1.2relating to state government; establishing the health and human services budget;
1.3modifying provisions related to health care, continuing care, human services
1.4licensing, chemical and mental health, managed care organizations, waiver
1.5provider standards, home care, and the Department of Health; redesigning home
1.6and community-based services; establishing payment methodologies for home
1.7and community-based services; adjusting nursing and ICF/DD facility rates;
1.8setting and modifying fees; modifying autism coverage; making technical
1.9changes; requiring studies; requiring reports; appropriating money;amending
1.10Minnesota Statutes 2012, sections 16A.152, subdivision 2; 16A.724, subdivisions
1.112, 3; 16C.10, subdivision 5; 16C.155, subdivision 1; 62J.692, subdivision 4;
1.1262Q.19, subdivision 1; 103I.005, by adding a subdivision; 103I.521; 119B.13,
1.13subdivision 7; 144.051, by adding subdivisions; 144.0724, subdivision 4;
1.14144.123, subdivision 1; 144.125, subdivision 1; 144.966, subdivisions 2, 3a;
1.15144.98, subdivisions 3, 5, by adding subdivisions; 144.99, subdivision 4;
1.16144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4; 145.986;
1.17145C.01, subdivision 7; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2,
1.183, 4, 5, 16, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by
1.19adding subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2,
1.204; 149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1,
1.212, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94;
1.22149A.96, subdivision 9; 174.30, subdivision 1; 214.40, subdivision 1; 243.166,
1.23subdivisions 4b, 7; 245.4661, subdivisions 5, 6; 245.4682, subdivision 2;
1.24245A.02, subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04,
1.25subdivision 13; 245A.042, subdivision 3; 245A.07, subdivision 3; 245A.08,
1.26subdivision 2a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435;
1.27245A.16, subdivision 1; 245C.04, by adding a subdivision; 245C.08, subdivision
1.281; 245D.02; 245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09;
1.29245D.10; 246.18, subdivision 8, by adding a subdivision; 246.54; 254B.04,
1.30subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions;
1.31256.9657, subdivisions 2, 3a; 256.9685, subdivision 2; 256.969, subdivisions
1.323a, 29; 256.975, subdivision 7, by adding subdivisions; 256.9754, subdivision 5,
1.33by adding subdivisions; 256B.02, by adding subdivisions; 256B.021, by adding
1.34subdivisions; 256B.04, subdivisions 18, 21, by adding a subdivision; 256B.055,
1.35subdivisions 3a, 6, 10, 14, 15, by adding a subdivision; 256B.056, subdivisions 1,
1.361c, 3, 4, as amended, 5c, 10, by adding a subdivision; 256B.057, subdivisions 1,
1.378, 10, by adding a subdivision; 256B.06, subdivision 4; 256B.0623, subdivision
1.382; 256B.0625, subdivisions 9, 13e, 19c, 31, 39, 48, 58, by adding subdivisions;
1.39256B.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; 256I.04, subdivision 3; 256I.05, subdivision
2.161e, by adding a subdivision; 256J.35; 256K.45; 256L.01, subdivisions 3a, 5, by
2.17adding subdivisions; 256L.02, subdivision 2, by adding subdivisions; 256L.03,
2.18subdivisions 1, 1a, 3, 5, 6, by adding a subdivision; 256L.04, subdivisions
2.191, 7, 8, 10, by adding subdivisions; 256L.05, subdivisions 1, 2, 3; 256L.06,
2.20subdivision 3; 256L.07, subdivisions 1, 2, 3; 256L.09, subdivision 2; 256L.11,
2.21subdivision 6; 256L.15, subdivisions 1, 2; 257.0755, subdivision 1; 260B.007,
2.22subdivisions 6, 16; 260C.007, subdivisions 6, 31; 471.59, subdivision 1;
2.23626.556, subdivisions 2, 3, 10d; 626.557, subdivisions 4, 9, 9a, 9e; 626.5572,
2.24subdivision 13; Laws 1998, chapter 407, article 6, section 116; Laws 2011,
2.25First Special Session chapter 9, article 2, section 27; article 10, section 3,
2.26subdivision 3, as amended; proposing coding for new law in Minnesota Statutes,
2.27chapters 62A; 62D; 144; 144A; 145; 149A; 214; 245; 245D; 254B; 256; 256B;
2.28256L; repealing Minnesota Statutes 2012, sections 103I.005, subdivision 20;
2.29144.123, subdivision 2; 144A.46; 144A.461; 149A.025; 149A.20, subdivision
2.308; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, subdivision 6;
2.31149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a;
2.32149A.53, subdivision 9; 245A.655; 245B.01; 245B.02; 245B.03; 245B.031;
2.33245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06; 245B.07;
2.34245B.08; 245D.08; 256B.055, subdivisions 3, 5, 10b; 256B.056, subdivision 5b;
2.35256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b, 4c; 256B.0917,
2.36subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096, subdivisions 1, 2, 3, 4;
2.37256B.14, subdivision 3a; 256B.49, subdivision 16a; 256B.4913, subdivisions 1,
2.382, 3, 4; 256B.5012, subdivision 13; 256J.24, subdivision 6; 256K.45, subdivision
2.392; 256L.01, subdivision 4a; 256L.031; 256L.04, subdivisions 1b, 9, 10a;
2.40256L.05, subdivision 3b; 256L.07, subdivisions 5, 8, 9; 256L.11, subdivision 5;
2.41256L.12; 256L.17, subdivisions 1, 2, 3, 4, 5; 485.14; 609.093; Laws 2011, First
2.42Special Session chapter 9, article 7, section 54, as amended; Minnesota Rules,
2.43parts 4668.0002; 4668.0003; 4668.0005; 4668.0008; 4668.0012; 4668.0016;
2.444668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040; 4668.0050;
2.454668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
2.464668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160;
2.474668.0170; 4668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220;
2.484668.0230; 4668.0240; 4668.0800; 4668.0805; 4668.0810; 4668.0815;
2.494668.0820; 4668.0825; 4668.0830; 4668.0835; 4668.0840; 4668.0845;
2.504668.0855; 4668.0860; 4668.0865; 4668.0870; 4669.0001; 4669.0010;
2.514669.0020; 4669.0030; 4669.0040; 4669.0050.
2.52BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:


3.4    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
3.5    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
3.6participation pertaining to administrative costs of the Minnesota health care reform waiver
3.7shall be deposited as nondedicated revenue in the health care access fund. Receipts
3.8received as a result of federal participation pertaining to grants shall be deposited in the
3.9federal fund and shall offset health care access funds for payments to providers. All federal
3.10funding received by Minnesota for implementation and administration of MinnesotaCare
3.11as a basic health program, as authorized in section 1331 of the Affordable Care Act,
3.12Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and
3.13shall be deposited into the health care access fund. Federal funding that is received for
3.14implementing and administering MinnesotaCare as a basic health program and deposited in
3.15the fund shall be used only for that program to purchase health care coverage for enrollees
3.16and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.
3.17EFFECTIVE DATE.This section is effective January 1, 2015.

3.18    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
3.19    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
3.20Regulations, title 25, part 20, persons eligible for medical assistance benefits under
3.21sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
3.22the income standards of section 256B.056, subdivision 4, and persons eligible for general
3.23assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
3.24dependency fund services. State money appropriated for this paragraph must be placed in
3.25a separate account established for this purpose.
3.26Persons with dependent children who are determined to be in need of chemical
3.27dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
3.28a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
3.29local agency to access needed treatment services. Treatment services must be appropriate
3.30for the individual or family, which may include long-term care treatment or treatment in a
3.31facility that allows the dependent children to stay in the treatment facility. The county
3.32shall pay for out-of-home placement costs, if applicable.
3.33(b) A person not entitled to services under paragraph (a), but with family income
3.34that is less than 215 percent of the federal poverty guidelines for the applicable family
4.1size, shall be eligible to receive chemical dependency fund services within the limit
4.2of funds appropriated for this group for the fiscal year. If notified by the state agency
4.3of limited funds, a county must give preferential treatment to persons with dependent
4.4children who are in need of chemical dependency treatment pursuant to an assessment
4.5under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
4.66 , or 260C.212. A county may spend money from its own sources to serve persons under
4.7this paragraph. State money appropriated for this paragraph must be placed in a separate
4.8account established for this purpose.
4.9(c) Persons whose income is between 215 percent and 412 percent of the federal
4.10poverty guidelines for the applicable family size shall be eligible for chemical dependency
4.11services on a sliding fee basis, within the limit of funds appropriated for this group for the
4.12fiscal year. Persons eligible under this paragraph must contribute to the cost of services
4.13according to the sliding fee scale established under subdivision 3. A county may spend
4.14money from its own sources to provide services to persons under this paragraph. State
4.15money appropriated for this paragraph must be placed in a separate account established
4.16for this purpose.

4.17    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
4.18to read:
4.19    Subd. 35. Federal approval. (a) The commissioner shall seek federal authority
4.20from the U.S. Department of Health and Human Services necessary to operate a health
4.21coverage program for Minnesotans with incomes up to 275 percent of the federal poverty
4.22guidelines (FPG). The proposal shall seek to secure all federal funding available from at
4.23least the following sources:
4.24(1) all premium tax credits and cost-sharing subsidies available under United States
4.25Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
4.26with incomes above 133 percent and at or below 275 percent of the federal poverty
4.27guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as
4.28defined in Minnesota Statutes, section 62V.02;
4.29(2) Medicaid funding; and
4.30(3) other funding sources identified by the commissioner that support coverage or
4.31care redesign in Minnesota.
4.32(b) Funding received shall be used to design and implement a health coverage
4.33program that creates a single streamlined program and meets the needs of Minnesotans with
4.34incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
5.1(1) payment reform characteristics included in the health care delivery system and
5.2accountable care organization payment models;
5.3(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
5.4needs in different income and health status situations and can provide a more seamless
5.5transition from public to private health care coverage;
5.6(3) flexibility in co-payment or premium structures to incent patients to seek
5.7high-quality, low-cost care settings; and
5.8(4) flexibility in premium structures to ease the transition from public to private
5.9health care coverage.
5.10(c) The commissioner shall develop and submit a proposal consistent with the above
5.11criteria and shall seek all federal authority necessary to implement the health coverage
5.12program. In developing the request, the commissioner shall consult with appropriate
5.13stakeholder groups and consumers.
5.14(d) The commissioner is authorized to seek any available waivers or federal
5.15approvals to accomplish the goals under paragraph (b) prior to 2017.
5.16(e) The commissioner shall report progress on implementing this subdivision to the
5.17chairs and ranking minority members of the legislative committees with jurisdiction over
5.18health and human services policy and finance by December 1, 2014.
5.19(f) The commissioner is authorized to accept and expend federal funds that support
5.20the purposes of this subdivision.

5.21    Sec. 4. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
5.22to read:
5.23    Subd. 18. Caretaker relative. "Caretaker relative" means a relative, by blood,
5.24adoption, or marriage, of a child under age 19 with whom the child is living and who
5.25assumes primary responsibility for the child's care.
5.26EFFECTIVE DATE.This section is effective January 1, 2014.

5.27    Sec. 5. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
5.28to read:
5.29    Subd. 19. Insurance affordability program. "Insurance affordability program"
5.30means one of the following programs:
5.31(1) medical assistance under this chapter;
5.32(2) a program that provides advance payments of the premium tax credits established
5.33under section 36B of the Internal Revenue Code or cost-sharing reductions established
5.34under section 1402 of the Affordable Care Act;
6.1(3) MinnesotaCare as defined in chapter 256L; and
6.2(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.
6.3EFFECTIVE DATE.This section is effective the day following final enactment.

6.4    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
6.5    Subd. 18. Applications for medical assistance. (a) The state agency may take
6.6 shall accept applications for medical assistance and conduct eligibility determinations for
6.7MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web
6.8site, and through other commonly available electronic means.
6.9    (b) The commissioner of human services shall modify the Minnesota health care
6.10programs application form to add a question asking applicants whether they have ever
6.11served in the United States military.
6.12    (c) For each individual who submits an application or whose eligibility is subject to
6.13renewal or whose eligibility is being redetermined pursuant to a change in circumstances,
6.14if the agency determines the individual is not eligible for medical assistance, the agency
6.15shall determine potential eligibility for other insurance affordability programs.
6.16EFFECTIVE DATE.This section is effective January 1, 2014.

6.17    Sec. 7. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
6.18    Subd. 3a. Families with children. Beginning July 1, 2002, Medical assistance may
6.19be paid for a person who is a child under the age of 18, or age 18 if a full-time student
6.20in a secondary school, or in the equivalent level of vocational or technical training, and
6.21reasonably expected to complete the program before reaching age 19; the parent or
6.22stepparent of a dependent child under the age of 19, including a pregnant woman; or a
6.23caretaker relative of a dependent child under the age of 19.
6.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
6.25approval, whichever is later. The commissioner of human services shall notify the revisor
6.26of statutes when federal approval is obtained.

6.27    Sec. 8. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
6.28    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
6.29for a pregnant woman who has written verification of a positive pregnancy test from a
6.30physician or licensed registered nurse, who meets the other eligibility criteria of this
6.31section and whose unborn child would be eligible as a needy child under subdivision 10 if
6.32born and living with the woman. In accordance with Code of Federal Regulations, title
7.142, section 435.956, the commissioner must accept self-attestation of pregnancy unless
7.2the agency has information that is not reasonably compatible with such attestation. For
7.3purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
7.4EFFECTIVE DATE.This section is effective January 1, 2014.

7.5    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
7.6    Subd. 10. Infants. Medical assistance may be paid for an infant less than one year
7.7of age, whose mother was eligible for and receiving medical assistance at the time of birth
7.8or who is less than two years of age and is in a family with countable income that is equal
7.9to or less than the income standard established under section 256B.057, subdivision 1.
7.10EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
7.11approval, whichever is later. The commissioner of human services shall notify the revisor
7.12of statutes when federal approval is obtained.

7.13    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
7.14    Subd. 15. Adults without children. Medical assistance may be paid for a person
7.15who is:
7.16(1) at least age 21 and under age 65;
7.17(2) not pregnant;
7.18(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
7.19of the Social Security Act;
7.20(4) not an adult in a family with children as defined in section 256L.01, subdivision
7.213a ; and not otherwise eligible under subdivision 7 as a person who meets the categorical
7.22eligibility requirements of the supplemental security income program;
7.23(5) not enrolled under subdivision 7 as a person who would meet the categorical
7.24eligibility requirements of the supplemental security income program except for excess
7.25income or assets; and
7.26(5) (6) not described in another subdivision of this section.
7.27EFFECTIVE DATE.This section is effective January 1, 2014.

7.28    Sec. 11. Minnesota Statutes 2012, section 256B.055, is amended by adding a
7.29subdivision to read:
7.30    Subd. 17. Adults who were in foster care at the age of 18. Medical assistance may
7.31be paid for a person under 26 years of age who was in foster care under the commissioner's
7.32responsibility on the date of attaining 18 years of age, and who was enrolled in medical
8.1assistance under the state plan or a waiver of the plan while in foster care, in accordance
8.2with section 2004 of the Affordable Care Act.
8.3EFFECTIVE DATE.This section is effective January 1, 2014.

8.4    Sec. 12. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
8.5    Subdivision 1. Residency. To be eligible for medical assistance, a person must
8.6reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
8.7 in accordance with the rules of the state agency Code of Federal Regulations, title 42,
8.8section 435.403.
8.9EFFECTIVE DATE.This section is effective January 1, 2014.

8.10    Sec. 13. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
8.11    Subd. 1c. Families with children income methodology. (a)(1) [Expired, 1Sp2003
8.12c 14 art 12 s 17]
8.13(2) For applications processed within one calendar month prior to July 1, 2003,
8.14eligibility shall be determined by applying the income standards and methodologies in
8.15effect prior to July 1, 2003, for any months in the six-month budget period before July
8.161, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
8.17months in the six-month budget period on or after that date. The income standards for
8.18each month shall be added together and compared to the applicant's total countable income
8.19for the six-month budget period to determine eligibility.
8.20(3) For children ages one through 18 whose eligibility is determined under section
8.21256B.057, subdivision 2, the following deductions shall be applied to income counted
8.22toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
8.2316, 1996: $90 work expense, dependent care, and child support paid under court order.
8.24This clause is effective October 1, 2003.
8.25(b) For families with children whose eligibility is determined using the standard
8.26specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
8.27earned income shall be disregarded for up to four months and the following deductions
8.28shall be applied to each individual's income counted toward eligibility as allowed under
8.29the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
8.30under court order.
8.31(c) If the four-month disregard in paragraph (b) has been applied to the wage
8.32earner's income for four months, the disregard shall not be applied again until the wage
9.1earner's income has not been considered in determining medical assistance eligibility for
9.212 consecutive months.
9.3(d) The commissioner shall adjust the income standards under this section each July
9.41 by the annual update of the federal poverty guidelines following publication by the
9.5United States Department of Health and Human Services except that the income standards
9.6shall not go below those in effect on July 1, 2009.
9.7(e) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
9.8organization to or for the benefit of the child with a life-threatening illness must be
9.9disregarded from income.

9.10    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
9.11    Subd. 3. Asset limitations for certain individuals and families. (a) To be
9.12eligible for medical assistance, a person must not individually own more than $3,000 in
9.13assets, or if a member of a household with two family members, husband and wife, or
9.14parent and child, the household must not own more than $6,000 in assets, plus $200 for
9.15each additional legal dependent. In addition to these maximum amounts, an eligible
9.16individual or family may accrue interest on these amounts, but they must be reduced to the
9.17maximum at the time of an eligibility redetermination. The accumulation of the clothing
9.18and personal needs allowance according to section 256B.35 must also be reduced to the
9.19maximum at the time of the eligibility redetermination. The value of assets that are not
9.20considered in determining eligibility for medical assistance is the value of those assets
9.21excluded under the supplemental security income program for aged, blind, and disabled
9.22persons, with the following exceptions:
9.23(1) household goods and personal effects are not considered;
9.24(2) capital and operating assets of a trade or business that the local agency determines
9.25are necessary to the person's ability to earn an income are not considered;
9.26(3) motor vehicles are excluded to the same extent excluded by the supplemental
9.27security income program;
9.28(4) assets designated as burial expenses are excluded to the same extent excluded by
9.29the supplemental security income program. Burial expenses funded by annuity contracts
9.30or life insurance policies must irrevocably designate the individual's estate as contingent
9.31beneficiary to the extent proceeds are not used for payment of selected burial expenses;
9.32(5) for a person who no longer qualifies as an employed person with a disability due
9.33to loss of earnings, assets allowed while eligible for medical assistance under section
9.34256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
10.1of ineligibility as an employed person with a disability, to the extent that the person's total
10.2assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
10.3    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
10.49 , is age 65 or older and has been enrolled during each of the 24 consecutive months
10.5before the person's 65th birthday, the assets owned by the person and the person's spouse
10.6must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
10.7when determining eligibility for medical assistance under section 256B.055, subdivision
10.87 . The income of a spouse of a person enrolled in medical assistance under section
10.9256B.057, subdivision 9 , during each of the 24 consecutive months before the person's
10.1065th birthday must be disregarded when determining eligibility for medical assistance
10.11under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
10.12the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
10.13is required to have qualified for medical assistance under section 256B.057, subdivision 9,
10.14prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
10.15(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
10.16required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
10.17Law 111-5. For purposes of this clause, an American Indian is any person who meets the
10.18definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
10.19(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
10.2015.
10.21EFFECTIVE DATE.This section is effective January 1, 2014.

10.22    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by
10.23Laws 2013, chapter 1, section 5, is amended to read:
10.24    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
10.25section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
10.26the federal poverty guidelines. Effective January 1, 2000, and each successive January,
10.27recipients of supplemental security income may have an income up to the supplemental
10.28security income standard in effect on that date.
10.29    (b) To be eligible for medical assistance, families and children may have an income
10.30up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
10.31AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
10.321996, shall be increased by three percent.
10.33    (c) Effective January 1, 2014, to be eligible for medical assistance, under section
10.34256B.055, subdivision 3a , a parent or caretaker relative may have an income up to 133
10.35percent of the federal poverty guidelines for the household size.
11.1    (d) To be eligible for medical assistance under section 256B.055, subdivision 15,
11.2a person may have an income up to 133 percent of federal poverty guidelines for the
11.3household size.
11.4    (e) To be eligible for medical assistance under section 256B.055, subdivision 16, a
11.5child age 19 to 20 may have an income up to 133 percent of the federal poverty guidelines
11.6for the household size.
11.7    (f) To be eligible for medical assistance under section 256B.055, subdivision 3a, a
11.8child under age 19 may have income up to 275 percent of the federal poverty guidelines
11.9for the household size or an equivalent standard when converted using modified adjusted
11.10gross income methodology as required under the Affordable Care Act. Children who are
11.11enrolled in medical assistance as of December 31, 2013, and are determined ineligible
11.12for medical assistance because of the elimination of income disregards under modified
11.13adjusted gross income methodology as defined in subdivision 1a remain eligible for
11.14medical assistance under the Children's Health Insurance Program Reauthorization Act
11.15of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility
11.16redetermination as required in section 256B.056, subdivision 7a.
11.17    (f) (g) In computing income to determine eligibility of persons under paragraphs (a)
11.18to (e) (f) who are not residents of long-term care facilities, the commissioner shall disregard
11.19increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
11.20For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
11.21Administration unusual medical expense payments are considered income to the recipient.
11.22EFFECTIVE DATE.This section is effective January 1, 2014.

11.23    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
11.24    Subd. 5c. Excess income standard. (a) The excess income standard for families
11.25with children parents and caretaker relatives, pregnant women, infants, and children ages
11.26two through 20 is the standard specified in subdivision 4, paragraph (c).
11.27(b) The excess income standard for a person whose eligibility is based on blindness,
11.28disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
11.29family size. Effective July 1, 2002, the excess income standard for this paragraph shall
11.30equal 75 percent of the federal poverty guidelines.
11.31EFFECTIVE DATE.This section is effective January 1, 2014.

11.32    Sec. 17. Minnesota Statutes 2012, section 256B.056, is amended by adding a
11.33subdivision to read:
12.1    Subd. 7a. Periodic renewal of eligibility. (a) The commissioner shall make an
12.2annual redetermination of eligibility based on information contained in the enrollee's case
12.3file and other information available to the agency, including but not limited to information
12.4accessed through an electronic database, without requiring the enrollee to submit any
12.5information when sufficient data is available for the agency to renew eligibility.
12.6(b) If the commissioner cannot renew eligibility in accordance with paragraph (a),
12.7the commissioner must provide the enrollee with a prepopulated renewal form containing
12.8eligibility information available to the agency and permit the enrollee to submit the form
12.9with any corrections or additional information to the agency and sign the renewal form via
12.10any of the modes of submission specified in section 256B.04, subdivision 18.
12.11(c) An enrollee who is terminated for failure to complete the renewal process may
12.12subsequently submit the renewal form and required information within four months after
12.13the date of termination and have coverage reinstated without a lapse, if otherwise eligible
12.14under this chapter.
12.15(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
12.16required to renew eligibility every six months.
12.17EFFECTIVE DATE.This section is effective January 1, 2014.

12.18    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
12.19    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
12.20are applying for the continuation of medical assistance coverage following the end of the
12.2160-day postpartum period to update their income and asset information and to submit
12.22any required income or asset verification.
12.23    (b) The commissioner shall determine the eligibility of private-sector health care
12.24coverage for infants less than one year of age eligible under section 256B.055, subdivision
12.2510 , or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
12.26if this is determined to be cost-effective.
12.27    (c) The commissioner shall verify assets and income for all applicants, and for all
12.28recipients upon renewal.
12.29    (d) The commissioner shall utilize information obtained through the electronic
12.30service established by the secretary of the United States Department of Health and Human
12.31Services and other available electronic data sources in Code of Federal Regulations, title
12.3242, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner
12.33shall establish standards to define when information obtained electronically is reasonably
12.34compatible with information provided by applicants and enrollees, including use of
13.1self-attestation, to accomplish real-time eligibility determinations and maintain program
13.2integrity.
13.3EFFECTIVE DATE.This section is effective January 1, 2014.

13.4    Sec. 19. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
13.5    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year
13.6 two years of age or a pregnant woman who has written verification of a positive pregnancy
13.7test from a physician or licensed registered nurse is eligible for medical assistance if the
13.8individual's countable family household income is equal to or less than 275 percent of the
13.9federal poverty guideline for the same family household size or an equivalent standard
13.10when converted using modified adjusted gross income methodology as required under
13.11the Affordable Care Act. For purposes of this subdivision, "countable family income"
13.12means the amount of income considered available using the methodology of the AFDC
13.13program under the state's AFDC plan as of July 16, 1996, as required by the Personal
13.14Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
13.15Law 104-193, except for the earned income disregard and employment deductions.
13.16    (2) For applications processed within one calendar month prior to the effective date,
13.17eligibility shall be determined by applying the income standards and methodologies in
13.18effect prior to the effective date for any months in the six-month budget period before
13.19that date and the income standards and methodologies in effect on the effective date for
13.20any months in the six-month budget period on or after that date. The income standards
13.21for each month shall be added together and compared to the applicant's total countable
13.22income for the six-month budget period to determine eligibility.
13.23    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
13.24    (2) For applications processed within one calendar month prior to July 1, 2003,
13.25eligibility shall be determined by applying the income standards and methodologies in
13.26effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
13.272003, and the income standards and methodologies in effect on the expiration date for any
13.28months in the six-month budget period on or after July 1, 2003. The income standards
13.29for each month shall be added together and compared to the applicant's total countable
13.30income for the six-month budget period to determine eligibility.
13.31    (3) An amount equal to the amount of earned income exceeding 275 percent of
13.32the federal poverty guideline, up to a maximum of the amount by which the combined
13.33total of 185 percent of the federal poverty guideline plus the earned income disregards
13.34and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
13.35by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
14.1Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
14.2pregnant women and infants less than one year of age.
14.3    (c) Dependent care and child support paid under court order shall be deducted from
14.4the countable income of pregnant women.
14.5    (d) (b) An infant born to a woman who was eligible for and receiving medical
14.6assistance on the date of the child's birth shall continue to be eligible for medical assistance
14.7without redetermination until the child's first birthday.
14.8EFFECTIVE DATE.This section is effective January 1, 2014.

14.9    Sec. 20. Minnesota Statutes 2012, section 256B.057, subdivision 8, is amended to read:
14.10    Subd. 8. Children under age two. Medical assistance may be paid for a child under
14.11two years of age whose countable family income is above 275 percent of the federal poverty
14.12guidelines for the same size family but less than or equal to 280 percent of the federal
14.13poverty guidelines for the same size family or an equivalent standard when converted using
14.14modified adjusted gross income methodology as required under the Affordable Care Act.
14.15EFFECTIVE DATE.This section is effective January 1, 2014.

14.16    Sec. 21. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
14.17    Subd. 10. Certain persons needing treatment for breast or cervical cancer. (a)
14.18Medical assistance may be paid for a person who:
14.19(1) has been screened for breast or cervical cancer by the Minnesota breast and
14.20cervical cancer control program, and program funds have been used to pay for the person's
14.21screening;
14.22(2) according to the person's treating health professional, needs treatment, including
14.23diagnostic services necessary to determine the extent and proper course of treatment, for
14.24breast or cervical cancer, including precancerous conditions and early stage cancer;
14.25(3) meets the income eligibility guidelines for the Minnesota breast and cervical
14.26cancer control program;
14.27(4) is under age 65;
14.28(5) is not otherwise eligible for medical assistance under United States Code, title
14.2942, section 1396a(a)(10)(A)(i); and
14.30(6) is not otherwise covered under creditable coverage, as defined under United
14.31States Code, title 42, section 1396a(aa).
15.1(b) Medical assistance provided for an eligible person under this subdivision shall
15.2be limited to services provided during the period that the person receives treatment for
15.3breast or cervical cancer.
15.4(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
15.5without meeting the eligibility criteria relating to income and assets in section 256B.056,
15.6subdivisions 1a to 5b 5a.

15.7    Sec. 22. Minnesota Statutes 2012, section 256B.057, is amended by adding a
15.8subdivision to read:
15.9    Subd. 12. Presumptive eligibility determinations made by qualified hospitals.
15.10The commissioner shall establish a process to qualify hospitals that are participating
15.11providers under the medical assistance program to determine presumptive eligibility for
15.12medical assistance for applicants who may have a basis of eligibility using the modified
15.13adjusted gross income methodology as defined in section 256B.056, subdivision 1a,
15.14paragraph (b), clause (1).
15.15EFFECTIVE DATE.This section is effective January 1, 2014.

15.16    Sec. 23. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
15.17    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
15.18to citizens of the United States, qualified noncitizens as defined in this subdivision, and
15.19other persons residing lawfully in the United States. Citizens or nationals of the United
15.20States must cooperate in obtaining satisfactory documentary evidence of citizenship or
15.21nationality according to the requirements of the federal Deficit Reduction Act of 2005,
15.22Public Law 109-171.
15.23(b) "Qualified noncitizen" means a person who meets one of the following
15.24immigration criteria:
15.25(1) admitted for lawful permanent residence according to United States Code, title 8;
15.26(2) admitted to the United States as a refugee according to United States Code,
15.27title 8, section 1157;
15.28(3) granted asylum according to United States Code, title 8, section 1158;
15.29(4) granted withholding of deportation according to United States Code, title 8,
15.30section 1253(h);
15.31(5) paroled for a period of at least one year according to United States Code, title 8,
15.32section 1182(d)(5);
15.33(6) granted conditional entrant status according to United States Code, title 8,
15.34section 1153(a)(7);
16.1(7) determined to be a battered noncitizen by the United States Attorney General
16.2according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
16.3title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
16.4(8) is a child of a noncitizen determined to be a battered noncitizen by the United
16.5States Attorney General according to the Illegal Immigration Reform and Immigrant
16.6Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
16.7Public Law 104-200; or
16.8(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
16.9Law 96-422, the Refugee Education Assistance Act of 1980.
16.10(c) All qualified noncitizens who were residing in the United States before August
16.1122, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
16.12medical assistance with federal financial participation.
16.13(d) Beginning December 1, 1996, qualified noncitizens who entered the United
16.14States on or after August 22, 1996, and who otherwise meet the eligibility requirements
16.15of this chapter are eligible for medical assistance with federal participation for five years
16.16if they meet one of the following criteria:
16.17(1) refugees admitted to the United States according to United States Code, title 8,
16.18section 1157;
16.19(2) persons granted asylum according to United States Code, title 8, section 1158;
16.20(3) persons granted withholding of deportation according to United States Code,
16.21title 8, section 1253(h);
16.22(4) veterans of the United States armed forces with an honorable discharge for
16.23a reason other than noncitizen status, their spouses and unmarried minor dependent
16.24children; or
16.25(5) persons on active duty in the United States armed forces, other than for training,
16.26their spouses and unmarried minor dependent children.
16.27 Beginning July 1, 2010, children and pregnant women who are noncitizens
16.28described in paragraph (b) or who are lawfully present in the United States as defined
16.29in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
16.30eligibility requirements of this chapter, are eligible for medical assistance with federal
16.31financial participation as provided by the federal Children's Health Insurance Program
16.32Reauthorization Act of 2009, Public Law 111-3.
16.33(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
16.34are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
16.35subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
16.36Code, title 8, section 1101(a)(15).
17.1(f) Payment shall also be made for care and services that are furnished to noncitizens,
17.2regardless of immigration status, who otherwise meet the eligibility requirements of
17.3this chapter, if such care and services are necessary for the treatment of an emergency
17.4medical condition.
17.5(g) For purposes of this subdivision, the term "emergency medical condition" means
17.6a medical condition that meets the requirements of United States Code, title 42, section
17.71396b(v).
17.8(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
17.9of an emergency medical condition are limited to the following:
17.10(i) services delivered in an emergency room or by an ambulance service licensed
17.11under chapter 144E that are directly related to the treatment of an emergency medical
17.12condition;
17.13(ii) services delivered in an inpatient hospital setting following admission from an
17.14emergency room or clinic for an acute emergency condition; and
17.15(iii) follow-up services that are directly related to the original service provided
17.16to treat the emergency medical condition and are covered by the global payment made
17.17to the provider.
17.18    (2) Services for the treatment of emergency medical conditions do not include:
17.19(i) services delivered in an emergency room or inpatient setting to treat a
17.20nonemergency condition;
17.21(ii) organ transplants, stem cell transplants, and related care;
17.22(iii) services for routine prenatal care;
17.23(iv) continuing care, including long-term care, nursing facility services, home health
17.24care, adult day care, day training, or supportive living services;
17.25(v) elective surgery;
17.26(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
17.27part of an emergency room visit;
17.28(vii) preventative health care and family planning services;
17.29(viii) dialysis;
17.30(ix) chemotherapy or therapeutic radiation services;
17.31(x) rehabilitation services;
17.32(xi) physical, occupational, or speech therapy;
17.33(xii) transportation services;
17.34(xiii) case management;
17.35(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
17.36(xv) dental services;
18.1(xvi) hospice care;
18.2(xvii) audiology services and hearing aids;
18.3(xviii) podiatry services;
18.4(xix) chiropractic services;
18.5(xx) immunizations;
18.6(xxi) vision services and eyeglasses;
18.7(xxii) waiver services;
18.8(xxiii) individualized education programs; or
18.9(xxiv) chemical dependency treatment.
18.10(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented,
18.11nonimmigrants, or lawfully present in the United States as defined in Code of Federal
18.12Regulations, title 8, section 103.12, ineligible for federally funded medical assistance
18.13 are not covered by a group health plan or health insurance coverage according to Code
18.14of Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility
18.15requirements of this chapter, are eligible for medical assistance through the period of
18.16pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal
18.17funds are available under title XXI of the Social Security Act, and the state children's
18.18health insurance program.
18.19(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
18.20services from a nonprofit center established to serve victims of torture and are otherwise
18.21ineligible for medical assistance under this chapter are eligible for medical assistance
18.22without federal financial participation. These individuals are eligible only for the period
18.23during which they are receiving services from the center. Individuals eligible under this
18.24paragraph shall not be required to participate in prepaid medical assistance.
18.25(k) Noncitizens who are lawfully present in the United States as defined in Code
18.26of Federal Regulations, title 8, section 103.12, who are not children or pregnant women
18.27as defined in paragraph (d), and who otherwise meet the eligibility requirements of this
18.28chapter, are eligible for medical assistance without federal financial participation. These
18.29individuals must cooperate with the United States Citizenship and Immigration Services to
18.30pursue any applicable immigration status, including citizenship, that would qualify them
18.31for medical assistance with federal financial participation.
18.32EFFECTIVE DATE.This section is effective January 1, 2014.

18.33    Sec. 24. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
18.34    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
18.35for the quality of care based on standards established under subdivision 1, paragraph (b),
19.1clause (10), and the cost of care or utilization of services provided to its enrollees under
19.2subdivision 1, paragraph (b), clause (1).
19.3(b) A health care delivery system may contract and coordinate with providers and
19.4clinics for the delivery of services and shall contract with community health clinics,
19.5federally qualified health centers, community mental health centers or programs, county
19.6agencies, and rural clinics to the extent practicable.
19.7(c) A health care delivery system must demonstrate how its services will be
19.8coordinated with other services affecting its attributed patients' health, quality of care,
19.9and cost of care that are provided by other providers and county agencies in the local
19.10service area. The health care delivery system must: (1) document how other providers
19.11and counties, including county-based purchasing plans, will provide services to persons
19.12attributed to the health care delivery system; (2) document how other providers and
19.13counties, including county-based purchasing plans, participated in developing the
19.14application; (3) provide verification that other providers and counties, including
19.15county-based purchasing plans, support the project and are willing to participate; and (4)
19.16document how it will address applicable local needs, priorities, and public health goals.
19.17EFFECTIVE DATE.This section applies to health care delivery system contracts
19.18entered into or renewed on or after July 1, 2013.

19.19    Sec. 25. Minnesota Statutes 2012, section 256B.694, is amended to read:
19.20256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
19.21CONTRACT.
19.22    (a) MS 2010 [Expired, 2008 c 364 s 10]
19.23    (b) The commissioner shall consider, and may approve, contracting on a
19.24single-health plan basis with other county-based purchasing plans, or with other qualified
19.25health plans that have coordination arrangements with counties, to serve persons with
19.26a disability who voluntarily enroll enrolled in state health care programs, in order to
19.27promote better coordination or integration of health care services, social services and
19.28other community-based services, provided that all requirements applicable to health plan
19.29purchasing, including those in section 256B.69, subdivision 23, are satisfied. Nothing in
19.30this paragraph supersedes or modifies the requirements in paragraph (a).

19.31    Sec. 26. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
19.32to read:
20.1    Subd. 1b. Affordable Care Act. "Affordable Care Act" means Public Law 111-148,
20.2as amended by the federal Health Care and Education Reconciliation Act of 2010, Public
20.3Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.

20.4    Sec. 27. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
20.5    Subd. 3a. Family with children. (a) "Family with children" means:
20.6(1) parents and their children residing in the same household; or
20.7(2) grandparents, foster parents, relative caretakers as defined in the medical
20.8assistance program, or legal guardians; and their wards who are children residing in the
20.9same household. "Family" has the meaning given for family and family size as defined
20.10in Code of Federal Regulations, title 26, section 1.36B-1.
20.11(b) The term includes children who are temporarily absent from the household in
20.12settings such as schools, camps, or parenting time with noncustodial parents.
20.13EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
20.14approval, whichever is later. The commissioner of human services shall notify the revisor
20.15of statutes when federal approval is obtained.

20.16    Sec. 28. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
20.17to read:
20.18    Subd. 4b. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
20.19means the Minnesota Insurance Marketplace as defined in Minnesota Statutes, section
20.2062V.02.

20.21    Sec. 29. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
20.22    Subd. 5. Income. (a) "Income" has the meaning given for earned and unearned
20.23income for families and children in the medical assistance program, according to the
20.24state's aid to families with dependent children plan in effect as of July 16, 1996. The
20.25definition does not include medical assistance income methodologies and deeming
20.26requirements. The earned income of full-time and part-time students under age 19 is
20.27not counted as income. Public assistance payments and supplemental security income
20.28are not excluded income modified adjusted gross income, as defined in Code of Federal
20.29Regulations, title 26, section 1.36B-1.
20.30(b) For purposes of this subdivision, and unless otherwise specified in this section,
20.31the commissioner shall use reasonable methods to calculate gross earned and unearned
20.32income including, but not limited to, projecting income based on income received within
20.33the past 30 days, the last 90 days, or the last 12 months.
21.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.2approval, whichever is later. The commissioner of human services shall notify the revisor
21.3of statutes when federal approval is obtained.

21.4    Sec. 30. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
21.5to read:
21.6    Subd. 8. Participating entity. "Participating entity" means a health carrier as
21.7defined in section 62A.011, subdivision 2; a county-based purchasing plan established
21.8under section 256B.692; an accountable care organization or other entity operating a
21.9health care delivery systems demonstration project authorized under section 256B.0755;
21.10an entity operating a county integrated health care delivery network pilot project
21.11authorized under section 256B.0756; or a network of health care providers established to
21.12offer services under MinnesotaCare.
21.13EFFECTIVE DATE.This section is effective January 1, 2015.

21.14    Sec. 31. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
21.15    Subd. 2. Commissioner's duties. The commissioner shall establish an office for the
21.16state administration of this plan. The plan shall be used to provide covered health services
21.17for eligible persons. Payment for these services shall be made to all eligible providers
21.18 participating entities under contract with the commissioner. The commissioner shall
21.19adopt rules to administer the MinnesotaCare program. Nothing in this chapter is intended
21.20to violate the requirements of the Affordable Care Act. The commissioner shall not
21.21implement any provision of this chapter if the provision is found to violate the Affordable
21.22Care Act. The commissioner shall establish marketing efforts to encourage potentially
21.23eligible persons to receive information about the program and about other medical care
21.24programs administered or supervised by the Department of Human Services. A toll-free
21.25telephone number and Web site must be used to provide information about medical
21.26programs and to promote access to the covered services.
21.27EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.28approval, whichever is later, except that the amendment related to "participating entities"
21.29is effective January 1, 2015. The commissioner of human services shall notify the revisor
21.30when federal approval is obtained.

21.31    Sec. 32. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
21.32to read:
22.1    Subd. 6. Federal approval. (a) The commissioner of human services shall seek
22.2federal approval to implement the MinnesotaCare program under this chapter as a basic
22.3health program. In any agreement with the Centers for Medicare and Medicaid Services
22.4to operate MinnesotaCare as a basic health program, the commissioner shall seek to
22.5include procedures to ensure that federal funding is predictable, stable, and sufficient
22.6to sustain ongoing operation of MinnesotaCare. These procedures must address issues
22.7related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
22.8and minimization of state financial risk. The commissioner shall consult with the
22.9commissioner of management and budget when developing the proposal for establishing
22.10MinnesotaCare as a basic health program to be submitted to the Centers for Medicare
22.11and Medicaid Services.
22.12(b) The commissioner of human services, in consultation with the commissioner of
22.13management and budget, shall work with the Centers for Medicare and Medicaid Services
22.14to establish a process for reconciliation and adjustment of federal payments that balances
22.15state and federal liability over time. The commissioner of human services shall request that
22.16the secretary of health and human services hold the state, and enrollees, harmless in the
22.17reconciliation process for the first three years, to allow the state to develop a statistically
22.18valid methodology for predicting enrollment trends and their net effect on federal payments.
22.19(c) The commissioner of human services, through December 31, 2015, may modify
22.20the MinnesotaCare program as specified in this chapter, if it is necessary to enhance
22.21health benefits, expand provider access, or reduce cost-sharing and premiums in order
22.22to comply with the terms and conditions of federal approval as a basic health program.
22.23The commissioner may not reduce benefits, impose greater limits on access to providers,
22.24or increase cost-sharing and premiums by enrollees under the authority granted by this
22.25paragraph. If the commissioner modifies the terms and requirements for MinnesotaCare
22.26under this paragraph, the commissioner shall provide the legislature with notice of
22.27implementation of the modifications at least ten working days before notifying enrollees
22.28and participating entities. The costs of any changes to the program necessary to comply
22.29with federal approval shall become part of the program's base funding for purposes of
22.30future budget forecasts.
22.31EFFECTIVE DATE.This section is effective the day following final enactment.

22.32    Sec. 33. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
22.33to read:
23.1    Subd. 7. Coordination with Minnesota Insurance Marketplace. MinnesotaCare
23.2shall be considered a public health care program for purposes of Minnesota Statutes,
23.3chapter 62V.
23.4EFFECTIVE DATE.This section is effective January 1, 2014.

23.5    Sec. 34. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
23.6    Subdivision 1. Covered health services. (a) "Covered health services" means the
23.7health services reimbursed under chapter 256B, and all essential health benefits required
23.8under section 1302 of the Affordable Care Act, with the exception of inpatient hospital
23.9services, special education services, private duty nursing services, adult dental care
23.10services other than services covered under section 256B.0625, subdivision 9, orthodontic
23.11services, nonemergency medical transportation services, personal care assistance and case
23.12management services, and nursing home or intermediate care facilities services, inpatient
23.13mental health services, and chemical dependency services.
23.14    (b) No public funds shall be used for coverage of abortion under MinnesotaCare
23.15except where the life of the female would be endangered or substantial and irreversible
23.16impairment of a major bodily function would result if the fetus were carried to term; or
23.17where the pregnancy is the result of rape or incest.
23.18    (c) Covered health services shall be expanded as provided in this section.
23.19EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
23.20approval, whichever is later. The commissioner of human services shall notify the revisor
23.21of statutes when federal approval is obtained.

23.22    Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
23.23    Subd. 1a. Pregnant women and Children; MinnesotaCare health care reform
23.24waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage
23.25of all services that are eligible for reimbursement under the medical assistance program
23.26according to chapter 256B, except that abortion services under MinnesotaCare shall be
23.27limited as provided under subdivision 1. Pregnant women and Children are exempt from
23.28the provisions of subdivision 5, regarding co-payments. Pregnant women and Children
23.29who are lawfully residing in the United States but who are not "qualified noncitizens" under
23.30title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
23.31Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
23.32of all services provided under the medical assistance program according to chapter 256B.
24.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.2approval, whichever is later. The commissioner of human services shall notify the revisor
24.3of statutes when federal approval is obtained.

24.4    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
24.5    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
24.6inpatient hospital services, including inpatient hospital mental health services and inpatient
24.7hospital and residential chemical dependency treatment, subject to those limitations
24.8necessary to coordinate the provision of these services with eligibility under the medical
24.9assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
24.10section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
24.112 , with family gross income that exceeds 200 percent of the federal poverty guidelines or
24.12215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
24.13pregnant, is subject to an annual limit of $10,000.
24.14    (b) Admissions for inpatient hospital services paid for under section 256L.11,
24.15subdivision 3 , must be certified as medically necessary in accordance with Minnesota
24.16Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
24.17    (1) all admissions must be certified, except those authorized under rules established
24.18under section 254A.03, subdivision 3, or approved under Medicare; and
24.19    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
24.20for admissions for which certification is requested more than 30 days after the day of
24.21admission. The hospital may not seek payment from the enrollee for the amount of the
24.22payment reduction under this clause.
24.23EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.24approval, whichever is later. The commissioner of human services shall notify the revisor
24.25of statutes when federal approval is obtained.

24.26    Sec. 37. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
24.27to read:
24.28    Subd. 4b. Loss ratio. Health coverage provided through the MinnesotaCare
24.29program must have a medical loss ratio of at least 85 percent, as defined using the loss
24.30ratio methodology described in section 1001 of the Affordable Care Act.
24.31EFFECTIVE DATE.This section is effective January 1, 2015.

24.32    Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
25.1    Subd. 5. Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
25.2 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
25.3requirements for all enrollees:
25.4    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
25.5subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
25.6    (2) $3 per prescription for adult enrollees;
25.7    (3) $25 for eyeglasses for adult enrollees;
25.8    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
25.9episode of service which is required because of a recipient's symptoms, diagnosis, or
25.10established illness, and which is delivered in an ambulatory setting by a physician or
25.11physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
25.12audiologist, optician, or optometrist;
25.13    (5) $6 for nonemergency visits to a hospital-based emergency room for services
25.14provided through December 31, 2010, and $3.50 effective January 1, 2011; and
25.15(6) a family deductible equal to the maximum amount allowed under Code of
25.16Federal Regulations, title 42, part 447.54.
25.17    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
25.18 families with children under the age of 21.
25.19    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
25.20    (d) Paragraph (a), clause (4), does not apply to mental health services.
25.21    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
25.22poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
25.23and who are not pregnant shall be financially responsible for the coinsurance amount, if
25.24applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
25.25    (f) (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
25.26or changes from one prepaid health plan to another during a calendar year, any charges
25.27submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
25.28expenses incurred by the enrollee for inpatient services, that were submitted or incurred
25.29prior to enrollment, or prior to the change in health plans, shall be disregarded.
25.30(g) (f) MinnesotaCare reimbursements to fee-for-service providers and payments to
25.31managed care plans or county-based purchasing plans shall not be increased as a result of
25.32the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
25.33(h) (g) The commissioner, through the contracting process under section 256L.12,
25.34may allow managed care plans and county-based purchasing plans to waive the family
25.35deductible under paragraph (a), clause (6). The value of the family deductible shall not be
25.36included in the capitation payment to managed care plans and county-based purchasing
26.1plans. Managed care plans and county-based purchasing plans shall certify annually to the
26.2commissioner the dollar value of the family deductible.
26.3EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
26.4approval, whichever is later. The commissioner of human services shall notify the revisor
26.5of statutes when federal approval is obtained.

26.6    Sec. 39. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
26.7    Subd. 6. Lien. When the state agency provides, pays for, or becomes liable for
26.8covered health services, the agency shall have a lien for the cost of the covered health
26.9services upon any and all causes of action accruing to the enrollee, or to the enrollee's
26.10legal representatives, as a result of the occurrence that necessitated the payment for the
26.11covered health services. All liens under this section shall be subject to the provisions
26.12of section 256.015. For purposes of this subdivision, "state agency" includes prepaid
26.13health plans participating entities, under contract with the commissioner according to
26.14sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
26.15purchasing entities under section 256B.692 section 256L.121.
26.16EFFECTIVE DATE.This section is effective January 1, 2015.

26.17    Sec. 40. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
26.18    Subdivision 1. Families with children. (a) Families with children with family
26.19income above 133 percent of the federal poverty guidelines and equal to or less than
26.20275 200 percent of the federal poverty guidelines for the applicable family size shall be
26.21eligible for MinnesotaCare according to this section. All other provisions of sections
26.22256L.01 to 256L.18, including the insurance-related barriers to enrollment under section
26.23256L.07, shall apply unless otherwise specified.
26.24    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
26.25if the children are eligible. Children may be enrolled separately without enrollment by
26.26parents. However, if one parent in the household enrolls, both parents must enroll, unless
26.27other insurance is available. If one child from a family is enrolled, all children must
26.28be enrolled, unless other insurance is available. If one spouse in a household enrolls,
26.29the other spouse in the household must also enroll, unless other insurance is available.
26.30Families cannot choose to enroll only certain uninsured members.
26.31    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
26.32to the MinnesotaCare program. These persons are no longer counted in the parental
26.33household and may apply as a separate household.
27.1    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
27.2(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
27.38 , are exempt from the eligibility requirements of this subdivision.
27.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.5approval, whichever is later. The commissioner of human services shall notify the revisor
27.6of statutes when federal approval is obtained.

27.7    Sec. 41. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
27.8to read:
27.9    Subd. 1c. General requirements. To be eligible for coverage under MinnesotaCare,
27.10a person must meet the eligibility requirements of this section. A person eligible for
27.11MinnesotaCare shall not be treated as a qualified individual under section 1312 of the
27.12Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
27.13through the health benefit exchange under section 1331 of the Affordable Care Act.
27.14EFFECTIVE DATE.This section is effective January 1, 2015.

27.15    Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
27.16    Subd. 7. Single adults and households with no children. (a) The definition of
27.17eligible persons includes all individuals and households families with no children who
27.18have gross family incomes that are above 133 percent and equal to or less than 200 percent
27.19of the federal poverty guidelines for the applicable family size.
27.20    (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
27.21and households with no children who have gross family incomes that are equal to or less
27.22than 250 percent of the federal poverty guidelines.
27.23EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.24approval, whichever is later. The commissioner of human services shall notify the revisor
27.25of statutes when federal approval is obtained.

27.26    Sec. 43. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
27.27    Subd. 8. Applicants potentially eligible for medical assistance. (a) Individuals
27.28who receive supplemental security income or retirement, survivors, or disability benefits
27.29due to a disability, or other disability-based pension, who qualify under subdivision 7, but
27.30who are potentially eligible for medical assistance without a spenddown shall be allowed
27.31to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
27.32conditions of eligibility. The commissioner shall identify and refer the applications of
28.1such individuals to their county social service agency. The county and the commissioner
28.2shall cooperate to ensure that the individuals obtain medical assistance coverage for any
28.3months for which they are eligible.
28.4(b) The enrollee must cooperate with the county social service agency in determining
28.5medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
28.6cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
28.7from the plan within one calendar month. Persons disenrolled for nonapplication for
28.8medical assistance may not reenroll until they have obtained a medical assistance
28.9eligibility determination. Persons disenrolled for noncooperation with medical assistance
28.10may not reenroll until they have cooperated with the county agency and have obtained a
28.11medical assistance eligibility determination.
28.12(c) Beginning January 1, 2000, counties that choose to become MinnesotaCare
28.13enrollment sites shall consider MinnesotaCare applications to also be applications for
28.14medical assistance. Applicants who are potentially eligible for medical assistance, except
28.15for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
28.16medical assistance.
28.17(d) The commissioner shall redetermine provider payments made under
28.18MinnesotaCare to the appropriate medical assistance payments for those enrollees who
28.19subsequently become eligible for medical assistance.
28.20EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
28.21approval, whichever is later. The commissioner of human services shall notify the revisor
28.22of statutes when federal approval is obtained.

28.23    Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
28.24    Subd. 10. Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to
28.25citizens or nationals of the United States, qualified noncitizens, and other persons residing
28.26 and lawfully in the United States present noncitizens as defined in Code of Federal
28.27Regulations, title 8, section 103.12. Undocumented noncitizens and nonimmigrants
28.28 are ineligible for MinnesotaCare. For purposes of this subdivision, a nonimmigrant
28.29is an individual in one or more of the classes listed in United States Code, title 8,
28.30section 1101(a)(15), and an undocumented noncitizen is an individual who resides in the
28.31United States without the approval or acquiescence of the United States Citizenship and
28.32Immigration Services. Families with children who are citizens or nationals of the United
28.33States must cooperate in obtaining satisfactory documentary evidence of citizenship or
28.34nationality according to the requirements of the federal Deficit Reduction Act of 2005,
28.35Public Law 109-171.
29.1(b) Eligible persons include individuals who are lawfully present and ineligible for
29.2medical assistance by reason of immigration status, who have family income equal to or
29.3less than 200 percent of the federal poverty guidelines for the applicable family size.
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. 45. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
29.8to read:
29.9    Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
29.10medical assistance under chapter 256B are not eligible for MinnesotaCare under this
29.11section.
29.12(b) The commissioner shall coordinate eligibility and coverage to ensure that
29.13individuals transitioning between medical assistance and MinnesotaCare have seamless
29.14eligibility and access to health care services.
29.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.16approval, whichever is later. The commissioner of human services shall notify the revisor
29.17of statutes when federal approval is obtained.

29.18    Sec. 46. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
29.19    Subdivision 1. Application assistance and information availability. (a) Applicants
29.20may submit applications online, in person, by mail, or by phone in accordance with the
29.21Affordable Care Act, and by any other means by which medical assistance applications
29.22may be submitted. Applicants may submit applications through the Minnesota Insurance
29.23Marketplace or through the MinnesotaCare program. Applications and application
29.24assistance must be made available at provider offices, local human services agencies,
29.25school districts, public and private elementary schools in which 25 percent or more of
29.26the students receive free or reduced price lunches, community health offices, Women,
29.27Infants and Children (WIC) program sites, Head Start program sites, public housing
29.28councils, crisis nurseries, child care centers, early childhood education and preschool
29.29program sites, legal aid offices, and libraries, and at any other locations at which medical
29.30assistance applications must be made available. These sites may accept applications and
29.31forward the forms to the commissioner or local county human services agencies that
29.32choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
29.33commissioner or to participating local county human services agencies.
30.1(b) Application assistance must be available for applicants choosing to file an online
30.2application through the Minnesota Insurance Marketplace.
30.3EFFECTIVE DATE.This section is effective January 1, 2014.

30.4    Sec. 47. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
30.5    Subd. 2. Commissioner's duties. The commissioner or county agency shall use
30.6electronic verification through the Minnesota Insurance Marketplace as the primary
30.7method of income verification. If there is a discrepancy between reported income
30.8and electronically verified income, an individual may be required to submit additional
30.9verification to the extent permitted under the Affordable Care Act. In addition, the
30.10commissioner shall perform random audits to verify reported income and eligibility. The
30.11commissioner may execute data sharing arrangements with the Department of Revenue
30.12and any other governmental agency in order to perform income verification related to
30.13eligibility and premium payment under the MinnesotaCare program.
30.14EFFECTIVE DATE.This section is effective January 1, 2014.

30.15    Sec. 48. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
30.16    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
30.17first day of the month following the month in which eligibility is approved and the first
30.18premium payment has been received. As provided in section 256B.057, coverage for
30.19newborns is automatic from the date of birth and must be coordinated with other health
30.20coverage. The effective date of coverage for eligible newly adoptive children added to a
30.21family receiving covered health services is the month of placement. The effective date
30.22of coverage for other new members added to the family is the first day of the month
30.23following the month in which the change is reported. All eligibility criteria must be met
30.24by the family at the time the new family member is added. The income of the new family
30.25member is included with the family's modified adjusted gross income and the adjusted
30.26premium begins in the month the new family member is added.
30.27(b) The initial premium must be received by the last working day of the month for
30.28coverage to begin the first day of the following month.
30.29(c) Benefits are not available until the day following discharge if an enrollee is
30.30hospitalized on the first day of coverage.
30.31(d) (c) Notwithstanding any other law to the contrary, benefits under sections
30.32256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
30.33an eligible person may have coverage and the commissioner shall use cost avoidance
31.1techniques to ensure coordination of any other health coverage for eligible persons. The
31.2commissioner shall identify eligible persons who may have coverage or benefits under
31.3other plans of insurance or who become eligible for medical assistance.
31.4(e) (d) The effective date of coverage for individuals or families who are exempt
31.5from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first
31.6day of the month following the month in which verification of American Indian status
31.7is received or eligibility is approved, whichever is later.
31.8(f) (e) The effective date of coverage for children eligible under section 256L.07,
31.9subdivision 8, is the first day of the month following the date of termination from foster
31.10care or release from a juvenile residential correctional facility.
31.11EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
31.12approval, whichever is later. The commissioner of human services shall notify the revisor
31.13of statutes when federal approval is obtained.

31.14    Sec. 49. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
31.15    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
31.16commissioner for MinnesotaCare.
31.17    (b) The commissioner shall develop and implement procedures to: (1) require
31.18enrollees to report changes in income; (2) adjust sliding scale premium payments, based
31.19upon both increases and decreases in enrollee income, at the time the change in income
31.20is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
31.21premiums. Failure to pay includes payment with a dishonored check, a returned automatic
31.22bank withdrawal, or a refused credit card or debit card payment. The commissioner may
31.23demand a guaranteed form of payment, including a cashier's check or a money order, as
31.24the only means to replace a dishonored, returned, or refused payment.
31.25    (c) Premiums are calculated on a calendar month basis and may be paid on a
31.26monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
31.27commissioner of the premium amount required. The commissioner shall inform applicants
31.28and enrollees of these premium payment options. Premium payment is required before
31.29enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
31.30received before noon are credited the same day. Premium payments received after noon
31.31are credited on the next working day.
31.32    (d) Nonpayment of the premium will result in disenrollment from the plan effective
31.33for the calendar month for which the premium was due. Persons disenrolled for
31.34nonpayment or who voluntarily terminate coverage from the program may not reenroll
31.35until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
32.1all past due premiums as well as current premiums due, including premiums due for the
32.2period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
32.3to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
32.4terminate coverage from the program may not reenroll for four calendar months unless
32.5the person demonstrates good cause for nonpayment. Good cause does not exist if a
32.6person chooses to pay other family expenses instead of the premium. The commissioner
32.7shall define good cause in rule.
32.8EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
32.9approval, whichever is later. The commissioner of human services shall notify the revisor
32.10of statutes when federal approval is obtained.

32.11    Sec. 50. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
32.12    Subdivision 1. General requirements. (a) Children enrolled in the original
32.13children's health plan as of September 30, 1992, children who enrolled in the
32.14MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
32.15article 4, section 17, and children who have family gross incomes that are equal to or
32.16less than 200 percent of the federal poverty guidelines are eligible without meeting the
32.17requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
32.18they maintain continuous coverage in the MinnesotaCare program or medical assistance.
32.19    Parents Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 1,
32.20and individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose
32.21income increases above 275 200 percent of the federal poverty guidelines, are no longer
32.22eligible for the program and shall be disenrolled by the commissioner. Beginning January
32.231, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision
32.247 , whose income increases above 200 percent of the federal poverty guidelines or 250
32.25percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
32.26the program and shall be disenrolled by the commissioner. For persons disenrolled under
32.27this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
32.28following the month in which the commissioner determines that the income of a family or
32.29individual exceeds program income limits.
32.30    (b) Children may remain enrolled in MinnesotaCare if their gross family income as
32.31defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty
32.32guidelines. The premium for children remaining eligible under this paragraph shall be the
32.33maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
32.34    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
32.35gross household income exceeds $57,500 for the 12-month period of eligibility.
33.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.2approval, whichever is later. The commissioner of human services shall notify the revisor
33.3of statutes when federal approval is obtained.

33.4    Sec. 51. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
33.5    Subd. 2. Must not have access to employer-subsidized minimum essential
33.6 coverage. (a) To be eligible, a family or individual must not have access to subsidized
33.7health coverage through an employer and must not have had access to employer-subsidized
33.8coverage through a current employer for 18 months prior to application or reapplication.
33.9A family or individual whose employer-subsidized coverage is lost due to an employer
33.10terminating health care coverage as an employee benefit during the previous 18 months is
33.11not eligible that is affordable and provides minimum value as defined in Code of Federal
33.12Regulations, title 26, section 1.36B-2.
33.13(b) This subdivision does not apply to a family or individual who was enrolled
33.14in MinnesotaCare within six months or less of reapplication and who no longer has
33.15employer-subsidized coverage due to the employer terminating health care coverage as an
33.16employee benefit. This subdivision does not apply to children with family gross incomes
33.17that are equal to or less than 200 percent of federal poverty guidelines.
33.18(c) For purposes of this requirement, subsidized health coverage means health
33.19coverage for which the employer pays at least 50 percent of the cost of coverage for
33.20the employee or dependent, or a higher percentage as specified by the commissioner.
33.21Children are eligible for employer-subsidized coverage through either parent, including
33.22the noncustodial parent. The commissioner must treat employer contributions to Internal
33.23Revenue Code Section 125 plans and any other employer benefits intended to pay
33.24health care costs as qualified employer subsidies toward the cost of health coverage for
33.25employees for purposes of this subdivision.
33.26EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.27approval, whichever is later. The commissioner of human services shall notify the revisor
33.28of statutes when federal approval is obtained.

33.29    Sec. 52. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
33.30    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
33.31MinnesotaCare program must have no To be eligible, a family must not have minimum
33.32essential health coverage while enrolled, as defined by section 5000A of the Internal
33.33Revenue Code. Children with family gross incomes equal to or greater than 200 percent
33.34of federal poverty guidelines, and adults, must have had no health coverage for at least
34.1four months prior to application and renewal. Children enrolled in the original children's
34.2health plan and children in families with income equal to or less than 200 percent of the
34.3federal poverty guidelines, who have other health insurance, are eligible if the coverage:
34.4(1) lacks two or more of the following:
34.5(i) basic hospital insurance;
34.6(ii) medical-surgical insurance;
34.7(iii) prescription drug coverage;
34.8(iv) dental coverage; or
34.9(v) vision coverage;
34.10(2) requires a deductible of $100 or more per person per year; or
34.11(3) lacks coverage because the child has exceeded the maximum coverage for a
34.12particular diagnosis or the policy excludes a particular diagnosis.
34.13The commissioner may change this eligibility criterion for sliding scale premiums
34.14in order to remain within the limits of available appropriations. The requirement of no
34.15health coverage does not apply to newborns.
34.16(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
34.17assistance, and the Civilian Health and Medical Program of the Uniformed Service,
34.18CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
34.19part II, chapter 55, are not considered insurance or health coverage for purposes of the
34.20four-month requirement described in this subdivision.
34.21(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
34.22Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
34.23Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
34.24to have minimum essential health coverage. An applicant or enrollee who is entitled to
34.25premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
34.26to establish eligibility for MinnesotaCare.
34.27(d) Applicants who were recipients of medical assistance within one month of
34.28application must meet the provisions of this subdivision and subdivision 2.
34.29(e) Cost-effective health insurance that was paid for by medical assistance is not
34.30considered health coverage for purposes of the four-month requirement under this
34.31section, except if the insurance continued after medical assistance no longer considered it
34.32cost-effective or after medical assistance closed.
34.33EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.34approval, whichever is later. The commissioner of human services shall notify the revisor
34.35of statutes when federal approval is obtained.

35.1    Sec. 53. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
35.2    Subd. 2. Residency requirement. To be eligible for health coverage under the
35.3MinnesotaCare program, pregnant women, individuals, and families with children must
35.4meet the residency requirements as provided by Code of Federal Regulations, title 42,
35.5section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply
35.6upon receipt of federal approval.
35.7EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
35.8approval, whichever is later. The commissioner of human services shall notify the revisor
35.9of statutes when federal approval is obtained.

35.10    Sec. 54. Minnesota Statutes 2012, section 256L.11, subdivision 6, is amended to read:
35.11    Subd. 6. Enrollees 18 or older Reimbursement of inpatient hospital services.
35.12Payment by the MinnesotaCare program for inpatient hospital services provided to
35.13MinnesotaCare enrollees eligible under section 256L.04, subdivision 7, or who qualify
35.14under section 256L.04, subdivisions subdivision 1 and 2, with family gross income that
35.15exceeds 175 percent of the federal poverty guidelines and who are not pregnant, who
35.16are 18 years old or older on the date of admission to the inpatient hospital must be in
35.17accordance with paragraphs (a) and (b). Payment for adults who are not pregnant and are
35.18eligible under section 256L.04, subdivisions 1 and 2, and whose incomes are equal to or
35.19less than 175 percent of the federal poverty guidelines, shall be as provided for under
35.20paragraph (c)., shall be at the medical assistance rate minus any co-payment required
35.21under section 256L.03, subdivision 5. The hospital must not seek payment from the
35.22enrollee in addition to the co-payment. The MinnesotaCare payment plus the co-payment
35.23must be treated as payment in full.
35.24(a) If the medical assistance rate minus any co-payment required under section
35.25256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's
35.26benefit limit under section 256L.03, subdivision 3, payment must be the medical
35.27assistance rate minus any co-payment required under section 256L.03, subdivision 4. The
35.28hospital must not seek payment from the enrollee in addition to the co-payment. The
35.29MinnesotaCare payment plus the co-payment must be treated as payment in full.
35.30(b) If the medical assistance rate minus any co-payment required under section
35.31256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit
35.32under section 256L.03, subdivision 3, payment must be the lesser of:
35.33(1) the amount remaining in the enrollee's benefit limit; or
35.34(2) charges submitted for the inpatient hospital services less any co-payment
35.35established under section 256L.03, subdivision 4.
36.1The hospital may seek payment from the enrollee for the amount by which usual and
36.2customary charges exceed the payment under this paragraph. If payment is reduced under
36.3section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the
36.4enrollee for the amount of the reduction.
36.5(c) For admissions occurring on or after July 1, 2011, for single adults and
36.6households without children who are eligible under section 256L.04, subdivision 7, the
36.7commissioner shall pay hospitals directly, up to the medical assistance payment rate,
36.8for inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus
36.9any co-payment required under section 256L.03, subdivision 5. Inpatient services paid
36.10directly by the commissioner under this paragraph do not include chemical dependency
36.11hospital-based and residential treatment.
36.12EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.13approval, whichever is later. The commissioner of human services shall notify the revisor
36.14of statutes when federal approval is obtained.

36.15    Sec. 55. [256L.121] SERVICE DELIVERY.
36.16    Subdivision 1. Competitive process. The commissioner of human services shall
36.17establish a competitive process for entering into contracts with participating entities for
36.18the offering of standard health plans through MinnesotaCare. Coverage through standard
36.19health plans must be available to enrollees beginning January 1, 2015. Each standard
36.20health plan must cover the health services listed in and meet the requirements of section
36.21256L.03. The competitive process must meet the requirements of section 1331 of the
36.22Affordable Care Act and be designed to ensure enrollee access to high-quality health care
36.23coverage options. The commissioner, to the extent feasible, shall seek to ensure that
36.24enrollees have a choice of coverage from more than one participating entity within a
36.25geographic area. In rural areas other than metropolitan statistical areas, the commissioner
36.26shall use the medical assistance competitive procurement process under section 256B.69,
36.27subdivisions 1 to 32, under which selection of entities is based on criteria related to
36.28provider network access, coordination of health care with other local services, alignment
36.29with local public health goals, and other factors.
36.30    Subd. 2. Other requirements for participating entities. The commissioner shall
36.31require participating entities, as a condition of contract, to document to the commissioner:
36.32(1) the provision of culturally and linguistically appropriate services, including
36.33marketing materials, to MinnesotaCare enrollees; and
36.34(2) the inclusion in provider networks of providers designated as essential
36.35community providers under section 62Q.19.
37.1    Subd. 3. Coordination with state-administered health programs. The
37.2commissioner shall coordinate the administration of the MinnesotaCare program with
37.3medical assistance to maximize efficiency and improve the continuity of care. This
37.4includes, but is not limited to:
37.5(1) establishing geographic areas for MinnesotaCare that are consistent with the
37.6geographic areas of the medical assistance program, within which participating entities
37.7may offer health plans;
37.8(2) requiring, as a condition of participation in MinnesotaCare, participating entities
37.9to also participate in the medical assistance program;
37.10(3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and
37.11256B.694, when contracting with MinnesotaCare participating entities;
37.12(4) providing MinnesotaCare enrollees, to the extent possible, with the option to
37.13remain in the same health plan and provider network, if they later become eligible for
37.14medical assistance or coverage through the Minnesota health benefit exchange and if, in
37.15the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health
37.16plan is also a medical assistance health plan in the enrollee's county of residence; and
37.17(5) establishing requirements and criteria for selection that ensure that covered
37.18health care services will be coordinated with local public health services, social services,
37.19long-term care services, mental health services, and other local services affecting
37.20enrollees' health, access, and quality of care.
37.21EFFECTIVE DATE.This section is effective the day following final enactment.

37.22    Sec. 56. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
37.23    Subdivision 1. Premium determination. (a) Families with children and individuals
37.24shall pay a premium determined according to subdivision 2.
37.25    (b) Pregnant women and children under age two are exempt from the provisions
37.26of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
37.27for failure to pay premiums. For pregnant women, this exemption continues until the
37.28first day of the month following the 60th day postpartum. Women who remain enrolled
37.29during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
37.30disenrolled on the first of the month following the 60th day postpartum for the penalty
37.31period that otherwise applies under section 256L.06, unless they begin paying premiums.
37.32    (c) (b) Members of the military and their families who meet the eligibility criteria
37.33for MinnesotaCare upon eligibility approval made within 24 months following the end
37.34of the member's tour of active duty shall have their premiums paid by the commissioner.
37.35The effective date of coverage for an individual or family who meets the criteria of this
38.1paragraph shall be the first day of the month following the month in which eligibility is
38.2approved. This exemption applies for 12 months.
38.3(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
38.4their families shall have their premiums waived by the commissioner in accordance with
38.5section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
38.6An individual must document status as an American Indian, as defined under Code of
38.7Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
38.8EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
38.9approval, whichever is later. The commissioner of human services shall notify the revisor
38.10of statutes when federal approval is obtained.

38.11    Sec. 57. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
38.12    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
38.13commissioner shall establish a sliding fee scale to determine the percentage of monthly
38.14gross individual or family income that households at different income levels must pay to
38.15obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
38.16on the enrollee's monthly gross individual or family income. The sliding fee scale must
38.17contain separate tables based on enrollment of one, two, or three or more persons. Until
38.18June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
38.19individual or family income for individuals or families with incomes below the limits for
38.20the medical assistance program for families and children in effect on January 1, 1999, and
38.21proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
38.228.8 percent. These percentages are matched to evenly spaced income steps ranging from
38.23the medical assistance income limit for families and children in effect on January 1, 1999,
38.24to 275 percent of the federal poverty guidelines for the applicable family size, up to a
38.25family size of five. The sliding fee scale for a family of five must be used for families of
38.26more than five. The sliding fee scale and percentages are not subject to the provisions of
38.27chapter 14. If a family or individual reports increased income after enrollment, premiums
38.28shall be adjusted at the time the change in income is reported.
38.29    (b) Children in families whose gross income is above 275 percent of the federal
38.30poverty guidelines shall pay the maximum premium. The maximum premium is defined
38.31as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
38.32cases paid the maximum premium, the total revenue would equal the total cost of
38.33MinnesotaCare medical coverage and administration. In this calculation, administrative
38.34costs shall be assumed to equal ten percent of the total. The costs of medical coverage
38.35for pregnant women and children under age two and the enrollees in these groups shall
39.1be excluded from the total. The maximum premium for two enrollees shall be twice the
39.2maximum premium for one, and the maximum premium for three or more enrollees shall
39.3be three times the maximum premium for one.
39.4    (c) (b) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums
39.5according to the premium scale specified in paragraph (d) (c) with the exception that
39.6children in families with income at or below 200 percent of the federal poverty guidelines
39.7shall pay no premiums. For purposes of paragraph (d) (c), "minimum" means a monthly
39.8premium of $4.
39.9    (d) (c) The following premium scale is established for individuals and families with
39.10gross family incomes of 275 200 percent of the federal poverty guidelines or less:

39.11	Federal Poverty Guideline Range	Percent of Average Gross Monthly Income
39.12	0-45%	minimum
39.13 39.14	46-54%	$4 or 1.1% of family income, whichever is greater
39.15	55-81%	1.6%
39.16	82-109%	2.2%
39.17	110-136%	2.9%
39.18	137-164%	3.6%
39.19 39.20	165-191 165-200%	4.6%
39.21	192-219%	5.6%
39.22	220-248%	6.5%
39.23	249-275%	7.2%

39.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
39.25approval, whichever is later. The commissioner of human services shall notify the revisor
39.26of statutes when federal approval is obtained.

39.27    Sec. 58. DETERMINATION OF FUNDING ADEQUACY.
39.28The commissioners of revenue and management and budget, in consultation with
39.29the commissioner of human services, shall conduct an assessment of health care taxes,
39.30including the gross premiums tax, the provider tax, and Medicaid surcharges, and their
39.31relationship to the long-term solvency of the health care access fund, as part of the state
39.32revenue and expenditure forecast in November 2013. The commissioners shall determine
39.33the amount of state funding that will be required after December 31, 2019, in addition to
39.34the federal payments made available under section 1331 of the Affordable Care Act, for
39.35the MinnesotaCare program. The commissioners shall evaluate the stability and likelihood
39.36of long-term federal funding for the MinnesotaCare program under section 1331. The
39.37commissioners shall report the results of this assessment to the legislature by January 15,
40.12014, along with recommendations for changes to state revenue for the health care access
40.2fund, if state funding will continue to be required beyond December 31, 2019.

40.3    Sec. 59. STATE-BASED RISK ADJUSTMENT SYSTEM ASSESSMENT.
40.4(a) The commissioners of health, human services, and commerce, and the board of
40.5MNsure, shall study whether Minnesota-based risk adjustment of the individual and small
40.6group insurance market, using either the federal risk adjustment model or a state-based
40.7alternative, can be more cost-effective and perform better than risk adjustment conducted
40.8by federal agencies. The study shall assess the policies, infrastructure, and resources
40.9necessary to satisfy the requirements of Code of Federal Regulations, title 45, section
40.10153, subpart D. The study shall also evaluate the extent to which Minnesota-based risk
40.11adjustment could meet requirements established in Code of Federal Regulations, title
40.1245, section 153.330, including:
40.13(1) explaining the variation in health care costs of a given population;
40.14(2) linking risk factors to daily clinical practices and that which is clinically
40.15meaningful to providers;
40.16(3) encouraging favorable behavior among health care market participants and
40.17discouraging unfavorable behavior;
40.18(4) whether risk adjustment factors are relatively easy for stakeholders to understand
40.19and participate in;
40.20(5) providing stable risk scores over time and across health plan products;
40.21(6) minimizing administrative costs;
40.22(7) accounting for risk selection across metal levels;
40.23(8) aligning each of the elements of the methodology; and
40.24(9) can be conducted at a per-member cost equal to or lower than the projected
40.25cost of the federal risk adjustment model.
40.26(b) In conducting the study, and notwithstanding Minnesota Rules, chapter 4653,
40.27and as part of responsibilities under Minnesota Statutes, section 62U.04, subdivision
40.284, paragraph (b), the commissioner of health shall collect from health carriers in the
40.29individual and small group health insurance market, beginning on January 1, 2014, and for
40.30service dates in calendar year 2014, all data required for conducting risk adjustment with
40.31standard risk adjusters such as the Adjusted Clinical Groups or the Hierarchical Condition
40.32Category System, including but not limited to:
40.33(1) an indicator identifying the health plan product under which an enrollee is covered;
40.34(2) an indicator identifying whether an enrollee's policy is an individual or small
40.35group market policy;
41.1(3) an indicator identifying, if applicable, the metal level of an enrollee's health plan
41.2product, and whether the policy is a catastrophic policy; and
41.3(4) additional identified demographic data necessary to link individuals' data across
41.4carriers and insurance affordability programs with 95 percent accuracy. The commissioner
41.5shall not collect more than the last four digits of an individual's social security number.
41.6(c) The commissioner of health shall also asses the extent to which data collected
41.7under paragraph (b) and under Minnesota Statutes, section 62U.04, subdivision 4,
41.8paragraph (a), are sufficient for developing and operating a state alternative risk adjustment
41.9methodology consistent with applicable federal rules by evaluating:
41.10(1) if the data submitted are adequately complete, accurate, and timely;
41.11(2) if the data should be further enriched by nontraditional risk adjusters that help
41.12in better explaining variation in health care costs of a given population and account for
41.13risk selection across metal levels;
41.14(3) whether additional data or identifiers have the potential to strengthen a
41.15Minnesota-based risk adjustment approach; and
41.16(4) what if any changes to the technical infrastructure will be necessary to effectively
41.17perform state-based risk adjustment.
41.18For purposes of this paragraph, the commissioner of health shall have the authority to
41.19use identified data to validate and audit a statistically valid sample of data for each
41.20health carrier in the individual and small group market. In conducting the study, the
41.21commissioners shall contract with entities that do not have an economic interest in the
41.22outcome of Minnesota-based risk adjustment but do have demonstrated expertise in
41.23actuarial science or health economics and demonstrated experience with designing and
41.24implementing risk adjustment models.
41.25(d) The commissioner of human services shall evaluate opportunities to maximize
41.26federal funding under section 1331 of the federal Patient and Protection and Affordable
41.27Care Act, Public Law 111-148, and further defined through amendments to the act and
41.28regulations issued under the act. The commissioner of human services shall make
41.29recommendations on risk adjustment strategies to maximize federal funding to the state
41.30of Minnesota.
41.31(e) The commissioners and board of MNsure shall submit to the legislature by March
41.3215, 2014, an interim report with preliminary findings from the assessment conducted in
41.33paragraphs (c) and (d). The interim report shall include legislative recommendations
41.34for any necessary changes to Minnesota Statutes, section 62Q.03. A final report shall
41.35be submitted by the commissioners and board of MNsure to the legislature by October
42.11, 2015. The final report must include findings from the overall assessment and a
42.2recommendation whether to conduct state-based risk adjustment.
42.3(f) For purposes of this section, the board of MNsure means the board established
42.4under Minnesota Statutes, section 62V.03.

42.5    Sec. 60. REQUEST FOR FEDERAL AUTHORITY.
42.6The commissioner of human services shall seek authority from the federal Centers
42.7for Medicare and Medicaid Services to allow persons under age 65, participating in
42.8a home and community-based services waiver under section 1915(c) of the Social
42.9Security Act, to continue to disregard spousal income and assets, in place of the spousal
42.10impoverishment provisions under the federal Patient Protection and Affordable Care Act,
42.11Public Law 111-148, section 2404, as amended by the federal Health Care and Education
42.12Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations
42.13and guidance issued under, those acts.

42.14    Sec. 61. REVISOR'S INSTRUCTION.
42.15The revisor shall remove cross-references to the sections repealed in this article
42.16wherever they appear in Minnesota Statutes and Minnesota Rules and make changes
42.17necessary to correct the punctuation, grammar, or structure of the remaining text and
42.18preserve its meaning.

42.19    Sec. 62. REPEALER.
42.20(a) Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.031; 256L.04,
42.21subdivisions 1b, 9, and 10a; 256L.05, subdivision 3b; 256L.07, subdivisions 5, 8, and 9;
42.22256L.11, subdivision 5; and 256L.17, subdivisions 1, 2, 3, 4, and 5, are repealed effective
42.23January 1, 2014.
42.24(b) Minnesota Statutes 2012, section 256L.12, is repealed effective January 1, 2015.
42.25(c) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b;
42.26256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed effective
42.27January 1, 2014.


42.30    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
42.31    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
42.32electronically submit to the commissioner of health case mix assessments that conform
43.1with the assessment schedule defined by Code of Federal Regulations, title 42, section
43.2483.20, and published by the United States Department of Health and Human Services,
43.3Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
43.4Instrument User's Manual, version 3.0, and subsequent updates when issued by the
43.5Centers for Medicare and Medicaid Services. The commissioner of health may substitute
43.6successor manuals or question and answer documents published by the United States
43.7Department of Health and Human Services, Centers for Medicare and Medicaid Services,
43.8to replace or supplement the current version of the manual or document.
43.9(b) The assessments used to determine a case mix classification for reimbursement
43.10include the following:
43.11(1) a new admission assessment must be completed by day 14 following admission;
43.12(2) an annual assessment which must have an assessment reference date (ARD)
43.13within 366 days of the ARD of the last comprehensive assessment;
43.14(3) a significant change assessment must be completed within 14 days of the
43.15identification of a significant change; and
43.16(4) all quarterly assessments must have an assessment reference date (ARD) within
43.1792 days of the ARD of the previous assessment.
43.18(c) In addition to the assessments listed in paragraph (b), the assessments used to
43.19determine nursing facility level of care include the following:
43.20(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a
43.21county, tribe, or managed care organization under contract with the Department of Human
43.22Services 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line
43.23or other organization under contract with the Minnesota Board on Aging; and
43.24(2) a nursing facility level of care determination as provided for under section
43.25256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
43.26completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
43.27managed care organization under contract with the Department of Human Services.

43.28    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
43.29144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
43.30REPORT AND STUDY REQUIRED.
43.31    Subdivision 1. Report requirements. The commissioners of health and human
43.32services, with the cooperation of counties and in consultation with stakeholders, including
43.33persons who need or are using long-term care services and supports, lead agencies,
43.34regional entities, senior, disability, and mental health organization representatives, service
43.35providers, and community members shall prepare a report to the legislature by August 15,
44.12013, and biennially thereafter, regarding the status of the full range of long-term care
44.2services and supports for the elderly and children and adults with disabilities and mental
44.3illnesses in Minnesota. The report shall address:
44.4    (1) demographics and need for long-term care services and supports in Minnesota;
44.5    (2) summary of county and regional reports on long-term care gaps, surpluses,
44.6imbalances, and corrective action plans;
44.7    (3) status of long-term care services and related mental health services, housing
44.8options, and supports by county and region including:
44.9    (i) changes in availability of the range of long-term care services and housing options;
44.10    (ii) access problems, including access to the least restrictive and most integrated
44.11services and settings, regarding long-term care services; and
44.12    (iii) comparative measures of long-term care services availability, including serving
44.13people in their home areas near family, and changes over time; and
44.14    (4) recommendations regarding goals for the future of long-term care services and
44.15supports, policy and fiscal changes, and resource development and transition needs.
44.16    Subd. 2. Critical access study. The commissioner shall conduct a onetime study to
44.17assess local capacity and availability of home and community-based services for older
44.18adults, people with disabilities, and people with mental illnesses. The study must assess
44.19critical access at the community level and identify potential strategies to build home and
44.20community-based service capacity in critical access areas. The report shall be submitted
44.21to the legislature no later than August 15, 2015.

44.22    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
44.23    Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
44.24licensure of city, county, and state agency social workers is voluntary, except an individual
44.25who is newly employed by a city or state agency after July 1, 2016, must be licensed
44.26if the individual who provides social work services, as those services are defined in
44.27section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title
44.28incorporating the words "social work" or "social worker."
44.29(b) City, county, and state agencies employing social workers and staff who are
44.30designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
44.31256.01, subdivision 24, are not required to employ licensed social workers.

44.32    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
45.1    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
45.22 , the commissioner of human services shall carry out the specific duties in paragraphs (a)
45.3through (cc) (dd):
45.4    (a) Administer and supervise all forms of public assistance provided for by state law
45.5and other welfare activities or services as are vested in the commissioner. Administration
45.6and supervision of human services activities or services includes, but is not limited to,
45.7assuring timely and accurate distribution of benefits, completeness of service, and quality
45.8program management. In addition to administering and supervising human services
45.9activities vested by law in the department, the commissioner shall have the authority to:
45.10    (1) require county agency participation in training and technical assistance programs
45.11to promote compliance with statutes, rules, federal laws, regulations, and policies
45.12governing human services;
45.13    (2) monitor, on an ongoing basis, the performance of county agencies in the
45.14operation and administration of human services, enforce compliance with statutes, rules,
45.15federal laws, regulations, and policies governing welfare services and promote excellence
45.16of administration and program operation;
45.17    (3) develop a quality control program or other monitoring program to review county
45.18performance and accuracy of benefit determinations;
45.19    (4) require county agencies to make an adjustment to the public assistance benefits
45.20issued to any individual consistent with federal law and regulation and state law and rule
45.21and to issue or recover benefits as appropriate;
45.22    (5) delay or deny payment of all or part of the state and federal share of benefits and
45.23administrative reimbursement according to the procedures set forth in section 256.017;
45.24    (6) make contracts with and grants to public and private agencies and organizations,
45.25both profit and nonprofit, and individuals, using appropriated funds; and
45.26    (7) enter into contractual agreements with federally recognized Indian tribes with
45.27a reservation in Minnesota to the extent necessary for the tribe to operate a federally
45.28approved family assistance program or any other program under the supervision of the
45.29commissioner. The commissioner shall consult with the affected county or counties in
45.30the contractual agreement negotiations, if the county or counties wish to be included,
45.31in order to avoid the duplication of county and tribal assistance program services. The
45.32commissioner may establish necessary accounts for the purposes of receiving and
45.33disbursing funds as necessary for the operation of the programs.
45.34    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
45.35regulation, and policy necessary to county agency administration of the programs.
46.1    (c) Administer and supervise all child welfare activities; promote the enforcement of
46.2laws protecting disabled, dependent, neglected and delinquent children, and children born
46.3to mothers who were not married to the children's fathers at the times of the conception
46.4nor at the births of the children; license and supervise child-caring and child-placing
46.5agencies and institutions; supervise the care of children in boarding and foster homes or
46.6in private institutions; and generally perform all functions relating to the field of child
46.7welfare now vested in the State Board of Control.
46.8    (d) Administer and supervise all noninstitutional service to disabled persons,
46.9including those who are visually impaired, hearing impaired, or physically impaired
46.10or otherwise disabled. The commissioner may provide and contract for the care and
46.11treatment of qualified indigent children in facilities other than those located and available
46.12at state hospitals when it is not feasible to provide the service in state hospitals.
46.13    (e) Assist and actively cooperate with other departments, agencies and institutions,
46.14local, state, and federal, by performing services in conformity with the purposes of Laws
46.151939, chapter 431.
46.16    (f) Act as the agent of and cooperate with the federal government in matters of
46.17mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
46.18431, including the administration of any federal funds granted to the state to aid in the
46.19performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
46.20and including the promulgation of rules making uniformly available medical care benefits
46.21to all recipients of public assistance, at such times as the federal government increases its
46.22participation in assistance expenditures for medical care to recipients of public assistance,
46.23the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
46.24    (g) Establish and maintain any administrative units reasonably necessary for the
46.25performance of administrative functions common to all divisions of the department.
46.26    (h) Act as designated guardian of both the estate and the person of all the wards of
46.27the state of Minnesota, whether by operation of law or by an order of court, without any
46.28further act or proceeding whatever, except as to persons committed as developmentally
46.29disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
46.30recognized by the Secretary of the Interior whose interests would be best served by
46.31adoptive placement, the commissioner may contract with a licensed child-placing agency
46.32or a Minnesota tribal social services agency to provide adoption services. A contract
46.33with a licensed child-placing agency must be designed to supplement existing county
46.34efforts and may not replace existing county programs or tribal social services, unless the
46.35replacement is agreed to by the county board and the appropriate exclusive bargaining
46.36representative, tribal governing body, or the commissioner has evidence that child
47.1placements of the county continue to be substantially below that of other counties. Funds
47.2encumbered and obligated under an agreement for a specific child shall remain available
47.3until the terms of the agreement are fulfilled or the agreement is terminated.
47.4    (i) Act as coordinating referral and informational center on requests for service for
47.5newly arrived immigrants coming to Minnesota.
47.6    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
47.7way be construed to be a limitation upon the general transfer of powers herein contained.
47.8    (k) Establish county, regional, or statewide schedules of maximum fees and charges
47.9which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
47.10nursing home care and medicine and medical supplies under all programs of medical
47.11care provided by the state and for congregate living care under the income maintenance
47.12programs.
47.13    (l) Have the authority to conduct and administer experimental projects to test methods
47.14and procedures of administering assistance and services to recipients or potential recipients
47.15of public welfare. To carry out such experimental projects, it is further provided that the
47.16commissioner of human services is authorized to waive the enforcement of existing specific
47.17statutory program requirements, rules, and standards in one or more counties. The order
47.18establishing the waiver shall provide alternative methods and procedures of administration,
47.19shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
47.20in no event shall the duration of a project exceed four years. It is further provided that no
47.21order establishing an experimental project as authorized by the provisions of this section
47.22shall become effective until the following conditions have been met:
47.23    (1) the secretary of health and human services of the United States has agreed, for
47.24the same project, to waive state plan requirements relative to statewide uniformity; and
47.25    (2) a comprehensive plan, including estimated project costs, shall be approved by
47.26the Legislative Advisory Commission and filed with the commissioner of administration.
47.27    (m) According to federal requirements, establish procedures to be followed by
47.28local welfare boards in creating citizen advisory committees, including procedures for
47.29selection of committee members.
47.30    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
47.31control error rates for the aid to families with dependent children program formerly
47.32codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
47.33following manner:
47.34    (1) one-half of the total amount of the disallowance shall be borne by the county
47.35boards responsible for administering the programs. For the medical assistance and the
47.36AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
48.1shared by each county board in the same proportion as that county's expenditures for the
48.2sanctioned program are to the total of all counties' expenditures for the AFDC program
48.3formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
48.4food stamp program, sanctions shall be shared by each county board, with 50 percent of
48.5the sanction being distributed to each county in the same proportion as that county's
48.6administrative costs for food stamps are to the total of all food stamp administrative costs
48.7for all counties, and 50 percent of the sanctions being distributed to each county in the
48.8same proportion as that county's value of food stamp benefits issued are to the total of
48.9all benefits issued for all counties. Each county shall pay its share of the disallowance
48.10to the state of Minnesota. When a county fails to pay the amount due hereunder, the
48.11commissioner may deduct the amount from reimbursement otherwise due the county, or
48.12the attorney general, upon the request of the commissioner, may institute civil action
48.13to recover the amount due; and
48.14    (2) notwithstanding the provisions of clause (1), if the disallowance results from
48.15knowing noncompliance by one or more counties with a specific program instruction, and
48.16that knowing noncompliance is a matter of official county board record, the commissioner
48.17may require payment or recover from the county or counties, in the manner prescribed in
48.18clause (1), an amount equal to the portion of the total disallowance which resulted from the
48.19noncompliance, and may distribute the balance of the disallowance according to clause (1).
48.20    (o) Develop and implement special projects that maximize reimbursements and
48.21result in the recovery of money to the state. For the purpose of recovering state money,
48.22the commissioner may enter into contracts with third parties. Any recoveries that result
48.23from projects or contracts entered into under this paragraph shall be deposited in the
48.24state treasury and credited to a special account until the balance in the account reaches
48.25$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
48.26transferred and credited to the general fund. All money in the account is appropriated to
48.27the commissioner for the purposes of this paragraph.
48.28    (p) Have the authority to make direct payments to facilities providing shelter
48.29to women and their children according to section 256D.05, subdivision 3. Upon
48.30the written request of a shelter facility that has been denied payments under section
48.31256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
48.32a determination within 30 days of the request for review regarding issuance of direct
48.33payments to the shelter facility. Failure to act within 30 days shall be considered a
48.34determination not to issue direct payments.
48.35    (q) Have the authority to establish and enforce the following county reporting
48.36requirements:
49.1    (1) the commissioner shall establish fiscal and statistical reporting requirements
49.2necessary to account for the expenditure of funds allocated to counties for human
49.3services programs. When establishing financial and statistical reporting requirements, the
49.4commissioner shall evaluate all reports, in consultation with the counties, to determine if
49.5the reports can be simplified or the number of reports can be reduced;
49.6    (2) the county board shall submit monthly or quarterly reports to the department
49.7as required by the commissioner. Monthly reports are due no later than 15 working days
49.8after the end of the month. Quarterly reports are due no later than 30 calendar days after
49.9the end of the quarter, unless the commissioner determines that the deadline must be
49.10shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
49.11or risking a loss of federal funding. Only reports that are complete, legible, and in the
49.12required format shall be accepted by the commissioner;
49.13    (3) if the required reports are not received by the deadlines established in clause (2),
49.14the commissioner may delay payments and withhold funds from the county board until
49.15the next reporting period. When the report is needed to account for the use of federal
49.16funds and the late report results in a reduction in federal funding, the commissioner shall
49.17withhold from the county boards with late reports an amount equal to the reduction in
49.18federal funding until full federal funding is received;
49.19    (4) a county board that submits reports that are late, illegible, incomplete, or not
49.20in the required format for two out of three consecutive reporting periods is considered
49.21noncompliant. When a county board is found to be noncompliant, the commissioner
49.22shall notify the county board of the reason the county board is considered noncompliant
49.23and request that the county board develop a corrective action plan stating how the
49.24county board plans to correct the problem. The corrective action plan must be submitted
49.25to the commissioner within 45 days after the date the county board received notice
49.26of noncompliance;
49.27    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
49.28after the date the report was originally due. If the commissioner does not receive a report
49.29by the final deadline, the county board forfeits the funding associated with the report for
49.30that reporting period and the county board must repay any funds associated with the
49.31report received for that reporting period;
49.32    (6) the commissioner may not delay payments, withhold funds, or require repayment
49.33under clause (3) or (5) if the county demonstrates that the commissioner failed to
49.34provide appropriate forms, guidelines, and technical assistance to enable the county to
49.35comply with the requirements. If the county board disagrees with an action taken by the
50.1commissioner under clause (3) or (5), the county board may appeal the action according
50.2to sections 14.57 to 14.69; and
50.3    (7) counties subject to withholding of funds under clause (3) or forfeiture or
50.4repayment of funds under clause (5) shall not reduce or withhold benefits or services to
50.5clients to cover costs incurred due to actions taken by the commissioner under clause
50.6(3) or (5).
50.7    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
50.8federal fiscal disallowances or sanctions are based on a statewide random sample in direct
50.9proportion to each county's claim for that period.
50.10    (s) Be responsible for ensuring the detection, prevention, investigation, and
50.11resolution of fraudulent activities or behavior by applicants, recipients, and other
50.12participants in the human services programs administered by the department.
50.13    (t) Require county agencies to identify overpayments, establish claims, and utilize
50.14all available and cost-beneficial methodologies to collect and recover these overpayments
50.15in the human services programs administered by the department.
50.16    (u) Have the authority to administer a drug rebate program for drugs purchased
50.17pursuant to the prescription drug program established under section 256.955 after the
50.18beneficiary's satisfaction of any deductible established in the program. The commissioner
50.19shall require a rebate agreement from all manufacturers of covered drugs as defined in
50.20section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
50.21or after July 1, 2002, must include rebates for individuals covered under the prescription
50.22drug program who are under 65 years of age. For each drug, the amount of the rebate shall
50.23be equal to the rebate as defined for purposes of the federal rebate program in United
50.24States Code, title 42, section 1396r-8. The manufacturers must provide full payment
50.25within 30 days of receipt of the state invoice for the rebate within the terms and conditions
50.26used for the federal rebate program established pursuant to section 1927 of title XIX of
50.27the Social Security Act. The manufacturers must provide the commissioner with any
50.28information necessary to verify the rebate determined per drug. The rebate program shall
50.29utilize the terms and conditions used for the federal rebate program established pursuant to
50.30section 1927 of title XIX of the Social Security Act.
50.31    (v) Have the authority to administer the federal drug rebate program for drugs
50.32purchased under the medical assistance program as allowed by section 1927 of title XIX
50.33of the Social Security Act and according to the terms and conditions of section 1927.
50.34Rebates shall be collected for all drugs that have been dispensed or administered in an
50.35outpatient setting and that are from manufacturers who have signed a rebate agreement
50.36with the United States Department of Health and Human Services.
51.1    (w) Have the authority to administer a supplemental drug rebate program for drugs
51.2purchased under the medical assistance program. The commissioner may enter into
51.3supplemental rebate contracts with pharmaceutical manufacturers and may require prior
51.4authorization for drugs that are from manufacturers that have not signed a supplemental
51.5rebate contract. Prior authorization of drugs shall be subject to the provisions of section
51.6256B.0625, subdivision 13 .
51.7    (x) Operate the department's communication systems account established in Laws
51.81993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
51.9communication costs necessary for the operation of the programs the commissioner
51.10supervises. A communications account may also be established for each regional
51.11treatment center which operates communications systems. Each account must be used
51.12to manage shared communication costs necessary for the operations of the programs the
51.13commissioner supervises. The commissioner may distribute the costs of operating and
51.14maintaining communication systems to participants in a manner that reflects actual usage.
51.15Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
51.16other costs as determined by the commissioner. Nonprofit organizations and state, county,
51.17and local government agencies involved in the operation of programs the commissioner
51.18supervises may participate in the use of the department's communications technology and
51.19share in the cost of operation. The commissioner may accept on behalf of the state any
51.20gift, bequest, devise or personal property of any kind, or money tendered to the state for
51.21any lawful purpose pertaining to the communication activities of the department. Any
51.22money received for this purpose must be deposited in the department's communication
51.23systems accounts. Money collected by the commissioner for the use of communication
51.24systems must be deposited in the state communication systems account and is appropriated
51.25to the commissioner for purposes of this section.
51.26    (y) Receive any federal matching money that is made available through the medical
51.27assistance program for the consumer satisfaction survey. Any federal money received for
51.28the survey is appropriated to the commissioner for this purpose. The commissioner may
51.29expend the federal money received for the consumer satisfaction survey in either year of
51.30the biennium.
51.31    (z) Designate community information and referral call centers and incorporate
51.32cost reimbursement claims from the designated community information and referral
51.33call centers into the federal cost reimbursement claiming processes of the department
51.34according to federal law, rule, and regulations. Existing information and referral centers
51.35provided by Greater Twin Cities United Way or existing call centers for which Greater
51.36Twin Cities United Way has legal authority to represent, shall be included in these
52.1designations upon review by the commissioner and assurance that these services are
52.2accredited and in compliance with national standards. Any reimbursement is appropriated
52.3to the commissioner and all designated information and referral centers shall receive
52.4payments according to normal department schedules established by the commissioner
52.5upon final approval of allocation methodologies from the United States Department of
52.6Health and Human Services Division of Cost Allocation or other appropriate authorities.
52.7    (aa) Develop recommended standards for foster care homes that address the
52.8components of specialized therapeutic services to be provided by foster care homes with
52.9those services.
52.10    (bb) Authorize the method of payment to or from the department as part of the
52.11human services programs administered by the department. This authorization includes the
52.12receipt or disbursement of funds held by the department in a fiduciary capacity as part of
52.13the human services programs administered by the department.
52.14    (cc) Have the authority to administer a drug rebate program for drugs purchased for
52.15persons eligible for general assistance medical care under section 256D.03, subdivision 3.
52.16For manufacturers that agree to participate in the general assistance medical care rebate
52.17program, the commissioner shall enter into a rebate agreement for covered drugs as
52.18defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
52.19rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
52.20United States Code, title 42, section 1396r-8. The manufacturers must provide payment
52.21within the terms and conditions used for the federal rebate program established under
52.22section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
52.23the terms and conditions used for the federal rebate program established under section
52.241927 of title XIX of the Social Security Act.
52.25    Effective January 1, 2006, drug coverage under general assistance medical care shall
52.26be limited to those prescription drugs that:
52.27    (1) are covered under the medical assistance program as described in section
52.28256B.0625, subdivisions 13 and 13d ; and
52.29    (2) are provided by manufacturers that have fully executed general assistance
52.30medical care rebate agreements with the commissioner and comply with such agreements.
52.31Prescription drug coverage under general assistance medical care shall conform to
52.32coverage under the medical assistance program according to section 256B.0625,
52.33subdivisions 13 to 13g .
52.34    The rebate revenues collected under the drug rebate program are deposited in the
52.35general fund.
53.1(dd) Designate the agencies that operate the Senior LinkAge Line under section
53.2256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
53.3of Minnesota Aging and the Disability Resource Centers under United States Code, title
53.442, section 3001, the Older Americans Act Amendments of 2006 and incorporate cost
53.5reimbursement claims from the designated centers into the federal cost reimbursement
53.6claiming processes of the department according to federal law, rule, and regulations. Any
53.7reimbursement must be appropriated to the commissioner and all Aging and Disability
53.8Resource Center designated agencies shall receive payments of grant funding that supports
53.9the activity and generates the federal financial participation according to Board on Aging
53.10administrative granting mechanisms.

53.11    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
53.12    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
53.13Linkage Line, to who shall serve people with disabilities as the designated Aging and
53.14Disability Resource Center under United States Code, title 42, section 3001, the Older
53.15Americans Act Amendments of 2006 in partnership with the Senior LinkAge Line and
53.16shall serve as Minnesota's neutral access point for statewide disability information and
53.17assistance and must be available during business hours through a statewide toll-free
53.18number and the internet. The Disability Linkage Line shall:
53.19(1) deliver information and assistance based on national and state standards;
53.20    (2) provide information about state and federal eligibility requirements, benefits,
53.21and service options;
53.22(3) provide benefits and options counseling;
53.23    (4) make referrals to appropriate support entities;
53.24    (5) educate people on their options so they can make well-informed choices and link
53.25them to quality profiles;
53.26    (6) help support the timely resolution of service access and benefit issues;
53.27(7) inform people of their long-term community services and supports;
53.28(8) provide necessary resources and supports that can lead to employment and
53.29increased economic stability of people with disabilities; and
53.30(9) serve as the technical assistance and help center for the Web-based tool,
53.31Minnesota's Disability Benefits 101.org.; and
53.32(10) provide preadmission screening for individuals under 60 years of age using
53.33the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911,
53.34subdivision 4d.

54.1    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
54.2    Subd. 7. Consumer information and assistance and long-term care options
54.3counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
54.4statewide service to aid older Minnesotans and their families in making informed choices
54.5about long-term care options and health care benefits. Language services to persons
54.6with limited English language skills may be made available. The service, known as
54.7Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
54.8Resource Center under United States Code, title 42, section 3001, the Older Americans
54.9Act Amendments of 2006 in partnership with the Disability LinkAge Line under section
54.10256.01, subdivision 24, and must be available during business hours through a statewide
54.11toll-free number and must also be available through the Internet. The Minnesota Board
54.12on Aging shall consult with, and when appropriate work through, the area agencies on
54.13aging to provide and maintain the telephony infrastructure and related support for the
54.14Aging and Disability Resource Center partners which agree by memorandum to access
54.15the infrastructure, including the designated providers of the Senior LinkAge Line and the
54.16Disability Linkage Line.
54.17    (b) The service must provide long-term care options counseling by assisting older
54.18adults, caregivers, and providers in accessing information and options counseling about
54.19choices in long-term care services that are purchased through private providers or available
54.20through public options. The service must:
54.21    (1) develop a comprehensive database that includes detailed listings in both
54.22consumer- and provider-oriented formats;
54.23    (2) make the database accessible on the Internet and through other telecommunication
54.24and media-related tools;
54.25    (3) link callers to interactive long-term care screening tools and make these tools
54.26available through the Internet by integrating the tools with the database;
54.27    (4) develop community education materials with a focus on planning for long-term
54.28care and evaluating independent living, housing, and service options;
54.29    (5) conduct an outreach campaign to assist older adults and their caregivers in
54.30finding information on the Internet and through other means of communication;
54.31    (6) implement a messaging system for overflow callers and respond to these callers
54.32by the next business day;
54.33    (7) link callers with county human services and other providers to receive more
54.34in-depth assistance and consultation related to long-term care options;
55.1    (8) link callers with quality profiles for nursing facilities and other home and
55.2community-based services providers developed by the commissioner commissioners of
55.3health and human services;
55.4    (9) incorporate information about the availability of housing options, as well as
55.5registered housing with services and consumer rights within the MinnesotaHelp.info
55.6network long-term care database to facilitate consumer comparison of services and costs
55.7among housing with services establishments and with other in-home services and to
55.8support financial self-sufficiency as long as possible. Housing with services establishments
55.9and their arranged home care providers shall provide information that will facilitate price
55.10comparisons, including delineation of charges for rent and for services available. The
55.11commissioners of health and human services shall align the data elements required by
55.12section 144G.06, the Uniform Consumer Information Guide, and this section to provide
55.13consumers standardized information and ease of comparison of long-term care options.
55.14The commissioner of human services shall provide the data to the Minnesota Board on
55.15Aging for inclusion in the MinnesotaHelp.info network long-term care database;
55.16(10) provide long-term care options counseling. Long-term care options counselors
55.17shall:
55.18(i) for individuals not eligible for case management under a public program or public
55.19funding source, provide interactive decision support under which consumers, family
55.20members, or other helpers are supported in their deliberations to determine appropriate
55.21long-term care choices in the context of the consumer's needs, preferences, values, and
55.22individual circumstances, including implementing a community support plan;
55.23(ii) provide Web-based educational information and collateral written materials to
55.24familiarize consumers, family members, or other helpers with the long-term care basics,
55.25issues to be considered, and the range of options available in the community;
55.26(iii) provide long-term care futures planning, which means providing assistance to
55.27individuals who anticipate having long-term care needs to develop a plan for the more
55.28distant future; and
55.29(iv) provide expertise in benefits and financing options for long-term care, including
55.30Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
55.31private pay options, and ways to access low or no-cost services or benefits through
55.32volunteer-based or charitable programs;
55.33(11) using risk management and support planning protocols, provide long-term care
55.34options counseling to current residents of nursing homes deemed appropriate for discharge
55.35by the commissioner and older adults who request service after consultation with the
55.36Senior LinkAge Line under clause (12). In order to meet this requirement, The Senior
56.1LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The
56.2Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge
56.3by developing targeting criteria in consultation with the commissioner who shall provide
56.4designated Senior LinkAge Line contact centers with a list of nursing home residents that
56.5meet the criteria as being appropriate for discharge planning via a secure Web portal.
56.6Senior LinkAge Line shall provide these residents, if they indicate a preference to
56.7receive long-term care options counseling, with initial assessment, review of risk factors,
56.8independent living support consultation, or and, if appropriate, a referral to:
56.9(i) long-term care consultation services under section 256B.0911;
56.10(ii) designated care coordinators of contracted entities under section 256B.035 for
56.11persons who are enrolled in a managed care plan; or
56.12(iii) the long-term care consultation team for those who are appropriate eligible
56.13 for relocation service coordination due to high-risk factors or psychological or physical
56.14disability; and
56.15(12) develop referral protocols and processes that will assist certified health care
56.16homes and hospitals to identify at-risk older adults and determine when to refer these
56.17individuals to the Senior LinkAge Line for long-term care options counseling under this
56.18section. The commissioner is directed to work with the commissioner of health to develop
56.19protocols that would comply with the health care home designation criteria and protocols
56.20available at the time of hospital discharge. The commissioner shall keep a record of the
56.21number of people who choose long-term care options counseling as a result of this section.

56.22    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
56.23to read:
56.24    Subd. 7a. Preadmission screening activities related to nursing facility
56.25admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
56.26including certified boarding care facilities, must be screened prior to admission regardless
56.27of income, assets, or funding sources for nursing facility care, except as described in
56.28subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
56.29need for nursing facility level of care as described in section 256B.0911, subdivision
56.304e, and to complete activities required under federal law related to mental illness and
56.31developmental disability as outlined in paragraph (b).
56.32(b) A person who has a diagnosis or possible diagnosis of mental illness or
56.33developmental disability must receive a preadmission screening before admission
56.34regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
56.35the need for further evaluation and specialized services, unless the admission prior to
57.1screening is authorized by the local mental health authority or the local developmental
57.2disabilities case manager, or unless authorized by the county agency according to Public
57.3Law 101-508.
57.4(c) The following criteria apply to the preadmission screening:
57.5(1) requests for preadmission screenings must be submitted via an online form
57.6developed by the commissioner;
57.7(2) the Senior LinkAge Line must use forms and criteria developed by the
57.8commissioner to identify persons who require referral for further evaluation and
57.9determination of the need for specialized services; and
57.10(3) the evaluation and determination of the need for specialized services must be
57.11done by:
57.12(i) a qualified independent mental health professional, for persons with a primary or
57.13secondary diagnosis of a serious mental illness; or
57.14(ii) a qualified developmental disability professional, for persons with a primary or
57.15secondary diagnosis of developmental disability. For purposes of this requirement, a
57.16qualified developmental disability professional must meet the standards for a qualified
57.17developmental disability professional under Code of Federal Regulations, title 42, section
57.18483.430.
57.19(d) The local county mental health authority or the state developmental disability
57.20authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
57.21nursing facility if the individual does not meet the nursing facility level of care criteria or
57.22needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
57.23purposes of this section, "specialized services" for a person with developmental disability
57.24means active treatment as that term is defined under Code of Federal Regulations, title
57.2542, section 483.440(a)(1).
57.26(e) In assessing a person's needs, the screener shall:
57.27(1) use an automated system designated by the commissioner;
57.28(2) consult with care transitions coordinators or physician; and
57.29(3) consider the assessment of the individual's physician.
57.30Other personnel may be included in the level of care determination as deemed
57.31necessary by the screener.
57.32EFFECTIVE DATE.This section is effective October 1, 2013.

57.33    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
57.34to read:
58.1    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
58.2screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
58.3(1) a person who, having entered an acute care facility from a certified nursing
58.4facility, is returning to a certified nursing facility; or
58.5(2) a person transferring from one certified nursing facility in Minnesota to another
58.6certified nursing facility in Minnesota.
58.7(b) Persons who are exempt from preadmission screening for purposes of level of
58.8care determination include:
58.9(1) persons described in paragraph (a);
58.10(2) an individual who has a contractual right to have nursing facility care paid for
58.11indefinitely by the Veterans' Administration;
58.12(3) an individual enrolled in a demonstration project under section 256B.69,
58.13subdivision 8, at the time of application to a nursing facility; and
58.14(4) an individual currently being served under the alternative care program or under
58.15a home and community-based services waiver authorized under section 1915(c) of the
58.16federal Social Security Act.
58.17(c) Persons admitted to a Medicaid-certified nursing facility from the community
58.18on an emergency basis as described in paragraph (d) or from an acute care facility on a
58.19nonworking day must be screened the first working day after admission.
58.20(d) Emergency admission to a nursing facility prior to screening is permitted when
58.21all of the following conditions are met:
58.22(1) a person is admitted from the community to a certified nursing or certified
58.23boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and
58.24older and Disability Linkage Line nonworking hours for under age 60;
58.25(2) a physician has determined that delaying admission until preadmission screening
58.26is completed would adversely affect the person's health and safety;
58.27(3) there is a recent precipitating event that precludes the client from living safely in
58.28the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
58.29inability to continue to provide care;
58.30(4) the attending physician has authorized the emergency placement and has
58.31documented the reason that the emergency placement is recommended; and
58.32(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first
58.33working day following the emergency admission.
58.34Transfer of a patient from an acute care hospital to a nursing facility is not considered
58.35an emergency except for a person who has received hospital services in the following
58.36situations: hospital admission for observation, care in an emergency room without hospital
59.1admission, or following hospital 24-hour bed care and from whom admission is being
59.2sought on a nonworking day.
59.3(e) A nursing facility must provide written information to all persons admitted
59.4regarding the person's right to request and receive long-term care consultation services as
59.5defined in section 256B.0911, subdivision 1a. The information must be provided prior to
59.6the person's discharge from the facility and in a format specified by the commissioner.
59.7EFFECTIVE DATE.This section is effective October 1, 2013.

59.8    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
59.9to read:
59.10    Subd. 7c. Screening requirements. (a) A person may be screened for nursing
59.11facility admission by telephone or in a face-to-face screening interview. The Senior
59.12LinkAge Line shall identify each individual's needs using the following categories:
59.13(1) the person needs no face-to-face long-term care consultation assessment
59.14completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
59.15managed care organization under contract with the Department of Human Services to
59.16determine the need for nursing facility level of care based on information obtained from
59.17other health care professionals;
59.18(2) the person needs an immediate face-to-face long-term care consultation
59.19assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
59.20tribe, or managed care organization under contract with the Department of Human
59.21Services to determine the need for nursing facility level of care and complete activities
59.22required under subdivision 7a; or
59.23(3) the person may be exempt from screening requirements as outlined in subdivision
59.247b, but will need transitional assistance after admission or in-person follow-along after
59.25a return home.
59.26(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities
59.27with only a telephone screening must receive a face-to-face assessment from the long-term
59.28care consultation team member of the county in which the facility is located or from the
59.29recipient's county case manager within 40 calendar days of admission as described in
59.30section 256B.0911, subdivision 4d, paragraph (c).
59.31(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
59.32facility must be screened prior to admission.
59.33(d) Screenings provided by the Senior LinkAge Line must include processes
59.34to identify persons who may require transition assistance described in subdivision 7,
59.35paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
60.1EFFECTIVE DATE.This section is effective October 1, 2013.

60.2    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
60.3to read:
60.4    Subd. 7d. Payment for preadmission screening. Funding for preadmission
60.5screening shall be provided to the Minnesota Board on Aging for the population 60
60.6years of age and older by the Department of Human Services to cover screener salaries
60.7and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota
60.8Board on Aging shall employ, or contract with other agencies to employ, within the limits
60.9of available funding, sufficient personnel to provide preadmission screening and level of
60.10care determination services and shall seek to maximize federal funding for the service as
60.11provided under section 256.01, subdivision 2, paragraph (dd).
60.12EFFECTIVE DATE.This section is effective October 1, 2013.

60.13    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
60.14subdivision to read:
60.15    Subd. 3a. Priority for other grants. The commissioner of health shall give priority
60.16to a grantee selected under subdivision 3 when awarding technology-related grants, if the
60.17grantee is using technology as part of the proposal unless that priority conflicts with
60.18existing state or federal guidance related to grant awards by the Department of Health.
60.19The commissioner of transportation shall give priority to a grantee under subdivision 3
60.20when distributing transportation-related funds to create transportation options for older
60.21adults unless that preference conflicts with existing state or federal guidance related to
60.22grant awards by the Department of Transportation.

60.23    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
60.24subdivision to read:
60.25    Subd. 3b. State waivers. The commissioner of health may waive applicable state
60.26laws and rules on a time-limited basis if the commissioner of health determines that a
60.27participating grantee requires a waiver in order to achieve demonstration project goals.

60.28    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
60.29    Subd. 5. Grant preference. The commissioner of human services shall give
60.30preference when awarding grants under this section to areas where nursing facility
60.31closures have occurred or are occurring or areas with service needs identified by section
60.32144A.351. The commissioner may award grants to the extent grant funds are available
61.1and to the extent applications are approved by the commissioner. Denial of approval of an
61.2application in one year does not preclude submission of an application in a subsequent
61.3year. The maximum grant amount is limited to $750,000.

61.4    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
61.5subdivision to read:
61.6    Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
61.7subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
61.8(1) an impact assessment focusing on program outcomes, especially those
61.9experienced directly by the person receiving services;
61.10(2) study samples drawn from the population of interest for each project; and
61.11(3) a time series analysis to examine aggregate trends in average monthly
61.12utilization, expenditures, and other outcomes in the targeted populations before and after
61.13implementation of the initiatives.

61.14    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
61.15subdivision to read:
61.16    Subd. 6. Work, empower, and encourage independence. As provided under
61.17subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
61.18demonstration project to provide navigation, employment supports, and benefits planning
61.19services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
61.20This demonstration shall promote economic stability, increase independence, and reduce
61.21applications for disability benefits while providing a positive impact on the health and
61.22future of participants.

61.23    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
61.24subdivision to read:
61.25    Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
61.26upon federal approval, the commissioner shall establish a demonstration project to provide
61.27service coordination, outreach, in-reach, tenancy support, and community living assistance
61.28to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
61.29demonstration shall promote housing stability, reduce costly medical interventions, and
61.30increase opportunities for independent community living.

61.31    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
62.1    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
62.2services is to assist persons with long-term or chronic care needs in making care
62.3decisions and selecting support and service options that meet their needs and reflect
62.4their preferences. The availability of, and access to, information and other types of
62.5assistance, including assessment and support planning, is also intended to prevent or delay
62.6institutional placements and to provide access to transition assistance after admission.
62.7Further, the goal of these services is to contain costs associated with unnecessary
62.8institutional admissions. Long-term consultation services must be available to any person
62.9regardless of public program eligibility. The commissioner of human services shall seek
62.10to maximize use of available federal and state funds and establish the broadest program
62.11possible within the funding available.
62.12(b) These services must be coordinated with long-term care options counseling
62.13provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and
62.14section 256.01, subdivision 24. The lead agency providing long-term care consultation
62.15services shall encourage the use of volunteers from families, religious organizations, social
62.16clubs, and similar civic and service organizations to provide community-based services.

62.17    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
62.18read:
62.19    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
62.20    (a) Until additional requirements apply under paragraph (b), "long-term care
62.21consultation services" means:
62.22    (1) intake for and access to assistance in identifying services needed to maintain an
62.23individual in the most inclusive environment;
62.24    (2) providing recommendations for and referrals to cost-effective community
62.25services that are available to the individual;
62.26    (3) development of an individual's person-centered community support plan;
62.27    (4) providing information regarding eligibility for Minnesota health care programs;
62.28    (5) face-to-face long-term care consultation assessments, which may be completed
62.29in a hospital, nursing facility, intermediate care facility for persons with developmental
62.30disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
62.31residence;
62.32    (6) federally mandated preadmission screening activities described under
62.33subdivisions 4a and 4b;
62.34    (7) (6) determination of home and community-based waiver and other service
62.35eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level
63.1of care determination for individuals who need an institutional level of care as determined
63.2under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and
63.3community support plan development, appropriate referrals to obtain necessary diagnostic
63.4information, and including an eligibility determination for consumer-directed community
63.5supports;
63.6    (8) (7) providing recommendations for institutional placement when there are no
63.7cost-effective community services available;
63.8    (9) (8) providing access to assistance to transition people back to community settings
63.9after institutional admission; and
63.10(10) (9) providing information about competitive employment, with or without
63.11supports, for school-age youth and working-age adults and referrals to the Disability
63.12Linkage Line and Disability Benefits 101 to ensure that an informed choice about
63.13competitive employment can be made. For the purposes of this subdivision, "competitive
63.14employment" means work in the competitive labor market that is performed on a full-time
63.15or part-time basis in an integrated setting, and for which an individual is compensated at or
63.16above the minimum wage, but not less than the customary wage and level of benefits paid
63.17by the employer for the same or similar work performed by individuals without disabilities.
63.18(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
63.192c, and 3a, "long-term care consultation services" also means:
63.20(1) service eligibility determination for state plan home care services identified in:
63.21(i) section 256B.0625, subdivisions 7, 19a, and 19c;
63.22(ii) section 256B.0657; or
63.23(iii) consumer support grants under section 256.476;
63.24(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
63.25determination of eligibility for case management services available under sections
63.26256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part
63.279525.0016;
63.28(3) determination of institutional level of care, home and community-based service
63.29waiver, and other service eligibility as required under section 256B.092, determination
63.30of eligibility for family support grants under section 252.32, semi-independent living
63.31services under section 252.275, and day training and habilitation services under section
63.32256B.092 ; and
63.33(4) obtaining necessary diagnostic information to determine eligibility under clauses
63.34(2) and (3).
63.35    (c) "Long-term care options counseling" means the services provided by the linkage
63.36lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and
64.1also includes telephone assistance and follow up once a long-term care consultation
64.2assessment has been completed.
64.3    (d) "Minnesota health care programs" means the medical assistance program under
64.4chapter 256B and the alternative care program under section 256B.0913.
64.5    (e) "Lead agencies" means counties administering or tribes and health plans under
64.6contract with the commissioner to administer long-term care consultation assessment and
64.7support planning services.

64.8    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
64.9read:
64.10    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
64.11services planning, or other assistance intended to support community-based living,
64.12including persons who need assessment in order to determine waiver or alternative care
64.13program eligibility, must be visited by a long-term care consultation team within 20
64.14calendar days after the date on which an assessment was requested or recommended.
64.15Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
64.16applies to an assessment of a person requesting personal care assistance services and
64.17private duty nursing. The commissioner shall provide at least a 90-day notice to lead
64.18agencies prior to the effective date of this requirement. Face-to-face assessments must be
64.19conducted according to paragraphs (b) to (i).
64.20    (b) The lead agency may utilize a team of either the social worker or public health
64.21nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
64.22use certified assessors to conduct the assessment. The consultation team members must
64.23confer regarding the most appropriate care for each individual screened or assessed. For
64.24a person with complex health care needs, a public health or registered nurse from the
64.25team must be consulted.
64.26    (c) The assessment must be comprehensive and include a person-centered assessment
64.27of the health, psychological, functional, environmental, and social needs of referred
64.28individuals and provide information necessary to develop a community support plan that
64.29meets the consumers needs, using an assessment form provided by the commissioner.
64.30    (d) The assessment must be conducted in a face-to-face interview with the person
64.31being assessed and the person's legal representative, and other individuals as requested by
64.32the person, who can provide information on the needs, strengths, and preferences of the
64.33person necessary to develop a community support plan that ensures the person's health and
64.34safety, but who is not a provider of service or has any financial interest in the provision
64.35of services. For persons who are to be assessed for elderly waiver customized living
65.1services under section 256B.0915, with the permission of the person being assessed or
65.2the person's designated or legal representative, the client's current or proposed provider
65.3of services may submit a copy of the provider's nursing assessment or written report
65.4outlining its recommendations regarding the client's care needs. The person conducting
65.5the assessment will notify the provider of the date by which this information is to be
65.6submitted. This information shall be provided to the person conducting the assessment
65.7prior to the assessment.
65.8    (e) If the person chooses to use community-based services, the person or the person's
65.9legal representative must be provided with a written community support plan within 40
65.10calendar days of the assessment visit, regardless of whether the individual is eligible for
65.11Minnesota health care programs. The written community support plan must include:
65.12(1) a summary of assessed needs as defined in paragraphs (c) and (d);
65.13(2) the individual's options and choices to meet identified needs, including all
65.14available options for case management services and providers;
65.15(3) identification of health and safety risks and how those risks will be addressed,
65.16including personal risk management strategies;
65.17(4) referral information; and
65.18(5) informal caregiver supports, if applicable.
65.19For a person determined eligible for state plan home care under subdivision 1a,
65.20paragraph (b), clause (1), the person or person's representative must also receive a copy of
65.21the home care service plan developed by the certified assessor.
65.22(f) A person may request assistance in identifying community supports without
65.23participating in a complete assessment. Upon a request for assistance identifying
65.24community support, the person must be transferred or referred to long-term care options
65.25counseling services available under sections 256.975, subdivision 7, and 256.01,
65.26subdivision 24, for telephone assistance and follow up.
65.27    (g) The person has the right to make the final decision between institutional
65.28placement and community placement after the recommendations have been provided,
65.29except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
65.30    (h) The lead agency must give the person receiving assessment or support planning,
65.31or the person's legal representative, materials, and forms supplied by the commissioner
65.32containing the following information:
65.33    (1) written recommendations for community-based services and consumer-directed
65.34options;
65.35(2) documentation that the most cost-effective alternatives available were offered to
65.36the individual. For purposes of this clause, "cost-effective" means community services and
66.1living arrangements that cost the same as or less than institutional care. For an individual
66.2found to meet eligibility criteria for home and community-based service programs under
66.3section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
66.4approved waiver plan for each program;
66.5(3) the need for and purpose of preadmission screening conducted by long-term
66.6care options counselors according to section 256.975, subdivisions 7a to 7c, and section
66.7256.01, subdivision 24, if the person selects nursing facility placement. If the individual
66.8selects nursing facility placement, the lead agency shall forward information needed to
66.9complete the level of care determinations and screening for developmental disability and
66.10mental illness collected during the assessment to the long-term care options counselor
66.11using forms provided by the commissioner;
66.12    (4) the role of long-term care consultation assessment and support planning in
66.13eligibility determination for waiver and alternative care programs, and state plan home
66.14care, case management, and other services as defined in subdivision 1a, paragraphs (a),
66.15clause (7), and (b);
66.16    (5) information about Minnesota health care programs;
66.17    (6) the person's freedom to accept or reject the recommendations of the team;
66.18    (7) the person's right to confidentiality under the Minnesota Government Data
66.19Practices Act, chapter 13;
66.20    (8) the certified assessor's decision regarding the person's need for institutional level
66.21of care as determined under criteria established in section 256B.0911, subdivision 4a,
66.22paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services
66.23and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
66.24    (9) the person's right to appeal the certified assessor's decision regarding eligibility
66.25for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
66.26(b), and incorporating the decision regarding the need for institutional level of care or the
66.27lead agency's final decisions regarding public programs eligibility according to section
66.28256.045, subdivision 3 .
66.29    (i) Face-to-face assessment completed as part of eligibility determination for
66.30the alternative care, elderly waiver, community alternatives for disabled individuals,
66.31community alternative care, and brain injury waiver programs under sections 256B.0913,
66.32256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60
66.33calendar days after the date of assessment.
66.34(j) The effective eligibility start date for programs in paragraph (i) can never be
66.35prior to the date of assessment. If an assessment was completed more than 60 days
66.36before the effective waiver or alternative care program eligibility start date, assessment
67.1and support plan information must be updated in a face-to-face visit and documented in
67.2the department's Medicaid Management Information System (MMIS). Notwithstanding
67.3retroactive medical assistance coverage of state plan services, the effective date of
67.4eligibility for programs included in paragraph (i) cannot be prior to the date the most
67.5recent updated assessment is completed.

