License applications. Each application for a home care provider
464.22license must include information sufficient to show that the applicant meets the
464.23requirements of licensure, including:
464.24    (1) the applicant's name, e-mail address, physical address, and mailing address,
464.25including the name of the county in which the applicant resides and has a principal
464.26place of business;
464.27(2) the initial license fee in the amount specified in subdivision 7;
464.28(3) the e-mail address, physical address, mailing address, and telephone number of
464.29the principal administrative office;
464.30(4) the e-mail address, physical address, mailing address, and telephone number of
464.31each branch office, if any;
464.32(5) the names, e-mail and mailing addresses, and telephone numbers of all owners
464.33and managerial officials;
465.1(6) documentation of compliance with the background study requirements of section
465.2144A.476 for all persons involved in the management, operation, or control of the home
465.3care provider;
465.4(7) documentation of a background study as required by section 144.057 for any
465.5individual seeking employment, paid or volunteer, with the home care provider;
465.6(8) evidence of workers' compensation coverage as required by sections 176.181
465.7and 176.182;
465.8(9) documentation of liability coverage, if the provider has it;
465.9(10) identification of the license level the provider is seeking;
465.10(11) documentation that identifies the managerial official who is in charge of
465.11day-to-day operations and attestation that the person has reviewed and understands the
465.12home care provider regulations;
465.13(12) documentation that the applicant has designated one or more owners,
465.14managerial officials, or employees as an agent or agents, which shall not affect the legal
465.15responsibility of any other owner or managerial official under this chapter;
465.16(13) the signature of the officer or managing agent on behalf of an entity, corporation,
465.17association, or unit of government;
465.18(14) verification that the applicant has the following policies and procedures in place
465.19so that if a license is issued, the applicant will implement the policies and procedures
465.20and keep them current:
465.21    (i) requirements in sections 626.556, reporting of maltreatment of minors, and
465.22626.557, reporting of maltreatment of vulnerable adults;
465.23(ii) conducting and handling background studies on employees;
465.24(iii) orientation, training, and competency evaluations of home care staff, and a
465.25process for evaluating staff performance;
465.26(iv) handling complaints from clients, family members, or client representatives
465.27regarding staff or services provided by staff;
465.28(v) conducting initial evaluation of clients' needs and the providers' ability to provide
465.29those services;
465.30(vi) conducting initial and ongoing client evaluations and assessments and how
465.31changes in a client's condition are identified, managed, and communicated to staff and
465.32other health care providers as appropriate;
465.33(vii) orientation to and implementation of the home care client bill of rights;
465.34(viii) infection control practices;
465.35(ix) reminders for medications, treatments, or exercises, if provided; and
466.1(x) conducting appropriate screenings, or documentation of prior screenings, to
466.2show that staff are free of tuberculosis, consistent with current United States Centers for
466.3Disease Control and Prevention standards; and
466.4(15) other information required by the department.
466.5    Subd. 2. Comprehensive home care license applications. In addition to the
466.6information and fee required in subdivision 1, applicants applying for a comprehensive
466.7home care license must also provide verification that the applicant has the following
466.8policies and procedures in place so that if a license is issued, the applicant will implement
466.9the policies and procedures in this subdivision and keep them current:
466.10(1) conducting initial and ongoing assessments of the client's needs by a registered
466.11nurse or appropriate licensed health professional, including how changes in the client's
466.12conditions are identified, managed, and communicated to staff and other health care
466.13providers, as appropriate;
466.14(2) ensuring that nurses and licensed health professionals have current and valid
466.15licenses to practice;
466.16(3) medication and treatment management;
466.17(4) delegation of home care tasks by registered nurses or licensed health professionals;
466.18(5) supervision of registered nurses and licensed health professionals; and
466.19(6) supervision of unlicensed personnel performing delegated home care tasks.
466.20    Subd. 3. License renewal. (a) Except as provided in section 144A.475, a license
466.21may be renewed for a period of one year if the licensee satisfies the following:
466.22(1) submits an application for renewal in the format provided by the commissioner
466.23at least 30 days before expiration of the license;
466.24(2) submits the renewal fee in the amount specified in subdivision 7;
466.25(3) has provided home care services within the past 12 months;
466.26(4) complies with sections 144A.43 to 144A.4798;
466.27(5) provides information sufficient to show that the applicant meets the requirements
466.28of licensure, including items required under subdivision 1;
466.29(6) provides verification that all policies under subdivision 1 are current; and
466.30(7) provides any other information deemed necessary by the commissioner.
466.31(b) A renewal applicant who holds a comprehensive home care license must also
466.32provide verification that policies listed under subdivision 2 are current.
466.33    Subd. 4. Multiple units. Multiple units or branches of a licensee must be separately
466.34licensed if the commissioner determines that the units cannot adequately share supervision
466.35and administration of services from the main office.
467.1    Subd. 5. Transfers prohibited; changes in ownership. Any home care license
467.2issued by the commissioner may not be transferred to another party. Before acquiring
467.3ownership of a home care provider business, a prospective applicant must apply for a
467.4new temporary license. A change of ownership is a transfer of operational control to
467.5a different business entity and includes:
467.6(1) transfer of the business to a different or new corporation;
467.7(2) in the case of a partnership, the dissolution or termination of the partnership under
467.8chapter 323A, with the business continuing by a successor partnership or other entity;
467.9(3) relinquishment of control of the provider to another party, including to a contract
467.10management firm that is not under the control of the owner of the business' assets;
467.11(4) transfer of the business by a sole proprietor to another party or entity; or
467.12(5) in the case of a privately held corporation, the change in ownership or control of
467.1350 percent or more of the outstanding voting stock.
467.14    Subd. 6. Notification of changes of information. The temporary licensee or
467.15licensee shall notify the commissioner in writing within ten working days after any
467.16change in the information required in subdivision 1, except the information required in
467.17subdivision 1, clause (5), is required at the time of license renewal.
467.18    Subd. 7. Fees; application, change of ownership, and renewal. (a) An initial
467.19applicant seeking a temporary home care licensure must submit the following application
467.20fee to the commissioner along with a completed application:
467.21(1) for a basic home care provider, $2,100; or
467.22(2) for a comprehensive home care provider, $4,200.
467.23(b) A home care provider who is filing a change of ownership as required under
467.24subdivision 5 must submit the following application fee to the commissioner, along with
467.25the documentation required for the change of ownership:
467.26(1) for a basic home care provider, $2,100; or
467.27(2) for a comprehensive home care provider, $4,200.
467.28(c) A home care provider who is seeking to renew the provider's license shall pay a
467.29fee to the commissioner based on revenues derived from the provision of home care
467.30services during the calendar year prior to the year in which the application is submitted,
467.31according to the following schedule:
467.32License Renewal Fee

467.33	Provider Annual Revenue	Fee
467.34	greater than $1,500,000	$6,625
467.35 467.36	greater than $1,275,000 and no more than $1,500,000	$5,797
468.1 468.2	greater than $1,100,000 and no more than $1,275,000	$4,969
468.3 468.4	greater than $950,000 and no more than $1,100,000	$4,141
468.5 468.6	greater than $850,000 and no more than $950,000	$3,727
468.7 468.8	greater than $750,000 and no more than $850,000	$3,313
468.9 468.10	greater than $650,000 and no more than $750,000	$2,898
468.11 468.12	greater than $550,000 and no more than $650,000	$2,485
468.13 468.14	greater than $450,000 and no more than $550,000	$2,070
468.15 468.16	greater than $350,000 and no more than $450,000	$1,656
468.17 468.18	greater than $250,000 and no more than $350,000	$1,242
468.19 468.20	greater than $100,000 and no more than $250,000	$828
468.21	greater than $50,000 and no more than $100,000	$500
468.22	greater than $25,000 and no more than $50,000	$400
468.23	no more than $25,000	$200

468.24(d) If requested, the home care provider shall provide the commissioner information
468.25to verify the provider's annual revenues or other information as needed, including copies
468.26of documents submitted to the Department of Revenue.
468.27(e) At each annual renewal, a home care provider may elect to pay the highest
468.28renewal fee for its license category, and not provide annual revenue information to the
468.29commissioner.
468.30(f) A temporary license or license applicant, or temporary licensee or licensee that
468.31knowingly provides the commissioner incorrect revenue amounts for the purpose of
468.32paying a lower license fee shall be subject to a civil penalty in the amount of double the
468.33fee the provider should have paid.
468.34(g) Fees and penalties collected under this section shall be deposited in the state
468.35treasury and credited to the special state government revenue fund.
468.36(h) The license renewal fee schedule in this subdivision is effective July 1, 2016.

468.37    Sec. 12. [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE
468.38RENEWAL.
468.39    Subdivision 1. Temporary license and renewal of license. (a) The department
468.40shall review each application to determine the applicant's knowledge of and compliance
468.41with Minnesota home care regulations. Before granting a temporary license or renewing a
469.1license, the commissioner may further evaluate the applicant or licensee by requesting
469.2additional information or documentation or by conducting an on-site survey of the
469.3applicant to determine compliance with sections 144A.43 to 144A.482.
469.4(b) Within 14 calendar days after receiving an application for a license,
469.5the commissioner shall acknowledge receipt of the application in writing. The
469.6acknowledgment must indicate whether the application appears to be complete or whether
469.7additional information is required before the application will be considered complete.
469.8(c) Within 90 days after receiving a complete application, the commissioner shall
469.9issue a temporary license, renew the license, or deny the license.
469.10(d) The commissioner shall issue a license that contains the home care provider's
469.11name, address, license level, expiration date of the license, and unique license number. All
469.12licenses are valid for one year from the date of issuance.
469.13    Subd. 2. Temporary license. (a) For new license applicants, the commissioner
469.14shall issue a temporary license for either the basic or comprehensive home care level. A
469.15temporary license is effective for one year from the date of issuance. Temporary licensees
469.16must comply with sections 144A.43 to 144A.482.
469.17(b) During the temporary license year, the commissioner shall survey the temporary
469.18licensee after the commissioner is notified or has evidence that the temporary licensee
469.19is providing home care services.
469.20(c) Within five days of beginning the provision of services, the temporary
469.21licensee must notify the commissioner that it is serving clients. The notification to the
469.22commissioner may be mailed or e-mailed to the commissioner at the address provided by
469.23the commissioner. If the temporary licensee does not provide home care services during
469.24the temporary license year, then the temporary license expires at the end of the year and
469.25the applicant must reapply for a temporary home care license.
469.26(d) A temporary licensee may request a change in the level of licensure prior to
469.27being surveyed and granted a license by notifying the commissioner in writing and
469.28providing additional documentation or materials required to update or complete the
469.29changed temporary license application. The applicant must pay the difference between
469.30the application fees when changing from the basic level to the comprehensive level of
469.31licensure. No refund will be made if the provider chooses to change the license application
469.32to the basic level.
469.33(e) If the temporary licensee notifies the commissioner that the licensee has clients
469.34within 45 days prior to the temporary license expiration, the commissioner may extend the
469.35temporary license for up to 60 days in order to allow the commissioner to complete the
469.36on-site survey required under this section and follow-up survey visits.
470.1    Subd. 3. Temporary licensee survey. (a) If the temporary licensee is in substantial
470.2compliance with the survey, the commissioner shall issue either a basic or comprehensive
470.3home care license. If the temporary licensee is not in substantial compliance with the
470.4survey, the commissioner shall not issue a basic or comprehensive license and there will
470.5be no contested hearing right under chapter 14.
470.6(b) If the temporary licensee whose basic or comprehensive license has been denied
470.7disagrees with the conclusions of the commissioner, then the licensee may request a
470.8reconsideration by the commissioner or commissioner's designee. The reconsideration
470.9request process must be conducted internally by the commissioner or commissioner's
470.10designee, and chapter 14 does not apply.
470.11(c) The temporary licensee requesting reconsideration must make the request in
470.12writing and must list and describe the reasons why the licensee disagrees with the decision
470.13to deny the basic or comprehensive home care license.
470.14(d) A temporary licensee whose license is denied must comply with the requirements
470.15for notification and transfer of clients in section 144A.475, subdivision 5.

470.16    Sec. 13. [144A.474] SURVEYS AND INVESTIGATIONS.
470.17    Subdivision 1. Surveys. The commissioner shall conduct surveys of each home
470.18care provider. By June 30, 2016, the commissioner shall conduct a survey of home care
470.19providers on a frequency of at least once every three years. Survey frequency may be
470.20based on the license level, the provider's compliance history, number of clients served,
470.21or other factors as determined by the department deemed necessary to ensure the health,
470.22safety, and welfare of clients and compliance with the law.
470.23    Subd. 2. Types of home care surveys. (a) "Initial full survey" means the survey of
470.24a new temporary licensee conducted after the department is notified or has evidence that
470.25the temporary licensee is providing home care services to determine if the provider is in
470.26compliance with home care requirements. Initial full surveys must be completed within 14
470.27months after the department's issuance of a temporary basic or comprehensive license.
470.28(b) "Core survey" means periodic inspection of home care providers to determine
470.29ongoing compliance with the home care requirements, focusing on the essential health and
470.30safety requirements. Core surveys are available to licensed home care providers who have
470.31been licensed for three years and surveyed at least once in the past three years with the
470.32latest survey having no widespread violations beyond Level 1 as provided in subdivision
470.3311. Providers must also not have had any substantiated licensing complaints, substantiated
470.34complaints against the agency under the Vulnerable Adults Act or Maltreatment of Minors
470.35Act, or an enforcement action as authorized in section 144A.475 in the past three years.
471.1(1) The core survey for basic home care providers must review compliance in the
471.2following areas:
471.3(i) reporting of maltreatment;
471.4(ii) orientation to and implementation of Home Care Client Bill of Rights;
471.5(iii) statement of home care services;
471.6(iv) initial evaluation of clients and initiation of services;
471.7(v) client review and monitoring;
471.8(vi) service plan implementation and changes to the service plan;
471.9(vii) client complaint and investigative process;
471.10(viii) competency of unlicensed personnel; and
471.11(ix) infection control.
471.12(2) For comprehensive home care providers, the core survey must include everything
471.13in the basic core survey plus these areas:
471.14(i) delegation to unlicensed personnel;
471.15(ii) assessment, monitoring, and reassessment of clients; and
471.16(iii) medication, treatment, and therapy management.
471.17(c) "Full survey" means the periodic inspection of home care providers to determine
471.18ongoing compliance with the home care requirements that cover the core survey areas
471.19and all the legal requirements for home care providers. A full survey is conducted for all
471.20temporary licensees and for providers who do not meet the requirements needed for a core
471.21survey, and when a surveyor identifies unacceptable client health or safety risks during a
471.22core survey. A full survey must include all the tasks identified as part of the core survey
471.23and any additional review deemed necessary by the department, including additional
471.24observation, interviewing, or records review of additional clients and staff.
471.25(d) "Follow-up surveys" means surveys conducted to determine if a home care
471.26provider has corrected deficient issues and systems identified during a core survey, full
471.27survey, or complaint investigation. Follow-up surveys may be conducted via phone,
471.28e-mail, fax, mail, or on-site reviews. Follow-up surveys, other than complaint surveys,
471.29shall be concluded with an exit conference and written information provided on the
471.30process for requesting a reconsideration of the survey results.
471.31(e) Upon receiving information alleging that a home care provider has violated or
471.32is currently violating a requirement of sections 144A.43 to 144A.482, the commissioner
471.33shall investigate the complaint according to sections 144A.51 to 144A.54.
471.34    Subd. 3. Survey process. (a) The survey process for core surveys shall include the
471.35following as applicable to the particular licensee and setting surveyed:
472.1(1) presurvey review of pertinent documents and notification to the ombudsman
472.2for long-term care;
472.3(2) an entrance conference with available staff;
472.4(3) communication with managerial officials or the registered nurse in charge, if
472.5available, and ongoing communication with key staff throughout the survey regarding
472.6information needed by the surveyor, clarifications regarding home care requirements, and
472.7applicable standards of practice;
472.8(4) presentation of written contact information to the provider about the survey staff
472.9conducting the survey, the supervisor, and the process for requesting a reconsideration of
472.10the survey results;
472.11(5) a brief tour of a sample of the housing with services establishments in which the
472.12provider is providing home care services;
472.13(6) a sample selection of home care clients;
472.14(7) information-gathering through client and staff observations, client and staff
472.15interviews, and reviews of records, policies, procedures, practices, and other agency
472.16information;
472.17(8) interviews of clients' family members, if available, with clients' consent when the
472.18client can legally give consent;
472.19(9) except for complaint surveys conducted by the Office of Health Facilities
472.20Complaints, an on-site exit conference, with preliminary findings shared and discussed
472.21with the provider, documentation that an exit conference occurred, and written information
472.22provided on the process for requesting a reconsideration of the survey results; and
472.23(10) postsurvey analysis of findings and formulation of survey results, including
472.24correction orders when applicable.
472.25    Subd. 4. Scheduling surveys. Surveys and investigations shall be conducted
472.26without advance notice to home care providers. Surveyors may contact the home care
472.27provider on the day of a survey to arrange for someone to be available at the survey site.
472.28The contact does not constitute advance notice.
472.29    Subd. 5. Information provided by home care provider. The home care provider
472.30shall provide accurate and truthful information to the department during a survey,
472.31investigation, or other licensing activities.
472.32    Subd. 6. Providing client records. Upon request of a surveyor, home care providers
472.33shall provide a list of current and past clients or client representatives that includes
472.34addresses and telephone numbers and any other information requested about the services
472.35to clients within a reasonable period of time.
473.1    Subd. 7. Contacting and visiting clients. Surveyors may contact or visit a home
473.2care provider's clients to gather information without notice to the home care provider.
473.3Before visiting a client, a surveyor shall obtain the client's or client's representative's
473.4permission by telephone, mail, or in person. Surveyors shall inform all clients or client's
473.5representatives of their right to decline permission for a visit.
473.6    Subd. 8. Correction orders. (a) A correction order may be issued whenever the
473.7commissioner finds upon survey or during a complaint investigation that a home care
473.8provider, a managerial official, or an employee of the provider is not in compliance with
473.9sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
473.10document areas of noncompliance and the time allowed for correction.
473.11(b) The commissioner shall mail copies of any correction order within 30 calendar
473.12days after an exit survey to the last known address of the home care provider. A copy of
473.13each correction order and copies of any documentation supplied to the commissioner shall
473.14be kept on file by the home care provider, and public documents shall be made available
473.15for viewing by any person upon request. Copies may be kept electronically.
473.16(c) By the correction order date, the home care provider must document in the
473.17provider's records any action taken to comply with the correction order. The commissioner
473.18may request a copy of this documentation and the home care provider's action to respond
473.19to the correction order in future surveys, upon a complaint investigation, and as otherwise
473.20needed.
473.21    Subd. 9. Follow-up surveys. For providers that have Level 3 or Level 4 violations,
473.22under subdivision 11, or any violations determined to be widespread, the department shall
473.23conduct a follow-up survey within 90 calendar days of the survey. When conducting a
473.24follow-up survey, the surveyor will focus on whether the previous violations have been
473.25corrected and may also address any new violations that are observed while evaluating the
473.26corrections that have been made. If a new violation is identified on a follow-up survey, no
473.27fine will be imposed unless it is not corrected on the next follow-up survey.
473.28    Subd. 10. Performance incentive. A licensee is eligible for a performance
473.29incentive if there are no violations identified in a core or full survey. The performance
473.30incentive is a ten percent discount on the licensee's next home care renewal license fee.
473.31    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be
473.32assessed based on the level and scope of the violations described in paragraph (c) as follows:
473.33(1) Level 1, no fines or enforcement;
473.34(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
473.35mechanisms authorized in section 144A.475 for widespread violations;
474.1(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement
474.2mechanisms authorized in section 144A.475; and
474.3(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the
474.4enforcement mechanisms authorized in section 144A.475.
474.5(b) Correction orders for violations are categorized by both level and scope and
474.6fines shall be assessed as follows:
474.7(1) Level of violation:
474.8(i) Level 1 is a violation that has no potential to cause more than a minimal impact
474.9on the client and does not affect health or safety;
474.10(ii) Level 2 is a violation that did not harm a client's health or safety but had the
474.11potential to have harmed a client's health or safety, but was not likely to cause serious
474.12injury, impairment, or death;
474.13(iii) Level 3 is a violation that harmed a client's health or safety, not including
474.14serious injury, impairment, or death, or a violation that has the potential to lead to serious
474.15injury, impairment, or death; and
474.16(iv) Level 4 is a violation that results in serious injury, impairment, or death.
474.17(2) Scope of violation:
474.18(i) isolated, when one or a limited number of clients are affected or one or a limited
474.19number of staff are involved or the situation has occurred only occasionally;
474.20(ii) pattern, when more than a limited number of clients are affected, more than a
474.21limited number of staff are involved, or the situation has occurred repeatedly but is not
474.22found to be pervasive; and
474.23(iii) widespread, when problems are pervasive or represent a systemic failure that
474.24has affected or has the potential to affect a large portion or all of the clients.
474.25(c) If the commissioner finds that the applicant or a home care provider required
474.26to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the
474.27date specified in the correction order or conditional license resulting from a survey or
474.28complaint investigation, the commissioner may impose a fine. A notice of noncompliance
474.29with a correction order must be mailed to the applicant's or provider's last known address.
474.30The noncompliance notice must list the violations not corrected.
474.31(d) The license holder must pay the fines assessed on or before the payment date
474.32specified. If the license holder fails to fully comply with the order, the commissioner
474.33may issue a second fine or suspend the license until the license holder complies by
474.34paying the fine. A timely appeal shall stay payment of the fine until the commissioner
474.35issues a final order.
475.1(e) A license holder shall promptly notify the commissioner in writing when a
475.2violation specified in the order is corrected. If upon reinspection the commissioner
475.3determines that a violation has not been corrected as indicated by the order, the
475.4commissioner may issue a second fine. The commissioner shall notify the license holder by
475.5mail to the last known address in the licensing record that a second fine has been assessed.
475.6The license holder may appeal the second fine as provided under this subdivision.
475.7(f) A home care provider that has been assessed a fine under this subdivision has a
475.8right to a reconsideration or a hearing under this section and chapter 14.
475.9(g) When a fine has been assessed, the license holder may not avoid payment by
475.10closing, selling, or otherwise transferring the licensed program to a third party. In such an
475.11event, the license holder shall be liable for payment of the fine.
475.12(h) In addition to any fine imposed under this section, the commissioner may assess
475.13costs related to an investigation that results in a final order assessing a fine or other
475.14enforcement action authorized by this chapter.
475.15(i) Fines collected under this subdivision shall be deposited in the state government
475.16special revenue fund and credited to an account separate from the revenue collected under
475.17section 144A.472. Subject to an appropriation by the legislature, the revenue from the
475.18fines collected may be used by the commissioner for special projects to improve home care
475.19in Minnesota as recommended by the advisory council established in section 144A.4799.
475.20    Subd. 12. Reconsideration. (a) The commissioner shall make available to home
475.21care providers a correction order reconsideration process. This process may be used
475.22to challenge the correction order issued, including the level and scope described in
475.23subdivision 11, and any fine assessed. During the correction order reconsideration
475.24request, the issuance for the correction orders under reconsideration are not stayed, but
475.25the department shall post information on the Web site with the correction order that the
475.26licensee has requested a reconsideration and that the review is pending.
475.27(b) A licensed home care provider may request from the commissioner, in writing,
475.28a correction order reconsideration regarding any correction order issued to the provider.
475.29The correction order reconsideration shall not be reviewed by any surveyor, investigator,
475.30or supervisor that participated in the writing or reviewing of the correction order
475.31being disputed. The correction order reconsiderations may be conducted in person, by
475.32telephone, by another electronic form, or in writing, as determined by the commissioner.
475.33The commissioner shall respond in writing to the request from a home care provider
475.34for a correction order reconsideration within 60 days of the date the provider requests a
475.35reconsideration. The commissioner's response shall identify the commissioner's decision
475.36regarding each citation challenged by the home care provider.
476.1(c) The findings of a correction order reconsideration process shall be one or more of
476.2the following:
476.3(1) supported in full, the correction order is supported in full, with no deletion of
476.4findings to the citation;
476.5(2) supported in substance, the correction order is supported, but one or more
476.6findings are deleted or modified without any change in the citation;
476.7(3) correction order cited an incorrect home care licensing requirement, the correction
476.8order is amended by changing the correction order to the appropriate statutory reference;
476.9(4) correction order was issued under an incorrect citation, the correction order is
476.10amended to be issued under the more appropriate correction order citation;
476.11(5) the correction order is rescinded;
476.12(6) fine is amended, it is determined that the fine assigned to the correction order
476.13was applied incorrectly; or
476.14(7) the level or scope of the citation is modified based on the reconsideration.
476.15(d) If the correction order findings are changed by the commissioner, the
476.16commissioner shall update the correction order Web site.
476.17    Subd. 13. Home care surveyor training. (a) Before conducting a home care
476.18survey, each home care surveyor must receive training on the following topics:
476.19(1) Minnesota home care licensure requirements;
476.20(2) Minnesota Home Care Client Bill of Rights;
476.21(3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors;
476.22(4) principles of documentation;
476.23(5) survey protocol and processes;
476.24(6) Offices of the Ombudsman roles;
476.25(7) Office of Health Facility Complaints;
476.26(8) Minnesota landlord-tenant and housing with services laws;
476.27(9) types of payors for home care services; and
476.28(10) Minnesota Nurse Practice Act for nurse surveyors.
476.29(b) Materials used for the training in paragraph (a) shall be posted on the department
476.30Web site. Requisite understanding of these topics will be reviewed as part of the quality
476.31improvement plan in section 144A.483.

476.32    Sec. 14. [144A.475] ENFORCEMENT.
476.33    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a temporary
476.34license, renew a license, suspend or revoke a license, or impose a conditional license if the
476.35home care provider or owner or managerial official of the home care provider:
477.1(1) is in violation of, or during the term of the license has violated, any of the
477.2requirements in sections 144A.471 to 144A.482;
477.3(2) permits, aids, or abets the commission of any illegal act in the provision of
477.4home care;
477.5(3) performs any act detrimental to the health, safety, and welfare of a client;
477.6(4) obtains the license by fraud or misrepresentation;
477.7(5) knowingly made or makes a false statement of a material fact in the application
477.8for a license or in any other record or report required by this chapter;
477.9(6) denies representatives of the department access to any part of the home care
477.10provider's books, records, files, or employees;
477.11(7) interferes with or impedes a representative of the department in contacting the
477.12home care provider's clients;
477.13(8) interferes with or impedes a representative of the department in the enforcement
477.14of this chapter or has failed to fully cooperate with an inspection, survey, or investigation
477.15by the department;
477.16(9) destroys or makes unavailable any records or other evidence relating to the home
477.17care provider's compliance with this chapter;
477.18(10) refuses to initiate a background study under section 144.057 or 245A.04;
477.19(11) fails to timely pay any fines assessed by the department;
477.20(12) violates any local, city, or township ordinance relating to home care services;
477.21(13) has repeated incidents of personnel performing services beyond their
477.22competency level; or
477.23(14) has operated beyond the scope of the home care provider's license level.
477.24    (b) A violation by a contractor providing the home care services of the home care
477.25provider is a violation by the home care provider.
477.26    Subd. 2. Terms to suspension or conditional license. A suspension or conditional
477.27license designation may include terms that must be completed or met before a suspension
477.28or conditional license designation is lifted. A conditional license designation may include
477.29restrictions or conditions that are imposed on the provider. Terms for a suspension or
477.30conditional license may include one or more of the following and the scope of each will be
477.31determined by the commissioner:
477.32(1) requiring a consultant to review, evaluate, and make recommended changes to
477.33the home care provider's practices and submit reports to the commissioner at the cost of
477.34the home care provider;
478.1(2) requiring supervision of the home care provider or staff practices at the cost
478.2of the home care provider by an unrelated person who has sufficient knowledge and
478.3qualifications to oversee the practices and who will submit reports to the commissioner;
478.4(3) requiring the home care provider or employees to obtain training at the cost of
478.5the home care provider;
478.6(4) requiring the home care provider to submit reports to the commissioner;
478.7(5) prohibiting the home care provider from taking any new clients for a period
478.8of time; or
478.9(6) any other action reasonably required to accomplish the purpose of this
478.10subdivision and section 144A.45, subdivision 2.
478.11    Subd. 3. Notice. Prior to any suspension, revocation, or refusal to renew a license,
478.12the home care provider shall be entitled to notice and a hearing as provided by sections
478.1314.57 to 14.69. In addition to any other remedy provided by law, the commissioner may,
478.14without a prior contested case hearing, temporarily suspend a license or prohibit delivery
478.15of services by a provider for not more than 90 days if the commissioner determines that
478.16the health or safety of a consumer is in imminent danger, provided:
478.17(1) advance notice is given to the home care provider;
478.18(2) after notice, the home care provider fails to correct the problem;
478.19(3) the commissioner has reason to believe that other administrative remedies are not
478.20likely to be effective; and
478.21(4) there is an opportunity for a contested case hearing within the 90 days.
478.22    Subd. 4. Time limits for appeals. To appeal the assessment of civil penalties
478.23under section 144A.45, subdivision 2, clause (5), and an action against a license under
478.24this section, a provider must request a hearing no later than 15 days after the provider
478.25receives notice of the action.
478.26    Subd. 5. Plan required. (a) The process of suspending or revoking a license
478.27must include a plan for transferring affected clients to other providers by the home care
478.28provider, which will be monitored by the commissioner. Within three business days of
478.29being notified of the final revocation or suspension action, the home care provider shall
478.30provide the commissioner, the lead agencies as defined in section 256B.0911, and the
478.31ombudsman for long-term care with the following information:
478.32(1) a list of all clients, including full names and all contact information on file;
478.33(2) a list of each client's representative or emergency contact person, including full
478.34names and all contact information on file;
478.35(3) the location or current residence of each client;
479.1(4) the payor sources for each client, including payor source identification numbers;
479.2and
479.3(5) for each client, a copy of the client's service plan, and a list of the types of
479.4services being provided.
479.5(b) The revocation or suspension notification requirement is satisfied by mailing the
479.6notice to the address in the license record. The home care provider shall cooperate with
479.7the commissioner and the lead agencies during the process of transferring care of clients to
479.8qualified providers. Within three business days of being notified of the final revocation or
479.9suspension action, the home care provider must notify and disclose to each of the home
479.10care provider's clients, or the client's representative or emergency contact persons, that
479.11the commissioner is taking action against the home care provider's license by providing a
479.12copy of the revocation or suspension notice issued by the commissioner.
479.13    Subd. 6. Owners and managerial officials; refusal to grant license. (a) The
479.14owner and managerial officials of a home care provider whose Minnesota license has not
479.15been renewed or that has been revoked because of noncompliance with applicable laws or
479.16rules shall not be eligible to apply for nor will be granted a home care license, including
479.17other licenses under this chapter, or be given status as an enrolled personal care assistance
479.18provider agency or personal care assistant by the Department of Human Services under
479.19section 256B.0659 for five years following the effective date of the nonrenewal or
479.20revocation. If the owner and managerial officials already have enrollment status, their
479.21enrollment will be terminated by the Department of Human Services.
479.22(b) The commissioner shall not issue a license to a home care provider for five
479.23years following the effective date of license nonrenewal or revocation if the owner or
479.24managerial official, including any individual who was an owner or managerial official
479.25of another home care provider, had a Minnesota license that was not renewed or was
479.26revoked as described in paragraph (a).
479.27(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall
479.28suspend or revoke, the license of any home care provider that includes any individual
479.29as an owner or managerial official who was an owner or managerial official of a home
479.30care provider whose Minnesota license was not renewed or was revoked as described in
479.31paragraph (a) for five years following the effective date of the nonrenewal or revocation.
479.32(d) The commissioner shall notify the home care provider 30 days in advance of
479.33the date of nonrenewal, suspension, or revocation of the license. Within ten days after
479.34the receipt of the notification, the home care provider may request, in writing, that the
479.35commissioner stay the nonrenewal, revocation, or suspension of the license. The home
479.36care provider shall specify the reasons for requesting the stay; the steps that will be taken
480.1to attain or maintain compliance with the licensure laws and regulations; any limits on the
480.2authority or responsibility of the owners or managerial officials whose actions resulted in
480.3the notice of nonrenewal, revocation, or suspension; and any other information to establish
480.4that the continuing affiliation with these individuals will not jeopardize client health, safety,
480.5or well-being. The commissioner shall determine whether the stay will be granted within
480.630 days of receiving the provider's request. The commissioner may propose additional
480.7restrictions or limitations on the provider's license and require that the granting of the stay
480.8be contingent upon compliance with those provisions. The commissioner shall take into
480.9consideration the following factors when determining whether the stay should be granted:
480.10(1) the threat that continued involvement of the owners and managerial officials with
480.11the home care provider poses to client health, safety, and well-being;
480.12(2) the compliance history of the home care provider; and
480.13(3) the appropriateness of any limits suggested by the home care provider.
480.14    If the commissioner grants the stay, the order shall include any restrictions or
480.15limitation on the provider's license. The failure of the provider to comply with any
480.16restrictions or limitations shall result in the immediate removal of the stay and the
480.17commissioner shall take immediate action to suspend, revoke, or not renew the license.
480.18    Subd. 7. Request for hearing. A request for a hearing must be in writing and must:
480.19(1) be mailed or delivered to the department or the commissioner's designee;
480.20(2) contain a brief and plain statement describing every matter or issue contested; and
480.21(3) contain a brief and plain statement of any new matter that the applicant or home
480.22care provider believes constitutes a defense or mitigating factor.
480.23    Subd. 8. Informal conference. At any time, the applicant or home care provider
480.24and the commissioner may hold an informal conference to exchange information, clarify
480.25issues, or resolve issues.
480.26    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the
480.27commissioner may bring an action in district court to enjoin a person who is involved in
480.28the management, operation, or control of a home care provider or an employee of the
480.29home care provider from illegally engaging in activities regulated by sections 144A.43 to
480.30144A.482. The commissioner may bring an action under this subdivision in the district
480.31court in Ramsey County or in the district in which a home care provider is providing
480.32services. The court may grant a temporary restraining order in the proceeding if continued
480.33activity by the person who is involved in the management, operation, or control of a home
480.34care provider, or by an employee of the home care provider, would create an imminent
480.35risk of harm to a recipient of home care services.
481.1    Subd. 10. Subpoena. In matters pending before the commissioner under sections
481.2144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance
481.3of witnesses and the production of all necessary papers, books, records, documents, and
481.4other evidentiary material. If a person fails or refuses to comply with a subpoena or
481.5order of the commissioner to appear or testify regarding any matter about which the
481.6person may be lawfully questioned or to produce any papers, books, records, documents,
481.7or evidentiary materials in the matter to be heard, the commissioner may apply to the
481.8district court in any district, and the court shall order the person to comply with the
481.9commissioner's order or subpoena. The commissioner of health may administer oaths to
481.10witnesses or take their affirmation. Depositions may be taken in or outside the state in the
481.11manner provided by law for the taking of depositions in civil actions. A subpoena or other
481.12process or paper may be served on a named person anywhere in the state by an officer
481.13authorized to serve subpoenas in civil actions, with the same fees and mileage and in the
481.14same manner as prescribed by law for a process issued out of a district court. A person
481.15subpoenaed under this subdivision shall receive the same fees, mileage, and other costs
481.16that are paid in proceedings in district court.

481.17    Sec. 15. [144A.476] BACKGROUND STUDIES.
481.18    Subdivision 1. Prior criminal convictions; owner and managerial officials. (a)
481.19Before the commissioner issues a temporary license or renews a license, an owner or
481.20managerial official is required to complete a background study under section 144.057. No
481.21person may be involved in the management, operation, or control of a home care provider
481.22if the person has been disqualified under chapter 245C. If an individual is disqualified
481.23under section 144.057 or chapter 245C, the individual may request reconsideration of
481.24the disqualification. If the individual requests reconsideration and the commissioner
481.25sets aside or rescinds the disqualification, the individual is eligible to be involved in the
481.26management, operation, or control of the provider. If an individual has a disqualification
481.27under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's
481.28disqualification is barred from a set aside, and the individual must not be involved in the
481.29management, operation, or control of the provider.
481.30(b) For purposes of this section, owners of a home care provider subject to the
481.31background check requirement are those individuals whose ownership interest provides
481.32sufficient authority or control to affect or change decisions related to the operation of the
481.33home care provider. An owner includes a sole proprietor, a general partner, or any other
481.34individual whose individual ownership interest can affect the management and direction
481.35of the policies of the home care provider.
482.1(c) For the purposes of this section, managerial officials subject to the background
482.2check requirement are individuals who provide direct contact as defined in section
482.3245C.02, subdivision 11, or individuals who have the responsibility for the ongoing
482.4management or direction of the policies, services, or employees of the home care provider.
482.5Data collected under this subdivision shall be classified as private data on individuals
482.6under section 13.02, subdivision 12.
482.7(d) The department shall not issue any license if the applicant or owner or managerial
482.8official has been unsuccessful in having a background study disqualification set aside
482.9under section 144.057 and chapter 245C; if the owner or managerial official, as an owner
482.10or managerial official of another home care provider, was substantially responsible for
482.11the other home care provider's failure to substantially comply with sections 144A.43 to
482.12144A.482; or if an owner that has ceased doing business, either individually or as an
482.13owner of a home care provider, was issued a correction order for failing to assist clients in
482.14violation of this chapter.
482.15    Subd. 2. Employees, contractors, and volunteers. (a) Employees, contractors,
482.16and volunteers of a home care provider are subject to the background study required by
482.17section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall
482.18be construed to prohibit a home care provider from requiring self-disclosure of criminal
482.19conviction information.
482.20(b) Termination of an employee in good faith reliance on information or records
482.21obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not
482.22subject the home care provider to civil liability or liability for unemployment benefits.

482.23    Sec. 16. [144A.477] COMPLIANCE.
482.24    Subdivision 1. Medicare-certified providers; coordination of surveys. If feasible,
482.25the commissioner shall survey licensees to determine compliance with this chapter at the
482.26same time as surveys for certification for Medicare if Medicare certification is based on
482.27compliance with the federal conditions of participation and on survey and enforcement
482.28by the Department of Health as agent for the United States Department of Health and
482.29Human Services.
482.30    Subd. 2. Medicare-certified providers; equivalent requirements. For home care
482.31providers licensed to provide comprehensive home care services that are also certified for
482.32participation in Medicare as a home health agency under Code of Federal Regulations,
482.33title 42, part 484, the following state licensure regulations are considered equivalent to
482.34the federal requirements:
482.35(1) quality management, section 144A.479, subdivision 3;
483.1(2) personnel records, section 144A.479, subdivision 7;
483.2(3) acceptance of clients, section 144A.4791, subdivision 4;
483.3(4) referrals, section 144A.4791, subdivision 5;
483.4(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792,
483.5subdivisions 2 and 3;
483.6(6) individualized monitoring and reassessment, sections 144A.4791, subdivision
483.78, and 144A.4792, subdivisions 2 and 3;
483.8(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792,
483.9subdivision 5, and 144A.4793, subdivision 3;
483.10(8) client complaint and investigation process, section 144A.4791, subdivision 11;
483.11(9) prescription orders, section 144A.4792, subdivisions 13 to 16;
483.12(10) client records, section 144A.4794, subdivisions 1 to 3;
483.13(11) qualifications for unlicensed personnel performing delegated tasks, section
483.14144A.4795;
483.15(12) training and competency staff, section 144A.4795;
483.16(13) training and competency for unlicensed personnel, section 144A.4795,
483.17subdivision 7;
483.18(14) delegation of home care services, section 144A.4795, subdivision 4;
483.19(15) availability of contact person, section 144A.4797, subdivision 1; and
483.20(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.
483.21Violations of requirements in clauses (1) to (16) may lead to enforcement actions
483.22under section 144A.474.

483.23    Sec. 17. [144A.478] INNOVATION VARIANCE.
483.24    Subdivision 1. Definition. For purposes of this section, "innovation variance"
483.25means a specified alternative to a requirement of this chapter. An innovation variance
483.26may be granted to allow a home care provider to offer home care services of a type or
483.27in a manner that is innovative, will not impair the services provided, will not adversely
483.28affect the health, safety, or welfare of the clients, and is likely to improve the services
483.29provided. The innovative variance cannot change any of the client's rights under section
483.30144A.44, home care bill of rights.
483.31    Subd. 2. Conditions. The commissioner may impose conditions on the granting of
483.32an innovation variance that the commissioner considers necessary.
483.33    Subd. 3. Duration and renewal. The commissioner may limit the duration of any
483.34innovation variance and may renew a limited innovation variance.
484.1    Subd. 4. Applications; innovation variance. An application for innovation
484.2variance from the requirements of this chapter may be made at any time, must be made in
484.3writing to the commissioner, and must specify the following:
484.4(1) the statute or law from which the innovation variance is requested;
484.5(2) the time period for which the innovation variance is requested;
484.6(3) the specific alternative action that the licensee proposes;
484.7(4) the reasons for the request; and
484.8(5) justification that an innovation variance will not impair the services provided,
484.9will not adversely affect the health, safety, or welfare of clients, and is likely to improve
484.10the services provided.
484.11The commissioner may require additional information from the home care provider before
484.12acting on the request.
484.13    Subd. 5. Grants and denials. The commissioner shall grant or deny each request
484.14for an innovation variance in writing within 45 days of receipt of a complete request.
484.15Notice of a denial shall contain the reasons for the denial. The terms of a requested
484.16innovation variance may be modified upon agreement between the commissioner and
484.17the home care provider.
484.18    Subd. 6. Violation of innovation variances. A failure to comply with the terms of
484.19an innovation variance shall be deemed to be a violation of this chapter.
484.20    Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or
484.21deny renewal of an innovation variance if:
484.22(1) it is determined that the innovation variance is adversely affecting the health,
484.23safety, or welfare of the licensee's clients;
484.24(2) the home care provider has failed to comply with the terms of the innovation
484.25variance;
484.26(3) the home care provider notifies the commissioner in writing that it wishes to
484.27relinquish the innovation variance and be subject to the statute previously varied; or
484.28(4) the revocation or denial is required by a change in law.

484.29    Sec. 18. [144A.479] HOME CARE PROVIDER RESPONSIBILITIES;
484.30BUSINESS OPERATION.
484.31    Subdivision 1. Display of license. The original current license must be displayed
484.32in the home care providers' principal business office and copies must be displayed in
484.33any branch office. The home care provider must provide a copy of the license to any
484.34person who requests it.
485.1    Subd. 2. Advertising. Home care providers shall not use false, fraudulent,
485.2or misleading advertising in the marketing of services. For purposes of this section,
485.3advertising includes any verbal, written, or electronic means of communicating to
485.4potential clients about the availability, nature, or terms of home care services.
485.5    Subd. 3. Quality management. The home care provider shall engage in quality
485.6management appropriate to the size of the home care provider and relevant to the type
485.7of services the home care provider provides. The quality management activity means
485.8evaluating the quality of care by periodically reviewing client services, complaints made,
485.9and other issues that have occurred and determining whether changes in services, staffing,
485.10or other procedures need to be made in order to ensure safe and competent services to
485.11clients. Documentation about quality management activity must be available for two
485.12years. Information about quality management must be available to the commissioner at
485.13the time of the survey, investigation, or renewal.
485.14    Subd. 4. Provider restrictions. (a) This subdivision does not apply to licensees
485.15that are Minnesota counties or other units of government.
485.16(b) A home care provider or staff cannot accept powers-of-attorney from clients for
485.17any purpose, and may not accept appointments as guardians or conservators of clients.
485.18(c) A home care provider cannot serve as a client's representative.
485.19    Subd. 5. Handling of client's finances and property. (a) A home care provider
485.20may assist clients with household budgeting, including paying bills and purchasing
485.21household goods, but may not otherwise manage a client's property. A home care provider
485.22must provide a client with receipts for all transactions and purchases paid with the client's
485.23funds. When receipts are not available, the transaction or purchase must be documented.
485.24A home care provider must maintain records of all such transactions.
485.25(b) A home care provider or staff may not borrow a client's funds or personal or
485.26real property, nor in any way convert a client's property to the home care provider's or
485.27staff's possession.
485.28(c) Nothing in this section precludes a home care provider or staff from accepting
485.29gifts of minimal value, or precludes the acceptance of donations or bequests made to a
485.30home care provider that are exempt from income tax under section 501(c) of the Internal
485.31Revenue Code of 1986.
485.32    Subd. 6. Reporting maltreatment of vulnerable adults and minors. (a) All home
485.33care providers must comply with requirements for the reporting of maltreatment of minors
485.34in section 626.556 and the requirements for the reporting of maltreatment of vulnerable
485.35adults in section 626.557. Each home care provider must establish and implement a
485.36written procedure to ensure that all cases of suspected maltreatment are reported.
486.1(b) Each home care provider must develop and implement an individual abuse
486.2prevention plan for each vulnerable minor or adult for whom home care services are
486.3provided by a home care provider. The plan shall contain an individualized review or
486.4assessment of the person's susceptibility to abuse by another individual, including other
486.5vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors;
486.6and statements of the specific measures to be taken to minimize the risk of abuse to that
486.7person and other vulnerable adults or minors. For purposes of the abuse prevention plan,
486.8the term abuse includes self-abuse.
486.9    Subd. 7. Employee records. The home care provider must maintain current records
486.10of each paid employee, regularly scheduled volunteers providing home care services, and
486.11of each individual contractor providing home care services. The records must include
486.12the following information:
486.13(1) evidence of current professional licensure, registration, or certification, if
486.14licensure, registration, or certification is required by this statute, or other rules;
486.15(2) records of orientation, required annual training and infection control training,
486.16and competency evaluations;
486.17(3) current job description, including qualifications, responsibilities, and
486.18identification of staff providing supervision;
486.19(4) documentation of annual performance reviews which identify areas of
486.20improvement needed and training needs;
486.21(5) for individuals providing home care services, verification that required health
486.22screenings under section 144A.4798 have taken place and the dates of those screenings; and
486.23(6) documentation of the background study as required under section 144.057.
486.24Each employee record must be retained for at least three years after a paid employee,
486.25home care volunteer, or contractor ceases to be employed by or under contract with the
486.26home care provider. If a home care provider ceases operation, employee records must be
486.27maintained for three years.

486.28    Sec. 19. [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH
486.29RESPECT TO CLIENTS.
486.30    Subdivision 1. Home care bill of rights; notification to client. (a) The home care
486.31provider shall provide the client or the client's representative a written notice of the rights
486.32under section 144A.44 before the initiation of services to that client. The provider shall
486.33make all reasonable efforts to provide notice of the rights to the client or the client's
486.34representative in a language the client or client's representative can understand.
487.1(b) In addition to the text of the home care bill of rights in section 144A.44,
487.2subdivision 1, the notice shall also contain the following statement describing how to file
487.3a complaint with these offices.
487.4"If you have a complaint about the provider or the person providing your
487.5home care services, you may call, write, or visit the Office of Health Facility
487.6Complaints, Minnesota Department of Health. You may also contact the Office of
487.7Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health
487.8and Developmental Disabilities."
487.9The statement should include the telephone number, Web site address, e-mail
487.10address, mailing address, and street address of the Office of Health Facility Complaints at
487.11the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care,
487.12and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
487.13statement should also include the home care provider's name, address, e-mail, telephone
487.14number, and name or title of the person at the provider to whom problems or complaints
487.15may be directed. It must also include a statement that the home care provider will not
487.16retaliate because of a complaint.
487.17(c) The home care provider shall obtain written acknowledgment of the client's
487.18receipt of the home care bill of rights or shall document why an acknowledgment cannot
487.19be obtained. The acknowledgment may be obtained from the client or the client's
487.20representative. Acknowledgment of receipt shall be retained in the client's record.
487.21    Subd. 2. Notice of services for dementia, Alzheimer's disease, or related
487.22disorders. The home care provider that provides services to clients with dementia shall
487.23provide in written or electronic form, to clients and families or other persons who request
487.24it, a description of the training program and related training it provides, including the
487.25categories of employees trained, the frequency of training, and the basic topics covered.
487.26This information satisfies the disclosure requirements in section 325F.72, subdivision
487.272, clause (4).
487.28    Subd. 3. Statement of home care services. Prior to the initiation of services,
487.29a home care provider must provide to the client or the client's representative a written
487.30statement which identifies if the provider has a basic or comprehensive home care license,
487.31the services the provider is authorized to provide, and which services the provider cannot
487.32provide under the scope of the provider's license. The home care provider shall obtain
487.33written acknowledgment from the clients that the provider has provided the statement or
487.34must document why the provider could not obtain the acknowledgment.
487.35    Subd. 4. Acceptance of clients. No home care provider may accept a person as a
487.36client unless the home care provider has staff, sufficient in qualifications, competency,
488.1and numbers, to adequately provide the services agreed to in the service plan and that
488.2are within the provider's scope of practice.
488.3    Subd. 5. Referrals. If a home care provider reasonably believes that a client is in
488.4need of another medical or health service, including a licensed health professional, or
488.5social service provider, the home care provider shall:
488.6(1) determine the client's preferences with respect to obtaining the service; and
488.7(2) inform the client of resources available, if known, to assist the client in obtaining
488.8services.
488.9    Subd. 6. Initiation of services. When a provider initiates services and the
488.10individualized review or assessment required in subdivisions 7 and 8 has not been
488.11completed, the provider must complete a temporary plan and agreement with the client for
488.12services.
488.13    Subd. 7. Basic individualized client review and monitoring. (a) When services
488.14being provided are basic home care services, an individualized initial review of the client's
488.15needs and preferences must be conducted at the client's residence with the client or client's
488.16representative. This initial review must be completed within 30 days after the initiation of
488.17the home care services.
488.18(b) Client monitoring and review must be conducted as needed based on changes
488.19in the needs of the client and cannot exceed 90 days from the date of the last review.
488.20The monitoring and review may be conducted at the client's residence or through the
488.21utilization of telecommunication methods based on practice standards that meet the
488.22individual client's needs.
488.23    Subd. 8. Comprehensive assessment, monitoring, and reassessment. (a) When
488.24the services being provided are comprehensive home care services, an individualized
488.25initial assessment must be conducted in-person by a registered nurse. When the services
488.26are provided by other licensed health professionals, the assessment must be conducted by
488.27the appropriate health professional. This initial assessment must be completed within five
488.28days after initiation of home care services.
488.29(b) Client monitoring and reassessment must be conducted in the client's home no
488.30more than 14 days after initiation of services.
488.31(c) Ongoing client monitoring and reassessment must be conducted as needed based
488.32on changes in the needs of the client and cannot exceed 90 days from the last date of the
488.33assessment. The monitoring and reassessment may be conducted at the client's residence
488.34or through the utilization of telecommunication methods based on practice standards that
488.35meet the individual client's needs.
489.1    Subd. 9. Service plan, implementation, and revisions to service plan. (a) No later
489.2than 14 days after the initiation of services, a home care provider shall finalize a current
489.3written service plan.
489.4(b) The service plan and any revisions must include a signature or other
489.5authentication by the home care provider and by the client or the client's representative
489.6documenting agreement on the services to be provided. The service plan must be revised,
489.7if needed, based on client review or reassessment under subdivisions 7 and 8. The provider
489.8must provide information to the client about changes to the provider's fee for services and
489.9how to contact the Office of the Ombudsman for Long-Term Care.
489.10(c) The home care provider must implement and provide all services required by
489.11the current service plan.
489.12(d) The service plan and revised service plan must be entered into the client's record,
489.13including notice of a change in a client's fees when applicable.
489.14(e) Staff providing home care services must be informed of the current written
489.15service plan.
489.16(f) The service plan must include:
489.17(1) a description of the home care services to be provided, the fees for services, and
489.18the frequency of each service, according to the client's current review or assessment and
489.19client preferences;
489.20(2) the identification of the staff or categories of staff who will provide the services;
489.21(3) the schedule and methods of monitoring reviews or assessments of the client;
489.22(4) the frequency of sessions of supervision of staff and type of personnel who
489.23will supervise staff; and
489.24(5) a contingency plan that includes:
489.25(i) the action to be taken by the home care provider and by the client or client's
489.26representative if the scheduled service cannot be provided;
489.27(ii) information and method for a client or client's representative to contact the
489.28home care provider;
489.29(iii) names and contact information of persons the client wishes to have notified
489.30in an emergency or if there is a significant adverse change in the client's condition,
489.31including identification of and information as to who has authority to sign for the client in
489.32an emergency; and
489.33(iv) the circumstances in which emergency medical services are not to be summoned
489.34consistent with chapters 145B and 145C, and declarations made by the client under those
489.35chapters.
490.1    Subd. 10. Termination of service plan. (a) If a home care provider terminates a
490.2service plan with a client, and the client continues to need home care services, the home
490.3care provider shall provide the client and the client's representative, if any, with a written
490.4notice of termination which includes the following information:
490.5(1) the effective date of termination;
490.6(2) the reason for termination;
490.7(3) a list of known licensed home care providers in the client's immediate geographic
490.8area;
490.9(4) a statement that the home care provider will participate in a coordinated transfer
490.10of care of the client to another home care provider, health care provider, or caregiver, as
490.11required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
490.12(5) the name and contact information of a person employed by the home care
490.13provider with whom the client may discuss the notice of termination; and
490.14(6) if applicable, a statement that the notice of termination of home care services
490.15does not constitute notice of termination of the housing with services contract with a
490.16housing with services establishment.
490.17(b) When the home care provider voluntarily discontinues services to all clients, the
490.18home care provider must notify the commissioner, lead agencies, and the ombudsman for
490.19long-term care about its clients and comply with the requirements in this subdivision.
490.20    Subd. 11. Client complaint and investigative process. (a) The home care
490.21provider must have a written policy and system for receiving, investigating, reporting,
490.22and attempting to resolve complaints from its clients or clients' representatives. The
490.23policy should clearly identify the process by which clients may file a complaint or concern
490.24about home care services and an explicit statement that the home care provider will not
490.25discriminate or retaliate against a client for expressing concerns or complaints. A home
490.26care provider must have a process in place to conduct investigations of complaints made
490.27by the client or the client's representative about the services in the client's plan that are or
490.28are not being provided or other items covered in the client's home care bill of rights. This
490.29complaint system must provide reasonable accommodations for any special needs of the
490.30client or client's representative if requested.
490.31(b) The home care provider must document the complaint, name of the client,
490.32investigation, and resolution of each complaint filed. The home care provider must
490.33maintain a record of all activities regarding complaints received, including the date the
490.34complaint was received, and the home care provider's investigation and resolution of the
490.35complaint. This complaint record must be kept for each event for at least two years after
490.36the date of entry and must be available to the commissioner for review.
491.1(c) The required complaint system must provide for written notice to each client or
491.2client's representative that includes:
491.3(1) the client's right to complain to the home care provider about the services received;
491.4(2) the name or title of the person or persons with the home care provider to contact
491.5with complaints;
491.6(3) the method of submitting a complaint to the home care provider; and
491.7(4) a statement that the provider is prohibited against retaliation according to
491.8paragraph (d).
491.9(d) A home care provider must not take any action that negatively affects a client
491.10in retaliation for a complaint made or a concern expressed by the client or the client's
491.11representative.
491.12    Subd. 12. Disaster planning and emergency preparedness plan. The home care
491.13provider must have a written plan of action to facilitate the management of the client's care
491.14and services in response to a natural disaster, such as flood and storms, or other emergencies
491.15that may disrupt the home care provider's ability to provide care or services. The licensee
491.16must provide adequate orientation and training of staff on emergency preparedness.
491.17    Subd. 13. Request for discontinuation of life-sustaining treatment. (a) If a
491.18client, family member, or other caregiver of the client requests that an employee or other
491.19agent of the home care provider discontinue a life-sustaining treatment, the employee or
491.20agent receiving the request:
491.21(1) shall take no action to discontinue the treatment; and
491.22(2) shall promptly inform the supervisor or other agent of the home care provider of
491.23the client's request.
491.24(b) Upon being informed of a request for termination of treatment, the home care
491.25provider shall promptly:
491.26(1) inform the client that the request will be made known to the physician who
491.27ordered the client's treatment;
491.28(2) inform the physician of the client's request; and
491.29(3) work with the client and the client's physician to comply with the provisions of
491.30the Health Care Directive Act in chapter 145C.
491.31(c) This section does not require the home care provider to discontinue treatment,
491.32except as may be required by law or court order.
491.33(d) This section does not diminish the rights of clients to control their treatments,
491.34refuse services, or terminate their relationships with the home care provider.
491.35(e) This section shall be construed in a manner consistent with chapter 145B or
491.36145C, whichever applies, and declarations made by clients under those chapters.

