1.2relating to state government; establishing the health and human services budget;
1.3modifying provisions related to health care, continuing care, nursing facility
1.4admission, children and family services, human services licensing, chemical
1.5and mental health, program integrity, managed care organizations, waiver
1.6provider standards, home care, and the Department of Health; redesigning
1.7home and community-based services; establishing community first services and
1.8supports and Northstar Care for Children; providing for fraud investigations
1.9in the child care assistance program; establishing autism early intensive
1.10intervention benefits; creating a human services performance council; making
1.11technical changes; requiring a study; requiring reports; appropriating money;
1.12repealing MinnesotaCare;amending Minnesota Statutes 2012, sections 13.381,
1.13subdivisions 2, 10; 13.411, subdivision 7; 13.461, by adding subdivisions;
1.1416A.724, subdivision 3; 16C.10, subdivision 5; 16C.155, subdivision 1; 62J.692,
1.15subdivisions 1, 3, 4, 5, 7a, 9, by adding a subdivision; 62Q.19, subdivision 1;
1.16103I.005, by adding a subdivision; 103I.521; 119B.05, subdivision 1; 119B.13,
1.17subdivisions 1, 7; 144.051, by adding subdivisions; 144.0724, subdivisions
1.184, 6; 144.123, subdivision 1; 144.125, subdivision 1; 144.212; 144.213;
1.19144.215, subdivisions 3, 4; 144.216, subdivision 1; 144.217, subdivision 2;
1.20144.218, subdivision 5; 144.225, subdivisions 1, 4, 7, 8; 144.226; 144.966,
1.21subdivisions 2, 3a; 144.98, subdivisions 3, 5, by adding subdivisions; 144.99,
1.22subdivision 4; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision 4;
1.23145.906; 145.986; 145A.17, subdivision 1; 145C.01, subdivision 7; 148B.17,
1.24subdivision 2; 148E.065, subdivision 4a; 149A.02, subdivisions 1a, 2, 3, 4, 5,
1.2516, 23, 27, 34, 35, 37, by adding subdivisions; 149A.03; 149A.65, by adding
1.26subdivisions; 149A.70, subdivisions 1, 2, 3, 5; 149A.71, subdivisions 2, 4;
1.27149A.72, subdivisions 3, 9, by adding a subdivision; 149A.73, subdivisions 1,
1.282, 4; 149A.74; 149A.91, subdivision 9; 149A.93, subdivisions 3, 6; 149A.94;
1.29149A.96, subdivision 9; 151.01, subdivision 27; 151.19, subdivisions 1, 3;
1.30151.26, subdivision 1; 151.37, subdivision 4; 151.47, subdivision 1, by adding
1.31a subdivision; 151.49; 152.126; 174.30, subdivision 1; 214.12, by adding
1.32a subdivision; 214.40, subdivision 1; 243.166, subdivisions 4b, 7; 245.03,
1.33subdivision 1; 245.462, subdivision 20; 245.4661, subdivisions 5, 6; 245.4682,
1.34subdivision 2; 245.4875, subdivision 8; 245.4881, subdivision 1; 245A.02,
1.35subdivisions 1, 9, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04, subdivision
1.3613; 245A.042, subdivision 3; 245A.07, subdivisions 2a, 3; 245A.08, subdivision
1.372a; 245A.10; 245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.1435; 245A.144;
1.38245A.1444; 245A.16, subdivision 1; 245A.40, subdivision 5; 245A.50; 245C.04,
1.39by adding a subdivision; 245C.08, subdivision 1; 245C.32, subdivision
2.12; 245D.02; 245D.03; 245D.04; 245D.05; 245D.06; 245D.07; 245D.09;
2.2245D.10; 246.18, subdivision 8, by adding a subdivision; 252.27, subdivision
2.32a; 252.291, by adding a subdivision; 253B.10, subdivision 1; 254B.04,
2.4subdivision 1; 254B.13; 256.01, subdivisions 2, 24, 34, by adding subdivisions;
2.5256.82, subdivision 3; 256.9657, subdivision 3; 256.969, subdivisions 3a,
2.629; 256.975, subdivision 7, by adding subdivisions; 256.9754, subdivision
2.75, by adding subdivisions; 256B.02, by adding subdivisions; 256B.021, by
2.8adding subdivisions; 256B.04, subdivisions 18, 21, by adding a subdivision;
2.9256B.055, subdivisions 3a, 6, 10, 14, 15, by adding a subdivision; 256B.056,
2.10subdivisions 1, 1c, 3, 4, as amended, 5c, 10, by adding a subdivision; 256B.057,
2.11subdivisions 1, 10, by adding a subdivision; 256B.059, subdivision 1; 256B.06,
2.12subdivision 4; 256B.0623, subdivision 2; 256B.0625, subdivisions 13e, 19c, 31,
2.1339, 48, 56, 58, by adding subdivisions; 256B.0631, subdivision 1; 256B.064,
2.14subdivisions 1a, 1b, 2; 256B.0659, subdivision 21; 256B.0755, subdivision 3;
2.15256B.0756; 256B.0911, subdivisions 1, 1a, 3a, 4d, 6, 7, by adding a subdivision;
2.16256B.0913, subdivision 4, by adding a subdivision; 256B.0915, subdivisions 3a,
2.175, by adding a subdivision; 256B.0916, by adding a subdivision; 256B.0917,
2.18subdivisions 6, 13, by adding subdivisions; 256B.092, subdivisions 11, 12, by
2.19adding a subdivision; 256B.0943, subdivisions 1, 2, 7, by adding a subdivision;
2.20256B.0946; 256B.095; 256B.0951, subdivisions 1, 4; 256B.0952, subdivisions 1,
2.215; 256B.0955; 256B.097, subdivisions 1, 3; 256B.196, subdivision 2; 256B.431,
2.22subdivision 44; 256B.434, subdivision 4; 256B.437, subdivision 6; 256B.439,
2.23subdivisions 1, 2, 3, 4, by adding a subdivision; 256B.441, subdivisions 13,
2.2453, 55, 56, 62; 256B.49, subdivisions 11a, 12, 14, 15, by adding subdivisions;
2.25256B.4912, subdivisions 1, 2, 3, 7, by adding subdivisions; 256B.4913,
2.26subdivisions 5, 6, by adding a subdivision; 256B.492; 256B.493, subdivision 2;
2.27256B.501, by adding a subdivision; 256B.5011, subdivision 2; 256B.5012, by
2.28adding subdivisions; 256B.69, subdivisions 5c, 31, by adding a subdivision;
2.29256B.694; 256B.76, subdivisions 1, 2, 4, by adding a subdivision; 256B.761;
2.30256B.764; 256B.766; 256D.44, subdivision 5; 256I.05, subdivision 1e, by
2.31adding a subdivision; 256J.08, subdivision 24; 256J.21, subdivision 3; 256J.24,
2.32subdivisions 5, 5a, 7; 256J.621; 256J.626, subdivision 7; 256K.45; 256L.01,
2.33subdivisions 3a, 5, by adding subdivisions; 256L.02, subdivision 2, by adding
2.34subdivisions; 256L.03, subdivisions 1, 1a, 3, 5, 6, by adding a subdivision;
2.35256L.04, subdivisions 1, 7, 8, 10, 12, by adding subdivisions; 256L.05,
2.36subdivisions 1, 2, 3, 3c; 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3;
2.37256L.09, subdivision 2; 256L.11, subdivisions 1, 3; 256L.15, subdivisions 1, 2;
2.38256M.40, subdivision 1; 257.75, subdivision 7; 257.85, subdivision 11; 259A.05,
2.39subdivision 5; 259A.20, subdivision 4; 260B.007, subdivisions 6, 16; 260C.007,
2.40subdivisions 6, 31; 260C.635, subdivision 1; 299C.093; 471.59, subdivision 1;
2.41517.001; 518A.60; 524.5-118, subdivision 1, by adding a subdivision; 524.5-303;
2.42524.5-316; 524.5-403; 524.5-420; 626.556, subdivisions 2, 3, 10d; 626.557,
2.43subdivisions 4, 9, 9a, 9e; 626.5572, subdivision 13; Laws 1998, chapter 407,
2.44article 6, section 116; Laws 2011, First Special Session chapter 9, article 7,
2.45section 39, subdivision 14; Laws 2012, chapter 247, article 1, section 28; article
2.466, section 4; Laws 2013, chapter 1, sections 1; 6; proposing coding for new law in
2.47Minnesota Statutes, chapters 144; 144A; 145; 149A; 151; 214; 245; 245A; 245D;
2.48254B; 256B; 256J; 256L; proposing coding for new law as Minnesota Statutes,
2.49chapter 245E; repealing Minnesota Statutes 2012, sections 62J.693; 103I.005,
2.50subdivision 20; 144.123, subdivision 2; 144A.46; 144A.461; 149A.025;
2.51149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8;
2.52149A.45, subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7;
2.53149A.52, subdivision 5a; 149A.53, subdivision 9; 151.19, subdivision 2; 151.25;
2.54151.45; 151.47, subdivision 2; 151.48; 245A.655; 245B.01; 245B.02; 245B.03;
2.55245B.031; 245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06;
2.56245B.07; 245B.08; 245D.08; 256B.055, subdivisions 3, 5, 10b; 256B.056,
2.57subdivision 5b; 256B.057, subdivisions 1c, 2; 256B.0911, subdivisions 4a, 4b,
2.584c; 256B.0917, subdivisions 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.096,
3.1subdivisions 1, 2, 3, 4; 256B.49, subdivision 16a; 256B.4913, subdivisions 1, 2,
3.23, 4; 256B.5012, subdivision 13; 256J.24, subdivision 6; 256L.01, subdivisions
3.33, 4a; 256L.02, subdivision 3; 256L.03, subdivision 4; 256L.031; 256L.04,
3.4subdivisions 1b, 2a, 7a, 9; 256L.07, subdivisions 1, 4, 5, 8, 9; 256L.09,
3.5subdivisions 1, 4, 5, 6, 7; 256L.11, subdivisions 2a, 5, 6; 256L.12, subdivisions
3.61, 2, 3, 4, 5, 6, 7, 8, 9a, 9b; 256L.17, subdivisions 1, 2, 3, 4, 5; 485.14;
3.7609.093; Laws 2011, First Special Session chapter 9, article 7, section 54, as
3.8amended; Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
3.94668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035;
3.104668.0040; 4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075;
3.114668.0080; 4668.0100; 4668.0110; 4668.0120; 4668.0130; 4668.0140;
3.124668.0150; 4668.0160; 4668.0170; 4668.0180; 4668.0190; 4668.0200;
3.134668.0218; 4668.0220; 4668.0230; 4668.0240; 4668.0800; 4668.0805;
3.144668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 4668.0835;
3.154668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
3.164669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; 4669.0050.
3.17BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:


3.21    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
3.22    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
3.23participation pertaining to administrative costs of the Minnesota health care reform waiver
3.24shall be deposited as nondedicated revenue in the health care access fund. Receipts
3.25received as a result of federal participation pertaining to grants shall be deposited in the
3.26federal fund and shall offset health care access funds for payments to providers. All federal
3.27funding received by Minnesota for implementation and administration of MinnesotaCare
3.28as a basic health program, as authorized in section 1331 of the Affordable Care Act,
3.29Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and
3.30shall be deposited into the health care access fund. Federal funding that is received for
3.31implementing and administering MinnesotaCare as a basic health program and deposited in
3.32the fund shall be used only for that program to purchase health care coverage for enrollees
3.33and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.
3.34EFFECTIVE DATE.This section is effective January 1, 2015.

3.35    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
3.36    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
3.37Regulations, title 25, part 20, persons eligible for medical assistance benefits under
3.38sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
3.39the income standards of section 256B.056, subdivision 4, and persons eligible for general
4.1assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
4.2dependency fund services. State money appropriated for this paragraph must be placed in
4.3a separate account established for this purpose.
4.4Persons with dependent children who are determined to be in need of chemical
4.5dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
4.6a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
4.7local agency to access needed treatment services. Treatment services must be appropriate
4.8for the individual or family, which may include long-term care treatment or treatment in a
4.9facility that allows the dependent children to stay in the treatment facility. The county
4.10shall pay for out-of-home placement costs, if applicable.
4.11(b) A person not entitled to services under paragraph (a), but with family income
4.12that is less than 215 percent of the federal poverty guidelines for the applicable family
4.13size, shall be eligible to receive chemical dependency fund services within the limit
4.14of funds appropriated for this group for the fiscal year. If notified by the state agency
4.15of limited funds, a county must give preferential treatment to persons with dependent
4.16children who are in need of chemical dependency treatment pursuant to an assessment
4.17under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
4.186 , or 260C.212. A county may spend money from its own sources to serve persons under
4.19this paragraph. State money appropriated for this paragraph must be placed in a separate
4.20account established for this purpose.
4.21(c) Persons whose income is between 215 percent and 412 percent of the federal
4.22poverty guidelines for the applicable family size shall be eligible for chemical dependency
4.23services on a sliding fee basis, within the limit of funds appropriated for this group for the
4.24fiscal year. Persons eligible under this paragraph must contribute to the cost of services
4.25according to the sliding fee scale established under subdivision 3. A county may spend
4.26money from its own sources to provide services to persons under this paragraph. State
4.27money appropriated for this paragraph must be placed in a separate account established
4.28for this purpose.

4.29    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
4.30to read:
4.31    Subd. 35. Federal approval. (a) The commissioner shall seek federal authority
4.32from the U.S. Department of Health and Human Services necessary to operate a health
4.33coverage program for Minnesotans with incomes up to 275 percent of the federal poverty
4.34guidelines (FPG). The proposal shall seek to secure all federal funding available from at
4.35least the following services:
5.1(1) all premium tax credits and cost sharing subsidies available under United States
5.2Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
5.3with incomes above 133 percent and at or below 275 percent of the federal poverty
5.4guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as
5.5defined in section 62V.02;
5.6(2) Medicaid funding; and
5.7(3) other funding sources identified by the commissioner that support coverage or
5.8care redesign in Minnesota.
5.9(b) Funding received shall be used to design and implement a health coverage
5.10program that creates a single streamlined program and meets the needs of Minnesotans with
5.11incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
5.12(1) payment reform characteristics included in the health care delivery system and
5.13accountable care organization payment models;
5.14(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
5.15needs in different income and health status situations and can provide a more seamless
5.16transition from public to private health care coverage;
5.17(3) flexibility in co-payment or premium structures to incent patients to seek
5.18high-quality, low-cost care settings; and
5.19(4) flexibility in premium structures to ease the transition from public to private
5.20health care coverage.
5.21(c) The commissioner shall develop and submit a proposal consistent with the above
5.22criteria and shall seek all federal authority necessary to implement the health coverage
5.23program. In developing the request, the commissioner shall consult with appropriate
5.24stakeholder groups and consumers.
5.25(d) The commissioner is authorized to seek any available waivers or federal
5.26approvals to accomplish the goals under paragraph (b) prior to 2017.
5.27(e) The commissioner shall report to the chairs and ranking minority members of
5.28the legislative committees with jurisdiction over health and human services policy and
5.29financing by January 15, 2015, on the progress of receiving a federal waiver and shall
5.30make recommendations on any legislative changes necessary to accomplish the project
5.31in this subdivision. Any implementation of the waiver that requires a state financial
5.32contribution shall be contingent on legislative action approving the contribution.
5.33(f) The commissioner is authorized to accept and expend federal funds that support
5.34the purposes of this subdivision.

6.1    Sec. 4. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.2to read:
6.3    Subd. 18. Caretaker relative. "Caretaker relative" means a relative, by blood,
6.4adoption, or marriage, of a child under age 19 with whom the child is living and who
6.5assumes primary responsibility for the child's care.
6.6EFFECTIVE DATE.This section is effective January 1, 2014.