67.6    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
67.7read:
67.8    Subd. 4d. Preadmission screening of individuals under 65 60 years of age. (a)
67.9It is the policy of the state of Minnesota to ensure that individuals with disabilities or
67.10chronic illness are served in the most integrated setting appropriate to their needs and have
67.11the necessary information to make informed choices about home and community-based
67.12service options.
67.13    (b) Individuals under 65 60 years of age who are admitted to a Medicaid-certified
67.14 nursing facility from a hospital must be screened prior to admission as outlined in
67.15subdivisions 4a through 4c according to the requirements outlined in section 256.975,
67.16subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required
67.17under section 256.01, subdivision 24.
67.18    (c) Individuals under 65 years of age who are admitted to nursing facilities with
67.19only a telephone screening must receive a face-to-face assessment from the long-term
67.20care consultation team member of the county in which the facility is located or from the
67.21recipient's county case manager within 40 calendar days of admission.
67.22    (d) Individuals under 65 years of age who are admitted to a nursing facility
67.23without preadmission screening according to the exemption described in subdivision 4b,
67.24paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
67.25a face-to-face assessment within 40 days of admission.
67.26    (e) (d) At the face-to-face assessment, the long-term care consultation team member
67.27or county case manager must perform the activities required under subdivision 3b.
67.28    (f) (e) For individuals under 21 years of age, a screening interview which
67.29recommends nursing facility admission must be face-to-face and approved by the
67.30commissioner before the individual is admitted to the nursing facility.
67.31    (g) (f) In the event that an individual under 65 60 years of age is admitted to a
67.32nursing facility on an emergency basis, the county Disability Linkage Line must be
67.33notified of the admission on the next working day, and a face-to-face assessment as
67.34described in paragraph (c) must be conducted within 40 calendar days of admission.
68.1    (h) (g) At the face-to-face assessment, the long-term care consultation team member
68.2or the case manager must present information about home and community-based options,
68.3including consumer-directed options, so the individual can make informed choices. If the
68.4individual chooses home and community-based services, the long-term care consultation
68.5team member or case manager must complete a written relocation plan within 20 working
68.6days of the visit. The plan shall describe the services needed to move out of the facility
68.7and a time line for the move which is designed to ensure a smooth transition to the
68.8individual's home and community.
68.9    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive
68.10a face-to-face assessment at least every 12 months to review the person's service choices
68.11and available alternatives unless the individual indicates, in writing, that annual visits are
68.12not desired. In this case, the individual must receive a face-to-face assessment at least
68.13once every 36 months for the same purposes.
68.14    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay
68.15county agencies directly for face-to-face assessments for individuals under 65 years of age
68.16who are being considered for placement or residing in a nursing facility.
68.17(j) Funding for preadmission screening shall be provided to the Disability Linkage
68.18Line for the under 60 population by the Department of Human Services to cover screener
68.19salaries and expenses to provide the services described in subdivisions 7a to 7c. The
68.20Disability Linkage Line shall employ, or contract with other agencies to employ, within
68.21the limits of available funding, sufficient personnel to provide preadmission screening and
68.22level of care determination services and shall seek to maximize federal funding for the
68.23service as provided under section 256.01, subdivision 2, paragraph (dd).
68.24EFFECTIVE DATE.This section is effective October 1, 2013.

68.25    Sec. 21. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
68.26subdivision to read:
68.27    Subd. 4e. Determination of institutional level of care. The determination of the
68.28need for nursing facility, hospital, and intermediate care facility levels of care must be
68.29made according to criteria developed by the commissioner, and in section 256B.092,
68.30using forms developed by the commissioner. Effective January 1, 2014, for individuals
68.31age 21 and older, the determination of need for nursing facility level of care shall be
68.32based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
68.33determination of the need for nursing facility level of care must be made according to
68.34criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
68.35becomes effective on or after October 1, 2019.

69.1    Sec. 22. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
69.2    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
69.3reimbursement for nursing facilities shall be authorized for a medical assistance recipient
69.4only if a preadmission screening has been conducted prior to admission or the county has
69.5authorized an exemption. Medical assistance reimbursement for nursing facilities shall
69.6not be provided for any recipient who the local screener has determined does not meet the
69.7level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
69.8if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
69.9Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
69.10mental illness is approved by the local mental health authority or an admission for a
69.11recipient with developmental disability is approved by the state developmental disability
69.12authority.
69.13    (b) The nursing facility must not bill a person who is not a medical assistance
69.14recipient for resident days that preceded the date of completion of screening activities
69.15as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing
69.16facility must include unreimbursed resident days in the nursing facility resident day totals
69.17reported to the commissioner.

69.18    Sec. 23. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
69.19    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
69.20    (a) Funding for services under the alternative care program is available to persons who
69.21meet the following criteria:
69.22    (1) the person has been determined by a community assessment under section
69.23256B.0911 to be a person who would require the level of care provided in a nursing
69.24facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for
69.25the provision of services under the alternative care program;
69.26    (2) the person is age 65 or older;
69.27    (3) the person would be eligible for medical assistance within 135 days of admission
69.28to a nursing facility;
69.29    (4) the person is not ineligible for the payment of long-term care services by the
69.30medical assistance program due to an asset transfer penalty under section 256B.0595 or
69.31equity interest in the home exceeding $500,000 as stated in section 256B.056;
69.32    (5) the person needs long-term care services that are not funded through other
69.33state or federal funding, or other health insurance or other third-party insurance such as
69.34long-term care insurance;
70.1    (6) except for individuals described in clause (7), the monthly cost of the alternative
70.2care services funded by the program for this person does not exceed 75 percent of the
70.3monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
70.4does not prohibit the alternative care client from payment for additional services, but in no
70.5case may the cost of additional services purchased under this section exceed the difference
70.6between the client's monthly service limit defined under section 256B.0915, subdivision
70.73 , and the alternative care program monthly service limit defined in this paragraph. If
70.8care-related supplies and equipment or environmental modifications and adaptations are or
70.9will be purchased for an alternative care services recipient, the costs may be prorated on a
70.10monthly basis for up to 12 consecutive months beginning with the month of purchase.
70.11If the monthly cost of a recipient's other alternative care services exceeds the monthly
70.12limit established in this paragraph, the annual cost of the alternative care services shall be
70.13determined. In this event, the annual cost of alternative care services shall not exceed 12
70.14times the monthly limit described in this paragraph;
70.15    (7) for individuals assigned a case mix classification A as described under section
70.16256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
70.17living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
70.18when the dependency score in eating is three or greater as determined by an assessment
70.19performed under section 256B.0911, the monthly cost of alternative care services funded
70.20by the program cannot exceed $593 per month for all new participants enrolled in
70.21the program on or after July 1, 2011. This monthly limit shall be applied to all other
70.22participants who meet this criteria at reassessment. This monthly limit shall be increased
70.23annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly
70.24limit does not prohibit the alternative care client from payment for additional services, but
70.25in no case may the cost of additional services purchased exceed the difference between the
70.26client's monthly service limit defined in this clause and the limit described in clause (6)
70.27for case mix classification A; and
70.28(8) the person is making timely payments of the assessed monthly fee.
70.29A person is ineligible if payment of the fee is over 60 days past due, unless the person
70.30agrees to:
70.31    (i) the appointment of a representative payee;
70.32    (ii) automatic payment from a financial account;
70.33    (iii) the establishment of greater family involvement in the financial management of
70.34payments; or
70.35    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
71.1    The lead agency may extend the client's eligibility as necessary while making
71.2arrangements to facilitate payment of past-due amounts and future premium payments.
71.3Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
71.4reinstated for a period of 30 days.
71.5    (b) Alternative care funding under this subdivision is not available for a person who
71.6is a medical assistance recipient or who would be eligible for medical assistance without a
71.7spenddown or waiver obligation. A person whose initial application for medical assistance
71.8and the elderly waiver program is being processed may be served under the alternative care
71.9program for a period up to 60 days. If the individual is found to be eligible for medical
71.10assistance, medical assistance must be billed for services payable under the federally
71.11approved elderly waiver plan and delivered from the date the individual was found eligible
71.12for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
71.13care funds may not be used to pay for any service the cost of which: (i) is payable by
71.14medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
71.15pay a medical assistance income spenddown for a person who is eligible to participate in the
71.16federally approved elderly waiver program under the special income standard provision.
71.17    (c) Alternative care funding is not available for a person who resides in a licensed
71.18nursing home, certified boarding care home, hospital, or intermediate care facility, except
71.19for case management services which are provided in support of the discharge planning
71.20process for a nursing home resident or certified boarding care home resident to assist with
71.21a relocation process to a community-based setting.
71.22    (d) Alternative care funding is not available for a person whose income is greater
71.23than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
71.24to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
71.25year for which alternative care eligibility is determined, who would be eligible for the
71.26elderly waiver with a waiver obligation.

71.27    Sec. 24. Minnesota Statutes 2012, section 256B.0913, is amended by adding a
71.28subdivision to read:
71.29    Subd. 17. Essential community supports grants. (a) Notwithstanding subdivisions
71.301 to 14, the purpose of the essential community supports grant program is to provide
71.31targeted services to persons age 65 and older who need essential community support, but
71.32whose needs do not meet the level of care required for nursing facility placement under
71.33section 144.0724, subdivision 11.
72.1(b) Essential community supports grants are available not to exceed $400 per person
72.2per month. Essential community supports service grants may be used as authorized within
72.3an authorization period not to exceed 12 months. Grants must be available to a person who:
72.4(1) is age 65 or older;
72.5(2) is not eligible for medical assistance;
72.6(3) would otherwise be financially eligible for the alternative care program under
72.7subdivision 4;
72.8(4) has received a community assessment under section 256B.0911, subdivision 3a
72.9or 3b, and does not require the level of care provided in a nursing facility;
72.10(5) has a community support plan; and
72.11(6) has been determined by a community assessment under section 256B.0911,
72.12subdivision 3a or 3b, to be a person who would require provision of at least one of the
72.13following services, as defined in the approved elderly waiver plan, in order to maintain
72.14their community residence:
72.15(i) caregiver support;
72.16(ii) homemaker support;
72.17(iii) chores; or
72.18(iv) a personal emergency response device or system.
72.19(c) The person receiving any of the essential community supports in this subdivision
72.20must also receive service coordination, not to exceed $600 in a 12-month authorization
72.21period, as part of their community support plan.
72.22(d) A person who has been determined to be eligible for an essential community
72.23supports grant must be reassessed at least annually and continue to meet the criteria in
72.24paragraph (b) to remain eligible for an essential community supports grant.
72.25(e) The commissioner is authorized to use federal matching funds for essential
72.26community supports as necessary and to meet demand for essential community supports
72.27grants as outlined in paragraphs (f) and (g), and that amount of federal funds is
72.28appropriated to the commissioner for this purpose.
72.29(f) Upon federal approval and following a reasonable implementation period
72.30determined by the commissioner, essential community supports are available to an
72.31individual who:
72.32(1) is receiving nursing facility services or home and community-based long-term
72.33services and supports under section 256B.0915 or 256B.49 on the effective date of
72.34implementation of the revised nursing facility level of care under section 144.0724,
72.35subdivision 11;
72.36(2) meets one of the following criteria:
73.1(i) due to the implementation of the revised nursing facility level of care, loses
73.2eligibility for continuing medical assistance payment of nursing facility services at the
73.3first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or
73.4after the effective date of the revised nursing facility level of care criteria under section
73.5144.0724, subdivision 11; or
73.6(ii) due to the implementation of the revised nursing facility level of care, loses
73.7eligibility for continuing medical assistance payment of home and community-based
73.8long-term services and supports under section 256B.0915 or 256B.49 at the first
73.9reassessment required under those sections that occurs on or after the effective date of
73.10implementation of the revised nursing facility level of care under section 144.0724,
73.11subdivision 11;
73.12(3) is not eligible for personal care attendant services; and
73.13(4) has an assessed need for one or more of the supportive services offered under
73.14essential community supports.
73.15Individuals eligible under this paragraph includes individuals who continue to be
73.16eligible for medical assistance state plan benefits and those who are not or are no longer
73.17financially eligible for medical assistance.
73.18(g) Upon federal approval and following a reasonable implementation period
73.19determined by the commissioner, the services available through essential community
73.20supports include the services and grants provided in paragraphs (b) and (c), home-delivered
73.21meals, and community living assistance as defined by the commissioner. These services
73.22are available to all eligible recipients including those outlined in paragraphs (b) and (f).
73.23Recipients are eligible if they have a need for any of these services and meet all other
73.24eligibility criteria.

73.25    Sec. 25. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to
73.26read:
73.27    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
73.28waivered services to an individual elderly waiver client except for individuals described in
73.29paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility
73.30rate of the case mix resident class to which the elderly waiver client would be assigned
73.31under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance
73.32needs allowance as described in subdivision 1d, paragraph (a), until the first day of the
73.33state fiscal year in which the resident assessment system as described in section 256B.438
73.34for nursing home rate determination is implemented. Effective on the first day of the state
73.35fiscal year in which the resident assessment system as described in section 256B.438 for
74.1nursing home rate determination is implemented and the first day of each subsequent state
74.2fiscal year, the monthly limit for the cost of waivered services to an individual elderly
74.3waiver client shall be the rate of the case mix resident class to which the waiver client
74.4would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on
74.5the last day of the previous state fiscal year, adjusted by any legislatively adopted home
74.6and community-based services percentage rate adjustment.
74.7    (b) The monthly limit for the cost of waivered services to an individual elderly
74.8waiver client assigned to a case mix classification A under paragraph (a) with:
74.9(1) no dependencies in activities of daily living; or
74.10(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
74.11when the dependency score in eating is three or greater as determined by an assessment
74.12performed under section 256B.0911
74.13shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in
74.14the program on or after July 1, 2011. This monthly limit shall be applied to all other
74.15participants who meet this criteria at reassessment. This monthly limit shall be increased
74.16annually as described in paragraph (a).
74.17(c) If extended medical supplies and equipment or environmental modifications are
74.18or will be purchased for an elderly waiver client, the costs may be prorated for up to
74.1912 consecutive months beginning with the month of purchase. If the monthly cost of a
74.20recipient's waivered services exceeds the monthly limit established in paragraph (a) or
74.21(b), the annual cost of all waivered services shall be determined. In this event, the annual
74.22cost of all waivered services shall not exceed 12 times the monthly limit of waivered
74.23services as described in paragraph (a) or (b).
74.24(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
74.25any necessary home care services described in section 256B.0651, subdivision 2, for
74.26individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
74.27subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
74.28amount established for home care services as described in section 256B.0652, subdivision
74.297, and the annual average contracted amount established by the commissioner for nursing
74.30facility services for ventilator-dependent individuals. This monthly limit shall be increased
74.31annually as described in paragraph (a).

74.32    Sec. 26. Minnesota Statutes 2012, section 256B.0915, is amended by adding a
74.33subdivision to read:
74.34    Subd. 3j. Individual community living support. Upon federal approval, there
74.35is established a new service called individual community living support (ICLS) that is
75.1available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor
75.2have any interest in the recipient's housing. ICLS must be delivered in a single-family
75.3home or apartment where the service recipient or their family owns or rents, as
75.4demonstrated by a lease agreement, and maintains control over the individual unit. Case
75.5managers or care coordinators must develop individual ICLS plans in consultation with
75.6the client using a tool developed by the commissioner. The commissioner shall establish
75.7payment rates and mechanisms to align payments with the type and amount of service
75.8provided, assure statewide uniformity for payment rates, and assure cost-effectiveness.
75.9Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and
75.10Human Services to avoid conflict with provider regulatory standards pursuant to section
75.11144A.43 and chapter 245D.

75.12    Sec. 27. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
75.13    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
75.14shall receive an initial assessment of strengths, informal supports, and need for services
75.15in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
75.16client served under the elderly waiver must be conducted at least every 12 months and at
75.17other times when the case manager determines that there has been significant change in
75.18the client's functioning. This may include instances where the client is discharged from
75.19the hospital. There must be a determination that the client requires nursing facility level
75.20of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and
75.21subsequent assessments to initiate and maintain participation in the waiver program.
75.22(b) Regardless of other assessments identified in section 144.0724, subdivision
75.234, as appropriate to determine nursing facility level of care for purposes of medical
75.24assistance payment for nursing facility services, only face-to-face assessments conducted
75.25according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
75.26level of care determination will be accepted for purposes of initial and ongoing access to
75.27waiver service payment.

75.28    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
75.29subdivision to read:
75.30    Subd. 1a. Home and community-based services for older adults. (a) The purpose
75.31of projects selected by the commissioner of human services under this section is to
75.32make strategic changes in the long-term services and supports system for older adults
75.33including statewide capacity for local service development and technical assistance, and
75.34statewide availability of home and community-based services for older adult services,
76.1caregiver support and respite care services, and other supports in the state of Minnesota.
76.2These projects are intended to create incentives for new and expanded home and
76.3community-based services in Minnesota in order to:
76.4(1) reach older adults early in the progression of their need for long-term services
76.5and supports, providing them with low-cost, high-impact services that will prevent or
76.6delay the use of more costly services;
76.7(2) support older adults to live in the most integrated, least restrictive community
76.8setting;
76.9(3) support the informal caregivers of older adults;
76.10(4) develop and implement strategies to integrate long-term services and supports
76.11with health care services, in order to improve the quality of care and enhance the quality
76.12of life of older adults and their informal caregivers;
76.13(5) ensure cost-effective use of financial and human resources;
76.14(6) build community-based approaches and community commitment to delivering
76.15long-term services and supports for older adults in their own homes;
76.16(7) achieve a broad awareness and use of lower-cost in-home services as an
76.17alternative to nursing homes and other residential services;
76.18(8) strengthen and develop additional home and community-based services and
76.19alternatives to nursing homes and other residential services; and
76.20(9) strengthen programs that use volunteers.
76.21(b) The services provided by these projects are available to older adults who are
76.22eligible for medical assistance and the elderly waiver under section 256B.0915, the
76.23alternative care program under section 256B.0913, or essential community supports grant
76.24under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
76.25services.

76.26    Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
76.27subdivision to read:
76.28    Subd. 1b. Definitions. (a) For purposes of this section, the following terms have
76.29the meanings given.
76.30(b) "Community" means a town; township; city; or targeted neighborhood within a
76.31city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
76.32(c) "Core home and community-based services provider" means a Faith in Action,
76.33Living at Home Block Nurse, Congregational Nurse, or similar community-based
76.34program governed by a board, the majority of whose members reside within the program's
76.35service area, that organizes and uses volunteers and paid staff to deliver nonmedical
77.1services intended to assist older adults to identify and manage risks and to maintain their
77.2community living and integration in the community.
77.3(d) "Eldercare development partnership" means a team of representatives of county
77.4social service and public health agencies, the area agency on aging, local nursing home
77.5providers, local home care providers, and other appropriate home and community-based
77.6providers in the area agency's planning and service area.
77.7(e) "Long-term services and supports" means any service available under the
77.8elderly waiver program or alternative care grant programs; nursing facility services;
77.9transportation services; caregiver support and respite care services; and other home and
77.10community-based services identified as necessary either to maintain lifestyle choices for
77.11older adults or to support them to remain in their own home.
77.12(f) "Older adult" refers to an individual who is 65 years of age or older.

77.13    Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
77.14subdivision to read:
77.15    Subd. 1c. Eldercare development partnerships. The commissioner of human
77.16services shall select and contract with eldercare development partnerships sufficient to
77.17provide statewide availability of service development and technical assistance using a
77.18request for proposals process. Eldercare development partnerships shall:
77.19(1) develop a local long-term services and supports strategy consistent with state
77.20goals and objectives;
77.21(2) identify and use existing local skills, knowledge and relationships, and build
77.22on these assets;
77.23(3) coordinate planning for funds to provide services to older adults, including funds
77.24received under Title III of the Older Americans Act, Title XX of the Social Security Act,
77.25and the Local Public Health Act;
77.26(4) target service development and technical assistance where nursing facility
77.27closures have occurred or are occurring or in areas where service needs have been
77.28identified through activities under section 144A.351;
77.29(5) provide sufficient staff for development and technical support in its designated
77.30area; and
77.31(6) designate a single public or nonprofit member of the eldercare development
77.32partnerships to apply grant funding and manage the project.

77.33    Sec. 31. 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(3) assure the health and safety of the older adults;
78.13(4) identify at-risk caregivers;
78.14(5) provide information, education, and training for caregivers in the designated
78.15community; and
78.16(6) demonstrate the need in the proposed service area particularly where nursing
78.17facility closures have occurred or are occurring or areas with service needs identified
78.18by section 144A.351. Preference must be given for projects that reach underserved
78.19populations.
78.20(b) The caregiver support and respite care funds shall be available to the four to six
78.21local long-term care strategy projects designated in subdivisions 1 to 5.
78.22(c) The commissioner shall publish a notice in the State Register to solicit proposals
78.23from public or private nonprofit agencies for the projects not included in the four to six
78.24local long-term care strategy projects defined in subdivision 2. A county agency may,
78.25alone or in combination with other county agencies, apply for caregiver support and
78.26respite care project funds. A public or nonprofit agency within a designated SAIL project
78.27area may apply for project funds if the agency has a letter of agreement with the county
78.28or counties in which services will be developed, stating the intention of the county or
78.29counties to coordinate their activities with the agency requesting a grant.
78.30(d) The commissioner shall select grantees based on the following criteria (b)
78.31Projects must clearly describe:
78.32(1) the ability of the proposal to demonstrate need in the area served, as evidenced
78.33by a community needs assessment or other demographic data;
78.34(2) the ability of the proposal to clearly describe how the project (1) how they will
78.35achieve 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) their 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. 32. 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. 33. 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. 34. Minnesota Statutes 2012, section 256B.092, is amended by adding a
80.18subdivision to read:
80.19    Subd. 14. Reduce avoidable behavioral crisis emergency room, psychiatric
80.20inpatient hospitalizations, and commitments to institutions. (a) Persons receiving
80.21home and community-based services authorized under this section who have had two
80.22or more admissions within a calendar year to an emergency room, psychiatric unit,
80.23or institution must receive consultation from a mental health professional as defined in
80.24section 245.462, subdivision 18, or a behavioral professional as defined in the home and
80.25community-based services state plan within 30 days of discharge. The mental health
80.26professional or behavioral professional must:
80.27(1) conduct a functional assessment of the crisis incident as defined in section
80.28245D.02, subdivision 11, which led to the hospitalization with the goal of developing
80.29proactive strategies as well as necessary reactive strategies to reduce the likelihood of
80.30future avoidable hospitalizations due to a behavioral crisis;
80.31(2) use the results of the functional assessment to amend the coordinated service and
80.32support plan set forth in section 245D.02, subdivision 4b, to address the potential need
80.33for additional staff training, increased staffing, access to crisis mobility services, mental
81.1health services, use of technology, and crisis stabilization services in section 256B.0624,
81.2subdivision 7; and
81.3(3) identify the need for additional consultation, testing, and mental health crisis
81.4intervention team services as defined in section 245D.02, subdivision 20, psychotropic
81.5medication use and monitoring under section 245D.051, as well as the frequency and
81.6duration of ongoing consultation.
81.7(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
81.8the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

81.9    Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
81.10    Subdivision 1. Development and implementation of quality profiles. (a) The
81.11commissioner of human services, in cooperation with the commissioner of health,
81.12shall develop and implement a quality profile system profiles for nursing facilities and,
81.13beginning not later than July 1, 2004 2014, other providers of long-term care services,
81.14except when the quality profile system would duplicate requirements under section
81.15256B.5011 , 256B.5012, or 256B.5013. The system quality profiles must be developed
81.16and implemented to the extent possible without the collection of significant amounts of
81.17new data. To the extent possible, the system using existing data sets maintained by the
81.18commissioners of health and human services to the extent possible. The profiles must
81.19incorporate or be coordinated with information on quality maintained by area agencies on
81.20aging, long-term care trade associations, the ombudsman offices, counties, tribes, health
81.21plans, and other entities and the long-term care database maintained under section 256.975,
81.22subdivision 7. The system profiles must be designed to provide information on quality to:
81.23(1) consumers and their families to facilitate informed choices of service providers;
81.24(2) providers to enable them to measure the results of their quality improvement
81.25efforts and compare quality achievements with other service providers; and
81.26(3) public and private purchasers of long-term care services to enable them to
81.27purchase high-quality care.
81.28(b) The system profiles must be developed in consultation with the long-term care
81.29task force, area agencies on aging, and representatives of consumers, providers, and labor
81.30unions. Within the limits of available appropriations, the commissioners may employ
81.31consultants to assist with this project.

81.32    Sec. 36. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
81.33    Subd. 2. Quality measurement tools. The commissioners shall identify and apply
81.34existing quality measurement tools to:
82.1(1) emphasize quality of care and its relationship to quality of life; and
82.2(2) address the needs of various users of long-term care services, including, but not
82.3limited to, short-stay residents, persons with behavioral problems, persons with dementia,
82.4and persons who are members of minority groups.
82.5    The tools must be identified and applied, to the extent possible, without requiring
82.6providers to supply information beyond current state and federal requirements.

82.7    Sec. 37. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
82.8    Subd. 3. Consumer surveys of nursing facilities residents. Following
82.9identification of the quality measurement tool, the commissioners shall conduct surveys
82.10of long-term care service consumers of nursing facilities to develop quality profiles
82.11of providers. To the extent possible, surveys must be conducted face-to-face by state
82.12employees or contractors. At the discretion of the commissioners, surveys may be
82.13conducted by telephone or by provider staff. Surveys must be conducted periodically to
82.14update quality profiles of individual service nursing facilities providers.

82.15    Sec. 38. Minnesota Statutes 2012, section 256B.439, is amended by adding a
82.16subdivision to read:
82.17    Subd. 3a. Home and community-based services report card in cooperation with
82.18the commissioner of health. The profiles developed for home and community-based
82.19services providers under this section shall be incorporated into a report card and
82.20maintained by the Minnesota Board on Aging pursuant to section 256.975, subdivision
82.217, paragraph (b), clause (2), as data becomes available. The commissioner, in
82.22cooperation with the commissioner of health, shall use consumer choice, quality of life,
82.23care approaches, and cost or flexible purchasing categories to organize the consumer
82.24information in the profiles. The final categories used shall include consumer input and
82.25survey data to the extent that is available through the state agencies. The commissioner
82.26shall develop and disseminate the qualify profiles for a limited number of provider types
82.27initially, and develop quality profiles for additional provider types as measurement tools
82.28are developed and data becomes available. This includes providers of services to older
82.29adults and people with disabilities, regardless of payor source.

82.30    Sec. 39. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
82.31    Subd. 4. Dissemination of quality profiles. By July 1, 2003 2014, the
82.32commissioners shall implement a system public awareness effort to disseminate the quality
82.33profiles developed from consumer surveys using the quality measurement tool. Profiles
83.1may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and
83.2to consumers, providers, and purchasers of long-term care services through all feasible
83.3printed and electronic outlets. The commissioners may conduct a public awareness
83.4campaign to inform potential users regarding profile contents and potential uses.

83.5    Sec. 40. 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. 41. 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. 42. Minnesota Statutes 2012, section 256B.49, is amended by adding a
84.16subdivision to read:
84.17    Subd. 25. Reduce avoidable behavioral crisis emergency room, psychiatric
84.18inpatient hospitalizations, and commitments to institutions. (a) Persons receiving
84.19home and community-based services authorized under this section who have two or more
84.20admissions within a calendar year to an emergency room, psychiatric unit, or institution
84.21must receive consultation from a mental health professional as defined in section 245.462,
84.22subdivision 18, or a behavioral professional as defined in the home and community-based
84.23services state plan within 30 days of discharge. The mental health professional or
84.24behavioral professional must:
84.25(1) conduct a functional assessment of the crisis incident as defined in section
84.26245D.02, subdivision 11, which led to the hospitalization with the goal of developing
84.27proactive strategies as well as necessary reactive strategies to reduce the likelihood of
84.28future avoidable hospitalizations due to a behavioral crisis;
84.29(2) use the results of the functional assessment to amend the coordinated service and
84.30support plan in section 245D.02, subdivision 4b, to address the potential need for additional
84.31staff training, increased staffing, access to crisis mobility services, mental health services,
84.32use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
84.33(3) identify the need for additional consultation, testing, mental health crisis
84.34intervention team services as defined in section 245D.02, subdivision 20, psychotropic
85.1medication use and monitoring under section 245D.051, as well as the frequency and
85.2duration of ongoing consultation.
85.3(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
85.4the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

85.5    Sec. 43. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
85.6    Subdivision 1. Basis and scope. (a) Upon federal approval, the commissioner
85.7shall establish a medical assistance state plan option for the provision of home and
85.8community-based personal assistance service and supports called "community first
85.9services and supports (CFSS)."
85.10(b) CFSS is a participant-controlled method of selecting and providing services
85.11and supports that allows the participant maximum control of the services and supports.
85.12Participants may choose the degree to which they direct and manage their supports by
85.13choosing to have a significant and meaningful role in the management of services and
85.14supports including by directly employing support workers with the necessary supports
85.15to perform that function.
85.16(c) CFSS is available statewide to eligible individuals to assist with accomplishing
85.17activities of daily living (ADLs), instrumental activities of daily living (IADLs), and
85.18health-related procedures and tasks through hands-on assistance to complete the task or
85.19supervision and cueing to complete the task; and to assist with acquiring, maintaining, and
85.20enhancing the skills necessary to accomplish ADLs, IADLs, and health-related procedures
85.21and tasks. CFSS allows payment for certain supports and goods such as environmental
85.22modifications and technology that are intended to replace or decrease the need for human
85.23assistance.
85.24(d) Upon federal approval, CFSS will replace the personal care assistance program
85.25under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
85.26    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
85.27this subdivision have the meanings given.
85.28(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming,
85.29dressing, bathing, mobility, positioning, and transferring.
85.30(c) "Agency-provider model" means a method of CFSS under which a qualified
85.31agency provides services and supports through the agency's own employees and policies.
85.32The agency must allow the participant to have a significant role in the selection and
85.33dismissal of support workers of their choice for the delivery of their specific services
85.34and supports.
86.1(d) "Behavior" means a category to determine the home care rating and is based on the
86.2criteria in section 256B.0659. "Level I behavior" means physical aggression towards self,
86.3others, or destruction of property that requires the immediate response of another person.
86.4(e) "Complex health-related needs" means a category to determine the home care
86.5rating and is based on the criteria in section 256B.0659.
86.6(f) "Community first services and supports" or "CFSS" means the assistance and
86.7supports program under this section needed for accomplishing activities of daily living,
86.8instrumental activities of daily living, and health-related tasks through hands-on assistance
86.9to complete the task or supervision and cueing to complete the task, or the purchase of
86.10goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for
86.11human assistance.
86.12(g) "Community first services and supports service delivery plan" or "service delivery
86.13plan" means a written summary of the services and supports, that is based on the community
86.14support plan identified in section 256B.0911 and coordinated services and support plan
86.15and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined
86.16by the participant to meet the assessed needs, using a person-centered planning process.
86.17(h) "Critical activities of daily living" means transferring, mobility, eating, and
86.18toileting.
86.19(i) "Dependency" in activities of daily living means a person requires assistance to
86.20begin and complete one or more of the activities of daily living.
86.21(j) "Financial management services contractor or vendor" means a qualified
86.22organization having a written contract with the department to provide services necessary
86.23to use the flexible spending model under subdivision 13, that include but are not limited
86.24to: participant education and technical assistance; CFSS service delivery planning and
86.25budgeting; billing, making payments, and monitoring of spending; and assisting the
86.26participant in fulfilling employer-related requirements in accordance with Section 3504 of
86.27the IRS code and the IRS Revenue Procedure 70-6.
86.28(k) "Flexible spending model" means a service delivery method of CFSS that uses
86.29an individualized CFSS service delivery plan and service budget and assistance from the
86.30financial management services contractor to facilitate participant employment of support
86.31workers and the acquisition of supports and goods.
86.32(l) "Health-related procedures and tasks" means procedures and tasks related to
86.33the specific needs of an individual that can be delegated or assigned by a state-licensed
86.34healthcare or behavioral health professional and performed by a support worker.
86.35(m) "Instrumental activities of daily living" means activities related to living
86.36independently in the community, including but not limited to: meal planning, preparation,
87.1and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning;
87.2assistance with medications; managing money; communicating needs, preferences, and
87.3activities; arranging supports; and assistance with traveling around and participating
87.4in the community.
87.5(n) "Legal representative" means parent of a minor, a court-appointed guardian, or
87.6another representative with legal authority to make decisions about services and supports
87.7for the participant. Other representatives with legal authority to make decisions include
87.8but are not limited to a health care agent or an attorney-in-fact authorized through a health
87.9care directive or power of attorney.
87.10(o) "Medication assistance" means providing verbal or visual reminders to take
87.11regularly scheduled medication and includes any of the following supports:
87.12(1) under the direction of the participant or the participant's representative, bringing
87.13medications to the participant including medications given through a nebulizer, opening a
87.14container of previously set up medications, emptying the container into the participant's
87.15hand, opening and giving the medication in the original container to the participant, or
87.16bringing to the participant liquids or food to accompany the medication;
87.17(2) organizing medications as directed by the participant or the participant's
87.18representative; and
87.19(3) providing verbal or visual reminders to perform regularly scheduled medications.
87.20(p) "Participant's representative" means a parent, family member, advocate, or
87.21other adult authorized by the participant to serve as a representative in connection with
87.22the provision of CFSS. This authorization must be in writing or by another method
87.23that clearly indicates the participant's free choice. The participant's representative must
87.24have no financial interest in the provision of any services included in the participant's
87.25service delivery plan and must be capable of providing the support necessary to assist
87.26the participant in the use of CFSS. If through the assessment process described in
87.27subdivision 5 a participant is determined to be in need of a participant's representative, one
87.28must be selected. If the participant is unable to assist in the selection of a participant's
87.29representative, the legal representative shall appoint one. Two persons may be designated
87.30as a participant's representative for reasons such as divided households and court-ordered
87.31custodies. Duties of a participant's representatives may include:
87.32(1) being available while care is provided in a method agreed upon by the participant
87.33or the participant's legal representative and documented in the participant's CFSS service
87.34delivery plan;
87.35(2) monitoring CFSS services to ensure the participant's CFSS service delivery
87.36plan is being followed; and
88.1(3) reviewing and signing CFSS time sheets after services are provided to provide
88.2verification of the CFSS services.
88.3(q) "Person-centered planning process" means a process that is driven by the
88.4participant for discovering and planning services and supports that ensures the participant
88.5makes informed choices and decisions. The person-centered planning process must:
88.6(1) include people chosen by the participant;
88.7(2) provide necessary information and support to ensure that the participant directs
88.8the process to the maximum extent possible, and is enabled to make informed choices
88.9and decisions;
88.10(3) be timely and occur at time and locations of convenience to the participant;
88.11(4) reflect cultural considerations of the participant;
88.12(5) include strategies for solving conflict or disagreement within the process,
88.13including clear conflict-of-interest guidelines for all planning;
88.14(6) offers choices to the participant regarding the services and supports they receive
88.15and from whom;
88.16(7) include a method for the participant to request updates to the plan; and
88.17(8) record the alternative home and community-based settings that were considered
88.18by the participant.
88.19(r) "Shared services" means the provision of CFSS services by the same CFSS
88.20support worker to two or three participants who voluntarily enter into an agreement to
88.21receive services at the same time and in the same setting by the same provider.
88.22(s) "Support specialist" means a professional with the skills and ability to assist the
88.23participant using either the agency provider model under subdivision 11 or the flexible
88.24spending model under subdivision 13, in services including, but not limited to assistance
88.25regarding:
88.26(1) the development, implementation, and evaluation of the CFSS service delivery
88.27plan under subdivision 6;
88.28(2) recruitment, training, or supervision, including supervision of health-related
88.29tasks or behavioral supports appropriately delegated by a health care professional, and
88.30evaluation of support workers; and
88.31(3) facilitating the use of informal and community supports, goods, or resources.
88.32(t) "Support worker" means an employee of the agency provider or of the participant
88.33who has direct contact with the participant and provides services as specified within the
88.34participant's service delivery plan.
88.35(u) "Wages and benefits" means the hourly wages and salaries, the employer's
88.36share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
89.1compensation, mileage reimbursement, health and dental insurance, life insurance,
89.2disability insurance, long-term care insurance, uniform allowance, contributions to
89.3employee retirement accounts, or other forms of employee compensation and benefits.
89.4    Subd. 3. Eligibility. (a) CFSS is available to a person who meets one of the
89.5following:
89.6(1) is a recipient of medical assistance as determined under section 256B.055,
89.7256B.056, or 256B.057, subdivisions 5 and 9;
89.8(2) is a recipient of the alternative care program under section 256B.0913;
89.9(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093,
89.10or 256B.49; or
89.11(4) has medical services identified in a participant's individualized education
89.12program and is eligible for services as determined in section 256B.0625, subdivision 26.
89.13(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
89.14meet all of the following:
89.15(1) require assistance and be determined dependent in one activity of daily living or
89.16Level I behavior based on assessment under section 256B.0911;
89.17(2) is not a recipient under the family support grant under section 252.32;
89.18(3) lives in the person's own apartment or home including a family foster care setting
89.19licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a
89.20noncertified boarding care or boarding and lodging establishments under chapter 157;
89.21unless transitioning into the community from an institution; and
89.22(4) has not been excluded or disenrolled from the flexible spending model.
89.23(c) The commissioner shall disenroll or exclude participants from the flexible
89.24spending model and transfer them to the agency-provider model under the following
89.25circumstances that include but are not limited to:
89.26(1) when a participant has been restricted by the Minnesota restricted recipient
89.27program, the participant may be excluded for a specified time period;
89.28(2) when a participant exits the flexible spending service delivery model during the
89.29participant's service plan year. Upon transfer, the participant shall not access the flexible
89.30spending model for the remainder of that service plan year; or
89.31(3) when the department determines that the participant or participant's representative
89.32or legal representative cannot manage participant responsibilities under the service
89.33delivery model. The commissioner must develop policies for determining if a participant
89.34is unable to manage responsibilities under a service model.
90.1(d) A participant may appeal in writing to the department to contest the department's
90.2decision under paragraph (c), clause (3), to remove or exclude the participant from the
90.3flexible spending model.
90.4    Subd. 4. Eligibility for other services. Selection of CFSS by a participant must not
90.5restrict access to other medically necessary care and services furnished under the state
90.6plan medical assistance benefit or other services available through alternative care.
90.7    Subd. 5. Assessment requirements. (a) The assessment of functional need must:
90.8(1) be conducted by a certified assessor according to the criteria established in
90.9section 256B.0911;
90.10(2) be conducted face-to-face, initially and at least annually thereafter, or when there
90.11is a significant change in the participant's condition or a change in the need for services
90.12and supports; and
90.13(3) be completed using the format established by the commissioner.
90.14(b) A participant who is residing in a facility may be assessed and choose CFSS for
90.15the purpose of using CFSS to return to the community as described in subdivisions 3
90.16and 7, paragraph (a), clause (5).
90.17(c) The results of the assessment and any recommendations and authorizations for
90.18CFSS must be determined and communicated in writing by the lead agency's certified
90.19assessor as defined in section 256B.0911 to the participant and the agency-provider or
90.20financial management services provider chosen by the participant within 40 calendar days
90.21and must include the participant's right to appeal under section 256.045.
90.22    Subd. 6. Community first services and support service delivery plan. (a) The
90.23CFSS service delivery plan must be developed, implemented, and evaluated through a
90.24person-centered planning process by the participant, or the participant's representative
90.25or legal representative who may be assisted by a support specialist. The CFSS service
90.26delivery plan must reflect the services and supports that are important to the participant
90.27and for the participant to meet the needs assessed by the certified assessor and identified
90.28in the community support plan under section 256B.0911 or the coordinated services and
90.29support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS
90.30service delivery plan must be reviewed by the participant and the agency-provider or
90.31financial management services contractor at least annually upon reassessment, or when
90.32there is a significant change in the participant's condition, or a change in the need for
90.33services and supports.
90.34(b) The commissioner shall establish the format and criteria for the CFSS service
90.35delivery plan.
90.36(c) The CFSS service delivery plan must be person-centered and:
91.1(1) specify the agency-provider or financial management services contractor selected
91.2by the participant;
91.3(2) reflect the setting in which the participant resides that is chosen by the participant;
91.4(3) reflect the participant's strengths and preferences;
91.5(4) include the means to address the clinical and support needs as identified through
91.6an assessment of functional needs;
91.7(5) include individually identified goals and desired outcomes;
91.8(6) reflect the services and supports, paid and unpaid, that will assist the participant
91.9to achieve identified goals, and the providers of those services and supports, including
91.10natural supports;
91.11(7) identify the amount and frequency of face-to-face supports and amount and
91.12frequency of remote supports and technology that will be used;
91.13(8) identify risk factors and measures in place to minimize them, including
91.14individualized backup plans;
91.15(9) be understandable to the participant and the individuals providing support;
91.16(10) identify the individual or entity responsible for monitoring the plan;
91.17(11) be finalized and agreed to in writing by the participant and signed by all
91.18individuals and providers responsible for its implementation;
91.19(12) be distributed to the participant and other people involved in the plan; and
91.20(13) prevent the provision of unnecessary or inappropriate care.
91.21(d) The total units of agency-provider services or the budget allocation amount for
91.22the flexible spending model include both annual totals and a monthly average amount
91.23that cover the number of months of the service authorization. The amount used each
91.24month may vary, but additional funds must not be provided above the annual service
91.25authorization amount unless a change in condition is assessed and authorized by the
91.26certified assessor and documented in the community support plan, coordinated services
91.27and supports plan, and service delivery plan.
91.28    Subd. 7. Community first services and supports; covered services. Services
91.29and supports covered under CFSS include:
91.30(1) assistance to accomplish activities of daily living (ADLs), instrumental activities
91.31of daily living (IADLs), and health-related procedures and tasks through hands-on
91.32assistance to complete the task or supervision and cueing to complete the task;
91.33(2) assistance to acquire, maintain, or enhance the skills necessary for the participant
91.34to accomplish activities of daily living, instrumental activities of daily living, or
91.35health-related tasks;
92.1(3) expenditures for items, services, supports, environmental modifications, or
92.2goods, including assistive technology. These expenditures must:
92.3(i) relate to a need identified in a participant's CFSS service delivery plan;
92.4(ii) increase independence or substitute for human assistance to the extent that
92.5expenditures would otherwise be made for human assistance for the participant's assessed
92.6needs; and
92.7(iii) fit within the annual limit of the participant's approved service allocation
92.8or budget;
92.9(4) observation and redirection for episodes where there is a need for redirection
92.10due to participant behaviors or intervention needed due to a participant's symptoms. An
92.11assessment of behaviors must meet the criteria in this clause. A recipient qualifies as
92.12having a need for assistance due to behaviors if the recipient's behavior requires assistance
92.13at least four times per week and shows one or more of the following behaviors:
92.14(i) physical aggression towards self or others, or destruction of property that requires
92.15the immediate response of another person;
92.16(ii) increased vulnerability due to cognitive deficits or socially inappropriate
92.17behavior; or
92.18(iii) increased need for assistance for recipients who are verbally aggressive or
92.19resistive to care so that time needed to perform activities of daily living is increased;
92.20(5) back-up systems or mechanisms, such as the use of pagers or other electronic
92.21devices, to ensure continuity of the participant's services and supports;
92.22(6) transition costs, including:
92.23(i) deposits for rent and utilities;
92.24(ii) first month's rent and utilities;
92.25(iii) bedding;
92.26(iv) basic kitchen supplies;
92.27(v) other necessities, to the extent that these necessities are not otherwise covered
92.28under any other funding that the participant is eligible to receive; and
92.29(vi) other required necessities for an individual to make the transition from a nursing
92.30facility, institution for mental diseases, or intermediate care facility for persons with
92.31developmental disabilities to a community-based home setting where the participant
92.32resides; and
92.33(7) services by a support specialist defined under subdivision 2 that are chosen
92.34by the participant.
92.35    Subd. 8. Determination of CFSS service methodology. (a) All community first
92.36services and supports must be authorized by the commissioner or the commissioner's
93.1designee before services begin except for the assessments established in section
93.2256B.0911. The authorization for CFSS must be completed within 30 days after receiving
93.3a complete request.
93.4(b) The amount of CFSS authorized must be based on the recipient's home
93.5care rating. The home care rating shall be determined by the commissioner or the
93.6commissioner's designee based on information submitted to the commissioner identifying
93.7the following for a recipient:
93.8(1) the total number of dependencies of activities of daily living as defined in
93.9subdivision 2;
93.10(2) the presence of complex health-related needs as defined in subdivision 2; and
93.11(3) the presence of Level I behavior as defined in subdivision 2.
93.12(c) For purposes meeting the criteria in paragraph (b), the methodology to determine
93.13the total minutes for CFSS for each home care rating is based on the median paid units
93.14per day for each home care rating from fiscal year 2007 data for the PCA program. Each
93.15home care rating has a base number of minutes assigned. Additional minutes are added
93.16through the assessment and identification of the following:
93.17(1) 30 additional minutes per day for a dependency in each critical activity of daily
93.18living as defined in subdivision 2;
93.19(2) 30 additional minutes per day for each complex health-related function as
93.20defined in subdivision 2; and
93.21(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2.
93.22    Subd. 9. Noncovered services. (a) Services or supports that are not eligible for
93.23payment under this section include those that:
93.24(1) are not authorized by the certified assessor or included in the written service
93.25delivery plan;
93.26(2) are provided prior to the authorization of services and the approval of the written
93.27CFSS service delivery plan;
93.28(3) are duplicative of other paid services in the written service delivery plan;
93.29(4) supplant natural unpaid supports that are provided voluntarily to the participant
93.30and are selected by the participant in lieu of a support worker and appropriately meeting
93.31the participant's needs;
93.32(5) are not effective means to meet the participant's needs; and
93.33(6) are available through other funding sources, including, but not limited to, funding
93.34through Title IV-E of the Social Security Act.
93.35(b) Additional services, goods, or supports that are not covered include:
93.36(1) those that are not for the direct benefit of the participant;
94.1(2) any fees incurred by the participant, such as Minnesota health care programs fees
94.2and co-pays, legal fees, or costs related to advocate agencies;
94.3(3) insurance, except for insurance costs related to employee coverage;
94.4(4) room and board costs for the participant with the exception of allowable
94.5transition costs in subdivision 7, clause (6);
94.6(5) services, supports, or goods that are not related to the assessed needs;
94.7(6) special education and related services provided under the Individuals with
94.8Disabilities Education Act and vocational rehabilitation services provided under the
94.9Rehabilitation Act of 1973;
94.10(7) assistive technology devices and assistive technology services other than those
94.11for back-up systems or mechanisms to ensure continuity of service and supports listed in
94.12subdivision 7;
94.13(8) medical supplies and equipment;
94.14(9) environmental modifications, except as specified in subdivision 7;
94.15(10) expenses for travel, lodging, or meals related to training the participant, the
94.16participant's representative, legal representative, or paid or unpaid caregivers that exceed
94.17$500 in a 12-month period;
94.18(11) experimental treatments;
94.19(12) any service or good covered by other medical assistance state plan services,
94.20including prescription and over-the-counter medications, compounds, and solutions and
94.21related fees, including premiums and co-payments;
94.22(13) membership dues or costs, except when the service is necessary and appropriate
94.23to treat a physical condition or to improve or maintain the participant's physical condition.
94.24The condition must be identified in the participant's CFSS plan and monitored by a
94.25physician enrolled in a Minnesota health care program;
94.26(14) vacation expenses other than the cost of direct services;
94.27(15) vehicle maintenance or modifications not related to the disability, health
94.28condition, or physical need; and
94.29(16) tickets and related costs to attend sporting or other recreational or entertainment
94.30events.
94.31    Subd. 10. Provider qualifications and general requirements. (a)
94.32Agency-providers delivering services under the agency-provider model under subdivision
94.3311 or financial management service (FMS) contractors under subdivision 13 shall:
94.34(1) enroll as a medical assistance Minnesota health care programs provider and meet
94.35all applicable provider standards;
94.36(2) comply with medical assistance provider enrollment requirements;
95.1(3) demonstrate compliance with law and policies of CFSS as determined by the
95.2commissioner;
95.3(4) comply with background study requirements under chapter 245C;
95.4(5) verify and maintain records of all services and expenditures by the participant,
95.5including hours worked by support workers and support specialists;
95.6(6) not engage in any agency-initiated direct contact or marketing in person, by
95.7telephone, or other electronic means to potential participants, guardians, family member
95.8or participants' representatives;
95.9(7) pay support workers and support specialists based upon actual hours of services
95.10provided;
95.11(8) withhold and pay all applicable federal and state payroll taxes;
95.12(9) make arrangements and pay unemployment insurance, taxes, workers'
95.13compensation, liability insurance, and other benefits, if any;
95.14(10) enter into a written agreement with the participant, participant's representative,
95.15or legal representative that assigns roles and responsibilities to be performed before
95.16services, supports, or goods are provided using a format established by the commissioner;
95.17(11) report suspected neglect and abuse to the common entry point according to
95.18sections 256B.0651 and 626.557; and
95.19(12) provide the participant with a copy of the service-related rights under
95.20subdivision 19 at the start of services and supports.
95.21(b) The commissioner shall develop policies and procedures designed to ensure
95.22program integrity and fiscal accountability for goods and services provided in this section.
95.23    Subd. 11. Agency-provider model. (a) The agency-provider model is limited to
95.24the services provided by support workers and support specialists who are employed by
95.25an agency-provider that is licensed according to chapter 245A or meets other criteria
95.26established by the commissioner, including required training.
95.27(b) The agency-provider shall allow the participant to retain the ability to have a
95.28significant role in the selection and dismissal of the support workers for the delivery of the
95.29services and supports specified in the service delivery plan.
95.30(c) A participant may use authorized units of CFSS services as needed within
95.31a service authorization that is not greater than 12 months. Using authorized units
95.32agency-provider services or the budget allocation amount for the flexible spending model
95.33flexibly does not increase the total amount of services and supports authorized for a
95.34participant or included in the participant's service delivery plan.
95.35(d) A participant may share CFSS services. Two or three CFSS participants may
95.36share services at the same time provided by the same support worker.
96.1(e) The agency-provider must use a minimum of 72.5 percent of the revenue
96.2generated by the medical assistance payment for CFSS for support worker wages and
96.3benefits. The agency-provider must document how this requirement is being met. The
96.4revenue generated by the support specialist and the reasonable costs associated with the
96.5support specialist must not be used in making this calculation.
96.6(f) The agency-provider model must be used by individuals who have been restricted
96.7by the Minnesota restricted recipient program.
96.8    Subd. 12. Requirements for initial enrollment of CFSS provider agencies. (a)
96.9All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider
96.10agency in a format determined by the commissioner, information and documentation that
96.11includes, but is not limited to, the following:
96.12(1) the CFSS provider agency's current contact information including address,
96.13telephone number, and e-mail address;
96.14(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
96.15provider's payments from Medicaid in the previous year, whichever is less;
96.16(3) proof of fidelity bond coverage in the amount of $20,000;
96.17(4) proof of workers' compensation insurance coverage;
96.18(5) proof of liability insurance;
96.19(6) a description of the CFSS provider agency's organization identifying the names
96.20or all owners, managing employees, staff, board of directors, and the affiliations of the
96.21directors, owners, or staff to other service providers;
96.22(7) a copy of the CFSS provider agency's written policies and procedures including:
96.23hiring of employees; training requirements; service delivery; and employee and consumer
96.24safety including process for notification and resolution of consumer grievances,
96.25identification and prevention of communicable diseases, and employee misconduct;
96.26(8) copies of all other forms the CFSS provider agency uses in the course of daily
96.27business including, but not limited to:
96.28(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from
96.29the standard time sheet for CFSS services approved by the commissioner, and a letter
96.30requesting approval of the CFSS provider agency's nonstandard time sheet;
96.31(ii) the CFSS provider agency's template for the CFSS care plan; and
96.32(iii) the CFSS provider agency's template for the written agreement in subdivision
96.3321 for recipients using the CFSS choice option, if applicable;
96.34(9) a list of all training and classes that the CFSS provider agency requires of its
96.35staff providing CFSS services;
97.1(10) documentation that the CFSS provider agency and staff have successfully
97.2completed all the training required by this section;
97.3(11) documentation of the agency's marketing practices;
97.4(12) disclosure of ownership, leasing, or management of all residential properties
97.5that is used or could be used for providing home care services;
97.6(13) documentation that the agency will use the following percentages of revenue
97.7generated from the medical assistance rate paid for CFSS services for employee personal
97.8care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The
97.9revenue generated by the support specialist and the reasonable costs associated with the
97.10support specialist shall not be used in making this calculation; and
97.11(14) documentation that the agency does not burden recipients' free exercise of their
97.12right to choose service providers by requiring personal care assistants to sign an agreement
97.13not to work with any particular CFSS recipient or for another CFSS provider agency after
97.14leaving the agency and that the agency is not taking action on any such agreements or
97.15requirements regardless of the date signed.
97.16(b) CFSS provider agencies shall provide the information specified in paragraph
97.17(a) to the commissioner.
97.18(c) All CFSS provider agencies shall require all employees in management and
97.19supervisory positions and owners of the agency who are active in the day-to-day
97.20management and operations of the agency to complete mandatory training as determined
97.21by the commissioner. Employees in management and supervisory positions and owners
97.22who are active in the day-to-day operations of an agency who have completed the required
97.23training as an employee with a CFSS provider agency do not need to repeat the required
97.24training if they are hired by another agency, if they have completed the training within
97.25the past three years. CFSS provider agency billing staff shall complete training about
97.26CFSS program financial management. Any new owners or employees in management
97.27and supervisory positions involved in the day-to-day operations are required to complete
97.28mandatory training as a requisite of working for the agency. CFSS provider agencies
97.29certified for participation in Medicare as home health agencies are exempt from the
97.30training required in this subdivision.
97.31    Subd. 13. Flexible spending model. (a) Under the flexible spending model
97.32participants can exercise more responsibility and control over the services and supports
97.33described and budgeted within the CFSS service delivery plan. Under this model:
97.34(1) participants directly employ support workers;
97.35(2) participants may use a budget allocation to obtain supports and goods as defined
97.36in subdivision 7; and
98.1(3) from the financial management services (FMS) contractor the participant may
98.2choose a range of support assistance services relating to:
98.3(i) planning, budgeting, and management of services and support;
98.4(ii) the participant's employment, training, supervision, and evaluation of workers;
98.5(iii) acquisition and payment for supports and goods; and
98.6(iv) evaluation of individual service outcomes as needed for the scope of the
98.7participant's degree of control and responsibility.
98.8(b) Participants who are unable to fulfill any of the functions listed in paragraph (a)
98.9may authorize a legal representative or participant's representative to do so on their behalf.
98.10(c) The FMS contractor shall not provide CFSS services and supports under the
98.11agency-provider service model. The FMS contractor shall provide service functions as
98.12determined by the commissioner that include but are not limited to:
98.13(1) information and consultation about CFSS;
98.14(2) assistance with the development of the service delivery plan and flexible
98.15spending model as requested by the participant;
98.16(3) billing and making payments for flexible spending model expenditures;
98.17(4) assisting participants in fulfilling employer-related requirements according to
98.18Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,
98.19regulation 137036-08, which includes assistance with filing and paying payroll taxes, and
98.20obtaining worker compensation coverage;
98.21(5) data recording and reporting of participant spending; and
98.22(6) other duties established in the contract with the department.
98.23(d) A participant who requests to purchase goods and supports along with support
98.24worker services under the agency-provider model must use flexible spending model
98.25with a service delivery plan that specifies the amount of services to be authorized to the
98.26agency-provider and the expenditures to be paid by the FMS contractor.
98.27(e) The FMS contractor shall:
98.28(1) not limit or restrict the participant's choice of service or support providers or
98.29service delivery models as authorized by the commissioner;
98.30(2) provide the participant and the targeted case manager, if applicable, with a
98.31monthly written summary of the spending for services and supports that were billed
98.32against the spending budget;
98.33(3) be knowledgeable of state and federal employment regulations under the Fair
98.34Labor Standards Act of 1938, and comply with the requirements under the Internal
98.35Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax
98.36Liability for vendor or fiscal employer agent, and any requirements necessary to process
99.1employer and employee deductions, provide appropriate and timely submission of
99.2employer tax liabilities, and maintain documentation to support medical assistance claims;
99.3(4) have current and adequate liability insurance and bonding and sufficient cash
99.4flow as determined by the commission and have on staff or under contract a certified
99.5public accountant or an individual with a baccalaureate degree in accounting;
99.6(5) assume fiscal accountability for state funds designated for the program; and
99.7(6) maintain documentation of receipts, invoices, and bills to track all services and
99.8supports expenditures for any goods purchased and maintain time records of support
99.9workers. The documentation and time records must be maintained for a minimum of
99.10five years from the claim date and be available for audit or review upon request by the
99.11commissioner. Claims submitted by the FMS contractor to the commissioner for payment
99.12must correspond with services, amounts, and time periods as authorized in the participant's
99.13spending budget and service plan.
99.14(f) The commissioner of human services shall:
99.15(1) establish rates and payment methodology for the FMS contractor;
99.16(2) identify a process to ensure quality and performance standards for the FMS
99.17contractor and ensure statewide access to FMS contractors; and
99.18(3) establish a uniform protocol for delivering and administering CFSS services
99.19to be used by eligible FMS contractors.
99.20(g) Participants who are disenrolled from the model shall be transferred to the
99.21agency-provider model.
99.22    Subd. 14. Participant's responsibilities under flexible spending model. (a) A
99.23participant using the flexible spending model must use a FMS contractor or vendor that is
99.24under contract with the department. Upon a determination of eligibility and completion of
99.25the assessment and community support plan, the participant shall choose a FMS contractor
99.26from a list of eligible vendors maintained by the department.
99.27(b) When the participant, participant's representative, or legal representative chooses
99.28to be the employer of the support worker, they are responsible for recruiting, interviewing,
99.29hiring, training, scheduling, supervising, and discharging direct support workers.
99.30(c) In addition to the employer responsibilities in paragraph (b), the participant,
99.31participant's representative, or legal representative is responsible for:
99.32(1) tracking the services provided and all expenditures for goods or other supports;
99.33(2) preparing and submitting time sheets, signed by both the participant and support
99.34worker, to the FMS contractor on a regular basis and in a timely manner according to
99.35the FMS contractor's procedures;
100.1(3) notifying the FMS contractor within ten days of any changes in circumstances
100.2affecting the CFSS service plan or in the participant's place of residence including, but
100.3not limited to, any hospitalization of the participant or change in the participant's address,
100.4telephone number, or employment;
100.5(4) notifying the FMS contractor of any changes in the employment status of each
100.6participant support worker; and
100.7(5) reporting any problems resulting from the quality of services rendered by the
100.8support worker to the FMS contractor. If the participant is unable to resolve any problems
100.9resulting from the quality of service rendered by the support worker with the assistance of
100.10the FMS contractor, the participant shall report the situation to the department.
100.11    Subd. 15. Documentation of support services provided. (a) Support services
100.12provided to a participant by a support worker employed by either an agency-provider
100.13or the participant acting as the employer must be documented daily by each support
100.14worker, on a time sheet form approved by the commissioner. All documentation may be
100.15Web-based, electronic, or paper documentation. The completed form must be submitted
100.16on a monthly basis to the provider or the participant and the FMS contractor selected by
100.17the participant to provide assistance with meeting the participant's employer obligations
100.18and kept in the recipient's health record.
100.19(b) The activity documentation must correspond to the written service delivery plan
100.20and be reviewed by the agency provider or the participant and the FMS contractor when
100.21the participant is acting as the employer of the support worker.
100.22(c) The time sheet must be on a form approved by the commissioner documenting
100.23time the support worker provides services in the home. The following criteria must be
100.24included in the time sheet:
100.25(1) full name of the support worker and individual provider number;
100.26(2) provider name and telephone numbers, if an agency-provider is responsible for
100.27delivery services under the written service plan;
100.28(3) full name of the participant;
100.29(4) consecutive dates, including month, day, and year, and arrival and departure
100.30times with a.m. or p.m. notations;
100.31(5) signatures of the participant or the participant's representative;
100.32(6) personal signature of the support worker;
100.33(7) any shared care provided, if applicable;
100.34(8) a statement that it is a federal crime to provide false information on CFSS
100.35billings for medical assistance payments; and
100.36(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
101.1    Subd. 16. Support workers requirements. (a) Support workers shall:
101.2(1) enroll with the department as a support worker after a background study under
101.3chapter 245C has been completed and the support worker has received a notice from the
101.4commissioner that:
101.5(i) the support worker is not disqualified under section 245C.14; or
101.6(ii) is disqualified, but the support worker has received a set-aside of the
101.7disqualification under section 245C.22;
101.8(2) have the ability to effectively communicate with the participant or the
101.9participant's representative;
101.10(3) have the skills and ability to provide the services and supports according to the
101.11person's CFSS service delivery plan and respond appropriately to the participant's needs;
101.12(4) not be a participant of CFSS;
101.13(5) complete the basic standardized training as determined by the commissioner
101.14before completing enrollment. The training must be available in languages other than
101.15English and to those who need accommodations due to disabilities. Support worker
101.16training must include successful completion of the following training components: basic
101.17first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles
101.18and responsibilities of support workers including information about basic body mechanics,
101.19emergency preparedness, orientation to positive behavioral practices, orientation to
101.20responding to a mental health crisis, fraud issues, time cards and documentation, and an
101.21overview of person-centered planning and self-direction. Upon completion of the training
101.22components, the support worker must pass the certification test to provide assistance
101.23to participants;
101.24(6) complete training and orientation on the participant's individual needs; and
101.25(7) maintain the privacy and confidentiality of the participant, and not independently
101.26determine the medication dose or time for medications for the participant.
101.27(b) The commissioner may deny or terminate a support worker's provider enrollment
101.28and provider number if the support worker:
101.29(1) lacks the skills, knowledge, or ability to adequately or safely perform the
101.30required work;
101.31(2) fails to provide the authorized services required by the participant employer;
101.32(3) has been intoxicated by alcohol or drugs while providing authorized services to
101.33the participant or while in the participant's home;
101.34(4) has manufactured or distributed drugs while providing authorized services to the
101.35participant or while in the participant's home; or
102.1(5) has been excluded as a provider by the commissioner of human services, or the
102.2United States Department of Health and Human Services, Office of Inspector General,
102.3from participation in Medicaid, Medicare, or any other federal health care program.
102.4(c) A support worker may appeal in writing to the commissioner to contest the
102.5decision to terminate the support worker's provider enrollment and provider number.
102.6    Subd. 17. Support specialist requirements and payments. The commissioner
102.7shall develop qualifications, scope of functions, and payment rates and service limits for a
102.8support specialist that may provide additional or specialized assistance necessary to plan,
102.9implement, arrange, augment, or evaluate services and supports.
102.10    Subd. 18. Service unit and budget allocation requirements. (a) For the
102.11agency-provider model, services will be authorized in units of service. The total service
102.12unit amount must be established based upon the assessed need for CFSS services, and
102.13must not exceed the maximum number of units available as determined by section
102.14256B.0652, subdivision 6. The unit rate established by the commissioner is used with
102.15assessed units to determine the maximum available CFSS allocation.
102.16(b) For the flexible spending model, services and supports are authorized under
102.17a budget limit.
102.18(c) The maximum available CFSS participant budget allocation shall be established
102.19by multiplying the number of units authorized under subdivision 8 by the payment rate
102.20established by the commissioner.
102.21    Subd. 19. Support system. (a) The commissioner shall provide information,
102.22consultation, training, and assistance to ensure the participant is able to manage the
102.23services and supports and budgets, if applicable. This support shall include individual
102.24consultation on how to select and employ workers, manage responsibilities under CFSS,
102.25and evaluate personal outcomes.
102.26(b) The commissioner shall provide assistance with the development of risk
102.27management agreements.
102.28    Subd. 20. Service-related rights. Participants must be provided with adequate
102.29information, counseling, training, and assistance, as needed, to ensure that the participant
102.30is able to choose and manage services, models, and budgets. This support shall include
102.31information regarding: (1) person-centered planning; (2) the range and scope of individual
102.32choices; (3) the process for changing plans, services and budgets; (4) the grievance
102.33process; (5) individual rights; (6) identifying and assessing appropriate services; (7) risks
102.34and responsibilities; and (8) risk management. A participant who appeals a reduction in
102.35previously authorized CFSS services may continue previously authorized services pending
102.36an appeal under section 256.045. The commissioner must ensure that the participant
103.1has a copy of the most recent service delivery plan that contains a detailed explanation
103.2of which areas of covered CFSS are reduced, and provide notice of the amount of the
103.3budget reduction, and the reasons for the reduction in the participant's notice of denial,
103.4termination, or reduction.
103.5    Subd. 21. Development and Implementation Council. The commissioner
103.6shall establish a Development and Implementation Council of which the majority of
103.7members are individuals with disabilities, elderly individuals, and their representatives.
103.8The commissioner shall consult and collaborate with the council when developing and
103.9implementing this section.
103.10    Subd. 22. Quality assurance and risk management system. (a) The commissioner
103.11shall establish quality assurance and risk management measures for use in developing and
103.12implementing CFSS including those that (1) recognize the roles and responsibilities of those
103.13involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and budgets
103.14based upon a recipient's resources and capabilities. Risk management measures must
103.15include background studies, and backup and emergency plans, including disaster planning.
103.16(b) The commissioner shall provide ongoing technical assistance and resource and
103.17educational materials for CFSS participants.
103.18(c) Performance assessment measures, such as a participant's satisfaction with the
103.19services and supports, and ongoing monitoring of health and well-being shall be identified
103.20in consultation with the council established in subdivision 21.
103.21    Subd. 23. Commissioner's access. When the commissioner is investigating a
103.22possible overpayment of Medicaid funds, the commissioner must be given immediate
103.23access without prior notice to the agency provider or FMS contractor's office during
103.24regular business hours and to documentation and records related to services provided and
103.25submission of claims for services provided. Denying the commissioner access to records
103.26is cause for immediate suspension of payment and terminating the agency provider's
103.27enrollment according to section 256B.064 or terminating the FMS contract.
103.28    Subd. 24. CFSS agency-providers; background studies. CFSS agency-providers
103.29enrolled to provide personal care assistance services under the medical assistance program
103.30shall comply with the following:
103.31(1) owners who have a five percent interest or more and all managing employees
103.32are subject to a background study as provided in chapter 245C. This applies to currently
103.33enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS
103.34agency-provider. "Managing employee" has the same meaning as Code of Federal
103.35Regulations, title 42, section 455. An organization is barred from enrollment if:
104.1(i) the organization has not initiated background studies on owners managing
104.2employees; or
104.3(ii) the organization has initiated background studies on owners and managing
104.4employees, but the commissioner has sent the organization a notice that an owner or
104.5managing employee of the organization has been disqualified under section 245C.14, and
104.6the owner or managing employee has not received a set-aside of the disqualification
104.7under section 245C.22;
104.8(2) a background study must be initiated and completed for all support specialists; and
104.9(3) a background study must be initiated and completed for all support workers.
104.10EFFECTIVE DATE.This section is effective upon federal approval. The
104.11commissioner of human services shall notify the revisor of statutes when this occurs.

104.12    Sec. 44. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
104.13to read:
104.14    Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
104.15negotiate a supplementary service rate under this section for any individual that has been
104.16determined to be eligible for Housing Stability Services as approved by the Centers
104.17for Medicare and Medicaid Services, and who resides in an establishment voluntarily
104.18registered under section 144D.025, as a supportive housing establishment or participates
104.19in the Minnesota supportive housing demonstration program under section 256I.04,
104.20subdivision 3, paragraph (a), clause (4).

104.21    Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
104.22    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
104.23shall immediately make an oral report to the common entry point. The common entry
104.24point may accept electronic reports submitted through a Web-based reporting system
104.25established by the commissioner. Use of a telecommunications device for the deaf or other
104.26similar device shall be considered an oral report. The common entry point may not require
104.27written reports. To the extent possible, the report must be of sufficient content to identify
104.28the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
104.29any evidence of previous maltreatment, the name and address of the reporter, the time,
104.30date, and location of the incident, and any other information that the reporter believes
104.31might be helpful in investigating the suspected maltreatment. A mandated reporter may
104.32disclose not public data, as defined in section 13.02, and medical records under sections
104.33144.291 to 144.298, to the extent necessary to comply with this subdivision.
105.1(b) A boarding care home that is licensed under sections 144.50 to 144.58 and
105.2certified under Title 19 of the Social Security Act, a nursing home that is licensed under
105.3section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a
105.4hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under
105.5Code of Federal Regulations, title 42, section 482.66, may submit a report electronically
105.6to the common entry point instead of submitting an oral report. The report may be a
105.7duplicate of the initial report the facility submits electronically to the commissioner of
105.8health to comply with the reporting requirements under Code of Federal Regulations, title
105.942, section 483.13. The commissioner of health may modify these reporting requirements
105.10to include items required under paragraph (a) that are not currently included in the
105.11electronic reporting form.
105.12EFFECTIVE DATE.This section is effective July 1, 2014.

105.13    Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
105.14    Subd. 9. Common entry point designation. (a) Each county board shall designate
105.15a common entry point for reports of suspected maltreatment. Two or more county boards
105.16may jointly designate a single The commissioner of human services shall establish a
105.17 common entry point effective July 1, 2014. The common entry point is the unit responsible
105.18for receiving the report of suspected maltreatment under this section.
105.19(b) The common entry point must be available 24 hours per day to take calls from
105.20reporters of suspected maltreatment. The common entry point shall use a standard intake
105.21form that includes:
105.22(1) the time and date of the report;
105.23(2) the name, address, and telephone number of the person reporting;
105.24(3) the time, date, and location of the incident;
105.25(4) the names of the persons involved, including but not limited to, perpetrators,
105.26alleged victims, and witnesses;
105.27(5) whether there was a risk of imminent danger to the alleged victim;
105.28(6) a description of the suspected maltreatment;
105.29(7) the disability, if any, of the alleged victim;
105.30(8) the relationship of the alleged perpetrator to the alleged victim;
105.31(9) whether a facility was involved and, if so, which agency licenses the facility;
105.32(10) any action taken by the common entry point;
105.33(11) whether law enforcement has been notified;
105.34(12) whether the reporter wishes to receive notification of the initial and final
105.35reports; and
106.1(13) if the report is from a facility with an internal reporting procedure, the name,
106.2mailing address, and telephone number of the person who initiated the report internally.
106.3(c) The common entry point is not required to complete each item on the form prior
106.4to dispatching the report to the appropriate lead investigative agency.
106.5(d) The common entry point shall immediately report to a law enforcement agency
106.6any incident in which there is reason to believe a crime has been committed.
106.7(e) If a report is initially made to a law enforcement agency or a lead investigative
106.8agency, those agencies shall take the report on the appropriate common entry point intake
106.9forms and immediately forward a copy to the common entry point.
106.10(f) The common entry point staff must receive training on how to screen and
106.11dispatch reports efficiently and in accordance with this section.
106.12(g) The commissioner of human services shall maintain a centralized database
106.13for the collection of common entry point data, lead investigative agency data including
106.14maltreatment report disposition, and appeals data. The common entry point shall
106.15have access to the centralized database and must log the reports into the database and
106.16immediately identify and locate prior reports of abuse, neglect, or exploitation.
106.17(h) When appropriate, the common entry point staff must refer calls that do not
106.18allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
106.19that might resolve the reporter's concerns.
106.20(i) a common entry point must be operated in a manner that enables the
106.21commissioner of human services to:
106.22(1) track critical steps in the reporting, evaluation, referral, response, disposition,
106.23and investigative process to ensure compliance with all requirements for all reports;
106.24(2) maintain data to facilitate the production of aggregate statistical reports for
106.25monitoring patterns of abuse, neglect, or exploitation;
106.26(3) serve as a resource for the evaluation, management, and planning of preventative
106.27and remedial services for vulnerable adults who have been subject to abuse, neglect,
106.28or exploitation;
106.29(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
106.30of the common entry point; and
106.31(5) track and manage consumer complaints related to the common entry point.
106.32(j) The commissioners of human services and health shall collaborate on the
106.33creation of a system for referring reports to the lead investigative agencies. This system
106.34shall enable the commissioner of human services to track critical steps in the reporting,
106.35evaluation, referral, response, disposition, investigation, notification, determination, and
106.36appeal processes.

107.1    Sec. 47. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
107.2    Subd. 9e. Education requirements. (a) The commissioners of health, human
107.3services, and public safety shall cooperate in the development of a joint program for
107.4education of lead investigative agency investigators in the appropriate techniques for
107.5investigation of complaints of maltreatment. This program must be developed by July
107.61, 1996. The program must include but need not be limited to the following areas: (1)
107.7information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
107.8conclusions based on evidence; (5) interviewing skills, including specialized training to
107.9interview people with unique needs; (6) report writing; (7) coordination and referral
107.10to other necessary agencies such as law enforcement and judicial agencies; (8) human
107.11relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
107.12systems and the appropriate methods for interviewing relatives in the course of the
107.13assessment or investigation; (10) the protective social services that are available to protect
107.14alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
107.15which lead investigative agency investigators and law enforcement workers cooperate in
107.16conducting assessments and investigations in order to avoid duplication of efforts; and
107.17(12) data practices laws and procedures, including provisions for sharing data.
107.18(b) The commissioner of human services shall conduct an outreach campaign to
107.19promote the common entry point for reporting vulnerable adult maltreatment. This
107.20campaign shall use the Internet and other means of communication.
107.21(b) (c) The commissioners of health, human services, and public safety shall offer at
107.22least annual education to others on the requirements of this section, on how this section is
107.23implemented, and investigation techniques.
107.24(c) (d) The commissioner of human services, in coordination with the commissioner
107.25of public safety shall provide training for the common entry point staff as required in this
107.26subdivision and the program courses described in this subdivision, at least four times
107.27per year. At a minimum, the training shall be held twice annually in the seven-county
107.28metropolitan area and twice annually outside the seven-county metropolitan area. The
107.29commissioners shall give priority in the program areas cited in paragraph (a) to persons
107.30currently performing assessments and investigations pursuant to this section.
107.31(d) (e) The commissioner of public safety shall notify in writing law enforcement
107.32personnel of any new requirements under this section. The commissioner of public
107.33safety shall conduct regional training for law enforcement personnel regarding their
107.34responsibility under this section.
108.1(e) (f) Each lead investigative agency investigator must complete the education
108.2program specified by this subdivision within the first 12 months of work as a lead
108.3investigative agency investigator.
108.4A lead investigative agency investigator employed when these requirements take
108.5effect must complete the program within the first year after training is available or as soon
108.6as training is available.
108.7All lead investigative agency investigators having responsibility for investigation
108.8duties under this section must receive a minimum of eight hours of continuing education
108.9or in-service training each year specific to their duties under this section.

108.10    Sec. 48. REPEALER.
108.11(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
108.123, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
108.13(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
108.14repealed effective October 1, 2013.

108.15    Sec. 49. EFFECTIVE DATE; CONTINGENT SYSTEMS MODERNIZATION
108.16APPROPRIATION.
108.17    Subdivision 1. Definitions. (a) For the purposes of this section, the terms in this
108.18subdivision have the meanings given.
108.19(b) Unless otherwise indicated, "commissioner" means the commissioner of human
108.20services.
108.21(c) "Contingent systems modernization appropriation" refers to the appropriation in
108.22article 15, section 2.
108.23(d) "Department" means the Department of Human Services.
108.24(e) "Plan" means the plan that outlines how the provisions in this article, and the
108.25contingent appropriation for systems modernization, are implemented once federal action
108.26on Reform 2020 has occurred.
108.27(f) Unless otherwise indicated, "Reform 2020" means the commissioner's request
108.28for any necessary federal approval of provisions in this article that modify or provide
108.29new medical assistance services, or that otherwise modify the federal role in the state's
108.30long-term care system.
108.31    Subd. 2. Intent; effective dates generally. (a) Because the changes contained in
108.32this article generate savings that are contingent on federal approval of Reform 2020,
108.33the legislature has also made an appropriation for systems modernization contingent on
108.34federal approval of Reform 2020. The purpose of this section is to outline how this article
109.1and the contingent systems modernization appropriation in article 15 are implemented if
109.2Reform 2020 is fully, partially, or incrementally approved or denied.
109.3(b) In order for sections 1 to 48 of this article to be effective, the commissioner must
109.4follow the provisions of subdivisions 3 and 4, as applicable, notwithstanding any other
109.5effective dates for those sections.
109.6    Subd. 3. Federal approval. (a) The implementation of this article is contingent
109.7on federal approval.
109.8(b) Upon full or partial approval of the waiver application, the commissioner shall
109.9develop a plan for implementing the provisions in this article that received federal
109.10approval as well as any that do not require federal approval. The plan must:
109.11(1) include fiscal estimates for the 2014-2015 and 2016-2017 biennia;
109.12(2) include the contingent systems modernization appropriation, which cannot
109.13exceed $16,992,000 for the biennium ending June 30, 2015; and
109.14(3) include spending estimates that, with federal administrative reimbursement, do
109.15not exceed the department's net general fund appropriations for the 2014-2015 biennium.
109.16(c) Upon approval by the commissioner of management and budget, the department
109.17may implement the plan.
109.18(d) The commissioner may follow this plan and implement parts of Reform 2020
109.19consistent with federal law if federal approval is denied, received incrementally, or
109.20significantly delayed.
109.21(e) The commissioner must notify the chairs and ranking minority members of the
109.22legislative committees with jurisdiction over health and human services funding of the
109.23plan. The plan must be made publicly available online.
109.24    Subd. 4. Disbursement; implementation. The commissioner of management and
109.25budget shall disburse the appropriations in article 15, section 2, to the commissioner to
109.26allow for implementation of the approved plan and make necessary adjustments in the
109.27accounting system to reflect any modified funding levels. Notwithstanding Minnesota
109.28Statutes, section 16A.11, subdivision 3, paragraph (b), these fiscal estimates must be
109.29considered in establishing the appropriation base for the biennium ending June 30, 2017.
109.30The commissioner of management and budget shall reflect the modified funding levels in
109.31the first fund balance following the approval of the plan.


109.34    Section 1. Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to
109.35read:
110.1    Subd. 2. Payment methodologies. (a) The commissioner shall establish, as defined
110.2under section 256B.4914, statewide payment methodologies that meet federal waiver
110.3requirements for home and community-based waiver services for individuals with
110.4disabilities. The payment methodologies must abide by the principles of transparency
110.5and equitability across the state. The methodologies must involve a uniform process of
110.6structuring rates for each service and must promote quality and participant choice.
110.7    (b) As of January 1, 2012, counties shall not implement changes to established
110.8processes for rate-setting methodologies for individuals using components of or data
110.9from research rates.

110.10    Sec. 2. Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:
110.11    Subd. 3. Payment requirements. The payment methodologies established under
110.12this section shall accommodate:
110.13(1) supervision costs;
110.14(2) staffing patterns staff compensation;
110.15(3) staffing and supervisory patterns;
110.16(3) (4) program-related expenses;
110.17(4) (5) general and administrative expenses; and
110.18(5) (6) consideration of recipient intensity.

110.19    Sec. 3. Minnesota Statutes 2012, section 256B.4913, is amended by adding a
110.20subdivision to read:
110.21    Subd. 4a. Rate stabilization adjustment. (a) The commissioner of human services
110.22shall adjust individual reimbursement rates by no more than 1.0 percent per year effective
110.23January 1, 2016. Rates determined under section 256B.4914 must be adjusted so that
110.24the unit rate varies no more than 1.0 percent per year from the rate effective December
110.251 of the prior calendar year. This adjustment is made annually for three calendar years
110.26from the date of implementation.
110.27(b) Rate stabilization adjustment applies to services that are authorized in a
110.28recipient's service plan prior to January 1, 2016.
110.29(c) Exemptions shall be made only when there is a significant change in the
110.30recipient's assessed needs which results in a service authorization change. Exemption
110.31adjustments shall be limited to the difference in the authorized framework rate specific to
110.32change in assessed need. Exemptions shall be managed within lead agencies' budgets per
110.33existing allocation procedures.
110.34(d) This subdivision expires January 1, 2019.

111.1    Sec. 4. Minnesota Statutes 2012, section 256B.4913, subdivision 5, is amended to read:
111.2    Subd. 5. Stakeholder consultation. The commissioner shall continue consultation
111.3on regular intervals with the existing stakeholder group established as part of the
111.4rate-setting methodology process and others, to gather input, concerns, and data, and
111.5exchange ideas for the legislative proposals for to assist in the full implementation of
111.6 the new rate payment system and to make pertinent information available to the public
111.7through the department's Web site.

111.8    Sec. 5. Minnesota Statutes 2012, section 256B.4913, subdivision 6, is amended to read:
111.9    Subd. 6. Implementation. (a) The commissioner may shall implement changes
111.10no sooner than on January 1, 2014, to payment rates for individuals receiving home and
111.11community-based waivered services after the enactment of legislation that establishes
111.12specific payment methodology frameworks, processes for rate calculations, and specific
111.13values to populate the payment methodology frameworks disability waiver rates system.
111.14(b) On January 1, 2014, all new service authorizations must use the disability waiver
111.15rates system. Beginning January 1, 2014, all renewing individual service plans must use the
111.16disability waiver rates system as reassessment and reauthorization occurs. By December
111.1731, 2014, data for all recipients must be entered into the disability waiver rates system.

111.18    Sec. 6. [256B.4914] HOME AND COMMUNITY-BASED SERVICES WAIVERS;
111.19RATE SETTING.
111.20    Subdivision 1. Application. The payment methodologies in this section apply to
111.21home and community-based services waivers under sections 256B.092 and 256B.49. This
111.22section does not change existing waiver policies and procedures.
111.23    Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
111.24meanings given them, unless the context clearly indicates otherwise.
111.25(b) "Commissioner" means the commissioner of human services.
111.26(c) "Component value" means underlying factors that are part of the cost of providing
111.27services that are built into the waiver rates methodology to calculate service rates.
111.28(d) "Customized living tool" means a methodology for setting service rates which
111.29delineates and documents the amount of each component service included in a recipient's
111.30customized living service plan.
111.31(e) "Disability Waiver Rates System" means a statewide system which establishes
111.32rates that are based on uniform processes and captures the individualized nature of waiver
111.33services and recipient needs.
112.1(f) "Lead agency" means a county, partnership of counties, or tribal agency charged
112.2with administering waivered services under sections 256B.092 and 256B.49.
112.3(g) "Median" means the amount that divides distribution into two equal groups, half
112.4above the median and half below the median.
112.5(h) "Payment or rate" means reimbursement to an eligible provider for services
112.6provided to a qualified individual based on an approved service authorization.
112.7(i) "Rates management system" means a web-based software application that uses
112.8a framework and component values, as determined by the commissioner, to establish
112.9service rates.
112.10(j) "Recipient" means a person receiving home and community-based services
112.11funded under any of the disability waivers.
112.12    Subd. 3. Applicable services. Applicable services are those authorized under the
112.13state's home and community-based services waivers under sections 256B.092 and 256B.49
112.14including, as defined in the federally approved home and community-based services plan:
112.15(1) 24-hour customized living;
112.16(2) adult day care;
112.17(3) adult day care bath;
112.18(4) behavioral programming;
112.19(5) companion services;
112.20(6) customized living;
112.21(7) day training and habilitation;
112.22(8) housing access coordination;
112.23(9) independent living skills;
112.24(10) in-home family support;
112.25(11) night supervision;
112.26(12) personal support;
112.27(13) prevocational services;
112.28(14) residential care services;
112.29(15) residential support services;
112.30(16) respite services;
112.31(17) structured day services;
112.32(18) supported employment services;
112.33(19) supported living services;
112.34(20) transportation services; and
112.35(21) other services as approved by the federal government in the state home and
112.36community-based services plan.
113.1    Subd. 4. Data collection for rate determination. (a) Rates for all applicable home
113.2and community-based waivered services, including rate exceptions under subdivision 12
113.3are set via the rates management system.
113.4(b) Only data and information in the rates management system may be used to
113.5calculate an individual's rate.
113.6(c) Service providers, with information from the community support plan, shall enter
113.7values and information needed to calculate an individual's rate into the rates management
113.8system. These values and information include:
113.9(1) shared staffing hours;
113.10(2) individual staffing hours;
113.11(3) staffing ratios;
113.12(4) information to document variable levels of service qualification for variable
113.13levels of reimbursement in each framework;
113.14(5) shared or individualized arrangements for unit-based services, including the
113.15staffing ratio; and
113.16(6) number of trips and miles for transportation services.
113.17(d) Updates to individual data shall include:
113.18(1) data for each individual that is updated annually when renewing service plans; and
113.19(2) requests by individuals or lead agencies to update a rate whenever there is a
113.20change in an individual's service needs, with accompanying documentation.
113.21(e) Lead agencies shall review and approve values to calculate the final payment rate
113.22for each individual. Lead agencies must notify the individual and the service provider
113.23of the final agreed upon values and rate. If a value used was mistakenly or erroneously
113.24entered and used to calculate a rate, a provider may petition lead agencies to correct it.
113.25Lead agencies must respond to these requests.
113.26    Subd. 5. Base wage index and standard component values. (a) The base wage
113.27index is established to determine staffing costs associated with providing services to
113.28individuals receiving home and community-based services. For purposes of developing
113.29and calculating the proposed base wage, Minnesota-specific wages taken from job
113.30descriptions and standard occupational classification (SOC) codes from the Bureau of
113.31Labor Statistics, as defined in the most recent edition of the Occupational Handbook shall
113.32be used. The base wage index shall be calculated as follows:
113.33(1) for residential direct care basic staff, 50 percent of the median wage for personal
113.34and home health aide (SOC code 39-9021); 30 percent of the median wage for nursing
113.35aide (SOC code 31-1012); and 20 percent of the median wage for social and human
113.36services aide (SOC code 21-1093);
114.1(2) for residential direct care intensive staff, 20 percent of the median wage for home
114.2health aide (SOC code 31-1011); 20 percent of the median wage for personal and home
114.3health aide (SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code
114.421-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
114.5and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
114.6(3) for day services, 20 percent of the median wage for nursing aide (SOC Code
114.731-1012); 20 percent of the median wage for psychiatric technician (SOC Code 29-2053);
114.8and 60 percent of the median wage for social and human services code (SOC Code
114.921-1093);
114.10(4) for residential asleep overnight staff, the wage will be $7.66 per hour, except
114.11in a family foster care setting the wage is $2.80 per hour;
114.12(5) for behavior program analyst staff: 100 percent of the median wage for mental
114.13health counselors (SOC code 21-1014);
114.14(6) for behavior program professional staff: 100 percent of the median wage for
114.15clinical counseling and school psychologist (SOC code 19-3031);
114.16(7) for behavior program specialist staff: 100 percent of the median wage for
114.17psychiatric technicians (SOC code 29-2053);
114.18(8) for supportive living services staff: 20 percent of the median wage for nursing
114.19aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
114.20code 29-2053); and 60 percent of the median wage for social and human services aide
114.21(SOC code 21-1093);
114.22(9) for housing access coordination staff: 50 percent of the median wage for
114.23community and social services specialist (SOC code 21-1099); and 50 percent of the
114.24median wage for social and human services aide (SOC code 21-1093);
114.25(10) for in-home family support staff: 20 percent of the median wage for nursing
114.26aide (SOC code 31-1012); 30 percent of community social service specialist (SOC code
114.2721-1099); 40 percent of the median wage for social and human services aide (SOC code
114.2821-1093); and 10 percent of the median wage for psychiatric technician (SOC code
114.2929-2053);
114.30(11) for independent living skills staff: 40 percent of the median wage for
114.31community social service specialist (SOC code 21-1099); 50 percent of the median wage
114.32for social and human services aide (SOC code 21-1093); and 10 percent of the median
114.33wage for psychiatric technician (SOC code 29-2053);
114.34(12) for supported employment staff: 20 percent of the median wage for nursing
114.35aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
115.1code 29-2053); and 60 percent of the median wage for social and human services aide
115.2(SOC code 21-1093);
115.3(13) for adult companion staff: 50 percent of the median wage for personal and
115.4home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
115.5orderlies, and attendants (SOC code 31-1012);
115.6(14) for night supervision staff: 20 percent of the median wage for home health aide
115.7(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
115.8(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012);
115.920 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20
115.10percent of the median wage for social and human services aide (SOC code 21-1093);
115.11(15) for respite staff: 50 percent of the median wage for personal and home care aide
115.12(SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, and
115.13attendants (SOC code 31-1012);
115.14(16) for personal support staff: 50 percent of the median wage for personal and
115.15home care aide (SOC code 39-9021); and 50 percent of the median wage for nursing
115.16aides, orderlies, and attendants (SOC code 31-1012); and
115.17(17) for supervisory staff: the basic wage is $17.43 per hour with exception of the
115.18supervisor of behavior analyst and behavior specialists which shall be $30.75 per hour.
115.19(b) Component values for residential support services, excluding family foster
115.20care, are:
115.21(1) supervisory span of control ratio: 11 percent;
115.22(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
115.23(3) employee-related cost ratio: 23.6 percent;
115.24(4) general administrative support ratio: 13.25 percent;
115.25(5) program-related expense ratio: 1.3 percent; and
115.26(6) absence and utilization factor ratio: 3.9 percent.
115.27(c) Component values for family foster care are:
115.28(1) supervisory span of control ratio: 11 percent;
115.29(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
115.30(3) employee-related cost ratio: 23.6 percent;
115.31(4) general administrative support ratio: 3.3 percent; and
115.32(5) program-related expense ratio: 1.3 percent.
115.33(d) Component values for day services for all services are:
115.34(1) supervisory span of control ratio: 11 percent;
115.35(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
115.36(3) employee-related cost ratio: 23.6 percent;
116.1(4) program plan support ratio: 5.6 percent;
116.2(5) client programming and support ratio: 10 percent;
116.3(6) general administrative support ratio: 13.25 percent;
116.4(7) program-related expense ratio: 1.8 percent; and
116.5(8) absence and utilization factor ratio: 3.9 percent.
116.6(e) Component values for unit-based with program services are:
116.7(1) supervisory span of control ratio: 11 percent;
116.8(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
116.9(3) employee-related cost ratio: 23.6 percent;
116.10(4) program plan supports ratio: 3.1 percent;
116.11(5) client programming and support ratio: 8.6 percent;
116.12(6) general administrative support ratio: 13.25 percent;
116.13(7) program-related expense ratio: 6.1 percent; and
116.14(8) absence and utilization factor ratio: 3.9 percent.
116.15(f) Component values for unit-based services without programming except respite
116.16are:
116.17(1) supervisory span of control ratio: 11 percent;
116.18(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
116.19(3) employee-related cost ratio: 23.6 percent;
116.20(4) program plan support ratio: 3.1 percent;
116.21(5) client programming and support ratio: 8.6 percent;
116.22(6) general administrative support ratio: 13.25 percent;
116.23(7) program-related expense ratio: 6.1 percent; and
116.24(8) absence and utilization factor ratio: 3.9 percent.
116.25(g) Component values for unit-based services without programming for respite are:
116.26(1) supervisory span of control ratio: 11 percent;
116.27(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
116.28(3) employee-related cost ratio: 23.6 percent;
116.29(4) general administrative support ratio: 13.25 percent;
116.30(5) program-related expense ratio: 6.1 percent; and
116.31(6) absence and utilization factor ratio: 3.9 percent.
116.32(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
116.33(a) based on the wage data by standard occupational code (SOC) from the Bureau of
116.34Labor Statistics available on December 31, 2016. The commissioner shall publish these
116.35updated values and load them into the rate management system. This adjustment shall
117.1occur every five years. For adjustments in 2021 and beyond, the commissioner shall use
117.2the data available on December 31 of the calendar year five years prior.
117.3(i) On July 1, 2017, the commissioner shall update the framework components in
117.4paragraph (c) for changes in the Consumer Price Index. The commissioner must adjust
117.5these values higher or lower by the percentage change in the Consumer Price Index-All
117.6Items (United States city average) (CPI-U) from January 1, 2014, to January 1, 2017. The
117.7commissioner shall publish these updated values and load them into the rate management
117.8system. This adjustment shall occur every five years. For adjustments in 2021 and
117.9beyond, the commissioner shall use the data available on January 1 of the calendar year
117.10four years prior and January 1 of the current calendar year.
117.11    Subd. 6. Payments for residential support services. (a) Payments for residential
117.12support services, as defined in sections 256B.092, subdivision 11, and 256B.49 subdivision
117.1322, must be calculated as follows:
117.14(1) determine the number of units of service to meet a recipient's needs;
117.15(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
117.16national and Minnesota-specific rates or rates derived by the commissioner as provided in
117.17subdivision 5. This is defined as the direct care rate;
117.18(3) for a recipient requiring customization for deaf or hard-of-hearing language
117.19accessibility under subdivision 12, add the customization rate provided in subdivision 12
117.20to the result of clause (2). This is defined as the customized direct care rate;
117.21(4) multiply the number of residential services direct staff hours by the appropriate
117.22staff wage in subdivision 5, paragraph (a), or the customized direct care rate;
117.23(5) multiply the number of direct staff hours by the product of the supervision span
117.24of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision
117.25wage in subdivision 5, paragraph (a), clause (17);
117.26(6) combine the results of clauses (4) and (5), and multiply the result by one plus
117.27the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b),
117.28clause (2). This is defined as the direct staffing cost;
117.29(7) for employee-related expenses, multiply the direct staffing cost by one plus the
117.30employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
117.31(8) for client programming and supports, the commissioner shall add $2,179; and
117.32(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
117.33customized for adapted transport per year.
117.34(b) The total rate shall be calculated using the following steps:
117.35(1) subtotal paragraph (a), clauses (7) to (9);
118.1(2) sum the standard general and administrative rate, the program-related expense
118.2ratio, and the absence and utilization ratio; and
118.3(3) divide the result of clause (1) by one minus the result of clause (2). This is
118.4the total payment amount.
118.5    Subd. 7. Payments for day programs. Payments for services with day programs
118.6including adult day care, day treatment and habilitation, prevocational services, and
118.7structured day services must be calculated as follows:
118.8(1) determine the number of units of service to meet a recipient's needs;
118.9(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
118.10Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
118.11(3) for a recipient requiring customization for deaf or hard-of-hearing language
118.12accessibility under subdivision 12, add the customization rate provided in subdivision 12
118.13to the result of clause (2). This is defined as the customized direct care rate;
118.14(4) multiply the number of day program direct staff hours by the appropriate staff
118.15wage in subdivision 5, paragraph (a), or the customized direct care rate;
118.16(5) multiply the number of day program direct staff hours by the product of the
118.17supervision span of control ratio in subdivision 5, paragraph (d), clause (1), and the
118.18appropriate supervision wage in subdivision 5, paragraph (a), clause (17);
118.19(6) combine the results of clauses (4) and (5), and multiply the result by one plus
118.20the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d),
118.21clause (2). This is defined as the direct staffing rate;
118.22(7) for program plan support, multiply the result of clause (6) by one plus the
118.23program plan support ratio in subdivision 5, paragraph (d), clause (4);
118.24(8) for employee-related expenses, multiply the result of clause (7) by one plus the
118.25employee-related cost ratio in subdivision 5, paragraph (d), clause (3);
118.26(9) for client programming and supports, multiply the result of clause (8) by one plus
118.27the client programming and support ratio in subdivision 5, paragraph (d), clause (5);
118.28(10) for program facility costs, add $8.30 per week with consideration of staffing
118.29ratios to meet individual needs;
118.30(11) for adult day bath services, add $7.01 per 15 minute unit;
118.31(12) this is the subtotal rate;
118.32(13) sum the standard general and administrative rate, the program-related expense
118.33ratio, and the absence and utilization factor ratio;
118.34(14) divide the result of clause (12) by one minus the result of clause (13). This is
118.35the total payment amount;
119.1(15) for transportation provided as part of day training and habilitation for an
119.2individual who does not require a lift, add:
119.3(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle
119.4without a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared
119.5ride in a vehicle with a lift;
119.6(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle
119.7without a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared
119.8ride in a vehicle with a lift;
119.9(iii) $25.75 for a trip between 21and 50 miles for a nonshared ride in a vehicle
119.10without a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared
119.11ride in a vehicle with a lift; or
119.12(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a
119.13lift, $16.50 for a shared ride in a vehicle without a lift, and $20.75 for a shared ride in a
119.14vehicle with a lift;
119.15(16) for transportation provide as part of day training and habilitation for an
119.16individual who does require a lift, add:
119.17(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with
119.18a lift, and $15.05 for a shared ride in a vehicle with a lift;
119.19(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a
119.20lift, and $28.16 for a shared ride in a vehicle with a lift;
119.21(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with
119.22a lift, and $58.76 for a shared ride in a vehicle with a lift; or
119.23(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a
119.24lift, and $80.93 for a shared ride in a vehicle with a lift.
119.25    Subd. 8. Payments for unit-based services with programming. Payments for
119.26unit-based services with programming, including behavior programming, housing access
119.27coordination, in-home family support, independent living skills training, hourly supported
119.28living services, and supported employment provided to an individual outside of any day or
119.29residential service plan must be calculated as follows, unless the services are authorized
119.30separately under subdivision 6 or 7:
119.31(1) determine the number of units of service to meet a recipient's needs;
119.32(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
119.33Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
119.34(3) for a recipient requiring customization for deaf or hard-of-hearing language
119.35accessibility under subdivision 12, add the customization rate provided in subdivision 12
119.36to the result of clause (2). This is defined as the customized direct care rate;
120.1(4) multiply the number of direct staff hours by the appropriate staff wage in
120.2subdivision 5, paragraph (a), or the customized direct care rate;
120.3(5) multiply the number of direct staff hours by the product of the supervision span
120.4of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
120.5wage in subdivision 5, paragraph (a), clause (17);
120.6(6) combine the results of clauses (4) and (5), and multiply the result by one plus
120.7the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e),
120.8clause (2). This is defined as the direct staffing rate;
120.9(7) for program plan support, multiply the result of clause (6) by one plus the
120.10program plan supports ratio in subdivision 5, paragraph (e), clause (4);
120.11(8) for employee-related expenses, multiply the result of clause (7) by one plus the
120.12employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
120.13(9) for client programming and supports, multiply the result of clause (8) by one plus
120.14the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
120.15(10) this is the subtotal rate;
120.16(11) sum the standard general and administrative rate, the program-related expense
120.17ratio, and the absence and utilization factor ratio; and
120.18(12) divide the result of clause (10) by one minus the result of clause (11). This is
120.19the total payment amount.
120.20    Subd. 9. Payments for unit-based services without programming. Payments
120.21for unit-based without program services including night supervision, personal support,
120.22respite, and companion care provided to an individual outside of any day or residential
120.23service plan must be calculated as follows unless the services are authorized separately
120.24under subdivision 6 or 7:
120.25(1) for all services except respite, determine the number of units of service to meet
120.26a recipient's needs;
120.27(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
120.28Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
120.29(3) for a recipient requiring customization for deaf or hard-of-hearing language
120.30accessibility under subdivision 12, add the customization rate provided in subdivision 12
120.31to the result of clause (2). This is defined as the customized direct care rate;
120.32(4) multiply the number of direct staff hours by the appropriate staff wage in
120.33subdivision 5 or the customized direct care rate;
120.34(5) multiply the number of direct staff hours by the product of the supervision span
120.35of control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision
120.36wage in subdivision 5, paragraph (a), clause (17);
121.1(6) combine the results of clauses (4) and (5) and multiply the result by one plus
121.2the employee vacation, sick, and training allowance ratio in, subdivision 5, paragraph (f),
121.3clause (2). This is defined as the direct staffing rate;
121.4(7) for program plan support, multiply the result of clause (6) by one plus the
121.5program plan support ratio in subdivision 5, paragraph (f), clause (4);
121.6(8) for employee-related expenses, multiply the result of clause (7) by one plus the
121.7employee-related cost ratio in subdivision 5, paragraph (f), clause (3);
121.8(9) For client programming and supports, multiply the result of clause (8) by one
121.9plus the client programming and support ratio in subdivision 5, paragraph (f), clause (5);
121.10(10) this is the subtotal rate;
121.11(11) sum the standard general and administrative rate, the program-related expense
121.12ratio, and the absence and utilization factor ratio;
121.13(12) divide the result of clause (10) by one minus the result of clause (11). This is
121.14the total payment amount;
121.15(13) for respite services, determine the number of daily units of service to meet an
121.16individual's needs;
121.17(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
121.18Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
121.19(15) for a recipient requiring deaf or hard-of-hearing customization under
121.20subdivision 12, add the customization rate provided in subdivision 12 to the result of
121.21clause (14). This is defined as the customized direct care rate;
121.22(16) multiply the number of direct staff hours by the appropriate staff wage in
121.23subdivision 5, paragraph (a);
121.24(17) multiply the number of direct staff hours by the product of the supervisory span
121.25of control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision
121.26wage in subdivision 5, paragraph (a), clause (17);
121.27(18) combine the results of clauses (16) and (17) and multiply the result by one plus
121.28the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g),
121.29clause (2). This is defined as the direct staffing rate;
121.30(19) for employee-related expenses, multiply the result of clause (18) by one plus
121.31the employee-related cost ratio in subdivision 5, paragraph (g), clause (3).
121.32(20) this is the subtotal rate;
121.33(21) sum the standard general and administrative rate, the program-related expense
121.34ratio, and the absence and utilization factor ratio; and
121.35(22) divide the result of clause (20) by one minus the result of clause (21). This is
121.36the total payment amount.
122.1    Subd. 10. Updating payment values and additional information. (a) The
122.2commissioner shall develop and implement uniform procedures to refine terms and update
122.3or adjust values used to calculate payment rates in this section. For calendar year 2014,
122.4the commissioner shall use the values, terms, and procedures provided in this section.
122.5(b) The commissioner shall work with stakeholders to assess efficacy of values
122.6and payment rates. The commissioner shall report back to the legislature with proposed
122.7changes for component values and recommendations for revisions on the schedule
122.8provided in paragraphs (c) and (d).
122.9(c) The commissioner shall work with stakeholders to continue refining a
122.10subset of component values, which are to be referred to as interim values, and report
122.11recommendations to the legislature by February 15, 2014. Interim component values are:
122.12transportation rates for day training and habilitation; transportation for adult day, structured
122.13day, and prevocational services; geographic difference factor; day program facility rate;
122.14services where monitoring technology replaces staff time; shared services for independent
122.15living skills training; and supported employment and billing for indirect services.
122.16(d) The commissioner shall report and make recommendations to the legislature on:
122.17February 15, 2015, February 15, 2017, February 15, 2019, and February 15, 2021. After
122.182021, reports shall be provided on a four-year cycle.
122.19(e) The commissioner shall provide a public notice via list serve in October of each
122.20year beginning October 1, 2014. The notice shall contain information detailing legislatively
122.21approved changes in: calculation values including derived wage rates and related employee
122.22and administrative factors; services utilization; county and tribal allocation changes
122.23and; information on adjustments to be made to calculation values and timing of those
122.24adjustments. Information in this notice shall be effective January 1 of the following year.
122.25    Subd. 11. Payment implementation. Upon implementation of the payment
122.26methodologies under this section, those payment rates supersede rates established in county
122.27contracts for recipients receiving waiver services under sections 256B.092 or 256B.49.
122.28    Subd. 12. Customization of rates for individuals. (a) For persons determined to
122.29have higher needs based on being deaf or hard-of-hearing, the direct care costs must be
122.30increased by an adjustment factor prior to calculating the rate under subdivisions 6, 7, 8,
122.31and 9. The customization rate with respect to deaf or hard-of-hearing persons shall be
122.32$2.50 per hour for waiver recipients who meet the respective criteria as determined by
122.33the commissioner.
122.34(b) For the purposes of this section, "Deaf or Hard of Hearing" means:
122.35(1)(i) the person has a developmental disability and an assessment score which
122.36indicates a hearing impairment that is severe or that the person has no useful hearing;
123.1(ii) the person has a developmental disability and an expressive communications
123.2score that indicates the person uses single signs or gestures, uses an augmentative
123.3communication aid, or does not have functional communication, or the person's expressive
123.4communications are unknown; and
123.5(iii) the person has a developmental disability and a communication score which
123.6indicates the person comprehends signs, gestures, and modeling prompts or does not
123.7comprehend verbal, visual, or gestural communication or that the person's receptive
123.8communications score is unknown; or
123.9(2)(i) the person receives long-term care services and has an assessment score which
123.10indicates they hear only very loud sounds, have no useful hearing, or a determination
123.11cannot be made; and
123.12(ii) the person receives long-term care services and has an assessment which
123.13indicates the person communicates needs with sign language, symbol board, written
123.14messages, gestures or an interpreter; communicates with inappropriate content; makes
123.15garbled sounds or displays echolalia; or does not communicate needs.
123.16    Subd. 13. Transportation. The commissioner shall require that the purchase
123.17of transportation services be cost-effective and be limited to market rates where the
123.18transportation mode is generally available and accessible.
123.19    Subd. 14. Exceptions. (a) In a format prescribed by the commissioner, lead
123.20agencies must identify individuals with exceptional needs that cannot be met under the
123.21disability waiver rate system. The commissioner shall use that information to evaluate
123.22and, if necessary, approve an alternative payment rate for those individuals.
123.23(b) Lead agencies must submit exception requests to the state.
123.24(c) An application for a rate exception may be submitted for the following criteria:
123.25(1) an individual has service needs that cannot be met through additional units
123.26of service; or
123.27(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 results in an
123.28individual being discharged.
123.29(d) Exception requests must include the following information:
123.30(1) the service needs required by each individual that are not accounted for in
123.31subdivisions 6, 7, 8, and 9;
123.32(2) the service rate requested and the difference from the rate determined in
123.33subdivisions 6, 7, 8, and 9;
123.34(3) a basis for the underlying costs used for the rate exception and any accompanying
123.35documentation;
123.36(4) the duration of the rate exception; and
124.1(5) any contingencies for approval.
124.2(e) Approved rate exceptions shall be managed within lead agency allocations under
124.3sections 256B.092 and 256B.49.
124.4(f) Individual disability waiver recipients may request that a lead agency submit an
124.5exception request. A lead agency that denies such a request shall notify the individual
124.6waiver recipient of its decision and the reasons for denying the request in writing no later
124.7than 30 days after the individual's request has been made.
124.8(g) The commissioner shall determine whether to approve or deny an exception
124.9request no more than 30 days after receiving the request. If the commissioner denies the
124.10request, the commissioner shall notify the lead agency and the individual disability waiver
124.11recipient in writing of the reasons for the denial.
124.12(h) The individual disability waiver recipient may appeal any denial of an exception
124.13request by either the lead agency or the commissioner, pursuant to sections 256.045 and
124.14256.0451. When the denial of an exception request results in the proposed demission of a
124.15waiver recipient from a residential or day habilitation program, the commissioner shall
124.16issue a temporary stay of demission, when requested by the disability waiver recipient,
124.17consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c).
124.18The temporary stay shall remain in effect until the lead agency can provide an informed
124.19choice of appropriate, alternative services to the disability waiver.
124.20(i) Providers may petition lead agencies to update values that were entered
124.21incorrectly or erroneously into the rate management system, based on past service level
124.22discussions and determination in subdivision 4, without applying for a rate exception.
124.23    Subd. 15. County or tribal allocations. (a) Upon implementation of the Disability
124.24Waiver Rates Management System on January 1, 2014, the commissioner shall establish
124.25a method of tracking and reporting the fiscal impact of the Disability Waiver Rates
124.26Management System on individual lead agencies.
124.27(b) Beginning January 1, 2014, and continuing through full implementation on
124.28December 31, 2017, the commissioner shall make annual adjustments to lead agencies'
124.29home and community-based waivered service budget allocations to adjust for rate
124.30differences and the resulting impact on county allocations upon implementation of the
124.31disability waiver rates system.
124.32    Subd. 16. Budget neutrality adjustment. The commissioner shall calculate the
124.33total spending for all home and community-based waiver services under the payments as
124.34defined in subdivisions 6, 7, 8, and 9 for all recipients as of July 1, 2013, and compare it to
124.35spending for services defined for subdivisions 6, 7, 8, and 9 under current law. If spending
124.36for services in one particular subdivision differs, there will be a percentage adjustment
125.1to increase or decrease individual rates for the services defined in each subdivision so
125.2aggregate spending matches projections under current law.
125.3    Subd. 17. Implementation. (a) On January 1, 2014, the commissioner shall fully
125.4implement the calculation of rates for waivered services under sections 256B.092 and
125.5256B.49, without additional legislative approval.
125.6(b) The commissioner shall phase in the application of rates determined in
125.7subdivisions 6 to 9 for two years.
125.8(c) The commissioner shall preserve rates in effect on December 31, 2013, for
125.9the two-year period.
125.10(d) The commissioner shall calculate and measure the difference in cost per
125.11individual using the historical rate and the rates under subdivisions 6 to 9, for all
125.12individuals enrolled as of December 31, 2013. This measurement shall occur statewide,
125.13and for individuals in every county.
125.14The commissioner shall provide the results of this analysis, by county for calendar
125.15year 2014, to the legislative committees with jurisdiction over health and human services
125.16finance by February 15, 2015.
125.17(e) The commissioner shall calculate the average rate per unit for each service by
125.18county. For individuals enrolled after January 1, 2014, individuals will receive the higher
125.19of the rate produced under subdivisions 6 to 9, or the by-county average rate.
125.20(f) On January 1, 2016, the rates determined in subdivisions 6 to 9 shall be applied.

125.21    Sec. 7. REPEALER.
125.22Minnesota Statutes 2012, section 256B.4913, subdivisions 1, 2, 3, and 4, are repealed.


125.25    Section 1. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
125.26    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
125.27the exception of the placement of a Minnesota specialty treatment facility as defined in
125.28paragraph (c), must be developed under the direction of the county board, or multiple
125.29county boards acting jointly, as the local mental health authority. The planning process
125.30for each pilot shall include, but not be limited to, mental health consumers, families,
125.31advocates, local mental health advisory councils, local and state providers, representatives
125.32of state and local public employee bargaining units, and the department of human services.
125.33As part of the planning process, the county board or boards shall designate a managing
125.34entity responsible for receipt of funds and management of the pilot project.
126.1(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
126.2request for proposal for regions in which a need has been identified for services.
126.3(c) For purposes of this section, Minnesota specialty treatment facility is defined as
126.4an intensive rehabilitative mental health service under section 256B.0622, subdivision 2,
126.5paragraph (b).

126.6    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
126.7    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
126.8commissioner shall facilitate integration of funds or other resources as needed and
126.9requested by each project. These resources may include:
126.10(1) residential services funds administered under Minnesota Rules, parts 9535.2000
126.11to 9535.3000, in an amount to be determined by mutual agreement between the project's
126.12managing entity and the commissioner of human services after an examination of the
126.13county's historical utilization of facilities located both within and outside of the county
126.14and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
126.15(2) community support services funds administered under Minnesota Rules, parts
126.169535.1700 to 9535.1760;
126.17(3) other mental health special project funds;
126.18(4) medical assistance, general assistance medical care, MinnesotaCare and group
126.19residential housing if requested by the project's managing entity, and if the commissioner
126.20determines this would be consistent with the state's overall health care reform efforts; and
126.21(5) regional treatment center resources consistent with section 246.0136, subdivision
126.221 .; and
126.23(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
126.24participate in mental health specialty treatment services, awarded to providers through
126.25a request for proposal process.
126.26(b) The commissioner shall consider the following criteria in awarding start-up and
126.27implementation grants for the pilot projects:
126.28(1) the ability of the proposed projects to accomplish the objectives described in
126.29subdivision 2;
126.30(2) the size of the target population to be served; and
126.31(3) geographical distribution.
126.32(c) The commissioner shall review overall status of the projects initiatives at least
126.33every two years and recommend any legislative changes needed by January 15 of each
126.34odd-numbered year.
127.1(d) The commissioner may waive administrative rule requirements which are
127.2incompatible with the implementation of the pilot project.
127.3(e) The commissioner may exempt the participating counties from fiscal sanctions
127.4for noncompliance with requirements in laws and rules which are incompatible with the
127.5implementation of the pilot project.
127.6(f) The commissioner may award grants to an entity designated by a county board or
127.7group of county boards to pay for start-up and implementation costs of the pilot project.

127.8    Sec. 3. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
127.9    Subd. 2. General provisions. (a) In the design and implementation of reforms to
127.10the mental health system, the commissioner shall:
127.11    (1) consult with consumers, families, counties, tribes, advocates, providers, and
127.12other stakeholders;
127.13    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
127.14January 15, 2008, recommendations for legislation to update the role of counties and to
127.15clarify the case management roles, functions, and decision-making authority of health
127.16plans and counties, and to clarify county retention of the responsibility for the delivery of
127.17social services as required under subdivision 3, paragraph (a);
127.18    (3) withhold implementation of any recommended changes in case management
127.19roles, functions, and decision-making authority until after the release of the report due
127.20January 15, 2008;
127.21    (4) ensure continuity of care for persons affected by these reforms including
127.22ensuring client choice of provider by requiring broad provider networks and developing
127.23mechanisms to facilitate a smooth transition of service responsibilities;
127.24    (5) provide accountability for the efficient and effective use of public and private
127.25resources in achieving positive outcomes for consumers;
127.26    (6) ensure client access to applicable protections and appeals; and
127.27    (7) make budget transfers necessary to implement the reallocation of services and
127.28client responsibilities between counties and health care programs that do not increase the
127.29state and county costs and efficiently allocate state funds.
127.30    (b) When making transfers under paragraph (a) necessary to implement movement
127.31of responsibility for clients and services between counties and health care programs,
127.32the commissioner, in consultation with counties, shall ensure that any transfer of state
127.33grants to health care programs, including the value of case management transfer grants
127.34under section 256B.0625, subdivision 20, does not exceed the value of the services being
127.35transferred for the latest 12-month period for which data is available. The commissioner
128.1may make quarterly adjustments based on the availability of additional data during the
128.2first four quarters after the transfers first occur. If case management transfer grants under
128.3section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
128.4to repeal, exceeds the value of the services being transferred, the difference becomes an
128.5ongoing part of each county's adult and children's mental health grants under sections
128.6245.4661 , 245.4889, and 256E.12.
128.7    (c) This appropriation is not authorized to be expended after December 31, 2010,
128.8unless approved by the legislature.

128.9    Sec. 4. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
128.10    Subd. 8. State-operated services account. (a) The state-operated services account is
128.11established in the special revenue fund. Revenue generated by new state-operated services
128.12listed under this section established after July 1, 2010, that are not enterprise activities must
128.13be deposited into the state-operated services account, unless otherwise specified in law:
128.14(1) intensive residential treatment services;
128.15(2) foster care services; and
128.16(3) psychiatric extensive recovery treatment services.
128.17(b) Funds deposited in the state-operated services account are available to the
128.18commissioner of human services for the purposes of:
128.19(1) providing services needed to transition individuals from institutional settings
128.20within state-operated services to the community when those services have no other
128.21adequate funding source;
128.22(2) grants to providers participating in mental health specialty treatment services
128.23under section 245.4661; and
128.24(3) to fund the operation of the Intensive Residential Treatment Service program in
128.25Willmar.

128.26    Sec. 5. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
128.27to read:
128.28    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
128.29to the account in subdivision 8 for noncovered allowable costs of a provider certified and
128.30licensed under section 256B.0622, and operating under section 246.014.

128.31    Sec. 6. Minnesota Statutes 2012, section 254B.13, is amended to read:
128.32254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
129.1    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
129.2approve and implement navigator pilot projects developed under the planning process
129.3required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
129.4enhance coordination of the delivery of chemical health services required under section
129.5254B.03 .
129.6    Subd. 2. Program design and implementation. (a) The commissioner and
129.7counties participating in the navigator pilot projects shall continue to work in partnership
129.8to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
129.979, article 7, section 26.
129.10    (b) The commissioner and counties participating in the navigator pilot projects shall
129.11complete the planning phase by June 30, 2010, and, if approved by the commissioner for
129.12implementation, enter into agreements governing the operation of the navigator pilot
129.13projects with implementation scheduled no earlier than July 1, 2010.
129.14    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
129.15participation in a navigator pilot program, an individual must:
129.16    (1) be a resident of a county with an approved navigator program;
129.17    (2) be eligible for consolidated chemical dependency treatment fund services;
129.18    (3) be a voluntary participant in the navigator program;
129.19    (4) satisfy one of the following items:
129.20    (i) have at least one severity rating of three or above in dimension four, five, or six in
129.21a comprehensive assessment under Minnesota Rules, part 9530.6422; or
129.22    (ii) have at least one severity rating of two or above in dimension four, five, or six in
129.23a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
129.24participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
129.259530.6505, or be within 60 days following discharge after participation in a Rule 31
129.26treatment program; and
129.27    (5) have had at least two treatment episodes in the past two years, not limited
129.28to episodes reimbursed by the consolidated chemical dependency treatment funds. An
129.29admission to an emergency room, a detoxification program, or a hospital may be substituted
129.30for one treatment episode if it resulted from the individual's substance use disorder.
129.31    (b) New eligibility criteria may be added as mutually agreed upon by the
129.32commissioner and participating navigator programs.
129.33    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
129.34projects under this section and report the results of the evaluation to the chairs and
129.35ranking minority members of the legislative committees with jurisdiction over chemical
129.36health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
130.1based on outcome evaluation criteria negotiated with the navigator pilot projects prior
130.2to implementation.
130.3    Subd. 4. Notice of navigator project discontinuation. Each county's participation
130.4in the navigator pilot project may be discontinued for any reason by the county or the
130.5commissioner of human services after 30 days' written notice to the other party. Any
130.6unspent funds held for the exiting county's pro rata share in the special revenue fund under
130.7the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
130.8chemical dependency treatment fund following discontinuation of the pilot project.
130.9    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
130.10this chapter, the commissioner may authorize navigator pilot projects to use chemical
130.11dependency treatment funds to pay for nontreatment navigator pilot services:
130.12    (1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
130.13(a); and
130.14    (2) by vendors in addition to those authorized under section 254B.05 when not
130.15providing chemical dependency treatment services.
130.16    (b) For purposes of this section, "nontreatment navigator pilot services" include
130.17navigator services, peer support, family engagement and support, housing support, rent
130.18subsidies, supported employment, and independent living skills.
130.19    (c) State expenditures for chemical dependency services and nontreatment navigator
130.20pilot services provided by or through the navigator pilot projects must not be greater than
130.21the chemical dependency treatment fund expected share of forecasted expenditures in the
130.22absence of the navigator pilot projects. The commissioner may restructure the schedule of
130.23payments between the state and participating counties under the local agency share and
130.24division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
130.25facilitate the operation of the navigator pilot projects.
130.26    (d) To the extent that state fiscal year expenditures within a pilot project are less
130.27than the expected share of forecasted expenditures in the absence of the pilot projects,
130.28the commissioner shall deposit the unexpended funds in a separate account within the
130.29consolidated chemical dependency treatment fund, and make these funds available for
130.30expenditure by the pilot projects the following year. To the extent that treatment and
130.31nontreatment pilot services expenditures within the pilot project exceed the amount
130.32expected in the absence of the pilot projects, the pilot project county or counties are
130.33responsible for the portion of nontreatment pilot services expenditures in excess of the
130.34otherwise expected share of forecasted expenditures.
130.35    (e) (d) The commissioner may waive administrative rule requirements that are
130.36incompatible with the implementation of the navigator pilot project, except that any
131.1chemical dependency treatment funded under this section must continue to be provided
131.2by a licensed treatment provider.
131.3    (f) (e) The commissioner shall not approve or enter into any agreement related to
131.4navigator pilot projects authorized under this section that puts current or future federal
131.5funding at risk.
131.6    (f) The commissioner shall provide participating navigator pilot projects with
131.7transactional data, reports, provider data, and other data generated by county activity to
131.8assess and measure outcomes. This information must be transmitted or made available in
131.9an acceptable form to participating navigator pilot projects at least once every six months
131.10or within a reasonable time following the commissioner's receipt of information from the
131.11counties needed to comply with this paragraph.
131.12    Subd. 6. Duties of county board. The county board, or other county entity that
131.13is approved to administer a navigator pilot project, shall:
131.14    (1) administer the navigator pilot project in a manner consistent with the objectives
131.15described in subdivision 2 and the planning process in subdivision 5;
131.16    (2) ensure that no one is denied chemical dependency treatment services for which
131.17they would otherwise be eligible under section 254A.03, subdivision 3; and
131.18    (3) provide the commissioner with timely and pertinent information as negotiated in
131.19agreements governing operation of the navigator pilot projects.
131.20    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
131.21program under subdivision 2a is excluded from mandatory enrollment in managed care
131.22until these services are included in the health plan's benefit set.
131.23    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
131.24projects implemented pursuant to subdivision 1 are authorized to continue operation after
131.25July 1, 2013, under existing agreements governing operation of the pilot projects.
131.26EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
131.27August 1, 2013. Subdivision 7 is effective July 1, 2013.