492.1    Sec. 20. [144A.4792] MEDICATION MANAGEMENT.
492.2    Subdivision 1. Medication management services; comprehensive home care
492.3license. (a) This subdivision applies only to home care providers with a comprehensive
492.4home care license that provide medication management services to clients. Medication
492.5management services may not be provided by a home care provider who has a basic
492.6home care license.
492.7(b) A comprehensive home care provider who provides medication management
492.8services must develop, implement, and maintain current written medication management
492.9policies and procedures. The policies and procedures must be developed under the
492.10supervision and direction of a registered nurse, licensed health professional, or pharmacist
492.11consistent with current practice standards and guidelines.
492.12(c) The written policies and procedures must address requesting and receiving
492.13prescriptions for medications; preparing and giving medications; verifying that
492.14prescription drugs are administered as prescribed; documenting medication management
492.15activities; controlling and storing medications; monitoring and evaluating medication use;
492.16resolving medication errors; communicating with the prescriber, pharmacist, and client
492.17and client representative, if any; disposing of unused medications; and educating clients
492.18and client representatives about medications. When controlled substances are being
492.19managed, the policies and procedures must also identify how the provider will ensure
492.20security and accountability for the overall management, control, and disposition of those
492.21substances in compliance with state and federal regulations and with subdivision 22.
492.22    Subd. 2. Provision of medication management services. (a) For each client who
492.23requests medication management services, the comprehensive home care provider shall,
492.24prior to providing medication management services, have a registered nurse, licensed
492.25health professional, or authorized prescriber under section 151.37 conduct an assessment
492.26to determine what medication management services will be provided and how the services
492.27will be provided. This assessment must be conducted face-to-face with the client. The
492.28assessment must include an identification and review of all medications the client is known
492.29to be taking. The review and identification must include indications for medications, side
492.30effects, contraindications, allergic or adverse reactions, and actions to address these issues.
492.31(b) The assessment must identify interventions needed in management of
492.32medications to prevent diversion of medication by the client or others who may have
492.33access to the medications. "Diversion of medications" means the misuse, theft, or illegal
492.34or improper disposition of medications.
492.35    Subd. 3. Individualized medication monitoring and reassessment. The
492.36comprehensive home care provider must monitor and reassess the client's medication
493.1management services as needed under subdivision 14 when the client presents with
493.2symptoms or other issues that may be medication-related and, at a minimum, annually.
493.3    Subd. 4. Client refusal. The home care provider must document in the client's
493.4record any refusal for an assessment for medication management by the client. The
493.5provider must discuss with the client the possible consequences of the client's refusal and
493.6document the discussion in the client's record.
493.7    Subd. 5. Individualized medication management plan. (a) For each client
493.8receiving medication management services, the comprehensive home care provider must
493.9prepare and include in the service plan a written statement of the medication management
493.10services that will be provided to the client. The provider must develop and maintain a
493.11current individualized medication management record for each client based on the client's
493.12assessment that must contain the following:
493.13(1) a statement describing the medication management services that will be provided;
493.14(2) a description of storage of medications based on the client's needs and
493.15preferences, risk of diversion, and consistent with the manufacturer's directions;
493.16(3) documentation of specific client instructions relating to the administration
493.17of medications;
493.18(4) identification of persons responsible for monitoring medication supplies and
493.19ensuring that medication refills are ordered on a timely basis;
493.20(5) identification of medication management tasks that may be delegated to
493.21unlicensed personnel;
493.22(6) procedures for staff notifying a registered nurse or appropriate licensed health
493.23professional when a problem arises with medication management services; and
493.24(7) any client-specific requirements relating to documenting medication
493.25administration, verifications that all medications are administered as prescribed, and
493.26monitoring of medication use to prevent possible complications or adverse reactions.
493.27(b) The medication management record must be current and updated when there are
493.28any changes.
493.29    Subd. 6. Administration of medication. Medications may be administered by a
493.30nurse, physician, or other licensed health practitioner authorized to administer medications
493.31or by unlicensed personnel who have been delegated medication administration tasks by
493.32a registered nurse.
493.33    Subd. 7. Delegation of medication administration. When administration of
493.34medications is delegated to unlicensed personnel, the comprehensive home care provider
493.35must ensure that the registered nurse has:
494.1(1) instructed the unlicensed personnel in the proper methods to administer the
494.2medications, and the unlicensed personnel has demonstrated ability to competently follow
494.3the procedures;
494.4(2) specified, in writing, specific instructions for each client and documented those
494.5instructions in the client's records; and
494.6(3) communicated with the unlicensed personnel about the individual needs of
494.7the client.
494.8    Subd. 8. Documentation of administration of medications. Each medication
494.9administered by comprehensive home care provider staff must be documented in the
494.10client's record. The documentation must include the signature and title of the person
494.11who administered the medication. The documentation must include the medication
494.12name, dosage, date and time administered, and method and route of administration. The
494.13staff must document the reason why medication administration was not completed as
494.14prescribed and document any follow-up procedures that were provided to meet the client's
494.15needs when medication was not administered as prescribed and in compliance with the
494.16client's medication management plan.
494.17    Subd. 9. Documentation of medication setup. Documentation of dates of
494.18medication setup, name of medication, quantity of dose, times to be administered, route
494.19of administration, and name of person completing medication setup must be done at
494.20time of setup.
494.21    Subd. 10. Medication management for clients who will be away from home. (a)
494.22A home care provider who is providing medication management services to the client and
494.23controls the client's access to the medications must develop and implement policies and
494.24procedures for giving accurate and current medications to clients for planned or unplanned
494.25times away from home according to the client's individualized medication management
494.26plan. The policy and procedures must state that:
494.27(1) for planned time away, the medications must be obtained from the pharmacy or
494.28set up by the registered nurse according to appropriate state and federal laws and nursing
494.29standards of practice;
494.30(2) for unplanned time away, when the pharmacy is not able to provide the
494.31medications, a licensed nurse or unlicensed personnel shall give the client or client's
494.32representative medications in amounts and dosages needed for the length of the anticipated
494.33absence, not to exceed 120 hours;
494.34(3) the client, or the client's representative, must be provided written information
494.35on medications, including any special instructions for administering or handling the
494.36medications, including controlled substances;
495.1(4) the medications must be placed in a medication container or containers
495.2appropriate to the provider's medication system and must be labeled with the client's name
495.3and the dates and times that the medications are scheduled; and
495.4(5) the client or client's representative must be provided in writing the home care
495.5provider's name and information on how to contact the home care provider.
495.6(b) For unplanned time away when the licensed nurse is not available, the registered
495.7nurse may delegate this task to unlicensed personnel if:
495.8(1) the registered nurse has trained the unlicensed staff and determined the
495.9unlicensed staff is competent to follow the procedures for giving medications to clients;
495.10(2) the registered nurse has developed written procedures for the unlicensed
495.11personnel, including any special instructions or procedures regarding controlled substances
495.12that are prescribed for the client. The procedures must address:
495.13(i) the type of container or containers to be used for the medications appropriate to
495.14the provider's medication system;
495.15(ii) how the container or containers must be labeled;
495.16(iii) the written information about the medications to be given to the client or client's
495.17representative;
495.18(iv) how the unlicensed staff must document in the client's record that medications
495.19have been given to the client or the client's representative, including documenting the date
495.20the medications were given to the client or the client's representative and who received the
495.21medications, the person who gave the medications to the client, the number of medications
495.22that were given to the client, and other required information;
495.23(v) how the registered nurse shall be notified that medications have been given to
495.24the client or client's representative and whether the registered nurse needs to be contacted
495.25before the medications are given to the client or the client's representative; and
495.26(vi) a review by the registered nurse of the completion of this task to verify that this
495.27task was completed accurately by the unlicensed personnel.
495.28    Subd. 11. Prescribed and nonprescribed medication. The comprehensive home
495.29care provider must determine whether the comprehensive home care provider shall require
495.30a prescription for all medications the provider manages. The comprehensive home care
495.31provider must inform the client or the client's representative whether the comprehensive
495.32home care provider requires a prescription for all over-the-counter and dietary supplements
495.33before the comprehensive home care provider agrees to manage those medications.
495.34    Subd. 12. Medications; over-the-counter; dietary supplements not prescribed.
495.35A comprehensive home care provider providing medication management services for
495.36over-the-counter drugs or dietary supplements must retain those items in the original labeled
496.1container with directions for use prior to setting up for immediate or later administration.
496.2The provider must verify that the medications are up-to-date and stored as appropriate.
496.3    Subd. 13. Prescriptions. There must be a current written or electronically recorded
496.4prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed
496.5medications that the comprehensive home care provider is managing for the client.
496.6    Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least
496.7every 12 months or more frequently as indicated by the assessment in subdivision 2.
496.8Prescriptions for controlled substances must comply with chapter 152.
496.9    Subd. 15. Verbal prescription orders. Verbal prescription orders from an
496.10authorized prescriber must be received by a nurse or pharmacist. The order must be
496.11handled according to Minnesota Rules, part 6800.6200.
496.12    Subd. 16. Written or electronic prescription. When a written or electronic
496.13prescription is received, it must be communicated to the registered nurse in charge and
496.14recorded or placed in the client's record.
496.15    Subd. 17. Records confidential. A prescription or order received verbally, in
496.16writing, or electronically must be kept confidential according to sections 144.291 to
496.17144.298 and 144A.44.
496.18    Subd. 18. Medications provided by client or family members. When the
496.19comprehensive home care provider is aware of any medications or dietary supplements
496.20that are being used by the client and are not included in the assessment for medication
496.21management services, the staff must advise the registered nurse and document that in
496.22the client's record.
496.23    Subd. 19. Storage of medications. A comprehensive home care provider providing
496.24storage of medications outside of the client's private living space must store all prescription
496.25medications in securely locked and substantially constructed compartments according to
496.26the manufacturer's directions and permit only authorized personnel to have access.
496.27    Subd. 20. Prescription drugs. A prescription drug, prior to being set up for
496.28immediate or later administration, must be kept in the original container in which it was
496.29dispensed by the pharmacy bearing the original prescription label with legible information
496.30including the expiration or beyond-use date of a time-dated drug.
496.31    Subd. 21. Prohibitions. No prescription drug supply for one client may be used or
496.32saved for use by anyone other than the client.
496.33    Subd. 22. Disposition of medications. (a) Any current medications being managed
496.34by the comprehensive home care provider must be given to the client or the client's
496.35representative when the client's service plan ends or medication management services are
496.36no longer part of the service plan. Medications that have been stored in the client's private
497.1living space for a client who is deceased or that have been discontinued or that have
497.2expired may be given to the client or the client's representative for disposal.
497.3(b) The comprehensive home care provider will dispose of any medications
497.4remaining with the comprehensive home care provider that are discontinued or expired or
497.5upon the termination of the service contract or the client's death according to state and
497.6federal regulations for disposition of medications and controlled substances.
497.7(c) Upon disposition, the comprehensive home care provider must document in the
497.8client's record the disposition of the medication including the medication's name, strength,
497.9prescription number as applicable, quantity, to whom the medications were given, date of
497.10disposition, and names of staff and other individuals involved in the disposition.
497.11    Subd. 23. Loss or spillage. (a) Comprehensive home care providers providing
497.12medication management must develop and implement procedures for loss or spillage of all
497.13controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must
497.14require that when a spillage of a controlled substance occurs, a notation must be made
497.15in the client's record explaining the spillage and the actions taken. The notation must
497.16be signed by the person responsible for the spillage and include verification that any
497.17contaminated substance was disposed of according to state or federal regulations.
497.18(b) The procedures must require the comprehensive home care provider of
497.19medication management to investigate any known loss or unaccounted for prescription
497.20drugs and take appropriate action required under state or federal regulations and document
497.21the investigation in required records.

497.22    Sec. 21. [144A.4793] TREATMENT AND THERAPY MANAGEMENT
497.23SERVICES.
497.24    Subdivision 1. Providers with a comprehensive home care license. This section
497.25applies only to home care providers with a comprehensive home care license that provide
497.26treatment or therapy management services to clients. Treatment or therapy management
497.27services cannot be provided by a home care provider that has a basic home care license.
497.28    Subd. 2. Policies and procedures. (a) A comprehensive home care provider who
497.29provides treatment and therapy management services must develop, implement, and
497.30maintain up-to-date written treatment or therapy management policies and procedures.
497.31The policies and procedures must be developed under the supervision and direction of
497.32a registered nurse or appropriate licensed health professional consistent with current
497.33practice standards and guidelines.
497.34(b) The written policies and procedures must address requesting and receiving
497.35orders or prescriptions for treatments or therapies, providing the treatment or therapy,
498.1documenting of treatment or therapy activities, educating and communicating with clients
498.2about treatments or therapy they are receiving, monitoring and evaluating the treatment
498.3and therapy, and communicating with the prescriber.
498.4    Subd. 3. Individualized treatment or therapy management plan. For each
498.5client receiving management of ordered or prescribed treatments or therapy services, the
498.6comprehensive home care provider must prepare and include in the service plan a written
498.7statement of the treatment or therapy services that will be provided to the client. The
498.8provider must also develop and maintain a current individualized treatment and therapy
498.9management record for each client which must contain at least the following:
498.10(1) a statement of the type of services that will be provided;
498.11(2) documentation of specific client instructions relating to the treatments or therapy
498.12administration;
498.13(3) identification of treatment or therapy tasks that will be delegated to unlicensed
498.14personnel;
498.15(4) procedures for notifying a registered nurse or appropriate licensed health
498.16professional when a problem arises with treatments or therapy services; and
498.17(5) any client-specific requirements relating to documentation of treatment
498.18and therapy received, verification that all treatment and therapy was administered as
498.19prescribed, and monitoring of treatment or therapy to prevent possible complications or
498.20adverse reactions. The treatment or therapy management record must be current and
498.21updated when there are any changes.
498.22    Subd. 4. Administration of treatments and therapy. Ordered or prescribed
498.23treatments or therapies must be administered by a nurse, physician, or other licensed health
498.24professional authorized to perform the treatment or therapy, or may be delegated or assigned
498.25to unlicensed personnel by the licensed health professional according to the appropriate
498.26practice standards for delegation or assignment. When administration of a treatment or
498.27therapy is delegated or assigned to unlicensed personnel, the home care provider must
498.28ensure that the registered nurse or authorized licensed health professional has:
498.29(1) instructed the unlicensed personnel in the proper methods with respect to each
498.30client and the unlicensed personnel has demonstrated the ability to competently follow
498.31the procedures;
498.32(2) specified, in writing, specific instructions for each client and documented those
498.33instructions in the client's record; and
498.34(3) communicated with the unlicensed personnel about the individual needs of
498.35the client.
499.1    Subd. 5. Documentation of administration of treatments and therapies. Each
499.2treatment or therapy administered by a comprehensive home care provider must be
499.3documented in the client's record. The documentation must include the signature and title
499.4of the person who administered the treatment or therapy and must include the date and
499.5time of administration. When treatment or therapies are not administered as ordered or
499.6prescribed, the provider must document the reason why it was not administered and any
499.7follow-up procedures that were provided to meet the client's needs.
499.8    Subd. 6. Orders or prescriptions. There must be an up-to-date written or
499.9electronically recorded order or prescription for all treatments and therapies. The order
499.10must contain the name of the client, description of the treatment or therapy to be provided,
499.11and the frequency and other information needed to administer the treatment or therapy.

499.12    Sec. 22. [144A.4794] CLIENT RECORD REQUIREMENTS.
499.13    Subdivision 1. Client record. (a) The home care provider must maintain records
499.14for each client for whom it is providing services. Entries in the client records must be
499.15current, legible, permanently recorded, dated, and authenticated with the name and title
499.16of the person making the entry.
499.17(b) Client records, whether written or electronic, must be protected against loss,
499.18tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
499.19relevant federal and state laws. The home care provider shall establish and implement
499.20written procedures to control use, storage, and security of client's records and establish
499.21criteria for release of client information.
499.22(c) The home care provider may not disclose to any other person any personal,
499.23financial, medical, or other information about the client, except:
499.24(1) as may be required by law;
499.25(2) to employees or contractors of the home care provider, another home care
499.26provider, other health care practitioner or provider, or inpatient facility needing
499.27information in order to provide services to the client, but only such information that
499.28is necessary for the provision of services;
499.29(3) to persons authorized in writing by the client or the client's representative to
499.30receive the information, including third-party payers; and
499.31(4) to representatives of the commissioner authorized to survey or investigate home
499.32care providers under this chapter or federal laws.
499.33    Subd. 2. Access to records. The home care provider must ensure that the
499.34appropriate records are readily available to employees or contractors authorized to access
500.1the records. Client records must be maintained in a manner that allows for timely access,
500.2printing, or transmission of the records.
500.3    Subd. 3. Contents of client record. Contents of a client record include the
500.4following for each client:
500.5(1) identifying information, including the client's name, date of birth, address, and
500.6telephone number;
500.7(2) the name, address, and telephone number of an emergency contact, family
500.8members, client's representative, if any, or others as identified;
500.9(3) names, addresses, and telephone numbers of the client's health and medical
500.10service providers and other home care providers, if known;
500.11(4) health information, including medical history, allergies, and when the provider
500.12is managing medications, treatments or therapies that require documentation, and other
500.13relevant health records;
500.14(5) client's advance directives, if any;
500.15(6) the home care provider's current and previous assessments and service plans;
500.16(7) all records of communications pertinent to the client's home care services;
500.17(8) documentation of significant changes in the client's status and actions taken in
500.18response to the needs of the client including reporting to the appropriate supervisor or
500.19health care professional;
500.20(9) documentation of incidents involving the client and actions taken in response
500.21to the needs of the client including reporting to the appropriate supervisor or health
500.22care professional;
500.23(10) documentation that services have been provided as identified in the service plan;
500.24(11) documentation that the client has received and reviewed the home care bill
500.25of rights;
500.26(12) documentation that the client has been provided the statement of disclosure on
500.27limitations of services under section 144A.4791, subdivision 3;
500.28(13) documentation of complaints received and resolution;
500.29(14) discharge summary, including service termination notice and related
500.30documentation, when applicable; and
500.31(15) other documentation required under this chapter and relevant to the client's
500.32services or status.
500.33    Subd. 4. Transfer of client records. If a client transfers to another home care
500.34provider or other health care practitioner or provider, or is admitted to an inpatient facility,
500.35the home care provider, upon request of the client or the client's representative, shall take
501.1steps to ensure a coordinated transfer including sending a copy or summary of the client's
501.2record to the new home care provider, facility, or the client, as appropriate.
501.3    Subd. 5. Record retention. Following the client's discharge or termination of
501.4services, a home care provider must retain a client's record for at least five years, or as
501.5otherwise required by state or federal regulations. Arrangements must be made for secure
501.6storage and retrieval of client records if the home care provider ceases business.

501.7    Sec. 23. [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.
501.8    Subdivision 1. Qualifications, training, and competency. All staff providing home
501.9care services must: (1) be trained and competent in the provision of home care services
501.10consistent with current practice standards appropriate to the client's needs; and (2) be
501.11informed of the home care bill of rights under section 144A.44.
501.12    Subd. 2. Licensed health professionals and nurses. (a) Licensed health
501.13professionals and nurses providing home care services as an employee of a licensed home
501.14care provider must possess current Minnesota license or registration to practice.
501.15(b) Licensed health professionals and registered nurses must be competent in
501.16assessing client needs, planning appropriate home care services to meet client needs,
501.17implementing services, and supervising staff if assigned.
501.18(c) Nothing in this section limits or expands the rights of nurses or licensed health
501.19professionals to provide services within the scope of their licenses or registrations, as
501.20provided by law.
501.21    Subd. 3. Unlicensed personnel. (a) Unlicensed personnel providing basic home
501.22care services must have:
501.23(1) successfully completed a training and competency evaluation appropriate to
501.24the services provided by the home care provider and the topics listed in subdivision 7,
501.25paragraph (b); or
501.26(2) demonstrated competency by satisfactorily completing a written or oral test on
501.27the tasks the unlicensed personnel will perform and in the topics listed in subdivision
501.287, paragraph (b); and successfully demonstrate competency of topics in subdivision 7,
501.29paragraph (b), clauses (5), (7), and (8), by a practical skills test.
501.30Unlicensed personnel providing home care services for a basic home care provider may
501.31not perform delegated nursing or therapy tasks.
501.32(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive
501.33home care provider must:
501.34(1) have successfully completed training and demonstrated competency by
501.35successfully completing a written or oral test of the topics in subdivision 7, paragraphs (b)
502.1and (c), and a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5)
502.2and (7), and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform;
502.3(2) satisfy the current requirements of Medicare for training or competency of home
502.4health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
502.5section 483 or section 484.36; or
502.6(3) have, before April 19, 1993, completed a training course for nursing assistants
502.7that was approved by the commissioner.
502.8(c) Unlicensed personnel performing therapy or treatment tasks delegated or
502.9assigned by a licensed health professional must meet the requirements for delegated
502.10tasks in subdivision 4 and any other training or competency requirements within the
502.11licensed health professional scope of practice relating to delegation or assignment of tasks
502.12to unlicensed personnel.
502.13    Subd. 4. Delegation of home care tasks. A registered nurse or licensed health
502.14professional may delegate tasks only to staff that are competent and possess the knowledge
502.15and skills consistent with the complexity of the tasks and according to the appropriate
502.16Minnesota Practice Act. The comprehensive home care provider must establish and
502.17implement a system to communicate up-to-date information to the registered nurse or
502.18licensed health professional regarding the current available staff and their competency so
502.19the registered nurse or licensed health professional has sufficient information to determine
502.20the appropriateness of delegating tasks to meet individual client needs and preferences.
502.21    Subd. 5. Individual contractors. When a home care provider contracts with an
502.22individual contractor excluded from licensure under section 144A.471 to provide home
502.23care services, the contractor must meet the same requirements required by this section for
502.24personnel employed by the home care provider.
502.25    Subd. 6. Temporary staff. When a home care provider contracts with a temporary
502.26staffing agency excluded from licensure under section 144A.471, those individuals must
502.27meet the same requirements required by this section for personnel employed by the home
502.28care provider and shall be treated as if they are staff of the home care provider.
502.29    Subd. 7. Requirements for instructors, training content, and competency
502.30evaluations for unlicensed personnel. (a) Instructors and competency evaluators must
502.31meet the following requirements:
502.32(1) training and competency evaluations of unlicensed personnel providing basic
502.33home care services must be conducted by individuals with work experience and training in
502.34providing home care services listed in section 144A.471, subdivisions 6 and 7; and
502.35(2) training and competency evaluations of unlicensed personnel providing
502.36comprehensive home care services must be conducted by a registered nurse, or another
503.1instructor may provide training in conjunction with the registered nurse. If the home care
503.2provider is providing services by licensed health professionals only, then that specific
503.3training and competency evaluation may be conducted by the licensed health professionals
503.4as appropriate.
503.5(b) Training and competency evaluations for all unlicensed personnel must include
503.6the following:
503.7(1) documentation requirements for all services provided;
503.8(2) reports of changes in the client's condition to the supervisor designated by the
503.9home care provider;
503.10(3) basic infection control, including blood-borne pathogens;
503.11(4) maintenance of a clean and safe environment;
503.12(5) appropriate and safe techniques in personal hygiene and grooming, including:
503.13(i) hair care and bathing;
503.14(ii) care of teeth, gums, and oral prosthetic devices;
503.15(iii) care and use of hearing aids; and
503.16(iv) dressing and assisting with toileting;
503.17(6) training on the prevention of falls for providers working with the elderly or
503.18individuals at risk of falls;
503.19(7) standby assistance techniques and how to perform them;
503.20(8) medication, exercise, and treatment reminders;
503.21(9) basic nutrition, meal preparation, food safety, and assistance with eating;
503.22(10) preparation of modified diets as ordered by a licensed health professional;
503.23(11) communication skills that include preserving the dignity of the client and
503.24showing respect for the client and the client's preferences, cultural background, and family;
503.25(12) awareness of confidentiality and privacy;
503.26(13) understanding appropriate boundaries between staff and clients and the client's
503.27family;
503.28(14) procedures to utilize in handling various emergency situations; and
503.29(15) awareness of commonly used health technology equipment and assistive devices.
503.30(c) In addition to paragraph (b), training and competency evaluation for unlicensed
503.31personnel providing comprehensive home care services must include:
503.32(1) observation, reporting, and documenting of client status;
503.33(2) basic knowledge of body functioning and changes in body functioning, injuries,
503.34or other observed changes that must be reported to appropriate personnel;
503.35(3) reading and recording temperature, pulse, and respirations of the client;
503.36(4) recognizing physical, emotional, cognitive, and developmental needs of the client;
504.1(5) safe transfer techniques and ambulation;
504.2(6) range of motioning and positioning; and
504.3(7) administering medications or treatments as required.
504.4(d) When the registered nurse or licensed health professional delegates tasks, they
504.5must ensure that prior to the delegation the unlicensed personnel is trained in the proper
504.6methods to perform the tasks or procedures for each client and are able to demonstrate
504.7the ability to competently follow the procedures and perform the tasks. If an unlicensed
504.8personnel has not regularly performed the delegated home care task for a period of 24
504.9consecutive months, the unlicensed personnel must demonstrate competency in the task
504.10to the registered nurse or appropriate licensed health professional. The registered nurse
504.11or licensed health professional must document instructions for the delegated tasks in
504.12the client's record.

504.13    Sec. 24. [144A.4796] ORIENTATION AND ANNUAL TRAINING
504.14REQUIREMENTS.
504.15    Subdivision 1. Orientation of staff and supervisors to home care. All staff
504.16providing and supervising direct home care services must complete an orientation to home
504.17care licensing requirements and regulations before providing home care services to clients.
504.18The orientation may be incorporated into the training required under subdivision 6. The
504.19orientation need only be completed once for each staff person and is not transferable
504.20to another home care provider.
504.21    Subd. 2. Content. The orientation must contain the following topics:
504.22    (1) an overview of sections 144A.43 to 144A.4798;
504.23(2) introduction and review of all the provider's policies and procedures related to
504.24the provision of home care services;
504.25(3) handling of emergencies and use of emergency services;
504.26(4) compliance with and reporting of the maltreatment of minors or vulnerable
504.27adults under sections 626.556 and 626.557;
504.28(5) home care bill of rights, under section 144A.44;
504.29(6) handling of clients' complaints; reporting of complaints and where to report
504.30complaints including information on the Office of Health Facility Complaints and the
504.31Common Entry Point;
504.32(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
504.33Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
504.34Ombudsman at the Department of Human Services, county managed care advocates,
504.35or other relevant advocacy services; and
505.1(8) review of the types of home care services the employee will be providing and
505.2the provider's scope of licensure.
505.3    Subd. 3. Verification and documentation of orientation. Each home care provider
505.4shall retain evidence in the employee record of each staff person having completed the
505.5orientation required by this section.
505.6    Subd. 4. Orientation to client. Staff providing home care services must be oriented
505.7specifically to each individual client and the services to be provided. This orientation may
505.8be provided in person, orally, in writing, or electronically.
505.9    Subd. 5. Training required relating to Alzheimer's disease and related disorders.
505.10For home care providers that provide services for persons with Alzheimer's or related
505.11disorders, all direct care staff and supervisors working with those clients must receive
505.12training that includes a current explanation of Alzheimer's disease and related disorders,
505.13effective approaches to use to problem solve when working with a client's challenging
505.14behaviors, and how to communicate with clients who have Alzheimer's or related disorders.
505.15    Subd. 6. Required annual training. All staff that perform direct home care
505.16services must complete at least eight hours of annual training for each 12 months of
505.17employment. The training may be obtained from the home care provider or another source
505.18and must include topics relevant to the provision of home care services. The annual
505.19training must include:
505.20(1) training on reporting of maltreatment of minors under section 626.556 and
505.21maltreatment of vulnerable adults under section 626.557, whichever is applicable to the
505.22services provided;
505.23(2) review of the home care bill of rights in section 144A.44;
505.24(3) review of infection control techniques used in the home and implementation of
505.25infection control standards including a review of hand washing techniques; the need for
505.26and use of protective gloves, gowns, and masks; appropriate disposal of contaminated
505.27materials and equipment, such as dressings, needles, syringes, and razor blades;
505.28disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of
505.29communicable diseases; and
505.30(4) review of the provider's policies and procedures relating to the provision of home
505.31care services and how to implement those policies and procedures.
505.32    Subd. 7. Documentation. A home care provider must retain documentation in the
505.33employee records of the staff that have satisfied the orientation and training requirements
505.34of this section.

505.35    Sec. 25. [144A.4797] PROVISION OF SERVICES.
506.1    Subdivision 1. Availability of contact person to staff. (a) A home care provider
506.2with a basic home care license must have a person available to staff for consultation on
506.3items relating to the provision of services or about the client.
506.4(b) A home care provider with a comprehensive home care license must have a
506.5registered nurse available for consultation to staff performing delegated nursing tasks
506.6and must have an appropriate licensed health professional available if performing other
506.7delegated services such as therapies.
506.8(c) The appropriate contact person must be readily available either in person, by
506.9telephone, or by other means to the staff at times when the staff is providing services.
506.10    Subd. 2. Supervision of staff; basic home care services. (a) Staff who perform
506.11basic home care services must be supervised periodically where the services are being
506.12provided to verify that the work is being performed competently and to identify problems
506.13and solutions to address issues relating to the staff's ability to provide the services. The
506.14supervision of the unlicensed personnel must be done by staff of the home care provider
506.15having the authority, skills, and ability to provide the supervision of unlicensed personnel
506.16and who can implement changes as needed, and train staff.
506.17(b) Supervision includes direct observation of unlicensed personnel while the
506.18unlicensed personnel are providing the services and may also include indirect methods of
506.19gaining input such as gathering feedback from the client. Supervisory review of staff must
506.20be provided at a frequency based on the staff person's competency and performance.
506.21(c) For an individual who is licensed as a home care provider, this section does
506.22not apply.
506.23    Subd. 3. Supervision of staff providing delegated nursing or therapy home
506.24care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must be
506.25supervised by an appropriate licensed health professional or a registered nurse periodically
506.26where the services are being provided to verify that the work is being performed
506.27competently and to identify problems and solutions related to the staff person's ability to
506.28perform the tasks. Supervision of staff performing medication or treatment administration
506.29shall be provided by a registered nurse or appropriate licensed health professional and
506.30must include observation of the staff administering the medication or treatment and the
506.31interaction with the client.
506.32(b) The direct supervision of staff performing delegated tasks must be provided
506.33within 30 days after the individual begins working for the home care provider and
506.34thereafter as needed based on performance. This requirement also applies to staff who
506.35have not performed delegated tasks for one year or longer.
507.1    Subd. 4. Documentation. A home care provider must retain documentation of
507.2supervision activities in the personnel records.
507.3    Subd. 5. Exemption. This section does not apply to an individual licensed under
507.4sections 144A.43 to 144A.4798.

507.5    Sec. 26. [144A.4798] EMPLOYEE HEALTH STATUS.
507.6    Subdivision 1. Tuberculosis (TB) prevention and control. A home care provider
507.7must establish and maintain a TB prevention and control program based on the most
507.8current guidelines issued by the Centers for Disease Control and Prevention (CDC).
507.9Components of a TB prevention and control program include screening all staff providing
507.10home care services, both paid and unpaid, at the time of hire for active TB disease and
507.11latent TB infection, and developing and implementing a written TB infection control plan.
507.12The commissioner shall make the most recent CDC standards available to home care
507.13providers on the department's Web site.
507.14    Subd. 2. Communicable diseases. A home care provider must follow
507.15current federal or state guidelines for prevention, control, and reporting of human
507.16immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
507.17communicable diseases as defined in Minnesota Rules, part 4605.7040.

507.18    Sec. 27. [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE
507.19PROVIDER ADVISORY COUNCIL.
507.20    Subdivision 1. Membership. The commissioner of health shall appoint eight
507.21persons to a home care provider advisory council consisting of the following:
507.22(1) three public members as defined in section 214.02 who shall be either persons
507.23who are currently receiving home care services or have family members receiving home
507.24care services, or persons who have family members who have received home care services
507.25within five years of the application date;
507.26(2) three Minnesota home care licensees representing basic and comprehensive
507.27levels of licensure who may be a managerial official, an administrator, a supervising
507.28registered nurse, or an unlicensed personnel performing home care tasks;
507.29(3) one member representing the Minnesota Board of Nursing; and
507.30(4) one member representing the ombudsman for long-term care.
507.31    Subd. 2. Organizations and meetings. The advisory council shall be organized
507.32and administered under section 15.059 with per diems and costs paid within the limits of
507.33available appropriations. Meetings will be held quarterly and hosted by the department.
508.1Subcommittees may be developed as necessary by the commissioner. Advisory council
508.2meetings are subject to the Open Meeting Law under chapter 13D.
508.3    Subd. 3. Duties. At the commissioner's request, the advisory council shall provide
508.4advice regarding regulations of Department of Health licensed home care providers in
508.5this chapter such as:
508.6(1) advice to the commissioner regarding community standards for home care
508.7practices;
508.8(2) advice to the commissioner on enforcement of licensing standards and whether
508.9certain disciplinary actions are appropriate;
508.10(3) advice to the commissioner about ways of distributing information to licensees
508.11and consumers of home care;
508.12(4) advice to the commissioner about training standards;
508.13(5) identify emerging issues and opportunities in the home care field, including the
508.14use of technology in home and telehealth capabilities; and
508.15(6) perform other duties as directed by the commissioner.

508.16    Sec. 28. [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR
508.17NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.
508.18    Subdivision 1. Temporary home care licenses and changes of ownership. (a)
508.19Beginning January 1, 2014, all temporary license applicants must apply for either a
508.20temporary basic or comprehensive home care license.
508.21(b) Temporary home care licenses issued beginning January 1, 2014, shall be
508.22issued according to sections 144A.43 to 144A.4798, and the fees in section 144A.472.
508.23Temporary licensees must comply with the requirements of this chapter.
508.24(c) No temporary license applications will be accepted nor temporary licenses issued
508.25between December 1, 2013, and December 31, 2013.
508.26(d) Beginning October 1, 2013, changes in ownership applications will require
508.27payment of the new fees listed in section 144A.472. Providers who are providing
508.28nursing, delegated nursing, or professional health care services, must submit the fee for
508.29comprehensive home care providers, and all other providers must submit the fee for basic
508.30home care providers as provided in section 144A.472. Change of ownership applicants will
508.31be issued a new home care license based on the licensure law in effect on June 30, 2013.
508.32    Subd. 2. Current home care licensees with licenses prior to July 1, 2013. (a)
508.33Beginning July 1, 2014, department licensed home care providers must apply for either
508.34the basic or comprehensive home care license on their regularly scheduled renewal date.
509.1(b) By June 30, 2015, all home care providers must either have a basic or
509.2comprehensive home care license or temporary license.
509.3    Subd. 3. Renewal application of home care licensure during transition period.
509.4(a) Renewal and change of ownership applications of home care licenses issued beginning
509.5July 1, 2014, will be issued according to sections 144A.43 to 144A.4798 and, upon license
509.6renewal or issuance of a new license for a change of ownership, providers must comply
509.7with sections 144A.43 to 144A.4798. Prior to renewal, providers must comply with the
509.8home care licensure law in effect on June 30, 2013.
509.9(b) The fees charged for licenses renewed between July 1, 2014, and June 30, 2016,
509.10shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000
509.11increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.
509.12(c) For fiscal year 2014 only, the fees for providers with revenues greater than
509.13$25,000 and no more than $100,000 will be $313 and for providers with revenues no
509.14more than $25,000 the fee will be $125.

509.15    Sec. 29. [144A.482] REGISTRATION OF HOME MANAGEMENT
509.16PROVIDERS.
509.17(a) For purposes of this section, a home management provider is a person or
509.18organization that provides at least two of the following services: housekeeping, meal
509.19preparation, and shopping to a person who is unable to perform these activities due to
509.20illness, disability, or physical condition.
509.21(b) A person or organization that provides only home management services may not
509.22operate in the state without a current certificate of registration issued by the commissioner
509.23of health. To obtain a certificate of registration, the person or organization must annually
509.24submit to the commissioner the name, mailing and physical addresses, e-mail address, and
509.25telephone number of the person or organization and a signed statement declaring that the
509.26person or organization is aware that the home care bill of rights applies to their clients and
509.27that the person or organization will comply with the home care bill of rights provisions
509.28contained in section 144A.44. A person or organization applying for a certificate must
509.29also provide the name, business address, and telephone number of each of the persons
509.30responsible for the management or direction of the organization.
509.31(c) The commissioner shall charge an annual registration fee of $20 for persons and
509.32$50 for organizations. The registration fee shall be deposited in the state treasury and
509.33credited to the state government special revenue fund.
509.34(d) A home care provider that provides home management services and other home
509.35care services must be licensed, but licensure requirements other than the home care bill of
510.1rights do not apply to those employees or volunteers who provide only home management
510.2services to clients who do not receive any other home care services from the provider.
510.3A licensed home care provider need not be registered as a home management service
510.4provider but must provide an orientation on the home care bill of rights to its employees
510.5or volunteers who provide home management services.
510.6(e) An individual who provides home management services under this section must,
510.7within 120 days after beginning to provide services, attend an orientation session approved
510.8by the commissioner that provides training on the home care bill of rights and an orientation
510.9on the aging process and the needs and concerns of elderly and disabled persons.
510.10(f) The commissioner may suspend or revoke a provider's certificate of registration
510.11or assess fines for violation of the home care bill of rights. Any fine assessed for a
510.12violation of the home care bill of rights by a provider registered under this section shall be
510.13in the amount established in the licensure rules for home care providers. As a condition
510.14of registration, a provider must cooperate fully with any investigation conducted by the
510.15commissioner, including providing specific information requested by the commissioner on
510.16clients served and the employees and volunteers who provide services. Fines collected
510.17under this paragraph shall be deposited in the state treasury and credited to the fund
510.18specified in the statute or rule in which the penalty was established.
510.19(g) The commissioner may use any of the powers granted in sections 144A.43 to
510.20144A.4798 to administer the registration system and enforce the home care bill of rights
510.21under this section.

510.22    Sec. 30. [144A.483] AGENCY QUALITY IMPROVEMENT PROGRAM.
510.23    Subdivision 1. Annual legislative report on home care licensing. The
510.24commissioner shall establish a quality improvement program for the home care survey
510.25and home care complaint investigation processes. The commissioner shall submit to the
510.26legislature an annual report, beginning October 1, 2015, and each October 1 thereafter.
510.27Each report will review the previous state fiscal year of home care licensing and regulatory
510.28activities. The report must include, but is not limited to, an analysis of:
510.29(1) the number of FTE's in the Division of Compliance Monitoring, including the
510.30Office of Health Facility Complaints units assigned to home care licensing, survey,
510.31investigation and enforcement process;
510.32(2) numbers of and descriptive information about licenses issued, complaints
510.33received and investigated, including allegations made and correction orders issued,
510.34surveys completed and timelines, and correction order reconsiderations and results;
511.1(3) descriptions of emerging trends in home care provision and areas of concern
511.2identified by the department in its regulation of home care providers;
511.3(4) information and data regarding performance improvement projects underway
511.4and planned by the commissioner in the area of home care surveys; and
511.5(5) work of the Department of Health Home Care Advisory Council.
511.6    Subd. 2. Study of correction order appeal process. Starting July 1, 2015, the
511.7commissioner shall study whether to add a correction order appeal process conducted by
511.8an independent reviewer such as an administrative law judge or other office and submit a
511.9report to the legislature by February 1, 2016. The commissioner shall review home care
511.10regulatory systems in other states as part of that study. The commissioner shall consult
511.11with the home care providers and representatives.

511.12    Sec. 31. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
511.13AND COMMUNITY-BASED SERVICES.
511.14(a) The Department of Health Compliance Monitoring Division and the Department
511.15of Human Services Licensing Division shall jointly develop an integrated licensing system
511.16for providers of both home care services subject to licensure under Minnesota Statutes,
511.17chapter 144A, and for home and community-based services subject to licensure under
511.18Minnesota Statutes, chapter 245D. The integrated licensing system shall:
511.19(1) require only one license of any provider of services under Minnesota Statutes,
511.20sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
511.21(2) promote quality services that recognize a person's individual needs and protect
511.22the person's health, safety, rights, and well-being;
511.23(3) promote provider accountability through application requirements, compliance
511.24inspections, investigations, and enforcement actions;
511.25(4) reference other applicable requirements in existing state and federal laws,
511.26including the federal Affordable Care Act;
511.27(5) establish internal procedures to facilitate ongoing communications between the
511.28agencies, and with providers and services recipients about the regulatory activities;
511.29(6) create a link between the agency Web sites so that providers and the public can
511.30access the same information regardless of which Web site is accessed initially; and
511.31(7) collect data on identified outcome measures as necessary for the agencies to
511.32report to the Centers for Medicare and Medicaid Services.
511.33(b) The joint recommendations for legislative changes to implement the integrated
511.34licensing system are due to the legislature by February 15, 2014.
512.1(c) Before implementation of the integrated licensing system, providers licensed as
512.2home care providers under Minnesota Statutes, chapter 144A, may also provide home
512.3and community-based services subject to licensure under Minnesota Statutes, chapter
512.4245D, without obtaining a home and community-based services license under Minnesota
512.5Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
512.6apply to these providers:
512.7(1) the provider must comply with all requirements under Minnesota Statutes, chapter
512.8245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
512.9(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
512.10enforced by the Department of Health under the enforcement authority set forth in
512.11Minnesota Statutes, section 144A.475; and
512.12(3) the Department of Health will provide information to the Department of Human
512.13Services about each provider licensed under this section, including the provider's license
512.14application, licensing documents, inspections, information about complaints received, and
512.15investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

512.16    Sec. 32. STUDY OF CORRECTION ORDER APPEAL PROCESS.
512.17Beginning July 1, 2015, the commissioner of health shall study whether to use
512.18a correction order appeal process conducted by an independent reviewer, such as
512.19an administrative law judge or other office. The commissioner shall review home
512.20care regulatory systems in other states and consult with the home care providers and
512.21representatives. By February 1, 2016, the commissioner shall submit a report to the chairs
512.22and ranking minority members of the committees of the legislature with jurisdiction over
512.23health and human services and judiciary issues with any recommendations regarding
512.24an independent appeal process.

512.25    Sec. 33. REPEALER.
512.26(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.
512.27(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
512.284668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040;
512.294668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
512.304668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170;
512.314668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240;
512.324668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830;
512.334668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
512.344669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.

513.1    Sec. 34. EFFECTIVE DATE.
513.2This article is effective the day following final enactment.

513.3ARTICLE 12

513.4HEALTH DEPARTMENT

513.5    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 2, is amended to read:
513.6    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
513.7resources in the health care access fund exceed expenditures in that fund, effective for
513.8the biennium beginning July 1, 2007, the commissioner of management and budget shall
513.9transfer the excess funds from the health care access fund to the general fund on June 30
513.10of each year, provided that the amount transferred in any fiscal biennium shall not exceed
513.11$96,000,000. The purpose of this transfer is to meet the rate increase required under Laws
513.122003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
513.13    (b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and,
513.14if necessary, the commissioner shall reduce these transfers from the health care access
513.15fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
513.16transfer sufficient funds from the general fund to the health care access fund to meet
513.17annual MinnesotaCare expenditures.
513.18(c) Notwithstanding section 295.581, to the extent available resources in the health
513.19care access fund exceed expenditures in that fund after the transfer required in paragraph
513.20(a), effective for the biennium beginning July 1, 2013, the commissioner of management
513.21and budget shall transfer $1,000,000 each fiscal year from the health access fund to
513.22the medical education and research costs fund established under section 62J.692, for
513.23distribution under section 62J.692, subdivision 4, paragraph (c).

513.24    Sec. 2. Minnesota Statutes 2012, section 43A.23, is amended by adding a subdivision
513.25to read:
513.26    Subd. 4. Coverage for autism spectrum disorders. For participants in the state
513.27employee group insurance program, the commissioner of management and budget must
513.28administer the identical benefit as is required under section 62A.3094.
513.29EFFECTIVE DATE.This section is effective January 1, 2016, or the date a
513.30collective bargaining agreement or compensation plan that includes changes to this section
513.31is approved under Minnesota Statutes, section 3.855, whichever is earlier.

513.32    Sec. 3. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
514.1    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
514.2paragraphs (b) to (d) have the meanings given.
514.3(b) "Autism spectrum disorders" means the conditions as determined by criteria
514.4set forth in the most recent edition of the Diagnostic and Statistical Manual of Mental
514.5Disorders of the American Psychiatric Association.
514.6(c) "Medically necessary care" means health care services appropriate, in terms of
514.7type, frequency, level, setting, and duration, to the enrollee's condition, and diagnostic
514.8testing and preventative services. Medically necessary care must be consistent with
514.9generally accepted practice parameters as determined by physicians and licensed
514.10psychologists who typically manage patients who have autism spectrum disorders.
514.11(d) "Mental health professional" means a mental health professional as defined in
514.12section 245.4871, subdivision 27, clause (1), (2), (3), (4), or (6), who has training and
514.13expertise in autism spectrum disorder and child development.
514.14    Subd. 2. Coverage required. (a) A health plan issued to a large employer, as
514.15defined in section 62Q.18, subdivision 1, must provide coverage for the diagnosis,
514.16evaluation, multidisciplinary assessment, and medically necessary care of children under
514.1718 with autism spectrum disorders, including but not limited to the following:
514.18(1) early intensive behavioral and developmental therapy based in behavioral and
514.19developmental science, including, but not limited to, all types of applied behavior analysis,
514.20intensive early intervention behavior therapy, and intensive behavior intervention;
514.21(2) neurodevelopmental and behavioral health treatments and management;
514.22(3) speech therapy;
514.23(4) occupational therapy;
514.24(5) physical therapy; and
514.25(6) medications.
514.26(b) The diagnosis, evaluation, and assessment must include an assessment of the
514.27child's developmental skills, functional behavior, needs, and capacities.
514.28(c) The coverage required under this subdivision must include treatment that is in
514.29accordance with an individualized treatment plan prescribed by the enrollee's treating
514.30physician or mental health professional.
514.31(d) A health carrier may not refuse to renew or reissue, or otherwise terminate or
514.32restrict, coverage of an individual solely because the individual is diagnosed with an
514.33autism spectrum disorder.
514.34(e) A health carrier may request an updated treatment plan only once every six
514.35months, unless the health carrier and the treating physician or mental health professional
514.36agree that a more frequent review is necessary due to emerging circumstances.
515.1(g) An independent progress evaluation conducted by a mental health professional
515.2with expertise and training in autism spectrum disorder and child development must be
515.3completed to determine if progress toward function and generalizable gains, as determined
515.4in the treatment plan, is being made.
515.5    Subd. 3. No effect on other law. Nothing in this section limits the coverage
515.6required under section 62Q.47.
515.7    Subd. 4. State health care programs. This section does not affect benefits available
515.8under the medical assistance and MinnesotaCare programs and does not limit, restrict, or
515.9otherwise reduce coverage under these programs.
515.10EFFECTIVE DATE.This section is effective for health plans offered, sold, issued,
515.11or renewed on or after January 1, 2014.

515.12    Sec. 4. Minnesota Statutes 2012, section 62J.692, subdivision 1, is amended to read:
515.13    Subdivision 1. Definitions. For purposes of this section, the following definitions
515.14apply:
515.15    (a) "Accredited clinical training" means the clinical training provided by a medical
515.16education program that is accredited through an organization recognized by the Department
515.17of Education, the Centers for Medicare and Medicaid Services, or another national body
515.18who reviews the accrediting organizations for multiple disciplines and whose standards
515.19for recognizing accrediting organizations are reviewed and approved by the commissioner
515.20of health in consultation with the Medical Education and Research Advisory Committee.
515.21    (b) "Commissioner" means the commissioner of health.
515.22    (c) "Clinical medical education program" means the accredited clinical training of
515.23physicians (medical students and residents), doctor of pharmacy practitioners, doctors
515.24of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
515.25registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
515.26 physician assistants, dental therapists and advanced dental therapists, psychologists,
515.27clinical social workers, community paramedics, and community health workers.
515.28    (d) "Sponsoring institution" means a hospital, school, or consortium located in
515.29Minnesota that sponsors and maintains primary organizational and financial responsibility
515.30for a clinical medical education program in Minnesota and which is accountable to the
515.31accrediting body.
515.32    (e) "Teaching institution" means a hospital, medical center, clinic, or other
515.33organization that conducts a clinical medical education program in Minnesota.
515.34    (f) "Trainee" means a student or resident involved in a clinical medical education
515.35program.
516.1    (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
516.2equivalent counts, that are at training sites located in Minnesota with currently active
516.3medical assistance enrollment status and a National Provider Identification (NPI) number
516.4where training occurs in either an inpatient or ambulatory patient care setting and where
516.5the training is funded, in part, by patient care revenues. Training that occurs in nursing
516.6facility settings is not eligible for funding under this section.

516.7    Sec. 5. Minnesota Statutes 2012, section 62J.692, subdivision 3, is amended to read:
516.8    Subd. 3. Application process. (a) A clinical medical education program conducted
516.9in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners,
516.10dentists, chiropractors, or physician assistants is, dental therapists and advanced dental
516.11therapists, psychologists, clinical social workers, community paramedics, or community
516.12health workers are eligible for funds under subdivision 4 if the program:
516.13(1) is funded, in part, by patient care revenues;
516.14(2) occurs in patient care settings that face increased financial pressure as a result
516.15of competition with nonteaching patient care entities; and
516.16(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
516.17(b) A clinical medical education program for advanced practice nursing is eligible for
516.18funds under subdivision 4 if the program meets the eligibility requirements in paragraph
516.19(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health
516.20Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges
516.21and Universities system or members of the Minnesota Private College Council.
516.22(c) Applications must be submitted to the commissioner by a sponsoring institution
516.23on behalf of an eligible clinical medical education program and must be received by
516.24October 31 of each year for distribution in the following year. An application for funds
516.25must contain the following information:
516.26(1) the official name and address of the sponsoring institution and the official
516.27name and site address of the clinical medical education programs on whose behalf the
516.28sponsoring institution is applying;
516.29(2) the name, title, and business address of those persons responsible for
516.30administering the funds;
516.31(3) for each clinical medical education program for which funds are being sought;
516.32the type and specialty orientation of trainees in the program; the name, site address, and
516.33medical assistance provider number and national provider identification number of each
516.34training site used in the program; the federal tax identification number of each training site
517.1used in the program, where available; the total number of trainees at each training site; and
517.2the total number of eligible trainee FTEs at each site; and
517.3(4) other supporting information the commissioner deems necessary to determine
517.4program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
517.5equitable distribution of funds.
517.6(d) An application must include the information specified in clauses (1) to (3) for
517.7each clinical medical education program on an annual basis for three consecutive years.
517.8After that time, an application must include the information specified in clauses (1) to (3)
517.9when requested, at the discretion of the commissioner:
517.10(1) audited clinical training costs per trainee for each clinical medical education
517.11program when available or estimates of clinical training costs based on audited financial
517.12data;
517.13(2) a description of current sources of funding for clinical medical education costs,
517.14including a description and dollar amount of all state and federal financial support,
517.15including Medicare direct and indirect payments; and
517.16(3) other revenue received for the purposes of clinical training.
517.17(e) An applicant that does not provide information requested by the commissioner
517.18shall not be eligible for funds for the current funding cycle.

517.19    Sec. 6. Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:
517.20    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute the
517.21available medical education funds to all qualifying applicants based on a distribution
517.22formula that reflects a summation of two factors:
517.23    (1) a public program volume factor, which is determined by the total volume of
517.24public program revenue received by each training site as a percentage of all public
517.25program revenue received by all training sites in the fund pool; and
517.26    (2) a supplemental public program volume factor, which is determined by providing
517.27a supplemental payment of 20 percent of each training site's grant to training sites whose
517.28public program revenue accounted for at least 0.98 percent of the total public program
517.29revenue received by all eligible training sites. Grants to training sites whose public
517.30program revenue accounted for less than 0.98 percent of the total public program revenue
517.31received by all eligible training sites shall be reduced by an amount equal to the total
517.32value of the supplemental payment.
517.33    Public program revenue for the distribution formula includes revenue from medical
517.34assistance, prepaid medical assistance, general assistance medical care, and prepaid
517.35general assistance medical care. Training sites that receive no public program revenue
518.1are ineligible for funds available under this subdivision. For purposes of determining
518.2training-site level grants to be distributed under paragraph (a) this paragraph, total
518.3statewide average costs per trainee for medical residents is based on audited clinical
518.4training costs per trainee in primary care clinical medical education programs for medical
518.5residents. Total statewide average costs per trainee for dental residents is based on
518.6audited clinical training costs per trainee in clinical medical education programs for
518.7dental students. Total statewide average costs per trainee for pharmacy residents is based
518.8on audited clinical training costs per trainee in clinical medical education programs for
518.9pharmacy students. Training sites whose training site level grant is less than $1,000
518.10 $5,000, based on the formula described in this paragraph, or that train fewer than 0.1 FTE
518.11eligible trainees, are ineligible for funds available under this subdivision. No training sites
518.12shall receive a grant per FTE trainee that is in excess of the 95th percentile grant per FTE
518.13across all eligible training sites; grants in excess of this amount will be redistributed to
518.14other eligible sites based on the formula described in this paragraph.
518.15(b) For funds distributed in fiscal years 2014 and 2015, the distribution formula shall
518.16include a supplemental public program volume factor, which is determined by providing
518.17a supplemental payment to training sites whose public program revenue accounted for
518.18at least 0.98 percent of the total public program revenue received by all eligible training
518.19sites. The supplemental public program volume factor shall be equal to ten percent of each
518.20training sites grant for funds distributed in fiscal year 2014 and for funds distributed in
518.21fiscal year 2015. Grants to training sites whose public program revenue accounted for less
518.22than 0.98 percent of the total public program revenue received by all eligible training sites
518.23shall be reduced by an amount equal to the total value of the supplemental payment. For
518.24fiscal year 2016 and beyond, the distribution of funds shall be based solely on the public
518.25program volume factor as described in paragraph (a).
518.26(c) Of available medical education funds, $1,000,000 shall be distributed each year
518.27for grants to family medicine residency programs located outside of the seven-county
518.28metropolitan area, as defined in section 473.121, subdivision 4, focused on eduction and
518.29training of family medicine physicians to serve communities outside the metropolitan area.
518.30To be eligible for a grant under this paragraph, a family medicine residency program must
518.31demonstrate that over the most recent three calendar years, at least 25 percent of its residents
518.32practice in Minnesota communities outside of the metropolitan area. Grant funds must be
518.33allocated proportionally based on the number of residents per eligible residency program.
518.34    (b) (d) Funds distributed shall not be used to displace current funding appropriations
518.35from federal or state sources.
519.1    (c) (e) Funds shall be distributed to the sponsoring institutions indicating the amount
519.2to be distributed to each of the sponsor's clinical medical education programs based on
519.3the criteria in this subdivision and in accordance with the commissioner's approval letter.
519.4Each clinical medical education program must distribute funds allocated under paragraph
519.5 paragraphs (a) and (b) to the training sites as specified in the commissioner's approval
519.6letter. Sponsoring institutions, which are accredited through an organization recognized
519.7by the Department of Education or the Centers for Medicare and Medicaid Services, may
519.8contract directly with training sites to provide clinical training. To ensure the quality of
519.9clinical training, those accredited sponsoring institutions must:
519.10    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
519.11training conducted at sites; and
519.12    (2) take necessary action if the contract requirements are not met. Action may include
519.13the withholding of payments under this section or the removal of students from the site.
519.14    (d) (f) Use of funds is limited to expenses related to clinical training program costs
519.15for eligible programs.
519.16    (g) Any funds not distributed in accordance with the commissioner's approval letter
519.17must be returned to the medical education and research fund within 30 days of receiving
519.18notice from the commissioner. The commissioner shall distribute returned funds to the
519.19appropriate training sites in accordance with the commissioner's approval letter.
519.20    (e) (h) A maximum of $150,000 of the funds dedicated to the commissioner
519.21under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
519.22administrative expenses associated with implementing this section.

519.23    Sec. 7. Minnesota Statutes 2012, section 62J.692, subdivision 5, is amended to read:
519.24    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section
519.25must sign and submit a medical education grant verification report (GVR) to verify that
519.26the correct grant amount was forwarded to each eligible training site. If the sponsoring
519.27institution fails to submit the GVR by the stated deadline, or to request and meet
519.28the deadline for an extension, the sponsoring institution is required to return the full
519.29amount of funds received to the commissioner within 30 days of receiving notice from
519.30the commissioner. The commissioner shall distribute returned funds to the appropriate
519.31training sites in accordance with the commissioner's approval letter.
519.32    (b) The reports must provide verification of the distribution of the funds and must
519.33include:
519.34    (1) the total number of eligible trainee FTEs in each clinical medical education
519.35program;
520.1    (2) the name of each funded program and, for each program, the dollar amount
520.2distributed to each training site and a training site expenditure report;
520.3    (3) documentation of any discrepancies between the initial grant distribution notice
520.4included in the commissioner's approval letter and the actual distribution;
520.5    (4) a statement by the sponsoring institution stating that the completed grant
520.6verification report is valid and accurate; and
520.7    (5) other information the commissioner, with advice from the advisory committee,
520.8 deems appropriate to evaluate the effectiveness of the use of funds for medical education.
520.9    (c) By February 15 of Each year, the commissioner, with advice from the
520.10advisory committee, shall provide an annual summary report to the legislature on the
520.11implementation of this section.

520.12    Sec. 8. Minnesota Statutes 2012, section 62J.692, subdivision 9, is amended to read:
520.13    Subd. 9. Review of eligible providers. The commissioner and the Medical
520.14Education and Research Costs Advisory Committee may review provider groups included
520.15in the definition of a clinical medical education program to assure that the distribution
520.16of the funds continue to be consistent with the purpose of this section. The results of
520.17any such reviews must be reported to the chairs and ranking minority members of the
520.18legislative committees with jurisdiction over health care policy and finance.

520.19    Sec. 9. Minnesota Statutes 2012, section 62J.692, is amended by adding a subdivision
520.20to read:
520.21    Subd. 11. Distribution of funds. If federal approval is not received for the formula
520.22described in subdivision 4, paragraphs (a) and (b), 100 percent of available medical
520.23education and research funds shall be distributed based on a distribution formula that
520.24reflects as summation of two factors:
520.25(1) a public program volume factor, that is determined by the total volume of public
520.26program revenue received by each training site as a percentage of all public program
520.27revenue received by all training sites in the fund pool; and
520.28(2) a supplemental public program volume factor, that is determined by providing a
520.29supplemental payment of 20 percent of each training site's grant to training sites whose
520.30public program revenue accounted for a least 0.98 percent of the total public program
520.31revenue received by all eligible training sites. Grants to training sites whose public
520.32program revenue accounted for less than 0.98 percent of the total public program revenue
520.33received by all eligible training sites shall be reduced by an amount equal to the total
520.34value of the supplemental payment.

521.1    Sec. 10. Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:
521.2    Subdivision 1. Designation. (a) The commissioner shall designate essential
521.3community providers. The criteria for essential community provider designation shall be
521.4the following:
521.5(1) a demonstrated ability to integrate applicable supportive and stabilizing services
521.6with medical care for uninsured persons and high-risk and special needs populations,
521.7underserved, and other special needs populations; and
521.8(2) a commitment to serve low-income and underserved populations by meeting the
521.9following requirements:
521.10(i) has nonprofit status in accordance with chapter 317A;
521.11(ii) has tax-exempt status in accordance with the Internal Revenue Service Code,
521.12section 501(c)(3);
521.13(iii) charges for services on a sliding fee schedule based on current poverty income
521.14guidelines; and
521.15(iv) does not restrict access or services because of a client's financial limitation;
521.16(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
521.17hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
521.18government, an Indian health service unit, or a community health board as defined in
521.19chapter 145A;
521.20(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
521.21bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
521.22conditions;
521.23(5) a sole community hospital. For these rural hospitals, the essential community
521.24provider designation applies to all health services provided, including both inpatient and
521.25outpatient services. For purposes of this section, "sole community hospital" means a
521.26rural hospital that:
521.27(i) is eligible to be classified as a sole community hospital according to Code
521.28of Federal Regulations, title 42, section 412.92, or is located in a community with a
521.29population of less than 5,000 and located more than 25 miles from a like hospital currently
521.30providing acute short-term services;
521.31(ii) has experienced net operating income losses in two of the previous three
521.32most recent consecutive hospital fiscal years for which audited financial information is
521.33available; and
521.34(iii) consists of 40 or fewer licensed beds; or
521.35(6) a birth center licensed under section 144.615; or
522.1(7) a hospital and affiliated specialty clinics that predominantly serve patients who
522.2are under 21 years of age and meet the following criteria:
522.3(i) provide intensive specialty pediatric services that are routinely provided in fewer
522.4than five hospitals in the state; and
522.5(ii) serve children from at least half of the counties in the state.
522.6(b) Prior to designation, the commissioner shall publish the names of all applicants
522.7in the State Register. The public shall have 30 days from the date of publication to submit
522.8written comments to the commissioner on the application. No designation shall be made
522.9by the commissioner until the 30-day period has expired.
522.10(c) The commissioner may designate an eligible provider as an essential community
522.11provider for all the services offered by that provider or for specific services designated by
522.12the commissioner.
522.13(d) For the purpose of this subdivision, supportive and stabilizing services include at
522.14a minimum, transportation, child care, cultural, and linguistic services where appropriate.
522.15EFFECTIVE DATE.This section is effective the day following final enactment.

522.16    Sec. 11. Minnesota Statutes 2012, section 103I.005, is amended by adding a
522.17subdivision to read:
522.18    Subd. 1a. Bored geothermal heat exchanger. "Bored geothermal heat exchanger"
522.19means an earth-coupled heating or cooling device consisting of a sealed closed-loop
522.20piping system installed in a boring in the ground to transfer heat to or from the surrounding
522.21earth with no discharge.

522.22    Sec. 12. Minnesota Statutes 2012, section 103I.521, is amended to read:
522.23103I.521 FEES DEPOSITED WITH COMMISSIONER OF MANAGEMENT
522.24AND BUDGET.
522.25Unless otherwise specified, fees collected for licenses or registration by the
522.26commissioner under this chapter shall be deposited in the state treasury and credited to
522.27the state government special revenue fund.

522.28    Sec. 13. Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:
522.29    Subdivision 1. Who must pay. Except for the limitation contained in this section,
522.30the commissioner of health shall charge a handling fee may enter into a contractual
522.31agreement to recover costs incurred for analysis for diagnostic purposes for each specimen
522.32submitted to the Department of Health for analysis for diagnostic purposes by any hospital,
523.1private laboratory, private clinic, or physician. No fee shall be charged to any entity which
523.2receives direct or indirect financial assistance from state or federal funds administered by
523.3the Department of Health, including any public health department, nonprofit community
523.4clinic, sexually transmitted disease clinic, or similar entity. No fee will be charged The
523.5commissioner shall not charge for any biological materials submitted to the Department
523.6of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
523.7materials requested by the department to gather information for disease prevention or
523.8control purposes. The commissioner of health may establish other exceptions to the
523.9handling fee as may be necessary to protect the public's health. All fees collected pursuant
523.10to this section shall be deposited in the state treasury and credited to the state government
523.11special revenue fund. Funds generated in a contractual agreement made pursuant to this
523.12section shall be deposited in a special account and are appropriated to the commissioner
523.13for purposes of providing the services specified in the contracts. All such contractual
523.14agreements shall be processed in accordance with the provisions of chapter 16C.
523.15EFFECTIVE DATE.This section is effective July 1, 2014.