6.7    Sec. 5. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
6.8to read:
6.9    Subd. 19. Insurance affordability program. "Insurance affordability program"
6.10means one of the following programs:
6.11(1) medical assistance under this chapter;
6.12(2) a program that provides advance payments of the premium tax credits established
6.13under section 36B of the Internal Revenue Code or cost-sharing reductions established
6.14under section 1402 of the Affordable Care Act;
6.15(3) MinnesotaCare as defined in chapter 256L; and
6.16(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.
6.17EFFECTIVE DATE.This section is effective the day following final enactment.

6.18    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
6.19    Subd. 18. Applications for medical assistance. (a) The state agency may take
6.20 shall accept applications for medical assistance and conduct eligibility determinations for
6.21MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web
6.22site, and through other commonly available electronic means.
6.23    (b) The commissioner of human services shall modify the Minnesota health care
6.24programs application form to add a question asking applicants whether they have ever
6.25served in the United States military.
6.26    (c) For each individual who submits an application or whose eligibility is subject to
6.27renewal or whose eligibility is being redetermined pursuant to a change in circumstances,
6.28if the agency determines the individual is not eligible for medical assistance, the agency
6.29shall determine potential eligibility for other insurance affordability programs.
6.30EFFECTIVE DATE.This section is effective January 1, 2014.

6.31    Sec. 7. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
7.1    Subd. 3a. Families with children. Beginning July 1, 2002, Medical assistance may
7.2be paid for a person who is a child under the age of 18, or age 18 if a full-time student
7.3in a secondary school, or in the equivalent level of vocational or technical training, and
7.4reasonably expected to complete the program before reaching age 19; the parent or
7.5stepparent of a dependent child under the age of 19, including a pregnant woman; or a
7.6caretaker relative of a dependent child under the age of 19.
7.7EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
7.8approval, whichever is later. The commissioner of human services shall notify the revisor
7.9of statutes when federal approval is obtained.

7.10    Sec. 8. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
7.11    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
7.12for a pregnant woman who has written verification of a positive pregnancy test from a
7.13physician or licensed registered nurse, who meets the other eligibility criteria of this
7.14section and whose unborn child would be eligible as a needy child under subdivision 10 if
7.15born and living with the woman. In accordance with Code of Federal Regulations, title
7.1642, section 435.956, the commissioner must accept self-attestation of pregnancy unless
7.17the agency has information that is not reasonably compatible with such attestation. For
7.18purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
7.19EFFECTIVE DATE.This section is effective January 1, 2014.

7.20    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
7.21    Subd. 10. Infants. Medical assistance may be paid for an infant less than one year
7.22of age, whose mother was eligible for and receiving medical assistance at the time of birth
7.23or who is less than two years of age and is in a family with countable income that is equal
7.24to or less than the income standard established under section 256B.057, subdivision 1.
7.25EFFECTIVE DATE.This section is effective January 1, 2014.

7.26    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
7.27    Subd. 15. Adults without children. Medical assistance may be paid for a person
7.28who is:
7.29(1) at least age 21 and under age 65;
7.30(2) not pregnant;
7.31(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
7.32of the Social Security Act;
8.1(4) not an adult in a family with children as defined in section 256L.01, subdivision
8.23a ; and not otherwise eligible under subdivision 7 as a person who meets the categorical
8.3eligibility requirements of the supplemental security income program;
8.4(5) not enrolled under subdivision 7 as a person who would meet the categorical
8.5eligibility requirements of the supplemental security income program except for excess
8.6income or assets; and
8.7(5) (6) not described in another subdivision of this section.
8.8EFFECTIVE DATE.This section is effective January 1, 2014.

8.9    Sec. 11. Minnesota Statutes 2012, section 256B.055, is amended by adding a
8.10subdivision to read:
8.11    Subd. 17. Adults who were in foster care at the age of 18. Medical assistance may
8.12be paid for a person under 26 years of age who was in foster care under the commissioner's
8.13responsibility on the date of attaining 18 years of age, and who was enrolled in medical
8.14assistance under the state plan or a waiver of the plan while in foster care, in accordance
8.15with section 2004 of the Affordable Care Act.
8.16EFFECTIVE DATE.This section is effective January 1, 2014.

8.17    Sec. 12. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
8.18    Subdivision 1. Residency. To be eligible for medical assistance, a person must
8.19reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
8.20 in accordance with the rules of the state agency Code of Federal Regulations, title 42,
8.21section 435.403.
8.22EFFECTIVE DATE.This section is effective January 1, 2014.

8.23    Sec. 13. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
8.24    Subd. 1c. Families with children income methodology. (a)(1) [Expired, 1Sp2003
8.25c 14 art 12 s 17]
8.26(2) For applications processed within one calendar month prior to July 1, 2003,
8.27eligibility shall be determined by applying the income standards and methodologies in
8.28effect prior to July 1, 2003, for any months in the six-month budget period before July
8.291, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
8.30months in the six-month budget period on or after that date. The income standards for
8.31each month shall be added together and compared to the applicant's total countable income
8.32for the six-month budget period to determine eligibility.
9.1(3) For children ages one through 18 whose eligibility is determined under section
9.2256B.057, subdivision 2, the following deductions shall be applied to income counted
9.3toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
9.416, 1996: $90 work expense, dependent care, and child support paid under court order.
9.5This clause is effective October 1, 2003.
9.6(b) For families with children whose eligibility is determined using the standard
9.7specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
9.8earned income shall be disregarded for up to four months and the following deductions
9.9shall be applied to each individual's income counted toward eligibility as allowed under
9.10the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
9.11under court order.
9.12(c) If the four-month disregard in paragraph (b) has been applied to the wage
9.13earner's income for four months, the disregard shall not be applied again until the wage
9.14earner's income has not been considered in determining medical assistance eligibility for
9.1512 consecutive months.
9.16(d)(b) The commissioner shall adjust the income standards under this section each
9.17July 1 by the annual update of the federal poverty guidelines following publication by the
9.18United States Department of Health and Human Services except that the income standards
9.19shall not go below those in effect on July 1, 2009.
9.20(e) (c) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
9.21organization to or for the benefit of the child with a life-threatening illness must be
9.22disregarded from income.

9.23    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
9.24    Subd. 3. Asset limitations for certain individuals and families. (a) To be
9.25eligible for medical assistance, a person must not individually own more than $3,000 in
9.26assets, or if a member of a household with two family members, husband and wife, or
9.27parent and child, the household must not own more than $6,000 in assets, plus $200 for
9.28each additional legal dependent. In addition to these maximum amounts, an eligible
9.29individual or family may accrue interest on these amounts, but they must be reduced to the
9.30maximum at the time of an eligibility redetermination. The accumulation of the clothing
9.31and personal needs allowance according to section 256B.35 must also be reduced to the
9.32maximum at the time of the eligibility redetermination. The value of assets that are not
9.33considered in determining eligibility for medical assistance is the value of those assets
9.34excluded under the supplemental security income program for aged, blind, and disabled
9.35persons, with the following exceptions:
10.1(1) household goods and personal effects are not considered;
10.2(2) capital and operating assets of a trade or business that the local agency determines
10.3are necessary to the person's ability to earn an income are not considered;
10.4(3) motor vehicles are excluded to the same extent excluded by the supplemental
10.5security income program;
10.6(4) assets designated as burial expenses are excluded to the same extent excluded by
10.7the supplemental security income program. Burial expenses funded by annuity contracts
10.8or life insurance policies must irrevocably designate the individual's estate as contingent
10.9beneficiary to the extent proceeds are not used for payment of selected burial expenses;
10.10(5) for a person who no longer qualifies as an employed person with a disability due
10.11to loss of earnings, assets allowed while eligible for medical assistance under section
10.12256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
10.13of ineligibility as an employed person with a disability, to the extent that the person's total
10.14assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
10.15    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
10.169 , is age 65 or older and has been enrolled during each of the 24 consecutive months
10.17before the person's 65th birthday, the assets owned by the person and the person's spouse
10.18must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
10.19when determining eligibility for medical assistance under section 256B.055, subdivision
10.207 . The income of a spouse of a person enrolled in medical assistance under section
10.21256B.057, subdivision 9 , during each of the 24 consecutive months before the person's
10.2265th birthday must be disregarded when determining eligibility for medical assistance
10.23under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
10.24the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
10.25is required to have qualified for medical assistance under section 256B.057, subdivision 9,
10.26prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
10.27(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
10.28required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
10.29Law 111-5. For purposes of this clause, an American Indian is any person who meets the
10.30definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
10.31(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
10.3215.
10.33EFFECTIVE DATE.This section is effective January 1, 2014.