131.28    Sec. 7. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL
131.29HEALTH CARE.
131.30    Subdivision 1. Authorization for continuum of care pilot projects. The
131.31commissioner shall establish chemical dependency continuum of care pilot projects to
131.32begin implementing the measures developed with stakeholder input and identified in the
131.33report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot
131.34projects are intended to improve the effectiveness and efficiency of the service continuum
132.1for chemically dependent individuals in Minnesota while reducing duplication of efforts
132.2and promoting scientifically supported practices.
132.3    Subd. 2. Program implementation. (a) The commissioner, in coordination with
132.4representatives of the Minnesota Association of County Social Service Administrators
132.5and the Minnesota Inter-County Association, shall develop a process for identifying and
132.6selecting interested counties and providers for participation in the continuum of care pilot
132.7projects. There will be three pilot projects; one representing the northern region, one for
132.8the metro region, and one for the southern region. The selection process of counties and
132.9providers must include consideration of population size, geographic distribution, cultural
132.10and racial demographics, and provider accessibility. The commissioner shall identify
132.11counties and providers that are selected for participation in the continuum of care pilot
132.12projects no later than September 30, 2013.
132.13(b) The commissioner and entities participating in the continuum of care pilot
132.14projects shall enter into agreements governing the operation of the continuum of care pilot
132.15projects. The agreements shall identify pilot project outcomes and include timelines for
132.16implementation and beginning operation of the pilot projects.
132.17(c) Entities that are currently participating in the navigator pilot project are
132.18eligible to participate in the continuum of care pilot project subsequent to or instead of
132.19participating in the navigator pilot project.
132.20(d) The commissioner may waive administrative rule requirements that are
132.21incompatible with implementation of the continuum of care pilot projects.
132.22(e) Notwithstanding section 254A.19, the commissioner may designate noncounty
132.23entities to complete chemical use assessments and placement authorizations required
132.24under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section
132.25254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the
132.26discretion of the commissioner.
132.27    Subd. 3. Program design. (a) The operation of the pilot projects shall include:
132.28(1) new services that are responsive to the chronic nature of substance use disorder;
132.29(2) telehealth services, when appropriate to address barriers to services;
132.30(3) services that assure integration with the mental health delivery system when
132.31appropriate;
132.32(4) services that address the needs of diverse populations; and
132.33(5) an assessment and access process that permits clients to present directly to a
132.34service provider for a substance use disorder assessment and authorization of services.
132.35(b) Prior to implementation of the continuum of care pilot projects, a utilization
132.36review process must be developed and agreed to by the commissioner, participating
133.1counties, and providers. The utilization review process shall be described in the
133.2agreements governing operation of the continuum of care pilot projects.
133.3    Subd. 4. Notice of project discontinuation. Each entity's participation in the
133.4continuum of care pilot project may be discontinued for any reason by the county or the
133.5commissioner after 30 days' written notice to the entity.
133.6    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
133.7chapter, the commissioner may authorize chemical dependency treatment funds to pay for
133.8nontreatment services arranged by continuum of care pilot projects. Individuals who are
133.9currently accessing Rule 31 treatment services are eligible for concurrent participation in
133.10the continuum of care pilot projects.
133.11(b) County expenditures for continuum of care pilot project services shall not
133.12be greater than their expected share of forecasted expenditures in the absence of the
133.13continuum of care pilot projects.
133.14EFFECTIVE DATE.This section is effective August 1, 2013.

133.15    Sec. 8. [256.478] HOME AND COMMUNITY-BASED SERVICES
133.16TRANSITIONS GRANTS.
133.17(a) The commissioner shall make available home and community-based services
133.18transition grants to serve individuals who do not meet eligibility criteria for the medical
133.19assistance program under section 256B.056 or 256B.057, but who otherwise meet the
133.20criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24.
133.21(b) For the purposes of this section, the commissioner has the authority to transfer
133.22funds between the medical assistance account and the home and community-based
133.23services transitions grants account.
133.24EFFECTIVE DATE.This section is effective July 1, 2015.

133.25    Sec. 9. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
133.26    Subd. 2. Definitions. For purposes of this section, the following terms have the
133.27meanings given them.
133.28(a) "Adult rehabilitative mental health services" means mental health services
133.29which are rehabilitative and enable the recipient to develop and enhance psychiatric
133.30stability, social competencies, personal and emotional adjustment, and independent living,
133.31parenting skills, and community skills, when these abilities are impaired by the symptoms
133.32of mental illness. Adult rehabilitative mental health services are also appropriate when
133.33provided to enable a recipient to retain stability and functioning, if the recipient would
134.1be at risk of significant functional decompensation or more restrictive service settings
134.2without these services.
134.3(1) Adult rehabilitative mental health services instruct, assist, and support the
134.4recipient in areas such as: interpersonal communication skills, community resource
134.5utilization and integration skills, crisis assistance, relapse prevention skills, health care
134.6directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
134.7and nutrition skills, transportation skills, medication education and monitoring, mental
134.8illness symptom management skills, household management skills, employment-related
134.9skills, parenting skills, and transition to community living services.
134.10(2) These services shall be provided to the recipient on a one-to-one basis in the
134.11recipient's home or another community setting or in groups.
134.12(b) "Medication education services" means services provided individually or in
134.13groups which focus on educating the recipient about mental illness and symptoms; the role
134.14and effects of medications in treating symptoms of mental illness; and the side effects of
134.15medications. Medication education is coordinated with medication management services
134.16and does not duplicate it. Medication education services are provided by physicians,
134.17pharmacists, physician's assistants, or registered nurses.
134.18(c) "Transition to community living services" means services which maintain
134.19continuity of contact between the rehabilitation services provider and the recipient and
134.20which facilitate discharge from a hospital, residential treatment program under Minnesota
134.21Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
134.22living services are not intended to provide other areas of adult rehabilitative mental health
134.23services.

134.24    Sec. 10. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
134.25subdivision to read:
134.26    Subd. 35c. School-linked mental health services. Medical assistance covers mental
134.27health services provided in a school as part of a school-linked mental health program by
134.28an individual who is licensed by the Board of Behavioral Health and Therapy, Board of
134.29Marriage and Family Therapy, Board of Psychology, or Board of Social Work, and who also
134.30meets the definition of a mental health practitioner under section 245.462, subdivision 17,
134.31or 245.4871, subdivision 26. For purposes of this subdivision, an individual who meets the
134.32definition of mental health practitioner under section 245.462, subdivision 17, or 245.4871,
134.33subdivision 26, is not limited to having less than 4,000 hours of post-master's experience.
134.34The mental health practitioner must be supervised by a licensed mental health professional.

135.1    Sec. 11. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to
135.2read:
135.3    Subd. 48. Psychiatric consultation to primary care practitioners. Effective
135.4January 1, 2006, Medical assistance covers consultation provided by a psychiatrist or
135.5psychologist via telephone, e-mail, facsimile, or other means of communication to primary
135.6care practitioners, including pediatricians. The need for consultation and the receipt of the
135.7consultation must be documented in the patient record maintained by the primary care
135.8practitioner. If the patient consents, and subject to federal limitations and data privacy
135.9provisions, the consultation may be provided without the patient present.

135.10    Sec. 12. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
135.11subdivision to read:
135.12    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
135.13federal approval, whichever is later, medical assistance covers family psychoeducation
135.14services provided to a child up to age 21 with a diagnosed mental health condition when
135.15identified in the child's individual treatment plan and provided by a licensed mental health
135.16professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
135.17clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
135.18has determined it medically necessary to involve family members in the child's care. For
135.19the purposes of this subdivision, "family psychoeducation services" means information
135.20or demonstration provided to an individual or family as part of an individual, family,
135.21multifamily group, or peer group session to explain, educate, and support the child and
135.22family in understanding a child's symptoms of mental illness, the impact on the child's
135.23development, and needed components of treatment and skill development so that the
135.24individual, family, or group can help the child to prevent relapse, prevent the acquisition
135.25of comorbid disorders, and to achieve optimal mental health and long-term resilience.

135.26    Sec. 13. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
135.27subdivision to read:
135.28    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
135.29federal approval, whichever is later, medical assistance covers clinical care consultation
135.30for a person up to age 21 who is diagnosed with a complex mental health condition or a
135.31mental health condition that co-occurs with other complex and chronic conditions, when
135.32described in the person's individual treatment plan and provided by a licensed mental
135.33health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
135.34the purposes of this subdivision, "clinical care consultation" means communication from a
136.1treating mental health professional to other providers not under the clinical supervision of
136.2the treating mental health professional who are working with the same client to inform,
136.3inquire, and instruct regarding the client's symptoms; strategies for effective engagement,
136.4care, and intervention needs; and treatment expectations across service settings; and to
136.5direct and coordinate clinical service components provided to the client and family.

136.6    Sec. 14. Minnesota Statutes 2012, section 256B.092, is amended by adding a
136.7subdivision to read:
136.8    Subd. 13. Waiver allocations for transition populations. (a) The commissioner
136.9shall make available additional waiver allocations and additional necessary resources
136.10to assure timely discharges from the Anoka Metro Regional Treatment Center and the
136.11Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
136.12(1) are otherwise eligible for the developmental disabilities waiver under this section;
136.13(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
136.14the Minnesota Security Hospital;
136.15(3) whose discharge would be significantly delayed without the available waiver
136.16allocation; and
136.17(4) who have met treatment objectives and no longer meet hospital level of care.
136.18(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
136.19requirements of the federal approved waiver plan.
136.20(c) Any corporate foster care home developed under this subdivision must be
136.21considered an exception under section 245A.03, subdivision 7, paragraph (a).
136.22EFFECTIVE DATE.This section is effective July 1, 2015.

136.23    Sec. 15. Minnesota Statutes 2012, section 256B.0946, is amended to read:
136.24256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
136.25    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
136.26 upon enactment and subject to federal approval, medical assistance covers medically
136.27necessary intensive treatment services described under paragraph (b) that are provided
136.28by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
136.29who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
136.30to 2960.3340.
136.31(b) Intensive treatment services to children with severe emotional disturbance mental
136.32illness residing in treatment foster care family settings must meet the relevant standards
136.33for mental health services under sections 245.487 to 245.4889. In addition, that comprise
137.1 specific required service components provided in clauses (1) to (5), are reimbursed by
137.2medical assistance must when they meet the following standards:
137.3(1) case management service component must meet the standards in Minnesota
137.4Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
137.5(1) psychotherapy provided by a mental health professional as defined in Minnesota
137.6Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
137.7Rules, part 9505.0371, subpart 5, item C;
137.8(2) psychotherapy, crisis assistance, and skills training components must meet the
137.9 provided according to standards for children's therapeutic services and supports in section
137.10256B.0943 ; and
137.11(3) individual family, and group psychoeducation services under supervision of,
137.12defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
137.13clinical trainee;
137.14(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
137.15health professional or a clinical trainee; and
137.16(5) service delivery payment requirements as provided under subdivision 4.
137.17    Subd. 1a. Definitions. For the purposes of this section, the following terms have
137.18the meanings given them.
137.19(a) "Clinical care consultation" means communication from a treating clinician to
137.20other providers working with the same client to inform, inquire, and instruct regarding
137.21the client's symptoms, strategies for effective engagement, care and intervention needs,
137.22and treatment expectations across service settings, including but not limited to the client's
137.23school, social services, day care, probation, home, primary care, medication prescribers,
137.24disabilities services, and other mental health providers and to direct and coordinate clinical
137.25service components provided to the client and family.
137.26(b) "Clinical supervision" means the documented time a clinical supervisor and
137.27supervisee spend together to discuss the supervisee's work, to review individual client
137.28cases, and for the supervisee's professional development. It includes the documented
137.29oversight and supervision responsibility for planning, implementation, and evaluation of
137.30services for a client's mental health treatment.
137.31(c) "Clinical supervisor" means the mental health professional who is responsible
137.32for clinical supervision.
137.33(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
137.34subpart 5, item C;
138.1(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
138.2including the development of a plan that addresses prevention and intervention strategies
138.3to be used in a potential crisis, but does not include actual crisis intervention.
138.4(f) "Culturally appropriate" means providing mental health services in a manner that
138.5incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
138.6subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
138.7strengths and resources to promote overall wellness.
138.8(g) "Culture" means the distinct ways of living and understanding the world that
138.9are used by a group of people and are transmitted from one generation to another or
138.10adopted by an individual.
138.11(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
138.129505.0370, subpart 11.
138.13(i) "Family" means a person who is identified by the client or the client's parent or
138.14guardian as being important to the client's mental health treatment. Family may include,
138.15but is not limited to, parents, foster parents, children, spouse, committed partners, former
138.16spouses, persons related by blood or adoption, persons who are a part of the client's
138.17permanency plan, or persons who are presently residing together as a family unit.
138.18(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
138.19(k) "Foster family setting" means the foster home in which the license holder resides.
138.20(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
138.219505.0370, subpart 15.
138.22(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
138.239505.0370, subpart 17.
138.24(n) "Mental health professional" has the meaning given in Minnesota Rules, part
138.259505.0370, subpart 18.
138.26(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
138.27subpart 20.
138.28(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
138.29(q) "Psychoeducation services" means information or demonstration provided to
138.30an individual, family, or group to explain, educate, and support the individual, family, or
138.31group in understanding a child's symptoms of mental illness, the impact on the child's
138.32development, and needed components of treatment and skill development so that the
138.33individual, family, or group can help the child to prevent relapse, prevent the acquisition
138.34of comorbid disorders, and to achieve optimal mental health and long-term resilience.
138.35(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
138.36subpart 27.
139.1(s) "Team consultation and treatment planning" means the coordination of treatment
139.2plans and consultation among providers in a group concerning the treatment needs of the
139.3child, including disseminating the child's treatment service schedule to all members of the
139.4service team. Team members must include all mental health professionals working with
139.5the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
139.6and at least two of the following: an individualized education program case manager;
139.7probation agent; children's mental health case manager; child welfare worker, including
139.8adoption or guardianship worker; primary care provider; foster parent; and any other
139.9member of the child's service team.
139.10    Subd. 2. Determination of client eligibility. A client's eligibility to receive
139.11treatment foster care under this section shall be determined by An eligible recipient is an
139.12individual, from birth through age 20, who is currently placed in a foster home licensed
139.13under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
139.14assessment, and an evaluation of level of care needed, and development of an individual
139.15treatment plan, as defined in paragraphs (a) to (c) and (b).
139.16(a) The diagnostic assessment must:
139.17(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
139.18conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
139.19worker that is mental health professional or a clinical trainee;
139.20(2) determine whether or not a child meets the criteria for mental illness, as defined
139.21in Minnesota Rules, part 9505.0370, subpart 20;
139.22(3) document that intensive treatment services are medically necessary within a
139.23foster family setting to ameliorate identified symptoms and functional impairments;
139.24(4) be performed within 180 days prior to before the start of service; and
139.25(2) include current diagnoses on all five axes of the client's current mental health
139.26status;
139.27(3) determine whether or not a child meets the criteria for severe emotional
139.28disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
139.29in section 245.462, subdivision 20; and
139.30(4) be completed annually until age 18. For individuals between age 18 and 21,
139.31unless a client's mental health condition has changed markedly since the client's most
139.32recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
139.33"updating" means a written summary, including current diagnoses on all five axes, by a
139.34mental health professional of the client's current mental status and service needs.
139.35(5) be completed as either a standard or extended diagnostic assessment annually to
139.36determine continued eligibility for the service.
140.1(b) The evaluation of level of care must be conducted by the placing county with
140.2an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
140.3described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
140.4 approved by the commissioner of human services and not subject to the rulemaking
140.5process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
140.6evaluation demonstrates that the child requires intensive intervention without 24-hour
140.7medical monitoring. The commissioner shall update the list of approved level of care
140.8instruments tools annually and publish on the department's Web site.
140.9(c) The individual treatment plan must be:
140.10(1) based on the information in the client's diagnostic assessment;
140.11(2) developed through a child-centered, family driven planning process that identifies
140.12service needs and individualized, planned, and culturally appropriate interventions that
140.13contain specific measurable treatment goals and objectives for the client and treatment
140.14strategies for the client's family and foster family;
140.15(3) reviewed at least once every 90 days and revised; and
140.16(4) signed by the client or, if appropriate, by the client's parent or other person
140.17authorized by statute to consent to mental health services for the client.
140.18    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
140.19intensive children's mental health services in a foster family setting must be certified
140.20by the state and have a service provision contract with a county board or a reservation
140.21tribal council and must be able to demonstrate the ability to provide all of the services
140.22required in this section.
140.23(b) For purposes of this section, a provider agency must have an individual
140.24placement agreement for each recipient and must be a licensed child placing agency, under
140.25Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
140.26(1) a county county-operated entity certified by the state;
140.27(2) an Indian Health Services facility operated by a tribe or tribal organization under
140.28funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
140.29Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
140.30(3) a noncounty entity under contract with a county board.
140.31(c) Certified providers that do not meet the service delivery standards required in
140.32this section shall be subject to a decertification process.
140.33(d) For the purposes of this section, all services delivered to a client must be
140.34provided by a mental health professional or a clinical trainee.
140.35    Subd. 4. Eligible provider responsibilities Service delivery payment
140.36requirements. (a) To be an eligible provider for payment under this section, a provider
141.1must develop and practice written policies and procedures for treatment foster care services
141.2 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
141.3(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
141.4(b) In delivering services under this section, a treatment foster care provider must
141.5ensure that staff caseload size reasonably enables the provider to play an active role in
141.6service planning, monitoring, delivering, and reviewing for discharge planning to meet
141.7the needs of the client, the client's foster family, and the birth family, as specified in each
141.8client's individual treatment plan.
141.9(b) A qualified clinical supervisor, as defined in and performing in compliance with
141.10Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
141.11provision of services described in this section.
141.12(c) Each client receiving treatment services must receive an extended diagnostic
141.13assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
141.1430 days of enrollment in this service unless the client has a previous extended diagnostic
141.15assessment that the client, parent, and mental health professional agree still accurately
141.16describes the client's current mental health functioning.
141.17(d) Each previous and current mental health, school, and physical health treatment
141.18provider must be contacted to request documentation of treatment and assessments that the
141.19eligible client has received and this information must be reviewed and incorporated into
141.20the diagnostic assessment and team consultation and treatment planning review process.
141.21(e) Each client receiving treatment must be assessed for a trauma history and
141.22the client's treatment plan must document how the results of the assessment will be
141.23incorporated into treatment.
141.24(f) Each client receiving treatment services must have an individual treatment plan
141.25that is reviewed, evaluated, and signed every 90 days using the team consultation and
141.26treatment planning process, as defined in subdivision 1a, paragraph (s).
141.27(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
141.28in accordance with the client's individual treatment plan.
141.29(h) Each client must have a crisis assistance plan within ten days of initiating
141.30services and must have access to clinical phone support 24 hours per day, seven days per
141.31week, during the course of treatment, and the crisis plan must demonstrate coordination
141.32with the local or regional mobile crisis intervention team.
141.33(i) Services must be delivered and documented at least three days per week, equaling
141.34at least six hours of treatment per week, unless reduced units of service are specified on
141.35the treatment plan as part of transition or on a discharge plan to another service or level of
141.36care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
142.1(j) Location of service delivery must be in the client's home, day care setting,
142.2school, or other community-based setting that is specified on the client's individualized
142.3treatment plan.
142.4(k) Treatment must be developmentally and culturally appropriate for the client.
142.5(l) Services must be delivered in continual collaboration and consultation with the
142.6client's medical providers and, in particular, with prescribers of psychotropic medications,
142.7including those prescribed on an off-label basis, and members of the service team must be
142.8aware of the medication regimen and potential side effects.
142.9(m) Parents, siblings, foster parents, and members of the child's permanency plan
142.10must be involved in treatment and service delivery unless otherwise noted in the treatment
142.11plan.
142.12(n) Transition planning for the child must be conducted starting with the first
142.13treatment plan and must be addressed throughout treatment to support the child's
142.14permanency plan and postdischarge mental health service needs.
142.15    Subd. 5. Service authorization. The commissioner will administer authorizations
142.16for services under this section in compliance with section 256B.0625, subdivision 25.
142.17    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
142.18under this section and are not eligible for medical assistance payment as components of
142.19intensive treatment in foster care services, but may be billed separately:
142.20(1) treatment foster care services provided in violation of medical assistance policy
142.21in Minnesota Rules, part 9505.0220;
142.22(2) service components of children's therapeutic services and supports
142.23simultaneously provided by more than one treatment foster care provider;
142.24(3) home and community-based waiver services; and
142.25(4) treatment foster care services provided to a child without a level of care
142.26determination according to section 245.4885, subdivision 1.
142.27(1) inpatient psychiatric hospital treatment;
142.28(2) mental health targeted case management;
142.29(3) partial hospitalization;
142.30(4) medication management;
142.31(5) children's mental health day treatment services;
142.32(6) crisis response services under section 256B.0944; and
142.33(7) transportation.
142.34(b) Children receiving intensive treatment in foster care services are not eligible for
142.35medical assistance reimbursement for the following services while receiving intensive
142.36treatment in foster care:
143.1(1) mental health case management services under section 256B.0625, subdivision
143.220 ; and
143.3(2) (1) psychotherapy and skill skills training components of children's therapeutic
143.4services and supports under section 256B.0625, subdivision 35b.;
143.5(2) mental health behavioral aide services as defined in section 256B.0943,
143.6subdivision 1, paragraph (m);
143.7(3) home and community-based waiver services;
143.8(4) mental health residential treatment; and
143.9(5) room and board costs as defined in section 256I.03, subdivision 6.
143.10    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
143.11establish a single daily per-client encounter rate for intensive treatment in foster care
143.12services. The rate must be constructed to cover only eligible services delivered to an
143.13eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

143.14    Sec. 16. Minnesota Statutes 2012, section 256B.49, is amended by adding a
143.15subdivision to read:
143.16    Subd. 24. Waiver allocations for transition populations. (a) The commissioner
143.17shall make available additional waiver allocations and additional necessary resources
143.18to assure timely discharges from the Anoka Metro Regional Treatment Center and the
143.19Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
143.20(1) are otherwise eligible for the brain injury, community alternatives for disabled
143.21individuals, or community alternative care waivers under this section;
143.22(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
143.23the Minnesota Security Hospital;
143.24(3) whose discharge would be significantly delayed without the available waiver
143.25allocation; and
143.26(4) who have met treatment objectives and no longer meet hospital level of care.
143.27(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
143.28requirements of the federal approved waiver plan.
143.29(c) Any corporate foster care home developed under this subdivision must be
143.30considered an exception under section 245A.03, subdivision 7, paragraph (a).
143.31EFFECTIVE DATE.This section is effective July 1, 2015.

143.32    Sec. 17. Minnesota Statutes 2012, section 256B.761, is amended to read:
143.33256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
144.1(a) Effective for services rendered on or after July 1, 2001, payment for medication
144.2management provided to psychiatric patients, outpatient mental health services, day
144.3treatment services, home-based mental health services, and family community support
144.4services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
144.550th percentile of 1999 charges.
144.6(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
144.7services provided by an entity that operates: (1) a Medicare-certified comprehensive
144.8outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
144.91993, with at least 33 percent of the clients receiving rehabilitation services in the most
144.10recent calendar year who are medical assistance recipients, will be increased by 38 percent,
144.11when those services are provided within the comprehensive outpatient rehabilitation
144.12facility and provided to residents of nursing facilities owned by the entity.
144.13(c) The commissioner shall establish three levels of payment for mental health
144.14diagnostic assessment, based on three levels of complexity. The aggregate payment under
144.15the tiered rates must not exceed the projected aggregate payments for mental health
144.16diagnostic assessment under the previous single rate. The new rate structure is effective
144.17January 1, 2011, or upon federal approval, whichever is later.
144.18(d) In addition to rate increases otherwise provided, the commissioner may
144.19restructure coverage policy and rates to improve access to adult rehabilitative mental
144.20health services under section 256B.0623 and related mental health support services under
144.21section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
144.222016, the projected state share of increased costs due to this paragraph is transferred
144.23from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
144.24fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
144.25made to managed care plans and county-based purchasing plans under sections 256B.69,
144.26256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

144.27    Sec. 18. STATE ASSISTANCE TO COUNTIES; TRANSITIONS FOR HIGH
144.28NEEDS POPULATIONS.
144.29(a) Effective immediately, the commissioner of human services shall work with
144.30counties that request assistance to assure timely discharge from Anoka Metro Regional
144.31Treatment Center and the Minnesota Security Hospital for individuals who are ready
144.32for discharge but for whom the county may not have provider resources or appropriate
144.33placement available. Special consideration must be given to uninsured individuals who are
144.34not eligible for medical assistance and who may need continued treatment, and individuals
145.1with complex needs and other factors that hinder county efforts to place the individual in a
145.2safe, affordable setting.
145.3(b) The commissioner shall assure that, given Olmstead court directives and the
145.4role family and friends play in treatment progress, metropolitan area residents are asked
145.5whether they wished to be placed in an Intensive Residential Treatment Service program
145.6at Willmar or Cambridge or to be placed in a location more accessible to family, friends,
145.7and health providers.

145.8    Sec. 19. INSTRUCTIONS TO THE COMMISSIONER.
145.9In consultation with labor organizations, the commissioner of human services shall
145.10develop clear and consistent standards for state-operated services programs to:
145.11(1) address direct service staffing shortages;
145.12(2) identify and help resolve workplace safety issues; and
145.13(3) elevate the use and visibility of performance measures and objectives related to
145.14overtime use.


145.17    Section 1. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
145.18    Subd. 7. Use of data. (a) Except as otherwise provided in subdivision 7a or sections
145.19244.052 and 299C.093, the data provided under this section is private data on individuals
145.20under section 13.02, subdivision 12.
145.21(b) The data may be used only for by law enforcement and corrections agencies for
145.22 law enforcement and corrections purposes.
145.23(c) The commissioner of human services is authorized to have access to the data for:
145.24(1) state-operated services, as defined in section 246.014, are also authorized to
145.25have access to the data for the purposes described in section 246.13, subdivision 2,
145.26paragraph (b); and
145.27(2) purposes of completing background studies under chapter 245C.

145.28    Sec. 2. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision
145.29to read:
145.30    Subd. 4a. Agency background studies. (a) The commissioner shall develop
145.31and implement an electronic process for the regular transfer of new criminal history
145.32information that is added to the Minnesota court information system. The commissioner's
145.33system must include for review only information that relates to individuals who have been
146.1the subject of a background study under this chapter that remain affiliated with the agency
146.2that initiated the background study. For purposes of this paragraph, an individual remains
146.3affiliated with an agency that initiated the background study until the agency informs the
146.4commissioner that the individual is no longer affiliated. When any individual no longer
146.5affiliated according to this paragraph returns to a position requiring a background study
146.6under this chapter, the agency with whom the individual is again affiliated shall initiate
146.7a new background study regardless of the length of time the individual was no longer
146.8affiliated with the agency.
146.9(b) The commissioner shall develop and implement an online system for agencies that
146.10initiate background studies under this chapter to access and maintain records of background
146.11studies initiated by that agency. The system must show all active background study subjects
146.12affiliated with that agency and the status of each individual's background study. Each
146.13agency that initiates background studies must use this system to notify the commissioner
146.14of discontinued affiliation for purposes of the processes required under paragraph (a).

146.15    Sec. 3. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
146.16    Subdivision 1. Background studies conducted by Department of Human
146.17Services. (a) For a background study conducted by the Department of Human Services,
146.18the commissioner shall review:
146.19    (1) information related to names of substantiated perpetrators of maltreatment of
146.20vulnerable adults that has been received by the commissioner as required under section
146.21626.557, subdivision 9c , paragraph (j);
146.22    (2) the commissioner's records relating to the maltreatment of minors in licensed
146.23programs, and from findings of maltreatment of minors as indicated through the social
146.24service information system;
146.25    (3) information from juvenile courts as required in subdivision 4 for individuals
146.26listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
146.27    (4) information from the Bureau of Criminal Apprehension, including information
146.28regarding a background study subject's registration in Minnesota as a predatory offender
146.29under section 243.166;
146.30    (5) except as provided in clause (6), information from the national crime information
146.31system when the commissioner has reasonable cause as defined under section 245C.05,
146.32subdivision 5; and
146.33    (6) for a background study related to a child foster care application for licensure or
146.34adoptions, the commissioner shall also review:
147.1    (i) information from the child abuse and neglect registry for any state in which the
147.2background study subject has resided for the past five years; and
147.3    (ii) information from national crime information databases, when the background
147.4study subject is 18 years of age or older.
147.5    (b) Notwithstanding expungement by a court, the commissioner may consider
147.6information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
147.7received notice of the petition for expungement and the court order for expungement is
147.8directed specifically to the commissioner.
147.9    (c) The commissioner shall also review criminal history information received
147.10according to section 245C.04, subdivision 4a, from the Minnesota court information
147.11system that relates to individuals who have already been studied under this chapter and
147.12who remain affiliated with the agency that initiated the background study.

147.13    Sec. 4. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
147.14    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
147.15Medicare and Medicaid Services determines that a provider is designated "high-risk," the
147.16commissioner may withhold payment from providers within that category upon initial
147.17enrollment for a 90-day period. The withholding for each provider must begin on the date
147.18of the first submission of a claim.
147.19(b) An enrolled provider that is also licensed by the commissioner under chapter
147.20245A must designate an individual as the entity's compliance officer. The compliance
147.21officer must:
147.22(1) develop policies and procedures to assure adherence to medical assistance laws
147.23and regulations and to prevent inappropriate claims submissions;
147.24(2) train the employees of the provider entity, and any agents or subcontractors of
147.25the provider entity including billers, on the policies and procedures under clause (1);
147.26(3) respond to allegations of improper conduct related to the provision or billing of
147.27medical assistance services, and implement action to remediate any resulting problems;
147.28(4) use evaluation techniques to monitor compliance with medical assistance laws
147.29and regulations;
147.30(5) promptly report to the commissioner any identified violations of medical
147.31assistance laws or regulations; and
147.32    (6) within 60 days of discovery by the provider of a medical assistance
147.33reimbursement overpayment, report the overpayment to the commissioner and make
147.34arrangements with the commissioner for the commissioner's recovery of the overpayment.
148.1The commissioner may require, as a condition of enrollment in medical assistance, that a
148.2provider within a particular industry sector or category establish a compliance program that
148.3contains the core elements established by the Centers for Medicare and Medicaid Services.
148.4(c) The commissioner may revoke the enrollment of an ordering or rendering
148.5provider for a period of not more than one year, if the provider fails to maintain and, upon
148.6request from the commissioner, provide access to documentation relating to written orders
148.7or requests for payment for durable medical equipment, certifications for home health
148.8services, or referrals for other items or services written or ordered by such provider, when
148.9the commissioner has identified a pattern of a lack of documentation. A pattern means a
148.10failure to maintain documentation or provide access to documentation on more than one
148.11occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a
148.12provider under the provisions of section 256B.064.
148.13(d) The commissioner shall terminate or deny the enrollment of any individual or
148.14entity if the individual or entity has been terminated from participation in Medicare or
148.15under the Medicaid program or Children's Health Insurance Program of any other state.
148.16(e) As a condition of enrollment in medical assistance, the commissioner shall
148.17require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
148.18and Medicaid Services or the Minnesota Department of Human Services commissioner
148.19 permit the Centers for Medicare and Medicaid Services, its agents, or its designated
148.20contractors and the state agency, its agents, or its designated contractors to conduct
148.21unannounced on-site inspections of any provider location. The commissioner shall publish
148.22in the Minnesota Health Care Program Provider Manual a list of provider types designated
148.23"limited," "moderate," or "high-risk," based on the criteria and standards used to designate
148.24Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and
148.25criteria are not subject to the requirements of chapter 14. The commissioner's designations
148.26are not subject to administrative appeal.
148.27(f) As a condition of enrollment in medical assistance, the commissioner shall
148.28require that a high-risk provider, or a person with a direct or indirect ownership interest in
148.29the provider of five percent or higher, consent to criminal background checks, including
148.30fingerprinting, when required to do so under state law or by a determination by the
148.31commissioner or the Centers for Medicare and Medicaid Services that a provider is
148.32designated high-risk for fraud, waste, or abuse.
148.33(g) As a condition of enrollment, all durable medical equipment, prosthetics,
148.34orthotics, and supplies (DMEPOS) suppliers operating in Minnesota are required to name
148.35the Department of Human Services, in addition to the Centers for Medicare and Medicaid
148.36Services, as an obligee on all surety performance bonds required pursuant to section
149.14312(a) of the Balanced Budget Act of 1997, Public Law 105-33, amending Social
149.2Security Act, section 1834(a). The performance bond must also allow for recovery of
149.3costs and fees in pursuing a claim on the bond.
149.4(h) The Department of Human Services may require a provider to purchase a
149.5performance surety bond as a condition of initial enrollment, reenrollment, reinstatement,
149.6or continued enrollment if: (1) the provider fails to demonstrate financial viability, (2) the
149.7department determines there is significant evidence of or potential for fraud and abuse by
149.8the provider, or (3) the provider or category of providers is designated high-risk pursuant
149.9to paragraph (a) and as per Code of Federal Regulations, title 42, section 455.450, or the
149.10department otherwise finds it is in the best interest of the Medicaid program to do so. The
149.11performance bond must be in an amount of $100,000 or ten percent of the provider's
149.12payments from Medicaid during the immediately preceding 12 months, whichever is
149.13greater. The performance bond must name the Department of Human Services as an
149.14obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.
149.15EFFECTIVE DATE.This section is effective the day following final enactment.

149.16    Sec. 5. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
149.17to read:
149.18    Subd. 22. Application fee. (a) The commissioner must collect and retain federally
149.19required nonrefundable application fees to pay for provider screening activities in
149.20accordance with Code of Federal Regulations, title 42, section 455, subpart E. The
149.21enrollment application must be made under the procedures specified by the commissioner,
149.22in the form specified by the commissioner, and accompanied by an application fee
149.23described in paragraph (b), or a request for a hardship exception as described in the
149.24specified procedures. Application fees must be deposited in the provider screening account
149.25in the special revenue fund. Amounts in the provider screening account are appropriated
149.26to the commissioner for costs associated with the provider screening activities required
149.27in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner
149.28shall conduct screening activities as required by Code of Federal Regulations, title 42,
149.29section 455, subpart E, and as otherwise provided by law, to include database checks,
149.30unannounced pre- and postenrollment site visits, fingerprinting, and criminal background
149.31studies. The commissioner must revalidate all providers under this subdivision at least
149.32once every five years.
149.33(b) The application fee under this subdivision is $532 for the calendar year 2013.
149.34For calendar year 2014 and subsequent years, the fee:
150.1(1) is adjusted by the percentage change to the consumer price index for all urban
150.2consumers, United States city average, for the 12-month period ending with June of the
150.3previous year. The resulting fee must be announced in the Federal Register;
150.4(2) is effective from January 1 to December 31 of a calendar year;
150.5(3) is required on the submission of an initial application, an application to establish
150.6a new practice location, an application for re-enrollment when the provider is not enrolled
150.7at the time of application of re-enrollment, or at revalidation when required by federal
150.8regulation; and
150.9(4) must be in the amount in effect for the calendar year during which the application
150.10for enrollment, new practice location, or re-enrollment is being submitted.
150.11(c) The application fee under this subdivision cannot be charged to:
150.12(1) providers who are enrolled in Medicare or who provide documentation of
150.13payment of the fee to, and enrollment with, another state;
150.14(2) providers who are enrolled but are required to submit new applications for
150.15purposes of re-enrollment; or
150.16(3) a provider who enrolls as an individual.
150.17EFFECTIVE DATE.This section is effective the day following final enactment.

150.18    Sec. 6. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
150.19    Subd. 1a. Grounds for sanctions against vendors. The commissioner may
150.20impose sanctions against a vendor of medical care for any of the following: (1) fraud,
150.21theft, or abuse in connection with the provision of medical care to recipients of public
150.22assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
150.23not medically necessary; (3) a pattern of making false statements of material facts for
150.24the purpose of obtaining greater compensation than that to which the vendor is legally
150.25entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
150.26agency access during regular business hours to examine all records necessary to disclose
150.27the extent of services provided to program recipients and appropriateness of claims for
150.28payment; (6) failure to repay an overpayment or a fine finally established under this
150.29section; and (7) failure to correct errors in the maintenance of health service or financial
150.30records for which a fine was imposed or after issuance of a warning by the commissioner;
150.31and (8) any reason for which a vendor could be excluded from participation in the
150.32Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
150.33The determination of services not medically necessary may be made by the commissioner
150.34in consultation with a peer advisory task force appointed by the commissioner on the
151.1recommendation of appropriate professional organizations. The task force expires as
151.2provided in section 15.059, subdivision 5.

151.3    Sec. 7. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
151.4    Subd. 1b. Sanctions available. The commissioner may impose the following
151.5sanctions for the conduct described in subdivision 1a: suspension or withholding of
151.6payments to a vendor and suspending or terminating participation in the program, or
151.7imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
151.8this section, the commissioner shall consider the nature, chronicity, or severity of the
151.9conduct and the effect of the conduct on the health and safety of persons served by the
151.10vendor. Regardless of imposition of sanctions, the commissioner may make a referral
151.11to the appropriate state licensing board.

151.12    Sec. 8. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
151.13    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
151.14shall determine any monetary amounts to be recovered and sanctions to be imposed upon
151.15a vendor of medical care under this section. Except as provided in paragraphs (b) and
151.16(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
151.17without prior notice and an opportunity for a hearing, according to chapter 14, on the
151.18commissioner's proposed action, provided that the commissioner may suspend or reduce
151.19payment to a vendor of medical care, except a nursing home or convalescent care facility,
151.20after notice and prior to the hearing if in the commissioner's opinion that action is
151.21necessary to protect the public welfare and the interests of the program.
151.22(b) Except when the commissioner finds good cause not to suspend payments under
151.23Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
151.24withhold or reduce payments to a vendor of medical care without providing advance
151.25notice of such withholding or reduction if either of the following occurs:
151.26(1) the vendor is convicted of a crime involving the conduct described in subdivision
151.271a; or
151.28(2) the commissioner determines there is a credible allegation of fraud for which an
151.29investigation is pending under the program. A credible allegation of fraud is an allegation
151.30which has been verified by the state, from any source, including but not limited to:
151.31(i) fraud hotline complaints;
151.32(ii) claims data mining; and
151.33(iii) patterns identified through provider audits, civil false claims cases, and law
151.34enforcement investigations.
152.1Allegations are considered to be credible when they have an indicia of reliability
152.2and the state agency has reviewed all allegations, facts, and evidence carefully and acts
152.3judiciously on a case-by-case basis.
152.4(c) The commissioner must send notice of the withholding or reduction of payments
152.5under paragraph (b) within five days of taking such action unless requested in writing by a
152.6law enforcement agency to temporarily withhold the notice. The notice must:
152.7(1) state that payments are being withheld according to paragraph (b);
152.8(2) set forth the general allegations as to the nature of the withholding action, but
152.9need not disclose any specific information concerning an ongoing investigation;
152.10(3) except in the case of a conviction for conduct described in subdivision 1a, state
152.11that the withholding is for a temporary period and cite the circumstances under which
152.12withholding will be terminated;
152.13(4) identify the types of claims to which the withholding applies; and
152.14(5) inform the vendor of the right to submit written evidence for consideration by
152.15the commissioner.
152.16The withholding or reduction of payments will not continue after the commissioner
152.17determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
152.18relating to the alleged fraud are completed, unless the commissioner has sent notice of
152.19intention to impose monetary recovery or sanctions under paragraph (a).
152.20(d) The commissioner shall suspend or terminate a vendor's participation in the
152.21program without providing advance notice and an opportunity for a hearing when the
152.22suspension or termination is required because of the vendor's exclusion from participation
152.23in Medicare. Within five days of taking such action, the commissioner must send notice of
152.24the suspension or termination. The notice must:
152.25(1) state that suspension or termination is the result of the vendor's exclusion from
152.26Medicare;
152.27(2) identify the effective date of the suspension or termination; and
152.28(3) inform the vendor of the need to be reinstated to Medicare before reapplying
152.29for participation in the program.
152.30(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
152.31sanction is to be imposed, a vendor may request a contested case, as defined in section
152.3214.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
152.33appeal request must be received by the commissioner no later than 30 days after the date
152.34the notification of monetary recovery or sanction was mailed to the vendor. The appeal
152.35request must specify:
153.1(1) each disputed item, the reason for the dispute, and an estimate of the dollar
153.2amount involved for each disputed item;
153.3(2) the computation that the vendor believes is correct;
153.4(3) the authority in statute or rule upon which the vendor relies for each disputed item;
153.5(4) the name and address of the person or entity with whom contacts may be made
153.6regarding the appeal; and
153.7(5) other information required by the commissioner.
153.8(f) The commissioner may order a vendor to forfeit a fine for failure to fully
153.9document services according to standards in this chapter and Minnesota Rules, chapter
153.109505. Fines may be assessed when the commissioner has no evidence that services were
153.11not provided and services are partially documented in the health service or financial
153.12record, but specific required components of documentation are missing. The fine for
153.13incomplete documentation shall equal 20 percent of the amount paid on the claims for
153.14reimbursement submitted by the vendor, or up to $5,000, whichever is less.
153.15(g) The vendor shall pay the fine assessed on or before the payment date specified. If
153.16the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
153.17recover the amount of the fine. A timely appeal shall stay payment of the fine until the
153.18commissioner issues a final order.

153.19    Sec. 9. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to read:
153.20    Subd. 21. Requirements for initial enrollment of personal care assistance
153.21provider agencies. (a) All personal care assistance provider agencies must provide, at the
153.22time of enrollment as a personal care assistance provider agency in a format determined
153.23by the commissioner, information and documentation that includes, but is not limited to,
153.24the following:
153.25    (1) the personal care assistance provider agency's current contact information
153.26including address, telephone number, and e-mail address;
153.27    (2) proof of surety bond coverage in the amount of $50,000 $100,000 or ten percent
153.28of the provider's payments from Medicaid in the previous year, whichever is less more.
153.29The performance bond must be in a form approved by the commissioner, must be renewed
153.30annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;
153.31    (3) proof of fidelity bond coverage in the amount of $20,000;
153.32    (4) proof of workers' compensation insurance coverage;
153.33    (5) proof of liability insurance;
154.1    (6) a description of the personal care assistance provider agency's organization
154.2identifying the names of all owners, managing employees, staff, board of directors, and
154.3the affiliations of the directors, owners, or staff to other service providers;
154.4    (7) a copy of the personal care assistance provider agency's written policies and
154.5procedures including: hiring of employees; training requirements; service delivery;
154.6and employee and consumer safety including process for notification and resolution
154.7of consumer grievances, identification and prevention of communicable diseases, and
154.8employee misconduct;
154.9    (8) copies of all other forms the personal care assistance provider agency uses in
154.10the course of daily business including, but not limited to:
154.11    (i) a copy of the personal care assistance provider agency's time sheet if the time
154.12sheet varies from the standard time sheet for personal care assistance services approved
154.13by the commissioner, and a letter requesting approval of the personal care assistance
154.14provider agency's nonstandard time sheet;
154.15    (ii) the personal care assistance provider agency's template for the personal care
154.16assistance care plan; and
154.17    (iii) the personal care assistance provider agency's template for the written
154.18agreement in subdivision 20 for recipients using the personal care assistance choice
154.19option, if applicable;
154.20    (9) a list of all training and classes that the personal care assistance provider agency
154.21requires of its staff providing personal care assistance services;
154.22    (10) documentation that the personal care assistance provider agency and staff have
154.23successfully completed all the training required by this section;
154.24    (11) documentation of the agency's marketing practices;
154.25    (12) disclosure of ownership, leasing, or management of all residential properties
154.26that is used or could be used for providing home care services;
154.27    (13) documentation that the agency will use the following percentages of revenue
154.28generated from the medical assistance rate paid for personal care assistance services
154.29for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
154.30personal care assistance choice option and 72.5 percent of revenue from other personal
154.31care assistance providers. The revenue generated by the qualified professional and the
154.32reasonable costs associated with the qualified professional shall not be used in making
154.33this calculation; and
154.34    (14) effective May 15, 2010, documentation that the agency does not burden
154.35recipients' free exercise of their right to choose service providers by requiring personal
154.36care assistants to sign an agreement not to work with any particular personal care
155.1assistance recipient or for another personal care assistance provider agency after leaving
155.2the agency and that the agency is not taking action on any such agreements or requirements
155.3regardless of the date signed.
155.4    (b) Personal care assistance provider agencies shall provide the information specified
155.5in paragraph (a) to the commissioner at the time the personal care assistance provider
155.6agency enrolls as a vendor or upon request from the commissioner. The commissioner
155.7shall collect the information specified in paragraph (a) from all personal care assistance
155.8providers beginning July 1, 2009.
155.9    (c) All personal care assistance provider agencies shall require all employees in
155.10management and supervisory positions and owners of the agency who are active in the
155.11day-to-day management and operations of the agency to complete mandatory training
155.12as determined by the commissioner before enrollment of the agency as a provider.
155.13Employees in management and supervisory positions and owners who are active in
155.14the day-to-day operations of an agency who have completed the required training as
155.15an employee with a personal care assistance provider agency do not need to repeat
155.16the required training if they are hired by another agency, if they have completed the
155.17training within the past three years. By September 1, 2010, the required training must
155.18be available with meaningful access according to title VI of the Civil Rights Act and
155.19federal regulations adopted under that law or any guidance from the United States Health
155.20and Human Services Department. The required training must be available online or by
155.21electronic remote connection. The required training must provide for competency testing.
155.22Personal care assistance provider agency billing staff shall complete training about
155.23personal care assistance program financial management. This training is effective July 1,
155.242009. Any personal care assistance provider agency enrolled before that date shall, if it
155.25has not already, complete the provider training within 18 months of July 1, 2009. Any new
155.26owners or employees in management and supervisory positions involved in the day-to-day
155.27operations are required to complete mandatory training as a requisite of working for the
155.28agency. Personal care assistance provider agencies certified for participation in Medicare
155.29as home health agencies are exempt from the training required in this subdivision. When
155.30available, Medicare-certified home health agency owners, supervisors, or managers must
155.31successfully complete the competency test.
155.32EFFECTIVE DATE.This section is effective the day following final enactment.


156.3    Section 1. Minnesota Statutes 2012, section 256.9657, subdivision 2, is amended to read:
156.4    Subd. 2. Hospital surcharge. (a) Effective October 1, 1992, each Minnesota
156.5hospital except facilities of the federal Indian Health Service and regional treatment
156.6centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net
156.7patient revenues excluding net Medicare revenues reported by that provider to the health
156.8care cost information system according to the schedule in subdivision 4.
156.9(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56
156.10percent.
156.11(c) Effective July 1, 2013, the surcharge under paragraph (b) is increased to 2.68
156.12percent for all nongovernment-owned hospitals.
156.13(d) Notwithstanding the Medicare cost finding and allowable cost principles, the
156.14hospital surcharge is not an allowable cost for purposes of rate setting under sections
156.15256.9685 to 256.9695.
156.16EFFECTIVE DATE.This section is effective July 1, 2013.

156.17    Sec. 2. Minnesota Statutes 2012, section 256.9685, subdivision 2, is amended to read:
156.18    Subd. 2. Federal requirements. (a) If it is determined that a provision of this
156.19section or section 256.9686, 256.969, or 256.9695 conflicts with existing or future
156.20requirements of the United States government with respect to federal financial participation
156.21in medical assistance, the federal requirements prevail. The commissioner may, in the
156.22aggregate, prospectively and retrospectively, reduce payment rates and payments to avoid
156.23reduced federal financial participation resulting from rates and payments determined by
156.24the commissioner that are in excess of the Medicare upper payment limitations.
156.25(b) For rates and payments determined by the commissioner to be in excess of the
156.26Medicare upper payment limits for the nongovernment-owned limit category, rates and
156.27payments shall be reduced to the limits according to clauses (1) to (4):
156.28(1) rates and payments under section 256.969, subdivision 3a, paragraph (j), shall be
156.29reduced proportionately;
156.30(2) if rates and payments remain above the limit, medical education payments under
156.31section 62J.692, subdivision 8, shall be the first reduction for the government-owned
156.32limit category;
156.33(3) if rates and payments remain above the limit, rates and payments not included
156.34under clause (1) shall be reduced in total; and
157.1(4) the state share of payments under clauses (1) and (2) shall be returned to the
157.2hospital.

157.3    Sec. 3. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:
157.4    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
157.5assistance program must not be submitted until the recipient is discharged. However,
157.6the commissioner shall establish monthly interim payments for inpatient hospitals that
157.7have individual patient lengths of stay over 30 days regardless of diagnostic category.
157.8Except as provided in section 256.9693, medical assistance reimbursement for treatment
157.9of mental illness shall be reimbursed based on diagnostic classifications. Individual
157.10hospital payments established under this section and sections 256.9685, 256.9686, and
157.11256.9695 , in addition to third-party and recipient liability, for discharges occurring during
157.12the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
157.13inpatient services paid for the same period of time to the hospital. This payment limitation
157.14shall be calculated separately for medical assistance and general assistance medical
157.15care services. The limitation on general assistance medical care shall be effective for
157.16admissions occurring on or after July 1, 1991. Services that have rates established under
157.17subdivision 11 or 12, must be limited separately from other services. After consulting with
157.18the affected hospitals, the commissioner may consider related hospitals one entity and
157.19may merge the payment rates while maintaining separate provider numbers. The operating
157.20and property base rates per admission or per day shall be derived from the best Medicare
157.21and claims data available when rates are established. The commissioner shall determine
157.22the best Medicare and claims data, taking into consideration variables of recency of the
157.23data, audit disposition, settlement status, and the ability to set rates in a timely manner.
157.24The commissioner shall notify hospitals of payment rates by December 1 of the year
157.25preceding the rate year. The rate setting data must reflect the admissions data used to
157.26establish relative values. Base year changes from 1981 to the base year established for the
157.27rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
157.28to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
157.291. The commissioner may adjust base year cost, relative value, and case mix index data
157.30to exclude the costs of services that have been discontinued by the October 1 of the year
157.31preceding the rate year or that are paid separately from inpatient services. Inpatient stays
157.32that encompass portions of two or more rate years shall have payments established based
157.33on payment rates in effect at the time of admission unless the date of admission preceded
157.34the rate year in effect by six months or more. In this case, operating payment rates for
158.1services rendered during the rate year in effect and established based on the date of
158.2admission shall be adjusted to the rate year in effect by the hospital cost index.
158.3    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
158.4payment, before third-party liability and spenddown, made to hospitals for inpatient
158.5services is reduced by .5 percent from the current statutory rates.
158.6    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
158.7admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
158.8before third-party liability and spenddown, is reduced five percent from the current
158.9statutory rates. Mental health services within diagnosis related groups 424 to 432, and
158.10facilities defined under subdivision 16 are excluded from this paragraph.
158.11    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
158.12fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
158.13inpatient services before third-party liability and spenddown, is reduced 6.0 percent
158.14from the current statutory rates. Mental health services within diagnosis related groups
158.15424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
158.16Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
158.17assistance does not include general assistance medical care. Payments made to managed
158.18care plans shall be reduced for services provided on or after January 1, 2006, to reflect
158.19this reduction.
158.20    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
158.21fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
158.22to hospitals for inpatient services before third-party liability and spenddown, is reduced
158.233.46 percent from the current statutory rates. Mental health services with diagnosis related
158.24groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
158.25paragraph. Payments made to managed care plans shall be reduced for services provided
158.26on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
158.27    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
158.28fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made
158.29to hospitals for inpatient services before third-party liability and spenddown, is reduced
158.301.9 percent from the current statutory rates. Mental health services with diagnosis related
158.31groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
158.32paragraph. Payments made to managed care plans shall be reduced for services provided
158.33on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
158.34    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
158.35for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
158.36inpatient services before third-party liability and spenddown, is reduced 1.79 percent
159.1from the current statutory rates. Mental health services with diagnosis related groups
159.2424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
159.3Payments made to managed care plans shall be reduced for services provided on or after
159.4July 1, 2011, to reflect this reduction.
159.5(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
159.6payment for fee-for-service admissions occurring on or after July 1, 2009, made to
159.7hospitals for inpatient services before third-party liability and spenddown, is reduced
159.8one percent from the current statutory rates. Facilities defined under subdivision 16 are
159.9excluded from this paragraph. Payments made to managed care plans shall be reduced for
159.10services provided on or after October 1, 2009, to reflect this reduction.
159.11(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
159.12payment for fee-for-service admissions occurring on or after July 1, 2011, made to
159.13hospitals for inpatient services before third-party liability and spenddown, is reduced
159.141.96 percent from the current statutory rates. Facilities defined under subdivision 16 are
159.15excluded from this paragraph. Payments made to managed care plans shall be reduced for
159.16services provided on or after January 1, 2011, to reflect this reduction.
159.17(j) In order to offset the rateable reductions provided for in this subdivision, the total
159.18payment rate for medical assistance admissions for nongovernment-owned hospitals
159.19occurring on or after July 1, 2013, made to Minnesota hospitals for inpatient services
159.20before third-party liability and spenddown, shall be increased by 30 percent from the
159.21current statutory rates. The commissioner shall not adjust rates paid to a prepaid health
159.22plan under contract with the commissioner to reflect payments provided in this paragraph.
159.23The commissioner shall adjust rates and payments in excess of the Medicare upper limits
159.24on payments according to section 256.9685, subdivision 2.
159.25EFFECTIVE DATE.This section is effective July 1, 2013.

159.26    Sec. 4. Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:
159.27    Subd. 29. Reimbursement for the fee increase for the early hearing detection
159.28and intervention program. (a) For admissions occurring on or after July 1, 2010,
159.29payment rates shall be adjusted to include the increase to the fee that is effective on July 1,
159.302010, for the early hearing detection and intervention program recipients under section
159.31144.125, subdivision 1 , that is paid by the hospital for public program recipients. This
159.32payment increase shall be in effect until the increase is fully recognized in the base year
159.33cost under subdivision 2b. This payment shall be included in payments to contracted
159.34managed care organizations.
160.1    (b) For admissions occurring on or after July 1, 2013, payment rates shall be
160.2adjusted to include the increase to the fee that is effective July 1, 2013, for the early
160.3hearing detection and intervention program recipients under section 144.125, subdivision
160.41 , that is paid by the hospital for public program recipients. This payment increase shall
160.5be in effect until the increase is fully recognized in the base year cost under subdivision
160.62b. This payment shall be included in payments to contracted managed care organizations.

160.7    Sec. 5. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:
160.8    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
160.9inmate of a correctional facility who is conditionally released as authorized under section
160.10241.26 , 244.065, or 631.425, if the individual does not require the security of a public
160.11detention facility and is housed in a halfway house or community correction center, or
160.12under house arrest and monitored by electronic surveillance in a residence approved
160.13by the commissioner of corrections, and if the individual meets the other eligibility
160.14requirements of this chapter.
160.15    (b) An individual who is enrolled in medical assistance, and who is charged with a
160.16crime and incarcerated for less than 12 months shall be suspended from eligibility at the
160.17time of incarceration until the individual is released. Upon release, medical assistance
160.18eligibility is reinstated without reapplication using a reinstatement process and form, if the
160.19individual is otherwise eligible.
160.20    (c) An individual, regardless of age, who is considered an inmate of a public
160.21institution as defined in Code of Federal Regulations, title 42, section 435.1010, and
160.22who meets the eligibility requirements in section 256B.056, is not eligible for medical
160.23assistance, except for covered services received while an inpatient in a medical institution
160.24as defined in the Code of Federal Regulations, title 42, section 435.1010. Security issues
160.25related to the inpatient treatment of an inmate are the responsibility of the entity with
160.26jurisdiction over the inmate.
160.27EFFECTIVE DATE.This section is effective January 1, 2014.

160.28    Sec. 6. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
160.29    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
160.30to citizens of the United States, qualified noncitizens as defined in this subdivision, and
160.31other persons residing lawfully in the United States. Citizens or nationals of the United
160.32States must cooperate in obtaining satisfactory documentary evidence of citizenship or
160.33nationality according to the requirements of the federal Deficit Reduction Act of 2005,
160.34Public Law 109-171.
161.1(b) "Qualified noncitizen" means a person who meets one of the following
161.2immigration criteria:
161.3(1) admitted for lawful permanent residence according to United States Code, title 8;
161.4(2) admitted to the United States as a refugee according to United States Code,
161.5title 8, section 1157;
161.6(3) granted asylum according to United States Code, title 8, section 1158;
161.7(4) granted withholding of deportation according to United States Code, title 8,
161.8section 1253(h);
161.9(5) paroled for a period of at least one year according to United States Code, title 8,
161.10section 1182(d)(5);
161.11(6) granted conditional entrant status according to United States Code, title 8,
161.12section 1153(a)(7);
161.13(7) determined to be a battered noncitizen by the United States Attorney General
161.14according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
161.15title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
161.16(8) is a child of a noncitizen determined to be a battered noncitizen by the United
161.17States Attorney General according to the Illegal Immigration Reform and Immigrant
161.18Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
161.19Public Law 104-200; or
161.20(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
161.21Law 96-422, the Refugee Education Assistance Act of 1980.
161.22(c) All qualified noncitizens who were residing in the United States before August
161.2322, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
161.24medical assistance with federal financial participation.
161.25(d) Beginning December 1, 1996, qualified noncitizens who entered the United
161.26States on or after August 22, 1996, and who otherwise meet the eligibility requirements
161.27of this chapter are eligible for medical assistance with federal participation for five years
161.28if they meet one of the following criteria:
161.29(1) refugees admitted to the United States according to United States Code, title 8,
161.30section 1157;
161.31(2) persons granted asylum according to United States Code, title 8, section 1158;
161.32(3) persons granted withholding of deportation according to United States Code,
161.33title 8, section 1253(h);
161.34(4) veterans of the United States armed forces with an honorable discharge for
161.35a reason other than noncitizen status, their spouses and unmarried minor dependent
161.36children; or
162.1(5) persons on active duty in the United States armed forces, other than for training,
162.2their spouses and unmarried minor dependent children.
162.3 Beginning July 1, 2010, children and pregnant women who are noncitizens
162.4described in paragraph (b) or who are lawfully present in the United States as defined
162.5in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
162.6eligibility requirements of this chapter, are eligible for medical assistance with federal
162.7financial participation as provided by the federal Children's Health Insurance Program
162.8Reauthorization Act of 2009, Public Law 111-3.
162.9(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
162.10are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
162.11subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
162.12Code, title 8, section 1101(a)(15).
162.13(f) Payment shall also be made for care and services that are furnished to noncitizens,
162.14regardless of immigration status, who otherwise meet the eligibility requirements of
162.15this chapter, if such care and services are necessary for the treatment of an emergency
162.16medical condition.
162.17(g) For purposes of this subdivision, the term "emergency medical condition" means
162.18a medical condition that meets the requirements of United States Code, title 42, section
162.191396b(v).
162.20(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
162.21of an emergency medical condition are limited to the following:
162.22(i) services delivered in an emergency room or by an ambulance service licensed
162.23under chapter 144E that are directly related to the treatment of an emergency medical
162.24condition;
162.25(ii) services delivered in an inpatient hospital setting following admission from an
162.26emergency room or clinic for an acute emergency condition; and
162.27(iii) follow-up services that are directly related to the original service provided
162.28to treat the emergency medical condition and are covered by the global payment made
162.29to the provider.
162.30    (2) Services for the treatment of emergency medical conditions do not include:
162.31(i) services delivered in an emergency room or inpatient setting to treat a
162.32nonemergency condition;
162.33(ii) organ transplants, stem cell transplants, and related care;
162.34(iii) services for routine prenatal care;
162.35(iv) continuing care, including long-term care, nursing facility services, home health
162.36care, adult day care, day training, or supportive living services;
163.1(v) elective surgery;
163.2(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
163.3part of an emergency room visit;
163.4(vii) preventative health care and family planning services;
163.5(viii) dialysis;
163.6(ix) chemotherapy or therapeutic radiation services;
163.7(x) (viii) rehabilitation services;
163.8(xi) (ix) physical, occupational, or speech therapy;
163.9(xii) (x) transportation services;
163.10(xiii) (xi) case management;
163.11(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
163.12(xv) (xiii) dental services;
163.13(xvi) (xiv) hospice care;
163.14(xvii) (xv) audiology services and hearing aids;
163.15(xviii) (xvi) podiatry services;
163.16(xix) (xvii) chiropractic services;
163.17(xx) (xviii) immunizations;
163.18(xxi) (xix) vision services and eyeglasses;
163.19(xxii) (xx) waiver services;
163.20(xxiii) (xxi) individualized education programs; or
163.21(xxiv) (xxii) chemical dependency treatment.
163.22(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
163.23nonimmigrants, or lawfully present in the United States as defined in Code of Federal
163.24Regulations, title 8, section 103.12, are not covered by a group health plan or health
163.25insurance coverage according to Code of Federal Regulations, title 42, section 457.310,
163.26and who otherwise meet the eligibility requirements of this chapter, are eligible for
163.27medical assistance through the period of pregnancy, including labor and delivery, and 60
163.28days postpartum, to the extent federal funds are available under title XXI of the Social
163.29Security Act, and the state children's health insurance program.
163.30(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
163.31services from a nonprofit center established to serve victims of torture and are otherwise
163.32ineligible for medical assistance under this chapter are eligible for medical assistance
163.33without federal financial participation. These individuals are eligible only for the period
163.34during which they are receiving services from the center. Individuals eligible under this
163.35paragraph shall not be required to participate in prepaid medical assistance.
164.1(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
164.2emergency medical conditions under paragraph (f) except where coverage is prohibited
164.3under federal law:
164.4(1) dialysis services provided in a hospital or freestanding dialysis facility; and
164.5(2) surgery and the administration of chemotherapy, radiation, and related services
164.6necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission
164.7and requires surgery, chemotherapy, or radiation treatment.
164.8EFFECTIVE DATE.This section is effective July 1, 2013.

164.9    Sec. 7. Minnesota Statutes 2012, section 256B.0625, subdivision 9, is amended to read:
164.10    Subd. 9. Dental services. (a) Medical assistance covers dental services.
164.11(b) Medical assistance dental coverage for nonpregnant adults is limited to the
164.12following services:
164.13(1) comprehensive exams, limited to once every five years;
164.14(2) periodic exams, limited to one per year;
164.15(3) limited exams;
164.16(4) bitewing x-rays, limited to one per year;
164.17(5) periapical x-rays;
164.18(6) panoramic x-rays, limited to one every five years except (1) when medically
164.19necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma
164.20or (2) once every two years for patients who cannot cooperate for intraoral film due to
164.21a developmental disability or medical condition that does not allow for intraoral film
164.22placement;
164.23(7) prophylaxis, limited to one per year;
164.24(8) application of fluoride varnish, limited to one per year;
164.25(9) posterior fillings, all at the amalgam rate;
164.26(10) anterior fillings;
164.27(11) endodontics, limited to root canals on the anterior and premolars only;
164.28(12) removable prostheses, each dental arch limited to one every six years;
164.29(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
164.30abscesses;
164.31(14) palliative treatment and sedative fillings for relief of pain; and
164.32(15) full-mouth debridement, limited to one every five years.
164.33(c) In addition to the services specified in paragraph (b), medical assistance
164.34covers the following services for adults, if provided in an outpatient hospital setting or
164.35freestanding ambulatory surgical center as part of outpatient dental surgery:
165.1(1) periodontics, limited to periodontal scaling and root planing once every two years;
165.2(2) general anesthesia; and
165.3(3) full-mouth survey once every five years.
165.4(d) Medical assistance covers medically necessary dental services for children and
165.5pregnant women. The following guidelines apply:
165.6(1) posterior fillings are paid at the amalgam rate;
165.7(2) application of sealants are covered once every five years per permanent molar for
165.8children only;
165.9(3) application of fluoride varnish is covered once every six months; and
165.10(4) orthodontia is eligible for coverage for children only.
165.11(e) In addition to the services specified in paragraphs (b) and (c), medical assistance
165.12covers the following services for adults:
165.13(1) house calls or extended care facility calls for on-site delivery of covered services;
165.14(2) behavioral management when additional staff time is required to accommodate
165.15behavioral challenges and sedation is not used;
165.16(3) oral or IV sedation, if the covered dental service cannot be performed safely
165.17without it or would otherwise require the service to be performed under general anesthesia
165.18in a hospital or surgical center; and
165.19(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
165.20no more than four times per year.

165.21    Sec. 8. Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to
165.22read:
165.23    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
165.24shall be the lower of the actual acquisition costs of the drugs or the maximum allowable
165.25cost by the commissioner plus the fixed dispensing fee; or the usual and customary price
165.26charged to the public. The amount of payment basis must be reduced to reflect all discount
165.27amounts applied to the charge by any provider/insurer agreement or contract for submitted
165.28charges to medical assistance programs. The net submitted charge may not be greater
165.29than the patient liability for the service. The pharmacy dispensing fee shall be $3.65,
165.30except that the dispensing fee for intravenous solutions which must be compounded by
165.31the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and
165.32$30 per bag for total parenteral nutritional products dispensed in one liter quantities,
165.33or $44 per bag for total parenteral nutritional products dispensed in quantities greater
165.34than one liter. Actual acquisition cost includes quantity and other special discounts
165.35except time and cash discounts. The actual acquisition cost of a drug shall be estimated
166.1by the commissioner at wholesale acquisition cost plus four percent for independently
166.2owned pharmacies located in a designated rural area within Minnesota, and at wholesale
166.3acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently
166.4owned" if it is one of four or fewer pharmacies under the same ownership nationally.
166.5A "designated rural area" means an area defined as a small rural area or isolated rural
166.6area according to the four-category classification of the Rural Urban Commuting Area
166.7system developed for the United States Health Resources and Services Administration.
166.8The actual acquisition cost of a drug acquired through the federal 340B Drug Pricing
166.9Program shall be estimated by the commissioner at wholesale acquisition cost minus 44
166.10percent. Wholesale acquisition cost is defined as the manufacturer's list price for a drug or
166.11biological to wholesalers or direct purchasers in the United States, not including prompt
166.12pay or other discounts, rebates, or reductions in price, for the most recent month for which
166.13information is available, as reported in wholesale price guides or other publications of
166.14drug or biological pricing data. The maximum allowable cost of a multisource drug may
166.15be set by the commissioner and it shall be comparable to, but no higher than, the maximum
166.16amount paid by other third-party payors in this state who have maximum allowable cost
166.17programs. Establishment of the amount of payment for drugs shall not be subject to the
166.18requirements of the Administrative Procedure Act.
166.19    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
166.20to pharmacists for legend drug prescriptions dispensed to residents of long-term care
166.21facilities when a unit dose blister card system, approved by the department, is used. Under
166.22this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The
166.23National Drug Code (NDC) from the drug container used to fill the blister card must be
166.24identified on the claim to the department. The unit dose blister card containing the drug
166.25must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that
166.26govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will
166.27be required to credit the department for the actual acquisition cost of all unused drugs that
166.28are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in
166.29a quantity that is less than a 30-day supply.
166.30    (c) Whenever a maximum allowable cost has been set for a multisource drug,
166.31payment shall be the lower of the usual and customary price charged to the public or the
166.32maximum allowable cost established by the commissioner unless prior authorization
166.33for the brand name product has been granted according to the criteria established by
166.34the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the
166.35prescriber has indicated "dispense as written" on the prescription in a manner consistent
166.36with section 151.21, subdivision 2.
167.1    (d) The basis for determining the amount of payment for drugs administered in an
167.2outpatient setting shall be the lower of the usual and customary cost submitted by the
167.3provider or, 106 percent of the average sales price as determined by the United States
167.4Department of Health and Human Services pursuant to title XVIII, section 1847a of the
167.5federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
167.6set by the commissioner. If average sales price is unavailable, the amount of payment
167.7must be lower of the usual and customary cost submitted by the provider or, the wholesale
167.8acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the
167.9commissioner. The commissioner shall discount the payment rate for drugs obtained
167.10through the federal 340B Drug Pricing Program by 33 percent. The payment for drugs
167.11administered in an outpatient setting shall be made to the administering facility or
167.12practitioner. A retail or specialty pharmacy dispensing a drug for administration in an
167.13outpatient setting is not eligible for direct reimbursement.
167.14    (e) The commissioner may negotiate lower reimbursement rates for specialty
167.15pharmacy products than the rates specified in paragraph (a). The commissioner may
167.16require individuals enrolled in the health care programs administered by the department
167.17to obtain specialty pharmacy products from providers with whom the commissioner has
167.18negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
167.19used by a small number of recipients or recipients with complex and chronic diseases
167.20that require expensive and challenging drug regimens. Examples of these conditions
167.21include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
167.22C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
167.23of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
167.24biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
167.25that require complex care. The commissioner shall consult with the formulary committee
167.26to develop a list of specialty pharmacy products subject to this paragraph. In consulting
167.27with the formulary committee in developing this list, the commissioner shall take into
167.28consideration the population served by specialty pharmacy products, the current delivery
167.29system and standard of care in the state, and access to care issues. The commissioner shall
167.30have the discretion to adjust the reimbursement rate to prevent access to care issues.
167.31(f) Home infusion therapy services provided by home infusion therapy pharmacies
167.32must be paid at rates according to subdivision 8d.
167.33EFFECTIVE DATE.This section is effective January 1, 2014.

167.34    Sec. 9. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to read:
168.1    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
168.2supplies and equipment. Separate payment outside of the facility's payment rate shall
168.3be made for wheelchairs and wheelchair accessories for recipients who are residents
168.4of intermediate care facilities for the developmentally disabled. Reimbursement for
168.5wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
168.6conditions and limitations as coverage for recipients who do not reside in institutions. A
168.7wheelchair purchased outside of the facility's payment rate is the property of the recipient.
168.8The commissioner may set reimbursement rates for specified categories of medical
168.9supplies at levels below the Medicare payment rate.
168.10(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
168.11must enroll as a Medicare provider.
168.12(c) When necessary to ensure access to durable medical equipment, prosthetics,
168.13orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
168.14enrollment requirement if:
168.15(1) the vendor supplies only one type of durable medical equipment, prosthetic,
168.16orthotic, or medical supply;
168.17(2) the vendor serves ten or fewer medical assistance recipients per year;
168.18(3) the commissioner finds that other vendors are not available to provide same or
168.19similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
168.20(4) the vendor complies with all screening requirements in this chapter and Code of
168.21Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
168.22the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
168.23and Medicaid Services approved national accreditation organization as complying with
168.24the Medicare program's supplier and quality standards and the vendor serves primarily
168.25pediatric patients.
168.26(d) Durable medical equipment means a device or equipment that:
168.27(1) can withstand repeated use;
168.28(2) is generally not useful in the absence of an illness, injury, or disability; and
168.29(3) is provided to correct or accommodate a physiological disorder or physical
168.30condition or is generally used primarily for a medical purpose.
168.31(e) Electronic tablets may be considered durable medical equipment if the electronic
168.32tablet will be used as an augmentative and alternative communication system as defined
168.33under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
168.34must be locked in order to prevent use not related to communication.

169.1    Sec. 10. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
169.2subdivision to read:
169.3    Subd. 31b. Preferred diabetic testing supply program. (a) The commissioner
169.4shall adopt and implement a point of sale preferred diabetic testing supply program by
169.5January 1, 2014. Medical assistance coverage for diabetic testing supplies shall conform
169.6to the limitations established under the program. The commissioner may enter into a
169.7contract with a vendor for the purpose of participating in a preferred diabetic testing
169.8supply list and supplemental rebate program. The commissioner shall ensure that any
169.9contract meets all federal requirements and maximizes federal financial participation. The
169.10commissioner shall maintain an accurate and up-to-date list on the agency Web site.
169.11(b) The commissioner may add to, delete from, and otherwise modify the preferred
169.12diabetic testing supply program drug list after consulting with the Drug Formulary
169.13Committee and appropriate medial specialists and providing public notice and the
169.14opportunity for public comment.
169.15(c) The commissioner shall adopt and administer the preferred diabetic testing
169.16supply program as part of the administration of the diabetic testing supply rebate program.
169.17Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply
169.18list may be subject to prior authorization.
169.19(d) All claims for diabetic testing supplies in categories on the preferred diabetic
169.20testing supply list must be submitted by enrolled pharmacy providers using the most
169.21current National Council of Prescription Drug Providers electronic claims standard.
169.22(e) For purposes of this subdivision, "preferred diabetic testing supply list" means a
169.23list of diabetic testing supplies selected by the commissioner, for which prior authorization
169.24is not required.
169.25(f) The commissioner shall seek any federal waivers or approvals necessary to
169.26implement this subdivision.

169.27    Sec. 11. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to
169.28read:
169.29    Subd. 39. Childhood immunizations. Providers who administer pediatric vaccines
169.30within the scope of their licensure, and who are enrolled as a medical assistance provider,
169.31must enroll in the pediatric vaccine administration program established by section 13631
169.32of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an
169.33$8.50 fee per dose for administration of the vaccine to children eligible for medical
169.34assistance. Medical assistance does not pay for vaccines that are available at no cost from
169.35the pediatric vaccine administration program.

170.1    Sec. 12. Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to
170.2read:
170.3    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
170.4Medical assistance covers early and periodic screening, diagnosis, and treatment services
170.5(EPSDT). The payment amount for a complete EPSDT screening shall not include charges
170.6for vaccines that are available at no cost to the provider and shall not exceed the rate
170.7established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

170.8    Sec. 13. Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:
170.9    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
170.10assistance benefit plan shall include the following cost-sharing for all recipients, effective
170.11for services provided on or after September 1, 2011:
170.12    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
170.13of this subdivision, a visit means an episode of service which is required because of
170.14a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
170.15ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
170.16midwife, advanced practice nurse, audiologist, optician, or optometrist;
170.17    (2) $3.50 for nonemergency visits to a hospital-based emergency room, except that
170.18this co-payment shall be increased to $20 upon federal approval;
170.19    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
170.20subject to a $12 per month maximum for prescription drug co-payments. No co-payments
170.21shall apply to antipsychotic drugs when used for the treatment of mental illness;
170.22(4) effective January 1, 2012, a family deductible equal to the maximum amount
170.23allowed under Code of Federal Regulations, title 42, part 447.54; and
170.24    (5) for individuals identified by the commissioner with income at or below 100
170.25percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
170.26percent of family income. For purposes of this paragraph, family income is the total
170.27earned and unearned income of the individual and the individual's spouse, if the spouse is
170.28enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
170.29    (b) Recipients of medical assistance are responsible for all co-payments and
170.30deductibles in this subdivision.
170.31(c) Notwithstanding paragraph (b), the commissioner, through the contracting
170.32process under sections 256B.69 and 256B.692, may allow managed care plans and
170.33county-based purchasing plans to waive the family deductible under paragraph (a),
170.34clause (4). The value of the family deductible shall not be included in the capitation
170.35payment to managed care plans and county-based purchasing plans. Managed care plans
171.1and county-based purchasing plans shall certify annually to the commissioner the dollar
171.2value of the family deductible.
171.3(d) Notwithstanding paragraph (b), the commissioner may waive the collection of
171.4the family deductible described under paragraph (a), clause (4), from individuals and
171.5allow long-term care and waivered service providers to assume responsibility for payment.
171.6(e) Notwithstanding paragraph (b), the commissioner, through the contracting
171.7process under section 256B.0756 shall allow the pilot program in Hennepin County to
171.8waive co-payments. The value of the co-payments shall not be included in the capitation
171.9amount to the managed care organization.

171.10    Sec. 14. Minnesota Statutes 2012, section 256B.0756, is amended to read:
171.11256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.
171.12(a) The commissioner, upon federal approval of a new waiver request or amendment
171.13of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey
171.14County, or both, to test alternative and innovative integrated health care delivery networks.
171.15(b) Individuals eligible for the pilot program shall be individuals who are eligible for
171.16medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin
171.17County or Ramsey County. The commissioner may identify individuals to be enrolled in
171.18the Hennepin County pilot program based on zip code in Hennepin County or whether the
171.19individuals would benefit from an integrated health care delivery network.
171.20(c) Individuals enrolled in the pilot program shall be enrolled in an integrated
171.21health care delivery network in their county of residence. The integrated health care
171.22delivery network in Hennepin County shall be a network, such as an accountable care
171.23organization or a community-based collaborative care network, created by or including
171.24Hennepin County Medical Center. The integrated health care delivery network in Ramsey
171.25County shall be a network, such as an accountable care organization or community-based
171.26collaborative care network, created by or including Regions Hospital.
171.27(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for
171.28Hennepin County and 3,500 enrollees for Ramsey County.
171.29(e) (d) In developing a payment system for the pilot programs, the commissioner
171.30shall establish a total cost of care for the recipients enrolled in the pilot programs that
171.31equals the cost of care that would otherwise be spent for these enrollees in the prepaid
171.32medical assistance program.
171.33(f) Counties may transfer funds necessary to support the nonfederal share of
171.34payments for integrated health care delivery networks in their county. Such transfers per
171.35county shall not exceed 15 percent of the expected expenses for county enrollees.
172.1(g) (e) The commissioner shall apply to the federal government for, or as appropriate,
172.2cooperate with counties, providers, or other entities that are applying for any applicable
172.3grant or demonstration under the Patient Protection and Affordable Health Care Act, Public
172.4Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law
172.5111-152, that would further the purposes of or assist in the creation of an integrated health
172.6care delivery network for the purposes of this subdivision, including, but not limited to, a
172.7global payment demonstration or the community-based collaborative care network grants.

172.8    Sec. 15. Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:
172.9    Subd. 5c. Medical education and research fund. (a) The commissioner of human
172.10services shall transfer each year to the medical education and research fund established
172.11under section 62J.692, an amount specified in this subdivision. The commissioner shall
172.12calculate the following:
172.13(1) an amount equal to the reduction in the prepaid medical assistance payments as
172.14specified in this clause. Until January 1, 2002, the county medical assistance capitation
172.15base rate prior to plan specific adjustments and after the regional rate adjustments under
172.16subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
172.17metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
172.18January 1, 2002, the county medical assistance capitation base rate prior to plan specific
172.19adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
172.20metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
172.21facility and elderly waiver payments and demonstration project payments operating
172.22under subdivision 23 are excluded from this reduction. The amount calculated under
172.23this clause shall not be adjusted for periods already paid due to subsequent changes to
172.24the capitation payments;
172.25(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
172.26section;
172.27(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
172.28paid under this section; and
172.29(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
172.30under this section.
172.31(b) This subdivision shall be effective upon approval of a federal waiver which
172.32allows federal financial participation in the medical education and research fund. The
172.33amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount
172.34transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under
173.1paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally
173.2reduce the amount specified under paragraph (a), clause (1).
173.3(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner
173.4shall transfer $21,714,000 each fiscal year to the medical education and research fund.
173.5(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
173.6transfer under paragraph (c), the commissioner shall transfer to the medical education
173.7research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 $49,552,000 in
173.8fiscal year 2014 and thereafter.

173.9    Sec. 16. Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:
173.10    Subd. 31. Payment reduction. (a) Beginning September 1, 2011, the commissioner
173.11shall reduce payments and limit future rate increases paid to managed care plans and
173.12county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved
173.13on a statewide aggregate basis by program. The commissioner may use competitive
173.14bidding, payment reductions, or other reductions to achieve the reductions and limits
173.15in this subdivision.
173.16    (b) Beginning September 1, 2011, the commissioner shall reduce payments to
173.17managed care plans and county-based purchasing plans as follows:
173.18    (1) 2.0 percent for medical assistance elderly basic care. This shall not apply
173.19to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
173.20services;
173.21    (2) 2.82 percent for medical assistance families and children;
173.22    (3) 10.1 percent for medical assistance adults without children; and
173.23    (4) 6.0 percent for MinnesotaCare families and children.
173.24    (c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed
173.25care plans and county-based purchasing plans for calendar year 2012 to a percentage of
173.26the rates in effect on August 31, 2011, as follows:
173.27    (1) 98 percent for medical assistance elderly basic care. This shall not apply to
173.28Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
173.29services;
173.30    (2) 97.18 percent for medical assistance families and children;
173.31    (3) 89.9 percent for medical assistance adults without children; and
173.32    (4) 94 percent for MinnesotaCare families and children.
173.33    (d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit
173.34the maximum annual trend increases to rates paid to managed care plans and county-based
173.35purchasing plans as follows:
174.1    (1) 7.5 percent for medical assistance elderly basic care. This shall not apply
174.2to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
174.3services;
174.4    (2) 5.0 percent for medical assistance special needs basic care;
174.5    (3) 2.0 percent for medical assistance families and children;
174.6    (4) 3.0 percent for medical assistance adults without children;
174.7    (5) 3.0 percent for MinnesotaCare families and children; and
174.8    (6) 3.0 percent for MinnesotaCare adults without children.
174.9    (e) The commissioner may limit trend increases to less than the maximum.
174.10Beginning July January 1, 2014, the commissioner shall limit the maximum annual trend
174.11increases to rates paid to managed care plans and county-based purchasing plans as
174.12follows for calendar years 2014 and 2015:
174.13    (1) 7.5 3.25 percent for medical assistance elderly basic care. This shall not apply
174.14to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
174.15services;
174.16    (2) 5.0 2.5 percent for medical assistance special needs basic care;
174.17    (3) 2.0 percent for medical assistance families and children;
174.18    (4) 3.0 percent for medical assistance adults without children;
174.19    (5) 3.0 percent for MinnesotaCare families and children; and
174.20    (6) 4.0 3.0 percent for MinnesotaCare adults without children.
174.21    The commissioner may limit trend increases to less than the maximum.

174.22    Sec. 17. Minnesota Statutes 2012, section 256B.76, subdivision 2, is amended to read:
174.23    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
174.24October 1, 1992, the commissioner shall make payments for dental services as follows:
174.25    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
174.26percent above the rate in effect on June 30, 1992; and
174.27    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
174.28percentile of 1989, less the percent in aggregate necessary to equal the above increases.
174.29    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
174.30shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
174.31    (c) Effective for services rendered on or after January 1, 2000, payment rates for
174.32dental services shall be increased by three percent over the rates in effect on December
174.3331, 1999.
175.1    (d) Effective for services provided on or after January 1, 2002, payment for
175.2diagnostic examinations and dental x-rays provided to children under age 21 shall be the
175.3lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
175.4    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
175.52000, for managed care.
175.6(f) Effective for dental services rendered on or after October 1, 2010, by a
175.7state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
175.8on the Medicare principles of reimbursement. This payment shall be effective for services
175.9rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
175.10county-based purchasing plans.
175.11(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
175.12in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
175.13year, a supplemental state payment equal to the difference between the total payments
175.14in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
175.15services for the operation of the dental clinics.
175.16(h) If the cost-based payment system for state-operated dental clinics described in
175.17paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
175.18designated as critical access dental providers under subdivision 4, paragraph (b), and shall
175.19receive the critical access dental reimbursement rate as described under subdivision 4,
175.20paragraph (a).
175.21(i) Effective for services rendered on or after September 1, 2011, through June 30,
175.222013, payment rates for dental services shall be reduced by three percent. This reduction
175.23does not apply to state-operated dental clinics in paragraph (f).
175.24(j) Effective for services rendered on or after January 1, 2014, payment rates for
175.25dental services shall be increased by five percent from the rates in effect on December
175.2631, 2013. This increase does not apply to state-operated dental clinics in paragraph (f),
175.27federally qualified health centers, rural health centers, and Indian health services. Effective
175.28January 1, 2014, payments made to managed care plans and county-based purchasing
175.29plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment increase
175.30described in this paragraph.

175.31    Sec. 18. Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:
175.32    Subd. 4. Critical access dental providers. (a) Effective for dental services
175.33rendered on or after January 1, 2002, the commissioner shall increase reimbursements
175.34to dentists and dental clinics deemed by the commissioner to be critical access dental
175.35providers. For dental services rendered on or after July 1, 2007, the commissioner shall
176.1increase reimbursement by 30 percent above the reimbursement rate that would otherwise
176.2be paid to the critical access dental provider. The commissioner shall pay the managed
176.3care plans and county-based purchasing plans in amounts sufficient to reflect increased
176.4reimbursements to critical access dental providers as approved by the commissioner.
176.5    (b) The commissioner shall designate the following dentists and dental clinics as
176.6critical access dental providers:
176.7    (1) nonprofit community clinics that:
176.8    (i) have nonprofit status in accordance with chapter 317A;
176.9    (ii) have tax exempt status in accordance with the Internal Revenue Code, section
176.10501(c)(3);
176.11    (iii) are established to provide oral health services to patients who are low income,
176.12uninsured, have special needs, and are underserved;
176.13    (iv) have professional staff familiar with the cultural background of the clinic's
176.14patients;
176.15    (v) charge for services on a sliding fee scale designed to provide assistance to
176.16low-income patients based on current poverty income guidelines and family size;
176.17    (vi) do not restrict access or services because of a patient's financial limitations
176.18or public assistance status; and
176.19    (vii) have free care available as needed;
176.20    (2) federally qualified health centers, rural health clinics, and public health clinics;
176.21    (3) city or county owned and operated hospital-based dental clinics;
176.22    (4) a dental clinic or dental group owned and operated by a nonprofit corporation
176.23in accordance with chapter 317A with more than 10,000 patient encounters per year
176.24with patients who are uninsured or covered by medical assistance, general assistance
176.25medical care, or MinnesotaCare, if more than 50 percent of the dental clinic's patient
176.26encounters per year are with patients who are uninsured or covered by medical assistance
176.27or MinnesotaCare; and
176.28    (5) a dental clinic owned and operated by the University of Minnesota or the
176.29Minnesota State Colleges and Universities system.; and
176.30    (6) private practicing dentists if:
176.31    (i) the dentist's office is located within a health professional shortage area as defined
176.32under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
176.33section 254E;
176.34    (ii) more than 50 percent of the dentist's patient encounters per year are with patients
176.35who are uninsured or covered by medical assistance or MinnesotaCare;
177.1    (iii) the dentist does not restrict access or services because of a patient's financial
177.2limitations or public assistance status; and
177.3    (iv) the level of service provided by the dentist is critical to maintaining adequate
177.4levels of patient access within the service area in which the dentist operates.
177.5    (c) The commissioner may designate a dentist or dental clinic as a critical access
177.6dental provider if the dentist or dental clinic is willing to provide care to patients covered
177.7by medical assistance, general assistance medical care, or MinnesotaCare at a level which
177.8significantly increases access to dental care in the service area.
177.9    (d) A designated critical access clinic shall receive the reimbursement rate specified
177.10in paragraph (a) for dental services provided off site at a private dental office if the
177.11following requirements are met:
177.12    (1) the designated critical access dental clinic is located within a health professional
177.13shortage area as defined under Code of Federal Regulations, title 42, part 5, and United
177.14States Code, title 42, section 254E, and is located outside the seven-county metropolitan
177.15area;
177.16    (2) the designated critical access dental clinic is not able to provide the service
177.17and refers the patient to the off-site dentist;
177.18    (3) the service, if provided at the critical access dental clinic, would be reimbursed
177.19at the critical access reimbursement rate;
177.20    (4) the dentist and allied dental professionals providing the services off site are
177.21licensed and in good standing under chapter 150A;
177.22    (5) the dentist providing the services is enrolled as a medical assistance provider;
177.23    (6) the critical access dental clinic submits the claim for services provided off site
177.24and receives the payment for the services; and
177.25    (7) the critical access dental clinic maintains dental records for each claim submitted
177.26under this paragraph, including the name of the dentist, the off-site location, and the
177.27license number of the dentist and allied dental professionals providing the services.

177.28    Sec. 19. Minnesota Statutes 2012, section 256B.76, is amended by adding a
177.29subdivision to read:
177.30    Subd. 7. Payment for certain primary care services and immunization
177.31administration. Payment for certain primary care services and immunization
177.32administration services rendered on or after January 1, 2013, through December 31, 2014,
177.33shall be made in accordance with section 1902(a)(13) of the Social Security Act.

178.1    Sec. 20. Minnesota Statutes 2012, section 256B.764, is amended to read:
178.2256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
178.3    (a) Effective for services rendered on or after July 1, 2007, payment rates for family
178.4planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
178.5when these services are provided by a community clinic as defined in section 145.9268,
178.6subdivision 1.
178.7    (b) Effective for services rendered on or after July 1, 2013, payment rates for
178.8family planning services shall be increased by 20 percent over the rates in effect June
178.930, 2013, when these services are provided by a community clinic as defined in section
178.10145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care
178.11and county-based purchasing plans to reflect this increase, and shall require plans to pass
178.12on the full amount of the rate increase to eligible community clinics, in the form of higher
178.13payment rates for family planning services.
178.14EFFECTIVE DATE.This section is effective July 1, 2013.

178.15    Sec. 21. Minnesota Statutes 2012, section 256B.766, is amended to read:
178.16256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
178.17(a) Effective for services provided on or after July 1, 2009, total payments for basic
178.18care services, shall be reduced by three percent, except that for the period July 1, 2009,
178.19through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
178.20assistance and general assistance medical care programs, prior to third-party liability and
178.21spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
178.22therapy services, occupational therapy services, and speech-language pathology and
178.23related services as basic care services. The reduction in this paragraph shall apply to
178.24physical therapy services, occupational therapy services, and speech-language pathology
178.25and related services provided on or after July 1, 2010.
178.26(b) Payments made to managed care plans and county-based purchasing plans shall
178.27be reduced for services provided on or after October 1, 2009, to reflect the reduction
178.28effective July 1, 2009, and payments made to the plans shall be reduced effective October
178.291, 2010, to reflect the reduction effective July 1, 2010.
178.30(c) Effective for services provided on or after September 1, 2011, through June 30,
178.312013, total payments for outpatient hospital facility fees shall be reduced by five percent
178.32from the rates in effect on August 31, 2011.
178.33(d) Effective for services provided on or after September 1, 2011, through June
178.3430, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
179.1and durable medical equipment not subject to a volume purchase contract, prosthetics
179.2and orthotics, renal dialysis services, laboratory services, public health nursing services,
179.3physical therapy services, occupational therapy services, speech therapy services,
179.4eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
179.5purchase contract, anesthesia services, and hospice services shall be reduced by three
179.6percent from the rates in effect on August 31, 2011.
179.7(e) This section does not apply to physician and professional services, inpatient
179.8hospital services, family planning services, mental health services, dental services,
179.9prescription drugs, medical transportation, federally qualified health centers, rural health
179.10centers, Indian health services, and Medicare cost-sharing.
179.11(f) For services provided on or after July 1, 2013, fee-for-service payments made
179.12to pediatric hospitals as referenced in the Social Security Act, section 1886(d)(1)(B)(iii)
179.13and nonstate government hospitals located in cities of the first class for the provision of
179.14outpatient basic care services to persons under age 21 shall be increased by ... percent,
179.15subject to an aggregate spending limit under this paragraph of $500,000 for the biennium
179.16ending June 30, 2015.

179.17    Sec. 22. PAYMENT FOR MULTIPLE SERVICES PROVIDED ON THE SAME
179.18DAY.
179.19The commissioner of human services shall report by December 15, 2013, to the
179.20chairs and ranking minority members of the legislative committees with jurisdiction over
179.21health and human services policy and finance on the costs and savings to the medical
179.22assistance program of allowing medical assistance payment, including supplemental
179.23payments, for mental health services or dental services provided to a patient by a federally
179.24qualified health center, federally qualified health care center look-alike, or a rural health
179.25clinic on the same day as other covered health services furnished by the same provider.

179.26    Sec. 23. DENTAL ADMINISTRATION AND REIMBURSEMENT REPORT.
179.27(a) The commissioner of human services shall study the feasibility of a single
179.28administrator for all dental services provided under medical assistance and MinnesotaCare.
179.29Dental services shall include services provided through the prepaid medical assistance
179.30program and the fee-for-service system administered by the Department of Human
179.31Services. The commissioner's study shall address and include recommendations on:
179.32(1) possible administrative savings under a single administrator;
179.33(2) current reimbursement levels and alternative reimbursement that could target
179.34funding to assure greater access to dental services;
180.1(3) flexible scheduling and the coordination of referrals to encourage greater
180.2participation from private dental practitioners and clinics;
180.3(4) approaches to reduce emergency room visits; and
180.4(5) the use of a streamlined information system to provide information on patient
180.5eligibility and restrictions on benefits.
180.6(b) The commissioner shall also make recommendations on service delivery and
180.7reimbursement methods, including the continuation or modification of critical access dental
180.8provider payments under sections 256B.76, subdivision 4, and 256L.11, subdivision 7.
180.9(c) In conducting the study, the commissioner shall consult with dental providers
180.10currently providing services to enrollees of Minnesota health care programs, including
180.11those receiving enhanced payments through critical access dental provider payments,
180.12private practice dentists, safety net clinics, and the University of Minnesota Dental School.
180.13(d) The commissioner shall submit a report and recommendations relating to dental
180.14administration and reimbursement to the chairs and ranking minority members of the
180.15legislative committees with jurisdiction over health and human services policy and finance
180.16by December 15, 2013.

180.17    Sec. 24. EMERGENCY MEDICAL ASSISTANCE DEMONSTRATION
180.18PROJECT.
180.19(a) The commissioner of human services shall implement, beginning January 1,
180.202014, a pilot program to provide alternative services to high-risk individuals with complex
180.21and chronic conditions eligible for emergency medical assistance under Minnesota
180.22Statutes, section 256B.06, subdivision 4. The program must be offered to eligible persons
180.23with two or more chronic conditions who have had two or more acute care admissions in
180.24the past 12 months.
180.25(b) The pilot program must be designed to provide health care services to eligible
180.26persons in their own environment, to significantly reduce nonemergency inpatient hospital
180.27admissions and long-term nursing facility stays. The program must include visits by
180.28health care professionals to the residences of eligible persons, regardless of whether
180.29the residence is a home, shelter, long-term care facility, residential program, or other
180.30location. The program may include features such as patient education, assistance with
180.31treatment plan compliance, medication management, and coordination of care with other
180.32health care and social service providers.
180.33(c) The commissioner shall select, by September 1, 2013, one or more vendors: (1)
180.34experienced with providing in-home primary and acute care to a population similar to
180.35persons receiving emergency medical assistance services; and (2) that have data analysis
181.1skills and modeling capability to identify the target population and evaluate the quality
181.2and cost-effectiveness of the intervention. The vendor contract must guarantee a savings
181.3to the state through operation of the pilot program. Savings generated through this
181.4pilot project must be shared with the vendor. Prior to entering into a final contract, the
181.5commissioner shall require prospective vendors to conduct preliminary analysis and test
181.6model feasibility and effectiveness for the population to be served.


181.9    Section 1. Minnesota Statutes 2012, section 16A.152, subdivision 2, is amended to read:
181.10    Subd. 2. Additional revenues; priority. (a) If on the basis of a forecast of general
181.11fund revenues and expenditures, the commissioner of management and budget determines
181.12that there will be a positive unrestricted budgetary general fund balance at the close of
181.13the biennium, the commissioner of management and budget must allocate money to the
181.14following accounts and purposes in priority order:
181.15    (1) the cash flow account established in subdivision 1 until that account reaches
181.16$350,000,000;
181.17    (2) the budget reserve account established in subdivision 1a until that account
181.18reaches $653,000,000;
181.19    (3) the amount necessary to increase the aid payment schedule for school district
181.20aids and credits payments in section 127A.45 to not more than 90 percent rounded to the
181.21nearest tenth of a percent without exceeding the amount available and with any remaining
181.22funds deposited in the budget reserve;
181.23    (4) the amount necessary to restore all or a portion of the net aid reductions under
181.24section 127A.441 and to reduce the property tax revenue recognition shift under section
181.25123B.75, subdivision 5 , by the same amount; and
181.26(5) to the extent the balance is due to a reduction in the nursing facility and elderly
181.27waiver forecast, an equal amount shall be used to increase nursing facility operating
181.28payment rates and elderly waiver rates, including all components and limits, but that
181.29amount is not less than zero; and
181.30(5) (6) to the state airports fund, the amount necessary to restore the amount
181.31transferred from the state airports fund under Laws 2008, chapter 363, article 11, section
181.323, subdivision 5.
181.33    (b) The amounts necessary to meet the requirements of this section are appropriated
181.34from the general fund within two weeks after the forecast is released or, in the case of
182.1transfers under paragraph (a), clauses (3) and (4), as necessary to meet the appropriations
182.2schedules otherwise established in statute.
182.3    (c) The commissioner of management and budget shall certify the total dollar
182.4amount of the reductions under paragraph (a), clauses (3) and (4), to the commissioner of
182.5education. The commissioner of education shall increase the aid payment percentage and
182.6reduce the property tax shift percentage by these amounts and apply those reductions to
182.7the current fiscal year and thereafter.

182.8    Sec. 2. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
182.9    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
182.10initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
182.112960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
182.129555.6265, under this chapter for a physical location that will not be the primary residence
182.13of the license holder for the entire period of licensure. If a license is issued during this
182.14moratorium, and the license holder changes the license holder's primary residence away
182.15from the physical location of the foster care license, the commissioner shall revoke the
182.16license according to section 245A.07. Exceptions to the moratorium include:
182.17(1) foster care settings that are required to be registered under chapter 144D;
182.18(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
182.19and determined to be needed by the commissioner under paragraph (b);
182.20(3) new foster care licenses determined to be needed by the commissioner under
182.21paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
182.22restructuring of state-operated services that limits the capacity of state-operated facilities;
182.23(4) new foster care licenses determined to be needed by the commissioner under
182.24paragraph (b) for persons requiring hospital level care; or
182.25(5) new foster care licenses determined to be needed by the commissioner for the
182.26transition of people from personal care assistance to the home and community-based
182.27services.
182.28(b) The commissioner shall determine the need for newly licensed foster care homes
182.29as defined under this subdivision. As part of the determination, the commissioner shall
182.30consider the availability of foster care capacity in the area in which the licensee seeks to
182.31operate, and the recommendation of the local county board. The determination by the
182.32commissioner must be final. A determination of need is not required for a change in
182.33ownership at the same address.
183.1(c) The commissioner shall study the effects of the license moratorium under this
183.2subdivision and shall report back to the legislature by January 15, 2011. This study shall
183.3include, but is not limited to the following:
183.4(1) the overall capacity and utilization of foster care beds where the physical location
183.5is not the primary residence of the license holder prior to and after implementation
183.6of the moratorium;
183.7(2) the overall capacity and utilization of foster care beds where the physical
183.8location is the primary residence of the license holder prior to and after implementation
183.9of the moratorium; and
183.10(3) the number of licensed and occupied ICF/MR beds prior to and after
183.11implementation of the moratorium.
183.12(d) (c) When a foster care recipient moves out of a foster home that is not the
183.13primary residence of the license holder according to section 256B.49, subdivision 15,
183.14paragraph (f), the county shall immediately inform the Department of Human Services
183.15Licensing Division. The department shall decrease the statewide licensed capacity for
183.16foster care settings where the physical location is not the primary residence of the license
183.17holder, if the voluntary changes described in paragraph (f) (e) are not sufficient to meet the
183.18savings required by reductions in licensed bed capacity under Laws 2011, First Special
183.19Session chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide
183.20long-term care residential services capacity within budgetary limits. Implementation of
183.21the statewide licensed capacity reduction shall begin on July 1, 2013. The commissioner
183.22shall delicense up to 128 beds by June 30, 2014, using the needs determination process.
183.23Under this paragraph, the commissioner has the authority to reduce unused licensed
183.24capacity of a current foster care program to accomplish the consolidation or closure of
183.25settings. A decreased licensed capacity according to this paragraph is not subject to appeal
183.26under this chapter.
183.27(e) (d) Residential settings that would otherwise be subject to the decreased license
183.28capacity established in paragraph (d) (c) shall be exempt under the following circumstances:
183.29(1) until August 1, 2013, the license holder's beds occupied by residents whose
183.30primary diagnosis is mental illness and the license holder is:
183.31(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
183.32health services (ARMHS) as defined in section 256B.0623;
183.33(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
183.349520.0870;
183.35(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
183.369520.0870; or
184.1(iv) a provider of intensive residential treatment services (IRTS) licensed under
184.2Minnesota Rules, parts 9520.0500 to 9520.0670; or
184.3(2) the license holder is certified under the requirements in subdivision 6a.
184.4(f) (e) A resource need determination process, managed at the state level, using the
184.5available reports required by section 144A.351, and other data and information shall
184.6be used to determine where the reduced capacity required under paragraph (d) (c) will
184.7be implemented. The commissioner shall consult with the stakeholders described in
184.8section 144A.351, and employ a variety of methods to improve the state's capacity to
184.9meet long-term care service needs within budgetary limits, including seeking proposals
184.10from service providers or lead agencies to change service type, capacity, or location to
184.11improve services, increase the independence of residents, and better meet needs identified
184.12by the long-term care services reports and statewide data and information. By February
184.131 of each 2013 and August 1 of 2014 and each following year, the commissioner shall
184.14provide information and data on the overall capacity of licensed long-term care services,
184.15actions taken under this subdivision to manage statewide long-term care services and
184.16supports resources, and any recommendations for change to the legislative committees
184.17with jurisdiction over health and human services budget.
184.18    (g) (f) At the time of application and reapplication for licensure, the applicant and the
184.19license holder that are subject to the moratorium or an exclusion established in paragraph
184.20(a) are required to inform the commissioner whether the physical location where the foster
184.21care will be provided is or will be the primary residence of the license holder for the entire
184.22period of licensure. If the primary residence of the applicant or license holder changes, the
184.23applicant or license holder must notify the commissioner immediately. The commissioner
184.24shall print on the foster care license certificate whether or not the physical location is the
184.25primary residence of the license holder.
184.26    (h) (g) License holders of foster care homes identified under paragraph (g) (f) that
184.27are not the primary residence of the license holder and that also provide services in the
184.28foster care home that are covered by a federally approved home and community-based
184.29services waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must
184.30inform the human services licensing division that the license holder provides or intends to
184.31provide these waiver-funded services. These license holders must be considered registered
184.32under section 256B.092, subdivision 11, paragraph (c), and this registration status must
184.33be identified on their license certificates.

184.34    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
184.35to read:
185.1    Subd. 35. Commissioner must annually report certain prepaid medical
185.2assistance plan data. (a) The commissioner of human services and the commissioner
185.3of education may share private or nonpublic data to allow the commissioners to analyze
185.4the screening, diagnosis, and treatment of children with autism spectrum disorder and
185.5other developmental conditions. The commissioners may share the individual-level data
185.6necessary to:
185.7    (1) measure the prevalence of autism spectrum disorder and other developmental
185.8conditions;
185.9    (2) analyze the effectiveness of existing policies and procedures in the early
185.10identification of children with autism spectrum disorder and other developmental
185.11conditions;
185.12    (3) assess the effectiveness of screening, diagnosis, and treatment to allow children
185.13with autism spectrum disorder and other developmental conditions to meet developmental
185.14and social-emotional milestones;
185.15    (4) identify and address disparities in screening, diagnosis, and treatment related
185.16to the native language or race and ethnicity of the child;
185.17    (5) measure the effectiveness of public health care programs in addressing the medical
185.18needs of children with autism spectrum disorder and other developmental conditions; and
185.19    (6) determine the capacity of educational systems and health care systems to meet
185.20the needs of children with autism spectrum disorder and other developmental conditions.
185.21    (b) The commissioner of human services shall use the data shared with the
185.22commissioner of education under this subdivision to improve public health care program
185.23performance in early screening, diagnosis, and treatment for children once data are
185.24available and shall report on the results and any summary data, as defined in section 13.02,
185.25subdivision 19, on the department's public Web site by September 30 each year.

185.26    Sec. 4. Minnesota Statutes 2012, section 256.9657, subdivision 3a, is amended to read:
185.27    Subd. 3a. ICF/MR ICF/DD license surcharge. (a) Effective July 1, 2003, each
185.28non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay
185.29to the commissioner an annual surcharge according to the schedule in subdivision 4,
185.30paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of
185.31licensed beds is reduced, the surcharge shall be based on the number of remaining licensed
185.32beds the second month following the receipt of timely notice by the commissioner of
185.33human services that beds have been delicensed. The facility must notify the commissioner
185.34of health in writing when beds are delicensed. The commissioner of health must notify
185.35the commissioner of human services within ten working days after receiving written
186.1notification. If the notification is received by the commissioner of human services by
186.2the 15th of the month, the invoice for the second following month must be reduced to
186.3recognize the delicensing of beds. The commissioner may reduce, and may subsequently
186.4restore, the surcharge under this subdivision based on the commissioner's determination of
186.5a permissible surcharge.
186.6(b) Effective July 1, 2013, the surcharge under paragraph (a) is increased to $3,717
186.7per licensed bed.
186.8EFFECTIVE DATE.This section is effective July 1, 2013.

186.9    Sec. 5. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to read:
186.10    Subd. 4d. Preadmission screening of individuals under 65 years of age. (a)
186.11It is the policy of the state of Minnesota to ensure that individuals with disabilities or
186.12chronic illness are served in the most integrated setting appropriate to their needs and have
186.13the necessary information to make informed choices about home and community-based
186.14service options.
186.15    (b) Individuals under 65 years of age who are admitted to a nursing facility from a
186.16hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.
186.17    (c) Individuals under 65 years of age who are admitted to nursing facilities with
186.18only a telephone screening must receive a face-to-face assessment from the long-term
186.19care consultation team member of the county in which the facility is located or from the
186.20recipient's county case manager within 40 calendar days of admission.
186.21    (d) Individuals under 65 years of age who are admitted to a nursing facility
186.22without preadmission screening according to the exemption described in subdivision 4b,
186.23paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
186.24a face-to-face assessment within 40 days of admission.
186.25    (e) At the face-to-face assessment, the long-term care consultation team member or
186.26county case manager must perform the activities required under subdivision 3b.
186.27    (f) For individuals under 21 years of age, a screening interview which recommends
186.28nursing facility admission must be face-to-face and approved by the commissioner before
186.29the individual is admitted to the nursing facility.
186.30    (g) In the event that an individual under 65 years of age is admitted to a nursing
186.31facility on an emergency basis, the county must be notified of the admission on the
186.32next working day, and a face-to-face assessment as described in paragraph (c) must be
186.33conducted within 40 calendar days of admission.
186.34    (h) At the face-to-face assessment, the long-term care consultation team member or
186.35the case manager must present information about home and community-based options,
187.1including consumer-directed options, so the individual can make informed choices. If the
187.2individual chooses home and community-based services, the long-term care consultation
187.3team member or case manager must complete a written relocation plan within 20 working
187.4days of the visit. The plan shall describe the services needed to move out of the facility
187.5and a time line for the move which is designed to ensure a smooth transition to the
187.6individual's home and community.
187.7    (i) An individual under 65 years of age residing in a nursing facility shall receive a
187.8face-to-face assessment at least every 12 months to review the person's service choices
187.9and available alternatives unless the individual indicates, in writing, that annual visits are
187.10not desired. In this case, the individual must receive a face-to-face assessment at least
187.11once every 36 months for the same purposes.
187.12    (j) Notwithstanding the provisions of subdivision 6, the commissioner may pay
187.13county agencies directly for face-to-face assessments for individuals under 65 years of age
187.14who are being considered for placement or residing in a nursing facility. Until September
187.1530, 2013, payments for individuals under 65 years of age shall be made as described
187.16in this subdivision.

187.17    Sec. 6. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
187.18    Subd. 6. Payment for long-term care consultation services. (a) Until September
187.1930, 2013, payment for long-term care consultation face-to-face assessment shall be made
187.20as described in this subdivision.
187.21    (b) The total payment for each county must be paid monthly by certified nursing
187.22facilities in the county. The monthly amount to be paid by each nursing facility for each
187.23fiscal year must be determined by dividing the county's annual allocation for long-term
187.24care consultation services by 12 to determine the monthly payment and allocating the
187.25monthly payment to each nursing facility based on the number of licensed beds in the
187.26nursing facility. Payments to counties in which there is no certified nursing facility must be
187.27made by increasing the payment rate of the two facilities located nearest to the county seat.
187.28    (b) (c) The commissioner shall include the total annual payment determined under
187.29paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434,
187.30or 256B.441.
187.31    (c) (d) In the event of the layaway, delicensure and decertification, or removal from
187.32layaway of 25 percent or more of the beds in a facility, the commissioner may adjust the
187.33per diem payment amount in paragraph (b) (c) and may adjust the monthly payment
187.34amount in paragraph (a). The effective date of an adjustment made under this paragraph
188.1shall be on or after the first day of the month following the effective date of the layaway,
188.2delicensure and decertification, or removal from layaway.
188.3    (d) (e) Payments for long-term care consultation services are available to the county
188.4or counties to cover staff salaries and expenses to provide the services described in
188.5subdivision 1a. The county shall employ, or contract with other agencies to employ,
188.6within the limits of available funding, sufficient personnel to provide long-term care
188.7consultation services while meeting the state's long-term care outcomes and objectives as
188.8defined in subdivision 1. The county shall be accountable for meeting local objectives
188.9as approved by the commissioner in the biennial home and community-based services
188.10quality assurance plan on a form provided by the commissioner.
188.11    (e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment
188.12of the screening costs under the medical assistance program may not be recovered from
188.13a facility.
188.14    (f) (g) The commissioner of human services shall amend the Minnesota medical
188.15assistance plan to include reimbursement for the local consultation teams.
188.16    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented,
188.17the county may bill, as case management services, assessments, support planning, and
188.18follow-along provided to persons determined to be eligible for case management under
188.19Minnesota health care programs. No individual or family member shall be charged for an
188.20initial assessment or initial support plan development provided under subdivision 3a or 3b.
188.21(h) (i) The commissioner shall develop an alternative payment methodology,
188.22effective on October 1, 2013, for long-term care consultation services that includes
188.23the funding available under this subdivision, and for assessments authorized under
188.24sections 256B.092 and 256B.0659. In developing the new payment methodology, the
188.25commissioner shall consider the maximization of other funding sources, including federal
188.26administrative reimbursement through federal financial participation funding, for all
188.27long-term care consultation and preadmission screening activity. The alternative payment
188.28methodology shall include the use of the appropriate time studies and the state financing
188.29of nonfederal share as part of the state's medical assistance program.

188.30    Sec. 7. Minnesota Statutes 2012, section 256B.0916, is amended by adding a
188.31subdivision to read:
188.32    Subd. 11. Excess spending. County and tribal agencies are responsible for spending
188.33in excess of the allocation made by the commissioner. In the event a county or tribal
188.34agency spends in excess of the allocation made by the commissioner for a given allocation
188.35period, they must submit a corrective action plan to the commissioner. The plan must state
189.1the actions the agency will take to correct their overspending for the year following the
189.2period when the overspending occurred. Failure to correct overspending shall result in
189.3recoupment of spending in excess of the allocation. Nothing in this subdivision shall be
189.4construed as reducing the county's responsibility to offer and make available feasible
189.5home and community-based options to eligible waiver recipients within the resources
189.6allocated to them for that purpose.

189.7    Sec. 8. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
189.8    Subd. 11. Residential support services. (a) Upon federal approval, there is
189.9established a new service called residential support that is available on the community
189.10alternative care, community alternatives for disabled individuals, developmental
189.11disabilities, and brain injury waivers. Existing waiver service descriptions must be
189.12modified to the extent necessary to ensure there is no duplication between other services.
189.13Residential support services must be provided by vendors licensed as a community
189.14residential setting as defined in section 245A.11, subdivision 8.
189.15    (b) Residential support services must meet the following criteria:
189.16    (1) providers of residential support services must own or control the residential site;
189.17    (2) the residential site must not be the primary residence of the license holder;
189.18    (3) the residential site must have a designated program supervisor responsible for
189.19program oversight, development, and implementation of policies and procedures;
189.20    (4) the provider of residential support services must provide supervision, training,
189.21and assistance as described in the person's coordinated service and support plan; and
189.22    (5) the provider of residential support services must meet the requirements of
189.23licensure and additional requirements of the person's coordinated service and support plan.
189.24    (c) Providers of residential support services that meet the definition in paragraph
189.25(a) must be registered using a process determined by the commissioner beginning July
189.261, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts
189.272960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts
189.289555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision
189.297 , paragraph (g) (f), are considered registered under this section.

189.30    Sec. 9. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:
189.31    Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
189.32establish statewide priorities for individuals on the waiting list for developmental
189.33disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
189.34include, but are not limited to, individuals who continue to have a need for waiver services
190.1after they have maximized the use of state plan services and other funding resources,
190.2including natural supports, prior to accessing waiver services, and who meet at least one
190.3of the following criteria:
190.4(1) have unstable living situations due to the age, incapacity, or sudden loss of
190.5the primary caregivers;
190.6(2) are moving from an institution due to bed closures;
190.7(3) experience a sudden closure of their current living arrangement;
190.8(4) require protection from confirmed abuse, neglect, or exploitation;
190.9(5) experience a sudden change in need that can no longer be met through state plan
190.10services or other funding resources alone; or
190.11(6) meet other priorities established by the department.
190.12(b) When allocating resources to lead agencies, the commissioner must take into
190.13consideration the number of individuals waiting who meet statewide priorities and the
190.14lead agencies' current use of waiver funds and existing service options. The commissioner
190.15has the authority to transfer funds between counties, groups of counties, and tribes to
190.16accommodate statewide priorities and resource needs while accounting for a necessary
190.17base level reserve amount for each county, group of counties, and tribe.
190.18(c) The commissioner shall evaluate the impact of the use of statewide priorities and
190.19provide recommendations to the legislature on whether to continue the use of statewide
190.20priorities in the November 1, 2011, annual report required by the commissioner in sections
190.21256B.0916, subdivision 7, and 256B.49, subdivision 21.

190.22    Sec. 10. [256B.0949] AUTISM EARLY INTENSIVE INTERVENTION BENEFIT.
190.23    Subdivision 1. Purpose. This section creates a new benefit available under the
190.24medical assistance state plan when federal approval consistent with the provisions in
190.25subdivision 11 is obtained for a 1915(i) waiver pursuant to the Affordable Care Act, section
190.262402(c), amending United States Code, title 42, section 1396n(i)(1), or other option to
190.27provide early intensive intervention to a child with an autism spectrum disorder diagnosis.
190.28This benefit must provide coverage for diagnosis, multidisciplinary assessment, ongoing
190.29progress evaluation, and medically necessary treatment of autism spectrum disorder.
190.30    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
190.31this subdivision have the meanings given.
190.32    (b) "Autism spectrum disorder diagnosis" is defined by diagnostic code 299 in the
190.33current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
191.1    (c) "Child" means a person under the age of seven, or for two years at any age under
191.2age 18 if the person was not diagnosed with autism spectrum disorder before age five, or a
191.3person under age 18 pursuant to subdivision 12.
191.4    (d) "Commissioner" means the commissioner of human services, unless otherwise
191.5specified.
191.6    (e) "Early intensive intervention benefit" means autism treatment options based in
191.7behavioral and developmental science, which may include modalities such as applied
191.8behavior analysis, developmental treatment approaches, and naturalistic and parent
191.9training models.
191.10    (f) "Generalizable goals" means results or gains that are observed during a variety
191.11of activities with different people, such as providers, family members, other adults, and
191.12children, and in different environments including, but not limited to, clinics, homes,
191.13schools, and the community.
191.14    Subd. 3. Initial eligibility. This benefit is available to a child enrolled in medical
191.15assistance who:
191.16    (1) has an autism spectrum disorder diagnosis;
191.17    (2) has had a diagnostic assessment described in subdivision 5, which recommends
191.18early intensive intervention services;
191.19    (3) meets the criteria for medically necessary autism early intensive intervention
191.20services; and
191.21    (4) declines to enroll in the state services described in section 252.27.
191.22    Subd. 4. Diagnosis. (a) A diagnosis must:
191.23    (1) be based upon current DSM criteria including direct observations of the child
191.24and reports from parents or primary caregivers;
191.25    (2) be completed by a professional who has expertise and training in autism spectrum
191.26disorder and child development and who is a licensed physician, nurse practitioner, or
191.27a licensed mental health professional until the commissioner's assessment required in
191.28subdivision 8, clause (7), shows there are adequate professionals to avoid access problems
191.29or delays in diagnosis for young children if two professionals are required for a diagnosis
191.30pursuant to clause (3); and
191.31    (3) be completed by both a medical and mental health professional who have expertise
191.32and training in autism spectrum disorder and child development when the assessment in
191.33subdivision 8, clause (7), demonstrates that there are sufficient professionals available.
191.34    (b) Additional diagnostic assessment information including from special education
191.35evaluations and licensed school personnel, and from professionals licensed in the fields of
192.1medicine, speech and language, psychology, occupational therapy, and physical therapy
192.2may be considered.
192.3    Subd. 5. Diagnostic assessment. The following information and assessments must
192.4be performed, reviewed, and relied upon for the eligibility determination, treatment and
192.5services recommendations, and treatment plan development for the child:
192.6    (1) an assessment of the child's developmental skills, functional behavior, needs,
192.7and capacities based on direct observation of the child which must be administered by
192.8a licensed mental health professional and may also include observations from family
192.9members, licensed school personnel, child care providers, or other caregivers, as well as
192.10any medical or assessment information from other licensed professionals such as the
192.11child's physician, rehabilitation therapists, or mental health professionals; and
192.12    (2) an assessment of parental or caregiver capacity to participate in therapy including
192.13the type and level of parental or caregiver involvement and training recommended.
192.14    Subd. 6. Treatment plan. (a) Each child's treatment plan must be:
192.15    (1) based on the diagnostic assessment information specified in subdivisions 4 and 5;
192.16    (2) coordinated with medically necessary occupational, physical, and speech and
192.17language therapies, special education, and other services the child and family are receiving;
192.18    (3) family-centered;
192.19    (4) culturally sensitive; and
192.20    (5) individualized based on the child's developmental status and the child's and
192.21family's identified needs.
192.22    (b) The treatment plan must specify the:
192.23    (1) child's goals which are developmentally appropriate, functional, and
192.24generalizable;
192.25    (2) treatment modality;
192.26    (3) treatment intensity;
192.27    (4) setting; and
192.28    (5) level and type of parental or caregiver involvement.
192.29    (c) The treatment must be supervised by a professional with expertise and training in
192.30autism and child development who is a licensed physician, nurse practitioner, or mental
192.31health professional.
192.32    (d) The treatment plan must be submitted to the commissioner for approval in a
192.33manner determined by the commissioner for this purpose.
192.34    (e) Services authorized must be consistent with the child's approved treatment plan.
192.35    Subd. 7. Ongoing eligibility. (a) An independent progress evaluation conducted
192.36by a licensed mental health professional with expertise and training in autism spectrum
193.1disorder and child development must be completed after each six months of treatment,
193.2or more frequently as determined by the commissioner, to determine if progress is being
193.3made toward achieving generalizable gains and meeting functional goals contained in
193.4the treatment plan.
193.5    (b) The progress evaluation must include:
193.6    (1) the treating provider's report;
193.7    (2) parental or caregiver input;
193.8    (3) an independent observation of the child which can be performed by the child's
193.9licensed special education staff;
193.10    (4) any treatment plan modifications; and
193.11    (5) recommendations for continued treatment services.
193.12    (c) Progress evaluations must be submitted to the commissioner in a manner
193.13determined by the commissioner for this purpose.
193.14    (d) A child who continues to achieve generalizable gains and treatment goals as
193.15specified in the treatment plan is eligible to continue receiving this benefit.
193.16    (e) A child's treatment shall continue during the progress evaluation and during an
193.17appeal if continuation of services pending appeal have been requested pursuant to section
193.18256.045, subdivision 10.
193.19    Subd. 8. Refining the benefit with stakeholders. The commissioner must develop
193.20the implementation details of the benefit in consultation with stakeholders and consider
193.21recommendations from the Health Services Advisory Council, the Department of Human
193.22Services Autism Spectrum Disorder Advisory Council, the Legislative Autism Spectrum
193.23Disorder Task Force, and the Interagency Task Force of the Departments of Health,
193.24Education, and Human Services. The commissioner must release these details for a 30-day
193.25public comment period prior to submission to the federal government for approval. The
193.26implementation details include, but are not limited to, the following components:
193.27    (1) a definition of the qualifications, standards, and roles of the treatment team,
193.28including recommendations after stakeholder consultation on whether board-certified
193.29behavior analysts and other types of professionals trained in autism spectrum disorder and
193.30child development should be added as mental health or other professionals for treatment
193.31supervision or other function under medical assistance;
193.32    (2) development of initial, uniform parameters for comprehensive multidisciplinary
193.33diagnostic assessment information and progress evaluation standards;
193.34    (3) the design of an effective and consistent process for assessing parent and
193.35caregiver capacity to participate in the child's early intervention treatment and methods of
193.36involving the parents in the treatment of the child;
194.1    (4) formulation of a collaborative process in which professionals have opportunities
194.2to collectively inform the comprehensive, multidisciplinary diagnostic assessment and
194.3progress evaluation processes and standards to support quality improvement of early
194.4intensive intervention services;
194.5    (5) coordination of this benefit and its interaction with other services provided by the
194.6Departments of Human Services, Health, and Education;
194.7    (6) evaluation, on an ongoing basis, of research regarding the program and treatment
194.8modalities provided to children under this benefit; and
194.9    (7) determination of the availability of licensed medical and mental health
194.10professionals with expertise and training in autism spectrum disorder throughout the state
194.11in order to assess whether there are sufficient professionals to require involvement of
194.12both a medical and mental health professional to provide access and prevent delay in the
194.13diagnosis and treatment of young children so as to implement subdivision 4, paragraph
194.14(a), and to ensure treatment is effective, timely, and accessible.
194.15    Subd. 9. Revision of treatment options. (a) The commissioner may revise covered
194.16treatment options as needed based on outcome data and other evidence.
194.17    (b) Before the changes become effective, the commissioner must provide public
194.18notice of the changes, the reasons for the change, and a 30-day public comment period
194.19to those who request notice through an electronic list accessible to the public on the
194.20department's Web site.
194.21    Subd. 10. Coordination between agencies. The commissioners of human services
194.22and education must develop the capacity to coordinate services and information including
194.23diagnostic, functional, developmental, medical, and educational assessments; service
194.24delivery; and progress evaluations across health and education sectors.
194.25    Subd. 11. Federal approval of the autism benefit. The provisions of subdivision 9
194.26shall apply to state plan services under Title XIX of the Social Security Act when federal
194.27approval is granted under a 1915(i) waiver or other authority which allows children
194.28eligible for medical assistance through the TEFRA option under section 256B.055,
194.29subdivision 12, to qualify and includes children eligible for medical assistance in families
194.30over 150 percent of the federal poverty guidelines.
194.31    Subd. 12. Local school districts option to continue treatment. (a) A local school
194.32district may contract with the commissioner of human services to pay the state share of
194.33the benefits described under this section to continue this treatment as part of the special
194.34education services offered to all students in the district diagnosed with an autism spectrum
194.35disorder.
195.1    (b) A local school district may utilize third-party billing to seek reimbursement
195.2for the district for any services paid by the district under this section for which private
195.3insurance coverage was available to the child.
195.4EFFECTIVE DATE.The autism benefit under subdivisions 1 to 7, 9, and 12, is
195.5effective upon federal approval for the benefit under a 1915(i) waiver or other federal
195.6authority needed to meet the requirements of subdivision 11, but no earlier than March 1,
195.72014. Subdivisions 8, 10, and 11 are effective July 1, 2013.