523.16    Sec. 14. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:
523.17    Subdivision 1. Duty to perform testing. (a) It is the duty of (1) the administrative
523.18officer or other person in charge of each institution caring for infants 28 days or less
523.19of age, (2) the person required in pursuance of the provisions of section 144.215, to
523.20register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
523.21birth, to arrange to have administered to every infant or child in its care tests for heritable
523.22and congenital disorders according to subdivision 2 and rules prescribed by the state
523.23commissioner of health.
523.24    (b) Testing and the, recording and of test results, reporting of test results, and
523.25follow-up of infants with heritable congenital disorders, including hearing loss detected
523.26through the early hearing detection and intervention program in section 144.966, shall be
523.27performed at the times and in the manner prescribed by the commissioner of health. The
523.28commissioner shall charge a fee so that the total of fees collected will approximate the
523.29costs of conducting the tests and implementing and maintaining a system to follow-up
523.30infants with heritable or congenital disorders, including hearing loss detected through the
523.31early hearing detection and intervention program under section 144.966.
523.32    (c) The fee is $101 per specimen. Effective July 1, 2010, the fee shall be increased
523.33to $106 to support the newborn screening program, including tests administered under
523.34this section and section 144.966, shall be $135 per specimen. The increased fee amount
523.35shall be deposited in the general fund. Costs associated with capital expenditures and
524.1the development of new procedures may be prorated over a three-year period when
524.2calculating the amount of the fees. This fee amount shall be deposited in the state treasury
524.3and credited to the state government special revenue fund.
524.4(d) The fee to offset the cost of the support services provided under section 144.966,
524.5subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
524.6and credited to the general fund.

524.7    Sec. 15. [144.1251] NEWBORN SCREENING FOR CRITICAL CONGENITAL
524.8HEART DISEASE (CCHD).
524.9    Subdivision 1. Required testing and reporting. (a) Each licensed hospital or
524.10state-licensed birthing center or facility that provides maternity and newborn care services
524.11shall provide screening for congenital heart disease to all newborns prior to discharge
524.12using pulse oximetry screening. The screening must occur after the infant is 24 hours old,
524.13before discharge from the nursery. If discharge occurs before the infant is 24 hours old,
524.14the screening must occur as close as possible to the time of discharge.
524.15(b) For premature infants (less than 36 weeks of gestation) and infants admitted to a
524.16higher-level nursery (special care or intensive care), pulse oximetry must be performed
524.17when medically appropriate prior to discharge.
524.18(c) Results of the screening must be reported to the Department of Health.
524.19    Subd. 2. Implementation. The Department of Health shall:
524.20(1) communicate the screening protocol requirements;
524.21(2) make information and forms available to the hospitals, birthing centers, and other
524.22facilities that are required to provide the screening, health care providers who provide
524.23prenatal care and care to newborns, and expectant parents and parents of newborns. The
524.24information and forms must include screening protocol and reporting requirements and
524.25parental options;
524.26(3) provide training to ensure compliance with and appropriate implementation of
524.27the screening;
524.28(4) establish the mechanism for the required data collection and reporting of
524.29screening and follow-up diagnostic results to the Department of Health according to the
524.30Department of Health's recommendations;
524.31(5) coordinate the implementation of universal standardized screening;
524.32(6) act as a resource for providers as the screening program is implemented, and in
524.33consultation with the Advisory Committee on Heritable and Congenital Disorders, develop
524.34and implement policies for early medical and developmental intervention services and
524.35long-term follow-up services for children and their families identified with a CCHD; and
525.1(7) comply with sections 144.125 to 144.128.

525.2    Sec. 16. Minnesota Statutes 2012, section 144.212, is amended to read:
525.3144.212 DEFINITIONS.
525.4    Subdivision 1. Scope. As used in sections 144.211 to 144.227, the following terms
525.5have the meanings given.
525.6    Subd. 1a. Amendment. "Amendment" means completion or correction of made
525.7to certification items on a vital record. after a certification has been issued or more
525.8than one year after the event, whichever occurs first, that does not result in a sealed or
525.9replaced record.
525.10    Subd. 1b. Authorized representative. "Authorized representative" means an agent
525.11designated in a written and witnessed statement signed by the subject of the record or
525.12other qualified applicant.
525.13    Subd. 1c. Certification item. "Certification item" means all individual items
525.14appearing on a certificate of birth and the demographic and legal items on a certificate
525.15of death.
525.16    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
525.17    Subd. 2a. Correction. "Correction" means a change made to a noncertification
525.18item, including information collected for medical and statistical purposes. A correction
525.19also means a change to a certification item within one year of the event provided that no
525.20certification, whether paper or electronic, has been issued.
525.21    Subd. 2b. Court of competent jurisdiction. "Court of competent jurisdiction"
525.22means a court within the United States with jurisdiction over the individual and such other
525.23individuals that the court deems necessary.
525.24    Subd. 2a 2c. Delayed registration. "Delayed registration" means registration of a
525.25record of birth or death filed one or more years after the date of birth or death.
525.26    Subd. 2d. Disclosure. "Disclosure" means to make available or make known
525.27personally identifiable information contained in a vital record, by any means of
525.28communication.
525.29    Subd. 3. File. "File" means to present a vital record or report for registration to the
525.30Office of the State Registrar Vital Records and to have the vital record or report accepted
525.31for registration by the Office of the State Registrar Vital Records.
525.32    Subd. 4. Final disposition. "Final disposition" means the burial, interment,
525.33cremation, removal from the state, or other authorized disposition of a dead body or
525.34dead fetus.
525.35    Subd. 4a. Institution. "Institution" means a public or private establishment that:
526.1(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment;
526.2or
526.3(2) provides nursing, custodial, or domiciliary care, or to which persons are
526.4committed by law.
526.5    Subd. 4b. Legal representative. "Legal representative" means a licensed attorney
526.6representing an individual.
526.7    Subd. 4c. Local issuance office. "Local issuance office" means a county
526.8governmental office authorized by the state registrar to issue certified birth and death
526.9records.
526.10    Subd. 4d. Record. "Record" means a report of a vital event that has been registered
526.11by the state registrar.
526.12    Subd. 5. Registration. "Registration" means the process by which vital records
526.13are completed, filed, and incorporated into the official records of the Office of the State
526.14 Vital Records Registrar.
526.15    Subd. 6. State registrar. "State registrar" means the commissioner of health or a
526.16designee.
526.17    Subd. 7. System of vital statistics. "System of vital statistics" includes the
526.18registration, collection, preservation, amendment, verification, maintenance of the security
526.19and integrity of, and certification of vital records, the collection of other reports required
526.20by sections 144.211 to 144.227, and related activities including the tabulation, analysis,
526.21publication, and dissemination of vital statistics.
526.22    Subd. 7a. Verification. "Verification" means a confirmation of the information on a
526.23vital record based on the facts contained in a certification.
526.24    Subd. 8. Vital record. "Vital record" means a record or report of birth, stillbirth,
526.25death, marriage, dissolution and annulment, and data related thereto. The birth record is
526.26not a medical record of the mother or the child.
526.27    Subd. 9. Vital statistics. "Vital statistics" means the data derived from records and
526.28reports of birth, death, fetal death, induced abortion, marriage, dissolution and annulment,
526.29and related reports.
526.30    Subd. 10. Local registrar. "Local registrar" means an individual designated under
526.31section 144.214, subdivision 1, to perform the duties of a local registrar.
526.32    Subd. 11. Consent to disclosure. "Consent to disclosure" means an affidavit filed
526.33with the state registrar which sets forth the following information:
526.34(1) the current name and address of the affiant;
526.35(2) any previous name by which the affiant was known;
527.1(3) the original and adopted names, if known, of the adopted child whose original
527.2birth record is to be disclosed;
527.3(4) the place and date of birth of the adopted child;
527.4(5) the biological relationship of the affiant to the adopted child; and
527.5(6) the affiant's consent to disclosure of information from the original birth record of
527.6the adopted child.

527.7    Sec. 17. Minnesota Statutes 2012, section 144.213, is amended to read:
527.8144.213 OFFICE OF THE STATE REGISTRAR VITAL RECORDS.
527.9    Subdivision 1. Creation; state registrar; Office of Vital Records. The
527.10commissioner shall establish an Office of the State Registrar Vital Records under the
527.11supervision of the state registrar. The commissioner shall furnish to local registrars the
527.12forms necessary for correct reporting of vital statistics, and shall instruct the local registrars
527.13in the collection and compilation of the data. The commissioner shall promulgate rules for
527.14the collection, filing, and registering of vital statistics information by the state and local
527.15registrars registrar, physicians, morticians, and others. Except as otherwise provided in
527.16sections 144.211 to 144.227, rules previously promulgated by the commissioner relating to
527.17the collection, filing and registering of vital statistics shall remain in effect until repealed,
527.18modified or superseded by a rule promulgated by the commissioner.
527.19    Subd. 2. General duties. (a) The state registrar shall coordinate the work of
527.20local registrars to maintain a statewide system of vital statistics. The state registrar is
527.21responsible for the administration and enforcement of sections 144.211 to 144.227, and
527.22shall supervise local registrars in the enforcement of sections 144.211 to 144.227 and the
527.23rules promulgated thereunder. Local issuance offices that fail to comply with the statutes
527.24or rules or to properly train employees may have their issuance privileges and access to
527.25the vital records system revoked.
527.26(b) To preserve vital records the state registrar is authorized to prepare typewritten,
527.27photographic, electronic or other reproductions of original records and files in the Office
527.28of Vital Records. The reproductions when certified by the state registrar shall be accepted
527.29as the original records.
527.30(c) The state registrar shall also:
527.31(1) establish, designate, and eliminate offices in the state to aid in the efficient
527.32issuance of vital records;
527.33(2) direct the activities of all persons engaged in activities pertaining to the operation
527.34of the system of vital statistics;
528.1(3) develop and conduct training programs to promote uniformity of policy and
528.2procedures throughout the state in matters pertaining to the system of vital statistics; and
528.3(4) prescribe, furnish, and distribute all forms required by sections 144.211 to
528.4144.227 and any rules adopted under these sections, and prescribe other means for the
528.5transmission of data, including electronic submission, that will accomplish the purpose of
528.6complete, accurate, and timely reporting and registration.
528.7    Subd. 3. Record keeping. To preserve vital records the state registrar is authorized
528.8to prepare typewritten, photographic, electronic or other reproductions of original records
528.9and files in the Office of the State Registrar. The reproductions when certified by the state
528.10or local registrar shall be accepted as the original records.

528.11    Sec. 18. [144.2131] SECURITY OF VITAL RECORDS SYSTEM.
528.12The state registrar shall:
528.13(1) authenticate all users of the system of vital statistics and document that all users
528.14require access based on their official duties;
528.15(2) authorize authenticated users of the system of vital statistics to access specific
528.16components of the vital statistics systems necessary for their official roles and duties;
528.17(3) establish separation of duties between staff roles that may be susceptible to fraud
528.18or misuse and routinely perform audits of staff work for the purposes of identifying fraud
528.19or misuse within the vital statistics system;
528.20(4) require that authenticated and authorized users of the system of vital
528.21statistics maintain a specified level of training related to security and provide written
528.22acknowledgment of security procedures and penalties;
528.23(5) validate data submitted for registration through site visits or with independent
528.24sources outside the registration system at a frequency specified by the state registrar to
528.25maximize the integrity of the data collected;
528.26(6) protect personally identifiable information and maintain systems pursuant to
528.27applicable state and federal laws;
528.28(7) accept a report of death if the decedent was born in Minnesota or if the decedent
528.29was a resident of Minnesota from the United States Department of Defense or the United
528.30States Department of State when the death of a United States citizen occurs outside the
528.31United States;
528.32(8) match death records registered in Minnesota and death records provided from
528.33other jurisdictions to live birth records in Minnesota;
529.1(9) match death records received from the United States Department of Defense
529.2or the United States Department of State for deaths of United States citizens occurring
529.3outside the United States to live birth records in Minnesota;
529.4(10) work with law enforcement to initiate and provide evidence for active fraud
529.5investigations;
529.6(11) provide secure workplace, storage, and technology environments that have
529.7limited role-based access;
529.8(12) maintain overt, covert, and forensic security measures for certifications,
529.9verifications, and automated systems that are part of the vital statistics system; and
529.10(13) comply with applicable state and federal laws and rules associated with
529.11information technology systems and related information security requirements.

529.12    Sec. 19. Minnesota Statutes 2012, section 144.215, subdivision 3, is amended to read:
529.13    Subd. 3. Father's name; child's name. In any case in which paternity of a child is
529.14determined by a court of competent jurisdiction, a declaration of parentage is executed
529.15under section 257.34, or a recognition of parentage is executed under section 257.75, the
529.16name of the father shall be entered on the birth record. If the order of the court declares
529.17the name of the child, it shall also be entered on the birth record. If the order of the court
529.18does not declare the name of the child, or there is no court order, then upon the request of
529.19both parents in writing, the surname of the child shall be defined by both parents.

529.20    Sec. 20. Minnesota Statutes 2012, section 144.215, subdivision 4, is amended to read:
529.21    Subd. 4. Social Security number registration. (a) Parents of a child born within
529.22this state shall give the parents' Social Security numbers to the Office of the State Registrar
529.23 Vital Records at the time of filing the birth record, but the numbers shall not appear on
529.24the certified record.
529.25(b) The Social Security numbers are classified as private data, as defined in section
529.2613.02, subdivision 12, on individuals, but the Office of the State Registrar Vital Records
529.27 shall provide a Social Security number to the public authority responsible for child support
529.28services upon request by the public authority for use in the establishment of parentage and
529.29the enforcement of child support obligations.

529.30    Sec. 21. Minnesota Statutes 2012, section 144.216, subdivision 1, is amended to read:
529.31    Subdivision 1. Reporting a foundling. Whoever finds a live born infant of unknown
529.32parentage shall report within five days to the Office of the State Registrar Vital Records
529.33 such information as the commissioner may by rule require to identify the foundling.

530.1    Sec. 22. Minnesota Statutes 2012, section 144.217, subdivision 2, is amended to read:
530.2    Subd. 2. Court petition. If a delayed record of birth is rejected under subdivision
530.31, a person may petition the appropriate court in the county in which the birth allegedly
530.4occurred for an order establishing a record of the date and place of the birth and the
530.5parentage of the person whose birth is to be registered. The petition shall state:
530.6(1) that the person for whom a delayed record of birth is sought was born in this state;
530.7(2) that no record of birth can be found in the Office of the State Registrar Vital
530.8Records;
530.9(3) that diligent efforts by the petitioner have failed to obtain the evidence required
530.10in subdivision 1;
530.11(4) that the state registrar has refused to register a delayed record of birth; and
530.12(5) other information as may be required by the court.

530.13    Sec. 23. Minnesota Statutes 2012, section 144.218, subdivision 5, is amended to read:
530.14    Subd. 5. Replacement of vital records. Upon the order of a court of this state, upon
530.15the request of a court of another state, upon the filing of a declaration of parentage under
530.16section 257.34, or upon the filing of a recognition of parentage with a the state registrar, a
530.17replacement birth record must be registered consistent with the findings of the court, the
530.18declaration of parentage, or the recognition of parentage.

530.19    Sec. 24. [144.2181] AMENDMENT AND CORRECTION OF VITAL RECORDS.
530.20(a) A vital record registered under sections 144.212 to 144.227 may be amended
530.21or corrected only according to sections 144.212 to 144.227 and rules adopted by the
530.22commissioner of health to protect the integrity and accuracy of vital records.
530.23(b)(1) A vital record that is amended under this section shall indicate that it has been
530.24amended, except as otherwise provided in this section or by rule.
530.25(2) Electronic documentation shall be maintained by the state registrar that
530.26identifies the evidence upon which the amendment or correction was based, the date
530.27of the amendment or correction, and the identity of the authorized person making the
530.28amendment or correction.
530.29(c) Upon receipt of a certified copy of an order of a court of competent jurisdiction
530.30changing the name of a person whose birth is registered in Minnesota and upon request of
530.31such person if 18 years of age or older or having the status of emancipated minor, the state
530.32registrar shall amend the birth record to show the new name. If the person is a minor or
530.33an incapacitated person then a parent, guardian, or legal representative of the minor or
530.34incapacitated person may make the request.
531.1(d) When an applicant does not submit the minimum documentation required for
531.2amending a vital record or when the state registrar has cause to question the validity
531.3or completeness of the applicant's statements or the documentary evidence, and the
531.4deficiencies are not corrected, the state registrar shall not amend the vital record. The
531.5state registrar shall advise the applicant of the reason for this action and shall further
531.6advise the applicant of the right of appeal to a court with competent jurisdiction over
531.7the Department of Health.

531.8    Sec. 25. Minnesota Statutes 2012, section 144.225, subdivision 1, is amended to read:
531.9    Subdivision 1. Public information; access to vital records. Except as otherwise
531.10provided for in this section and section 144.2252, information contained in vital records
531.11shall be public information. Physical access to vital records shall be subject to the
531.12supervision and regulation of the state and local registrars registrar and their employees
531.13pursuant to rules promulgated by the commissioner in order to protect vital records from
531.14loss, mutilation or destruction and to prevent improper disclosure of vital records which
531.15are confidential or private data on individuals, as defined in section 13.02, subdivisions
531.163 and 12.

531.17    Sec. 26. Minnesota Statutes 2012, section 144.225, subdivision 4, is amended to read:
531.18    Subd. 4. Access to records for research purposes. The state registrar may permit
531.19persons performing medical research access to the information restricted in subdivision
531.202 or 2a if those persons agree in writing not to disclose private or confidential data on
531.21individuals.

531.22    Sec. 27. Minnesota Statutes 2012, section 144.225, subdivision 7, is amended to read:
531.23    Subd. 7. Certified birth or death record. (a) The state or local registrar or local
531.24issuance office shall issue a certified birth or death record or a statement of no vital record
531.25found to an individual upon the individual's proper completion of an attestation provided
531.26by the commissioner and payment of the required fee:
531.27    (1) to a person who has a tangible interest in the requested vital record. A person
531.28who has a tangible interest is:
531.29    (i) the subject of the vital record;
531.30    (ii) a child of the subject;
531.31    (iii) the spouse of the subject;
531.32    (iv) a parent of the subject;
531.33    (v) the grandparent or grandchild of the subject;
532.1    (vi) if the requested record is a death record, a sibling of the subject;
532.2    (vii) the party responsible for filing the vital record;
532.3    (viii) the legal custodian, guardian or conservator, or health care agent of the subject;
532.4    (ix) a personal representative, by sworn affidavit of the fact that the certified copy is
532.5required for administration of the estate;
532.6    (x) a successor of the subject, as defined in section 524.1-201, if the subject is
532.7deceased, by sworn affidavit of the fact that the certified copy is required for administration
532.8of the estate;
532.9    (xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of
532.10the fact that the certified copy is needed for the proper administration of the trust;
532.11    (xii) a person or entity who demonstrates that a certified vital record is necessary for
532.12the determination or protection of a personal or property right, pursuant to rules adopted
532.13by the commissioner; or
532.14    (xiii) adoption agencies in order to complete confidential postadoption searches as
532.15required by section 259.83;
532.16    (2) to any local, state, or federal governmental agency upon request if the certified
532.17vital record is necessary for the governmental agency to perform its authorized duties.
532.18An authorized governmental agency includes the Department of Human Services, the
532.19Department of Revenue, and the United States Citizenship and Immigration Services;
532.20    (3) to an attorney upon evidence of the attorney's license;
532.21    (4) pursuant to a court order issued by a court of competent jurisdiction. For
532.22purposes of this section, a subpoena does not constitute a court order; or
532.23    (5) to a representative authorized by a person under clauses (1) to (4).
532.24    (b) The state or local registrar or local issuance office shall also issue a certified
532.25death record to an individual described in paragraph (a), clause (1), items (ii) to (viii), if,
532.26on behalf of the individual, a licensed mortician furnishes the registrar with a properly
532.27completed attestation in the form provided by the commissioner within 180 days of the
532.28time of death of the subject of the death record. This paragraph is not subject to the
532.29requirements specified in Minnesota Rules, part 4601.2600, subpart 5, item B.

532.30    Sec. 28. Minnesota Statutes 2012, section 144.225, subdivision 8, is amended to read:
532.31    Subd. 8. Standardized format for certified birth and death records. No later than
532.32July 1, 2000, The commissioner shall develop maintain a standardized format for certified
532.33birth records and death records issued by the state and local registrars registrar and local
532.34issuance offices. The format shall incorporate security features in accordance with this
532.35section. The standardized format must be implemented on a statewide basis by July 1, 2001.

533.1    Sec. 29. Minnesota Statutes 2012, section 144.226, is amended to read:
533.2144.226 FEES.
533.3    Subdivision 1. Which services are for fee. The fees for the following services shall
533.4be the following or an amount prescribed by rule of the commissioner:
533.5(a) The fee for the issuance of administrative review and processing of a request for
533.6 a certified vital record or a certification that the vital record cannot be found is $9. No
533.7fee shall be charged for a certified birth, stillbirth, or death record that is reissued within
533.8one year of the original issue, if an amendment is made to the vital record and if the
533.9previously issued vital record is surrendered. The fee is payable at the time of application
533.10and is nonrefundable.
533.11(b) The fee for processing a request for the replacement of a birth record for
533.12all events, except when filing a recognition of parentage pursuant to section 257.73,
533.13subdivision 1 , is $40. The fee is payable at the time of application and is nonrefundable.
533.14(c) The fee for administrative review and processing of a request for the filing of a
533.15delayed registration of birth, stillbirth, or death is $40. The fee is payable at the time of
533.16application and is nonrefundable. This fee includes one subsequent review of the request
533.17if the request is not acceptable upon the initial receipt.
533.18(d) The fee for administrative review and processing of a request for the amendment
533.19of any vital record when requested more than 45 days after the filing of the vital record is
533.20$40. No fee shall be charged for an amendment requested within 45 days after the filing
533.21of the vital record. The fee is payable at the time of application and is nonrefundable.
533.22This fee includes one subsequent review of the request if the request is not acceptable
533.23upon the initial receipt.
533.24(e) The fee for administrative review and processing of a request for the verification
533.25of information from vital records is $9 when the applicant furnishes the specific
533.26information to locate the vital record. When the applicant does not furnish specific
533.27information, the fee is $20 per hour for staff time expended. Specific information includes
533.28the correct date of the event and the correct name of the registrant subject of the record.
533.29Fees charged shall approximate the costs incurred in searching and copying the vital
533.30records. The fee is payable at the time of application and is nonrefundable.
533.31(f) The fee for administrative review and processing of a request for the issuance
533.32of a copy of any document on file pertaining to a vital record or statement that a related
533.33document cannot be found is $9. The fee is payable at the time of application and is
533.34nonrefundable.
534.1    Subd. 2. Fees to state government special revenue fund. Fees collected under
534.2this section by the state registrar shall be deposited in the state treasury and credited to
534.3the state government special revenue fund.
534.4    Subd. 3. Birth record surcharge. (a) In addition to any fee prescribed under
534.5subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
534.6stillbirth record and for a certification that the vital record cannot be found. The local or
534.7 state registrar or local issuance office shall forward this amount to the commissioner of
534.8management and budget for deposit into the account for the children's trust fund for the
534.9prevention of child abuse established under section 256E.22. This surcharge shall not be
534.10charged under those circumstances in which no fee for a certified birth or stillbirth record
534.11is permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of
534.12management and budget that the assets in that fund exceed $20,000,000, this surcharge
534.13shall be discontinued.
534.14(b) In addition to any fee prescribed under subdivision 1, there shall be a
534.15nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
534.16or local issuance office shall forward this amount to the commissioner of management and
534.17budget for deposit in the general fund. This surcharge shall not be charged under those
534.18circumstances in which no fee for a certified birth record is permitted under subdivision 1,
534.19paragraph (a).
534.20    Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
534.21subdivision 1, there is a nonrefundable surcharge of $2 $4 for each certified and
534.22noncertified birth, stillbirth, or death record, and for a certification that the record cannot
534.23be found. The local issuance office or state registrar shall forward this amount to the
534.24commissioner of management and budget to be deposited into the state government special
534.25revenue fund. This surcharge shall not be charged under those circumstances in which no
534.26fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).
534.27(b) Effective August 1, 2005, the surcharge in paragraph (a) is $4.
534.28    Subd. 5. Electronic verification. A fee for the electronic verification or electronic
534.29certification of a vital event, when the information being verified or certified is obtained
534.30from a certified birth or death record, shall be established through contractual or
534.31interagency agreements with interested local, state, or federal government agencies.
534.32    Subd. 6. Alternative payment methods. Notwithstanding subdivision 1, alternative
534.33payment methods may be approved and implemented by the state registrar or a local
534.34registrar issuance office.

534.35    Sec. 30. [144.492] DEFINITIONS.
535.1    Subdivision 1. Applicability. For the purposes of sections 144.492 to 144.494, the
535.2terms defined in this section have the meanings given them.
535.3    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
535.4    Subd. 3. Joint commission. "Joint commission" means the independent,
535.5not-for-profit organization that accredits and certifies health care organizations and
535.6programs in the United States.
535.7    Subd. 4. Stroke. "Stroke" means the sudden death of brain cells in a localized
535.8area due to inadequate blood flow.

535.9    Sec. 31. [144.493] CRITERIA.
535.10    Subdivision 1. Comprehensive stroke center. A hospital meets the criteria for a
535.11comprehensive stroke center if the hospital has been certified as a comprehensive stroke
535.12center by the joint commission or another nationally recognized accreditation entity.
535.13    Subd. 2. Primary stroke center. A hospital meets the criteria for a primary stroke
535.14center if the hospital has been certified as a primary stroke center by the joint commission
535.15or another nationally recognized accreditation entity.
535.16    Subd. 3. Acute stroke ready hospital. A hospital meets the criteria for an acute
535.17stroke ready hospital if the hospital has the following elements of an acute stroke ready
535.18hospital:
535.19(1) an acute stroke team available or on-call 24 hours a days, seven days a week;
535.20(2) written stroke protocols, including triage, stabilization of vital functions, initial
535.21diagnostic tests, and use of medications;
535.22(3) a written plan and letter of cooperation with emergency medical services regarding
535.23triage and communication that are consistent with regional patient care procedures;
535.24(4) emergency department personnel who are trained in diagnosing and treating
535.25acute stroke;
535.26(5) the capacity to complete basic laboratory tests, electrocardiograms, and chest
535.27x-rays 24 hours a day, seven days a week;
535.28(6) the capacity to perform and interpret brain injury imaging studies 24 hours a
535.29day, seven days a week;
535.30(7) written protocols that detail available emergent therapies and reflect current
535.31treatment guidelines, which include performance measures and are revised at least annually;
535.32(8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan;
535.33(9) transfer protocols and agreements for stroke patients; and
535.34(10) a designated medical director with experience and expertise in acute stroke care.

536.1    Sec. 32. [144.494] DESIGNATING STROKE CENTERS AND STROKE
536.2HOSPITALS.
536.3    Subdivision 1. Naming privileges. Unless it has been designated as a stroke center
536.4or stroke hospital pursuant to section 144.493, no hospital shall use the term "stroke
536.5center" or "stroke hospital" in its name or its advertising or shall otherwise indicate it
536.6has stroke treatment capabilities.
536.7    Subd. 2. Designation. A hospital that voluntarily meets the criteria for a
536.8comprehensive stroke center, primary stroke center, or acute stroke ready hospital may
536.9apply to the commissioner for designation, and upon the commissioner's review and
536.10approval of the application, shall be designated as a comprehensive stroke center, a
536.11primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital
536.12loses its certification as a comprehensive stroke center or primary stroke center from
536.13the joint commission or other nationally recognized accreditation entity, its Minnesota
536.14designation shall be immediately withdrawn. Prior to the expiration of the three-year
536.15designation, a hospital seeking to remain part of the voluntary acute stroke system may
536.16reapply to the commissioner for designation.

536.17    Sec. 33. [144.554] HEALTH FACILITIES CONSTRUCTION PLAN
536.18SUBMITTAL AND FEES.
536.19For hospitals, nursing homes, boarding care homes, residential hospices, supervised
536.20living facilities, freestanding outpatient surgical centers, and end-stage renal disease
536.21facilities, the commissioner shall collect a fee for the review and approval of architectural,
536.22mechanical, and electrical plans and specifications submitted before construction begins
536.23for each project relative to construction of new buildings, additions to existing buildings,
536.24or remodeling or alterations of existing buildings. All fees collected in this section shall
536.25be deposited in the state treasury and credited to the state government special revenue
536.26fund. Fees must be paid at the time of submission of final plans for review and are not
536.27refundable. The fee is calculated as follows:

536.28	Construction project total estimated cost	Fee
536.29	$0 - $10,000	$30
536.30	$10,001 - $50,000	$150
536.31	$50,001 - $100,000	$300
536.32	$100,001 - $150,000	$450
536.33	$150,001 - $200,000	$600
536.34	$200,001 - $250,000	$750
536.35	$250,001 - $300,000	$900
536.36	$300,001 - $350,000	$1,050
537.1	$350,001 - $400,000	$1,200
537.2	$400,001 - $450,000	$1,350
537.3	$450,001 - $500,000	$1,500
537.4	$500,001 - $550,000	$1,650
537.5	$550,001 - $600,000	$1,800
537.6	$600,001 - $650,000	$1,950
537.7	$650,001 - $700,000	$2,100
537.8	$700,001 - $750,000	$2,250
537.9	$750,001 - $800,000	$2,400
537.10	$800,001 - $850,000	$2,550
537.11	$850,001 - $900,000	$2,700
537.12	$900,001 - $950,000	$2,850
537.13	$950,001 - $1,000,000	$3,000
537.14	$1,000,001 - $1,050,000	$3,150
537.15	$1,050,001 - $1,100,000	$3,300
537.16	$1,100,001 - $1,150,000	$3,450
537.17	$1,150,001 - $1,200,000	$3,600
537.18	$1,200,001 - $1,250,000	$3,750
537.19	$1,250,001 - $1,300,000	$3,900
537.20	$1,300,001 - $1,350,000	$4,050
537.21	$1,350,001 - $1,400,000	$4,200
537.22	$1,400,001 - $1,450,000	$4,350
537.23	$1,450,001 - $1,500,000	$4,500
537.24	$1,500,001 and over	$4,800

537.25    Sec. 34. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:
537.26    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
537.27commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
537.28to advise and assist the Department of Health and the Department of Education in:
537.29    (1) developing protocols and timelines for screening, rescreening, and diagnostic
537.30audiological assessment and early medical, audiological, and educational intervention
537.31services for children who are deaf or hard-of-hearing;
537.32    (2) designing protocols for tracking children from birth through age three that may
537.33have passed newborn screening but are at risk for delayed or late onset of permanent
537.34hearing loss;
537.35    (3) designing a technical assistance program to support facilities implementing the
537.36screening program and facilities conducting rescreening and diagnostic audiological
537.37assessment;
537.38    (4) designing implementation and evaluation of a system of follow-up and tracking;
537.39and
538.1    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
538.2culturally appropriate services for children with a confirmed hearing loss and their families.
538.3    (b) The commissioner of health shall appoint at least one member from each of the
538.4following groups with no less than two of the members being deaf or hard-of-hearing:
538.5    (1) a representative from a consumer organization representing culturally deaf
538.6persons;
538.7    (2) a parent with a child with hearing loss representing a parent organization;
538.8    (3) a consumer from an organization representing oral communication options;
538.9    (4) a consumer from an organization representing cued speech communication
538.10options;
538.11    (5) an audiologist who has experience in evaluation and intervention of infants
538.12and young children;
538.13    (6) a speech-language pathologist who has experience in evaluation and intervention
538.14of infants and young children;
538.15    (7) two primary care providers who have experience in the care of infants and young
538.16children, one of which shall be a pediatrician;
538.17    (8) a representative from the early hearing detection intervention teams;
538.18    (9) a representative from the Department of Education resource center for the deaf
538.19and hard-of-hearing or the representative's designee;
538.20    (10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing
538.21Minnesotans;
538.22    (11) a representative from the Department of Human Services Deaf and
538.23Hard-of-Hearing Services Division;
538.24    (12) one or more of the Part C coordinators from the Department of Education, the
538.25Department of Health, or the Department of Human Services or the department's designees;
538.26    (13) the Department of Health early hearing detection and intervention coordinators;
538.27    (14) two birth hospital representatives from one rural and one urban hospital;
538.28    (15) a pediatric geneticist;
538.29    (16) an otolaryngologist;
538.30    (17) a representative from the Newborn Screening Advisory Committee under
538.31this subdivision; and
538.32    (18) a representative of the Department of Education regional low-incidence
538.33facilitators.
538.34The commissioner must complete the appointments required under this subdivision by
538.35September 1, 2007.
539.1    (c) The Department of Health member shall chair the first meeting of the committee.
539.2At the first meeting, the committee shall elect a chair from its membership. The committee
539.3shall meet at the call of the chair, at least four times a year. The committee shall adopt
539.4written bylaws to govern its activities. The Department of Health shall provide technical
539.5and administrative support services as required by the committee. These services shall
539.6include technical support from individuals qualified to administer infant hearing screening,
539.7rescreening, and diagnostic audiological assessments.
539.8    Members of the committee shall receive no compensation for their service, but
539.9shall be reimbursed as provided in section 15.059 for expenses incurred as a result of
539.10their duties as members of the committee.
539.11    (d) This subdivision expires June 30, 2013 2019.

539.12    Sec. 35. Minnesota Statutes 2012, section 144.966, subdivision 3a, is amended to read:
539.13    Subd. 3a. Support services to families. (a) The commissioner shall contract with a
539.14nonprofit organization to provide support and assistance to families with children who are
539.15deaf or have a hearing loss. The family support provided must include:
539.16    (1) direct hearing loss specific parent-to-parent assistance and unbiased information
539.17on communication, educational, and medical options; and
539.18    (2) individualized deaf or hard-of-hearing mentors who provide education, including
539.19instruction in American Sign Language as an available option.
539.20The commissioner shall give preference to a nonprofit organization that has the ability to
539.21provide these services throughout the state.
539.22    (b) Family participation in the support and assistance services is voluntary.

539.23    Sec. 36. Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:
539.24    Subd. 3. Annual fees. (a) An application for accreditation under subdivision 6 must
539.25be accompanied by the annual fees specified in this subdivision. The annual fees include:
539.26(1) base accreditation fee, $1,500 $600;
539.27(2) sample preparation techniques fee, $200 per technique;
539.28(3) an administrative fee for laboratories located outside this state, $3,750 $2,000; and
539.29(4) test category fees.
539.30(b) For the programs in subdivision 3a, the commissioner may accredit laboratories
539.31for fields of testing under the categories listed in clauses (1) to (10) upon completion of
539.32the application requirements provided by subdivision 6 and receipt of the fees for each
539.33category under each program that accreditation is requested. The categories offered and
539.34related fees include:
540.1(1) microbiology, $450 $200;
540.2(2) inorganics, $450 $200;
540.3(3) metals, $1,000 $500;
540.4(4) volatile organics, $1,300 $1,000;
540.5(5) other organics, $1,300 $1,000;
540.6(6) radiochemistry, $1,500 $750;
540.7(7) emerging contaminants, $1,500 $1,000;
540.8(8) agricultural contaminants, $1,250 $1,000;
540.9(9) toxicity (bioassay), $1,000 $500; and
540.10(10) physical characterization, $250.
540.11(c) The total annual fee includes the base fee, the sample preparation techniques
540.12fees, the test category fees per program, and, when applicable, an administrative fee for
540.13out-of-state laboratories.
540.14EFFECTIVE DATE.This section is effective the day following final enactment.

540.15    Sec. 37. Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:
540.16    Subd. 5. State government special revenue fund. Fees collected by the
540.17commissioner under this section must be deposited in the state treasury and credited to
540.18the state government special revenue fund.
540.19EFFECTIVE DATE.This section is effective the day following final enactment.

540.20    Sec. 38. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
540.21to read:
540.22    Subd. 10. Establishing a selection committee. (a) The commissioner shall
540.23establish a selection committee for the purpose of recommending approval of qualified
540.24laboratory assessors and assessment bodies. Committee members shall demonstrate
540.25competence in assessment practices. The committee shall initially consist of seven
540.26members appointed by the commissioner as follows:
540.27(1) one member from a municipal laboratory accredited by the commissioner;
540.28(2) one member from an industrial treatment laboratory accredited by the
540.29commissioner;
540.30(3) one member from a commercial laboratory located in this state and accredited by
540.31the commissioner;
540.32(4) one member from a commercial laboratory located outside the state and
540.33accredited by the commissioner;
541.1(5) one member from a nongovernmental client of environmental laboratories;
541.2(6) one member from a professional organization with a demonstrated interest in
541.3environmental laboratory data and accreditation; and
541.4(7) one employee of the laboratory accreditation program administered by the
541.5department.
541.6(b) Committee appointments begin on January 1 and end on December 31 of the
541.7same year.
541.8(c) The commissioner shall appoint persons to fill vacant committee positions,
541.9expand the total number of appointed positions, or change the designated positions upon
541.10the advice of the committee.
541.11(d) The commissioner shall rescind the appointment of a selection committee
541.12member for sufficient cause as the commissioner determines, such as:
541.13(1) neglect of duty;
541.14(2) failure to notify the commissioner of a real or perceived conflict of interest;
541.15(3) nonconformance with committee procedures;
541.16(4) failure to demonstrate competence in assessment practices; or
541.17(5) official misconduct.
541.18(e) Members of the selection committee shall be compensated according to the
541.19provisions in section 15.059, subdivision 3.

541.20    Sec. 39. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
541.21to read:
541.22    Subd. 11. Activities of the selection committee. (a) The selection committee shall
541.23determine assessor and assessment organization application requirements, the frequency
541.24of application submittal, and the application review schedule. The commissioner shall
541.25publish the application requirements and procedures on the accreditation program Web site.
541.26(b) In its selection process, the committee shall ensure its application requirements
541.27and review process:
541.28(1) meet the standards implemented in subdivision 2a;
541.29(2) ensure assessors have demonstrated competence in technical disciplines offered
541.30for accreditation by the commissioner; and
541.31(3) consider any history of repeated nonconformance or complaints regarding
541.32assessors or assessment bodies.
541.33(c) The selection committee shall consider an application received from qualified
541.34applicants and shall supply a list of recommended assessors and assessment bodies to
542.1the commissioner of health no later than 90 days after the commissioner notifies the
542.2committee of the need for review of applications.

542.3    Sec. 40. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
542.4to read:
542.5    Subd. 12. Commissioner approval of assessors and scheduling of assessments.
542.6(a) The commissioner shall approve assessors who:
542.7(1) are employed by the commissioner for the purpose of accrediting laboratories
542.8and demonstrate competence in assessment practices for environmental laboratories; or
542.9(2) are employed by a state or federal agency with established agreements for
542.10mutual assistance or recognition with the commissioner and demonstrate competence in
542.11assessment practices for environmental laboratories.
542.12(b) The commissioner may approve other assessors or assessment organizations who
542.13are recommended by the selection committee according to subdivision 11, paragraph
542.14(c). The commissioner shall publish the list of assessors and assessment organizations
542.15approved from the recommendations.
542.16(c) The commissioner shall rescind approval for an assessor or assessment
542.17organization for sufficient cause as the commissioner determines, such as:
542.18(1) failure to meet the minimum qualifications for performing assessments;
542.19(2) lack of availability;
542.20(3) nonconformance with the applicable laws, rules, standards, policies, and
542.21procedures;
542.22(4) misrepresentation of application information regarding qualifications and
542.23training; or
542.24(5) excessive cost to perform the assessment activities.

542.25    Sec. 41. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
542.26to read:
542.27    Subd. 13. Laboratory requirements for assessor selection and scheduling
542.28assessments. (a) A laboratory accredited or seeking accreditation that requires an
542.29assessment by the commissioner must select an assessor, group of assessors, or assessment
542.30organization from the published list specified in subdivision 12, paragraph (b). An
542.31accredited laboratory must complete an assessment and make all corrective actions at least
542.32once every 24 months. Unless the commissioner grants interim accreditation, a laboratory
542.33seeking accreditation must complete an assessment and make all corrective actions
543.1prior to, but no earlier than, 18 months prior to the date the application is submitted to
543.2the commissioner.
543.3(b) A laboratory shall not select the same assessor more than twice in succession
543.4for assessments of the same facility unless the laboratory receives written approval
543.5from the commissioner for the selection. The laboratory must supply a written request
543.6to the commissioner for approval and must justify the reason for the request and provide
543.7the alternate options considered.
543.8(c) A laboratory must select assessors appropriate to the size and scope of the
543.9laboratory's application or existing accreditation.
543.10(d) A laboratory must enter into its own contract for direct payment of the assessors
543.11or assessment organization. The contract must authorize the assessor, assessment
543.12organization, or subcontractors to release all records to the commissioner regarding the
543.13assessment activity, when the assessment is performed in compliance with this section.
543.14(e) A laboratory must agree to permit other assessors as selected by the commissioner
543.15to participate in the assessment activities.
543.16(f) If the laboratory determines no approved assessor is available to perform
543.17the assessment, the laboratory must notify the commissioner in writing and provide a
543.18justification for the determination. If the commissioner confirms no approved assessor
543.19is available, the commissioner may designate an alternate assessor from those approved
543.20in subdivision 12, paragraph (a), or the commissioner may delay the assessment until
543.21an assessor is available. If an approved alternate assessor performs the assessment, the
543.22commissioner may collect fees equivalent to the cost of performing the assessment
543.23activities.
543.24(g) Fees collected under this section are deposited in a special account and are
543.25annually appropriated to the commissioner for the purpose of performing assessment
543.26activities.
543.27EFFECTIVE DATE.This section is effective the day following final enactment.

543.28    Sec. 42. Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:
543.29    Subd. 4. Administrative penalty orders. (a) The commissioner may issue an
543.30order requiring violations to be corrected and administratively assessing monetary
543.31penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The
543.32procedures in section 144.991 must be followed when issuing administrative penalty
543.33orders. Except in the case of repeated or serious violations, the penalty assessed in the
543.34order must be forgiven if the person who is subject to the order demonstrates in writing
543.35to the commissioner before the 31st day after receiving the order that the person has
544.1corrected the violation or has developed a corrective plan acceptable to the commissioner.
544.2The maximum amount of an administrative penalty order is $10,000 for each violator for
544.3all violations by that violator identified in an inspection or review of compliance.
544.4(b) Notwithstanding paragraph (a), the commissioner may issue to a large public
544.5water supply, serving a population of more than 10,000 persons, an administrative penalty
544.6order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000
544.7for each violation of sections 144.381 to 144.385 and rules adopted thereunder.
544.8(c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead
544.9firm or person performing regulated lead work, an administrative penalty order imposing a
544.10penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of
544.11sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from
544.12monetary penalties in this section shall be deposited in the state treasury and credited to
544.13the state government special revenue fund.

544.14    Sec. 43. [145.4716] SAFE HARBOR FOR SEXUALLY EXPLOITED YOUTH.
544.15    Subdivision 1. Director. The commissioner of health shall establish a position for a
544.16director of child sex trafficking prevention.
544.17    Subd. 2. Duties of director. The director of child sex trafficking prevention is
544.18responsible for the following:
544.19    (1) developing and providing comprehensive training on sexual exploitation of
544.20youth for social service professionals, medical professionals, public health workers, and
544.21criminal justice professionals;
544.22    (2) collecting, organizing, maintaining, and disseminating information on sexual
544.23exploitation and services across the state, including maintaining a list of resources on the
544.24Department of Health Web site;
544.25    (3) monitoring and applying for federal funding for antitrafficking efforts that may
544.26benefit victims in the state;
544.27    (4) managing grant programs established under this act;
544.28    (5) identifying best practices in serving sexually exploited youth, as defined in
544.29section 260C.007, subdivision 31;
544.30    (6) providing oversight of and technical support to regional navigators pursuant to
544.31section 145.4717;
544.32    (7) conducting a comprehensive evaluation of the statewide program for safe harbor
544.33of sexually exploited youth; and
545.1    (8) developing a policy, consistent with the requirements of chapter 13, for sharing
545.2data related to sexually exploited youth, as defined in section 260C.007, subdivision 31,
545.3among regional navigators and community-based advocates.

545.4    Sec. 44. [145.4717] REGIONAL NAVIGATOR GRANTS.
545.5    The commissioner of health, through its director of child sex trafficking prevention,
545.6established in section 145.4716, shall provide grants to regional navigators serving six
545.7regions of the state to be determined by the commissioner. Each regional navigator must
545.8develop and annually submit a work plan to the director of child sex trafficking prevention.
545.9The work plans must include, but are not limited to, the following information:
545.10    (1) a needs statement specific to the region, including an examination of the
545.11population at risk;
545.12    (2) regional resources available to sexually exploited youth, as defined in section
545.13260C.007, subdivision 31;
545.14    (3) grant goals and measurable outcomes; and
545.15    (4) grant activities including timelines.

545.16    Sec. 45. [145.4718] PROGRAM EVALUATION.
545.17    (a) The director of child sex trafficking prevention, established under section
545.18145.4716, must conduct, or contract for, comprehensive evaluation of the statewide
545.19program for safe harbor for sexually exploited youth. The first evaluation must be
545.20completed by June 30, 2015, and must be submitted to the commissioner of health by
545.21September 1, 2015, and every two years thereafter. The evaluation must consider whether
545.22the program is reaching intended victims and whether support services are available,
545.23accessible, and adequate for sexually exploited youth, as defined in section 260C.007,
545.24subdivision 31.
545.25    (b) In conducting the evaluation, the director of child sex trafficking prevention must
545.26consider evaluation of outcomes, including whether the program increases identification
545.27of sexually exploited youth, coordination of investigations, access to services and housing
545.28available for sexually exploited youth, and improved effectiveness of services. The
545.29evaluation must also include examination of the ways in which penalties under section
545.30609.3241 are assessed, collected, and distributed to ensure funding for investigation,
545.31prosecution, and victim services to combat sexual exploitation of youth.

545.32    Sec. 46. Minnesota Statutes 2012, section 145.906, is amended to read:
545.33145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
546.1(a) The commissioner of health shall work with health care facilities, licensed health
546.2and mental health care professionals, the women, infants, and children (WIC) program,
546.3mental health advocates, consumers, and families in the state to develop materials and
546.4information about postpartum depression, including treatment resources, and develop
546.5policies and procedures to comply with this section.
546.6(b) Physicians, traditional midwives, and other licensed health care professionals
546.7providing prenatal care to women must have available to women and their families
546.8information about postpartum depression.
546.9(c) Hospitals and other health care facilities in the state must provide departing new
546.10mothers and fathers and other family members, as appropriate, with written information
546.11about postpartum depression, including its symptoms, methods of coping with the illness,
546.12and treatment resources.
546.13(d) Information about postpartum depression, including its symptoms, potential
546.14impact on families, and treatment resources, must be available at WIC sites.
546.15(e) The commissioner of health, in collaboration with the commissioner of human
546.16services and to the extent authorized by the federal Centers for Disease Control and
546.17Prevention, shall review the materials and information related to postpartum depression to
546.18determine their effectiveness in transmitting the information in a way that reduces racial
546.19health disparities as reported in surveys of maternal attitudes and experiences before,
546.20during, and after pregnancy, including those conducted by the commissioner of health. The
546.21commissioner shall implement changes to reduce racial health disparities in the information
546.22reviewed, as needed, and ensure that women of color are receiving the information.

546.23    Sec. 47. [145.907] MATERNAL DEPRESSION; DEFINITION.
546.24"Maternal depression" means depression or other perinatal mood or anxiety disorder
546.25experienced by a woman during pregnancy or during the first year following the birth of
546.26her child.

546.27    Sec. 48. Minnesota Statutes 2012, section 145.986, is amended to read:
546.28145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.
546.29    Subdivision 1. Grants to local communities Purpose. The purpose of the statewide
546.30health improvement program is to:
546.31(1) address the top three leading preventable causes of illness and death: tobacco use
546.32and exposure, poor diet, and lack of regular physical activity;
546.33(2) promote the development, availability, and use of evidence-based, community
546.34level, comprehensive strategies to create healthy communities; and
547.1(3) measure the impact of the evidence-based, community health improvement
547.2practices which over time work to contain health care costs and reduce chronic diseases.
547.3    Subd. 1a. Grants to local communities. (a) Beginning July 1, 2009, the
547.4commissioner of health shall award competitive grants to community health boards
547.5established pursuant to section 145A.09 and tribal governments to convene, coordinate,
547.6and implement evidence-based strategies targeted at reducing the percentage of
547.7Minnesotans who are obese or overweight and to reduce the use of tobacco. Grants shall
547.8be awarded to all community health boards and tribal governments whose proposals
547.9demonstrate the ability to implement programs designed to achieve the purposes in
547.10subdivision 1 and other requirements of this section.
547.11    (b) Grantee activities shall:
547.12    (1) be based on scientific evidence;
547.13    (2) be based on community input;
547.14    (3) address behavior change at the individual, community, and systems levels;
547.15    (4) occur in community, school, worksite, and health care settings; and
547.16    (5) be focused on policy, systems, and environmental changes that support healthy
547.17behaviors.; and
547.18(6) address the health disparities and inequities that exist in the grantee's community.
547.19    (c) To receive a grant under this section, community health boards and tribal
547.20governments must submit proposals to the commissioner. A local match of ten percent
547.21of the total funding allocation is required. This local match may include funds donated
547.22by community partners.
547.23    (d) In order to receive a grant, community health boards and tribal governments
547.24must submit a health improvement plan to the commissioner of health for approval. The
547.25commissioner may require the plan to identify a community leadership team, community
547.26partners, and a community action plan that includes an assessment of area strengths and
547.27needs, proposed action strategies, technical assistance needs, and a staffing plan.
547.28    (e) The grant recipient must implement the health improvement plan, evaluate the
547.29effectiveness of the interventions strategies, and modify or discontinue interventions
547.30 strategies found to be ineffective.
547.31    (f) By January 15, 2011, the commissioner of health shall recommend whether any
547.32funding should be distributed to community health boards and tribal governments based
547.33on health disparities demonstrated in the populations served.
547.34    (g) (f) Grant recipients shall report their activities and their progress toward the
547.35outcomes established under subdivision 2 to the commissioner in a format and at a time
547.36specified by the commissioner.
548.1    (h) (g) All grant recipients shall be held accountable for making progress toward
548.2the measurable outcomes established in subdivision 2. The commissioner shall require a
548.3corrective action plan and may reduce the funding level of grant recipients that do not
548.4make adequate progress toward the measurable outcomes.
548.5    Subd. 2. Outcomes. (a) The commissioner shall set measurable outcomes to meet
548.6the goals specified in subdivision 1, and annually review the progress of grant recipients
548.7in meeting the outcomes.
548.8    (b) The commissioner shall measure current public health status, using existing
548.9measures and data collection systems when available, to determine baseline data against
548.10which progress shall be monitored.
548.11    Subd. 3. Technical assistance and oversight. (a) The commissioner shall provide
548.12content expertise, technical expertise, and training to grant recipients and advice on
548.13evidence-based strategies, including those based on populations and types of communities
548.14served. The commissioner shall ensure that the statewide health improvement program
548.15meets the outcomes established under subdivision 2 by conducting a comprehensive
548.16statewide evaluation and assisting grant recipients to modify or discontinue interventions
548.17found to be ineffective.
548.18(b) For the purposes of carrying out the grant program under this section, including
548.19for administrative purposes, the commissioner shall award contracts to appropriate entities
548.20to assist in training and provide technical assistance to grantees.
548.21(c) Contracts awarded under paragraph (b) may be used to provide technical
548.22assistance and training in the areas of:
548.23(1) community engagement and capacity building;
548.24(2) tribal support;
548.25(3) community asset building and risk behavior reduction;
548.26(4) legal;
548.27(5) communications;
548.28(6) community, school, health care, work site, and other site-specific strategies; and
548.29(7) health equity.
548.30    Subd. 4. Evaluation. (a) Using the outcome measures established in subdivision 3,
548.31the commissioner shall conduct a biennial evaluation of the statewide health improvement
548.32program funded under this section. Grant recipients shall cooperate with the commissioner
548.33in the evaluation and provide the commissioner with the information necessary to conduct
548.34the evaluation.
549.1(b) Grant recipients will collect, monitor, and submit to the Department of Health
549.2baseline and annual data and provide information to improve the quality and impact of
549.3community health improvement strategies.
549.4(c) For the purposes of carrying out the grant program under this section, including
549.5for administrative purposes, the commissioner shall award contracts to appropriate entities
549.6to assist in designing and implementing evaluation systems.
549.7(d) Contracts awarded under paragraph (c) may be used to:
549.8(1) develop grantee monitoring and reporting systems to track grantee progress,
549.9including aggregated and disaggregated data;
549.10(2) manage, analyze, and report program evaluation data results; and
549.11(3) utilize innovative support tools to analyze and predict the impact of prevention
549.12strategies on health outcomes and state health care costs over time.
549.13    Subd. 5. Report. The commissioner shall submit a biennial report to the legislature
549.14on the statewide health improvement program funded under this section. These reports
549.15 The report must include information on each grant recipients recipient, including the
549.16activities that were conducted by the grantee using grant funds, evaluation data, and
549.17outcome measures, if available. the grantee's progress toward achieving the measurable
549.18outcomes established under subdivision 2, and the data provided to the commissioner by
549.19the grantee to measure these outcomes for grant activities. The commissioner shall provide
549.20information on grants in which a corrective action plan was required under subdivision
549.211a, the types of plan action, and the progress that has been made toward meeting the
549.22measurable outcomes. In addition, the commissioner shall provide recommendations
549.23on future areas of focus for health improvement. These reports are due by January 15
549.24of every other year, beginning in 2010. In the report due on January 15, 2010, the
549.25commissioner shall include recommendations on a sustainable funding source for the
549.26statewide health improvement program other than the health care access fund In the report
549.27due on January 15, 2014, the commissioner shall include a description of the contracts
549.28awarded under subdivision 4, paragraph (c), and the monitoring and evaluation systems
549.29that were designed and implemented under these contracts.
549.30    Subd. 6. Supplantation of existing funds. Community health boards and tribal
549.31governments must use funds received under this section to develop new programs, expand
549.32current programs that work to reduce the percentage of Minnesotans who are obese or
549.33overweight or who use tobacco, or replace discontinued state or federal funds previously
549.34used to reduce the percentage of Minnesotans who are obese or overweight or who use
549.35tobacco. Funds must not be used to supplant current state or local funding to community
550.1health boards or tribal governments used to reduce the percentage of Minnesotans who are
550.2obese or overweight or to reduce tobacco use.

550.3    Sec. 49. Minnesota Statutes 2012, section 145A.17, subdivision 1, is amended to read:
550.4    Subdivision 1. Establishment; goals. The commissioner shall establish a program
550.5to fund family home visiting programs designed to foster healthy beginnings, improve
550.6pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce
550.7juvenile delinquency, promote positive parenting and resiliency in children, and promote
550.8family health and economic self-sufficiency for children and families. The commissioner
550.9shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
550.10professionals and paraprofessionals from the fields of public health nursing, social work,
550.11and early childhood education. A program funded under this section must serve families
550.12at or below 200 percent of the federal poverty guidelines, and other families determined
550.13to be at risk, including but not limited to being at risk for child abuse, child neglect, or
550.14juvenile delinquency. Programs must begin prenatally whenever possible and must be
550.15targeted to families with:
550.16    (1) adolescent parents;
550.17    (2) a history of alcohol or other drug abuse;
550.18    (3) a history of child abuse, domestic abuse, or other types of violence;
550.19    (4) a history of domestic abuse, rape, or other forms of victimization;
550.20    (5) reduced cognitive functioning;
550.21    (6) a lack of knowledge of child growth and development stages;
550.22    (7) low resiliency to adversities and environmental stresses;
550.23    (8) insufficient financial resources to meet family needs;
550.24    (9) a history of homelessness;
550.25    (10) a risk of long-term welfare dependence or family instability due to employment
550.26barriers; or
550.27(11) a serious mental health disorder, including maternal depression as defined in
550.28section 145.907; or
550.29    (11) (12) other risk factors as determined by the commissioner.

550.30    Sec. 50. Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:
550.31    Subd. 1a. Alkaline hydrolysis. "Alkaline hydrolysis" means the reduction of a dead
550.32human body to essential elements through exposure to a combination of heat and alkaline
550.33hydrolysis and the repositioning or movement of the body during the process to facilitate
550.34reduction, a water-based dissolution process using alkaline chemicals, heat, agitation, and
551.1pressure to accelerate natural decomposition; the processing of the hydrolyzed remains
551.2after removal from the alkaline hydrolysis chamber, vessel; placement of the processed
551.3remains in a hydrolyzed remains container,; and release of the hydrolyzed remains to an
551.4appropriate party. Alkaline hydrolysis is a form of final disposition.

551.5    Sec. 51. Minnesota Statutes 2012, section 149A.02, is amended by adding a
551.6subdivision to read:
551.7    Subd. 1b. Alkaline hydrolysis container. "Alkaline hydrolysis container" means a
551.8hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily
551.9fluids that encases the body and into which a dead human body is placed prior to insertion
551.10into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or
551.11biodegradable alternative containers or caskets.

551.12    Sec. 52. Minnesota Statutes 2012, section 149A.02, is amended by adding a
551.13subdivision to read:
551.14    Subd. 1c. Alkaline hydrolysis facility. "Alkaline hydrolysis facility" means a
551.15building or structure containing one or more alkaline hydrolysis vessels for the alkaline
551.16hydrolysis of dead human bodies.

551.17    Sec. 53. Minnesota Statutes 2012, section 149A.02, is amended by adding a
551.18subdivision to read:
551.19    Subd. 1d. Alkaline hydrolysis vessel. "Alkaline hydrolysis vessel" means the
551.20container in which the alkaline hydrolysis of a dead human body is performed.

551.21    Sec. 54. Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:
551.22    Subd. 2. Alternative container. "Alternative container" means a nonmetal
551.23receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed
551.24for the encasement of dead human bodies and is made of hydrolyzable or biodegradable
551.25materials, corrugated cardboard, fiberboard, pressed-wood, or other like materials.

551.26    Sec. 55. Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:
551.27    Subd. 3. Arrangements for disposition. "Arrangements for disposition" means
551.28any action normally taken by a funeral provider in anticipation of or preparation for the
551.29entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

551.30    Sec. 56. Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:
552.1    Subd. 4. Cash advance item. "Cash advance item" means any item of service
552.2or merchandise described to a purchaser as a "cash advance," "accommodation," "cash
552.3disbursement," or similar term. A cash advance item is also any item obtained from a
552.4third party and paid for by the funeral provider on the purchaser's behalf. Cash advance
552.5items include, but are not limited to, cemetery, alkaline hydrolysis, or crematory services,
552.6pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary
552.7notices, gratuities, and death records.

552.8    Sec. 57. Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:
552.9    Subd. 5. Casket. "Casket" means a rigid container which is designed for the
552.10encasement of a dead human body and is usually constructed of hydrolyzable or
552.11biodegradable materials, wood, metal, fiberglass, plastic, or like material, and ornamented
552.12and lined with fabric.

552.13    Sec. 58. Minnesota Statutes 2012, section 149A.02, is amended by adding a
552.14subdivision to read:
552.15    Subd. 12a. Crypt. "Crypt" means a space in a mausoleum of sufficient size, used or
552.16intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.

552.17    Sec. 59. Minnesota Statutes 2012, section 149A.02, is amended by adding a
552.18subdivision to read:
552.19    Subd. 12b. Direct alkaline hydrolysis. "Direct alkaline hydrolysis" means a
552.20final disposition of a dead human body by alkaline hydrolysis, without formal viewing,
552.21visitation, or ceremony with the body present.

552.22    Sec. 60. Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:
552.23    Subd. 16. Final disposition. "Final disposition" means the acts leading to and the
552.24entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

552.25    Sec. 61. Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:
552.26    Subd. 23. Funeral services. "Funeral services" means any services which may
552.27be used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis,
552.28cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral
552.29ceremony or the final disposition of dead human bodies.

553.1    Sec. 62. Minnesota Statutes 2012, section 149A.02, is amended by adding a
553.2subdivision to read:
553.3    Subd. 24b. Hydrolyzed remains. "Hydrolyzed remains" means the remains of a
553.4dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not
553.5include pacemakers, prostheses, or similar foreign materials.

553.6    Sec. 63. Minnesota Statutes 2012, section 149A.02, is amended by adding a
553.7subdivision to read:
553.8    Subd. 24c. Hydrolyzed remains container. "Hydrolyzed remains container" means
553.9a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a
553.10hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage
553.11jewelry.

553.12    Sec. 64. Minnesota Statutes 2012, section 149A.02, is amended by adding a
553.13subdivision to read:
553.14    Subd. 26a. Inurnment. "Inurnment" means placing hydrolyzed or cremated remains
553.15in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.