10.34    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, as amended by
10.35Laws 2013, chapter 1, section 5, is amended to read:
11.1    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
11.2section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
11.3the federal poverty guidelines. Effective January 1, 2000, and each successive January,
11.4recipients of supplemental security income may have an income up to the supplemental
11.5security income standard in effect on that date.
11.6(b) To be eligible for medical assistance, families and children may have an income
11.7up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
11.8AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
11.91996, shall be increased by three percent.
11.10(c) (b) Effective January 1, 2014, to be eligible for medical assistance, under section
11.11256B.055, subdivision 3a , a parent or caretaker relative may have an income up to 133
11.12percent of the federal poverty guidelines for the household size.
11.13(d) (c) To be eligible for medical assistance under section 256B.055, subdivision
11.1415 , a person may have an income up to 133 percent of federal poverty guidelines for
11.15the household size.
11.16(e) (d) To be eligible for medical assistance under section 256B.055, subdivision
11.1716 , a child age 19 to 20 may have an income up to 133 percent of the federal poverty
11.18guidelines for the household size.
11.19(f) (e) To be eligible for medical assistance under section 256B.055, subdivision 3a,
11.20a child under age 19 may have income up to 275 percent of the federal poverty guidelines
11.21for the household size or an equivalent standard when converted using modified adjusted
11.22gross income methodology as required under the Affordable Care Act. Children who are
11.23enrolled in medical assistance as of December 31, 2013, and are determined ineligible
11.24for medical assistance because of the elimination of income disregards under modified
11.25adjusted gross income methodology as defined in subdivision 1a remain eligible for
11.26medical assistance under the Children's Health Insurance Program Reauthorization Act
11.27of 2009, Public Law 111-3, until the date of their next regularly scheduled eligibility
11.28redetermination as required in section 256B.056, subdivision 7a.
11.29(f) In computing income to determine eligibility of persons under paragraphs (a) to
11.30(e) who are not residents of long-term care facilities, the commissioner shall disregard
11.31increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
11.32For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
11.33Administration unusual medical expense payments are considered income to the recipient.
11.34EFFECTIVE DATE.This section is effective January 1, 2014.

11.35    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
12.1    Subd. 5c. Excess income standard. (a) The excess income standard for families
12.2with children parents and caretaker relatives, pregnant women, infants, and children ages
12.3two through 20 is the standard specified in subdivision 4, paragraph (b).
12.4(b) The excess income standard for a person whose eligibility is based on blindness,
12.5disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
12.6family size. Effective July 1, 2002, the excess income standard for this paragraph shall
12.7equal 75 percent of the federal poverty guidelines.
12.8EFFECTIVE DATE.This section is effective January 1, 2014.

12.9    Sec. 17. Minnesota Statutes 2012, section 256B.056, is amended by adding a
12.10subdivision to read:
12.11    Subd. 7a. Periodic renewal of eligibility. (a) The commissioner shall make an
12.12annual redetermination of eligibility based on information contained in the enrollee's case
12.13file and other information available to the agency, including but not limited to information
12.14accessed through an electronic database, without requiring the enrollee to submit any
12.15information when sufficient data is available for the agency to renew eligibility.
12.16(b) If the commissioner cannot renew eligibility in accordance with paragraph (a),
12.17the commissioner must provide the enrollee with a prepopulated renewal form containing
12.18eligibility information available to the agency and permit the enrollee to submit the form
12.19with any corrections or additional information to the agency and sign the renewal form via
12.20any of the modes of submission specified in section 256B.04, subdivision 18.
12.21(c) An enrollee who is terminated for failure to complete the renewal process may
12.22subsequently submit the renewal form and required information within four months after
12.23the date of termination and have coverage reinstated without a lapse, if otherwise eligible
12.24under this chapter.
12.25(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
12.26required to renew eligibility every six months.
12.27EFFECTIVE DATE.This section is effective January 1, 2014.

12.28    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
12.29    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
12.30are applying for the continuation of medical assistance coverage following the end of the
12.3160-day postpartum period to update their income and asset information and to submit
12.32any required income or asset verification.
13.1    (b) The commissioner shall determine the eligibility of private-sector health care
13.2coverage for infants less than one year of age eligible under section 256B.055, subdivision
13.310 , or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
13.4if this is determined to be cost-effective.
13.5    (c) The commissioner shall verify assets and income for all applicants, and for all
13.6recipients upon renewal.
13.7    (d) The commissioner shall utilize information obtained through the electronic
13.8service established by the secretary of the United States Department of Health and Human
13.9Services and other available electronic data sources in Code of Federal Regulations, title
13.1042, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner
13.11shall establish standards to define when information obtained electronically is reasonably
13.12compatible with information provided by applicants and enrollees, including use of
13.13self-attestation, to accomplish real-time eligibility determinations and maintain program
13.14integrity.
13.15EFFECTIVE DATE.This section is effective January 1, 2014.

13.16    Sec. 19. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
13.17    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year
13.18 two years of age or a pregnant woman who has written verification of a positive pregnancy
13.19test from a physician or licensed registered nurse is eligible for medical assistance if the
13.20individual's countable family household income is equal to or less than 275 percent of the
13.21federal poverty guideline for the same family household size or an equivalent standard
13.22when converted using modified adjusted gross income methodology as required under
13.23the Affordable Care Act. For purposes of this subdivision, "countable family income"
13.24means the amount of income considered available using the methodology of the AFDC
13.25program under the state's AFDC plan as of July 16, 1996, as required by the Personal
13.26Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
13.27Law 104-193, except for the earned income disregard and employment deductions.
13.28    (2) For applications processed within one calendar month prior to the effective date,
13.29eligibility shall be determined by applying the income standards and methodologies in
13.30effect prior to the effective date for any months in the six-month budget period before
13.31that date and the income standards and methodologies in effect on the effective date for
13.32any months in the six-month budget period on or after that date. The income standards
13.33for each month shall be added together and compared to the applicant's total countable
13.34income for the six-month budget period to determine eligibility.
13.35    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
14.1    (2) For applications processed within one calendar month prior to July 1, 2003,
14.2eligibility shall be determined by applying the income standards and methodologies in
14.3effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
14.42003, and the income standards and methodologies in effect on the expiration date for any
14.5months in the six-month budget period on or after July 1, 2003. The income standards
14.6for each month shall be added together and compared to the applicant's total countable
14.7income for the six-month budget period to determine eligibility.
14.8    (3) An amount equal to the amount of earned income exceeding 275 percent of
14.9the federal poverty guideline, up to a maximum of the amount by which the combined
14.10total of 185 percent of the federal poverty guideline plus the earned income disregards
14.11and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
14.12by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
14.13Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
14.14pregnant women and infants less than one year of age.
14.15    (c) Dependent care and child support paid under court order shall be deducted from
14.16the countable income of pregnant women.
14.17    (d) (b) An infant born to a woman who was eligible for and receiving medical
14.18assistance on the date of the child's birth shall continue to be eligible for medical assistance
14.19without redetermination until the child's first birthday.
14.20EFFECTIVE DATE.This section is effective January 1, 2014.