195.8    Sec. 11. Minnesota Statutes 2012, section 256B.095, is amended to read:
195.9256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
195.10    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
195.11disabilities, which includes an alternative quality assurance licensing system for programs,
195.12is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
195.13Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
195.14services provided to persons with developmental disabilities. A county, at its option, may
195.15choose to have all programs for persons with developmental disabilities located within
195.16the county licensed under chapter 245A using standards determined under the alternative
195.17quality assurance licensing system or may continue regulation of these programs under the
195.18licensing system operated by the commissioner. The project expires on June 30, 2014.
195.19    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
195.20participate in the quality assurance system established under paragraph (a). The
195.21commission established under section 256B.0951 may, at its option, allow additional
195.22counties to participate in the system.
195.23    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
195.24may establish a quality assurance system under this section. A new system established
195.25under this section shall have the same rights and duties as the system established
195.26under paragraph (a). A new system shall be governed by a commission under section
195.27256B.0951 . The commissioner shall appoint the initial commission members based
195.28on recommendations from advocates, families, service providers, and counties in the
195.29geographic area included in the new system. Counties that choose to participate in a
195.30new system shall have the duties assigned under section 256B.0952. The new system
195.31shall establish a quality assurance process under section 256B.0953. The provisions of
195.32section 256B.0954 shall apply to a new system established under this paragraph. The
195.33commissioner shall delegate authority to a new system established under this paragraph
195.34according to section 256B.0955.
196.1    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
196.2programs for persons with disabilities and older adults.
196.3(e) Effective July 1, 2013, a provider of service located in a county listed in
196.4paragraph (a) that is a non-opted-in county may opt-in to the quality assurance system
196.5provided the county where services are provided indicates its agreement with a county
196.6with a delegation agreement with the Department of Human Services.
196.7EFFECTIVE DATE.This section is effective July 1, 2013.

196.8    Sec. 12. Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:
196.9    Subdivision 1. Membership. The Quality Assurance Commission is established.
196.10The commission consists of at least 14 but not more than 21 members as follows: at
196.11least three but not more than five members representing advocacy organizations; at
196.12least three but not more than five members representing consumers, families, and their
196.13legal representatives; at least three but not more than five members representing service
196.14providers; at least three but not more than five members representing counties; and the
196.15commissioner of human services or the commissioner's designee. The first commission
196.16shall establish membership guidelines for the transition and recruitment of membership for
196.17the commission's ongoing existence. Members of the commission who do not receive a
196.18salary or wages from an employer for time spent on commission duties may receive a per
196.19diem payment when performing commission duties and functions. All members may be
196.20reimbursed for expenses related to commission activities. Notwithstanding the provisions
196.21of section 15.059, subdivision 5, the commission expires on June 30, 2014.

196.22    Sec. 13. Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:
196.23    Subd. 4. Commission's authority to recommend variances of licensing
196.24standards. The commission may recommend to the commissioners of human services
196.25and health variances from the standards governing licensure of programs for persons with
196.26developmental disabilities in order to improve the quality of services by implementing
196.27an alternative developmental disabilities licensing system if the commission determines
196.28that the alternative licensing system does not adversely affect the health or safety of
196.29persons being served by the licensed program nor compromise the qualifications of staff
196.30to provide services.

196.31    Sec. 14. Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:
196.32    Subdivision 1. Notification. Counties or providers shall give notice to the
196.33commission and commissioners of human services and health of intent to join the
197.1alternative quality assurance licensing system. A county or provider choosing to participate
197.2in the alternative quality assurance licensing system commits to participate for three years.

197.3    Sec. 15. Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:
197.4    Subd. 5. Quality assurance teams. Quality assurance teams shall be comprised
197.5of county staff; providers; consumers, families, and their legal representatives; members
197.6of advocacy organizations; and other involved community members. Team members
197.7must satisfactorily complete the training program approved by the commission and must
197.8demonstrate performance-based competency. Team members are not considered to be
197.9county employees for purposes of workers' compensation, unemployment insurance, or
197.10state retirement laws solely on the basis of participation on a quality assurance team. The
197.11county may pay A per diem may be paid to team members for time spent on alternative
197.12quality assurance process matters. All team members may be reimbursed for expenses
197.13related to their participation in the alternative process.

197.14    Sec. 16. Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:
197.15    Subdivision 1. Scope. (a) In order to improve the quality of services provided to
197.16Minnesotans with disabilities and to meet the requirements of the federally approved home
197.17and community-based waivers under section 1915c of the Social Security Act, a State
197.18Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving
197.19disability services is enacted. This system is a partnership between the Department of
197.20Human Services and the State Quality Council established under subdivision 3.
197.21    (b) This system is a result of the recommendations from the Department of Human
197.22Services' licensing and alternative quality assurance study mandated under Laws 2005,
197.23First Special Session chapter 4, article 7, section 57, and presented to the legislature
197.24in February 2007.
197.25    (c) The disability services eligible under this section include:
197.26    (1) the home and community-based services waiver programs for persons with
197.27developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
197.28including brain injuries and services for those who qualify for nursing facility level of care
197.29or hospital facility level of care and any other services licensed under chapter 245D;
197.30    (2) home care services under section 256B.0651;
197.31    (3) family support grants under section 252.32;
197.32    (4) consumer support grants under section 256.476;
197.33    (5) semi-independent living services under section 252.275; and
198.1    (6) services provided through an intermediate care facility for the developmentally
198.2disabled.
198.3    (d) For purposes of this section, the following definitions apply:
198.4    (1) "commissioner" means the commissioner of human services;
198.5    (2) "council" means the State Quality Council under subdivision 3;
198.6    (3) "Quality Assurance Commission" means the commission under section
198.7256B.0951 ; and
198.8    (4) "system" means the State Quality Assurance, Quality Improvement and
198.9Licensing System under this section.

198.10    Sec. 17. Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:
198.11    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
198.12Council which must define regional quality councils, and carry out a community-based,
198.13person-directed quality review component, and a comprehensive system for effective
198.14incident reporting, investigation, analysis, and follow-up.
198.15    (b) By August 1, 2011, the commissioner of human services shall appoint the
198.16members of the initial State Quality Council. Members shall include representatives
198.17from the following groups:
198.18    (1) disability service recipients and their family members;
198.19    (2) during the first two four years of the State Quality Council, there must be at least
198.20three members from the Region 10 stakeholders. As regional quality councils are formed
198.21under subdivision 4, each regional quality council shall appoint one member;
198.22    (3) disability service providers;
198.23    (4) disability advocacy groups; and
198.24    (5) county human services agencies and staff from the Department of Human
198.25Services and Ombudsman for Mental Health and Developmental Disabilities.
198.26    (c) Members of the council who do not receive a salary or wages from an employer
198.27for time spent on council duties may receive a per diem payment when performing council
198.28duties and functions.
198.29    (d) The State Quality Council shall:
198.30    (1) assist the Department of Human Services in fulfilling federally mandated
198.31obligations by monitoring disability service quality and quality assurance and
198.32improvement practices in Minnesota;
198.33    (2) establish state quality improvement priorities with methods for achieving results
198.34and provide an annual report to the legislative committees with jurisdiction over policy
199.1and funding of disability services on the outcomes, improvement priorities, and activities
199.2undertaken by the commission during the previous state fiscal year;
199.3(3) identify issues pertaining to financial and personal risk that impede Minnesotans
199.4with disabilities from optimizing choice of community-based services; and
199.5(4) recommend to the chairs and ranking minority members of the legislative
199.6committees with jurisdiction over human services and civil law by January 15, 2013
199.7 2014, statutory and rule changes related to the findings under clause (3) that promote
199.8individualized service and housing choices balanced with appropriate individualized
199.9protection.
199.10    (e) The State Quality Council, in partnership with the commissioner, shall:
199.11    (1) approve and direct implementation of the community-based, person-directed
199.12system established in this section;
199.13    (2) recommend an appropriate method of funding this system, and determine the
199.14feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
199.15    (3) approve measurable outcomes in the areas of health and safety, consumer
199.16evaluation, education and training, providers, and systems;
199.17    (4) establish variable licensure periods not to exceed three years based on outcomes
199.18achieved; and
199.19    (5) in cooperation with the Quality Assurance Commission, design a transition plan
199.20for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
199.21    (f) The State Quality Council shall notify the commissioner of human services that a
199.22facility, program, or service has been reviewed by quality assurance team members under
199.23subdivision 4, paragraph (b), clause (13), and qualifies for a license.
199.24    (g) The State Quality Council, in partnership with the commissioner, shall establish
199.25an ongoing review process for the system. The review shall take into account the
199.26comprehensive nature of the system which is designed to evaluate the broad spectrum of
199.27licensed and unlicensed entities that provide services to persons with disabilities. The
199.28review shall address efficiencies and effectiveness of the system.
199.29    (h) The State Quality Council may recommend to the commissioner certain
199.30variances from the standards governing licensure of programs for persons with disabilities
199.31in order to improve the quality of services so long as the recommended variances do
199.32not adversely affect the health or safety of persons being served or compromise the
199.33qualifications of staff to provide services.
199.34    (i) The safety standards, rights, or procedural protections referenced under
199.35subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
199.36recommendations to the commissioner or to the legislature in the report required under
200.1paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
200.2procedural protections referenced under subdivision 2, paragraph (c).
200.3    (j) The State Quality Council may hire staff to perform the duties assigned in this
200.4subdivision.

200.5    Sec. 18. Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:
200.6    Subd. 44. Property rate increase increases for a facility in Bloomington effective
200.7November 1, 2010 certain nursing facilities. (a) Notwithstanding any other law to the
200.8contrary, money available for moratorium projects under section 144A.073, subdivision
200.911 , shall be used, effective November 1, 2010, to fund an approved moratorium exception
200.10project for a nursing facility in Bloomington licensed for 137 beds as of November 1,
200.112010, up to a total property rate adjustment of $19.33.
200.12(b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110
200.13beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow
200.14$1,129,463 of a completed construction project to increase the property payment rate.
200.15Notwithstanding any other law to the contrary, money available under section 144A.073,
200.16subdivision 11, after the completion of the moratorium exception approval process in 2013
200.17under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the
200.18medical assistance budget for the increase in the replacement-cost-new limit.
200.19EFFECTIVE DATE.This section is effective retroactively from June 1, 2012.

200.20    Sec. 19. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:
200.21    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
200.22have their payment rates determined under this section rather than section 256B.431, the
200.23commissioner shall establish a rate under this subdivision. The nursing facility must enter
200.24into a written contract with the commissioner.
200.25    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
200.26contract under this section is the payment rate the facility would have received under
200.27section 256B.431.
200.28    (c) A nursing facility's case mix payment rates for the second and subsequent years
200.29of a facility's contract under this section are the previous rate year's contract payment
200.30rates plus an inflation adjustment and, for facilities reimbursed under this section or
200.31section 256B.431, an adjustment to include the cost of any increase in Health Department
200.32licensing fees for the facility taking effect on or after July 1, 2001. The index for the
200.33inflation adjustment must be based on the change in the Consumer Price Index-All Items
200.34(United States City average) (CPI-U) forecasted by the commissioner of management and
201.1budget's national economic consultant, as forecasted in the fourth quarter of the calendar
201.2year preceding the rate year. The inflation adjustment must be based on the 12-month
201.3period from the midpoint of the previous rate year to the midpoint of the rate year for
201.4which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
201.52000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
201.6July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall
201.7apply only to the property-related payment rate. For the rate years beginning on October
201.81, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and
201.9October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning
201.10in 2005, adjustment to the property payment rate under this section and section 256B.431
201.11shall be effective on October 1. In determining the amount of the property-related payment
201.12rate adjustment under this paragraph, the commissioner shall determine the proportion of
201.13the facility's rates that are property-related based on the facility's most recent cost report.
201.14    (d) The commissioner shall develop additional incentive-based payments of up to
201.15five percent above a facility's operating payment rate for achieving outcomes specified
201.16in a contract. The commissioner may solicit contract amendments and implement those
201.17which, on a competitive basis, best meet the state's policy objectives. The commissioner
201.18shall limit the amount of any incentive payment and the number of contract amendments
201.19under this paragraph to operate the incentive payments within funds appropriated for this
201.20purpose. The contract amendments may specify various levels of payment for various
201.21levels of performance. Incentive payments to facilities under this paragraph may be in the
201.22form of time-limited rate adjustments or onetime supplemental payments. In establishing
201.23the specified outcomes and related criteria, the commissioner shall consider the following
201.24state policy objectives:
201.25    (1) successful diversion or discharge of residents to the residents' prior home or other
201.26community-based alternatives;
201.27    (2) adoption of new technology to improve quality or efficiency;
201.28    (3) improved quality as measured in the Nursing Home Report Card;
201.29    (4) reduced acute care costs; and
201.30    (5) any additional outcomes proposed by a nursing facility that the commissioner
201.31finds desirable.
201.32    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
201.33take action to come into compliance with existing or pending requirements of the life
201.34safety code provisions or federal regulations governing sprinkler systems must receive
201.35reimbursement for the costs associated with compliance if all of the following conditions
201.36are met:
202.1    (1) the expenses associated with compliance occurred on or after January 1, 2005,
202.2and before December 31, 2008;
202.3    (2) the costs were not otherwise reimbursed under subdivision 4f or section
202.4144A.071 or 144A.073; and
202.5    (3) the total allowable costs reported under this paragraph are less than the minimum
202.6threshold established under section 256B.431, subdivision 15, paragraph (e), and
202.7subdivision 16.
202.8The commissioner shall use money appropriated for this purpose to provide to qualifying
202.9nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
202.102008. Nursing facilities that have spent money or anticipate the need to spend money
202.11to satisfy the most recent life safety code requirements by (1) installing a sprinkler
202.12system or (2) replacing all or portions of an existing sprinkler system may submit to the
202.13commissioner by June 30, 2007, on a form provided by the commissioner the actual
202.14costs of a completed project or the estimated costs, based on a project bid, of a planned
202.15project. The commissioner shall calculate a rate adjustment equal to the allowable
202.16costs of the project divided by the resident days reported for the report year ending
202.17September 30, 2006. If the costs from all projects exceed the appropriation for this
202.18purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
202.19qualifying facilities by reducing the rate adjustment determined for each facility by an
202.20equal percentage. Facilities that used estimated costs when requesting the rate adjustment
202.21shall report to the commissioner by January 31, 2009, on the use of this money on a
202.22form provided by the commissioner. If the nursing facility fails to provide the report, the
202.23commissioner shall recoup the money paid to the facility for this purpose. If the facility
202.24reports expenditures allowable under this subdivision that are less than the amount received
202.25in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

202.26    Sec. 20. Minnesota Statutes 2012, section 256B.434, is amended by adding a
202.27subdivision to read:
202.28    Subd. 19a. Nursing facility rate adjustments beginning October 1, 2013. (a)
202.29For the rate year beginning October 1, 2013, the commissioner shall make available to
202.30each nursing facility reimbursed under this section a two percent operating payment
202.31rate increase.
202.32(b) Seventy-five percent of the money resulting from the rate adjustment under
202.33paragraph (a) must be used for increases in compensation-related costs for employees
202.34directly employed by the nursing facility on or after the effective date of the rate
202.35adjustment, except:
203.1(1) the administrator;
203.2(2) persons employed in the central office of a corporation that has an ownership
203.3interest in the nursing facility or exercises control over the nursing facility; and
203.4(3) persons paid by the nursing facility under a management contract.
203.5(c) The commissioner shall allow as compensation-related costs all costs for:
203.6(1) wages and salaries;
203.7(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
203.8compensation;
203.9(3) the employer's share of health and dental insurance, life insurance, disability
203.10insurance, long-term care insurance, uniform allowance, and pensions; and
203.11(4) other benefits provided and workforce needs including the recruiting and training
203.12of employees, subject to the approval of the commissioner.
203.13(d) The portion of the rate adjustment under paragraph (a) that is not subject to the
203.14requirements of paragraph (b) shall be provided to nursing facilities effective October 1.
203.15Nursing facilities may apply for the portion of the rate adjustment under paragraph (a)
203.16that is subject to the requirements in paragraph (b). The application must be submitted
203.17to the commissioner within six months of the effective date of the rate adjustment, and
203.18the nursing facility must provide additional information required by the commissioner
203.19within nine months of the effective date of the rate adjustment. The commissioner must
203.20respond to all applications within three weeks of receipt. The commissioner may waive
203.21the deadlines in this paragraph under extraordinary circumstances, to be determined at the
203.22sole discretion of the commissioner. The application must contain:
203.23(1) an estimate of the amounts of money that must be used as specified in paragraph
203.24(b);
203.25(2) a detailed distribution plan specifying the allowable compensation-related and
203.26wage increases the nursing facility will implement to use the funds available in clause (1);
203.27(3) a description of how the nursing facility will notify eligible employees of
203.28the contents of the approved application, which must provide for giving each eligible
203.29employee a copy of the approved application, excluding the information required in clause
203.30(1), or posting a copy of the approved application, excluding the information required in
203.31clause (1), for a period of at least six weeks in an area of the nursing facility to which all
203.32eligible employees have access; and
203.33(4) instructions for employees who believe they have not received the
203.34compensation-related or wage increases specified in clause (2), as approved by the
203.35commissioner, and which must include a mailing address, e-mail address, and the
204.1telephone number that may be used by the employee to contact the commissioner or the
204.2commissioner's representative.
204.3(e) For the October 1, 2013, rate increase, the commissioner shall ensure that cost
204.4increases in distribution plans under paragraph (d), clause (2), that may be included in
204.5approved applications, comply with the following requirements:
204.6(1) a portion of the costs resulting from tenure-related wage or salary increases
204.7may be considered to be allowable wage increases, according to formulas that the
204.8commissioner shall provide, where employee retention is above the average statewide
204.9rate of retention of direct care employees;
204.10(2) the annualized amount of increases in costs for the employer's share of health
204.11and dental insurance, life insurance, disability insurance, and workers' compensation
204.12shall be allowable compensation-related increases if they are effective on or after April
204.131, 2013, and prior to April 1, 2014; and
204.14(3) for nursing facilities in which employees are represented by an exclusive
204.15bargaining representative, the commissioner shall approve the application only upon
204.16receipt of a letter of acceptance of the distribution plan, in regard to members of the
204.17bargaining unit, signed by the exclusive bargaining agent and dated after May 25, 2013.
204.18Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of
204.19this provision as having been met in regard to the members of the bargaining unit.
204.20(f) The commissioner shall review applications received under paragraph (e) and
204.21shall provide the portion of the rate adjustment under paragraph (b) if the requirements
204.22of this statute have been met. The rate adjustment shall be effective October 1.
204.23Notwithstanding paragraph (a), if the approved application distributes less money than is
204.24available, the amount of the rate adjustment shall be reduced so that the amount of money
204.25made available is equal to the amount to be distributed.
204.26(g) The increase in this subdivision shall be applied as a total percentage to
204.27operating rates effective September 30, 2013, except that they shall not increase any
204.28performance-based incentive payments under section 256B.434, subdivision 4, paragraph
204.29(d), awarded prior to the effective date of the rate adjustment. Facilities receiving equitable
204.30cost-sharing for publicly owned nursing facilities program rate adjustments under section
204.31256B.441, subdivision 55a, must have rate increases under this paragraph computed based
204.32on rates in effect before the increases given under section 256B.441, subdivision 55a.

204.33    Sec. 21. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:
205.1    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
205.2services shall calculate the amount of the planned closure rate adjustment available under
205.3subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
205.4(1) the amount available is the net reduction of nursing facility beds multiplied
205.5by $2,080;
205.6(2) the total number of beds in the nursing facility or facilities receiving the planned
205.7closure rate adjustment must be identified;
205.8(3) capacity days are determined by multiplying the number determined under
205.9clause (2) by 365; and
205.10(4) the planned closure rate adjustment is the amount available in clause (1), divided
205.11by capacity days determined under clause (3).
205.12(b) A planned closure rate adjustment under this section is effective on the first day
205.13of the month following completion of closure of the facility designated for closure in
205.14the application and becomes part of the nursing facility's total operating external fixed
205.15 payment rate.
205.16(c) Applicants may use the planned closure rate adjustment to allow for a property
205.17payment for a new nursing facility or an addition to an existing nursing facility or as
205.18an operating payment external fixed rate adjustment. Applications approved under this
205.19subdivision are exempt from other requirements for moratorium exceptions under section
205.20144A.073 , subdivisions 2 and 3.
205.21(d) Upon the request of a closing facility, the commissioner must allow the facility a
205.22closure rate adjustment as provided under section 144A.161, subdivision 10.
205.23(e) A facility that has received a planned closure rate adjustment may reassign it
205.24to another facility that is under the same ownership at any time within three years of its
205.25effective date. The amount of the adjustment shall be computed according to paragraph (a).
205.26(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
205.27the commissioner shall recalculate planned closure rate adjustments for facilities that
205.28delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
205.29bed dollar amount. The recalculated planned closure rate adjustment shall be effective
205.30from the date the per bed dollar amount is increased.
205.31(g) For planned closures approved after June 30, 2009, the commissioner of human
205.32services shall calculate the amount of the planned closure rate adjustment available under
205.33subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
205.34(h) Beginning Between July 16, 2011, and June 30, 2013, the commissioner shall no
205.35longer not accept applications for planned closure rate adjustments under subdivision 3.

206.1    Sec. 22. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
206.2    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
206.3nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
206.4section 144.122; until September 30, 2013, long-term care consultation fees under
206.5section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
206.6scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
206.7under section 256B.437; or single bed room incentives under section 256B.431,
206.8subdivision 42 ; property taxes and property insurance; and PERA.

206.9    Sec. 23. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
206.10    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
206.11shall calculate a payment rate for external fixed costs.
206.12    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
206.13shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
206.14home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
206.15result of its number of nursing home beds divided by its total number of licensed beds.
206.16    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
206.17shall be the amount of the fee divided by actual resident days.
206.18    (c) The portion related to scholarships shall be determined under section 256B.431,
206.19subdivision 36.
206.20    (d) Until September 30, 2013, the portion related to long-term care consultation shall
206.21be determined according to section 256B.0911, subdivision 6.
206.22    (e) The portion related to development and education of resident and family advisory
206.23councils under section 144A.33 shall be $5 divided by 365.
206.24    (f) The portion related to planned closure rate adjustments shall be as determined
206.25under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
206.26Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
206.27be included in the payment rate for external fixed costs beginning October 1, 2016.
206.28Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
206.29longer be included in the payment rate for external fixed costs beginning on October 1 of
206.30the first year not less than two years after their effective date.
206.31    (g) The portions related to property insurance, real estate taxes, special assessments,
206.32and payments made in lieu of real estate taxes directly identified or allocated to the nursing
206.33facility shall be the actual amounts divided by actual resident days.
206.34    (h) The portion related to the Public Employees Retirement Association shall be
206.35actual costs divided by resident days.
207.1    (i) The single bed room incentives shall be as determined under section 256B.431,
207.2subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
207.3no longer be included in the payment rate for external fixed costs beginning October 1,
207.42016. Single bed room incentives that take effect on or after October 1, 2014, shall no
207.5longer be included in the payment rate for external fixed costs beginning on October 1 of
207.6the first year not less than two years after their effective date.
207.7    (j) The payment rate for external fixed costs shall be the sum of the amounts in
207.8paragraphs (a) to (i).

207.9    Sec. 24. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:
207.10    Subd. 11a. Waivered services statewide priorities. (a) The commissioner shall
207.11establish statewide priorities for individuals on the waiting list for community alternative
207.12care, community alternatives for disabled individuals, and brain injury waiver services,
207.13as of January 1, 2010. The statewide priorities must include, but are not limited to,
207.14individuals who continue to have a need for waiver services after they have maximized the
207.15use of state plan services and other funding resources, including natural supports, prior to
207.16accessing waiver services, and who meet at least one of the following criteria:
207.17(1) have unstable living situations due to the age, incapacity, or sudden loss of
207.18the primary caregivers;
207.19(2) are moving from an institution due to bed closures;
207.20(3) experience a sudden closure of their current living arrangement;
207.21(4) require protection from confirmed abuse, neglect, or exploitation;
207.22(5) experience a sudden change in need that can no longer be met through state plan
207.23services or other funding resources alone; or
207.24(6) meet other priorities established by the department.
207.25(b) When allocating resources to lead agencies, the commissioner must take into
207.26consideration the number of individuals waiting who meet statewide priorities and the
207.27lead agencies' current use of waiver funds and existing service options. The commissioner
207.28has the authority to transfer funds between counties, groups of counties, and tribes to
207.29accommodate statewide priorities and resource needs while accounting for a necessary
207.30base level reserve amount for each county, group of counties, and tribe.
207.31(c) The commissioner shall evaluate the impact of the use of statewide priorities and
207.32provide recommendations to the legislature on whether to continue the use of statewide
207.33priorities in the November 1, 2011, annual report required by the commissioner in sections
207.34256B.0916, subdivision 7, and 256B.49, subdivision 21.

208.1    Sec. 25. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
208.2    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
208.3shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
208.4With the permission of the recipient or the recipient's designated legal representative,
208.5the recipient's current provider of services may submit a written report outlining their
208.6recommendations regarding the recipient's care needs prepared by a direct service
208.7employee with at least 20 hours of service to that client. The person conducting the
208.8assessment or reassessment must notify the provider of the date by which this information
208.9is to be submitted. This information shall be provided to the person conducting the
208.10assessment and the person or the person's legal representative and must be considered
208.11prior to the finalization of the assessment or reassessment.
208.12(b) There must be a determination that the client requires a hospital level of care or a
208.13nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
208.14(d), at initial and subsequent assessments to initiate and maintain participation in the
208.15waiver program.
208.16(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
208.17appropriate to determine nursing facility level of care for purposes of medical assistance
208.18payment for nursing facility services, only face-to-face assessments conducted according
208.19to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
208.20determination or a nursing facility level of care determination must be accepted for
208.21purposes of initial and ongoing access to waiver services payment.
208.22(d) Recipients who are found eligible for home and community-based services under
208.23this section before their 65th birthday may remain eligible for these services after their
208.2465th birthday if they continue to meet all other eligibility factors.
208.25(e) The commissioner shall develop criteria to identify recipients whose level of
208.26functioning is reasonably expected to improve and reassess these recipients to establish
208.27a baseline assessment. Recipients who meet these criteria must have a comprehensive
208.28transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
208.29reassessed every six months until there has been no significant change in the recipient's
208.30functioning for at least 12 months. Upon federal approval, if the recipient is able to have
208.31the recipient's needs met through alternative services in a less restrictive setting, the
208.32case manager shall help the recipient develop a plan to transition to an appropriate less
208.33restrictive setting. After there has been no significant change in the recipient's functioning
208.34for at least 12 months, reassessments of the recipient's strengths, informal support systems,
208.35and need for services shall be conducted at least every 12 months and at other times
208.36when there has been a significant change in the recipient's functioning. Counties, case
209.1managers, and service providers are responsible for conducting these reassessments and
209.2shall complete the reassessments out of existing funds.
209.3EFFECTIVE DATE.This section is effective January 1, 2014.

209.4    Sec. 26. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:
209.5    Subd. 15. Coordinated service and support plan; comprehensive transitional
209.6service plan; maintenance service plan. (a) Each recipient of home and community-based
209.7waivered services shall be provided a copy of the written coordinated service and support
209.8plan which meets the requirements in section 256B.092, subdivision 1b.
209.9(b) In developing the comprehensive transitional service plan, the individual
209.10receiving services, the case manager, and the guardian, if applicable, will identify the
209.11transitional service plan fundamental service outcome and anticipated timeline to achieve
209.12this outcome. Within the first 20 days following a recipient's request for an assessment or
209.13reassessment, the transitional service planning team must be identified. A team leader must
209.14be identified who will be responsible for assigning responsibility and communicating with
209.15team members to ensure implementation of the transition plan and ongoing assessment and
209.16communication process. The team leader should be an individual, such as the case manager
209.17or guardian, who has the opportunity to follow the recipient to the next level of service.
209.18Within ten days following an assessment, a comprehensive transitional service plan
209.19must be developed incorporating elements of a comprehensive functional assessment and
209.20including short-term measurable outcomes and timelines for achievement of and reporting
209.21on these outcomes. Functional milestones must also be identified and reported according
209.22to the timelines agreed upon by the transitional service planning team. In addition, the
209.23comprehensive transitional service plan must identify additional supports that may assist
209.24in the achievement of the fundamental service outcome such as the development of greater
209.25natural community support, increased collaboration among agencies, and technological
209.26supports.
209.27The timelines for reporting on functional milestones will prompt a reassessment of
209.28services provided, the units of services, rates, and appropriate service providers. It is
209.29the responsibility of the transitional service planning team leader to review functional
209.30milestone reporting to determine if the milestones are consistent with observable skills
209.31and that milestone achievement prompts any needed changes to the comprehensive
209.32transitional service plan.
209.33For those whose fundamental transitional service outcome involves the need to
209.34procure housing, a plan for the recipient to seek the resources necessary to secure the least
210.1restrictive housing possible should be incorporated into the plan, including employment
210.2and public supports such as housing access and shelter needy funding.
210.3(c) Counties and other agencies responsible for funding community placement and
210.4ongoing community supportive services are responsible for the implementation of the
210.5comprehensive transitional service plans. Oversight responsibilities include both ensuring
210.6effective transitional service delivery and efficient utilization of funding resources.
210.7(d) Following one year of transitional services, the transitional services planning team
210.8will make a determination as to whether or not the individual receiving services requires
210.9the current level of continuous and consistent support in order to maintain the recipient's
210.10current level of functioning. Recipients who are determined to have not had a significant
210.11change in functioning for 12 months must move from a transitional to a maintenance
210.12service plan. Recipients on a maintenance service plan must be reassessed to determine if
210.13the recipient would benefit from a transitional service plan at least every 12 months and at
210.14other times when there has been a significant change in the recipient's functioning. This
210.15assessment should consider any changes to technological or natural community supports.
210.16(e) When a county is evaluating denials, reductions, or terminations of home and
210.17community-based services under section 256B.49 for an individual, the case manager
210.18shall offer to meet with the individual or the individual's guardian in order to discuss
210.19the prioritization of service needs within the coordinated service and support plan,
210.20comprehensive transitional service plan, or maintenance service plan. The reduction in
210.21the authorized services for an individual due to changes in funding for waivered services
210.22may not exceed the amount needed to ensure medically necessary services to meet the
210.23individual's health, safety, and welfare.
210.24(f) At the time of reassessment, local agency case managers shall assess each recipient
210.25of community alternatives for disabled individuals or brain injury waivered services
210.26currently residing in a licensed adult foster home that is not the primary residence of the
210.27license holder, or in which the license holder is not the primary caregiver, to determine if
210.28that recipient could appropriately be served in a community-living setting. If appropriate
210.29for the recipient, the case manager shall offer the recipient, through a person-centered
210.30planning process, the option to receive alternative housing and service options. In the
210.31event that the recipient chooses to transfer from the adult foster home, the vacated bed
210.32shall not be filled with another recipient of waiver services and group residential housing
210.33and the licensed capacity shall be reduced accordingly, unless the savings required by the
210.34licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7,
210.35sections 1 and 40, paragraph (f), for foster care settings where the physical location is not
210.36the primary residence of the license holder are met through voluntary changes described
211.1in section 245A.03, subdivision 7, paragraph (f) (e), or as provided under paragraph (a),
211.2clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers,
211.3the county agency, with the assistance of the department, shall facilitate a consolidation of
211.4settings or closure. This reassessment process shall be completed by July 1, 2013.

211.5    Sec. 27. Minnesota Statutes 2012, section 256B.49, is amended by adding a
211.6subdivision to read:
211.7    Subd. 25. Excess allocations. County and tribal agencies will be responsible for
211.8authorizations in excess of the allocation made by the commissioner. In the event a county
211.9or tribal agency authorizes in excess of the allocation made by the commissioner for a
211.10given allocation period, they must submit a corrective action plan to the commissioner.
211.11The plan must state the actions the agency will take to correct their over-authorization for
211.12the year following the period when the over-authorization occurred. Failure to correct
211.13over-authorizations shall result in recoupment of authorizations in excess of the allocation.
211.14Nothing in this subdivision shall be construed as reducing the county's responsibility to
211.15offer and make available feasible home and community-based options to eligible waiver
211.16recipients within the resources allocated to them for that purpose.

211.17    Sec. 28. Minnesota Statutes 2012, section 256B.492, is amended to read:
211.18256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
211.19WITH DISABILITIES.
211.20(a) Individuals receiving services under a home and community-based waiver under
211.21section 256B.092 or 256B.49 may receive services in the following settings:
211.22(1) an individual's own home or family home;
211.23(2) a licensed adult foster care setting of up to five people; and
211.24(3) community living settings as defined in section 256B.49, subdivision 23, where
211.25individuals with disabilities may reside in all of the units in a building of four or fewer
211.26units, and no more than the greater of four or 25 percent of the units in a multifamily
211.27building of more than four units, unless required by the Housing Opportunities for Persons
211.28with AIDS program.
211.29(b) The settings in paragraph (a) must not:
211.30(1) be located in a building that is a publicly or privately operated facility that
211.31provides institutional treatment or custodial care;
211.32(2) be located in a building on the grounds of or adjacent to a public or private
211.33institution;
212.1(3) be a housing complex designed expressly around an individual's diagnosis or
212.2disability, unless required by the Housing Opportunities for Persons with AIDS program;
212.3(4) be segregated based on a disability, either physically or because of setting
212.4characteristics, from the larger community; and
212.5(5) have the qualities of an institution which include, but are not limited to:
212.6regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
212.7agreed to and documented in the person's individual service plan shall not result in a
212.8residence having the qualities of an institution as long as the restrictions for the person are
212.9not imposed upon others in the same residence and are the least restrictive alternative,
212.10imposed for the shortest possible time to meet the person's needs.
212.11(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
212.12individuals receive services under a home and community-based waiver as of July 1,
212.132012, and the setting does not meet the criteria of this section.
212.14(d) Notwithstanding paragraph (c), a program in Hennepin County established as
212.15part of a Hennepin County demonstration project is qualified for the exception allowed
212.16under paragraph (c).
212.17(e) The commissioner shall submit an amendment to the waiver plan no later than
212.18December 31, 2012.

212.19    Sec. 29. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:
212.20    Subd. 2. Planned closure process needs determination. The commissioner shall
212.21announce and implement a program for planned closure of adult foster care homes. Planned
212.22closure shall be the preferred method for achieving necessary budgetary savings required by
212.23the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph (d)
212.24 (c). If additional closures are required to achieve the necessary savings, the commissioner
212.25shall use the process and priorities in section 245A.03, subdivision 7, paragraph (d) (c).

212.26    Sec. 30. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
212.27subdivision to read:
212.28    Subd. 14. Rate increase effective June 1, 2013. For rate periods beginning on or
212.29after June 1, 2013, the commissioner shall increase the total operating payment rate for
212.30each facility reimbursed under this section by $7.81 per day. The increase shall not be
212.31subject to any annual percentage increase.
212.32EFFECTIVE DATE.This section is effective June 1, 2013.

213.1    Sec. 31. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
213.2subdivision to read:
213.3    Subd. 15. ICF/DD rate increases effective July 1, 2013. (a) Notwithstanding
213.4subdivision 12, for each facility reimbursed under this section, for the rate period
213.5beginning July 1, 2013, the commissioner shall increase operating payments equal to two
213.6percent of the operating payment rates in effect on June 30, 2013.
213.7(b) For each facility, the commissioner shall apply the rate increase based on
213.8occupied beds, using the percentage specified in this subdivision multiplied by the total
213.9payment rate, including the variable rate, but excluding the property-related payment
213.10rate in effect on the preceding date. The total rate increase shall include the adjustment
213.11provided in section 256B.501, subdivision 12.

213.12    Sec. 32. Minnesota Statutes 2012, section 256B.69, is amended by adding a
213.13subdivision to read:
213.14    Subd. 32a. Initiatives to improve early screening, diagnosis, and treatment of
213.15children with autism spectrum disorder and other developmental conditions. (a) The
213.16commissioner shall require managed care plans and county-based purchasing plans, as
213.17a condition of contract, to implement strategies that facilitate access for young children
213.18between the ages of one and three years to periodic developmental and social-emotional
213.19screenings, as recommended by the Minnesota Interagency Developmental Screening
213.20Task Force, and that those children who do not meet milestones are provided access to
213.21appropriate evaluation and assessment, including treatment recommendations, expected to
213.22improve the child's functioning, with the goal of meeting milestones by age five.
213.23    (b) The managed care plans must report the following data annually:
213.24    (1) the number of children who received a diagnostic assessment;
213.25    (2) the total number of children ages one to six with a diagnosis of autism spectrum
213.26disorder who received treatments;
213.27    (3) the number of children identified under clause (2) reported by each 12-month
213.28age group beginning with age one and ending with age six;
213.29    (4) the types of treatments provided to children identified under clause (2) listed by
213.30billing code, including the number of units billed for each child;
213.31    (5) barriers to providing screening, diagnosis, and treatment of young children
213.32between the ages of one and three years and any strategies implemented to address
213.33those barriers; and
214.1    (6) recommendations on how to measure and report on the effectiveness of the
214.2strategies implemented to facilitate access for young children to provide developmental
214.3and social-emotional screening, diagnosis, and treatment.

214.4    Sec. 33. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
214.53, as amended by Laws 2012, chapter 247, article 4, section 43, is amended to read:

214.6

Subd. 3.Forecasted Programs

214.7The amounts that may be spent from this
214.8appropriation for each purpose are as follows:

214.9

(a) MFIP/DWP Grants

214.10	Appropriations by Fund
214.11	General	84,680,000	91,978,000
214.12	Federal TANF	84,425,000	75,417,000

214.13

(b) MFIP Child Care Assistance Grants

55,456,000

30,923,000

214.14

(c) General Assistance Grants

49,192,000

46,938,000

214.15General Assistance Standard. The
214.16commissioner shall set the monthly standard
214.17of assistance for general assistance units
214.18consisting of an adult recipient who is
214.19childless and unmarried or living apart
214.20from parents or a legal guardian at $203.
214.21The commissioner may reduce this amount
214.22according to Laws 1997, chapter 85, article
214.233, section 54.
214.24Emergency General Assistance. The
214.25amount appropriated for emergency general
214.26assistance funds is limited to no more than
214.27$6,689,812 in fiscal year 2012 and $6,729,812
214.28in fiscal year 2013. Funds to counties shall
214.29be allocated by the commissioner using the
214.30allocation method specified in Minnesota
214.31Statutes, section 256D.06.

214.32

(d) Minnesota Supplemental Aid Grants

38,095,000

39,120,000

214.33

(e) Group Residential Housing Grants

121,080,000

129,238,000

215.1

(f) MinnesotaCare Grants

295,046,000

317,272,000

215.2This appropriation is from the health care
215.3access fund.

215.4

(g) Medical Assistance Grants

4,501,582,000

4,437,282,000

215.5Managed Care Incentive Payments. The
215.6commissioner shall not make managed care
215.7incentive payments for expanding preventive
215.8services during fiscal years beginning July 1,
215.92011, and July 1, 2012.
215.10Reduction of Rates for Congregate
215.11Living for Individuals with Lower Needs.
215.12Beginning October 1, 2011, lead agencies
215.13must reduce rates in effect on January 1, 2011,
215.14by ten percent for individuals with lower
215.15needs living in foster care settings where the
215.16license holder does not share the residence
215.17with recipients on the CADI and DD waivers
215.18and customized living settings for CADI.
215.19Lead agencies shall consult with providers to
215.20review individual service plans and identify
215.21changes or modifications to reduce the
215.22utilization of services while maintaining the
215.23health and safety of the individual receiving
215.24services. Lead agencies must adjust contracts
215.25within 60 days of the effective date. If
215.26federal waiver approval is obtained under
215.27the long-term care realignment waiver
215.28application submitted on February 13,
215.292012, and federal financial participation is
215.30authorized for the alternative care program,
215.31the commissioner shall adjust this payment
215.32rate reduction from ten to five percent for
215.33services rendered on or after July 1, 2012, or
215.34the first day of the month following federal
215.35approval, whichever is later. Effective
216.1August 1, 2013, this provision does not apply
216.2to individuals whose primary diagnosis is
216.3mental illness and who are living in foster
216.4care settings where the license holder is
216.5also (1) a provider of assertive community
216.6treatment (ACT) or adult rehabilitative
216.7mental health services (ARMHS) as defined
216.8in Minnesota Statutes, section 256B.0623;
216.9(2) a mental health center or mental health
216.10clinic certified under Minnesota Rules, parts
216.119520.0750 to 9520.0870; or (3) a provider
216.12of intensive residential treatment services
216.13(IRTS) licensed under Minnesota Rules,
216.14parts 9520.0500 to 9520.0670.
216.15Reduction of Lead Agency Waiver
216.16Allocations to Implement Rate Reductions
216.17for Congregate Living for Individuals
216.18with Lower Needs. Beginning October 1,
216.192011, the commissioner shall reduce lead
216.20agency waiver allocations to implement the
216.21reduction of rates for individuals with lower
216.22needs living in foster care settings where the
216.23license holder does not share the residence
216.24with recipients on the CADI and DD waivers
216.25and customized living settings for CADI.
216.26Reduce customized living and 24-hour
216.27customized living component rates.
216.28Effective July 1, 2011, the commissioner
216.29shall reduce elderly waiver customized living
216.30and 24-hour customized living component
216.31service spending by five percent through
216.32reductions in component rates and service
216.33rate limits. The commissioner shall adjust
216.34the elderly waiver capitation payment
216.35rates for managed care organizations paid
216.36under Minnesota Statutes, section 256B.69,
217.1subdivisions 6a and 23, to reflect reductions
217.2in component spending for customized living
217.3services and 24-hour customized living
217.4services under Minnesota Statutes, section
217.5256B.0915, subdivisions 3e and 3h, for the
217.6contract period beginning January 1, 2012.
217.7To implement the reduction specified in
217.8this provision, capitation rates paid by the
217.9commissioner to managed care organizations
217.10under Minnesota Statutes, section 256B.69,
217.11shall reflect a ten percent reduction for the
217.12specified services for the period January 1,
217.132012, to June 30, 2012, and a five percent
217.14reduction for those services on or after July
217.151, 2012.
217.16Limit Growth in the Developmental
217.17Disability Waiver. The commissioner
217.18shall limit growth in the developmental
217.19disability waiver to six diversion allocations
217.20per month beginning July 1, 2011, through
217.21June 30, 2013, and 15 diversion allocations
217.22per month beginning July 1, 2013, through
217.23June 30, 2015. Waiver allocations shall
217.24be targeted to individuals who meet the
217.25priorities for accessing waiver services
217.26identified in Minnesota Statutes, 256B.092,
217.27subdivision 12 . The limits do not include
217.28conversions from intermediate care facilities
217.29for persons with developmental disabilities.
217.30Notwithstanding any contrary provisions in
217.31this article, this paragraph expires June 30,
217.322015.
217.33Limit Growth in the Community
217.34Alternatives for Disabled Individuals
217.35Waiver. The commissioner shall limit
217.36growth in the community alternatives for
218.1disabled individuals waiver to 60 allocations
218.2per month beginning July 1, 2011, through
218.3June 30, 2013, and 85 allocations per
218.4month beginning July 1, 2013, through
218.5June 30, 2015. Waiver allocations must
218.6be targeted to individuals who meet the
218.7priorities for accessing waiver services
218.8identified in Minnesota Statutes, section
218.9256B.49, subdivision 11a . The limits include
218.10conversions and diversions, unless the
218.11commissioner has approved a plan to convert
218.12funding due to the closure or downsizing
218.13of a residential facility or nursing facility
218.14to serve directly affected individuals on
218.15the community alternatives for disabled
218.16individuals waiver. Notwithstanding any
218.17contrary provisions in this article, this
218.18paragraph expires June 30, 2015.
218.19Personal Care Assistance Relative
218.20Care. The commissioner shall adjust the
218.21capitation payment rates for managed care
218.22organizations paid under Minnesota Statutes,
218.23section 256B.69, to reflect the rate reductions
218.24for personal care assistance provided by
218.25a relative pursuant to Minnesota Statutes,
218.26section 256B.0659, subdivision 11. This rate
218.27reduction is effective July 1, 2013.

218.28

(h) Alternative Care Grants

46,421,000

46,035,000

218.29Alternative Care Transfer. Any money
218.30allocated to the alternative care program that
218.31is not spent for the purposes indicated does
218.32not cancel but shall be transferred to the
218.33medical assistance account.

218.34

(i) Chemical Dependency Entitlement Grants

94,675,000

93,298,000

218.35EFFECTIVE DATE.This section is effective August 1, 2013.

219.1    Sec. 34. RECOMMENDATIONS FOR CONCENTRATION LIMITS ON HOME
219.2AND COMMUNITY-BASED SETTINGS.
219.3The commissioner of human services shall consult with the Minnesota Olmstead
219.4subcabinet, advocates, providers, and city representatives to develop recommendations
219.5on concentration limits on home and community-based settings, as defined in
219.6Minnesota Statutes, section 256B.492, as well as any other exceptions to the definition.
219.7The recommendations must be consistent with Minnesota's Olmstead plan. The
219.8recommendations and proposed legislation must be submitted to the chairs and ranking
219.9minority members of the legislative committees with jurisdiction over health and human
219.10services policy and finance by February 1, 2014.

219.11    Sec. 35. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JULY
219.121, 2013.
219.13(a) The commissioner of human services shall increase reimbursement rates, grants,
219.14allocations, individual limits, and rate limits, as applicable, by two percent for the rate
219.15period beginning July 1, 2013, for services rendered on or after those dates. County or
219.16tribal contracts for services specified in this section must be amended to pass through
219.17these rate increases within 60 days of the effective date.
219.18(b) The rate changes described in this section must be provided to:
219.19(1) home and community-based waivered services for persons with developmental
219.20disabilities or related conditions, including consumer-directed community supports, under
219.21Minnesota Statutes, section 256B.501;
219.22(2) waivered services under community alternatives for disabled individuals,
219.23including consumer-directed community supports, under Minnesota Statutes, section
219.24256B.49;
219.25(3) community alternative care waivered services, including consumer-directed
219.26community supports, under Minnesota Statutes, section 256B.49;
219.27(4) traumatic brain injury waivered services, including consumer-directed
219.28community supports, under Minnesota Statutes, section 256B.49;
219.29(5) home and community-based waivered services for the elderly under Minnesota
219.30Statutes, section 256B.0915;
219.31(6) nursing services and home health services under Minnesota Statutes, section
219.32256B.0625, subdivision 6a;
219.33(7) personal care services and qualified professional supervision of personal care
219.34services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
220.1(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
220.2subdivision 7;
220.3(9) day training and habilitation services for adults with developmental disabilities
220.4or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
220.5additional cost of rate adjustments on day training and habilitation services, provided as a
220.6social service, under Minnesota Statutes, section 256M.60;
220.7(10) alternative care services under Minnesota Statutes, section 256B.0913;
220.8(11) living skills training programs for persons with intractable epilepsy who need
220.9assistance in the transition to independent living under Laws 1988, chapter 689;
220.10(12) semi-independent living services (SILS) under Minnesota Statutes, section
220.11252.275, including SILS funding under county social services grants formerly funded
220.12under Minnesota Statutes, chapter 256I;
220.13(13) consumer support grants under Minnesota Statutes, section 256.476;
220.14(14) family support grants under Minnesota Statutes, section 252.32;
220.15(15) housing access grants under Minnesota Statutes, section 256B.0658;
220.16(16) self-advocacy grants under Laws 2009, chapter 101; and
220.17(17) technology grants under Laws 2009, chapter 79.
220.18(c) A managed care plan receiving state payments for the services in this section
220.19must include these increases in their payments to providers. To implement the rate increase
220.20in this section, capitation rates paid by the commissioner to managed care organizations
220.21under Minnesota Statutes, section 256B.69, shall reflect a two percent increase for the
220.22specified services for the period beginning July 1, 2013.
220.23(d) Counties shall increase the budget for each recipient of consumer-directed
220.24community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).

220.25    Sec. 36. TRAINING OF AUTISM SERVICE PROVIDERS.
220.26    The commissioners of health and human services shall ensure that the departments'
220.27autism-related service providers receive training in culturally appropriate approaches to
220.28serving the Somali, Latino, Hmong, and Indigenous American Indian communities, and
220.29other cultural groups experiencing a disproportionate incidence of autism.

220.30    Sec. 37. DIRECTION TO COMMISSIONER.
220.31    By January 1, 2014, the commissioner of human services shall apply to the federal
220.32Centers for Medicare and Medicaid Services for a waiver or other authority to provide
220.33applied behavioral analysis services to children with autism spectrum disorder and related
220.34conditions under the medical assistance program.
221.1EFFECTIVE DATE.This section is effective the day following final enactment.

221.2    Sec. 38. RECOMMENDATIONS ON RAISING THE ASSET LIMITS FOR
221.3SENIORS AND PERSONS WITH DISABILITIES.
221.4The commissioner of human services shall consult with interested stakeholders to
221.5develop recommendations to increase the asset limit a reasonable amount considering
221.6changes since the limit was established for (1) individuals who are not homeowners and (2)
221.7homeowners eligible for medical assistance due to disability or age who are not residing in
221.8a nursing facility, intermediate care facility for persons with developmental disabilities,
221.9or other institution whose costs for room and board are covered by medical assistance or
221.10state funds. The recommendations must be provided to the legislative committees with
221.11jurisdiction over health and human services policy and finance by February 1, 2014.

221.12    Sec. 39. NURSING HOME LEVEL OF CARE REPORT.
221.13(a) The commissioner of human services shall report on the impact of the nursing
221.14home level of care implementation including the following:
221.15(1) the number of individuals who lost waivered services and medical assistance;
221.16(2) the result of the loss of services;
221.17(3) information on where individuals were living before and after the nursing home
221.18level of care changes took effect to show the impact on an individual's ability to maintain
221.19independence in the community; and
221.20(4) utilization data before and after nursing home level of care implementation for
221.21those who retained medical assistance including which essential community support
221.22and personal care assistant services were used, and to what extent the $400 essential
221.23community support grant was sufficient to meet needs.
221.24(b) The commissioner of human services shall report to the chairs of the legislative
221.25committees with jurisdiction over health and human services policy and finance with the
221.26information required under paragraph (a) on October 1, 2014, and annually thereafter.

221.27    Sec. 40. REPEALER.
221.28(a) Minnesota Statutes 2012, sections 256B.14, subdivision 3a; and 256B.5012,
221.29subdivision 13; and Laws 2011, First Special Session chapter 9, article 7, section 54, as
221.30amended by Laws 2012, chapter 247, article 4, section 42, and Laws 2012, chapter 298,
221.31section 3, are repealed.
221.32(b) Minnesota Statutes 2012, section 256B.096, subdivisions 1, 2, 3, and 4, are
221.33repealed.


222.3    Section 1. Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:
222.4    Subd. 7. Health care facility. "Health care facility" means a hospital or other entity
222.5licensed under sections 144.50 to 144.58, a nursing home licensed to serve adults under
222.6section 144A.02, a home care provider licensed under sections 144A.43 to 144A.47,
222.7an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts
222.89555.5105 to 9555.6265, a community residential setting licensed under chapter 245D, or
222.9a hospice provider licensed under sections 144A.75 to 144A.755.

222.10    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:
222.11    Subd. 4b. Health care facility; notice of status. (a) For the purposes of this
222.12subdivision, "health care facility" means a facility:
222.13(1) licensed by the commissioner of health as a hospital, boarding care home or
222.14supervised living facility under sections 144.50 to 144.58, or a nursing home under
222.15chapter 144A;
222.16(2) registered by the commissioner of health as a housing with services establishment
222.17as defined in section 144D.01; or
222.18(3) licensed by the commissioner of human services as a residential facility under
222.19chapter 245A to provide adult foster care, adult mental health treatment, chemical
222.20dependency treatment to adults, or residential services to persons with developmental
222.21 disabilities.
222.22(b) Prior to admission to a health care facility, a person required to register under
222.23this section shall disclose to:
222.24(1) the health care facility employee processing the admission the person's status
222.25as a registered predatory offender under this section; and
222.26(2) the person's corrections agent, or if the person does not have an assigned
222.27corrections agent, the law enforcement authority with whom the person is currently
222.28required to register, that inpatient admission will occur.
222.29(c) A law enforcement authority or corrections agent who receives notice under
222.30paragraph (b) or who knows that a person required to register under this section is
222.31planning to be admitted and receive, or has been admitted and is receiving health care
222.32at a health care facility shall notify the administrator of the facility and deliver a fact
222.33sheet to the administrator containing the following information: (1) name and physical
222.34description of the offender; (2) the offender's conviction history, including the dates of
223.1conviction; (3) the risk level classification assigned to the offender under section 244.052,
223.2if any; and (4) the profile of likely victims.
223.3(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care
223.4facility receives a fact sheet under paragraph (c) that includes a risk level classification for
223.5the offender, and if the facility admits the offender, the facility shall distribute the fact
223.6sheet to all residents at the facility. If the facility determines that distribution to a resident
223.7is not appropriate given the resident's medical, emotional, or mental status, the facility
223.8shall distribute the fact sheet to the patient's next of kin or emergency contact.

223.9    Sec. 3. [245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY
223.10MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
223.11    Subdivision 1. Rules. The commissioner of human services shall, within 24 months
223.12of enactment of this section, adopt rules governing the use of positive support strategies,
223.13safety interventions, and emergency use of manual restraint in facilities and services
223.14licensed under chapter 245D.
223.15    Subd. 2. Data collection. (a) The commissioner shall, with stakeholder input,
223.16develop data collection elements specific to incidents on the use of controlled procedures
223.17with persons receiving services from providers regulated under Minnesota Rules, parts
223.189525.2700 to 9525.2810, and incidents involving persons receiving services from
223.19providers identified to be licensed under chapter 245D effective January 1, 2014. Providers
223.20shall report the data in a format and at a frequency provided by the commissioner of
223.21human services.
223.22(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts
223.239525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures
223.24in a format and at a frequency provided by the commissioner.

223.25    Sec. 4. Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:
223.26    Subd. 10. Nonresidential program. "Nonresidential program" means care,
223.27supervision, rehabilitation, training or habilitation of a person provided outside the
223.28person's own home and provided for fewer than 24 hours a day, including adult day
223.29care programs; and chemical dependency or chemical abuse programs that are located
223.30in a nursing home or hospital and receive public funds for providing chemical abuse or
223.31chemical dependency treatment services under chapter 254B. Nonresidential programs
223.32include home and community-based services and semi-independent living services for
223.33persons with developmental disabilities or persons age 65 and older that are provided in
223.34or outside of a person's own home under chapter 245D.

224.1    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:
224.2    Subd. 14. Residential program. "Residential program" means a program
224.3that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training,
224.4education, habilitation, or treatment outside a person's own home, including a program
224.5in an intermediate care facility for four or more persons with developmental disabilities;
224.6and chemical dependency or chemical abuse programs that are located in a hospital
224.7or nursing home and receive public funds for providing chemical abuse or chemical
224.8dependency treatment services under chapter 254B. Residential programs include home
224.9and community-based services for persons with developmental disabilities or persons age
224.1065 and older that are provided in or outside of a person's own home under chapter 245D.

224.11    Sec. 6. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
224.12    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial
224.13license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,
224.14or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under
224.15this chapter for a physical location that will not be the primary residence of the license
224.16holder for the entire period of licensure. If a license is issued during this moratorium, and
224.17the license holder changes the license holder's primary residence away from the physical
224.18location of the foster care license, the commissioner shall revoke the license according
224.19to section 245A.07. The commissioner shall not issue an initial license for a community
224.20residential setting licensed under chapter 245D. Exceptions to the moratorium include:
224.21(1) foster care settings that are required to be registered under chapter 144D;
224.22(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
224.23community residential setting licenses replacing adult foster care licenses in existence on
224.24December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
224.25(3) new foster care licenses or community residential setting licenses determined to
224.26be needed by the commissioner under paragraph (b) for the closure of a nursing facility,
224.27ICF/MR, or regional treatment center, or restructuring of state-operated services that
224.28limits the capacity of state-operated facilities;
224.29(4) new foster care licenses or community residential setting licenses determined
224.30to be needed by the commissioner under paragraph (b) for persons requiring hospital
224.31level care; or
224.32(5) new foster care licenses or community residential setting licenses determined to
224.33be needed by the commissioner for the transition of people from personal care assistance
224.34to the home and community-based services.
225.1(b) The commissioner shall determine the need for newly licensed foster care
225.2homes or community residential settings as defined under this subdivision. As part of the
225.3determination, the commissioner shall consider the availability of foster care capacity in
225.4the area in which the licensee seeks to operate, and the recommendation of the local
225.5county board. The determination by the commissioner must be final. A determination of
225.6need is not required for a change in ownership at the same address.
225.7(c) The commissioner shall study the effects of the license moratorium under this
225.8subdivision and shall report back to the legislature by January 15, 2011. This study shall
225.9include, but is not limited to the following:
225.10(1) the overall capacity and utilization of foster care beds where the physical location
225.11is not the primary residence of the license holder prior to and after implementation
225.12of the moratorium;
225.13(2) the overall capacity and utilization of foster care beds where the physical
225.14location is the primary residence of the license holder prior to and after implementation
225.15of the moratorium; and
225.16(3) the number of licensed and occupied ICF/MR beds prior to and after
225.17implementation of the moratorium.
225.18(d) When a foster care recipient resident served by the program moves out of a
225.19foster home that is not the primary residence of the license holder according to section
225.20256B.49, subdivision 15 , paragraph (f), or the community residential setting, the county
225.21shall immediately inform the Department of Human Services Licensing Division.
225.22The department shall decrease the statewide licensed capacity for foster care settings
225.23where the physical location is not the primary residence of the license holder, or for
225.24community residential settings, if the voluntary changes described in paragraph (f) are
225.25not sufficient to meet the savings required by reductions in licensed bed capacity under
225.26Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
225.27and maintain statewide long-term care residential services capacity within budgetary
225.28limits. Implementation of the statewide licensed capacity reduction shall begin on July
225.291, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the
225.30needs determination process. Under this paragraph, the commissioner has the authority
225.31to reduce unused licensed capacity of a current foster care program, or the community
225.32residential settings, to accomplish the consolidation or closure of settings. A decreased
225.33licensed capacity according to this paragraph is not subject to appeal under this chapter.
225.34(e) Residential settings that would otherwise be subject to the decreased license
225.35capacity established in paragraph (d) shall be exempt under the following circumstances:
226.1(1) until August 1, 2013, the license holder's beds occupied by residents whose
226.2primary diagnosis is mental illness and the license holder is:
226.3(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
226.4health services (ARMHS) as defined in section 256B.0623;
226.5(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
226.69520.0870;
226.7(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
226.89520.0870; or
226.9(iv) a provider of intensive residential treatment services (IRTS) licensed under
226.10Minnesota Rules, parts 9520.0500 to 9520.0670; or
226.11(2) the license holder is certified under the requirements in subdivision 6a or section
226.12245D.33.
226.13(f) A resource need determination process, managed at the state level, using the
226.14available reports required by section 144A.351, and other data and information shall
226.15be used to determine where the reduced capacity required under paragraph (d) will be
226.16implemented. The commissioner shall consult with the stakeholders described in section
226.17144A.351 , and employ a variety of methods to improve the state's capacity to meet
226.18long-term care service needs within budgetary limits, including seeking proposals from
226.19service providers or lead agencies to change service type, capacity, or location to improve
226.20services, increase the independence of residents, and better meet needs identified by the
226.21long-term care services reports and statewide data and information. By February 1 of each
226.22year, the commissioner shall provide information and data on the overall capacity of
226.23licensed long-term care services, actions taken under this subdivision to manage statewide
226.24long-term care services and supports resources, and any recommendations for change to
226.25the legislative committees with jurisdiction over health and human services budget.
226.26    (g) At the time of application and reapplication for licensure, the applicant and the
226.27license holder that are subject to the moratorium or an exclusion established in paragraph
226.28(a) are required to inform the commissioner whether the physical location where the foster
226.29care will be provided is or will be the primary residence of the license holder for the entire
226.30period of licensure. If the primary residence of the applicant or license holder changes, the
226.31applicant or license holder must notify the commissioner immediately. The commissioner
226.32shall print on the foster care license certificate whether or not the physical location is the
226.33primary residence of the license holder.
226.34    (h) License holders of foster care homes identified under paragraph (g) that are not
226.35the primary residence of the license holder and that also provide services in the foster care
226.36home that are covered by a federally approved home and community-based services
227.1waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the
227.2human services licensing division that the license holder provides or intends to provide
227.3these waiver-funded services. These license holders must be considered registered under
227.4section 256B.092, subdivision 11, paragraph (c), and this registration status must be
227.5identified on their license certificates.

227.6    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:
227.7    Subd. 8. Excluded providers seeking licensure. Nothing in this section shall
227.8prohibit a program that is excluded from licensure under subdivision 2, paragraph
227.9(a), clause (28) (26), from seeking licensure. The commissioner shall ensure that any
227.10application received from such an excluded provider is processed in the same manner as
227.11all other applications for child care center licensure.

227.12    Sec. 8. Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:
227.13    Subd. 3. Implementation. (a) The commissioner shall implement the
227.14responsibilities of this chapter according to the timelines in paragraphs (b) and (c)
227.15only within the limits of available appropriations or other administrative cost recovery
227.16methodology.
227.17(b) The licensure of home and community-based services according to this section
227.18shall be implemented January 1, 2014. License applications shall be received and
227.19processed on a phased-in schedule as determined by the commissioner beginning July
227.201, 2013. Licenses will be issued thereafter upon the commissioner's determination that
227.21the application is complete according to section 245A.04.
227.22(c) Within the limits of available appropriations or other administrative cost recovery
227.23methodology, implementation of compliance monitoring must be phased in after January
227.241, 2014.
227.25(1) Applicants who do not currently hold a license issued under this chapter 245B
227.26 must receive an initial compliance monitoring visit after 12 months of the effective date of
227.27the initial license for the purpose of providing technical assistance on how to achieve and
227.28maintain compliance with the applicable law or rules governing the provision of home and
227.29community-based services under chapter 245D. If during the review the commissioner
227.30finds that the license holder has failed to achieve compliance with an applicable law or
227.31rule and this failure does not imminently endanger the health, safety, or rights of the
227.32persons served by the program, the commissioner may issue a licensing review report with
227.33recommendations for achieving and maintaining compliance.
228.1(2) Applicants who do currently hold a license issued under this chapter must receive
228.2a compliance monitoring visit after 24 months of the effective date of the initial license.
228.3(d) Nothing in this subdivision shall be construed to limit the commissioner's
228.4authority to suspend or revoke a license or issue a fine at any time under section 245A.07,
228.5or make issue correction orders and make a license conditional for failure to comply with
228.6applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity
228.7of the violation of law or rule and the effect of the violation on the health, safety, or
228.8rights of persons served by the program.

228.9    Sec. 9. Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:
228.10    Subd. 2a. Consolidated contested case hearings. (a) When a denial of a license
228.11under section 245A.05 or a licensing sanction under section 245A.07, subdivision 3, is
228.12based on a disqualification for which reconsideration was requested and which was not
228.13set aside under section 245C.22, the scope of the contested case hearing shall include the
228.14disqualification and the licensing sanction or denial of a license, unless otherwise specified
228.15in this subdivision. When the licensing sanction or denial of a license is based on a
228.16determination of maltreatment under section 626.556 or 626.557, or a disqualification for
228.17serious or recurring maltreatment which was not set aside, the scope of the contested case
228.18hearing shall include the maltreatment determination, disqualification, and the licensing
228.19sanction or denial of a license, unless otherwise specified in this subdivision. In such
228.20cases, a fair hearing under section 256.045 shall not be conducted as provided for in
228.21sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.
228.22    (b) Except for family child care and child foster care, reconsideration of a
228.23maltreatment determination under sections 626.556, subdivision 10i, and 626.557,
228.24subdivision 9d, and reconsideration of a disqualification under section 245C.22, shall
228.25not be conducted when:
228.26    (1) a denial of a license under section 245A.05, or a licensing sanction under section
228.27245A.07 , is based on a determination that the license holder is responsible for maltreatment
228.28or the disqualification of a license holder is based on serious or recurring maltreatment;
228.29    (2) the denial of a license or licensing sanction is issued at the same time as the
228.30maltreatment determination or disqualification; and
228.31    (3) the license holder appeals the maltreatment determination or disqualification,
228.32and denial of a license or licensing sanction. In these cases, a fair hearing shall not be
228.33conducted under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision
228.349d. The scope of the contested case hearing must include the maltreatment determination,
228.35disqualification, and denial of a license or licensing sanction.
229.1    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
229.2determination or disqualification, but does not appeal the denial of a license or a licensing
229.3sanction, reconsideration of the maltreatment determination shall be conducted under
229.4sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
229.5disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
229.6shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
229.7626.557, subdivision 9d .
229.8    (c) In consolidated contested case hearings regarding sanctions issued in family child
229.9care, child foster care, family adult day services, and adult foster care, and community
229.10residential settings, the county attorney shall defend the commissioner's orders in
229.11accordance with section 245A.16, subdivision 4.
229.12    (d) The commissioner's final order under subdivision 5 is the final agency action
229.13on the issue of maltreatment and disqualification, including for purposes of subsequent
229.14background studies under chapter 245C and is the only administrative appeal of the final
229.15agency determination, specifically, including a challenge to the accuracy and completeness
229.16of data under section 13.04.
229.17    (e) When consolidated hearings under this subdivision involve a licensing sanction
229.18based on a previous maltreatment determination for which the commissioner has issued
229.19a final order in an appeal of that determination under section 256.045, or the individual
229.20failed to exercise the right to appeal the previous maltreatment determination under
229.21section 626.556, subdivision 10i, or 626.557, subdivision 9d, the commissioner's order is
229.22conclusive on the issue of maltreatment. In such cases, the scope of the administrative
229.23law judge's review shall be limited to the disqualification and the licensing sanction or
229.24denial of a license. In the case of a denial of a license or a licensing sanction issued to
229.25a facility based on a maltreatment determination regarding an individual who is not the
229.26license holder or a household member, the scope of the administrative law judge's review
229.27includes the maltreatment determination.
229.28    (f) The hearings of all parties may be consolidated into a single contested case
229.29hearing upon consent of all parties and the administrative law judge, if:
229.30    (1) a maltreatment determination or disqualification, which was not set aside under
229.31section 245C.22, is the basis for a denial of a license under section 245A.05 or a licensing
229.32sanction under section 245A.07;
229.33    (2) the disqualified subject is an individual other than the license holder and upon
229.34whom a background study must be conducted under section 245C.03; and
229.35    (3) the individual has a hearing right under section 245C.27.
230.1    (g) When a denial of a license under section 245A.05 or a licensing sanction under
230.2section 245A.07 is based on a disqualification for which reconsideration was requested
230.3and was not set aside under section 245C.22, and the individual otherwise has no hearing
230.4right under section 245C.27, the scope of the administrative law judge's review shall
230.5include the denial or sanction and a determination whether the disqualification should
230.6be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In
230.7determining whether the disqualification should be set aside, the administrative law judge
230.8shall consider the factors under section 245C.22, subdivision 4, to determine whether the
230.9individual poses a risk of harm to any person receiving services from the license holder.
230.10    (h) Notwithstanding section 245C.30, subdivision 5, when a licensing sanction
230.11under section 245A.07 is based on the termination of a variance under section 245C.30,
230.12subdivision 4 , the scope of the administrative law judge's review shall include the sanction
230.13and a determination whether the disqualification should be set aside, unless section
230.14245C.24 prohibits the set-aside of the disqualification. In determining whether the
230.15disqualification should be set aside, the administrative law judge shall consider the factors
230.16under section 245C.22, subdivision 4, to determine whether the individual poses a risk of
230.17harm to any person receiving services from the license holder.

230.18    Sec. 10. Minnesota Statutes 2012, section 245A.10, is amended to read:
230.19245A.10 FEES.
230.20    Subdivision 1. Application or license fee required, programs exempt from fee.
230.21(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
230.22of applications and inspection of programs which are licensed under this chapter.
230.23(b) Except as provided under subdivision 2, no application or license fee shall be
230.24charged for child foster care, adult foster care, or family and group family child care, or
230.25a community residential setting.
230.26    Subd. 2. County fees for background studies and licensing inspections. (a) For
230.27purposes of family and group family child care licensing under this chapter, a county
230.28agency may charge a fee to an applicant or license holder to recover the actual cost of
230.29background studies, but in any case not to exceed $100 annually. A county agency may
230.30also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
230.31license or $100 for a two-year license.
230.32    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
230.33applicant for authorization to recover the actual cost of background studies completed
230.34under section 119B.125, but in any case not to exceed $100 annually.
230.35    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
231.1    (1) in cases of financial hardship;
231.2    (2) if the county has a shortage of providers in the county's area;
231.3    (3) for new providers; or
231.4    (4) for providers who have attained at least 16 hours of training before seeking
231.5initial licensure.
231.6    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
231.7an installment basis for up to one year. If the provider is receiving child care assistance
231.8payments from the state, the provider may have the fees under paragraph (a) or (b)
231.9deducted from the child care assistance payments for up to one year and the state shall
231.10reimburse the county for the county fees collected in this manner.
231.11    (e) For purposes of adult foster care and child foster care licensing, and licensing
231.12the physical plant of a community residential setting, under this chapter, a county agency
231.13may charge a fee to a corporate applicant or corporate license holder to recover the actual
231.14cost of licensing inspections, not to exceed $500 annually.
231.15    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
231.16following circumstances:
231.17(1) in cases of financial hardship;
231.18(2) if the county has a shortage of providers in the county's area; or
231.19(3) for new providers.
231.20    Subd. 3. Application fee for initial license or certification. (a) For fees required
231.21under subdivision 1, an applicant for an initial license or certification issued by the
231.22commissioner shall submit a $500 application fee with each new application required
231.23under this subdivision. An applicant for an initial day services facility license under
231.24chapter 245D shall submit a $250 application fee with each new application. The
231.25application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license
231.26or certification fee that expires on December 31. The commissioner shall not process an
231.27application until the application fee is paid.
231.28(b) Except as provided in clauses (1) to (4) (3), an applicant shall apply for a license
231.29to provide services at a specific location.
231.30(1) For a license to provide residential-based habilitation services to persons with
231.31developmental disabilities under chapter 245B, an applicant shall submit an application
231.32for each county in which the services will be provided. Upon licensure, the license
231.33holder may provide services to persons in that county plus no more than three persons
231.34at any one time in each of up to ten additional counties. A license holder in one county
231.35may not provide services under the home and community-based waiver for persons with
231.36developmental disabilities to more than three people in a second county without holding
232.1a separate license for that second county. Applicants or licensees providing services
232.2under this clause to not more than three persons remain subject to the inspection fees
232.3established in section 245A.10, subdivision 2, for each location. The license issued by
232.4the commissioner must state the name of each additional county where services are being
232.5provided to persons with developmental disabilities. A license holder must notify the
232.6commissioner before making any changes that would alter the license information listed
232.7under section 245A.04, subdivision 7, paragraph (a), including any additional counties
232.8where persons with developmental disabilities are being served. For a license to provide
232.9home and community-based services to persons with disabilities or age 65 and older under
232.10chapter 245D, an applicant shall submit an application to provide services statewide.
232.11(2) For a license to provide supported employment, crisis respite, or
232.12semi-independent living services to persons with developmental disabilities under chapter
232.13245B, an applicant shall submit a single application to provide services statewide.
232.14(3) For a license to provide independent living assistance for youth under section
232.15245A.22 , an applicant shall submit a single application to provide services statewide.
232.16(4) (3) For a license for a private agency to provide foster care or adoption services
232.17under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
232.18application to provide services statewide.
232.19(c) The initial application fee charged under this subdivision does not include the
232.20temporary license surcharge under section 16E.22.
232.21    Subd. 4. License or certification fee for certain programs. (a) Child care centers
232.22shall pay an annual nonrefundable license fee based on the following schedule:

232.23		Licensed Capacity	Child Care CenterLicense Fee
232.24		1 to 24 persons	$200
232.25		25 to 49 persons	$300
232.26		50 to 74 persons	$400
232.27		75 to 99 persons	$500
232.28		100 to 124 persons	$600
232.29		125 to 149 persons	$700
232.30		150 to 174 persons	$800
232.31		175 to 199 persons	$900
232.32		200 to 224 persons	$1,000
232.33		225 or more persons	$1,100

232.34    (b) A day training and habilitation program serving persons with developmental
232.35disabilities or related conditions shall pay an annual nonrefundable license fee based on
232.36the following schedule:

232.37		Licensed Capacity	License Fee
232.38		1 to 24 persons	$800
233.1		25 to 49 persons	$1,000
233.2		50 to 74 persons	$1,200
233.3		75 to 99 persons	$1,400
233.4		100 to 124 persons	$1,600
233.5		125 to 149 persons	$1,800
233.6		150 or more persons	$2,000

233.7Except as provided in paragraph (c), when a day training and habilitation program
233.8serves more than 50 percent of the same persons in two or more locations in a community,
233.9the day training and habilitation program shall pay a license fee based on the licensed
233.10capacity of the largest facility and the other facility or facilities shall be charged a license
233.11fee based on a licensed capacity of a residential program serving one to 24 persons.
233.12    (c) When a day training and habilitation program serving persons with developmental
233.13disabilities or related conditions seeks a single license allowed under section 245B.07,
233.14subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
233.15capacity for each location.
233.16(d) A program licensed to provide supported employment services to persons
233.17with developmental disabilities under chapter 245B shall pay an annual nonrefundable
233.18license fee of $650.
233.19(e) A program licensed to provide crisis respite services to persons with
233.20developmental disabilities under chapter 245B shall pay an annual nonrefundable license
233.21fee of $700.
233.22(f) A program licensed to provide semi-independent living services to persons
233.23with developmental disabilities under chapter 245B shall pay an annual nonrefundable
233.24license fee of $700.
233.25(g) A program licensed to provide residential-based habilitation services under the
233.26home and community-based waiver for persons with developmental disabilities shall pay
233.27an annual license fee that includes a base rate of $690 plus $60 times the number of clients
233.28served on the first day of July of the current license year.
233.29(h) A residential program certified by the Department of Health as an intermediate
233.30care facility for persons with developmental disabilities (ICF/MR) and a noncertified
233.31residential program licensed to provide health or rehabilitative services for persons
233.32with developmental disabilities shall pay an annual nonrefundable license fee based on
233.33the following schedule:

233.34		Licensed Capacity	License Fee
233.35		1 to 24 persons	$535
233.36		25 to 49 persons	$735
233.37		50 or more persons	$935

234.1(b) A program licensed to provide one or more of the home and community-based
234.2services and supports identified under chapter 245D to persons with disabilities or age
234.365 and older, shall pay an annual nonrefundable license fee that includes a base rate of
234.4$2,250, plus $92 times the number of persons served, on average, greater than 40 hours per
234.5week for the month of June of the current license year for programs serving ten or more
234.6persons. The fee is limited to a maximum of 200 persons, regardless of the actual number
234.7of persons served. Programs serving nine or fewer persons pay only half of the base rate.
234.8(c) A facility licensed under chapter 245D to provide day services shall pay an
234.9annual nonrefundable license fee of $100.
234.10(i) (d) A chemical dependency treatment program licensed under Minnesota Rules,
234.11parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an
234.12annual nonrefundable license fee based on the following schedule:

234.13		Licensed Capacity	License Fee
234.14		1 to 24 persons	$600
234.15		25 to 49 persons	$800
234.16		50 to 74 persons	$1,000
234.17		75 to 99 persons	$1,200
234.18		100 or more persons	$1,400

234.19(j) (e) A chemical dependency program licensed under Minnesota Rules, parts
234.209530.6510 to 9530.6590, to provide detoxification services shall pay an annual
234.21nonrefundable license fee based on the following schedule:

234.22		Licensed Capacity	License Fee
234.23		1 to 24 persons	$760
234.24		25 to 49 persons	$960
234.25		50 or more persons	$1,160

234.26(k) (f) Except for child foster care, a residential facility licensed under Minnesota
234.27Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
234.28based on the following schedule:

234.29		Licensed Capacity	License Fee
234.30		1 to 24 persons	$1,000
234.31		25 to 49 persons	$1,100
234.32		50 to 74 persons	$1,200
234.33		75 to 99 persons	$1,300
234.34		100 or more persons	$1,400

234.35(l) (g) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
234.369520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
234.37fee based on the following schedule:

235.1		Licensed Capacity	License Fee
235.2		1 to 24 persons	$2,525
235.3		25 or more persons	$2,725

235.4(m) (h) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
235.59570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
235.6license fee based on the following schedule:

235.7		Licensed Capacity	License Fee
235.8		1 to 24 persons	$450
235.9		25 to 49 persons	$650
235.10		50 to 74 persons	$850
235.11		75 to 99 persons	$1,050
235.12		100 or more persons	$1,250

235.13(n) (i) A program licensed to provide independent living assistance for youth under
235.14section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
235.15(o) (j) A private agency licensed to provide foster care and adoption services under
235.16Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
235.17license fee of $875.
235.18(p) (k) A program licensed as an adult day care center licensed under Minnesota
235.19Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based
235.20on the following schedule:

235.21		Licensed Capacity	License Fee
235.22		1 to 24 persons	$500
235.23		25 to 49 persons	$700
235.24		50 to 74 persons	$900
235.25		75 to 99 persons	$1,100
235.26		100 or more persons	$1,300

235.27(q) (l) A program licensed to provide treatment services to persons with sexual
235.28psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
235.299515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
235.30(r) (m) A mental health center or mental health clinic requesting certification for
235.31purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
235.32parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
235.33mental health center or mental health clinic provides services at a primary location with
235.34satellite facilities, the satellite facilities shall be certified with the primary location without
235.35an additional charge.
235.36    Subd. 6. License not issued until license or certification fee is paid. The
235.37commissioner shall not issue a license or certification until the license or certification fee
236.1is paid. The commissioner shall send a bill for the license or certification fee to the billing
236.2address identified by the license holder. If the license holder does not submit the license or
236.3certification fee payment by the due date, the commissioner shall send the license holder
236.4a past due notice. If the license holder fails to pay the license or certification fee by the
236.5due date on the past due notice, the commissioner shall send a final notice to the license
236.6holder informing the license holder that the program license will expire on December 31
236.7unless the license fee is paid before December 31. If a license expires, the program is no
236.8longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2,
236.9must not operate after the expiration date. After a license expires, if the former license
236.10holder wishes to provide licensed services, the former license holder must submit a new
236.11license application and application fee under subdivision 3.
236.12    Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding
236.13section 16A.1285, subdivision 2, related to activities for which the commissioner charges
236.14a fee, the commissioner must plan to fully recover direct expenditures for licensing
236.15activities under this chapter over a five-year period. The commissioner may have
236.16anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
236.17revenues accumulated in previous bienniums.
236.18    Subd. 8. Deposit of license fees. A human services licensing account is created in
236.19the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
236.20be deposited in the human services licensing account and are annually appropriated to the
236.21commissioner for licensing activities authorized under this chapter.
236.22EFFECTIVE DATE.This section is effective July 1, 2013.

236.23    Sec. 11. Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:
236.24    Subd. 2a. Adult foster care and community residential setting license capacity.
236.25(a) The commissioner shall issue adult foster care and community residential setting
236.26 licenses with a maximum licensed capacity of four beds, including nonstaff roomers and
236.27boarders, except that the commissioner may issue a license with a capacity of five beds,
236.28including roomers and boarders, according to paragraphs (b) to (f).
236.29(b) An adult foster care The license holder may have a maximum license capacity
236.30of five if all persons in care are age 55 or over and do not have a serious and persistent
236.31mental illness or a developmental disability.
236.32(c) The commissioner may grant variances to paragraph (b) to allow a foster care
236.33provider facility with a licensed capacity of five persons to admit an individual under the
236.34age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of
237.1the variance is recommended by the county in which the licensed foster care provider
237.2 facility is located.
237.3(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
237.4bed for emergency crisis services for a person with serious and persistent mental illness
237.5or a developmental disability, regardless of age, if the variance complies with section
237.6245A.04, subdivision 9 , and approval of the variance is recommended by the county in
237.7which the licensed foster care provider facility is located.
237.8(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a
237.9fifth bed for respite services, as defined in section 245A.02, for persons with disabilities,
237.10regardless of age, if the variance complies with sections 245A.03, subdivision 7, and
237.11245A.04, subdivision 9 , and approval of the variance is recommended by the county in
237.12which the licensed foster care provider facility is licensed located. Respite care may be
237.13provided under the following conditions:
237.14(1) staffing ratios cannot be reduced below the approved level for the individuals
237.15being served in the home on a permanent basis;
237.16(2) no more than two different individuals can be accepted for respite services in
237.17any calendar month and the total respite days may not exceed 120 days per program in
237.18any calendar year;
237.19(3) the person receiving respite services must have his or her own bedroom, which
237.20could be used for alternative purposes when not used as a respite bedroom, and cannot be
237.21the room of another person who lives in the foster care home facility; and
237.22(4) individuals living in the foster care home facility must be notified when the
237.23variance is approved. The provider must give 60 days' notice in writing to the residents
237.24and their legal representatives prior to accepting the first respite placement. Notice must
237.25be given to residents at least two days prior to service initiation, or as soon as the license
237.26holder is able if they receive notice of the need for respite less than two days prior to
237.27initiation, each time a respite client will be served, unless the requirement for this notice is
237.28waived by the resident or legal guardian.
237.29(f) The commissioner may issue an adult foster care or community residential setting
237.30 license with a capacity of five adults if the fifth bed does not increase the overall statewide
237.31capacity of licensed adult foster care or community residential setting beds in homes that
237.32are not the primary residence of the license holder, as identified in a plan submitted to the
237.33commissioner by the county, when the capacity is recommended by the county licensing
237.34agency of the county in which the facility is located and if the recommendation verifies that:
237.35(1) the facility meets the physical environment requirements in the adult foster
237.36care licensing rule;
238.1(2) the five-bed living arrangement is specified for each resident in the resident's:
238.2(i) individualized plan of care;
238.3(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
238.4(iii) individual resident placement agreement under Minnesota Rules, part
238.59555.5105, subpart 19, if required;
238.6(3) the license holder obtains written and signed informed consent from each
238.7resident or resident's legal representative documenting the resident's informed choice
238.8to remain living in the home and that the resident's refusal to consent would not have
238.9resulted in service termination; and
238.10(4) the facility was licensed for adult foster care before March 1, 2011.
238.11(g) The commissioner shall not issue a new adult foster care license under paragraph
238.12(f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care
238.13license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five
238.14adults if the license holder continues to comply with the requirements in paragraph (f).

238.15    Sec. 12. Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:
238.16    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The
238.17commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
238.18requiring a caregiver to be present in an adult foster care home during normal sleeping
238.19hours to allow for alternative methods of overnight supervision. The commissioner may
238.20grant the variance if the local county licensing agency recommends the variance and the
238.21county recommendation includes documentation verifying that:
238.22    (1) the county has approved the license holder's plan for alternative methods of
238.23providing overnight supervision and determined the plan protects the residents' health,
238.24safety, and rights;
238.25    (2) the license holder has obtained written and signed informed consent from
238.26each resident or each resident's legal representative documenting the resident's or legal
238.27representative's agreement with the alternative method of overnight supervision; and
238.28    (3) the alternative method of providing overnight supervision, which may include
238.29the use of technology, is specified for each resident in the resident's: (i) individualized
238.30plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
238.31required; or (iii) individual resident placement agreement under Minnesota Rules, part
238.329555.5105, subpart 19, if required.
238.33    (b) To be eligible for a variance under paragraph (a), the adult foster care license
238.34holder must not have had a conditional license issued under section 245A.06, or any
238.35other licensing sanction issued under section 245A.07 during the prior 24 months based
239.1on failure to provide adequate supervision, health care services, or resident safety in
239.2the adult foster care home.
239.3    (c) A license holder requesting a variance under this subdivision to utilize
239.4technology as a component of a plan for alternative overnight supervision may request
239.5the commissioner's review in the absence of a county recommendation. Upon receipt of
239.6such a request from a license holder, the commissioner shall review the variance request
239.7with the county.
239.8(d) A variance granted by the commissioner according to this subdivision before
239.9January 1, 2014, to a license holder for an adult foster care home must transfer with the
239.10license when the license converts to a community residential setting license under chapter
239.11245D. The terms and conditions of the variance remain in effect as approved at the time
239.12the variance was granted.

239.13    Sec. 13. Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:
239.14    Subd. 7a. Alternate overnight supervision technology; adult foster care license
239.15 and community residential setting licenses. (a) The commissioner may grant an
239.16applicant or license holder an adult foster care or community residential setting license
239.17for a residence that does not have a caregiver in the residence during normal sleeping
239.18hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, or section
239.19245D.02, subdivision 33b, but uses monitoring technology to alert the license holder
239.20when an incident occurs that may jeopardize the health, safety, or rights of a foster
239.21care recipient. The applicant or license holder must comply with all other requirements
239.22under Minnesota Rules, parts 9555.5105 to 9555.6265, or applicable requirements under
239.23chapter 245D, and the requirements under this subdivision. The license printed by the
239.24commissioner must state in bold and large font:
239.25    (1) that the facility is under electronic monitoring; and
239.26    (2) the telephone number of the county's common entry point for making reports of
239.27suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
239.28(b) Applications for a license under this section must be submitted directly to
239.29the Department of Human Services licensing division. The licensing division must
239.30immediately notify the host county and lead county contract agency and the host county
239.31licensing agency. The licensing division must collaborate with the county licensing
239.32agency in the review of the application and the licensing of the program.
239.33    (c) Before a license is issued by the commissioner, and for the duration of the
239.34license, the applicant or license holder must establish, maintain, and document the
240.1implementation of written policies and procedures addressing the requirements in
240.2paragraphs (d) through (f).
240.3    (d) The applicant or license holder must have policies and procedures that:
240.4    (1) establish characteristics of target populations that will be admitted into the home,
240.5and characteristics of populations that will not be accepted into the home;
240.6    (2) explain the discharge process when a foster care recipient resident served by the
240.7program requires overnight supervision or other services that cannot be provided by the
240.8license holder due to the limited hours that the license holder is on site;
240.9    (3) describe the types of events to which the program will respond with a physical
240.10presence when those events occur in the home during time when staff are not on site, and
240.11how the license holder's response plan meets the requirements in paragraph (e), clause
240.12(1) or (2);
240.13    (4) establish a process for documenting a review of the implementation and
240.14effectiveness of the response protocol for the response required under paragraph (e),
240.15clause (1) or (2). The documentation must include:
240.16    (i) a description of the triggering incident;
240.17    (ii) the date and time of the triggering incident;
240.18    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
240.19    (iv) whether the response met the resident's needs;
240.20    (v) whether the existing policies and response protocols were followed; and
240.21    (vi) whether the existing policies and protocols are adequate or need modification.
240.22    When no physical presence response is completed for a three-month period, the
240.23license holder's written policies and procedures must require a physical presence response
240.24drill to be conducted for which the effectiveness of the response protocol under paragraph
240.25(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
240.26    (5) establish that emergency and nonemergency phone numbers are posted in a
240.27prominent location in a common area of the home where they can be easily observed by a
240.28person responding to an incident who is not otherwise affiliated with the home.
240.29    (e) The license holder must document and include in the license application which
240.30response alternative under clause (1) or (2) is in place for responding to situations that
240.31present a serious risk to the health, safety, or rights of people receiving foster care services
240.32in the home residents served by the program:
240.33    (1) response alternative (1) requires only the technology to provide an electronic
240.34notification or alert to the license holder that an event is underway that requires a response.
240.35Under this alternative, no more than ten minutes will pass before the license holder will be
240.36physically present on site to respond to the situation; or
241.1    (2) response alternative (2) requires the electronic notification and alert system under
241.2alternative (1), but more than ten minutes may pass before the license holder is present on
241.3site to respond to the situation. Under alternative (2), all of the following conditions are met:
241.4    (i) the license holder has a written description of the interactive technological
241.5applications that will assist the license holder in communicating with and assessing the
241.6needs related to the care, health, and safety of the foster care recipients. This interactive
241.7technology must permit the license holder to remotely assess the well being of the foster
241.8care recipient resident served by the program without requiring the initiation of the
241.9foster care recipient. Requiring the foster care recipient to initiate a telephone call does
241.10not meet this requirement;
241.11(ii) the license holder documents how the remote license holder is qualified and
241.12capable of meeting the needs of the foster care recipients and assessing foster care
241.13recipients' needs under item (i) during the absence of the license holder on site;
241.14(iii) the license holder maintains written procedures to dispatch emergency response
241.15personnel to the site in the event of an identified emergency; and
241.16    (iv) each foster care recipient's resident's individualized plan of care, individual
241.17service plan coordinated service and support plan under section sections 256B.0913,
241.18subdivision 8; 256B.0915, subdivision 6; 256B.092, subdivision 1b; and 256B.49,
241.19subdivision 15, if required, or individual resident placement agreement under Minnesota
241.20Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time,
241.21which may be greater than ten minutes, for the license holder to be on site for that foster
241.22care recipient resident.
241.23    (f) Each foster care recipient's resident's placement agreement, individual service
241.24agreement, and plan must clearly state that the adult foster care or community residential
241.25setting license category is a program without the presence of a caregiver in the residence
241.26during normal sleeping hours; the protocols in place for responding to situations that
241.27present a serious risk to the health, safety, or rights of foster care recipients residents
241.28served by the program under paragraph (e), clause (1) or (2); and a signed informed
241.29consent from each foster care recipient resident served by the program or the person's
241.30legal representative documenting the person's or legal representative's agreement with
241.31placement in the program. If electronic monitoring technology is used in the home, the
241.32informed consent form must also explain the following:
241.33    (1) how any electronic monitoring is incorporated into the alternative supervision
241.34system;
241.35    (2) the backup system for any electronic monitoring in times of electrical outages or
241.36other equipment malfunctions;
242.1    (3) how the caregivers or direct support staff are trained on the use of the technology;
242.2    (4) the event types and license holder response times established under paragraph (e);
242.3    (5) how the license holder protects the foster care recipient's each resident's privacy
242.4related to electronic monitoring and related to any electronically recorded data generated
242.5by the monitoring system. A foster care recipient resident served by the program may
242.6not be removed from a program under this subdivision for failure to consent to electronic
242.7monitoring. The consent form must explain where and how the electronically recorded
242.8data is stored, with whom it will be shared, and how long it is retained; and
242.9    (6) the risks and benefits of the alternative overnight supervision system.
242.10    The written explanations under clauses (1) to (6) may be accomplished through
242.11cross-references to other policies and procedures as long as they are explained to the
242.12person giving consent, and the person giving consent is offered a copy.
242.13(g) Nothing in this section requires the applicant or license holder to develop or
242.14maintain separate or duplicative policies, procedures, documentation, consent forms, or
242.15individual plans that may be required for other licensing standards, if the requirements of
242.16this section are incorporated into those documents.
242.17(h) The commissioner may grant variances to the requirements of this section
242.18according to section 245A.04, subdivision 9.
242.19(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
242.20under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
242.21contractors affiliated with the license holder.
242.22(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
242.23remotely determine what action the license holder needs to take to protect the well-being
242.24of the foster care recipient.
242.25(k) The commissioner shall evaluate license applications using the requirements
242.26in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
242.27including a checklist of criteria needed for approval.
242.28(l) To be eligible for a license under paragraph (a), the adult foster care or community
242.29residential setting license holder must not have had a conditional license issued under
242.30section 245A.06 or any licensing sanction under section 245A.07 during the prior 24
242.31months based on failure to provide adequate supervision, health care services, or resident
242.32safety in the adult foster care home or community residential setting.
242.33(m) The commissioner shall review an application for an alternative overnight
242.34supervision license within 60 days of receipt of the application. When the commissioner
242.35receives an application that is incomplete because the applicant failed to submit required
242.36documents or that is substantially deficient because the documents submitted do not meet
243.1licensing requirements, the commissioner shall provide the applicant written notice
243.2that the application is incomplete or substantially deficient. In the written notice to the
243.3applicant, the commissioner shall identify documents that are missing or deficient and
243.4give the applicant 45 days to resubmit a second application that is substantially complete.
243.5An applicant's failure to submit a substantially complete application after receiving
243.6notice from the commissioner is a basis for license denial under section 245A.05. The
243.7commissioner shall complete subsequent review within 30 days.
243.8(n) Once the application is considered complete under paragraph (m), the
243.9commissioner will approve or deny an application for an alternative overnight supervision
243.10license within 60 days.
243.11(o) For the purposes of this subdivision, "supervision" means:
243.12(1) oversight by a caregiver or direct support staff as specified in the individual
243.13resident's place agreement or coordinated service and support plan and awareness of the
243.14resident's needs and activities; and
243.15(2) the presence of a caregiver or direct support staff in a residence during normal
243.16sleeping hours, unless a determination has been made and documented in the individual's
243.17 coordinated service and support plan that the individual does not require the presence of a
243.18caregiver or direct support staff during normal sleeping hours.

243.19    Sec. 14. Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:
243.20    Subd. 7b. Adult foster care data privacy and security. (a) An adult foster care
243.21 or community residential setting license holder who creates, collects, records, maintains,
243.22stores, or discloses any individually identifiable recipient data, whether in an electronic
243.23or any other format, must comply with the privacy and security provisions of applicable
243.24privacy laws and regulations, including:
243.25(1) the federal Health Insurance Portability and Accountability Act of 1996
243.26(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
243.27title 45, part 160, and subparts A and E of part 164; and
243.28(2) the Minnesota Government Data Practices Act as codified in chapter 13.
243.29(b) For purposes of licensure, the license holder shall be monitored for compliance
243.30with the following data privacy and security provisions:
243.31(1) the license holder must control access to data on foster care recipients residents
243.32served by the program according to the definitions of public and private data on individuals
243.33under section 13.02; classification of the data on individuals as private under section
243.3413.46, subdivision 2 ; and control over the collection, storage, use, access, protection,
244.1and contracting related to data according to section 13.05, in which the license holder is
244.2assigned the duties of a government entity;
244.3(2) the license holder must provide each foster care recipient resident served by
244.4the program with a notice that meets the requirements under section 13.04, in which
244.5the license holder is assigned the duties of the government entity, and that meets the
244.6requirements of Code of Federal Regulations, title 45, part 164.52. The notice shall
244.7describe the purpose for collection of the data, and to whom and why it may be disclosed
244.8pursuant to law. The notice must inform the recipient individual that the license holder
244.9uses electronic monitoring and, if applicable, that recording technology is used;
244.10(3) the license holder must not install monitoring cameras in bathrooms;
244.11(4) electronic monitoring cameras must not be concealed from the foster care
244.12recipients residents served by the program; and
244.13(5) electronic video and audio recordings of foster care recipients residents served
244.14by the program shall be stored by the license holder for five days unless: (i) a foster care
244.15recipient resident served by the program or legal representative requests that the recording
244.16be held longer based on a specific report of alleged maltreatment; or (ii) the recording
244.17captures an incident or event of alleged maltreatment under section 626.556 or 626.557 or
244.18a crime under chapter 609. When requested by a recipient resident served by the program
244.19 or when a recording captures an incident or event of alleged maltreatment or a crime, the
244.20license holder must maintain the recording in a secured area for no longer than 30 days
244.21to give the investigating agency an opportunity to make a copy of the recording. The
244.22investigating agency will maintain the electronic video or audio recordings as required in
244.23section 626.557, subdivision 12b.
244.24(c) The commissioner shall develop, and make available to license holders and
244.25county licensing workers, a checklist of the data privacy provisions to be monitored
244.26for purposes of licensure.

244.27    Sec. 15. Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:
244.28    Subd. 8. Community residential setting license. (a) The commissioner shall
244.29establish provider standards for residential support services that integrate service standards
244.30and the residential setting under one license. The commissioner shall propose statutory
244.31language and an implementation plan for licensing requirements for residential support
244.32services to the legislature by January 15, 2012, as a component of the quality outcome
244.33standards recommendations required by Laws 2010, chapter 352, article 1, section 24.
244.34(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
244.35for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105
245.1to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340;
245.2and meeting the provisions of section 256B.092, subdivision 11, paragraph (b) section
245.3245D.02, subdivision 4a, must be required to obtain a community residential setting license.

245.4    Sec. 16. Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:
245.5    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
245.6private agencies that have been designated or licensed by the commissioner to perform
245.7licensing functions and activities under section 245A.04 and background studies for family
245.8child care under chapter 245C; to recommend denial of applicants under section 245A.05;
245.9to issue correction orders, to issue variances, and recommend a conditional license under
245.10section 245A.06, or to recommend suspending or revoking a license or issuing a fine under
245.11section 245A.07, shall comply with rules and directives of the commissioner governing
245.12those functions and with this section. The following variances are excluded from the
245.13delegation of variance authority and may be issued only by the commissioner:
245.14    (1) dual licensure of family child care and child foster care, dual licensure of child
245.15and adult foster care, and adult foster care and family child care;
245.16    (2) adult foster care maximum capacity;
245.17    (3) adult foster care minimum age requirement;
245.18    (4) child foster care maximum age requirement;
245.19    (5) variances regarding disqualified individuals except that county agencies may
245.20issue variances under section 245C.30 regarding disqualified individuals when the county
245.21is responsible for conducting a consolidated reconsideration according to sections 245C.25
245.22and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
245.23and a disqualification based on serious or recurring maltreatment; and
245.24    (6) the required presence of a caregiver in the adult foster care residence during
245.25normal sleeping hours; and
245.26    (7) variances for community residential setting licenses under chapter 245D.
245.27Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency
245.28must not grant a license holder a variance to exceed the maximum allowable family child
245.29care license capacity of 14 children.
245.30    (b) County agencies must report information about disqualification reconsiderations
245.31under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances
245.32granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
245.33prescribed by the commissioner.
245.34    (c) For family day care programs, the commissioner may authorize licensing reviews
245.35every two years after a licensee has had at least one annual review.
246.1    (d) For family adult day services programs, the commissioner may authorize
246.2licensing reviews every two years after a licensee has had at least one annual review.
246.3    (e) A license issued under this section may be issued for up to two years.

246.4    Sec. 17. Minnesota Statutes 2012, section 245D.02, is amended to read:
246.5245D.02 DEFINITIONS.
246.6    Subdivision 1. Scope. The terms used in this chapter have the meanings given
246.7them in this section.
246.8    Subd. 2. Annual and annually. "Annual" and "annually" have the meaning given
246.9in section 245A.02, subdivision 2b.
246.10    Subd. 2a. Authorized representative. "Authorized representative" means a parent,
246.11family member, advocate, or other adult authorized by the person or the person's legal
246.12representative, to serve as a representative in connection with the provision of services
246.13licensed under this chapter. This authorization must be in writing or by another method
246.14that clearly indicates the person's free choice. The authorized representative must have no
246.15financial interest in the provision of any services included in the person's service delivery
246.16plan and must be capable of providing the support necessary to assist the person in the use
246.17of home and community-based services licensed under this chapter.
246.18    Subd. 3. Case manager. "Case manager" means the individual designated
246.19to provide waiver case management services, care coordination, or long-term care
246.20consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
246.21or successor provisions.
246.22    Subd. 3a. Certification. "Certification" means the commissioner's written
246.23authorization for a license holder to provide specialized services based on certification
246.24standards in section 245D.33. The term certification and its derivatives have the same
246.25meaning and may be substituted for the term licensure and its derivatives in this chapter
246.26and chapter 245A.
246.27    Subd. 4. Commissioner. "Commissioner" means the commissioner of the
246.28Department of Human Services or the commissioner's designated representative.
246.29    Subd. 4a. Community residential setting. "Community residential setting" means
246.30a residential program as identified in section 245A.11, subdivision 8, where residential
246.31supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause
246.32(3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant
246.33of the facility licensed according to this chapter, and the license holder does not reside
246.34in the facility.
247.1    Subd. 4b. Coordinated service and support plan. "Coordinated service and support
247.2plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision
247.36; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions.
247.4    Subd. 4c. Coordinated service and support plan addendum. "Coordinated
247.5service and support plan addendum" means the documentation that this chapter requires
247.6of the license holder for each person receiving services.
247.7    Subd. 4d. Corporate foster care. "Corporate foster care" means a child foster
247.8residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340,
247.9or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to
247.109555.6265, where the license holder does not live in the home.
247.11    Subd. 4e. Cultural competence or culturally competent. "Cultural competence"
247.12or "culturally competent" means the ability and the will to respond to the unique needs of
247.13a person that arise from the person's culture and the ability to use the person's culture as a
247.14resource or tool to assist with the intervention and help meet the person's needs.
247.15    Subd. 4f. Day services facility. "Day services facility" means a facility licensed
247.16according to this chapter at which persons receive day services licensed under this chapter
247.17from the license holder's direct support staff for a cumulative total of more than 30 days
247.18within any 12-month period and the license holder is the owner, lessor, or tenant of the
247.19facility.
247.20    Subd. 5. Department. "Department" means the Department of Human Services.
247.21    Subd. 6. Direct contact. "Direct contact" has the meaning given in section 245C.02,
247.22subdivision 11 , and is used interchangeably with the term "direct support service."
247.23    Subd. 6a. Direct support staff or staff. "Direct support staff" or "staff" means
247.24employees of the license holder who have direct contact with persons served by the
247.25program and includes temporary staff or subcontractors, regardless of employer, providing
247.26program services for hire under the control of the license holder who have direct contact
247.27with persons served by the program.
247.28    Subd. 7. Drug. "Drug" has the meaning given in section 151.01, subdivision 5.
247.29    Subd. 8. Emergency. "Emergency" means any event that affects the ordinary
247.30daily operation of the program including, but not limited to, fires, severe weather, natural
247.31disasters, power failures, or other events that threaten the immediate health and safety of
247.32a person receiving services and that require calling 911, emergency evacuation, moving
247.33to an emergency shelter, or temporary closure or relocation of the program to another
247.34facility or service site for more than 24 hours.
247.35    Subd. 8a. Emergency use of manual restraint. "Emergency use of manual
247.36restraint" means using a manual restraint when a person poses an imminent risk of
248.1physical harm to self or others and is the least restrictive intervention that would achieve
248.2safety. Property damage, verbal aggression, or a person's refusal to receive or participate
248.3in treatment or programming on their own, do not constitute an emergency.
248.4    Subd. 8b. Expanded support team. "Expanded support team" means the members
248.5of the support team defined in subdivision 46, and a licensed health or mental health
248.6professional or other licensed, certified, or qualified professionals or consultants working
248.7with the person and included in the team at the request of the person or the person's legal
248.8representative.
248.9    Subd. 8c. Family foster care. "Family foster care" means a child foster family
248.10setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult
248.11foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265,
248.12where the license holder lives in the home.
248.13    Subd. 9. Health services. "Health services" means any service or treatment
248.14consistent with the physical and mental health needs of the person, such as medication
248.15administration and monitoring, medical, dental, nutritional, health monitoring, wellness
248.16education, and exercise.
248.17    Subd. 10. Home and community-based services. "Home and community-based
248.18services" means the services subject to the provisions of this chapter identified in section
248.19245D.03, subdivision 1, and as defined in:
248.20(1) the federal federally approved waiver plans governed by United States Code,
248.21title 42, sections 1396 et seq., or the state's alternative care program according to section
248.22256B.0913, including the waivers for persons with disabilities under section 256B.49,
248.23subdivision 11, including the brain injury (BI) waiver, plan; the community alternative
248.24care (CAC) waiver, plan; the community alternatives for disabled individuals (CADI)
248.25waiver, plan; the developmental disability (DD) waiver, plan under section 256B.092,
248.26subdivision 5; the elderly waiver (EW), and plan under section 256B.0915, subdivision 1;
248.27or successor plans respective to each waiver; or
248.28(2) the alternative care (AC) program under section 256B.0913.
248.29    Subd. 11. Incident. "Incident" means an occurrence that affects the which involves
248.30a person and requires the program to make a response that is not a part of the program's
248.31 ordinary provision of services to a that person, and includes any of the following:
248.32(1) serious injury of a person as determined by section 245.91, subdivision 6;
248.33(2) a person's death;
248.34(3) any medical emergency, unexpected serious illness, or significant unexpected
248.35change in an illness or medical condition, or the mental health status of a person that
249.1requires calling the program to call 911 or a mental health crisis intervention team,
249.2physician treatment, or hospitalization;
249.3(4) any mental health crisis that requires the program to call 911 or a mental health
249.4crisis intervention team;
249.5(5) an act or situation involving a person that requires the program to call 911,
249.6law enforcement, or the fire department;
249.7(4) (6) a person's unauthorized or unexplained absence from a program;
249.8(5) (7) physical aggression conduct by a person receiving services against another
249.9person receiving services that causes physical pain, injury, or persistent emotional distress,
249.10including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting,
249.11pushing, and spitting;:
249.12(i) is so severe, pervasive, or objectively offensive that it substantially interferes with
249.13a person's opportunities to participate in or receive service or support;
249.14(ii) places the person in actual and reasonable fear of harm;
249.15(iii) places the person in actual and reasonable fear of damage to property of the
249.16person; or
249.17(iv) substantially disrupts the orderly operation of the program;
249.18(6) (8) any sexual activity between persons receiving services involving force or
249.19coercion as defined under section 609.341, subdivisions 3 and 14; or
249.20(9) any emergency use of manual restraint as identified in section 245D.061; or
249.21(7) (10) a report of alleged or suspected child or vulnerable adult maltreatment
249.22under section 626.556 or 626.557.
249.23    Subd. 11a. Intermediate care facility for persons with developmental disabilities
249.24or ICF/DD. "Intermediate care facility for persons with developmental disabilities" or
249.25"ICF/DD" means a residential program licensed to serve four or more persons with
249.26developmental disabilities under section 252.28 and chapter 245A and licensed as a
249.27supervised living facility under chapter 144, which together are certified by the Department
249.28of Health as an intermediate care facility for persons with developmental disabilities.
249.29    Subd. 11b. Least restrictive alternative. "Least restrictive alternative" means
249.30the alternative method for providing supports and services that is the least intrusive and
249.31most normalized given the level of supervision and protection required for the person.
249.32This level of supervision and protection allows risk taking to the extent that there is no
249.33reasonable likelihood that serious harm will happen to the person or others.
249.34    Subd. 12. Legal representative. "Legal representative" means the parent of a
249.35person who is under 18 years of age, a court-appointed guardian, or other representative
249.36with legal authority to make decisions about services for a person. Other representatives
250.1with legal authority to make decisions include but are not limited to a health care agent or
250.2an attorney-in-fact authorized through a health care directive or power of attorney.
250.3    Subd. 13. License. "License" has the meaning given in section 245A.02,
250.4subdivision 8 .
250.5    Subd. 14. Licensed health professional. "Licensed health professional" means a
250.6person licensed in Minnesota to practice those professions described in section 214.01,
250.7subdivision 2 .
250.8    Subd. 15. License holder. "License holder" has the meaning given in section
250.9245A.02, subdivision 9 .
250.10    Subd. 16. Medication. "Medication" means a prescription drug or over-the-counter
250.11drug. For purposes of this chapter, "medication" includes dietary supplements.
250.12    Subd. 17. Medication administration. "Medication administration" means
250.13performing the following set of tasks to ensure a person takes both prescription and
250.14over-the-counter medications and treatments according to orders issued by appropriately
250.15licensed professionals, and includes the following:
250.16(1) checking the person's medication record;
250.17(2) preparing the medication for administration;
250.18(3) administering the medication to the person;
250.19(4) documenting the administration of the medication or the reason for not
250.20administering the medication; and
250.21(5) reporting to the prescriber or a nurse any concerns about the medication,
250.22including side effects, adverse reactions, effectiveness, or the person's refusal to take the
250.23medication or the person's self-administration of the medication.
250.24    Subd. 18. Medication assistance. "Medication assistance" means providing verbal
250.25or visual reminders to take regularly scheduled medication, which includes either of
250.26the following:
250.27(1) bringing to the person and opening a container of previously set up medications
250.28and emptying the container into the person's hand or opening and giving the medications
250.29in the original container to the person, or bringing to the person liquids or food to
250.30accompany the medication; or
250.31(2) providing verbal or visual reminders to perform regularly scheduled treatments
250.32and exercises.
250.33    Subd. 19. Medication management. "Medication management" means the
250.34provision of any of the following:
250.35(1) medication-related services to a person;
250.36(2) medication setup;
251.1(3) medication administration;
251.2(4) medication storage and security;
251.3(5) medication documentation and charting;
251.4(6) verification and monitoring of effectiveness of systems to ensure safe medication
251.5handling and administration;
251.6(7) coordination of medication refills;
251.7(8) handling changes to prescriptions and implementation of those changes;
251.8(9) communicating with the pharmacy; or
251.9(10) coordination and communication with prescriber.
251.10For the purposes of this chapter, medication management does not mean "medication
251.11therapy management services" as identified in section 256B.0625, subdivision 13h.
251.12    Subd. 20. Mental health crisis intervention team. "Mental health crisis
251.13intervention team" means a mental health crisis response providers provider as identified
251.14in section 256B.0624, subdivision 2, paragraph (d), for adults, and in section 256B.0944,
251.15subdivision 1 , paragraph (d), for children.
251.16    Subd. 20a. Most integrated setting. "Most integrated setting" means a setting that
251.17enables individuals with disabilities to interact with nondisabled persons to the fullest
251.18extent possible.
251.19    Subd. 21. Over-the-counter drug. "Over-the-counter drug" means a drug that
251.20is not required by federal law to bear the statement "Caution: Federal law prohibits
251.21dispensing without prescription."
251.22    Subd. 21a. Outcome. "Outcome" means the behavior, action, or status attained by
251.23the person that can be observed, measured, and determined reliable and valid.
251.24    Subd. 22. Person. "Person" has the meaning given in section 245A.02, subdivision
251.2511 .
251.26    Subd. 23. Person with a disability. "Person with a disability" means a person
251.27determined to have a disability by the commissioner's state medical review team as
251.28identified in section 256B.055, subdivision 7, the Social Security Administration, or
251.29the person is determined to have a developmental disability as defined in Minnesota
251.30Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section
251.31252.27, subdivision 1a .
251.32    Subd. 23a. Physician. "Physician" means a person who is licensed under chapter
251.33147.
251.34    Subd. 24. Prescriber. "Prescriber" means a licensed practitioner as defined in
251.35section 151.01, subdivision 23, person who is authorized under section sections 148.235;
252.1151.01, subdivision 23; or 151.37 to prescribe drugs. For the purposes of this chapter, the
252.2term "prescriber" is used interchangeably with "physician."
252.3    Subd. 25. Prescription drug. "Prescription drug" has the meaning given in section
252.4151.01, subdivision 17 16 .
252.5    Subd. 26. Program. "Program" means either the nonresidential or residential
252.6program as defined in section 245A.02, subdivisions 10 and 14.
252.7    Subd. 27. Psychotropic medication. "Psychotropic medication" means any
252.8medication prescribed to treat the symptoms of mental illness that affect thought processes,
252.9mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic
252.10(neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and
252.11stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder.
252.12Other miscellaneous medications are considered to be a psychotropic medication when
252.13they are specifically prescribed to treat a mental illness or to control or alter behavior.
252.14    Subd. 28. Restraint. "Restraint" means physical or mechanical limiting of the free
252.15and normal movement of body or limbs.
252.16    Subd. 29. Seclusion. "Seclusion" means separating a person from others in a way
252.17that prevents social contact and prevents the person from leaving the situation if he or she
252.18chooses the placement of a person alone in a room from which exit is prohibited by a staff
252.19person or a mechanism such as a lock, a device, or an object positioned to hold the door
252.20closed or otherwise prevent the person from leaving the room.
252.21    Subd. 29a. Self-determination. "Self-determination" means the person makes
252.22decisions independently, plans for the person's own future, determines how money is spent
252.23for the person's supports, and takes responsibility for making these decisions. If a person
252.24has a legal representative, the legal representative's decision-making authority is limited to
252.25the scope of authority granted by the court or allowed in the document authorizing the
252.26legal representative to act.
252.27    Subd. 29b. Semi-independent living services. "Semi-independent living services"
252.28has the meaning given in section 252.275.
252.29    Subd. 30. Service. "Service" means care, training, supervision, counseling,
252.30consultation, or medication assistance assigned to the license holder in the coordinated
252.31service and support plan.
252.32    Subd. 31. Service plan. "Service plan" means the individual service plan or
252.33individual care plan identified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
252.34or successor provisions, and includes any support plans or service needs identified as
252.35a result of long-term care consultation, or a support team meeting that includes the
253.1participation of the person, the person's legal representative, and case manager, or assigned
253.2to a license holder through an authorized service agreement.
253.3    Subd. 32. Service site. "Service site" means the location where the service is
253.4provided to the person, including, but not limited to, a facility licensed according to
253.5chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's
253.6own home; or a community-based location.
253.7    Subd. 33. Staff. "Staff" means an employee who will have direct contact with a
253.8person served by the facility, agency, or program.
253.9    Subd. 33a. Supervised living facility. "Supervised living facility" has the meaning
253.10given in Minnesota Rules, part 4665.0100, subpart 10.
253.11    Subd. 33b. Supervision. (a) "Supervision" means:
253.12(1) oversight by direct support staff as specified in the person's coordinated service
253.13and support plan or coordinated service and support plan addendum and awareness of
253.14the person's needs and activities;
253.15(2) responding to situations that present a serious risk to the health, safety, or rights
253.16of the person while services are being provided; and
253.17(3) the presence of direct support staff at a service site while services are being
253.18provided, unless a determination has been made and documented in the person's coordinated
253.19service and support plan or coordinated service and support plan addendum that the person
253.20does not require the presence of direct support staff while services are being provided.
253.21(b) For the purposes of this definition, "while services are being provided," means
253.22any period of time during which the license holder will seek reimbursement for services.
253.23    Subd. 34. Support team. "Support team" means the service planning team
253.24identified in section 256B.49, subdivision 15, or the interdisciplinary team identified in
253.25Minnesota Rules, part 9525.0004, subpart 14.
253.26    Subd. 34a. Time out. "Time out" means removing a person involuntarily from an
253.27ongoing activity to a room, either locked or unlocked, or otherwise separating a person
253.28from others in a way that prevents social contact and prevents the person from leaving
253.29the situation if the person chooses. For the purpose of chapter 245D, "time out" does
253.30not mean voluntary removal or self-removal for the purpose of calming, prevention of
253.31escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out"
253.32does not include a person voluntarily moving from an ongoing activity to an unlocked
253.33room or otherwise separating from a situation or social contact with others if the person
253.34chooses. For the purposes of this definition, "voluntarily" means without being forced,
253.35compelled, or coerced.
254.1    Subd. 35. Unit of government. "Unit of government" means every city, county,
254.2town, school district, other political subdivisions of the state, and any agency of the state
254.3or the United States, and includes any instrumentality of a unit of government.
254.4    Subd. 35a. Treatment. "Treatment" means the provision of care, other than
254.5medications, ordered or prescribed by a licensed health or mental health professional,
254.6provided to a person to cure, rehabilitate, or ease symptoms.
254.7    Subd. 36. Volunteer. "Volunteer" means an individual who, under the direction of the
254.8license holder, provides direct services without pay to a person served by the license holder.
254.9EFFECTIVE DATE.This section is effective January 1, 2014.

254.10    Sec. 18. Minnesota Statutes 2012, section 245D.03, is amended to read:
254.11245D.03 APPLICABILITY AND EFFECT.
254.12    Subdivision 1. Applicability. (a) The commissioner shall regulate the provision of
254.13home and community-based services to persons with disabilities and persons age 65 and
254.14older pursuant to this chapter. The licensing standards in this chapter govern the provision
254.15of the following basic support services: and intensive support services.
254.16(1) housing access coordination as defined under the current BI, CADI, and DD
254.17waiver plans or successor plans;
254.18(2) respite services as defined under the current CADI, BI, CAC, DD, and EW
254.19waiver plans or successor plans when the provider is an individual who is not an employee
254.20of a residential or nonresidential program licensed by the Department of Human Services
254.21or the Department of Health that is otherwise providing the respite service;
254.22(3) behavioral programming as defined under the current BI and CADI waiver
254.23plans or successor plans;
254.24(4) specialist services as defined under the current DD waiver plan or successor plans;
254.25(5) companion services as defined under the current BI, CADI, and EW waiver
254.26plans or successor plans, excluding companion services provided under the Corporation
254.27for National and Community Services Senior Companion Program established under the
254.28Domestic Volunteer Service Act of 1973, Public Law 98-288;
254.29(6) personal support as defined under the current DD waiver plan or successor plans;
254.30(7) 24-hour emergency assistance, on-call and personal emergency response as
254.31defined under the current CADI and DD waiver plans or successor plans;
254.32(8) night supervision services as defined under the current BI waiver plan or
254.33successor plans;
255.1(9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW
255.2waiver plans or successor plans, excluding providers licensed by the Department of Health
255.3under chapter 144A and those providers providing cleaning services only;
255.4(10) independent living skills training as defined under the current BI and CADI
255.5waiver plans or successor plans;
255.6(11) prevocational services as defined under the current BI and CADI waiver plans
255.7or successor plans;
255.8(12) structured day services as defined under the current BI waiver plan or successor
255.9plans; or
255.10(13) supported employment as defined under the current BI and CADI waiver plans
255.11or successor plans.
255.12(b) Basic support services provide the level of assistance, supervision, and care that
255.13is necessary to ensure the health and safety of the person and do not include services that
255.14are specifically directed toward the training, treatment, habilitation, or rehabilitation of
255.15the person. Basic support services include:
255.16(1) in-home and out-of-home respite care services as defined in section 245A.02,
255.17subdivision 15, and under the brain injury, community alternative care, community
255.18alternatives for disabled individuals, developmental disability, and elderly waiver plans;
255.19(2) companion services as defined under the brain injury, community alternatives for
255.20disabled individuals, and elderly waiver plans, excluding companion services provided
255.21under the Corporation for National and Community Services Senior Companion Program
255.22established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
255.23(3) personal support as defined under the developmental disability waiver plan;
255.24(4) 24-hour emergency assistance, personal emergency response as defined under the
255.25community alternatives for disabled individuals and developmental disability waiver plans;
255.26(5) night supervision services as defined under the brain injury waiver plan; and
255.27(6) homemaker services as defined under the community alternatives for disabled
255.28individuals, brain injury, community alternative care, developmental disability, and elderly
255.29waiver plans, excluding providers licensed by the Department of Health under chapter
255.30144A and those providers providing cleaning services only.
255.31(c) Intensive support services provide assistance, supervision, and care that is
255.32necessary to ensure the health and safety of the person and services specifically directed
255.33toward the training, habilitation, or rehabilitation of the person. Intensive support services
255.34include:
255.35(1) intervention services, including:
256.1(i) behavioral support services as defined under the brain injury and community
256.2alternatives for disabled individuals waiver plans;
256.3(ii) in-home or out-of-home crisis respite services as defined under the developmental
256.4disability waiver plan; and
256.5(iii) specialist services as defined under the current developmental disability waiver
256.6plan;
256.7(2) in-home support services, including:
256.8(i) in-home family support and supported living services as defined under the
256.9developmental disability waiver plan;
256.10(ii) independent living services training as defined under the brain injury and
256.11community alternatives for disabled individuals waiver plans; and
256.12(iii) semi-independent living services;
256.13(3) residential supports and services, including:
256.14(i) supported living services as defined under the developmental disability waiver
256.15plan provided in a family or corporate child foster care residence, a family adult foster
256.16care residence, a community residential setting, or a supervised living facility;
256.17(ii) foster care services as defined in the brain injury, community alternative care,
256.18and community alternatives for disabled individuals waiver plans provided in a family or
256.19corporate child foster care residence, a family adult foster care residence, or a community
256.20residential setting; and
256.21(iii) residential services provided in a supervised living facility that is certified by
256.22the Department of Health as an ICF/DD;
256.23(4) day services, including:
256.24(i) structured day services as defined under the brain injury waiver plan;
256.25(ii) day training and habilitation services under sections 252.40 to 252.46, and as
256.26defined under the developmental disability waiver plan; and
256.27(iii) prevocational services as defined under the brain injury and community
256.28alternatives for disabled individuals waiver plans; and
256.29(5) supported employment as defined under the brain injury, developmental
256.30disability, and community alternatives for disabled individuals waiver plans.
256.31    Subd. 2. Relationship to other standards governing home and community-based
256.32services. (a) A license holder governed by this chapter is also subject to the licensure
256.33requirements under chapter 245A.
256.34(b) A license holder concurrently providing child foster care services licensed
256.35according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed
256.36under this chapter is exempt from section 245D.04 as it applies to the person. A corporate
257.1or family child foster care site controlled by a license holder and providing services
257.2governed by this chapter is exempt from compliance with section 245D.04. This exemption
257.3applies to foster care homes where at least one resident is receiving residential supports
257.4and services licensed according to this chapter. This chapter does not apply to corporate or
257.5family child foster care homes that do not provide services licensed under this chapter.
257.6(c) A family adult foster care site controlled by a license holder and providing
257.7services governed by this chapter is exempt from compliance with Minnesota Rules, parts
257.89555.6185; 9555.6225, subpart 8; 9555.6235, item C; 9555.6245; 9555.6255, subpart
257.92; and 9555.6265. These exemptions apply to family adult foster care homes where at
257.10least one resident is receiving residential supports and services licensed according to this
257.11chapter. This chapter does not apply to family adult foster care homes that do not provide
257.12services licensed under this chapter.
257.13(d) A license holder providing services licensed according to this chapter in a
257.14supervised living facility is exempt from compliance with sections 245D.04; 245D.05,
257.15subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
257.16(e) A license holder providing residential services to persons in an ICF/DD is exempt
257.17from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision
257.182, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09,
257.19subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
257.20(c) (f) A license holder concurrently providing home care homemaker services
257.21registered licensed according to sections 144A.43 to 144A.49 to the same person receiving
257.22home management services licensed under this chapter and registered according to chapter
257.23144A is exempt from compliance with section 245D.04 as it applies to the person.
257.24(d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt
257.25from compliance with sections 245A.65, subdivision 2, paragraph (a), and 626.557,
257.26subdivision 14 , paragraph (b).
257.27(e) Notwithstanding section 245D.06, subdivision 5, a license holder providing
257.28structured day, prevocational, or supported employment services under this chapter
257.29and day training and habilitation or supported employment services licensed under
257.30chapter 245B within the same program is exempt from compliance with this chapter
257.31when the license holder notifies the commissioner in writing that the requirements under
257.32chapter 245B will be met for all persons receiving these services from the program. For
257.33the purposes of this paragraph, if the license holder has obtained approval from the
257.34commissioner for an alternative inspection status according to section 245B.031, that
257.35approval will apply to all persons receiving services in the program.
258.1(g) Nothing in this chapter prohibits a license holder from concurrently serving
258.2persons without disabilities or people who are or are not age 65 and older, provided this
258.3chapter's standards are met as well as other relevant standards.
258.4(h) The documentation required under sections 245D.07 and 245D.071 must meet
258.5the individual program plan requirements identified in section 256B.092 or successor
258.6provisions.
258.7    Subd. 3. Variance. If the conditions in section 245A.04, subdivision 9, are met,
258.8the commissioner may grant a variance to any of the requirements in this chapter, except
258.9sections 245D.04, and 245D.10, subdivision 4, paragraph (b) 245D.06, subdivision 4,
258.10paragraph (b), and 245D.061, subdivision 3, or provisions governing data practices and
258.11information rights of persons.
258.12    Subd. 4. License holders with multiple 245D licenses. (a) When a person changes
258.13service from one license to a different license held by the same license holder, the license
258.14holder is exempt from the requirements in section 245D.10, subdivision 4, paragraph (b).
258.15(b) When a staff person begins providing direct service under one or more licenses
258.16held by the same license holder, other than the license for which staff orientation was
258.17initially provided according to section 245D.09, subdivision 4, the license holder is
258.18exempt from those staff orientation requirements, except the staff person must review each
258.19person's service plan and medication administration procedures in accordance with section
258.20245D.09, subdivision 4, paragraph (c), if not previously reviewed by the staff person.
258.21    Subd. 5. Program certification. An applicant or a license holder may apply for
258.22program certification as identified in section 245D.33.
258.23EFFECTIVE DATE.This section is effective January 1, 2014.