553.16    Sec. 65. Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:
553.17    Subd. 27. Licensee. "Licensee" means any person or entity that has been issued
553.18a license to practice mortuary science, to operate a funeral establishment, to operate an
553.19alkaline hydrolysis facility, or to operate a crematory by the Minnesota commissioner
553.20of health.

553.21    Sec. 66. Minnesota Statutes 2012, section 149A.02, is amended by adding a
553.22subdivision to read:
553.23    Subd. 30a. Niche. "Niche" means a space in a columbarium used, or intended to be
553.24used, for the placement of hydrolyzed or cremated remains.

553.25    Sec. 67. Minnesota Statutes 2012, section 149A.02, is amended by adding a
553.26subdivision to read:
553.27    Subd. 32a. Placement. "Placement" means the placing of a container holding
553.28hydrolyzed or cremated remains in a crypt, vault, or niche.

553.29    Sec. 68. Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:
554.1    Subd. 34. Preparation of the body. "Preparation of the body" means placement of
554.2the body into an appropriate cremation or alkaline hydrolysis container, embalming of
554.3the body or such items of care as washing, disinfecting, shaving, positioning of features,
554.4restorative procedures, application of cosmetics, dressing, and casketing.

554.5    Sec. 69. Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:
554.6    Subd. 35. Processing. "Processing" means the removal of foreign objects, drying or
554.7cooling, and the reduction of the hydrolyzed or cremated remains by mechanical means
554.8including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance
554.9appropriate for final disposition.

554.10    Sec. 70. Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:
554.11    Subd. 37. Public transportation. "Public transportation" means all manner of
554.12transportation via common carrier available to the general public including airlines, buses,
554.13railroads, and ships. For purposes of this chapter, a livery service providing transportation
554.14to private funeral establishments, alkaline hydrolysis facilities, or crematories is not public
554.15transportation.

554.16    Sec. 71. Minnesota Statutes 2012, section 149A.02, is amended by adding a
554.17subdivision to read:
554.18    Subd. 37c. Scattering. "Scattering" means the authorized dispersal of hydrolyzed
554.19or cremated remains in a defined area of a dedicated cemetery or in areas where no local
554.20prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable
554.21to the public, are not in a container, and that the person who has control over disposition
554.22of the hydrolyzed or cremated remains has obtained written permission of the property
554.23owner or governing agency to scatter on the property.

554.24    Sec. 72. Minnesota Statutes 2012, section 149A.02, is amended by adding a
554.25subdivision to read:
554.26    Subd. 41. Vault. "Vault" means a space in a mausoleum of sufficient size, used or
554.27intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.
554.28Vault may also mean a sealed and lined casket enclosure.

554.29    Sec. 73. Minnesota Statutes 2012, section 149A.03, is amended to read:
554.30149A.03 DUTIES OF COMMISSIONER.
554.31    The commissioner shall:
555.1    (1) enforce all laws and adopt and enforce rules relating to the:
555.2    (i) removal, preparation, transportation, arrangements for disposition, and final
555.3disposition of dead human bodies;
555.4    (ii) licensure and professional conduct of funeral directors, morticians, interns,
555.5practicum students, and clinical students;
555.6    (iii) licensing and operation of a funeral establishment; and
555.7(iv) licensing and operation of an alkaline hydrolysis facility; and
555.8    (iv) (v) licensing and operation of a crematory;
555.9    (2) provide copies of the requirements for licensure and permits to all applicants;
555.10    (3) administer examinations and issue licenses and permits to qualified persons
555.11and other legal entities;
555.12    (4) maintain a record of the name and location of all current licensees and interns;
555.13    (5) perform periodic compliance reviews and premise inspections of licensees;
555.14    (6) accept and investigate complaints relating to conduct governed by this chapter;
555.15    (7) maintain a record of all current preneed arrangement trust accounts;
555.16    (8) maintain a schedule of application, examination, permit, and licensure fees,
555.17initial and renewal, sufficient to cover all necessary operating expenses;
555.18    (9) educate the public about the existence and content of the laws and rules for
555.19mortuary science licensing and the removal, preparation, transportation, arrangements
555.20for disposition, and final disposition of dead human bodies to enable consumers to file
555.21complaints against licensees and others who may have violated those laws or rules;
555.22    (10) evaluate the laws, rules, and procedures regulating the practice of mortuary
555.23science in order to refine the standards for licensing and to improve the regulatory and
555.24enforcement methods used; and
555.25    (11) initiate proceedings to address and remedy deficiencies and inconsistencies in
555.26the laws, rules, or procedures governing the practice of mortuary science and the removal,
555.27preparation, transportation, arrangements for disposition, and final disposition of dead
555.28human bodies.

555.29    Sec. 74. [149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS
555.30FACILITY.
555.31    Subdivision 1. License requirement. Except as provided in section 149A.01,
555.32subdivision 3, a place or premise shall not be maintained, managed, or operated which
555.33is devoted to or used in the holding and alkaline hydrolysis of a dead human body
555.34without possessing a valid license to operate an alkaline hydrolysis facility issued by the
555.35commissioner of health.
556.1    Subd. 2. Requirements for an alkaline hydrolysis facility. (a) An alkaline
556.2hydrolysis facility licensed under this section must consist of:
556.3(1) a building or structure that complies with applicable local and state building
556.4codes, zoning laws and ordinances, and wastewater management and environmental
556.5standards, containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of
556.6dead human bodies;
556.7(2) a method approved by the commissioner of health to dry the hydrolyzed remains
556.8and which is located within the licensed facility;
556.9(3) a means approved by the commissioner of health for refrigeration of dead human
556.10bodies awaiting alkaline hydrolysis;
556.11(4) an appropriate means of processing hydrolyzed remains to a granulated
556.12appearance appropriate for final disposition; and
556.13(5) an appropriate holding facility for dead human bodies awaiting alkaline
556.14hydrolysis.
556.15(b) An alkaline hydrolysis facility licensed under this section may also contain a
556.16display room for funeral goods.
556.17    Subd. 3. Application procedure; documentation; initial inspection. An
556.18application to license and operate an alkaline hydrolysis facility shall be submitted to the
556.19commissioner of health. A completed application includes:
556.20(1) a completed application form, as provided by the commissioner;
556.21(2) proof of business form and ownership;
556.22(3) proof of liability insurance coverage or other financial documentation, as
556.23determined by the commissioner, that demonstrates the applicant's ability to respond in
556.24damages for liability arising from the ownership, maintenance management, or operation
556.25of an alkaline hydrolysis facility; and
556.26(4) copies of wastewater and other environmental regulatory permits and
556.27environmental regulatory licenses necessary to conduct operations.
556.28Upon receipt of the application and appropriate fee, the commissioner shall review and
556.29verify all information. Upon completion of the verification process and resolution of any
556.30deficiencies in the application information, the commissioner shall conduct an initial
556.31inspection of the premises to be licensed. After the inspection and resolution of any
556.32deficiencies found and any reinspections as may be necessary, the commissioner shall
556.33make a determination, based on all the information available, to grant or deny licensure. If
556.34the commissioner's determination is to grant the license, the applicant shall be notified and
556.35the license shall issue and remain valid for a period prescribed on the license, but not to
556.36exceed one calendar year from the date of issuance of the license. If the commissioner's
557.1determination is to deny the license, the commissioner must notify the applicant in writing
557.2of the denial and provide the specific reason for denial.
557.3    Subd. 4. Nontransferability of license. A license to operate an alkaline hydrolysis
557.4facility is not assignable or transferable and shall not be valid for any entity other than the
557.5one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the
557.6location identified on the license. A 50 percent or more change in ownership or location of
557.7the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall
557.8be required of two or more persons or other legal entities operating from the same location.
557.9    Subd. 5. Display of license. Each license to operate an alkaline hydrolysis
557.10facility must be conspicuously displayed in the alkaline hydrolysis facility at all times.
557.11Conspicuous display means in a location where a member of the general public within the
557.12alkaline hydrolysis facility is able to observe and read the license.
557.13    Subd. 6. Period of licensure. All licenses to operate an alkaline hydrolysis facility
557.14issued by the commissioner are valid for a period of one calendar year beginning on July 1
557.15and ending on June 30, regardless of the date of issuance.
557.16    Subd. 7. Reporting changes in license information. Any change of license
557.17information must be reported to the commissioner, on forms provided by the
557.18commissioner, no later than 30 calendar days after the change occurs. Failure to report
557.19changes is grounds for disciplinary action.
557.20    Subd. 8. Notification to the commissioner. If the licensee is operating under a
557.21wastewater or an environmental permit or license that is subsequently revoked, denied,
557.22or terminated, the licensee shall notify the commissioner.
557.23    Subd. 9. Application information. All information submitted to the commissioner
557.24for a license to operate an alkaline hydrolysis facility is classified as licensing data under
557.25section 13.41, subdivision 5.

557.26    Sec. 75. [149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE
557.27HYDROLYSIS FACILITY.
557.28    Subdivision 1. Renewal required. All licenses to operate an alkaline hydrolysis
557.29facility issued by the commissioner expire on June 30 following the date of issuance of the
557.30license and must be renewed to remain valid.
557.31    Subd. 2. Renewal procedure and documentation. Licensees who wish to renew
557.32their licenses must submit to the commissioner a completed renewal application no later
557.33than June 30 following the date the license was issued. A completed renewal application
557.34includes:
557.35(1) a completed renewal application form, as provided by the commissioner; and
558.1(2) proof of liability insurance coverage or other financial documentation, as
558.2determined by the commissioner, that demonstrates the applicant's ability to respond in
558.3damages for liability arising from the ownership, maintenance, management, or operation
558.4of an alkaline hydrolysis facility.
558.5Upon receipt of the completed renewal application, the commissioner shall review and
558.6verify the information. Upon completion of the verification process and resolution of
558.7any deficiencies in the renewal application information, the commissioner shall make a
558.8determination, based on all the information available, to reissue or refuse to reissue the
558.9license. If the commissioner's determination is to reissue the license, the applicant shall
558.10be notified and the license shall issue and remain valid for a period prescribed on the
558.11license, but not to exceed one calendar year from the date of issuance of the license. If
558.12the commissioner's determination is to refuse to reissue the license, section 149A.09,
558.13subdivision 2, applies.
558.14    Subd. 3. Penalty for late filing. Renewal applications received after the expiration
558.15date of a license will result in the assessment of a late filing penalty. The late filing penalty
558.16must be paid before the reissuance of the license and received by the commissioner no
558.17later than 31 calendar days after the expiration date of the license.
558.18    Subd. 4. Lapse of license. Licenses to operate alkaline hydrolysis facilities
558.19shall automatically lapse when a completed renewal application is not received by the
558.20commissioner within 31 calendar days after the expiration date of a license, or a late
558.21filing penalty assessed under subdivision 3 is not received by the commissioner within 31
558.22calendar days after the expiration of a license.
558.23    Subd. 5. Effect of lapse of license. Upon the lapse of a license, the person to whom
558.24the license was issued is no longer licensed to operate an alkaline hydrolysis facility in
558.25Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed
558.26license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue
558.27any additional lawful remedies as justified by the case.
558.28    Subd. 6. Restoration of lapsed license. The commissioner may restore a lapsed
558.29license upon receipt and review of a completed renewal application, receipt of the late
558.30filing penalty, and reinspection of the premises, provided that the receipt is made within
558.31one calendar year from the expiration date of the lapsed license and the cease and desist
558.32order issued by the commissioner has not been violated. If a lapsed license is not restored
558.33within one calendar year from the expiration date of the lapsed license, the holder of the
558.34lapsed license cannot be relicensed until the requirements in section 149A.54 are met.
558.35    Subd. 7. Reporting changes in license information. Any change of license
558.36information must be reported to the commissioner, on forms provided by the
559.1commissioner, no later than 30 calendar days after the change occurs. Failure to report
559.2changes is grounds for disciplinary action.
559.3    Subd. 8. Application information. All information submitted to the commissioner
559.4by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is
559.5classified as licensing data under section 13.41, subdivision 5.

559.6    Sec. 76. Minnesota Statutes 2012, section 149A.65, is amended by adding a
559.7subdivision to read:
559.8    Subd. 6. Alkaline hydrolysis facilities. The initial and renewal fee for an alkaline
559.9hydrolysis facility is $300. The late fee charge for a license renewal is $25.

559.10    Sec. 77. Minnesota Statutes 2012, section 149A.65, is amended by adding a
559.11subdivision to read:
559.12    Subd. 7. State government special revenue fund. Fees collected by the
559.13commissioner under this section must be deposited in the state treasury and credited to
559.14the state government special revenue fund.

559.15    Sec. 78. Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:
559.16    Subdivision 1. Use of titles. Only a person holding a valid license to practice
559.17mortuary science issued by the commissioner may use the title of mortician, funeral
559.18director, or any other title implying that the licensee is engaged in the business or practice
559.19of mortuary science. Only the holder of a valid license to operate an alkaline hydrolysis
559.20facility issued by the commissioner may use the title of alkaline hydrolysis facility, water
559.21cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or
559.22any other title, word, or term implying that the licensee operates an alkaline hydrolysis
559.23facility. Only the holder of a valid license to operate a funeral establishment issued by the
559.24commissioner may use the title of funeral home, funeral chapel, funeral service, or any
559.25other title, word, or term implying that the licensee is engaged in the business or practice
559.26of mortuary science. Only the holder of a valid license to operate a crematory issued by
559.27the commissioner may use the title of crematory, crematorium, green-cremation, or any
559.28other title, word, or term implying that the licensee operates a crematory or crematorium.

559.29    Sec. 79. Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:
559.30    Subd. 2. Business location. A funeral establishment, alkaline hydrolysis facility, or
559.31crematory shall not do business in a location that is not licensed as a funeral establishment,
560.1alkaline hydrolysis facility, or crematory and shall not advertise a service that is available
560.2from an unlicensed location.

560.3    Sec. 80. Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:
560.4    Subd. 3. Advertising. No licensee, clinical student, practicum student, or intern
560.5shall publish or disseminate false, misleading, or deceptive advertising. False, misleading,
560.6or deceptive advertising includes, but is not limited to:
560.7    (1) identifying, by using the names or pictures of, persons who are not licensed to
560.8practice mortuary science in a way that leads the public to believe that those persons will
560.9provide mortuary science services;
560.10    (2) using any name other than the names under which the funeral establishment,
560.11alkaline hydrolysis facility, or crematory is known to or licensed by the commissioner;
560.12    (3) using a surname not directly, actively, or presently associated with a licensed
560.13funeral establishment, alkaline hydrolysis facility, or crematory, unless the surname had
560.14been previously and continuously used by the licensed funeral establishment, alkaline
560.15hydrolysis facility, or crematory; and
560.16    (4) using a founding or establishing date or total years of service not directly or
560.17continuously related to a name under which the funeral establishment, alkaline hydrolysis
560.18facility, or crematory is currently or was previously licensed.
560.19    Any advertising or other printed material that contains the names or pictures of
560.20persons affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory
560.21shall state the position held by the persons and shall identify each person who is licensed
560.22or unlicensed under this chapter.

560.23    Sec. 81. Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:
560.24    Subd. 5. Reimbursement prohibited. No licensee, clinical student, practicum
560.25student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other
560.26reimbursement in consideration for recommending or causing a dead human body to
560.27be disposed of by a specific body donation program, funeral establishment, alkaline
560.28hydrolysis facility, crematory, mausoleum, or cemetery.

560.29    Sec. 82. Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:
560.30    Subd. 2. Preventive requirements. (a) To prevent unfair or deceptive acts or
560.31practices, the requirements of this subdivision must be met.
560.32    (b) Funeral providers must tell persons who ask by telephone about the funeral
560.33provider's offerings or prices any accurate information from the price lists described in
561.1paragraphs (c) to (e) and any other readily available information that reasonably answers
561.2the questions asked.
561.3    (c) Funeral providers must make available for viewing to people who inquire in
561.4person about the offerings or prices of funeral goods or burial site goods, separate printed
561.5or typewritten price lists using a ten-point font or larger. Each funeral provider must have a
561.6separate price list for each of the following types of goods that are sold or offered for sale:
561.7    (1) caskets;
561.8    (2) alternative containers;
561.9    (3) outer burial containers;
561.10(4) alkaline hydrolysis containers;
561.11    (4) (5) cremation containers;
561.12(6) hydrolyzed remains containers;
561.13    (5) (7) cremated remains containers;
561.14    (6) (8) markers; and
561.15    (7) (9) headstones.
561.16    (d) Each separate price list must contain the name of the funeral provider's place
561.17of business, address, and telephone number and a caption describing the list as a price
561.18list for one of the types of funeral goods or burial site goods described in paragraph (c),
561.19clauses (1) to (7) (9). The funeral provider must offer the list upon beginning discussion
561.20of, but in any event before showing, the specific funeral goods or burial site goods and
561.21must provide a photocopy of the price list, for retention, if so asked by the consumer. The
561.22list must contain, at least, the retail prices of all the specific funeral goods and burial site
561.23goods offered which do not require special ordering, enough information to identify each,
561.24and the effective date for the price list. However, funeral providers are not required to
561.25make a specific price list available if the funeral providers place the information required
561.26by this paragraph on the general price list described in paragraph (e).
561.27    (e) Funeral providers must give a printed price list, for retention, to persons who
561.28inquire in person about the funeral goods, funeral services, burial site goods, or burial site
561.29services or prices offered by the funeral provider. The funeral provider must give the list
561.30upon beginning discussion of either the prices of or the overall type of funeral service or
561.31disposition or specific funeral goods, funeral services, burial site goods, or burial site
561.32services offered by the provider. This requirement applies whether the discussion takes
561.33place in the funeral establishment or elsewhere. However, when the deceased is removed
561.34for transportation to the funeral establishment, an in-person request for authorization to
561.35embalm does not, by itself, trigger the requirement to offer the general price list. If the
561.36provider, in making an in-person request for authorization to embalm, discloses that
562.1embalming is not required by law except in certain special cases, the provider is not
562.2required to offer the general price list. Any other discussion during that time about prices
562.3or the selection of funeral goods, funeral services, burial site goods, or burial site services
562.4triggers the requirement to give the consumer a general price list. The general price list
562.5must contain the following information:
562.6    (1) the name, address, and telephone number of the funeral provider's place of
562.7business;
562.8    (2) a caption describing the list as a "general price list";
562.9    (3) the effective date for the price list;
562.10    (4) the retail prices, in any order, expressed either as a flat fee or as the prices per
562.11hour, mile, or other unit of computation, and other information described as follows:
562.12    (i) forwarding of remains to another funeral establishment, together with a list of
562.13the services provided for any quoted price;
562.14    (ii) receiving remains from another funeral establishment, together with a list of
562.15the services provided for any quoted price;
562.16    (iii) separate prices for each alkaline hydrolysis or cremation offered by the funeral
562.17provider, with the price including an alternative container or alkaline hydrolysis or
562.18cremation container, any alkaline hydrolysis or crematory charges, and a description of the
562.19services and container included in the price, where applicable, and the price of alkaline
562.20hydrolysis or cremation where the purchaser provides the container;
562.21    (iv) separate prices for each immediate burial offered by the funeral provider,
562.22including a casket or alternative container, and a description of the services and container
562.23included in that price, and the price of immediate burial where the purchaser provides the
562.24casket or alternative container;
562.25    (v) transfer of remains to the funeral establishment or other location;
562.26    (vi) embalming;
562.27    (vii) other preparation of the body;
562.28    (viii) use of facilities, equipment, or staff for viewing;
562.29    (ix) use of facilities, equipment, or staff for funeral ceremony;
562.30    (x) use of facilities, equipment, or staff for memorial service;
562.31    (xi) use of equipment or staff for graveside service;
562.32    (xii) hearse or funeral coach;
562.33    (xiii) limousine; and
562.34    (xiv) separate prices for all cemetery-specific goods and services, including all goods
562.35and services associated with interment and burial site goods and services and excluding
562.36markers and headstones;
563.1    (5) the price range for the caskets offered by the funeral provider, together with the
563.2statement "A complete price list will be provided at the funeral establishment or casket
563.3sale location." or the prices of individual caskets, as disclosed in the manner described
563.4in paragraphs (c) and (d);
563.5    (6) the price range for the alternative containers offered by the funeral provider,
563.6together with the statement "A complete price list will be provided at the funeral
563.7establishment or alternative container sale location." or the prices of individual alternative
563.8containers, as disclosed in the manner described in paragraphs (c) and (d);
563.9    (7) the price range for the outer burial containers offered by the funeral provider,
563.10together with the statement "A complete price list will be provided at the funeral
563.11establishment or outer burial container sale location." or the prices of individual outer
563.12burial containers, as disclosed in the manner described in paragraphs (c) and (d);
563.13(8) the price range for the alkaline hydrolysis container offered by the funeral
563.14provider, together with the statement: "A complete price list will be provided at the funeral
563.15establishment or alkaline hydrolysis container sale location.", or the prices of individual
563.16alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c)
563.17and (d);
563.18(9) the price range for the hydrolyzed remains container offered by the funeral
563.19provider, together with the statement: "A complete price list will be provided at the
563.20funeral establishment or hydrolyzed remains container sale location.", or the prices
563.21of individual hydrolyzed remains container, as disclosed in the manner described in
563.22paragraphs (c) and (d);
563.23    (8) (10) the price range for the cremation containers offered by the funeral provider,
563.24together with the statement "A complete price list will be provided at the funeral
563.25establishment or cremation container sale location." or the prices of individual cremation
563.26containers and cremated remains containers, as disclosed in the manner described in
563.27paragraphs (c) and (d);
563.28    (9) (11) the price range for the cremated remains containers offered by the funeral
563.29provider, together with the statement, "A complete price list will be provided at the funeral
563.30establishment or cremation cremated remains container sale location," or the prices of
563.31individual cremation containers as disclosed in the manner described in paragraphs (c)
563.32and (d);
563.33    (10) (12) the price for the basic services of funeral provider and staff, together with a
563.34list of the principal basic services provided for any quoted price and, if the charge cannot
563.35be declined by the purchaser, the statement "This fee for our basic services will be added
563.36to the total cost of the funeral arrangements you select. (This fee is already included in
564.1our charges for alkaline hydrolysis, direct cremations, immediate burials, and forwarding
564.2or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted
564.3price shall include all charges for the recovery of unallocated funeral provider overhead,
564.4and funeral providers may include in the required disclosure the phrase "and overhead"
564.5after the word "services." This services fee is the only funeral provider fee for services,
564.6facilities, or unallocated overhead permitted by this subdivision to be nondeclinable,
564.7unless otherwise required by law;
564.8    (11) (13) the price range for the markers and headstones offered by the funeral
564.9provider, together with the statement "A complete price list will be provided at the funeral
564.10establishment or marker or headstone sale location." or the prices of individual markers
564.11and headstones, as disclosed in the manner described in paragraphs (c) and (d); and
564.12    (12) (14) any package priced funerals offered must be listed in addition to and
564.13following the information required in paragraph (e) and must clearly state the funeral
564.14goods and services being offered, the price being charged for those goods and services,
564.15and the discounted savings.
564.16    (f) Funeral providers must give an itemized written statement, for retention, to each
564.17consumer who arranges an at-need funeral or other disposition of human remains at the
564.18conclusion of the discussion of the arrangements. The itemized written statement must be
564.19signed by the consumer selecting the goods and services as required in section 149A.80.
564.20If the statement is provided by a funeral establishment, the statement must be signed by
564.21the licensed funeral director or mortician planning the arrangements. If the statement is
564.22provided by any other funeral provider, the statement must be signed by an authorized
564.23agent of the funeral provider. The statement must list the funeral goods, funeral services,
564.24burial site goods, or burial site services selected by that consumer and the prices to be paid
564.25for each item, specifically itemized cash advance items (these prices must be given to the
564.26extent then known or reasonably ascertainable if the prices are not known or reasonably
564.27ascertainable, a good faith estimate shall be given and a written statement of the actual
564.28charges shall be provided before the final bill is paid), and the total cost of goods and
564.29services selected. At the conclusion of an at-need arrangement, the funeral provider is
564.30required to give the consumer a copy of the signed itemized written contract that must
564.31contain the information required in this paragraph.
564.32    (g) Upon receiving actual notice of the death of an individual with whom a funeral
564.33provider has entered a preneed funeral agreement, the funeral provider must provide
564.34a copy of all preneed funeral agreement documents to the person who controls final
564.35disposition of the human remains or to the designee of the person controlling disposition.
564.36The person controlling final disposition shall be provided with these documents at the time
565.1of the person's first in-person contact with the funeral provider, if the first contact occurs
565.2in person at a funeral establishment, alkaline hydrolysis facility, crematory, or other place
565.3of business of the funeral provider. If the contact occurs by other means or at another
565.4location, the documents must be provided within 24 hours of the first contact.

565.5    Sec. 83. Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:
565.6    Subd. 4. Casket, alternate container, alkaline hydrolysis container, and
565.7cremation container sales; records; required disclosures. Any funeral provider who
565.8sells or offers to sell a casket, alternate container, or alkaline hydrolysis container,
565.9hydrolyzed remains container, cremation container, or cremated remains container to
565.10the public must maintain a record of each sale that includes the name of the purchaser,
565.11the purchaser's mailing address, the name of the decedent, the date of the decedent's
565.12death, and the place of death. These records shall be open to inspection by the regulatory
565.13agency. Any funeral provider selling a casket, alternate container, or cremation container
565.14to the public, and not having charge of the final disposition of the dead human body,
565.15shall provide a copy of the statutes and rules controlling the removal, preparation,
565.16transportation, arrangements for disposition, and final disposition of a dead human body.
565.17This subdivision does not apply to morticians, funeral directors, funeral establishments,
565.18crematories, or wholesale distributors of caskets, alternate containers, alkaline hydrolysis
565.19containers, or cremation containers.

565.20    Sec. 84. Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:
565.21    Subd. 3. Casket for alkaline hydrolysis or cremation provisions; deceptive acts
565.22or practices. In selling or offering to sell funeral goods or funeral services to the public, it
565.23is a deceptive act or practice for a funeral provider to represent that a casket is required for
565.24alkaline hydrolysis or cremations by state or local law or otherwise.

565.25    Sec. 85. Minnesota Statutes 2012, section 149A.72, is amended by adding a
565.26subdivision to read:
565.27    Subd. 3a. Casket for alkaline hydrolysis provision; preventive measures. To
565.28prevent deceptive acts or practices, funeral providers must place the following disclosure
565.29in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota
565.30law does not require you to purchase a casket for alkaline hydrolysis. If you want to
565.31arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline
565.32hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant
565.33to leakage of bodily fluids that encases the body and into which a dead human body is
566.1placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide
566.2are (specify containers provided)." This disclosure is required only if the funeral provider
566.3arranges alkaline hydrolysis.

566.4    Sec. 86. Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:
566.5    Subd. 9. Deceptive acts or practices. In selling or offering to sell funeral goods,
566.6funeral services, burial site goods, or burial site services to the public, it is a deceptive act
566.7or practice for a funeral provider to represent that federal, state, or local laws, or particular
566.8cemeteries, alkaline hydrolysis facilities, or crematories, require the purchase of any funeral
566.9goods, funeral services, burial site goods, or burial site services when that is not the case.

566.10    Sec. 87. Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:
566.11    Subdivision 1. Casket for alkaline hydrolysis or cremation provisions; deceptive
566.12acts or practices. In selling or offering to sell funeral goods, funeral services, burial site
566.13goods, or burial site services to the public, it is a deceptive act or practice for a funeral
566.14provider to require that a casket be purchased for alkaline hydrolysis or cremation.

566.15    Sec. 88. Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:
566.16    Subd. 2. Casket for alkaline hydrolysis or cremation; preventive requirements.
566.17To prevent unfair or deceptive acts or practices, if funeral providers arrange for alkaline
566.18hydrolysis or cremations, they must make a an alkaline hydrolysis container or cremation
566.19container available for alkaline hydrolysis or cremations.

566.20    Sec. 89. Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:
566.21    Subd. 4. Required purchases of funeral goods or services; preventive
566.22requirements. To prevent unfair or deceptive acts or practices, funeral providers must
566.23place the following disclosure in the general price list, immediately above the prices
566.24required by section 149A.71, subdivision 2, paragraph (e), clauses (4) to (10): "The goods
566.25and services shown below are those we can provide to our customers. You may choose
566.26only the items you desire. If legal or other requirements mean that you must buy any items
566.27you did not specifically ask for, we will explain the reason in writing on the statement we
566.28provide describing the funeral goods, funeral services, burial site goods, and burial site
566.29services you selected." However, if the charge for "services of funeral director and staff"
566.30cannot be declined by the purchaser, the statement shall include the sentence "However,
566.31any funeral arrangements you select will include a charge for our basic services." between
566.32the second and third sentences of the sentences specified in this subdivision. The statement
567.1may include the phrase "and overhead" after the word "services" if the fee includes a
567.2charge for the recovery of unallocated funeral overhead. If the funeral provider does
567.3not include this disclosure statement, then the following disclosure statement must be
567.4placed in the statement of funeral goods, funeral services, burial site goods, and burial site
567.5services selected, as described in section 149A.71, subdivision 2, paragraph (f): "Charges
567.6are only for those items that you selected or that are required. If we are required by law or
567.7by a cemetery, alkaline hydrolysis facility, or crematory to use any items, we will explain
567.8the reasons in writing below." A funeral provider is not in violation of this subdivision by
567.9failing to comply with a request for a combination of goods or services which would be
567.10impossible, impractical, or excessively burdensome to provide.

567.11    Sec. 90. Minnesota Statutes 2012, section 149A.74, is amended to read:
567.12149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.
567.13    Subdivision 1. Services provided without prior approval; deceptive acts or
567.14practices. In selling or offering to sell funeral goods or funeral services to the public, it
567.15is a deceptive act or practice for any funeral provider to embalm a dead human body
567.16unless state or local law or regulation requires embalming in the particular circumstances
567.17regardless of any funeral choice which might be made, or prior approval for embalming
567.18has been obtained from an individual legally authorized to make such a decision. In
567.19seeking approval to embalm, the funeral provider must disclose that embalming is not
567.20required by law except in certain circumstances; that a fee will be charged if a funeral
567.21is selected which requires embalming, such as a funeral with viewing; and that no
567.22embalming fee will be charged if the family selects a service which does not require
567.23embalming, such as direct alkaline hydrolysis, direct cremation, or immediate burial.
567.24    Subd. 2. Services provided without prior approval; preventive requirement.
567.25To prevent unfair or deceptive acts or practices, funeral providers must include on
567.26the itemized statement of funeral goods or services, as described in section 149A.71,
567.27subdivision 2 , paragraph (f), the statement "If you selected a funeral that may require
567.28embalming, such as a funeral with viewing, you may have to pay for embalming. You do
567.29not have to pay for embalming you did not approve if you selected arrangements such
567.30as direct alkaline hydrolysis, direct cremation, or immediate burial. If we charged for
567.31embalming, we will explain why below."

567.32    Sec. 91. Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:
567.33    Subd. 9. Embalmed Bodies awaiting final disposition. All embalmed bodies
567.34awaiting final disposition shall be kept in an appropriate holding facility or preparation
568.1and embalming room. The holding facility must be secure from access by anyone except
568.2the authorized personnel of the funeral establishment, preserve the dignity and integrity of
568.3the body, and protect the health and safety of the personnel of the funeral establishment.

568.4    Sec. 92. Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:
568.5    Subd. 3. Disposition permit. A disposition permit is required before a body can
568.6be buried, entombed, alkaline hydrolyzed, or cremated. No disposition permit shall be
568.7issued until a fact of death record has been completed and filed with the local or state
568.8registrar of vital statistics.

568.9    Sec. 93. Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:
568.10    Subd. 6. Conveyances permitted for transportation. A dead human body may be
568.11transported by means of private vehicle or private aircraft, provided that the body must be
568.12encased in an appropriate container, that meets the following standards:
568.13    (1) promotes respect for and preserves the dignity of the dead human body;
568.14    (2) shields the body from being viewed from outside of the conveyance;
568.15    (3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket,
568.16alternative container, alkaline hydrolysis container, or cremation container in a horizontal
568.17position;
568.18    (4) is designed to permit loading and unloading of the body without excessive tilting
568.19of the cot, stretcher, rigid tray, casket, alternative container, alkaline hydrolysis container,
568.20 or cremation container; and
568.21    (5) if used for the transportation of more than one dead human body at one time,
568.22the vehicle must be designed so that a body or container does not rest directly on top of
568.23another body or container and that each body or container is secured to prevent the body
568.24or container from excessive movement within the conveyance.
568.25    A vehicle that is a dignified conveyance and was specified for use by the deceased
568.26or by the family of the deceased may be used to transport the body to the place of final
568.27disposition.

568.28    Sec. 94. Minnesota Statutes 2012, section 149A.94, is amended to read:
568.29149A.94 FINAL DISPOSITION.
568.30    Subdivision 1. Generally. Every dead human body lying within the state, except
568.31unclaimed bodies delivered for dissection by the medical examiner, those delivered for
568.32anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through
568.33the state for the purpose of disposition elsewhere; and the remains of any dead human
569.1body after dissection or anatomical study, shall be decently buried, or entombed in a
569.2public or private cemetery, alkaline hydrolyzed or cremated, within a reasonable time
569.3after death. Where final disposition of a body will not be accomplished within 72 hours
569.4following death or release of the body by a competent authority with jurisdiction over the
569.5body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body
569.6may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry
569.7ice for a period that exceeds four calendar days, from the time of death or release of the
569.8body from the coroner or medical examiner.
569.9    Subd. 3. Permit required. No dead human body shall be buried, entombed, or
569.10cremated without a disposition permit. The disposition permit must be filed with the person
569.11in charge of the place of final disposition. Where a dead human body will be transported out
569.12of this state for final disposition, the body must be accompanied by a certificate of removal.
569.13    Subd. 4. Alkaline hydrolysis or cremation. Inurnment of alkaline hydrolyzed or
569.14cremated remains and release to an appropriate party is considered final disposition and no
569.15further permits or authorizations are required for transportation, interment, entombment, or
569.16placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

569.17    Sec. 95. [149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE
569.18HYDROLYSIS.
569.19    Subdivision 1. License required. A dead human body may only be hydrolyzed in
569.20this state at an alkaline hydrolysis facility licensed by the commissioner of health.
569.21    Subd. 2. General requirements. Any building to be used as an alkaline hydrolysis
569.22facility must comply with all applicable local and state building codes, zoning laws and
569.23ordinances, wastewater management regulations, and environmental statutes, rules, and
569.24standards. An alkaline hydrolysis facility must have, on site, a purpose built human
569.25alkaline hydrolysis system approved by the commissioner of health, a system approved by
569.26the commissioner of health for drying the hydrolyzed remains, a motorized mechanical
569.27device approved by the commissioner of health for processing hydrolyzed remains, and in
569.28the building a holding facility approved by the commissioner of health for the retention
569.29of dead human bodies awaiting alkaline hydrolysis. The holding facility must be secure
569.30from access by anyone except the authorized personnel of the alkaline hydrolysis facility,
569.31preserve the dignity of the remains, and protect the health and safety of the alkaline
569.32hydrolysis facility personnel.
569.33    Subd. 3. Lighting and ventilation. The room where the alkaline hydrolysis vessel
569.34is located and the room where the chemical storage takes place shall be properly lit and
569.35ventilated with an exhaust fan that provides at least 12 air changes per hour.
570.1    Subd. 4. Plumbing connections. All plumbing fixtures, water supply lines,
570.2plumbing vents, and waste drains shall be properly vented and connected pursuant to the
570.3Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a
570.4functional sink with hot and cold running water.
570.5    Subd. 5. Flooring, walls, ceiling, doors, and windows. The room where the
570.6alkaline hydrolysis vessel is located and the room where the chemical storage takes place
570.7shall have nonporous flooring, so that a sanitary condition is provided. The walls and
570.8ceiling of the room where the alkaline hydrolysis vessel is located and the room where
570.9the chemical storage takes place shall run from floor to ceiling and be covered with tile,
570.10or by plaster or sheetrock painted with washable paint or other appropriate material so
570.11that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be
570.12constructed to prevent odors from entering any other part of the building. All windows
570.13or other openings to the outside must be screened, and all windows must be treated in a
570.14manner that prevents viewing into the room where the alkaline hydrolysis vessel is located
570.15and the room where the chemical storage takes place. A viewing window for authorized
570.16family members or their designees is not a violation of this subdivision.
570.17    Subd. 6. Equipment and supplies. The alkaline hydrolysis facility must have a
570.18functional emergency eye wash and quick drench shower.
570.19    Subd. 7. Access and privacy. (a) The room where the alkaline hydrolysis vessel is
570.20located and the room where the chemical storage takes place must be private and have no
570.21general passageway through it. The room shall, at all times, be secure from the entrance of
570.22unauthorized persons. Authorized persons are:
570.23(1) licensed morticians;
570.24(2) registered interns or students as described in section 149A.91, subdivision 6;
570.25(3) public officials or representatives in the discharge of their official duties;
570.26(4) trained alkaline hydrolysis facility operators; and
570.27(5) the person or persons with the right to control the dead human body as defined in
570.28section 149A.80, subdivision 2, and their designees.
570.29    (b) Each door allowing ingress or egress shall carry a sign that indicates that the
570.30room is private and access is limited. All authorized persons who are present in or enter
570.31the room where the alkaline hydrolysis vessel is located while a body is being prepared for
570.32final disposition must be attired according to all applicable state and federal regulations
570.33regarding the control of infectious disease and occupational and workplace health and
570.34safety.
570.35    Subd. 8. Sanitary conditions and permitted use. The room where the alkaline
570.36hydrolysis vessel is located and the room where the chemical storage takes place and all
571.1fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies
571.2stored or used in the room must be maintained in a clean and sanitary condition at all times.
571.3    Subd. 9. Boiler use. When a boiler is required by the manufacturer of the alkaline
571.4hydrolysis vessel for its operation, all state and local regulations for that boiler must be
571.5followed.
571.6    Subd. 10. Occupational and workplace safety. All applicable provisions of state
571.7and federal regulations regarding exposure to workplace hazards and accidents shall be
571.8followed in order to protect the health and safety of all authorized persons at the alkaline
571.9hydrolysis facility.
571.10    Subd. 11. Licensed personnel. A licensed alkaline hydrolysis facility must employ
571.11a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body.
571.12It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for
571.13all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for
571.14compliance with this chapter and other applicable state and federal regulations regarding
571.15occupational and workplace health and safety.
571.16    Subd. 12. Authorization to hydrolyze required. No alkaline hydrolysis facility
571.17shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part
571.18without receiving written authorization to do so from the person or persons who have the
571.19legal right to control disposition as described in section 149A.80 or the person's legal
571.20designee. The written authorization must include:
571.21(1) the name of the deceased and the date of death of the deceased;
571.22(2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body;
571.23(3) the name, address, telephone number, relationship to the deceased, and signature
571.24of the person or persons with legal right to control final disposition or a legal designee;
571.25(4) directions for the disposition of any nonhydrolyzed materials or items recovered
571.26from the alkaline hydrolysis vessel;
571.27(5) acknowledgment that the hydrolyzed remains will be dried and mechanically
571.28reduced to a granulated appearance and placed in an appropriate container and
571.29authorization to place any hydrolyzed remains that a selected urn or container will not
571.30accommodate into a temporary container;
571.31(6) acknowledgment that, even with the exercise of reasonable care, it is not possible
571.32to recover all particles of the hydrolyzed remains and that some particles may inadvertently
571.33become commingled with particles of other hydrolyzed remains that remain in the alkaline
571.34hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains;
571.35(7) directions for the ultimate disposition of the hydrolyzed remains; and
572.1(8) a statement that includes, but is not limited to, the following information:
572.2"During the alkaline hydrolysis process, chemical dissolution using heat, water, and an
572.3alkaline solution is used to chemically break down the human tissue and the hydrolyzable
572.4alkaline hydrolysis container. After the process is complete, the liquid effluent solution
572.5contains the chemical by-products of the alkaline hydrolysis process except for the
572.6deceased's bone fragments. The solution is cooled and released according to local
572.7environmental regulations. A water rinse is applied to the hydrolyzed remains which are
572.8then dried and processed to facilitate inurnment or scattering."
572.9    Subd. 13. Limitation of liability. A licensed alkaline hydrolysis facility acting in
572.10good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an
572.11authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from
572.12civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis
572.13facility.
572.14    Subd. 14. Acceptance of delivery of body. (a) No dead human body shall be
572.15accepted for final disposition by alkaline hydrolysis unless:
572.16(1) encased in an appropriate alkaline hydrolysis container;
572.17(2) accompanied by a disposition permit issued pursuant to section 149A.93,
572.18subdivision 3, including a photocopy of the completed death record or a signed release
572.19authorizing alkaline hydrolysis of the body received from the coroner or medical
572.20examiner; and
572.21(3) accompanied by an alkaline hydrolysis authorization that complies with
572.22subdivision 12.
572.23    (b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline
572.24hydrolysis container where there is:
572.25(1) evidence of leakage of fluids from the alkaline hydrolysis container;
572.26(2) a known dispute concerning hydrolysis of the body delivered;
572.27(3) a reasonable basis for questioning any of the representations made on the written
572.28authorization to hydrolyze; or
572.29(4) any other lawful reason.
572.30    Subd. 15. Bodies awaiting hydrolysis. A dead human body must be hydrolyzed
572.31within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of
572.32the body.
572.33    Subd. 16. Handling of alkaline hydrolysis containers for dead human bodies.
572.34All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for
572.35dead human bodies shall use universal precautions and otherwise exercise all reasonable
573.1precautions to minimize the risk of transmitting any communicable disease from the body.
573.2No dead human body shall be removed from the container in which it is delivered.
573.3    Subd. 17. Identification of body. All licensed alkaline hydrolysis facilities shall
573.4develop, implement, and maintain an identification procedure whereby dead human
573.5bodies can be identified from the time the alkaline hydrolysis facility accepts delivery
573.6of the remains until the hydrolyzed remains are released to an authorized party. After
573.7hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the
573.8hydrolyzed remains container before the hydrolyzed remains are released from the alkaline
573.9hydrolysis facility. Each identification disk, tab, or label shall have a number that shall
573.10be recorded on all paperwork regarding the decedent. This procedure shall be designed
573.11to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains
573.12are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the
573.13inability to individually identify the hydrolyzed remains is a violation of this subdivision.
573.14    Subd. 18. Alkaline hydrolysis vessel for human remains. A licensed alkaline
573.15hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains
573.16in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for
573.17infectious disease control.
573.18    Subd. 19. Alkaline hydrolysis procedures; privacy. The final disposition of
573.19dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is
573.20written authorization from the person with the legal right to control the disposition,
573.21only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline
573.22hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting
573.23alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline
573.24hydrolysis vessel, or being processed and placed in a hydrolyzed remains container.
573.25    Subd. 20. Alkaline hydrolysis procedures; commingling of hydrolyzed remains
573.26prohibited. Except with the express written permission of the person with the legal right
573.27to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one
573.28dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce
573.29a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have
573.30been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze
573.31a dead human body and other human remains at the same time and in the same alkaline
573.32hydrolysis vessel. This section does not apply where commingling of human remains
573.33during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental
573.34and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is
573.35not a violation of this subdivision.
574.1    Subd. 21. Alkaline hydrolysis procedures; removal from alkaline hydrolysis
574.2vessel. Upon completion of the alkaline hydrolysis process, reasonable efforts shall be
574.3made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed
574.4remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be
574.5made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed
574.6human remains and dispose of these materials in a lawful manner, by the alkaline
574.7hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate
574.8container to be transported to the processing area.
574.9    Subd. 22. Drying device or mechanical processor procedures; commingling of
574.10hydrolyzed remains prohibited. Except with the express written permission of the
574.11person with the legal right to control the final disposition or otherwise provided by
574.12law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed
574.13human remains of more than one body at a time in the same drying device or mechanical
574.14processor, or introduce the hydrolyzed human remains of a second body into a drying
574.15device or mechanical processor until processing of any preceding hydrolyzed human
574.16remains has been terminated and reasonable efforts have been employed to remove all
574.17fragments of the preceding hydrolyzed remains. The fact that there is incidental and
574.18unavoidable residue in the drying device, the mechanical processor, or any container used
574.19in a prior alkaline hydrolysis process, is not a violation of this provision.
574.20    Subd. 23. Alkaline hydrolysis procedures; processing hydrolyzed remains. The
574.21hydrolyzed human remains shall be dried and then reduced by a motorized mechanical
574.22device to a granulated appearance appropriate for final disposition and placed in an
574.23alkaline hydrolysis remains container along with the appropriate identifying disk, tab,
574.24or permanent label. Processing must take place within the licensed alkaline hydrolysis
574.25facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they
574.26can be identified, may be removed prior to processing the hydrolyzed remains, only by
574.27staff licensed or registered by the commissioner of health; however, any dental gold and
574.28silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains
574.29container unless otherwise directed by the person or persons having the right to control the
574.30final disposition. Every person who removes or possesses dental gold or silver, jewelry,
574.31or mementos from any hydrolyzed remains without specific written permission of the
574.32person or persons having the right to control those remains is guilty of a misdemeanor.
574.33The fact that residue and any unavoidable dental gold or dental silver, or other precious
574.34metals remain in the alkaline hydrolysis vessel or other equipment or any container used
574.35in a prior hydrolysis is not a violation of this section.
575.1    Subd. 24. Alkaline hydrolysis procedures; container of insufficient capacity.
575.2If a hydrolyzed remains container is of insufficient capacity to accommodate all
575.3hydrolyzed remains of a given dead human body, subject to directives provided in the
575.4written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess
575.5hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the
575.6second container, in a manner so as not to be easily detached through incidental contact, to
575.7the primary alkaline hydrolysis remains container. The secondary container shall contain a
575.8duplicate of the identification disk, tab, or permanent label that was placed in the primary
575.9container and all paperwork regarding the given body shall include a notation that the
575.10hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature
575.11hydrolyzed remains containers are not subject to the requirements of this subdivision.
575.12    Subd. 25. Disposition procedures; commingling of hydrolyzed remains
575.13prohibited. No hydrolyzed remains shall be disposed of or scattered in a manner or in
575.14a location where the hydrolyzed remains are commingled with those of another person
575.15without the express written permission of the person with the legal right to control
575.16disposition or as otherwise provided by law. This subdivision does not apply to the
575.17scattering or burial of hydrolyzed remains at sea or in a body of water from individual
575.18containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to
575.19the disposal in a dedicated cemetery of accumulated residue removed from an alkaline
575.20hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members
575.21of the same family in a common container designed for the hydrolyzed remains of more
575.22than one body, or to the inurnment in a container or interment in a space that has been
575.23previously designated, at the time of sale or purchase, as being intended for the inurnment
575.24or interment of the hydrolyzed remains of more than one person.
575.25    Subd. 26. Alkaline hydrolysis procedures; disposition of accumulated residue.
575.26Every alkaline hydrolysis facility shall provide for the removal and disposition in a
575.27dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel,
575.28drying device, mechanical processor, container, or other equipment used in alkaline
575.29hydrolysis. Disposition of accumulated residue shall be according to the regulations of the
575.30dedicated cemetery and any applicable local ordinances.
575.31    Subd. 27. Alkaline hydrolysis procedures; release of hydrolyzed remains.
575.32Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be
575.33released according to the instructions given on the written authorization to hydrolyze. If
575.34the hydrolyzed remains are to be shipped, they must be securely packaged and transported
575.35by a method which has an internal tracing system available and which provides for a
575.36receipt signed by the person accepting delivery. Where there is a dispute over release
576.1or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit
576.2the hydrolyzed remains with a court of competent jurisdiction pending resolution of the
576.3dispute or retain the hydrolyzed remains until the person with the legal right to control
576.4disposition presents satisfactory indication that the dispute is resolved.
576.5    Subd. 28. Unclaimed hydrolyzed remains. If, after 30 calendar days following
576.6the inurnment, the hydrolyzed remains are not claimed or disposed of according to the
576.7written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment
576.8may give written notice, by certified mail, to the person with the legal right to control
576.9the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and
576.10requesting further release directions. Should the hydrolyzed remains be unclaimed 120
576.11calendar days following the mailing of the written notification, the alkaline hydrolysis
576.12facility or funeral establishment may dispose of the hydrolyzed remains in any lawful
576.13manner deemed appropriate.
576.14    Subd. 29. Required records. Every alkaline hydrolysis facility shall create and
576.15maintain on its premises or other business location in Minnesota an accurate record of
576.16every hydrolyzation provided. The record shall include all of the following information
576.17for each hydrolyzation:
576.18(1) the name of the person or funeral establishment delivering the body for alkaline
576.19hydrolysis;
576.20(2) the name of the deceased and the identification number assigned to the body;
576.21(3) the date of acceptance of delivery;
576.22(4) the names of the alkaline hydrolysis vessel, drying device, and mechanical
576.23processor operator;
576.24(5) the time and date that the body was placed in and removed from the alkaline
576.25hydrolysis vessel;
576.26(6) the time and date that processing and inurnment of the hydrolyzed remains
576.27was completed;
576.28(7) the time, date, and manner of release of the hydrolyzed remains;
576.29(8) the name and address of the person who signed the authorization to hydrolyze;
576.30(9) all supporting documentation, including any transit or disposition permits, a
576.31photocopy of the death record, and the authorization to hydrolyze; and
576.32(10) the type of alkaline hydrolysis container.
576.33    Subd. 30. Retention of records. Records required under subdivision 29 shall be
576.34maintained for a period of three calendar years after the release of the hydrolyzed remains.
576.35Following this period and subject to any other laws requiring retention of records, the
576.36alkaline hydrolysis facility may then place the records in storage or reduce them to
577.1microfilm, microfiche, laser disc, or any other method that can produce an accurate
577.2reproduction of the original record, for retention for a period of ten calendar years from
577.3the date of release of the hydrolyzed remains. At the end of this period and subject to any
577.4other laws requiring retention of records, the alkaline hydrolysis facility may destroy
577.5the records by shredding, incineration, or any other manner that protects the privacy of
577.6the individuals identified.

577.7    Sec. 96. Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:
577.8    Subd. 9. Hydrolyzed and cremated remains. Subject to section 149A.95,
577.9subdivision 16 , inurnment of the hydrolyzed or cremated remains and release to an
577.10appropriate party is considered final disposition and no further permits or authorizations
577.11are required for disinterment, transportation, or placement of the hydrolyzed or cremated
577.12remains.

577.13    Sec. 97. Minnesota Statutes 2012, section 257.75, subdivision 7, is amended to read:
577.14    Subd. 7. Hospital and Department of Health; recognition form. Hospitals that
577.15provide obstetric services and the state registrar of vital statistics shall distribute the
577.16educational materials and recognition of parentage forms prepared by the commissioner of
577.17human services to new parents, shall assist parents in understanding the recognition of
577.18parentage form, including following the provisions for notice under subdivision 5, shall
577.19provide notary services for parents who complete the recognition of parentage form, and
577.20shall timely file the completed recognition of parentage form with the Office of the State
577.21Registrar of Vital Statistics Records unless otherwise instructed by the Office of the State
577.22Registrar of Vital Statistics Records. On and after January 1, 1994, hospitals may not
577.23distribute the declaration of parentage forms.

577.24    Sec. 98. Minnesota Statutes 2012, section 260C.635, subdivision 1, is amended to read:
577.25    Subdivision 1. Legal effect. (a) Upon adoption, the adopted child becomes the legal
577.26child of the adopting parent and the adopting parent becomes the legal parent of the child
577.27with all the rights and duties between them of a birth parent and child.
577.28(b) The child shall inherit from the adoptive parent and the adoptive parent's
577.29relatives the same as though the child were the birth child of the parent, and in case of the
577.30child's death intestate, the adoptive parent and the adoptive parent's relatives shall inherit
577.31the child's estate as if the child had been the adoptive parent's birth child.
577.32(c) After a decree of adoption is entered, the birth parents or previous legal parents
577.33of the child shall be relieved of all parental responsibilities for the child except child
578.1support that has accrued to the date of the order for guardianship to the commissioner
578.2which continues to be due and owing. The child's birth or previous legal parent shall not
578.3exercise or have any rights over the adopted child or the adopted child's property, person,
578.4privacy, or reputation.
578.5(d) The adopted child shall not owe the birth parents or the birth parent's relatives
578.6any legal duty nor shall the adopted child inherit from the birth parents or kindred unless
578.7otherwise provided for in a will of the birth parent or kindred.
578.8    (e) Upon adoption, the court shall complete a certificate of adoption form and mail
578.9the form to the Office of the State Registrar Vital Records at the Minnesota Department
578.10of Health. Upon receiving the certificate of adoption, the state registrar shall register a
578.11replacement vital record in the new name of the adopted child as required under section
578.12144.218 .

578.13    Sec. 99. Minnesota Statutes 2012, section 517.001, is amended to read:
578.14517.001 DEFINITION.
578.15As used in this chapter, "local registrar" has the meaning given in section 144.212,
578.16subdivision 10 means an individual designated by the county board of commissioners to
578.17register marriages.

578.18    Sec. 100. Laws 2011, First Special Session chapter 9, article 2, section 27, is amended
578.19to read:
578.20    Sec. 27. MINNESOTA TASK FORCE ON PREMATURITY.
578.21    Subdivision 1. Establishment. The Minnesota Task Force on Prematurity is
578.22established to evaluate and make recommendations on methods for reducing prematurity
578.23and improving premature infant health care in the state.
578.24    Subd. 2. Membership; meetings; staff. (a) The task force shall be composed of at
578.25least the following members, who serve at the pleasure of their appointing authority:
578.26(1) 15 11 representatives of the Minnesota Prematurity Coalition including, but not
578.27limited to, health care providers who treat pregnant women or neonates, organizations
578.28focused on preterm births, early childhood education and development professionals, and
578.29families affected by prematurity;
578.30(2) one representative appointed by the commissioner of human services;
578.31(3) two representatives appointed by the commissioner of health;
578.32(4) one representative appointed by the commissioner of education;
578.33(5) two members of the house of representatives, one appointed by the speaker of
578.34the house and one appointed by the minority leader; and
579.1(6) two members of the senate, appointed according to the rules of the senate.
579.2(b) Members of the task force serve without compensation or payment of expenses.
579.3(c) The commissioner of health must convene the first meeting of the Minnesota
579.4Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
579.5least quarterly. Staffing and technical assistance shall be provided by the Minnesota
579.6Perinatal Coalition.
579.7    Subd. 3. Duties. The task force must report the current state of prematurity in
579.8Minnesota and develop recommendations on strategies for reducing prematurity and
579.9improving premature infant health care in the state by considering the following:
579.10(1) promoting adherence to standards of care for premature infants born less than 37
579.11weeks gestational age, including recommendations to improve utilization of appropriate
579.12 hospital discharge and follow-up care procedures;
579.13(2) coordination of information among appropriate professional and advocacy
579.14organizations on measures to improve health care for infants born prematurely;
579.15(3) identification and centralization of available resources to improve access and
579.16awareness for caregivers of premature infants; and
579.17(4) development and dissemination of evidence-based practices through networking
579.18and educational opportunities;
579.19(5) a review of relevant evidence-based research regarding the causes and effects of
579.20premature births in Minnesota;
579.21(6) a review of relevant evidence-based research regarding premature infant health
579.22care, including methods for improving quality of and access to care for premature infants;
579.23(7) (4) a review of the potential improvements in health status related to the use of
579.24health care homes to provide and coordinate pregnancy-related services; and.
579.25(8) identification of gaps in public reporting measures and possible effects of these
579.26measures on prematurity rates.
579.27    Subd. 4. Report; expiration. (a) By November 30, 2011 January 15, 2015, the
579.28task force must submit a final report to the chairs and ranking minority members of
579.29the legislative policy committees on health and human services on the current state of
579.30prematurity in Minnesota to the chairs of the legislative policy committees on health and
579.31human services, including any recommendations to reduce premature births and improve
579.32premature infant health in the state.
579.33(b) By January 15, 2013, the task force must report its final recommendations,
579.34including any draft legislation necessary for implementation, to the chairs of the legislative
579.35policy committees on health and human services.
580.1(c) (b) This task force expires on January 31, 2013 2015, or upon submission of the
580.2final report required in paragraph (b) (a), whichever is earlier.

580.3    Sec. 101. FUNERAL ESTABLISHMENTS; BRANCH LOCATIONS.
580.4    The commissioner of health shall review the statutory requirements for preparation
580.5and embalming rooms and develop legislation with input from stakeholders that provides
580.6appropriate health and safety protection for funeral home locations where deceased bodies
580.7are present, but are branch locations associated through a majority ownership of a licensed
580.8funeral establishment that meets the requirements of Minnesota Statutes, sections 149A.50
580.9and 149A.92, subdivisions 2 to 10. The review shall include consideration of distance
580.10between the main location and branch, and other health and safety issues.

580.11    Sec. 102. HEALTH EQUITY REPORT.
580.12By February 1, 2014, the commissioner of health, in consultation with local public
580.13health, health care, and community partners, must submit a report to the chairs and ranking
580.14minority members of the committees with jurisdiction over health policy and finance, on a
580.15plan for advancing health equity in Minnesota. The report must include the following:
580.16(1) assessment of health disparities that exist in the state and how these disparities
580.17relate to health equity;
580.18(2) identification of policies, processes, and systems that contribute to health
580.19inequity in the state;
580.20(3) recommendations for changes to policies, processes and systems within the
580.21Department of Health that would increase the department's leadership in addressing health
580.22inequities;
580.23(4) identification of best practices for local public health, health care, and community
580.24partners to provide culturally responsive services and advance health equity; and
580.25(5) recommendations for strategies for the use of data to document and monitor
580.26existing health inequities and to evaluate effectiveness of policies, processes, systems,
580.27and environmental changes that will advance health equity.

580.28    Sec. 103. GUARANTEED RENEWABILITY STUDY.
580.29The commissioner of commerce, in consultation with the commissioner of health,
580.30and representatives of health carriers and consumer advocates, shall study guaranteed
580.31renewability of health plans in the individual market and assess the need for statutory
580.32provisions related to permitting the discontinuance or modification of health plan
580.33coverage in the individual market by a health carrier. The commissioner shall submit
581.1recommendations and draft legislation, if needed, to the chairs and ranking minority
581.2members of the legislative committees with jurisdiction over health insurance policy
581.3issues by February 1, 2014.

581.4    Sec. 104. CAPITAL RESERVES LIMITS STUDY.
581.5By February 1, 2014, the commissioner of health, in consultation with the
581.6commissioners of human services and commerce, shall study methodologies for
581.7determining appropriate levels for capital reserves of health maintenance organizations
581.8and requirements for reducing capital reserves to any recommended maximum levels.
581.9In conducting the study, the commissioner shall consult with health maintenance
581.10organizations, stakeholders, consumers, and other states' insurance regulators. The
581.11commissioner shall make recommendations on the need for a level of capital reserves, and
581.12framework for implementing any recommended levels. The commissioner shall submit
581.13a report to the chairs and ranking minority members of the legislative committees with
581.14jurisdiction over health and human services.

581.15    Sec. 105. STUDY AND RECOMMENDATIONS REGARDING MINNESOTA
581.16COMPREHENSIVE HEALTH ASSOCIATION.
581.17By August 15, 2013, the Department of Commerce shall study and report to the
581.18legislature on reasonable and efficient options for coverage for high-quality, medically
581.19necessary, evidence-based treatment of autism spectrum disorders up to age 18, including
581.20whether the Minnesota Comprehensive Health Association could provide coverage
581.21options through January 1, 2016, under Minnesota Statutes, chapter 62E.

581.22    Sec. 106. ESSENTIAL HEALTH BENEFITS.
581.23By December 31, 2014, the Department of Commerce shall request that the United
581.24States Department of Human Services include autism services in Minnesota's Essential
581.25Health Benefits when the next benefit set is selected in 2016. These services should
581.26include but not be limited to the services listed in Minnesota Statutes, section 62A.3094,
581.27subdivision 2, paragraph (a).

581.28    Sec. 107. ATTORNEY GENERAL LEGAL OPINION REQUIRED.
581.29Pursuant to the requirements of Minnesota Statutes, section 8.05, and no later than
581.30October 1, 2013, the attorney general shall give a written legal opinion on whether a
581.31health plan, as defined by Minnesota Statutes, section 62Q.01, subdivision 3, is required
581.32to provide coverage of treatment for mental health and mental health-related illnesses,
582.1including autism spectrum disorders and any other mental health condition as determined
582.2by criteria set forth in the most recent edition of the Diagnostic and Statistical Manual of
582.3Mental Disorders of the American Psychiatric Association. The attorney general shall
582.4provide copies of this legal opinion to the commissioners of commerce and human
582.5services, the board of directors of the Minnesota Insurance Marketplace, and the legislative
582.6chairs with jurisdiction over commerce and health policy.