14.21    Sec. 20. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
14.22    Subd. 10. Certain persons needing treatment for breast or cervical cancer. (a)
14.23Medical assistance may be paid for a person who:
14.24(1) has been screened for breast or cervical cancer by the Minnesota breast and
14.25cervical cancer control program, and program funds have been used to pay for the person's
14.26screening;
14.27(2) according to the person's treating health professional, needs treatment, including
14.28diagnostic services necessary to determine the extent and proper course of treatment, for
14.29breast or cervical cancer, including precancerous conditions and early stage cancer;
14.30(3) meets the income eligibility guidelines for the Minnesota breast and cervical
14.31cancer control program;
14.32(4) is under age 65;
14.33(5) is not otherwise eligible for medical assistance under United States Code, title
14.3442, section 1396a(a)(10)(A)(i); and
15.1(6) is not otherwise covered under creditable coverage, as defined under United
15.2States Code, title 42, section 1396a(aa).
15.3(b) Medical assistance provided for an eligible person under this subdivision shall
15.4be limited to services provided during the period that the person receives treatment for
15.5breast or cervical cancer.
15.6(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
15.7without meeting the eligibility criteria relating to income and assets in section 256B.056,
15.8subdivisions 1a to 5b 5a.
15.9EFFECTIVE DATE.This section is effective January 1, 2014.

15.10    Sec. 21. Minnesota Statutes 2012, section 256B.057, is amended by adding a
15.11subdivision to read:
15.12    Subd. 12. Presumptive eligibility determinations made by qualified hospitals.
15.13The commissioner shall establish a process to qualify hospitals that are participating
15.14providers under the medical assistance program to determine presumptive eligibility for
15.15medical assistance for applicants who may have a basis of eligibility using the modified
15.16adjusted gross income methodology as defined in section 256B.056, subdivision 1a,
15.17paragraph (b), clause (1).
15.18EFFECTIVE DATE.This section is effective January 1, 2014.

15.19    Sec. 22. Minnesota Statutes 2012, section 256B.059, subdivision 1, is amended to read:
15.20    Subdivision 1. Definitions. (a) For purposes of this section and sections 256B.058
15.21and 256B.0595, the terms defined in this subdivision have the meanings given them.
15.22    (b) "Community spouse" means the spouse of an institutionalized spouse.
15.23    (c) "Spousal share" means one-half of the total value of all assets, to the extent that
15.24either the institutionalized spouse or the community spouse had an ownership interest at
15.25the time of the first continuous period of institutionalization.
15.26    (d) "Assets otherwise available to the community spouse" means assets individually
15.27or jointly owned by the community spouse, other than assets excluded by subdivision 5,
15.28paragraph (c).
15.29    (e) "Community spouse asset allowance" is the value of assets that can be transferred
15.30under subdivision 3.
15.31    (f) "Institutionalized spouse" means a person who is:
15.32    (1) in a hospital, nursing facility, or intermediate care facility for persons with
15.33developmental disabilities, or receiving home and community-based services under section
16.1256B.0915 , 256B.092, or 256B.49 and is expected to remain in the facility or institution
16.2or receive the home and community-based services for at least 30 consecutive days; and
16.3    (2) married to a person who is not in a hospital, nursing facility, or intermediate
16.4care facility for persons with developmental disabilities, and is not receiving home and
16.5community-based services under section 256B.0915, 256B.092, or 256B.49.
16.6    (g) "For the sole benefit of" means no other individual or entity can benefit in any
16.7way from the assets or income at the time of a transfer or at any time in the future.
16.8    (h) "Continuous period of institutionalization" means a 30-consecutive-day period
16.9of time in which a person is expected to stay in a medical or long-term care facility, or
16.10receive home and community-based services that would qualify for coverage under the
16.11elderly waiver (EW) or alternative care (AC) programs section 256B.0913, 256B.0915,
16.12256B.092, or 256B.49. For a stay in a facility, the 30-consecutive-day period begins
16.13on the date of entry into a medical or long-term care facility. For receipt of home and
16.14community-based services, the 30-consecutive-day period begins on the date that the
16.15following conditions are met:
16.16    (1) the person is receiving services that meet the nursing facility level of care
16.17determined by a long-term care consultation;
16.18    (2) the person has received the long-term care consultation within the past 60 days;
16.19    (3) the services are paid by the EW program under section 256B.0915 or the AC
16.20program under section 256B.0913, 256B.0915, 256B.092, or 256B.49 or would qualify
16.21for payment under the EW or AC programs those sections if the person were otherwise
16.22eligible for either program, and but for the receipt of such services the person would have
16.23resided in a nursing facility; and
16.24    (4) the services are provided by a licensed provider qualified to provide home and
16.25community-based services.
16.26EFFECTIVE DATE.This section is effective January 1, 2014.

16.27    Sec. 23. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
16.28    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
16.29to citizens of the United States, qualified noncitizens as defined in this subdivision, and
16.30other persons residing lawfully in the United States. Citizens or nationals of the United
16.31States must cooperate in obtaining satisfactory documentary evidence of citizenship or
16.32nationality according to the requirements of the federal Deficit Reduction Act of 2005,
16.33Public Law 109-171.
16.34(b) "Qualified noncitizen" means a person who meets one of the following
16.35immigration criteria:
17.1(1) admitted for lawful permanent residence according to United States Code, title 8;
17.2(2) admitted to the United States as a refugee according to United States Code,
17.3title 8, section 1157;
17.4(3) granted asylum according to United States Code, title 8, section 1158;
17.5(4) granted withholding of deportation according to United States Code, title 8,
17.6section 1253(h);
17.7(5) paroled for a period of at least one year according to United States Code, title 8,
17.8section 1182(d)(5);
17.9(6) granted conditional entrant status according to United States Code, title 8,
17.10section 1153(a)(7);
17.11(7) determined to be a battered noncitizen by the United States Attorney General
17.12according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
17.13title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
17.14(8) is a child of a noncitizen determined to be a battered noncitizen by the United
17.15States Attorney General according to the Illegal Immigration Reform and Immigrant
17.16Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
17.17Public Law 104-200; or
17.18(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
17.19Law 96-422, the Refugee Education Assistance Act of 1980.
17.20(c) All qualified noncitizens who were residing in the United States before August
17.2122, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
17.22medical assistance with federal financial participation.
17.23(d) Beginning December 1, 1996, qualified noncitizens who entered the United
17.24States on or after August 22, 1996, and who otherwise meet the eligibility requirements
17.25of this chapter are eligible for medical assistance with federal participation for five years
17.26if they meet one of the following criteria:
17.27(1) refugees admitted to the United States according to United States Code, title 8,
17.28section 1157;
17.29(2) persons granted asylum according to United States Code, title 8, section 1158;
17.30(3) persons granted withholding of deportation according to United States Code,
17.31title 8, section 1253(h);
17.32(4) veterans of the United States armed forces with an honorable discharge for
17.33a reason other than noncitizen status, their spouses and unmarried minor dependent
17.34children; or
17.35(5) persons on active duty in the United States armed forces, other than for training,
17.36their spouses and unmarried minor dependent children.
18.1 Beginning July 1, 2010, children and pregnant women who are noncitizens
18.2described in paragraph (b) or who are lawfully present in the United States as defined
18.3in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
18.4eligibility requirements of this chapter, are eligible for medical assistance with federal
18.5financial participation as provided by the federal Children's Health Insurance Program
18.6Reauthorization Act of 2009, Public Law 111-3.
18.7(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
18.8are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
18.9subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
18.10Code, title 8, section 1101(a)(15).
18.11(f) Payment shall also be made for care and services that are furnished to noncitizens,
18.12regardless of immigration status, who otherwise meet the eligibility requirements of
18.13this chapter, if such care and services are necessary for the treatment of an emergency
18.14medical condition.
18.15(g) For purposes of this subdivision, the term "emergency medical condition" means
18.16a medical condition that meets the requirements of United States Code, title 42, section
18.171396b(v).
18.18(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
18.19of an emergency medical condition are limited to the following:
18.20(i) services delivered in an emergency room or by an ambulance service licensed
18.21under chapter 144E that are directly related to the treatment of an emergency medical
18.22condition;
18.23(ii) services delivered in an inpatient hospital setting following admission from an
18.24emergency room or clinic for an acute emergency condition; and
18.25(iii) follow-up services that are directly related to the original service provided
18.26to treat the emergency medical condition and are covered by the global payment made
18.27to the provider.
18.28    (2) Services for the treatment of emergency medical conditions do not include:
18.29(i) services delivered in an emergency room or inpatient setting to treat a
18.30nonemergency condition;
18.31(ii) organ transplants, stem cell transplants, and related care;
18.32(iii) services for routine prenatal care;
18.33(iv) continuing care, including long-term care, nursing facility services, home health
18.34care, adult day care, day training, or supportive living services;
18.35(v) elective surgery;
19.1(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
19.2part of an emergency room visit;
19.3(vii) preventative health care and family planning services;
19.4(viii) dialysis;
19.5(ix) chemotherapy or therapeutic radiation services;
19.6(x) rehabilitation services;
19.7(xi) physical, occupational, or speech therapy;
19.8(xii) transportation services;
19.9(xiii) case management;
19.10(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
19.11(xv) dental services;
19.12(xvi) hospice care;
19.13(xvii) audiology services and hearing aids;
19.14(xviii) podiatry services;
19.15(xix) chiropractic services;
19.16(xx) immunizations;
19.17(xxi) vision services and eyeglasses;
19.18(xxii) waiver services;
19.19(xxiii) individualized education programs; or
19.20(xxiv) chemical dependency treatment.
19.21(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented,
19.22nonimmigrants, or lawfully present in the United States as defined in Code of Federal
19.23Regulations, title 8, section 103.12, ineligible for federally funded medical assistance
19.24because of immigration status are not covered by a group health plan or health insurance
19.25coverage according to Code of Federal Regulations, title 42, section 457.310, and who
19.26otherwise meet the eligibility requirements of this chapter, are eligible for medical
19.27assistance through the period of pregnancy, including labor and delivery, and 60 days
19.28postpartum, to the extent federal funds are available under title XXI of the Social Security
19.29Act, and the state children's health insurance program.
19.30(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
19.31services from a nonprofit center established to serve victims of torture and are otherwise
19.32ineligible for medical assistance under this chapter are eligible for medical assistance
19.33without federal financial participation. These individuals are eligible only for the period
19.34during which they are receiving services from the center. Individuals eligible under this
19.35paragraph shall not be required to participate in prepaid medical assistance.
19.36EFFECTIVE DATE.This section is effective January 1, 2014.