258.24    Sec. 19. Minnesota Statutes 2012, section 245D.04, is amended to read:
258.25245D.04 SERVICE RECIPIENT RIGHTS.
258.26    Subdivision 1. License holder responsibility for individual rights of persons
258.27served by the program. The license holder must:
258.28(1) provide each person or each person's legal representative with a written notice
258.29that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of
258.30those rights within five working days of service initiation and annually thereafter;
258.31(2) make reasonable accommodations to provide this information in other formats
258.32or languages as needed to facilitate understanding of the rights by the person and the
258.33person's legal representative, if any;
259.1(3) maintain documentation of the person's or the person's legal representative's
259.2receipt of a copy and an explanation of the rights; and
259.3(4) ensure the exercise and protection of the person's rights in the services provided
259.4by the license holder and as authorized in the coordinated service and support plan.
259.5    Subd. 2. Service-related rights. A person's service-related rights include the right to:
259.6(1) participate in the development and evaluation of the services provided to the
259.7person;
259.8(2) have services and supports identified in the coordinated service and support plan
259.9and the coordinated service and support plan addendum provided in a manner that respects
259.10and takes into consideration the person's preferences according to the requirements in
259.11sections 245D.07 and 245D.071;
259.12(3) refuse or terminate services and be informed of the consequences of refusing
259.13or terminating services;
259.14(4) know, in advance, limits to the services available from the license holder,
259.15including the license holder's knowledge, skill, and ability to meet the person's service and
259.16support needs based on the information required in section 245D.031, subdivision 2;
259.17(5) know conditions and terms governing the provision of services, including the
259.18license holder's admission criteria and policies and procedures related to temporary
259.19service suspension and service termination;
259.20(6) a coordinated transfer to ensure continuity of care when there will be a change
259.21in the provider;
259.22(7) know what the charges are for services, regardless of who will be paying for the
259.23services, and be notified of changes in those charges;
259.24(7) (8) know, in advance, whether services are covered by insurance, government
259.25funding, or other sources, and be told of any charges the person or other private party
259.26may have to pay; and
259.27(8) (9) receive services from an individual who is competent and trained, who has
259.28professional certification or licensure, as required, and who meets additional qualifications
259.29identified in the person's coordinated service and support plan. or coordinated service and
259.30support plan addendum.
259.31    Subd. 3. Protection-related rights. (a) A person's protection-related rights include
259.32the right to:
259.33(1) have personal, financial, service, health, and medical information kept private,
259.34and be advised of disclosure of this information by the license holder;
259.35(2) access records and recorded information about the person in accordance with
259.36applicable state and federal law, regulation, or rule;
260.1(3) be free from maltreatment;
260.2(4) be free from restraint, time out, or seclusion used for a purpose other than except
260.3for emergency use of manual restraint to protect the person from imminent danger to self
260.4or others according to the requirements in section 245D.06;
260.5(5) receive services in a clean and safe environment when the license holder is the
260.6owner, lessor, or tenant of the service site;
260.7(6) be treated with courtesy and respect and receive respectful treatment of the
260.8person's property;
260.9(7) reasonable observance of cultural and ethnic practice and religion;
260.10(8) be free from bias and harassment regarding race, gender, age, disability,
260.11spirituality, and sexual orientation;
260.12(9) be informed of and use the license holder's grievance policy and procedures,
260.13including knowing how to contact persons responsible for addressing problems and to
260.14appeal under section 256.045;
260.15(10) know the name, telephone number, and the Web site, e-mail, and street
260.16addresses of protection and advocacy services, including the appropriate state-appointed
260.17ombudsman, and a brief description of how to file a complaint with these offices;
260.18(11) assert these rights personally, or have them asserted by the person's family,
260.19authorized representative, or legal representative, without retaliation;
260.20(12) give or withhold written informed consent to participate in any research or
260.21experimental treatment;
260.22(13) associate with other persons of the person's choice;
260.23(14) personal privacy; and
260.24(15) engage in chosen activities.
260.25(b) For a person residing in a residential site licensed according to chapter 245A,
260.26or where the license holder is the owner, lessor, or tenant of the residential service site,
260.27protection-related rights also include the right to:
260.28(1) have daily, private access to and use of a non-coin-operated telephone for local
260.29calls and long-distance calls made collect or paid for by the person;
260.30(2) receive and send, without interference, uncensored, unopened mail or electronic
260.31correspondence or communication; and
260.32(3) have use of and free access to common areas in the residence; and
260.33(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious
260.34advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including
260.35privacy in the person's bedroom.
261.1(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a),
261.2clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure
261.3the health, safety, and well-being of the person. Any restriction of those rights must be
261.4documented in the person's coordinated service and support plan for the person and or
261.5coordinated service and support plan addendum. The restriction must be implemented
261.6in the least restrictive alternative manner necessary to protect the person and provide
261.7support to reduce or eliminate the need for the restriction in the most integrated setting
261.8and inclusive manner. The documentation must include the following information:
261.9(1) the justification for the restriction based on an assessment of the person's
261.10vulnerability related to exercising the right without restriction;
261.11(2) the objective measures set as conditions for ending the restriction;
261.12(3) a schedule for reviewing the need for the restriction based on the conditions for
261.13ending the restriction to occur, at a minimum, every three months for persons who do not
261.14have a legal representative and annually for persons who do have a legal representative
261.15 semiannually from the date of initial approval, at a minimum, or more frequently if
261.16requested by the person, the person's legal representative, if any, and case manager; and
261.17(4) signed and dated approval for the restriction from the person, or the person's
261.18legal representative, if any. A restriction may be implemented only when the required
261.19approval has been obtained. Approval may be withdrawn at any time. If approval is
261.20withdrawn, the right must be immediately and fully restored.
261.21EFFECTIVE DATE.This section is effective January 1, 2014.

261.22    Sec. 20. Minnesota Statutes 2012, section 245D.05, is amended to read:
261.23245D.05 HEALTH SERVICES.
261.24    Subdivision 1. Health needs. (a) The license holder is responsible for providing
261.25 meeting health services service needs assigned in the coordinated service and support plan
261.26and or the coordinated service and support plan addendum, consistent with the person's
261.27health needs. The license holder is responsible for promptly notifying the person or
261.28 the person's legal representative, if any, and the case manager of changes in a person's
261.29physical and mental health needs affecting assigned health services service needs assigned
261.30to the license holder in the coordinated service and support plan or the coordinated service
261.31and support plan addendum, when discovered by the license holder, unless the license
261.32holder has reason to know the change has already been reported. The license holder
261.33must document when the notice is provided.
262.1(b) When assigned in the service plan, If responsibility for meeting the person's
262.2health service needs has been assigned to the license holder in the coordinated service and
262.3support plan or the coordinated service and support plan addendum, the license holder is
262.4required to must maintain documentation on how the person's health needs will be met,
262.5including a description of the procedures the license holder will follow in order to:
262.6(1) provide medication administration, assistance or medication assistance, or
262.7medication management administration according to this chapter;
262.8(2) monitor health conditions according to written instructions from the person's
262.9physician or a licensed health professional;
262.10(3) assist with or coordinate medical, dental, and other health service appointments; or
262.11(4) use medical equipment, devices, or adaptive aides or technology safely and
262.12correctly according to written instructions from the person's physician or a licensed
262.13health professional.
262.14    Subd. 1a. Medication setup. For the purposes of this subdivision, "medication
262.15setup" means the arranging of medications according to instructions from the pharmacy,
262.16the prescriber, or a licensed nurse, for later administration when the license holder
262.17is assigned responsibility for medication assistance or medication administration in
262.18the coordinated service and support plan or the coordinated service and support plan
262.19addendum. A prescription label or the prescriber's written or electronically recorded order
262.20for the prescription is sufficient to constitute written instructions from the prescriber. The
262.21license holder must document in the person's medication administration record: dates
262.22of setup, name of medication, quantity of dose, times to be administered, and route of
262.23administration at time of setup; and, when the person will be away from home, to whom
262.24the medications were given.
262.25    Subd. 1b. Medication assistance. If responsibility for medication assistance
262.26is assigned to the license holder in the coordinated service and support plan or the
262.27coordinated service and support plan addendum, the license holder must ensure that
262.28the requirements of subdivision 2, paragraph (b), have been met when staff provides
262.29medication assistance to enable a person to self-administer medication or treatment when
262.30the person is capable of directing the person's own care, or when the person's legal
262.31representative is present and able to direct care for the person. For the purposes of this
262.32subdivision, "medication assistance" means any of the following:
262.33(1) bringing to the person and opening a container of previously set up medications,
262.34emptying the container into the person's hand, or opening and giving the medications in
262.35the original container to the person;
262.36(2) bringing to the person liquids or food to accompany the medication; or
263.1(3) providing reminders to take regularly scheduled medication or perform regularly
263.2scheduled treatments and exercises.
263.3    Subd. 2. Medication administration. (a) If responsibility for medication
263.4administration is assigned to the license holder in the coordinated service and support plan
263.5or the coordinated service and support plan addendum, the license holder must implement
263.6the following medication administration procedures to ensure a person takes medications
263.7and treatments as prescribed:
263.8(1) checking the person's medication record;
263.9(2) preparing the medication as necessary;
263.10(3) administering the medication or treatment to the person;
263.11(4) documenting the administration of the medication or treatment or the reason for
263.12not administering the medication or treatment; and
263.13(5) reporting to the prescriber or a nurse any concerns about the medication or
263.14treatment, including side effects, effectiveness, or a pattern of the person refusing to
263.15take the medication or treatment as prescribed. Adverse reactions must be immediately
263.16reported to the prescriber or a nurse.
263.17(b)(1) The license holder must ensure that the following criteria requirements in
263.18clauses (2) to (4) have been met before staff that is not a licensed health professional
263.19administers administering medication or treatment:.
263.20(1) (2) The license holder must obtain written authorization has been obtained from
263.21the person or the person's legal representative to administer medication or treatment
263.22orders; and must obtain reauthorization annually as needed. If the person or the person's
263.23legal representative refuses to authorize the license holder to administer medication, the
263.24medication must not be administered. The refusal to authorize medication administration
263.25must be reported to the prescriber as expediently as possible.
263.26(2) (3) The staff person has completed responsible for administering the medication
263.27or treatment must complete medication administration training according to section
263.28245D.09, subdivision 4 , paragraph 4a, paragraphs (a) and (c), clause (2); and, as applicable
263.29to the person, paragraph (d).
263.30(3) The medication or treatment will be administered under administration
263.31procedures established for the person in consultation with a licensed health professional.
263.32written instruction from the person's physician may constitute the medication
263.33administration procedures. A prescription label or the prescriber's order for the
263.34prescription is sufficient to constitute written instructions from the prescriber. A licensed
263.35health professional may delegate medication administration procedures.
264.1(4) For a license holder providing intensive support services, the medication or
264.2treatment must be administered according to the license holder's medication administration
264.3policy and procedures as required under section 245D.11, subdivision 2, clause (3).
264.4(b) (c) The license holder must ensure the following information is documented in
264.5the person's medication administration record:
264.6(1) the information on the current prescription label or the prescriber's current written
264.7or electronically recorded order or prescription that includes directions for the person's
264.8name, description of the medication or treatment to be provided, and the frequency and
264.9other information needed to safely and correctly administering administer the medication
264.10or treatment to ensure effectiveness;
264.11(2) information on any discomforts, risks, or other side effects that are reasonable to
264.12expect, and any contraindications to its use. This information must be readily available
264.13to all staff administering the medication;
264.14(3) the possible consequences if the medication or treatment is not taken or
264.15administered as directed;
264.16(4) instruction from the prescriber on when and to whom to report the following:
264.17(i) if the a dose of medication or treatment is not administered or treatment is not
264.18performed as prescribed, whether by error by the staff or the person or by refusal by
264.19the person; and
264.20(ii) the occurrence of possible adverse reactions to the medication or treatment;
264.21(5) notation of any occurrence of a dose of medication not being administered or
264.22treatment not performed as prescribed, whether by error by the staff or the person or by
264.23refusal by the person, or of adverse reactions, and when and to whom the report was
264.24made; and
264.25(6) notation of when a medication or treatment is started, administered, changed, or
264.26discontinued.
264.27(c) The license holder must ensure that the information maintained in the medication
264.28administration record is current and is regularly reviewed with the person or the person's
264.29legal representative and the staff administering the medication to identify medication
264.30administration issues or errors. At a minimum, the review must be conducted every three
264.31months or more often if requested by the person or the person's legal representative.
264.32Based on the review, the license holder must develop and implement a plan to correct
264.33medication administration issues or errors. If issues or concerns are identified related to
264.34the medication itself, the license holder must report those as required under subdivision 4.
264.35    Subd. 3. Medication assistance. The license holder must ensure that the
264.36requirements of subdivision 2, paragraph (a), have been met when staff provides assistance
265.1to enable a person to self-administer medication when the person is capable of directing
265.2the person's own care, or when the person's legal representative is present and able to
265.3direct care for the person.
265.4    Subd. 4. Reviewing and reporting medication and treatment issues. The
265.5following medication administration issues must be reported to the person or the person's
265.6legal representative and case manager as they occur or following timelines established
265.7in the person's service plan or as requested in writing by the person or the person's legal
265.8representative, or the case manager: (a) When assigned responsibility for medication
265.9administration, the license holder must ensure that the information maintained in
265.10the medication administration record is current and is regularly reviewed to identify
265.11medication administration errors. At a minimum, the review must be conducted every
265.12three months, or more frequently as directed in the coordinated service and support plan
265.13or coordinated service and support plan addendum or as requested by the person or the
265.14person's legal representative. Based on the review, the license holder must develop and
265.15implement a plan to correct patterns of medication administration errors when identified.
265.16(b) If assigned responsibility for medication assistance or medication administration,
265.17the license holder must report the following to the person's legal representative and case
265.18manager as they occur or as otherwise directed in the coordinated service and support plan
265.19or the coordinated service and support plan addendum:
265.20(1) any reports made to the person's physician or prescriber required under
265.21subdivision 2, paragraph (b) (c), clause (4);
265.22(2) a person's refusal or failure to take or receive medication or treatment as
265.23prescribed; or
265.24(3) concerns about a person's self-administration of medication or treatment.
265.25    Subd. 5. Injectable medications. Injectable medications may be administered
265.26according to a prescriber's order and written instructions when one of the following
265.27conditions has been met:
265.28(1) a registered nurse or licensed practical nurse will administer the subcutaneous or
265.29intramuscular injection;
265.30(2) a supervising registered nurse with a physician's order has delegated the
265.31administration of subcutaneous injectable medication to an unlicensed staff member
265.32and has provided the necessary training; or
265.33(3) there is an agreement signed by the license holder, the prescriber, and the
265.34person or the person's legal representative specifying what subcutaneous injections may
265.35be given, when, how, and that the prescriber must retain responsibility for the license
266.1holder's giving the injections. A copy of the agreement must be placed in the person's
266.2service recipient record.
266.3Only licensed health professionals are allowed to administer psychotropic
266.4medications by injection.
266.5EFFECTIVE DATE.This section is effective January 1, 2014.

266.6    Sec. 21. [245D.051] PSYCHOTROPIC MEDICATION USE AND
266.7MONITORING.
266.8    Subdivision 1. Conditions for psychotropic medication administration. (a)
266.9When a person is prescribed a psychotropic medication and the license holder is assigned
266.10responsibility for administration of the medication in the person's coordinated service
266.11and support plan or the coordinated service and support plan addendum, the license
266.12holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05,
266.13subdivision 2, are met.
266.14(b) Use of the medication must be included in the person's coordinated service and
266.15support plan or in the coordinated service and support plan addendum and based on a
266.16prescriber's current written or electronically recorded prescription.
266.17(c) The license holder must develop, implement, and maintain the following
266.18documentation in the person's coordinated service and support plan addendum according
266.19to the requirements in sections 245D.07 and 245D.071:
266.20(1) a description of the target symptoms that the psychotropic medication is to
266.21alleviate; and
266.22(2) documentation methods the license holder will use to monitor and measure
266.23changes in the target symptoms that are to be alleviated by the psychotropic medication if
266.24required by the prescriber. The license holder must collect and report on medication and
266.25symptom-related data as instructed by the prescriber. The license holder must provide
266.26the monitoring data to the expanded support team for review every three months, or as
266.27otherwise requested by the person or the person's legal representative.
266.28For the purposes of this section, "target symptom" refers to any perceptible
266.29diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic
266.30and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or
266.31successive editions that has been identified for alleviation.
266.32(d) If a person is prescribed a psychotropic medication, monitoring the use of the
266.33psychotropic medication must be assigned to the license holder in the coordinated service
266.34and support plan or the coordinated service and support plan addendum. The assigned
266.35license holder must monitor the psychotropic medication as required by this section.
267.1    Subd. 2. Refusal to authorize psychotropic medication. If the person or the
267.2person's legal representative refuses to authorize the administration of a psychotropic
267.3medication as ordered by the prescriber, the license holder must follow the requirement
267.4in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal
267.5to the prescriber, the license holder must follow any directives or orders given by the
267.6prescriber. A court order must be obtained to override the refusal. Refusal to authorize
267.7administration of a specific psychotropic medication is not grounds for service termination
267.8and does not constitute an emergency. A decision to terminate services must be reached in
267.9compliance with section 245D.10, subdivision 3.
267.10EFFECTIVE DATE.This section is effective January 1, 2014.

267.11    Sec. 22. Minnesota Statutes 2012, section 245D.06, is amended to read:
267.12245D.06 PROTECTION STANDARDS.
267.13    Subdivision 1. Incident response and reporting. (a) The license holder must
267.14respond to all incidents under section 245D.02, subdivision 11, that occur while providing
267.15services to protect the health and safety of and minimize risk of harm to the person.
267.16(b) The license holder must maintain information about and report incidents to the
267.17person's legal representative or designated emergency contact and case manager within 24
267.18hours of an incident occurring while services are being provided, or within 24 hours of
267.19discovery or receipt of information that an incident occurred, unless the license holder
267.20has reason to know that the incident has already been reported, or as otherwise directed
267.21in a person's coordinated service and support plan or coordinated service and support
267.22plan addendum. An incident of suspected or alleged maltreatment must be reported as
267.23required under paragraph (d), and an incident of serious injury or death must be reported
267.24as required under paragraph (e).
267.25(c) When the incident involves more than one person, the license holder must not
267.26disclose personally identifiable information about any other person when making the report
267.27to each person and case manager unless the license holder has the consent of the person.
267.28(d) Within 24 hours of reporting maltreatment as required under section 626.556
267.29or 626.557, the license holder must inform the case manager of the report unless there is
267.30reason to believe that the case manager is involved in the suspected maltreatment. The
267.31license holder must disclose the nature of the activity or occurrence reported and the
267.32agency that received the report.
267.33(e) The license holder must report the death or serious injury of the person to the legal
267.34representative, if any, and case manager, as required in paragraph (b) and to the Department
268.1of Human Services Licensing Division, and the Office of Ombudsman for Mental Health
268.2and Developmental Disabilities as required under section 245.94, subdivision 2a, within
268.324 hours of the death, or receipt of information that the death occurred, unless the license
268.4holder has reason to know that the death has already been reported.
268.5(f) When a death or serious injury occurs in a facility certified as an intermediate
268.6care facility for persons with developmental disabilities, the death or serious injury must
268.7be reported to the Department of Health, Office of Health Facility Complaints, and the
268.8Office of Ombudsman for Mental Health and Developmental Disabilities, as required
268.9under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
268.10know that the death has already been reported.
268.11(f) (g) The license holder must conduct a an internal review of incident reports of
268.12deaths and serious injuries that occurred while services were being provided and that
268.13were not reported by the program as alleged or suspected maltreatment, for identification
268.14of incident patterns, and implementation of corrective action as necessary to reduce
268.15occurrences. The review must include an evaluation of whether related policies and
268.16procedures were followed, whether the policies and procedures were adequate, whether
268.17there is a need for additional staff training, whether the reported event is similar to past
268.18events with the persons or the services involved, and whether there is a need for corrective
268.19action by the license holder to protect the health and safety of persons receiving services.
268.20Based on the results of this review, the license holder must develop, document, and
268.21implement a corrective action plan designed to correct current lapses and prevent future
268.22lapses in performance by staff or the license holder, if any.
268.23(h) The license holder must verbally report the emergency use of manual restraint of
268.24a person as required in paragraph (b), within 24 hours of the occurrence. The license holder
268.25must ensure the written report and internal review of all incident reports of the emergency
268.26use of manual restraints are completed according to the requirements in section 245D.061.
268.27    Subd. 2. Environment and safety. The license holder must:
268.28(1) ensure the following when the license holder is the owner, lessor, or tenant
268.29of the an unlicensed service site:
268.30(i) the service site is a safe and hazard-free environment;
268.31(ii) doors are locked or toxic substances or dangerous items normally accessible are
268.32inaccessible to persons served by the program are stored in locked cabinets, drawers, or
268.33containers only to protect the safety of a person receiving services and not as a substitute
268.34for staff supervision or interactions with a person who is receiving services. If doors are
268.35locked or toxic substances or dangerous items normally accessible to persons served by the
268.36program are stored in locked cabinets, drawers, or containers are made inaccessible, the
269.1license holder must justify and document how this determination was made in consultation
269.2with the person or person's legal representative, and how access will otherwise be provided
269.3to the person and all other affected persons receiving services; and document an assessment
269.4of the physical plant, its environment, and its population identifying the risk factors which
269.5require toxic substances or dangerous items to be inaccessible and a statement of specific
269.6measures to be taken to minimize the safety risk to persons receiving services;
269.7(iii) doors are locked from the inside to prevent a person from exiting only when
269.8necessary to protect the safety of a person receiving services and not as a substitute for
269.9staff supervision or interactions with the person. If doors are locked from the inside, the
269.10license holder must document an assessment of the physical plant, the environment and
269.11the population served, identifying the risk factors which require the use of locked doors,
269.12and a statement of specific measures to be taken to minimize the safety risk to persons
269.13receiving services at the service site; and
269.14(iii) (iv) a staff person is available on site who is trained in basic first aid and, when
269.15required in a person's coordinated service and support plan or coordinated service and
269.16support plan addendum, cardiopulmonary resuscitation, whenever persons are present and
269.17staff are required to be at the site to provide direct service. The training must include
269.18in-person instruction, hands-on practice, and an observed skills assessment under the
269.19direct supervision of a first aid instructor;
269.20(2) maintain equipment, vehicles, supplies, and materials owned or leased by the
269.21license holder in good condition when used to provide services;
269.22(3) follow procedures to ensure safe transportation, handling, and transfers of the
269.23person and any equipment used by the person, when the license holder is responsible for
269.24transportation of a person or a person's equipment;
269.25(4) be prepared for emergencies and follow emergency response procedures to
269.26ensure the person's safety in an emergency; and
269.27(5) follow universal precautions and sanitary practices, including hand washing, for
269.28infection prevention and control, and to prevent communicable diseases.
269.29    Subd. 3. Compliance with fire and safety codes. When services are provided at a
269.30 service site licensed according to chapter 245A or where the license holder is the owner,
269.31lessor, or tenant of the service site, the license holder must document compliance with
269.32applicable building codes, fire and safety codes, health rules, and zoning ordinances, or
269.33document that an appropriate waiver has been granted.
269.34    Subd. 4. Funds and property. (a) Whenever the license holder assists a person
269.35with the safekeeping of funds or other property according to section 245A.04, subdivision
269.3613 , the license holder must have obtain written authorization to do so from the person or
270.1the person's legal representative and the case manager. Authorization must be obtained
270.2within five working days of service initiation and renewed annually thereafter. At the time
270.3initial authorization is obtained, the license holder must survey, document, and implement
270.4the preferences of the person or the person's legal representative and the case manager
270.5for frequency of receiving a statement that itemizes receipts and disbursements of funds
270.6or other property. The license holder must document changes to these preferences when
270.7they are requested.
270.8(b) A license holder or staff person may not accept powers-of-attorney from a
270.9person receiving services from the license holder for any purpose, and may not accept an
270.10appointment as guardian or conservator of a person receiving services from the license
270.11holder. This does not apply to license holders that are Minnesota counties or other
270.12units of government or to staff persons employed by license holders who were acting
270.13as power-of-attorney, guardian, or conservator attorney-in-fact for specific individuals
270.14prior to April 23, 2012 implementation of this chapter. The license holder must maintain
270.15documentation of the power-of-attorney, guardianship, or conservatorship in the service
270.16recipient record.
270.17(c) Upon the transfer or death of a person, any funds or other property of the person
270.18must be surrendered to the person or the person's legal representative, or given to the
270.19executor or administrator of the estate in exchange for an itemized receipt.
270.20    Subd. 5. Prohibitions. (a) The license holder is prohibited from using psychotropic
270.21medication chemical restraints, mechanical restraint practices, manual restraints, time out,
270.22or seclusion as a substitute for adequate staffing, for a behavioral or therapeutic program
270.23to reduce or eliminate behavior, as punishment, or for staff convenience, or for any reason
270.24other than as prescribed.
270.25(b) The license holder is prohibited from using restraints or seclusion under any
270.26circumstance, unless the commissioner has approved a variance request from the license
270.27holder that allows for the emergency use of restraints and seclusion according to terms
270.28and conditions approved in the variance. Applicants and license holders who have
270.29reason to believe they may be serving an individual who will need emergency use of
270.30restraints or seclusion may request a variance on the application or reapplication, and
270.31the commissioner shall automatically review the request for a variance as part of the
270.32application or reapplication process. License holders may also request the variance any
270.33time after issuance of a license. In the event a license holder uses restraint or seclusion for
270.34any reason without first obtaining a variance as required, the license holder must report
270.35the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the
270.36occurrence and request the required variance.
271.1(b) For the purposes of this subdivision, "chemical restraint" means the
271.2administration of a drug or medication to control the person's behavior or restrict the
271.3person's freedom of movement and is not a standard treatment of dosage for the person's
271.4medical or psychological condition.
271.5(c) For the purposes of this subdivision, "mechanical restraint practice" means the
271.6use of any adaptive equipment or safety device to control the person's behavior or restrict
271.7the person's freedom of movement and not as ordered by a licensed health professional.
271.8Mechanical restraint practices include, but are not limited to, the use of bed rails or similar
271.9devices on a bed to prevent the person from getting out of bed, chairs that prevent a person
271.10from rising, or placing a person in a wheelchair so close to a wall that the wall prevents
271.11the person from rising. Wrist bands or devices on clothing that trigger electronic alarms to
271.12warn staff that a person is leaving a room or area do not, in and of themselves, restrict
271.13freedom of movement and should not be considered restraints.
271.14(d) A license holder must not use manual restraints, time out, or seclusion under any
271.15circumstance, except for emergency use of manual restraints according to the requirements
271.16in section 245D.061 or the use of controlled procedures with a person with a developmental
271.17disability as governed by Minnesota Rules, parts 9525.2700 to 9525.2810, or its successor
271.18provisions. License holders implementing nonemergency use of manual restraint, or any
271.19other programmatic use of mechanical restraint, time out, or seclusion with persons who
271.20do not have a developmental disability that is not subject to the requirements of Minnesota
271.21Rules, parts 9525.2700 to 9525.2810, must submit a variance request to the commissioner
271.22for continued use of the procedure within three months of implementation of this chapter.
271.23EFFECTIVE DATE.This section is effective January 1, 2014.

271.24    Sec. 23. [245D.061] EMERGENCY USE OF MANUAL RESTRAINTS.
271.25    Subdivision 1. Standards for emergency use of manual restraints. Except
271.26for the emergency use of controlled procedures with a person with a developmental
271.27disability as governed by Minnesota Rules, part 9525.2770, or its successor provisions,
271.28the license holder must ensure that emergency use of manual restraints complies with the
271.29requirements of this chapter and the license holder's policy and procedures as required
271.30under subdivision 10.
271.31    Subd. 2. Definitions. (a) The terms used in this section have the meaning given
271.32them in this subdivision.
271.33(b) "Manual restraint" means physical intervention intended to hold a person
271.34immobile or limit a person's voluntary movement by using body contact as the only source
271.35of physical restraint.
272.1(c) "Mechanical restraint" means the use of devices, materials, or equipment attached
272.2or adjacent to the person's body, or the use of practices which restrict freedom of movement
272.3or normal access to one's body or body parts, or limits a person's voluntary movement
272.4or holds a person immobile as an intervention precipitated by a person's behavior. The
272.5term does apply to mechanical restraint used to prevent injury with persons who engage in
272.6self-injurious behaviors, such as head-banging, gouging, or other actions resulting in tissue
272.7damage that have caused or could cause medical problems resulting from the self-injury.
272.8    Subd. 3. Conditions for emergency use of manual restraint. Emergency use of
272.9manual restraint must meet the following conditions:
272.10(1) immediate intervention must be needed to protect the person or others from
272.11imminent risk of physical harm; and
272.12(2) the type of manual restraint used must be the least restrictive intervention to
272.13eliminate the immediate risk of harm and effectively achieve safety. The manual restraint
272.14must end when the threat of harm ends.
272.15    Subd. 4. Permitted instructional techniques and therapeutic conduct. (a) Use of
272.16physical contact as therapeutic conduct or as an instructional technique as identified in
272.17paragraphs (b) and (c), is permitted and is not subject to the requirements of this section
272.18when such use is addressed in a person's coordinated service and support plan addendum
272.19and the required conditions have been met. For the purposes of this subdivision,
272.20"therapeutic conduct" has the meaning given in section 626.5572, subdivision 20.
272.21(b) Physical contact or instructional techniques must use the least restrictive
272.22alternative possible to meet the needs of the person and may be used:
272.23(1) to calm or comfort a person by holding that person with no resistance from
272.24that person;
272.25(2) to protect a person known to be at risk of injury due to frequent falls as a result of
272.26a medical condition; or
272.27(3) to position a person with physical disabilities in a manner specified in the
272.28person's coordinated service and support plan addendum.
272.29(c) Restraint may be used as therapeutic conduct:
272.30(1) to allow a licensed health care professional to safely conduct a medical
272.31examination or to provide medical treatment ordered by a licensed health care professional
272.32to a person necessary to promote healing or recovery from an acute, meaning short-term,
272.33medical condition;
272.34(2) to facilitate the person's completion of a task or response when the person does
272.35not resist or the person's resistance is minimal in intensity and duration;
273.1(3) to briefly block or redirect a person's limbs or body without holding the person
273.2or limiting the person's movement to interrupt the person's behavior that may result in
273.3injury to self or others; or
273.4(4) to assist in the safe evacuation of a person in the event of an emergency or to
273.5redirect a person who is at imminent risk of harm in a dangerous situation.
273.6(d) A plan for using restraint as therapeutic conduct must be developed according to
273.7the requirements in sections 245D.07 and 245D.071, and must include methods to reduce
273.8or eliminate the use of and need for restraint.
273.9    Subd. 5. Restrictions when implementing emergency use of manual restraint.
273.10(a) Emergency use of manual restraint procedures must not:
273.11(1) be implemented with a child in a manner that constitutes sexual abuse, neglect,
273.12physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
273.13(2) be implemented with an adult in a manner that constitutes abuse or neglect as
273.14defined in section 626.5572, subdivisions 2 and 17;
273.15(3) be implemented in a manner that violates a person's rights and protections
273.16identified in section 245D.04;
273.17(4) restrict a person's normal access to a nutritious diet, drinking water, adequate
273.18ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping
273.19conditions, or necessary clothing, or to any protection required by state licensing standards
273.20and federal regulations governing the program;
273.21(5) deny the person visitation or ordinary contact with legal counsel, a legal
273.22representative, or next of kin;
273.23(6) be used as a substitute for adequate staffing, for the convenience of staff, as
273.24punishment, or as a consequence if the person refuses to participate in the treatment
273.25or services provided by the program; or
273.26(7) use prone restraint. For the purposes of this section, "prone restraint" means use
273.27of manual restraint that places a person in a face-down position. This does not include
273.28brief physical holding of a person who, during an emergency use of manual restraint, rolls
273.29into a prone position, and the person is restored to a standing, sitting, or side-lying position
273.30as quickly as possible. Applying back or chest pressure while a person is in the prone or
273.31supine position or face-up is prohibited.
273.32    Subd. 6. Monitoring emergency use of manual restraint. The license holder shall
273.33monitor a person's health and safety during an emergency use of a manual restraint. Staff
273.34monitoring the procedure must not be the staff implementing the procedure when possible.
273.35The license holder shall complete a monitoring form, approved by the commissioner, for
273.36each incident involving the emergency use of a manual restraint.
274.1    Subd. 7. Reporting emergency use of manual restraint incident. (a) Within
274.2three calendar days after an emergency use of a manual restraint, the staff person who
274.3implemented the emergency use must report in writing to the designated coordinator the
274.4following information about the emergency use:
274.5(1) the staff and persons receiving services who were involved in the incident
274.6leading up to the emergency use of manual restraint;
274.7(2) a description of the physical and social environment, including who was present
274.8before and during the incident leading up to the emergency use of manual restraint;
274.9(3) a description of what less restrictive alternative measures were attempted to
274.10de-escalate the incident and maintain safety before the manual restraint was implemented
274.11that identifies when, how, and how long the alternative measures were attempted before
274.12manual restraint was implemented;
274.13(4) a description of the mental, physical, and emotional condition of the person who
274.14was restrained, and other persons involved in the incident leading up to, during, and
274.15following the manual restraint;
274.16(5) whether there was any injury to the person who was restrained or other persons
274.17involved in the incident, including staff, before or as a result of the use of manual
274.18restraint; and
274.19(6) whether there was an attempt to debrief with the staff, and, if not contraindicated,
274.20with the person who was restrained and other persons who were involved in or who
274.21witnessed the restraint, following the incident and the outcome of the debriefing. If the
274.22debriefing was not conducted at the time the incident report was made, the report should
274.23identify whether a debriefing is planned.
274.24(b) Each single incident of emergency use of manual restraint must be reported
274.25separately. For the purposes of this subdivision, an incident of emergency use of manual
274.26restraint is a single incident when the following conditions have been met:
274.27(1) after implementing the manual restraint, staff attempt to release the person at the
274.28moment staff believe the person's conduct no longer poses an imminent risk of physical
274.29harm to self or others and less restrictive strategies can be implemented to maintain safety;
274.30(2) upon the attempt to release the restraint, the person's behavior immediately
274.31re-escalates; and
274.32(3) staff must immediately reimplement the restraint in order to maintain safety.
274.33    Subd. 8. Internal review of emergency use of manual restraint. (a) Within five
274.34working days of the emergency use of manual restraint, the license holder must complete
274.35an internal review of each report of emergency use of manual restraint. The review must
274.36include an evaluation of whether:
275.1(1) the person's service and support strategies developed according to sections
275.2245D.07 and 245D.071 need to be revised;
275.3(2) related policies and procedures were followed;
275.4(3) the policies and procedures were adequate;
275.5(4) there is a need for additional staff training;
275.6(5) the reported event is similar to past events with the persons, staff, or the services
275.7involved; and
275.8(6) there is a need for corrective action by the license holder to protect the health
275.9and safety of persons.
275.10(b) Based on the results of the internal review, the license holder must develop,
275.11document, and implement a corrective action plan for the program designed to correct
275.12current lapses and prevent future lapses in performance by individuals or the license
275.13holder, if any. The corrective action plan, if any, must be implemented within 30 days of
275.14the internal review being completed.
275.15    Subd. 9. Expanded support team review. (a) Within five working days after the
275.16completion of the internal review required in subdivision 8, the license holder must consult
275.17with the expanded support team following the emergency use of manual restraint to:
275.18(1) discuss the incident reported in subdivision 7, to define the antecedent or event
275.19that gave rise to the behavior resulting in the manual restraint and identify the perceived
275.20function the behavior served; and
275.21(2) determine whether the person's coordinated service and support plan addendum
275.22needs to be revised according to sections 245D.07 and 245D.071 to positively and
275.23effectively help the person maintain stability and to reduce or eliminate future occurrences
275.24requiring emergency use of manual restraint.
275.25    Subd. 10. Emergency use of manual restraints policy and procedures. The
275.26license holder must develop, document, and implement a policy and procedures that
275.27promote service recipient rights and protect health and safety during the emergency use of
275.28manual restraints. The policy and procedures must comply with the requirements of this
275.29section and must specify the following:
275.30(1) a description of the positive support strategies and techniques staff must use to
275.31attempt to de-escalate a person's behavior before it poses an imminent risk of physical
275.32harm to self or others;
275.33(2) a description of the types of manual restraints the license holder allows staff to
275.34use on an emergency basis, if any. If the license holder will not allow the emergency use
275.35of manual restraint, the policy and procedure must identify the alternative measures the
276.1license holder will require staff to use when a person's conduct poses an imminent risk of
276.2physical harm to self or others and less restrictive strategies would not achieve safety;
276.3(3) instructions for safe and correct implementation of the allowed manual restraint
276.4procedures;
276.5(4) the training that staff must complete and the timelines for completion, before they
276.6may implement an emergency use of manual restraint. In addition to the training on this
276.7policy and procedure and the orientation and annual training required in section 245D.09,
276.8subdivision 4, the training for emergency use of manual restraint must incorporate the
276.9following subjects:
276.10(i) alternatives to manual restraint procedures, including techniques to identify
276.11events and environmental factors that may escalate conduct that poses an imminent risk of
276.12physical harm to self or others;
276.13(ii) de-escalation methods, positive support strategies, and how to avoid power
276.14struggles;
276.15(iii) simulated experiences of administering and receiving manual restraint
276.16procedures allowed by the license holder on an emergency basis;
276.17(iv) how to properly identify thresholds for implementing and ceasing restrictive
276.18procedures;
276.19(v) how to recognize, monitor, and respond to the person's physical signs of distress,
276.20including positional asphyxia;
276.21(vi) the physiological and psychological impact on the person and the staff when
276.22restrictive procedures are used;
276.23(vii) the communicative intent of behaviors; and
276.24(viii) relationship building;
276.25(5) the procedures and forms to be used to monitor the emergency use of manual
276.26restraints, including what must be monitored and the frequency of monitoring per
276.27each incident of emergency use of manual restraint, and the person or position who is
276.28responsible for monitoring the use;
276.29(6) the instructions, forms, and timelines required for completing and submitting an
276.30incident report by the person or persons who implemented the manual restraint; and
276.31(7) the procedures and timelines for conducting the internal review and the expanded
276.32support team review, and the person or position responsible for completing the reviews and
276.33who is responsible for ensuring that corrective action is taken or the person's coordinated
276.34service and support plan addendum is revised, when determined necessary.
276.35EFFECTIVE DATE.This section is effective January 1, 2014.

277.1    Sec. 24. Minnesota Statutes 2012, section 245D.07, is amended to read:
277.2245D.07 SERVICE NEEDS PLANNING AND DELIVERY.
277.3    Subdivision 1. Provision of services. The license holder must provide services as
277.4specified assigned in the coordinated service and support plan and assigned to the license
277.5holder. The provision of services must comply with the requirements of this chapter and
277.6the federal waiver plans.
277.7    Subd. 1a. Person-centered planning and service delivery. (a) The license holder
277.8must provide services in response to the person's identified needs, interests, preferences,
277.9and desired outcomes as specified in the coordinated service and support plan, the
277.10coordinated service and support plan addendum, and in compliance with the requirements
277.11of this chapter. License holders providing intensive support services must also provide
277.12outcome-based services according to the requirements in section 245D.071.
277.13(b) Services must be provided in a manner that supports the person's preferences,
277.14daily needs, and activities and accomplishment of the person's personal goals and service
277.15outcomes, consistent with the principles of:
277.16(1) person-centered service planning and delivery that:
277.17(i) identifies and supports what is important to the person as well as what is
277.18important for the person, including preferences for when, how, and by whom direct
277.19support service is provided;
277.20(ii) uses that information to identify outcomes the person desires; and
277.21(iii) respects each person's history, dignity, and cultural background;
277.22(2) self-determination that supports and provides:
277.23(i) opportunities for the development and exercise of functional and age-appropriate
277.24skills, decision making and choice, personal advocacy, and communication; and
277.25(ii) the affirmation and protection of each person's civil and legal rights;
277.26(3) providing the most integrated setting and inclusive service delivery that supports,
277.27promotes, and allows:
277.28(i) inclusion and participation in the person's community as desired by the person
277.29in a manner that enables the person to interact with nondisabled persons to the fullest
277.30extent possible and supports the person in developing and maintaining a role as a valued
277.31community member;
277.32(ii) opportunities for self-sufficiency as well as developing and maintaining social
277.33relationships and natural supports; and
277.34(iii) a balance between risk and opportunity, meaning the least restrictive supports or
277.35interventions necessary are provided in the most integrated settings in the most inclusive
278.1manner possible to support the person to engage in activities of the person's own choosing
278.2that may otherwise present a risk to the person's health, safety, or rights.
278.3    Subd. 2. Service planning requirements for basic support services. (a) License
278.4holders providing basic support services must meet the requirements of this subdivision.
278.5(b) Within 15 days of service initiation the license holder must complete a
278.6preliminary coordinated service and support plan addendum based on the coordinated
278.7service and support plan.
278.8(c) Within 60 days of service initiation the license holder must review and revise as
278.9needed the preliminary coordinated service and support plan addendum to document the
278.10services that will be provided including how, when, and by whom services will be provided,
278.11and the person responsible for overseeing the delivery and coordination of services.
278.12(d) The license holder must participate in service planning and support team
278.13meetings related to for the person following stated timelines established in the person's
278.14 coordinated service and support plan or as requested by the support team, the person, or
278.15the person's legal representative, the support team or the expanded support team.
278.16    Subd. 3. Reports. The license holder must provide written reports regarding the
278.17person's progress or status as requested by the person, the person's legal representative, the
278.18case manager, or the team.
278.19EFFECTIVE DATE.This section is effective January 1, 2014.

278.20    Sec. 25. [245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE
278.21SUPPORT SERVICES.
278.22    Subdivision 1. Requirements for intensive support services. A license holder
278.23providing intensive support services identified in section 245D.03, subdivision 1,
278.24paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1
278.25and 3, and this section.
278.26    Subd. 2. Abuse prevention. Prior to or upon initiating services, the license holder
278.27must develop, document, and implement an abuse prevention plan according to section
278.28245A.65, subdivision 2.
278.29    Subd. 3. Assessment and initial service planning. (a) Within 15 days of service
278.30initiation the license holder must complete a preliminary coordinated service and support
278.31plan addendum based on the coordinated service and support plan.
278.32(b) Within 45 days of service initiation the license holder must meet with the person,
278.33the person's legal representative, the case manager, and other members of the support team
278.34or expanded support team to assess and determine the following based on the person's
279.1coordinated service and support plan and the requirements in subdivision 4 and section
279.2245D.07, subdivision 1a:
279.3(1) the scope of the services to be provided to support the person's daily needs
279.4and activities;
279.5(2) the person's desired outcomes and the supports necessary to accomplish the
279.6person's desired outcomes;
279.7(3) the person's preferences for how services and supports are provided;
279.8(4) whether the current service setting is the most integrated setting available and
279.9appropriate for the person; and
279.10(5) how services must be coordinated across other providers licensed under this
279.11chapter serving the same person to ensure continuity of care for the person.
279.12(c) Within the scope of services, the license holder must, at a minimum, assess
279.13the following areas:
279.14(1) the person's ability to self-manage health and medical needs to maintain or
279.15improve physical, mental, and emotional well-being, including, when applicable, allergies,
279.16seizures, choking, special dietary needs, chronic medical conditions, self-administration
279.17of medication or treatment orders, preventative screening, and medical and dental
279.18appointments;
279.19(2) the person's ability to self-manage personal safety to avoid injury or accident in
279.20the service setting, including, when applicable, risk of falling, mobility, regulating water
279.21temperature, community survival skills, water safety skills, and sensory disabilities; and
279.22(3) the person's ability to self-manage symptoms or behavior that may otherwise
279.23result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to
279.24(7), suspension or termination of services by the license holder, or other symptoms
279.25or behaviors that may jeopardize the health and safety of the person or others. The
279.26assessments must produce information about the person that is descriptive of the person's
279.27overall strengths, functional skills and abilities, and behaviors or symptoms.
279.28    Subd. 4. Service outcomes and supports. (a) Within ten working days of the
279.2945-day meeting, the license holder must develop and document the service outcomes and
279.30supports based on the assessments completed under subdivision 3 and the requirements
279.31in section 245D.07, subdivision 1a. The outcomes and supports must be included in the
279.32coordinated service and support plan addendum.
279.33(b) The license holder must document the supports and methods to be implemented
279.34to support the accomplishment of outcomes related to acquiring, retaining, or improving
279.35skills. The documentation must include:
280.1(1) the methods or actions that will be used to support the person and to accomplish
280.2the service outcomes, including information about:
280.3(i) any changes or modifications to the physical and social environments necessary
280.4when the service supports are provided;
280.5(ii) any equipment and materials required; and
280.6(iii) techniques that are consistent with the person's communication mode and
280.7learning style;
280.8(2) the measurable and observable criteria for identifying when the desired outcome
280.9has been achieved and how data will be collected;
280.10(3) the projected starting date for implementing the supports and methods and
280.11the date by which progress towards accomplishing the outcomes will be reviewed and
280.12evaluated; and
280.13(4) the names of the staff or position responsible for implementing the supports
280.14and methods.
280.15(c) Within 20 working days of the 45-day meeting, the license holder must obtain
280.16dated signatures from the person or the person's legal representative and case manager
280.17to document completion and approval of the assessment and coordinated service and
280.18support plan addendum.
280.19    Subd. 5. Progress reviews. (a) The license holder must give the person or the
280.20person's legal representative and case manager an opportunity to participate in the ongoing
280.21review and development of the methods used to support the person and accomplish
280.22outcomes identified in subdivisions 3 and 4. The license holder, in coordination with
280.23the person's support team or expanded support team, must meet with the person, the
280.24person's legal representative, and the case manager, and participate in progress review
280.25meetings following stated timelines established in the person's coordinated service and
280.26support plan or coordinated service and support plan addendum or within 30 days of a
280.27written request by the person, the person's legal representative, or the case manager,
280.28at a minimum of once per year.
280.29(b) The license holder must summarize the person's progress toward achieving the
280.30identified outcomes and make recommendations and identify the rationale for changing,
280.31continuing, or discontinuing implementation of supports and methods identified in
280.32subdivision 4 in a written report sent to the person or the person's legal representative
280.33and case manager five working days prior to the review meeting, unless the person, the
280.34person's legal representative, or the case manager request to receive the report at the
280.35time of the meeting.
281.1(c) Within ten working days of the progress review meeting, the license holder
281.2must obtain dated signatures from the person or the person's legal representative and
281.3the case manager to document approval of any changes to the coordinated service and
281.4support plan addendum.
281.5EFFECTIVE DATE.This section is effective January 1, 2014.

281.6    Sec. 26. [245D.081] PROGRAM COORDINATION, EVALUATION, AND
281.7OVERSIGHT.
281.8    Subdivision 1. Program coordination and evaluation. (a) The license holder
281.9is responsible for:
281.10(1) coordination of service delivery and evaluation for each person served by the
281.11program as identified in subdivision 2; and
281.12(2) program management and oversight that includes evaluation of the program
281.13quality and program improvement for services provided by the license holder as identified
281.14in subdivision 3.
281.15(b) The same person may perform the functions in paragraph (a) if the work and
281.16education qualifications are met in subdivisions 2 and 3.
281.17    Subd. 2. Coordination and evaluation of individual service delivery. (a) Delivery
281.18and evaluation of services provided by the license holder must be coordinated by a
281.19designated staff person. The designated coordinator must provide supervision, support,
281.20and evaluation of activities that include:
281.21(1) oversight of the license holder's responsibilities assigned in the person's
281.22coordinated service and support plan and the coordinated service and support plan
281.23addendum;
281.24(2) taking the action necessary to facilitate the accomplishment of the outcomes
281.25according to the requirements in section 245D.07;
281.26(3) instruction and assistance to direct support staff implementing the coordinated
281.27service and support plan and the service outcomes, including direct observation of service
281.28delivery sufficient to assess staff competency; and
281.29(4) evaluation of the effectiveness of service delivery, methodologies, and progress on
281.30the person's outcomes based on the measurable and observable criteria for identifying when
281.31the desired outcome has been achieved according to the requirements in section 245D.07.
281.32(b) The license holder must ensure that the designated coordinator is competent to
281.33perform the required duties identified in paragraph (a) through education and training in
281.34human services and disability-related fields, and work experience in providing direct care
281.35services and supports to persons with disabilities. The designated coordinator must have
282.1the skills and ability necessary to develop effective plans and to design and use data
282.2systems to measure effectiveness of services and supports. The license holder must verify
282.3and document competence according to the requirements in section 245D.09, subdivision
282.43. The designated coordinator must minimally have:
282.5(1) a baccalaureate degree in a field related to human services, and one year of
282.6full-time work experience providing direct care services to persons with disabilities or
282.7persons age 65 and older;
282.8(2) an associate degree in a field related to human services, and two years of
282.9full-time work experience providing direct care services to persons with disabilities or
282.10persons age 65 and older;
282.11(3) a diploma in a field related to human services from an accredited postsecondary
282.12institution and three years of full-time work experience providing direct care services to
282.13persons with disabilities or persons age 65 and older; or
282.14(4) a minimum of 50 hours of education and training related to human services
282.15and disabilities; and
282.16(5) four years of full-time work experience providing direct care services to persons
282.17with disabilities or persons age 65 and older under the supervision of a staff person who
282.18meets the qualifications identified in clauses (1) to (3).
282.19    Subd. 3. Program management and oversight. (a) The license holder must
282.20designate a managerial staff person or persons to provide program management and
282.21oversight of the services provided by the license holder. The designated manager is
282.22responsible for the following:
282.23(1) maintaining a current understanding of the licensing requirements sufficient to
282.24ensure compliance throughout the program as identified in section 245A.04, subdivision
282.251, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21,
282.26paragraph (b);
282.27(2) ensuring the duties of the designated coordinator are fulfilled according to the
282.28requirements in subdivision 2;
282.29(3) ensuring the program implements corrective action identified as necessary
282.30by the program following review of incident and emergency reports according to the
282.31requirements in section 245D.11, subdivision 2, clause (7). An internal review of
282.32incident reports of alleged or suspected maltreatment must be conducted according to the
282.33requirements in section 245A.65, subdivision 1, paragraph (b);
282.34(4) evaluation of satisfaction of persons served by the program, the person's legal
282.35representative, if any, and the case manager, with the service delivery and progress
283.1towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and
283.2ensuring and protecting each person's rights as identified in section 245D.04;
283.3(5) ensuring staff competency requirements are met according to the requirements in
283.4section 245D.09, subdivision 3, and ensuring staff orientation and training is provided
283.5according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
283.6(6) ensuring corrective action is taken when ordered by the commissioner and that
283.7the terms and condition of the license and any variances are met; and
283.8(7) evaluating the information identified in clauses (1) to (6) to develop, document,
283.9and implement ongoing program improvements.
283.10(b) The designated manager must be competent to perform the duties as required and
283.11must minimally meet the education and training requirements identified in subdivision
283.122, paragraph (b), and have a minimum of three years of supervisory level experience in
283.13a program providing direct support services to persons with disabilities or persons age
283.1465 and older.
283.15EFFECTIVE DATE.This section is effective January 1, 2014.

283.16    Sec. 27. Minnesota Statutes 2012, section 245D.09, is amended to read:
283.17245D.09 STAFFING STANDARDS.
283.18    Subdivision 1. Staffing requirements. The license holder must provide the level of
283.19 direct service support staff sufficient supervision, assistance, and training necessary:
283.20(1) to ensure the health, safety, and protection of rights of each person; and
283.21(2) to be able to implement the responsibilities assigned to the license holder in each
283.22person's coordinated service and support plan or identified in the coordinated service and
283.23support plan addendum, according to the requirements of this chapter.
283.24    Subd. 2. Supervision of staff having direct contact. Except for a license holder
283.25who is the sole direct service support staff, the license holder must provide adequate
283.26supervision of staff providing direct service support to ensure the health, safety, and
283.27protection of rights of each person and implementation of the responsibilities assigned to
283.28the license holder in each person's service plan coordinated service and support plan or
283.29coordinated service and support plan addendum.
283.30    Subd. 3. Staff qualifications. (a) The license holder must ensure that staff providing
283.31direct support, or staff who have responsibilities related to supervising or managing the
283.32provision of direct support service, is competent as demonstrated through skills and
283.33knowledge training, experience, and education to meet the person's needs and additional
283.34requirements as written in the coordinated service and support plan or coordinated
284.1service and support plan addendum, or when otherwise required by the case manager or
284.2the federal waiver plan. The license holder must verify and maintain evidence of staff
284.3competency, including documentation of:
284.4(1) education and experience qualifications relevant to the job responsibilities
284.5assigned to the staff and the needs of the general population of persons served by the
284.6program, including a valid degree and transcript, or a current license, registration, or
284.7certification, when a degree or licensure, registration, or certification is required by this
284.8chapter or in the coordinated service and support plan or coordinated service and support
284.9plan addendum;
284.10(2) completion of required demonstrated competency in the orientation and training
284.11 areas required under this chapter, including and when applicable, completion of continuing
284.12education required to maintain professional licensure, registration, or certification
284.13requirements. Competency in these areas is determined by the license holder through
284.14knowledge testing and observed skill assessment conducted by the trainer or instructor; and
284.15(3) except for a license holder who is the sole direct service support staff, periodic
284.16 performance evaluations completed by the license holder of the direct service support staff
284.17person's ability to perform the job functions based on direct observation.
284.18(b) Staff under 18 years of age may not perform overnight duties or administer
284.19medication.
284.20    Subd. 4. Orientation to program requirements. (a) Except for a license holder
284.21who does not supervise any direct service support staff, within 90 days of hiring direct
284.22service staff 60 days of hire, unless stated otherwise, the license holder must provide
284.23and ensure completion of orientation for direct support staff that combines supervised
284.24on-the-job training with review of and instruction on in the following areas:
284.25(1) the job description and how to complete specific job functions, including:
284.26(i) responding to and reporting incidents as required under section 245D.06,
284.27subdivision 1; and
284.28(ii) following safety practices established by the license holder and as required in
284.29section 245D.06, subdivision 2;
284.30(2) the license holder's current policies and procedures required under this chapter,
284.31including their location and access, and staff responsibilities related to implementation
284.32of those policies and procedures;
284.33(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the
284.34federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff
284.35responsibilities related to complying with data privacy practices;
285.1(4) the service recipient rights under section 245D.04, and staff responsibilities
285.2related to ensuring the exercise and protection of those rights according to the requirements
285.3in section 245D.04;
285.4(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment
285.5reporting and service planning for children and vulnerable adults, and staff responsibilities
285.6related to protecting persons from maltreatment and reporting maltreatment. This
285.7orientation must be provided within 72 hours of first providing direct contact services and
285.8annually thereafter according to section 245A.65, subdivision 3;
285.9(6) what constitutes use of restraints, seclusion, and psychotropic medications,
285.10and staff responsibilities related to the prohibitions of their use the principles of
285.11person-centered service planning and delivery as identified in section 245D.07, subdivision
285.121a, and how they apply to direct support service provided by the staff person; and
285.13(7) other topics as determined necessary in the person's coordinated service and
285.14support plan by the case manager or other areas identified by the license holder.
285.15(b) License holders who provide direct service themselves must complete the
285.16orientation required in paragraph (a), clauses (3) to (7).
285.17    Subd. 4a. Orientation to individual service recipient needs. (c) (a) Before
285.18providing having unsupervised direct service to contact with a person served by the
285.19program, or for whom the staff person has not previously provided direct service support,
285.20or any time the plans or procedures identified in clauses (1) and (2) paragraphs (b) to
285.21(f) are revised, the staff person must review and receive instruction on the following
285.22as it relates requirements in paragraphs (b) to (f) as they relate to the staff person's job
285.23functions for that person:.
285.24(b) Orientation training and competency evaluation of direct care staff in a program
285.25providing 24-hour care for a client with corporate supervision must be provided under
285.26the direction of a registered nurse. Training and competency evaluations must include
285.27the following:
285.28(1) documentation requirements for all services provided;
285.29(2) reports of changes in the client's condition to the supervisor designated by the
285.30home care provider;
285.31(3) basic infection control, including blood-borne pathogens;
285.32(4) maintenance of a clean and safe environment;
285.33(5) appropriate and safe techniques in personal hygiene and grooming, including
285.34hair care; bathing; care of teeth, gums, and oral prosthetic devices; and other activities
285.35of daily living (ADLs);
286.1(6) an understanding of what constitutes a healthy diet according to data from the
286.2Centers for Disease Control and the skills necessary to prepare that diet;
286.3(7) skills necessary to provide appropriate support in instrumental activities of
286.4daily living (IADLs); and
286.5(8) demonstrated competence in providing first aid.
286.6(1) (c) The staff person must review and receive instruction on the person's
286.7 coordinated service and support plan or coordinated service and support plan addendum as
286.8it relates to the responsibilities assigned to the license holder, and when applicable, the
286.9person's individual abuse prevention plan according to section 245A.65, to achieve and
286.10demonstrate an understanding of the person as a unique individual, and how to implement
286.11those plans; and.
286.12(2) (d) The staff person must review and receive instruction on medication
286.13administration procedures established for the person when medication administration is
286.14 assigned to the license holder according to section 245D.05, subdivision 1, paragraph
286.15(b). Unlicensed staff may administer medications only after successful completion of a
286.16medication administration training, from a training curriculum developed by a registered
286.17nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse
286.18practitioner, physician's assistant, or physician incorporating. The training curriculum
286.19must incorporate an observed skill assessment conducted by the trainer to ensure staff
286.20demonstrate the ability to safely and correctly follow medication procedures.
286.21Medication administration must be taught by a registered nurse, clinical nurse
286.22specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of
286.23service initiation or any time thereafter, the person has or develops a health care condition
286.24that affects the service options available to the person because the condition requires:
286.25(i) (1) specialized or intensive medical or nursing supervision; and
286.26(ii) (2) nonmedical service providers to adapt their services to accommodate the
286.27health and safety needs of the person; and.
286.28(iii) necessary training in order to meet the health service needs of the person as
286.29determined by the person's physician.
286.30(e) The staff person must review and receive instruction on the safe and correct
286.31operation of medical equipment used by the person to sustain life, including but not
286.32limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided
286.33by a licensed health care professional or a manufacturer's representative and incorporate
286.34an observed skill assessment to ensure staff demonstrate the ability to safely and correctly
286.35operate the equipment according to the treatment orders and the manufacturer's instructions.
287.1(f) The staff person must review and receive instruction on what constitutes use of
287.2restraints, time out, and seclusion, including chemical restraint, and staff responsibilities
287.3related to the prohibitions of their use according to the requirements in section 245D.06,
287.4subdivision 5, why such procedures are not effective for reducing or eliminating symptoms
287.5or undesired behavior and why they are not safe, and the safe and correct use of manual
287.6restraint on an emergency basis according to the requirements in section 245D.061.
287.7(g) In the event of an emergency service initiation, the license holder must ensure
287.8the training required in this subdivision occurs within 72 hours of the direct support staff
287.9person first having unsupervised contact with the person receiving services. The license
287.10holder must document the reason for the unplanned or emergency service initiation and
287.11maintain the documentation in the person's service recipient record.
287.12(h) License holders who provide direct support services themselves must complete
287.13the orientation required in subdivision 4, clauses (3) to (7).
287.14    Subd. 5. Annual training. (a) A license holder must provide annual training to
287.15direct service support staff on the topics identified in subdivision 4, paragraph (a), clauses
287.16(3) to (6) (7), and subdivision 4a, paragraphs (a) to (h). A license holder providing 24-hour
287.17care with corporate supervision must provide a minimum of 24 hours of annual training
287.18to direct service staff in topics described in subdivisions 4, clauses (1) to (7), and 4a,
287.19paragraphs (a) to (h). Training on relevant topics received from sources other than the
287.20license holder may count toward training requirements.
287.21(b) A license holder providing behavioral programming, specialist services, personal
287.22support, 24-hour emergency assistance, night supervision, independent living skills,
287.23structured day, prevocational, or supported employment services must provide a minimum
287.24of eight hours of annual training to direct service staff that addresses:
287.25(1) topics related to the general health, safety, and service needs of the population
287.26served by the license holder; and
287.27(2) other areas identified by the license holder or in the person's current service plan.
287.28Training on relevant topics received from sources other than the license holder
287.29may count toward training requirements.
287.30(c) When the license holder is the owner, lessor, or tenant of the service site and
287.31whenever a person receiving services is present at the site, the license holder must have
287.32a staff person available on site who is trained in basic first aid and, when required in a
287.33person's service plan, cardiopulmonary resuscitation.
287.34    Subd. 5a. Alternative sources of training. Orientation or training received by the
287.35staff person from sources other than the license holder in the same subjects as identified
287.36in subdivision 4 may count toward the orientation and annual training requirements if
288.1received in the 12-month period before the staff person's date of hire. The license holder
288.2must maintain documentation of the training received from other sources and of each staff
288.3person's competency in the required area according to the requirements in subdivision 3.
288.4    Subd. 6. Subcontractors and temporary staff. If the license holder uses a
288.5subcontractor or temporary staff to perform services licensed under this chapter on the
288.6license holder's behalf, the license holder must ensure that the subcontractor or temporary
288.7staff meets and maintains compliance with all requirements under this chapter that apply
288.8to the services to be provided, including training, orientation, and supervision necessary
288.9to fulfill their responsibilities. The license holder must ensure that a background study
288.10has been completed according to the requirements in sections 245C.03, subdivision 1,
288.11and 245C.04. Subcontractors and temporary staff hired by the license holder must meet
288.12the Minnesota licensing requirements applicable to the disciplines in which they are
288.13providing services. The license holder must maintain documentation that the applicable
288.14requirements have been met.
288.15    Subd. 7. Volunteers. The license holder must ensure that volunteers who provide
288.16direct support services to persons served by the program receive the training, orientation,
288.17and supervision necessary to fulfill their responsibilities. The license holder must ensure
288.18that a background study has been completed according to the requirements in sections
288.19245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation
288.20that the applicable requirements have been met.
288.21    Subd. 8. Staff orientation and training plan. The license holder must develop
288.22a staff orientation and training plan documenting when and how compliance with
288.23subdivisions 4, 4a, and 5 will be met.
288.24EFFECTIVE DATE.This section is effective January 1, 2014.

288.25    Sec. 28. [245D.091] INTERVENTION SERVICES.
288.26    Subdivision 1. Licensure requirements. An individual meeting the staff
288.27qualification requirements of this section who is an employee of a program licensed
288.28according to this chapter and providing behavioral support services, specialist services,
288.29or crisis respite services is not required to hold a separate license under this chapter.
288.30An individual meeting the staff qualifications of this section who is not providing these
288.31services as an employee of a program licensed according to this chapter must obtain a
288.32license according to this chapter.
288.33    Subd. 2. Behavior professional qualifications. A behavior professional, as defined
288.34in the brain injury and community alternatives for disabled individuals waiver plans or
288.35successor plans, must have competencies in areas related to:
289.1(1) ethical considerations;
289.2(2) functional assessment;
289.3(3) functional analysis;
289.4(4) measurement of behavior and interpretation of data;
289.5(5) selecting intervention outcomes and strategies;
289.6(6) behavior reduction and elimination strategies that promote least restrictive
289.7approved alternatives;
289.8(7) data collection;
289.9(8) staff and caregiver training;
289.10(9) support plan monitoring;
289.11(10) co-occurring mental disorders or neuro-cognitive disorder;
289.12(11) demonstrated expertise with populations being served; and
289.13(12) must be a:
289.14(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the
289.15Board of Psychology competencies in the above identified areas;
289.16(ii) clinical social worker licensed as an independent clinical social worker under
289.17chapter 148D, or a person with a master's degree in social work from an accredited college
289.18or university, with at least 4,000 hours of post-master's supervised experience in the
289.19delivery of clinical services in the areas identified in clauses (1) to (11);
289.20(iii) physician licensed under chapter 147 and certified by the American Board
289.21of Psychiatry and Neurology or eligible for board certification in psychiatry with
289.22competencies in the areas identified in clauses (1) to (11);
289.23(iv) licensed professional clinical counselor licensed under sections 148B.29 to
289.24148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery
289.25of clinical services who has demonstrated competencies in the areas identified in clauses
289.26(1) to (11);
289.27(v) person with a master's degree from an accredited college or university in one
289.28of the behavioral sciences or related fields, with at least 4,000 hours of post-master's
289.29supervised experience in the delivery of clinical services with demonstrated competencies
289.30in the areas identified in clauses (1) to (11); or
289.31(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is
289.32certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
289.33mental health nursing by a national nurse certification organization, or who has a master's
289.34degree in nursing or one of the behavioral sciences or related fields from an accredited
289.35college or university or its equivalent, with at least 4,000 hours of post-master's supervised
289.36experience in the delivery of clinical services.
290.1    Subd. 3. Behavior analyst qualifications. (a) A behavior analyst, as defined in
290.2the brain injury and community alternatives for disabled individuals waiver plans or
290.3successor plans, must:
290.4(1) have obtained a baccalaureate degree, master's degree, or a PhD in a social
290.5services discipline; or
290.6(2) meet the qualifications of a mental health practitioner as defined in section
290.7245.462, subdivision 17.
290.8(b) In addition, a behavior analyst must:
290.9(1) have four years of supervised experience working with individuals who exhibit
290.10challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder;
290.11(2) have received ten hours of instruction in functional assessment and functional
290.12analysis;
290.13(3) have received 20 hours of instruction in the understanding of the function of
290.14behavior;
290.15(4) have received ten hours of instruction on design of positive practices behavior
290.16support strategies;
290.17(5) have received 20 hours of instruction on the use of behavior reduction approved
290.18strategies used only in combination with behavior positive practices strategies;
290.19(6) be determined by a behavior professional to have the training and prerequisite
290.20skills required to provide positive practice strategies as well as behavior reduction
290.21approved and permitted intervention to the person who receives behavioral support; and
290.22(7) be under the direct supervision of a behavior professional.
290.23    Subd. 4. Behavior specialist qualifications. (a) A behavior specialist, as defined
290.24in the brain injury and community alternatives for disabled individuals waiver plans or
290.25successor plans, must meet the following qualifications:
290.26(1) have an associate's degree in a social services discipline; or
290.27(2) have two years of supervised experience working with individuals who exhibit
290.28challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder.
290.29(b) In addition, a behavior specialist must:
290.30(1) have received a minimum of four hours of training in functional assessment;
290.31(2) have received 20 hours of instruction in the understanding of the function of
290.32behavior;
290.33(3) have received ten hours of instruction on design of positive practices behavioral
290.34support strategies;
291.1(4) be determined by a behavior professional to have the training and prerequisite
291.2skills required to provide positive practices strategies as well as behavior reduction
291.3approved intervention to the person who receives behavioral support; and
291.4(5) be under the direct supervision of a behavior professional.
291.5    Subd. 5. Specialist services qualifications. An individual providing specialist
291.6services, as defined in the developmental disabilities waiver plan or successor plan, must
291.7have:
291.8(1) the specific experience and skills required of the specialist to meet the needs of
291.9the person identified by the person's service planning team; and
291.10(2) the qualifications of the specialist identified in the person's coordinated service
291.11and support plan.
291.12EFFECTIVE DATE.This section is effective January 1, 2014.

291.13    Sec. 29. [245D.095] RECORD REQUIREMENTS.
291.14    Subdivision 1. Record-keeping systems. The license holder must ensure that the
291.15content and format of service recipient, personnel, and program records are uniform and
291.16legible according to the requirements of this chapter.
291.17    Subd. 2. Admission and discharge register. The license holder must keep a written
291.18or electronic register, listing in chronological order the dates and names of all persons
291.19served by the program who have been admitted, discharged, or transferred, including
291.20service terminations initiated by the license holder and deaths.
291.21    Subd. 3. Service recipient record. (a) The license holder must maintain a record of
291.22current services provided to each person on the premises where the services are provided
291.23or coordinated. When the services are provided in a licensed facility, the records must
291.24be maintained at the facility, otherwise the records must be maintained at the license
291.25holder's program office. The license holder must protect service recipient records against
291.26loss, tampering, or unauthorized disclosure according to the requirements in sections
291.2713.01 to 13.10 and 13.46.
291.28(b) The license holder must maintain the following information for each person:
291.29(1) an admission form signed by the person or the person's legal representative
291.30that includes:
291.31(i) identifying information, including the person's name, date of birth, address,
291.32and telephone number; and
291.33(ii) the name, address, and telephone number of the person's legal representative, if
291.34any, and a primary emergency contact, the case manager, and family members or others as
291.35identified by the person or case manager;
292.1(2) service information, including service initiation information, verification of the
292.2person's eligibility for services, documentation verifying that services have been provided
292.3as identified in the coordinated service and support plan or coordinated service and support
292.4plan addendum according to paragraph (a), and date of admission or readmission;
292.5(3) health information, including medical history, special dietary needs, and
292.6allergies, and when the license holder is assigned responsibility for meeting the person's
292.7health service needs according to section 245D.05:
292.8(i) current orders for medication, treatments, or medical equipment and a signed
292.9authorization from the person or the person's legal representative to administer or assist in
292.10administering the medication or treatments, if applicable;
292.11(ii) a signed statement authorizing the license holder to act in a medical emergency
292.12when the person's legal representative, if any, cannot be reached or is delayed in arriving;
292.13(iii) medication administration procedures;
292.14(iv) a medication administration record documenting the implementation of the
292.15medication administration procedures, the medication administration record reviews, and
292.16including any agreements for administration of injectable medications by the license
292.17holder according to the requirements in section 245D.05; and
292.18(v) a medical appointment schedule when the license holder is assigned
292.19responsibility for assisting with medical appointments;
292.20(4) the person's current coordinated service and support plan or that portion of the
292.21plan assigned to the license holder;
292.22(5) copies of the individual abuse prevention plan and assessments as required under
292.23section 245D.071, subdivisions 2 and 3;
292.24(6) a record of other service providers serving the person when the person's
292.25coordinated service and support plan or coordinated service and support plan addendum
292.26identifies the need for coordination between the service providers, that includes a contact
292.27person and telephone numbers, services being provided, and names of staff responsible for
292.28coordination;
292.29(7) documentation of orientation to service recipient rights according to section
292.30245D.04, subdivision 1, and maltreatment reporting policies and procedures according to
292.31section 245A.65, subdivision 1, paragraph (c);
292.32(8) copies of authorizations to handle a person's funds, according to section 245D.06,
292.33subdivision 4, paragraph (a);
292.34(9) documentation of complaints received and grievance resolution;
292.35(10) incident reports involving the person, required under section 245D.06,
292.36subdivision 1;
293.1(11) copies of written reports regarding the person's status when requested according
293.2to section 245D.07, subdivision 3, progress review reports as required under section
293.3245D.071, subdivision 5, progress or daily log notes that are recorded by the program,
293.4and reports received from other agencies involved in providing services or care to the
293.5person; and
293.6(12) discharge summary, including service termination notice and related
293.7documentation, when applicable.
293.8    Subd. 4. Access to service recipient records. The license holder must ensure that
293.9the following people have access to the information in subdivision 1 in accordance with
293.10applicable state and federal law, regulation, or rule:
293.11(1) the person, the person's legal representative, and anyone properly authorized
293.12by the person;
293.13(2) the person's case manager;
293.14(3) staff providing services to the person unless the information is not relevant to
293.15carrying out the coordinated service and support plan or coordinated service and support
293.16plan addendum; and
293.17(4) the county child or adult foster care licensor, when services are also licensed as
293.18child or adult foster care.
293.19    Subd. 5. Personnel records. (a) The license holder must maintain a personnel
293.20record of each employee to document and verify staff qualifications, orientation, and
293.21training. The personnel record must include:
293.22(1) the employee's date of hire, completed application, an acknowledgement signed
293.23by the employee that job duties were reviewed with the employee and the employee
293.24understands those duties, and documentation that the employee meets the position
293.25requirements as determined by the license holder;
293.26 (2) documentation of staff qualifications, orientation, training, and performance
293.27evaluations as required under section 245D.09, subdivisions 3 to 5, including the date
293.28the training was completed, the number of hours per subject area, and the name of the
293.29trainer or instructor; and
293.30(3) a completed background study as required under chapter 245C.
293.31(b) For employees hired after January 1, 2014, the license holder must maintain
293.32documentation in the personnel record or elsewhere, sufficient to determine the date of the
293.33employee's first supervised direct contact with a person served by the program, and the
293.34date of first unsupervised direct contact with a person served by the program.
293.35EFFECTIVE DATE.This section is effective January 1, 2014.

294.1    Sec. 30. Minnesota Statutes 2012, section 245D.10, is amended to read:
294.2245D.10 POLICIES AND PROCEDURES.
294.3    Subdivision 1. Policy and procedure requirements. The A license holder
294.4 providing either basic or intensive supports and services must establish, enforce, and
294.5maintain policies and procedures as required in this chapter, chapter 245A, and other
294.6applicable state and federal laws and regulations governing the provision of home and
294.7community-based services licensed according to this chapter.
294.8    Subd. 2. Grievances. The license holder must establish policies and procedures
294.9that provide promote service recipient rights by providing a simple complaint process for
294.10persons served by the program and their authorized representatives to bring a grievance that:
294.11(1) provides staff assistance with the complaint process when requested, and the
294.12addresses and telephone numbers of outside agencies to assist the person;
294.13(2) allows the person to bring the complaint to the highest level of authority in the
294.14program if the grievance cannot be resolved by other staff members, and that provides
294.15the name, address, and telephone number of that person;
294.16(3) requires the license holder to promptly respond to all complaints affecting a
294.17person's health and safety. For all other complaints, the license holder must provide an
294.18initial response within 14 calendar days of receipt of the complaint. All complaints must
294.19be resolved within 30 calendar days of receipt or the license holder must document the
294.20reason for the delay and a plan for resolution;
294.21(4) requires a complaint review that includes an evaluation of whether:
294.22(i) related policies and procedures were followed and adequate;
294.23(ii) there is a need for additional staff training;
294.24(iii) the complaint is similar to past complaints with the persons, staff, or services
294.25involved; and
294.26(iv) there is a need for corrective action by the license holder to protect the health
294.27and safety of persons receiving services;
294.28(5) based on the review in clause (4), requires the license holder to develop,
294.29document, and implement a corrective action plan designed to correct current lapses and
294.30prevent future lapses in performance by staff or the license holder, if any;
294.31(6) provides a written summary of the complaint and a notice of the complaint
294.32resolution to the person and case manager that:
294.33(i) identifies the nature of the complaint and the date it was received;
294.34(ii) includes the results of the complaint review;
294.35(iii) identifies the complaint resolution, including any corrective action; and
295.1(7) requires that the complaint summary and resolution notice be maintained in the
295.2service recipient record.
295.3    Subd. 3. Service suspension and service termination. (a) The license holder must
295.4establish policies and procedures for temporary service suspension and service termination
295.5that promote continuity of care and service coordination with the person and the case
295.6manager and with other licensed caregivers, if any, who also provide support to the person.
295.7(b) The policy must include the following requirements:
295.8(1) the license holder must notify the person or the person's legal representative and
295.9case manager in writing of the intended termination or temporary service suspension, and
295.10the person's right to seek a temporary order staying the termination of service according to
295.11the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
295.12(2) notice of the proposed termination of services, including those situations
295.13that began with a temporary service suspension, must be given at least 60 days before
295.14the proposed termination is to become effective when a license holder is providing
295.15independent living skills training, structured day, prevocational or supported employment
295.16services to the person intensive supports and services identified in section 245D.03,
295.17subdivision 1, paragraph (c), and 30 days prior to termination for all other services
295.18licensed under this chapter;
295.19(3) the license holder must provide information requested by the person or case
295.20manager when services are temporarily suspended or upon notice of termination;
295.21(4) prior to giving notice of service termination or temporary service suspension,
295.22the license holder must document actions taken to minimize or eliminate the need for
295.23service suspension or termination;
295.24(5) during the temporary service suspension or service termination notice period,
295.25the license holder will work with the appropriate county agency to develop reasonable
295.26alternatives to protect the person and others;
295.27(6) the license holder must maintain information about the service suspension or
295.28termination, including the written termination notice, in the service recipient record; and
295.29(7) the license holder must restrict temporary service suspension to situations in
295.30which the person's behavior causes immediate and serious danger to the health and safety
295.31of the person or others conduct poses an imminent risk of physical harm to self or others
295.32and less restrictive or positive support strategies would not achieve safety.
295.33    Subd. 4. Availability of current written policies and procedures. (a) The license
295.34holder must review and update, as needed, the written policies and procedures required
295.35under this chapter.
296.1(b)(1) The license holder must inform the person and case manager of the policies
296.2and procedures affecting a person's rights under section 245D.04, and provide copies of
296.3those policies and procedures, within five working days of service initiation.
296.4(2) If a license holder only provides basic services and supports, this includes the:
296.5(i) grievance policy and procedure required under subdivision 2; and
296.6(ii) service suspension and termination policy and procedure required under
296.7subdivision 3.
296.8(3) For all other license holders this includes the:
296.9(i) policies and procedures in clause (2);
296.10(ii) emergency use of manual restraints policy and procedure required under
296.11subdivision 3a; and
296.12(iii) data privacy requirements under section 245D.11, subdivision 3.
296.13(c) The license holder must provide a written notice at least 30 days before
296.14implementing any revised policies and procedures procedural revisions to policies
296.15 affecting a person's service-related or protection-related rights under section 245D.04 and
296.16maltreatment reporting policies and procedures. The notice must explain the revision that
296.17was made and include a copy of the revised policy and procedure. The license holder
296.18must document the reason reasonable cause for not providing the notice at least 30 days
296.19before implementing the revisions.
296.20(d) Before implementing revisions to required policies and procedures, the license
296.21holder must inform all employees of the revisions and provide training on implementation
296.22of the revised policies and procedures.
296.23(e) The license holder must annually notify all persons, or their legal representatives,
296.24and case managers of any procedural revisions to policies required under this chapter,
296.25other than those in paragraph (c). Upon request, the license holder must provide the
296.26person, or the person's legal representative, and case manager with copies of the revised
296.27policies and procedures.
296.28EFFECTIVE DATE.This section is effective January 1, 2014.

296.29    Sec. 31. [245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT
296.30SERVICES.
296.31    Subdivision 1. Policy and procedure requirements. A license holder providing
296.32intensive support services as identified in section 245D.03, subdivision 1, paragraph (c),
296.33must establish, enforce, and maintain policies and procedures as required in this section.
296.34    Subd. 2. Health and safety. The license holder must establish policies and
296.35procedures that promote health and safety by ensuring:
297.1(1) use of universal precautions and sanitary practices in compliance with section
297.2245D.06, subdivision 2, clause (5);
297.3(2) if the license holder operates a residential program, health service coordination
297.4and care according to the requirements in section 245D.05, subdivision 1;
297.5(3) safe medication assistance and administration according to the requirements
297.6in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in
297.7consultation with a registered nurse, nurse practitioner, physician's assistant, or medical
297.8doctor and require completion of medication administration training according to the
297.9requirements in section 245D.09, subdivision 4a, paragraph (c). Medication assistance
297.10and administration includes, but is not limited to:
297.11(i) providing medication-related services for a person;
297.12(ii) medication setup;
297.13(iii) medication administration;
297.14(iv) medication storage and security;
297.15(v) medication documentation and charting;
297.16(vi) verification and monitoring of effectiveness of systems to ensure safe medication
297.17handling and administration;
297.18(vii) coordination of medication refills;
297.19(viii) handling changes to prescriptions and implementation of those changes;
297.20(ix) communicating with the pharmacy; and
297.21(x) coordination and communication with prescriber;
297.22(4) safe transportation, when the license holder is responsible for transportation of
297.23persons, with provisions for handling emergency situations according to the requirements
297.24in section 245D.06, subdivision 2, clauses (2) to (4);
297.25(5) a plan for ensuring the safety of persons served by the program in emergencies as
297.26defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies
297.27to the license holder. A license holder with a community residential setting or a day service
297.28facility license must ensure the policy and procedures comply with the requirements in
297.29section 245D.22, subdivision 4;
297.30(6) a plan for responding to all incidents as defined in section 245D.02, subdivision
297.3111; and reporting all incidents required to be reported according to section 245D.06,
297.32subdivision 1. The plan must:
297.33(i) provide the contact information of a source of emergency medical care and
297.34transportation; and
298.1(ii) require staff to first call 911 when the staff believes a medical emergency may be
298.2life threatening, or to call the mental health crisis intervention team when the person is
298.3experiencing a mental health crisis; and
298.4(7) a procedure for the review of incidents and emergencies to identify trends or
298.5patterns, and corrective action if needed. The license holder must establish and maintain
298.6a record-keeping system for the incident and emergency reports. Each incident and
298.7emergency report file must contain a written summary of the incident. The license holder
298.8must conduct a review of incident reports for identification of incident patterns, and
298.9implementation of corrective action as necessary to reduce occurrences. Each incident
298.10report must include:
298.11(i) the name of the person or persons involved in the incident. It is not necessary
298.12to identify all persons affected by or involved in an emergency unless the emergency
298.13resulted in an incident;
298.14(ii) the date, time, and location of the incident or emergency;
298.15(iii) a description of the incident or emergency;
298.16(iv) a description of the response to the incident or emergency and whether a person's
298.17coordinated service and support plan addendum or program policies and procedures were
298.18implemented as applicable;
298.19(v) the name of the staff person or persons who responded to the incident or
298.20emergency; and
298.21(vi) the determination of whether corrective action is necessary based on the results
298.22of the review.
298.23    Subd. 3. Data privacy. The license holder must establish policies and procedures that
298.24promote service recipient rights by ensuring data privacy according to the requirements in:
298.25(1) the Minnesota Government Data Practices Act, section 13.46, and all other
298.26applicable Minnesota laws and rules in handling all data related to the services provided;
298.27and
298.28(2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the
298.29extent that the license holder performs a function or activity involving the use of protected
298.30health information as defined under Code of Federal Regulations, title 45, section 164.501,
298.31including, but not limited to, providing health care services; health care claims processing
298.32or administration; data analysis, processing, or administration; utilization review; quality
298.33assurance; billing; benefit management; practice management; repricing; or as otherwise
298.34provided by Code of Federal Regulations, title 45, section 160.103. The license holder
298.35must comply with the Health Insurance Portability and Accountability Act of 1996 and
299.1its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164,
299.2and all applicable requirements.
299.3    Subd. 4. Admission criteria. The license holder must establish policies and
299.4procedures that promote continuity of care by ensuring that admission or service initiation
299.5criteria:
299.6(1) is consistent with the license holder's registration information identified in the
299.7requirements in section 245D.031, subdivision 2, and with the service-related rights
299.8identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8);
299.9(2) identifies the criteria to be applied in determining whether the license holder
299.10can develop services to meet the needs specified in the person's coordinated service and
299.11support plan;
299.12(3) requires a license holder providing services in a health care facility to comply
299.13with the requirements in section 243.166, subdivision 4b, to provide notification to
299.14residents when a registered predatory offender is admitted into the program or to a
299.15potential admission when the facility was already serving a registered predatory offender.
299.16For purposes of this clause, "health care facility" means a facility licensed by the
299.17commissioner as a residential facility under chapter 245A to provide adult foster care or
299.18residential services to persons with disabilities; and
299.19(4) requires that when a person or the person's legal representative requests services
299.20from the license holder, a refusal to admit the person must be based on an evaluation of
299.21the person's assessed needs and the license holder's lack of capacity to meet the needs of
299.22the person. The license holder must not refuse to admit a person based solely on the
299.23type of residential services the person is receiving, or solely on the person's severity of
299.24disability, orthopedic or neurological handicaps, sight or hearing impairments, lack of
299.25communication skills, physical disabilities, toilet habits, behavioral disorders, or past
299.26failure to make progress. Documentation of the basis for refusal must be provided to the
299.27person or the person's legal representative and case manager upon request.
299.28EFFECTIVE DATE.This section is effective January 1, 2014.

299.29    Sec. 32. [245D.21] FACILITY LICENSURE REQUIREMENTS AND
299.30APPLICATION PROCESS.
299.31    Subdivision 1. Community residential settings and day service facilities. For
299.32purposes of this section, "facility" means both a community residential setting and day
299.33service facility and the physical plant.
299.34    Subd. 2. Inspections and code compliance. (a) Physical plants must comply with
299.35applicable state and local fire, health, building, and zoning codes.
300.1(b)(1) The facility must be inspected by a fire marshal or their delegate within
300.212 months before initial licensure to verify that it meets the applicable occupancy
300.3requirements as defined in the State Fire Code and that the facility complies with the fire
300.4safety standards for that occupancy code contained in the State Fire Code.
300.5(2) The fire marshal inspection of a community residential setting must verify the
300.6residence is a dwelling unit within a residential occupancy as defined in section 9.117 of
300.7the State Fire Code. A home safety checklist, approved by the commissioner, must be
300.8completed for a community residential setting by the license holder and the commissioner
300.9before the satellite license is reissued.
300.10(3) The facility shall be inspected according to the facility capacity specified on the
300.11initial application form.
300.12(4) If the commissioner has reasonable cause to believe that a potentially hazardous
300.13condition may be present or the licensed capacity is increased, the commissioner shall
300.14request a subsequent inspection and written report by a fire marshal to verify the absence
300.15of hazard.
300.16(5) Any condition cited by a fire marshal, building official, or health authority as
300.17hazardous or creating an immediate danger of fire or threat to health and safety must be
300.18corrected before a license is issued by the department, and for community residential
300.19settings, before a license is reissued.
300.20(c) The facility must maintain in a permanent file the reports of health, fire, and
300.21other safety inspections.
300.22(d) The facility's plumbing, ventilation, heating, cooling, lighting, and other
300.23fixtures and equipment, including elevators or food service, if provided, must conform to
300.24applicable health, sanitation, and safety codes and regulations.
300.25EFFECTIVE DATE.This section is effective January 1, 2014.

300.26    Sec. 33. [245D.22] FACILITY SANITATION AND HEALTH.
300.27    Subdivision 1. General maintenance. The license holder must maintain the interior
300.28and exterior of buildings, structures, or enclosures used by the facility, including walls,
300.29floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a
300.30sanitary and safe condition. The facility must be clean and free from accumulations of
300.31dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must
300.32correct building and equipment deterioration, safety hazards, and unsanitary conditions.
300.33    Subd. 2. Hazards and toxic substances. (a) The license holder must ensure that
300.34service sites owned or leased by the license holder are free from hazards that would
301.1threaten the health or safety of a person receiving services by ensuring the requirements
301.2in paragraphs (b) to (h) are met.
301.3(b) Chemicals, detergents, and other hazardous or toxic substances must not be
301.4stored with food products or in any way that poses a hazard to persons receiving services.
301.5(c) The license holder must install handrails and nonslip surfaces on interior and
301.6exterior runways, stairways, and ramps according to the applicable building code.
301.7(d) If there are elevators in the facility, the license holder must have elevators
301.8inspected each year. The date of the inspection, any repairs needed, and the date the
301.9necessary repairs were made must be documented.
301.10(e) The license holder must keep stairways, ramps, and corridors free of obstructions.
301.11(f) Outside property must be free from debris and safety hazards. Exterior stairs and
301.12walkways must be kept free of ice and snow.
301.13(g) Heating, ventilation, air conditioning units, and other hot surfaces and moving
301.14parts of machinery must be shielded or enclosed.
301.15(h) Use of dangerous items or equipment by persons served by the program must be
301.16allowed in accordance with the person's coordinated service and support plan addendum
301.17or the program abuse prevention plan, if not addressed in the coordinated service and
301.18support plan addendum.
301.19    Subd. 3. Storage and disposal of medication. Schedule II controlled substances in
301.20the facility that are named in section 152.02, subdivision 3, must be stored in a locked
301.21storage area permitting access only by persons and staff authorized to administer the
301.22medication. This must be incorporated into the license holder's medication administration
301.23policy and procedures required under section 245D.11, subdivision 2, clause (3).
301.24Medications must be disposed of according to the Environmental Protection Agency
301.25recommendations.
301.26    Subd. 4. First aid must be available on site. (a) A staff person trained in first aid
301.27must be available on site and, when required in a person's coordinated service and support
301.28plan or coordinated service and support plan addendum, cardiopulmonary resuscitation,
301.29whenever persons are present and staff are required to be at the site to provide direct
301.30service. The training must include in-person instruction, hands-on practice, and an
301.31observed skills assessment under the direct supervision of a first aid instructor.
301.32(b) A facility must have first aid kits readily available for use by, and that meets
301.33the needs of, persons receiving services and staff. At a minimum, the first aid kit must
301.34be equipped with accessible first aid supplies including bandages, sterile compresses,
301.35scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap,
301.36adhesive tape, and first aid manual.
302.1    Subd. 5. Emergencies. (a) The license holder must have a written plan for
302.2responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the
302.3safety of persons served in the facility. The plan must include:
302.4(1) procedures for emergency evacuation and emergency sheltering, including:
302.5(i) how to report a fire or other emergency;
302.6(ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive
302.7procedures or equipment to assist with the safe evacuation of persons with physical or
302.8sensory disabilities; and
302.9(iii) instructions on closing off the fire area, using fire extinguishers, and activating
302.10and responding to alarm systems;
302.11(2) a floor plan that identifies:
302.12(i) the location of fire extinguishers;
302.13(ii) the location of audible or visual alarm systems, including but not limited to
302.14manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and
302.15sprinkler systems;
302.16(iii) the location of exits, primary and secondary evacuation routes, and accessible
302.17egress routes, if any; and
302.18(iv) the location of emergency shelter within the facility;
302.19(3) a site plan that identifies:
302.20(i) designated assembly points outside the facility;
302.21(ii) the locations of fire hydrants; and
302.22(iii) the routes of fire department access;
302.23(4) the responsibilities each staff person must assume in case of emergency;
302.24(5) procedures for conducting quarterly drills each year and recording the date of
302.25each drill in the file of emergency plans;
302.26(6) procedures for relocation or service suspension when services are interrupted
302.27for more than 24 hours;
302.28(7) for a community residential setting with three or more dwelling units, a floor
302.29plan that identifies the location of enclosed exit stairs; and
302.30(8) an emergency escape plan for each resident.
302.31(b) The license holder must:
302.32(1) maintain a log of quarterly fire drills on file in the facility;
302.33(2) provide an emergency response plan that is readily available to staff and persons
302.34receiving services;
303.1(3) inform each person of a designated area within the facility where the person
303.2should go to for emergency shelter during severe weather and the designated assembly
303.3points outside the facility; and
303.4(4) maintain emergency contact information for persons served at the facility that
303.5can be readily accessed in an emergency.
303.6    Subd. 6. Emergency equipment. The facility must have a flashlight and a portable
303.7radio or television set that do not require electricity and can be used if a power failure
303.8occurs.
303.9    Subd. 7. Telephone and posted numbers. A facility must have a non-coin operated
303.10telephone that is readily accessible. A list of emergency numbers must be posted in a
303.11prominent location. When an area has a 911 number or a mental health crisis intervention
303.12team number, both numbers must be posted and the emergency number listed must be
303.13911. In areas of the state without a 911 number, the numbers listed must be those of the
303.14local fire department, police department, emergency transportation, and poison control
303.15center. The names and telephone numbers of each person's representative, physician, and
303.16dentist must be readily available.
303.17EFFECTIVE DATE.This section is effective January 1, 2014.

303.18    Sec. 34. [245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE
303.19LICENSURE REQUIREMENTS AND APPLICATION PROCESS.
303.20    Subdivision 1. Separate satellite license required for separate sites. (a) A license
303.21holder providing residential support services must obtain a separate satellite license for
303.22each community residential setting located at separate addresses when the community
303.23residential settings are to be operated by the same license holder. For purposes of this
303.24chapter, a community residential setting is a satellite of the home and community-based
303.25services license.
303.26(b) Community residential settings are permitted single-family use homes. After a
303.27license has been issued, the commissioner shall notify the local municipality where the
303.28residence is located of the approved license.
303.29    Subd. 2. Notification to local agency. The license holder must notify the local
303.30agency within 24 hours of the onset of changes in a residence resulting from construction,
303.31remodeling, or damages requiring repairs that require a building permit or may affect a
303.32licensing requirement in this chapter.
303.33    Subd. 3. Alternate overnight supervision. A license holder granted an alternate
303.34overnight supervision technology adult foster care license according to section 245A.11,
304.1subdivision 7a, that converts to a community residential setting satellite license according
304.2to this chapter must retain that designation.
304.3EFFECTIVE DATE.This section is effective January 1, 2014.

304.4    Sec. 35. [245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL
304.5PLANT AND ENVIRONMENT.
304.6    Subdivision 1. Occupancy. The residence must meet the definition of a dwelling
304.7unit in a residential occupancy.
304.8    Subd. 2. Common area requirements. The living area must be provided with an
304.9adequate number of furnishings for the usual functions of daily living and social activities.
304.10The dining area must be furnished to accommodate meals shared by all persons living in
304.11the residence. These furnishings must be in good repair and functional to meet the daily
304.12needs of the persons living in the residence.
304.13    Subd. 3. Bedrooms. (a) People receiving services must mutually consent, in
304.14writing, to sharing a bedroom with one another. No more than two people receiving
304.15services may share one bedroom.
304.16(b) A single occupancy bedroom must have at least 80 square feet of floor space with
304.17a 7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor
304.18space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and
304.19other habitable rooms by floor to ceiling walls containing no openings except doorways
304.20and must not serve as a corridor to another room used in daily living.
304.21(c) A person's personal possessions and items for the person's own use are the only
304.22items permitted to be stored in a person's bedroom.
304.23(d) Unless otherwise documented through assessment as a safety concern for the
304.24person, each person must be provided with the following furnishings:
304.25(1) a separate bed of proper size and height for the convenience and comfort of the
304.26person, with a clean mattress in good repair;
304.27(2) clean bedding appropriate for the season for each person;
304.28(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal
304.29possessions and clothing; and
304.30(4) a mirror for grooming.
304.31(e) When possible, a person must be allowed to have items of furniture that the
304.32person personally owns in the bedroom, unless doing so would interfere with safety
304.33precautions, violate a building or fire code, or interfere with another person's use of the
304.34bedroom. A person may choose to not have a cabinet, dresser, shelves, or a mirror in the
304.35bedroom, as otherwise required under paragraph (d), clause (3) or (4). A person may
305.1choose to use a mattress other than an innerspring mattress and may choose to not have
305.2the mattress on a mattress frame or support. If a person chooses not to have a piece of
305.3required furniture, the license holder must document this choice and is not required to
305.4provide the item. If a person chooses to use a mattress other than an innerspring mattress
305.5or chooses to not have a mattress frame or support, the license holder must document this
305.6choice and allow the alternative desired by the person.
305.7(f) A person must be allowed to bring personal possessions into the bedroom
305.8and other designated storage space, if such space is available, in the residence. The
305.9person must be allowed to accumulate possessions to the extent the residence is able to
305.10accommodate them, unless doing so is contraindicated for the person's physical or mental
305.11health, would interfere with safety precautions or another person's use of the bedroom, or
305.12would violate a building or fire code. The license holder must allow for locked storage
305.13of personal items. Any restriction on the possession or locked storage of personal items,
305.14including requiring a person to use a lock provided by the license holder, must comply
305.15with section 245D.04, subdivision 3, paragraph (c), and allow the person to be present if
305.16and when the license holder opens the lock.
305.17EFFECTIVE DATE.This section is effective January 1, 2014.

305.18    Sec. 36. [245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND
305.19WATER.
305.20    Subdivision 1. Water. Potable water from privately owned wells must be tested
305.21annually by a Department of Health-certified laboratory for coliform bacteria and nitrate
305.22nitrogens to verify safety. The health authority may require retesting and corrective
305.23measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in
305.24the event of a flooding or incident which may put the well at risk of contamination. To
305.25prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.
305.26    Subd. 2. Food. Food served must meet any special dietary needs of a person as
305.27prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day
305.28must be served or made available to persons, and nutritious snacks must be available
305.29between meals.
305.30    Subd. 3. Food safety. Food must be obtained, handled, and properly stored to
305.31prevent contamination, spoilage, or a threat to the health of a person.
305.32EFFECTIVE DATE.This section is effective January 1, 2014.

306.1    Sec. 37. [245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION
306.2AND HEALTH.
306.3    Subdivision 1. Goods provided by the license holder. Individual clean bed linens
306.4appropriate for the season and the person's comfort, including towels and wash cloths,
306.5must be available for each person. Usual or customary goods for the operation of a
306.6residence which are communally used by all persons receiving services living in the
306.7residence must be provided by the license holder, including household items for meal
306.8preparation, cleaning supplies to maintain the cleanliness of the residence, window
306.9coverings on windows for privacy, toilet paper, and hand soap.
306.10    Subd. 2. Personal items. Personal health and hygiene items must be stored in a
306.11safe and sanitary manner.
306.12    Subd. 3. Pets and service animals. Pets and service animals housed within
306.13the residence must be immunized and maintained in good health as required by local
306.14ordinances and state law. The license holder must ensure that the person and the person's
306.15representative is notified before admission of the presence of pets in the residence.
306.16    Subd. 4. Smoking in the residence. License holders must comply with the
306.17requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when
306.18smoking is permitted in the residence.
306.19    Subd. 5. Weapons. Weapons and ammunition must be stored separately in locked
306.20areas that are inaccessible to a person receiving services. For purposes of this subdivision,
306.21"weapons" means firearms and other instruments or devices designed for and capable of
306.22producing bodily harm.
306.23EFFECTIVE DATE.This section is effective January 1, 2014.

306.24    Sec. 38. [245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE
306.25REQUIREMENTS AND APPLICATION PROCESS.
306.26Except for day service facilities on the same or adjoining lot, the license holder
306.27providing day services must apply for a separate license for each facility-based service
306.28site when the license holder is the owner, lessor, or tenant of the service site at which
306.29persons receive day services and the license holder's employees who provide day services
306.30are present for a cumulative total of more than 30 days within any 12-month period. For
306.31purposes of this chapter, a day services facility license is a satellite license of the day
306.32services program. A day services program may operate multiple licensed day service
306.33facilities in one or more counties in the state. For the purposes of this section, "adjoining
306.34lot" means day services facilities that are next door to or across the street from one another.
307.1EFFECTIVE DATE.This section is effective January 1, 2014.

307.2    Sec. 39. [245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND
307.3SPACE REQUIREMENTS.
307.4    Subdivision 1. Facility capacity and useable space requirements. (a) The facility
307.5capacity of each day service facility must be determined by the amount of primary space
307.6available, the scheduling of activities at other service sites, and the space requirements of
307.7all persons receiving services at the facility, not just the licensed services. The facility
307.8capacity must specify the maximum number of persons that may receive services on
307.9site at any one time.
307.10(b) When a facility is located in a multifunctional organization, the facility may
307.11share common space with the multifunctional organization if the required available
307.12primary space for use by persons receiving day services is maintained while the facility is
307.13operating. The license holder must comply at all times with all applicable fire and safety
307.14codes under section 245A.04, subdivision 2a, and adequate supervision requirements
307.15under section 245D.31 for all persons receiving day services.
307.16(c) A day services facility must have a minimum of 40 square feet of primary
307.17space available for each consumer who is present at the site at any one time. Primary
307.18space does not include:
307.19(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms,
307.20and kitchens;
307.21(2) floor areas beneath stationary equipment; or
307.22(3) any space occupied by persons associated with the multifunctional organization
307.23while persons receiving day services are using common space.
307.24    Subd. 2. Individual personal articles. Each person must be provided space in a
307.25closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own
307.26use while receiving services at the facility, unless doing so would interfere with safety
307.27precautions, another person's work space, or violate a building or fire code.
307.28EFFECTIVE DATE.This section is effective January 1, 2014.

307.29    Sec. 40. [245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY
307.30REQUIREMENTS.
307.31    Subdivision 1. Refrigeration. If the license holder provides refrigeration at service
307.32sites owned or leased by the license holder for storing perishable foods and perishable
307.33portions of bag lunches, whether the foods are supplied by the license holder or the
308.1persons receiving services, the refrigeration must have a temperature of 40 degrees
308.2Fahrenheit or less.
308.3    Subd. 2. Drinking water. Drinking water must be available to all persons
308.4receiving services. If a person is unable to request or obtain drinking water, it must be
308.5provided according to that person's individual needs. Drinking water must be provided in
308.6single-service containers or from drinking fountains accessible to all persons.
308.7    Subd. 3. Individuals who become ill during the day. There must be an area in
308.8which a person receiving services can rest if:
308.9(1) the person becomes ill during the day;
308.10(2) the person does not live in a licensed residential site;
308.11(3) the person requires supervision; and
308.12(4) there is not a caretaker immediately available. Supervision must be provided
308.13until the caretaker arrives to bring the person home.
308.14    Subd. 4. Safety procedures. The license holder must establish general written
308.15safety procedures that include criteria for selecting, training, and supervising persons who
308.16work with hazardous machinery, tools, or substances. Safety procedures specific to each
308.17person's activities must be explained and be available in writing to all staff members
308.18and persons receiving services.
308.19EFFECTIVE DATE.This section is effective January 1, 2014.

308.20    Sec. 41. [245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND
308.21FACILITY COVERAGE.
308.22    Subdivision 1. Scope. This section applies only to facility-based day services.
308.23    Subd. 2. Factors. (a) The number of direct support service staff members that a
308.24license holder must have on duty at the facility at a given time to meet the minimum
308.25staffing requirements established in this section varies according to:
308.26(1) the number of persons who are enrolled and receiving direct support services
308.27at that given time;
308.28(2) the staff ratio requirement established under subdivision 3 for each person who
308.29is present; and
308.30(3) whether the conditions described in subdivision 8 exist and warrant additional
308.31staffing beyond the number determined to be needed under subdivision 7.
308.32(b) The commissioner must consider the factors in paragraph (a) in determining a
308.33license holder's compliance with the staffing requirements and must further consider
308.34whether the staff ratio requirement established under subdivision 3 for each person
308.35receiving services accurately reflects the person's need for staff time.
309.1    Subd. 3. Staff ratio requirement for each person receiving services. The case
309.2manager, in consultation with the interdisciplinary team, must determine at least once each
309.3year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving
309.4services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio
309.5assigned each person and the documentation of how the ratio was arrived at must be kept
309.6in each person's individual service plan. Documentation must include an assessment of the
309.7person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard
309.8assessment form required by the commissioner.
309.9    Subd. 4. Person requiring staff ratio of one to four. A person must be assigned a
309.10staff ratio requirement of one to four if:
309.11(1) on a daily basis the person requires total care and monitoring or constant
309.12hand-over-hand physical guidance to successfully complete at least three of the following
309.13activities: toileting, communicating basic needs, eating, ambulating; or is not capable of
309.14taking appropriate action for self-preservation under emergency conditions; or
309.15(2) the person engages in conduct that poses an imminent risk of physical harm to
309.16self or others at a documented level of frequency, intensity, or duration requiring frequent
309.17daily ongoing intervention and monitoring as established in the person's coordinated
309.18service and support plan or coordinated service and support plan addendum.
309.19    Subd. 5. Person requiring staff ratio of one to eight. A person must be assigned a
309.20staff ratio requirement of one to eight if:
309.21(1) the person does not meet the requirements in subdivision 4; and
309.22(2) on a daily basis the person requires verbal prompts or spot checks and minimal
309.23or no physical assistance to successfully complete at least four of the following activities:
309.24toileting, communicating basic needs, eating, ambulating, or taking appropriate action for
309.25self-preservation under emergency conditions.
309.26    Subd. 6. Person requiring staff ratio of one to six. A person who does not have
309.27any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio
309.28requirement of one to six.
309.29    Subd. 7. Determining number of direct support service staff required. The
309.30minimum number of direct support service staff members required at any one time to
309.31meet the combined staff ratio requirements of the persons present at that time can be
309.32determined by the following steps:
309.33(1) assign each person in attendance the three-digit decimal below that corresponds
309.34to the staff ratio requirement assigned to that person. A staff ratio requirement of one to
309.35four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio
309.36requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100;
310.1(2) add all of the three-digit decimals (one three-digit decimal for every person in
310.2attendance) assigned in clause (1);
310.3(3) when the sum in clause (2) falls between two whole numbers, round off the sum
310.4to the larger of the two whole numbers; and
310.5(4) the larger of the two whole numbers in clause (3) equals the number of direct
310.6support service staff members needed to meet the staff ratio requirements of the persons
310.7in attendance.
310.8    Subd. 8. Staff to be included in calculating minimum staffing requirement.
310.9Only staff providing direct support must be counted as staff members in calculating the
310.10staff-to-participant ratio. A volunteer may be counted as a staff providing direct support
310.11in calculating the staff-to-participant ratio if the volunteer meets the same standards
310.12and requirements as paid staff. No person receiving services must be counted as or be
310.13substituted for a staff member in calculating the staff-to-participant ratio.
310.14    Subd. 9. Conditions requiring additional direct support staff. The license holder
310.15must increase the number of direct support staff members present at any one time beyond
310.16the number arrived at in subdivision 4 if necessary when any one or combination of the
310.17following circumstances can be documented by the commissioner as existing:
310.18(1) the health and safety needs of the persons receiving services cannot be met by
310.19the number of staff members available under the staffing pattern in effect even though the
310.20number has been accurately calculated under subdivision 7; or
310.21(2) the person's conduct frequently presents an imminent risk of physical harm to
310.22self or others.
310.23    Subd. 10. Supervision requirements. (a) At no time must one direct support
310.24staff member be assigned responsibility for supervision and training of more than ten
310.25persons receiving supervision and training, except as otherwise stated in each person's risk
310.26management plan.
310.27(b) In the temporary absence of the director or a supervisor, a direct support staff
310.28member must be designated to supervise the center.
310.29    Subd. 11. Multifunctional programs. A multifunctional program may count other
310.30employees of the organization besides direct support staff of the day service facility in
310.31calculating the staff to participant ratio if the employee is assigned to the day services
310.32facility for a specified amount of time, during which the employee is not assigned to
310.33another organization or program.
310.34EFFECTIVE DATE.This section is effective January 1, 2014.

310.35    Sec. 42. [245D.32] ALTERNATIVE LICENSING INSPECTIONS.
311.1    Subdivision 1. Eligibility for an alternative licensing inspection. (a) A license
311.2holder providing services licensed under this chapter, with a qualifying accreditation and
311.3meeting the eligibility criteria in paragraphs (b) and (c) may request approval for an
311.4alternative licensing inspection when all services provided under the license holder's
311.5license are accredited. A license holder with a qualifying accreditation and meeting
311.6the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative
311.7licensing inspection for individual community residential settings or day services facilities
311.8licensed under this chapter.
311.9(b) In order to be eligible for an alternative licensing inspection, the program must
311.10have had at least one inspection by the commissioner following issuance of the initial
311.11license. For programs operating a day services facility, each facility must have had at least
311.12one on-site inspection by the commissioner following issuance of the initial license.
311.13(c) In order to be eligible for an alternative licensing inspection, the program must
311.14have been in "substantial and consistent compliance" at the time of the last licensing
311.15inspection and during the current licensing period. For purposes of this section, substantial
311.16and consistent compliance means:
311.17(1) the license holder's license was not made conditional, suspended, or revoked;
311.18(2) there have been no substantiated allegations of maltreatment against the license
311.19holder;
311.20(3) there were no program deficiencies identified that would jeopardize the health,
311.21safety, or rights of persons being served; and
311.22(4) the license holder maintained substantial compliance with the other requirements
311.23of chapters 245A and 245C and other applicable laws and rules.
311.24(d) For the purposes of this section, the license holder's license includes services
311.25licensed under this chapter that were previously licensed under chapter 245B until
311.26December 31, 2013.
311.27    Subd. 2. Qualifying accreditation. The commissioner must accept a three-year
311.28accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF)
311.29as a qualifying accreditation.
311.30    Subd. 3. Request for approval of an alternative inspection status. (a) A request
311.31for an alternative inspection must be made on the forms and in the manner prescribed
311.32by the commissioner. When submitting the request, the license holder must submit all
311.33documentation issued by the accrediting body verifying that the license holder has obtained
311.34and maintained the qualifying accreditation and has complied with recommendations
311.35or requirements from the accrediting body during the period of accreditation. Based
312.1on the request and the additional required materials, the commissioner may approve
312.2an alternative inspection status.
312.3(b) The commissioner must notify the license holder in writing that the request for
312.4an alternative inspection status has been approved. Approval must be granted until the
312.5end of the qualifying accreditation period.
312.6(c) The license holder must submit a written request for approval to be renewed
312.7one month before the end of the current approval period according to the requirements
312.8in paragraph (a). If the license holder does not submit a request to renew approval as
312.9required, the commissioner must conduct a licensing inspection.
312.10    Subd. 4. Programs approved for alternative licensing inspection; deemed
312.11compliance licensing requirements. (a) A license holder approved for alternative
312.12licensing inspection under this section is required to maintain compliance with all
312.13licensing standards according to this chapter.
312.14(b) A license holder approved for alternative licensing inspection under this section
312.15must be deemed to be in compliance with all the requirements of this chapter, and the
312.16commissioner must not perform routine licensing inspections.
312.17(c) Upon receipt of a complaint regarding the services of a license holder approved
312.18for alternative licensing inspection under this section, the commissioner must investigate
312.19the complaint and may take any action as provided under section 245A.06 or 245A.07.
312.20    Subd. 5. Investigations of alleged or suspected maltreatment. Nothing in this
312.21section changes the commissioner's responsibilities to investigate alleged or suspected
312.22maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557.
312.23    Subd. 6. Termination or denial of subsequent approval. Following approval of
312.24an alternative licensing inspection, the commissioner may terminate or deny subsequent
312.25approval of an alternative licensing inspection if the commissioner determines that:
312.26(1) the license holder has not maintained the qualifying accreditation;
312.27(2) the commissioner has substantiated maltreatment for which the license holder or
312.28facility is determined to be responsible during the qualifying accreditation period; or
312.29(3) during the qualifying accreditation period, the license holder has been issued
312.30an order for conditional license, fine, suspension, or license revocation that has not been
312.31reversed upon appeal.
312.32    Subd. 7. Appeals. The commissioner's decision that the conditions for approval for
312.33an alternative licensing inspection have not been met is final and not subject to appeal
312.34under the provisions of chapter 14.
313.1    Subd. 8. Commissioner's programs. Home and community-based services licensed
313.2under this chapter for which the commissioner is the license holder with a qualifying
313.3accreditation are excluded from being approved for an alternative licensing inspection.
313.4EFFECTIVE DATE.This section is effective January 1, 2014.

313.5    Sec. 43. [245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS.
313.6(a) The commissioner of human services shall issue a mental health certification
313.7for services licensed under this chapter, when a license holder is determined to have met
313.8the requirements under paragraph (b). This certification is voluntary for license holders.
313.9The certification shall be printed on the license and identified on the commissioner's
313.10public Web site.
313.11(b) The requirements for certification are:
313.12(1) all staff have received at least seven hours of annual training covering all of
313.13the following topics:
313.14(i) mental health diagnoses;
313.15(ii) mental health crisis response and de-escalation techniques;
313.16(iii) recovery from mental illness;
313.17(iv) treatment options, including evidence-based practices;
313.18(v) medications and their side effects;
313.19(vi) co-occurring substance abuse and health conditions; and
313.20(vii) community resources;
313.21(2) a mental health professional, as defined in section 245.462, subdivision 18, or a
313.22mental health practitioner as defined in section 245.462, subdivision 17, is available
313.23for consultation and assistance;
313.24(3) there is a plan and protocol in place to address a mental health crisis; and
313.25(4) each person's individual service and support plan identifies who is providing
313.26clinical services and their contact information, and includes an individual crisis prevention
313.27and management plan developed with the person.
313.28(c) License holders seeking certification under this section must request this
313.29certification on forms and in the manner prescribed by the commissioner.
313.30(d) If the commissioner finds that the license holder has failed to comply with the
313.31certification requirements under paragraph (b), the commissioner may issue a correction
313.32order and an order of conditional license in accordance with section 245A.06 or may
313.33issue a sanction in accordance with section 245A.07, including and up to removal of
313.34the certification.
314.1(e) A denial of the certification or the removal of the certification based on a
314.2determination that the requirements under paragraph (b) have not been met is not subject to
314.3appeal. A license holder that has been denied a certification or that has had a certification
314.4removed may again request certification when the license holder is in compliance with the
314.5requirements of paragraph (b).
314.6EFFECTIVE DATE.This section is effective January 1, 2014.

314.7    Sec. 44. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
314.8    Subd. 11. Residential support services. (a) Upon federal approval, there is
314.9established a new service called residential support that is available on the community
314.10alternative care, community alternatives for disabled individuals, developmental
314.11disabilities, and brain injury waivers. Existing waiver service descriptions must be
314.12modified to the extent necessary to ensure there is no duplication between other services.
314.13Residential support services must be provided by vendors licensed as a community
314.14residential setting as defined in section 245A.11, subdivision 8, a foster care setting
314.15licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care
314.16setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
314.17    (b) Residential support services must meet the following criteria:
314.18    (1) providers of residential support services must own or control the residential site;
314.19    (2) the residential site must not be the primary residence of the license holder;
314.20    (3) (1) the residential site must have a designated program supervisor person
314.21 responsible for program management, oversight, development, and implementation of
314.22policies and procedures;
314.23    (4) (2) the provider of residential support services must provide supervision, training,
314.24and assistance as described in the person's coordinated service and support plan; and
314.25    (5) (3) the provider of residential support services must meet the requirements of
314.26licensure and additional requirements of the person's coordinated service and support plan.
314.27    (c) Providers of residential support services that meet the definition in paragraph (a)
314.28must be registered using a process determined by the commissioner beginning July 1, 2009
314.29 must be licensed according to chapter 245D. Providers licensed to provide child foster care
314.30under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under
314.31Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section
314.32245A.03, subdivision 7 , paragraph (g), are considered registered under this section.

314.33    Sec. 45. Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:
315.1    Subdivision 1. Provider qualifications. (a) For the home and community-based
315.2waivers providing services to seniors and individuals with disabilities under sections
315.3256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
315.4(1) agreements with enrolled waiver service providers to ensure providers meet
315.5Minnesota health care program requirements;
315.6(2) regular reviews of provider qualifications, and including requests of proof of
315.7documentation; and
315.8(3) processes to gather the necessary information to determine provider qualifications.
315.9    (b) Beginning July 1, 2012, staff that provide direct contact, as defined in section
315.10245C.02, subdivision 11 , for services specified in the federally approved waiver plans
315.11must meet the requirements of chapter 245C prior to providing waiver services and as
315.12part of ongoing enrollment. Upon federal approval, this requirement must also apply to
315.13consumer-directed community supports.
315.14    (c) Beginning January 1, 2014, service owners and managerial officials overseeing
315.15the management or policies of services that provide direct contact as specified in the
315.16federally approved waiver plans must meet the requirements of chapter 245C prior to
315.17reenrollment or, for new providers, prior to initial enrollment if they have not already done
315.18so as a part of service licensure requirements.

315.19    Sec. 46. Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:
315.20    Subd. 7. Applicant and license holder training. An applicant or license holder
315.21for the home and community-based waivers providing services to seniors and individuals
315.22with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 that is
315.23not enrolled as a Minnesota health care program home and community-based services
315.24waiver provider at the time of application must ensure that at least one controlling
315.25individual completes a onetime training on the requirements for providing home and
315.26community-based services from a qualified source as determined by the commissioner,
315.27before a provider is enrolled or license is issued. Within six months of enrollment, a newly
315.28enrolled home and community-based waiver service provider must ensure that at least one
315.29controlling individual has completed training on waiver and related program billing.

315.30    Sec. 47. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
315.31subdivision to read:
315.32    Subd. 8. Data on use of emergency use of manual restraint. Beginning July 1,
315.332013, facilities and services to be licensed under chapter 245D shall submit data regarding
316.1the use of emergency use of manual restraint as identified in section 245D.061 in a format
316.2and at a frequency identified by the commissioner.

316.3    Sec. 48. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
316.4subdivision to read:
316.5    Subd. 9. Definitions. (a) For the purposes of this section the following terms have
316.6the meanings given them.
316.7(b) "Controlling individual" means a public body, governmental agency, business
316.8entity, officer, owner, or managerial official whose responsibilities include the direction of
316.9the management or policies of a program.
316.10(c) "Managerial official" means an individual who has decision-making authority
316.11related to the operation of the program and responsibility for the ongoing management of
316.12or direction of the policies, services, or employees of the program.
316.13(d) "Owner" means an individual who has direct or indirect ownership interest in
316.14a corporation or partnership, or business association enrolling with the Department of
316.15Human Services as a provider of waiver services.

316.16    Sec. 49. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
316.17subdivision to read:
316.18    Subd. 10. Enrollment requirements. All home and community-based waiver
316.19providers must provide, at the time of enrollment and within 30 days of a request, in a
316.20format determined by the commissioner, information and documentation that includes, but
316.21is not limited to, the following:
316.22(1) proof of surety bond coverage in the amount of $50,000 or ten percent of the
316.23provider's payments from Medicaid in the previous calendar year, whichever is greater;
316.24(2) proof of fidelity bond coverage in the amount of $20,000; and
316.25(3) proof of liability insurance.

316.26    Sec. 50. Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:
316.27    Subd. 9a. Evaluation and referral of reports made to common entry point unit.
316.28    The common entry point must screen the reports of alleged or suspected maltreatment for
316.29immediate risk and make all necessary referrals as follows:
316.30    (1) if the common entry point determines that there is an immediate need for
316.31adult protective services, the common entry point agency shall immediately notify the
316.32appropriate county agency;
317.1    (2) if the report contains suspected criminal activity against a vulnerable adult, the
317.2common entry point shall immediately notify the appropriate law enforcement agency;
317.3    (3) the common entry point shall refer all reports of alleged or suspected
317.4maltreatment to the appropriate lead investigative agency as soon as possible, but in any
317.5event no longer than two working days; and
317.6    (4) if the report involves services licensed by the Department of Human Services
317.7and subject to chapter 245D, the common entry point shall refer the report to the county as
317.8the lead agency according to clause (3), but shall also notify the Department of Human
317.9Services of the report; and
317.10    (5) (4) if the report contains information about a suspicious death, the common
317.11entry point shall immediately notify the appropriate law enforcement agencies, the local
317.12medical examiner, and the ombudsman for mental health and developmental disabilities
317.13established under section 245.92. Law enforcement agencies shall coordinate with the
317.14local medical examiner and the ombudsman as provided by law.

317.15    Sec. 51. Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:
317.16    Subd. 13. Lead investigative agency. "Lead investigative agency" is the primary
317.17administrative agency responsible for investigating reports made under section 626.557.
317.18(a) The Department of Health is the lead investigative agency for facilities or
317.19services licensed or required to be licensed as hospitals, home care providers, nursing
317.20homes, boarding care homes, hospice providers, residential facilities that are also federally
317.21certified as intermediate care facilities that serve people with developmental disabilities,
317.22or any other facility or service not listed in this subdivision that is licensed or required to
317.23be licensed by the Department of Health for the care of vulnerable adults. "Home care
317.24provider" has the meaning provided in section 144A.43, subdivision 4, and applies when
317.25care or services are delivered in the vulnerable adult's home, whether a private home or a
317.26housing with services establishment registered under chapter 144D, including those that
317.27offer assisted living services under chapter 144G.
317.28(b) Except as provided under paragraph (c), for services licensed according to
317.29chapter 245D, The Department of Human Services is the lead investigative agency for
317.30facilities or services licensed or required to be licensed as adult day care, adult foster care,
317.31programs for people with developmental disabilities, family adult day services, mental
317.32health programs, mental health clinics, chemical dependency programs, the Minnesota
317.33sex offender program, or any other facility or service not listed in this subdivision that is
317.34licensed or required to be licensed by the Department of Human Services.
318.1(c) The county social service agency or its designee is the lead investigative agency
318.2for all other reports, including, but not limited to, reports involving vulnerable adults
318.3receiving services from a personal care provider organization under section 256B.0659,
318.4or receiving home and community-based services licensed by the Department of Human
318.5Services and subject to chapter 245D.

318.6    Sec. 52. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
318.7AND COMMUNITY-BASED SERVICES.
318.8(a) The Department of Health Compliance Monitoring Division and the Department
318.9of Human Services Licensing Division shall jointly develop an integrated licensing system
318.10for providers of both home care services subject to licensure under Minnesota Statutes,
318.11chapter 144A, and for home and community-based services subject to licensure under
318.12Minnesota Statutes, chapter 245D. The integrated licensing system shall:
318.13(1) require only one license of any provider of services under Minnesota Statutes,
318.14sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
318.15(2) promote quality services that recognize a person's individual needs and protect
318.16the person's health, safety, rights, and well-being;
318.17(3) promote provider accountability through application requirements, compliance
318.18inspections, investigations, and enforcement actions;
318.19(4) reference other applicable requirements in existing state and federal laws,
318.20including the federal Affordable Care Act;
318.21(5) establish internal procedures to facilitate ongoing communications between the
318.22agencies, and with providers and services recipients about the regulatory activities;
318.23(6) create a link between the agency Web sites so that providers and the public can
318.24access the same information regardless of which Web site is accessed initially; and
318.25(7) collect data on identified outcome measures as necessary for the agencies to
318.26report to the Centers for Medicare and Medicaid Services.
318.27(b) The joint recommendations for legislative changes to implement the integrated
318.28licensing system are due to the legislature by February 15, 2014.
318.29(c) Before implementation of the integrated licensing system, providers licensed as
318.30home care providers under Minnesota Statutes, chapter 144A, may also provide home
318.31and community-based services subject to licensure under Minnesota Statutes, chapter
318.32245D, without obtaining a home and community-based services license under Minnesota
318.33Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
318.34apply to these providers:
319.1(1) the provider must comply with all requirements under Minnesota Statutes, chapter
319.2245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
319.3(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
319.4enforced by the Department of Health under the enforcement authority set forth in
319.5Minnesota Statutes, section 144A.475; and
319.6(3) the Department of Health will provide information to the Department of Human
319.7Services about each provider licensed under this section, including the provider's license
319.8application, licensing documents, inspections, information about complaints received, and
319.9investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

319.10    Sec. 53. REPEALER.
319.11(a) Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031;
319.12245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and
319.13245B.08, are repealed effective January 1, 2014.
319.14(b) Minnesota Statutes 2012, section 245D.08, is repealed.