582.7    Sec. 108. REVISOR'S INSTRUCTION.
582.8The revisor shall substitute the term "vertical heat exchangers" or "vertical
582.9heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat
582.10exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions
582.112 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208,
582.12subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3.

582.13    Sec. 109. REPEALER.
582.14(a) Minnesota Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 149A.025;
582.15149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45,
582.16subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a;
582.17149A.53, subdivision 9; and 485.14, are repealed.
582.18(b) Minnesota Statutes 2012, section 144.123, subdivision 2, is repealed effective
582.19July 1, 2014.

582.20ARTICLE 13

582.21PAYMENT METHODOLOGIES FOR HOME AND
582.22COMMUNITY-BASED SERVICES

582.23    Section 1. Minnesota Statutes 2012, section 252.41, subdivision 3, is amended to read:
582.24    Subd. 3. Day training and habilitation services for adults with developmental
582.25disabilities. "Day training and habilitation services for adults with developmental
582.26disabilities" means services that:
582.27(1) include supervision, training, assistance, and supported employment,
582.28work-related activities, or other community-integrated activities designed and
582.29implemented in accordance with the individual service and individual habilitation plans
582.30required under Minnesota Rules, parts 9525.0015 to 9525.0165, to help an adult reach
582.31and maintain the highest possible level of independence, productivity, and integration
582.32into the community; and
583.1(2) are provided under contract with the county where the services are delivered
583.2 by a vendor licensed under sections 245A.01 to 245A.16 and 252.28, subdivision 2, to
583.3provide day training and habilitation services.
583.4Day training and habilitation services reimbursable under this section do not include
583.5special education and related services as defined in the Education of the Individuals with
583.6Disabilities Act, United States Code, title 20, chapter 33, section 1401, clauses (6) and
583.7(17), or vocational services funded under section 110 of the Rehabilitation Act of 1973,
583.8United States Code, title 29, section 720, as amended.
583.9EFFECTIVE DATE.This section is effective January 1, 2014.

583.10    Sec. 2. Minnesota Statutes 2012, section 252.42, is amended to read:
583.11252.42 SERVICE PRINCIPLES.
583.12The design and delivery of services eligible for reimbursement under the rates
583.13established in section 252.46 should reflect the following principles:
583.14(1) services must suit a person's chronological age and be provided in the least
583.15restrictive environment possible, consistent with the needs identified in the person's
583.16individual service and individual habilitation plans under Minnesota Rules, parts
583.179525.0015 to 9525.0165;
583.18(2) a person with a developmental disability whose individual service and individual
583.19habilitation plans authorize employment or employment-related activities shall be given
583.20the opportunity to participate in employment and employment-related activities in which
583.21nondisabled persons participate;
583.22(3) a person with a developmental disability participating in work shall be paid
583.23wages commensurate with the rate for comparable work and productivity except as
583.24regional centers are governed by section 246.151;
583.25(4) a person with a developmental disability shall receive services which include
583.26services offered in settings used by the general public and designed to increase the person's
583.27active participation in ordinary community activities;
583.28(5) a person with a developmental disability shall participate in the patterns,
583.29conditions, and rhythms of everyday living and working that are consistent with the norms
583.30of the mainstream of society.
583.31EFFECTIVE DATE.This section is effective January 1, 2014.

583.32    Sec. 3. Minnesota Statutes 2012, section 252.43, is amended to read:
583.33252.43 COMMISSIONER'S DUTIES.
584.1The commissioner shall supervise county boards' provision of day training and
584.2habilitation services to adults with developmental disabilities. The commissioner shall:
584.3(1) determine the need for day training and habilitation services under section 252.28;
584.4(2) approve establish payment rates established by a county under section 252.46,
584.5subdivision 1 as provided under section 256B.4914;
584.6(3) adopt rules for the administration and provision of day training and habilitation
584.7services under sections 252.40 252.41 to 252.46 and sections 245A.01 to 245A.16 and
584.8252.28, subdivision 2 ;
584.9(4) enter into interagency agreements necessary to ensure effective coordination and
584.10provision of day training and habilitation services;
584.11(5) monitor and evaluate the costs and effectiveness of day training and habilitation
584.12services; and
584.13(6) provide information and technical help to county boards and vendors in their
584.14administration and provision of day training and habilitation services.
584.15EFFECTIVE DATE.This section is effective January 1, 2014.

584.16    Sec. 4. Minnesota Statutes 2012, section 252.44, is amended to read:
584.17252.44 COUNTY BOARD RESPONSIBILITIES.
584.18(a) When the need for day training and habilitation services in a county has been
584.19determined under section 252.28, the board of commissioners for that county shall:
584.20(1) authorize the delivery of services according to the individual service and
584.21habilitation plans required as part of the county's provision of case management services
584.22under Minnesota Rules, parts 9525.0015 to 9525.0165. For calendar years for which
584.23section 252.46, subdivisions 2 to 10, apply, the county board shall not authorize a change
584.24in service days from the number of days authorized for the previous calendar year unless
584.25there is documentation for the change in the individual service plan. An increase in service
584.26days must also be supported by documentation that the goals and objectives assigned to the
584.27vendor cannot be met more economically and effectively by other available community
584.28services and that without the additional days of service the individual service plan could
584.29not be implemented in a manner consistent with the service principles in section 252.42;
584.30(2) contract with licensed vendors, as specified in paragraph (b), under sections
584.31256E.12 and 256B.092 and rules adopted under those sections;
584.32(3) (2) ensure that transportation is provided or arranged by the vendor in the most
584.33efficient and reasonable way possible; and
584.34(4) set payment rates under section 252.46;
585.1(5) (3) monitor and evaluate the cost and effectiveness of the services; and.
585.2(6) reimburse vendors for the provision of authorized services according to the rates,
585.3procedures, and regulations governing reimbursement.
585.4(b) With all vendors except regional centers, the contract must include the approved
585.5payment rates, the projected budget for the contract period, and any actual expenditures
585.6of previous and current contract periods. With all vendors, including regional centers,
585.7the contract must also include the amount, availability, and components of day training
585.8and habilitation services to be provided, the performance standards governing service
585.9provision and evaluation, and the time period in which the contract is effective.
585.10EFFECTIVE DATE.This section is effective January 1, 2014.

585.11    Sec. 5. Minnesota Statutes 2012, section 252.45, is amended to read:
585.12252.45 VENDOR'S DUTIES.
585.13A vendor's responsibility vendor enrolled with the commissioner is responsible for
585.14items under clauses (1), (2), and (3), and extends only to the provision of services that are
585.15reimbursable under state and federal law. A vendor under contract with a county board to
585.16provide providing day training and habilitation services shall:
585.17(1) provide the amount and type of services authorized in the individual service plan
585.18under Minnesota Rules, parts 9525.0015 to 9525.0165;
585.19(2) design the services to achieve the outcomes assigned to the vendor in the
585.20individual service plan;
585.21(3) provide or arrange for transportation of persons receiving services to and from
585.22service sites;
585.23(4) enter into agreements with community-based intermediate care facilities for
585.24persons with developmental disabilities to ensure compliance with applicable federal
585.25regulations; and
585.26(5) comply with state and federal law.
585.27EFFECTIVE DATE.This section is effective January 1, 2014.

585.28    Sec. 6. Minnesota Statutes 2012, section 252.46, subdivision 1a, is amended to read:
585.29    Subd. 1a. Day training and habilitation rates. The commissioner shall establish
585.30a statewide rate-setting methodology for all day training and habilitation services as
585.31provided under section 256B.4914. The rate-setting methodology must abide by the
585.32principles of transparency and equitability across the state. The methodology must involve
586.1a uniform process of structuring rates for each service and must promote quality and
586.2participant choice.
586.3EFFECTIVE DATE.This section is effective January 1, 2014.

586.4    Sec. 7. Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to read:
586.5    Subd. 2. Payment methodologies. (a) The commissioner shall establish, as defined
586.6under section 256B.4914, statewide payment methodologies that meet federal waiver
586.7requirements for home and community-based waiver services for individuals with
586.8disabilities. The payment methodologies must abide by the principles of transparency
586.9and equitability across the state. The methodologies must involve a uniform process of
586.10structuring rates for each service and must promote quality and participant choice.
586.11    (b) As of January 1, 2012, counties shall not implement changes to established
586.12processes for rate-setting methodologies for individuals using components of or data
586.13from research rates.

586.14    Sec. 8. Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:
586.15    Subd. 3. Payment requirements. The payment methodologies established under
586.16this section shall accommodate:
586.17(1) supervision costs;
586.18(2) staffing patterns staff compensation;
586.19(3) staffing and supervisory patterns;
586.20(3) (4) program-related expenses;
586.21(4) (5) general and administrative expenses; and
586.22(5) (6) consideration of recipient intensity.

586.23    Sec. 9. Minnesota Statutes 2012, section 256B.4913, is amended by adding a
586.24subdivision to read:
586.25    Subd. 4a. Rate stabilization adjustment. (a) For purposes of this subdivision,
586.26"implementation period" shall mean the period beginning January 1, 2014, and ending
586.27on the last day of the month in which the rate management system is populated with the
586.28data necessary to calculate rates for substantially all individuals receiving home and
586.29community-based services.
586.30(b) For purposes of this subdivision, the banding value for all service recipients
586.31shall mean the individual reimbursement rate for a recipient in effect on December 1,
586.322013, except that:
587.1(1)(i) for day training and habilitation pilot program service recipients, the banding
587.2value shall be the authorized rate for the provider in the county of service effective
587.3December 1, 2013, if the recipient: was not authorized to receive these waiver services
587.4prior to January 1, 2014; added a new service or services on or after January 1, 2014; or
587.5changed providers on or after January 1, 2014; and
587.6(ii) for all other unit or day service recipients, the banding value shall be the
587.7weighted average authorized rate for each provider number in the county of service
587.8effective December 1, 2013, if the recipient: was not authorized to receive these waiver
587.9services prior to January 1, 2014; added a new service or services on or after January 1,
587.102014; or changed providers on or after January 1, 2014; and
587.11(2) for residential service recipients who change providers on or after January 1,
587.122014, the banding value shall be set by each lead agency within their county aggregate
587.13budget using their respective methodology for residential services effective December 1,
587.142013, for determining the provider rate for a similarly situated recipient being served by
587.15that provider.
587.16(c) The commissioner shall adjust individual reimbursement rates determined under
587.17this section so that the unit rate is no higher or lower than:
587.18(1) 0.5 percent from the banding value for the implementation period;
587.19(2) 0.5 percent from the rate in effect in clause (1), for the 12-month period
587.20immediately following the time period of clause (1);
587.21(3) 1.0 percent from the rate in effect in clause (2), for the 12-month period
587.22immediately following the time period of clause (2);
587.23(4) 1.0 percent from the rate in effect in clause (3), for the 12-month period
587.24immediately following the time period of clause (3); and
587.25(5) 1.0 percent from the rate in effect in clause (4), for the 12-month period
587.26immediately following the time period of clause (4).
587.27(d) This subdivision shall not apply to rates for recipients served by providers new
587.28to a given county after January 1, 2014.

587.29    Sec. 10. Minnesota Statutes 2012, section 256B.4913, subdivision 5, is amended to read:
587.30    Subd. 5. Stakeholder consultation. The commissioner shall continue consultation
587.31on regular intervals with the existing stakeholder group established as part of the
587.32rate-setting methodology process and others, to gather input, concerns, and data, and
587.33exchange ideas for the legislative proposals for to assist in the full implementation of
587.34 the new rate payment system and to make pertinent information available to the public
587.35through the department's Web site.

588.1    Sec. 11. Minnesota Statutes 2012, section 256B.4913, subdivision 6, is amended to read:
588.2    Subd. 6. Implementation. (a) The commissioner may shall implement changes
588.3no sooner than on January 1, 2014, to payment rates for individuals receiving home and
588.4community-based waivered services after the enactment of legislation that establishes
588.5specific payment methodology frameworks, processes for rate calculations, and specific
588.6values to populate the payment methodology frameworks disability waiver rates system.
588.7(b) On January 1, 2014, all new service authorizations must use the disability waiver
588.8rates system. Beginning January 1, 2014, all renewing individual service plans must use the
588.9disability waiver rates system as reassessment and reauthorization occurs. By December
588.1031, 2014, data for all recipients must be entered into the disability waiver rates system.

588.11    Sec. 12. [256B.4914] HOME AND COMMUNITY-BASED SERVICES
588.12WAIVERS; RATE SETTING.
588.13    Subdivision 1. Application. The payment methodologies in this section apply to
588.14home and community-based services waivers under sections 256B.092 and 256B.49. This
588.15section does not change existing waiver policies and procedures.
588.16    Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
588.17meanings given them, unless the context clearly indicates otherwise.
588.18(b) "Commissioner" means the commissioner of human services.
588.19(c) "Component value" means underlying factors that are part of the cost of providing
588.20services that are built into the waiver rates methodology to calculate service rates.
588.21(d) "Customized living tool" means a methodology for setting service rates that
588.22delineates and documents the amount of each component service included in a recipient's
588.23customized living service plan.
588.24(e) "Disability waiver rates system" means a statewide system that establishes rates
588.25that are based on uniform processes and captures the individualized nature of waiver
588.26services and recipient needs.
588.27(f) "Lead agency" means a county, partnership of counties, or tribal agency charged
588.28with administering waivered services under sections 256B.092 and 256B.49.
588.29(g) "Median" means the amount that divides distribution into two equal groups,
588.30one-half above the median and one-half below the median.
588.31(h) "Payment or rate" means reimbursement to an eligible provider for services
588.32provided to a qualified individual based on an approved service authorization.
588.33(i) "Rates management system" means a Web-based software application that uses
588.34a framework and component values, as determined by the commissioner, to establish
588.35service rates.
589.1(j) "Recipient" means a person receiving home and community-based services
589.2funded under any of the disability waivers.
589.3    Subd. 3. Applicable services. Applicable services are those authorized under
589.4the state's home and community-based services waivers under sections 256B.092 and
589.5256B.49, including the following, as defined in the federally approved home and
589.6community-based services plan:
589.7(1) 24 hour customized living;
589.8(2) adult day care;
589.9(3) adult day care bath;
589.10(4) behavioral programming;
589.11(5) companion services;
589.12(6) customized living;
589.13(7) day training and habilitation;
589.14(8) housing access coordination;
589.15(9) independent living skills;
589.16(10) in-home family support;
589.17(11) night supervision;
589.18(12) personal support;
589.19(13) prevocational services;
589.20(14) residential care services;
589.21(15) residential support services;
589.22(16) respite services;
589.23(17) structured day services;
589.24(18) supported employment services;
589.25(19) supported living services;
589.26(20) transportation services; and
589.27(21) other services as approved by the federal government in the state home and
589.28community-based services plan.
589.29    Subd. 4. Data collection for rate determination. (a) Rates for applicable home
589.30and community-based waivered services, including rate exceptions under subdivision 12,
589.31are set by the rates management system.
589.32(b) Data for services under section 256B.4913, subdivision 4a, shall be collected in a
589.33manner prescribed by the commissioner.
589.34(c) Data and information in the rates management system may be used to calculate
589.35an individual's rate.
590.1(d) Service providers, with information from the community support plan and
590.2oversight by lead agencies, shall provide values and information needed to calculate an
590.3individual's rate into the rates management system. These values and information include:
590.4(1) shared staffing hours;
590.5(2) individual staffing hours;
590.6(3) direct RN hours;
590.7(4) direct LPN hours;
590.8(5) staffing ratios;
590.9(6) information to document variable levels of service qualification for variable
590.10levels of reimbursement in each framework;
590.11(7) shared or individualized arrangements for unit-based services, including the
590.12staffing ratio;
590.13(8) number of trips and miles for transportation services; and
590.14(9) service hours provided through monitoring technology.
590.15(e) Updates to individual data shall include:
590.16(1) data for each individual that is updated annually when renewing service plans; and
590.17(2) requests by individuals or lead agencies to update a rate whenever there is a
590.18change in an individual's service needs, with accompanying documentation.
590.19(f) Lead agencies shall review and approve values to calculate the final payment rate
590.20for each individual. Lead agencies must notify the individual and the service provider
590.21of the final agreed-upon values and rate. If a value used was mistakenly or erroneously
590.22entered and used to calculate a rate, a provider may petition lead agencies to correct it.
590.23Lead agencies must respond to these requests.
590.24    Subd. 5. Base wage index and standard component values. (a) The base wage
590.25index is established to determine staffing costs associated with providing services to
590.26individuals receiving home and community-based services. For purposes of developing
590.27and calculating the proposed base wage, Minnesota-specific wages taken from job
590.28descriptions and standard occupational classification (SOC) codes from the Bureau of
590.29Labor Statistics as defined in the most recent edition of the Occupational Handbook shall
590.30be used. The base wage index shall be calculated as follows:
590.31(1) for residential direct care staff, the sum of:
590.32(i) 15 percent of the subtotal of 50 percent of the median wage for personal and
590.33home health aide (SOC code 39-9021); 30 percent of the median wage for nursing aide
590.34(SOC code 31-1012); and 20 percent of the median wage for social and human services
590.35aide (SOC code 21-1093); and
591.1(ii) 85 percent of the subtotal of 20 percent of the median wage for home health aide
591.2(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
591.3(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012);
591.420 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20
591.5percent of the median wage for social and human services aide (SOC code 21-1093);
591.6(2) for day services, 20 percent of the median wage for nursing aide (SOC code
591.731-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
591.8and 60 percent of the median wage for social and human services aide (SOC code 21-1093);
591.9(3) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in
591.10a family foster care setting, the wage is $2.80 per hour;
591.11(4) for behavior program analyst staff, 100 percent of the median wage for mental
591.12health counselors (SOC code 21-1014);
591.13(5) for behavior program professional staff, 100 percent of the median wage for
591.14clinical counseling and school psychologist (SOC code 19-3031);
591.15(6) for behavior program specialist staff, 100 percent of the median wage for
591.16psychiatric technicians (SOC code 29-2053);
591.17(7) for supportive living services staff, 20 percent of the median wage for nursing
591.18aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
591.19code 29-2053); and 60 percent of the median wage for social and human services aide
591.20(SOC code 21-1093);
591.21(8) for housing access coordination staff, 50 percent of the median wage for
591.22community and social services specialist (SOC code 21-1099); and 50 percent of the
591.23median wage for social and human services aide (SOC code 21-1093);
591.24(9) for in-home family support staff, 20 percent of the median wage for nursing
591.25aide (SOC code 31-1012); 30 percent of the median wage for community social service
591.26specialist (SOC code 21-1099); 40 percent of the median wage for social and human
591.27services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
591.28technician (SOC code 29-2053);
591.29(10) for independent living skills staff, 40 percent of the median wage for community
591.30social service specialist (SOC code 21-1099); 50 percent of the median wage for social
591.31and human services aide (SOC code 21-1093); and ten percent of the median wage for
591.32psychiatric technician (SOC code 29-2053);
591.33(11) for supported employment staff, 20 percent of the median wage for nursing aide
591.34(SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
591.35code 29-2053); and 60 percent of the median wage for social and human services aide
591.36(SOC code 21-1093);
592.1(12) for adult companion staff, 50 percent of the median wage for personal and home
592.2care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
592.3orderlies, and attendants (SOC code 31-1012);
592.4(13) for night supervision staff, 20 percent of the median wage for home health aide
592.5(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
592.6(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012);
592.720 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20
592.8percent of the median wage for social and human services aide (SOC code 21-1093);
592.9(14) for respite staff, 50 percent of the median wage for personal and home care aide
592.10(SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, and
592.11attendants (SOC code 31-1012);
592.12(15) for personal support staff, 50 percent of the median wage for personal and home
592.13care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
592.14orderlies, and attendants (SOC code 31-1012);
592.15(16) for supervisory staff, the basic wage is $17.43 per hour with exception of the
592.16supervisor of behavior analyst and behavior specialists, which shall be $30.75 per hour;
592.17(17) for RN, the basic wage is $30.82 per hour; and
592.18(18) for LPN, the basic wage is $18.64 per hour.
592.19(b) Component values for residential support services are:
592.20(1) supervisory span of control ratio: 11 percent;
592.21(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
592.22(3) employee-related cost ratio: 23.6 percent;
592.23(4) general administrative support ratio: 13.25 percent;
592.24(5) program-related expense ratio: 1.3 percent; and
592.25(6) absence and utilization factor ratio: 3.9 percent.
592.26(c) Component values for family foster care are:
592.27(1) supervisory span of control ratio: 11 percent;
592.28(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
592.29(3) employee-related cost ratio: 23.6 percent;
592.30(4) general administrative support ratio: 3.3 percent;
592.31(5) program-related expense ratio: 1.3 percent; and
592.32(6) absence factor: 1.7 percent.
592.33(d) Component values for day services for all services are:
592.34(1) supervisory span of control ratio: 11 percent;
592.35(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
592.36(3) employee-related cost ratio: 23.6 percent;
593.1(4) program plan support ratio: 5.6 percent;
593.2(5) client programming and support ratio: ten percent;
593.3(6) general administrative support ratio: 13.25 percent;
593.4(7) program-related expense ratio: 1.8 percent; and
593.5(8) absence and utilization factor ratio: 3.9 percent.
593.6(e) Component values for unit-based services with programming are:
593.7(1) supervisory span of control ratio: 11 percent;
593.8(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
593.9(3) employee-related cost ratio: 23.6 percent;
593.10(4) program plan supports ratio: 3.1 percent;
593.11(5) client programming and supports ratio: 8.6 percent;
593.12(6) general administrative support ratio: 13.25 percent;
593.13(7) program-related expense ratio: 6.1 percent; and
593.14(8) absence and utilization factor ratio: 3.9 percent.
593.15(f) Component values for unit-based services without programming except respite
593.16are:
593.17(1) supervisory span of control ratio: 11 percent;
593.18(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
593.19(3) employee-related cost ratio: 23.6 percent;
593.20(4) program plan support ratio: 3.1 percent;
593.21(5) client programming and support ratio: 8.6 percent;
593.22(6) general administrative support ratio: 13.25 percent;
593.23(7) program-related expense ratio: 6.1 percent; and
593.24(8) absence and utilization factor ratio: 3.9 percent.
593.25(g) Component values for unit-based services without programming for respite are:
593.26(1) supervisory span of control ratio: 11 percent;
593.27(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
593.28(3) employee-related cost ratio: 23.6 percent;
593.29(4) general administrative support ratio: 13.25 percent;
593.30(5) program-related expense ratio: 6.1 percent; and
593.31(6) absence and utilization factor ratio: 3.9 percent.
593.32(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
593.33(b) based on the wage data by standard occupational code (SOC) from the Bureau of
593.34Labor Statistics available on December 31, 2016. The commissioner shall publish these
593.35updated values and load them into the rate management system. This adjustment occurs
594.1every five years. For adjustments in 2021 and beyond, the commissioner shall use the data
594.2available on December 31 of the calendar year five years prior.
594.3(i) On July 1, 2017, the commissioner shall update the framework components in
594.4paragraph (c) for changes in the Consumer Price Index. The commissioner will adjust
594.5these values higher or lower by the percentage change in the Consumer Price Index-All
594.6Items, United States city average (CPI-U) from January 1, 2014, to January 1, 2017. The
594.7commissioner shall publish these updated values and load them into the rate management
594.8system. This adjustment occurs every five years. For adjustments in 2021 and beyond, the
594.9commissioner shall use the data available on January 1 of the calendar year four years
594.10prior and January 1 of the current calendar year.
594.11    Subd. 6. Payments for residential support services. (a) Payments for residential
594.12support services, as defined in sections 256B.092, subdivision 11, and 256B.49,
594.13subdivision 22, must be calculated as follows:
594.14(1) determine the number of shared and individual direct staff hours to meet a
594.15recipient's needs provided on-site or through monitoring technology;
594.16(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
594.17Minnesota-specific rates or rates derived by the commissioner as provided in subdivision
594.185. This is defined as the direct-care rate;
594.19(3) for a recipient requiring customization for deaf and hard-of-hearing language
594.20accessibility under subdivision 12, add the customization rate provided in subdivision 12
594.21to the result of clause (2). This is defined as the customized direct-care rate;
594.22(4) multiply the number of shared and individual direct staff hours provided on-site
594.23or through monitoring technology and direct nursing hours by the appropriate staff wages
594.24in subdivision 5, paragraph (a), or the customized direct-care rate;
594.25(5) multiply the number of shared and individual direct staff hours provided
594.26on-site or through monitoring technology and direct nursing hours by the product of
594.27the supervision span of control ratio in subdivision 5, paragraph (b), clause (1), and the
594.28appropriate supervision wage in subdivision 5, paragraph (a), clause (16);
594.29(6) combine the results of clauses (4) and (5), excluding any shared and individual
594.30direct staff hours provided through monitoring technology, and multiply the result by one
594.31plus the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph
594.32(b), clause (2). This is defined as the direct staffing cost;
594.33(7) for employee-related expenses, multiply the direct staffing cost, excluding any
594.34shared and individual direct staff hours provided through monitoring technology, by one
594.35plus the employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
594.36(8) for client programming and supports, the commissioner shall add $2,179; and
595.1(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
595.2customized for adapted transport, per year.
595.3(b) The total rate shall be calculated using the following steps:
595.4(1) subtotal paragraph (a), clauses (7) to (9), and the direct staffing cost of any
595.5shared and individual direct staff hours provided through monitoring technology that
595.6was excluded in clause (7);
595.7(2) sum the standard general and administrative rate, the program-related expense
595.8ratio, and the absence and utilization ratio;
595.9(3) divide the result of clause (1) by one minus the result of clause (2). This is
595.10the total payment amount; and
595.11(4) adjust the result of clause (3) by a factor to be determined by the commissioner
595.12to adjust for regional differences in the cost of providing services.
595.13(c) The payment methodology for customized living, 24-hour customized living, and
595.14residential care services shall be the customized living tool. Revisions to the customized
595.15living tool shall be made to reflect the services and activities unique to disability-related
595.16recipient needs.
595.17(d) The commissioner shall establish a Monitoring Technology Review Panel to
595.18annually review and approve the plans, safeguards, and rates that include residential
595.19direct care provided remotely through monitoring technology. Lead agencies shall submit
595.20individual service plans that include supervision using monitoring technology to the
595.21Monitoring Technology Review Panel for approval. Individual service plans that include
595.22supervision using monitoring technology as of December 31, 2013, shall be submitted to
595.23the Monitoring Technology Review Panel, but the plans are not subject to approval.
595.24    Subd. 7. Payments for day programs. Payments for services with day programs
595.25including adult day care, day treatment and habilitation, prevocational services, and
595.26structured day services must be calculated as follows:
595.27(1) determine the number of units of service to meet a recipient's needs;
595.28(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
595.29Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
595.30(3) for a recipient requiring customization for deaf and hard-of-hearing language
595.31accessibility under subdivision 12, add the customization rate provided in subdivision 12
595.32to the result of clause (2). This is defined as the customized direct-care rate;
595.33(4) multiply the number of day program direct staff hours and direct nursing hours
595.34by the appropriate staff wage in subdivision 5, paragraph (a), or the customized direct-care
595.35rate;
596.1(5) multiply the number of day direct staff hours by the product of the supervision
596.2span of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate
596.3supervision wage in subdivision 5, paragraph (a), clause (16);
596.4(6) combine the results of clauses (4) and (5), and multiply the result by one plus
596.5the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d),
596.6clause (2). This is defined as the direct staffing rate;
596.7(7) for program plan support, multiply the result of clause (6) by one plus the
596.8program plan support ratio in subdivision 5, paragraph (d), clause (4);
596.9(8) for employee-related expenses, multiply the result of clause (7) by one plus the
596.10employee-related cost ratio in subdivision 5, paragraph (d), clause (3);
596.11(9) for client programming and supports, multiply the result of clause (8) by one plus
596.12the client programming and support ratio in subdivision 5, paragraph (d), clause (5);
596.13(10) for program facility costs, add $19.30 per week with consideration of staffing
596.14ratios to meet individual needs;
596.15(11) for adult day bath services, add $7.01 per 15 minute unit;
596.16(12) this is the subtotal rate;
596.17(13) sum the standard general and administrative rate, the program-related expense
596.18ratio, and the absence and utilization factor ratio;
596.19(14) divide the result of clause (12) by one minus the result of clause (13). This is
596.20the total payment amount;
596.21(15) adjust the result of clause (14) by a factor to be determined by the commissioner
596.22to adjust for regional differences in the cost of providing services;
596.23(16) for transportation provided as part of day training and habilitation for an
596.24individual who does not require a lift, add:
596.25(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle
596.26without a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared
596.27ride in a vehicle with a lift;
596.28(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle
596.29without a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared
596.30ride in a vehicle with a lift;
596.31(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle
596.32without a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared
596.33ride in a vehicle with a lift; or
596.34(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a
596.35lift, $16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a
596.36vehicle with a lift;
597.1(17) for transportation provide as part of day training and habilitation for an
597.2individual who does require a lift, add:
597.3(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with
597.4a lift, and $15.05 for a shared ride in a vehicle with a lift;
597.5(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a
597.6lift, and $28.16 for a shared ride in a vehicle with a lift;
597.7(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with
597.8a lift, and $58.76 for a shared ride in a vehicle with a lift; or
597.9(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a
597.10lift, and $80.93 for a shared ride in a vehicle with a lift.
597.11    Subd. 8. Payments for unit-based services with programming. Payments for
597.12unit-based with program services, including behavior programming, housing access
597.13coordination, in-home family support, independent living skills training, hourly supported
597.14living services, and supported employment provided to an individual outside of any day or
597.15residential service plan must be calculated as follows, unless the services are authorized
597.16separately under subdivision 6 or 7:
597.17(1) determine the number of units of service to meet a recipient's needs;
597.18(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
597.19Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
597.20(3) for a recipient requiring customization for deaf and hard-of-hearing language
597.21accessibility under subdivision 12, add the customization rate provided in subdivision 12
597.22to the result of clause (2). This is defined as the customized direct-care rate;
597.23(4) multiply the number of direct staff hours by the appropriate staff wage in
597.24subdivision 5, paragraph (a), or the customized direct care rate;
597.25(5) multiply the number of direct staff hours by the product of the supervision span
597.26of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
597.27wage in subdivision 5, paragraph (a), clause (16);
597.28(6) combine the results of clauses (4) and (5), and multiply the result by one plus
597.29the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e),
597.30clause (2). This is defined as the direct staffing rate;
597.31(7) for program plan support, multiply the result of clause (6) by one plus the
597.32program plan supports ratio in subdivision 5, paragraph (e), clause (4);
597.33(8) for employee-related expenses, multiply the result of clause (7) by one plus the
597.34employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
597.35(9) for client programming and supports, multiply the result of clause (8) by one plus
597.36the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
598.1(10) this is the subtotal rate;
598.2(11) sum the standard general and administrative rate, the program-related expense
598.3ratio, and the absence and utilization factor ratio;
598.4(12) divide the result of clause (10) by one minus the result of clause (11). This is
598.5the total payment amount;
598.6(13) for supported employment provided in a shared manner, divide the total
598.7payment amount in clause (12) by the number of service recipients, not to exceed three.
598.8For independent living skills training provided in a shared manner, divide the total
598.9payment amount in clause (12) by the number of service recipients, not to exceed two; and
598.10(14) adjust the result of clause (13) by a factor to be determined by the commissioner
598.11to adjust for regional differences in the cost of providing services.
598.12    Subd. 9. Payments for unit-based services without programming. Payments
598.13for unit-based without program services, including night supervision, personal support,
598.14respite, and companion care provided to an individual outside of any day or residential
598.15service plan must be calculated as follows unless the services are authorized separately
598.16under subdivision 6 or 7:
598.17(1) for all services except respite, determine the number of units of service to meet
598.18a recipient's needs;
598.19(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
598.20Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
598.21(3) for a recipient requiring customization for deaf and hard-of-hearing language
598.22accessibility under subdivision 12, add the customization rate provided in subdivision 12
598.23to the result of clause (2). This is defined as the customized direct care rate;
598.24(4) multiply the number of direct staff hours by the appropriate staff wage in
598.25subdivision 5 or the customized direct care rate;
598.26(5) multiply the number of direct staff hours by the product of the supervision span
598.27of control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision
598.28wage in subdivision 5, paragraph (a), clause (16);
598.29(6) combine the results of clauses (4) and (5), and multiply the result by one plus
598.30the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (f),
598.31clause (2). This is defined as the direct staffing rate;
598.32(7) for program plan support, multiply the result of clause (6) by one plus the
598.33program plan support ratio in subdivision 5, paragraph (f), clause (4);
598.34(8) for employee-related expenses, multiply the result of clause (7) by one plus the
598.35employee-related cost ratio in subdivision 5, paragraph (f), clause (3);
599.1(9) for client programming and supports, multiply the result of clause (8) by one plus
599.2the client programming and support ratio in subdivision 5, paragraph (f), clause (5);
599.3(10) this is the subtotal rate;
599.4(11) sum the standard general and administrative rate, the program-related expense
599.5ratio, and the absence and utilization factor ratio;
599.6(12) divide the result of clause (10) by one minus the result of clause (11). This is
599.7the total payment amount;
599.8(13) for respite services, determine the number of daily units of service to meet an
599.9individual's needs;
599.10(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
599.11Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
599.12(15) for a recipient requiring deaf and hard-of-hearing customization under
599.13subdivision 12, add the customization rate provided in subdivision 12 to the result of
599.14clause (14). This is defined as the customized direct care rate;
599.15(16) multiply the number of direct staff hours by the appropriate staff wage in
599.16subdivision 5, paragraph (a);
599.17(17) multiply the number of direct staff hours by the product of the supervisory span
599.18of control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision
599.19wage in subdivision 5, paragraph (a), clause (16);
599.20(18) combine the results of clauses (16) and (17), and multiply the result by one plus
599.21the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g),
599.22clause (2). This is defined as the direct staffing rate;
599.23(19) for employee-related expenses, multiply the result of clause (18) by one plus
599.24the employee-related cost ratio in subdivision 5, paragraph (g), clause (3).
599.25(20) this is the subtotal rate;
599.26(21) sum the standard general and administrative rate, the program-related expense
599.27ratio, and the absence and utilization factor ratio;
599.28(22) divide the result of clause (20) by one minus the result of clause (21). This is
599.29the total payment amount; and
599.30(23) adjust the result of clauses (12) and (22) by a factor to be determined by the
599.31commissioner to adjust for regional differences in the cost of providing services.
599.32    Subd. 10. Updating payment values and additional information. (a) From
599.33January 1, 2014, through December 31, 2017, the commissioner shall develop and
599.34implement uniform procedures to refine terms and adjust values used to calculate payment
599.35rates in this section.
600.1(b) The commissioner shall, within available resources, conduct research and
600.2gather data and information from existing state systems or other outside sources on the
600.3following items:
600.4(1) differences in the underlying cost to provide services and care across the state; and
600.5(2) mileage and utilization of transportation for all day and unit-based services.
600.6(c) Using a statistically valid set of rates management system data, the commissioner,
600.7in consultation with stakeholders, shall analyze for each service the average difference in
600.8the rate on December 31, 2013, and the framework rate at the individual, provider, lead
600.9agency, and state levels.
600.10(d) The commissioner, in consultation with stakeholders, shall review and evaluate
600.11the following values already in subdivisions 6 to 9, or issues that impact all services,
600.12including, but not limited to:
600.13(1) values for transportation rates for day services;
600.14(2) values for transportation rates in residential services;
600.15(3) values for services where monitoring technology replaces staff time;
600.16(4) values for indirect services;
600.17(5) values for nursing;
600.18(6) component values for independent living skills;
600.19(7) component values for family foster care that reflect licensing requirements;
600.20(8) adjustments to other components to replace the budget neutrality factor;
600.21(9) remote monitoring technology for nonresidential services;
600.22(10) values for basic and intensive services in residential services;
600.23(11) values for the facility use rate in day services;
600.24(12) values for workers compensation as part of employee-related expenses;
600.25(13) values for unemployment insurance as part of employee-related expenses;
600.26(14) a component value to reflect costs for individuals with rates previously adjusted
600.27for the inclusion of group residential housing rate 3 costs, only for any individual enrolled
600.28as of December 31, 2013; and
600.29(15) any changes in state or federal law with an impact on the underlying cost of
600.30providing home and community-based services.
600.31(e) The commissioner shall report to the chairs and the ranking minority members of
600.32the legislative committees and divisions with jurisdiction over health and human services
600.33policy and finance with the information and data gathered under paragraphs (b) to (d)
600.34on the following dates:
600.35(1) January 15, 2015, with preliminary results and data;
601.1(2) January 15, 2016, with a status implementation update, and additional data
601.2and summary information;
601.3(3) January 15, 2017, with the full report; and
601.4(4) January 15, 2019, with another full report, and a full report once every four
601.5years thereafter.
601.6(f) Based on the commissioner's evaluation of the information and data collected in
601.7paragraphs (b) to (d), the commissioner may make recommendations to the legislature
601.8to address any potential issues.
601.9(g) The commissioner shall implement a regional adjustment factor to all rate
601.10calculations in subdivisions 6 to 9, effective no later than January 1, 2015. Prior to
601.11implementation, the commissioner shall consult with stakeholders on the methodology to
601.12calculate the adjustment.
601.13(h) The commissioner shall provide a public notice via LISTSERV in October of
601.14each year beginning October 1, 2014, containing information detailing legislatively
601.15approved changes in:
601.16(1) calculation values including derived wage rates and related employee and
601.17administrative factors;
601.18(2) service utilization;
601.19(3) county and tribal allocation changes; and
601.20(4) information on adjustments made to calculation values and the timing of those
601.21adjustments.
601.22The information in this notice shall be effective January 1 of the following year.
601.23    Subd. 11. Payment implementation. Upon implementation of the payment
601.24methodologies under this section, those payment rates supersede rates established in county
601.25contracts for recipients receiving waiver services under section 256B.092 or 256B.49.
601.26    Subd. 12. Customization of rates for individuals. (a) For persons determined to
601.27have higher needs based on being deaf or hard-of-hearing, the direct-care costs must be
601.28increased by an adjustment factor prior to calculating the rate under subdivisions 6, 7, 8,
601.29and 9. The customization rate with respect to deaf or hard-of-hearing persons shall be
601.30$2.50 per hour for waiver recipients who meet the respective criteria as determined by
601.31the commissioner.
601.32(b) For the purposes of this section, "deaf and hard-of-hearing" means:
601.33(1) the person has a developmental disability and an assessment score which
601.34indicates a hearing impairment that is severe or that the person has no useful hearing;
601.35(2) the person has a developmental disability and an expressive communications
601.36score that indicates the person uses single signs or gestures, uses an augmentative
602.1communication aid, or does not have functional communication, or the person's expressive
602.2communications is unknown; and
602.3(3) the person has a developmental disability and a communication score which
602.4indicates the person comprehends signs, gestures and modeling prompts or does not
602.5comprehend verbal, visual or gestural communication or that the person's receptive
602.6communication score is unknown; or
602.7(4) the person receives long-term care services and has an assessment score that
602.8indicates they hear only very loud sounds, have no useful hearing, or a determination
602.9cannot be made; and the person receives long-term care services and has an assessment
602.10that indicates the person communicates needs with sign language, symbol board, written
602.11messages, gestures or an interpreter; communicates with inappropriate content, makes
602.12garbled sounds or displays echolalia, or does not communicate needs.
602.13    Subd. 13. Transportation. The commissioner shall require that the purchase
602.14of transportation services be cost-effective and be limited to market rates where the
602.15transportation mode is generally available and accessible.
602.16    Subd. 14. Exceptions. (a) In a format prescribed by the commissioner, lead
602.17agencies must identify individuals with exceptional needs that cannot be met under the
602.18disability waiver rate system. The commissioner shall use that information to evaluate
602.19and, if necessary, approve an alternative payment rate for those individuals.
602.20(b) Lead agencies must submit exception requests to the state.
602.21(c) An application for a rate exception may be submitted for the following criteria:
602.22(1) an individual has service needs that cannot be met through additional units
602.23of service; or
602.24(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 results in an
602.25individual being discharged.
602.26(d) Exception requests must include the following information:
602.27(1) the service needs required by each individual that are not accounted for in
602.28subdivisions 6, 7, 8, and 9;
602.29(2) the service rate requested and the difference from the rate determined in
602.30subdivisions 6, 7, 8, and 9;
602.31(3) a basis for the underlying costs used for the rate exception and any accompanying
602.32documentation;
602.33(4) the duration of the rate exception; and
602.34(5) any contingencies for approval.
602.35(e) Approved rate exceptions shall be managed within lead agency allocations under
602.36sections 256B.092 and 256B.49.
603.1(f) Individual disability waiver recipients may request that a lead agency submit an
603.2exception request. A lead agency that denies such a request shall notify the individual
603.3waiver recipient of its decision and the reasons for denying the request in writing no later
603.4than 30 days after the individual's request has been made.
603.5(g) The commissioner shall determine whether to approve or deny an exception
603.6request no more than 30 days after receiving the request. If the commissioner denies the
603.7request, the commissioner shall notify the lead agency and the individual disability waiver
603.8recipient in writing of the reasons for the denial.
603.9(h) The individual disability waiver recipient may appeal any denial of an exception
603.10request by either the lead agency or the commissioner, pursuant to sections 256.045 and
603.11256.0451. When the denial of an exception request results in the proposed demission of a
603.12waiver recipient from a residential or day habilitation program, the commissioner shall
603.13issue a temporary stay of demission, when requested by the disability waiver recipient,
603.14consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c).
603.15The temporary stay shall remain in effect until the lead agency can provide an informed
603.16choice of appropriate, alternative services to the disability waiver.
603.17(i) Providers may petition lead agencies to update values that were entered
603.18incorrectly or erroneously into the rate management system, based on past service level
603.19discussions and determination in subdivision 4, without applying for a rate exception.
603.20    Subd. 15. County or tribal allocations. (a) Upon implementation of the disability
603.21waiver rates management system on January 1, 2014, the commissioner shall establish
603.22a method of tracking and reporting the fiscal impact of the disability waiver rates
603.23management system on individual lead agencies.
603.24(b) Beginning January 1, 2014, the commissioner shall make annual adjustments to
603.25lead agencies' home and community-based waivered service budget allocations to adjust
603.26for rate differences and the resulting impact on county allocations upon implementation of
603.27the disability waiver rates system.
603.28    Subd. 16. Budget neutrality adjustments. (a) The commissioner shall use the
603.29following adjustments to the rate generated by the framework to assure budget neutrality
603.30until the rate information is available to implement paragraph (b). The rate generated by
603.31the framework shall be multiplied by the appropriate factor, as designated below:
603.32(1) for residential services: 1.003;
603.33(2) for day services: 1.000;
603.34(3) for unit-based services with programming: 0.941; and
603.35(4) for unit-based services without programming: 0.796.
604.1(b) Within 12 months of January 1, 2014, the commissioner shall compare estimated
604.2spending for all home and community-based waiver services under the new payment rates
604.3defined in subdivisions 6 to 9 with estimated spending for the same recipients and services
604.4under the rates in effect on July 1, 2013. This comparison must distinguish spending under
604.5each of subdivisions 6, 7, 8, and 9. The comparison must be based on actual recipients
604.6and services for one or more service months after the new rates have gone into effect.
604.7The commissioner shall consult with the commissioner of management and budget on
604.8this analysis to ensure budget neutrality. If estimated spending under the new rates for
604.9services under one or more subdivisions differs in this comparison by 0.3 percent or
604.10more, the commissioner shall assure aggregate budget neutrality across all service areas
604.11by adjusting the budget neutrality factor in paragraph (a) in each subdivision so that total
604.12estimated spending for each subdivision under the new rates matches estimated spending
604.13under the rates in effect on July 1, 2013.

604.14    Sec. 13. FEDERAL APPROVAL.
604.15During the transition to a new disability waivers payment methodology system, the
604.16commissioner of human services has the authority to manage the disability home and
604.17community-based service waiver programs within federally required parameters. The
604.18commissioner may negotiate an agreement with the Centers for Medicare and Medicaid
604.19Services for the implementation of the disability waivers payment methodology system
604.20in order to prevent federal action that would withhold or disallow federal funding for
604.21current waiver recipients, or new waiver recipients as authorized by the legislature. The
604.22commissioner must provide for public notice and comment, as required by state and
604.23federal law, to changes related to federal approval of the disability waivers payment
604.24methodology system. If the Centers for Medicare and Medicaid Services requires
604.25changes to the disability waivers payment rate methodology implementation plan, the
604.26commissioner shall implement the changes in accordance with Minnesota Statutes, section
604.27256B.4914, subdivision 16, and upon:
604.28(1) public notice;
604.29(2) federal approval;
604.30(3) Legislative Advisory Commission review and recommendation, in a manner
604.31described under Minnesota Statutes, section 3.3005, subdivision 4; and
604.32(4) recommendation of necessary legislation to the chairs and ranking minority
604.33members of the legislative committees with jurisdiction over health and human services
604.34policy and finance by January 15, 2014. The changed implementation plan must provide
604.35for a transition from the historical to the new rate setting methodology.

605.1    Sec. 14. REPEALER.
605.2(a) Minnesota Statutes 2012, sections 252.40; 252.46, subdivisions 1, 2, 3, 4, 5, 6,
605.37, 8, 9, 10, 11, 16, 17, 18, 19, 20, and 21; 256B.4913, subdivisions 1, 2, 3, and 4; and
605.4256B.501, subdivision 8, are repealed effective January 1, 2014.
605.5(b) Minnesota Rules, part 9525.1860, subparts 3, items B and C and 4, item D, are
605.6repealed effective January 1, 2014.

605.7ARTICLE 14

605.8HEALTH AND HUMAN SERVICES APPROPRIATIONS

605.9

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

605.10The sums shown in the columns marked "Appropriations" are appropriated to the
605.11agencies and for the purposes specified in this article. The appropriations are from the
605.12general fund, or another named fund, and are available for the fiscal years indicated
605.13for each purpose. The figures "2014" and "2015" used in this article mean that the
605.14appropriations listed under them are available for the fiscal year ending June 30, 2014, or
605.15June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
605.16year 2015. "The biennium" is fiscal years 2014 and 2015.

605.17				APPROPRIATIONS
605.18				Available for the Year
605.19				Ending June 30
605.20					2014		2015

605.21 605.22

Sec. 2. COMMISSIONER OF HUMAN SERVICES

605.23

Subdivision 1.Total Appropriation

$

6,438,485,000

$

6,457,117,000

605.24	Appropriations by Fund
605.25		2014	2015
605.26	General	5,654,765,000	5,677,458,000
605.27 605.28	State Government Special Revenue	4,099,000	4,510,000
605.29	Health Care Access	519,816,000	518,446,000
605.30	Federal TANF	257,915,000	254,813,000
605.31	Lottery Prize Fund	1,890,000	1,890,000

605.32Receipts for Systems Projects.
605.33Appropriations and federal receipts for
605.34information systems projects for MAXIS,
605.35PRISM, MMIS, and SSIS must be deposited
605.36in the state system account authorized
606.1in Minnesota Statutes, section 256.014.
606.2Money appropriated for computer projects
606.3approved by the commissioner of Minnesota
606.4information technology services, funded
606.5by the legislature, and approved by the
606.6commissioner of management and budget,
606.7may be transferred from one project to
606.8another and from development to operations
606.9as the commissioner of human services
606.10considers necessary. Any unexpended
606.11balance in the appropriation for these
606.12projects does not cancel but is available for
606.13ongoing development and operations.
606.14Nonfederal Share Transfers. The
606.15nonfederal share of activities for which
606.16federal administrative reimbursement is
606.17appropriated to the commissioner may be
606.18transferred to the special revenue fund.
606.19ARRA Supplemental Nutrition Assistance
606.20Benefit Increases. The funds provided for
606.21food support benefit increases under the
606.22Supplemental Nutrition Assistance Program
606.23provisions of the American Recovery and
606.24Reinvestment Act (ARRA) of 2009 must be
606.25used for benefit increases beginning July 1,
606.262009.
606.27Supplemental Nutrition Assistance
606.28Program Employment and Training.
606.29(1) Notwithstanding Minnesota Statutes,
606.30sections 256D.051, subdivisions 1a, 6b,
606.31and 6c, and 256J.626, federal Supplemental
606.32Nutrition Assistance employment and
606.33training funds received as reimbursement of
606.34MFIP consolidated fund grant expenditures
606.35for diversionary work program participants
607.1and child care assistance program
607.2expenditures must be deposited in the general
607.3fund. The amount of funds must be limited to
607.4$4,900,000 per year in fiscal years 2014 and
607.52015, and to $4,400,000 per year in fiscal
607.6years 2016 and 2017, contingent on approval
607.7by the federal Food and Nutrition Service.
607.8(2) Consistent with the receipt of the federal
607.9funds, the commissioner may adjust the
607.10level of working family credit expenditures
607.11claimed as TANF maintenance of effort.
607.12Notwithstanding any contrary provision in
607.13this article, this rider expires June 30, 2017.
607.14TANF Maintenance of Effort. (a) In order
607.15to meet the basic maintenance of effort
607.16(MOE) requirements of the TANF block grant
607.17specified under Code of Federal Regulations,
607.18title 45, section 263.1, the commissioner may
607.19only report nonfederal money expended for
607.20allowable activities listed in the following
607.21clauses as TANF/MOE expenditures:
607.22(1) MFIP cash, diversionary work program,
607.23and food assistance benefits under Minnesota
607.24Statutes, chapter 256J;
607.25(2) the child care assistance programs
607.26under Minnesota Statutes, sections 119B.03
607.27and 119B.05, and county child care
607.28administrative costs under Minnesota
607.29Statutes, section 119B.15;
607.30(3) state and county MFIP administrative
607.31costs under Minnesota Statutes, chapters
607.32256J and 256K;
608.1(4) state, county, and tribal MFIP
608.2employment services under Minnesota
608.3Statutes, chapters 256J and 256K;
608.4(5) expenditures made on behalf of legal
608.5noncitizen MFIP recipients who qualify for
608.6the MinnesotaCare program under Minnesota
608.7Statutes, chapter 256L;
608.8(6) qualifying working family credit
608.9expenditures under Minnesota Statutes,
608.10section 290.0671;
608.11(7) qualifying Minnesota education credit
608.12expenditures under Minnesota Statutes,
608.13section 290.0674; and
608.14(8) qualifying Head Start expenditures under
608.15Minnesota Statutes, section 119A.50.
608.16(b) The commissioner shall ensure that
608.17sufficient qualified nonfederal expenditures
608.18are made each year to meet the state's
608.19TANF/MOE requirements. For the activities
608.20listed in paragraph (a), clauses (2) to
608.21(8), the commissioner may only report
608.22expenditures that are excluded from the
608.23definition of assistance under Code of
608.24Federal Regulations, title 45, section 260.31.
608.25(c) For fiscal years beginning with state fiscal
608.26year 2003, the commissioner shall ensure
608.27that the maintenance of effort used by the
608.28commissioner of management and budget
608.29for the February and November forecasts
608.30required under Minnesota Statutes, section
608.3116A.103, contains expenditures under
608.32paragraph (a), clause (1), equal to at least 16
608.33percent of the total required under Code of
608.34Federal Regulations, title 45, section 263.1.
609.1(d) The requirement in Minnesota Statutes,
609.2section 256.011, subdivision 3, that federal
609.3grants or aids secured or obtained under that
609.4subdivision be used to reduce any direct
609.5appropriations provided by law, do not apply
609.6if the grants or aids are federal TANF funds.
609.7(e) For the federal fiscal years beginning on
609.8or after October 1, 2007, the commissioner
609.9may not claim an amount of TANF/MOE in
609.10excess of the 75 percent standard in Code
609.11of Federal Regulations, title 45, section
609.12263.1(a)(2), except:
609.13(1) to the extent necessary to meet the 80
609.14percent standard under Code of Federal
609.15Regulations, title 45, section 263.1(a)(1),
609.16if it is determined by the commissioner
609.17that the state will not meet the TANF work
609.18participation target rate for the current year;
609.19(2) to provide any additional amounts
609.20under Code of Federal Regulations, title 45,
609.21section 264.5, that relate to replacement of
609.22TANF funds due to the operation of TANF
609.23penalties; and
609.24(3) to provide any additional amounts that
609.25may contribute to avoiding or reducing
609.26TANF work participation penalties through
609.27the operation of the excess MOE provisions
609.28of Code of Federal Regulations, title 45,
609.29section 261.43(a)(2).
609.30For the purposes of clauses (1) to (3),
609.31the commissioner may supplement the
609.32MOE claim with working family credit
609.33expenditures or other qualified expenditures
609.34to the extent such expenditures are otherwise
609.35available after considering the expenditures
610.1allowed in this subdivision and subdivisions
610.22 and 3.
610.3(f) Notwithstanding any contrary provision
610.4in this article, paragraphs (a) to (e) expire
610.5June 30, 2017.
610.6Working Family Credit Expenditures
610.7as TANF/MOE. The commissioner may
610.8claim as TANF maintenance of effort up to
610.9$6,707,000 per year of working family credit
610.10expenditures in each fiscal year.

610.11 610.12

Subd. 2.Working Family Credit to be Claimed for TANF/MOE

610.13The commissioner may count the following
610.14amounts of working family credit
610.15expenditures as TANF/MOE:
610.16(1) fiscal year 2014, $50,272,000;
610.17(2) fiscal year 2015, $34,894,000;
610.18(3) fiscal year 2016, $0; and
610.19(4) fiscal year 2017, $1,283,000.

610.20 610.21

Subd. 3.TANF Transfer to Federal Child Care and Development Fund

610.22(a) The following TANF fund amounts
610.23are appropriated to the commissioner for
610.24purposes of MFIP/transition year child care
610.25assistance under Minnesota Statutes, section
610.26119B.05:
610.27(1) fiscal year 2014; $14,020,000; and
610.28(2) fiscal year 2015, $14,020,000.
610.29(b) The commissioner shall authorize the
610.30transfer of sufficient TANF funds to the
610.31federal child care and development fund to
610.32meet this appropriation and shall ensure that
610.33all transferred funds are expended according
611.1to federal child care and development fund
611.2regulations.

611.3

Subd. 4.Central Office

611.4The amounts that may be spent from this
611.5appropriation for each purpose are as follows:

611.6

(a) Operations

611.7	Appropriations by Fund
611.8	General	101,979,000	96,858,000
611.9 611.10	State Government Special Revenue	3,974,000	4,385,000
611.11	Health Care Access	13,177,000	13,004,000
611.12	Federal TANF	100,000	100,000

611.13DHS Receipt Center Accounting. The
611.14commissioner is authorized to transfer
611.15appropriations to, and account for DHS
611.16receipt center operations in, the special
611.17revenue fund.
611.18Administrative Recovery; Set-Aside. The
611.19commissioner may invoice local entities
611.20through the SWIFT accounting system as an
611.21alternative means to recover the actual cost
611.22of administering the following provisions:
611.23(1) Minnesota Statutes, section 125A.744,
611.24subdivision 3;
611.25(2) Minnesota Statutes, section 245.495,
611.26paragraph (b);
611.27(3) Minnesota Statutes, section 256B.0625,
611.28subdivision 20, paragraph (k);
611.29(4) Minnesota Statutes, section 256B.0924,
611.30subdivision 6, paragraph (g);
611.31(5) Minnesota Statutes, section 256B.0945,
611.32subdivision 4, paragraph (d); and
612.1(6) Minnesota Statutes, section 256F.10,
612.2subdivision 6, paragraph (b).
612.3Systems Modernization. The following
612.4amounts are appropriated for transfer to
612.5the state systems account authorized in
612.6Minnesota Statutes, section 256.014:
612.7(1) $1,825,000 in fiscal year 2014 and
612.8$2,502,000 in fiscal year 2015 is for the
612.9state share of Medicaid-allocated costs of
612.10the health insurance exchange information
612.11technology and operational structure. The
612.12funding base is $3,222,000 in fiscal year 2016
612.13and $3,037,000 in fiscal year 2017 but shall
612.14not be included in the base thereafter; and
612.15(2) $9,344,000 in fiscal year 2014 and
612.16$3,660,000 in fiscal year 2015 are for the
612.17modernization and streamlining of agency
612.18eligibility and child support systems. The
612.19funding base is $5,921,000 in fiscal year
612.202016 and $1,792,000 in fiscal year 2017 but
612.21shall not be included in the base thereafter.
612.22The unexpended balance of the $9,344,000
612.23appropriation in fiscal year 2014 and the
612.24$3,660,000 appropriation in fiscal year 2015
612.25must be transferred from the Department of
612.26Human Services state systems account to
612.27the Office of Enterprise Technology when
612.28the Office of Enterprise Technology has
612.29negotiated a federally approved internal
612.30service fund rates and billing process with
612.31sufficient internal accounting controls to
612.32properly maximize federal reimbursement
612.33to Minnesota for human services system
612.34modernization projects, but not later than
612.35June 30, 2015.
613.1If contingent funding is fully or partially
613.2disbursed under article 15, section 3, and
613.3transferred to the state systems account, the
613.4unexpended balance of that appropriation
613.5must be transferred to the Office of Enterprise
613.6Technology in accordance with this clause.
613.7Contingent funding must not exceed
613.8$11,598,000 for the biennium.
613.9Base Adjustment. The general fund base
613.10is increased by $2,868,000 in fiscal year
613.112016 and decreased by $1,206,000 in fiscal
613.12year 2017. The health access fund base is
613.13decreased by $551,000 in fiscal years 2016
613.14and 2017. The state government special
613.15revenue fund base is increased by $4,000 in
613.16fiscal year 2016 and decreased by $236,000
613.17in fiscal year 2017.

613.18

(b) Children and Families

613.19	Appropriations by Fund
613.20	General	8,023,000	8,015,000
613.21	Federal TANF	2,282,000	2,282,000

613.22Financial Institution Data Match and
613.23Payment of Fees. The commissioner is
613.24authorized to allocate up to $310,000 each
613.25year in fiscal years 2014 and 2015 from the
613.26PRISM special revenue account to make
613.27payments to financial institutions in exchange
613.28for performing data matches between account
613.29information held by financial institutions
613.30and the public authority's database of child
613.31support obligors as authorized by Minnesota
613.32Statutes, section 13B.06, subdivision 7.
613.33Base Adjustment. The general fund base is
613.34decreased by $300,000 in fiscal years 2016
614.1and 2017. The TANF fund base is increased
614.2by $300,000 in fiscal years 2016 and 2017.

614.3

(c) Health Care

614.4	Appropriations by Fund
614.5	General	14,028,000	13,826,000
614.6	Health Care Access	28,442,000	31,137,000

614.7Base Adjustment. The general fund base
614.8is decreased by $86,000 in fiscal year 2016
614.9and by $86,000 in fiscal year 2017. The
614.10health care access fund base is increased
614.11by $6,954,000 in fiscal year 2016 and by
614.12$5,489,000 in fiscal year 2017.

614.13

(d) Continuing Care

614.14	Appropriations by Fund
614.15	General	20,993,000	22,359,000
614.16 614.17	State Government Special Revenue	125,000	125,000

614.18Base Adjustment. The general fund base is
614.19increased by $1,690,000 in fiscal year 2016
614.20and by $798,000 in fiscal year 2017.

614.21

(e) Chemical and Mental Health

614.22	Appropriations by Fund
614.23	General	4,639,000	4,490,000
614.24	Lottery Prize Fund	157,000	157,000

614.25

Subd. 5.Forecasted Programs

614.26The amounts that may be spent from this
614.27appropriation for each purpose are as follows:

614.28

(a) MFIP/DWP

614.29	Appropriations by Fund
614.30	General	72,583,000	76,927,000
614.31	Federal TANF	80,342,000	76,851,000

614.32

(b) MFIP Child Care Assistance

61,701,000

69,294,000

614.33

(c) General Assistance

54,787,000

56,068,000

615.1General Assistance Standard. The
615.2commissioner shall set the monthly standard
615.3of assistance for general assistance units
615.4consisting of an adult recipient who is
615.5childless and unmarried or living apart
615.6from parents or a legal guardian at $203.
615.7The commissioner may reduce this amount
615.8according to Laws 1997, chapter 85, article
615.93, section 54.
615.10Emergency General Assistance. The
615.11amount appropriated for emergency general
615.12assistance funds is limited to no more
615.13than $6,729,812 in fiscal year 2014 and
615.14$6,729,812 in fiscal year 2015. Funds
615.15to counties shall be allocated by the
615.16commissioner using the allocation method in
615.17Minnesota Statutes, section 256D.06.