20.1    Sec. 24. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
20.2    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
20.3for the quality of care based on standards established under subdivision 1, paragraph (b),
20.4clause (10), and the cost of care or utilization of services provided to its enrollees under
20.5subdivision 1, paragraph (b), clause (1).
20.6(b) A health care delivery system may contract and coordinate with providers and
20.7clinics for the delivery of services and shall contract with community health clinics,
20.8federally qualified health centers, community mental health centers or programs, county
20.9agencies, and rural clinics to the extent practicable.
20.10(c) A health care delivery system must demonstrate how its services will be
20.11coordinated with other services affecting its attributed patients' health, quality of care, and
20.12cost of care that are provided by other providers and county agencies in the local service
20.13area. The health care delivery system must document how other providers and counties,
20.14including county-based purchasing plans, will provide services to attributed patients of
20.15the health care delivery system, and how it will address applicable local needs, priorities,
20.16and public health goals. As part of this documentation, the health care delivery system
20.17must describe the involvement of local providers and counties, including county-based
20.18purchasing plans, in developing the application to participate in the demonstration project.
20.19EFFECTIVE DATE.This section is effective July 1, 2013, and applies to health
20.20care delivery system contracts entered into on or after that date.

20.21    Sec. 25. Minnesota Statutes 2012, section 256B.694, is amended to read:
20.22256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
20.23CONTRACT.
20.24    (a) MS 2010 [Expired, 2008 c 364 s 10]
20.25    (b) The commissioner shall consider, and may approve, contracting on a
20.26single-health plan basis with other county-based purchasing plans, or with other qualified
20.27health plans that have coordination arrangements with counties, to serve persons with a
20.28disability who voluntarily enroll enrolled in state public health care programs, in order
20.29to promote better coordination or integration of health care services, social services and
20.30other community-based services, provided that all requirements applicable to health plan
20.31purchasing, including those in section 256B.69, subdivision 23, are satisfied. Nothing in
20.32this paragraph supersedes or modifies the requirements in paragraph (a).

21.1    Sec. 26. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
21.2to read:
21.3    Subd. 1b. Affordable Care Act. "Affordable Care Act" means Public Law 111-148,
21.4as amended by the federal Health Care and Education Reconciliation Act of 2010, Public
21.5Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.

21.6    Sec. 27. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
21.7    Subd. 3a. Family with children. (a) "Family with children" means:
21.8(1) parents and their children residing in the same household; or
21.9(2) grandparents, foster parents, relative caretakers as defined in the medical
21.10assistance program, or legal guardians; and their wards who are children residing in the
21.11same household. "Family" has the meaning given for family and family size as defined
21.12in Code of Federal Regulations, title 26, section 1.36B-1.
21.13(b) The term includes children who are temporarily absent from the household in
21.14settings such as schools, camps, or parenting time with noncustodial parents.
21.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.16approval, whichever is later. The commissioner of human services shall notify the revisor
21.17of statutes when federal approval is obtained.

21.18    Sec. 28. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
21.19    Subd. 5. Income. (a) "Income" has the meaning given for earned and unearned
21.20income for families and children in the medical assistance program, according to the
21.21state's aid to families with dependent children plan in effect as of July 16, 1996. The
21.22definition does not include medical assistance income methodologies and deeming
21.23requirements. The earned income of full-time and part-time students under age 19 is
21.24not counted as income. Public assistance payments and supplemental security income
21.25are not excluded income modified adjusted gross income, as defined in Code of Federal
21.26Regulations, title 26, section 1.36B-1.
21.27(b) For purposes of this subdivision, and unless otherwise specified in this section,
21.28the commissioner shall use reasonable methods to calculate gross earned and unearned
21.29income including, but not limited to, projecting income based on income received within
21.30the past 30 days, the last 90 days, or the last 12 months.
21.31EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.32approval, whichever is later. The commissioner of human services shall notify the revisor
21.33of statutes when federal approval is obtained.

22.1    Sec. 29. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.2to read:
22.3    Subd. 6. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
22.4means the Minnesota Insurance Marketplace as defined in section 62V.02.

22.5    Sec. 30. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
22.6to read:
22.7    Subd. 7. Participating entity. "Participating entity" means a health carrier as
22.8defined in section 62A.01, subdivision 2; a county-based purchasing plan established
22.9under section 256B.692; an accountable care organization or other entity operating a
22.10health care delivery systems demonstration project authorized under section 256B.0755;
22.11an entity operating a county integrated health care delivery network pilot project
22.12authorized under section 256B.0756; or a network of health care providers established to
22.13offer services under MinnesotaCare.
22.14EFFECTIVE DATE.This section is effective January 1, 2015.

22.15    Sec. 31. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
22.16    Subd. 2. Commissioner's duties. (a) The commissioner shall establish an office
22.17for the state administration of this plan. The plan shall be used to provide covered health
22.18services for eligible persons. Payment for these services shall be made to all eligible
22.19providers participating entities under contract with the commissioner. The commissioner
22.20shall adopt rules to administer the MinnesotaCare program. The commissioner shall
22.21establish marketing efforts to encourage potentially eligible persons to receive information
22.22about the program and about other medical care programs administered or supervised by
22.23the Department of Human Services.
22.24(b) A toll-free telephone number and Web site must be used to provide information
22.25about medical programs and to promote access to the covered services.
22.26EFFECTIVE DATE.Paragraph (a) is effective January 1, 2015. Paragraph (b) is
22.27effective January 1, 2014.