319.17    Section 1. Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:
319.18    Subd. 5. Specific purchases. The solicitation process described in this chapter is
319.19not required for acquisition of the following:
319.20(1) merchandise for resale purchased under policies determined by the commissioner;
319.21(2) farm and garden products which, as determined by the commissioner, may be
319.22purchased at the prevailing market price on the date of sale;
319.23(3) goods and services from the Minnesota correctional facilities;
319.24(4) goods and services from rehabilitation facilities and extended employment
319.25providers that are certified by the commissioner of employment and economic
319.26development, and day training and habilitation services licensed under sections 245B.01
319.27to 245B.08 chapter 245D;
319.28(5) goods and services for use by a community-based facility operated by the
319.29commissioner of human services;
319.30(6) goods purchased at auction or when submitting a sealed bid at auction provided
319.31that before authorizing such an action, the commissioner consult with the requesting
319.32agency to determine a fair and reasonable value for the goods considering factors
319.33including, but not limited to, costs associated with submitting a bid, travel, transportation,
319.34and storage. This fair and reasonable value must represent the limit of the state's bid;
320.1(7) utility services where no competition exists or where rates are fixed by law or
320.2ordinance; and
320.3(8) goods and services from Minnesota sex offender program facilities.
320.4EFFECTIVE DATE.This section is effective January 1, 2014.

320.5    Sec. 2. Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:
320.6    Subdivision 1. Service contracts. The commissioner of administration shall
320.7ensure that a portion of all contracts for janitorial services; document imaging;
320.8document shredding; and mailing, collating, and sorting services be awarded by the
320.9state to rehabilitation programs and extended employment providers that are certified
320.10by the commissioner of employment and economic development, and day training and
320.11habilitation services licensed under sections 245B.01 to 245B.08 chapter 245D. The
320.12amount of each contract awarded under this section may exceed the estimated fair market
320.13price as determined by the commissioner for the same goods and services by up to six
320.14percent. The aggregate value of the contracts awarded to eligible providers under this
320.15section in any given year must exceed 19 percent of the total value of all contracts for
320.16janitorial services; document imaging; document shredding; and mailing, collating, and
320.17sorting services entered into in the same year. For the 19 percent requirement to be
320.18applicable in any given year, the contract amounts proposed by eligible providers must be
320.19within six percent of the estimated fair market price for at least 19 percent of the contracts
320.20awarded for the corresponding service area.
320.21EFFECTIVE DATE.This section is effective January 1, 2014.

320.22    Sec. 3. Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:
320.23    Subd. 4. Housing with services establishment or establishment. (a) "Housing
320.24with services establishment" or "establishment" means:
320.25(1) an establishment providing sleeping accommodations to one or more adult
320.26residents, at least 80 percent of which are 55 years of age or older, and offering or
320.27providing, for a fee, one or more regularly scheduled health-related services or two or
320.28more regularly scheduled supportive services, whether offered or provided directly by the
320.29establishment or by another entity arranged for by the establishment; or
320.30(2) an establishment that registers under section 144D.025.
320.31(b) Housing with services establishment does not include:
320.32(1) a nursing home licensed under chapter 144A;
321.1(2) a hospital, certified boarding care home, or supervised living facility licensed
321.2under sections 144.50 to 144.56;
321.3(3) a board and lodging establishment licensed under chapter 157 and Minnesota
321.4Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660,
321.5or 9530.4100 to 9530.4450, or under chapter 245B 245D;
321.6(4) a board and lodging establishment which serves as a shelter for battered women
321.7or other similar purpose;
321.8(5) a family adult foster care home licensed by the Department of Human Services;
321.9(6) private homes in which the residents are related by kinship, law, or affinity with
321.10the providers of services;
321.11(7) residential settings for persons with developmental disabilities in which the
321.12services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable
321.13successor rules or laws;
321.14(8) a home-sharing arrangement such as when an elderly or disabled person or
321.15single-parent family makes lodging in a private residence available to another person
321.16in exchange for services or rent, or both;
321.17(9) a duly organized condominium, cooperative, common interest community, or
321.18owners' association of the foregoing where at least 80 percent of the units that comprise the
321.19condominium, cooperative, or common interest community are occupied by individuals
321.20who are the owners, members, or shareholders of the units; or
321.21(10) services for persons with developmental disabilities that are provided under
321.22a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until
321.23January 1, 1998, or under chapter 245B 245D.
321.24EFFECTIVE DATE.This section is effective January 1, 2014.

321.25    Sec. 4. Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:
321.26    Subdivision 1. Applicability. (a) The operating standards for special transportation
321.27service adopted under this section do not apply to special transportation provided by:
321.28(1) a common carrier operating on fixed routes and schedules;
321.29(2) a volunteer driver using a private automobile;
321.30(3) a school bus as defined in section 169.011, subdivision 71; or
321.31(4) an emergency ambulance regulated under chapter 144.
321.32(b) The operating standards adopted under this section only apply to providers
321.33of special transportation service who receive grants or other financial assistance from
321.34either the state or the federal government, or both, to provide or assist in providing that
321.35service; except that the operating standards adopted under this section do not apply
322.1to any nursing home licensed under section 144A.02, to any board and care facility
322.2licensed under section 144.50, or to any day training and habilitation services, day care,
322.3or group home facility licensed under sections 245A.01 to 245A.19 unless the facility or
322.4program provides transportation to nonresidents on a regular basis and the facility receives
322.5reimbursement, other than per diem payments, for that service under rules promulgated
322.6by the commissioner of human services.
322.7(c) Notwithstanding paragraph (b), the operating standards adopted under this
322.8section do not apply to any vendor of services licensed under chapter 245B 245D that
322.9provides transportation services to consumers or residents of other vendors licensed under
322.10chapter 245B 245D and transports 15 or fewer persons, including consumers or residents
322.11and the driver.
322.12EFFECTIVE DATE.This section is effective January 1, 2014.

322.13    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:
322.14    Subdivision 1. Scope. The terms used in this chapter and chapter 245B have the
322.15meanings given them in this section.
322.16EFFECTIVE DATE.This section is effective January 1, 2014.

322.17    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:
322.18    Subd. 9. License holder. "License holder" means an individual, corporation,
322.19partnership, voluntary association, or other organization that is legally responsible for the
322.20operation of the program, has been granted a license by the commissioner under this chapter
322.21or chapter 245B 245D and the rules of the commissioner, and is a controlling individual.
322.22EFFECTIVE DATE.This section is effective January 1, 2014.

322.23    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:
322.24    Subd. 9. Permitted services by an individual who is related. Notwithstanding
322.25subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a
322.26person receiving supported living services may provide licensed services to that person if:
322.27(1) the person who receives supported living services received these services in a
322.28residential site on July 1, 2005;
322.29(2) the services under clause (1) were provided in a corporate foster care setting for
322.30adults and were funded by the developmental disabilities home and community-based
322.31services waiver defined in section 256B.092;
323.1(3) the individual who is related obtains and maintains both a license under chapter
323.2245B 245D and an adult foster care license under Minnesota Rules, parts 9555.5105
323.3to 9555.6265; and
323.4(4) the individual who is related is not the guardian of the person receiving supported
323.5living services.
323.6EFFECTIVE DATE.This section is effective January 1, 2014.

323.7    Sec. 8. Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:
323.8    Subd. 13. Funds and property; other requirements. (a) A license holder must
323.9ensure that persons served by the program retain the use and availability of personal funds
323.10or property unless restrictions are justified in the person's individual plan. This subdivision
323.11does not apply to programs governed by the provisions in section 245B.07, subdivision 10.
323.12(b) The license holder must ensure separation of funds of persons served by the
323.13program from funds of the license holder, the program, or program staff.
323.14(c) Whenever the license holder assists a person served by the program with the
323.15safekeeping of funds or other property, the license holder must:
323.16(1) immediately document receipt and disbursement of the person's funds or other
323.17property at the time of receipt or disbursement, including the person's signature, or the
323.18signature of the conservator or payee; and
323.19(2) return to the person upon the person's request, funds and property in the license
323.20holder's possession subject to restrictions in the person's treatment plan, as soon as
323.21possible, but no later than three working days after the date of request.
323.22(d) License holders and program staff must not:
323.23(1) borrow money from a person served by the program;
323.24(2) purchase personal items from a person served by the program;
323.25(3) sell merchandise or personal services to a person served by the program;
323.26(4) require a person served by the program to purchase items for which the license
323.27holder is eligible for reimbursement; or
323.28(5) use funds of persons served by the program to purchase items for which the
323.29facility is already receiving public or private payments.
323.30EFFECTIVE DATE.This section is effective January 1, 2014.

323.31    Sec. 9. Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:
323.32    Subd. 3. License suspension, revocation, or fine. (a) The commissioner may
323.33suspend or revoke a license, or impose a fine if:
324.1(1) a license holder fails to comply fully with applicable laws or rules;
324.2(2) a license holder, a controlling individual, or an individual living in the household
324.3where the licensed services are provided or is otherwise subject to a background study has
324.4a disqualification which has not been set aside under section 245C.22;
324.5(3) a license holder knowingly withholds relevant information from or gives false
324.6or misleading information to the commissioner in connection with an application for
324.7a license, in connection with the background study status of an individual, during an
324.8investigation, or regarding compliance with applicable laws or rules; or
324.9(4) after July 1, 2012, and upon request by the commissioner, a license holder fails
324.10to submit the information required of an applicant under section 245A.04, subdivision 1,
324.11paragraph (f) or (g).
324.12A license holder who has had a license suspended, revoked, or has been ordered
324.13to pay a fine must be given notice of the action by certified mail or personal service. If
324.14mailed, the notice must be mailed to the address shown on the application or the last
324.15known address of the license holder. The notice must state the reasons the license was
324.16suspended, revoked, or a fine was ordered.
324.17    (b) If the license was suspended or revoked, the notice must inform the license
324.18holder of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
324.191400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
324.20a license. The appeal of an order suspending or revoking a license must be made in writing
324.21by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
324.22the commissioner within ten calendar days after the license holder receives notice that the
324.23license has been suspended or revoked. If a request is made by personal service, it must be
324.24received by the commissioner within ten calendar days after the license holder received
324.25the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits
324.26a timely appeal of an order suspending or revoking a license, the license holder may
324.27continue to operate the program as provided in section 245A.04, subdivision 7, paragraphs
324.28(g) and (h), until the commissioner issues a final order on the suspension or revocation.
324.29    (c)(1) If the license holder was ordered to pay a fine, the notice must inform the
324.30license holder of the responsibility for payment of fines and the right to a contested case
324.31hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal
324.32of an order to pay a fine must be made in writing by certified mail or personal service. If
324.33mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
324.34days after the license holder receives notice that the fine has been ordered. If a request is
324.35made by personal service, it must be received by the commissioner within ten calendar
324.36days after the license holder received the order.
325.1    (2) The license holder shall pay the fines assessed on or before the payment date
325.2specified. If the license holder fails to fully comply with the order, the commissioner
325.3may issue a second fine or suspend the license until the license holder complies. If the
325.4license holder receives state funds, the state, county, or municipal agencies or departments
325.5responsible for administering the funds shall withhold payments and recover any payments
325.6made while the license is suspended for failure to pay a fine. A timely appeal shall stay
325.7payment of the fine until the commissioner issues a final order.
325.8    (3) A license holder shall promptly notify the commissioner of human services,
325.9in writing, when a violation specified in the order to forfeit a fine is corrected. If upon
325.10reinspection the commissioner determines that a violation has not been corrected as
325.11indicated by the order to forfeit a fine, the commissioner may issue a second fine. The
325.12commissioner shall notify the license holder by certified mail or personal service that a
325.13second fine has been assessed. The license holder may appeal the second fine as provided
325.14under this subdivision.
325.15    (4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for
325.16each determination of maltreatment of a child under section 626.556 or the maltreatment
325.17of a vulnerable adult under section 626.557 for which the license holder is determined
325.18responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i),
325.19or 626.557, subdivision 9c, paragraph (c); the license holder shall forfeit $200 for each
325.20occurrence of a violation of law or rule governing matters of health, safety, or supervision,
325.21including but not limited to the provision of adequate staff-to-child or adult ratios, and
325.22failure to comply with background study requirements under chapter 245C; and the license
325.23holder shall forfeit $100 for each occurrence of a violation of law or rule other than
325.24those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence"
325.25means each violation identified in the commissioner's fine order. Fines assessed against a
325.26license holder that holds a license to provide the residential-based habilitation home and
325.27community-based services, as defined under identified in section 245B.02, subdivision
325.2820 245D.03, subdivision 1, and a community residential setting or day services facility
325.29license to provide foster care under chapter 245D where the services are provided, may be
325.30assessed against both licenses for the same occurrence, but the combined amount of the
325.31fines shall not exceed the amount specified in this clause for that occurrence.
325.32    (5) When a fine has been assessed, the license holder may not avoid payment by
325.33closing, selling, or otherwise transferring the licensed program to a third party. In such an
325.34event, the license holder will be personally liable for payment. In the case of a corporation,
325.35each controlling individual is personally and jointly liable for payment.
326.1(d) Except for background study violations involving the failure to comply with an
326.2order to immediately remove an individual or an order to provide continuous, direct
326.3supervision, the commissioner shall not issue a fine under paragraph (c) relating to a
326.4background study violation to a license holder who self-corrects a background study
326.5violation before the commissioner discovers the violation. A license holder who has
326.6previously exercised the provisions of this paragraph to avoid a fine for a background
326.7study violation may not avoid a fine for a subsequent background study violation unless at
326.8least 365 days have passed since the license holder self-corrected the earlier background
326.9study violation.
326.10EFFECTIVE DATE.This section is effective January 1, 2014.

326.11    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to
326.12read:
326.13    Subd. 19c. Personal care. Medical assistance covers personal care assistance
326.14services provided by an individual who is qualified to provide the services according to
326.15subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a
326.16plan, and supervised by a qualified professional.
326.17"Qualified professional" means a mental health professional as defined in section
326.18245.462, subdivision 18 , clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6);
326.19or a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker
326.20as defined in sections 148E.010 and 148E.055, or a qualified developmental disabilities
326.21specialist under section 245B.07, subdivision 4 designated coordinator under section
326.22245D.081, subdivision 2. The qualified professional shall perform the duties required in
326.23section 256B.0659.
326.24EFFECTIVE DATE.This section is effective January 1, 2014.

326.25    Sec. 11. Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:
326.26    Subd. 2. Contract provisions. (a) The service contract with each intermediate
326.27care facility must include provisions for:
326.28(1) modifying payments when significant changes occur in the needs of the
326.29consumers;
326.30(2) appropriate and necessary statistical information required by the commissioner;
326.31(3) annual aggregate facility financial information; and
326.32(4) additional requirements for intermediate care facilities not meeting the standards
326.33set forth in the service contract.
327.1(b) The commissioner of human services and the commissioner of health, in
327.2consultation with representatives from counties, advocacy organizations, and the provider
327.3community, shall review the consolidated standards under chapter 245B and the home and
327.4community-based services standards under chapter 245D and the supervised living facility
327.5rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota
327.6Rules, chapter 4665, may be waived by the commissioner of health for intermediate care
327.7facilities in order to enable facilities to implement the performance measures in their
327.8contract and provide quality services to residents without a duplication of or increase in
327.9regulatory requirements.
327.10EFFECTIVE DATE.This section is effective January 1, 2014.

327.11    Sec. 12. Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:
327.12    Subdivision 1. Agreement. Two or more governmental units, by agreement entered
327.13into through action of their governing bodies, may jointly or cooperatively exercise
327.14any power common to the contracting parties or any similar powers, including those
327.15which are the same except for the territorial limits within which they may be exercised.
327.16The agreement may provide for the exercise of such powers by one or more of the
327.17participating governmental units on behalf of the other participating units. The term
327.18"governmental unit" as used in this section includes every city, county, town, school
327.19district, independent nonprofit firefighting corporation, other political subdivision of
327.20this or another state, another state, federally recognized Indian tribe, the University
327.21of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under
327.22sections 144.50 to 144.56, rehabilitation facilities and extended employment providers
327.23that are certified by the commissioner of employment and economic development, day
327.24training and habilitation services licensed under sections 245B.01 to 245B.08, day and
327.25supported employment services licensed under chapter 245D, and any agency of the state
327.26of Minnesota or the United States, and includes any instrumentality of a governmental
327.27unit. For the purpose of this section, an instrumentality of a governmental unit means an
327.28instrumentality having independent policy-making and appropriating authority.
327.29EFFECTIVE DATE.This section is effective January 1, 2014.

327.30    Sec. 13. Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:
327.31    Subd. 2. Definitions. As used in this section, the following terms have the meanings
327.32given them unless the specific content indicates otherwise:
328.1    (a) "Family assessment" means a comprehensive assessment of child safety, risk
328.2of subsequent child maltreatment, and family strengths and needs that is applied to a
328.3child maltreatment report that does not allege substantial child endangerment. Family
328.4assessment does not include a determination as to whether child maltreatment occurred
328.5but does determine the need for services to address the safety of family members and the
328.6risk of subsequent maltreatment.
328.7    (b) "Investigation" means fact gathering related to the current safety of a child
328.8and the risk of subsequent maltreatment that determines whether child maltreatment
328.9occurred and whether child protective services are needed. An investigation must be used
328.10when reports involve substantial child endangerment, and for reports of maltreatment in
328.11facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
328.12144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
328.1313, and 124D.10; or in a nonlicensed personal care provider association as defined in
328.14sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
328.15    (c) "Substantial child endangerment" means a person responsible for a child's care,
328.16and in the case of sexual abuse includes a person who has a significant relationship to the
328.17child as defined in section 609.341, or a person in a position of authority as defined in
328.18section 609.341, who by act or omission commits or attempts to commit an act against a
328.19child under their care that constitutes any of the following:
328.20    (1) egregious harm as defined in section 260C.007, subdivision 14;
328.21    (2) sexual abuse as defined in paragraph (d);
328.22    (3) abandonment under section 260C.301, subdivision 2;
328.23    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
328.24child's physical or mental health, including a growth delay, which may be referred to as
328.25failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
328.26    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
328.27609.195 ;
328.28    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
328.29    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
328.30609.223 ;
328.31    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
328.32    (9) criminal sexual conduct under sections 609.342 to 609.3451;
328.33    (10) solicitation of children to engage in sexual conduct under section 609.352;
328.34    (11) malicious punishment or neglect or endangerment of a child under section
328.35609.377 or 609.378;
328.36    (12) use of a minor in sexual performance under section 617.246; or
329.1    (13) parental behavior, status, or condition which mandates that the county attorney
329.2file a termination of parental rights petition under section 260C.301, subdivision 3,
329.3paragraph (a).
329.4    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
329.5child's care, by a person who has a significant relationship to the child, as defined in
329.6section 609.341, or by a person in a position of authority, as defined in section 609.341,
329.7subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
329.8conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
329.9609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
329.10in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
329.11abuse also includes any act which involves a minor which constitutes a violation of
329.12prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
329.13threatened sexual abuse which includes the status of a parent or household member
329.14who has committed a violation which requires registration as an offender under section
329.15243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
329.16243.166, subdivision 1b, paragraph (a) or (b).
329.17    (e) "Person responsible for the child's care" means (1) an individual functioning
329.18within the family unit and having responsibilities for the care of the child such as a
329.19parent, guardian, or other person having similar care responsibilities, or (2) an individual
329.20functioning outside the family unit and having responsibilities for the care of the child
329.21such as a teacher, school administrator, other school employees or agents, or other lawful
329.22custodian of a child having either full-time or short-term care responsibilities including,
329.23but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
329.24and coaching.
329.25    (f) "Neglect" means the commission or omission of any of the acts specified under
329.26clauses (1) to (9), other than by accidental means:
329.27    (1) failure by a person responsible for a child's care to supply a child with necessary
329.28food, clothing, shelter, health, medical, or other care required for the child's physical or
329.29mental health when reasonably able to do so;
329.30    (2) failure to protect a child from conditions or actions that seriously endanger the
329.31child's physical or mental health when reasonably able to do so, including a growth delay,
329.32which may be referred to as a failure to thrive, that has been diagnosed by a physician and
329.33is due to parental neglect;
329.34    (3) failure to provide for necessary supervision or child care arrangements
329.35appropriate for a child after considering factors as the child's age, mental ability, physical
330.1condition, length of absence, or environment, when the child is unable to care for the
330.2child's own basic needs or safety, or the basic needs or safety of another child in their care;
330.3    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
330.4260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's
330.5child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
330.6    (5) nothing in this section shall be construed to mean that a child is neglected solely
330.7because the child's parent, guardian, or other person responsible for the child's care in
330.8good faith selects and depends upon spiritual means or prayer for treatment or care of
330.9disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
330.10or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
330.11if a lack of medical care may cause serious danger to the child's health. This section does
330.12not impose upon persons, not otherwise legally responsible for providing a child with
330.13necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
330.14    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
330.15subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
330.16symptoms in the child at birth, results of a toxicology test performed on the mother at
330.17delivery or the child at birth, medical effects or developmental delays during the child's
330.18first year of life that medically indicate prenatal exposure to a controlled substance, or the
330.19presence of a fetal alcohol spectrum disorder;
330.20    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
330.21    (8) chronic and severe use of alcohol or a controlled substance by a parent or
330.22person responsible for the care of the child that adversely affects the child's basic needs
330.23and safety; or
330.24    (9) emotional harm from a pattern of behavior which contributes to impaired
330.25emotional functioning of the child which may be demonstrated by a substantial and
330.26observable effect in the child's behavior, emotional response, or cognition that is not
330.27within the normal range for the child's age and stage of development, with due regard to
330.28the child's culture.
330.29    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
330.30inflicted by a person responsible for the child's care on a child other than by accidental
330.31means, or any physical or mental injury that cannot reasonably be explained by the child's
330.32history of injuries, or any aversive or deprivation procedures, or regulated interventions,
330.33that have not been authorized under section 121A.67 or 245.825.
330.34    Abuse does not include reasonable and moderate physical discipline of a child
330.35administered by a parent or legal guardian which does not result in an injury. Abuse does
330.36not include the use of reasonable force by a teacher, principal, or school employee as
331.1allowed by section 121A.582. Actions which are not reasonable and moderate include,
331.2but are not limited to, any of the following that are done in anger or without regard to the
331.3safety of the child:
331.4    (1) throwing, kicking, burning, biting, or cutting a child;
331.5    (2) striking a child with a closed fist;
331.6    (3) shaking a child under age three;
331.7    (4) striking or other actions which result in any nonaccidental injury to a child
331.8under 18 months of age;
331.9    (5) unreasonable interference with a child's breathing;
331.10    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
331.11    (7) striking a child under age one on the face or head;
331.12    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
331.13substances which were not prescribed for the child by a practitioner, in order to control or
331.14punish the child; or other substances that substantially affect the child's behavior, motor
331.15coordination, or judgment or that results in sickness or internal injury, or subjects the
331.16child to medical procedures that would be unnecessary if the child were not exposed
331.17to the substances;
331.18    (9) unreasonable physical confinement or restraint not permitted under section
331.19609.379 , including but not limited to tying, caging, or chaining; or
331.20    (10) in a school facility or school zone, an act by a person responsible for the child's
331.21care that is a violation under section 121A.58.
331.22    (h) "Report" means any report received by the local welfare agency, police
331.23department, county sheriff, or agency responsible for assessing or investigating
331.24maltreatment pursuant to this section.
331.25    (i) "Facility" means:
331.26    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
331.27sanitarium, or other facility or institution required to be licensed under sections 144.50 to
331.28144.58 , 241.021, or 245A.01 to 245A.16, or chapter 245B 245D;
331.29    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
331.30124D.10 ; or
331.31    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
331.32subdivision 16, and 256B.0625, subdivision 19a.
331.33    (j) "Operator" means an operator or agency as defined in section 245A.02.
331.34    (k) "Commissioner" means the commissioner of human services.
332.1    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
332.2not limited to employee assistance counseling and the provision of guardian ad litem and
332.3parenting time expeditor services.
332.4    (m) "Mental injury" means an injury to the psychological capacity or emotional
332.5stability of a child as evidenced by an observable or substantial impairment in the child's
332.6ability to function within a normal range of performance and behavior with due regard to
332.7the child's culture.
332.8    (n) "Threatened injury" means a statement, overt act, condition, or status that
332.9represents a substantial risk of physical or sexual abuse or mental injury. Threatened
332.10injury includes, but is not limited to, exposing a child to a person responsible for the
332.11child's care, as defined in paragraph (e), clause (1), who has:
332.12    (1) subjected a child to, or failed to protect a child from, an overt act or condition
332.13that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
332.14similar law of another jurisdiction;
332.15    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
332.16(4), or a similar law of another jurisdiction;
332.17    (3) committed an act that has resulted in an involuntary termination of parental rights
332.18under section 260C.301, or a similar law of another jurisdiction; or
332.19    (4) committed an act that has resulted in the involuntary transfer of permanent
332.20legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
332.21260C.201, subdivision 11 , paragraph (d), clause (1), section 260C.515, subdivision 4, or a
332.22similar law of another jurisdiction.
332.23A child is the subject of a report of threatened injury when the responsible social
332.24services agency receives birth match data under paragraph (o) from the Department of
332.25Human Services.
332.26(o) Upon receiving data under section 144.225, subdivision 2b, contained in a
332.27birth record or recognition of parentage identifying a child who is subject to threatened
332.28injury under paragraph (n), the Department of Human Services shall send the data to the
332.29responsible social services agency. The data is known as "birth match" data. Unless the
332.30responsible social services agency has already begun an investigation or assessment of the
332.31report due to the birth of the child or execution of the recognition of parentage and the
332.32parent's previous history with child protection, the agency shall accept the birth match
332.33data as a report under this section. The agency may use either a family assessment or
332.34investigation to determine whether the child is safe. All of the provisions of this section
332.35apply. If the child is determined to be safe, the agency shall consult with the county
332.36attorney to determine the appropriateness of filing a petition alleging the child is in need
333.1of protection or services under section 260C.007, subdivision 6, clause (16), in order to
333.2deliver needed services. If the child is determined not to be safe, the agency and the county
333.3attorney shall take appropriate action as required under section 260C.301, subdivision 3.
333.4    (p) Persons who conduct assessments or investigations under this section shall take
333.5into account accepted child-rearing practices of the culture in which a child participates
333.6and accepted teacher discipline practices, which are not injurious to the child's health,
333.7welfare, and safety.
333.8    (q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
333.9occurrence or event which:
333.10    (1) is not likely to occur and could not have been prevented by exercise of due
333.11care; and
333.12    (2) if occurring while a child is receiving services from a facility, happens when the
333.13facility and the employee or person providing services in the facility are in compliance
333.14with the laws and rules relevant to the occurrence or event.
333.15(r) "Nonmaltreatment mistake" means:
333.16(1) at the time of the incident, the individual was performing duties identified in the
333.17center's child care program plan required under Minnesota Rules, part 9503.0045;
333.18(2) the individual has not been determined responsible for a similar incident that
333.19resulted in a finding of maltreatment for at least seven years;
333.20(3) the individual has not been determined to have committed a similar
333.21nonmaltreatment mistake under this paragraph for at least four years;
333.22(4) any injury to a child resulting from the incident, if treated, is treated only with
333.23remedies that are available over the counter, whether ordered by a medical professional or
333.24not; and
333.25(5) except for the period when the incident occurred, the facility and the individual
333.26providing services were both in compliance with all licensing requirements relevant to the
333.27incident.
333.28This definition only applies to child care centers licensed under Minnesota
333.29Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
333.30substantiated maltreatment by the individual, the commissioner of human services shall
333.31determine that a nonmaltreatment mistake was made by the individual.
333.32EFFECTIVE DATE.This section is effective January 1, 2014.

333.33    Sec. 14. Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:
333.34    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
333.35to believe a child is being neglected or physically or sexually abused, as defined in
334.1subdivision 2, or has been neglected or physically or sexually abused within the preceding
334.2three years, shall immediately report the information to the local welfare agency, agency
334.3responsible for assessing or investigating the report, police department, or the county
334.4sheriff if the person is:
334.5    (1) a professional or professional's delegate who is engaged in the practice of
334.6the healing arts, social services, hospital administration, psychological or psychiatric
334.7treatment, child care, education, correctional supervision, probation and correctional
334.8services, or law enforcement; or
334.9    (2) employed as a member of the clergy and received the information while
334.10engaged in ministerial duties, provided that a member of the clergy is not required by
334.11this subdivision to report information that is otherwise privileged under section 595.02,
334.12subdivision 1 , paragraph (c).
334.13    The police department or the county sheriff, upon receiving a report, shall
334.14immediately notify the local welfare agency or agency responsible for assessing or
334.15investigating the report, orally and in writing. The local welfare agency, or agency
334.16responsible for assessing or investigating the report, upon receiving a report, shall
334.17immediately notify the local police department or the county sheriff orally and in writing.
334.18The county sheriff and the head of every local welfare agency, agency responsible
334.19for assessing or investigating reports, and police department shall each designate a
334.20person within their agency, department, or office who is responsible for ensuring that
334.21the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
334.22this subdivision shall be construed to require more than one report from any institution,
334.23facility, school, or agency.
334.24    (b) Any person may voluntarily report to the local welfare agency, agency responsible
334.25for assessing or investigating the report, police department, or the county sheriff if the
334.26person knows, has reason to believe, or suspects a child is being or has been neglected or
334.27subjected to physical or sexual abuse. The police department or the county sheriff, upon
334.28receiving a report, shall immediately notify the local welfare agency or agency responsible
334.29for assessing or investigating the report, orally and in writing. The local welfare agency or
334.30agency responsible for assessing or investigating the report, upon receiving a report, shall
334.31immediately notify the local police department or the county sheriff orally and in writing.
334.32    (c) A person mandated to report physical or sexual child abuse or neglect occurring
334.33within a licensed facility shall report the information to the agency responsible for
334.34licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
334.35chapter 245B 245D; or a nonlicensed personal care provider organization as defined in
334.36sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections
335.1agency receiving a report may request the local welfare agency to provide assistance
335.2pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees
335.3perform work within a school facility, upon receiving a complaint of alleged maltreatment,
335.4shall provide information about the circumstances of the alleged maltreatment to the
335.5commissioner of education. Section 13.03, subdivision 4, applies to data received by the
335.6commissioner of education from a licensing entity.
335.7    (d) Any person mandated to report shall receive a summary of the disposition of
335.8any report made by that reporter, including whether the case has been opened for child
335.9protection or other services, or if a referral has been made to a community organization,
335.10unless release would be detrimental to the best interests of the child. Any person who is
335.11not mandated to report shall, upon request to the local welfare agency, receive a concise
335.12summary of the disposition of any report made by that reporter, unless release would be
335.13detrimental to the best interests of the child.
335.14    (e) For purposes of this section, "immediately" means as soon as possible but in
335.15no event longer than 24 hours.
335.16EFFECTIVE DATE.This section is effective January 1, 2014.

335.17    Sec. 15. Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:
335.18    Subd. 10d. Notification of neglect or abuse in facility. (a) When a report is
335.19received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while
335.20in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
335.21sanitarium, or other facility or institution required to be licensed according to sections
335.22144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B 245D, or a school as
335.23defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed
335.24personal care provider organization as defined in section 256B.04, subdivision 16, and
335.25256B.0625, subdivision 19a , the commissioner of the agency responsible for assessing
335.26or investigating the report or local welfare agency investigating the report shall provide
335.27the following information to the parent, guardian, or legal custodian of a child alleged to
335.28have been neglected, physically abused, sexually abused, or the victim of maltreatment
335.29of a child in the facility: the name of the facility; the fact that a report alleging neglect,
335.30physical abuse, sexual abuse, or maltreatment of a child in the facility has been received;
335.31the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child
335.32in the facility; that the agency is conducting an assessment or investigation; any protective
335.33or corrective measures being taken pending the outcome of the investigation; and that a
335.34written memorandum will be provided when the investigation is completed.
336.1(b) The commissioner of the agency responsible for assessing or investigating the
336.2report or local welfare agency may also provide the information in paragraph (a) to the
336.3parent, guardian, or legal custodian of any other child in the facility if the investigative
336.4agency knows or has reason to believe the alleged neglect, physical abuse, sexual
336.5abuse, or maltreatment of a child in the facility has occurred. In determining whether
336.6to exercise this authority, the commissioner of the agency responsible for assessing
336.7or investigating the report or local welfare agency shall consider the seriousness of the
336.8alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the
336.9number of children allegedly neglected, physically abused, sexually abused, or victims of
336.10maltreatment of a child in the facility; the number of alleged perpetrators; and the length
336.11of the investigation. The facility shall be notified whenever this discretion is exercised.
336.12(c) When the commissioner of the agency responsible for assessing or investigating
336.13the report or local welfare agency has completed its investigation, every parent, guardian,
336.14or legal custodian previously notified of the investigation by the commissioner or
336.15local welfare agency shall be provided with the following information in a written
336.16memorandum: the name of the facility investigated; the nature of the alleged neglect,
336.17physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's
336.18name; a summary of the investigation findings; a statement whether maltreatment was
336.19found; and the protective or corrective measures that are being or will be taken. The
336.20memorandum shall be written in a manner that protects the identity of the reporter and
336.21the child and shall not contain the name, or to the extent possible, reveal the identity of
336.22the alleged perpetrator or of those interviewed during the investigation. If maltreatment
336.23is determined to exist, the commissioner or local welfare agency shall also provide the
336.24written memorandum to the parent, guardian, or legal custodian of each child in the facility
336.25who had contact with the individual responsible for the maltreatment. When the facility is
336.26the responsible party for maltreatment, the commissioner or local welfare agency shall also
336.27provide the written memorandum to the parent, guardian, or legal custodian of each child
336.28who received services in the population of the facility where the maltreatment occurred.
336.29This notification must be provided to the parent, guardian, or legal custodian of each child
336.30receiving services from the time the maltreatment occurred until either the individual
336.31responsible for maltreatment is no longer in contact with a child or children in the facility
336.32or the conclusion of the investigation. In the case of maltreatment within a school facility,
336.33as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10, the commissioner
336.34of education need not provide notification to parents, guardians, or legal custodians of
336.35each child in the facility, but shall, within ten days after the investigation is completed,
336.36provide written notification to the parent, guardian, or legal custodian of any student
337.1alleged to have been maltreated. The commissioner of education may notify the parent,
337.2guardian, or legal custodian of any student involved as a witness to alleged maltreatment.
337.3EFFECTIVE DATE.This section is effective January 1, 2014.

337.4    Sec. 16. REPEALER.
337.5Minnesota Statutes 2012, section 256B.49, subdivision 16a, is repealed effective
337.6January 1, 2014.


337.9    Section 1. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
337.10    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
337.11must not be reimbursed for more than ten 25 full-day absent days per child, excluding
337.12holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal
337.13nonlicensed family child care providers must not be reimbursed for absent days. If a child
337.14attends for part of the time authorized to be in care in a day, but is absent for part of the
337.15time authorized to be in care in that same day, the absent time must be reimbursed but
337.16the time must not count toward the ten absent day days limit. Child care providers must
337.17only be reimbursed for absent days if the provider has a written policy for child absences
337.18and charges all other families in care for similar absences.
337.19(b) Notwithstanding paragraph (a), children with documented medical conditions
337.20that cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
337.21full-day absent days limit. Absences due to a documented medical condition of a parent
337.22or sibling who lives in the same residence as the child receiving child care assistance
337.23do not count against the absent days limit in a fiscal year. Documentation of medical
337.24conditions must be on the forms and submitted according to the timelines established by
337.25the commissioner. A public health nurse or school nurse may verify the illness in lieu of
337.26a medical practitioner. If a provider sends a child home early due to a medical reason,
337.27including, but not limited to, fever or contagious illness, the child care center director or
337.28lead teacher may verify the illness in lieu of a medical practitioner.
337.29(b) (c) Notwithstanding paragraph (a), children in families may exceed the ten absent
337.30days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school
337.31or general equivalency diploma; and (3) is a student in a school district or another similar
337.32program that provides or arranges for child care, parenting support, social services, career
337.33and employment supports, and academic support to achieve high school graduation, upon
338.1request of the program and approval of the county. If a child attends part of an authorized
338.2day, payment to the provider must be for the full amount of care authorized for that day.
338.3    (c) (d) Child care providers must be reimbursed for up to ten federal or state holidays
338.4or designated holidays per year when the provider charges all families for these days and the
338.5holiday or designated holiday falls on a day when the child is authorized to be in attendance.
338.6Parents may substitute other cultural or religious holidays for the ten recognized state and
338.7federal holidays. Holidays do not count toward the ten absent day days limit.
338.8    (d) (e) A family or child care provider must not be assessed an overpayment for an
338.9absent day payment unless (1) there was an error in the amount of care authorized for the
338.10family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
338.11the family or provider did not timely report a change as required under law.
338.12    (e) (f) The provider and family shall receive notification of the number of absent
338.13days used upon initial provider authorization for a family and ongoing notification of the
338.14number of absent days used as of the date of the notification.
338.15(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent
338.16days per child, excluding holidays, in a fiscal year; and ten consecutive full-day absent days.

338.17    Sec. 2. [214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL
338.18BACKGROUND CHECKS.
338.19    Subdivision 1. Applications. (a) By January 1, 2018, each health-related licensing
338.20board, as defined in section 214.01, subdivision 2, shall require applicants for initial
338.21licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse
338.22in licensure, as defined by the individual health-related licensing boards to submit to
338.23a criminal history records check of state data completed by the Bureau of Criminal
338.24Apprehension (BCA) and a national criminal history records check, including a search of
338.25the records of the Federal Bureau of Investigation (FBI).
338.26(b) An applicant must complete a criminal background check if more than one year
338.27has elapsed since the applicant last submitted a background check to the board.
338.28    Subd. 2. Investigations. If a health-related licensing board has reasonable cause
338.29to believe a licensee has been charged with or convicted of a crime in this or any other
338.30jurisdiction, the health-related licensing board may require the licensee to submit to a
338.31criminal history records check of state data completed by the BCA and a national criminal
338.32history records check, including a search of the records of the FBI.
338.33    Subd. 3. Consent form; fees; fingerprints. In order to effectuate the federal
338.34and state level, fingerprint-based criminal background check, the applicant or licensee
338.35must submit a completed criminal history records check consent form and a full set of
339.1fingerprints to the respective health-related licensing board or a designee in the manner
339.2and form specified by the board. The applicant or licensee is responsible for all fees
339.3associated with preparation of the fingerprints, the criminal records check consent form,
339.4and the criminal background check. The fees for the criminal records background check
339.5shall be set by the BCA and the FBI and are not refundable.
339.6    Subd. 4. Refusal to consent. (a) The health-related licensing boards shall not issue
339.7a license to any applicant who refuses to consent to a criminal background check or fails
339.8to submit fingerprints within 90 days after submission of an application for licensure. Any
339.9fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent
339.10to the criminal background check or fails to submit the required fingerprints.
339.11(b) The failure of a licensee to submit to a criminal background check as provided in
339.12subdivision 3 is grounds for disciplinary action by the respective health licensing board.
339.13    Subd. 5. Submission of fingerprints to BCA. The health-related licensing board
339.14or designee shall submit applicant or licensee fingerprints to the BCA. The BCA shall
339.15perform a check for state criminal justice information and shall forward the applicant's
339.16or licensee's fingerprints to the FBI to perform a check for national criminal justice
339.17information regarding the applicant or licensee. The BCA shall report to the board the
339.18results of the state and national criminal justice information checks.
339.19    Subd. 6. Alternatives to fingerprint-based criminal background checks. The
339.20health-related licensing board may require an alternative method of criminal history
339.21checks for an applicant or licensee who has submitted at least three sets of fingerprints in
339.22accordance with this section that have been unreadable by the BCA or FBI.
339.23    Subd. 7. Opportunity to challenge accuracy of report. Prior to taking disciplinary
339.24action against an applicant or a licensee based on a criminal conviction, the health-related
339.25licensing board shall provide the applicant or licensee an opportunity to complete or
339.26challenge the accuracy of the criminal history information reported to the board. The
339.27applicant or licensee shall have 30 calendar days following notice from the board of the
339.28intent to deny licensure or take disciplinary action to request an opportunity to correct or
339.29complete the record prior to the board taking disciplinary action based on the information
339.30reported to the board. The board shall provide the applicant up to 180 days to challenge
339.31the accuracy or completeness of the report with the agency responsible for the record. This
339.32subdivision does not affect the right of the subject of the data to contest the accuracy or
339.33completeness under section 13.04, subdivision 4.
339.34    Subd. 8. Instructions to the board; plans. The health-related licensing boards, in
339.35collaboration with the commissioner of human services and the BCA, shall establish a
339.36plan for completing criminal background checks of all licensees who were licensed before
340.1the effective date requirement under subdivision 1. The plan must seek to minimize
340.2duplication of requirements for background checks of licensed health professionals. The
340.3plan for background checks of current licensees shall be developed no later than January
340.41, 2017, and may be contingent upon the implementation of a system by the BCA or FBI
340.5in which any new crimes that an applicant or licensee commits after an initial background
340.6check are flagged in the BCA's or FBI's database and reported back to the board. The plan
340.7shall include recommendations for any necessary statutory changes.

340.8    Sec. 3. Minnesota Statutes 2012, section 214.40, subdivision 1, is amended to read:
340.9    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this
340.10section.
340.11(b) "Administrative services unit" means the administrative services unit for the
340.12health-related licensing boards.
340.13(c) "Charitable organization" means a charitable organization within the meaning of
340.14section 501(c)(3) of the Internal Revenue Code that has as a purpose the sponsorship or
340.15support of programs designed to improve the quality, awareness, and availability of health
340.16care services and that serves as a funding mechanism for providing those services.
340.17(d) "Health care facility or organization" means a health care facility licensed under
340.18chapter 144 or 144A, or a charitable organization.
340.19(e) "Health care provider" means a physician licensed under chapter 147, physician
340.20assistant registered and practicing under chapter 147A, nurse licensed and registered to
340.21practice under chapter 148, or dentist or, dental hygienist, dental therapist, or advanced
340.22dental therapist licensed under chapter 150A.
340.23(f) "Health care services" means health promotion, health monitoring, health
340.24education, diagnosis, treatment, minor surgical procedures, the administration of local
340.25anesthesia for the stitching of wounds, and primary dental services, including preventive,
340.26diagnostic, restorative, and emergency treatment. Health care services do not include the
340.27administration of general anesthesia or surgical procedures other than minor surgical
340.28procedures.
340.29(g) "Medical professional liability insurance" means medical malpractice insurance
340.30as defined in section 62F.03.
340.31EFFECTIVE DATE.This section is effective the day following final enactment.

341.1    Sec. 4. Minnesota Statutes 2012, section 245A.1435, is amended to read:
341.2245A.1435 REDUCTION OF RISK OF SUDDEN INFANT DEATH
341.3SYNDROME IN LICENSED PROGRAMS.
341.4    (a) When a license holder is placing an infant to sleep, the license holder must
341.5place the infant on the infant's back, unless the license holder has documentation from
341.6the infant's parent doctor directing an alternative sleeping position for the infant. The
341.7parent doctor directive must be on a form approved by the commissioner and must include
341.8a statement that the parent or legal guardian has read the information provided by the
341.9Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance of
341.10placing an infant or child on its back to sleep to reduce the risk of SIDS remain on file at
341.11the licensed location. An infant who independently rolls over onto its stomach after being
341.12placed to sleep on its back may be allowed to remain on its stomach.
341.13(b) The license holder must place the infant in a crib directly on a firm mattress with
341.14a fitted crib sheet that fits tightly on the mattress and overlaps the underside of the mattress
341.15so it cannot be dislodged by pulling on the corner of the sheet with reasonable effort. The
341.16license holder must not place pillows, quilts, comforters, sheepskin, pillow-like stuffed
341.17toys, or other soft products in the crib with the infant. The requirements of this section
341.18apply to license holders serving infants up to and including 12 months of age younger
341.19than the age of one year. Licensed child care providers must meet the crib requirements
341.20under section 245A.146.

341.21    Sec. 5. Minnesota Statutes 2012, section 246.54, is amended to read:
341.22246.54 LIABILITY OF COUNTY; REIMBURSEMENT.
341.23    Subdivision 1. County portion for cost of care. (a) Except for chemical
341.24dependency services provided under sections 254B.01 to 254B.09, the client's county
341.25shall pay to the state of Minnesota a portion of the cost of care provided in a regional
341.26treatment center or a state nursing facility to a client legally settled in that county. A
341.27county's payment shall be made from the county's own sources of revenue and payments
341.28shall equal a percentage of the cost of care, as determined by the commissioner, for each
341.29day, or the portion thereof, that the client spends at a regional treatment center or a state
341.30nursing facility according to the following schedule:
341.31    (1) zero percent for the first 30 days;
341.32    (2) 20 percent for days 31 to 60; and
341.33    (3) 50 75 percent for any days over 60.
342.1    (b) The increase in the county portion for cost of care under paragraph (a), clause
342.2(3), shall be imposed when the treatment facility has determined that it is clinically
342.3appropriate for the client to be discharged.
342.4    (c) If payments received by the state under sections 246.50 to 246.53 exceed 80
342.5percent of the cost of care for days 31 to 60, or 50 25 percent for days over 60, the county
342.6shall be responsible for paying the state only the remaining amount. The county shall
342.7not be entitled to reimbursement from the client, the client's estate, or from the client's
342.8relatives, except as provided in section 246.53.
342.9    Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
342.10Minnesota Security Hospital or the Minnesota extended treatment options program. For
342.11services at these facilities the Minnesota Security Hospital, a county's payment shall be
342.12made from the county's own sources of revenue and payments shall be paid as follows:.
342.13Excluding the state-operated forensic transition service, payments to the state from the
342.14county shall equal ten percent of the cost of care, as determined by the commissioner, for
342.15each day, or the portion thereof, that the client spends at the facility. For the state-operated
342.16forensic transition service, payments to the state from the county shall equal 50 percent of
342.17the cost of care, as determined by the commissioner, for each day, or the portion thereof,
342.18that the client spends in the program. If payments received by the state under sections
342.19246.50 to 246.53 for services provided at the Minnesota Security Hospital, excluding the
342.20state-operated forensic transition service, exceed 90 percent of the cost of care, the county
342.21shall be responsible for paying the state only the remaining amount. If payments received
342.22by the state under sections 246.50 to 246.53 for the state-operated forensic transition service
342.23exceed 50 percent of the cost of care, the county shall be responsible for paying the state
342.24only the remaining amount. The county shall not be entitled to reimbursement from the
342.25client, the client's estate, or from the client's relatives, except as provided in section 246.53.
342.26    (b) Regardless of the facility to which the client is committed, subdivision 1 does
342.27not apply to the following individuals:
342.28    (1) clients who are committed as mentally ill and dangerous under section 253B.02,
342.29subdivision 17;
342.30    (2) (1) clients who are committed as sexual psychopathic personalities under section
342.31253B.02, subdivision 18b ; and
342.32    (3) (2) clients who are committed as sexually dangerous persons under section
342.33253B.02 , subdivision 18c.
342.34    For each of the individuals in clauses (1) to (3), the payment by the county to the state
342.35shall equal ten percent of the cost of care for each day as determined by the commissioner.

343.1    Sec. 6. [256.999] CULTURAL AND ETHNIC COMMUNITIES LEADERSHIP
343.2COUNCIL.
343.3    Subdivision 1. Establishment; purpose. There is hereby established the Cultural
343.4and Ethnic Communities Leadership Council for the Department of Human Services. The
343.5purpose of the council is to advise the commissioner of human services on reducing
343.6disparities that affect racial and ethnic groups.
343.7    Subd. 2. Members. (a) The council must consist of no fewer than 15 and no more
343.8than 25 members appointed by the commissioner of human services, in consultation with
343.9county, tribal, cultural, and ethnic communities; diverse program participants; and parent
343.10representatives from these communities. The commissioner shall direct the development
343.11of guidelines defining the membership of the council; setting out definitions; and
343.12developing duties of the commissioner, the council, and council members regarding racial
343.13and ethnic disparities reduction. The guidelines must be developed in consultation with:
343.14(1) the chairs of relevant committees; and
343.15(2) county, tribal, and cultural communities and program participants from these
343.16communities.
343.17(b) Members must be appointed to allow for representation of the following groups:
343.18(1) racial and ethnic minority groups;
343.19(2) tribal service providers;
343.20(3) culturally and linguistically specific advocacy groups and service providers;
343.21(4) human services program participants;
343.22(5) public and private institutions;
343.23(6) parents of human services program participants;
343.24(7) members of the faith community;
343.25(8) Department of Human Services employees;
343.26(9) chairs of relevant legislative committees; and
343.27(10) any other group the commissioner deems appropriate to facilitate the goals
343.28and duties of the council.
343.29(c) Each member of the council must be appointed to either a one-year or two-year
343.30term. The commissioner shall appoint one member as chair.
343.31(d) Notwithstanding section 15.059, members of the council shall receive no
343.32compensation for their services.
343.33    Subd. 3. Duties of commissioner. (a) The commissioner of human services or the
343.34commissioner's designee shall:
343.35(1) maintain the council established in this section;
344.1(2) supervise and coordinate policies for persons from racial, ethnic, cultural,
344.2linguistic, and tribal communities who experience disparities in access and outcomes;
344.3(3) identify human services rules or statutes affecting persons from racial, ethnic,
344.4cultural, linguistic, and tribal communities that may need to be revised;
344.5(4) investigate and implement cost-effective models of service delivery such as
344.6careful adaptation of clinically proven services that constitute one strategy for increasing
344.7the number of culturally relevant services available to currently underserved populations;
344.8(5) based on recommendations of the council, review identified department
344.9policies that maintain racial, ethnic, cultural, linguistic, and tribal disparities, and make
344.10adjustments to ensure those disparities are not perpetuated; and
344.11(6) based on recommendations of the council, submit legislation to reduce disparities
344.12affecting racial and ethnic groups, increase access to programs, and promote better
344.13outcomes.
344.14(b) The commissioner of human services or the commissioner's designee shall
344.15consult with the council and receive recommendations from the council when meeting
344.16the requirements of this section.
344.17    Subd. 4. Duties of council. The Cultural and Ethnic Communities Leadership
344.18Council shall:
344.19(1) recommend to the commissioner for review identified policies in the Department
344.20of Human Services that maintain racial, ethnic, cultural, linguistic, and tribal disparities;
344.21(2) identify issues regarding disparities by engaging diverse populations in human
344.22services programs;
344.23(3) engage in mutual learning essential for achieving human services parity and
344.24optimal wellness for service recipients;
344.25(4) raise awareness about human services disparities to the legislature and media;
344.26(5) provide technical assistance and consultation support to counties, private
344.27nonprofit agencies, and other service providers to build their capacity to provide equitable
344.28human services for persons from racial, ethnic, cultural, linguistic, and tribal communities
344.29who experience disparities in access and outcomes;
344.30(6) provide technical assistance to promote statewide development of culturally
344.31and linguistically appropriate, accessible, and cost-effective human services and related
344.32policies;
344.33(7) provide training and outreach to facilitate access to culturally and linguistically
344.34appropriate, accessible, and cost-effective human services to prevent disparities;
344.35(8) facilitate culturally appropriate and culturally sensitive admissions, continued
344.36services, discharges, and utilization review for human services agencies and institutions;
345.1(9) form work groups to help carry out the duties of the council that include, but are
345.2not limited to, persons who provide and receive services and representatives of advocacy
345.3groups, and provide the work groups with clear guidelines, standardized parameters, and
345.4tasks for the work groups to accomplish; and
345.5(10) promote information-sharing in the human services community and statewide.
345.6    Subd. 5. Duties of council members. The members of the council shall:
345.7(1) attend and participate in scheduled meetings and be prepared by reviewing
345.8meeting notes;
345.9(2) maintain open communication channels with respective constituencies;
345.10(3) identify and communicate issues and risks that could impact the timely
345.11completion of tasks;
345.12(4) collaborate on disparity reduction efforts;
345.13(5) communicate updates of the council's work progress and status on the
345.14Department of Human Services Web site; and
345.15(6) participate in any activities the council or chair deem appropriate and necessary
345.16to facilitate the goals and duties of the council.
345.17    Subd. 6. Expiration. Notwithstanding section 15.059, the council does not expire
345.18unless directed by the commissioner.

345.19    Sec. 7. Minnesota Statutes 2012, section 256I.04, subdivision 3, is amended to read:
345.20    Subd. 3. Moratorium on development of group residential housing beds. (a)
345.21County agencies shall not enter into agreements for new group residential housing beds
345.22with total rates in excess of the MSA equivalent rate except:
345.23(1) for group residential housing establishments licensed under Minnesota Rules,
345.24parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction
345.25targets for persons with developmental disabilities at regional treatment centers;
345.26(2) to ensure compliance with the federal Omnibus Budget Reconciliation Act
345.27alternative disposition plan requirements for inappropriately placed persons with
345.28developmental disabilities or mental illness;
345.29(3) up to 80 beds in a single, specialized facility located in Hennepin County that will
345.30provide housing for chronic inebriates who are repetitive users of detoxification centers
345.31and are refused placement in emergency shelters because of their state of intoxication,
345.32and planning for the specialized facility must have been initiated before July 1, 1991,
345.33in anticipation of receiving a grant from the Housing Finance Agency under section
345.34462A.05, subdivision 20a , paragraph (b);
346.1(4) notwithstanding the provisions of subdivision 2a, for up to 190 supportive
346.2housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a
346.3mental illness, a history of substance abuse, or human immunodeficiency virus or acquired
346.4immunodeficiency syndrome. For purposes of this section, "homeless adult" means a
346.5person who is living on the street or in a shelter or discharged from a regional treatment
346.6center, community hospital, or residential treatment program and has no appropriate
346.7housing available and lacks the resources and support necessary to access appropriate
346.8housing. At least 70 percent of the supportive housing units must serve homeless adults
346.9with mental illness, substance abuse problems, or human immunodeficiency virus or
346.10acquired immunodeficiency syndrome who are about to be or, within the previous six
346.11months, has been discharged from a regional treatment center, or a state-contracted
346.12psychiatric bed in a community hospital, or a residential mental health or chemical
346.13dependency treatment program. If a person meets the requirements of subdivision 1,
346.14paragraph (a), and receives a federal or state housing subsidy, the group residential housing
346.15rate for that person is limited to the supplementary rate under section 256I.05, subdivision
346.161a , and is determined by subtracting the amount of the person's countable income that
346.17exceeds the MSA equivalent rate from the group residential housing supplementary rate.
346.18A resident in a demonstration project site who no longer participates in the demonstration
346.19program shall retain eligibility for a group residential housing payment in an amount
346.20determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service
346.21funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching
346.22funds are available and the services can be provided through a managed care entity. If
346.23federal matching funds are not available, then service funding will continue under section
346.24256I.05, subdivision 1a ;
346.25(5) for group residential housing beds in settings meeting the requirements of
346.26subdivision 2a, clauses (1) and (3), which are used exclusively for recipients receiving
346.27home and community-based waiver services under sections 256B.0915, 256B.092,
346.28subdivision 5 , 256B.093, and 256B.49, and who resided in a nursing facility for the six
346.29months immediately prior to the month of entry into the group residential housing setting.
346.30The group residential housing rate for these beds must be set so that the monthly group
346.31residential housing payment for an individual occupying the bed when combined with the
346.32nonfederal share of services delivered under the waiver for that person does not exceed the
346.33nonfederal share of the monthly medical assistance payment made for the person to the
346.34nursing facility in which the person resided prior to entry into the group residential housing
346.35establishment. The rate may not exceed the MSA equivalent rate plus $426.37 for any case;
347.1(6) for an additional two beds, resulting in a total of 32 beds, for a facility located in
347.2Hennepin County providing services for recovering and chemically dependent men that
347.3has had a group residential housing contract with the county and has been licensed as a
347.4board and lodge facility with special services since 1980;
347.5(7) for a group residential housing provider located in the city of St. Cloud, or a county
347.6contiguous to the city of St. Cloud, that operates a 40-bed facility, that received financing
347.7through the Minnesota Housing Finance Agency Ending Long-Term Homelessness
347.8Initiative and serves chemically dependent clientele, providing 24-hour-a-day supervision;
347.9(8) for a new 65-bed facility in Crow Wing County that will serve chemically
347.10dependent persons, operated by a group residential housing provider that currently
347.11operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
347.12(9) for a group residential housing provider that operates two ten-bed facilities, one
347.13located in Hennepin County and one located in Ramsey County, that provide community
347.14support and 24-hour-a-day supervision to serve the mental health needs of individuals
347.15who have chronically lived unsheltered; and
347.16(10) for a group residential facility in Hennepin County with a capacity of up to 48
347.17beds that has been licensed since 1978 as a board and lodging facility and that until August
347.181, 2007, operated as a licensed chemical dependency treatment program.
347.19    (b) A county agency may enter into a group residential housing agreement for beds
347.20with rates in excess of the MSA equivalent rate in addition to those currently covered
347.21under a group residential housing agreement if the additional beds are only a replacement
347.22of beds with rates in excess of the MSA equivalent rate which have been made available
347.23due to closure of a setting, a change of licensure or certification which removes the beds
347.24from group residential housing payment, or as a result of the downsizing of a group
347.25residential housing setting. The transfer of available beds from one county to another can
347.26only occur by the agreement of both counties.
347.27(c) Effective July 1, 2013, 35 beds with rates in excess of the MSA-equivalent rate
347.28must be designated for youth victims of sex trafficking.

347.29    Sec. 8. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:
347.30    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
347.31provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
347.32negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
347.33exceed $700 per month, including any legislatively authorized inflationary adjustments,
347.34for a group residential housing provider that:
348.1(1) is located in Hennepin County and has had a group residential housing contract
348.2with the county since June 1996;
348.3(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
348.426-bed facility; and
348.5(3) serves a chemically dependent clientele, providing 24 hours per day supervision
348.6and limiting a resident's maximum length of stay to 13 months out of a consecutive
348.724-month period.
348.8(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
348.9supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
348.10per month, including any legislatively authorized inflationary adjustments, of a group
348.11residential provider that:
348.12(1) is located in St. Louis County and has had a group residential housing contract
348.13with the county since 2006;
348.14(2) operates a 62-bed facility; and
348.15(3) serves a chemically dependent adult male clientele, providing 24 hours per
348.16day supervision and limiting a resident's maximum length of stay to 13 months out of
348.17a consecutive 24-month period.
348.18(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
348.19shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
348.20to exceed $700 per month, including any legislatively authorized inflationary adjustments,
348.21for the group residential provider described under paragraphs (a) and (b), not to exceed
348.22an additional 115 beds.

348.23    Sec. 9. Minnesota Statutes 2012, section 256J.35, is amended to read:
348.24256J.35 AMOUNT OF ASSISTANCE PAYMENT.
348.25Except as provided in paragraphs (a) to (c) (d), the amount of an assistance payment
348.26is equal to the difference between the MFIP standard of need or the Minnesota family
348.27wage level in section 256J.24 and countable income.
348.28(a) When MFIP eligibility exists for the month of application, the amount of the
348.29assistance payment for the month of application must be prorated from the date of
348.30application or the date all other eligibility factors are met for that applicant, whichever is
348.31later. This provision applies when an applicant loses at least one day of MFIP eligibility.
348.32(b) MFIP overpayments to an assistance unit must be recouped according to section
348.33256J.38, subdivision 4 .
348.34(c) An initial assistance payment must not be made to an applicant who is not
348.35eligible on the date payment is made.
349.1(d) MFIP assistance units whose housing costs exceed 50 percent of their monthly
349.2cash grant are eligible for an additional cash amount in the form of a housing assistance
349.3grant. The housing assistance grant must be equal to 50 percent of the difference between
349.4the assistance unit's cash grant and its housing costs, with a maximum housing assistance
349.5grant of $250 per month. MFIP assistance units must report their housing costs to the lead
349.6agency on the forms and according to the timelines established by the commissioner.
349.7EFFECTIVE DATE.This section is effective December 1, 2013.

349.8    Sec. 10. Minnesota Statutes 2012, section 256K.45, is amended to read:
349.9256K.45 RUNAWAY AND HOMELESS YOUTH ACT.
349.10    Subdivision 1. Mission. The mission of the Homeless Youth Act is to reduce
349.11the incidence of homelessness among youth by providing integrated and supportive
349.12services and housing to homeless youth, youth at risk of homelessness, and runaways.
349.13The commissioner shall establish a Homeless Youth Act fund and award grants to
349.14providers who are committed to serving homeless youth, to provide street and community
349.15outreach and drop-in programs, emergency shelter programs, and supportive housing and
349.16transitional living programs, consistent with the program descriptions in this act.
349.17    Subd. 1a. Definitions. (a) The definitions in this subdivision apply to this section.
349.18(b) "Commissioner" means the commissioner of human services.
349.19(c) "Homeless youth" means a person 21 years of age or younger who is
349.20unaccompanied by a parent or guardian and is without shelter where appropriate care and
349.21supervision are available, whose parent or legal guardian is unable or unwilling to provide
349.22shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
349.23following are not fixed, regular, or adequate nighttime residences:
349.24(1) a supervised publicly or privately operated shelter designed to provide temporary
349.25living accommodations;
349.26(2) an institution or a publicly or privately operated shelter designed to provide
349.27temporary living accommodations;
349.28(3) transitional housing;
349.29(4) a temporary placement with a peer, friend, or family member that has not offered
349.30permanent residence, a residential lease, or temporary lodging for more than 30 days; or
349.31(5) a public or private place not designed for, nor ordinarily used as, a regular
349.32sleeping accommodation for human beings.
349.33Homeless youth does not include persons incarcerated or otherwise detained under
349.34federal or state law.
350.1(d) "Youth at risk of homelessness" means a person 21 years of age or younger
350.2whose status or circumstances indicate a significant danger of experiencing homelessness
350.3in the near future. Status or circumstances that indicate a significant danger may include:
350.4(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
350.5youth whose parents or primary caregivers are or were previously homeless; (4) youth
350.6who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
350.7with parents due to chemical or alcohol dependency, mental health disabilities, or other
350.8disabilities; and (6) runaways.
350.9(e) "Runaway" means an unmarried child under the age of 18 years who is absent
350.10from the home of a parent or guardian or other lawful placement without the consent of
350.11the parent, guardian, or lawful custodian.
350.12    Subd. 2. Homeless and runaway youth report. The commissioner shall develop a
350.13report for homeless youth, youth at risk of homelessness, and runaways. The report shall
350.14include coordination of services as defined under subdivisions 3 to 5.
350.15    Subd. 3. Street and community outreach and drop-in program. Youth drop-in
350.16centers must provide walk-in access to crisis intervention and ongoing supportive services
350.17including one-to-one case management services on a self-referral basis. Street and
350.18community outreach programs must locate, contact, and provide information, referrals,
350.19and services to homeless youth, youth at risk of homelessness, and runaways. Information,
350.20referrals, and services provided may include, but are not limited to:
350.21(1) family reunification services;
350.22(2) conflict resolution or mediation counseling;
350.23(3) assistance in obtaining temporary emergency shelter;
350.24(4) assistance in obtaining food, clothing, medical care, or mental health counseling;
350.25(5) counseling regarding violence, prostitution, substance abuse, sexually transmitted
350.26diseases, and pregnancy;
350.27(6) referrals to other agencies that provide support services to homeless youth,
350.28youth at risk of homelessness, and runaways;
350.29(7) assistance with education, employment, and independent living skills;
350.30(8) aftercare services;
350.31(9) specialized services for highly vulnerable runaways and homeless youth,
350.32including teen parents, emotionally disturbed and mentally ill youth, and sexually
350.33exploited youth; and
350.34(10) homelessness prevention.
350.35    Subd. 4. Emergency shelter program. (a) Emergency shelter programs must
350.36provide homeless youth and runaways with referral and walk-in access to emergency,
351.1short-term residential care. The program shall provide homeless youth and runaways with
351.2safe, dignified shelter, including private shower facilities, beds, and at least one meal each
351.3day; and shall assist a runaway and homeless youth with reunification with the family or
351.4legal guardian when required or appropriate.
351.5(b) The services provided at emergency shelters may include, but are not limited to:
351.6(1) family reunification services;
351.7(2) individual, family, and group counseling;
351.8(3) assistance obtaining clothing;
351.9(4) access to medical and dental care and mental health counseling;
351.10(5) education and employment services;
351.11(6) recreational activities;
351.12(7) advocacy and referral services;
351.13(8) independent living skills training;
351.14(9) aftercare and follow-up services;
351.15(10) transportation; and
351.16(11) homelessness prevention.
351.17    Subd. 5. Supportive housing and transitional living programs. Transitional
351.18living programs must help homeless youth and youth at risk of homelessness to find and
351.19maintain safe, dignified housing. The program may also provide rental assistance and
351.20related supportive services, or refer youth to other organizations or agencies that provide
351.21such services. Services provided may include, but are not limited to:
351.22(1) educational assessment and referrals to educational programs;
351.23(2) career planning, employment, work skill training, and independent living skills
351.24training;
351.25(3) job placement;
351.26(4) budgeting and money management;
351.27(5) assistance in securing housing appropriate to needs and income;
351.28(6) counseling regarding violence, prostitution, substance abuse, sexually transmitted
351.29diseases, and pregnancy;
351.30(7) referral for medical services or chemical dependency treatment;
351.31(8) parenting skills;
351.32(9) self-sufficiency support services or life skill training;
351.33(10) aftercare and follow-up services; and
351.34(11) homelessness prevention.
351.35    Subd. 6. Funding. Any Funds appropriated for this section may be expended on
351.36programs described under subdivisions 3 to 5, technical assistance, and capacity building.
352.1Up to four percent of funds appropriated may be used for the purpose of monitoring and
352.2evaluating runaway and homeless youth programs receiving funding under this section.
352.3Funding shall be directed to meet the greatest need, with a significant share of the funding
352.4focused on homeless youth providers in greater Minnesota to meet the greatest need
352.5on a statewide basis.

352.6    Sec. 11. Minnesota Statutes 2012, section 257.0755, subdivision 1, is amended to read:
352.7    Subdivision 1. Creation. One Each ombudsperson shall operate independently from
352.8but in collaboration with each of the following groups the community-specific board that
352.9appointed the ombudsperson under section 257.0768: the Indian Affairs Council, the
352.10Council on Affairs of Chicano/Latino people, the Council on Black Minnesotans, and
352.11the Council on Asian-Pacific Minnesotans.

352.12    Sec. 12. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:
352.13    Subd. 6. Delinquent child. (a) Except as otherwise provided in paragraphs (b)
352.14and (c), "delinquent child" means a child:
352.15    (1) who has violated any state or local law, except as provided in section 260B.225,
352.16subdivision 1 , and except for juvenile offenders as described in subdivisions 16 to 18;
352.17    (2) who has violated a federal law or a law of another state and whose case has been
352.18referred to the juvenile court if the violation would be an act of delinquency if committed
352.19in this state or a crime or offense if committed by an adult;
352.20    (3) who has escaped from confinement to a state juvenile correctional facility after
352.21being committed to the custody of the commissioner of corrections; or
352.22    (4) who has escaped from confinement to a local juvenile correctional facility after
352.23being committed to the facility by the court.
352.24    (b) The term delinquent child does not include a child alleged to have committed
352.25murder in the first degree after becoming 16 years of age, but the term delinquent child
352.26does include a child alleged to have committed attempted murder in the first degree.
352.27    (c) The term delinquent child does not include a child under the age of 16 years
352.28 alleged to have engaged in conduct which would, if committed by an adult, violate any
352.29federal, state, or local law relating to being hired, offering to be hired, or agreeing to be
352.30hired by another individual to engage in sexual penetration or sexual conduct.
352.31EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
352.32offenses committed on or after that date.

352.33    Sec. 13. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:
353.1    Subd. 16. Juvenile petty offender; juvenile petty offense. (a) "Juvenile petty
353.2offense" includes a juvenile alcohol offense, a juvenile controlled substance offense,
353.3a violation of section 609.685, or a violation of a local ordinance, which by its terms
353.4prohibits conduct by a child under the age of 18 years which would be lawful conduct if
353.5committed by an adult.
353.6    (b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also
353.7includes an offense that would be a misdemeanor if committed by an adult.
353.8    (c) "Juvenile petty offense" does not include any of the following:
353.9    (1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242,
353.10609.324 , subdivision 2 or 3, 609.5632, 609.576, 609.66, 609.746, 609.748, 609.79,
353.11or 617.23;
353.12    (2) a major traffic offense or an adult court traffic offense, as described in section
353.13260B.225 ;
353.14    (3) a misdemeanor-level offense committed by a child whom the juvenile court
353.15previously has found to have committed a misdemeanor, gross misdemeanor, or felony
353.16offense; or
353.17    (4) a misdemeanor-level offense committed by a child whom the juvenile court
353.18has found to have committed a misdemeanor-level juvenile petty offense on two or
353.19more prior occasions, unless the county attorney designates the child on the petition
353.20as a juvenile petty offender notwithstanding this prior record. As used in this clause,
353.21"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that
353.22would have been a juvenile petty offense if it had been committed on or after July 1, 1995.
353.23    (d) A child who commits a juvenile petty offense is a "juvenile petty offender." The
353.24term juvenile petty offender does not include a child under the age of 16 years alleged
353.25to have violated any law relating to being hired, offering to be hired, or agreeing to be
353.26hired by another individual to engage in sexual penetration or sexual conduct which, if
353.27committed by an adult, would be a misdemeanor.
353.28EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
353.29offenses committed on or after that date.

353.30    Sec. 14. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:
353.31    Subd. 6. Child in need of protection or services. "Child in need of protection or
353.32services" means a child who is in need of protection or services because the child:
353.33    (1) is abandoned or without parent, guardian, or custodian;
353.34    (2)(i) has been a victim of physical or sexual abuse as defined in section 626.556,
353.35subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in
354.1subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
354.2would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or
354.3child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment
354.4as defined in subdivision 15;
354.5    (3) is without necessary food, clothing, shelter, education, or other required care
354.6for the child's physical or mental health or morals because the child's parent, guardian,
354.7or custodian is unable or unwilling to provide that care;
354.8    (4) is without the special care made necessary by a physical, mental, or emotional
354.9condition because the child's parent, guardian, or custodian is unable or unwilling to
354.10provide that care;
354.11    (5) is medically neglected, which includes, but is not limited to, the withholding of
354.12medically indicated treatment from a disabled infant with a life-threatening condition. The
354.13term "withholding of medically indicated treatment" means the failure to respond to the
354.14infant's life-threatening conditions by providing treatment, including appropriate nutrition,
354.15hydration, and medication which, in the treating physician's or physicians' reasonable
354.16medical judgment, will be most likely to be effective in ameliorating or correcting all
354.17conditions, except that the term does not include the failure to provide treatment other
354.18than appropriate nutrition, hydration, or medication to an infant when, in the treating
354.19physician's or physicians' reasonable medical judgment:
354.20    (i) the infant is chronically and irreversibly comatose;
354.21    (ii) the provision of the treatment would merely prolong dying, not be effective in
354.22ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
354.23futile in terms of the survival of the infant; or
354.24    (iii) the provision of the treatment would be virtually futile in terms of the survival
354.25of the infant and the treatment itself under the circumstances would be inhumane;
354.26    (6) is one whose parent, guardian, or other custodian for good cause desires to be
354.27relieved of the child's care and custody, including a child who entered foster care under a
354.28voluntary placement agreement between the parent and the responsible social services
354.29agency under section 260C.227;
354.30    (7) has been placed for adoption or care in violation of law;
354.31    (8) is without proper parental care because of the emotional, mental, or physical
354.32disability, or state of immaturity of the child's parent, guardian, or other custodian;
354.33    (9) is one whose behavior, condition, or environment is such as to be injurious or
354.34dangerous to the child or others. An injurious or dangerous environment may include, but
354.35is not limited to, the exposure of a child to criminal activity in the child's home;
355.1    (10) is experiencing growth delays, which may be referred to as failure to thrive, that
355.2have been diagnosed by a physician and are due to parental neglect;
355.3    (11) has engaged in prostitution as defined in section 609.321, subdivision 9 is a
355.4sexually exploited youth;
355.5    (12) has committed a delinquent act or a juvenile petty offense before becoming
355.6ten years old;
355.7    (13) is a runaway;
355.8    (14) is a habitual truant;
355.9    (15) has been found incompetent to proceed or has been found not guilty by reason
355.10of mental illness or mental deficiency in connection with a delinquency proceeding, a
355.11certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
355.12proceeding involving a juvenile petty offense; or
355.13    (16) has a parent whose parental rights to one or more other children were
355.14involuntarily terminated or whose custodial rights to another child have been involuntarily
355.15transferred to a relative and there is a case plan prepared by the responsible social services
355.16agency documenting a compelling reason why filing the termination of parental rights
355.17petition under section 260C.301, subdivision 3, is not in the best interests of the child; or.
355.18    (17) is a sexually exploited youth.
355.19EFFECTIVE DATE.This section is effective August 1, 2014.

355.20    Sec. 15. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:
355.21    Subd. 31. Sexually exploited youth. "Sexually exploited youth" means an
355.22individual who:
355.23    (1) is alleged to have engaged in conduct which would, if committed by an adult,
355.24violate any federal, state, or local law relating to being hired, offering to be hired, or
355.25agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;
355.26    (2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
355.27609.3451 , 609.3453, 609.352, 617.246, or 617.247;
355.28    (3) is a victim of a crime described in United States Code, title 18, section 2260;
355.292421; 2422; 2423; 2425; 2425A; or 2256; or
355.30    (4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.
355.31EFFECTIVE DATE.This section is effective the day following final enactment.

355.32    Sec. 16. Laws 1998, chapter 407, article 6, section 116, is amended to read:
355.33    Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
356.1    The commissioner of human services shall request and receive approval from the
356.2legislature before adjusting the payment to not subsidize retailers for electronic benefit
356.3transfer transaction costs Supplemental Nutrition Assistance Program transactions.
356.4EFFECTIVE DATE.This section is effective 30 days after the commissioner
356.5notifies retailers of the termination of their agreement with the state. The commissioner of
356.6human services must notify the revisor of statutes of that date.

356.7    Sec. 17. INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO
356.8CRIMINAL BACKGROUND CHECKS.
356.9(a) If the Department of Health is not reviewed by the Sunset Advisory Commission
356.10according to the schedule in Minnesota Statutes, section 3D.21, the commissioner
356.11of health, as the regulator for occupational therapy practitioners, speech-language
356.12pathologists, audiologists, and hearing instrument dispensers, shall require applicants
356.13for licensure or renewal to submit to a criminal history records check as required under
356.14Minnesota Statutes, section 214.075, for other health-related licensed occupations
356.15regulated by the health-related licensing boards.
356.16(b) Any statutory changes necessary to include the commissioner of health to
356.17Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota
356.18Statutes, section 214.075, subdivision 8.

356.19    Sec. 18. DIRECTION TO COMMISSIONERS; INCOME AND ASSET
356.20EXCLUSION.
356.21(a) The commissioner of human services shall not count conditional cash transfers
356.22made to families participating in a family independence demonstration as income or
356.23assets for purposes of determining or redetermining eligibility for child care assistance
356.24programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota
356.25Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I;
356.26the Minnesota family investment program, work benefit program, or diversionary work
356.27program under Minnesota Statutes, chapter 256J; or the MinnesotaCare program under
356.28Minnesota Statutes, chapter 256L, during the duration of the demonstration.
356.29(b) The commissioner of human services shall not count conditional cash transfers
356.30made to families participating in a family independence demonstration as income or assets
356.31for purposes of determining or redetermining eligibility for medical assistance, except
356.32that for enrollees subject to a modified adjusted gross income calculation to determine
356.33eligibility, the conditional cash transfer payments shall be counted as income if they are
357.1included on the enrollee's federal tax return as income or if the payments can be taken into
357.2account in the month of receipt as a lump sum payment.
357.3(c) The commissioner of the Minnesota Housing Finance Agency shall not count
357.4conditional cash transfers made to families participating in a family independence
357.5demonstration as income or assets for purposes of determining or redetermining eligibility
357.6for housing assistance programs under Minnesota Statutes, section 462A.201, during the
357.7duration of the demonstration. For purposes of this section:
357.8(1) "conditional cash transfer" means a payment made to a participant in a family
357.9independence demonstration by a sponsoring organization to incent, support, or facilitate
357.10participation; and
357.11(2) "family independence demonstration" means an initiative sponsored or
357.12cosponsored by a governmental or nongovernmental organization, the goal of which is
357.13to facilitate individualized goal setting and peer support for cohorts of no more than 12
357.14families each toward the development of financial and nonfinancial assets that enable the
357.15participating families to achieve financial independence.

357.16    Sec. 19. REPEALER.
357.17(a) Minnesota Statutes 2012, sections 256J.24, subdivision 6; and 256K.45,
357.18subdivision 2, are repealed.
357.19(b) Minnesota Statutes 2012, section 609.093, is repealed.
357.20EFFECTIVE DATE.Paragraph (b) is effective the day following final enactment.


357.23    Section 1. Minnesota Statutes 2012, section 144.051, is amended by adding a
357.24subdivision to read:
357.25    Subd. 3. Data classification; private data. For providers regulated pursuant to
357.26sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
357.27commissioner are classified as "private data" as defined in section 13.02, subdivision 12:
357.28(1) data submitted by or on behalf of applicants for licenses prior to issuance of
357.29the license;
357.30(2) the identity of complainants who have made reports concerning licensees or
357.31applicants unless the complainant consents to the disclosure;
357.32(3) the identity of individuals who provide information as part of surveys and
357.33investigations;
358.1(4) Social Security numbers; and
358.2(5) health record data.

358.3    Sec. 2. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
358.4to read:
358.5    Subd. 4. Data classification; public data. For providers regulated pursuant to
358.6sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
358.7commissioner are classified as "public data" as defined in section 13.02, subdivision 15:
358.8(1) all application data on licensees, license numbers, license status;
358.9(2) licensing information about licenses previously held under this chapter;
358.10(3) correction orders, including information about compliance with the order and
358.11whether the fine was paid;
358.12(4) final enforcement actions pursuant to chapter 14;
358.13(5) orders for hearing, findings of fact and conclusions of law; and
358.14(6) when the licensee and department agree to resolve the matter without a hearing,
358.15the agreement and specific reasons for the agreement are public data.

358.16    Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
358.17to read:
358.18    Subd. 5. Data classification; confidential data. For providers regulated pursuant to
358.19sections 144A.43 to 144A.482, the following data collected, created, or maintained by
358.20the Department of Health are classified as "confidential data" as defined in section 13.02,
358.21subdivision 3: active investigative data relating to the investigation of potential violations
358.22of law by licensee including data from the survey process before the correction order is
358.23issued by the department.

358.24    Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
358.25to read:
358.26    Subd. 6. Release of private or confidential data. For providers regulated pursuant
358.27to sections 144A.43 to 144A.482, the department may release private or confidential
358.28data, except Social Security numbers, to the appropriate state, federal, or local agency
358.29and law enforcement office to enhance investigative or enforcement efforts or further
358.30public health protective process. Types of offices include, but are not limited to, Adult
358.31Protective Services, Office of the Ombudsmen for Long-Term Care and Office of the
358.32Ombudsmen for Mental Health and Developmental Disabilities, the health licensing
359.1boards, Department of Human Services, county or city attorney's offices, police, and local
359.2or county public health offices.

359.3    Sec. 5. Minnesota Statutes 2012, section 144A.43, is amended to read:
359.4144A.43 DEFINITIONS.
359.5    Subdivision 1. Applicability. The definitions in this section apply to sections
359.6144.699, subdivision 2 , and 144A.43 to 144A.47 144A.482.
359.7    Subd. 1a. Agent. "Agent" means the person upon whom all notices and orders shall
359.8be served and who is authorized to accept service of notices and orders on behalf of
359.9the home care provider.
359.10    Subd. 1b. Applicant. "Applicant" means an individual, organization, association,
359.11corporation, unit of government, or other entity that applies for a temporary license,
359.12license, or renewal of their home care provider license under section 144A.472.
359.13    Subd. 1c. Client. "Client" means a person to whom home care services are provided.
359.14    Subd. 1d. Client record. "Client record" means all records that document
359.15information about the home care services provided to the client by the home care provider.
359.16    Subd. 1e. Client representative. "Client representative" means a person who,
359.17because of the client's needs, makes decisions about the client's care on behalf of the
359.18client. A client representative may be a guardian, health care agent, family member, or
359.19other agent of the client. Nothing in this section expands or diminishes the rights of
359.20persons to act on behalf of clients under other law.
359.21    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
359.22    Subd. 2a. Controlled substance. "Controlled substance" has the meaning given
359.23in section 152.01, subdivision 4.
359.24    Subd. 2b. Department. "Department" means the Minnesota Department of Health.
359.25    Subd. 2c. Dietary supplement. "Dietary supplement" means a product taken by
359.26mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary
359.27ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and
359.28substances such as enzymes, organ tissue, glandulars, or metabolites.
359.29    Subd. 2d. Dietitian. "Dietitian" is a person licensed under sections 148.621 to
359.30148.633.
359.31    Subd. 2e. Dietetics or nutrition practice. "Dietetics or nutrition practice" is
359.32performed by a licensed dietician or licensed nutritionist and includes the activities of
359.33assessment, setting priorities and objectives, providing nutrition counseling, developing
359.34and implementing nutrition care services, and evaluating and maintaining appropriate
359.35standards of quality of nutrition care under sections 148.621 to 148.633.
360.1    Subd. 3. Home care service. "Home care service" means any of the following
360.2services when delivered in a place of residence to the home of a person whose illness,
360.3disability, or physical condition creates a need for the service:
360.4(1) nursing services, including the services of a home health aide;
360.5(2) personal care services not included under sections 148.171 to 148.285;
360.6(3) physical therapy;
360.7(4) speech therapy;
360.8(5) respiratory therapy;
360.9(6) occupational therapy;
360.10(7) nutritional services;
360.11(8) home management services when provided to a person who is unable to perform
360.12these activities due to illness, disability, or physical condition. Home management
360.13services include at least two of the following services: housekeeping, meal preparation,
360.14and shopping;
360.15(9) medical social services;
360.16(10) the provision of medical supplies and equipment when accompanied by the
360.17provision of a home care service; and
360.18(11) other similar medical services and health-related support services identified by
360.19the commissioner in rule.
360.20"Home care service" does not include the following activities conducted by the
360.21commissioner of health or a board of health as defined in section 145A.02, subdivision 2:
360.22communicable disease investigations or testing; administering or monitoring a prescribed
360.23therapy necessary to control or prevent a communicable disease; or the monitoring
360.24of an individual's compliance with a health directive as defined in section 144.4172,
360.25subdivision 6 .
360.26(1) assistive tasks provided by unlicensed personnel;
360.27(2) services provided by a registered nurse or licensed practical nurse, physical
360.28therapist, respiratory therapist, occupational therapist, speech-language pathologist,
360.29dietitian or nutritionist, or social worker;
360.30(3) medication and treatment management services; or
360.31(4) the provision of durable medical equipment services when provided with any of
360.32the home care services listed in clauses (1) to (3).
360.33    Subd. 3a. Hands-on-assistance. "Hands-on-assistance" means physical help by
360.34another person without which the client is not able to perform the activity.
360.35    Subd. 3b. Home. "Home" means the client's temporary or permanent place of
360.36residence.
361.1    Subd. 4. Home care provider. "Home care provider" means an individual,
361.2organization, association, corporation, unit of government, or other entity that is regularly
361.3engaged in the delivery of at least one home care service, directly or by contractual
361.4arrangement, of home care services in a client's home for a fee and who has a valid current
361.5temporary license or license issued under sections 144A.43 to 144A.482. At least one
361.6home care service must be provided directly, although additional home care services may
361.7be provided by contractual arrangements. "Home care provider" does not include:
361.8(1) any home care or nursing services conducted by and for the adherents of any
361.9recognized church or religious denomination for the purpose of providing care and
361.10services for those who depend upon spiritual means, through prayer alone, for healing;
361.11(2) an individual who only provides services to a relative;
361.12(3) an individual not connected with a home care provider who provides assistance
361.13with home management services or personal care needs if the assistance is provided
361.14primarily as a contribution and not as a business;
361.15(4) an individual not connected with a home care provider who shares housing with
361.16and provides primarily housekeeping or homemaking services to an elderly or disabled
361.17person in return for free or reduced-cost housing;
361.18(5) an individual or agency providing home-delivered meal services;
361.19(6) an agency providing senior companion services and other older American
361.20volunteer programs established under the Domestic Volunteer Service Act of 1973,
361.21Public Law 98-288;
361.22(7) an employee of a nursing home licensed under this chapter or an employee of a
361.23boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
361.24emergency calls from individuals residing in a residential setting that is attached to or
361.25located on property contiguous to the nursing home or boarding care home;
361.26(8) a member of a professional corporation organized under chapter 319B that does
361.27not regularly offer or provide home care services as defined in subdivision 3;
361.28(9) the following organizations established to provide medical or surgical services
361.29that do not regularly offer or provide home care services as defined in subdivision 3:
361.30a business trust organized under sections 318.01 to 318.04, a nonprofit corporation
361.31organized under chapter 317A, a partnership organized under chapter 323, or any other
361.32entity determined by the commissioner;
361.33(10) an individual or agency that provides medical supplies or durable medical
361.34equipment, except when the provision of supplies or equipment is accompanied by a
361.35home care service;
361.36(11) an individual licensed under chapter 147; or
362.1(12) an individual who provides home care services to a person with a developmental
362.2disability who lives in a place of residence with a family, foster family, or primary caregiver.
362.3    Subd. 5. Medication reminder. "Medication reminder" means providing a verbal
362.4or visual reminder to a client to take medication. This includes bringing the medication
362.5to the client and providing liquids or nutrition to accompany medication that a client is
362.6self-administering.
362.7    Subd. 6. License. "License" means a basic or comprehensive home care license
362.8issued by the commissioner to a home care provider.
362.9    Subd. 7. Licensed health professional. "Licensed health professional" means a
362.10person, other than a registered nurse or licensed practical nurse, who provides home care
362.11services within the scope of practice of the person's health occupation license, registration,
362.12or certification as regulated and who is licensed by the appropriate Minnesota state board
362.13or agency.
362.14    Subd. 8. Licensee. "Licensee" means a home care provider that is licensed under
362.15this chapter.
362.16    Subd. 9. Managerial official. "Managerial official" means an administrator,
362.17director, officer, trustee, or employee of a home care provider, however designated, who
362.18has the authority to establish or control business policy.
362.19    Subd. 10. Medication. "Medication" means a prescription or over-the-counter drug.
362.20For purposes of this chapter only, medication includes dietary supplements.
362.21    Subd. 11. Medication administration. "Medication administration" means
362.22performing a set of tasks to ensure a client takes medications, and includes the following:
362.23(1) checking the client's medication record;
362.24(2) preparing the medication as necessary;
362.25(3) administering the medication to the client;
362.26(4) documenting the administration or reason for not administering the medication;
362.27and
362.28(5) reporting to a nurse any concerns about the medication, the client, or the client's
362.29refusal to take the medication.
362.30    Subd. 12. Medication management. "Medication management" means the
362.31provision of any of the following medication-related services to a client:
362.32(1) performing medication setup;
362.33(2) administering medication;
362.34(3) storing and securing medications;
362.35(4) documenting medication activities;
363.1(5) verifying and monitoring effectiveness of systems to ensure safe handling and
363.2administration;
363.3(6) coordinating refills;
363.4(7) handling and implementing changes to prescriptions;
363.5(8) communicating with the pharmacy about the client's medications; and
363.6(9) coordinating and communicating with the prescriber.
363.7    Subd. 13. Medication setup. "Medication setup" means arranging medications by a
363.8nurse, pharmacy, or authorized prescriber for later administration by the client or by
363.9comprehensive home care staff.
363.10    Subd. 14. Nurse. "Nurse" means a person who is licensed under sections 148.171 to
363.11148.285.
363.12    Subd. 15. Occupational therapist. "Occupational therapist" means a person who is
363.13licensed under sections 148.6401 to 148.6450.
363.14    Subd. 16. Over-the-counter drug. "Over-the-counter drug" means a drug that is
363.15not required by federal law to bear the symbol "Rx only."
363.16    Subd. 17. Owner. "Owner" means a proprietor, general partner, limited partner who
363.17has five percent or more of equity interest in a limited partnership, a person who owns or
363.18controls voting stock in a corporation in an amount equal to or greater than five percent of
363.19the shares issued and outstanding, or a corporation that owns equity interest in a licensee
363.20or applicant for a license.
363.21    Subd. 18. Pharmacist. "Pharmacist" has the meaning given in section 151.01,
363.22subdivision 3.
363.23    Subd. 19. Physical therapist. "Physical therapist" means a person who is licensed
363.24under sections 148.65 to 148.78.
363.25    Subd. 20. Physician. "Physician" means a person who is licensed under chapter 147.
363.26    Subd. 21. Prescriber. "Prescriber" means a person who is authorized by sections
363.27148.235; 151.01, subdivision 23; and 151.37, to prescribe prescription drugs.
363.28    Subd. 22. Prescription. "Prescription" has the meaning given in section 151.01,
363.29subdivision 16.
363.30    Subd. 23. Regularly scheduled. "Regularly scheduled" means ordered or planned
363.31to be completed at predetermined times or according to a predetermined routine.
363.32    Subd. 24. Reminder. "Reminder" means providing a verbal or visual reminder
363.33to a client.
363.34    Subd. 25. Respiratory therapist. "Respiratory therapist" means a person who
363.35is licensed under chapter 147C.
364.1    Subd. 26. Revenues. "Revenues" means all money received by a licensee derived
364.2from the provision of home care services, including fees for services and appropriations
364.3of public money for home care services.
364.4    Subd. 27. Service plan. "Service plan" means the written plan between the client or
364.5client's representative and the temporary licensee or licensee about the services that will
364.6be provided to the client.
364.7    Subd. 28. Social worker. "Social worker" means a person who is licensed under
364.8chapter 148D or 148E.
364.9    Subd. 29. Speech language pathologist. "Speech language pathologist" has the
364.10meaning given in section 148.512.
364.11    Subd. 30. Standby assistance. "Standby assistance" means the presence of another
364.12person within arm's reach to minimize the risk of injury while performing daily activities
364.13through physical intervention or cuing.
364.14    Subd. 31. Substantial compliance. "Substantial compliance" means complying
364.15with the requirements in this chapter sufficiently to prevent unacceptable health or safety
364.16risks to the home care client.
364.17    Subd. 32. Survey. "Survey" means an inspection of a licensee or applicant for
364.18licensure for compliance with this chapter.
364.19    Subd. 33. Surveyor. "Surveyor" means a staff person of the department authorized
364.20to conduct surveys of home care providers and applicants.
364.21    Subd. 34. Temporary license. "Temporary license" means the initial basic or
364.22comprehensive home care license the department issues after approval of a complete
364.23written application and before the department completes the temporary license survey and
364.24determines that the temporary licensee is in substantial compliance.
364.25    Subd. 35. Treatment or therapy. "Treatment" or "therapy" means the provision
364.26of care, other than medications, ordered or prescribed by a licensed health professional
364.27provided to a client to cure, rehabilitate, or ease symptoms.
364.28    Subd. 36. Unit of government. "Unit of government" means every city, county,
364.29town, school district, other political subdivisions of the state, and any agency of the state
364.30or federal government, which includes any instrumentality of a unit of government.
364.31    Subd. 37. Unlicensed personnel. "Unlicensed personnel" are individuals not
364.32otherwise licensed or certified by a governmental health board or agency who provide
364.33home care services in the client's home.
364.34    Subd. 38. Verbal. "Verbal" means oral and not in writing.

365.1    Sec. 6. Minnesota Statutes 2012, section 144A.44, is amended to read:
365.2144A.44 HOME CARE BILL OF RIGHTS.
365.3    Subdivision 1. Statement of rights. A person who receives home care services
365.4has these rights:
365.5(1) the right to receive written information about rights in advance of before
365.6receiving care or during the initial evaluation visit before the initiation of treatment
365.7 services, including what to do if rights are violated;
365.8(2) the right to receive care and services according to a suitable and up-to-date plan,
365.9and subject to accepted health care, medical or nursing standards, to take an active part
365.10in creating and changing the plan developing, modifying, and evaluating care the plan
365.11 and services;
365.12(3) the right to be told in advance of before receiving care about the services that will
365.13be provided, the disciplines that will furnish care the type and disciplines of staff who will
365.14be providing the services, the frequency of visits proposed to be furnished, other choices
365.15that are available for addressing home care needs, and the consequences of these choices
365.16including the potential consequences of refusing these services;
365.17(4) the right to be told in advance of any change recommended changes by the
365.18provider in the service plan of care and to take an active part in any change decisions
365.19about changes to the service plan;
365.20(5) the right to refuse services or treatment;
365.21(6) the right to know, in advance before receiving services or during the initial
365.22visit, any limits to the services available from a home care provider, and the provider's
365.23grounds for a termination of services;
365.24(7) the right to know in advance of receiving care whether the services are covered
365.25by health insurance, medical assistance, or other health programs, the charges for services
365.26that will not be covered by Medicare, and the charges that the individual may have to pay;
365.27(8) (7) the right to know be told before services are initiated what the provider
365.28charges are for the services, no matter who will be paying the bill and if known to what
365.29extent payment may be expected from health insurance, public programs or other sources,
365.30and what charges the client may be responsible for paying;
365.31(9) (8) the right to know that there may be other services available in the community,
365.32including other home care services and providers, and to know where to go for find
365.33 information about these services;
365.34(10) (9) the right to choose freely among available providers and to change providers
365.35after services have begun, within the limits of health insurance, long-term care insurance,
365.36medical assistance, or other health programs;
366.1(11) (10) the right to have personal, financial, and medical information kept private,
366.2and to be advised of the provider's policies and procedures regarding disclosure of such
366.3information;
366.4(12) (11) the right to be allowed access to the client's own records and written
366.5information from those records in accordance with sections 144.291 to 144.298;
366.6(13) (12) the right to be served by people who are properly trained and competent
366.7to perform their duties;
366.8(14) (13) the right to be treated with courtesy and respect, and to have the patient's
366.9 client's property treated with respect;
366.10(15) (14) the right to be free from physical and verbal abuse, neglect, financial
366.11exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and
366.12the Maltreatment of Minors Act;
366.13(16) (15) the right to reasonable, advance notice of changes in services or charges,
366.14including;
366.15(16) the right to know the provider's reason for termination of services;
366.16(17) the right to at least ten days' advance notice of the termination of a service by a
366.17provider, except in cases where:
366.18(i) the recipient of services client engages in conduct that significantly alters the
366.19conditions of employment as specified in the employment contract between terms of
366.20the service plan with the home care provider and the individual providing home care
366.21services, or creates;
366.22(ii) the client, person who lives with the client, or others create an abusive or unsafe
366.23work environment for the individual person providing home care services; or
366.24(ii) (iii) an emergency for the informal caregiver or a significant change in the
366.25recipient's client's condition has resulted in service needs that exceed the current service
366.26provider agreement plan and that cannot be safely met by the home care provider;
366.27(17) (18) the right to a coordinated transfer when there will be a change in the
366.28provider of services;
366.29(18) (19) the right to voice grievances regarding treatment or care that is complain
366.30about services that are provided, or fails to be, furnished, or regarding fail to be provided,
366.31and the lack of courtesy or respect to the patient client or the patient's client's property;
366.32(19) (20) the right to know how to contact an individual associated with the home
366.33care provider who is responsible for handling problems and to have the home care provider
366.34investigate and attempt to resolve the grievance or complaint;
366.35(20) (21) the right to know the name and address of the state or county agency to
366.36contact for additional information or assistance; and
367.1(21) (22) the right to assert these rights personally, or have them asserted by
367.2the patient's family or guardian when the patient has been judged incompetent, client's
367.3representative or by anyone on behalf of the client, without retaliation.
367.4    Subd. 2. Interpretation and enforcement of rights. These rights are established
367.5for the benefit of persons clients who receive home care services. "Home care services"
367.6means home care services as defined in section 144A.43, subdivision 3, and unlicensed
367.7personal care assistance services, including services covered by medical assistance under
367.8section 256B.0625, subdivision 19a. All home care providers, including those exempted
367.9under section 144A.471, must comply with this section. The commissioner shall enforce
367.10this section and the home care bill of rights requirement against home care providers
367.11exempt from licensure in the same manner as for licensees. A home care provider may
367.12not request or require a person client to surrender any of these rights as a condition of
367.13receiving services. A guardian or conservator or, when there is no guardian or conservator,
367.14a designated person, may seek to enforce these rights. This statement of rights does not
367.15replace or diminish other rights and liberties that may exist relative to persons clients
367.16 receiving home care services, persons providing home care services, or providers licensed
367.17under Laws 1987, chapter 378. A copy of these rights must be provided to an individual
367.18at the time home care services, including personal care assistance services, are initiated.
367.19The copy shall also contain the address and phone number of the Office of Health Facility
367.20Complaints and the Office of Ombudsman for Long-Term Care and a brief statement
367.21describing how to file a complaint with these offices. Information about how to contact
367.22the Office of Ombudsman for Long-Term Care shall be included in notices of change in
367.23client fees and in notices where home care providers initiate transfer or discontinuation of
367.24services sections 144A.43 to 144A.482.

367.25    Sec. 7. Minnesota Statutes 2012, section 144A.45, is amended to read:
367.26144A.45 REGULATION OF HOME CARE SERVICES.
367.27    Subdivision 1. Rules Regulations. The commissioner shall adopt rules for the
367.28regulation of regulate home care providers pursuant to sections 144A.43 to 144A.47
367.29 144A.482. The rules regulations shall include the following:
367.30    (1) provisions to assure, to the extent possible, the health, safety and well-being,
367.31and appropriate treatment of persons who receive home care services while respecting
367.32clients' autonomy and choice;
367.33    (2) requirements that home care providers furnish the commissioner with specified
367.34information necessary to implement sections 144A.43 to 144A.47 144A.482;
368.1    (3) standards of training of home care provider personnel, which may vary according
368.2to the nature of the services provided or the health status of the consumer;
368.3(4) standards for provision of home care services;
368.4    (4) (5) standards for medication management which may vary according to the
368.5nature of the services provided, the setting in which the services are provided, or the
368.6status of the consumer. Medication management includes the central storage, handling,
368.7distribution, and administration of medications;
368.8    (5) (6) standards for supervision of home care services requiring supervision by a
368.9registered nurse or other appropriate health care professional which must occur on site
368.10at least every 62 days, or more frequently if indicated by a clinical assessment, and in
368.11accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a
368.12person performing home care aide tasks for a class B licensee providing paraprofessional
368.13services does not require nursing supervision;
368.14    (6) (7) standards for client evaluation or assessment which may vary according to
368.15the nature of the services provided or the status of the consumer;
368.16    (7) (8) requirements for the involvement of a consumer's physician client's health
368.17care provider, the documentation of physicians' health care providers' orders, if required,
368.18and the consumer's treatment client's service plan, and;
368.19(9) the maintenance of accurate, current clinical client records;
368.20    (8) (10) the establishment of different classes basic and comprehensive levels of
368.21licenses for different types of providers and different standards and requirements for
368.22different kinds of home care based on services provided; and
368.23    (9) operating procedures required to implement (11) provisions to enforce these
368.24regulations and the home care bill of rights.
368.25    Subd. 1a. Home care aide tasks. Notwithstanding the provisions of Minnesota
368.26Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
368.27toileting, transfers, and ambulation if the client is ambulatory and if the client has no
368.28serious acute illness or infectious disease.
368.29    Subd. 1b. Home health aide qualifications. Notwithstanding the provisions of
368.30Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks
368.31if the person maintains current registration as a nursing assistant on the Minnesota nursing
368.32assistant registry. Maintaining current registration on the Minnesota nursing assistant
368.33registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110,
368.34subpart 3.
368.35    Subd. 2. Regulatory functions. (a) The commissioner shall:
369.1(1) evaluate, monitor, and license, survey, and monitor without advance notice, home
369.2care providers in accordance with sections 144A.45 to 144A.47 144A.43 to 144A.482;
369.3(2) inspect the office and records of a provider during regular business hours without
369.4advance notice to the home care provider;
369.5(2) survey every temporary licensee within one year of the temporary license issuance
369.6date subject to the temporary licensee providing home care services to a client or clients;
369.7(3) survey all licensed home care providers on an interval that will promote the
369.8health and safety of clients;
369.9(3) (4) with the consent of the consumer client, visit the home where services are
369.10being provided;
369.11(4) (5) issue correction orders and assess civil penalties in accordance with section
369.12144.653, subdivisions 5 to 8 , for violations of sections 144A.43 to 144A.47 or the rules
369.13adopted under those sections 144A.482;
369.14(5) (6) take action as authorized in section 144A.46, subdivision 3 144A.475; and
369.15(6) (7) take other action reasonably required to accomplish the purposes of sections
369.16144A.43 to 144A.47 144A.482.
369.17(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the
369.18commissioner shall comply with the applicable requirements of section 144.122, the
369.19Government Data Practices Act, and the Administrative Procedure Act.
369.20    Subd. 4. Medicaid reimbursement. Notwithstanding the provisions of section
369.21256B.37 or state plan requirements to the contrary, certification by the federal Medicare
369.22program must not be a requirement of Medicaid payment for services delivered under
369.23section 144A.4605.
369.24    Subd. 5. Home care providers; services for Alzheimer's disease or related
369.25disorder. (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets
369.26or otherwise promotes services for persons with Alzheimer's disease or related disorders,
369.27the facility's direct care staff and their supervisors must be trained in dementia care.
369.28(b) Areas of required training include:
369.29(1) an explanation of Alzheimer's disease and related disorders;
369.30(2) assistance with activities of daily living;
369.31(3) problem solving with challenging behaviors; and
369.32(4) communication skills.
369.33(c) The licensee shall provide to consumers in written or electronic form a
369.34description of the training program, the categories of employees trained, the frequency
369.35of training, and the basic topics covered.

370.1    Sec. 8. [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.
370.2    Subdivision 1. License required. A home care provider may not open, operate,
370.3manage, conduct, maintain, or advertise itself as a home care provider or provide home
370.4care services in Minnesota without a temporary or current home care provider license
370.5issued by the commissioner of health.
370.6    Subd. 2. Determination of direct home care service. "Direct home care service"
370.7means a home care service provided to a client by the home care provider or its employees,
370.8and not by contract. Factors that must be considered in determining whether an individual
370.9or a business entity provides at least one home care service directly include, but are not
370.10limited to, whether the individual or business entity:
370.11    (1) has the right to control, and does control, the types of services provided;
370.12(2) has the right to control, and does control, when and how the services are provided;
370.13    (3) establishes the charges;
370.14(4) collects fees from the clients or receives payment from third-party payers on
370.15the clients' behalf;
370.16(5) pays individuals providing services compensation on an hourly, weekly, or
370.17similar basis;
370.18(6) treats the individuals providing services as employees for the purposes of payroll
370.19taxes and workers' compensation insurance; and
370.20(7) holds itself out as a provider of home care services or acts in a manner that
370.21leads clients or potential clients to believe that it is a home care provider providing home
370.22care services.
370.23    None of the factors listed in this subdivision is solely determinative.
370.24    Subd. 3. Determination of regularly engaged. "Regularly engaged" means
370.25providing, or offering to provide, home care services as a regular part of a business. The
370.26following factors must be considered by the commissioner in determining whether an
370.27individual or a business entity is regularly engaged in providing home care services:
370.28    (1) whether the individual or business entity states or otherwise promotes that the
370.29individual or business entity provides home care services;
370.30    (2) whether persons receiving home care services constitute a substantial part of the
370.31individual's or the business entity's clientele; and
370.32(3) whether the home care services provided are other than occasional or incidental
370.33to the provision of services other than home care services.
370.34    None of the factors listed in this subdivision is solely determinative.
370.35    Subd. 4. Penalties for operating without license. A person involved in the
370.36management, operation, or control of a home care provider that operates without an
371.1appropriate license is guilty of a misdemeanor. This section does not apply to a person
371.2who has no legal authority to affect or change decisions related to the management,
371.3operation, or control of a home care provider.
371.4    Subd. 5. Basic and comprehensive levels of licensure. An applicant seeking
371.5to become a home care provider must apply for either a basic or comprehensive home
371.6care license.
371.7    Subd. 6. Basic home care license provider. Home care services that can be
371.8provided with a basic home care license are assistive tasks provided by licensed or
371.9unlicensed personnel that include:
371.10(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting,
371.11and bathing;
371.12(2) providing standby assistance;
371.13(3) providing verbal or visual reminders to the client to take regularly scheduled
371.14medication which includes bringing the client previously set-up medication, medication in
371.15original containers, or liquid or food to accompany the medication;
371.16(4) providing verbal or visual reminders to the client to perform regularly scheduled
371.17treatments and exercises;
371.18(5) preparing modified diets ordered by a licensed health professional; and
371.19(6) assisting with laundry, housekeeping, meal preparation, shopping, or other
371.20household chores and services if the provider is also providing at least one of the activities
371.21in clauses (1) to (5)
371.22    Subd. 7. Comprehensive home care license provider. Home care services that
371.23may be provided with a comprehensive home care license include any of the basic home
371.24care services listed in subdivision 6, and one or more of the following:
371.25(1) services of an advanced practice nurse, registered nurse, licensed practical
371.26nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
371.27pathologist, dietician or nutritionist, or social worker;
371.28(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a
371.29licensed health professional within the person's scope of practice;
371.30(3) medication management services;
371.31(4) hands-on assistance with transfers and mobility;
371.32(5) assisting clients with eating when the clients have complicating eating problems
371.33as identified in the client record or through an assessment such as difficulty swallowing,
371.34recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
371.35instruments to be fed; or
371.36(6) providing other complex or specialty health care services.
372.1    Subd. 8. Exemptions from home care services licensure. (a) Except as otherwise
372.2provided in this chapter, home care services that are provided by the state, counties, or
372.3other units of government must be licensed under this chapter.
372.4(b) An exemption under this subdivision does not excuse the exempted individual or
372.5organization from complying with applicable provisions of the home care bill of rights
372.6in section 144A.44. The following individuals or organizations are exempt from the
372.7requirement to obtain a home care provider license:
372.8(1) an individual or organization that offers, provides, or arranges for personal care
372.9assistance services under the medical assistance program as authorized under sections
372.10256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;
372.11(2) a provider that is licensed by the commissioner of human services to provide
372.12semi-independent living services for persons with developmental disabilities under section
372.13252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
372.14(3) a provider that is licensed by the commissioner of human services to provide
372.15home and community-based services for persons with developmental disabilities under
372.16section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
372.17(4) an individual or organization that provides only home management services, if
372.18the individual or organization is registered under section 144A.482; or
372.19(5) an individual who is licensed in this state as a nurse, dietitian, social worker,
372.20occupational therapist, physical therapist, or speech-language pathologist who provides
372.21health care services in the home independently and not through any contractual or
372.22employment relationship with a home care provider or other organization.
372.23    Subd. 9. Exclusions from home care licensure. The following are excluded from
372.24home care licensure and are not required to provide the home care bill of rights:
372.25(1) an individual or business entity providing only coordination of home care that
372.26includes one or more of the following:
372.27(i) determination of whether a client needs home care services, or assisting a client
372.28in determining what services are needed;
372.29(ii) referral of clients to a home care provider;
372.30(iii) administration of payments for home care services; or
372.31(iv) administration of a health care home established under section 256B.0751;
372.32(2) an individual who is not an employee of a licensed home care provider if the
372.33individual:
372.34(i) only provides services as an independent contractor to one or more licensed
372.35home care providers;
372.36(ii) provides no services under direct agreements or contracts with clients; and
373.1(iii) is contractually bound to perform services in compliance with the contracting
373.2home care provider's policies and service plans;
373.3(3) a business that provides staff to home care providers, such as a temporary
373.4employment agency, if the business:
373.5(i) only provides staff under contract to licensed or exempt providers;
373.6(ii) provides no services under direct agreements with clients; and
373.7(iii) is contractually bound to perform services under the contracting home care
373.8provider's direction and supervision;
373.9(4) any home care services conducted by and for the adherents of any recognized
373.10church or religious denomination for its members through spiritual means, or by prayer
373.11for healing;
373.12(5) an individual who only provides home care services to a relative;
373.13(6) an individual not connected with a home care provider that provides assistance
373.14with basic home care needs if the assistance is provided primarily as a contribution and
373.15not as a business;
373.16(7) an individual not connected with a home care provider that shares housing with
373.17and provides primarily housekeeping or homemaking services to an elderly or disabled
373.18person in return for free or reduced-cost housing;
373.19(8) an individual or provider providing home-delivered meal services;
373.20(9) an individual providing senior companion services and other Older American
373.21Volunteer Programs (OAVP) established under the Domestic Volunteer Service Act of
373.221973, United States Code, title 42, chapter 66;
373.23(10) an employee of a nursing home licensed under this chapter or an employee of a
373.24boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
373.25emergency calls from individuals residing in a residential setting that is attached to or
373.26located on property contiguous to the nursing home or boarding care home;
373.27(11) a member of a professional corporation organized under chapter 319B that
373.28does not regularly offer or provide home care services as defined in section 144A.43,
373.29subdivision 3;
373.30(12) the following organizations established to provide medical or surgical services
373.31that do not regularly offer or provide home care services as defined in section 144A.43,
373.32subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
373.33corporation organized under chapter 317A, a partnership organized under chapter 323, or
373.34any other entity determined by the commissioner;
374.1(13) an individual or agency that provides medical supplies or durable medical
374.2equipment, except when the provision of supplies or equipment is accompanied by a
374.3home care service;
374.4(14) a physician licensed under chapter 147;
374.5(15) an individual who provides home care services to a person with a developmental
374.6disability who lives in a place of residence with a family, foster family, or primary caregiver;
374.7(16) a business that only provides services that are primarily instructional and not
374.8medical services or health-related support services;
374.9(17) an individual who performs basic home care services for no more than 14 hours
374.10each calendar week to no more than one client;
374.11(18) an individual or business licensed as hospice as defined in sections 144A.75 to
374.12144A.755 who is not providing home care services independent of hospice service;
374.13(19) activities conducted by the commissioner of health or a board of health as
374.14defined in section 145A.02, subdivision 2, including communicable disease investigations
374.15or testing; or
374.16(20) administering or monitoring a prescribed therapy necessary to control or
374.17prevent a communicable disease, or the monitoring of an individual's compliance with a
374.18health directive as defined in section 144.4172, subdivision 6.

374.19    Sec. 9. [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION AND
374.20RENEWAL.
374.21    Subdivision 1. License applications. Each application for a home care provider
374.22license must include information sufficient to show that the applicant meets the
374.23requirements of licensure, including:
374.24    (1) the applicant's name, e-mail address, physical address, and mailing address,
374.25including the name of the county in which the applicant resides and has a principal
374.26place of business;
374.27(2) the initial license fee in the amount specified in subdivision 7;
374.28(3) e-mail address, physical address, mailing address, and telephone number of the
374.29principal administrative office;
374.30(4) e-mail address, physical address, mailing address, and telephone number of
374.31each branch office, if any;
374.32(5) names, e-mail and mailing addresses, and telephone numbers of all owners
374.33and managerial officials;
375.1(6) documentation of compliance with the background study requirements of section
375.2144A.476 for all persons involved in the management, operation, or control of the home
375.3care provider;
375.4(7) documentation of a background study as required by section 144.057 for any
375.5individual seeking employment, paid or volunteer, with the home care provider;
375.6(8) evidence of workers' compensation coverage as required by sections 176.181
375.7and 176.182;
375.8(9) documentation of liability coverage, if the provider has it;
375.9(10) identification of the license level the provider is seeking;
375.10(11) documentation that identifies the managerial official who is in charge of
375.11day-to-day operations and attestation that the person has reviewed and understands the
375.12home care provider regulations;
375.13(12) documentation that the applicant has designated one or more owners,
375.14managerial officials, or employees as an agent or agents, which shall not affect the legal
375.15responsibility of any other owner or managerial official under this chapter;
375.16(13) the signature of the officer or managing agent on behalf of an entity, corporation,
375.17association, or unit of government;
375.18(14) verification that the applicant has the following policies and procedures in place
375.19so that if a license is issued, the applicant will implement the policies and procedures
375.20and keep them current:
375.21    (i) requirements in sections 626.556, reporting of maltreatment of minors, and
375.22626.557, reporting of maltreatment of vulnerable adults;
375.23(ii) conducting and handling background studies on employees;
375.24(iii) orientation, training, and competency evaluations of home care staff, and a
375.25process for evaluating staff performance;
375.26(iv) handling complaints from clients, family members, or client representatives
375.27regarding staff or services provided by staff;
375.28(v) conducting initial evaluation of clients' needs and the providers' ability to provide
375.29those services;
375.30(vi) conducting initial and ongoing client evaluations and assessments and how
375.31changes in a client's condition are identified, managed, and communicated to staff and
375.32other health care providers as appropriate;
375.33(vii) orientation to and implementation of the home care client bill of rights;
375.34(viii) infection control practices;
375.35(ix) reminders for medications, treatments, or exercises, if provided; and
376.1(x) conducting appropriate screenings, or documentation of prior screenings, to
376.2show that staff are free of tuberculosis, consistent with current United States Centers for
376.3Disease Control standards; and
376.4(15) other information required by the department.
376.5    Subd. 2. Comprehensive home care license applications. In addition to the
376.6information and fee required in subdivision 1, applicants applying for a comprehensive
376.7home care license must also provide verification that the applicant has the following
376.8policies and procedures in place so that if a license is issued, the applicant will implement
376.9the policies and procedures in this subdivision and keep them current:
376.10(1) conducting initial and ongoing assessments of the client's needs by a registered
376.11nurse or appropriate licensed health professional, including how changes in the client's
376.12conditions are identified, managed, and communicated to staff and other health care
376.13providers, as appropriate;
376.14(2) ensuring that nurses and licensed health professionals have current and valid
376.15licenses to practice;
376.16(3) medication and treatment management;
376.17(4) delegation of home care tasks by registered nurses or licensed health professionals;
376.18(5) supervision of registered nurses and licensed health professionals; and
376.19(6) supervision of unlicensed personnel performing delegated home care tasks.
376.20    Subd. 3. License renewal. (a) Except as provided in section 144A.475, a license
376.21may be renewed for a period of one year if the licensee satisfies the following:
376.22(1) submits an application for renewal in the format provided by the commissioner
376.23at least 30 days before expiration of the license;
376.24(2) submits the renewal fee in the amount specified in subdivision 7;
376.25(3) has provided home care services within the past 12 months;
376.26(4) complies with sections 144A.43 to 144A.4799;
376.27(5) provides information sufficient to show that the applicant meets the requirements
376.28of licensure, including items required under subdivision 1;
376.29(6) provides verification that all policies under subdivision 1, are current; and
376.30(7) provides any other information deemed necessary by the commissioner.
376.31(b) A renewal applicant who holds a comprehensive home care license must also
376.32provide verification that policies listed under subdivision 2 are current.
376.33    Subd. 4. Multiple units. Multiple units or branches of a licensee must be separately
376.34licensed if the commissioner determines that the units cannot adequately share supervision
376.35and administration of services from the main office.
377.1    Subd. 5. Transfers prohibited; changes in ownership. Any home care license
377.2issued by the commissioner may not be transferred to another party. Before acquiring
377.3ownership of a home care provider business, a prospective applicant must apply for a
377.4new temporary license. A change of ownership is a transfer of operational control to
377.5a different business entity, and includes:
377.6(1) transfer of the business to a different or new corporation;
377.7(2) in the case of a partnership, the dissolution or termination of the partnership under
377.8chapter 323A, with the business continuing by a successor partnership or other entity;
377.9(3) relinquishment of control of the provider to another party, including to a contract
377.10management firm that is not under the control of the owner of the business' assets;
377.11(4) transfer of the business by a sole proprietor to another party or entity; or
377.12(5) in the case of a privately held corporation, the change in ownership or control of
377.1350 percent or more of the outstanding voting stock.
377.14    Subd. 6. Notification of changes of information. The temporary licensee or
377.15licensee shall notify the commissioner in writing within ten working days after any
377.16change in the information required in subdivision 1, except the information required in
377.17subdivision 1, clause (5), is required at the time of license renewal.
377.18    Subd. 7. Fees; application, change of ownership, and renewal. (a) An initial
377.19applicant seeking a temporary home care licensure must submit the following application
377.20fee to the commissioner along with a completed application:
377.21(1) basic home care provider, $2,100; or
377.22(2) comprehensive home care provider, $4,200.
377.23(b) A home care provider who is filing a change of ownership as required under
377.24subdivision 5 must submit the following application fee to the commissioner, along with
377.25the documentation required for the change of ownership:
377.26(1) basic home care provider, $2,100; or
377.27(2) comprehensive home care provider, $4,200.
377.28(c) A home care provider who is seeking to renew the provider's license shall pay a
377.29fee to the commissioner based on revenues derived from the provision of home care
377.30services during the calendar year prior to the year in which the application is submitted,
377.31according to the following schedule:
377.32License Renewal Fee

377.33	Provider Annual Revenue	Fee
377.34	greater than $1,500,000	$6,625
377.35 377.36	greater than $1,275,000 and no more than $1,500,000	$5,797
378.1 378.2	greater than $1,100,000 and no more than $1,275,000	$4,969
378.3 378.4	greater than $950,000 and no more than $1,100,000	$4,141
378.5 378.6	greater than $850,000 and no more than $950,000	$3,727
378.7 378.8	greater than $750,000 and no more than $850,000	$3,313
378.9 378.10	greater than $650,000 and no more than $750,000	$2,898
378.11 378.12	greater than $550,000 and no more than $650,000	$2,485
378.13 378.14	greater than $450,000 and no more than $550,000	$2,070
378.15 378.16	greater than $350,000 and no more than $450,000	$1,656
378.17 378.18	greater than $250,000 and no more than $350,000	$1,242
378.19 378.20	greater than $100,000 and no more than $250,000	$828
378.21	greater than $50,000 and no more than $100,000	$500
378.22	greater than $25,000 and no more than $50,000	$400
378.23	no more than $25,000	$200

378.24(d) If requested, the home care provider shall provide the commissioner information
378.25to verify the provider's annual revenues or other information as needed, including copies
378.26of documents submitted to the Department of Revenue.
378.27(e) At each annual renewal, a home care provider may elect to pay the highest
378.28renewal fee for its license category, and not provide annual revenue information to the
378.29commissioner.
378.30(f) A temporary license or license applicant, or temporary licensee or licensee that
378.31knowingly provides the commissioner incorrect revenue amounts for the purpose of
378.32paying a lower license fee, shall be subject to a civil penalty in the amount of double the
378.33fee the provider should have paid.
378.34(g) Fees and penalties collected under this section shall be deposited in the state
378.35treasury and credited to the special state government revenue fund.
378.36(h) The license renewal fee schedule in this subdivision is effective July 1, 2016.

378.37    Sec. 10. [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE
378.38RENEWAL.
378.39    Subdivision 1. Temporary license and renewal of license. (a) The department
378.40shall review each application to determine the applicant's knowledge of and compliance
378.41with Minnesota home care regulations. Before granting a temporary license or renewing a
379.1license, the commissioner may further evaluate the applicant or licensee by requesting
379.2additional information or documentation or by conducting an on-site survey of the
379.3applicant to determine compliance with sections 144A.43 to 144A.482.
379.4(b) Within 14 calendar days after receiving an application for a license,
379.5the commissioner shall acknowledge receipt of the application in writing. The
379.6acknowledgment must indicate whether the application appears to be complete or whether
379.7additional information is required before the application will be considered complete.
379.8(c) Within 90 days after receiving a complete application, the commissioner shall
379.9issue a temporary license, renew the license, or deny the license.
379.10(d) The commissioner shall issue a license that contains the home care provider's
379.11name, address, license level, expiration date of the license, and unique license number. All
379.12licenses are valid for one year from the date of issuance.
379.13    Subd. 2. Temporary license. (a) For new license applicants, the commissioner
379.14shall issue a temporary license for either the basic or comprehensive home care level. A
379.15temporary license is effective for one year from the date of issuance. Temporary licensees
379.16must comply with sections 144A.43 to 144A.482.
379.17(b) During the temporary license year, the commissioner shall survey the temporary
379.18licensee after the commissioner is notified or has evidence that the temporary licensee
379.19is providing home care services.
379.20(c) Within five days of beginning the provision of services, the temporary
379.21licensee must notify the commissioner that it is serving clients. The notification to the
379.22commissioner may be mailed or e-mailed to the commissioner at the address provided by
379.23the commissioner. If the temporary licensee does not provide home care services during
379.24the temporary license year, then the temporary license expires at the end of the year and
379.25the applicant must reapply for a temporary home care license.
379.26(d) A temporary licensee may request a change in the level of licensure prior to
379.27being surveyed and granted a license by notifying the commissioner in writing and
379.28providing additional documentation or materials required to update or complete the
379.29changed temporary license application. The applicant must pay the difference between the
379.30application fees when changing from the basic to the comprehensive level of licensure.
379.31No refund will be made if the provider chooses to change the license application to the
379.32basic level.
379.33(e) If the temporary licensee notifies the commissioner that the licensee has clients
379.34within 45 days prior to the temporary license expiration, the commissioner may extend the
379.35temporary license for up to 60 days in order to allow the commissioner to complete the
379.36on-site survey required under this section and follow-up survey visits.
380.1    Subd. 3. Temporary licensee survey. (a) If the temporary licensee is in substantial
380.2compliance with the survey, the commissioner shall issue either a basic or comprehensive
380.3home care license. If the temporary licensee is not in substantial compliance with the
380.4survey, the commissioner shall not issue a basic or comprehensive license and there will
380.5be no contested hearing right under chapter 14.
380.6(b) If the temporary licensee whose basic or comprehensive license has been denied
380.7disagrees with the conclusions of the commissioner, then the licensee may request a
380.8reconsideration by the commissioner or commissioner's designee. The reconsideration
380.9request process will be conducted internally by the commissioner or commissioner's
380.10designee, and chapter 14 does not apply.
380.11(c) The temporary licensee requesting reconsideration must make the request in
380.12writing and must list and describe the reasons why the licensee disagrees with the decision
380.13to deny the basic or comprehensive home care license.
380.14(d) A temporary licensee whose license is denied must comply with the requirements
380.15for notification and transfer of clients in section 144A.475, subdivision 5.