615.18

(d) MN Supplemental Assistance

38,646,000

39,821,000

615.19

(e) Group Residential Housing

141,138,000

150,988,000

615.20

(f) MinnesotaCare

297,707,000

247,284,000

615.21This appropriation is from the health care
615.22access fund.

615.23

(g) Medical Assistance

615.24	Appropriations by Fund
615.25	General	4,443,768,000	4,431,612,000
615.26	Health Care Access	179,550,000	226,081,000

615.27Spending to be apportioned. The
615.28commissioner shall apportion expenditures
615.29under this paragraph consistent with the
615.30requirements of section 12.
615.31Support Services for Deaf and
615.32Hard-of-Hearing. $121,000 in fiscal
615.33year 2014 and $141,000 in fiscal year 2015;
615.34and $10,000 in fiscal year 2014 and $13,000
616.1in fiscal year 2015 are from the health care
616.2access fund for the hospital reimbursement
616.3increase in Minnesota Statutes, section
616.4256.969, subdivision 29, paragraph (b).
616.5Disproportionate Share Payments.
616.6 Effective for services provided on or after
616.7July 1, 2011, through June 30, 2015, the
616.8commissioner of human services shall
616.9deposit, in the health care access fund,
616.10additional federal matching funds received
616.11under Minnesota Statutes, section 256B.199,
616.12paragraph (e), as disproportionate share
616.13hospital payments for inpatient hospital
616.14services provided under MinnesotaCare to
616.15lawfully present noncitizens who are not
616.16eligible for MinnesotaCare with federal
616.17financial participation due to immigration
616.18status. The amount deposited shall not exceed
616.19$2,200,000 for the time period specified.
616.20Funding for Services Provided to EMA
616.21Recipients. $2,200,000 in fiscal year 2014 is
616.22from the health care access fund to provide
616.23services to emergency medical assistance
616.24recipients under Minnesota Statutes, section
616.25256B.06, subdivision 4, paragraph (l). This
616.26is a onetime appropriation and is available in
616.27either year of the biennium.

616.28

(h) Alternative Care

50,776,000

54,922,000

616.29Alternative Care Transfer. Any money
616.30allocated to the alternative care program that
616.31is not spent for the purposes indicated does
616.32not cancel but shall be transferred to the
616.33medical assistance account.

616.34

(i) CD Treatment Fund

81,440,000

74,875,000

617.1Balance Transfer. The commissioner must
617.2transfer $18,188,000 from the consolidated
617.3chemical dependency treatment fund to the
617.4general fund by September 30, 2013.

617.5

Subd. 6.Grant Programs

617.6The amounts that may be spent from this
617.7appropriation for each purpose are as follows:

617.8

(a) Support Services Grants

617.9	Appropriations by Fund
617.10	General	8,915,000	13,333,000
617.11	Federal TANF	94,611,000	94,611,000

617.12Paid Work Experience. $2,168,000
617.13each year in fiscal years 2015 and 2016
617.14is from the general fund for paid work
617.15experience for long-term MFIP recipients.
617.16Paid work includes full and partial wage
617.17subsidies and other related services such as
617.18job development, marketing, preworksite
617.19training, job coaching, and postplacement
617.20services. These are onetime appropriations.
617.21Unexpended funds for fiscal year 2015 do not
617.22cancel, but are available to the commissioner
617.23for this purpose in fiscal year 2016.
617.24Work Study Funding for MFIP
617.25Participants. $250,000 each year in fiscal
617.26years 2015 and 2016 is from the general fund
617.27to pilot work study jobs for MFIP recipients
617.28in approved postsecondary education
617.29programs. This is a onetime appropriation.
617.30Unexpended funds for fiscal year 2015 do
617.31not cancel, but are available for this purpose
617.32in fiscal year 2016.
617.33Local Strategies to Reduce Disparities.
617.34 $2,000,000 each year in fiscal years 2015
618.1and 2016 is from the general fund for
618.2local projects that focus on services for
618.3subgroups within the MFIP caseload
618.4who are experiencing poor employment
618.5outcomes. These are onetime appropriations.
618.6Unexpended funds for fiscal year 2015 do not
618.7cancel, but are available to the commissioner
618.8for this purpose in fiscal year 2016.
618.9Home Visiting Collaborations for MFIP
618.10Teen Parents. $200,000 per year in fiscal
618.11years 2014 and 2015 is from the general fund
618.12and $200,000 in fiscal year 2016 is from the
618.13federal TANF fund for technical assistance
618.14and training to support local collaborations
618.15that provide home visiting services for
618.16MFIP teen parents. The general fund
618.17appropriation is onetime. The federal TANF
618.18fund appropriation is added to the base.
618.19Performance Bonus Funds for Counties.
618.20 The TANF fund base is increased by
618.21$1,500,000 each year in fiscal years 2016
618.22and 2017. The commissioner must allocate
618.23this amount each year to counties that exceed
618.24their expected range of performance on the
618.25annualized three-year self-support index
618.26as defined in Minnesota Statutes, section
618.27256J.751, subdivision 2, clause (6). This is a
618.28permanent base adjustment. Notwithstanding
618.29any contrary provisions in this article, this
618.30provision expires June 30, 2016.
618.31Base Adjustment. The general fund base is
618.32decreased by $200,000 in fiscal year 2016
618.33and $4,618,000 in fiscal year 2017. The
618.34TANF fund base is increased by $1,700,000
618.35in fiscal years 2016 and 2017.

619.1 619.2

(b) Basic Sliding Fee Child Care Assistance Grants

36,836,000

42,318,000

619.3Base Adjustment. The general fund base is
619.4increased by $3,778,000 in fiscal year 2016
619.5and by $3,849,000 in fiscal year 2017.

619.6

(c) Child Care Development Grants

1,612,000

1,737,000

619.7

(d) Child Support Enforcement Grants

50,000

50,000

619.8Federal Child Support Demonstration
619.9Grants. Federal administrative
619.10reimbursement resulting from the federal
619.11child support grant expenditures authorized
619.12under United States Code, title 42, section
619.131315, is appropriated to the commissioner
619.14for this activity.

619.15

(e) Children's Services Grants

619.16	Appropriations by Fund
619.17	General	49,760,000	52,961,000
619.18	Federal TANF	140,000	140,000

619.19Adoption Assistance and Relative Custody
619.20Assistance. $37,453,000 in fiscal year 2014
619.21and $37,453,000 in fiscal year 2015 is for
619.22the adoption assistance and relative custody
619.23assistance programs. The commissioner
619.24shall determine with the commissioner of
619.25Minnesota Management and Budget the
619.26appropriation for Northstar Care for Children
619.27effective January 1, 2015. The commissioner
619.28may transfer appropriations for adoption
619.29assistance, relative custody assistance, and
619.30Northstar Care for Children between fiscal
619.31years and among programs to adjust for
619.32transfers across the programs.
619.33Title IV-E Adoption Assistance. Additional
619.34federal reimbursements to the state as a result
620.1of the Fostering Connections to Success
620.2and Increasing Adoptions Act's expanded
620.3eligibility for Title IV-E adoption assistance
620.4are appropriated for postadoption services,
620.5including a parent-to-parent support network.
620.6Privatized Adoption Grants. Federal
620.7reimbursement for privatized adoption grant
620.8and foster care recruitment grant expenditures
620.9is appropriated to the commissioner for
620.10adoption grants and foster care and adoption
620.11administrative purposes.
620.12Adoption Assistance Incentive Grants.
620.13 Federal funds available during fiscal years
620.142014 and 2015 for adoption incentive grants
620.15are appropriated for postadoption services,
620.16including a parent-to-parent support network.
620.17Base Adjustment. The general fund base is
620.18increased by $5,913,000 in fiscal year 2016
620.19and by $10,297,000 in fiscal year 2017.

620.20

(f) Child and Community Service Grants

53,301,000

53,301,000

620.21

(g) Child and Economic Support Grants

21,047,000

20,848,000

620.22Minnesota Food Assistance Program.
620.23Unexpended funds for the Minnesota food
620.24assistance program for fiscal year 2014 do
620.25not cancel but are available for this purpose
620.26in fiscal year 2015.
620.27Transitional Housing. $250,000 each year
620.28is for the transitional housing programs under
620.29Minnesota Statutes, section 256E.33.
620.30Emergency Services. $250,000 each year
620.31is for emergency services grants under
620.32Minnesota Statutes, section 256E.36.
621.1Family Assets for Independence. $250,000
621.2each year is for the Family Assets for
621.3Independence Minnesota program. This
621.4appropriation is available in either year of the
621.5biennium and may be transferred between
621.6fiscal years.
621.7Food Shelf Programs. $375,000 in fiscal
621.8year 2014 and $375,000 in fiscal year
621.92015 are for food shelf programs under
621.10Minnesota Statutes, section 256E.34. If the
621.11appropriation for either year is insufficient,
621.12the appropriation for the other year is
621.13available for it. Notwithstanding Minnesota
621.14Statutes, section 256E.34, subdivision 4, no
621.15portion of this appropriation may be used
621.16by Hunger Solutions for its administrative
621.17expenses, including but not limited to rent
621.18and salaries.
621.19Homeless Youth Act. $2,000,000 in fiscal
621.20year 2014 and $2,000,000 in fiscal year 2015
621.21is for purposes of Minnesota Statutes, section
621.22256K.45.
621.23Safe Harbor Shelter and Housing.
621.24$500,000 in fiscal year 2014 and $500,000 in
621.25fiscal year 2015 is for a safe harbor shelter
621.26and housing fund for housing and supportive
621.27services for youth who are sexually exploited.

621.28

(h) Health Care Grants

621.29	Appropriations by Fund
621.30	General	190,000	190,000
621.31	Health Care Access	190,000	190,000

621.32Emergency Medical Assistance Referral
621.33and Assistance Grants. (a) The
621.34commissioner of human services shall
621.35award grants to nonprofit programs that
622.1provide immigration legal services based
622.2on indigency to provide legal services for
622.3immigration assistance to individuals with
622.4emergency medical conditions or complex
622.5and chronic health conditions who are not
622.6currently eligible for medical assistance
622.7or other public health care programs, but
622.8who may meet eligibility requirements with
622.9immigration assistance.
622.10(b) The grantees, in collaboration with
622.11hospitals and safety net providers, shall
622.12provide referral assistance to connect
622.13individuals identified in paragraph (a) with
622.14alternative resources and services to assist in
622.15meeting their health care needs. $100,000
622.16is appropriated in fiscal year 2014 and
622.17$100,000 in fiscal year 2015. This is a
622.18onetime appropriation.
622.19Base Adjustment. The general fund is
622.20decreased by $100,000 in fiscal year 2016
622.21and $100,000 in fiscal year 2017.

622.22

(i) Aging and Adult Services Grants

14,827,000

15,010,000

622.23Base Adjustment. The general fund is
622.24increased by $1,150,000 in fiscal year 2016
622.25and $1,151,000 in fiscal year 2017.
622.26Community Service Development
622.27Grants and Community Services Grants.
622.28 Community service development grants and
622.29community services grants are reduced by
622.30$1,150,000 each year. This is a onetime
622.31reduction.

622.32

(j) Deaf and Hard-of-Hearing Grants

1,771,000

1,785,000

622.33

(k) Disabilities Grants

18,605,000

18,823,000

623.1Advocating Change Together. $310,000 in
623.2fiscal year 2014 is for a grant to Advocating
623.3Change Together (ACT) to maintain and
623.4promote services for persons with intellectual
623.5and developmental disabilities throughout
623.6the state. This appropriation is onetime. Of
623.7this appropriation:
623.8(1) $120,000 is for direct costs associated
623.9with the delivery and evaluation of
623.10peer-to-peer training programs administered
623.11throughout the state, focusing on education,
623.12employment, housing, transportation, and
623.13voting;
623.14(2) $100,000 is for delivery of statewide
623.15conferences focusing on leadership and
623.16skill development within the disability
623.17community; and
623.18(3) $90,000 is for administrative and general
623.19operating costs associated with managing
623.20or maintaining facilities, program delivery,
623.21staff, and technology.
623.22Base Adjustment. The general fund base
623.23is increased by $535,000 in fiscal year 2016
623.24and by $709,000 in fiscal year 2017.

623.25

(l) Adult Mental Health Grants

623.26	Appropriations by Fund
623.27	General	71,199,000	69,530,000
623.28	Health Care Access	750,000	750,000
623.29	Lottery Prize	1,733,000	1,733,000

623.30Problem Gambling. $225,000 in fiscal year
623.312014 and $225,000 in fiscal year 2015 is
623.32appropriated from the lottery prize fund for a
623.33grant to the state affiliate recognized by the
623.34National Council on Problem Gambling. The
624.1affiliate must provide services to increase
624.2public awareness of problem gambling,
624.3education and training for individuals and
624.4organizations providing effective treatment
624.5services to problem gamblers and their
624.6families, and research relating to problem
624.7gambling.
624.8Funding Usage. Up to 75 percent of a fiscal
624.9year's appropriations for adult mental health
624.10grants may be used to fund allocations in that
624.11portion of the fiscal year ending December
624.1231.
624.13Base Adjustment. The general fund base is
624.14decreased by $4,427,000 in fiscal years 2016
624.15and 2017.
624.16Mental Health Pilot Project. $230,000
624.17each year is for a grant to the Zumbro
624.18Valley Mental Health Center. The grant
624.19shall be used to implement a pilot project
624.20to test an integrated behavioral health care
624.21coordination model. The grant recipient must
624.22report measurable outcomes and savings
624.23to the commissioner of human services
624.24by January 15, 2016. This is a onetime
624.25appropriation.
624.26High-risk adults. $200,000 in fiscal
624.27year 2014 is for a grant to the nonprofit
624.28organization selected to administer the
624.29demonstration project for high-risk adults
624.30under Laws 2007, chapter 54, article 1,
624.31section 19, in order to complete the project.
624.32This is a onetime appropriation.

624.33

(m) Child Mental Health Grants

18,246,000

20,636,000

625.1Text Message Suicide Prevention
625.2Program. $625,000 in fiscal year 2014 and
625.3$625,000 in fiscal year 2015 is for a grant
625.4to a nonprofit organization to establish and
625.5implement a statewide text message suicide
625.6prevention program. The program shall
625.7implement a suicide prevention counseling
625.8text line designed to use text messaging to
625.9connect with crisis counselors and to obtain
625.10emergency information and referrals to
625.11local resources in the local community. The
625.12program shall include training within schools
625.13and communities to encourage the use of the
625.14program.
625.15Mental Health First Aid Training. $22,000
625.16in fiscal year 2014 and $23,000 in fiscal
625.17year 2015 is to train teachers, social service
625.18personnel, law enforcement, and others who
625.19come into contact with children with mental
625.20illnesses, in children and adolescents mental
625.21health first aid training.
625.22Funding Usage. Up to 75 percent of a fiscal
625.23year's appropriation for child mental health
625.24grants may be used to fund allocations in that
625.25portion of the fiscal year ending December
625.2631.

625.27

(n) CD Treatment Support Grants

1,816,000

1,816,000

625.28SBIRT Training. (1) $300,000 each year is
625.29for grants to train primary care clinicians to
625.30provide substance abuse brief intervention
625.31and referral to treatment (SBIRT). This is a
625.32onetime appropriation. The commissioner of
625.33human services shall apply to SAMHSA for
625.34an SBIRT professional training grant.
626.1(2) If the commissioner of human services
626.2receives a grant under clause (1) funds
626.3appropriated under this clause, equal to
626.4the grant amount, up to the available
626.5appropriation, shall be transferred to the
626.6Minnesota Organization on Fetal Alcohol
626.7Syndrome (MOFAS). MOFAS must use
626.8the funds for grants. Grant recipients must
626.9be selected from communities that are
626.10not currently served by federal Substance
626.11Abuse Prevention and Treatment Block
626.12Grant funds. Grant money must be used to
626.13reduce the rates of fetal alcohol syndrome
626.14and fetal alcohol effects, and the number of
626.15drug-exposed infants. Grant money may be
626.16used for prevention and intervention services
626.17and programs, including, but not limited to,
626.18community grants, professional eduction,
626.19public awareness, and diagnosis.
626.20Fetal Alcohol Syndrome Grant. $180,000
626.21each year from the general fund is for a
626.22grant to the Minnesota Organization on Fetal
626.23Alcohol Syndrome (MOFAS) to support
626.24nonprofit Fetal Alcohol Spectrum Disorders
626.25(FASD) outreach prevention programs
626.26in Olmsted County. This is a onetime
626.27appropriation.
626.28Base Adjustment. The general fund base is
626.29decreased by $480,000 in fiscal year 2016
626.30and $480,000 in fiscal year 2017.

626.31

Subd. 7.State-Operated Services

626.32Transfer Authority Related to
626.33State-Operated Services. Money
626.34appropriated for state-operated services
626.35may be transferred between fiscal years
627.1of the biennium with the approval of the
627.2commissioner of management and budget.
627.3The amounts that may be spent from the
627.4appropriation for each purpose are as follows:

627.5

(a) SOS Mental Health

115,738,000

115,738,000

627.6Dedicated Receipts Available. Of the
627.7revenue received under Minnesota Statutes,
627.8section 246.18, subdivision 8, paragraph
627.9(a), $1,000,000 each year is available for
627.10the purposes of paragraph (b), clause (1),
627.11of that subdivision, $1,000,000 each year
627.12is available to transfer to the adult mental
627.13health budget activity for the purposes of
627.14paragraph (b), clause (2), of that subdivision,
627.15and up to $2,713,000 each year is available
627.16for the purposes of paragraph (b), clause (3),
627.17of that subdivision.

627.18

(b) SOS MN Security Hospital

69,582,000

69,582,000

627.19

Subd. 8.Sex Offender Program

76,769,000

79,745,000

627.20Transfer Authority Related to Minnesota
627.21Sex Offender Program. Money
627.22appropriated for the Minnesota sex offender
627.23program may be transferred between fiscal
627.24years of the biennium with the approval of the
627.25commissioner of management and budget.

627.26

Subd. 9.Technical Activities

80,440,000

80,829,000

627.27This appropriation is from the federal TANF
627.28fund.
627.29Base Adjustment. The federal TANF fund
627.30base is increased by $278,000 in fiscal year
627.312016 and increased by $651,000 in fiscal
627.32year 2017.

627.33

Subd. 10.C.A.R.E.

628.1(a) Notwithstanding Minnesota Statutes,
628.2section 254B.06, subdivision 1, $2,200,000
628.3is transferred from the consolidated chemical
628.4dependency treatment fund administrative
628.5account in the special revenue fund and
628.6deposited into the enterprise fund for the
628.7Community Addiction Recovery Enterprise
628.8in fiscal year 2013.
628.9(b) Notwithstanding Minnesota Statutes,
628.10section 245.037, $1,000,000 must be
628.11transferred from the dedicated services
628.12- Lease Income Brainerd account in the
628.13special revenue fund and deposited into the
628.14enterprise fund for the Community Addiction
628.15Recovery Enterprise in fiscal year 2013.
628.16(c) Paragraphs (a) and (b) are effective the
628.17day following final enactment.

628.18

Sec. 3. COMMISSIONER OF HEALTH

628.19

Subdivision 1.Total Appropriation

$

169,326,000

$

165,531,000

628.20	Appropriations by Fund
628.21		2014	2015
628.22	General	79,476,000	74,256,000
628.23 628.24	State Government Special Revenue	48,094,000	50,119,000
628.25	Health Care Access	29,743,000	29,143,000
628.26	Federal TANF	11,713,000	11,713,000
628.27	Special Revenue	300,000	300,000

628.28The amounts that may be spent for each
628.29purpose are specified in the following
628.30subdivisions.

628.31

Subd. 2.Health Improvement

628.32	Appropriations by Fund
628.33	General	52,864,000	47,644,000
628.34 628.35	State Government Special Revenue	1,033,000	1,033,000
629.1	Health Care Access	17,500,000	17,500,000
629.2	Federal TANF	11,713,000	11,713,000

629.3Notwithstanding the cancellation requirement
629.4in Minnesota Statutes, section 256J.02,
629.5subdivision 6, TANF funds awarded under
629.6Minnesota Statutes, section 145.928, during
629.7fiscal year 2013 to grantees determined
629.8during the application process to have limited
629.9financial capacity, are available until June
629.1030, 2014.
629.11Statewide Health Improvement Program.
629.12$17,500,000 in fiscal year 2014 and
629.13$17,500,000 in fiscal year 2015 is from the
629.14health care access fund for the statewide
629.15health improvement program under
629.16Minnesota Statutes, section 145.986. Funds
629.17appropriated under this paragraph are
629.18available until expended. No more than 16
629.19percent of the SHIP budget may be used
629.20for administration, technical assistance,
629.21and state-level evaluation costs. The
629.22commissioner shall incorporate strategies
629.23for improving health outcomes and reducing
629.24health care costs in populations over age 60
629.25to the menu of statewide health improvement
629.26program strategies.
629.27Statewide Cancer Surveillance System. Of
629.28the general fund appropriation, $350,000 in
629.29fiscal year 2014 and $350,000 in fiscal year
629.302015 is to develop and implement a new
629.31cancer reporting system under Minnesota
629.32Statutes, sections 144.671 to 144.69. Any
629.33information technology development or
629.34support costs necessary for the cancer
629.35surveillance system must be incorporated
630.1into the agency's service level agreement and
630.2paid to the Office of Enterprise Technology.
630.3Minnesota Poison Information Center.
630.4 $500,000 in fiscal year 2014 and $500,000
630.5in fiscal year 2015 from the general fund
630.6is for regional poison information centers
630.7according to Minnesota Statutes, section
630.8145.93.
630.9Support Services for Deaf and
630.10Hard-of-Hearing. (a) $365,000 in fiscal
630.11year 2014 and $349,000 in fiscal year 2015
630.12are for providing support services to families
630.13as required under Minnesota Statutes, section
630.14144.966, subdivision 3a.
630.15(b) $164,000 in fiscal year 2014 and $156,000
630.16in fiscal year 2015 are for home-based
630.17education in American Sign Language for
630.18families with children who are deaf or have
630.19hearing loss, as required under Minnesota
630.20Statutes, section 144.966, subdivision 3a.
630.21Reproductive Health Strategic Plan to
630.22Reduce Health Disparities for Somali
630.23Women. To the extent funds are available
630.24for fiscal years 2014 and 2015 for grants
630.25provided pursuant to Minnesota Statutes,
630.26section 145.928, the commissioner
630.27shall provide a grant to a Somali-based
630.28organization located in the metropolitan area
630.29to develop a reproductive health strategic
630.30plan to eliminate reproductive health
630.31disparities for Somali women. The plan shall
630.32develop initiatives to provide educational
630.33and information resources to health care
630.34providers, community organizations, and
630.35Somali women to ensure effective interaction
631.1with Somali culture and western medicine
631.2and the delivery of appropriate health care
631.3services, and the achievement of better health
631.4outcomes for Somali women. The plan must
631.5engage health care providers, the Somali
631.6community, and Somali health-centered
631.7organizations. The commissioner shall
631.8submit a report to the chairs and ranking
631.9minority members of the senate and house
631.10committees with jurisdiction over health
631.11policy on the strategic plan developed under
631.12this grant for eliminating reproductive health
631.13disparities for Somali women. The report
631.14must be submitted by February 15, 2014.
631.15Sexual Violence Prevention. Within
631.16available appropriations, by January 15,
631.172015, the commissioner must report to the
631.18legislature on its activities to prevent sexual
631.19violence, including activities to promote
631.20coordination of existing state programs and
631.21services to achieve maximum impact on
631.22addressing the root causes of sexual violence.
631.23Safe Harbor for Sexually Exploited
631.24Youth. (a) $375,000 in fiscal year 2014 and
631.25$375,000 in fiscal year 2015 are for grants
631.26to six regional navigators under Minnesota
631.27Statutes, section 145.4717.
631.28(b) $100,000 in fiscal year 2014 and $100,000
631.29in fiscal year 2015 are for the director of
631.30child sex trafficking prevention position.
631.31(c) $50,000 in fiscal year 2015 is for program
631.32evaluation required under Minnesota
631.33Statutes, section 145.4718.
631.34TANF Appropriations. (1) $1,156,000 of
631.35the TANF funds is appropriated each year of
632.1the biennium to the commissioner for family
632.2planning grants under Minnesota Statutes,
632.3section 145.925.
632.4(2) $3,579,000 of the TANF funds is
632.5appropriated each year of the biennium to
632.6the commissioner for home visiting and
632.7nutritional services listed under Minnesota
632.8Statutes, section 145.882, subdivision 7,
632.9clauses (6) and (7). Funds must be distributed
632.10to community health boards according to
632.11Minnesota Statutes, section 145A.131,
632.12subdivision 1.
632.13(3) $2,000,000 of the TANF funds is
632.14appropriated each year of the biennium to
632.15the commissioner for decreasing racial and
632.16ethnic disparities in infant mortality rates
632.17under Minnesota Statutes, section 145.928,
632.18subdivision 7.
632.19(4) $4,978,000 of the TANF funds is
632.20appropriated each year of the biennium to the
632.21commissioner for the family home visiting
632.22grant program according to Minnesota
632.23Statutes, section 145A.17. $4,000,000 of the
632.24funding must be distributed to community
632.25health boards according to Minnesota
632.26Statutes, section 145A.131, subdivision 1.
632.27$978,000 of the funding must be distributed
632.28to tribal governments based on Minnesota
632.29Statutes, section 145A.14, subdivision 2a.
632.30(5) The commissioner may use up to 6.23
632.31percent of the funds appropriated each fiscal
632.32year to conduct the ongoing evaluations
632.33required under Minnesota Statutes, section
632.34145A.17, subdivision 7, and training and
632.35technical assistance as required under
633.1Minnesota Statutes, section 145A.17,
633.2subdivisions 4 and 5.
633.3TANF Carryforward. Any unexpended
633.4balance of the TANF appropriation in the
633.5first year of the biennium does not cancel but
633.6is available for the second year.

633.7

Subd. 3.Policy Quality and Compliance

633.8	Appropriations by Fund
633.9	General	9,391,000	9,391,000
633.10 633.11	State Government Special Revenue	14,428,000	16,450,000
633.12	Health Care Access	12,243,000	11,643,000

633.13The health care access fund appropriation
633.14includes the base appropriation for health
633.15care homes activities.
633.16Base Level Adjustment. The health care
633.17access base shall be increased by $600,000
633.18in fiscal year 2016.
633.19Criminal Background Checks. The state
633.20government special revenue fund base for
633.21fiscal year 2017 includes $111,000 for the
633.22implementation of criminal background
633.23checks for occupational therapy practitioners,
633.24speech-language pathologists, audiologists,
633.25and hearing aid dispensers, if the Sunset
633.26Advisory Commission under Minnesota
633.27Statutes, section 3D.03, is repealed before
633.28June 30, 2014.

633.29

Subd. 4.Health Protection

633.30	Appropriations by Fund
633.31	General	9,201,000	9,201,000
633.32 633.33	State Government Special Revenue	32,633,000	32,636,000
633.34	Special Revenue	300,000	300,000

634.1Infectious Disease Laboratory. Of the
634.2general fund appropriation, $200,000 in
634.3fiscal year 2014 and $200,000 in fiscal year
634.42015 are to monitor infectious disease trends
634.5and investigate infectious disease outbreaks.
634.6Surveillance for Elevated Blood Lead
634.7Levels. Of the general fund appropriation,
634.8$100,000 in fiscal year 2014 and $100,000
634.9in fiscal year 2015 are for the blood lead
634.10surveillance system under Minnesota
634.11Statutes, section 144.9502.
634.12Base Level Adjustment. The state
634.13government special revenue base is increased
634.14by $6,000 in fiscal year 2016 and by $13,000
634.15in fiscal year 2017.

634.16

Subd. 5.Administrative Support Services

8,020,000

8,020,000

634.17The general fund appropriation includes the
634.18base appropriation for the Office of the State
634.19Epidemiologist.
634.20Regional Support for Local Public Health
634.21Departments. $350,000 in fiscal year
634.222014 and $350,000 in fiscal year 2015 is
634.23for regional staff who provide specialized
634.24expertise to local public health departments.

634.25

Sec. 4. HEALTH-RELATED BOARDS

634.26

Subdivision 1.Total Appropriation

$

20,040,000

$

18,446,000

634.27This appropriation is from the state
634.28government special revenue fund.
634.29The amounts that may be spent for each
634.30purpose are specified in the following
634.31subdivisions.

634.32

Subd. 2.Board of Chiropractic Examiners

508,000

490,000

635.1This appropriation includes $10,000
635.2for information technology hardware
635.3to streamline board operations. This
635.4is a onetime appropriation. $15,000 is
635.5for a LEAN evaluation. This is a onetime
635.6appropriation. $2,000 in fiscal years 2014 and
635.72015 is for rental of additional storage space.

635.8

Subd. 3.Board of Dentistry

2,059,000

2,056,000

635.9This appropriation includes $843,000 in fiscal
635.10year 2014 and $837,000 in fiscal year 2015
635.11for the health professional services program.
635.12$15,000 in fiscal year 2014 is for repairs,
635.13maintenance, furnishings, and ergonomic
635.14upgrades. This is a onetime appropriation.
635.15$35,000 in fiscal years 2014 and 2015 is for
635.16additional staff to implement new regulatory
635.17activity. $20,000 in fiscal years 2014 and
635.182015 is for database upgrades for regulatory
635.19and licensing activities. $10,000 in fiscal
635.20years 2014 and 2015 is for professional and
635.21technical contracts for expert consultants
635.22to review complex complaints, advise on
635.23specialty dentistry areas, and to serve as
635.24expert witnesses in contested case matters.

635.25 635.26

Subd. 4.Board of Dietetic and Nutrition Practice

111,000

111,000

635.27 635.28

Subd. 5.Board of Marriage and Family Therapy

254,000

226,000

635.29This appropriation includes $25,000 in fiscal
635.30year 2014 for rulemaking. This is a onetime
635.31appropriation. $31,000 in fiscal year 2014
635.32and $27,000 in fiscal year 2015 are for
635.33additional staff to improve licensing and
635.34licensing renewal activities. $30,000 in fiscal
635.35year 2014 and $31,000 in fiscal year 2015
636.1are to increase the executive director to a
636.2full-time position.
636.3The remaining balance of the state
636.4government special revenue fund
636.5appropriation in Laws 2011, First Special
636.6Session chapter 9, article 10, section 8,
636.7subdivision 5, for Board of Marriage and
636.8Family Therapy rulemaking, estimated to
636.9be $25,000, is canceled. This paragraph is
636.10effective the day following final enactment.

636.11

Subd. 6.Board of Medical Practice

3,867,000

3,867,000

636.12

Subd. 7.Board of Nursing

3,637,000

3,637,000

636.13 636.14

Subd. 8.Board of Nursing Home Administrators

3,742,000

2,252,000

636.15Administrative Services Unit - Operating
636.16Costs. Of this appropriation, $676,000
636.17in fiscal year 2014 and $626,000 in
636.18fiscal year 2015 are for operating costs
636.19of the administrative services unit. The
636.20administrative services unit may receive
636.21and expend reimbursements for services
636.22performed by other agencies.
636.23Administrative Services Unit - Volunteer
636.24Health Care Provider Program. Of this
636.25appropriation, $150,000 in fiscal year 2014
636.26and $150,000 in fiscal year 2015 are to pay
636.27for medical professional liability coverage
636.28required under Minnesota Statutes, section
636.29214.40.
636.30Administrative Services Unit - Contested
636.31Cases and Other Legal Proceedings. Of
636.32this appropriation, $200,000 in fiscal year
636.332014 and $200,000 in fiscal year 2015 are
636.34for costs of contested case hearings and other
637.1unanticipated costs of legal proceedings
637.2involving health-related boards funded
637.3under this section. Upon certification of a
637.4health-related board to the administrative
637.5services unit that the costs will be incurred
637.6and that there is insufficient money available
637.7to pay for the costs out of money currently
637.8available to that board, the administrative
637.9services unit is authorized to transfer money
637.10from this appropriation to the board for
637.11payment of those costs with the approval
637.12of the commissioner of management and
637.13budget.
637.14This appropriation includes $44,000 in
637.15fiscal year 2014 for rulemaking. This is
637.16a onetime appropriation. $1,441,000 in
637.17fiscal year 2014 and $420,000 in fiscal year
637.182015 are for the development of a shared
637.19disciplinary, regulatory, licensing, and
637.20information management system. $391,000
637.21in fiscal year 2014 is a onetime appropriation
637.22for retirement costs in the health-related
637.23boards. This funding may be transferred to
637.24the health boards incurring retirement costs.
637.25These funds are available either year of the
637.26biennium.
637.27This appropriation includes $16,000 in fiscal
637.28years 2014 and 2015 for evening security,
637.29$2,000 in fiscal years 2014 and 2015 for a
637.30state vehicle lease, and $18,000 in fiscal
637.31years 2014 and 2015 for shared office space
637.32and administrative support. $205,000 in
637.33fiscal year 2014 and $221,000 in fiscal year
637.342015 are for shared information technology
637.35services, equipment, and maintenance.
638.1The remaining balance of the state
638.2government special revenue fund
638.3appropriation in Laws 2011, First Special
638.4Session chapter 9, article 10, section 8,
638.5subdivision 8, for Board of Nursing Home
638.6Administrators rulemaking, estimated to
638.7be $44,000, is canceled, and the remaining
638.8balance of the state government special
638.9revenue fund appropriation in Laws 2011,
638.10First Special Session chapter 9, article 10,
638.11section 8, subdivision 8, for electronic
638.12licensing system adaptors, estimated to be
638.13$761,000, and for the development and
638.14implementation of a disciplinary, regulatory,
638.15licensing, and information management
638.16system, estimated to be $1,100,000, are
638.17canceled. This paragraph is effective the day
638.18following final enactment.
638.19Base Adjustment. The base is decreased by
638.20$370,000 in fiscal years 2016 and 2017.

638.21

Subd. 9.Board of Optometry

107,000

107,000

638.22

Subd. 10.Board of Pharmacy

2,555,000

2,555,000

638.23Prescription Electronic Reporting. Of
638.24this appropriation, $356,000 in fiscal year
638.252014 and $356,000 in fiscal year 2015 from
638.26the state government special revenue fund
638.27are to the board to operate the prescription
638.28monitoring program in Minnesota Statutes,
638.29section 152.126.

638.30

Subd. 11.Board of Physical Therapy

390,000

346,000

638.31This appropriation includes $44,000 in fiscal
638.32year 2014 for rulemaking. This is a onetime
638.33appropriation.
639.1The remaining balance of the state
639.2government special revenue fund
639.3appropriation in Laws 2011, First Special
639.4Session chapter 9, article 10, section 8,
639.5subdivision 11, for Board of Physical
639.6Therapy rulemaking, estimated to be
639.7$44,000, is canceled. This paragraph is
639.8effective the day following final enactment.

639.9

Subd. 12.Board of Podiatry

76,000

76,000

639.10

Subd. 13.Board of Psychology

892,000

892,000

639.11This appropriation includes $15,000 in
639.12fiscal years 2014 and 2015 for continuing
639.13educational programming. $5,000 in fiscal
639.14years 2014 and 2015 are for a public
639.15education program. $25,000 in fiscal years
639.162014 and 2015 are for development of
639.17educational materials. This is a onetime
639.18appropriation.
639.19Base Adjustment. The base is decreased by
639.20$45,000 in fiscal years 2016 and 2017.

639.21

Subd. 14.Board of Social Work

1,109,000

1,110,000

639.22This appropriation includes $55,000 in fiscal
639.23year 2014 and $56,000 in fiscal year 2015
639.24for additional staff to enhance the board's
639.25complaint resolution process.

639.26

Subd. 15.Board of Veterinary Medicine

262,000

256,000

639.27This appropriation includes $32,000 in fiscal
639.28year 2014 and $26,000 in fiscal year 2015
639.29for additional staff to improve the board's
639.30complaint resolution process.

639.31 639.32

Subd. 16.Board of Behavioral Health and Therapy

471,000

465,000

640.1This appropriation includes $56,000 in fiscal
640.2year 2014 and $50,000 in fiscal year 2015 for
640.3additional staff to enhance the licensing and
640.4complaint resolution processes of the board.

640.5 640.6

Sec. 5. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

2,741,000

$

2,741,000

640.7Regional Grants. $585,000 in fiscal year
640.82014 and $585,000 in fiscal year 2015 are
640.9for regional emergency medical services
640.10programs, to be distributed equally to the
640.11eight emergency medical service regions.
640.12Cooper/Sams Volunteer Ambulance
640.13Program. $700,000 in fiscal year 2014 and
640.14$700,000 in fiscal year 2015 are for the
640.15Cooper/Sams volunteer ambulance program
640.16under Minnesota Statutes, section 144E.40.
640.17(a) Of this amount, $611,000 in fiscal year
640.182014 and $611,000 in fiscal year 2015
640.19are for the ambulance service personnel
640.20longevity award and incentive program under
640.21Minnesota Statutes, section 144E.40.
640.22(b) Of this amount, $89,000 in fiscal year
640.232014 and $89,000 in fiscal year 2015 are
640.24for the operations of the ambulance service
640.25personnel longevity award and incentive
640.26program under Minnesota Statutes, section
640.27144E.40.
640.28Ambulance Training Grant. $361,000 in
640.29fiscal year 2014 and $361,000 in fiscal year
640.302015 are for training grants.
640.31EMSRB Board Operations. $1,095,000 in
640.32fiscal year 2014 and $1,095,000 in fiscal year
640.332015 are for operations.

641.1

Sec. 6. COUNCIL ON DISABILITY

$

614,000

$

614,000

641.2 641.3 641.4

Sec. 7. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,654,000

$

1,654,000

641.5

Sec. 8. OMBUDSPERSON FOR FAMILIES

$

333,000

$

334,000

641.6    Sec. 9. Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:
641.7    Subd. 34. Federal administrative reimbursement dedicated. Federal
641.8administrative reimbursement resulting from the following activities is appropriated to the
641.9commissioner for the designated purposes:
641.10(1) reimbursement for the Minnesota senior health options project; and
641.11(2) reimbursement related to prior authorization and inpatient admission certification
641.12by a professional review organization. A portion of these funds must be used for activities
641.13to decrease unnecessary pharmaceutical costs in medical assistance.; and
641.14(3) reimbursement resulting from the federal child support grant expenditures
641.15authorized under United States Code, title 42, section 1315.

641.16    Sec. 10. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
641.17to read:
641.18    Subd. 35. Federal reimbursement for privatized adoption grants. Federal
641.19reimbursement for privatized adoption grant and foster care recruitment grant expenditures
641.20is appropriated to the commissioner for adoption grants and foster care and adoption
641.21administrative purposes.

641.22    Sec. 11. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
641.23to read:
641.24    Subd. 36. DHS receipt center accounting. The commissioner may transfer
641.25appropriations to, and account for DHS receipt center operations in, the special revenue
641.26fund.

641.27    Sec. 12. APPROPRIATION ADJUSTMENTS.
641.28(a) The general fund appropriation in section 2, subdivision 5, paragraph (g),
641.29includes up to $53,391,000 in fiscal year 2014; $216,637,000 in fiscal year 2015;
641.30$261,660,000 in fiscal year 2016; and $279,984,000 in fiscal year 2017, for medical
641.31assistance eligibility and administration changes related to:
642.1(1) eligibility for children age two to 18 with income up to 275 percent of the federal
642.2poverty guidelines;
642.3(2) eligibility for pregnant women with income up to 275 percent of the federal
642.4poverty guidelines;
642.5(3) Affordable Care Act enrollment and renewal processes, including elimination
642.6of six-month renewals, ex parte eligibility reviews, preprinted renewal forms, changes
642.7in verification requirements, and other changes in the eligibility determination and
642.8enrollment and renewal process;
642.9(4) automatic eligibility for children who turn 18 in foster care until they reach age 26;
642.10(5) eligibility related to spousal impoverishment provisions for waiver recipients; and
642.11(6) presumptive eligibility determinations by hospitals.
642.12(b) The commissioner of human services shall determine the difference between the
642.13actual or forecasted costs to the medical assistance program attributable to the program
642.14changes in paragraph (a), clauses (1) to (6), and the costs of paragraph (a), clauses (1) to
642.15(6), that were estimated during the 2013 legislative session based on data from the 2013
642.16February forecast. The costs in this paragraph must be calculated between January 1,
642.172014, and June 30, 2017.
642.18(c) For each fiscal year from 2014 to 2017, the commissioner of human services
642.19shall certify the actual or forecasted cost differences to the medical assistance program
642.20determined under paragraph (b), and report the difference in costs to the commissioner of
642.21management and budget at least four weeks prior to a forecast under Minnesota Statutes,
642.22section 16A.103. No later than three weeks before the release of the forecast under
642.23Minnesota Statutes, section 16A.103, the commissioner of management and budget shall
642.24reduce the health care access fund appropriation in section 2, subdivision 5, paragraph (g),
642.25by the cumulative difference in costs determined in paragraph (b). If for any fiscal year,
642.26the amount of the cumulative cost differences determined under paragraph (b) is positive,
642.27no adjustment shall be made to the health care access fund appropriation. If for any fiscal
642.28year, the amount of the cumulative cost differences determined under paragraph (b) is less
642.29than the original appropriation, the appropriation for that fiscal year is zero.
642.30(d) This section expires on January 1, 2018.

642.31    Sec. 13. TRANSFERS.
642.32    Subdivision 1. Grants. The commissioner of human services, with the approval of
642.33the commissioner of management and budget, may transfer unencumbered appropriation
642.34balances for the biennium ending June 30, 2015, within fiscal years among the MFIP,
642.35general assistance, general assistance medical care under Minnesota Statutes 2009
643.1Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP
643.2child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental
643.3aid, group residential housing programs, the entitlement portion of the chemical
643.4dependency consolidated treatment fund, and between fiscal years of the biennium. The
643.5commissioner shall inform the chairs and ranking minority members of the senate Health
643.6and Human Services Finance Division and the house of representatives Health and Human
643.7Services Finance Committee quarterly about transfers made under this provision.
643.8    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
643.9money may be transferred within the Departments of Human Services and Health as the
643.10commissioners consider necessary, with the advance approval of the commissioner of
643.11management and budget. The commissioner shall inform the chairs and ranking minority
643.12members of the senate Health and Human Services Finance Division and the house of
643.13representatives Health and Human Services Finance Committee quarterly about transfers
643.14made under this provision.

643.15    Sec. 14. INDIRECT COSTS NOT TO FUND PROGRAMS.
643.16The commissioners of health and human services shall not use indirect cost
643.17allocations to pay for the operational costs of any program for which they are responsible.

643.18    Sec. 15. EXPIRATION OF UNCODIFIED LANGUAGE.
643.19All uncodified language contained in this article expires on June 30, 2015, unless a
643.20different expiration date is explicit.

643.21    Sec. 16. EFFECTIVE DATE.
643.22This article is effective July 1, 2013, unless a different effective date is specified.

643.23ARTICLE 15

643.24REFORM 2020 CONTINGENT APPROPRIATIONS

643.25

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

643.26The sums shown in the columns marked "Appropriations" are appropriated to the
643.27agencies and for the purposes specified in this article. The appropriations are from the
643.28general fund, or another named fund, and are available for the fiscal years indicated
643.29for each purpose. The figures "2014" and "2015" used in this article mean that the
643.30appropriations listed under them are available for the fiscal year ending June 30, 2014, or
643.31June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
643.32year 2015. "The biennium" is fiscal years 2014 and 2015.

644.1				APPROPRIATIONS
644.2				Available for the Year
644.3				Ending June 30
644.4					2014		2015

644.5 644.6

Sec. 2. COMMISSIONER OF HUMAN SERVICES

644.7

Subdivision 1.Total Appropriation

$

2,144,000

$

214,000

644.8

Subd. 2.Central Office

644.9The amounts that may be spent from this
644.10appropriation for each purpose are as follows:

644.11

(a) Operations

2,909,000

8,957,000

644.12Base Adjustment. The general fund base is
644.13decreased by $8,916,000 in fiscal year 2016
644.14and $8,916,000 in fiscal year 2017.

644.15

(b) Children and Families

109,000

206,000

644.16

(c) Continuing Care

2,849,000

3,574,000

644.17Base Adjustment. The general fund base is
644.18decreased by $2,000 in fiscal year 2016 and
644.19by $27,000 in fiscal year 2017.

644.20

(d) Group Residential Housing

(1,166,000)

(8,602,000)

644.21

(e) Medical Assistance

(3,950,000)

(6,420,000)

644.22

(f) Alternative Care

(7,386,000)

(6,851,000)

644.23

(g) Child and Community Service Grants

3,000,000

3,000,000

644.24

(h) Aging and Adult Services Grants

5,365,000

5,936,000

644.25Gaps Analysis. In fiscal year 2014, and
644.26in each even-numbered year thereafter,
644.27$435,000 is appropriated to conduct an
644.28analysis of gaps in long-term care services
644.29under Minnesota Statutes, section 144A.351.
644.30This is a biennial appropriation. The base is
644.31increased by $435,000 in fiscal year 2016.
645.1Notwithstanding any contrary provisions in
645.2this article, this provision does not expire.
645.3Base Adjustment. The general fund base is
645.4increased by $498,000 in fiscal year 2016,
645.5and decreased by $124,000 in fiscal year
645.62017.

645.7

(i) Disabilities Grants

414,000

414,000

645.8    Sec. 3. FEDERAL APPROVAL.
645.9(a) The implementation of this article and article 2 is contingent on federal approval.
645.10(b) Upon full or partial approval of the waiver application, the commissioner of
645.11human services shall submit to the commissioner of management and budget a plan for
645.12implementing the provisions in this article that received federal approval as well as any
645.13provisions that do not require federal approval. The plan must:
645.14(1) include fiscal estimates that, with federal administrative reimbursement, do
645.15not increase the general fund appropriations to the commissioner of human services in
645.16fiscal years 2014 and 2015; and
645.17(2) include a fiscal estimate for the systems modernization appropriation, which
645.18cannot exceed $11,598,000 for the biennium ending June 30, 2015.
645.19(c) Upon approval by the commissioner of management and budget, the
645.20commissioner of human services may implement the plan.
645.21(d) The commissioner of management and budget must notify the chairs and ranking
645.22minority members of the legislative committees with jurisdiction over health and human
645.23services finance when the plan is approved. The plan must be made publicly available.

645.24    Sec. 4. IMPLEMENTATION OF REFORM 2020 CONTINGENT PROVISIONS
645.25AND ADJUSTMENTS TO APPROPRIATIONS AND PLANNING ESTIMATES.
645.26Upon approval of the plan in section 3, the commissioner of management and
645.27budget shall make necessary adjustments to the appropriations in this article to reflect the
645.28effective date of federal approval. The adjustments must include the nondedicated revenue
645.29attributable to the provisions of this article and the related planning estimates for fiscal
645.30years 2016 and 2017 must reflect the revised fiscal estimates attributable to the provisions
645.31in this article. The revised appropriations for fiscal years 2014 and 2015 shall be included
645.32in the forecast and must not increase the appropriations to the commissioner of human
645.33services for fiscal years 2014 and 2015. If the adjustments to the planning estimates for
645.34fiscal years 2016 and 2017 result in increased general fund expenditure estimates for
646.1the commissioner of human services attributable to the provisions in this article, when
646.2compared to the planning estimates attributable to the provision in this article made in the
646.3February 2013 forecast, none of the provisions in this article shall be implemented.

646.4ARTICLE 16

646.5HUMAN SERVICES FORECAST ADJUSTMENTS

646.6 646.7

Section 1. COMMISSIONER OF HUMAN SERVICES

646.8

Subdivision 1.Total Appropriation

$

(161,031,000)

646.9	Appropriations by Fund
646.10		2013
646.11	General Fund	(158,668,000)
646.12	Health Care Access	(7,179,000)
646.13	TANF	4,816,000

646.14	Subd. 2.Forecasted Programs
646.15	(a) MFIP/DWP Grants

646.16	Appropriations by Fund
646.17	General Fund	(8,211,000)
646.18	TANF	4,399,000

646.19

(b) MFIP Child Care Assistance Grants

10,113,000

646.20

(c) General Assistance Grants

3,230,000

646.21

(d) Minnesota Supplemental Aid Grants

(1,008,000)

646.22

(e) Group Residential Housing Grants

(5,423,000)

646.23

(f) MinnesotaCare Grants

(7,179,000)

646.24This appropriation is from the health care
646.25access fund.

646.26

(g) Medical Assistance Grants

(159,733,000)

646.27

(h) Alternative Care Grants

-0-

646.28

(i) CD Entitlement Grants

2,364,000

646.29

Subd. 3.Technical Activities

417,000

646.30This appropriation is from the TANF fund.
646.31EFFECTIVE DATE.This section is effective the day following final enactment.

647.1ARTICLE 17

647.2NORTHSTAR CARE FOR CHILDREN

647.3    Section 1. Minnesota Statutes 2012, section 256.0112, is amended by adding a
647.4subdivision to read:
647.5    Subd. 10. Contracts for child foster care services. When local agencies negotiate
647.6lead county contracts or purchase of service contracts for child foster care services, the
647.7foster care maintenance payment made on behalf of the child shall follow the provisions of
647.8Northstar Care for Children, chapter 256N. Foster care maintenance payments as defined
647.9in section 256N.02, subdivision 15, represent costs for activities similar in nature to those
647.10expected of parents and do not cover services rendered by the licensed or tribally approved
647.11foster parent, facility, or administrative costs or fees. Payments made to foster parents
647.12must follow the requirements of section 256N.26, subdivision 15. The legally responsible
647.13agency must provide foster parents with the assessment and notice as specified in section
647.14256N.24. The financially responsible agency is permitted to make additional payments for
647.15specific services provided by the foster parents or facility, as permitted in section 256N.21,
647.16subdivision 5. These additional payments are not considered foster care maintenance.

647.17    Sec. 2. Minnesota Statutes 2012, section 256.82, subdivision 2, is amended to read:
647.18    Subd. 2. Foster care maintenance payments. Beginning January 1, 1986, For the
647.19purpose of foster care maintenance payments under title IV-E of the Social Security Act,
647.20United States Code, title 42, sections 670 to 676, the county paying the maintenance
647.21costs must be reimbursed for the costs from the federal money available for the purpose.
647.22Beginning July 1, 1997, for the purposes of determining a child's eligibility under title
647.23IV-E of the Social Security Act, the placing agency shall use AFDC requirements in
647.24effect on July 16, 1996.

647.25    Sec. 3. Minnesota Statutes 2012, section 256.82, subdivision 3, is amended to read:
647.26    Subd. 3. Setting foster care standard rates. (a) The commissioner shall annually
647.27establish minimum standard maintenance rates for foster care maintenance and including
647.28supplemental difficulty of care payments for all children in foster care eligible for
647.29Northstar Care for Children under chapter 256N.
647.30(b) All children entering foster care on or after January 1, 2015, are eligible for
647.31Northstar Care for Children under chapter 256N. Any increase in rates shall in no case
647.32exceed three percent per annum.
647.33(c) All children in foster care on December 31, 2014, must remain in the
647.34pre-Northstar Care for Children foster care program under sections 256N.21, subdivision
648.16, and 260C.4411, subdivision 1. The rates for the pre-Northstar Care for Children foster
648.2care program shall remain those in effect on January 1, 2013.

648.3    Sec. 4. [256N.001] CITATION.
648.4Sections 256N.001 to 256N.28 may be cited as the "Northstar Care for Children Act."
648.5Sections 256N.001 to 256N.28 establish Northstar Care for Children, which authorizes
648.6certain benefits to support a child in need who is served by the Minnesota child welfare
648.7system and who is the responsibility of the state, local county social service agencies, or
648.8tribal social service agencies authorized under section 256.01, subdivision 14b, or are
648.9otherwise eligible for federal adoption assistance. A child eligible under this chapter
648.10has experienced a child welfare intervention that has resulted in the child being placed
648.11away from the child's parents' care and is receiving foster care services consistent with
648.12chapter 260B, 260C, or 260D, or is in the permanent care of relatives through a transfer of
648.13permanent legal and physical custody, or in the permanent care of adoptive parents.

648.14    Sec. 5. [256N.01] PUBLIC POLICY.
648.15(a) The legislature declares that the public policy of this state is to keep children safe
648.16from harm and to ensure that when children suffer harmful or injurious experiences in
648.17their lives, appropriate services are immediately available to keep them safe.
648.18(b) Children do best in permanent, safe, nurturing homes where they can maintain
648.19lifelong relationships with adults. Whenever safely possible, children are best served
648.20when they can be nurtured and raised by their parents. Where services cannot be provided
648.21to allow a child to remain safely at home, an out-of-home placement may be required.
648.22When this occurs, reunification should be sought if it can be accomplished safely. When
648.23it is not possible for parents to provide safety and permanency for their children, an
648.24alternative permanent home must quickly be made available to the child, drawing from
648.25kinship sources whenever possible.
648.26(c) Minnesota understands the importance of having a comprehensive approach to
648.27temporary out-of-home care and to permanent homes for children who cannot be reunited
648.28with their families. It is critical that stable benefits be available to caregivers to ensure
648.29that the child's needs can be met whether the child's situation and best interests call for
648.30temporary foster care, transfer of permanent legal and physical custody to a relative, or
648.31adoption. Northstar Care for Children focuses on the child's needs and strengths, and
648.32the actual level of care provided by the caregiver, without consideration for the type of
648.33placement setting. In this way caregivers are not faced with the burden of making specific
648.34long-term decisions based upon competing financial incentives.

649.1    Sec. 6. [256N.02] DEFINITIONS.
649.2    Subdivision 1. Scope. For the purposes of sections 256N.001 to 256N.28, the terms
649.3defined in this section have the meanings given them.
649.4    Subd. 2. Adoption assistance. "Adoption assistance" means medical coverage as
649.5allowable under section 256B.055 and reimbursement of nonrecurring expenses associated
649.6with adoption and may include financial support provided under agreement with the
649.7financially responsible agency, the commissioner, and the parents of an adoptive child
649.8whose special needs would otherwise make it difficult to place the child for adoption to
649.9assist with the cost of caring for the child. Financial support may include a basic rate
649.10payment and a supplemental difficulty of care rate.
649.11    Subd. 3. Assessment. "Assessment" means the process under section 256N.24 that
649.12determines the benefits an eligible child may receive under section 256N.26.
649.13    Subd. 4. At-risk child. "At-risk child" means a child who does not have a
649.14documented disability but who is at risk of developing a physical, mental, emotional, or
649.15behavioral disability based on being related within the first or second degree to persons
649.16who have an inheritable physical, mental, emotional, or behavioral disabling condition,
649.17or from a background which has the potential to cause the child to develop a physical,
649.18mental, emotional, or behavioral disability that the child is at risk of developing. The
649.19disability must manifest during childhood.
649.20    Subd. 5. Basic rate. "Basic rate" means the maintenance payment made on behalf
649.21of a child to support the costs caregivers incur to provide for a child's needs consistent with
649.22the care parents customarily provide, including: food, clothing, shelter, daily supervision,
649.23school supplies, and a child's personal incidentals. It also supports typical travel to the
649.24child's home for visitation, and reasonable travel for the child to remain in the school in
649.25which the child is enrolled at the time of placement.
649.26    Subd. 6. Caregiver. "Caregiver" means the foster parent or parents of a child in
649.27foster care who meet the requirements of emergency relative placement, licensed foster
649.28parents under chapter 245A, or foster parents licensed or approved by a tribe; the relative
649.29custodian or custodians; or the adoptive parent or parents who have legally adopted a child.
649.30    Subd. 7. Commissioner. "Commissioner" means the commissioner of human
649.31services or any employee of the Department of Human Services to whom the
649.32commissioner has delegated appropriate authority.
649.33    Subd. 8. County board. "County board" means the board of county commissioners
649.34in each county.
649.35    Subd. 9. Disability. "Disability" means a physical, mental, emotional, or behavioral
649.36impairment that substantially limits one or more major life activities. Major life activities
650.1include, but are not limited to: thinking, walking, hearing, breathing, working, seeing,
650.2speaking, communicating, learning, developing and maintaining healthy relationships,
650.3safely caring for oneself, and performing manual tasks. The nature, duration, and severity
650.4of the impairment must be considered in determining if the limitation is substantial.
650.5    Subd. 10. Financially responsible agency. "Financially responsible agency" means
650.6the agency that is financially responsible for a child. These agencies include both local
650.7social service agencies under section 393.07 and tribal social service agencies authorized
650.8in section 256.01, subdivision 14b, as part of the American Indian Child Welfare Initiative,
650.9and Minnesota tribes who assume financial responsibility of children from other states.
650.10Under Northstar Care for Children, the agency that is financially responsible at the time of
650.11placement for foster care continues to be responsible under section 256N.27 for the local
650.12share of any maintenance payments, even after finalization of the adoption of transfer of
650.13permanent legal and physical custody of a child.
650.14    Subd. 11. Guardianship assistance. "Guardianship assistance" means medical
650.15coverage, as allowable under section 256B.055, and reimbursement of nonrecurring
650.16expenses associated with obtaining permanent legal and physical custody of a child, and
650.17may include financial support provided under agreement with the financially responsible
650.18agency, the commissioner, and the relative who has received a transfer of permanent legal
650.19and physical custody of a child. Financial support may include a basic rate payment and a
650.20supplemental difficulty of care rate to assist with the cost of caring for the child.
650.21    Subd. 12. Human services board. "Human services board" means a board
650.22established under section 402.02; Laws 1974, chapter 293; or Laws 1976, chapter 340.
650.23    Subd. 13. Initial assessment. "Initial assessment" means the assessment conducted
650.24within the first 30 days of a child's initial placement into foster care under section
650.25256N.24, subdivisions 4 and 5.
650.26    Subd. 14. Legally responsible agency. "Legally responsible agency" means the
650.27Minnesota agency that is assigned responsibility for placement, care, and supervision
650.28of the child through a court order, voluntary placement agreement, or voluntary
650.29relinquishment. These agencies include local social service agencies under section 393.07,
650.30tribal social service agencies authorized in section 256.01, subdivision 14b, and Minnesota
650.31tribes that assume court jurisdiction when legal responsibility is transferred to the tribal
650.32social service agency through a Minnesota district court order. A Minnesota local social
650.33service agency is otherwise financially responsible.
650.34    Subd. 15. Maintenance payments. "Maintenance payments" means the basic
650.35rate plus any supplemental difficulty of care rate under Northstar Care for Children. It
650.36specifically does not include the cost of initial clothing allowance, payment for social
651.1services, or administrative payments to a child-placing agency. Payments are paid
651.2consistent with section 256N.26.
651.3    Subd. 16. Permanent legal and physical custody. "Permanent legal and physical
651.4custody" means a transfer of permanent legal and physical custody to a relative ordered by
651.5a Minnesota juvenile court under section 260C.515, subdivision 4, or for a child under
651.6jurisdiction of a tribal court, a judicial determination under a similar provision in tribal
651.7code which means that a relative will assume the duty and authority to provide care,
651.8control, and protection of a child who is residing in foster care, and to make decisions
651.9regarding the child's education, health care, and general welfare until adulthood.
651.10    Subd. 17. Reassessment. "Reassessment" means an update of a previous assessment
651.11through the process under section 256N.24 for a child who has been continuously eligible
651.12for Northstar Care for Children, or when a child identified as an at-risk child (Level A)
651.13under guardianship or adoption assistance has manifested the disability upon which
651.14eligibility for the agreement was based according to section 256N.25, subdivision 3,
651.15paragraph (b). A reassessment may be used to update an initial assessment, a special
651.16assessment, or a previous reassessment.
651.17    Subd. 18. Relative. "Relative," as described in section 260C.007, subdivision 27,
651.18means a person related to the child by blood, marriage, or adoption, or an individual who
651.19is an important friend with whom the child has resided or had significant contact. For an
651.20Indian child, relative includes members of the extended family as defined by the law or
651.21custom of the Indian child's tribe or, in the absence of law or custom, nieces, nephews,
651.22or first or second cousins, as provided in the Indian Child Welfare Act of 1978, United
651.23States Code, title 25, section 1903.
651.24    Subd. 19. Relative custodian. "Relative custodian" means a person to whom
651.25permanent legal and physical custody of a child has been transferred under section
651.26260C.515, subdivision 4, or for a child under jurisdiction of a tribal court, a judicial
651.27determination under a similar provision in tribal code, which means that a relative will
651.28assume the duty and authority to provide care, control, and protection of a child who is
651.29residing in foster care, and to make decisions regarding the child's education, health
651.30care, and general welfare until adulthood.
651.31    Subd. 20. Special assessment. "Special assessment" means an assessment
651.32performed under section 256N.24 that determines the benefits that an eligible child may
651.33receive under section 256N.26 at the time when a special assessment is required. A
651.34special assessment is used when a child's status within Northstar Care is shifted from a
651.35pre-Northstar Care program into Northstar Care for Children and when the commissioner
652.1determines that a special assessment is appropriate instead of assigning the transition child
652.2to a level under section 256N.28.
652.3    Subd. 21. Supplemental difficulty of care rate. "Supplemental difficulty of care
652.4rate" means the supplemental payment under section 256N.26, if any, as determined by
652.5the financially responsible agency or the state, based upon an assessment under section
652.6256N.24. The rate must support activities consistent with the care a parent provides a child
652.7with special needs and not the equivalent of a purchased service. The rate must consider
652.8the capacity and intensity of the activities associated with parenting duties provided in
652.9the home to nurture the child, preserve the child's connections, and support the child's
652.10functioning in the home and community.