22.28    Sec. 32. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
22.29to read:
22.30    Subd. 6. Federal approval. (a) The commissioner of human services shall seek
22.31federal approval to implement the MinnesotaCare program under this chapter as a basic
22.32health program. In any agreement with the Centers for Medicare and Medicaid Services
23.1to operate MinnesotaCare as a basic health program, the commissioner shall seek to
23.2include procedures to ensure that federal funding is predictable, stable, and sufficient
23.3to sustain ongoing operation of MinnesotaCare. These procedures must address issues
23.4related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
23.5and minimization of state financial risk. The commissioner shall consult with the
23.6commissioner of management and budget, when developing the proposal for establishing
23.7MinnesotaCare as a basic health program to be submitted to the Centers for Medicare
23.8and Medicaid Services.
23.9(b) The commissioner of human services, in consultation with the commissioner
23.10of management and budget, shall work with the Centers for Medicare and Medicaid
23.11Services to establish a process for reconciliation and adjustment of federal payments that
23.12balances state and federal liability over time. The commissioner of human services shall
23.13request that the United States secretary of health and human services hold the state, and
23.14enrollees, harmless in the reconciliation process for the first three years, to allow the state
23.15to develop a statistically valid methodology for predicting enrollment trends and their
23.16net effect on federal payments.
23.17(c) The commissioner of human services, through December 31, 2015, may modify
23.18the MinnesotaCare program as specified in this chapter, if it is necessary to enhance
23.19health benefits, expand provider access, or reduce cost-sharing and premiums in order
23.20to comply with the terms and conditions of federal approval as a basic health program.
23.21The commissioner may not reduce benefits, impose greater limits on access to providers,
23.22or increase cost-sharing and premiums by enrollees under the authority granted by this
23.23paragraph. If the commissioner modifies the terms and requirements for MinnesotaCare
23.24under this paragraph, the commissioner shall provide the legislature with notice of
23.25implementation of the modifications at least ten working days before notifying enrollees
23.26and participating entities. The costs of any changes to the program necessary to comply
23.27with federal approval shall not become part of the program's base funding for purposes of
23.28future budget forecasts.
23.29EFFECTIVE DATE.This section is effective the day following final enactment.

23.30    Sec. 33. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
23.31to read:
23.32    Subd. 7. Coordination with Minnesota Insurance Marketplace. MinnesotaCare
23.33shall be considered a public health care program for purposes of chapter 62V.
23.34EFFECTIVE DATE.This section is effective January 1, 2014.

24.1    Sec. 34. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
24.2    Subdivision 1. Covered health services. (a) "Covered health services" means the
24.3health services reimbursed under chapter 256B, with the exception of inpatient hospital
24.4services, special education services, private duty nursing services, adult dental care
24.5services other than services covered under section 256B.0625, subdivision 9, orthodontic
24.6services, nonemergency medical transportation services, personal care assistance and case
24.7management services, and nursing home or intermediate care facilities services, inpatient
24.8mental health services, and chemical dependency services.
24.9    (b) No public funds shall be used for coverage of abortion under MinnesotaCare
24.10except where the life of the female would be endangered or substantial and irreversible
24.11impairment of a major bodily function would result if the fetus were carried to term; or
24.12where the pregnancy is the result of rape or incest.
24.13    (c) Covered health services shall be expanded as provided in this section.
24.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.15approval, whichever is later. The commissioner of human services shall notify the revisor
24.16of statutes when federal approval is obtained.

24.17    Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
24.18    Subd. 1a. Pregnant women and Children; MinnesotaCare health care reform
24.19waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage
24.20of all services that are eligible for reimbursement under the medical assistance program
24.21according to chapter 256B, except that abortion services under MinnesotaCare shall be
24.22limited as provided under subdivision 1. Pregnant women and Children are exempt from
24.23the provisions of subdivision 5, regarding co-payments. Pregnant women and Children
24.24who are lawfully residing in the United States but who are not "qualified noncitizens" under
24.25title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
24.26Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
24.27of all services provided under the medical assistance program according to chapter 256B.
24.28EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.29approval, whichever is later. The commissioner of human services shall notify the revisor
24.30of statutes when federal approval is obtained.

24.31    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
24.32    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
24.33inpatient hospital services, including inpatient hospital mental health services and inpatient
25.1hospital and residential chemical dependency treatment, subject to those limitations
25.2necessary to coordinate the provision of these services with eligibility under the medical
25.3assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
25.4section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
25.52 , with family gross income that exceeds 200 percent of the federal poverty guidelines or
25.6215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
25.7pregnant, is subject to an annual limit of $10,000.
25.8    (b) Admissions for inpatient hospital services paid for under section 256L.11,
25.9subdivision 3 , must be certified as medically necessary in accordance with Minnesota
25.10Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
25.11    (1) all admissions must be certified, except those authorized under rules established
25.12under section 254A.03, subdivision 3, or approved under Medicare; and
25.13    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
25.14for admissions for which certification is requested more than 30 days after the day of
25.15admission. The hospital may not seek payment from the enrollee for the amount of the
25.16payment reduction under this clause.
25.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
25.18approval, whichever is later. The commissioner of human services shall notify the revisor
25.19of statutes when federal approval is obtained.

25.20    Sec. 37. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
25.21to read:
25.22    Subd. 4a. Loss ratio. Health coverage provided through the MinnesotaCare
25.23program must have a medical loss ratio of at least 85 percent, as defined using the loss
25.24ratio methodology described in section 1001 of the Affordable Care Act.
25.25EFFECTIVE DATE.This section is effective January 1, 2015.

25.26    Sec. 38. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
25.27    Subd. 5. Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
25.28 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
25.29requirements for all enrollees:
25.30    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
25.31subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
25.32    (2) (1) $3 per prescription for adult enrollees;
25.33    (3) (2) $25 for eyeglasses for adult enrollees;
26.1    (4) (3) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means
26.2an episode of service which is required because of a recipient's symptoms, diagnosis, or
26.3established illness, and which is delivered in an ambulatory setting by a physician or
26.4physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
26.5audiologist, optician, or optometrist;
26.6    (5) (4) $6 for nonemergency visits to a hospital-based emergency room for services
26.7provided through December 31, 2010, and $3.50 effective January 1, 2011; and
26.8(6) (5) a family deductible equal to the maximum amount allowed under Code of
26.9Federal Regulations, title 42, part 447.54.
26.10    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
26.11children under the age of 21.
26.12    (c) (b) Paragraph (a) does not apply to pregnant women and children under the
26.13age of 21.
26.14    (d) (c) Paragraph (a), clause (4) (3), does not apply to mental health services.
26.15    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
26.16poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
26.17and who are not pregnant shall be financially responsible for the coinsurance amount, if
26.18applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
26.19    (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
26.20or changes from one prepaid health plan to another during a calendar year, any charges
26.21submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
26.22expenses incurred by the enrollee for inpatient services, that were submitted or incurred
26.23prior to enrollment, or prior to the change in health plans, shall be disregarded.
26.24(g) (d) MinnesotaCare reimbursements to fee-for-service providers and payments to
26.25managed care plans or county-based purchasing plans shall not be increased as a result of
26.26the reduction of the co-payments in paragraph (a), clause (5) (4), effective January 1, 2011.
26.27(h) (e) The commissioner, through the contracting process under section 256L.12,
26.28may allow managed care plans and county-based purchasing plans to waive the family
26.29deductible under paragraph (a), clause (6) (5). The value of the family deductible shall not
26.30be included in the capitation payment to managed care plans and county-based purchasing
26.31plans. Managed care plans and county-based purchasing plans shall certify annually to the
26.32commissioner the dollar value of the family deductible.
26.33EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
26.34approval, whichever is later. The commissioner of human services shall notify the revisor
26.35of statutes when federal approval is obtained.

27.1    Sec. 39. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
27.2    Subd. 6. Lien. When the state agency provides, pays for, or becomes liable for
27.3covered health services, the agency shall have a lien for the cost of the covered health
27.4services upon any and all causes of action accruing to the enrollee, or to the enrollee's
27.5legal representatives, as a result of the occurrence that necessitated the payment for the
27.6covered health services. All liens under this section shall be subject to the provisions
27.7of section 256.015. For purposes of this subdivision, "state agency" includes prepaid
27.8health plans participating entities, under contract with the commissioner according to
27.9sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
27.10purchasing entities under section 256B.692 section 256L.121.
27.11EFFECTIVE DATE.This section is effective January 1, 2015.