380.16    Sec. 11. [144A.474] SURVEYS AND INVESTIGATIONS.
380.17    Subdivision 1. Surveys. The commissioner shall conduct surveys of each home
380.18care provider. By June 30, 2016, the commissioner shall conduct a survey of home care
380.19providers on a frequency of at least once every three years. Survey frequency may be
380.20based on the license level, the provider's compliance history, number of clients served,
380.21or other factors as determined by the department deemed necessary to ensure the health,
380.22safety, and welfare of clients and compliance with the law.
380.23    Subd. 2. Types of home care surveys. (a) "Initial full survey" is the survey
380.24conducted of a new temporary licensee after the department is notified or has evidence that
380.25the licensee is providing home care services to determine if the provider is in compliance
380.26with home care requirements. Initial surveys must be completed within 14 months after
380.27the department's issuance of a temporary basic or comprehensive license.
380.28(b) "Core survey" means periodic inspection of home care providers to determine
380.29ongoing compliance with the home care requirements, focusing on the essential health and
380.30safety requirements. Core surveys are available to licensed home care providers who have
380.31been licensed for three years and surveyed at least once in the past three years with the
380.32latest survey having no widespread violations beyond Level 1 as provided in subdivision
380.3311. Providers must also not have had any substantiated licensing complaints, substantiated
380.34complaints against the agency under the Vulnerable Adults Act or Maltreatment of Minors
380.35Act, or an enforcement action as authorized in section 144A.475 in the past three years.
381.1(1) The core survey for basic license-level providers reviews compliance in the
381.2following areas:
381.3(i) reporting of maltreatment;
381.4(ii) orientation to and implementation of Home Care Client Bill of Rights;
381.5(iii) statement of home care services;
381.6(iv) initial evaluation of clients and initiation of services;
381.7(v) basic-license level client review and monitoring;
381.8(vi) service plan implementation and changes to the service plan;
381.9(vii) client complaint and investigative process;
381.10(viii) competency of unlicensed personnel; and
381.11(ix) infection control.
381.12(2) For comprehensive license-level providers, the core survey will include
381.13everything in the basic license-level core survey plus these areas:
381.14(i) delegation to unlicensed personnel;
381.15(ii) assessment, monitoring, and reassessment of clients; and
381.16(iii) medication, treatment, and therapy management.
381.17(c) "Full survey" means the periodic inspection of home care providers to determine
381.18ongoing compliance with the home care requirements that cover the core survey areas
381.19and all the legal requirements for home care providers. A full survey is conducted for all
381.20temporary licensees and for providers who do not meet the requirements needed for a core
381.21survey, and when a surveyor identifies unacceptable client health or safety risks during a
381.22core survey. A full survey will include all the tasks identified as part of the core survey
381.23and any additional review deemed necessary by the department, including additional
381.24observation, interviewing, or records review of additional clients and staff.
381.25(d) "Follow-up surveys" are conducted to determine if a home care provider has
381.26corrected deficient issues and systems identified during a core survey, full survey, or
381.27complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax,
381.28mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be
381.29concluded with an exit conference and written information provided on the process for
381.30requesting a reconsideration of the survey results.
381.31(e) Upon receiving information that a home care provider has violated or is currently
381.32violating a requirement of sections 144A.43 to 144A.482, the commissioner shall
381.33investigate the complaint according to sections 144A.51 to 144A.54.
381.34    Subd. 3. Survey process. (a) The survey process for core surveys shall include the
381.35following as applicable to the particular licensee and setting surveyed:
382.1(1) presurvey review of pertinent documents and notification to the ombudsman
382.2for long-term care;
382.3(2) an entrance conference with available staff;
382.4(3) communication with managerial officials or the registered nurse in charge, if
382.5available, and ongoing communication with key staff throughout the survey regarding
382.6information needed by the surveyor, clarifications regarding home care requirements, and
382.7applicable standards of practice;
382.8(4) presentation of written contact information to the provider about the survey staff
382.9conducting the survey, the supervisor, and the process for requesting a reconsideration of
382.10the survey results;
382.11(5) a brief tour of a sample of the housing with services establishments in which the
382.12provider is providing home care services;
382.13(6) a sample selection of home care clients;
382.14(7) information-gathering through client and staff observations, client and staff
382.15interviews, and reviews of records, policies, procedures, practices, and other agency
382.16information;
382.17(8) interviews of clients' family members, if available, with clients' consent when the
382.18client can legally give consent;
382.19(9) except for complaint surveys conducted by the Office of Health Facilities
382.20Complaints, exit conference, with preliminary findings shared and discussed with the
382.21provider and written information provided on the process for requesting a reconsideration
382.22of the survey results; and
382.23(10) postsurvey analysis of findings and formulation of survey results, including
382.24correction orders when applicable.
382.25    Subd. 4. Scheduling surveys. Surveys and investigations shall be conducted
382.26without advance notice to home care providers. Surveyors may contact the home care
382.27provider on the day of a survey to arrange for someone to be available at the survey site.
382.28The contact does not constitute advance notice.
382.29    Subd. 5. Information provided by home care provider. The home care provider
382.30shall provide accurate and truthful information to the department during a survey,
382.31investigation, or other licensing activities.
382.32    Subd. 6. Providing client records. Upon request of a surveyor, home care providers
382.33shall provide a list of current and past clients or client representatives that includes
382.34addresses and telephone numbers and any other information requested about the services
382.35to clients within a reasonable period of time.
383.1    Subd. 7. Contacting and visiting clients. Surveyors may contact or visit a home
383.2care provider's clients to gather information without notice to the home care provider.
383.3Before visiting a client, a surveyor shall obtain the client's or client's representative's
383.4permission by telephone, mail, or in person. Surveyors shall inform all clients or client's
383.5representatives of their right to decline permission for a visit.
383.6    Subd. 8. Correction orders. (a) A correction order may be issued whenever the
383.7commissioner finds upon survey or during a complaint investigation that a home care
383.8provider, a managerial official, or an employee of the provider is not in compliance with
383.9sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
383.10document areas of noncompliance and the time allowed for correction.
383.11(b) The commissioner shall mail copies of any correction order within 30 calendar
383.12days after exit survey to the last known address of the home care provider. A copy of each
383.13correction order and copies of any documentation supplied to the commissioner shall be
383.14kept on file by the home care provider, and public documents shall be made available for
383.15viewing by any person upon request. Copies may be kept electronically.
383.16(c) By the correction order date, the home care provider must document in the
383.17provider's records any action taken to comply with the correction order. The commissioner
383.18may request a copy of this documentation and the home care provider's action to respond
383.19to the correction order in future surveys, upon a complaint investigation, and as otherwise
383.20needed.
383.21    Subd. 9. Follow-up surveys. For providers that have Level 3 or Level 4 violations
383.22or any violations determined to be widespread, the department shall conduct a follow-up
383.23survey within 90 calendar days of the survey. When conducting a follow-up survey, the
383.24surveyor will focus on whether the previous violations have been corrected and may also
383.25address any new violations that are observed while evaluating the corrections that have
383.26been made. If a new violation is identified on a follow-up survey, no fine will be imposed
383.27unless it is not corrected on the next follow-up survey.
383.28    Subd. 10. Performance incentive. A licensee is eligible for a performance
383.29incentive if there are no violations identified in a core or full survey. The performance
383.30incentive is a ten percent discount on the licensee's next home care renewal license fee.
383.31    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be
383.32assessed based on the level and scope of the violations described in paragraph (c) as follows:
383.33(1) Level 1, no fines or enforcement;
383.34(2) Level 2, fines ranging from $0 to $500, in addition to any of the enforcement
383.35mechanisms authorized in section 144A.475 for widespread violations;
384.1(3) Level 3, fines ranging from $500 to $1,000, in addition to any of the enforcement
384.2mechanisms authorized in section 144A.475; and
384.3(4) Level 4, fines ranging from $1,000 to $5,000, in addition to any of the
384.4enforcement mechanisms authorized in section 144A.475.
384.5(b) Correction orders for violations are categorized by both level and scope as
384.6follows and fines will be assessed accordingly:
384.7(1) Level of violation:
384.8(i) Level 1. A violation that has no potential to cause more than a minimal impact on
384.9the client and does not affect health or safety.
384.10(ii) Level 2. A violation that did not harm the client's health or safety, but had the
384.11potential to have harmed a client's health or safety, but was not likely to cause serious
384.12injury, impairment, or death.
384.13(iii) Level 3. A violation that harmed a client's health or safety, not including serious
384.14injury, impairment, or death, or a violation that has the potential to lead to serious injury,
384.15impairment, or death.
384.16(iv) Level 4. A violation that results in serious injury, impairment, or death.
384.17(2) Scope of violation:
384.18(i) Isolated. When one or a limited number of clients are affected, or one or a limited
384.19number of staff are involved, or the situation has occurred only occasionally.
384.20(ii) Pattern. When more than a limited number of clients are affected, more than
384.21a limited number of staff are involved, or the situation has occurred repeatedly but is
384.22not found to be pervasive.
384.23(iii) Widespread. When problems are pervasive or represent a systemic failure that
384.24has affected or has the potential to affect a large portion or all of the clients.
384.25(c) If the commissioner finds that the applicant or a home care provider required
384.26to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the
384.27date specified in the correction order or conditional license resulting from a survey or
384.28complaint investigation, the commissioner may impose a fine. A notice of noncompliance
384.29with a correction order must be mailed to the applicant's or provider's last known address.
384.30The noncompliance notice must list the violations not corrected.
384.31(d) The license holder must pay the fines assessed on or before the payment date
384.32specified. If the license holder fails to fully comply with the order, the commissioner
384.33may issue a second fine or suspend the license until the license holder complies by
384.34paying the fine. A timely appeal shall stay payment of the fine until the commissioner
384.35issues a final order.
385.1(e) A license holder shall promptly notify the commissioner in writing when a
385.2violation specified in the order is corrected. If upon reinspection the commissioner
385.3determines that a violation has not been corrected as indicated by the order, the
385.4commissioner may issue a second fine. The commissioner shall notify the license holder by
385.5mail to the last known address in the licensing record that a second fine has been assessed.
385.6The license holder may appeal the second fine as provided under this subdivision.
385.7(f) A home care provider that has been assessed a fine under this subdivision has a
385.8right to a reconsideration or a hearing under this section and chapter 14.
385.9(g) When a fine has been assessed, the license holder may not avoid payment by
385.10closing, selling, or otherwise transferring the licensed program to a third party. In such an
385.11event, the license holder shall be liable for payment of the fine.
385.12(h) In addition to any fine imposed under this section, the commissioner may assess
385.13costs related to an investigation that results in a final order assessing a fine or other
385.14enforcement action authorized by this chapter.
385.15(i) Fines collected under this subdivision shall be deposited in the state government
385.16special revenue fund and credited to an account separate from the revenue collected under
385.17section 144A.472. Subject to an appropriation by the legislature, the revenue from the
385.18fines collected may be used by the commissioner for special projects to improve home care
385.19in Minnesota as recommended by the advisory council established in section 144A.4799.
385.20    Subd. 12. Reconsideration. The commissioner shall make available to home
385.21care providers a correction order reconsideration process. This process may be used
385.22to challenge the correction order issued, including the level and scope described in
385.23subdivision 9, and any fine assessed. During the correction order reconsideration request,
385.24the issuance for the correction orders under reconsideration are not stayed, but the
385.25department will post in formation on the Web site with the correction order that the
385.26licensee has requested a reconsideration required and that the review is pending.
385.27(a) A licensed home care provider may request from the commissioner, in writing,
385.28a correction order reconsideration regarding any correction order issued to the provider.
385.29The correction order reconsideration shall not be reviewed by any surveyor, investigator,
385.30or supervisor that participated in the writing or reviewing of the correction order being
385.31disputed. The correction order reconsiderations may be conducted in person by telephone,
385.32by another electronic form, or in writing, as determined by the commissioner. The
385.33commissioner shall respond in writing to the request from a home care provider for
385.34a correction order reconsideration within 60 days of the date the provider requests a
385.35reconsideration. The commissioner's response shall identify the commissioner's decision
385.36regarding each citation challenged by the home care provider.
386.1The findings of a correction order reconsideration process shall be one or more of
386.2the following:
386.3(1) Supported in full. The correction order is supported in full, with no deletion of
386.4findings to the citation.
386.5(2) Supported in substance. The correction order is supported, but one or more
386.6findings are deleted or modified without any change in the citation.
386.7(3) Correction order cited an incorrect home care licensing requirement. The
386.8correction order is amended by changing the correction order to the appropriate statutory
386.9reference.
386.10(4) Correction order was issued under an incorrect citation. The correction order is
386.11amended to be issued under the more appropriate correction order citation.
386.12(5) The correction order is rescinded.
386.13(6) Fine is amended. It is determined the fine assigned to the correction order was
386.14applied incorrectly.
386.15(7) The level or scope of the citation is modified based on the reconsideration.
386.16(b) If the correction order findings are changed by the commissioner, the
386.17commissioner shall update the correction order Web site accordingly.
386.18    Subd. 13. Home care surveyor training. Before conducting a home care survey,
386.19each home care surveyor must receive training on the following topics:
386.20(1) Minnesota home care licensure requirements;
386.21(2) Minnesota Home Care Client Bill of Rights;
386.22(3) Minnesota Vulnerable Adults Act and reporting of maltreatment of minors;
386.23(4) principles of documentation;
386.24(5) survey protocol and processes;
386.25(6) Offices of the Ombudsman roles;
386.26(7) Office of Health Facility Complaints;
386.27(8) Minnesota landlord-tenant and housing with services laws;
386.28(9) types of payors for home care services; and
386.29(10) Minnesota Nurse Practice Act for nurse surveyors.
386.30Materials used for this training will be posted on the department Web site. Requisite
386.31understanding of these topics will be reviewed as part of the quality improvement plan
386.32in section 28.

386.33    Sec. 12. [144A.475] ENFORCEMENT.
387.1    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a temporary
387.2license, renew a license, suspend or revoke a license, or impose a conditional license if the
387.3home care provider or owner or managerial official of the home care provider:
387.4(1) is in violation of, or during the term of the license has violated, any of the
387.5requirements in sections 144A.471 to 144A.482;
387.6(2) permits, aids, or abets the commission of any illegal act in the provision of
387.7home care;
387.8(3) performs any act detrimental to the health, safety, and welfare of a client;
387.9(4) obtains the license by fraud or misrepresentation;
387.10(5) knowingly made or makes a false statement of a material fact in the application
387.11for a license or in any other record or report required by this chapter;
387.12(6) denies representatives of the department access to any part of the home care
387.13provider's books, records, files, or employees;
387.14(7) interferes with or impedes a representative of the department in contacting the
387.15home care provider's clients;
387.16(8) interferes with or impedes a representative of the department in the enforcement
387.17of this chapter or has failed to fully cooperate with an inspection, survey, or investigation
387.18by the department;
387.19(9) destroys or makes unavailable any records or other evidence relating to the home
387.20care provider's compliance with this chapter;
387.21(10) refuses to initiate a background study under section 144.057 or 245A.04;
387.22(11) fails to timely pay any fines assessed by the department;
387.23(12) violates any local, city, or township ordinance relating to home care services;
387.24(13) has repeated incidents of personnel performing services beyond their
387.25competency level; or
387.26(14) has operated beyond the scope of the home care provider's license level.
387.27    (b) A violation by a contractor providing the home care services of the home care
387.28provider is a violation by the home care provider.
387.29    Subd. 2. Terms to suspension or conditional license. A suspension or conditional
387.30license designation may include terms that must be completed or met before a suspension
387.31or conditional license designation is lifted. A conditional license designation may include
387.32restrictions or conditions that are imposed on the provider. Terms for a suspension or
387.33conditional license may include one or more of the following and the scope of each will be
387.34determined by the commissioner:
388.1(1) requiring a consultant to review, evaluate, and make recommended changes to
388.2the home care provider's practices and submit reports to the commissioner at the cost of
388.3the home care provider;
388.4(2) requiring supervision of the home care provider or staff practices at the cost
388.5of the home care provider by an unrelated person who has sufficient knowledge and
388.6qualifications to oversee the practices and who will submit reports to the commissioner;
388.7(3) requiring the home care provider or employees to obtain training at the cost of
388.8the home care provider;
388.9(4) requiring the home care provider to submit reports to the commissioner;
388.10(5) prohibiting the home care provider from taking any new clients for a period
388.11of time; or
388.12(6) any other action reasonably required to accomplish the purpose of this
388.13subdivision and section 144A.45, subdivision 2.
388.14    Subd. 3. Notice. Prior to any suspension, revocation, or refusal to renew a license,
388.15the home care provider shall be entitled to notice and a hearing as provided by sections
388.1614.57 to 14.69. In addition to any other remedy provided by law, the commissioner may,
388.17without a prior contested case hearing, temporarily suspend a license or prohibit delivery
388.18of services by a provider for not more than 90 days if the commissioner determines that
388.19the health or safety of a consumer is in imminent danger, provided:
388.20(1) advance notice is given to the home care provider;
388.21(2) after notice, the home care provider fails to correct the problem;
388.22(3) the commissioner has reason to believe that other administrative remedies are not
388.23likely to be effective; and
388.24(4) there is an opportunity for a contested case hearing within the 90 days.
388.25    Subd. 4. Time limits for appeals. To appeal the assessment of civil penalties
388.26under section 144A.45, subdivision 2, clause (5), and an action against a license under
388.27this section, a provider must request a hearing no later than 15 days after the provider
388.28receives notice of the action.
388.29    Subd. 5. Plan required. (a) The process of suspending or revoking a license
388.30must include a plan for transferring affected clients to other providers by the home care
388.31provider, which will be monitored by the commissioner. Within three business days of
388.32being notified of the final revocation or suspension action, the home care provider shall
388.33provide the commissioner, the lead agencies as defined in section 256B.0911, and the
388.34ombudsman for long-term care with the following information:
388.35(1) a list of all clients, including full names and all contact information on file;
389.1(2) a list of each client's representative or emergency contact person, including full
389.2names and all contact information on file;
389.3(3) the location or current residence of each client;
389.4(4) the payor sources for each client, including payor source identification numbers;
389.5and
389.6(5) for each client, a copy of the client's service plan, and a list of the types of
389.7services being provided.
389.8(b) The revocation or suspension notification requirement is satisfied by mailing the
389.9notice to the address in the license record. The home care provider shall cooperate with
389.10the commissioner and the lead agencies during the process of transferring care of clients to
389.11qualified providers. Within three business days of being notified of the final revocation or
389.12suspension action, the home care provider must notify and disclose to each of the home
389.13care provider's clients, or the client's representative or emergency contact persons, that
389.14the commissioner is taking action against the home care provider's license by providing a
389.15copy of the revocation or suspension notice issued by the commissioner.
389.16    Subd. 6. Owners and managerial officials; refusal to grant license. (a) The
389.17owner and managerial officials of a home care provider whose Minnesota license has not
389.18been renewed or that has been revoked because of noncompliance with applicable laws or
389.19rules shall not be eligible to apply for nor will be granted a home care license, including
389.20other licenses under this chapter, or be given status as an enrolled personal care assistance
389.21provider agency or personal care assistant by the Department of Human Services under
389.22section 256B.0659 for five years following the effective date of the nonrenewal or
389.23revocation. If the owner and managerial officials already have enrollment status, their
389.24enrollment will be terminated by the Department of Human Services.
389.25(b) The commissioner shall not issue a license to a home care provider for five
389.26years following the effective date of license nonrenewal or revocation if the owner or
389.27managerial official, including any individual who was an owner or managerial official
389.28of another home care provider, had a Minnesota license that was not renewed or was
389.29revoked as described in paragraph (a).
389.30(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall
389.31suspend or revoke, the license of any home care provider that includes any individual
389.32as an owner or managerial official who was an owner or managerial official of a home
389.33care provider whose Minnesota license was not renewed or was revoked as described in
389.34paragraph (a) for five years following the effective date of the nonrenewal or revocation.
389.35(d) The commissioner shall notify the home care provider 30 days in advance of
389.36the date of nonrenewal, suspension, or revocation of the license. Within ten days after
390.1the receipt of the notification, the home care provider may request, in writing, that the
390.2commissioner stay the nonrenewal, revocation, or suspension of the license. The home
390.3care provider shall specify the reasons for requesting the stay; the steps that will be taken
390.4to attain or maintain compliance with the licensure laws and regulations; any limits on the
390.5authority or responsibility of the owners or managerial officials whose actions resulted in
390.6the notice of nonrenewal, revocation, or suspension; and any other information to establish
390.7that the continuing affiliation with these individuals will not jeopardize client health, safety,
390.8or well-being. The commissioner shall determine whether the stay will be granted within
390.930 days of receiving the provider's request. The commissioner may propose additional
390.10restrictions or limitations on the provider's license and require that the granting of the stay
390.11be contingent upon compliance with those provisions. The commissioner shall take into
390.12consideration the following factors when determining whether the stay should be granted:
390.13(1) the threat that continued involvement of the owners and managerial officials with
390.14the home care provider poses to client health, safety, and well-being;
390.15(2) the compliance history of the home care provider; and
390.16(3) the appropriateness of any limits suggested by the home care provider.
390.17    If the commissioner grants the stay, the order shall include any restrictions or
390.18limitation on the provider's license. The failure of the provider to comply with any
390.19restrictions or limitations shall result in the immediate removal of the stay and the
390.20commissioner shall take immediate action to suspend, revoke, or not renew the license.
390.21    Subd. 7. Request for hearing. A request for a hearing must be in writing and must:
390.22(1) be mailed or delivered to the department or the commissioner's designee;
390.23(2) contain a brief and plain statement describing every matter or issue contested; and
390.24(3) contain a brief and plain statement of any new matter that the applicant or home
390.25care provider believes constitutes a defense or mitigating factor.
390.26    Subd. 8. Informal conference. At any time, the applicant or home care provider
390.27and the commissioner may hold an informal conference to exchange information, clarify
390.28issues, or resolve issues.
390.29    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the
390.30commissioner may bring an action in district court to enjoin a person who is involved in
390.31the management, operation, or control of a home care provider or an employee of the
390.32home care provider from illegally engaging in activities regulated by sections 144A.43 to
390.33144A.482. The commissioner may bring an action under this subdivision in the district
390.34court in Ramsey County or in the district in which a home care provider is providing
390.35services. The court may grant a temporary restraining order in the proceeding if continued
390.36activity by the person who is involved in the management, operation, or control of a home
391.1care provider, or by an employee of the home care provider, would create an imminent
391.2risk of harm to a recipient of home care services.
391.3    Subd. 10. Subpoena. In matters pending before the commissioner under sections
391.4144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance
391.5of witnesses and the production of all necessary papers, books, records, documents, and
391.6other evidentiary material. If a person fails or refuses to comply with a subpoena or
391.7order of the commissioner to appear or testify regarding any matter about which the
391.8person may be lawfully questioned or to produce any papers, books, records, documents,
391.9or evidentiary materials in the matter to be heard, the commissioner may apply to the
391.10district court in any district, and the court shall order the person to comply with the
391.11commissioner's order or subpoena. The commissioner of health may administer oaths to
391.12witnesses or take their affirmation. Depositions may be taken in or outside the state in the
391.13manner provided by law for the taking of depositions in civil actions. A subpoena or other
391.14process or paper may be served on a named person anywhere in the state by an officer
391.15authorized to serve subpoenas in civil actions, with the same fees and mileage and in the
391.16same manner as prescribed by law for a process issued out of a district court. A person
391.17subpoenaed under this subdivision shall receive the same fees, mileage, and other costs
391.18that are paid in proceedings in district court.

391.19    Sec. 13. [144A.476] BACKGROUND STUDIES.
391.20    Subdivision 1. Prior criminal convictions; owner and managerial officials. (a)
391.21Before the commissioner issues a temporary license or renews a license, an owner or
391.22managerial official is required to complete a background study under section 144.057. No
391.23person may be involved in the management, operation, or control of a home care provider
391.24if the person has been disqualified under chapter 245C. If an individual is disqualified
391.25under section 144.057 or chapter 245C, the individual may request reconsideration of
391.26the disqualification. If the individual requests reconsideration and the commissioner
391.27sets aside or rescinds the disqualification, the individual is eligible to be involved in the
391.28management, operation, or control of the provider. If an individual has a disqualification
391.29under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's
391.30disqualification is barred from a set aside, and the individual must not be involved in the
391.31management, operation, or control of the provider.
391.32(b) For purposes of this section, owners of a home care provider subject to the
391.33background check requirement are those individuals whose ownership interest provides
391.34sufficient authority or control to affect or change decisions related to the operation of the
391.35home care provider. An owner includes a sole proprietor, a general partner, or any other
392.1individual whose individual ownership interest can affect the management and direction
392.2of the policies of the home care provider.
392.3(c) For the purposes of this section, managerial officials subject to the background
392.4check requirement are individuals who provide direct contact as defined in section 245C.02,
392.5subdivision 11, or individuals who have the responsibility for the ongoing management or
392.6direction of the policies, services, or employees of the home care provider. Data collected
392.7under this subdivision shall be classified as private data under section 13.02, subdivision 12.
392.8(d) The department shall not issue any license if the applicant or owner or managerial
392.9official has been unsuccessful in having a background study disqualification set aside
392.10under section 144.057 and chapter 245C; if the owner or managerial official, as an owner
392.11or managerial official of another home care provider, was substantially responsible for
392.12the other home care provider's failure to substantially comply with sections 144A.43 to
392.13144A.482; or if an owner that has ceased doing business, either individually or as an
392.14owner of a home care provider, was issued a correction order for failing to assist clients in
392.15violation of this chapter.
392.16    Subd. 2. Employees, contractors, and volunteers. (a) Employees, contractors,
392.17and volunteers of a home care provider are subject to the background study required by
392.18section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall
392.19be construed to prohibit a home care provider from requiring self-disclosure of criminal
392.20conviction information.
392.21(b) Termination of an employee in good faith reliance on information or records
392.22obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not
392.23subject the home care provider to civil liability or liability for unemployment benefits.

392.24    Sec. 14. [144A.477] COMPLIANCE.
392.25    Subdivision 1. Medicare-certified providers; coordination of surveys. If feasible,
392.26the commissioner shall survey licensees to determine compliance with this chapter at the
392.27same time as surveys for certification for Medicare if Medicare certification is based on
392.28compliance with the federal conditions of participation and on survey and enforcement
392.29by the Department of Health as agent for the United States Department of Health and
392.30Human Services.
392.31    Subd. 2. Medicare-certified providers; equivalent requirements. For home care
392.32providers licensed to provide comprehensive home care services that are also certified for
392.33participation in Medicare as a home health agency under Code of Federal Regulations,
392.34title 42, part 484, the following state licensure regulations are considered equivalent to
392.35the federal requirements:
393.1(1) quality management, section 144A.479, subdivision 3;
393.2(2) personnel records, section 144A.479, subdivision 7;
393.3(3) acceptance of clients, section 144A.4791, subdivision 4;
393.4(4) referrals, section 144A.4791, subdivision 5;
393.5(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792,
393.6subdivisions 2 and 3;
393.7(6) individualized monitoring and reassessment, sections 144A.4791, subdivision
393.88, and 144A.4792, subdivisions 2 and 3;
393.9(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792,
393.10subdivision 5, and 144A.4793, subdivision 3;
393.11(8) client complaint and investigation process, section 144A.4791, subdivision 11;
393.12(9) prescription orders, section 144A.4792, subdivisions 13 to 16;
393.13(10) client records, section 144A.4794, subdivisions 1 to 3;
393.14(11) qualifications for unlicensed personnel performing delegated tasks, section
393.15144A.4795;
393.16(12) training and competency staff, section 144A.4795;
393.17(13) training and competency for unlicensed personnel, section 144A.4795,
393.18subdivision 7;
393.19(14) delegation of home care services, section 144A.4795, subdivision 4;
393.20(15) availability of contact person, section 144A.4797, subdivision 1; and
393.21(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.
393.22Violations of requirements in clauses (1) to (16) may lead to enforcement actions
393.23under section 144A.474.

393.24    Sec. 15. [144A.478] INNOVATION VARIANCE.
393.25    Subdivision 1. Definition. For purposes of this section, "innovation variance"
393.26means a specified alternative to a requirement of this chapter. An innovation variance
393.27may be granted to allow a home care provider to offer home care services of a type or
393.28in a manner that is innovative, will not impair the services provided, will not adversely
393.29affect the health, safety, or welfare of the clients, and is likely to improve the services
393.30provided. The innovative variance cannot change any of the client's rights under section
393.31144A.44, home care bill of rights.
393.32    Subd. 2. Conditions. The commissioner may impose conditions on the granting of
393.33an innovation variance that the commissioner considers necessary.
393.34    Subd. 3. Duration and renewal. The commissioner may limit the duration of any
393.35innovation variance and may renew a limited innovation variance.
394.1    Subd. 4. Applications; innovation variance. An application for innovation
394.2variance from the requirements of this chapter may be made at any time, must be made in
394.3writing to the commissioner, and must specify the following:
394.4(1) the statute or law from which the innovation variance is requested;
394.5(2) the time period for which the innovation variance is requested;
394.6(3) the specific alternative action that the licensee proposes;
394.7(4) the reasons for the request; and
394.8(5) justification that an innovation variance will not impair the services provided,
394.9will not adversely affect the health, safety, or welfare of clients, and is likely to improve
394.10the services provided.
394.11The commissioner may require additional information from the home care provider before
394.12acting on the request.
394.13    Subd. 5. Grants and denials. The commissioner shall grant or deny each request
394.14for an innovation variance in writing within 45 days of receipt of a complete request.
394.15Notice of a denial shall contain the reasons for the denial. The terms of a requested
394.16innovation variance may be modified upon agreement between the commissioner and
394.17the home care provider.
394.18    Subd. 6. Violation of innovation variances. A failure to comply with the terms of
394.19an innovation variance shall be deemed to be a violation of this chapter.
394.20    Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or
394.21deny renewal of an innovation variance if:
394.22(1) it is determined that the innovation variance is adversely affecting the health,
394.23safety, or welfare of the licensee's clients;
394.24(2) the home care provider has failed to comply with the terms of the innovation
394.25variance;
394.26(3) the home care provider notifies the commissioner in writing that it wishes to
394.27relinquish the innovation variance and be subject to the statute previously varied; or
394.28(4) the revocation or denial is required by a change in law.

394.29    Sec. 16. [144A.479] HOME CARE PROVIDER RESPONSIBILITIES;
394.30BUSINESS OPERATION.
394.31    Subdivision 1. Display of license. The original current license must be displayed
394.32in the home care providers' principal business office and copies must be displayed in
394.33any branch office. The home care provider must provide a copy of the license to any
394.34person who requests it.
395.1    Subd. 2. Advertising. Home care providers shall not use false, fraudulent,
395.2or misleading advertising in the marketing of services. For purposes of this section,
395.3advertising includes any verbal, written, or electronic means of communicating to
395.4potential clients about the availability, nature, or terms of home care services.
395.5    Subd. 3. Quality management. The home care provider shall engage in quality
395.6management appropriate to the size of the home care provider and relevant to the type
395.7of services the home care provider provides. The quality management activity means
395.8evaluating the quality of care by periodically reviewing client services, complaints made,
395.9and other issues that have occurred and determining whether changes in services, staffing,
395.10or other procedures need to be made in order to ensure safe and competent services to
395.11clients. Documentation about quality management activity must be available for two
395.12years. Information about quality management must be available to the commissioner at
395.13the time of the survey, investigation, or renewal.
395.14    Subd. 4. Provider restrictions. (a) This subdivision does not apply to licensees
395.15that are Minnesota counties or other units of government.
395.16(b) A home care provider or staff cannot accept powers-of-attorney from clients for
395.17any purpose, and may not accept appointments as guardians or conservators of clients.
395.18(c) A home care provider cannot serve as a client's representative.
395.19    Subd. 5. Handling of client's finances and property. (a) A home care provider
395.20may assist clients with household budgeting, including paying bills and purchasing
395.21household goods, but may not otherwise manage a client's property. A home care provider
395.22must provide a client with receipts for all transactions and purchases paid with the clients'
395.23funds. When receipts are not available, the transaction or purchase must be documented.
395.24A home care provider must maintain records of all such transactions.
395.25(b) A home care provider or staff may not borrow a client's funds or personal or
395.26real property, nor in any way convert a client's property to the home care provider's or
395.27staff's possession.
395.28(c) Nothing in this section precludes a home care provider or staff from accepting
395.29gifts of minimal value, or precludes the acceptance of donations or bequests made to a
395.30home care provider that are exempt from income tax under section 501(c) of the Internal
395.31Revenue Code of 1986.
395.32    Subd. 6. Reporting maltreatment of vulnerable adults and minors. (a) All
395.33home care providers must comply with requirements for the reporting of maltreatment
395.34of minors in section 626.556 and the requirements for the reporting of maltreatment
395.35of vulnerable adults in section 626.557. Home care providers must report suspected
395.36maltreatment of minors and vulnerable adults to the common entry point. Each home
396.1care provider must establish and implement a written procedure to ensure that all cases
396.2of suspected maltreatment are reported.
396.3(b) Each home care provider must develop and implement an individual abuse
396.4prevention plan for each vulnerable minor or adult for whom home care services are
396.5provided by a home care provider. The plan shall contain an individualized review or
396.6assessment of the person's susceptibility to abuse by another individual, including other
396.7vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors;
396.8and statements of the specific measures to be taken to minimize the risk of abuse to that
396.9person and other vulnerable adults or minors. For purposes of the abuse prevention plan,
396.10the term abuse includes self-abuse.
396.11    Subd. 7. Employee records. The home care provider must maintain current records
396.12of each paid employee, regularly scheduled volunteers providing home care services, and
396.13of each individual contractor providing home care services. The records must include
396.14the following information:
396.15(1) evidence of current professional licensure, registration, or certification, if
396.16licensure, registration, or certification is required by this statute, or other rules;
396.17(2) records of orientation, required annual training and infection control training,
396.18and competency evaluations;
396.19(3) current job description, including qualifications, responsibilities, and
396.20identification of staff providing supervision;
396.21(4) documentation of annual performance reviews which identify areas of
396.22improvement needed and training needs;
396.23(5) for individuals providing home care services, verification that required health
396.24screenings under section 144A.4798 have taken place and the dates of those screenings; and
396.25(6) documentation of the background study as required under section 144.057.
396.26Each employee record must be retained for at least three years after a paid employee,
396.27home care volunteer, or contractor ceases to be employed by or under contract with the
396.28home care provider. If a home care provider ceases operation, employee records must be
396.29maintained for three years.

396.30    Sec. 17. [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH
396.31RESPECT TO CLIENTS.
396.32    Subdivision 1. Home care bill of rights; notification to client. (a) The home
396.33care provider shall provide the client or the client's representative a written notice of the
396.34rights under section 144A.44 in a language that the client or the client's representative
396.35can understand before the initiation of services to that client. If a written version is not
397.1available, the home care bill of rights must be communicated to the client or client's
397.2representative in a language they can understand.
397.3(b) In addition to the text of the home care bill of rights in section 144A.44,
397.4subdivision 1, the notice shall also contain the following statement describing how to file
397.5a complaint with these offices.
397.6"If you have a complaint about the provider or the person providing your
397.7home care services, you may call, write, or visit the Office of Health Facility
397.8Complaints, Minnesota Department of Health. You may also contact the Office of
397.9Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health
397.10and Developmental Disabilities."
397.11The statement should include the telephone number, Web site address, e-mail
397.12address, mailing address, and street address of the Office of Health Facility Complaints at
397.13the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care,
397.14and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
397.15statement should also include the home care provider's name, address, e-mail, telephone
397.16number, and name or title of the person at the provider to whom problems or complaints
397.17may be directed. It must also include a statement that the home care provider will not
397.18retaliate because of a complaint.
397.19(c) The home care provider shall obtain written acknowledgment of the client's
397.20receipt of the home care bill of rights or shall document why an acknowledgment cannot
397.21be obtained. The acknowledgment may be obtained from the client or the client's
397.22representative. Acknowledgment of receipt shall be retained in the client's record.
397.23    Subd. 2. Notice of services for dementia, Alzheimer's disease, or related
397.24disorders. The home care provider that provides services to clients with dementia shall
397.25provide in written or electronic form, to clients and families or other persons who request
397.26it, a description of the training program and related training it provides, including the
397.27categories of employees trained, the frequency of training, and the basic topics covered.
397.28This information satisfies the disclosure requirements in section 325F.72, subdivision
397.292, clause (4).
397.30    Subd. 3. Statement of home care services. Prior to the initiation of services,
397.31a home care provider must provide to the client or the client's representative a written
397.32statement which identifies if they have a basic or comprehensive home care license, the
397.33services they are authorized to provide, and which services they cannot provide under the
397.34scope of their license. The home care provider shall obtain written acknowledgment
397.35from the clients that they have provided the statement or must document why they could
397.36not obtain the acknowledgment.
398.1    Subd. 4. Acceptance of clients. No home care provider may accept a person as a
398.2client unless the home care provider has staff, sufficient in qualifications, competency,
398.3and numbers, to adequately provide the services agreed to in the service plan and that
398.4are within the provider's scope of practice.
398.5    Subd. 5. Referrals. If a home care provider reasonably believes that a client is in
398.6need of another medical or health service, including a licensed health professional, or
398.7social service provider, the home care provider shall:
398.8(1) determine the client's preferences with respect to obtaining the service; and
398.9(2) inform the client of resources available, if known, to assist the client in obtaining
398.10services.
398.11    Subd. 6. Initiation of services. When a provider initiates services and the
398.12individualized review or assessment required in subdivisions 7 and 8 has not been
398.13completed, the provider must complete a temporary plan and agreement with the client for
398.14services.
398.15    Subd. 7. Basic individualized client review and monitoring. (a) When services
398.16being provided are basic home care services, an individualized initial review of the client's
398.17needs and preferences must be conducted at the client's residence with the client or client's
398.18representative. This initial review must be completed within 30 days after the initiation of
398.19the home care services.
398.20(b) Client monitoring and review must be conducted as needed based on changes
398.21in the needs of the client and cannot exceed 90 days from the date of the last review.
398.22The monitoring and review may be conducted at the client's residence or through the
398.23utilization of telecommunication methods based on practice standards that meet the
398.24individual client's needs.
398.25    Subd. 8. Comprehensive assessment, monitoring, and reassessment. (a) When
398.26the services being provided are comprehensive home care services, an individualized
398.27initial assessment must be conducted in-person by a registered nurse. When the services
398.28are provided by other licensed health professionals, the assessment must be conducted by
398.29the appropriate health professional. This initial assessment must be completed within five
398.30days after initiation of home care services.
398.31(b) Client monitoring and reassessment must be conducted in the client's home no
398.32more than 14 days after initiation of services.
398.33(c) Ongoing client monitoring and reassessment must be conducted as needed based
398.34on changes in the needs of the client and cannot exceed 90 days from the last date of the
398.35assessment. The monitoring and reassessment may be conducted at the client's residence
399.1or through the utilization of telecommunication methods based on practice standards that
399.2meet the individual client's needs.
399.3    Subd. 9. Service plan, implementation, and revisions to service plan. (a) No later
399.4than 14 days after the initiation of services, a home care provider shall finalize a current
399.5written service plan.
399.6(b) The service plan and any revisions must include a signature or other
399.7authentication by the home care provider and by the client or the client's representative
399.8documenting agreement on the services to be provided. The service plan must be revised,
399.9if needed, based on client review or reassessment under subdivisions 7 and 8. The provider
399.10must provide information to the client about changes to the provider's fee for services and
399.11how to contact the Office of the Ombudsman for Long-Term Care.
399.12(c) The home care provider must implement and provide all services required by
399.13the current service plan.
399.14(d) The service plan and revised service plan must be entered into the client's record,
399.15including notice of a change in a client's fees when applicable.
399.16(e) Staff providing home care services must be informed of the current written
399.17service plan.
399.18(f) The service plan must include:
399.19(1) a description of the home care services to be provided, the fees for services, and
399.20the frequency of each service, according to the client's current review or assessment and
399.21client preferences;
399.22(2) the identification of the staff or categories of staff who will provide the services;
399.23(3) the schedule and methods of monitoring reviews or assessments of the client;
399.24(4) the frequency of sessions of supervision of staff and type of personnel who
399.25will supervise staff; and
399.26(5) a contingency plan that includes:
399.27(i) the action to be taken by the home care provider and by the client or client's
399.28representative if the scheduled service cannot be provided;
399.29(ii) information and method for a client or client's representative to contact the
399.30home care provider;
399.31(iii) names and contact information of persons the client wishes to have notified
399.32in an emergency or if there is a significant adverse change in the client's condition,
399.33including identification of and information as to who has authority to sign for the client in
399.34an emergency; and
400.1(iv) the circumstances in which emergency medical services are not to be summoned
400.2consistent with chapters 145B and 145C, and declarations made by the client under those
400.3chapters.
400.4    Subd. 10. Termination of service plan. (a) If a home care provider terminates a
400.5service plan with a client, and the client continues to need home care services, the home
400.6care provider shall provide the client and the client's representative, if any, with a written
400.7notice of termination which includes the following information:
400.8(1) the effective date of termination;
400.9(2) the reason for termination;
400.10(3) a list of known licensed home care providers in the client's immediate geographic
400.11area;
400.12(4) a statement that the home care provider will participate in a coordinated transfer
400.13of care of the client to another home care provider, health care provider, or caregiver, as
400.14required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
400.15(5) the name and contact information of a person employed by the home care
400.16provider with whom the client may discuss the notice of termination; and
400.17(6) if applicable, a statement that the notice of termination of home care services
400.18does not constitute notice of termination of the housing with services contract with a
400.19housing with services establishment.
400.20(b) When the home care provider voluntarily discontinues services to all clients, the
400.21home care provider must notify the commissioner, lead agencies, and the ombudsman for
400.22long-term care about its clients and comply with the requirements in this subdivision.
400.23    Subd. 11. Client complaint and investigative process. (a) The home care
400.24provider must have a written policy and system for receiving, investigating, reporting,
400.25and attempting to resolve complaints from its clients or clients' representatives. The
400.26policy should clearly identify the process by which clients may file a complaint or concern
400.27about home care services and an explicit statement that the home care provider will not
400.28discriminate or retaliate against a client for expressing concerns or complaints. A home
400.29care provider must have a process in place to conduct investigations of complaints made
400.30by the client or the client's representative about the services in the client's plan that are or
400.31are not being provided or other items covered in the client's home care bill of rights. This
400.32complaint system must provide reasonable accommodations for any special needs of the
400.33client or client's representative if requested.
400.34(b) The home care provider must document the complaint, name of the client,
400.35investigation, and resolution of each complaint filed. The home care provider must
400.36maintain a record of all activities regarding complaints received, including the date the
401.1complaint was received, and the home care provider's investigation and resolution of the
401.2complaint. This complaint record must be kept for each event for at least two years after
401.3the date of entry and must be available to the commissioner for review.
401.4(c) The required complaint system must provide for written notice to each client or
401.5client's representative that includes:
401.6(1) the client's right to complain to the home care provider about the services received;
401.7(2) the name or title of the person or persons with the home care provider to contact
401.8with complaints;
401.9(3) the method of submitting a complaint to the home care provider; and
401.10(4) a statement that the provider is prohibited against retaliation according to
401.11paragraph (d).
401.12(d) A home care provider must not take any action that negatively affects a client
401.13in retaliation for a complaint made or a concern expressed by the client or the client's
401.14representative.
401.15    Subd. 12. Disaster planning and emergency preparedness plan. The home care
401.16provider must have a written plan of action to facilitate the management of the client's care
401.17and services in response to a natural disaster, such as flood and storms, or other emergencies
401.18that may disrupt the home care provider's ability to provide care or services. The licensee
401.19must provide adequate orientation and training of staff on emergency preparedness.
401.20    Subd. 13. Request for discontinuation of life-sustaining treatment. (a) If a
401.21client, family member, or other caregiver of the client requests that an employee or other
401.22agent of the home care provider discontinue a life-sustaining treatment, the employee or
401.23agent receiving the request:
401.24(1) shall take no action to discontinue the treatment; and
401.25(2) shall promptly inform their supervisor or other agent of the home care provider
401.26of the client's request.
401.27(b) Upon being informed of a request for termination of treatment, the home care
401.28provider shall promptly:
401.29(1) inform the client that the request will be made known to the physician who
401.30ordered the client's treatment;
401.31(2) inform the physician of the client's request; and
401.32(3) work with the client and the client's physician to comply with the provisions of
401.33the Health Care Directive Act in chapter 145C.
401.34(c) This section does not require the home care provider to discontinue treatment,
401.35except as may be required by law or court order.
402.1(d) This section does not diminish the rights of clients to control their treatments,
402.2refuse services, or terminate their relationships with the home care provider.
402.3(e) This section shall be construed in a manner consistent with chapter 145B or
402.4145C, whichever applies, and declarations made by clients under those chapters.

402.5    Sec. 18. [144A.4792] MEDICATION MANAGEMENT.
402.6    Subdivision 1. Medication management services; comprehensive home care
402.7license. (a) This subdivision applies only to home care providers with a comprehensive
402.8home care license that provides medication management services to clients. Medication
402.9management services may not be provided by a home care provider that has a basic
402.10home care license.
402.11(b) A comprehensive home care provider who provides medication management
402.12services must develop, implement, and maintain current written medication management
402.13policies and procedures. The policies and procedures must be developed under the
402.14supervision and direction of a registered nurse, licensed health professional, or pharmacist
402.15consistent with current practice standards and guidelines.
402.16(c) The written policies and procedures must address requesting and receiving
402.17prescriptions for medications; preparing and giving medications; verifying that
402.18prescription drugs are administered as prescribed; documenting medication management
402.19activities; controlling and storing medications; monitoring and evaluating medication use;
402.20resolving medication errors; communicating with the prescriber, pharmacist, and client
402.21and client representative, if any; disposing of unused medications; and educating clients
402.22and client representatives about medications. When controlled substances are being
402.23managed, the policies and procedures must also identify how the provider will ensure
402.24security and accountability for the overall management, control, and disposition of those
402.25substances in compliance with state and federal regulations and with subdivision 22.
402.26    Subd. 2. Provision of medication management services. (a) For each client who
402.27requests medication management services, the comprehensive home care provider shall,
402.28prior to providing medication management services, have a registered nurse, licensed
402.29health professional, or authorized prescriber under section 151.37 conduct an assessment
402.30to determine what mediation management services will be provided and how the services
402.31will be provided. This assessment must be conducted face-to-face with the client. The
402.32assessment must include an identification and review of all medications the client is known
402.33to be taking. The review and identification must include indications for medications, side
402.34effects, contraindications, allergic or adverse reactions, and actions to address these issues.
403.1(b) The assessment must identify interventions needed in management of
403.2medications to prevent diversion of medication by the client or others who may have
403.3access to the medications. Diversion of medications means the misuse, theft, or illegal
403.4or improper disposition of medications.
403.5    Subd. 3. Individualized medication monitoring and reassessment. The
403.6comprehensive home care provider must monitor and reassess the client's medication
403.7management services as needed under subdivision 14 when the client presents with
403.8symptoms or other issues that may be medication-related and, at a minimum, annually.
403.9    Subd. 4. Client refusal. The home care provider must document in the client's
403.10record any refusal for an assessment for medication management by the client. The
403.11provider must discuss with the client the possible consequences of the client's refusal and
403.12document the discussion in the client's record.
403.13    Subd. 5. Individualized medication management plan. (a) For each client
403.14receiving medication management services, the comprehensive home care provider must
403.15prepare and include in the service plan a written statement of the medication management
403.16services that will be provided to the client. The provider must develop and maintain a
403.17current individualized medication management record for each client based on the client's
403.18assessment that must contain the following:
403.19(1) a statement describing the medication management services that will be provided;
403.20(2) a description of storage of medications based on the client's needs and
403.21preferences, risk of diversion, and consistent with the manufacturer's directions;
403.22(3) documentation of specific client instructions relating to the administration
403.23of medications;
403.24(4) identification of persons responsible for monitoring medication supplies and
403.25ensuring that medication refills are ordered on a timely basis;
403.26(5) identification of medication management tasks that may be delegated to
403.27unlicensed personnel;
403.28(6) procedures for staff notifying a registered nurse or appropriate licensed health
403.29professional when a problem arises with medication management services; and
403.30(7) any client-specific requirements relating to documenting medication
403.31administration, verifications that all medications are administered as prescribed, and
403.32monitoring of medication use to prevent possible complications or adverse reactions.
403.33(b) The medication management record must be current and updated when there are
403.34any changes.
403.35    Subd. 6. Administration of medication. Medications may be administered by a
403.36nurse, physician, or other licensed health practitioner authorized to administer medications
404.1or by unlicensed personnel who have been delegated medication administration tasks by
404.2a registered nurse.
404.3    Subd. 7. Delegation of medication administration. When administration of
404.4medications is delegated to unlicensed personnel, the comprehensive home care provider
404.5must ensure that the registered nurse has:
404.6(1) instructed the unlicensed personnel in the proper methods to administer the
404.7medications, and the unlicensed personnel has demonstrated ability to competently follow
404.8the procedures;
404.9(2) specified, in writing, specific instructions for each client and documented those
404.10instructions in the client's records; and
404.11(3) communicated with the unlicensed personnel about the individual needs of
404.12the client.
404.13    Subd. 8. Documentation of administration of medications. Each medication
404.14administered by comprehensive home care provider staff must be documented in the
404.15client's record. The documentation must include the signature and title of the person
404.16who administered the medication. The documentation must include the medication
404.17name, dosage, date and time administered, and method and route of administration. The
404.18staff must document the reason why medication administration was not completed as
404.19prescribed and document any follow-up procedures that were provided to meet the client's
404.20needs when medication was not administered as prescribed and in compliance with the
404.21client's medication management plan.
404.22    Subd. 9. Documentation of medication set up. Documentation of dates of
404.23medication set up, name of medication, quantity of dose, times to be administered, route
404.24of administration, and name of person completing medication set up must be done at
404.25time of set up.
404.26    Subd. 10. Medications management for clients who will be away from home. (a)
404.27A home care provider that is providing medication management services to the client and
404.28controls the client's access to the medications must develop and implement policies and
404.29procedures for giving accurate and current medications to clients for planned or unplanned
404.30times away from home according to the client's individualized medication management
404.31plan. The policy and procedures must state that:
404.32(1) for planned time away, the medications must be obtained from the pharmacy or
404.33set up by the registered nurse according to appropriate state and federal laws and nursing
404.34standards of practice;
404.35(2) for unplanned time away, when the pharmacy is not able to provide the
404.36medications, a licensed nurse or unlicensed personnel shall give the client or client's
405.1representative medications in amounts and dosages needed for the length of the anticipated
405.2absence, not to exceed 120 hours;
405.3(3) the client, or the client's representative, must be provided written information
405.4on medications, including any special instructions for administering or handling the
405.5medications, including controlled substances;
405.6(4) the medications must be placed in a medication container or containers
405.7appropriate to the provider's medication system and must be labeled with the client's name
405.8and the dates and times that the medications are scheduled; and
405.9(5) the client or client's representative must be provided in writing the home care
405.10provider's name and information on how to contact the home care provider.
405.11(b) For unplanned time away when the licensed nurse is not available, the registered
405.12nurse may delegate this task to unlicensed personnel if:
405.13(1) the registered nurse has trained the unlicensed staff and determined the
405.14unlicensed staff is competent to follow the procedures for giving medications to clients;
405.15(2) the registered nurse has developed written procedures for the unlicensed
405.16personnel, including any special instructions or procedures regarding controlled substances
405.17that are prescribed for the client. The procedures must address:
405.18(i) the type of container or containers to be used for the medications appropriate to
405.19the provider's medication system;
405.20(ii) how the container or containers must be labeled;
405.21(iii) the written information about the medications to be given to the client or client's
405.22representative;
405.23(iv) how the unlicensed staff will document in the client's record that medications
405.24have been given to the client or the client's representative, including documenting the date
405.25the medications were given to the client or the client's representative and who received the
405.26medications, the person who gave the medications to the client, the number of medications
405.27that were given to the client, and other required information;
405.28(v) how the registered nurse will be notified that medications have been given to
405.29the client or client's representative and whether the registered nurse needs to be contacted
405.30before the medications are given to the client or the client's representative; and
405.31(vi) a review by the registered nurse of the completion of this task to verify that this
405.32task was completed accurately by the unlicensed personnel.
405.33    Subd. 11. Prescribed and nonprescribed medication. The comprehensive home
405.34care provider must determine whether it will require a prescription for all medications it
405.35manages. The comprehensive home care provider must inform the client or the client's
405.36representative whether the comprehensive home care provider requires a prescription
406.1for all over-the-counter and dietary supplements before the comprehensive home care
406.2provider will agree to manage those medications.
406.3    Subd. 12. Medications; over-the-counter; dietary supplements not prescribed.
406.4A comprehensive home care provider providing medication management services for
406.5over-the-counter drugs or dietary supplements must retain those items in the original labeled
406.6container with directions for use prior to setting up for immediate or later administration.
406.7The provider must verify that the medications are up-to-date and stored as appropriate.
406.8    Subd. 13. Prescriptions. There must be a current written or electronically recorded
406.9prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed
406.10medications that the comprehensive home care provider is managing for the client.
406.11    Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least
406.12every 12 months or more frequently as indicated by the assessment in subdivision 2.
406.13Prescriptions for controlled substances must comply with chapter 152.
406.14    Subd. 15. Verbal prescription orders. Verbal prescription orders from an
406.15authorized prescriber must be received by a nurse or pharmacist. The order must be
406.16handled according to Minnesota Rules, part 6800.6200.
406.17    Subd. 16. Written or electronic prescription. When a written or electronic
406.18prescription is received, it must be communicated to the registered nurse in charge and
406.19recorded or placed in the client's record.
406.20    Subd. 17. Records confidential. A prescription or order received verbally, in
406.21writing, or electronically must be kept confidential according to sections 144.291 to
406.22144.298 and 144A.44.
406.23    Subd. 18. Medications provided by client or family members. When the
406.24comprehensive home care provider is aware of any medications or dietary supplements
406.25that are being used by the client and are not included in the assessment for medication
406.26management services, the staff must advise the registered nurse and document that in
406.27the client's record.
406.28    Subd. 19. Storage of drugs. A comprehensive home care provider providing
406.29storage of medications outside of the client's private living space must store all prescription
406.30drugs in securely locked and substantially constructed compartments according to the
406.31manufacturer's directions and permit only authorized personnel to have access.
406.32    Subd. 20. Prescription drugs. A prescription drug, prior to being set up for
406.33immediate or later administration, must be kept in the original container in which it was
406.34dispensed by the pharmacy bearing the original prescription label with legible information
406.35including the expiration or beyond-use date of a time-dated drug.
407.1    Subd. 21. Prohibitions. No prescription drug supply for one client may be used or
407.2saved for use by anyone other than the client.
407.3    Subd. 22. Disposition of drugs. (a) Any current medications being managed by the
407.4comprehensive home care provider must be given to the client or the client's representative
407.5when the client's service plan ends or medication management services are no longer part
407.6of the service plan. Medications that have been stored in the client's private living space
407.7for a client that is deceased or that have been discontinued or that have expired may be
407.8given to the client or the client's representative for disposal.
407.9(b) The comprehensive home care provider will dispose of any medications
407.10remaining with the comprehensive home care provider that are discontinued or expired or
407.11upon the termination of the service contract or the client's death according to state and
407.12federal regulations for disposition of drugs and controlled substances.
407.13(c) Upon disposition, the comprehensive home care provider must document in the
407.14client's record the disposition of the medications including the medication's name, strength,
407.15prescription number as applicable, quantity, to whom the medications were given, date of
407.16disposition, and names of staff and other individuals involved in the disposition.
407.17    Subd. 23. Loss or spillage. (a) Comprehensive home care providers providing
407.18medication management must develop and implement procedures for loss or spillage of all
407.19controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must
407.20require that when a spillage of a controlled substance occurs, a notation must be made
407.21in the client's record explaining the spillage and the actions taken. The notation must
407.22be signed by the person responsible for the spillage and include verification that any
407.23contaminated substance was disposed of according to state or federal regulations.
407.24(b) The procedures must require the comprehensive home care provider of
407.25medication management to investigate any known loss or unaccounted for prescription
407.26drugs and take appropriate action required under state or federal regulations and document
407.27the investigation in required records.

407.28    Sec. 19. [144A.4793] TREATMENT AND THERAPY MANAGEMENT
407.29SERVICES.
407.30    Subdivision 1. Providers with a comprehensive home care license. This section
407.31applies only to home care providers with a comprehensive home care license that provide
407.32treatment or therapy management services to clients. Treatment or therapy management
407.33services cannot be provided by a home care provider that has a basic home care license.
407.34    Subd. 2. Policies and procedures. (a) A comprehensive home care provider who
407.35provides treatment and therapy management services must develop, implement, and
408.1maintain up-to-date written treatment or therapy management policies and procedures.
408.2The policies and procedures must be developed under the supervision and direction of
408.3a registered nurse or appropriate licensed health professional consistent with current
408.4practice standards and guidelines.
408.5(b) The written policies and procedures must address requesting and receiving
408.6orders or prescriptions for treatments or therapies, providing the treatment or therapy,
408.7documenting of treatment or therapy activities, educating and communicating with clients
408.8about treatments or therapy they are receiving, monitoring and evaluating the treatment
408.9and therapy, and communicating with the prescriber.
408.10    Subd. 3. Individualized treatment or therapy management plan. For each
408.11client receiving management of ordered or prescribed treatments or therapy services, the
408.12comprehensive home care provider must prepare and include in the service plan a written
408.13statement of the treatment or therapy services that will be provided to the client. The
408.14provider must also develop and maintain a current individualized treatment and therapy
408.15management record for each client which must contain at least the following:
408.16(1) a statement of the type of services that will be provided;
408.17(2) documentation of specific client instructions relating to the treatments or therapy
408.18administration;
408.19(3) identification of treatment or therapy tasks that will be delegated to unlicensed
408.20personnel;
408.21(4) procedures for notifying a registered nurse or appropriate licensed health
408.22professional when a problem arises with treatments or therapy services; and
408.23(5) any client-specific requirements relating to documentation of treatment
408.24and therapy received, verification that all treatment and therapy was administered as
408.25prescribed, and monitoring of treatment or therapy to prevent possible complications or
408.26adverse reactions. The treatment or therapy management record must be current and
408.27updated when there are any changes.
408.28    Subd. 4. Administration of treatments and therapy. Ordered or prescribed
408.29treatments or therapies must be administered by a nurse, physician, or other licensed health
408.30professional authorized to perform the treatment or therapy, or may be delegated or assigned
408.31to unlicensed personnel by the licensed health professional according to the appropriate
408.32practice standards for delegation or assignment. When administration of a treatment or
408.33therapy is delegated or assigned to unlicensed personnel, the home care provider must
408.34ensure that the registered nurse or authorized licensed health professional has:
408.35(1) instructed the unlicensed personnel in the proper methods with respect to each
408.36client and has demonstrated their ability to competently follow the procedures;
409.1(2) specified, in writing, specific instructions for each client and documented those
409.2instructions in the client's record; and
409.3(3) communicated with the unlicensed personnel about the individual needs of
409.4the client.
409.5    Subd. 5. Documentation of administration of treatments and therapies. Each
409.6treatment or therapy administered by a comprehensive home care provider must be
409.7documented in the client's record. The documentation must include the signature and title
409.8of the person who administered the treatment or therapy and must include the date and
409.9time of administration. When treatment or therapies are not administered as ordered or
409.10prescribed, the provider must document the reason why it was not administered and any
409.11follow-up procedures that were provided to meet the client's needs.
409.12    Subd. 6. Orders or prescriptions. There must be an up-to-date written or
409.13electronically recorded order or prescription for all treatments and therapies. The order
409.14must contain the name of the client, description of the treatment or therapy to be provided,
409.15and the frequency and other information needed to administer the treatment or therapy.

409.16    Sec. 20. [144A.4794] CLIENT RECORD REQUIREMENTS.
409.17    Subdivision 1. Client record. (a) The home care provider must maintain records
409.18for each client for whom it is providing services. Entries in the client records must be
409.19current, legible, permanently recorded, dated, and authenticated with the name and title
409.20of the person making the entry.
409.21(b) Client records, whether written or electronic, must be protected against loss,
409.22tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
409.23relevant federal and state laws. The home care provider shall establish and implement
409.24written procedures to control use, storage, and security of client's records and establish
409.25criteria for release of client information.
409.26(c) The home care provider may not disclose to any other person any personal,
409.27financial, medical, or other information about the client, except:
409.28(1) as may be required by law;
409.29(2) to employees or contractors of the home care provider, another home care
409.30provider, other health care practitioner or provider, or inpatient facility needing
409.31information in order to provide services to the client, but only such information that
409.32is necessary for the provision of services;
409.33(3) to persons authorized in writing by the client or the client's representative to
409.34receive the information, including third-party payers; and
410.1(4) to representatives of the commissioner authorized to survey or investigate home
410.2care providers under this chapter or federal laws.
410.3    Subd. 2. Access to records. The home care provider must ensure that the
410.4appropriate records are readily available to employees or contractors authorized to access
410.5the records. Client records must be maintained in a manner that allows for timely access,
410.6printing, or transmission of the records.
410.7    Subd. 3. Contents of client record. Contents of a client record include the
410.8following for each client:
410.9(1) identifying information, including the client's name, date of birth, address, and
410.10telephone number;
410.11(2) the name, address, and telephone number of an emergency contact, family
410.12members, client's representative, if any, or others as identified;
410.13(3) names, addresses, and telephone numbers of the client's health and medical
410.14service providers and other home care providers, if known;
410.15(4) health information, including medical history, allergies, and when the provider
410.16is managing medications, treatments or therapies that require documentation, and other
410.17relevant health records;
410.18(5) client's advance directives, if any;
410.19(6) the home care provider's current and previous assessments and service plans;
410.20(7) all records of communications pertinent to the client's home care services;
410.21(8) documentation of significant changes in the client's status and actions taken in
410.22response to the needs of the client including reporting to the appropriate supervisor or
410.23health care professional;
410.24(9) documentation of incidents involving the client and actions taken in response
410.25to the needs of the client including reporting to the appropriate supervisor or health
410.26care professional;
410.27(10) documentation that services have been provided as identified in the service plan;
410.28(11) documentation that the client has received and reviewed the home care bill
410.29of rights;
410.30(12) documentation that the client has been provided the statement of disclosure on
410.31limitations of services under section 144A.4791, subdivision 3;
410.32(13) documentation of complaints received and resolution;
410.33(14) discharge summary, including service termination notice and related
410.34documentation, when applicable; and
410.35(15) other documentation required under this chapter and relevant to the client's
410.36services or status.
411.1    Subd. 4. Transfer of client records. If a client transfers to another home care
411.2provider or other health care practitioner or provider, or is admitted to an inpatient facility,
411.3the home care provider, upon request of the client or the client's representative, shall take
411.4steps to ensure a coordinated transfer including sending a copy or summary of the client's
411.5record to the new home care provider, facility, or the client, as appropriate.
411.6    Subd. 5. Record retention. Following the client's discharge or termination of
411.7services, a home care provider must retain a client's record for at least five years, or as
411.8otherwise required by state or federal regulations. Arrangements must be made for secure
411.9storage and retrieval of client records if the home care provider ceases business.

411.10    Sec. 21. [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.
411.11    Subdivision 1. Qualifications, training, and competency. All staff providing
411.12home care services must be trained and competent in the provision of home care services
411.13consistent with current practice standards appropriate to the client's needs.
411.14    Subd. 2. Licensed health professionals and nurses. (a) Licensed health
411.15professionals and nurses providing home care services as an employee of a licensed home
411.16care provider must possess current Minnesota license or registration to practice.
411.17(b) Licensed health professionals and registered nurses must be competent in
411.18assessing client needs, planning appropriate home care services to meet client needs,
411.19implementing services, and supervising staff if assigned.
411.20(c) Nothing in this section limits or expands the rights of nurses or licensed health
411.21professionals to provide services within the scope of their licenses or registrations, as
411.22provided by law.
411.23    Subd. 3. Unlicensed personnel. (a) Unlicensed personnel providing basic home
411.24care services must have:
411.25(1) successfully completed a training and competency evaluation appropriate to
411.26the services provided by the home care provider and the topics listed in subdivision 7,
411.27paragraph (b); or
411.28(2) demonstrated competency by satisfactorily completing a written or oral test on
411.29the tasks the unlicensed personnel will perform and in the topics listed in subdivision
411.307, paragraph (b); and successfully demonstrate competency of topics in subdivision 7,
411.31paragraph (b), clauses (5), (7), and (8), by a practical skills test.
411.32Unlicensed personnel providing home care services for a basic home care provider may
411.33not perform delegated nursing or therapy tasks.
411.34(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive
411.35home care provider must:
412.1(1) have successfully completed training and demonstrated competency by
412.2successfully completing a written or oral test of the topics in subdivision 7, paragraphs (b)
412.3and (c), and a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5)
412.4and (7), and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform;
412.5(2) satisfy the current requirements of Medicare for training or competency of home
412.6health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
412.7section 483 or section 484.36; or
412.8(3) have, before April 19, 1993, completed a training course for nursing assistants
412.9that was approved by the commissioner.
412.10(c) Unlicensed personnel performing therapy or treatment tasks delegated or
412.11assigned by a licensed health professional must meet the requirements for delegated
412.12tasks in subdivision 4 and any other training or competency requirements within the
412.13licensed health professional scope of practice relating to delegation or assignment of tasks
412.14to unlicensed personnel.
412.15    Subd. 4. Delegation of home care tasks. A registered nurse or licensed health
412.16professional may delegate tasks only to staff that are competent and possess the knowledge
412.17and skills consistent with the complexity of the tasks and according to the appropriate
412.18Minnesota Practice Act. The comprehensive home care provider must establish and
412.19implement a system to communicate up-to-date information to the registered nurse or
412.20licensed health professional regarding the current available staff and their competency so
412.21the registered nurse or licensed health professional has sufficient information to determine
412.22the appropriateness of delegating tasks to meet individual client needs and preferences.
412.23    Subd. 5. Individual contractors. When a home care provider contracts with an
412.24individual contractor excluded from licensure under section 144A.471 to provide home
412.25care services, the contractor must meet the same requirements required by this section for
412.26personnel employed by the home care provider.
412.27    Subd. 6. Temporary staff. When a home care provider contracts with a temporary
412.28staffing agency excluded from licensure under section 144A.471, those individuals must
412.29meet the same requirements required by this section for personnel employed by the home
412.30care provider and shall be treated as if they are staff of the home care provider.
412.31    Subd. 7. Requirements for instructors, training content, and competency
412.32evaluations for unlicensed personnel. (a) Instructors and competency evaluators must
412.33meet the following requirements:
412.34(1) training and competency evaluations of unlicensed personnel providing basic
412.35home care services must be conducted by individuals with work experience and training in
412.36providing home care services listed in section 144A.471, subdivisions 6 and 7; and
413.1(2) training and competency evaluations of unlicensed personnel providing
413.2comprehensive home care services must be conducted by a registered nurse, or another
413.3instructor may provide training in conjunction with the registered nurse. If the home care
413.4provider is providing services by licensed health professionals only, then that specific
413.5training and competency evaluation may be conducted by the licensed health professionals
413.6as appropriate.
413.7(b) Training and competency evaluations for all unlicensed personnel must include
413.8the following:
413.9(1) documentation requirements for all services provided;
413.10(2) reports of changes in the client's condition to the supervisor designated by the
413.11home care provider;
413.12(3) basic infection control, including blood-borne pathogens;
413.13(4) maintenance of a clean and safe environment;
413.14(5) appropriate and safe techniques in personal hygiene and grooming, including:
413.15(i) hair care and bathing;
413.16(ii) care of teeth, gums, and oral prosthetic devices;
413.17(iii) care and use of hearing aids; and
413.18(iv) dressing and assisting with toileting;
413.19(6) training on the prevention of falls for providers working with the elderly or
413.20individuals at risk of falls;
413.21(7) standby assistance techniques and how to perform them;
413.22(8) medication, exercise, and treatment reminders;
413.23(9) basic nutrition, meal preparation, food safety, and assistance with eating;
413.24(10) preparation of modified diets as ordered by a licensed health professional;
413.25(11) communication skills that include preserving the dignity of the client and
413.26showing respect for the client and the client's preferences, cultural background, and family;
413.27(12) awareness of confidentiality and privacy;
413.28(13) understanding appropriate boundaries between staff and clients and the client's
413.29family;
413.30(14) procedures to utilize in handling various emergency situations; and
413.31(15) awareness of commonly used health technology equipment and assistive devices.
413.32(c) In addition to paragraph (b), training and competency evaluation for unlicensed
413.33personnel providing comprehensive home care services must include:
413.34(1) observation, reporting, and documenting of client status;
413.35(2) basic knowledge of body functioning and changes in body functioning, injuries,
413.36or other observed changes that must be reported to appropriate personnel;
414.1(3) reading and recording temperature, pulse, and respirations of the client;
414.2(4) recognizing physical, emotional, cognitive, and developmental needs of the client;
414.3(5) safe transfer techniques and ambulation;
414.4(6) range of motioning and positioning; and
414.5(7) administering medications or treatments as required.
414.6(d) When the registered nurse or licensed health professional delegates tasks, they
414.7must ensure that prior to the delegation the unlicensed personnel is trained in the proper
414.8methods to perform the tasks or procedures for each client and are able to demonstrate
414.9the ability to competently follow the procedures and perform the tasks. If an unlicensed
414.10personnel has not regularly performed the delegated home care task for a period of 24
414.11consecutive months, the unlicensed personnel must demonstrate competency in the task
414.12to the registered nurse or appropriate licensed health professional. The registered nurse
414.13or licensed health professional must document instructions for the delegated tasks in
414.14the client's record.

414.15    Sec. 22. [144A.4796] ORIENTATION AND ANNUAL TRAINING
414.16REQUIREMENTS.
414.17    Subdivision 1. Orientation of staff and supervisors to home care. All staff
414.18providing and supervising direct home care services must complete an orientation to home
414.19care licensing requirements and regulations before providing home care services to clients.
414.20The orientation may be incorporated into the training required under subdivision 6. The
414.21orientation need only be completed once for each staff person and is not transferable
414.22to another home care provider.
414.23    Subd. 2. Content. The orientation must contain the following topics:
414.24    (1) an overview of sections 144A.43 to 144A.4798;
414.25(2) introduction and review of all the provider's policies and procedures related to
414.26the provision of home care services;
414.27(3) handling of emergencies and use of emergency services;
414.28(4) compliance with and reporting the maltreatment of minors or vulnerable adults
414.29under sections 626.556 and 626.557;
414.30(5) home care bill of rights, under section 144A.44;
414.31(6) handling of clients' complaints; reporting of complaints and where to report
414.32complaints including information on the Office of Health Facility Complaints and the
414.33Common Entry Point;
414.34(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
414.35Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
415.1Ombudsman at the Department of Human Services, county managed care advocates,
415.2or other relevant advocacy services; and
415.3(8) review of the types of home care services the employee will be providing and
415.4the provider's scope of licensure.
415.5    Subd. 3. Verification and documentation of orientation. Each home care provider
415.6shall retain evidence in the employee record of each staff person having completed the
415.7orientation required by this section.
415.8    Subd. 4. Orientation to client. Staff providing home care services must be oriented
415.9specifically to each individual client and the services to be provided. This orientation may
415.10be provided in person, orally, in writing, or electronically.
415.11    Subd. 5. Training required relating to Alzheimer's disease and related disorders.
415.12For home care providers that provide services for persons with Alzheimer's or related
415.13disorders, all direct care staff and supervisors working with those clients must receive
415.14training that includes a current explanation of Alzheimer's disease and related disorders
415.15effective approaches to use to problem solve when working with a client's challenging
415.16behaviors, and how to communicate with clients who have Alzheimer's or related disorders.
415.17    Subd. 6. Required annual training. All staff that perform direct home care
415.18services must complete at least eight hours of annual training for each 12 months of
415.19employment. The training may be obtained from the home care provider or another source
415.20and must include topics relevant to the provision of home care services. The annual
415.21training must include:
415.22(1) training on reporting of maltreatment of minors under section 626.556 and
415.23maltreatment of vulnerable adults under section 626.557, whichever is applicable to the
415.24services provided;
415.25(2) review of the home care bill of rights in section 144A.44;
415.26(3) review of infection control techniques used in the home and implementation of
415.27infection control standards including a review of hand washing techniques; the need for
415.28and use of protective gloves, gowns, and masks; appropriate disposal of contaminated
415.29materials and equipment, such as dressings, needles, syringes, and razor blades;
415.30disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of
415.31communicable diseases; and
415.32(4) review of the provider's policies and procedures relating to the provision of home
415.33care services and how to implement those policies and procedures.
415.34    Subd. 7. Documentation. A home care provider must retain documentation in the
415.35employee records of the staff that have satisfied the orientation and training requirements
415.36of this section.

416.1    Sec. 23. [144A.4797] PROVISION OF SERVICES.
416.2    Subdivision 1. Availability of contact person to staff. (a) A home care provider
416.3with a basic home care license must have a person available to staff for consultation on
416.4items relating to the provision of services or about the client.
416.5(b) A home care provider with a comprehensive home care license must have a
416.6registered nurse available for consultation to staff performing delegated nursing tasks
416.7and must have an appropriate licensed health professional available if performing other
416.8delegated services such as therapies.
416.9(c) The appropriate contact person must be readily available either in person, by
416.10telephone, or by other means to the staff at times when the staff is providing services.
416.11    Subd. 2. Supervision of staff; basic home care services. (a) Staff who perform
416.12basic home care services must be supervised periodically where the services are being
416.13provided to verify that the work is being performed competently and to identify problems
416.14and solutions to address issues relating to the staff's ability to provide the services. The
416.15supervision of the unlicensed personnel must be done by staff of the home care provider
416.16having the authority, skills, and ability to provide the supervision of unlicensed personnel
416.17and who can implement changes as needed, and train staff.
416.18(b) Supervision includes direct observation of unlicensed personnel while they
416.19are providing the services and may also include indirect methods of gaining input such
416.20as gathering feedback from the client. Supervisory review of staff must be provided at a
416.21frequency based on the staff person's competency and performance.
416.22(c) For an individual who is licensed as a home care provider, this section does
416.23not apply.
416.24    Subd. 3. Supervision of staff providing delegated nursing or therapy home
416.25care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must be
416.26supervised by an appropriate licensed health professional or a registered nurse periodically
416.27where the services are being provided to verify that the work is being performed
416.28competently and to identify problems and solutions related to the staff person's ability to
416.29perform the tasks. Supervision of staff performing medication or treatment administration
416.30shall be provided by a registered nurse or appropriate licensed health professional and
416.31must include observation of the staff administering the medication or treatment and the
416.32interaction with the client.
416.33(b) The direct supervision of staff performing delegated tasks must be provided
416.34within 30 days after the individual begins working for the home care provider and
416.35thereafter as needed based on performance. This requirement also applies to staff who
416.36have not performed delegated tasks for one year or longer.
417.1    Subd. 4. Documentation. A home care provider must retain documentation of
417.2supervision activities in the personnel records.
417.3    Subd. 5. Exemption. This section does not apply to an individual licensed under
417.4sections 144A.43 to 144A.4799.

417.5    Sec. 24. [144A.4798] EMPLOYEE HEALTH STATUS.
417.6    Subdivision 1. Tuberculosis (TB) prevention and control. A home care provider
417.7must establish and maintain a TB prevention and control program based on the most
417.8current guidelines issued by the Centers for Disease Control and Prevention (CDC).
417.9Components of a TB prevention and control program include screening all staff providing
417.10home care services, both paid and unpaid, at the time of hire for active TB disease and
417.11latent TB infection, and developing and implementing a written TB infection control plan.
417.12The commissioner shall make the most recent CDC standards available to home care
417.13providers on the department's Web site.
417.14    Subd. 2. Communicable diseases. A home care provider must follow
417.15current federal or state guidelines for prevention, control, and reporting of human
417.16immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
417.17communicable diseases as defined in Minnesota Rules, part 4605.7040.

417.18    Sec. 25. [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE
417.19PROVIDER ADVISORY COUNCIL.
417.20    Subdivision 1. Membership. The commissioner of health shall appoint eight
417.21persons to a home care provider advisory council consisting of the following:
417.22(1) three public members as defined in section 214.02 who shall be either persons
417.23who are currently receiving home care services or have family members receiving home
417.24care services, or persons who have family members who have received home care services
417.25within five years of the application date;
417.26(2) three Minnesota home care licensees representing basic and comprehensive
417.27levels of licensure who may be a managerial official, an administrator, a supervising
417.28registered nurse, or an unlicensed personnel performing home care tasks;
417.29(3) one member representing the Minnesota Board of Nursing; and
417.30(4) one member representing the ombudsman for long-term care.
417.31    Subd. 2. Organizations and meetings. The advisory council shall be organized
417.32and administered under section 15.059 with per diems and costs paid within the limits of
417.33available appropriations. Meetings will be held quarterly and hosted by the department.
418.1Subcommittees may be developed as necessary by the commissioner. Advisory council
418.2meetings are subject to the Open Meeting Law under chapter 13D.
418.3    Subd. 3. Duties. At the commissioner's request, the advisory council shall provide
418.4advice regarding regulations of Department of Health licensed home care providers in
418.5this chapter such as:
418.6(1) advice to the commissioner regarding community standards for home care
418.7practices;
418.8(2) advice to the commissioner on enforcement of licensing standards and whether
418.9certain disciplinary actions are appropriate;
418.10(3) advice to the commissioner about ways of distributing information to licensees
418.11and consumers of home care;
418.12(4) advice to the commissioner about training standards;
418.13(5) identify emerging issues and opportunities in the home care field, including the
418.14use of technology in home and telehealth capabilities; and
418.15(6) perform other duties as directed by the commissioner.

418.16    Sec. 26. [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR
418.17NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.
418.18    Subdivision 1. Temporary home care licenses and changes of ownership. (a)
418.19Beginning January 1, 2014, all temporary license applicants must apply for either a
418.20temporary basic or comprehensive home care license.
418.21(b) Temporary home care temporary licenses issued beginning January 1, 2014,
418.22will be issued according to the provisions in sections 144A.43 to 144A.4799 and fees in
418.23section 144A.472 and will be required to comply with this chapter.
418.24(c) No temporary licenses or licenses will be accepted or issued between October 1,
418.252013, and December 31, 2013.
418.26(d) Beginning October 1, 2013, changes in ownership applications will require
418.27payment of the new fees listed in section 144A.472.
418.28    Subd. 2. Current home care licensees with licenses prior to July 1, 2013. (a)
418.29Beginning July 1, 2014, department licensed home care providers must apply for either
418.30the basic or comprehensive home care license on their regularly scheduled renewal date.
418.31(b) By June 30, 2015, all home care providers must either have a basic or
418.32comprehensive home care license or temporary license.
418.33    Subd. 3. Renewal application of home care licensure during transition period.
418.34Renewal of home care licenses issued beginning July 1, 2014, will be issued according to
418.35sections 144A.43 to 144A.4799 and, upon license renewal, providers must comply with
419.1sections 144A.43 to 144A.4799. Prior to renewal, providers must comply with the home
419.2care licensure law in effect on June 30, 2013.
419.3The fees charged for licenses renewed between July 1, 2014, and June 30, 2016,
419.4shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000
419.5increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.
419.6For fiscal year 2014 only, the fees for providers with revenues greater than $25,000
419.7and no more than $100,000 will be $313 and for providers with revenues no more than
419.8$25,000 the fee will be $125.

419.9    Sec. 27. [144A.482] REGISTRATION OF HOME MANAGEMENT
419.10PROVIDERS.
419.11(a) For purposes of this section, a home management provider is an individual or
419.12organization that provides at least two of the following services: housekeeping, meal
419.13preparation, and shopping, to a person who is unable to perform these activities due to
419.14illness, disability, or physical condition.
419.15(b) A person or organization that provides only home management services may not
419.16operate in the state without a current certificate of registration issued by the commissioner
419.17of health. To obtain a certificate of registration, the person or organization must annually
419.18submit to the commissioner the name, mailing and physical address, e-mail address, and
419.19telephone number of the individual or organization and a signed statement declaring that
419.20the individual or organization is aware that the home care bill of rights applies to their
419.21clients and that the person or organization will comply with the home care bill of rights
419.22provisions contained in section 144A.44. An individual or organization applying for a
419.23certificate must also provide the name, business address, and telephone number of each of
419.24the individuals responsible for the management or direction of the organization.
419.25(c) The commissioner shall charge an annual registration fee of $20 for individuals
419.26and $50 for organizations. The registration fee shall be deposited in the state treasury and
419.27credited to the state government special revenue fund.
419.28(d) A home care provider that provides home management services and other home
419.29care services must be licensed, but licensure requirements other than the home care bill of
419.30rights do not apply to those employees or volunteers who provide only home management
419.31services to clients who do not receive any other home care services from the provider.
419.32A licensed home care provider need not be registered as a home management service
419.33provider, but must provide an orientation on the home care bill of rights to its employees
419.34or volunteers who provide home management services.
420.1(e) An individual who provides home management services under this section must,
420.2within 120 days after beginning to provide services, attend an orientation session approved
420.3by the commissioner that provides training on the home care bill of rights and an orientation
420.4on the aging process and the needs and concerns of elderly and disabled persons.
420.5(f) The commissioner may suspend or revoke a provider's certificate of registration
420.6or assess fines for violation of the home care bill of rights. Any fine assessed for a
420.7violation of the home care bill of rights by a provider registered under this section shall be
420.8in the amount established in the licensure rules for home care providers. As a condition
420.9of registration, a provider must cooperate fully with any investigation conducted by the
420.10commissioner, including providing specific information requested by the commissioner on
420.11clients served and the employees and volunteers who provide services. Fines collected
420.12under this paragraph shall be deposited in the state treasury and credited to the fund
420.13specified in the statute or rule in which the penalty was established.
420.14(g) The commissioner may use any of the powers granted in sections 144A.43 to
420.15144A.4799 to administer the registration system and enforce the home care bill of rights
420.16under this section.

420.17    Sec. 28. AGENCY QUALITY IMPROVEMENT PROGRAM.
420.18    Subdivision 1. Annual legislative report on home care licensing. The
420.19commissioner shall establish a quality improvement program for the home care survey
420.20and home care complaint investigation processes. The commissioner shall submit to the
420.21legislature an annual report, beginning October 1, 2015, and each October 1 thereafter.
420.22Each report will review the previous state fiscal year of home care licensing and regulatory
420.23activities. The report must include, but is not limited to, an analysis of:
420.24(1) the number of FTE's in the Division of Compliance Monitoring, including the
420.25Office of Health Facility Complaints units assigned to home care licensing, survey,
420.26investigation and enforcement process;
420.27(2) numbers of and descriptive information about licenses issued, complaints
420.28received and investigated, including allegations made and correction orders issued,
420.29surveys completed and timelines, and correction order reconsiderations and results;
420.30(3) descriptions of emerging trends in home care provision and areas of concern
420.31identified by the department in its regulation of home care providers;
420.32(4) information and data regarding performance improvement projects underway
420.33and planned by the commissioner in the area of home care surveys; and
420.34(5) work of the Department of Health Home Care Advisory Council.
421.1    Subd. 2. Study of correction order appeal process. Starting July 1, 2015, the
421.2commissioner shall study whether to add a correction order appeal process conducted by
421.3an independent reviewer such as an administrative law judge or other office and submit a
421.4report to the legislature by February 1, 2016. The commissioner shall review home care
421.5regulatory systems in other states as part of that study. The commissioner shall consult
421.6with the home care providers and representatives.

421.7    Sec. 29. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
421.8AND COMMUNITY-BASED SERVICES.
421.9(a) The Department of Health Compliance Monitoring Division and the Department
421.10of Human Services Licensing Division shall jointly develop an integrated licensing system
421.11for providers of both home care services subject to licensure under Minnesota Statutes,
421.12chapter 144A, and for home and community-based services subject to licensure under
421.13Minnesota Statutes, chapter 245D. The integrated licensing system shall:
421.14(1) require only one license of any provider of services under Minnesota Statutes,
421.15sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
421.16(2) promote quality services that recognize a person's individual needs and protect
421.17the person's health, safety, rights, and well-being;
421.18(3) promote provider accountability through application requirements, compliance
421.19inspections, investigations, and enforcement actions;
421.20(4) reference other applicable requirements in existing state and federal laws,
421.21including the federal Affordable Care Act;
421.22(5) establish internal procedures to facilitate ongoing communications between the
421.23agencies, and with providers and services recipients about the regulatory activities;
421.24(6) create a link between the agency Web sites so that providers and the public can
421.25access the same information regardless of which Web site is accessed initially; and
421.26(7) collect data on identified outcome measures as necessary for the agencies to
421.27report to the Centers for Medicare and Medicaid Services.
421.28(b) The joint recommendations for legislative changes to implement the integrated
421.29licensing system are due to the legislature by February 15, 2014.
421.30(c) Before implementation of the integrated licensing system, providers licensed as
421.31home care providers under Minnesota Statutes, chapter 144A, may also provide home
421.32and community-based services subject to licensure under Minnesota Statutes, chapter
421.33245D, without obtaining a home and community-based services license under Minnesota
421.34Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
421.35apply to these providers:
422.1(1) the provider must comply with all requirements under Minnesota Statutes, chapter
422.2245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
422.3(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
422.4enforced by the Department of Health under the enforcement authority set forth in
422.5Minnesota Statutes, section 144A.475; and
422.6(3) the Department of Health will provide information to the Department of Human
422.7Services about each provider licensed under this section, including the provider's license
422.8application, licensing documents, inspections, information about complaints received, and
422.9investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

422.10    Sec. 30. REPEALER.
422.11(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.
422.12(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
422.134668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040;
422.144668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
422.154668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170;
422.164668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240;
422.174668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830;
422.184668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
422.194669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.

422.20    Sec. 31. EFFECTIVE DATE.
422.21Sections 1 to 30 are effective the day following final enactment.


422.24    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 2, is amended to read:
422.25    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
422.26resources in the health care access fund exceed expenditures in that fund, effective for
422.27the biennium beginning July 1, 2007, the commissioner of management and budget shall
422.28transfer the excess funds from the health care access fund to the general fund on June 30
422.29of each year, provided that the amount transferred in any fiscal biennium shall not exceed
422.30$96,000,000. The purpose of this transfer is to meet the rate increase required under Laws
422.312003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
422.32    (b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and,
422.33if necessary, the commissioner shall reduce these transfers from the health care access
423.1fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
423.2transfer sufficient funds from the general fund to the health care access fund to meet
423.3annual MinnesotaCare expenditures.
423.4(c) Notwithstanding section 295.581, to the extent available resources in the health
423.5care access fund exceed expenditures in that fund, effective for the biennium beginning
423.6July 1, 2013, the commissioner of management and budget shall transfer $1,000,000 each
423.7fiscal year from the health access fund to the medical education and research costs fund
423.8established under section 62J.692, for distribution under section 62J.692, subdivision 4,
423.9paragraph (b).

423.10    Sec. 2. [62A.3094] COVERAGE FOR AUTISM SPECTRUM DISORDERS.
423.11    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
423.12paragraphs (b) to (e) have the meanings given.
423.13    (b) "Autism spectrum disorders" means the conditions as determined by criteria
423.14set forth in the most recent edition of the Diagnostic and Statistical Manual of Mental
423.15Disorders of the American Psychiatric Association.
423.16    (c) "Health plan" has the meaning given in section 62Q.01, subdivision 3.
423.17    (d) "Medically necessary care" means health care services appropriate, in terms of
423.18type, frequency, level, setting, and duration, to the enrollee's condition, and diagnostic
423.19testing and preventative services. Medically necessary care must be consistent with
423.20generally accepted practice parameters as determined by physicians and licensed
423.21psychologists who typically manage patients who have autism spectrum disorders.
423.22    (e) "Mental health professional" has the meaning given in section 245.4871,
423.23subdivision 27.
423.24    Subd. 2. Optional coverage required. (a) A health plan must provide:
423.25    (1) all health benefits related to the treatment of autism spectrum disorders required
423.26by the essential health benefits required under section 1302 of the Affordable Care Act;
423.27    (2) all health benefits required by this section or any other section of Minnesota
423.28Statutes as of December 31, 2012; and
423.29    (3) an offer of one or more options for the purchase of supplemental autism coverage
423.30for young children for children under age 18 for the diagnosis, evaluation, assessment,
423.31and medically necessary care of autism spectrum disorders, including but not limited to
423.32the following:
423.33    (i) early intensive behavioral and developmental therapy based in behavioral and
423.34developmental science, including but not limited to applied behavior analysis, intensive
424.1early intervention behavior therapy, intensive behavior intervention, and Lovaas therapy
424.2and developmental approaches;
424.3    (ii) neurodevelopmental and behavioral health treatments and management;
424.4    (iii) speech therapy;
424.5    (iv) occupational therapy;
424.6    (v) physical therapy; and
424.7    (vi) medications.
424.8    (b) The diagnosis, evaluation, and assessment must include an assessment of the
424.9child's developmental skills, functional behavior, needs, and capacities.
424.10    (c) The coverage option required under this section shall include treatment that is
424.11in accordance with an individualized treatment plan prescribed by the insured's treating
424.12physician or mental health professional.
424.13    (d) A health plan may not refuse to renew or reissue, or otherwise terminate or
424.14restrict, coverage of an individual solely because the individual is diagnosed with an
424.15autism spectrum disorder.
424.16    (e) A health plan may request an updated treatment plan only once every six months,
424.17unless the health plan and the treating physician or mental health professional agree that a
424.18more frequent review is necessary due to emerging circumstances.
424.19    (f) An independent progress evaluation conducted by a mental health professional
424.20with expertise and training in autism spectrum disorder and child development must
424.21be completed to determine if progress toward functional and generalizable gains, as
424.22determined in the treatment plan, is being made.
424.23    (g) A health plan may cap the dollar value of the supplemental coverage offered
424.24under this subdivision, but may not cap the value at less than $50,000 per calendar year
424.25per individual receiving a diagnosis of autism spectrum disorder.
424.26    Subd. 3. No effect on other law. Nothing in this section limits in any way the
424.27coverage required under section 62Q.47.
424.28    Subd. 4. State health care programs. This section does not affect benefits available
424.29under the medical assistance and MinnesotaCare programs and does not limit, restrict, or
424.30otherwise reduce coverage under these programs.
424.31EFFECTIVE DATE.This section is effective January 1, 2014, and sunsets effective
424.32December 31, 2015, and applies to coverage offered, issued, sold, renewed, or continued
424.33as defined in Minnesota Statutes, section 60A.02, subdivision 2a, on or after that date.

424.34    Sec. 3. [62D.0425] NET WORTH LIMIT.
425.1(a) Between July 1, 2013, and June 30, 2018, no health maintenance organization
425.2shall have a net worth of more than 25 percent of the sum of all expenses incurred during
425.3the most recent calendar year, except as provided in paragraph (b).
425.4(b) A health maintenance organization may have a net worth of more than 25 percent
425.5of the sum of all expenses incurred during the most recent calendar year if necessary to
425.6maintain capital reserves at the level of the product of 2.0 and its authorized control
425.7level risk-based capital, as required pursuant to sections 60A.50 to 60A.592 and 62D.04.
425.8Paragraphs (c) and (d) do not apply to health maintenance organizations permitted, under
425.9this paragraph, to have a net worth greater than 25 percent of the sum of all expenses
425.10incurred during the most recent calendar year.
425.11(c) By June 15, 2013, and annually thereafter until June 15, 2017, for a health
425.12maintenance organization that has a net worth of more than 25 percent of the sum of all
425.13expenses incurred during the most recent calendar year, the commissioner of health, in
425.14consultation with the commissioners of commerce and human services, shall determine:
425.15(1) capital reserves using the National Association of Insurance Commissioners
425.16definitions of admitted assets, which shall be used in clauses (2) to (5);
425.17(2) the proportion of capital reserves that are reasonably attributable to net
425.18underwriting gains in Minnesota public health care programs based on annual financial
425.19filings for calendar years 2003 through 2012;
425.20(3) the proportion of capital reserves that are reasonably attributable to investment
425.21gains associated with net underwriting gains in Minnesota public health care programs
425.22based on annual financial filings for calendar years 2003 through 2012;
425.23(4) any adjustments needed to clause (1) or (2) based on corporate reorganizations,
425.24since 2003; and
425.25(5) any adjustments needed to account for the impact of annual financial filings for
425.26calendar years 2013 through 2016.
425.27(d) A health maintenance organization that has a net worth of more than 25 percent
425.28of the sum of all expenses incurred during the most recent calendar year shall reduce its
425.29capital reserves as follows:
425.30(1) as determined by paragraph (c), the proportion of capital reserves that are greater
425.31than 25 percent of the sum of all expenses incurred during the most recent calendar
425.32year and that are reasonably attributable to net underwriting gains and investment gains
425.33associated with net underwriting gains in Minnesota public health care programs shall be
425.34spent down. The health maintenance organization shall place excess capital reserves in a
425.35special restricted account under the control of the health maintenance organization. The
425.36special restricted account may only be used to pay for a portion of the health maintenance
426.1organization's current public program enrollee premiums. The health maintenance
426.2organization shall spend no less than 50 percent of this special restricted account in any
426.3state fiscal year beginning on or after July 1, 2013; and
426.4(2) the proportion of capital reserves that are greater than 25 percent of the
426.5sum of all expenses incurred during the most recent calendar year and that are not
426.6reasonably attributable to net underwriting gains and investment gains associated with net
426.7underwriting gains in Minnesota public health care programs shall be spent down. The
426.8health maintenance organization shall place these excess capital reserves in a second
426.9special restricted account under the control of the health maintenance organization. The
426.10health maintenance organization may use this special restricted account to benefit current
426.11enrollees by moderating variation in premium increases, assisting enrollees in accessing
426.12new benefits, reducing health disparities, promoting health, wellness and preventive
426.13services, and improving care coordination. Prior to spending down excess reserves from
426.14this special revenue account, the health maintenance organization's spenddown plan must
426.15be approved by the commissioner of health. The health maintenance organization shall
426.16spend no less than 33 percent of this special restricted account in any state fiscal year
426.17beginning July 1, 2013.
426.18(e) The health maintenance organization must spend down all of the reserves placed
426.19in its special restricted accounts by July 1, 2018. All reserves placed in a special account
426.20must be spent according to paragraph (d), unless the reserves are necessary for the health
426.21maintenance organization to maintain capital reserves at the level of the product of 2.0 and
426.22its authorized control level risk-based capital, as required pursuant to sections 60A.50 to
426.2360A.592 and 62D.04, in which case the health maintenance organization may transfer funds
426.24out of its special restricted accounts in a manner approved by the commissioner of health.
426.25(f) The commissioner of health must approve all health maintenance organization
426.26expenditures for the acquisition of any asset that is not an admitted asset under National
426.27Association of Insurance Commissioners definitions. The commissioner shall disapprove
426.28any acquisition unless the health maintenance organization demonstrates that the
426.29acquisition is: (1) consistent with its long-standing business practices; or (2) more
426.30beneficial to enrollees than benefits to enrollees under paragraph (d).

426.31    Sec. 4. Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:
426.32    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute the
426.33available medical education funds to all qualifying applicants based on a distribution
426.34formula that reflects a summation of two factors:
427.1    (1) a public program volume factor, which is determined by the total volume of
427.2public program revenue received by each training site as a percentage of all public
427.3program revenue received by all training sites in the fund pool; and
427.4    (2) a supplemental public program volume factor, which is determined by providing
427.5a supplemental payment of 20 percent of each training site's grant to training sites whose
427.6public program revenue accounted for at least 0.98 percent of the total public program
427.7revenue received by all eligible training sites. Grants to training sites whose public
427.8program revenue accounted for less than 0.98 percent of the total public program revenue
427.9received by all eligible training sites shall be reduced by an amount equal to the total
427.10value of the supplemental payment.
427.11    Public program revenue for the distribution formula includes revenue from medical
427.12assistance, prepaid medical assistance, general assistance medical care, and prepaid
427.13general assistance medical care. Training sites that receive no public program revenue
427.14are ineligible for funds available under this subdivision. For purposes of determining
427.15training-site level grants to be distributed under paragraph (a), total statewide average
427.16costs per trainee for medical residents is based on audited clinical training costs per trainee
427.17in primary care clinical medical education programs for medical residents. Total statewide
427.18average costs per trainee for dental residents is based on audited clinical training costs
427.19per trainee in clinical medical education programs for dental students. Total statewide
427.20average costs per trainee for pharmacy residents is based on audited clinical training costs
427.21per trainee in clinical medical education programs for pharmacy students. Training sites
427.22whose training site level grant is less than $1,000, based on the formula described in this
427.23paragraph, are ineligible for funds available under this subdivision.
427.24    (b) Of available medical education funds, $1,000,000 shall be distributed each year
427.25for grants to family medicine residency programs located outside of the seven-county
427.26metropolitan area, as defined in section 473.121, subdivision 4, focused on eduction and
427.27training of family medicine physicians to serve communities outside the metropolitan area.
427.28To be eligible for a grant under this paragraph, a family medicine residency program must
427.29demonstrate that over the most recent three calendar years, at least 25 percent of its residents
427.30practice in Minnesota communities outside of the metropolitan area. Grant funds must be
427.31allocated proportionally based on the number of residents per eligible residency program.
427.32    (c) Funds distributed shall not be used to displace current funding appropriations
427.33from federal or state sources.
427.34    (c) (d) Funds shall be distributed to the sponsoring institutions indicating the amount
427.35to be distributed to each of the sponsor's clinical medical education programs based on
427.36the criteria in this subdivision and in accordance with the commissioner's approval letter.
428.1Each clinical medical education program must distribute funds allocated under paragraph
428.2(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
428.3institutions, which are accredited through an organization recognized by the Department
428.4of Education or the Centers for Medicare and Medicaid Services, may contract directly
428.5with training sites to provide clinical training. To ensure the quality of clinical training,
428.6those accredited sponsoring institutions must:
428.7    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
428.8training conducted at sites; and
428.9    (2) take necessary action if the contract requirements are not met. Action may include
428.10the withholding of payments under this section or the removal of students from the site.
428.11    (d) (e) Any funds not distributed in accordance with the commissioner's approval
428.12letter must be returned to the medical education and research fund within 30 days of
428.13receiving notice from the commissioner. The commissioner shall distribute returned funds
428.14to the appropriate training sites in accordance with the commissioner's approval letter.
428.15    (e) (f) A maximum of $150,000 of the funds dedicated to the commissioner
428.16under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
428.17administrative expenses associated with implementing this section.

428.18    Sec. 5. Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:
428.19    Subdivision 1. Designation. (a) The commissioner shall designate essential
428.20community providers. The criteria for essential community provider designation shall be
428.21the following:
428.22(1) a demonstrated ability to integrate applicable supportive and stabilizing services
428.23with medical care for uninsured persons and high-risk and special needs populations,
428.24underserved, and other special needs populations; and
428.25(2) a commitment to serve low-income and underserved populations by meeting the
428.26following requirements:
428.27(i) has nonprofit status in accordance with chapter 317A;
428.28(ii) has tax-exempt status in accordance with the Internal Revenue Service Code,
428.29section 501(c)(3);
428.30(iii) charges for services on a sliding fee schedule based on current poverty income
428.31guidelines; and
428.32(iv) does not restrict access or services because of a client's financial limitation;
428.33(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
428.34hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
429.1government, an Indian health service unit, or a community health board as defined in
429.2chapter 145A;
429.3(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
429.4bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
429.5conditions;
429.6(5) a sole community hospital. For these rural hospitals, the essential community
429.7provider designation applies to all health services provided, including both inpatient and
429.8outpatient services. For purposes of this section, "sole community hospital" means a
429.9rural hospital that:
429.10(i) is eligible to be classified as a sole community hospital according to Code
429.11of Federal Regulations, title 42, section 412.92, or is located in a community with a
429.12population of less than 5,000 and located more than 25 miles from a like hospital currently
429.13providing acute short-term services;
429.14(ii) has experienced net operating income losses in two of the previous three
429.15most recent consecutive hospital fiscal years for which audited financial information is
429.16available; and
429.17(iii) consists of 40 or fewer licensed beds; or
429.18(6) a birth center licensed under section 144.615.; or
429.19(7) a hospital, and its affiliated specialty clinics, whose inpatients are predominantly
429.20under 21 years of age and that meets the following criteria:
429.21(i) provides intensive specialty pediatric services that are routinely provided in
429.22only four or fewer hospitals in the state; and
429.23(ii) serves children from at least one-half of the counties in the state.
429.24(b) Prior to designation, the commissioner shall publish the names of all applicants
429.25in the State Register. The public shall have 30 days from the date of publication to submit
429.26written comments to the commissioner on the application. No designation shall be made
429.27by the commissioner until the 30-day period has expired.
429.28(c) The commissioner may designate an eligible provider as an essential community
429.29provider for all the services offered by that provider or for specific services designated by
429.30the commissioner.
429.31(d) For the purpose of this subdivision, supportive and stabilizing services include at
429.32a minimum, transportation, child care, cultural, and linguistic services where appropriate.

429.33    Sec. 6. Minnesota Statutes 2012, section 103I.005, is amended by adding a subdivision
429.34to read:
430.1    Subd. 1a. Bored geothermal heat exchanger. "Bored geothermal heat exchanger"
430.2means an earth-coupled heating or cooling device consisting of a sealed closed-loop
430.3piping system installed in a boring in the ground to transfer heat to or from the surrounding
430.4earth with no discharge.

430.5    Sec. 7. Minnesota Statutes 2012, section 103I.521, is amended to read:
430.6103I.521 FEES DEPOSITED WITH COMMISSIONER OF MANAGEMENT
430.7AND BUDGET.
430.8Unless otherwise specified, fees collected for licenses or registration by the
430.9commissioner under this chapter shall be deposited in the state treasury and credited to
430.10the state government special revenue fund.

430.11    Sec. 8. Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:
430.12    Subdivision 1. Who must pay. Except for the limitation contained in this section,
430.13the commissioner of health shall charge a handling fee may enter into a contractual
430.14agreement to recover costs incurred for analysis for diagnostic purposes for each specimen
430.15submitted to the Department of Health for analysis for diagnostic purposes by any hospital,
430.16private laboratory, private clinic, or physician. No fee shall be charged to any entity which
430.17receives direct or indirect financial assistance from state or federal funds administered by
430.18the Department of Health, including any public health department, nonprofit community
430.19clinic, sexually transmitted disease clinic, or similar entity. No fee will be charged The
430.20commissioner shall not charge for any biological materials submitted to the Department
430.21of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
430.22materials requested by the department to gather information for disease prevention or
430.23control purposes. The commissioner of health may establish other exceptions to the
430.24handling fee as may be necessary to protect the public's health. All fees collected pursuant
430.25to this section shall be deposited in the state treasury and credited to the state government
430.26special revenue fund. Funds generated in a contractual agreement made pursuant to this
430.27section shall be deposited in a special account and are appropriated to the commissioner
430.28for purposes of providing the services specified in the contracts. All such contractual
430.29agreements shall be processed in accordance with the provisions of chapter 16C.
430.30EFFECTIVE DATE.This section is effective July 1, 2014.

430.31    Sec. 9. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:
431.1    Subdivision 1. Duty to perform testing. (a) It is the duty of (1) the administrative
431.2officer or other person in charge of each institution caring for infants 28 days or less
431.3of age, (2) the person required in pursuance of the provisions of section 144.215, to
431.4register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
431.5birth, to arrange to have administered to every infant or child in its care tests for heritable
431.6and congenital disorders according to subdivision 2 and rules prescribed by the state
431.7commissioner of health.
431.8    (b) Testing and the, recording and of test results, reporting of test results, and
431.9follow-up of infants with heritable congenital disorders, including hearing loss detected
431.10through the early hearing detection and intervention program in section 144.966, shall be
431.11performed at the times and in the manner prescribed by the commissioner of health. The
431.12commissioner shall charge a fee so that the total of fees collected will approximate the
431.13costs of conducting the tests and implementing and maintaining a system to follow-up
431.14infants with heritable or congenital disorders, including hearing loss detected through the
431.15early hearing detection and intervention program under section 144.966.
431.16    (c) The fee is $101 per specimen. Effective July 1, 2010, the fee shall be increased
431.17to $106 to support the newborn screening program, including tests administered under
431.18this section and section 144.966, shall be $145 per specimen. The increased fee amount
431.19shall be deposited in the general fund. Costs associated with capital expenditures and
431.20the development of new procedures may be prorated over a three-year period when
431.21calculating the amount of the fees. This fee amount shall be deposited in the state treasury
431.22and credited to the state government special revenue fund.
431.23(d) The fee to offset the cost of the support services provided under section 144.966,
431.24subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
431.25and credited to the general fund.

431.26    Sec. 10. [144.1251] NEWBORN SCREENING FOR CRITICAL CONGENITAL
431.27HEART DISEASE (CCHD).
431.28    Subdivision 1. Required testing and reporting. Each licensed hospital or
431.29state-licensed birthing center or facility that provides maternity and newborn care services
431.30shall provide screening for congenital heart disease to all newborns prior to discharge
431.31using pulse oximetry screening. This screening should occur before discharge from the
431.32nursery, after the infant turns 24 hours of age. If discharge prior to 24 hours after birth
431.33occurs, screening should occur as close as possible to the time of discharge. Results of this
431.34screening must be reported to the Department of Health.
432.1For premature infants (less than 36 weeks of gestation) and infants admitted to a
432.2higher-level nursery (special care or intensive care), pulse oximetry should be performed
432.3when medically appropriate, but always prior to discharge.
432.4    Subd. 2. Implementation. The Department of Health shall:
432.5(1) communicate the screening protocol requirements;
432.6(2) make information and forms available to the persons with a duty to perform
432.7testing and reporting, health care providers, parents of newborns, and the public on
432.8screening and parental options;
432.9(3) provide training to ensure compliance with and appropriate implementation of
432.10the screening;
432.11(4) establish the mechanism for the required data collection and reporting of
432.12screening and follow-up diagnostic results to the Department of Health according to the
432.13Department of Health's recommendations;
432.14(5) coordinate the implementation of universal standardized screening;
432.15(6) act as a resource for providers as the screening program is implemented, and in
432.16consultation with the Advisory Committee on Heritable and Congenital Disorders, develop
432.17and implement policies for early medical and developmental intervention services and
432.18long-term follow-up services for children and their families identified with a CCHD; and
432.19(7) comply with sections 144.125 to 144.128.

432.20    Sec. 11. [144.492] DEFINITIONS.
432.21    Subdivision 1. Applicability. For the purposes of sections 144.492 to 144.494, the
432.22terms defined in this section have the meanings given them.
432.23    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
432.24    Subd. 3. Stroke. "Stroke" means the sudden death of brain cells in a localized
432.25area due to inadequate blood flow.

432.26    Sec. 12. [144.493] CRITERIA.
432.27    Subdivision 1. Comprehensive stroke center. A hospital meets the criteria for a
432.28comprehensive stroke center if the hospital has been certified as a comprehensive stroke
432.29center by the joint commission or another nationally recognized accreditation entity.
432.30    Subd. 2. Primary stroke center. A hospital meets the criteria for a primary stroke
432.31center if the hospital has been certified as a primary stroke center by the joint commission
432.32or another nationally recognized accreditation entity.
433.1    Subd. 3. Acute stroke ready hospital. A hospital meets the criteria for an acute
433.2stroke ready hospital if the hospital has the following elements of an acute stroke ready
433.3hospital:
433.4(1) an acute stroke team available and/or on-call 24 hours a days, seven days a week;
433.5(2) written stroke protocols, including triage, stabilization of vital functions, initial
433.6diagnostic tests, and use of medications;
433.7(3) a written plan and letter of cooperation with emergency medical services regarding
433.8triage and communication that are consistent with regional patient care procedures;
433.9(4) emergency department personnel who are trained in diagnosing and treating
433.10acute stroke;
433.11(5) the capacity to complete basic laboratory tests, electrocardiograms, and chest
433.12x-rays 24 hours a day, seven days a week;
433.13(6) the capacity to perform and interpret brain injury imaging studies 24 hours a
433.14days, seven days a week;
433.15(7) written protocols that detail available emergent therapies and reflect current
433.16treatment guidelines, which include performance measures and are revised at least annually;
433.17(8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan;
433.18(9) transfer protocols and agreements for stroke patients; and
433.19(10) a designated medical director with experience and expertise in acute stroke care.

433.20    Sec. 13. [144.494] DESIGNATING STROKE CENTERS AND STROKE
433.21HOSPITALS.
433.22    Subdivision 1. Naming privileges. Unless it has been designated as a stroke center
433.23or stroke hospital pursuant to section 144.493, no hospital shall use the term "stroke
433.24center" or "stroke hospital" in its name or its advertising or shall otherwise indicate it
433.25has stroke treatment capabilities.
433.26    Subd. 2. Designation. A hospital that voluntarily meets the criteria for a
433.27comprehensive stroke center, primary stroke center, or acute stroke ready hospital may
433.28apply to the commissioner for designation, and upon the commissioner's review and
433.29approval of the application, shall be designated as a comprehensive stroke center, a
433.30primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital
433.31loses its certification as a comprehensive stroke center or primary stroke center from
433.32the joint commission or other nationally recognized accreditation entity, its Minnesota
433.33designation will be immediately withdrawn. Prior to the expiration of the three-year
433.34designation, a hospital seeking to remain part of the voluntary acute stroke system may
433.35reapply to the commissioner for designation.

434.1    Sec. 14. [144.554] HEALTH FACILITIES CONSTRUCTION PLAN
434.2SUBMITTAL AND FEES.
434.3For hospitals, nursing homes, boarding care homes, residential hospices, supervised
434.4living facilities, freestanding outpatient surgical centers, and end-stage renal disease
434.5facilities, the commissioner shall collect a fee for the review and approval of architectural,
434.6mechanical, and electrical plans and specifications submitted before construction begins
434.7for each project relative to construction of new buildings, additions to existing buildings,
434.8or for remodeling or alterations of existing buildings. All fees collected in this section
434.9shall be deposited in the state treasury and credited to the state government special revenue
434.10fund. Fees must be paid at the time of submission of final plans for review and are not
434.11refundable. The fee is calculated as follows:

434.12	Construction project total estimated cost	Fee
434.13	$0 - $10,000	$30
434.14	$10,001 - $50,000	$150
434.15	$50,001 - $100,000	$300
434.16	$100,001 - $150,000	$450
434.17	$150,001 - $200,000	$600
434.18	$200,001 - $250,000	$750
434.19	$250,001 - $300,000	$900
434.20	$300,001 - $350,000	$1,050
434.21	$350,001 - $400,000	$1,200
434.22	$400,001 - $450,000	$1,350
434.23	$450,001 - $500,000	$1,500
434.24	$500,001 - $550,000	$1,650
434.25	$550,001 - $600,000	$1,800
434.26	$600,001 - $650,000	$1,950
434.27	$650,001 - $700,000	$2,100
434.28	$700,001 - $750,000	$2,250
434.29	$750,001 - $800,000	$2,400
434.30	$800,001 - $850,000	$2,550
434.31	$850,001 - $900,000	$2,700
434.32	$900,001 - $950,000	$2,850
434.33	$950,001 - $1,000,000	$3,000
434.34	$1,000,001 - $1,050,000	$3,150
434.35	$1,050,001 - $1,100,000	$3,300
434.36	$1,100,001 - $1,150,000	$3,450
434.37	$1,150,001 - $1,200,000	$3,600
434.38	$1,200,001 - $1,250,000	$3,750
434.39	$1,250,001 - $1,300,000	$3,900
434.40	$1,300,001 - $1,350,000	$4,050
434.41	$1,350,001 - $1,400,000	$4,200
435.1	$1,400,001 - $1,450,000	$4,350
435.2	$1,450,001 - $1,500,000	$4,500
435.3	$1,500,001 and over	$4,800

435.4    Sec. 15. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:
435.5    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
435.6commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
435.7to advise and assist the Department of Health and the Department of Education in:
435.8    (1) developing protocols and timelines for screening, rescreening, and diagnostic
435.9audiological assessment and early medical, audiological, and educational intervention
435.10services for children who are deaf or hard-of-hearing;
435.11    (2) designing protocols for tracking children from birth through age three that may
435.12have passed newborn screening but are at risk for delayed or late onset of permanent
435.13hearing loss;
435.14    (3) designing a technical assistance program to support facilities implementing the
435.15screening program and facilities conducting rescreening and diagnostic audiological
435.16assessment;
435.17    (4) designing implementation and evaluation of a system of follow-up and tracking;
435.18and
435.19    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
435.20culturally appropriate services for children with a confirmed hearing loss and their families.
435.21    (b) The commissioner of health shall appoint at least one member from each of the
435.22following groups with no less than two of the members being deaf or hard-of-hearing:
435.23    (1) a representative from a consumer organization representing culturally deaf
435.24persons;
435.25    (2) a parent with a child with hearing loss representing a parent organization;
435.26    (3) a consumer from an organization representing oral communication options;
435.27    (4) a consumer from an organization representing cued speech communication
435.28options;
435.29    (5) an audiologist who has experience in evaluation and intervention of infants
435.30and young children;
435.31    (6) a speech-language pathologist who has experience in evaluation and intervention
435.32of infants and young children;
435.33    (7) two primary care providers who have experience in the care of infants and young
435.34children, one of which shall be a pediatrician;
435.35    (8) a representative from the early hearing detection intervention teams;
436.1    (9) a representative from the Department of Education resource center for the deaf
436.2and hard-of-hearing or the representative's designee;
436.3    (10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing
436.4Minnesotans;
436.5    (11) a representative from the Department of Human Services Deaf and
436.6Hard-of-Hearing Services Division;
436.7    (12) one or more of the Part C coordinators from the Department of Education, the
436.8Department of Health, or the Department of Human Services or the department's designees;
436.9    (13) the Department of Health early hearing detection and intervention coordinators;
436.10    (14) two birth hospital representatives from one rural and one urban hospital;
436.11    (15) a pediatric geneticist;
436.12    (16) an otolaryngologist;
436.13    (17) a representative from the Newborn Screening Advisory Committee under
436.14this subdivision; and
436.15    (18) a representative of the Department of Education regional low-incidence
436.16facilitators.
436.17The commissioner must complete the appointments required under this subdivision by
436.18September 1, 2007.
436.19    (c) The Department of Health member shall chair the first meeting of the committee.
436.20At the first meeting, the committee shall elect a chair from its membership. The committee
436.21shall meet at the call of the chair, at least four times a year. The committee shall adopt
436.22written bylaws to govern its activities. The Department of Health shall provide technical
436.23and administrative support services as required by the committee. These services shall
436.24include technical support from individuals qualified to administer infant hearing screening,
436.25rescreening, and diagnostic audiological assessments.
436.26    Members of the committee shall receive no compensation for their service, but
436.27shall be reimbursed as provided in section 15.059 for expenses incurred as a result of
436.28their duties as members of the committee.
436.29    (d) This subdivision expires June 30, 2013 2019.

436.30    Sec. 16. Minnesota Statutes 2012, section 144.966, subdivision 3a, is amended to read:
436.31    Subd. 3a. Support services to families. The commissioner shall contract with a
436.32nonprofit organization to provide support and assistance to families with children who are
436.33deaf or have a hearing loss. The family support provided must include:
437.1    (1) direct hearing loss specific parent-to-parent assistance and unbiased information
437.2on communication, educational, and medical options, preferably provided by a program
437.3that is part of a national organization; and
437.4    (2) individualized deaf or hard of hearing mentors who provide education, including
437.5instruction in American Sign Language.
437.6The commissioner shall give preference to a nonprofit organization that has the ability to
437.7provide these services throughout the state.

437.8    Sec. 17. Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:
437.9    Subd. 3. Annual fees. (a) An application for accreditation under subdivision 6 must
437.10be accompanied by the annual fees specified in this subdivision. The annual fees include:
437.11(1) base accreditation fee, $1,500 $600;
437.12(2) sample preparation techniques fee, $200 per technique;
437.13(3) an administrative fee for laboratories located outside this state, $3,750 $2,000; and
437.14(4) test category fees.
437.15(b) For the programs in subdivision 3a, the commissioner may accredit laboratories
437.16for fields of testing under the categories listed in clauses (1) to (10) upon completion of
437.17the application requirements provided by subdivision 6 and receipt of the fees for each
437.18category under each program that accreditation is requested. The categories offered and
437.19related fees include:
437.20(1) microbiology, $450 $200;
437.21(2) inorganics, $450 $200;
437.22(3) metals, $1,000 $500;
437.23(4) volatile organics, $1,300 $1,000;
437.24(5) other organics, $1,300 $1,000;
437.25(6) radiochemistry, $1,500 $750;
437.26(7) emerging contaminants, $1,500 $1,000;
437.27(8) agricultural contaminants, $1,250 $1,000;
437.28(9) toxicity (bioassay), $1,000 $500; and
437.29(10) physical characterization, $250.
437.30(c) The total annual fee includes the base fee, the sample preparation techniques
437.31fees, the test category fees per program, and, when applicable, an administrative fee for
437.32out-of-state laboratories.
437.33EFFECTIVE DATE.This section is effective the day following final enactment.

438.1    Sec. 18. Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:
438.2    Subd. 5. State government special revenue fund. Fees collected by the
438.3commissioner under this section must be deposited in the state treasury and credited to
438.4the state government special revenue fund.
438.5EFFECTIVE DATE.This section is effective the day following final enactment.

438.6    Sec. 19. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
438.7to read:
438.8    Subd. 10. Establishing a selection committee. (a) The commissioner shall
438.9establish a selection committee for the purpose of recommending approval of qualified
438.10laboratory assessors and assessment bodies. Committee members shall demonstrate
438.11competence in assessment practices. The committee shall initially consist of seven
438.12members appointed by the commissioner as follows:
438.13(1) one member from a municipal laboratory accredited by the commissioner;
438.14(2) one member from an industrial treatment laboratory accredited by the
438.15commissioner;
438.16(3) one member from a commercial laboratory located in this state and accredited by
438.17the commissioner;
438.18(4) one member from a commercial laboratory located outside the state and
438.19accredited by the commissioner;
438.20(5) one member from a nongovernmental client of environmental laboratories;
438.21(6) one member from a professional organization with a demonstrated interest in
438.22environmental laboratory data and accreditation; and
438.23(7) one employee of the laboratory accreditation program administered by the
438.24department.
438.25(b) Committee appointments begin on January 1 and end on December 31 of the
438.26same year.
438.27(c) The commissioner shall appoint persons to fill vacant committee positions,
438.28expand the total number of appointed positions, or change the designated positions upon
438.29the advice of the committee.
438.30(d) The commissioner shall rescind the appointment of a selection committee
438.31member for sufficient cause as the commissioner determines, such as:
438.32(1) neglect of duty;
438.33(2) failure to notify the commissioner of a real or perceived conflict of interest;
438.34(3) nonconformance with committee procedures;
438.35(4) failure to demonstrate competence in assessment practices; or
439.1(5) official misconduct.
439.2(e) Members of the selection committee shall be compensated according to the
439.3provisions in section 15.059, subdivision 3.

439.4    Sec. 20. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
439.5to read:
439.6    Subd. 11. Activities of the selection committee. (a) The selection committee
439.7will determine assessor and assessment body application requirements, the frequency
439.8of application submittal, and the application review schedule. The commissioner shall
439.9publish the application requirements and procedures on the accreditation program Web site.
439.10(b) In its selection process, the committee shall ensure its application requirements
439.11and review process:
439.12(1) meet the standards implemented in subdivision 2a;
439.13(2) ensure assessors have demonstrated competence in technical disciplines offered
439.14for accreditation by the commissioner; and
439.15(3) consider any history of repeated nonconformance or complaints regarding
439.16assessors or assessment bodies.
439.17(c) The selection committee shall consider an application received from qualified
439.18applicants and shall supply a list of recommended assessors and assessment bodies to
439.19the commissioner of health no later than 90 days after the commissioner notifies the
439.20committee of the need for review of applications.

439.21    Sec. 21. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
439.22to read:
439.23    Subd. 12. Commissioner approval of assessors and scheduling of assessments.
439.24(a) The commissioner shall approve assessors who:
439.25(1) are employed by the commissioner for the purpose of accrediting laboratories
439.26and demonstrate competence in assessment practices for environmental laboratories; or
439.27(2) are employed by a state or federal agency with established agreements for
439.28mutual assistance or recognition with the commissioner and demonstrate competence in
439.29assessment practices for environmental laboratories.
439.30(b) The commissioner may approve other assessors or assessment bodies who are
439.31recommended by the selection committee according to subdivision 11, paragraph (c). The
439.32commissioner shall publish the list of assessors and assessment bodies approved from the
439.33recommendations.
440.1(c) The commissioner shall rescind approval for an assessor or assessment body for
440.2sufficient cause as the commissioner determines, such as:
440.3(1) failure to meet the minimum qualifications for performing assessments;
440.4(2) lack of availability;
440.5(3) nonconformance with the applicable laws, rules, standards, policies, and
440.6procedures;
440.7(4) misrepresentation of application information regarding qualifications and
440.8training; or
440.9(5) excessive cost to perform the assessment activities.

440.10    Sec. 22. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
440.11to read:
440.12    Subd. 13. Laboratory requirements for assessor selection and scheduling
440.13assessments. (a) A laboratory accredited or seeking accreditation that requires an
440.14assessment by the commissioner must select an assessor, group of assessors, or an
440.15assessment body from the published list specified in subdivision 12, paragraph (b). An
440.16accredited laboratory must complete an assessment and make all corrective actions at least
440.17once every 24 months. Unless the commissioner grants interim accreditation, a laboratory
440.18seeking accreditation must complete an assessment and make all corrective actions
440.19prior to, but no earlier than, 18 months prior to the date the application is submitted to
440.20the commissioner.
440.21(b) A laboratory shall not select the same assessor more than twice in succession
440.22for assessments of the same facility unless the laboratory receives written approval
440.23from the commissioner for the selection. The laboratory must supply a written request
440.24to the commissioner for approval and must justify the reason for the request and provide
440.25the alternate options considered.
440.26(c) A laboratory must select assessors appropriate to the size and scope of the
440.27laboratory's application or existing accreditation.
440.28(d) A laboratory must enter into its own contract for direct payment of the assessors
440.29or assessment body. The contract must authorize the assessor, assessment body, or
440.30subcontractors to release all records to the commissioner regarding the assessment activity,
440.31when the assessment is performed in compliance with this statute.
440.32(e) A laboratory must agree to permit other assessors as selected by the commissioner
440.33to participate in the assessment activities.
440.34(f) If the laboratory determines no approved assessor is available to perform
440.35the assessment, the laboratory must notify the commissioner in writing and provide a
441.1justification for the determination. If the commissioner confirms no approved assessor
441.2is available, the commissioner may designate an alternate assessor from those approved
441.3in subdivision 12, paragraph (a), or the commissioner may delay the assessment until
441.4an assessor is available. If an approved alternate assessor performs the assessment, the
441.5commissioner may collect fees equivalent to the cost of performing the assessment
441.6activities.
441.7(g) Fees collected under this section are deposited in a special account and are
441.8annually appropriated to the commissioner for the purpose of performing assessment
441.9activities.
441.10EFFECTIVE DATE.This section is effective the day following final enactment.