652.11    Sec. 7. [256N.20] NORTHSTAR CARE FOR CHILDREN; GENERALLY.
652.12    Subdivision 1. Eligibility. A child is eligible for Northstar Care for Children if
652.13the child is eligible for:
652.14(1) foster care under section 256N.21;
652.15(2) guardianship assistance under section 256N.22; or
652.16(3) adoption assistance under section 256N.23.
652.17    Subd. 2. Assessments. Except as otherwise specified, a child eligible for Northstar
652.18Care for Children shall receive an assessment under section 256N.24.
652.19    Subd. 3. Agreements. When a child is eligible for guardianship assistance or
652.20adoption assistance, negotiations with caregivers and the development of a written,
652.21binding agreement must be conducted under section 256N.25.
652.22    Subd. 4. Benefits and payments. A child eligible for Northstar Care for Children is
652.23entitled to benefits specified in section 256N.26, based primarily on assessments under
652.24section 256N.24, and, if appropriate, negotiations and agreements under section 256N.25.
652.25Although paid to the caregiver, these benefits must be considered benefits of the child
652.26rather than of the caregiver.
652.27    Subd. 5. Federal, state, and local shares. The cost of Northstar Care for Children
652.28must be shared among the federal government, state, counties of financial responsibility,
652.29and certain tribes as specified in section 256N.27.
652.30    Subd. 6. Administration and appeals. The commissioner and financially
652.31responsible agency, or other agency designated by the commissioner, shall administer
652.32Northstar Care for Children according to section 256N.28. The notification and fair
652.33hearing process applicable to this chapter is defined in section 256N.28.
652.34    Subd. 7. Transition. A child in foster care, relative custody assistance, or adoption
652.35assistance prior to January 1, 2015, who remains with the same caregivers continues
653.1to receive benefits under programs preceding Northstar Care for Children, unless the
653.2child moves to a new foster care placement, permanency is obtained for the child, or the
653.3commissioner initiates transition of a child receiving pre-Northstar Care for Children
653.4relative custody assistance, guardianship assistance, or adoption assistance under this
653.5chapter. Provisions for the transition to Northstar Care for Children for certain children in
653.6preceding programs are specified in section 256N.28, subdivisions 2 and 7. Additional
653.7provisions for children in: foster care are specified in section 256N.21, subdivision
653.86; relative custody assistance under section 257.85 are specified in section 256N.22,
653.9subdivision 12; and adoption assistance under chapter 259A are specified in section
653.10256N.23, subdivision 13.

653.11    Sec. 8. [256N.21] ELIGIBILITY FOR FOSTER CARE BENEFITS.
653.12    Subdivision 1. General eligibility requirements. (a) A child is eligible for foster
653.13care benefits under this section if the child meets the requirements of subdivision 2 on
653.14or after January 1, 2015.
653.15(b) The financially responsible agency shall make a title IV-E eligibility determination
653.16for all foster children meeting the requirements of subdivision 2, provided the agency has
653.17such authority under the state title IV-E plan. To be eligible for title IV-E foster care, a child
653.18must also meet any additional criteria specified in section 472 of the Social Security Act.
653.19(c) Except as provided under section 256N.26, subdivision 1 or 6, the foster care
653.20benefit to the child under this section must be determined under sections 256N.24 and
653.21256N.26 through an individual assessment. Information from this assessment must be
653.22used to determine a potential future benefit under guardianship assistance or adoption
653.23assistance, if needed.
653.24(d) When a child is eligible for additional services, subdivisions 3 and 4 govern
653.25the co-occurrence of program eligibility.
653.26    Subd. 2. Placement in foster care. To be eligible for foster care benefits under this
653.27section, the child must be in placement away from the child's legal parent or guardian and
653.28all of the following criteria must be met:
653.29(1) the legally responsible agency must have placement authority and care
653.30responsibility, including for a child 18 years old or older and under age 21, who maintains
653.31eligibility for foster care consistent with section 260C.451;
653.32(2) the legally responsible agency must have authority to place the child with a
653.33voluntary placement agreement or a court order, consistent with sections 260B.198,
653.34260C.001, 260D.01, or continued eligibility consistent with section 260C.451; and
654.1(3) the child must be placed in an emergency relative placement under section
654.2245A.035, a licensed foster family setting, foster residence setting, or treatment foster
654.3care setting licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, a family
654.4foster home licensed or approved by a tribal agency or, for a child 18 years old or older
654.5and under age 21, an unlicensed supervised independent living setting approved by the
654.6agency responsible for the youth's care.
654.7    Subd. 3. Minor parent. A child who is a minor parent in placement with the minor
654.8parent's child in the same home is eligible for foster care benefits under this section. The
654.9foster care benefit is limited to the minor parent, unless the legally responsible agency has
654.10separate legal authority for placement of the minor parent's child.
654.11    Subd. 4. Foster children ages 18 up to 21 placed in an unlicensed supervised
654.12independent living setting. A foster child 18 years old or older and under age 21 who
654.13maintains eligibility consistent with section 260C.451 and who is placed in an unlicensed
654.14supervised independent living setting shall receive the level of benefit under section
654.15256N.26.
654.16    Subd. 5. Excluded activities. The basic and supplemental difficulty of care
654.17payment represents costs for activities similar in nature to those expected of parents,
654.18and does not cover services rendered by the licensed or tribally approved foster parent,
654.19facility, or administrative costs or fees. The financially responsible agency may pay an
654.20additional fee for specific services provided by the licensed foster parent or facility. A
654.21foster parent or residence setting must distinguish such a service from the daily care of the
654.22child as assessed through the process under section 256N.24.
654.23    Subd. 6. Transition from pre-Northstar Care for Children program. (a) Section
654.24256.82 establishes the pre-Northstar Care for Children foster care program for all children
654.25residing in family foster care on December 31, 2014. Unless transitioned under paragraph
654.26(b), a child in foster care with the same caregiver receives benefits under this pre-Northstar
654.27Care for Children foster care program.
654.28(b) Transition from the pre-Northstar Care for Children foster care program to
654.29Northstar Care for Children takes place on or after January 1, 2015, when the child:
654.30(1) moves to a different foster home or unlicensed supervised independent living
654.31setting;
654.32(2) has permanent legal and physical custody transferred and, if applicable, meets
654.33eligibility requirements in section 256N.22;
654.34(3) is adopted and, if applicable, meets eligibility requirements in section 256N.23; or
654.35(4) re-enters foster care after reunification or a trial home visit.
655.1(c) Upon becoming eligible, a foster child must be assessed according to section
655.2256N.24 and then transitioned into Northstar Care for Children according to section
655.3256N.28.

655.4    Sec. 9. [256N.22] GUARDIANSHIP ASSISTANCE ELIGIBILITY.
655.5    Subdivision 1. General eligibility requirements. (a) To be eligible for guardianship
655.6assistance under this section, there must be a judicial determination under section
655.7260C.515, subdivision 4, that a transfer of permanent legal and physical custody to a
655.8relative is in the child's best interest. For a child under jurisdiction of a tribal court, a
655.9judicial determination under a similar provision in tribal code indicating that a relative
655.10will assume the duty and authority to provide care, control, and protection of a child who
655.11is residing in foster care, and to make decisions regarding the child's education, health
655.12care, and general welfare until adulthood, and that this is in the child's best interest is
655.13considered equivalent. Additionally, a child must:
655.14(1) have been removed from the child's home pursuant to a voluntary placement
655.15agreement or court order;
655.16(2)(i) have resided in foster care for at least six consecutive months in the home
655.17of the prospective relative custodian; or
655.18(ii) have received an exemption from the requirement in item (i) from the court
655.19based on a determination that:
655.20(A) an expedited move to permanency is in the child's best interest;
655.21(B) expedited permanency cannot be completed without provision of guardianship
655.22assistance; and
655.23(C) the prospective relative custodian is uniquely qualified to meet the child's needs
655.24on a permanent basis;
655.25(3) meet the agency determinations regarding permanency requirements in
655.26subdivision 2;
655.27(4) meet the applicable citizenship and immigration requirements in subdivision 3;
655.28(5) have been consulted regarding the proposed transfer of permanent legal and
655.29physical custody to a relative, if the child is at least 14 years of age or is expected to attain
655.3014 years of age prior to the transfer of permanent legal and physical custody; and
655.31(6) have a written, binding agreement under section 256N.25 among the caregiver or
655.32caregivers, the financially responsible agency, and the commissioner established prior to
655.33transfer of permanent legal and physical custody.
656.1(b) In addition to the requirements in paragraph (a), the child's prospective relative
656.2custodian or custodians must meet the applicable background study requirements in
656.3subdivision 4.
656.4(c) To be eligible for title IV-E guardianship assistance, a child must also meet any
656.5additional criteria in section 473(d) of the Social Security Act. The sibling of a child
656.6who meets the criteria for title IV-E guardianship assistance in section 473(d) of the
656.7Social Security Act is eligible for title IV-E guardianship assistance if the child and
656.8sibling are placed with the same prospective relative custodian or custodians, and the
656.9legally responsible agency, relatives, and commissioner agree on the appropriateness of
656.10the arrangement for the sibling. A child who meets all eligibility criteria except those
656.11specific to title IV-E guardianship assistance is entitled to guardianship assistance paid
656.12through funds other than title IV-E.
656.13    Subd. 2. Agency determinations regarding permanency. (a) To be eligible for
656.14guardianship assistance, the legally responsible agency must complete the following
656.15determinations regarding permanency for the child prior to the transfer of permanent
656.16legal and physical custody:
656.17(1) a determination that reunification and adoption are not appropriate permanency
656.18options for the child; and
656.19(2) a determination that the child demonstrates a strong attachment to the prospective
656.20relative custodian and the prospective relative custodian has a strong commitment to
656.21caring permanently for the child.
656.22(b) The legally responsible agency shall document the determinations in paragraph
656.23(a) and the supporting information for completing each determination in the case file and
656.24make them available for review as requested by the financially responsible agency and the
656.25commissioner during the guardianship assistance eligibility determination process.
656.26    Subd. 3. Citizenship and immigration status. A child must be a citizen of the
656.27United States or otherwise be eligible for federal public benefits according to the Personal
656.28Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order
656.29to be eligible for guardianship assistance.
656.30    Subd. 4. Background study. (a) A background study under section 245C.33 must
656.31be completed on each prospective relative custodian and any other adult residing in the
656.32home of the prospective relative custodian. A background study on the prospective
656.33relative custodian or adult residing in the household previously completed under section
656.34245C.04 for the purposes of foster care licensure may be used for the purposes of this
656.35section, provided that the background study is current at the time of the application for
656.36guardianship assistance.
657.1(b) If the background study reveals:
657.2(1) a felony conviction at any time for:
657.3(i) child abuse or neglect;
657.4(ii) spousal abuse;
657.5(iii) a crime against a child, including child pornography; or
657.6(iv) a crime involving violence, including rape, sexual assault, or homicide, but not
657.7including other physical assault or battery; or
657.8(2) a felony conviction within the past five years for:
657.9(i) physical assault;
657.10(ii) battery; or
657.11(iii) a drug-related offense;
657.12the prospective relative custodian is prohibited from receiving guardianship assistance
657.13on behalf of an otherwise eligible child.
657.14    Subd. 5. Responsibility for determining guardianship assistance eligibility. The
657.15commissioner shall determine eligibility for:
657.16(1) a child under the legal custody or responsibility of a Minnesota county social
657.17service agency who would otherwise remain in foster care;
657.18(2) a Minnesota child under tribal court jurisdiction who would otherwise remain
657.19in foster care; and
657.20(3) an Indian child being placed in Minnesota who meets title IV-E eligibility defined
657.21in section 473(d) of the Social Security Act. The agency or entity assuming responsibility
657.22for the child is responsible for the nonfederal share of the guardianship assistance payment.
657.23    Subd. 6. Exclusions. (a) A child with a guardianship assistance agreement under
657.24Northstar Care for Children is not eligible for the Minnesota family investment program
657.25child-only grant under chapter 256J.
657.26(b) The commissioner shall not enter into a guardianship assistance agreement with:
657.27(1) a child's biological parent;
657.28(2) an individual assuming permanent legal and physical custody of a child or the
657.29equivalent under tribal code without involvement of the child welfare system; or
657.30(3) an individual assuming permanent legal and physical custody of a child who was
657.31placed in Minnesota by another state or a tribe outside of Minnesota.
657.32    Subd. 7. Guardianship assistance eligibility determination. The financially
657.33responsible agency shall prepare a guardianship assistance eligibility determination
657.34for review and final approval by the commissioner. The eligibility determination must
657.35be completed according to requirements and procedures and on forms prescribed by
657.36the commissioner. Supporting documentation for the eligibility determination must be
658.1provided to the commissioner. The financially responsible agency and the commissioner
658.2must make every effort to establish a child's eligibility for title IV-E guardianship
658.3assistance. A child who is determined to be eligible for guardianship assistance must
658.4have a guardianship assistance agreement negotiated on the child's behalf according to
658.5section 256N.25.
658.6    Subd. 8. Termination of agreement. (a) A guardianship assistance agreement must
658.7be terminated in any of the following circumstances:
658.8(1) the child has attained the age of 18, or up to age 21 when the child meets a
658.9condition for extension in subdivision 11;
658.10(2) the child has not attained the age of 18 years of age, but the commissioner
658.11determines the relative custodian is no longer legally responsible for support of the child;
658.12(3) the commissioner determines the relative custodian is no longer providing
658.13financial support to the child up to age 21;
658.14(4) the death of the child; or
658.15(5) the relative custodian requests in writing termination of the guardianship
658.16assistance agreement.
658.17(b) A relative custodian is considered no longer legally responsible for support of
658.18the child in any of the following circumstances:
658.19(1) permanent legal and physical custody or guardianship of the child is transferred
658.20to another individual;
658.21(2) the death of the relative custodian under subdivision 9;
658.22(3) the child enlists in the military;
658.23(4) the child gets married; or
658.24(5) the child is determined an emancipated minor through legal action.
658.25    Subd. 9. Death of relative custodian or dissolution of custody. The guardianship
658.26assistance agreement ends upon death or dissolution of permanent legal and physical
658.27custody of both relative custodians in the case of assignment of custody to two individuals,
658.28or the sole relative custodian in the case of assignment of custody to one individual.
658.29Guardianship assistance eligibility may be continued according to subdivision 10.
658.30    Subd. 10. Assigning a child's guardianship assistance to a court-appointed
658.31guardian or custodian. (a) Guardianship assistance may be continued with the written
658.32consent of the commissioner to an individual who is a guardian or custodian appointed by
658.33a court for the child upon the death of both relative custodians in the case of assignment
658.34of custody to two individuals, or the sole relative custodian in the case of assignment
658.35of custody to one individual, unless the child is under the custody of a county, tribal,
658.36or child-placing agency.
659.1(b) Temporary assignment of guardianship assistance may be approved for a
659.2maximum of six consecutive months from the death of the relative custodian or custodians
659.3as provided in paragraph (a) and must adhere to the policies and procedures prescribed by
659.4the commissioner. If a court has not appointed a permanent legal guardian or custodian
659.5within six months, the guardianship assistance must terminate and must not be resumed.
659.6(c) Upon assignment of assistance payments under this subdivision, assistance must
659.7be provided from funds other than title IV-E.
659.8    Subd. 11. Extension of guardianship assistance after age 18. (a) Under the
659.9circumstances outlined in paragraph (e), a child may qualify for extension of the
659.10guardianship assistance agreement beyond the date the child attains age 18, up to the
659.11date the child attains the age of 21.
659.12(b) A request for extension of the guardianship assistance agreement must be
659.13completed in writing and submitted, including all supporting documentation, by the
659.14relative custodian to the commissioner at least 60 calendar days prior to the date that the
659.15current agreement will terminate.
659.16(c) A signed amendment to the current guardianship assistance agreement must be
659.17fully executed between the relative custodian and the commissioner at least ten business
659.18days prior to the termination of the current agreement. The request for extension and
659.19the fully executed amendment must be made according to requirements and procedures
659.20prescribed by the commissioner, including documentation of eligibility, and on forms
659.21prescribed by the commissioner.
659.22(d) If an agency is certifying a child for guardianship assistance and the child will
659.23attain the age of 18 within 60 calendar days of submission, the request for extension must
659.24be completed in writing and submitted, including all supporting documentation, with
659.25the guardianship assistance application.
659.26(e) A child who has attained the age of 16 prior to the effective date of the
659.27guardianship assistance agreement is eligible for extension of the agreement up to the
659.28date the child attains age 21 if the child:
659.29(1) is dependent on the relative custodian for care and financial support; and
659.30(2) meets at least one of the following conditions:
659.31(i) is completing a secondary education program or a program leading to an
659.32equivalent credential;
659.33(ii) is enrolled in an institution which provides postsecondary or vocational education;
659.34(iii) is participating in a program or activity designed to promote or remove barriers
659.35to employment;
659.36(iv) is employed for at least 80 hours per month; or
660.1(v) is incapable of doing any of the activities described in items (i) to (iv) due to
660.2a medical condition where incapability is supported by professional documentation
660.3according to the requirements and procedures prescribed by the commissioner.
660.4(f) A child who has not attained the age of 16 prior to the effective date of the
660.5guardianship assistance agreement is eligible for extension of the guardianship assistance
660.6agreement up to the date the child attains the age of 21 if the child is:
660.7(1) dependent on the relative custodian for care and financial support; and
660.8(2) possesses a physical or mental disability which impairs the capacity for
660.9independent living and warrants continuation of financial assistance, as determined by
660.10the commissioner.
660.11    Subd. 12. Beginning guardianship assistance component of Northstar Care for
660.12Children. Effective November 27, 2014, a child who meets the eligibility criteria for
660.13guardianship assistance in subdivision 1 may have a guardianship assistance agreement
660.14negotiated on the child's behalf according to section 256N.25. The effective date of the
660.15agreement must be January 1, 2015, or the date of the court order transferring permanent
660.16legal and physical custody, whichever is later. Except as provided under section 256N.26,
660.17subdivision 1, paragraph (c), the rate schedule for an agreement under this subdivision
660.18is determined under section 256N.26 based on the age of the child on the date that the
660.19prospective relative custodian signs the agreement.
660.20    Subd. 13. Transition to guardianship assistance under Northstar Care for
660.21Children. The commissioner may execute guardianship assistance agreements for a child
660.22with a relative custody agreement under section 257.85 executed on the child's behalf
660.23on or before November 26, 2014, in accordance with the priorities outlined in section
660.24256N.28, subdivision 7, paragraph (b). To facilitate transition into the guardianship
660.25assistance program, the commissioner may waive any guardianship assistance eligibility
660.26requirements for a child with a relative custody agreement under section 257.85 executed
660.27on the child's behalf on or before November 26, 2014. Agreements negotiated under
660.28this subdivision must be done according to the process outlined in section 256N.28,
660.29subdivision 7. The maximum rate used in the negotiation process for an agreement under
660.30this subdivision must be as outlined in section 256N.28, subdivision 7.

660.31    Sec. 10. [256N.23] ADOPTION ASSISTANCE ELIGIBILITY.
660.32    Subdivision 1. General eligibility requirements. (a) To be eligible for adoption
660.33assistance under this section, a child must:
660.34(1) be determined to be a child with special needs under subdivision 2;
660.35(2) meet the applicable citizenship and immigration requirements in subdivision 3;
661.1(3)(i) meet the criteria in section 473 of the Social Security Act; or
661.2(ii) have had foster care payments paid on the child's behalf while in out-of-home
661.3placement through the county or tribe and be either under the guardianship of the
661.4commissioner or under the jurisdiction of a Minnesota tribe and adoption, according to
661.5tribal law, is in the child's documented permanency plan; and
661.6(4) have a written, binding agreement under section 256N.25 among the adoptive
661.7parent, the financially responsible agency, or if there is no financially responsible agency,
661.8the agency designated by the commissioner, and the commissioner established prior to
661.9finalization of the adoption.
661.10(b) In addition to the requirements in paragraph (a), an eligible child's adoptive parent
661.11or parents must meet the applicable background study requirements in subdivision 4.
661.12(c) A child who meets all eligibility criteria except those specific to title IV-E adoption
661.13assistance shall receive adoption assistance paid through funds other than title IV-E.
661.14    Subd. 2. Special needs determination. (a) A child is considered a child with
661.15special needs under this section if the requirements in paragraphs (b) to (g) are met.
661.16(b) There must be a determination that the child must not or should not be returned
661.17to the home of the child's parents as evidenced by:
661.18(1) a court-ordered termination of parental rights;
661.19(2) a petition to terminate parental rights;
661.20(3) consent of parent to adoption accepted by the court under chapter 260C;
661.21(4) in circumstances when tribal law permits the child to be adopted without a
661.22termination of parental rights, a judicial determination by a tribal court indicating the valid
661.23reason why the child cannot or should not return home;
661.24(5) a voluntary relinquishment under section 259.25 or 259.47 or, if relinquishment
661.25occurred in another state, the applicable laws in that state; or
661.26(6) the death of the legal parent or parents if the child has two legal parents.
661.27(c) There exists a specific factor or condition of which it is reasonable to conclude
661.28that the child cannot be placed with adoptive parents without providing adoption
661.29assistance as evidenced by:
661.30(1) a determination by the Social Security Administration that the child meets all
661.31medical or disability requirements of title XVI of the Social Security Act with respect to
661.32eligibility for Supplemental Security Income benefits;
661.33(2) a documented physical, mental, emotional, or behavioral disability not covered
661.34under clause (1);
661.35(3) a member of a sibling group being adopted at the same time by the same parent;
662.1(4) an adoptive placement in the home of a parent who previously adopted a sibling
662.2for whom they receive adoption assistance; or
662.3(5) documentation that the child is an at-risk child.
662.4(d) A reasonable but unsuccessful effort must have been made to place the child
662.5with adoptive parents without providing adoption assistance as evidenced by:
662.6(1) a documented search for an appropriate adoptive placement; or
662.7(2) a determination by the commissioner that a search under clause (1) is not in the
662.8best interests of the child.
662.9(e) The requirement for a documented search for an appropriate adoptive placement
662.10under paragraph (d), including the registration of the child with the state adoption
662.11exchange and other recruitment methods under paragraph (f), must be waived if:
662.12(1) the child is being adopted by a relative and it is determined by the child-placing
662.13agency that adoption by the relative is in the best interests of the child;
662.14(2) the child is being adopted by a foster parent with whom the child has developed
662.15significant emotional ties while in the foster parent's care as a foster child and it is
662.16determined by the child-placing agency that adoption by the foster parent is in the best
662.17interests of the child; or
662.18(3) the child is being adopted by a parent that previously adopted a sibling of the
662.19child, and it is determined by the child-placing agency that adoption by this parent is
662.20in the best interests of the child.
662.21For an Indian child covered by the Indian Child Welfare Act, a waiver must not be
662.22granted unless the child-placing agency has complied with the placement preferences
662.23required by the Indian Child Welfare Act, United States Code, title 25, section 1915(a).
662.24(f) To meet the requirement of a documented search for an appropriate adoptive
662.25placement under paragraph (d), clause (1), the child-placing agency minimally must:
662.26(1) conduct a relative search as required by section 260C.221 and give consideration
662.27to placement with a relative, as required by section 260C.212, subdivision 2;
662.28(2) comply with the placement preferences required by the Indian Child Welfare Act
662.29when the Indian Child Welfare Act, United States Code, title 25, section 1915(a), applies;
662.30(3) locate prospective adoptive families by registering the child on the state adoption
662.31exchange, as required under section 259.75; and
662.32(4) if registration with the state adoption exchange does not result in the identification
662.33of an appropriate adoptive placement, the agency must employ additional recruitment
662.34methods prescribed by the commissioner.
662.35(g) Once the legally responsible agency has determined that placement with an
662.36identified parent is in the child's best interests and made full written disclosure about the
663.1child's social and medical history, the agency must ask the prospective adoptive parent if
663.2the prospective adoptive parent is willing to adopt the child without receiving adoption
663.3assistance under this section. If the identified parent is either unwilling or unable to
663.4adopt the child without adoption assistance, the legally responsible agency must provide
663.5documentation as prescribed by the commissioner to fulfill the requirement to make a
663.6reasonable effort to place the child without adoption assistance. If the identified parent is
663.7willing to adopt the child without adoption assistance, the parent must provide a written
663.8statement to this effect to the legally responsible agency and the statement must be
663.9maintained in the permanent adoption record of the legally responsible agency. For children
663.10under guardianship of the commissioner, the legally responsible agency shall submit a copy
663.11of this statement to the commissioner to be maintained in the permanent adoption record.
663.12    Subd. 3. Citizenship and immigration status. (a) A child must be a citizen of the
663.13United States or otherwise eligible for federal public benefits according to the Personal
663.14Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to
663.15be eligible for the title IV-E adoption assistance program.
663.16(b) A child must be a citizen of the United States or meet the qualified alien
663.17requirements as defined in the Personal Responsibility and Work Opportunity
663.18Reconciliation Act of 1996, as amended, in order to be eligible for adoption assistance
663.19paid through funds other than title IV-E.
663.20    Subd. 4. Background study. A background study under section 259.41 must be
663.21completed on each prospective adoptive parent. If the background study reveals:
663.22(1) a felony conviction at any time for:
663.23(i) child abuse or neglect;
663.24(ii) spousal abuse;
663.25(iii) a crime against a child, including child pornography; or
663.26(iv) a crime involving violence, including rape, sexual assault, or homicide, but not
663.27including other physical assault or battery; or
663.28(2) a felony conviction within the past five years for:
663.29(i) physical assault;
663.30(ii) battery; or
663.31(iii) a drug-related offense;
663.32the adoptive parent is prohibited from receiving adoption assistance on behalf of an
663.33otherwise eligible child.
663.34    Subd. 5. Responsibility for determining adoption assistance eligibility. The
663.35commissioner must determine eligibility for:
664.1(1) a child under the guardianship of the commissioner who would otherwise remain
664.2in foster care;
664.3(2) a child who is not under the guardianship of the commissioner who meets title
664.4IV-E eligibility defined in section 473 of the Social Security Act and no state agency has
664.5legal responsibility for placement and care of the child;
664.6(3) a Minnesota child under tribal jurisdiction who would otherwise remain in foster
664.7care; and
664.8(4) an Indian child being placed in Minnesota who meets title IV-E eligibility defined
664.9in section 473 of the Social Security Act. The agency or entity assuming responsibility for
664.10the child is responsible for the nonfederal share of the adoption assistance payment.
664.11    Subd. 6. Exclusions. The commissioner must not enter into an adoption assistance
664.12agreement with the following individuals:
664.13(1) a child's biological parent or stepparent;
664.14(2) a child's relative under section 260C.007, subdivision 27, with whom the child
664.15resided immediately prior to child welfare involvement unless:
664.16(i) the child was in the custody of a Minnesota county or tribal agency pursuant to
664.17an order under chapter 260C or equivalent provisions of tribal code and the agency had
664.18placement and care responsibility for permanency planning for the child; and
664.19(ii) the child is under guardianship of the commissioner of human services according
664.20to the requirements of section 260C.325, subdivision 1 or 3, or is a ward of a Minnesota
664.21tribal court after termination of parental rights, suspension of parental rights, or a finding
664.22by the tribal court that the child cannot safely return to the care of the parent;
664.23(3) an individual adopting a child who is the subject of a direct adoptive placement
664.24under section 259.47 or the equivalent in tribal code;
664.25(4) a child's legal custodian or guardian who is now adopting the child; or
664.26(5) an individual who is adopting a child who is not a citizen or resident of the
664.27United States and was either adopted in another country or brought to the United States
664.28for the purposes of adoption.
664.29    Subd. 7. Adoption assistance eligibility determination. (a) The financially
664.30responsible agency shall prepare an adoption assistance eligibility determination for
664.31review and final approval by the commissioner. When there is no financially responsible
664.32agency, the adoption assistance eligibility determination must be completed by the
664.33agency designated by the commissioner. The eligibility determination must be completed
664.34according to requirements and procedures and on forms prescribed by the commissioner.
664.35The financially responsible agency and the commissioner shall make every effort to
664.36establish a child's eligibility for title IV-E adoption assistance. Documentation from a
665.1qualified expert for the eligibility determination must be provided to the commissioner
665.2to verify that a child meets the special needs criteria in subdivision 2. A child who
665.3is determined to be eligible for adoption assistance must have an adoption assistance
665.4agreement negotiated on the child's behalf according to section 256N.25.
665.5(b) Documentation from a qualified expert of a disability is limited to evidence
665.6deemed appropriate by the commissioner and must be submitted to the commissioner with
665.7the eligibility determination. Examples of appropriate documentation include, but are not
665.8limited to, medical records, psychological assessments, educational or early childhood
665.9evaluations, court findings, and social and medical history.
665.10(c) Documentation that the child is at risk of developing physical, mental, emotional,
665.11or behavioral disabilities must be submitted according to policies and procedures
665.12prescribed by the commissioner.
665.13    Subd. 8. Termination of agreement. (a) An adoption assistance agreement must
665.14terminate in any of the following circumstances:
665.15(1) the child has attained the age of 18, or up to age 21 when the child meets a
665.16condition for extension in subdivision 12;
665.17(2) the child has not attained the age of 18, but the commissioner determines the
665.18adoptive parent is no longer legally responsible for support of the child;
665.19(3) the commissioner determines the adoptive parent is no longer providing financial
665.20support to the child up to age 21;
665.21(4) the death of the child; or
665.22(5) the adoptive parent requests in writing the termination of the adoption assistance
665.23agreement.
665.24(b) An adoptive parent is considered no longer legally responsible for support of the
665.25child in any of the following circumstances:
665.26(1) parental rights to the child are legally terminated or a court accepted the parent's
665.27consent to adoption under chapter 260C;
665.28(2) permanent legal and physical custody or guardianship of the child is transferred
665.29to another individual;
665.30(3) death of the adoptive parent under subdivision 9;
665.31(4) the child enlists in the military;
665.32(5) the child gets married; or
665.33(6) the child is determined an emancipated minor through legal action.
665.34    Subd. 9. Death of adoptive parent or adoption dissolution. The adoption
665.35assistance agreement ends upon death or termination of parental rights of both adoptive
665.36parents in the case of a two-parent adoption, or the sole adoptive parent in the case of
666.1a single-parent adoption. The child's adoption assistance eligibility may be continued
666.2according to subdivision 10.
666.3    Subd. 10. Continuing a child's title IV-E adoption assistance in a subsequent
666.4adoption. (a) The child maintains eligibility for title IV-E adoption assistance in a
666.5subsequent adoption if the following criteria are met:
666.6(1) the child is determined to be a child with special needs as outlined in subdivision
666.72; and
666.8(2) the subsequent adoptive parent resides in Minnesota.
666.9(b) If a child had a title IV-E adoption assistance agreement in effect prior to the
666.10death of the adoptive parent or dissolution of the adoption, and the subsequent adoptive
666.11parent resides outside of Minnesota, the commissioner is not responsible for determining
666.12whether the child meets the definition of special needs, entering into the adoption
666.13assistance agreement, and making any adoption assistance payments outlined in the new
666.14agreement unless a state agency in Minnesota has responsibility for placement and care of
666.15the child at the time of the subsequent adoption. If there is no state agency in Minnesota
666.16that has responsibility for placement and care of the child at the time of the subsequent
666.17adoption, the public child welfare agency in the subsequent adoptive parent's residence is
666.18responsible for determining whether the child meets the definition of special needs and
666.19entering into the adoption assistance agreement.
666.20    Subd. 11. Assigning a child's adoption assistance to a court-appointed guardian
666.21or custodian. (a) State-funded adoption assistance may be continued with the written
666.22consent of the commissioner to an individual who is a guardian appointed by a court for
666.23the child upon the death of both the adoptive parents in the case of a two-parent adoption,
666.24or the sole adoptive parent in the case of a single-parent adoption, unless the child is
666.25under the custody of a state agency.
666.26(b) Temporary assignment of adoption assistance may be approved by the
666.27commissioner for a maximum of six consecutive months from the death of the adoptive
666.28parent or parents under subdivision 9 and must adhere to the requirements and procedures
666.29prescribed by the commissioner. If, within six months, the child has not been adopted by a
666.30person agreed upon by the commissioner, or a court has not appointed a permanent legal
666.31guardian under section 260C.325, 525.5-313, or similar law of another jurisdiction, the
666.32adoption assistance must terminate.
666.33(c) Upon assignment of payments under this subdivision, assistance must be from
666.34funds other than title IV-E.
667.1    Subd. 12. Extension of adoption assistance agreement. (a) Under certain limited
667.2circumstances a child may qualify for extension of the adoption assistance agreement
667.3beyond the date the child attains age 18, up to the date the child attains the age of 21.
667.4(b) A request for extension of the adoption assistance agreement must be completed
667.5in writing and submitted, including all supporting documentation, by the adoptive parent
667.6to the commissioner at least 60 calendar days prior to the date that the current agreement
667.7will terminate.
667.8(c) A signed amendment to the current adoption assistance agreement must be
667.9fully executed between the adoptive parent and the commissioner at least ten business
667.10days prior to the termination of the current agreement. The request for extension and the
667.11fully executed amendment must be made according to the requirements and procedures
667.12prescribed by the commissioner, including documentation of eligibility, on forms
667.13prescribed by the commissioner.
667.14(d) If an agency is certifying a child for adoption assistance and the child will attain
667.15the age of 18 within 60 calendar days of submission, the request for extension must be
667.16completed in writing and submitted, including all supporting documentation, with the
667.17adoption assistance application.
667.18(e) A child who has attained the age of 16 prior to the finalization of the child's
667.19adoption is eligible for extension of the adoption assistance agreement up to the date the
667.20child attains age 21 if the child is:
667.21(1) dependent on the adoptive parent for care and financial support; and
667.22(2)(i) completing a secondary education program or a program leading to an
667.23equivalent credential;
667.24(ii) enrolled in an institution that provides postsecondary or vocational education;
667.25(iii) participating in a program or activity designed to promote or remove barriers to
667.26employment;
667.27(iv) employed for at least 80 hours per month; or
667.28(v) incapable of doing any of the activities described in items (i) to (iv) due to
667.29a medical condition where incapability is supported by documentation from an expert
667.30according to the requirements and procedures prescribed by the commissioner.
667.31(f) A child who has not attained the age of 16 prior to finalization of the child's
667.32adoption is eligible for extension of the adoption assistance agreement up to the date the
667.33child attains the age of 21 if the child is:
667.34(1) dependent on the adoptive parent for care and financial support; and
667.35(2)(i) enrolled in a secondary education program or a program leading to the
667.36equivalent; or
668.1(ii) possesses a physical or mental disability that impairs the capacity for independent
668.2living and warrants continuation of financial assistance as determined by the commissioner.
668.3    Subd. 13. Beginning adoption assistance under Northstar Care for Children.
668.4Effective November 27, 2014, a child who meets the eligibility criteria for adoption
668.5assistance in subdivision 1, may have an adoption assistance agreement negotiated on
668.6the child's behalf according to section 256N.25, and the effective date of the agreement
668.7must be January 1, 2015, or the date of the court order finalizing the adoption, whichever
668.8is later. Except as provided under section 256N.26, subdivision 1, paragraph (c), the
668.9maximum rate schedule for the agreement must be determined according to section
668.10256N.26 based on the age of the child on the date that the prospective adoptive parent or
668.11parents sign the agreement.
668.12    Subd. 14. Transition to adoption assistance under Northstar Care for Children.
668.13The commissioner may offer adoption assistance agreements under this chapter to a
668.14child with an adoption assistance agreement under chapter 259A executed on the child's
668.15behalf on or before November 26, 2014, according to the priorities outlined in section
668.16256N.28, subdivision 7, paragraph (b). To facilitate transition into the Northstar Care for
668.17Children adoption assistance program, the commissioner has the authority to waive any
668.18Northstar Care for Children adoption assistance eligibility requirements for a child with
668.19an adoption assistance agreement under chapter 259A executed on the child's behalf on
668.20or before November 26, 2014. Agreements negotiated under this subdivision must be in
668.21accordance with the process in section 256N.28, subdivision 7. The maximum rate used in
668.22the negotiation process for an agreement under this subdivision must be as outlined in
668.23section 256N.28, subdivision 7.

668.24    Sec. 11. [256N.24] ASSESSMENTS.
668.25    Subdivision 1. Assessment. (a) Each child eligible under sections 256N.21,
668.26256N.22, and 256N.23, must be assessed to determine the benefits the child may receive
668.27under section 256N.26, in accordance with the assessment tool, process, and requirements
668.28specified in subdivision 2.
668.29(b) If an agency applies the emergency foster care rate for initial placement under
668.30section 256N.26, the agency may wait up to 30 days to complete the initial assessment.
668.31(c) Unless otherwise specified in paragraph (d), a child must be assessed at the basic
668.32level, level B, or one of ten supplemental difficulty of care levels, levels C to L.
668.33(d) An assessment must not be completed for:
669.1(1) a child eligible for guardianship assistance under section 256N.22 or adoption
669.2assistance under section 256N.23 who is determined to be an at-risk child. A child under
669.3this clause must be assigned level A under section 256N.26, subdivision 1; and
669.4(2) a child transitioning into Northstar Care for Children under section 256N.28,
669.5subdivision 7, unless the commissioner determines an assessment is appropriate.
669.6    Subd. 2. Establishment of assessment tool, process, and requirements. Consistent
669.7with sections 256N.001 to 256N.28, the commissioner shall establish an assessment tool
669.8to determine the basic and supplemental difficulty of care, and shall establish the process
669.9to be followed and other requirements, including appropriate documentation, when
669.10conducting the initial assessment of a child entering Northstar Care for Children or when
669.11the special assessment and reassessments may be needed for children continuing in the
669.12program. The assessment tool must take into consideration the strengths and needs of the
669.13child and the extra parenting provided by the caregiver to meet the child's needs.
669.14    Subd. 3. Child care allowance portion of assessment. (a) The assessment tool
669.15established under subdivision 2 must include consideration of the caregiver's need for
669.16child care under this subdivision, with greater consideration for children of younger ages.
669.17(b) The child's assessment must include consideration of the caregiver's need for
669.18child care if the following criteria are met:
669.19(1) the child is under age 13;
669.20(2) all available adult caregivers are employed or attending educational or vocational
669.21training programs; and
669.22(3) the caregiver does not receive child care assistance for the child under chapter
669.23119B.
669.24(c) For children younger than seven years of age, the level determined by the
669.25non-child care portions of the assessment must be adjusted based on the average number
669.26of hours child care is needed each week due to employment or attending a training or
669.27educational program as follows:
669.28(1) fewer than ten hours or if the caregiver is participating in the child care assistance
669.29program under chapter 119B, no adjustment;
669.30(2) ten to 19 hours or if needed during school summer vacation or equivalent only,
669.31increase one level;
669.32(3) 20 to 29 hours, increase two levels;
669.33(4) 30 to 39 hours, increase three levels; and
669.34(5) 40 or more hours, increase four levels.
669.35(d) For children at least seven years of age but younger than 13, the level determined
669.36by the non-child care portions of the assessment must be adjusted based on the average
670.1number of hours child care is needed each week due to employment or attending a training
670.2or educational program as follows:
670.3(1) fewer than 20 hours, needed during school summer vacation or equivalent only,
670.4or if the caregiver is participating in the child care assistance program under chapter
670.5119B, no adjustment;
670.6(2) 20 to 39 hours, increase one level; and
670.7(3) 40 or more hours, increase two levels.
670.8(e) When the child attains the age of seven, the child care allowance must be reduced
670.9by reducing the level to that available under paragraph (d). For children in foster care,
670.10benefits under section 256N.26 must be automatically reduced when the child turns seven.
670.11For children who receive guardianship assistance or adoption assistance, agreements must
670.12include similar provisions to ensure that the benefit provided to these children does not
670.13exceed the benefit provided to children in foster care.
670.14(f) When the child attains the age of 13, the child care allowance must be eliminated
670.15by reducing the level to that available prior to any consideration of the caregiver's need
670.16for child care. For children in foster care, benefits under section 256N.26 must be
670.17automatically reduced when the child attains the age of 13. For children who receive
670.18guardianship assistance or adoption assistance, agreements must include similar provisions
670.19to ensure that the benefit provided to these children does not exceed the benefit provided
670.20to children in foster care.
670.21(g) The child care allowance under this subdivision is not available to caregivers
670.22who receive the child care assistance under chapter 119B. A caregiver receiving a child
670.23care allowance under this subdivision must notify the commissioner if the caregiver
670.24subsequently receives the child care assistance program under chapter 119B, and the
670.25level must be reduced to that available prior to any consideration of the caregiver's need
670.26for child care.
670.27(h) In establishing the assessment tool under subdivision 2, the commissioner must
670.28design the tool so that the levels applicable to the non-child care portions of the assessment
670.29at a given age accommodate the requirements of this subdivision.
670.30    Subd. 4. Extraordinary levels. (a) The assessment tool established under
670.31subdivision 2 must provide a mechanism through which up to five levels can be added
670.32to the supplemental difficulty of care for a particular child under section 256N.26,
670.33subdivision 4. In establishing the assessment tool, the commissioner must design the tool
670.34so that the levels applicable to the portions of the assessment other than the extraordinary
670.35levels can accommodate the requirements of this subdivision.
671.1(b) These extraordinary levels are available when all of the following circumstances
671.2apply:
671.3(1) the child has extraordinary needs as determined by the assessment tool provided
671.4for under subdivision 2, and the child meets other requirements established by the
671.5commissioner, such as a minimum score on the assessment tool;
671.6(2) the child's extraordinary needs require extraordinary care and intense supervision
671.7that is provided by the child's caregiver as part of the parental duties as described in the
671.8supplemental difficulty of care rate, section 256N.02, subdivision 21. This extraordinary
671.9care provided by the caregiver is required so that the child can be safely cared for in the
671.10home and community, and prevents residential placement;
671.11(3) the child is physically living in a foster family setting, as defined in Minnesota
671.12Rules, part 2960.3010, subpart 23, or physically living in the home with the adoptive
671.13parent or relative custodian; and
671.14(4) the child is receiving the services for which the child is eligible through medical
671.15assistance programs or other programs that provide necessary services for children with
671.16disabilities or other medical and behavioral conditions to live with the child's family, but
671.17the agency with caregiver's input has identified a specific support gap that cannot be met
671.18through home and community support waivers or other programs that are designed to
671.19provide support for children with special needs.
671.20(c) The agency completing an assessment, under subdivision 2, that suggests an
671.21extraordinary level must document as part of the assessment, the following:
671.22(1) the assessment tool that determined that the child's needs or disabilities require
671.23extraordinary care and intense supervision;
671.24(2) a summary of the extraordinary care and intense supervision that is provided by
671.25the caregiver as part of the parental duties as described in the supplemental difficulty of
671.26care rate, section 256N.02, subdivision 21;
671.27(3) confirmation that the child is currently physically residing in the foster family
671.28setting or in the home with the adoptive parent or relative custodian;
671.29(4) the efforts of the agency, caregiver, parents, and others to request support services
671.30in the home and community that would ease the degree of parental duties provided by the
671.31caregiver for the care and supervision of the child. This would include documentation of
671.32the services provided for the child's needs or disabilities, and the services that were denied
671.33or not available from the local social service agency, community agency, the local school
671.34district, local public health department, the parent or child's medical insurance provider;
671.35(5) the specific support gap identified that places the child's safety and well-being at
671.36risk in the home or community and is necessary to prevent residential placement; and
672.1(6) the extraordinary care and intense supervision provided by the foster, adoptive,
672.2or guardianship caregivers to maintain the child safely in the child's home and prevent
672.3residential placement that cannot be supported by medical assistance or other programs
672.4that provide services, necessary care for children with disabilities, or other medical or
672.5behavioral conditions in the home or community.
672.6(d) An agency completing an assessment under subdivision 2 that suggests
672.7an extraordinary level is appropriate must forward the assessment and required
672.8documentation to the commissioner. If the commissioner approves, the extraordinary
672.9levels must be retroactive to the date the assessment was forwarded.
672.10    Subd. 5. Timing of initial assessment. For a child entering Northstar Care for
672.11Children under section 256N.21, the initial assessment must be completed within 30
672.12days after the child is placed in foster care.
672.13    Subd. 6. Completion of initial assessment. (a) The assessment must be completed
672.14in consultation with the child's caregiver. Face-to-face contact with the caregiver is not
672.15required to complete the assessment.
672.16(b) Initial assessments are completed for foster children, eligible under section
672.17256N.21.
672.18(c) The initial assessment must be completed by the financially responsible agency,
672.19in consultation with the legally responsible agency if different, within 30 days of the
672.20child's placement in foster care.
672.21(d) If the foster parent is unable or unwilling to cooperate with the assessment process,
672.22the child shall be assigned the basic level, level B under section 256N.26, subdivision 3.
672.23(e) Notice to the foster parent shall be provided as specified in subdivision 12.
672.24    Subd. 7. Timing of special assessment. (a) A special assessment is required as part
672.25of the negotiation of the guardianship assistance agreement under section 256N.22 if:
672.26(1) the child was not placed in foster care with the prospective relative custodian
672.27or custodians prior to the negotiation of the guardianship assistance agreement under
672.28section 256N.25; or
672.29(2) any requirement for reassessment under subdivision 8 is met.
672.30(b) A special assessment is required as part of the negotiation of the adoption
672.31assistance agreement under section 256N.23 if:
672.32(1) the child was not placed in foster care with the prospective adoptive parent
672.33or parents prior to the negotiation of the adoption assistance agreement under section
672.34256N.25; or
672.35(2) any requirement for reassessment under subdivision 8 is met.
673.1(c) A special assessment is required when a child transitions from a pre-Northstar
673.2Care for Children program into Northstar Care for Children if the commissioner
673.3determines that a special assessment is appropriate instead of assigning the transition child
673.4to a level under section 256N.28.
673.5(d) The special assessment must be completed prior to the establishment of a
673.6guardianship assistance or adoption assistance agreement on behalf of the child.
673.7    Subd. 8. Completing the special assessment. (a) The special assessment must
673.8be completed in consultation with the child's caregiver. Face-to-face contact with the
673.9caregiver is not required to complete the special assessment.
673.10(b) If a new special assessment is required prior to the effective date of the
673.11guardianship assistance agreement, it must be completed by the financially responsible
673.12agency, in consultation with the legally responsible agency if different. If the prospective
673.13relative custodian is unable or unwilling to cooperate with the special assessment process,
673.14the child shall be assigned the basic level, level B under section 256N.26, subdivision 3,
673.15unless the child is known to be an at-risk child, in which case, the child shall be assigned
673.16level A under section 256N.26, subdivision 1.
673.17(c) If a special assessment is required prior to the effective date of the adoption
673.18assistance agreement, it must be completed by the financially responsible agency, in
673.19consultation with the legally responsible agency if different. If there is no financially
673.20responsible agency, the special assessment must be completed by the agency designated by
673.21the commissioner. If the prospective adoptive parent is unable or unwilling to cooperate
673.22with the special assessment process, the child must be assigned the basic level, level B
673.23under section 256N.26, subdivision 3, unless the child is known to be an at-risk child, in
673.24which case, the child shall be assigned level A under section 256N.26, subdivision 1.
673.25(d) Notice to the prospective relative custodians or prospective adoptive parents
673.26must be provided as specified in subdivision 12.
673.27    Subd. 9. Timing of and requests for reassessments. Reassessments for an eligible
673.28child must be completed within 30 days of any of the following events:
673.29(1) for a child in continuous foster care, when six months have elapsed since
673.30completion of the last assessment;
673.31(2) for a child in continuous foster care, change of placement location;
673.32(3) for a child in foster care, at the request of the financially responsible agency or
673.33legally responsible agency;
673.34(4) at the request of the commissioner; or
673.35(5) at the request of the caregiver under subdivision 9.
674.1    Subd. 10. Caregiver requests for reassessments. (a) A caregiver may initiate
674.2a reassessment request for an eligible child in writing to the financially responsible
674.3agency or, if there is no financially responsible agency, the agency designated by the
674.4commissioner. The written request must include the reason for the request and the
674.5name, address, and contact information of the caregivers. For an eligible child with a
674.6guardianship assistance or adoption assistance agreement, the caregiver may request a
674.7reassessment if at least six months have elapsed since any previously requested review.
674.8For an eligible foster child, a foster parent may request reassessment in less than six
674.9months with written documentation that there have been significant changes in the child's
674.10needs that necessitate an earlier reassessment.
674.11(b) A caregiver may request a reassessment of an at-risk child for whom a
674.12guardianship assistance or adoption assistance agreement has been executed if the
674.13caregiver has satisfied the commissioner with written documentation from a qualified
674.14expert that the potential disability upon which eligibility for the agreement was based has
674.15manifested itself, consistent with section 256N.25, subdivision 3, paragraph (b).
674.16(c) If the reassessment cannot be completed within 30 days of the caregiver's request,
674.17the agency responsible for reassessment must notify the caregiver of the reason for the
674.18delay and a reasonable estimate of when the reassessment can be completed.
674.19    Subd. 11. Completion of reassessment. (a) The reassessment must be completed
674.20in consultation with the child's caregiver. Face-to-face contact with the caregiver is not
674.21required to complete the reassessment.
674.22(b) For foster children eligible under section 256N.21, reassessments must be
674.23completed by the financially responsible agency, in consultation with the legally
674.24responsible agency if different.
674.25(c) If reassessment is required after the effective date of the guardianship assistance
674.26agreement, the reassessment must be completed by the financially responsible agency.
674.27(d) If a reassessment is required after the effective date of the adoption assistance
674.28agreement, it must be completed by the financially responsible agency or, if there is no
674.29financially responsible agency, the agency designated by the commissioner.
674.30(e) If the child's caregiver is unable or unwilling to cooperate with the reassessment,
674.31the child must be assessed at level B under section 256N.26, subdivision 3, unless the
674.32child has an adoption assistance or guardianship assistance agreement in place and is
674.33known to be an at-risk child, in which case the child must be assessed at level A under
674.34section 256N.26, subdivision 1.
674.35    Subd. 12. Approval of initial assessments, special assessments, and
674.36reassessments. (a) Any agency completing initial assessments, special assessments, or
675.1reassessments must designate one or more supervisors or other staff to examine and approve
675.2assessments completed by others in the agency under subdivision 2. The person approving
675.3an assessment must not be the case manager or staff member completing that assessment.
675.4(b) In cases where a special assessment or reassessment for guardian assistance
675.5and adoption assistance is required under subdivision 7 or 10, the commissioner shall
675.6review and approve the assessment as part of the eligibility determination process outlined
675.7in section 256N.22, subdivision 7, for guardianship assistance, or section 256N.23,
675.8subdivision 7, for adoption assistance. The assessment determines the maximum for the
675.9negotiated agreement amount under section 256N.25.
675.10(c) The new rate is effective the calendar month that the assessment is approved,
675.11or the effective date of the agreement, whichever is later.
675.12    Subd. 13. Notice for caregiver. (a) The agency as defined in subdivision 5 or 10
675.13that is responsible for completing the initial assessment or reassessment must provide the
675.14child's caregiver with written notice of the initial assessment or reassessment.
675.15(b) Initial assessment notices must be sent within 15 days of completion of the initial
675.16assessment and must minimally include the following:
675.17(1) a summary of the child's completed individual assessment used to determine the
675.18initial rating;
675.19(2) statement of rating and benefit level;
675.20(3) statement of the circumstances under which the agency must reassess the child;
675.21(4) procedure to seek reassessment;
675.22(5) notice that the caregiver has the right to a fair hearing review of the assessment
675.23and how to request a fair hearing, consistent with section 256.045, subdivision 3; and
675.24(6) the name, telephone number, and e-mail, if available, of a contact person at the
675.25agency completing the assessment.
675.26(c) Reassessment notices must be sent within 15 days after the completion of the
675.27reassessment and must minimally include the following:
675.28(1) a summary of the child's individual assessment used to determine the new rating;
675.29(2) any change in rating and its effective date;
675.30(3) procedure to seek reassessment;
675.31(4) notice that if a change in rating results in a reduction of benefits, the caregiver
675.32has the right to a fair hearing review of the assessment and how to request a fair hearing
675.33consistent with section 256.045, subdivision 3;
675.34(5) notice that a caregiver who requests a fair hearing of the reassessed rating within
675.35ten days may continue at the current rate pending the hearing, but the agency may recover
675.36any overpayment; and
676.1(6) name, telephone number, and e-mail, if available, of a contact person at the
676.2agency completing the reassessment.
676.3(d) Notice is not required for special assessments since the notice is part of the
676.4guardianship assistance or adoption assistance negotiated agreement completed according
676.5to section 256N.25.
676.6    Subd. 14. Assessment tool determines rate of benefits. The assessment tool
676.7established by the commissioner in subdivision 2 determines the monthly benefit level
676.8for children in foster care. The monthly payment for guardian assistance or adoption
676.9assistance may be negotiated up to the monthly benefit level under foster care for those
676.10children eligible for a payment under section 256N.26, subdivision 1.

676.11    Sec. 12. [256N.25] AGREEMENTS.
676.12    Subdivision 1. Agreement; guardianship assistance; adoption assistance. (a)
676.13In order to receive guardianship assistance or adoption assistance benefits on behalf of
676.14an eligible child, a written, binding agreement between the caregiver or caregivers, the
676.15financially responsible agency, or, if there is no financially responsible agency, the agency
676.16designated by the commissioner, and the commissioner must be established prior to
676.17finalization of the adoption or a transfer of permanent legal and physical custody. The
676.18agreement must be negotiated with the caregiver or caregivers under subdivision 2.
676.19(b) The agreement must be on a form approved by the commissioner and must
676.20specify the following:
676.21(1) duration of the agreement;
676.22(2) the nature and amount of any payment, services, and assistance to be provided
676.23under such agreement;
676.24(3) the child's eligibility for Medicaid services;
676.25(4) the terms of the payment, including any child care portion as specified in section
676.26256N.24, subdivision 3;
676.27(5) eligibility for reimbursement of nonrecurring expenses associated with adopting
676.28or obtaining permanent legal and physical custody of the child, to the extent that the
676.29total cost does not exceed $2,000 per child;
676.30(6) that the agreement must remain in effect regardless of the state of which the
676.31adoptive parents or relative custodians are residents at any given time;
676.32(7) provisions for modification of the terms of the agreement, including renegotiation
676.33of the agreement; and
676.34(8) the effective date of the agreement.
677.1(c) The caregivers, the commissioner, and the financially responsible agency, or, if
677.2there is no financially responsible agency, the agency designated by the commissioner, must
677.3sign the agreement. A copy of the signed agreement must be given to each party. Once
677.4signed by all parties, the commissioner shall maintain the official record of the agreement.
677.5(d) The effective date of the guardianship assistance agreement must be the date of the
677.6court order that transfers permanent legal and physical custody to the relative. The effective
677.7date of the adoption assistance agreement is the date of the finalized adoption decree.
677.8(e) Termination or disruption of the preadoptive placement or the foster care
677.9placement prior to assignment of custody makes the agreement with that caregiver void.
677.10    Subd. 2. Negotiation of agreement. (a) When a child is determined to be eligible
677.11for guardianship assistance or adoption assistance, the financially responsible agency, or,
677.12if there is no financially responsible agency, the agency designated by the commissioner,
677.13must negotiate with the caregiver to develop an agreement under subdivision 1. If and when
677.14the caregiver and agency reach concurrence as to the terms of the agreement, both parties
677.15shall sign the agreement. The agency must submit the agreement, along with the eligibility
677.16determination outlined in sections 256N.22, subdivision 7, and 256N.23, subdivision 7, to
677.17the commissioner for final review, approval, and signature according to subdivision 1.
677.18(b) A monthly payment is provided as part of the adoption assistance or guardianship
677.19assistance agreement to support the care of children unless the child is determined to be an
677.20at-risk child, in which case the special at-risk monthly payment under section 256N.26,
677.21subdivision 7, must be made until the caregiver obtains written documentation from a
677.22qualified expert that the potential disability upon which eligibility for the agreement
677.23was based has manifested itself.
677.24(1) The amount of the payment made on behalf of a child eligible for guardianship
677.25assistance or adoption assistance is determined through agreement between the prospective
677.26relative custodian or the adoptive parent and the financially responsible agency, or, if there
677.27is no financially responsible agency, the agency designated by the commissioner, using
677.28the assessment tool established by the commissioner in section 256N.24, subdivision 2,
677.29and the associated benefit and payments outlined in section 256N.26. Except as provided
677.30under section 256N.24, subdivision 1, paragraph (c), the assessment tool establishes
677.31the monthly benefit level for a child under foster care. The monthly payment under a
677.32guardianship assistance agreement or adoption assistance agreement may be negotiated up
677.33to the monthly benefit level under foster care. In no case may the amount of the payment
677.34under a guardianship assistance agreement or adoption assistance agreement exceed the
677.35foster care maintenance payment which would have been paid during the month if the
678.1child with respect to whom the guardianship assistance or adoption assistance payment is
678.2made had been in a foster family home in the state.
678.3(2) The rate schedule for the agreement is determined based on the age of the
678.4child on the date that the prospective adoptive parent or parents or relative custodian or
678.5custodians sign the agreement.
678.6(3) The income of the relative custodian or custodians or adoptive parent or parents
678.7must not be taken into consideration when determining eligibility for guardianship
678.8assistance or adoption assistance or the amount of the payments under section 256N.26.
678.9(4) With the concurrence of the relative custodian or adoptive parent, the amount of
678.10the payment may be adjusted periodically using the assessment tool established by the
678.11commissioner in section 256N.24, subdivision 2, and the agreement renegotiated under
678.12subdivision 3 when there is a change in the child's needs or the family's circumstances.
678.13(5) The guardianship assistance or adoption assistance agreement of a child who is
678.14identified as at-risk receives the special at-risk monthly payment under section 256N.26,
678.15subdivision 7, unless and until the potential disability manifests itself, as documented by
678.16an appropriate professional, and the commissioner authorizes commencement of payment
678.17by modifying the agreement accordingly. A relative custodian or adoptive parent of an
678.18at-risk child with a guardianship assistance or adoption assistance agreement may request
678.19a reassessment of the child under section 256N.24, subdivision 9, and renegotiation of
678.20the guardianship assistance or adoption assistance agreement under subdivision 3 to
678.21include a monthly payment, if the caregiver has written documentation from a qualified
678.22expert that the potential disability upon which eligibility for the agreement was based has
678.23manifested itself. Documentation of the disability must be limited to evidence deemed
678.24appropriate by the commissioner.
678.25(c) For guardianship assistance agreements:
678.26(1) the initial amount of the monthly guardianship assistance payment must be
678.27equivalent to the foster care rate in effect at the time that the agreement is signed less any
678.28offsets under section 256N.26, subdivision 11, or a lesser negotiated amount if agreed to
678.29by the prospective relative custodian and specified in that agreement, unless the child is
678.30identified as at-risk or the guardianship assistance agreement is entered into when a child
678.31is under the age of six;
678.32(2) an at-risk child must be assigned level A as outlined in section 256N.26 and
678.33receive the special at-risk monthly payment under section 256N.26, subdivision 7, unless
678.34and until the potential disability manifests itself, as documented by a qualified expert, and
678.35the commissioner authorizes commencement of payment by modifying the agreement
678.36accordingly; and
679.1(3) the amount of the monthly payment for a guardianship assistance agreement for
679.2a child, other than an at-risk child, who is under the age of six must be as specified in
679.3section 256N.26, subdivision 5.
679.4(d) For adoption assistance agreements:
679.5(1) for a child in foster care with the prospective adoptive parent immediately prior
679.6to adoptive placement, the initial amount of the monthly adoption assistance payment
679.7must be equivalent to the foster care rate in effect at the time that the agreement is signed
679.8less any offsets in section 256N.26, subdivision 11, or a lesser negotiated amount if agreed
679.9to by the prospective adoptive parents and specified in that agreement, unless the child is
679.10identified as at-risk or the adoption assistance agreement is entered into when a child is
679.11under the age of six;
679.12(2) an at-risk child must be assigned level A as outlined in section 256N.26 and
679.13receive the special at-risk monthly payment under section 256N.26, subdivision 7, unless
679.14and until the potential disability manifests itself, as documented by an appropriate
679.15professional, and the commissioner authorizes commencement of payment by modifying
679.16the agreement accordingly;
679.17(3) the amount of the monthly payment for an adoption assistance agreement for
679.18a child under the age of six, other than an at-risk child, must be as specified in section
679.19256N.26, subdivision 5;
679.20(4) for a child who is in the guardianship assistance program immediately prior
679.21to adoptive placement, the initial amount of the adoption assistance payment must be
679.22equivalent to the guardianship assistance payment in effect at the time that the adoption
679.23assistance agreement is signed or a lesser amount if agreed to by the prospective adoptive
679.24parent and specified in that agreement; and
679.25(5) for a child who is not in foster care placement or the guardianship assistance
679.26program immediately prior to adoptive placement or negotiation of the adoption assistance
679.27agreement, the initial amount of the adoption assistance agreement must be determined
679.28using the assessment tool and process in this section and the corresponding payment
679.29amount outlined in section 256N.26.
679.30    Subd. 3. Renegotiation of agreement. (a) A relative custodian or adoptive
679.31parent of a child with a guardianship assistance or adoption assistance agreement may
679.32request renegotiation of the agreement when there is a change in the needs of the child
679.33or in the family's circumstances. When a relative custodian or adoptive parent requests
679.34renegotiation of the agreement, a reassessment of the child must be completed consistent
679.35with section 256N.24, subdivisions 9 and 10. If the reassessment indicates that the
679.36child's level has changed, the financially responsible agency or, if there is no financially
680.1responsible agency, the agency designated by the commissioner or the commissioner's
680.2designee, and the caregiver must renegotiate the agreement to include a payment with
680.3the level determined through the reassessment process. The agreement must not be
680.4renegotiated unless the commissioner, the financially responsible agency, and the caregiver
680.5mutually agree to the changes. The effective date of any renegotiated agreement must be
680.6determined by the commissioner.
680.7(b) A relative custodian or adoptive parent of an at-risk child with a guardianship
680.8assistance or adoption assistance agreement may request renegotiation of the agreement to
680.9include a monthly payment higher than the special at-risk monthly payment under section
680.10256N.26, subdivision 7, if the caregiver has written documentation from a qualified
680.11expert that the potential disability upon which eligibility for the agreement was based has
680.12manifested itself. Documentation of the disability must be limited to evidence deemed
680.13appropriate by the commissioner. Prior to renegotiating the agreement, a reassessment
680.14of the child must be conducted as outlined in section 256N.24, subdivision 9. The
680.15reassessment must be used to renegotiate the agreement to include an appropriate monthly
680.16payment. The agreement must not be renegotiated unless the commissioner, the financially
680.17responsible agency, and the caregiver mutually agree to the changes. The effective date of
680.18any renegotiated agreement must be determined by the commissioner.
680.19(c) Renegotiation of a guardianship assistance or adoption assistance agreement is
680.20required when one of the circumstances outlined in section 256N.26, subdivision 13,
680.21occurs.

680.22    Sec. 13. [256N.26] BENEFITS AND PAYMENTS.
680.23    Subdivision 1. Benefits. (a) There are three benefits under Northstar Care for
680.24Children: medical assistance, basic payment, and supplemental difficulty of care payment.
680.25(b) A child is eligible for medical assistance under subdivision 2.
680.26(c) A child is eligible for the basic payment under subdivision 3, except for a child
680.27assigned level A under section 256N.24, subdivision 1, because the child is determined to
680.28be an at-risk child receiving guardianship assistance or adoption assistance.
680.29(d) A child, including a foster child age 18 to 21, is eligible for an additional
680.30supplemental difficulty of care payment under subdivision 4, as determined by the
680.31assessment under section 256N.24.
680.32(e) An eligible child entering guardianship assistance or adoption assistance under
680.33the age of six receives a basic payment and supplemental difficulty of care payment as
680.34specified in subdivision 5.
681.1(f) A child transitioning in from a pre-Northstar Care for Children program under
681.2section 256N.28, subdivision 7, shall receive basic and difficulty of care supplemental
681.3payments according to those provisions.
681.4    Subd. 2. Medical assistance. Eligibility for medical assistance under this chapter
681.5must be determined according to section 256B.055.
681.6    Subd. 3. Basic monthly rate. From January 1, 2015, to June 30, 2016, the basic
681.7monthly rate must be according to the following schedule:

681.8		Ages 0-5	$565 per month
681.9		Ages 6-12	$670 per month
681.10		Ages 13 and older	$790 per month

681.11    Subd. 4. Difficulty of care supplemental monthly rate. From January 1, 2015,
681.12to June 30, 2016, the supplemental difficulty of care monthly rate is determined by the
681.13following schedule:

681.14 681.15		Level A	none (special rate under subdivision 7 applies)
681.16		Level B	none (basic under subdivision 3 only)
681.17		Level C	$100 per month
681.18		Level D	$200 per month
681.19		Level E	$300 per month
681.20		Level F	$400 per month
681.21		Level G	$500 per month
681.22		Level H	$600 per month
681.23		Level I	$700 per month
681.24		Level J	$800 per month
681.25		Level K	$900 per month
681.26		Level L	$1,000 per month
681.27		Level M	$1,100 per month
681.28		Level N	$1,200 per month
681.29		Level O	$1,300 per month
681.30		Level P	$1,400 per month
681.31		Level Q	$1,500 per month

681.32A child assigned level A is not eligible for either the basic or supplemental difficulty
681.33of care payment, while a child assigned level B is not eligible for the supplemental
681.34difficulty of care payment but is eligible for the basic monthly rate under subdivision 3.
681.35    Subd. 5. Alternate rates for preschool entry and certain transitioned children.
681.36A child who entered the guardianship assistance or adoption assistance components
681.37of Northstar Care for Children while under the age of six shall receive 50 percent of
681.38the amount the child would otherwise be entitled to under subdivisions 3 and 4. The
682.1commissioner may also use the 50 percent rate for a child who was transitioned into those
682.2components through declaration of the commissioner under section 256N.28, subdivision 7.
682.3    Subd. 6. Emergency foster care rate for initial placement. (a) A child who enters
682.4foster care due to immediate custody by a police officer or court order, consistent with
682.5section 260C.175, subdivisions 1 and 2, or equivalent provision under tribal code, shall
682.6receive the emergency foster care rate for up to 30 days. The emergency foster care rate
682.7cannot be extended beyond 30 days of the child's placement.
682.8(b) For this payment rate to be applied, at least one of three conditions must apply:
682.9(1) the child's initial placement must be in foster care in Minnesota;
682.10(2) the child's previous placement was more than two years ago; or
682.11(3) the child's previous placement was for fewer than 30 days and an assessment
682.12under section 256N.24 was not completed by an agency under section 256N.24.
682.13(c) The emergency foster care rate consists of the appropriate basic monthly rate
682.14under subdivision 3 plus a difficulty of care supplemental monthly rate of level D under
682.15subdivision 4.
682.16(d) The emergency foster care rate ends under any of three conditions:
682.17(1) when an assessment under section 256N.24 is completed;
682.18(2) when the placement ends; or
682.19(3) after 30 days have elapsed.
682.20(e) The financially responsible agency, in consultation with the legally responsible
682.21agency, if different, may replace the emergency foster care rate at any time by completing
682.22an initial assessment on which a revised difficulty of care supplemental monthly rate
682.23would be based. Consistent with section 256N.24, subdivision 9, the caregiver may
682.24request a reassessment in writing for an initial assessment to replace the emergency foster
682.25care rate. This written request would initiate an initial assessment under section 256N.24,
682.26subdivision 5. If the revised difficulty of care supplemental level based on the initial
682.27assessment is higher than level D, then the revised higher rate shall apply retroactively to
682.28the beginning of the placement. If the revised level is lower, the lower rate shall apply on
682.29the date the initial assessment was completed.
682.30(f) If a child remains in foster care placement for more than 30 days, the emergency
682.31foster care rate ends after the 30th day of placement and an assessment under section
682.32256N.26 must be completed.
682.33    Subd. 7. Special at-risk monthly payment for at-risk children in guardianship
682.34assistance and adoption assistance. A child eligible for guardianship assistance under
682.35section 256N.22 or adoption assistance under section 256N.23 who is determined to be
682.36an at-risk child shall receive a special at-risk monthly payment of $1 per month basic,
683.1unless and until the potential disability manifests itself and the agreement is renegotiated
683.2to include reimbursement. Such an at-risk child shall receive neither a supplemental
683.3difficulty of care monthly rate under subdivision 4 nor home and vehicle modifications
683.4under subdivision 10, but must be considered for medical assistance under subdivision 2.
683.5    Subd. 8. Daily rates. (a) The commissioner shall establish prorated daily rates to
683.6the nearest cent for the monthly rates under subdivisions 3 to 7. Daily rates must be
683.7routinely used when a partial month is involved for foster care, guardianship assistance, or
683.8adoption assistance.
683.9(b) A full month payment is permitted if a foster child is temporarily absent from
683.10the foster home if the brief absence does not exceed 14 days and the child's placement
683.11continues with the same caregiver.
683.12    Subd. 9. Revision. By April 1, 2016, for fiscal year 2017, and by each succeeding
683.13April 1 for the subsequent fiscal year, the commissioner shall review and revise the rates
683.14under subdivisions 3 to 7 based on the United States Department of Agriculture, Estimates
683.15of the Cost of Raising a Child, published by the United States Department of Agriculture,
683.16Agricultural Resources Service, Publication 1411. The revision shall be the average
683.17percentage by which costs increase for the age ranges represented in the United States
683.18Department of Agriculture, Estimates of the Cost of Raising a Child, except that in no
683.19instance must the increase be more than three percent per annum. The monthly rates must
683.20be revised to the nearest dollar and the daily rates to the nearest cent.
683.21    Subd. 10. Home and vehicle modifications. (a) Except for a child assigned level A
683.22under section 256N.24, subdivision 1, paragraph (d), clause (1), a child who is eligible
683.23for an adoption assistance agreement may have reimbursement of home and vehicle
683.24modifications necessary to accommodate the child's special needs upon which eligibility
683.25for adoption assistance was based and included as part of the negotiation of the agreement
683.26under section 256N.25, subdivision 2. Reimbursement of home and vehicle modifications
683.27must not be available for a child who is assessed at level A under subdivision 1, unless
683.28and until the potential disability manifests itself and the agreement is renegotiated to
683.29include reimbursement.
683.30(b) Application for and reimbursement of modifications must be completed
683.31according to a process specified by the commissioner. The type and cost of each
683.32modification must be preapproved by the commissioner. The type of home and vehicle
683.33modifications must be limited to those specified by the commissioner.
683.34(c) Reimbursement for home modifications as outlined in this subdivision is limited
683.35to once every five years per child. Reimbursement for vehicle modifications as outlined in
683.36this subdivision is limited to once every five years per family.
684.1    Subd. 11. Child income or income attributable to the child. (a) A monthly
684.2guardianship assistance or adoption assistance payment must be considered as income
684.3and resources attributable to the child. Guardianship assistance and adoption assistance
684.4are exempt from garnishment, except as permissible under the laws of the state where the
684.5child resides.
684.6(b) When a child is placed into foster care, any income and resources attributable
684.7to the child are treated as provided in sections 252.27 and 260C.331, or 260B.331, as
684.8applicable to the child being placed.
684.9(c) Consideration of income and resources attributable to the child must be part of
684.10the negotiation process outlined in section 256N.25, subdivision 2. In some circumstances,
684.11the receipt of other income on behalf of the child may impact the amount of the monthly
684.12payment received by the relative custodian or adoptive parent on behalf of the child
684.13through Northstar Care for Children. Supplemental Security Income (SSI), retirement
684.14survivor's disability insurance (RSDI), veteran's benefits, railroad retirement benefits, and
684.15black lung benefits are considered income and resources attributable to the child.
684.16    Subd. 12. Treatment of Supplemental Security Income. If a child placed in foster
684.17care receives benefits through Supplemental Security Income (SSI) at the time of foster
684.18care placement or subsequent to placement in foster care, the financially responsible
684.19agency may apply to be the payee for the child for the duration of the child's placement in
684.20foster care. If a child continues to be eligible for SSI after finalization of the adoption or
684.21transfer of permanent legal and physical custody and is determined to be eligible for a
684.22payment under Northstar Care for Children, a permanent caregiver may choose to receive
684.23payment from both programs simultaneously. The permanent caregiver is responsible
684.24to report the amount of the payment to the Social Security Administration and the SSI
684.25payment will be reduced as required by the Social Security Administration.
684.26    Subd. 13. Treatment of retirement survivor's disability insurance, veteran's
684.27benefits, railroad retirement benefits, and black lung benefits. (a) If a child placed
684.28in foster care receives retirement survivor's disability insurance, veteran's benefits,
684.29railroad retirement benefits, or black lung benefits at the time of foster care placement or
684.30subsequent to placement in foster care, the financially responsible agency may apply to
684.31be the payee for the child for the duration of the child's placement in foster care. If it is
684.32anticipated that a child will be eligible to receive retirement survivor's disability insurance,
684.33veteran's benefits, railroad retirement benefits, or black lung benefits after finalization
684.34of the adoption or assignment of permanent legal and physical custody, the permanent
684.35caregiver shall apply to be the payee of those benefits on the child's behalf. The monthly
685.1amount of the other benefits must be considered an offset to the amount of the payment
685.2the child is determined eligible for under Northstar Care for Children.
685.3(b) If a child becomes eligible for retirement survivor's disability insurance, veteran's
685.4benefits, railroad retirement benefits, or black lung benefits, after the initial amount of the
685.5payment under Northstar Care for Children is finalized, the permanent caregiver shall
685.6contact the commissioner to redetermine the payment under Northstar Care for Children.
685.7The monthly amount of the other benefits must be considered an offset to the amount of
685.8the payment the child is determined eligible for under Northstar Care for Children.
685.9(c) If a child ceases to be eligible for retirement survivor's disability insurance,
685.10veteran's benefits, railroad retirement benefits, or black lung benefits after the initial amount
685.11of the payment under Northstar Care for Children is finalized, the permanent caregiver
685.12shall contact the commissioner to redetermine the payment under Northstar Care for
685.13Children. The monthly amount of the payment under Northstar Care for Children must be
685.14the amount the child was determined to be eligible for prior to consideration of any offset.
685.15(d) If the monthly payment received on behalf of the child under retirement survivor's
685.16disability insurance, veteran's benefits, railroad retirement benefits, or black lung benefits
685.17changes after the adoption assistance or guardianship assistance agreement is finalized,
685.18the permanent caregiver shall notify the commissioner as to the new monthly payment
685.19amount, regardless of the amount of the change in payment. If the monthly payment
685.20changes by $75 or more, even if the change occurs incrementally over the duration of
685.21the term of the adoption assistance or guardianship assistance agreement, the monthly
685.22payment under Northstar Care for Children must be adjusted without further consent
685.23to reflect the amount of the increase or decrease in the offset amount. Any subsequent
685.24change to the payment must be reported and handled in the same manner. A change of
685.25monthly payments of less than $75 is not a permissible reason to renegotiate the adoption
685.26assistance or guardianship assistance agreement under section 256N.25, subdivision 3.
685.27The commissioner shall review and revise the limit at which the adoption assistance or
685.28guardian assistance agreement must be renegotiated in accordance with subdivision 9.
685.29    Subd. 14. Treatment of child support and Minnesota family investment
685.30program. (a) If a child placed in foster care receives child support, the child support
685.31payment may be redirected to the financially responsible agency for the duration of the
685.32child's placement in foster care. In cases where the child qualifies for Northstar Care
685.33for Children by meeting the adoption assistance eligibility criteria or the guardianship
685.34assistance eligibility criteria, any court-ordered child support must not be considered
685.35income attributable to the child and must have no impact on the monthly payment.
686.1(b) Consistent with section 256J.24, a child eligible for Northstar Care for Children
686.2whose caregiver receives a payment on the child's behalf is excluded from a Minnesota
686.3family investment program assistance unit.
686.4    Subd. 15. Payments. (a) Payments to caregivers under Northstar Care for Children
686.5must be made monthly. Consistent with section 256N.24, subdivision 12, the financially
686.6responsible agency must send the caregiver the required written notice within 15 days of
686.7a completed assessment or reassessment.
686.8(b) Unless paragraph (c) or (d) applies, the financially responsible agency shall pay
686.9foster parents directly for eligible children in foster care.
686.10(c) When the legally responsible agency is different than the financially responsible
686.11agency, the legally responsible agency may make the payments to the caregiver, provided
686.12payments are made on a timely basis. The financially responsible agency must pay
686.13the legally responsible agency on a timely basis. Caregivers must have access to the
686.14financially and legally responsible agencies' records of the transaction, consistent with
686.15the retention schedule for the payments.
686.16(d) For eligible children in foster care, the financially responsible agency may pay
686.17the foster parent's payment for a licensed child-placing agency instead of paying the foster
686.18parents directly. The licensed child-placing agency must timely pay the foster parents
686.19and maintain records of the transaction. Caregivers must have access to the financially
686.20responsible agency's records of the transaction and the child-placing agency's records of
686.21the transaction, consistent with the retention schedule for the payments.
686.22    Subd. 16. Effect of benefit on other aid. Payments received under this section
686.23must not be considered as income for child care assistance under chapter 119B or any
686.24other financial benefit. Consistent with section 256J.24, a child receiving a maintenance
686.25payment under Northstar Care for Children is excluded from any Minnesota family
686.26investment program assistance unit.
686.27    Subd. 17. Home and community-based services waiver for persons with
686.28disabilities. A child in foster care may qualify for home and community-based waivered
686.29services, consistent with section 256B.092 for developmental disabilities, or section
686.30256B.49 for community alternative care, community alternatives for disabled individuals,
686.31or traumatic brain injury waivers. A waiver service must not be substituted for the foster
686.32care program. When the child is simultaneously eligible for waivered services and for
686.33benefits under Northstar Care for Children, the financially responsible agency must
686.34assess and provide basic and supplemental difficulty of care rates as determined by the
686.35assessment according to section 256N.24. If it is determined that additional services are
687.1needed to meet the child's needs in the home that is not or cannot be met by the foster care
687.2program, the need would be referred to the local waivered service program.
687.3    Subd. 18. Overpayments. The commissioner has the authority to collect any
687.4amount of foster care payment, adoption assistance, or guardianship assistance paid
687.5to a caregiver in excess of the payment due. Payments covered by this subdivision
687.6include basic maintenance needs payments, supplemental difficulty of care payments, and
687.7reimbursement of home and vehicle modifications under subdivision 10. Prior to any
687.8collection, the commissioner or the commissioner's designee shall notify the caregiver in
687.9writing, including:
687.10(1) the amount of the overpayment and an explanation of the cause of overpayment;
687.11(2) clarification of the corrected amount;
687.12(3) a statement of the legal authority for the decision;
687.13(4) information about how the caregiver can correct the overpayment;
687.14(5) if repayment is required, when the payment is due and a person to contact to
687.15review a repayment plan;
687.16(6) a statement that the caregiver has a right to a fair hearing review by the
687.17department; and
687.18(7) the procedure for seeking a fair hearing review by the department.
687.19    Subd. 19. Payee. For adoption assistance and guardianship assistance cases, the
687.20payment must only be made to the adoptive parent or relative custodian specified on the
687.21agreement. If there is more than one adoptive parent or relative custodian, both parties will
687.22be listed as the payee unless otherwise specified in writing according to policies outlined
687.23by the commissioner. In the event of divorce or separation of the caregivers, a change of
687.24payee must be made in writing according to policies outlined by the commissioner. If both
687.25caregivers are in agreement as to the change, it may be made according to a process outlined
687.26by the commissioner. If there is not agreement as to the change, a court order indicating
687.27the party who is to receive the payment is needed before a change can be processed. If the
687.28change of payee is disputed, the commissioner may withhold the payment until agreement
687.29is reached. A noncustodial caregiver may request notice in writing of review, modification,
687.30or termination of the adoption assistance or guardianship assistance agreement. In the
687.31event of the death of a payee, a change of payee consistent with sections 256N.22 and
687.32256N.23 may be made in writing according to policies outlined by the commissioner.
687.33    Subd. 20. Notification of change. (a) A caregiver who has an adoption assistance
687.34agreement or guardianship assistance agreement in place shall keep the agency
687.35administering the program informed of changes in status or circumstances which would
687.36make the child ineligible for the payments or eligible for payments in a different amount.
688.1(b) For the duration of the agreement, the caregiver agrees to notify the agency
688.2administering the program in writing within 30 days of any of the following:
688.3(1) a change in the child's or caregiver's legal name;
688.4(2) a change in the family's address;
688.5(3) a change in the child's legal custody status;
688.6(4) the child's completion of high school, if this occurs after the child attains age 18;
688.7(5) the end of the caregiver's legal responsibility to support the child based on
688.8termination of parental rights of the caregiver, transfer of guardianship to another person,
688.9or transfer of permanent legal and physical custody to another person;
688.10(6) the end of the caregiver's financial support of the child;
688.11(7) the death of the child;
688.12(8) the death of the caregiver;
688.13(9) the child enlists in the military;
688.14(10) the child gets married;
688.15(11) the child becomes an emancipated minor through legal action;
688.16(12) the caregiver separates or divorces; and
688.17(13) the child is residing outside the caregiver's home for a period of more than
688.1830 consecutive days.
688.19    Subd. 21. Correct and true information. The caregiver must be investigated for
688.20fraud if the caregiver reports information the caregiver knows is untrue, the caregiver
688.21fails to notify the commissioner of changes that may affect eligibility, or the agency
688.22administering the program receives relevant information that the caregiver did not report.
688.23    Subd. 22. Termination notice for caregiver. The agency that issues the
688.24maintenance payment shall provide the child's caregiver with written notice of termination
688.25of payment. Termination notices must be sent at least 15 days before the final payment or,
688.26in the case of an unplanned termination, the notice is sent within three days of the end of
688.27the payment. The written notice must minimally include the following:
688.28(1) the date payment will end;
688.29(2) the reason payments will end and the event that is the basis to terminate payment;
688.30(3) a statement that the provider has a right to a fair hearing review by the department
688.31consistent with section 256.045, subdivision 3;
688.32(4) the procedure to request a fair hearing; and
688.33(5) the name, telephone number, and e-mail address of a contact person at the agency.

688.34    Sec. 14. [256N.27] FEDERAL, STATE, AND LOCAL SHARES.
689.1    Subdivision 1. Federal share. For the purposes of determining a child's eligibility
689.2under title IV-E of the Social Security Act for a child in foster care, the financially
689.3responsible agency shall use the eligibility requirements outlined in section 472 of the
689.4Social Security Act. For a child who qualifies for guardianship assistance or adoption
689.5assistance, the financially responsible agency and the commissioner shall use the
689.6eligibility requirements outlined in section 473 of the Social Security Act. In each case,
689.7the agency paying the maintenance payments must be reimbursed for the costs from the
689.8federal money available for this purpose.
689.9    Subd. 2. State share. The commissioner shall pay the state share of the maintenance
689.10payments as determined under subdivision 4, and an identical share of the pre-Northstar
689.11Care foster care program under section 260C.4411, subdivision 1, the relative custody
689.12assistance program under section 257.85, and the pre-Northstar Care for Children adoption
689.13assistance program under chapter 259A. The commissioner may transfer funds into the
689.14account if a deficit occurs.
689.15    Subd. 3. Local share. (a) The financially responsible agency at the time of
689.16placement for foster care or finalization of the agreement for guardianship assistance or
689.17adoption assistance shall pay the local share of the maintenance payments as determined
689.18under subdivision 4, and an identical share of the pre-Northstar Care for Children foster
689.19care program under section 260C.4411, subdivision 1, the relative custody assistance
689.20program under section 257.85, and the pre-Northstar Care for Children adoption assistance
689.21program under chapter 259A.
689.22(b) The financially responsible agency shall pay the entire cost of any initial clothing
689.23allowance, administrative payments to child caring agencies specified in section 317A.907,
689.24or other support services it authorizes, except as provided under other provisions of law.
689.25(c) In cases of federally required adoption assistance where there is no financially
689.26responsible agency as provided in section 256N.24, subdivision 5, the commissioner
689.27shall pay the local share.
689.28(d) When an Indian child being placed in Minnesota meets title IV-E eligibility
689.29defined in section 473(d) of the Social Security Act and is receiving guardianship
689.30assistance or adoption assistance, the agency or entity assuming responsibility for the
689.31child is responsible for the nonfederal share of the payment.
689.32    Subd. 4. Nonfederal share. (a) The commissioner shall establish a percentage share
689.33of the maintenance payments, reduced by federal reimbursements under title IV-E of the
689.34Social Security Act, to be paid by the state and to be paid by the financially responsible
689.35agency.
690.1(b) These state and local shares must initially be calculated based on the ratio of the
690.2average appropriate expenditures made by the state and all financially responsible agencies
690.3during calendar years 2011, 2012, 2013, and 2014. For purposes of this calculation,
690.4appropriate expenditures for the financially responsible agencies must include basic and
690.5difficulty of care payments for foster care reduced by federal reimbursements, but not
690.6including any initial clothing allowance, administrative payments to child care agencies
690.7specified in section 317A.907, child care, or other support or ancillary expenditures. For
690.8purposes of this calculation, appropriate expenditures for the state shall include adoption
690.9assistance and relative custody assistance, reduced by federal reimbursements.
690.10(c) For each of the periods January 1, 2015, to June 30, 2016, and fiscal years 2017,
690.112018, and 2019, the commissioner shall adjust this initial percentage of state and local
690.12shares to reflect the relative expenditure trends during calendar years 2011, 2012, 2013, and
690.132014, taking into account appropriations for Northstar Care for Children and the turnover
690.14rates of the components. In making these adjustments, the commissioner's goal shall be to
690.15make these state and local expenditures other than the appropriations for Northstar Care for
690.16Children to be the same as they would have been had Northstar Care for Children not been
690.17implemented, or if that is not possible, proportionally higher or lower, as appropriate. The
690.18state and local share percentages for fiscal year 2019 must be used for all subsequent years.
690.19    Subd. 5. Adjustments for proportionate shares among financially responsible
690.20agencies. (a) The commissioner shall adjust the expenditures under subdivision 4 by each
690.21financially responsible agency so that its relative share is proportional to its foster care
690.22expenditures, with the goal of making the local share similar to what the county or tribe
690.23would have spent had Northstar Care for Children not been enacted.
690.24(b) For the period January 1, 2015, to June 30, 2016, the relative shares must be as
690.25determined under subdivision 4 for calendar years 2011, 2012, 2013, and 2014 compared
690.26with similar costs of all financially responsible agencies.
690.27(c) For subsequent fiscal years, the commissioner shall update the relative shares
690.28based on actual utilization of Northstar Care for Children by the financially responsible
690.29agencies during the previous period, so that those using relatively more than they did
690.30historically are adjusted upward and those using less are adjusted downward.
690.31(d) The commissioner must ensure that the adjustments are not unduly influenced by
690.32onetime events, anomalies, small changes that appear large compared to a narrow historic
690.33base, or fluctuations that are the results of the transfer of responsibilities to tribal social
690.34service agencies authorized in section 256.01, subdivision 14b, as part of the American
690.35Indian Child Welfare Initiative.

691.1    Sec. 15. [256N.28] ADMINISTRATION AND APPEALS.
691.2    Subdivision 1. Responsibilities. (a) The financially responsible agency shall
691.3determine the eligibility for Northstar Care for Children for children in foster care under
691.4section 256N.21, and for those children determined eligible, shall further determine each
691.5child's eligibility for title IV-E of the Social Security Act, provided the agency has such
691.6authority under the state title IV-E plan.
691.7(b) Subject to commissioner review and approval, the financially responsible agency
691.8shall prepare the eligibility determination for Northstar Care for Children for children in
691.9guardianship assistance under section 256N.22 and children in adoption assistance under
691.10section 256N.23. The AFDC relatedness determination, when necessary to determine a
691.11child's eligibility for title IV-E funding, shall be made only by an authorized agency
691.12according to policies and procedures prescribed by the commissioner.
691.13(c) The financially responsible agency is responsible for the administration of
691.14Northstar Care for Children for children in foster care. The agency designated by the
691.15commissioner is responsible for assisting the commissioner with the administration of
691.16Northstar Care for Children for children in guardianship assistance and adoption assistance
691.17by conducting assessments, reassessments, negotiations, and other activities as specified
691.18by the commissioner under subdivision 2.
691.19    Subd. 2. Procedures, requirements, and deadlines. The commissioner shall
691.20specify procedures, requirements, and deadlines for the administration of Northstar Care
691.21for Children in accordance with sections 256N.001 to 256N.28, including for children
691.22transitioning into Northstar Care for Children under subdivision 7. The commissioner
691.23shall periodically review all procedures, requirements, and deadlines, including the
691.24assessment tool and process under section 256N.24, in consultation with counties, tribes,
691.25and representatives of caregivers, and may alter them as needed.
691.26    Subd. 3. Administration of title IV-E programs. The title IV-E foster care,
691.27guardianship assistance, and adoption assistance programs must operate within the
691.28statutes, rules, and policies set forth by the federal government in the Social Security Act.
691.29    Subd. 4. Reporting. The commissioner shall specify required fiscal and statistical
691.30reports under section 256.01, subdivision 2, paragraph (q), and other reports as necessary.
691.31    Subd. 5. Promotion of programs. Families who adopt a child under the
691.32commissioner's guardianship must be informed as to the adoption tax credit. The
691.33commissioner shall actively seek ways to promote the guardianship assistance and
691.34adoption assistance programs, including informing prospective caregivers of eligible
691.35children of the availability of guardianship assistance and adoption assistance.
692.1    Subd. 6. Appeals and fair hearings. (a) A caregiver has the right to appeal to the
692.2commissioner under section 256.045 when eligibility for Northstar Care for Children is
692.3denied, and when payment or the agreement for an eligible child is modified or terminated.
692.4(b) A relative custodian or adoptive parent has additional rights to appeal to the
692.5commissioner pursuant to section 256.045. These rights include when the commissioner
692.6terminates or modifies the guardianship assistance or adoption assistance agreement or
692.7when the commissioner denies an application for guardianship assistance or adoption
692.8assistance. A prospective relative custodian or adoptive parent who disagrees with a
692.9decision by the commissioner before transfer of permanent legal and physical custody or
692.10finalization of the adoption may request review of the decision by the commissioner or
692.11may appeal the decision under section 256.045. A guardianship assistance or adoption
692.12assistance agreement must be signed and in effect before the court order that transfers
692.13permanent legal and physical custody or the adoption finalization; however, in some cases,
692.14there may be extenuating circumstances as to why an agreement was not entered into
692.15before finalization of permanency for the child. Caregivers who believe that extenuating
692.16circumstances exist in the case of their child may request a fair hearing. Caregivers have the
692.17responsibility of proving that extenuating circumstances exist. Caregivers must be required
692.18to provide written documentation of each eligibility criterion at the fair hearing. Examples
692.19of extenuating circumstances include: relevant facts regarding the child were known by
692.20the placing agency and not presented to the caregivers before transfer of permanent legal
692.21and physical custody or finalization of the adoption, or failure by the commissioner or a
692.22designee to advise potential caregivers about the availability of guardianship assistance or
692.23adoption assistance for children in the state foster care system. If an appeals judge finds
692.24through the fair hearing process that extenuating circumstances existed and that the child
692.25met all eligibility criteria at the time the transfer of permanent legal and physical custody
692.26was ordered or the adoption was finalized, the effective date and any associated federal
692.27financial participation shall be retroactive from the date of the request for a fair hearing.
692.28    Subd. 7. Transitions from pre-Northstar Care for Children programs. (a) A child
692.29in foster care who remains with the same caregiver shall continue to receive benefits under
692.30the pre-Northstar Care for Children foster care program under section 256.82. Transitions
692.31to Northstar Care for Children must occur as provided in section 256N.21, subdivision 6.
692.32(b) The commissioner may seek to transition into Northstar Care for Children a child
692.33who is in pre-Northstar Care for Children relative custody assistance under section 257.85
692.34or pre-Northstar Care for Children adoption assistance under chapter 259A, in accordance
692.35with these priorities, in order of priority:
692.36(1) financial and budgetary constraints;
693.1(2) complying with federal regulations;
693.2(3) converting pre-Northstar Care for Children relative custody assistance under
693.3section 257.85 to the guardianship assistance component of Northstar Care for Children;
693.4(4) improving permanency for a child or children;
693.5(5) maintaining permanency for a child or children;
693.6(6) accessing additional federal funds; and
693.7(7) administrative simplification.
693.8(c) Transitions shall be accomplished according to procedures, deadlines, and
693.9requirements specified by the commissioner under subdivision 2.
693.10(d) The commissioner may accomplish a transition of a child from pre-Northstar
693.11Care for Children relative custody assistance under section 257.85 to the guardianship
693.12assistance component of Northstar Care for Children by declaration and appropriate notice
693.13to the caregiver, provided that the benefit for a child under this paragraph is not reduced.
693.14(e) The commissioner may offer a transition of a child from pre-Northstar Care for
693.15Children adoption assistance under chapter 259A to the adoption assistance component
693.16of Northstar Care for Children by contacting the caregiver with an offer. The transition
693.17must be accomplished only when the caregiver agrees to the offer. The caregiver shall
693.18have a maximum of 90 days to review and accept the commissioner's offer. If the
693.19commissioner's offer is not accepted within 90 days, the pre-Northstar Care for Children
693.20adoption assistance agreement remains in effect until it terminates or a subsequent offer is
693.21made by the commissioner.
693.22(f) For a child transitioning into Northstar Care for Children, the commissioner shall
693.23assign an equivalent assessment level based on the most recently completed supplemental
693.24difficulty of care level assessment, unless the commissioner determines that arranging
693.25for a new assessment under section 256N.24 would be more appropriate based on the
693.26priorities specified in paragraph (b).
693.27(g) For a child transitioning into Northstar Care for Children, regardless of the age
693.28of the child, the commissioner shall use the rates under section 256N.26, subdivision 5,
693.29unless the rates under section 256N.26, subdivisions 3 and 4, are more appropriate based
693.30on the priorities specified in paragraph (b), as determined by the commissioner.
693.31    Subd. 8. Purchase of child-specific adoption services. The commissioner may
693.32reimburse the placing agency for appropriate adoption services for children eligible
693.33under section 259A.75.

693.34    Sec. 16. Minnesota Statutes 2012, section 257.85, subdivision 2, is amended to read:
694.1    Subd. 2. Scope. The provisions of this section apply to those situations in which
694.2the legal and physical custody of a child is established with a relative or important friend
694.3with whom the child has resided or had significant contact according to section 260C.515,
694.4subdivision 4, by a district court order issued on or after July 1, 1997, but on or before
694.5November 26, 2014, or a tribal court order issued on or after July 1, 2005, but on or
694.6before November 26, 2014, when the child has been removed from the care of the parent
694.7by previous district or tribal court order.

694.8    Sec. 17. Minnesota Statutes 2012, section 257.85, subdivision 5, is amended to read:
694.9    Subd. 5. Relative custody assistance agreement. (a) A relative custody assistance
694.10agreement will not be effective, unless it is signed by the local agency and the relative
694.11custodian no later than 30 days after the date of the order establishing permanent legal and
694.12physical custody, and on or before November 26, 2014, except that a local agency may
694.13enter into a relative custody assistance agreement with a relative custodian more than 30
694.14days after the date of the order if it certifies that the delay in entering the agreement was
694.15through no fault of the relative custodian and the agreement is signed and in effect on or
694.16before November 26, 2014. There must be a separate agreement for each child for whom
694.17the relative custodian is receiving relative custody assistance.
694.18(b) Regardless of when the relative custody assistance agreement is signed by the
694.19local agency and relative custodian, the effective date of the agreement shall be the date of
694.20the order establishing permanent legal and physical custody.
694.21(c) If MFIP is not the applicable program for a child at the time that a relative
694.22custody assistance agreement is entered on behalf of the child, when MFIP becomes
694.23the applicable program, if the relative custodian had been receiving custody assistance
694.24payments calculated based upon a different program, the amount of relative custody
694.25assistance payment under subdivision 7 shall be recalculated under the Minnesota family
694.26investment program.
694.27(d) The relative custody assistance agreement shall be in a form specified by the
694.28commissioner and shall include provisions relating to the following:
694.29(1) the responsibilities of all parties to the agreement;
694.30(2) the payment terms, including the financial circumstances of the relative
694.31custodian, the needs of the child, the amount and calculation of the relative custody
694.32assistance payments, and that the amount of the payments shall be reevaluated annually;
694.33(3) the effective date of the agreement, which shall also be the anniversary date for
694.34the purpose of submitting the annual affidavit under subdivision 8;
695.1(4) that failure to submit the affidavit as required by subdivision 8 will be grounds
695.2for terminating the agreement;
695.3(5) the agreement's expected duration, which shall not extend beyond the child's
695.4eighteenth birthday;
695.5(6) any specific known circumstances that could cause the agreement or payments
695.6to be modified, reduced, or terminated and the relative custodian's appeal rights under
695.7subdivision 9;
695.8(7) that the relative custodian must notify the local agency within 30 days of any of
695.9the following:
695.10(i) a change in the child's status;
695.11(ii) a change in the relationship between the relative custodian and the child;
695.12(iii) a change in composition or level of income of the relative custodian's family;
695.13(iv) a change in eligibility or receipt of benefits under MFIP, or other assistance
695.14program; and
695.15(v) any other change that could affect eligibility for or amount of relative custody
695.16assistance;
695.17(8) that failure to provide notice of a change as required by clause (7) will be
695.18grounds for terminating the agreement;
695.19(9) that the amount of relative custody assistance is subject to the availability of state
695.20funds to reimburse the local agency making the payments;
695.21(10) that the relative custodian may choose to temporarily stop receiving payments
695.22under the agreement at any time by providing 30 days' notice to the local agency and may
695.23choose to begin receiving payments again by providing the same notice but any payments
695.24the relative custodian chooses not to receive are forfeit; and
695.25(11) that the local agency will continue to be responsible for making relative custody
695.26assistance payments under the agreement regardless of the relative custodian's place of
695.27residence.

695.28    Sec. 18. Minnesota Statutes 2012, section 257.85, subdivision 6, is amended to read:
695.29    Subd. 6. Eligibility criteria. (a) A local agency shall enter into a relative custody
695.30assistance agreement under subdivision 5 if it certifies that the following criteria are met:
695.31(1) the juvenile court has determined or is expected to determine that the child,
695.32under the former or current custody of the local agency, cannot return to the home of
695.33the child's parents;
696.1(2) the court, upon determining that it is in the child's best interests, has issued
696.2or is expected to issue an order transferring permanent legal and physical custody of
696.3the child; and
696.4(3) the child either:
696.5(i) is a member of a sibling group to be placed together; or
696.6(ii) has a physical, mental, emotional, or behavioral disability that will require
696.7financial support.
696.8When the local agency bases its certification that the criteria in clause (1) or (2) are
696.9met upon the expectation that the juvenile court will take a certain action, the relative
696.10custody assistance agreement does not become effective until and unless the court acts as
696.11expected.
696.12(b) After November 26, 2014, new relative custody assistance agreements must not
696.13be executed. Agreements that were signed by all parties on or before November 26, 2014,
696.14and were not in effect because the proposed transfer of permanent legal and physical
696.15custody of the child did not occur on or before November 26, 2014, must be renegotiated
696.16under the terms of Northstar Care for Children in chapter 256N.

696.17    Sec. 19. [259A.12] NO NEW EXECUTION OF ADOPTION ASSISTANCE
696.18AGREEMENTS.
696.19After November 26, 2014, new adoption assistance agreements must not be executed
696.20under this section. Agreements that were signed on or before November 26, 2014, and
696.21were not in effect because the adoption finalization of the child did not occur on or before
696.22November 26, 2014, must be renegotiated according to the terms of Northstar Care for
696.23Children under chapter 256N. Agreements signed and in effect on or before November 26,
696.242014, must continue according to the terms of this section and applicable rules for the
696.25duration of the agreement, unless the commissioner and the adoptive parents choose to
696.26renegotiated the agreements under Northstar Care for Children consistent with section
696.27256N.28, subdivision 7. After November 26, 2014, this section and associated rules must
696.28be referred to as the pre-Northstar Care for Children adoption assistance program and
696.29shall apply to children whose adoption assistance agreements were in effect on or before
696.30November 26, 2014, and whose adoptive parents have not renegotiated their agreements
696.31according to the terms of Northstar Care for Children.

696.32    Sec. 20. [260C.4411] PRE-NORTHSTAR CARE FOR CHILDREN FOSTER
696.33CARE PROGRAM.
697.1    Subdivision 1. Pre-Northstar Care for Children foster care program. (a) For a
697.2child placed in family foster care on or before December 31, 2014, the county of financial
697.3responsibility under section 256G.02 or tribal agency authorized under section 256.01,
697.4subdivision 14b, shall pay the local share under section 256N.27, subdivision 3, for foster
697.5care maintenance including any difficulty of care as defined in Minnesota Rules, part
697.69560.0521, subparts 7 and 10. Family foster care includes:
697.7(1) emergency relative placement under section 245A.035;
697.8(2) licensed foster family settings, foster residence settings, or treatment foster care
697.9settings, licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, and served by
697.10a public or private child care agency authorized by Minnesota Rules, parts 9545.0755
697.11to 9545.0845;
697.12(3) family foster care homes approved by a tribal agency; and
697.13(4) unlicensed supervised settings for foster youth ages 18 to 21.
697.14(b) The county of financial responsibility under section 256G.02 or tribal social
697.15services agency authorized in section 256.01, subdivision 14b, shall pay the entire cost of
697.16any initial clothing allowance, administrative payments to child care agencies specified
697.17in section 317A.907, or any other support services it authorizes, except as otherwise
697.18provided by law.
697.19(c) The rates for the pre-Northstar Care for Children foster care program remain
697.20those in effect on January 1, 2013, continuing the preexisting rate structure for foster
697.21children who remain with the same caregivers and do not transition into Northstar Care for
697.22Children under section 256N.21, subdivision 6.
697.23(d) Difficulty of care payments must be maintained consistent with Minnesota Rules,
697.24parts 9560.0652 and 9560.0653, using the established reassessment tool in Minnesota
697.25Rules, part 9560.0654. The preexisting rate structure for the pre-Northstar Care for
697.26Children foster care program must be maintained, provided that when the number of
697.27foster children in the program is less than ten percent of the population in 2012, the
697.28commissioner may apply the same assessment tool to both the pre-Northstar Care for
697.29Children foster care program and Northstar Care for Children under the authority granted
697.30in section 256N.24, subdivision 2.
697.31(e) The county of financial responsibility under section 256G.02 or tribal agency
697.32authorized under section 256.01, subdivision 14b, shall document the determined
697.33pre-Northstar Care for Children foster care rate in the case record, including a description
697.34of each condition on which the difficulty of care assessment is based. The difficulty
697.35of care rate is reassessed:
697.36(1) every 12 months;
698.1(2) at the request of the foster parent; or
698.2(3) if the child's level of need changes in the current foster home.
698.3(f) The pre-Northstar Care for Children foster care program must maintain the
698.4following existing program features:
698.5(1) monthly payments must be made to the family foster home provider;
698.6(2) notice and appeal procedures must be consistent with Minnesota Rules, part
698.79560.0665; and
698.8(3) medical assistance eligibility for foster children must continue to be determined
698.9according to section 256B.055.
698.10(g) The county of financial responsibility under section 256G.02 or tribal agency
698.11authorized under section 256.01, subdivision 14b, may continue existing program features,
698.12including:
698.13(1) establishing a local fund of county money through which the agency may
698.14reimburse foster parents for the cost of repairing damage done to the home and contents by
698.15the foster child and the additional care insurance premium cost of a child who possesses a
698.16permit or license to drive a car; and
698.17(2) paying a fee for specific services provided by the foster parent, based on the
698.18parent's skills, experience, or training. This fee must not be considered foster care
698.19maintenance.
698.20(h) The following events end the child's enrollment in the pre-Northstar Care for
698.21Children foster care program:
698.22(1) reunification with parent or other relative;
698.23(2) adoption or transfer of permanent legal and physical custody;
698.24(3) removal from the current foster home to a different foster home;
698.25(4) another event that ends the current placement episode; or
698.26(5) attaining the age of 21.
698.27    Subd. 2. Consideration of other programs. (a) When a child in foster care
698.28is eligible to receive a grant of Retirement Survivors Disability Insurance (RSDI)
698.29or Supplemental Security Income for the aged, blind, and disabled, or a foster care
698.30maintenance payment under title IV-E of the Social Security Act, United States Code, title
698.3142, sections 670 to 676, the child's needs must be met through these programs. Every
698.32effort must be made to establish a child's eligibility for a title IV-E grant to reimburse the
698.33county or tribe from the federal funds available for this purpose.
698.34(b) When a child in foster care qualifies for home and community-based waivered
698.35services under section 256B.49 for community alternative care (CAC), community
698.36alternatives for disabled individuals (CADI), or traumatic brain injury (TBI) waivers,
699.1this service does not substitute for the child foster care program. When a foster child is
699.2receiving waivered services benefits, the county of financial responsibility under section
699.3256G.02 or tribal agency authorized under section 256.01, subdivision 14b, assesses and
699.4provides foster care maintenance including difficulty of care using the established tool in
699.5Minnesota Rules, part 9560.0654. If it is determined that additional services are needed to
699.6meet the child's needs in the home that are not or cannot be met by the foster care program,
699.7the needs must be referred to the waivered service program.

699.8    Sec. 21. [260C.4412] PAYMENT FOR RESIDENTIAL PLACEMENTS.
699.9When a child is placed in a foster care group residential setting under Minnesota
699.10Rules, parts 2960.0020 to 2960.0710, foster care maintenance payments must be made on
699.11behalf of the child to cover the cost of providing food, clothing, shelter, daily supervision,
699.12school supplies, child's personal incidentals and supports, reasonable travel for visitation,
699.13or other transportation needs associated with the items listed. Daily supervision in the
699.14group residential setting includes routine day-to-day direction and arrangements to
699.15ensure the well-being and safety of the child. It may also include reasonable costs of
699.16administration and operation of the facility.
699.17EFFECTIVE DATE.This section is effective January 1, 2015.

699.18    Sec. 22. [260C.4413] INITIAL CLOTHING ALLOWANCE.
699.19(a) An initial clothing allowance must be available to a child eligible for:
699.20(1) the pre-Northstar Care for Children foster care program under section 260C.4411,
699.21subdivision 1; and
699.22(2) the Northstar Care for Children benefits under section 256N.21.
699.23(b) An initial clothing allowance must also be available for a foster child in a group
699.24residential setting based on the child's individual needs during the first 60 days of the
699.25child's initial placement. The agency must consider the parent's ability to provide for a
699.26child's clothing needs and the residential facility contracts.
699.27(c) The county of financial responsibility under section 256G.02 or tribal agency
699.28authorized under section 256.01, subdivision 14b, shall approve an initial clothing
699.29allowance consistent with the child's needs. The amount of the initial clothing allowance
699.30must not exceed the monthly basic rate for the child's age group under section 256N.26,
699.31subdivision 3.
699.32EFFECTIVE DATE.This section is effective January 1, 2015.

700.1    Sec. 23. Minnesota Statutes 2012, section 260C.446, is amended to read:
700.2260C.446 DISTRIBUTION OF FUNDS RECOVERED FOR ASSISTANCE
700.3FURNISHED.
700.4When any amount shall be recovered from any source for assistance furnished
700.5under the provisions of sections 260C.001 to 260C.421 and 260C.441, there shall be paid
700.6into the treasury of the state or county in the proportion in which they have respectively
700.7contributed toward the total assistance paid.
700.8EFFECTIVE DATE.This section is effective January 1, 2015.

700.9    Sec. 24. REPEALER.
700.10(a) Minnesota Statutes 2012, sections 256.82, subdivision 4; and 260C.441, are
700.11repealed effective January 1, 2015.
700.12(b) Minnesota Rules, parts 9560.0650, subparts 1, 3, and 6; 9560.0651; and
700.139560.0655, are repealed effective January 1, 2015."
700.14Delete the title and insert:

700.15"A bill for an act

700.16relating to state government; establishing the health and human services budget;
700.17modifying provisions related to health care, continuing care, human services
700.18licensing, children and family services, program integrity, health-related
700.19licensing boards, chemical and mental health services, managed care
700.20organizations, waiver provider standards, home care, and the Department of
700.21Health; redesigning home and community-based services; establishing payment
700.22methodologies for home and community-based services; adjusting provider
700.23rates; setting and modifying fees; modifying autism coverage; modifying
700.24assistance programs; establishing Northstar care for children; making technical
700.25changes; requiring studies; requiring reports; appropriating money;amending
700.26Minnesota Statutes 2012, sections 13.381, subdivisions 2, 10; 13.461, by adding
700.27subdivisions; 16A.724, subdivisions 2, 3; 16C.10, subdivision 5; 16C.155,
700.28subdivision 1; 43A.23, by adding a subdivision; 62J.692, subdivisions 1, 3, 4,
700.295, 9, by adding a subdivision; 62Q.19, subdivision 1; 103I.005, by adding a
700.30subdivision; 103I.521; 119B.011, by adding a subdivision; 119B.02, by adding
700.31a subdivision; 119B.025, subdivision 1; 119B.03, subdivision 4; 119B.05,
700.32subdivision 1; 119B.13, subdivisions 1, 1a, 3a, 6, 7, by adding subdivisions;
700.33144.051, by adding subdivisions; 144.0724, subdivisions 4, 6; 144.123,
700.34subdivision 1; 144.125, subdivision 1; 144.212; 144.213; 144.215, subdivisions
700.353, 4; 144.216, subdivision 1; 144.217, subdivision 2; 144.218, subdivision 5;
700.36144.225, subdivisions 1, 4, 7, 8; 144.226; 144.966, subdivisions 2, 3a; 144.98,
700.37subdivisions 3, 5, by adding subdivisions; 144.99, subdivision 4; 144A.071,
700.38subdivision 4b; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4;
700.39145.906; 145.986; 145A.17, subdivision 1; 145C.01, subdivision 7; 148B.17,
700.40subdivision 2; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5,
700.4116, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding
700.42subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4;
700.43149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1,
700.442, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94;
700.45149A.96, subdivision 9; 151.19, subdivisions 1, 3; 151.37, subdivision 4; 151.47,
700.46subdivision 1, by adding a subdivision; 151.49; 174.30, subdivision 1; 214.12, by
701.1adding a subdivision; 214.40, subdivision 1; 243.166, subdivisions 4b, 7; 245.03,
701.2subdivision 1; 245.462, subdivision 20; 245.4661, subdivisions 5, 6; 245.4682,
701.3subdivision 2; 245.4871, subdivision 26; 245.4875, subdivision 8; 245.4881,
701.4subdivision 1; 245.91, by adding a subdivision; 245.94, subdivisions 2, 2a;
701.5245A.02, subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04,
701.6subdivision 13; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08,
701.7subdivision 2a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435;
701.8245A.144; 245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5;
701.9245A.50; 245C.04, by adding a subdivision; 245C.08, subdivision 1; 245D.02;
701.10245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09; 245D.10; 246.18,
701.11subdivision 8, by adding a subdivision; 246.54; 252.27, subdivision 2a;
701.12252.291, by adding a subdivision; 252.41, subdivision 3; 252.42; 252.43;
701.13252.44; 252.45; 252.46, subdivision 1a; 253B.10, subdivision 1; 254B.04,
701.14subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions;
701.15256.0112, by adding a subdivision; 256.015, subdivision 1; 256.82, subdivisions
701.162, 3; 256.9657, subdivisions 3, 3a, 4; 256.969, subdivision 29; 256.975,
701.17subdivision 7, by adding subdivisions; 256.9754, subdivision 5, by adding
701.18subdivisions; 256.98, subdivision 8; 256B.02, subdivision 17, as added, by
701.19adding subdivisions; 256B.021, by adding subdivisions; 256B.04, subdivisions
701.2018, 21, by adding a subdivision; 256B.055, subdivisions 3a, 6, 10, 14, 15, by
701.21adding a subdivision; 256B.056, subdivisions 1, 1c, 3, 4, as amended, 5c, 10, by
701.22adding a subdivision; 256B.057, subdivisions 1, 8, 10, by adding a subdivision;
701.23256B.06, subdivision 4; 256B.0623, subdivision 2; 256B.0625, subdivisions 9,
701.2413, 13e, 19c, 31, 39, 48, 56, 58, by adding subdivisions; 256B.0631, subdivision
701.251; 256B.064, subdivisions 1a, 1b, 2; 256B.0659, subdivision 21; 256B.0755,
701.26subdivision 3; 256B.0756; 256B.0911, subdivisions 1, 1a, 3a, 4d, 6, 7, by
701.27adding a subdivision; 256B.0913, subdivision 4; 256B.0915, subdivisions 3a,
701.285, by adding a subdivision; 256B.0916, by adding a subdivision; 256B.0917,
701.29subdivisions 6, 13, by adding subdivisions; 256B.092, subdivisions 1a, 7,
701.3011, 12, by adding subdivisions; 256B.0943, subdivisions 1, 2, 7, by adding a
701.31subdivision; 256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952,
701.32subdivisions 1, 5; 256B.0955; 256B.097, subdivisions 1, 3; 256B.196,
701.33subdivision 2; 256B.431, subdivision 44; 256B.434, subdivision 4, by adding
701.34subdivisions; 256B.437, subdivision 6; 256B.439, subdivisions 1, 2, 3, 4, by
701.35adding subdivisions; 256B.441, subdivisions 13, 44, 53, by adding subdivisions;
701.36256B.49, subdivisions 11a, 12, 13, 14, 15, by adding subdivisions; 256B.4912,
701.37subdivisions 1, 2, 3, 7, by adding subdivisions; 256B.4913, subdivisions 5, 6, by
701.38adding a subdivision; 256B.492; 256B.493, subdivision 2; 256B.501, by adding
701.39a subdivision; 256B.5011, subdivision 2; 256B.5012, by adding subdivisions;
701.40256B.69, subdivisions 5c, 5i, 8, 9c, 31, by adding subdivisions; 256B.694;
701.41256B.76, subdivisions 1, 2, 4, by adding a subdivision; 256B.761; 256B.764;
701.42256B.766; 256B.767; 256D.44, subdivision 5; 256I.05, by adding a subdivision;
701.43256J.08, subdivision 24; 256J.21, subdivisions 2, 3; 256J.24, subdivisions 5, 7;
701.44256J.35; 256J.621; 256J.626, subdivision 7; 256K.45; 256L.01, subdivisions
701.453a, 5, by adding subdivisions; 256L.02, subdivision 2, by adding subdivisions;
701.46256L.03, subdivisions 1, 1a, 3, 5, 6, by adding a subdivision; 256L.04,
701.47subdivisions 1, 7, 8, 10, 12, by adding subdivisions; 256L.05, subdivisions
701.481, 2, 3, 3c; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 256L.09,
701.49subdivision 2; 256L.11, subdivisions 1, 3; 256L.12, subdivision 1; 256L.15,
701.50subdivisions 1, 2; 256M.40, subdivision 1; 257.0755, subdivision 1; 257.75,
701.51subdivision 7; 257.85, subdivisions 2, 5, 6; 259A.20, subdivision 4; 260B.007,
701.52subdivisions 6, 16; 260C.007, subdivisions 6, 31; 260C.446; 260C.635,
701.53subdivision 1; 299C.093; 402A.10; 402A.18; 471.59, subdivision 1; 517.001;
701.54518A.60; 626.556, subdivisions 2, 3, 10d; 626.557, subdivisions 4, 9, 9a, 9e;
701.55626.5572, subdivision 13; Laws 1998, chapter 407, article 6, section 116; Laws
701.562011, First Special Session chapter 9, article 1, section 3; article 2, section 27;
701.57article 10, section 3, subdivision 3, as amended; Laws 2012, chapter 247, article
701.586, section 4; Laws 2013, chapter 1, section 6; proposing coding for new law in
702.1Minnesota Statutes, chapters 62A; 144; 144A; 145; 149A; 151; 214; 245; 245A;
702.2245D; 254B; 256; 256B; 256J; 256L; 259A; 260C; 402A; proposing coding
702.3for new law as Minnesota Statutes, chapters 245E; 256N; repealing Minnesota
702.4Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 144.123, subdivision
702.52; 144A.46; 144A.461; 149A.025; 149A.20, subdivision 8; 149A.30, subdivision
702.62; 149A.40, subdivision 8; 149A.45, subdivision 6; 149A.50, subdivision 6;
702.7149A.51, subdivision 7; 149A.52, subdivision 5a; 149A.53, subdivision 9;
702.8151.19, subdivision 2; 151.25; 151.45; 151.47, subdivision 2; 151.48; 245A.655;
702.9245B.01; 245B.02; 245B.03; 245B.031; 245B.04; 245B.05, subdivisions 1, 2,
702.103, 5, 6, 7; 245B.055; 245B.06; 245B.07; 245B.08; 245D.08; 252.40; 252.46,
702.11subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 16, 17, 18, 19, 20, 21; 256.82,
702.12subdivision 4; 256B.055, subdivisions 3, 5, 10b; 256B.056, subdivision 5b;
702.13256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b, 4c; 256B.0917,
702.14subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096, subdivisions 1, 2, 3,
702.154; 256B.14, subdivision 3a; 256B.49, subdivision 16a; 256B.4913, subdivisions
702.161, 2, 3, 4; 256B.501, subdivision 8; 256B.5012, subdivision 13; 256J.24;
702.17256L.01, subdivision 4a; 256L.031; 256L.04, subdivisions 1b, 9, 10a; 256L.05,
702.18subdivision 3b; 256L.07, subdivisions 1, 5, 8, 9; 256L.11, subdivisions 5, 6;
702.19256L.17, subdivisions 1, 2, 3, 4, 5; 260C.441; 485.14; 609.093; Laws 2011, First
702.20Special Session chapter 9, article 7, section 54, as amended; Minnesota Rules,
702.21parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; 4668.0012; 4668.0016;
702.224668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; 4668.0050;
702.234668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
702.244668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160;
702.254668.0170; 4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220;
702.264668.0230; 4668.0240; 4668.0800; 4668.0805; 4668.0810; 4668.0815;
702.274668.0820; 4668.0825; 4668.0830; 4668.0835; 4668.0840; 4668.0845;
702.284668.0855; 4668.0860; 4668.0865; 4668.0870; 4669.0001; 4669.0010;
702.294669.0020; 4669.0030; 4669.0040; 4669.0050; 9525.1860, subparts 3, items B,
702.30C, 4, item D; 9560.0650, subparts 1, 3, 6; 9560.0651; 9560.0655."

703.1	We request the adoption of this report and repassage of the bill.
703.2	House Conferees:
703.3	.....		.....
703.4	Thomas Huntley		Tina Liebling
703.5	.....		.....
703.6	Diane Loeffler		Rena Moran
703.7	.....
703.8	Jim Abeler
703.9	Senate Conferees:
703.10	.....		.....
703.11	Tony Lourey		Kathy Sheran
703.12	.....		.....
703.13	Jeff Hayden		Melisa Franzen
703.14	.....
703.15	Melissa H. Wiklund