441.11    Sec. 23. Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:
441.12    Subd. 4. Administrative penalty orders. (a) The commissioner may issue an
441.13order requiring violations to be corrected and administratively assessing monetary
441.14penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The
441.15procedures in section 144.991 must be followed when issuing administrative penalty
441.16orders. Except in the case of repeated or serious violations, the penalty assessed in the
441.17order must be forgiven if the person who is subject to the order demonstrates in writing
441.18to the commissioner before the 31st day after receiving the order that the person has
441.19corrected the violation or has developed a corrective plan acceptable to the commissioner.
441.20The maximum amount of an administrative penalty order is $10,000 for each violator for
441.21all violations by that violator identified in an inspection or review of compliance.
441.22(b) Notwithstanding paragraph (a), the commissioner may issue to a large public
441.23water supply, serving a population of more than 10,000 persons, an administrative penalty
441.24order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000
441.25for each violation of sections 144.381 to 144.385 and rules adopted thereunder.
441.26(c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead
441.27firm or person performing regulated lead work, an administrative penalty order imposing a
441.28penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of
441.29sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from
441.30monetary penalties in this section shall be deposited in the state treasury and credited to
441.31the state government special revenue fund.

441.32    Sec. 24. [145.4716] SAFE HARBOR FOR SEXUALLY EXPLOITED YOUTH.
441.33    Subdivision 1. Director. The commissioner of health shall establish a position for a
441.34director of child sex trafficking prevention.
442.1    Subd. 2. Duties of director. The director of child sex trafficking prevention is
442.2responsible for the following:
442.3    (1) developing and providing comprehensive training on sexual exploitation of
442.4youth for social service professionals, medical professionals, public health workers, and
442.5criminal justice professionals;
442.6    (2) collecting, organizing, maintaining, and disseminating information on sexual
442.7exploitation and services across the state, including maintaining a list of resources on the
442.8Department of Health Web site;
442.9    (3) monitoring and applying for federal funding for antitrafficking efforts that may
442.10benefit victims in the state;
442.11    (4) managing grant programs established under this act;
442.12    (5) identifying best practices in serving sexually exploited youth, as defined in
442.13section 260C.007, subdivision 31;
442.14    (6) providing oversight of and technical support to regional navigators pursuant to
442.15section 145.4717;
442.16    (7) conducting a comprehensive evaluation of the statewide program for safe harbor
442.17of sexually exploited youth; and
442.18    (8) developing a policy, consistent with the requirements of chapter 13, for sharing
442.19data related to sexually exploited youth, as defined in section 260C.007, subdivision 31,
442.20among regional navigators and community-based advocates.

442.21    Sec. 25. [145.4717] REGIONAL NAVIGATOR GRANTS.
442.22    The commissioner of health, through its director of child sex trafficking prevention,
442.23established in section 145.4716, shall provide grants to regional navigators serving six
442.24regions of the state to be determined by the commissioner. Each regional navigator must
442.25develop and annually submit a work plan to the director of child sex trafficking prevention.
442.26The work plans must include, but are not limited to, the following information:
442.27    (1) a needs statement specific to the region, including an examination of the
442.28population at risk;
442.29    (2) regional resources available to sexually exploited youth, as defined in section
442.30260C.007, subdivision 31;
442.31    (3) grant goals and measurable outcomes; and
442.32    (4) grant activities including timelines.

442.33    Sec. 26. [145.4718] PROGRAM EVALUATION.
443.1    (a) The director of child sex trafficking prevention, established under section
443.2145.4716, must conduct, or contract for, comprehensive evaluation of the statewide
443.3program for safe harbor for sexually exploited youth. The first evaluation must be
443.4completed by June 30, 2015, and must be submitted to the commissioner of health by
443.5September 1, 2015, and every two years thereafter. The evaluation must consider whether
443.6the program is reaching intended victims and whether support services are available,
443.7accessible, and adequate for sexually exploited youth, as defined in section 260C.007,
443.8subdivision 31.
443.9    (b) In conducting the evaluation, the director of child sex trafficking prevention must
443.10consider evaluation of outcomes, including whether the program increases identification
443.11of sexually exploited youth, coordination of investigations, access to services and housing
443.12available for sexually exploited youth, and improved effectiveness of services. The
443.13evaluation must also include examination of the ways in which penalties under section
443.14609.3241 are assessed, collected, and distributed to ensure funding for investigation,
443.15prosecution, and victim services to combat sexual exploitation of youth.

443.16    Sec. 27. Minnesota Statutes 2012, section 145.986, is amended to read:
443.17145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.
443.18    Subdivision 1. Grants to local communities Purpose. The purpose of the statewide
443.19health improvement program is to:
443.20(1) address the top three leading preventable causes of illness and death: tobacco use
443.21and exposure, poor diet, and lack of regular physical activity;
443.22(2) promote the development, availability, and use of evidence-based, community
443.23level, comprehensive strategies to create healthy communities; and
443.24(3) measure the impact of the evidence-based, community health improvement
443.25practices which over time work to contain health care costs and reduce chronic diseases.
443.26    Subd. 1a. Grants to local communities. (a) Beginning July 1, 2009, the
443.27commissioner of health shall award competitive grants to community health boards
443.28established pursuant to section 145A.09 and tribal governments to convene, coordinate,
443.29and implement evidence-based strategies targeted at reducing the percentage of
443.30Minnesotans who are obese or overweight and to reduce the use of tobacco.
443.31    (b) Grantee activities shall:
443.32    (1) be based on scientific evidence;
443.33    (2) be based on community input;
443.34    (3) address behavior change at the individual, community, and systems levels;
443.35    (4) occur in community, school, worksite, and health care settings; and
444.1    (5) be focused on policy, systems, and environmental changes that support healthy
444.2behaviors.; and
444.3(6) address the health disparities and inequities that exist in the grantee's community.
444.4    (c) To receive a grant under this section, community health boards and tribal
444.5governments must submit proposals to the commissioner. A local match of ten percent
444.6of the total funding allocation is required. This local match may include funds donated
444.7by community partners.
444.8    (d) In order to receive a grant, community health boards and tribal governments
444.9must submit a health improvement plan to the commissioner of health for approval. The
444.10commissioner may require the plan to identify a community leadership team, community
444.11partners, and a community action plan that includes an assessment of area strengths and
444.12needs, proposed action strategies, technical assistance needs, and a staffing plan.
444.13    (e) The grant recipient must implement the health improvement plan, evaluate the
444.14effectiveness of the interventions strategies, and modify or discontinue interventions
444.15 strategies found to be ineffective.
444.16    (f) By January 15, 2011, the commissioner of health shall recommend whether any
444.17funding should be distributed to community health boards and tribal governments based
444.18on health disparities demonstrated in the populations served.
444.19    (g) (f) Grant recipients shall report their activities and their progress toward the
444.20outcomes established under subdivision 2 to the commissioner in a format and at a time
444.21specified by the commissioner.
444.22    (h) (g) All grant recipients shall be held accountable for making progress toward
444.23the measurable outcomes established in subdivision 2. The commissioner shall require a
444.24corrective action plan and may reduce the funding level of grant recipients that do not
444.25make adequate progress toward the measurable outcomes.
444.26(h) Notwithstanding paragraph (a), the commissioner may award funding to
444.27convene, coordinate, and implement evidence-based strategies targeted at reducing other
444.28risk factors, aside from tobacco use and exposure, poor diet, and lack of regular physical
444.29activity, that are associated with chronic disease and may impact public health. The
444.30commissioner shall develop a criteria and procedures to allocate funding under this section.
444.31    Subd. 2. Outcomes. (a) The commissioner shall set measurable outcomes to meet
444.32the goals specified in subdivision 1, and annually review the progress of grant recipients
444.33in meeting the outcomes.
444.34    (b) The commissioner shall measure current public health status, using existing
444.35measures and data collection systems when available, to determine baseline data against
444.36which progress shall be monitored.
445.1    Subd. 3. Technical assistance and oversight. (a) The commissioner shall provide
445.2content expertise, technical expertise, and training to grant recipients and advice on
445.3evidence-based strategies, including those based on populations and types of communities
445.4served. The commissioner shall ensure that the statewide health improvement program
445.5meets the outcomes established under subdivision 2 by conducting a comprehensive
445.6statewide evaluation and assisting grant recipients to modify or discontinue interventions
445.7found to be ineffective.
445.8(b) For the purposes of carrying out the grant program under this section, including
445.9for administrative purposes, the commissioner shall award contracts to appropriate entities
445.10to assist in training and provide technical assistance to grantees.
445.11(c) Contracts awarded under paragraph (b) may be used to provide technical
445.12assistance and training in the areas of:
445.13(1) community engagement and capacity building;
445.14(2) tribal support;
445.15(3) community asset building and risk behavior reduction;
445.16(4) legal;
445.17(5) communications;
445.18(6) community, school, health care, work site, and other site-specific strategies; and
445.19(7) health equity.
445.20    Subd. 4. Evaluation. (a) Using the outcome measures established in subdivision
445.213, the commissioner shall conduct a biennial an evaluation of the statewide health
445.22improvement program funded under this section. Grant recipients shall cooperate with
445.23the commissioner in the evaluation and provide the commissioner with the information
445.24necessary to conduct the evaluation.
445.25(b) Grant recipients will collect, monitor, and submit to the Department of Health
445.26baseline and annual data, and provide information to improve the quality and impact of
445.27community health improvement strategies.
445.28(c) For the purposes of carrying out the grant program under this section, including
445.29for administrative purposes, the commissioner shall award contracts to appropriate entities
445.30to assist in designing and implementing evaluation systems.
445.31(d) Contracts awarded under paragraph (c) may be used to:
445.32(1) develop grantee monitoring and reporting systems to track grantee progress,
445.33including aggregated and disaggregated data;
445.34(2) manage, analyze, and report program evaluation data results; and
445.35(3) utilize innovative support tools to analyze and predict the impact of prevention
445.36strategies on health outcomes and state health care costs over time.
446.1    Subd. 5. Report. The commissioner shall submit a biennial report to the legislature
446.2on the statewide health improvement program funded under this section. These reports
446.3must include information on grant recipients, activities that were conducted using grant
446.4funds, evaluation data, and outcome measures, if available. In addition, the commissioner
446.5shall provide recommendations on future areas of focus for health improvement. These
446.6reports are due by January 15 of every other year, beginning in 2010. In the report due
446.7on January 15, 2010, the commissioner shall include recommendations on a sustainable
446.8funding source for the statewide health improvement program other than the health care
446.9access fund.
446.10    Subd. 6. Supplantation of existing funds. Community health boards and tribal
446.11governments must use funds received under this section to develop new programs, expand
446.12current programs that work to reduce the percentage of Minnesotans who are obese or
446.13overweight or who use tobacco, or replace discontinued state or federal funds previously
446.14used to reduce the percentage of Minnesotans who are obese or overweight or who use
446.15tobacco. Funds must not be used to supplant current state or local funding to community
446.16health boards or tribal governments used to reduce the percentage of Minnesotans who are
446.17obese or overweight or to reduce tobacco use.

446.18    Sec. 28. Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:
446.19    Subd. 1a. Alkaline hydrolysis. "Alkaline hydrolysis" means the reduction of a dead
446.20human body to essential elements through exposure to a combination of heat and alkaline
446.21hydrolysis and the repositioning or movement of the body during the process to facilitate
446.22reduction, a water-based dissolution process using alkaline chemicals, heat, agitation, and
446.23pressure to accelerate natural decomposition; the processing of the hydrolyzed remains
446.24after removal from the alkaline hydrolysis chamber, vessel; placement of the processed
446.25remains in a hydrolyzed remains container,; and release of the hydrolyzed remains to an
446.26appropriate party. Alkaline hydrolysis is a form of final disposition.

446.27    Sec. 29. Minnesota Statutes 2012, section 149A.02, is amended by adding a
446.28subdivision to read:
446.29    Subd. 1b. Alkaline hydrolysis container. "Alkaline hydrolysis container" means a
446.30hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily
446.31fluids that encases the body and into which a dead human body is placed prior to insertion
446.32into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or
446.33biodegradable alternative containers or caskets.

447.1    Sec. 30. Minnesota Statutes 2012, section 149A.02, is amended by adding a
447.2subdivision to read:
447.3    Subd. 1c. Alkaline hydrolysis facility. "Alkaline hydrolysis facility" means a
447.4building or structure containing one or more alkaline hydrolysis vessels for the alkaline
447.5hydrolysis of dead human bodies.

447.6    Sec. 31. Minnesota Statutes 2012, section 149A.02, is amended by adding a
447.7subdivision to read:
447.8    Subd. 1d. Alkaline hydrolysis vessel. "Alkaline hydrolysis vessel" means the
447.9container in which the alkaline hydrolysis of a dead human body is performed.

447.10    Sec. 32. Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:
447.11    Subd. 2. Alternative container. "Alternative container" means a nonmetal
447.12receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed
447.13for the encasement of dead human bodies and is made of hydrolyzable or biodegradable
447.14materials, corrugated cardboard, fiberboard, pressed-wood, or other like materials.

447.15    Sec. 33. Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:
447.16    Subd. 3. Arrangements for disposition. "Arrangements for disposition" means
447.17any action normally taken by a funeral provider in anticipation of or preparation for the
447.18entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

447.19    Sec. 34. Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:
447.20    Subd. 4. Cash advance item. "Cash advance item" means any item of service
447.21or merchandise described to a purchaser as a "cash advance," "accommodation," "cash
447.22disbursement," or similar term. A cash advance item is also any item obtained from a
447.23third party and paid for by the funeral provider on the purchaser's behalf. Cash advance
447.24items include, but are not limited to, cemetery, alkaline hydrolysis, or crematory services,
447.25pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary
447.26notices, gratuities, and death records.

447.27    Sec. 35. Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:
447.28    Subd. 5. Casket. "Casket" means a rigid container which is designed for the
447.29encasement of a dead human body and is usually constructed of hydrolyzable or
447.30biodegradable materials, wood, metal, fiberglass, plastic, or like material, and ornamented
447.31and lined with fabric.

448.1    Sec. 36. Minnesota Statutes 2012, section 149A.02, is amended by adding a
448.2subdivision to read:
448.3    Subd. 12a. Crypt. "Crypt" means a space in a mausoleum of sufficient size, used or
448.4intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.

448.5    Sec. 37. Minnesota Statutes 2012, section 149A.02, is amended by adding a
448.6subdivision to read:
448.7    Subd. 12b. Direct alkaline hydrolysis. "Direct alkaline hydrolysis" means a
448.8final disposition of a dead human body by alkaline hydrolysis, without formal viewing,
448.9visitation, or ceremony with the body present.

448.10    Sec. 38. Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:
448.11    Subd. 16. Final disposition. "Final disposition" means the acts leading to and the
448.12entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

448.13    Sec. 39. Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:
448.14    Subd. 23. Funeral services. "Funeral services" means any services which may
448.15be used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis,
448.16cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral
448.17ceremony or the final disposition of dead human bodies.

448.18    Sec. 40. Minnesota Statutes 2012, section 149A.02, is amended by adding a
448.19subdivision to read:
448.20    Subd. 24b. Hydrolyzed remains. "Hydrolyzed remains" means the remains of a
448.21dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not
448.22include pacemakers, prostheses, or similar foreign materials.

448.23    Sec. 41. Minnesota Statutes 2012, section 149A.02, is amended by adding a
448.24subdivision to read:
448.25    Subd. 24c. Hydrolyzed remains container. "Hydrolyzed remains container" means
448.26a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a
448.27hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage
448.28jewelry.

448.29    Sec. 42. Minnesota Statutes 2012, section 149A.02, is amended by adding a
448.30subdivision to read:
449.1    Subd. 26a. Inurnment. "Inurnment" means placing hydrolyzed or cremated remains
449.2in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.

449.3    Sec. 43. Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:
449.4    Subd. 27. Licensee. "Licensee" means any person or entity that has been issued
449.5a license to practice mortuary science, to operate a funeral establishment, to operate an
449.6alkaline hydrolysis facility, or to operate a crematory by the Minnesota commissioner
449.7of health.

449.8    Sec. 44. Minnesota Statutes 2012, section 149A.02, is amended by adding a
449.9subdivision to read:
449.10    Subd. 30a. Niche. "Niche" means a space in a columbarium used, or intended to be
449.11used, for the placement of hydrolyzed or cremated remains.

449.12    Sec. 45. Minnesota Statutes 2012, section 149A.02, is amended by adding a
449.13subdivision to read:
449.14    Subd. 32a. Placement. "Placement" means the placing of a container holding
449.15hydrolyzed or cremated remains in a crypt, vault, or niche.

449.16    Sec. 46. Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:
449.17    Subd. 34. Preparation of the body. "Preparation of the body" means placement of
449.18the body into an appropriate cremation or alkaline hydrolysis container, embalming of
449.19the body or such items of care as washing, disinfecting, shaving, positioning of features,
449.20restorative procedures, application of cosmetics, dressing, and casketing.

449.21    Sec. 47. Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:
449.22    Subd. 35. Processing. "Processing" means the removal of foreign objects, drying or
449.23cooling, and the reduction of the hydrolyzed or cremated remains by mechanical means
449.24including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance
449.25appropriate for final disposition.

449.26    Sec. 48. Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:
449.27    Subd. 37. Public transportation. "Public transportation" means all manner of
449.28transportation via common carrier available to the general public including airlines, buses,
449.29railroads, and ships. For purposes of this chapter, a livery service providing transportation
450.1to private funeral establishments, alkaline hydrolysis facilities, or crematories is not public
450.2transportation.

450.3    Sec. 49. Minnesota Statutes 2012, section 149A.02, is amended by adding a
450.4subdivision to read:
450.5    Subd. 37c. Scattering. "Scattering" means the authorized dispersal of hydrolyzed
450.6or cremated remains in a defined area of a dedicated cemetery or in areas where no local
450.7prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable
450.8to the public, are not in a container, and that the person who has control over disposition
450.9of the hydrolyzed or cremated remains has obtained written permission of the property
450.10owner or governing agency to scatter on the property.

450.11    Sec. 50. Minnesota Statutes 2012, section 149A.02, is amended by adding a
450.12subdivision to read:
450.13    Subd. 41. Vault. "Vault" means a space in a mausoleum of sufficient size, used or
450.14intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.
450.15Vault may also mean a sealed and lined casket enclosure.

450.16    Sec. 51. Minnesota Statutes 2012, section 149A.03, is amended to read:
450.17149A.03 DUTIES OF COMMISSIONER.
450.18    The commissioner shall:
450.19    (1) enforce all laws and adopt and enforce rules relating to the:
450.20    (i) removal, preparation, transportation, arrangements for disposition, and final
450.21disposition of dead human bodies;
450.22    (ii) licensure and professional conduct of funeral directors, morticians, interns,
450.23practicum students, and clinical students;
450.24    (iii) licensing and operation of a funeral establishment; and
450.25(iv) licensing and operation of an alkaline hydrolysis facility; and
450.26    (iv) (v) licensing and operation of a crematory;
450.27    (2) provide copies of the requirements for licensure and permits to all applicants;
450.28    (3) administer examinations and issue licenses and permits to qualified persons
450.29and other legal entities;
450.30    (4) maintain a record of the name and location of all current licensees and interns;
450.31    (5) perform periodic compliance reviews and premise inspections of licensees;
450.32    (6) accept and investigate complaints relating to conduct governed by this chapter;
450.33    (7) maintain a record of all current preneed arrangement trust accounts;
451.1    (8) maintain a schedule of application, examination, permit, and licensure fees,
451.2initial and renewal, sufficient to cover all necessary operating expenses;
451.3    (9) educate the public about the existence and content of the laws and rules for
451.4mortuary science licensing and the removal, preparation, transportation, arrangements
451.5for disposition, and final disposition of dead human bodies to enable consumers to file
451.6complaints against licensees and others who may have violated those laws or rules;
451.7    (10) evaluate the laws, rules, and procedures regulating the practice of mortuary
451.8science in order to refine the standards for licensing and to improve the regulatory and
451.9enforcement methods used; and
451.10    (11) initiate proceedings to address and remedy deficiencies and inconsistencies in
451.11the laws, rules, or procedures governing the practice of mortuary science and the removal,
451.12preparation, transportation, arrangements for disposition, and final disposition of dead
451.13human bodies.

451.14    Sec. 52. [149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS
451.15FACILITY.
451.16    Subdivision 1. License requirement. Except as provided in section 149A.01,
451.17subdivision 3, a place or premise shall not be maintained, managed, or operated which
451.18is devoted to or used in the holding and alkaline hydrolysis of a dead human body
451.19without possessing a valid license to operate an alkaline hydrolysis facility issued by the
451.20commissioner of health.
451.21    Subd. 2. Requirements for an alkaline hydrolysis facility. (a) An alkaline
451.22hydrolysis facility licensed under this section must consist of:
451.23(1) a building or structure that complies with applicable local and state building
451.24codes, zoning laws and ordinances, wastewater management and environmental standards,
451.25containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead
451.26human bodies;
451.27(2) a method approved by the commissioner of health to dry the hydrolyzed remains
451.28and which is located within the licensed facility;
451.29(3) a means approved by the commissioner of health for refrigeration of dead human
451.30bodies awaiting alkaline hydrolysis;
451.31(4) an appropriate means of processing hydrolyzed remains to a granulated
451.32appearance appropriate for final disposition; and
451.33(5) an appropriate holding facility for dead human bodies awaiting alkaline
451.34hydrolysis.
452.1(b) An alkaline hydrolysis facility licensed under this section may also contain a
452.2display room for funeral goods.
452.3    Subd. 3. Application procedure; documentation; initial inspection. An
452.4application to license and operate an alkaline hydrolysis facility shall be submitted to the
452.5commissioner of health. A completed application includes:
452.6(1) a completed application form, as provided by the commissioner;
452.7(2) proof of business form and ownership;
452.8(3) proof of liability insurance coverage or other financial documentation, as
452.9determined by the commissioner, that demonstrates the applicant's ability to respond in
452.10damages for liability arising from the ownership, maintenance management, or operation
452.11of an alkaline hydrolysis facility; and
452.12(4) copies of wastewater and other environmental regulatory permits and
452.13environmental regulatory licenses necessary to conduct operations.
452.14Upon receipt of the application and appropriate fee, the commissioner shall review and
452.15verify all information. Upon completion of the verification process and resolution of any
452.16deficiencies in the application information, the commissioner shall conduct an initial
452.17inspection of the premises to be licensed. After the inspection and resolution of any
452.18deficiencies found and any reinspections as may be necessary, the commissioner shall
452.19make a determination, based on all the information available, to grant or deny licensure. If
452.20the commissioner's determination is to grant the license, the applicant shall be notified and
452.21the license shall issue and remain valid for a period prescribed on the license, but not to
452.22exceed one calendar year from the date of issuance of the license. If the commissioner's
452.23determination is to deny the license, the commissioner must notify the applicant in writing
452.24of the denial and provide the specific reason for denial.
452.25    Subd. 4. Nontransferability of license. A license to operate an alkaline hydrolysis
452.26facility is not assignable or transferable and shall not be valid for any entity other than the
452.27one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the
452.28location identified on the license. A 50 percent or more change in ownership or location of
452.29the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall
452.30be required of two or more persons or other legal entities operating from the same location.
452.31    Subd. 5. Display of license. Each license to operate an alkaline hydrolysis
452.32facility must be conspicuously displayed in the alkaline hydrolysis facility at all times.
452.33Conspicuous display means in a location where a member of the general public within the
452.34alkaline hydrolysis facility will be able to observe and read the license.
453.1    Subd. 6. Period of licensure. All licenses to operate an alkaline hydrolysis facility
453.2issued by the commissioner are valid for a period of one calendar year beginning on July 1
453.3and ending on June 30, regardless of the date of issuance.
453.4    Subd. 7. Reporting changes in license information. Any change of license
453.5information must be reported to the commissioner, on forms provided by the
453.6commissioner, no later than 30 calendar days after the change occurs. Failure to report
453.7changes is grounds for disciplinary action.
453.8    Subd. 8. Notification to the commissioner. If the licensee is operating under a
453.9wastewater or an environmental permit or license that is subsequently revoked, denied,
453.10or terminated, the licensee shall notify the commissioner.
453.11    Subd. 9. Application information. All information submitted to the commissioner
453.12for a license to operate an alkaline hydrolysis facility is classified as licensing data under
453.13section 13.41, subdivision 5.

453.14    Sec. 53. [149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE
453.15HYDROLYSIS FACILITY.
453.16    Subdivision 1. Renewal required. All licenses to operate an alkaline hydrolysis
453.17facility issued by the commissioner expire on June 30 following the date of issuance of the
453.18license and must be renewed to remain valid.
453.19    Subd. 2. Renewal procedure and documentation. Licensees who wish to renew
453.20their licenses must submit to the commissioner a completed renewal application no later
453.21than June 30 following the date the license was issued. A completed renewal application
453.22includes:
453.23(1) a completed renewal application form, as provided by the commissioner; and
453.24(2) proof of liability insurance coverage or other financial documentation, as
453.25determined by the commissioner, that demonstrates the applicant's ability to respond in
453.26damages for liability arising from the ownership, maintenance, management, or operation
453.27of an alkaline hydrolysis facility.
453.28Upon receipt of the completed renewal application, the commissioner shall review and
453.29verify the information. Upon completion of the verification process and resolution of
453.30any deficiencies in the renewal application information, the commissioner shall make a
453.31determination, based on all the information available, to reissue or refuse to reissue the
453.32license. If the commissioner's determination is to reissue the license, the applicant shall
453.33be notified and the license shall issue and remain valid for a period prescribed on the
453.34license, but not to exceed one calendar year from the date of issuance of the license. If
454.1the commissioner's determination is to refuse to reissue the license, section 149A.09,
454.2subdivision 2, applies.
454.3    Subd. 3. Penalty for late filing. Renewal applications received after the expiration
454.4date of a license will result in the assessment of a late filing penalty. The late filing penalty
454.5must be paid before the reissuance of the license and received by the commissioner no
454.6later than 31 calendar days after the expiration date of the license.
454.7    Subd. 4. Lapse of license. Licenses to operate alkaline hydrolysis facilities
454.8shall automatically lapse when a completed renewal application is not received by the
454.9commissioner within 31 calendar days after the expiration date of a license, or a late
454.10filing penalty assessed under subdivision 3 is not received by the commissioner within 31
454.11calendar days after the expiration of a license.
454.12    Subd. 5. Effect of lapse of license. Upon the lapse of a license, the person to whom
454.13the license was issued is no longer licensed to operate an alkaline hydrolysis facility in
454.14Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed
454.15license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue
454.16any additional lawful remedies as justified by the case.
454.17    Subd. 6. Restoration of lapsed license. The commissioner may restore a lapsed
454.18license upon receipt and review of a completed renewal application, receipt of the late
454.19filing penalty, and reinspection of the premises, provided that the receipt is made within
454.20one calendar year from the expiration date of the lapsed license and the cease and desist
454.21order issued by the commissioner has not been violated. If a lapsed license is not restored
454.22within one calendar year from the expiration date of the lapsed license, the holder of the
454.23lapsed license cannot be relicensed until the requirements in section 149A.54 are met.
454.24    Subd. 7. Reporting changes in license information. Any change of license
454.25information must be reported to the commissioner, on forms provided by the
454.26commissioner, no later than 30 calendar days after the change occurs. Failure to report
454.27changes is grounds for disciplinary action.
454.28    Subd. 8. Application information. All information submitted to the commissioner
454.29by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is
454.30classified as licensing data under section 13.41, subdivision 5.

454.31    Sec. 54. Minnesota Statutes 2012, section 149A.65, is amended by adding a
454.32subdivision to read:
454.33    Subd. 6. Alkaline hydrolysis facilities. The initial and renewal fee for an alkaline
454.34hydrolysis facility is $300. The late fee charge for a license renewal is $25.

455.1    Sec. 55. Minnesota Statutes 2012, section 149A.65, is amended by adding a
455.2subdivision to read:
455.3    Subd. 7. State government special revenue fund. Fees collected by the
455.4commissioner under this section must be deposited in the state treasury and credited to
455.5the state government special revenue fund.

455.6    Sec. 56. Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:
455.7    Subdivision 1. Use of titles. Only a person holding a valid license to practice
455.8mortuary science issued by the commissioner may use the title of mortician, funeral
455.9director, or any other title implying that the licensee is engaged in the business or practice
455.10of mortuary science. Only the holder of a valid license to operate an alkaline hydrolysis
455.11facility issued by the commissioner may use the title of alkaline hydrolysis facility, water
455.12cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or
455.13any other title, word, or term implying that the licensee operates an alkaline hydrolysis
455.14facility. Only the holder of a valid license to operate a funeral establishment issued by the
455.15commissioner may use the title of funeral home, funeral chapel, funeral service, or any
455.16other title, word, or term implying that the licensee is engaged in the business or practice
455.17of mortuary science. Only the holder of a valid license to operate a crematory issued by
455.18the commissioner may use the title of crematory, crematorium, green-cremation, or any
455.19other title, word, or term implying that the licensee operates a crematory or crematorium.

455.20    Sec. 57. Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:
455.21    Subd. 2. Business location. A funeral establishment, alkaline hydrolysis facility, or
455.22crematory shall not do business in a location that is not licensed as a funeral establishment,
455.23alkaline hydrolysis facility, or crematory and shall not advertise a service that is available
455.24from an unlicensed location.

455.25    Sec. 58. Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:
455.26    Subd. 3. Advertising. No licensee, clinical student, practicum student, or intern
455.27shall publish or disseminate false, misleading, or deceptive advertising. False, misleading,
455.28or deceptive advertising includes, but is not limited to:
455.29    (1) identifying, by using the names or pictures of, persons who are not licensed to
455.30practice mortuary science in a way that leads the public to believe that those persons will
455.31provide mortuary science services;
455.32    (2) using any name other than the names under which the funeral establishment,
455.33alkaline hydrolysis facility, or crematory is known to or licensed by the commissioner;
456.1    (3) using a surname not directly, actively, or presently associated with a licensed
456.2funeral establishment, alkaline hydrolysis facility, or crematory, unless the surname had
456.3been previously and continuously used by the licensed funeral establishment, alkaline
456.4hydrolysis facility, or crematory; and
456.5    (4) using a founding or establishing date or total years of service not directly or
456.6continuously related to a name under which the funeral establishment, alkaline hydrolysis
456.7facility, or crematory is currently or was previously licensed.
456.8    Any advertising or other printed material that contains the names or pictures of
456.9persons affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory
456.10shall state the position held by the persons and shall identify each person who is licensed
456.11or unlicensed under this chapter.

456.12    Sec. 59. Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:
456.13    Subd. 5. Reimbursement prohibited. No licensee, clinical student, practicum
456.14student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other
456.15reimbursement in consideration for recommending or causing a dead human body to
456.16be disposed of by a specific body donation program, funeral establishment, alkaline
456.17hydrolysis facility, crematory, mausoleum, or cemetery.

456.18    Sec. 60. Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:
456.19    Subd. 2. Preventive requirements. (a) To prevent unfair or deceptive acts or
456.20practices, the requirements of this subdivision must be met.
456.21    (b) Funeral providers must tell persons who ask by telephone about the funeral
456.22provider's offerings or prices any accurate information from the price lists described in
456.23paragraphs (c) to (e) and any other readily available information that reasonably answers
456.24the questions asked.
456.25    (c) Funeral providers must make available for viewing to people who inquire in
456.26person about the offerings or prices of funeral goods or burial site goods, separate printed
456.27or typewritten price lists using a ten-point font or larger. Each funeral provider must have a
456.28separate price list for each of the following types of goods that are sold or offered for sale:
456.29    (1) caskets;
456.30    (2) alternative containers;
456.31    (3) outer burial containers;
456.32(4) alkaline hydrolysis containers;
456.33    (4) (5) cremation containers;
456.34(6) hydrolyzed remains containers;
457.1    (5) (7) cremated remains containers;
457.2    (6) (8) markers; and
457.3    (7) (9) headstones.
457.4    (d) Each separate price list must contain the name of the funeral provider's place
457.5of business, address, and telephone number and a caption describing the list as a price
457.6list for one of the types of funeral goods or burial site goods described in paragraph (c),
457.7clauses (1) to (7) (9). The funeral provider must offer the list upon beginning discussion
457.8of, but in any event before showing, the specific funeral goods or burial site goods and
457.9must provide a photocopy of the price list, for retention, if so asked by the consumer. The
457.10list must contain, at least, the retail prices of all the specific funeral goods and burial site
457.11goods offered which do not require special ordering, enough information to identify each,
457.12and the effective date for the price list. However, funeral providers are not required to
457.13make a specific price list available if the funeral providers place the information required
457.14by this paragraph on the general price list described in paragraph (e).
457.15    (e) Funeral providers must give a printed price list, for retention, to persons who
457.16inquire in person about the funeral goods, funeral services, burial site goods, or burial site
457.17services or prices offered by the funeral provider. The funeral provider must give the list
457.18upon beginning discussion of either the prices of or the overall type of funeral service or
457.19disposition or specific funeral goods, funeral services, burial site goods, or burial site
457.20services offered by the provider. This requirement applies whether the discussion takes
457.21place in the funeral establishment or elsewhere. However, when the deceased is removed
457.22for transportation to the funeral establishment, an in-person request for authorization to
457.23embalm does not, by itself, trigger the requirement to offer the general price list. If the
457.24provider, in making an in-person request for authorization to embalm, discloses that
457.25embalming is not required by law except in certain special cases, the provider is not
457.26required to offer the general price list. Any other discussion during that time about prices
457.27or the selection of funeral goods, funeral services, burial site goods, or burial site services
457.28triggers the requirement to give the consumer a general price list. The general price list
457.29must contain the following information:
457.30    (1) the name, address, and telephone number of the funeral provider's place of
457.31business;
457.32    (2) a caption describing the list as a "general price list";
457.33    (3) the effective date for the price list;
457.34    (4) the retail prices, in any order, expressed either as a flat fee or as the prices per
457.35hour, mile, or other unit of computation, and other information described as follows:
458.1    (i) forwarding of remains to another funeral establishment, together with a list of
458.2the services provided for any quoted price;
458.3    (ii) receiving remains from another funeral establishment, together with a list of
458.4the services provided for any quoted price;
458.5    (iii) separate prices for each alkaline hydrolysis or cremation offered by the funeral
458.6provider, with the price including an alternative container or alkaline hydrolysis or
458.7cremation container, any alkaline hydrolysis or crematory charges, and a description of the
458.8services and container included in the price, where applicable, and the price of alkaline
458.9hydrolysis or cremation where the purchaser provides the container;
458.10    (iv) separate prices for each immediate burial offered by the funeral provider,
458.11including a casket or alternative container, and a description of the services and container
458.12included in that price, and the price of immediate burial where the purchaser provides the
458.13casket or alternative container;
458.14    (v) transfer of remains to the funeral establishment or other location;
458.15    (vi) embalming;
458.16    (vii) other preparation of the body;
458.17    (viii) use of facilities, equipment, or staff for viewing;
458.18    (ix) use of facilities, equipment, or staff for funeral ceremony;
458.19    (x) use of facilities, equipment, or staff for memorial service;
458.20    (xi) use of equipment or staff for graveside service;
458.21    (xii) hearse or funeral coach;
458.22    (xiii) limousine; and
458.23    (xiv) separate prices for all cemetery-specific goods and services, including all goods
458.24and services associated with interment and burial site goods and services and excluding
458.25markers and headstones;
458.26    (5) the price range for the caskets offered by the funeral provider, together with the
458.27statement "A complete price list will be provided at the funeral establishment or casket
458.28sale location." or the prices of individual caskets, as disclosed in the manner described
458.29in paragraphs (c) and (d);
458.30    (6) the price range for the alternative containers offered by the funeral provider,
458.31together with the statement "A complete price list will be provided at the funeral
458.32establishment or alternative container sale location." or the prices of individual alternative
458.33containers, as disclosed in the manner described in paragraphs (c) and (d);
458.34    (7) the price range for the outer burial containers offered by the funeral provider,
458.35together with the statement "A complete price list will be provided at the funeral
459.1establishment or outer burial container sale location." or the prices of individual outer
459.2burial containers, as disclosed in the manner described in paragraphs (c) and (d);
459.3(8) the price range for the alkaline hydrolysis container offered by the funeral
459.4provider, together with the statement: "A complete price list will be provided at the funeral
459.5establishment or alkaline hydrolysis container sale location.", or the prices of individual
459.6alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c)
459.7and (d);
459.8(9) the price range for the hydrolyzed remains container offered by the funeral
459.9provider, together with the statement: "A complete price list will be provided at the
459.10funeral establishment or hydrolyzed remains container sale location.", or the prices
459.11of individual hydrolyzed remains container, as disclosed in the manner described in
459.12paragraphs (c) and (d);
459.13    (8) (10) the price range for the cremation containers offered by the funeral provider,
459.14together with the statement "A complete price list will be provided at the funeral
459.15establishment or cremation container sale location." or the prices of individual cremation
459.16containers and cremated remains containers, as disclosed in the manner described in
459.17paragraphs (c) and (d);
459.18    (9) (11) the price range for the cremated remains containers offered by the funeral
459.19provider, together with the statement, "A complete price list will be provided at the funeral
459.20establishment or cremation cremated remains container sale location," or the prices of
459.21individual cremation containers as disclosed in the manner described in paragraphs (c)
459.22and (d);
459.23    (10) (12) the price for the basic services of funeral provider and staff, together with a
459.24list of the principal basic services provided for any quoted price and, if the charge cannot
459.25be declined by the purchaser, the statement "This fee for our basic services will be added
459.26to the total cost of the funeral arrangements you select. (This fee is already included in
459.27our charges for alkaline hydrolysis, direct cremations, immediate burials, and forwarding
459.28or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted
459.29price shall include all charges for the recovery of unallocated funeral provider overhead,
459.30and funeral providers may include in the required disclosure the phrase "and overhead"
459.31after the word "services." This services fee is the only funeral provider fee for services,
459.32facilities, or unallocated overhead permitted by this subdivision to be nondeclinable,
459.33unless otherwise required by law;
459.34    (11) (13) the price range for the markers and headstones offered by the funeral
459.35provider, together with the statement "A complete price list will be provided at the funeral
460.1establishment or marker or headstone sale location." or the prices of individual markers
460.2and headstones, as disclosed in the manner described in paragraphs (c) and (d); and
460.3    (12) (14) any package priced funerals offered must be listed in addition to and
460.4following the information required in paragraph (e) and must clearly state the funeral
460.5goods and services being offered, the price being charged for those goods and services,
460.6and the discounted savings.
460.7    (f) Funeral providers must give an itemized written statement, for retention, to each
460.8consumer who arranges an at-need funeral or other disposition of human remains at the
460.9conclusion of the discussion of the arrangements. The itemized written statement must be
460.10signed by the consumer selecting the goods and services as required in section 149A.80.
460.11If the statement is provided by a funeral establishment, the statement must be signed by
460.12the licensed funeral director or mortician planning the arrangements. If the statement is
460.13provided by any other funeral provider, the statement must be signed by an authorized
460.14agent of the funeral provider. The statement must list the funeral goods, funeral services,
460.15burial site goods, or burial site services selected by that consumer and the prices to be paid
460.16for each item, specifically itemized cash advance items (these prices must be given to the
460.17extent then known or reasonably ascertainable if the prices are not known or reasonably
460.18ascertainable, a good faith estimate shall be given and a written statement of the actual
460.19charges shall be provided before the final bill is paid), and the total cost of goods and
460.20services selected. At the conclusion of an at-need arrangement, the funeral provider is
460.21required to give the consumer a copy of the signed itemized written contract that must
460.22contain the information required in this paragraph.
460.23    (g) Upon receiving actual notice of the death of an individual with whom a funeral
460.24provider has entered a preneed funeral agreement, the funeral provider must provide
460.25a copy of all preneed funeral agreement documents to the person who controls final
460.26disposition of the human remains or to the designee of the person controlling disposition.
460.27The person controlling final disposition shall be provided with these documents at the time
460.28of the person's first in-person contact with the funeral provider, if the first contact occurs
460.29in person at a funeral establishment, alkaline hydrolysis facility, crematory, or other place
460.30of business of the funeral provider. If the contact occurs by other means or at another
460.31location, the documents must be provided within 24 hours of the first contact.

460.32    Sec. 61. Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:
460.33    Subd. 4. Casket, alternate container, alkaline hydrolysis containers, and
460.34cremation container sales; records; required disclosures. Any funeral provider who
460.35sells or offers to sell a casket, alternate container, alkaline hydrolysis container, hydrolyzed
461.1remains container, or cremation container, or cremated remains container to the public
461.2must maintain a record of each sale that includes the name of the purchaser, the purchaser's
461.3mailing address, the name of the decedent, the date of the decedent's death, and the place
461.4of death. These records shall be open to inspection by the regulatory agency. Any funeral
461.5provider selling a casket, alternate container, or cremation container to the public, and not
461.6having charge of the final disposition of the dead human body, shall provide a copy of the
461.7statutes and rules controlling the removal, preparation, transportation, arrangements for
461.8disposition, and final disposition of a dead human body. This subdivision does not apply to
461.9morticians, funeral directors, funeral establishments, crematories, or wholesale distributors
461.10of caskets, alternate containers, alkaline hydrolysis containers, or cremation containers.

461.11    Sec. 62. Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:
461.12    Subd. 3. Casket for alkaline hydrolysis or cremation provisions; deceptive acts
461.13or practices. In selling or offering to sell funeral goods or funeral services to the public, it
461.14is a deceptive act or practice for a funeral provider to represent that a casket is required for
461.15alkaline hydrolysis or cremations by state or local law or otherwise.

461.16    Sec. 63. Minnesota Statutes 2012, section 149A.72, is amended by adding a
461.17subdivision to read:
461.18    Subd. 3a. Casket for alkaline hydrolysis provision; preventive measures. To
461.19prevent deceptive acts or practices, funeral providers must place the following disclosure
461.20in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota
461.21law does not require you to purchase a casket for alkaline hydrolysis. If you want to
461.22arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline
461.23hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant
461.24to leakage of bodily fluids that encases the body and into which a dead human body is
461.25placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide
461.26are (specify containers provided)." This disclosure is required only if the funeral provider
461.27arranges alkaline hydrolysis.

461.28    Sec. 64. Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:
461.29    Subd. 9. Deceptive acts or practices. In selling or offering to sell funeral goods,
461.30funeral services, burial site goods, or burial site services to the public, it is a deceptive act
461.31or practice for a funeral provider to represent that federal, state, or local laws, or particular
461.32cemeteries, alkaline hydrolysis facilities, or crematories, require the purchase of any funeral
461.33goods, funeral services, burial site goods, or burial site services when that is not the case.

462.1    Sec. 65. Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:
462.2    Subdivision 1. Casket for alkaline hydrolysis or cremation provisions; deceptive
462.3acts or practices. In selling or offering to sell funeral goods, funeral services, burial site
462.4goods, or burial site services to the public, it is a deceptive act or practice for a funeral
462.5provider to require that a casket be purchased for alkaline hydrolysis or cremation.

462.6    Sec. 66. Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:
462.7    Subd. 2. Casket for alkaline hydrolysis or cremation; preventive requirements.
462.8To prevent unfair or deceptive acts or practices, if funeral providers arrange for alkaline
462.9hydrolysis or cremations, they must make a an alkaline hydrolysis container or cremation
462.10container available for alkaline hydrolysis or cremations.

462.11    Sec. 67. Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:
462.12    Subd. 4. Required purchases of funeral goods or services; preventive
462.13requirements. To prevent unfair or deceptive acts or practices, funeral providers must
462.14place the following disclosure in the general price list, immediately above the prices
462.15required by section 149A.71, subdivision 2, paragraph (e), clauses (4) to (10): "The goods
462.16and services shown below are those we can provide to our customers. You may choose
462.17only the items you desire. If legal or other requirements mean that you must buy any items
462.18you did not specifically ask for, we will explain the reason in writing on the statement we
462.19provide describing the funeral goods, funeral services, burial site goods, and burial site
462.20services you selected." However, if the charge for "services of funeral director and staff"
462.21cannot be declined by the purchaser, the statement shall include the sentence "However,
462.22any funeral arrangements you select will include a charge for our basic services." between
462.23the second and third sentences of the sentences specified in this subdivision. The statement
462.24may include the phrase "and overhead" after the word "services" if the fee includes a
462.25charge for the recovery of unallocated funeral overhead. If the funeral provider does
462.26not include this disclosure statement, then the following disclosure statement must be
462.27placed in the statement of funeral goods, funeral services, burial site goods, and burial site
462.28services selected, as described in section 149A.71, subdivision 2, paragraph (f): "Charges
462.29are only for those items that you selected or that are required. If we are required by law or
462.30by a cemetery, alkaline hydrolysis facility, or crematory to use any items, we will explain
462.31the reasons in writing below." A funeral provider is not in violation of this subdivision by
462.32failing to comply with a request for a combination of goods or services which would be
462.33impossible, impractical, or excessively burdensome to provide.

463.1    Sec. 68. Minnesota Statutes 2012, section 149A.74, is amended to read:
463.2149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.
463.3    Subdivision 1. Services provided without prior approval; deceptive acts or
463.4practices. In selling or offering to sell funeral goods or funeral services to the public, it
463.5is a deceptive act or practice for any funeral provider to embalm a dead human body
463.6unless state or local law or regulation requires embalming in the particular circumstances
463.7regardless of any funeral choice which might be made, or prior approval for embalming
463.8has been obtained from an individual legally authorized to make such a decision. In
463.9seeking approval to embalm, the funeral provider must disclose that embalming is not
463.10required by law except in certain circumstances; that a fee will be charged if a funeral
463.11is selected which requires embalming, such as a funeral with viewing; and that no
463.12embalming fee will be charged if the family selects a service which does not require
463.13embalming, such as direct alkaline hydrolysis, direct cremation, or immediate burial.
463.14    Subd. 2. Services provided without prior approval; preventive requirement.
463.15To prevent unfair or deceptive acts or practices, funeral providers must include on
463.16the itemized statement of funeral goods or services, as described in section 149A.71,
463.17subdivision 2 , paragraph (f), the statement "If you selected a funeral that may require
463.18embalming, such as a funeral with viewing, you may have to pay for embalming. You do
463.19not have to pay for embalming you did not approve if you selected arrangements such
463.20as direct alkaline hydrolysis, direct cremation, or immediate burial. If we charged for
463.21embalming, we will explain why below."

463.22    Sec. 69. Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:
463.23    Subd. 9. Embalmed Bodies awaiting final disposition. All embalmed bodies
463.24awaiting final disposition shall be kept in an appropriate holding facility or preparation
463.25and embalming room. The holding facility must be secure from access by anyone except
463.26the authorized personnel of the funeral establishment, preserve the dignity and integrity of
463.27the body, and protect the health and safety of the personnel of the funeral establishment.

463.28    Sec. 70. Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:
463.29    Subd. 3. Disposition permit. A disposition permit is required before a body can
463.30be buried, entombed, alkaline hydrolyzed, or cremated. No disposition permit shall be
463.31issued until a fact of death record has been completed and filed with the local or state
463.32registrar of vital statistics.

463.33    Sec. 71. Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:
464.1    Subd. 6. Conveyances permitted for transportation. A dead human body may be
464.2transported by means of private vehicle or private aircraft, provided that the body must be
464.3encased in an appropriate container, that meets the following standards:
464.4    (1) promotes respect for and preserves the dignity of the dead human body;
464.5    (2) shields the body from being viewed from outside of the conveyance;
464.6    (3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket,
464.7alternative container, alkaline hydrolysis container, or cremation container in a horizontal
464.8position;
464.9    (4) is designed to permit loading and unloading of the body without excessive tilting
464.10of the cot, stretcher, rigid tray, casket, alternative container, alkaline hydrolysis container,
464.11 or cremation container; and
464.12    (5) if used for the transportation of more than one dead human body at one time,
464.13the vehicle must be designed so that a body or container does not rest directly on top of
464.14another body or container and that each body or container is secured to prevent the body
464.15or container from excessive movement within the conveyance.
464.16    A vehicle that is a dignified conveyance and was specified for use by the deceased
464.17or by the family of the deceased may be used to transport the body to the place of final
464.18disposition.

464.19    Sec. 72. Minnesota Statutes 2012, section 149A.94, is amended to read:
464.20149A.94 FINAL DISPOSITION.
464.21    Subdivision 1. Generally. Every dead human body lying within the state, except
464.22unclaimed bodies delivered for dissection by the medical examiner, those delivered for
464.23anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through
464.24the state for the purpose of disposition elsewhere; and the remains of any dead human
464.25body after dissection or anatomical study, shall be decently buried, or entombed in a
464.26public or private cemetery, alkaline hydrolyzed or cremated, within a reasonable time
464.27after death. Where final disposition of a body will not be accomplished within 72 hours
464.28following death or release of the body by a competent authority with jurisdiction over the
464.29body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body
464.30may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry
464.31ice for a period that exceeds four calendar days, from the time of death or release of the
464.32body from the coroner or medical examiner.
464.33    Subd. 3. Permit required. No dead human body shall be buried, entombed, or
464.34cremated without a disposition permit. The disposition permit must be filed with the person
465.1in charge of the place of final disposition. Where a dead human body will be transported out
465.2of this state for final disposition, the body must be accompanied by a certificate of removal.
465.3    Subd. 4. Alkaline hydrolysis or cremation. Inurnment of alkaline hydrolyzed or
465.4cremated remains and release to an appropriate party is considered final disposition and no
465.5further permits or authorizations are required for transportation, interment, entombment, or
465.6placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

465.7    Sec. 73. [149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE
465.8HYDROLYSIS.
465.9    Subdivision 1. License required. A dead human body may only be hydrolyzed in
465.10this state at an alkaline hydrolysis facility licensed by the commissioner of health.
465.11    Subd. 2. General requirements. Any building to be used as an alkaline hydrolysis
465.12facility must comply with all applicable local and state building codes, zoning laws and
465.13ordinances, wastewater management regulations, and environmental statutes, rules, and
465.14standards. An alkaline hydrolysis facility must have, on site, a purpose built human
465.15alkaline hydrolysis system approved by the commissioner of health, a system approved by
465.16the commissioner of health for drying the hydrolyzed remains, a motorized mechanical
465.17device approved by the commissioner of health for processing hydrolyzed remains and
465.18must have in the building a holding facility approved by the commissioner of health for
465.19the retention of dead human bodies awaiting alkaline hydrolysis. The holding facility
465.20must be secure from access by anyone except the authorized personnel of the alkaline
465.21hydrolysis facility, preserve the dignity of the remains, and protect the health and safety of
465.22the alkaline hydrolysis facility personnel.
465.23    Subd. 3. Lighting and ventilation. The room where the alkaline hydrolysis vessel
465.24is located and the room where the chemical storage takes place shall be properly lit and
465.25ventilated with an exhaust fan that provides at least 12 air changes per hour.
465.26    Subd. 4. Plumbing connections. All plumbing fixtures, water supply lines,
465.27plumbing vents, and waste drains shall be properly vented and connected pursuant to the
465.28Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a
465.29functional sink with hot and cold running water.
465.30    Subd. 5. Flooring, walls, ceiling, doors, and windows. The room where the
465.31alkaline hydrolysis vessel is located and the room where the chemical storage takes place
465.32shall have nonporous flooring, so that a sanitary condition is provided. The walls and
465.33ceiling of the room where the alkaline hydrolysis vessel is located and the room where
465.34the chemical storage takes place shall run from floor to ceiling and be covered with tile,
465.35or by plaster or sheetrock painted with washable paint or other appropriate material so
466.1that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be
466.2constructed to prevent odors from entering any other part of the building. All windows
466.3or other openings to the outside must be screened and all windows must be treated in a
466.4manner that prevents viewing into the room where the alkaline hydrolysis vessel is located
466.5and the room where the chemical storage takes place. A viewing window for authorized
466.6family members or their designees is not a violation of this subdivision.
466.7    Subd. 6. Equipment and supplies. The alkaline hydrolysis facility must have a
466.8functional emergency eye wash and quick drench shower.
466.9    Subd. 7. Access and privacy. (a) The room where the alkaline hydrolysis vessel is
466.10located and the room where the chemical storage takes place must be private and have no
466.11general passageway through it. The room shall, at all times, be secure from the entrance of
466.12unauthorized persons. Authorized persons are:
466.13(1) licensed morticians;
466.14(2) registered interns or students as described in section 149A.91, subdivision 6;
466.15(3) public officials or representatives in the discharge of their official duties;
466.16(4) trained alkaline hydrolysis facility operators; and
466.17(5) the person(s) with the right to control the dead human body as defined in section
466.18149A.80, subdivision 2, and their designees.
466.19    (b) Each door allowing ingress or egress shall carry a sign that indicates that the
466.20room is private and access is limited. All authorized persons who are present in or enter
466.21the room where the alkaline hydrolysis vessel is located while a body is being prepared for
466.22final disposition must be attired according to all applicable state and federal regulations
466.23regarding the control of infectious disease and occupational and workplace health and
466.24safety.
466.25    Subd. 8. Sanitary conditions and permitted use. The room where the alkaline
466.26hydrolysis vessel is located and the room where the chemical storage takes place and all
466.27fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies
466.28stored or used in the room must be maintained in a clean and sanitary condition at all times.
466.29    Subd. 9. Boiler use. When a boiler is required by the manufacturer of the alkaline
466.30hydrolysis vessel for its operation, all state and local regulations for that boiler must be
466.31followed.
466.32    Subd. 10. Occupational and workplace safety. All applicable provisions of state
466.33and federal regulations regarding exposure to workplace hazards and accidents shall be
466.34followed in order to protect the health and safety of all authorized persons at the alkaline
466.35hydrolysis facility.
467.1    Subd. 11. Licensed personnel. A licensed alkaline hydrolysis facility must employ
467.2a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body.
467.3It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for
467.4all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for
467.5compliance with this chapter and other applicable state and federal regulations regarding
467.6occupational and workplace health and safety.
467.7    Subd. 12. Authorization to hydrolyze required. No alkaline hydrolysis facility
467.8shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part
467.9without receiving written authorization to do so from the person or persons who have the
467.10legal right to control disposition as described in section 149A.80 or the person's legal
467.11designee. The written authorization must include:
467.12(1) the name of the deceased and the date of death of the deceased;
467.13(2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body;
467.14(3) the name, address, telephone number, relationship to the deceased, and signature
467.15of the person or persons with legal right to control final disposition or a legal designee;
467.16(4) directions for the disposition of any nonhydrolyzed materials or items recovered
467.17from the alkaline hydrolysis vessel;
467.18(5) acknowledgment that the hydrolyzed remains will be dried and mechanically
467.19reduced to a granulated appearance and placed in an appropriate container and
467.20authorization to place any hydrolyzed remains that a selected urn or container will not
467.21accommodate into a temporary container;
467.22(6) acknowledgment that, even with the exercise of reasonable care, it is not possible
467.23to recover all particles of the hydrolyzed remains and that some particles may inadvertently
467.24become commingled with particles of other hydrolyzed remains that remain in the alkaline
467.25hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains;
467.26(7) directions for the ultimate disposition of the hydrolyzed remains; and
467.27(8) a statement that includes, but is not limited to, the following information:
467.28"During the alkaline hydrolysis process, chemical dissolution using heat, water, and an
467.29alkaline solution is used to chemically break down the human tissue and the hydrolyzable
467.30alkaline hydrolysis container. After the process is complete, the liquid effluent solution
467.31contains the chemical by-products of the alkaline hydrolysis process except for the
467.32deceased's bone fragments. The solution is cooled and released according to local
467.33environmental regulations. A water rinse is applied to the hydrolyzed remains which are
467.34then dried and processed to facilitate inurnment or scattering."
467.35    Subd. 13. Limitation of liability. A licensed alkaline hydrolysis facility acting in
467.36good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an
468.1authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from
468.2civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis
468.3facility.
468.4    Subd. 14. Acceptance of delivery of body. (a) No dead human body shall be
468.5accepted for final disposition by alkaline hydrolysis unless:
468.6(1) encased in an appropriate alkaline hydrolysis container;
468.7(2) accompanied by a disposition permit issued pursuant to section 149A.93,
468.8subdivision 3, including a photocopy of the completed death record or a signed release
468.9authorizing alkaline hydrolysis of the body received from the coroner or medical
468.10examiner; and
468.11(3) accompanied by an alkaline hydrolysis authorization that complies with
468.12subdivision 12.
468.13    (b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline
468.14hydrolysis container where there is:
468.15(1) evidence of leakage of fluids from the alkaline hydrolysis container;
468.16(2) a known dispute concerning hydrolysis of the body delivered;
468.17(3) a reasonable basis for questioning any of the representations made on the written
468.18authorization to hydrolyze; or
468.19(4) any other lawful reason.
468.20    Subd. 15. Bodies awaiting hydrolysis. A dead human body must be hydrolyzed
468.21within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of
468.22the body.
468.23    Subd. 16. Handling of alkaline hydrolysis containers for dead human bodies.
468.24All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for
468.25dead human bodies shall use universal precautions and otherwise exercise all reasonable
468.26precautions to minimize the risk of transmitting any communicable disease from the body.
468.27No dead human body shall be removed from the container in which it is delivered.
468.28    Subd. 17. Identification of body. All licensed alkaline hydrolysis facilities shall
468.29develop, implement, and maintain an identification procedure whereby dead human
468.30bodies can be identified from the time the alkaline hydrolysis facility accepts delivery
468.31of the remains until the hydrolyzed remains are released to an authorized party. After
468.32hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the
468.33hydrolyzed remains container before the hydrolyzed remains are released from the alkaline
468.34hydrolysis facility. Each identification disk, tab, or label shall have a number that shall
468.35be recorded on all paperwork regarding the decedent. This procedure shall be designed
468.36to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains
469.1are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the
469.2inability to individually identify the hydrolyzed remains is a violation of this subdivision.
469.3    Subd. 18. Alkaline hydrolysis vessel for human remains. A licensed alkaline
469.4hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains
469.5in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for
469.6infectious disease control.
469.7    Subd. 19. Alkaline hydrolysis procedures; privacy. The final disposition of
469.8dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is
469.9written authorization from the person with the legal right to control the disposition,
469.10only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline
469.11hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting
469.12alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline
469.13hydrolysis vessel, or being processed and placed in a hydrolyzed remains container.
469.14    Subd. 20. Alkaline hydrolysis procedures; commingling of hydrolyzed remains
469.15prohibited. Except with the express written permission of the person with the legal right
469.16to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one
469.17dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce
469.18a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have
469.19been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze
469.20a dead human body and other human remains at the same time and in the same alkaline
469.21hydrolysis vessel. This section does not apply where commingling of human remains
469.22during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental
469.23and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is
469.24not a violation of this subdivision.
469.25    Subd. 21. Alkaline hydrolysis procedures; removal from alkaline hydrolysis
469.26vessel. Upon completion of the alkaline hydrolysis process, reasonable efforts shall be
469.27made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed
469.28remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be
469.29made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed
469.30human remains and dispose of these materials in a lawful manner, by the alkaline
469.31hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate
469.32container to be transported to the processing area.
469.33    Subd. 22. Drying device or mechanical processor procedures; commingling of
469.34hydrolyzed remains prohibited. Except with the express written permission of the
469.35person with the legal right to control the final disposition or otherwise provided by
469.36law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed
470.1human remains of more than one body at a time in the same drying device or mechanical
470.2processor, or introduce the hydrolyzed human remains of a second body into a drying
470.3device or mechanical processor until processing of any preceding hydrolyzed human
470.4remains has been terminated and reasonable efforts have been employed to remove all
470.5fragments of the preceding hydrolyzed remains. The fact that there is incidental and
470.6unavoidable residue in the drying device, the mechanical processor, or any container used
470.7in a prior alkaline hydrolysis process, is not a violation of this provision.
470.8    Subd. 23. Alkaline hydrolysis procedures; processing hydrolyzed remains. The
470.9hydrolyzed human remains shall be dried and then reduced by a motorized mechanical
470.10device to a granulated appearance appropriate for final disposition and placed in an
470.11alkaline hydrolysis remains container along with the appropriate identifying disk, tab,
470.12or permanent label. Processing must take place within the licensed alkaline hydrolysis
470.13facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they
470.14can be identified, may be removed prior to processing the hydrolyzed remains, only by
470.15staff licensed or registered by the commissioner of health; however, any dental gold and
470.16silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains
470.17container unless otherwise directed by the person or persons having the right to control the
470.18final disposition. Every person who removes or possesses dental gold or silver, jewelry,
470.19or mementos from any hydrolyzed remains without specific written permission of the
470.20person or persons having the right to control those remains is guilty of a misdemeanor.
470.21The fact that residue and any unavoidable dental gold or dental silver, or other precious
470.22metals remain in the alkaline hydrolysis vessel or other equipment or any container used
470.23in a prior hydrolysis is not a violation of this section.
470.24    Subd. 24. Alkaline hydrolysis procedures; container of insufficient capacity.
470.25If a hydrolyzed remains container is of insufficient capacity to accommodate all
470.26hydrolyzed remains of a given dead human body, subject to directives provided in the
470.27written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess
470.28hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the
470.29second container, in a manner so as not to be easily detached through incidental contact, to
470.30the primary alkaline hydrolysis remains container. The secondary container shall contain a
470.31duplicate of the identification disk, tab, or permanent label that was placed in the primary
470.32container and all paperwork regarding the given body shall include a notation that the
470.33hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature
470.34hydrolyzed remains containers are not subject to the requirements of this subdivision.
470.35    Subd. 25. Disposition procedures; commingling of hydrolyzed remains
470.36prohibited. No hydrolyzed remains shall be disposed of or scattered in a manner or in
471.1a location where the hydrolyzed remains are commingled with those of another person
471.2without the express written permission of the person with the legal right to control
471.3disposition or as otherwise provided by law. This subdivision does not apply to the
471.4scattering or burial of hydrolyzed remains at sea or in a body of water from individual
471.5containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to
471.6the disposal in a dedicated cemetery of accumulated residue removed from an alkaline
471.7hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members
471.8of the same family in a common container designed for the hydrolyzed remains of more
471.9than one body, or to the inurnment in a container or interment in a space that has been
471.10previously designated, at the time of sale or purchase, as being intended for the inurnment
471.11or interment of the hydrolyzed remains of more than one person.
471.12    Subd. 26. Alkaline hydrolysis procedures; disposition of accumulated residue.
471.13Every alkaline hydrolysis facility shall provide for the removal and disposition in a
471.14dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel,
471.15drying device, mechanical processor, container, or other equipment used in alkaline
471.16hydrolysis. Disposition of accumulated residue shall be according to the regulations of the
471.17dedicated cemetery and any applicable local ordinances.
471.18    Subd. 27. Alkaline hydrolysis procedures; release of hydrolyzed remains.
471.19Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be
471.20released according to the instructions given on the written authorization to hydrolyze. If
471.21the hydrolyzed remains are to be shipped, they must be securely packaged and transported
471.22by a method which has an internal tracing system available and which provides for a
471.23receipt signed by the person accepting delivery. Where there is a dispute over release
471.24or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit
471.25the hydrolyzed remains with a court of competent jurisdiction pending resolution of the
471.26dispute or retain the hydrolyzed remains until the person with the legal right to control
471.27disposition presents satisfactory indication that the dispute is resolved.
471.28    Subd. 28. Unclaimed hydrolyzed remains. If, after 30 calendar days following
471.29the inurnment, the hydrolyzed remains are not claimed or disposed of according to the
471.30written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment
471.31may give written notice, by certified mail, to the person with the legal right to control
471.32the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and
471.33requesting further release directions. Should the hydrolyzed remains be unclaimed 120
471.34calendar days following the mailing of the written notification, the alkaline hydrolysis
471.35facility or funeral establishment may dispose of the hydrolyzed remains in any lawful
471.36manner deemed appropriate.
472.1    Subd. 29. Required records. Every alkaline hydrolysis facility shall create and
472.2maintain on its premises or other business location in Minnesota an accurate record of
472.3every hydrolyzation provided. The record shall include all of the following information
472.4for each hydrolyzation:
472.5(1) the name of the person or funeral establishment delivering the body for alkaline
472.6hydrolysis;
472.7(2) the name of the deceased and the identification number assigned to the body;
472.8(3) the date of acceptance of delivery;
472.9(4) the names of the alkaline hydrolysis vessel, drying device, and mechanical
472.10processor operator;
472.11(5) the time and date that the body was placed in and removed from the alkaline
472.12hydrolysis vessel;
472.13(6) the time and date that processing and inurnment of the hydrolyzed remains
472.14was completed;
472.15(7) the time, date, and manner of release of the hydrolyzed remains;
472.16(8) the name and address of the person who signed the authorization to hydrolyze;
472.17(9) all supporting documentation, including any transit or disposition permits, a
472.18photocopy of the death record, and the authorization to hydrolyze; and
472.19(10) the type of alkaline hydrolysis container.
472.20    Subd. 30. Retention of records. Records required under subdivision 29 shall be
472.21maintained for a period of three calendar years after the release of the hydrolyzed remains.
472.22Following this period and subject to any other laws requiring retention of records, the
472.23alkaline hydrolysis facility may then place the records in storage or reduce them to
472.24microfilm, microfiche, laser disc, or any other method that can produce an accurate
472.25reproduction of the original record, for retention for a period of ten calendar years from
472.26the date of release of the hydrolyzed remains. At the end of this period and subject to any
472.27other laws requiring retention of records, the alkaline hydrolysis facility may destroy
472.28the records by shredding, incineration, or any other manner that protects the privacy of
472.29the individuals identified.

472.30    Sec. 74. Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:
472.31    Subd. 9. Hydrolyzed and cremated remains. Subject to section 149A.95,
472.32subdivision 16 , inurnment of the hydrolyzed or cremated remains and release to an
472.33appropriate party is considered final disposition and no further permits or authorizations
472.34are required for disinterment, transportation, or placement of the hydrolyzed or cremated
472.35remains.

473.1    Sec. 75. Laws 2011, First Special Session chapter 9, article 2, section 27, is amended to
473.2read:
473.3    Sec. 27. MINNESOTA TASK FORCE ON PREMATURITY.
473.4    Subdivision 1. Establishment. The Minnesota Task Force on Prematurity is
473.5established to evaluate and make recommendations on methods for reducing prematurity
473.6and improving premature infant health care in the state.
473.7    Subd. 2. Membership; meetings; staff. (a) The task force shall be composed of at
473.8least the following members, who serve at the pleasure of their appointing authority:
473.9(1) 15 representatives of the Minnesota Prematurity Coalition including, but not
473.10limited to, health care providers who treat pregnant women or neonates, organizations
473.11focused on preterm births, early childhood education and development professionals, and
473.12families affected by prematurity;
473.13(2) one representative appointed by the commissioner of human services;
473.14(3) two representatives appointed by the commissioner of health;
473.15(4) one representative appointed by the commissioner of education;
473.16(5) two members of the house of representatives, one appointed by the speaker of
473.17the house and one appointed by the minority leader; and
473.18(6) two members of the senate, appointed according to the rules of the senate.
473.19(b) Members of the task force serve without compensation or payment of expenses.
473.20(c) The commissioner of health must convene the first meeting of the Minnesota
473.21Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
473.22least quarterly. Staffing and technical assistance shall be provided by the Minnesota
473.23Perinatal Coalition.
473.24    Subd. 3. Duties. The task force must report the current state of prematurity in
473.25Minnesota and develop recommendations on strategies for reducing prematurity and
473.26improving premature infant health care in the state by considering the following:
473.27(1) promoting adherence to standards of care for premature infants born less than 37
473.28weeks gestational age, including recommendations to improve utilization of appropriate
473.29 hospital discharge and follow-up care procedures;
473.30(2) coordination of information among appropriate professional and advocacy
473.31organizations on measures to improve health care for infants born prematurely;
473.32(3) identification and centralization of available resources to improve access and
473.33awareness for caregivers of premature infants; and
473.34(4) development and dissemination of evidence-based practices through networking
473.35and educational opportunities;
474.1(5) a review of relevant evidence-based research regarding the causes and effects of
474.2premature births in Minnesota;
474.3(6) a review of relevant evidence-based research regarding premature infant health
474.4care, including methods for improving quality of and access to care for premature infants;
474.5(7) (4) a review of the potential improvements in health status related to the use of
474.6health care homes to provide and coordinate pregnancy-related services; and.
474.7(8) identification of gaps in public reporting measures and possible effects of these
474.8measures on prematurity rates.
474.9    Subd. 4. Report; expiration. (a) By November 30, 2011 January 15, 2015, the
474.10task force must submit a final report to the chairs and ranking minority members of
474.11the legislative policy committees on health and human services on the current state of
474.12prematurity in Minnesota to the chairs of the legislative policy committees on health and
474.13human services, including any recommendations to reduce premature births and improve
474.14premature infant health in the state.
474.15(b) By January 15, 2013, the task force must report its final recommendations,
474.16including any draft legislation necessary for implementation, to the chairs of the legislative
474.17policy committees on health and human services.
474.18(c) (b) This task force expires on January 31, 2013 2015, or upon submission of the
474.19final report required in paragraph (b) (a), whichever is earlier.

474.20    Sec. 76. FUNERAL ESTABLISHMENTS; BRANCH LOCATIONS.
474.21The commissioner of health shall review the statutory requirements for preparation
474.22and embalming rooms and develop legislation with input from stakeholders that provides
474.23appropriate health and safety protection for funeral home locations where deceased bodies
474.24are present but are branch locations associated through a majority ownership of a licensed
474.25funeral establishment that meets the requirements of Minnesota Statutes, sections 149A.50
474.26and 149A.92, subdivisions 2 to 10. The review shall include consideration of distance
474.27between the main location and branch and other health and safety issues.

474.28    Sec. 77. STAFFING PLAN DISCLOSURE ACT.
474.29    Subdivision 1. Definitions. (a) For the purposes of this section, the following terms
474.30have the meanings given.
474.31(b) "Core staffing plan" means the projected number of full-time equivalent
474.32nonmanagerial care staff that will be assigned in a 24-hour period to an inpatient care unit.
474.33(c) "Nonmanagerial care staff" means registered nurses, licensed practical nurses,
474.34and other health care workers, which may include but is not limited to nursing assistants,
475.1nursing aides, patient care technicians, and patient care assistants, who perform
475.2nonmanagerial direct patient care functions for more than 50 percent of their scheduled
475.3hours on a given patient care unit.
475.4(d) "Inpatient care unit" means a designated inpatient area for assigning patients and
475.5staff for which a distinct staffing plan exists and that operates 24 hours per day, seven days
475.6per week in a hospital setting. Inpatient care unit does not include any hospital-based
475.7clinic, long-term care facility, or outpatient hospital department.
475.8(e) "Staffing hours per patient day" means the number of full-time equivalent
475.9nonmanagerial care staff who will ordinarily be assigned to provide direct patient care
475.10divided by the expected average number of patients upon which such assignments are based.
475.11(f) "Patient acuity tool" means a system for measuring an individual patient's need
475.12for nursing care. This includes utilizing a professional registered nursing assessment of
475.13patient condition to assess staffing need.
475.14    Subd. 2. Hospital staffing report. (a) The chief nursing executive or nursing
475.15designee of every reporting hospital in Minnesota under section 144.50 will develop a
475.16core staffing plan for each patient care unit.
475.17(b) Core staffing plans shall specify the full-time equivalent for each patient care
475.18unit for each 24-hour period.
475.19(c) Prior to submitting the core staffing plan, as required in subdivision 3,
475.20hospitals shall consult with representatives of the hospital medical staff, managerial and
475.21nonmanagerial care staff, and other relevant hospital personnel about the core staffing plan
475.22and the expected average number of patients upon which the staffing plan is based.
475.23    Subd. 3. Standard electronic reporting developed. (a) Hospitals must submit
475.24the core staffing plans to the Minnesota Hospital Association by January 1, 2014. The
475.25Minnesota Hospital Association shall include each reporting hospital's core staffing plan on
475.26the Minnesota Hospital Association's Minnesota Hospital Quality Report Web site by April
475.271, 2014. Any substantial changes to the core staffing plan shall be updated within 30 days.
475.28(b) The Minnesota Hospital Association shall include on its Web site for each
475.29reporting hospital on a quarterly basis the actual direct patient care hours per patient and
475.30per unit. Hospitals must submit the direct patient care report to the Minnesota Hospital
475.31Association by July 1, 2014, and quarterly thereafter.

475.32    Sec. 78. STUDY; NURSE STAFFING LEVELS AND PATIENT OUTCOMES.
475.33The Department of Health shall convene a work group to study the correlation
475.34between nurse staffing levels and patient outcomes. This report shall be presented to the
476.1chairs and ranking minority members of the health and human services committees in the
476.2house of representatives and the senate by January 15, 2015.

476.3    Sec. 79. TRAUMA CENTERS.
476.4The commissioner of health, through the Office of Rural Health and Primary Care,
476.5and in consultation with the commissioner of human services, shall study the 24-hour
476.6costs of maintaining a level of readiness in hospitals designated as trauma centers under
476.7Minnesota Statutes, section 144.605, and shall present recommendations to the legislature,
476.8by December 15, 2013, on a state public programs level of readiness payment modifier
476.9for hospitals designated as trauma centers.

476.10    Sec. 80. HEALTH EQUITY REPORT.
476.11By February 1, 2014, the commissioner of health, in consultation with local public
476.12health, health care, and community partners, must submit a report to the chairs and ranking
476.13minority members of the committees with jurisdiction over health policy and finance, on a
476.14plan for advancing health equity in Minnesota. The report must include the following:
476.15(1) assessment of health disparities that exist in the state and how these disparities
476.16relate to health equity;
476.17(2) identification of policies, processes, and systems that contribute to health
476.18inequity in the state;
476.19(3) recommendations for changes to policies, processes and systems within the
476.20Department of Health that would increase the department's leadership in addressing health
476.21inequities;
476.22(4) identification of best practices for local public health, health care, and community
476.23partners to provide culturally responsive services and advance health equity; and
476.24(5) recommendations for strategies for the use of data to document and monitor
476.25existing health inequities and to evaluate effectiveness of policies, processes, systems,
476.26and environmental changes that will advance health equity.

476.27    Sec. 81. ELIMINATING HEALTH DISPARITIES GRANTS; ORGANIZATIONS
476.28WITH LIMITED FISCAL CAPACITY.
476.29For grants awarded from the general fund under Minnesota Statutes, section 145.928,
476.30during the fiscal years ending June 30, 2013, and June 30, 2014, the commissioner
476.31of health may provide working capital advanced to grantees determined during the
476.32application process to have limited financial capacity, in accordance with Office of Grant
476.33Management Policies.

477.1    Sec. 82. ASSESSMENT OF QUALITY METRICS FOR MEASURING THE
477.2SCREENING, DIAGNOSIS, AND TREATMENT OF YOUNG CHILDREN WITH
477.3AUTISM SPECTRUM DISORDER.
477.4    As part of the annual review and ongoing development of quality measures under
477.5Minnesota Statutes, section 62U.02, the commissioner of health shall assess the medical
477.6evidence and feasibility of adding a set of quality metrics for measuring the screening,
477.7diagnosis, and treatment of young children with autism spectrum disorder.

477.8    Sec. 83. REVISOR'S INSTRUCTION.
477.9The revisor shall substitute the term "vertical heat exchangers" or "vertical
477.10heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat
477.11exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions
477.122 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208,
477.13subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3.

477.14    Sec. 84. REPEALER.
477.15(a) Minnesota Statutes 2012, sections 103I.005, subdivision 20; 149A.025; 149A.20,
477.16subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, subdivision 6;
477.17149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a; 149A.53,
477.18subdivision 9; and 485.14, are repealed.
477.19(b) Minnesota Statutes 2012, section 144.123, subdivision 2, is repealed effective
477.20July 1, 2014.

477.23 477.24

Section 1. COMMISSIONER OF HUMAN SERVICES

477.25

Subdivision 1.Total Appropriation

$

(161,031,000)

477.26	Appropriations by Fund
477.27		2013
477.28	General Fund	(158,668,000)
477.29	Health Care Access	(7,179,000)
477.30	TANF	4,816,000

477.31	Subd. 2.Forecasted Programs
477.32	(a) MFIP/DWP Grants

478.1	Appropriations by Fund
478.2	General Fund	(8,211,000)
478.3	TANF	4,399,000

478.4

(b) MFIP Child Care Assistance Grants

10,113,000

478.5

(c) General Assistance Grants

3,230,000

478.6

(d) Minnesota Supplemental Aid Grants

(1,008,000)

478.7

(e) Group Residential Housing Grants

(5,423,000)

478.8

(f) MinnesotaCare Grants

(7,179,000)

478.9This appropriation is from the health care
478.10access fund.

478.11

(g) Medical Assistance Grants

(159,733,000)

478.12

(h) Alternative Care Grants

-0-

478.13

(i) CD Entitlement Grants

2,364,000

478.14

Subd. 3.Technical Activities

417,000

478.15This appropriation is from the TANF fund.

478.16    Sec. 2. EFFECTIVE DATE.
478.17Section 1 is effective the day following final enactment.

478.20

Section 1. SUMMARY OF APPROPRIATIONS.

478.21The amounts shown in this section summarize direct appropriations, by fund, made
478.22in this article.

478.23			2014		2015		Total
478.24	General	$	5,644,039,000	$	5,876,951,000	$	11,520,990,000
478.25 478.26	State Government Special Revenue		69,619,000		74,135,000		143,754,000
478.27	Health Care Access		664,161,000		427,466,000		1,091,628,000
478.28	Federal TANF		269,628,000		266,526,000		536,154,000
478.29	Lottery Prize Fund		1,667,000		1,668,000		3,335,000
478.30	Total	$	6,649,113,000	$	6,646,747,000	$	13,295,860,000

478.31

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

479.1The sums shown in the columns marked "Appropriations" are appropriated to the
479.2agencies and for the purposes specified in this article. The appropriations are from the
479.3general fund, or another named fund, and are available for the fiscal years indicated
479.4for each purpose. The figures "2014" and "2015" used in this article mean that the
479.5appropriations listed under them are available for the fiscal year ending June 30, 2014, or
479.6June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
479.7year 2015. "The biennium" is fiscal years 2014 and 2015.

479.8				APPROPRIATIONS
479.9				Available for the Year
479.10				Ending June 30
479.11					2014		2015

479.12 479.13

Sec. 3. COMMISSIONER OF HUMAN SERVICES

479.14

Subdivision 1.Total Appropriation

$

6,454,078,000

$

6,455,116,000

479.15	Appropriations by Fund
479.16		2014	2015
479.17	General	5,558,517,000	5,796,553,000
479.18 479.19	State Government Special Revenue	4,099,000	6,332,000
479.20	Health Care Access	631,881,000	395,749,000
479.21	Federal TANF	257,915,000	254,813,000
479.22	Lottery Prize Fund	1,667,000	1,668,000

479.23Receipts for Systems Projects.
479.24Appropriations and federal receipts for
479.25information systems projects for MAXIS,
479.26PRISM, MMIS, and SSIS must be deposited
479.27in the state system account authorized
479.28in Minnesota Statutes, section 256.014.
479.29Money appropriated for computer projects
479.30approved by the commissioner of Minnesota
479.31information technology services, funded
479.32by the legislature, and approved by the
479.33commissioner of management and budget,
479.34may be transferred from one project to
479.35another and from development to operations
479.36as the commissioner of human services
479.37considers necessary. Any unexpended
480.1balance in the appropriation for these
480.2projects does not cancel but is available for
480.3ongoing development and operations.
480.4Nonfederal Share Transfers. The
480.5nonfederal share of activities for which
480.6federal administrative reimbursement is
480.7appropriated to the commissioner may be
480.8transferred to the special revenue fund.
480.9ARRA Supplemental Nutrition Assistance
480.10Benefit Increases. The funds provided for
480.11food support benefit increases under the
480.12Supplemental Nutrition Assistance Program
480.13provisions of the American Recovery and
480.14Reinvestment Act (ARRA) of 2009 must be
480.15used for benefit increases beginning July 1,
480.162009.
480.17Supplemental Nutrition Assistance
480.18Program Employment and Training.
480.19(1) Notwithstanding Minnesota Statutes,
480.20sections 256D.051, subdivisions 1a, 6b,
480.21and 6c, and 256J.626, federal Supplemental
480.22Nutrition Assistance employment and
480.23training funds received as reimbursement of
480.24MFIP consolidated fund grant expenditures
480.25for diversionary work program participants
480.26and child care assistance program
480.27expenditures must be deposited in the general
480.28fund. The amount of funds must be limited to
480.29$4,900,000 per year in fiscal years 2014 and
480.302015, and to $4,400,000 per year in fiscal
480.31years 2016 and 2017, contingent on approval
480.32by the federal Food and Nutrition Service.
480.33(2) Consistent with the receipt of the federal
480.34funds, the commissioner may adjust the
480.35level of working family credit expenditures
481.1claimed as TANF maintenance of effort.
481.2Notwithstanding any contrary provision in
481.3this article, this rider expires June 30, 2017.
481.4TANF Maintenance of Effort. (a) In order
481.5to meet the basic maintenance of effort
481.6(MOE) requirements of the TANF block grant
481.7specified under Code of Federal Regulations,
481.8title 45, section 263.1, the commissioner may
481.9only report nonfederal money expended for
481.10allowable activities listed in the following
481.11clauses as TANF/MOE expenditures:
481.12(1) MFIP cash, diversionary work program,
481.13and food assistance benefits under Minnesota
481.14Statutes, chapter 256J;
481.15(2) the child care assistance programs
481.16under Minnesota Statutes, sections 119B.03
481.17and 119B.05, and county child care
481.18administrative costs under Minnesota
481.19Statutes, section 119B.15;
481.20(3) state and county MFIP administrative
481.21costs under Minnesota Statutes, chapters
481.22256J and 256K;
481.23(4) state, county, and tribal MFIP
481.24employment services under Minnesota
481.25Statutes, chapters 256J and 256K;
481.26(5) expenditures made on behalf of legal
481.27noncitizen MFIP recipients who qualify for
481.28the MinnesotaCare program under Minnesota
481.29Statutes, chapter 256L;
481.30(6) qualifying working family credit
481.31expenditures under Minnesota Statutes,
481.32section 290.0671;
482.1(7) qualifying Minnesota education credit
482.2expenditures under Minnesota Statutes,
482.3section 290.0674; and
482.4(8) qualifying Head Start expenditures under
482.5Minnesota Statutes, section 119A.50.
482.6(b) The commissioner shall ensure that
482.7sufficient qualified nonfederal expenditures
482.8are made each year to meet the state's
482.9TANF/MOE requirements. For the activities
482.10listed in paragraph (a), clauses (2) to
482.11(8), the commissioner may only report
482.12expenditures that are excluded from the
482.13definition of assistance under Code of
482.14Federal Regulations, title 45, section 260.31.
482.15(c) For fiscal years beginning with state fiscal
482.16year 2003, the commissioner shall ensure
482.17that the maintenance of effort used by the
482.18commissioner of management and budget
482.19for the February and November forecasts
482.20required under Minnesota Statutes, section
482.2116A.103, contains expenditures under
482.22paragraph (a), clause (1), equal to at least 16
482.23percent of the total required under Code of
482.24Federal Regulations, title 45, section 263.1.
482.25(d) The requirement in Minnesota Statutes,
482.26section 256.011, subdivision 3, that federal
482.27grants or aids secured or obtained under that
482.28subdivision be used to reduce any direct
482.29appropriations provided by law, do not apply
482.30if the grants or aids are federal TANF funds.
482.31(e) For the federal fiscal years beginning on
482.32or after October 1, 2007, the commissioner
482.33may not claim an amount of TANF/MOE in
482.34excess of the 75 percent standard in Code
483.1of Federal Regulations, title 45, section
483.2263.1(a)(2), except:
483.3(1) to the extent necessary to meet the 80
483.4percent standard under Code of Federal
483.5Regulations, title 45, section 263.1(a)(1),
483.6if it is determined by the commissioner
483.7that the state will not meet the TANF work
483.8participation target rate for the current year;
483.9(2) to provide any additional amounts
483.10under Code of Federal Regulations, title 45,
483.11section 264.5, that relate to replacement of
483.12TANF funds due to the operation of TANF
483.13penalties; and
483.14(3) to provide any additional amounts that
483.15may contribute to avoiding or reducing
483.16TANF work participation penalties through
483.17the operation of the excess MOE provisions
483.18of Code of Federal Regulations, title 45,
483.19section 261.43(a)(2).
483.20For the purposes of clauses (1) to (3),
483.21the commissioner may supplement the
483.22MOE claim with working family credit
483.23expenditures or other qualified expenditures
483.24to the extent such expenditures are otherwise
483.25available after considering the expenditures
483.26allowed in this subdivision and subdivisions
483.272 and 3.
483.28(f) Notwithstanding any contrary provision
483.29in this article, paragraphs (a) to (e) expire
483.30June 30, 2017.
483.31Working Family Credit Expenditures
483.32as TANF/MOE. The commissioner may
483.33claim as TANF maintenance of effort up to
483.34$6,707,000 per year of working family credit
483.35expenditures in each fiscal year.

484.1 484.2

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

484.3The commissioner may count the following
484.4amounts of working family credit
484.5expenditures as TANF/MOE:
484.6(1) fiscal year 2014, $43,576,000; and
484.7(2) fiscal year 2015, $43,548,000.

484.8 484.9

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

484.10(a) The following TANF fund amounts
484.11are appropriated to the commissioner for
484.12purposes of MFIP/transition year child care
484.13assistance under Minnesota Statutes, section
484.14119B.05:
484.15(1) fiscal year 2014; $14,020,000; and
484.16(2) fiscal year 2015, $14,020,000.
484.17(b) The commissioner shall authorize the
484.18transfer of sufficient TANF funds to the
484.19federal child care and development fund to
484.20meet this appropriation and shall ensure that
484.21all transferred funds are expended according
484.22to federal child care and development fund
484.23regulations.

484.24

Subd. 4.Central Office

484.25The amounts that may be spent from this
484.26appropriation for each purpose are as follows:

484.27

(a) Operations

484.28	Appropriations by Fund
484.29	General	88,410,000	89,985,000
484.30 484.31	State Government Special Revenue	3,974,000	6,207,000
484.32	Health Care Access	13,252,000	13,154,000
484.33	Federal TANF	117,000	100,000

485.1Return on Taxpayer Investment
485.2Implementation Study. $100,000 is
485.3appropriated in fiscal year 2014 from the
485.4general fund to the commissioner of human
485.5services for transfer to the commissioner
485.6of management and budget to develop
485.7recommendations for implementing a return
485.8on taxpayer investment (ROTI) methodology
485.9and practice related to human services and
485.10corrections programs administered and
485.11funded by state and county government.
485.12The scope of the study shall include
485.13assessments of ROTI initiatives in other
485.14states, design implications for Minnesota,
485.15and identification of one or more Minnesota
485.16institutions of higher education capable of
485.17providing rigorous and consistent nonpartisan
485.18institutional support for ROTI. The scope of
485.19the study shall also include recommendations
485.20on methods to evaluate the value of prepaid
485.21medical assistance services (PMAP)
485.22versus other ways of delivering public
485.23health care programs. The commissioner
485.24shall consult with representatives of other
485.25state agencies, counties, legislative staff,
485.26Minnesota institutions of higher education,
485.27and other stakeholders in developing
485.28recommendations. The commissioner shall
485.29report findings and recommendations to the
485.30governor and legislature by November 30,
485.312013.
485.32DHS Receipt Center Accounting. The
485.33commissioner is authorized to transfer
485.34appropriations to, and account for DHS
485.35receipt center operations in, the special
485.36revenue fund.
486.1Administrative Recovery; Set-Aside. The
486.2commissioner may invoice local entities
486.3through the SWIFT accounting system as an
486.4alternative means to recover the actual cost
486.5of administering the following provisions:
486.6(1) Minnesota Statutes, section 125A.744,
486.7subdivision 3;
486.8(2) Minnesota Statutes, section 245.495,
486.9paragraph (b);
486.10(3) Minnesota Statutes, section 256B.0625,
486.11subdivision 20, paragraph (k);
486.12(4) Minnesota Statutes, section 256B.0924,
486.13subdivision 6, paragraph (g);
486.14(5) Minnesota Statutes, section 256B.0945,
486.15subdivision 4, paragraph (d); and
486.16(6) Minnesota Statutes, section 256F.10,
486.17subdivision 6, paragraph (b).
486.18Systems Modernization. The following
486.19amounts are appropriated for transfer to
486.20the state systems account authorized in
486.21Minnesota Statutes, section 256.014:
486.22(1) $1,825,000 in fiscal year 2014 and
486.23$2,502,000 in fiscal year 2015 is for the
486.24state share of Medicaid-allocated costs of
486.25the health insurance exchange information
486.26technology and operational structure. The
486.27funding base is $3,222,000 in fiscal year 2016
486.28and $3,037,000 in fiscal year 2017 but shall
486.29not be included in the base thereafter; and
486.30(2) Any unexpended balance from
486.31the contingent system modernization
486.32appropriation in article 15 must be
486.33transferred from the Department of Human
486.34Services state systems account to the Office
487.1of Enterprise Technology when the Office
487.2of Enterprise Technology has negotiated a
487.3federally approved internal service fund rates
487.4and billing process with sufficient internal
487.5accounting controls to properly maximize
487.6federal reimbursement to Minnesota for
487.7human services system modernization
487.8projects, but not later than June 30, 2015.
487.9Base Adjustment. The general fund base
487.10is increased by $6,099,000 in fiscal year
487.112016 and $1,185,000 in fiscal year 2017.
487.12The health access fund base is decreased by
487.13$551,000 in fiscal years 2016 and 2017.

487.14

(b) Children and Families

487.15	Appropriations by Fund
487.16	General	7,626,000	7,634,000
487.17	Federal TANF	2,282,000	2,282,000

487.18Financial Institution Data Match and
487.19Payment of Fees. The commissioner is
487.20authorized to allocate up to $310,000 each
487.21year in fiscal years 2014 and 2015 from the
487.22PRISM special revenue account to make
487.23payments to financial institutions in exchange
487.24for performing data matches between account
487.25information held by financial institutions
487.26and the public authority's database of child
487.27support obligors as authorized by Minnesota
487.28Statutes, section 13B.06, subdivision 7.
487.29Base Adjustment. The general fund base is
487.30decreased by $300,000 in fiscal years 2016
487.31and 2017, and the federal TANF fund base is
487.32increased by $300,000 in fiscal years 2016
487.33and 2017.

487.34

(c) Health Care

488.1	Appropriations by Fund
488.2	General	13,924,000	13,795,000
488.3	Health Care Access	26,599,000	30,306,000

488.4Base Adjustment. The health care access
488.5fund base is increased by $8,177,000 in fiscal
488.6year 2016 and by $6,712,000 in fiscal year
488.72017.
488.8Medical assistance costs for inmates. The
488.9commissioner of corrections, for fiscal years
488.102014 through 2017, shall transfer to the
488.11commissioner of human services an amount
488.12equal to the state share of medical assistance
488.13costs related to implementation of Minnesota
488.14Statutes, section 256B.055, subdivision 14,
488.15paragraph (c).

488.16

(d) Continuing Care

488.17	Appropriations by Fund
488.18	General	18,734,000	19,272,000
488.19 488.20	State Government Special Revenue	125,000	125,000

488.21Base Adjustment. The general fund base is
488.22increased by $3,324,000 in fiscal year 2016
488.23and by $3,324,000 in fiscal year 2017.

488.24

(e) Chemical and Mental Health

488.25	Appropriations by Fund
488.26	General	4,480,000	4,300,000
488.27	Lottery Prize Fund	159,000	160,000

488.28

Subd. 5.Forecasted Programs

488.29The amounts that may be spent from this
488.30appropriation for each purpose are as follows:

488.31

(a) MFIP/DWP

488.32	Appropriations by Fund
488.33	General	72,583,000	74,634,000
488.34	Federal TANF	83,104,000	80,510,000

489.1

(b) MFIP Child Care Assistance

59,662,000

59,393,000

489.2Notwithstanding Minnesota Statutes, section
489.3256J.021, TANF funds may be used to pay for
489.4any additional costs related to repeal of the
489.5MFIP family cap for individuals identified
489.6under Minnesota Statutes, section 256J.021.

489.7

(c) General Assistance

54,787,000

56,068,000

489.8General Assistance Standard. The
489.9commissioner shall set the monthly standard
489.10of assistance for general assistance units
489.11consisting of an adult recipient who is
489.12childless and unmarried or living apart
489.13from parents or a legal guardian at $203.
489.14The commissioner may reduce this amount
489.15according to Laws 1997, chapter 85, article
489.163, section 54.
489.17Emergency General Assistance. The
489.18amount appropriated for emergency general
489.19assistance funds is limited to no more
489.20than $6,729,812 in fiscal year 2014 and
489.21$6,729,812 in fiscal year 2015. Funds
489.22to counties shall be allocated by the
489.23commissioner using the allocation method in
489.24Minnesota Statutes, section 256D.06.

489.25

(d) MN Supplemental Assistance

38,646,000

39,821,000

489.26

(e) Group Residential Housing

140,447,000

149,984,000

489.27

(f) MinnesotaCare

489.28

Health Care Access

296,272,000

226,606,000

489.29

(g) Medical Assistance

489.30	Appropriations by Fund
489.31	General	4,368,215,000	4,592,196,000
489.32	Health Care Access	292,771,000	123,507,000

490.1The Departments of Human Services and
490.2Management and Budget shall identify
490.3general fund medical assistance populations
490.4costing $239,934,000 for fiscal year 2016
490.5and $218,047,000 for fiscal year 2017 and
490.6transfer those costs to the HCAF. The base for
490.7these costs shall be counted in the health care
490.8access fund for fiscal years 2016 and 2017.
490.9Newborn Screening. $121,000 in fiscal
490.10year 2014 and $141,000 in fiscal year 2015
490.11are appropriated from the general fund, and
490.12$10,000 in fiscal year 2014 and $13,000 in
490.13fiscal year 2015 are appropriated from the
490.14health care access fund to the commissioner
490.15of human services for the hospital
490.16reimbursement increase in Minnesota
490.17Statutes, section 256.969, subdivision 29.
490.18The base for this appropriation in fiscal year
490.192016 is $14,000.
490.20Transfer. $704,000 in fiscal year 2014 and
490.21$2,090,000 in fiscal year 2015 is transferred
490.22from the health care access fund to the
490.23general fund to provide increases in dental
490.24payment rates under Minnesota Statutes,
490.25section 256B.76, subdivision 2, paragraph (j).

490.26

(h) Alternative Care

47,197,000

45,084,000

490.27Alternative Care Transfer. Any money
490.28allocated to the alternative care program that
490.29is not spent for the purposes indicated does
490.30not cancel but shall be transferred to the
490.31medical assistance account.

490.32

(i) CD Treatment Fund

81,440,000

74,875,000

490.33Balance Transfer. The commissioner must
490.34transfer $18,188,000 from the consolidated
491.1chemical dependency treatment fund to the
491.2general fund by September 30, 2013.

491.3

Subd. 6.Grant Programs

491.4The amounts that may be spent from this
491.5appropriation for each purpose are as follows:

491.6

(a) Support Services Grants

491.7	Appropriations by Fund
491.8	General	8,715,000	8,715,000
491.9	Federal TANF	91,832,000	90,952,000

491.10MFIP Housing Assistance Grants. MFIP
491.11housing assistance grants under Minnesota
491.12Statutes, section 256J.35, paragraph (d),
491.13must be paid out of support services grants
491.14under this paragraph.
491.15Paid Work Experience. $2,168,000 each
491.16year is from the general fund for paid work
491.17experience for long-term MFIP recipients.
491.18Paid work includes full and partial wage
491.19subsidies and other related services such as
491.20job development, marketing, preworksite
491.21training, job coaching, and postplacement
491.22services. These are onetime appropriations.
491.23Unexpended funds for fiscal year 2014 do not
491.24cancel but are available to the commissioner
491.25for this purpose in fiscal year 2015.
491.26Work Study Funding for MFIP
491.27Participants. $250,000 each year is from
491.28the general fund to pilot work study jobs for
491.29MFIP recipients in approved postsecondary
491.30education programs. This is a onetime
491.31appropriation. Unexpended funds for fiscal
491.32year 2014 do not cancel but are available for
491.33this purpose in fiscal year 2015.
492.1Local Strategies to Reduce Disparities.
492.2$2,000,000 each year is from the general
492.3fund, for local projects that focus on services
492.4for subgroups within the MFIP caseload
492.5who are experiencing poor employment
492.6outcomes. These are onetime appropriations.
492.7Unexpended funds for fiscal year 2014 do not
492.8cancel but are available to the commissioner
492.9for this purpose in fiscal year 2015.
492.10Home Visiting Collaborations for MFIP
492.11Teen Parents. $200,000 each year is from
492.12the general fund for technical assistance and
492.13training to support local collaborations that
492.14provide home visiting services for MFIP teen
492.15parents. The TANF fund base is increased by
492.16$200,000 in fiscal years 2016 and 2017.
492.17Base Adjustment. The general fund base is
492.18decreased by $4,618,000 in fiscal years 2016
492.19and 2017. The TANF fund base is increased
492.20by $1,700,000 in fiscal years 2016 and 2017.

492.21 492.22

(b) Basic Sliding Fee Child Care Assistance Grants

38,356,000

38,681,000

492.23Base Adjustment. The general fund base is
492.24increased by $1,278,000 in fiscal year 2016
492.25and by $1,349,000 in fiscal year 2017.

492.26

(c) Child Care Development Grants

1,487,000

1,487,000

492.27

(d) Child Support Enforcement Grants

50,000

50,000

492.28Federal Child Support Demonstration
492.29Grants. Federal administrative
492.30reimbursement resulting from the federal
492.31child support grant expenditures authorized
492.32under United States Code, title 42, section
492.331315, is appropriated to the commissioner
492.34for this activity.

493.1

(e) Children's Services Grants

493.2	Appropriations by Fund
493.3	General	47,438,000	47,801,000
493.4	Federal TANF	140,000	140,000

493.5Adoption Assistance and Relative Custody
493.6Assistance. The commissioner may transfer
493.7unencumbered appropriation balances for
493.8adoption assistance and relative custody
493.9assistance between fiscal years and between
493.10programs.
493.11Privatized Adoption Grants. Federal
493.12reimbursement for privatized adoption grant
493.13and foster care recruitment grant expenditures
493.14is appropriated to the commissioner for
493.15adoption grants and foster care and adoption
493.16administrative purposes.
493.17Adoption Assistance Incentive Grants.
493.18Federal funds available during fiscal years
493.192014 and 2015 for adoption incentive grants
493.20are appropriated to the commissioner for
493.21these purposes.
493.22Base Adjustment. The general fund base is
493.23increased by $5,139,000 in fiscal year 2016
493.24and by $9,155,000 in fiscal year 2017.

493.25

(f) Child and Community Service Grants

53,301,000

53,301,000

493.26

(g) Child and Economic Support Grants

16,572,000

16,573,000

493.27Minnesota Food Assistance Program.
493.28Unexpended funds for the Minnesota food
493.29assistance program for fiscal year 2014 do
493.30not cancel but are available for this purpose
493.31in fiscal year 2015.
493.32Family Assets for Independence. $250,000
493.33each year is for the Family Assets for
493.34Independence Minnesota program. This
494.1appropriation is available in either year of the
494.2biennium and may be transferred between
494.3fiscal years. This appropriation is added to
494.4the base.

494.5

(h) Health Care Grants

494.6	Appropriations by Fund
494.7	General	90,000	90,000
494.8	Health Care Access	2,228,000	1,413,000

494.9Premium Subsidy. $....... is appropriated
494.10from the general fund in fiscal year 2014
494.11and fiscal year 2015 to the commissioner of
494.12human services for the purpose of providing
494.13a premium subsidy to families purchasing
494.14supplemental autism coverage for young
494.15children on the private market if a family has
494.16an income below 400 percent of the federal
494.17poverty level. The commissioner may utilize
494.18the existing eligibility and enrollment system
494.19described in Minnesota Statutes, section
494.20252.27, to determine a family's eligibility
494.21for subsidies under this section. This
494.22appropriation is available until expended and
494.23does not become part of the base.
494.24Base Adjustment. The health care access
494.25fund is decreased by $1,223,000 in fiscal
494.26years 2016 and 2017.

494.27

(i) Aging and Adult Services Grants

22,149,000

23,015,000

494.28

(j) Deaf and Hard-of-Hearing Grants

1,767,000

1,767,000

494.29

(k) Disabilities Grants

17,984,000

17,861,000

494.30(a) $180,000 each year from the general fund
494.31is for a grant to the Minnesota Organization
494.32on Fetal Alcohol Syndrome (MOFAS) to
494.33support nonprofit Fetal Alcohol Spectrum
494.34Disorders (FASD) outreach prevention
495.1programs in Olmsted County. This is a
495.2onetime appropriation.
495.3Base Adjustment. The general fund base
495.4is increased by $502,000 in fiscal year 2016
495.5and by $676,000 in fiscal year 2017.

495.6

(l) Adult Mental Health Grants

495.7	Appropriations by Fund
495.8	General	71,257,000	69,588,000
495.9	Health Care Access	750,000	750,000
495.10	Lottery Prize	1,508,000	1,508,000

495.11Funding Usage. Up to 75 percent of a fiscal
495.12year's appropriations for adult mental health
495.13grants may be used to fund allocations in that
495.14portion of the fiscal year ending December
495.1531.
495.16Base Adjustment. The general fund base is
495.17decreased by $4,461,000 in fiscal years 2016
495.18and 2017.
495.19Mental Health Pilot Project. $230,000
495.20each year is for a grant to the Zumbro
495.21Valley Mental Health Center. The grant
495.22shall be used to implement a pilot project
495.23to test an integrated behavioral health care
495.24coordination model. The grant recipient must
495.25report measurable outcomes and savings
495.26to the commissioner of human services
495.27by January 15, 2016. This is a onetime
495.28appropriation.
495.29High-risk adults. $100,000 in fiscal year
495.302014 and $100,000 in fiscal year 2015 are
495.31appropriated from the general fund to the
495.32commissioner of human services for a grant
495.33to the nonprofit organization selected to
495.34administer the demonstration project for
495.35high-risk adults under Laws 2007, chapter
496.154, article 1, section 19, in order to complete
496.2the project. This is a onetime appropriation.

496.3

(m) Child Mental Health Grants

17,599,000

19,988,000

496.4Funding Usage. Up to 75 percent of a fiscal
496.5year's appropriation for child mental health
496.6grants may be used to fund allocations in that
496.7portion of the fiscal year ending December
496.831.

496.9

(n) CD Treatment Support Grants

1,516,000

1,516,000

496.10Base Adjustment. The general fund base is
496.11decreased by $300,000 in fiscal years 2016
496.12and 2017.

496.13

Subd. 7.State-Operated Services

186,744,000

188,183,000

496.14Transfer Authority Related to
496.15State-Operated Services. Money
496.16appropriated for state-operated services
496.17may be transferred between fiscal years
496.18of the biennium with the approval of the
496.19commissioner of management and budget.
496.20The amounts that may be spent from the
496.21appropriation for each purpose are as follows:

496.22

(a) SOS Mental Health

116,598,000

117,467,000

496.23Dedicated Receipts Available. Of the
496.24revenue received under Minnesota Statutes,
496.25section 246.18, subdivision 8, paragraph
496.26(a), $1,000,000 each year is available for
496.27the purposes of paragraph (b), clause (1),
496.28of that subdivision, $1,000,000 each year
496.29is available to transfer to the adult mental
496.30health budget activity for the purposes of
496.31paragraph (b), clause (2), of that subdivision,
496.32and up to $2,713,000 each year is available
496.33for the purposes of paragraph (b), clause (3),
496.34of that subdivision.

497.1

(b) SOS MN Security Hospital

70,146,000

70,715,000

497.2

Subd. 8.Sex Offender Program

77,341,000

80,895,000

497.3Transfer Authority Related to Minnesota
497.4Sex Offender Program. Money
497.5appropriated for the Minnesota sex offender
497.6program may be transferred between fiscal
497.7years of the biennium with the approval of the
497.8commissioner of management and budget.

497.9

Subd. 9.Technical Activities

80,440,000

80,829,000

497.10This appropriation is from the federal TANF
497.11fund.
497.12Base Adjustment. The federal TANF fund
497.13base is decreased by $22,000 in fiscal year
497.142016 and by $49,000 in fiscal year 2017.

497.15

Subd. 10.Transfer.

497.16The commissioner of management and
497.17budget must transfer $65,000,000 in fiscal
497.18year 2014 from the general fund to the health
497.19care access fund. This is a onetime transfer.

497.20

Sec. 4. COMMISSIONER OF HEALTH

497.21

Subdivision 1.Total Appropriation

$

172,440,000

$

168,946,000

497.22	Appropriations by Fund
497.23		2014	2015
497.24	General	80,151,000	75,001,000
497.25 497.26	State Government Special Revenue	48,296,000	50,515,000
497.27	Health Care Access	32,280,000	31,717,000
497.28	Federal TANF	11,713,000	11,713,000

497.29The amounts that may be spent for each
497.30purpose are specified in the following
497.31subdivisions.

497.32

Subd. 2.Health Improvement

498.1	Appropriations by Fund
498.2	General	53,475,000	48,260,000
498.3 498.4	State Government Special Revenue	1,040,000	1,047,000
498.5	Health Care Access	21,725,000	21,731,000
498.6	Federal TANF	11,713,000	11,713,000

498.7Notwithstanding the cancellation requirement
498.8in Minnesota Statutes, section 256J.02,
498.9subdivision 6, TANF funds awarded under
498.10Minnesota Statutes, section 145.928, during
498.11fiscal year 2013 to grantees determined
498.12during the application process to have limited
498.13financial capacity, are available until June
498.1430, 2014.
498.15Statewide Health Improvement Program.
498.16 $20,000,000 in fiscal year 2014 and
498.17$20,000,000 in fiscal year 2015 are
498.18appropriated from the health care access
498.19fund for the statewide health improvement
498.20program under Minnesota Statutes, section
498.21145.986.
498.22Statewide Cancer Surveillance System.
498.23 Of the general fund appropriation, $350,000
498.24in fiscal year 2014 and $350,000 in fiscal
498.25year 2015 are appropriated to develop and
498.26implement a new cancer reporting system
498.27under Minnesota Statutes, sections 144.671
498.28to 144.69. Any information technology
498.29development or support costs necessary
498.30for the cancer surveillance system must
498.31be incorporated into the agency's service
498.32level agreement and paid to the Office of
498.33Enterprise Technology.
498.34Eliminating Reproductive Health
498.35Disparities. To the extent funds are
498.36available for fiscal years 2014 and 2015
499.1for grants provided pursuant to Minnesota
499.2Statutes, section 145.928, the commissioner
499.3may provide a grant to a Somali-based
499.4organization located in Minnesota to
499.5develop a reproductive health strategic
499.6plan to eliminate reproductive health
499.7disparities for Somali women. The plan shall
499.8develop initiatives to provide educational
499.9and information resources to health care
499.10providers, community organizations, and
499.11Somali women to ensure effective interaction
499.12with Somali culture and western medicine
499.13and the delivery of appropriate health care
499.14services, and the achievement of better health
499.15outcomes for Somali women. The plan must
499.16engage health care providers, the Somali
499.17community, and Somali health-centered
499.18organizations. The commissioner shall
499.19submit a report to the chairs and ranking
499.20minority members of the senate and house
499.21committees with jurisdiction over health
499.22policy on the strategic plan developed under
499.23this grant for eliminating reproductive health
499.24disparities for Somali women. The report
499.25must be submitted by February 15, 2014.
499.26TANF Appropriations. (1) $1,156,000 of
499.27the TANF funds is appropriated each year of
499.28the biennium to the commissioner for family
499.29planning grants under Minnesota Statutes,
499.30section 145.925.
499.31(2) $3,579,000 of the TANF funds is
499.32appropriated each year of the biennium to
499.33the commissioner for home visiting and
499.34nutritional services listed under Minnesota
499.35Statutes, section 145.882, subdivision 7,
499.36clauses (6) and (7). Funds must be distributed
500.1to community health boards according to
500.2Minnesota Statutes, section 145A.131,
500.3subdivision 1.
500.4(3) $2,000,000 of the TANF funds is
500.5appropriated each year of the biennium to
500.6the commissioner for decreasing racial and
500.7ethnic disparities in infant mortality rates
500.8under Minnesota Statutes, section 145.928,
500.9subdivision 7.
500.10(4) $4,978,000 of the TANF funds is
500.11appropriated each year of the biennium to the
500.12commissioner for the family home visiting
500.13grant program according to Minnesota
500.14Statutes, section 145A.17. $4,000,000 of the
500.15funding must be distributed to community
500.16health boards according to Minnesota
500.17Statutes, section 145A.131, subdivision 1.
500.18$978,000 of the funding must be distributed
500.19to tribal governments based on Minnesota
500.20Statutes, section 145A.14, subdivision 2a.
500.21(5) The commissioner may use up to 6.23
500.22percent of the funds appropriated each fiscal
500.23year to conduct the ongoing evaluations
500.24required under Minnesota Statutes, section
500.25145A.17, subdivision 7, and training and
500.26technical assistance as required under
500.27Minnesota Statutes, section 145A.17,
500.28subdivisions 4 and 5.
500.29TANF Carryforward. Any unexpended
500.30balance of the TANF appropriation in the
500.31first year of the biennium does not cancel but
500.32is available for the second year.

500.33

Subd. 3.Policy Quality and Compliance

500.34	Appropriations by Fund
500.35	General	9,400,000	9,409,000
501.1 501.2	State Government Special Revenue	14,481,000	16,548,000
501.3	Health Care Access	10,555,000	9,986,000

501.4Base Level Adjustment. The state
501.5government special revenue fund base shall
501.6be reduced by $2,000 in fiscal year 2017. The
501.7health care access base shall be increased by
501.8$600,000 in fiscal year 2015.

501.9

Subd. 4.Health Protection

501.10	Appropriations by Fund
501.11	General	9,503,000	9,558,000
501.12 501.13	State Government Special Revenue	32,775,000	32,920,000

501.14Infectious Disease Laboratory. Of the
501.15general fund appropriation, $200,000 in
501.16fiscal year 2014 and $200,000 in fiscal year
501.172015 are appropriated to the commissioner
501.18to monitor infectious disease trends and
501.19investigate infectious disease outbreaks.
501.20Surveillance for Elevated Blood Lead
501.21Levels. Of the general fund appropriation,
501.22$100,000 in fiscal year 2014 and $100,000
501.23in fiscal year 2015 are appropriated to the
501.24commissioner for the blood lead surveillance
501.25system under Minnesota Statutes, section
501.26144.9502.
501.27Newborn Screening. (a) $365,000 in fiscal
501.28year 2014 and $349,000 in fiscal year 2015
501.29are appropriated for the purpose of providing
501.30support services to families as required
501.31under Minnesota Statutes, section 144.966,
501.32subdivision 3a.
501.33(b) $164,000 in fiscal year 2014 and
501.34$156,000 in fiscal year 2015 are appropriated
501.35for home-based education in American Sign
502.1Language for families with children who
502.2are deaf or have hearing loss, as required
502.3under Minnesota Statutes, section 144.966,
502.4subdivision 3a.
502.5Sexual Violence Prevention. Within
502.6available appropriations, by January 15,
502.72015, the commissioner must report to the
502.8legislature on its activities to prevent sexual
502.9violence, including activities to promote
502.10coordination of existing state programs and
502.11services to achieve maximum impact on
502.12addressing the root causes of sexual violence.
502.13Safe Harbor for Sexually Exploited
502.14Youth. (a) $1,000,000 in fiscal year 2014
502.15and $1,000,000 in fiscal year 2015 are
502.16for supportive service grants for the safe
502.17harbor for sexually exploited youth program,
502.18under Minnesota Statutes, section 145.4716,
502.19including advocacy services, civil legal
502.20services, health care services, mental and
502.21chemical health services, education and
502.22employment services, aftercare and relapse
502.23prevention, and family reunification services.
502.24This appropriation shall be added to the base.
502.25(b) $381,000 in fiscal year 2014 and
502.26$381,000 in fiscal year 2015 are for
502.27grants to six regional navigators under
502.28Minnesota Statutes, section 145.4717. This
502.29appropriation shall be added to the base.
502.30(c) $82,500 in fiscal year 2014 and $82,500
502.31in fiscal year 2015 are for the director of
502.32child sex trafficking prevention position.
502.33This appropriation shall be added to the base.
502.34(d) $72,900 in fiscal year 2015 is for
502.35program evaluation required under
503.1Minnesota Statutes, section 145.4718. This
503.2appropriation shall be added to the base.
503.3Base Level Adjustment. The state
503.4government special revenue base is increased
503.5by $6,000 in fiscal year 2016 and by $27,000
503.6in fiscal year 2017.

503.7

Subd. 5.Administrative Support Services

7,773,000

7,774,000

503.8Regional Support for Local Public Health
503.9Departments. $350,000 in fiscal year
503.102014 and $350,000 in fiscal year 2015
503.11are appropriated to the commissioner for
503.12regional staff who provide specialized
503.13expertise to local public health departments.

503.14

Sec. 5. HEALTH-RELATED BOARDS

503.15

Subdivision 1.Total Appropriation

$

17,224,000

$

17,288,000

503.16This appropriation is from the state
503.17government special revenue fund. The
503.18amounts that may be spent for each purpose
503.19are specified in the following subdivisions.

503.20

Subd. 2.Board of Chiropractic Examiners

473,000

477,000

503.21

Subd. 3.Board of Dentistry

1,835,000

1,850,000

503.22Health Professional Services Program. Of
503.23this appropriation, $704,000 in fiscal year
503.242014 and $704,000 in fiscal year 2015 from
503.25the state government special revenue fund are
503.26for the health professional services program.

503.27 503.28

Subd. 4.Board of Dietetic and Nutrition Practice

112,000

112,000

503.29 503.30

Subd. 5.Board of Marriage and Family Therapy

169,000

170,000

503.31

Subd. 6.Board of Medical Practice

3,883,000

3,900,000

503.32

Subd. 7.Board of Nursing

3,664,000

3,692,000

504.1 504.2

Subd. 8.Board of Nursing Home Administrators

1,630,000

1,586,000

504.3Administrative Services Unit - Operating
504.4Costs. Of this appropriation, $676,000
504.5in fiscal year 2014 and $626,000 in
504.6fiscal year 2015 are for operating costs
504.7of the administrative services unit. The
504.8administrative services unit may receive
504.9and expend reimbursements for services
504.10performed by other agencies.
504.11Administrative Services Unit - Volunteer
504.12Health Care Provider Program. Of this
504.13appropriation, $150,000 in fiscal year 2014
504.14and $150,000 in fiscal year 2015 are to pay
504.15for medical professional liability coverage
504.16required under Minnesota Statutes, section
504.17214.40.
504.18Administrative Services Unit - Contested
504.19Cases and Other Legal Proceedings. Of
504.20this appropriation, $200,000 in fiscal year
504.212014 and $200,000 in fiscal year 2015 are
504.22for costs of contested case hearings and other
504.23unanticipated costs of legal proceedings
504.24involving health-related boards funded
504.25under this section. Upon certification of a
504.26health-related board to the administrative
504.27services unit that the costs will be incurred
504.28and that there is insufficient money available
504.29to pay for the costs out of money currently
504.30available to that board, the administrative
504.31services unit is authorized to transfer money
504.32from this appropriation to the board for
504.33payment of those costs with the approval
504.34of the commissioner of management and
504.35budget. This appropriation does not cancel.
505.1Any unencumbered and unspent balances
505.2remain available for these expenditures in
505.3subsequent fiscal years.
505.4Criminal Background Checks. $390,000
505.5each year from the state government special
505.6revenue fund is for the Administrative
505.7Support Services Unit for the implementation
505.8of a criminal background check program.

505.9

Subd. 9.Board of Optometry

108,000

108,000

505.10

Subd. 10.Board of Pharmacy

2,362,000

2,380,000

505.11Prescription Electronic Reporting. Of
505.12this appropriation, $356,000 in fiscal year
505.132014 and $356,000 in fiscal year 2015 from
505.14the state government special revenue fund
505.15are to the board to operate the prescription
505.16electronic reporting system in Minnesota
505.17Statutes, section 152.126.

505.18

Subd. 11.Board of Physical Therapy

348,000

351,000

505.19

Subd. 12.Board of Podiatry

76,000

77,000

505.20

Subd. 13.Board of Psychology

853,000

861,000

505.21

Subd. 14.Board of Social Work

1,061,000

1,069,000

505.22

Subd. 15.Board of Veterinary Medicine

232,000

234,000

505.23 505.24

Subd. 16.Board of Behavioral Health and Therapy

418,000

421,000

505.25 505.26

Sec. 6. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

2,749,000

$

2,756,000

505.27Regional Grants. $585,000 in fiscal year
505.282014 and $585,000 in fiscal year 2015 are
505.29for regional emergency medical services
505.30programs, to be distributed equally to the
505.31eight emergency medical service regions.
505.32Cooper/Sams Volunteer Ambulance
505.33Program. $700,000 in fiscal year 2014 and
506.1$700,000 in fiscal year 2015 are for the
506.2Cooper/Sams volunteer ambulance program
506.3under Minnesota Statutes, section 144E.40.
506.4(a) Of this amount, $611,000 in fiscal year
506.52014 and $611,000 in fiscal year 2015
506.6are for the ambulance service personnel
506.7longevity award and incentive program under
506.8Minnesota Statutes, section 144E.40.
506.9(b) Of this amount, $89,000 in fiscal year
506.102014 and $89,000 in fiscal year 2015 are
506.11for the operations of the ambulance service
506.12personnel longevity award and incentive
506.13program under Minnesota Statutes, section
506.14144E.40.
506.15Ambulance Training Grant. $361,000 in
506.16fiscal year 2014 and $361,000 in fiscal year
506.172015 are for training grants.
506.18EMSRB Board Operations. $1,095,000 in
506.19fiscal year 2014 and $1,095,000 in fiscal year
506.202015 are for operations.

506.21

Sec. 7. COUNCIL ON DISABILITY

$

618,000

$

622,000

506.22 506.23 506.24

Sec. 8. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,668,000

$

1,680,000

506.25

Sec. 9. OMBUDSPERSON FOR FAMILIES

$

336,000

$

339,000

506.26    Sec. 10. Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:
506.27    Subd. 34. Federal administrative reimbursement dedicated. Federal
506.28administrative reimbursement resulting from the following activities is appropriated to the
506.29commissioner for the designated purposes:
506.30(1) reimbursement for the Minnesota senior health options project; and
506.31(2) reimbursement related to prior authorization and inpatient admission certification
506.32by a professional review organization. A portion of these funds must be used for activities
506.33to decrease unnecessary pharmaceutical costs in medical assistance.; and
507.1(3) reimbursement resulting from the federal child support grant expenditures
507.2authorized under United States Code, title 42, section 1315.

507.3    Sec. 11. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
507.4to read:
507.5    Subd. 35. Federal reimbursement for privatized adoption grants. Federal
507.6reimbursement for privatized adoption grant and foster care recruitment grant expenditures
507.7is appropriated to the commissioner for adoption grants and foster care and adoption
507.8administrative purposes.

507.9    Sec. 12. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
507.10to read:
507.11    Subd. 36. DHS receipt center accounting. The commissioner may transfer
507.12appropriations to, and account for DHS receipt center operations in, the special revenue
507.13fund.

507.14    Sec. 13. TRANSFERS.
507.15    Subdivision 1. Grants. The commissioner of human services, with the approval of
507.16the commissioner of management and budget, may transfer unencumbered appropriation
507.17balances for the biennium ending June 30, 2015, within fiscal years among the MFIP,
507.18general assistance, general assistance medical care under Minnesota Statutes 2009
507.19Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP
507.20child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental
507.21aid, group residential housing programs, the entitlement portion of the chemical
507.22dependency consolidated treatment fund, and between fiscal years of the biennium. The
507.23commissioner shall inform the chairs and ranking minority members of the senate Health
507.24and Human Services Finance Division and the house of representatives Health and Human
507.25Services Finance Committee quarterly about transfers made under this provision.
507.26    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
507.27money may be transferred within the Departments of Human Services and Health as the
507.28commissioners consider necessary, with the advance approval of the commissioner of
507.29management and budget. The commissioner shall inform the chairs and ranking minority
507.30members of the senate Health and Human Services Finance Division and the house of
507.31representatives Health and Human Services Finance Committee quarterly about transfers
507.32made under this provision.

508.1    Sec. 14. INDIRECT COSTS NOT TO FUND PROGRAMS.
508.2The commissioners of health and human services shall not use indirect cost
508.3allocations to pay for the operational costs of any program for which they are responsible.

508.4    Sec. 15. EXPIRATION OF UNCODIFIED LANGUAGE.
508.5All uncodified language contained in this article expires on June 30, 2015, unless a
508.6different expiration date is explicit.

508.7    Sec. 16. EFFECTIVE DATE.
508.8This article is effective July 1, 2013, unless a different effective date is specified.

508.11

Section 1. HUMAN SERVICES APPROPRIATIONS.

508.12The sums shown in the columns marked "Appropriations" are added to or, if shown
508.13in parentheses, subtracted from the appropriations in article 14 to the agencies and for the
508.14purposes specified in this article. The appropriations are from the general fund or other
508.15named fund and are available for the fiscal years indicated for each purpose. The figures
508.16"2014" and "2015" used in this article mean that the addition to or subtraction from the
508.17appropriation listed under them is available for the fiscal year ending June 30, 2014, or
508.18June 30, 2015, respectively. Supplemental appropriations and reductions to appropriations
508.19for the fiscal year ending June 30, 2014, are effective the day following final enactment
508.20unless a different effective date is explicit.

508.21				APPROPRIATIONS
508.22				Available for the Year
508.23				Ending June 30
508.24					2014		2015

508.25 508.26

Sec. 2. COMMISSIONER OF HUMAN SERVICES

508.27

Subdivision 1.Total Appropriation

$

1,906,000

$

2,047,000

508.28	Appropriations by Fund
508.29		2014	2015
508.30	General	1,906,000	2,047,000

508.31Reform 2020 Contingency. The
508.32appropriation from the general fund may
508.33be adjusted as provided in article 2, section
509.149, in order to implement Reform 2020 and
509.2systems modernization.

509.3

Subd. 2.Central Office Operations

509.4

(a) Operations

3,384,000

14,506,000

509.5Systems Modernization Transfer. If
509.6contingent funding is fully or partially
509.7disbursed as provided in article 2, section 49,
509.8and transferred to the state systems account,
509.9the unexpended balance of that appropriation
509.10must be transferred to the Office of Enterprise
509.11Technology in accordance with clause (2)
509.12of the systems modernization provision in
509.13article 14. Contingent funding under this
509.14provision must not exceed $16,992,000 for
509.15the biennium.

509.16

(b) Children and Families

109,000

206,000

509.17

(c) Health Care

100,000

100,000

509.18

(d) Continuing Care

5,236,000

5,541,000

509.19

Subd. 3.Forecasted Programs

509.20

(a) Group Residential Housing

(1,166,000)

(8,602,000)

509.21

(b) Medical Assistance

(3,770,000)

(10,086,000)

509.22

(c) Alternative Care

(6,981,000)

(4,394,000)

509.23

Subd. 4.Grant Programs

509.24

(a) Child and Community Services Grants

3,000,000

3,000,000

509.25

(b) Aging and Adult Services Grants

1,430,000

1,237,000

509.26

(c) Disability Grants

564,000

539,000