27.12    Sec. 40. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
27.13    Subdivision 1. Families with children. (a) Families with children with family
27.14income above 133 percent of the federal poverty guidelines and equal to or less than
27.15275 200 percent of the federal poverty guidelines for the applicable family size shall be
27.16eligible for MinnesotaCare according to this section. All other provisions of sections
27.17256L.01 to 256L.18, including the insurance-related barriers to enrollment under section
27.18256L.07, shall apply unless otherwise specified.
27.19    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
27.20if the children are eligible. Children may be enrolled separately without enrollment by
27.21parents. However, if one parent in the household enrolls, both parents must enroll, unless
27.22other insurance is available. If one child from a family is enrolled, all children must
27.23be enrolled, unless other insurance is available. If one spouse in a household enrolls,
27.24the other spouse in the household must also enroll, unless other insurance is available.
27.25Families cannot choose to enroll only certain uninsured members.
27.26    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
27.27to the MinnesotaCare program. These persons are no longer counted in the parental
27.28household and may apply as a separate household.
27.29    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
27.30(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
27.318 , are exempt from the eligibility requirements of this subdivision.
27.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.33approval, whichever is later. The commissioner of human services shall notify the revisor
27.34of statutes when federal approval is obtained.

28.1    Sec. 41. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
28.2to read:
28.3    Subd. 1c. General requirements. To be eligible for coverage under MinnesotaCare,
28.4a person must meet the eligibility requirements of this section. A person eligible for
28.5MinnesotaCare shall not be considered a qualified individual under section 1312 of the
28.6Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
28.7through the Minnesota Insurance Marketplace under chapter 62V.
28.8EFFECTIVE DATE.This section is effective January 1, 2014.

28.9    Sec. 42. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
28.10    Subd. 7. Single adults and households with no children. (a) The definition of
28.11eligible persons includes all individuals and households families with no children who
28.12have gross family incomes that are above 133 percent and equal to or less than 200 percent
28.13of the federal poverty guidelines for the applicable family size.
28.14    (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
28.15and households with no children who have gross family incomes that are equal to or less
28.16than 250 percent of the federal poverty guidelines.
28.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
28.18approval, whichever is later. The commissioner of human services shall notify the revisor
28.19of statutes when federal approval is obtained.

28.20    Sec. 43. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
28.21    Subd. 8. Applicants potentially eligible for medical assistance. (a) Individuals
28.22who receive supplemental security income or retirement, survivors, or disability benefits
28.23due to a disability, or other disability-based pension, who qualify under subdivision 7, but
28.24who are potentially eligible for medical assistance without a spenddown shall be allowed
28.25to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
28.26conditions of eligibility. The commissioner shall identify and refer the applications of
28.27such individuals to their county social service agency. The county and the commissioner
28.28shall cooperate to ensure that the individuals obtain medical assistance coverage for any
28.29months for which they are eligible.
28.30(b) The enrollee must cooperate with the county social service agency in determining
28.31medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
28.32cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
28.33from the plan within one calendar month. Persons disenrolled for nonapplication for
29.1medical assistance may not reenroll until they have obtained a medical assistance
29.2eligibility determination. Persons disenrolled for noncooperation with medical assistance
29.3may not reenroll until they have cooperated with the county agency and have obtained a
29.4medical assistance eligibility determination.
29.5(c) Beginning January 1, 2000, Counties that choose to become MinnesotaCare
29.6enrollment sites shall consider MinnesotaCare applications to also be applications for
29.7medical assistance. Applicants who are potentially eligible for medical assistance, except
29.8for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
29.9medical assistance.
29.10(d) The commissioner shall redetermine provider payments made under
29.11MinnesotaCare to the appropriate medical assistance payments for those enrollees who
29.12subsequently become eligible for medical assistance.
29.13EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.14approval, whichever is later. The commissioner of human services shall notify the revisor
29.15of statutes when federal approval is obtained.

29.16    Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
29.17    Subd. 10. Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to
29.18citizens or nationals of the United States, qualified noncitizens, and other persons residing
29.19 lawfully in the United States present noncitizens as defined in Code of Federal Regulations,
29.20title 8, section 103.12. Undocumented noncitizens and nonimmigrants are ineligible for
29.21MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in one
29.22or more of the classes listed in United States Code, title 8, section 1101(a)(15), and an
29.23undocumented noncitizen is an individual who resides in the United States without the
29.24approval or acquiescence of the United States Citizenship and Immigration Services.
29.25Families with children who are citizens or nationals of the United States must cooperate in
29.26obtaining satisfactory documentary evidence of citizenship or nationality according to the
29.27requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.
29.28(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and
29.29individuals who are lawfully present and ineligible for medical assistance by reason of
29.30immigration status and who have incomes equal to or less than 200 percent of federal
29.31poverty guidelines.
29.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.33approval, whichever is later. The commissioner of human services shall notify the revisor
29.34of statutes when federal approval is obtained.

30.1    Sec. 45. Minnesota Statutes 2012, section 256L.04, subdivision 12, is amended to read:
30.2    Subd. 12. Persons in detention. Beginning January 1, 1999, An applicant or
30.3enrollee residing in a correctional or detention facility is not eligible for MinnesotaCare,
30.4unless the applicant or enrollee is awaiting disposition of charges. An enrollee residing in
30.5a correctional or detention facility is not eligible at renewal of eligibility under section
30.6256L.05, subdivision 3a.
30.7EFFECTIVE DATE.This section is effective January 1, 2014.

30.8    Sec. 46. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
30.9to read:
30.10    Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
30.11medical assistance under chapter 256B are not eligible for MinnesotaCare under this
30.12section.
30.13(b) The commissioner shall coordinate eligibility and coverage to ensure that
30.14individuals transitioning between medical assistance and MinnesotaCare have seamless
30.15eligibility and access to health care services.
30.16EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
30.17approval, whichever is later. The commissioner of human services shall notify the revisor
30.18of statutes when federal approval is obtained.

30.19    Sec. 47. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
30.20    Subdivision 1. Application assistance and information availability. (a) Applicants
30.21may submit applications online, in person, by mail, or by phone in accordance with the
30.22Affordable Care Act, and by any other means by which medical assistance applications
30.23may be submitted. Applicants may submit applications through the Minnesota Insurance
30.24Marketplace or through the MinnesotaCare program. Applications and application
30.25assistance must be made available at provider offices, local human services agencies,
30.26school districts, public and private elementary schools in which 25 percent or more of
30.27the students receive free or reduced price lunches, community health offices, Women,
30.28Infants and Children (WIC) program sites, Head Start program sites, public housing
30.29councils, crisis nurseries, child care centers, early childhood education and preschool
30.30program sites, legal aid offices, and libraries, and at any other locations at which medical
30.31assistance applications must be made available. These sites may accept applications and
30.32forward the forms to the commissioner or local county human services agencies that
31.1choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
31.2commissioner or to participating local county human services agencies.
31.3(b) Application assistance must be available for applicants choosing to file an online
31.4application through the Minnesota Insurance Marketplace.
31.5EFFECTIVE DATE.This section is effective January 1, 2014.

31.6    Sec. 48. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
31.7    Subd. 2. Commissioner's duties. The commissioner or county agency shall use
31.8electronic verification through the Minnesota Insurance Marketplace as the primary
31.9method of income verification. If there is a discrepancy between reported income
31.10and electronically verified income, an individual may be required to submit additional
31.11verification to the extent permitted under the Affordable Care Act. In addition, the
31.12commissioner shall perform random audits to verify reported income and eligibility. The
31.13commissioner may execute data sharing arrangements with the Department of Revenue
31.14and any other governmental agency in order to perform income verification related to
31.15eligibility and premium payment under the MinnesotaCare program.
31.16EFFECTIVE DATE.This section is effective January 1, 2014.

31.17    Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
31.18    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
31.19first day of the month following the month in which eligibility is approved and the first
31.20premium payment has been received. As provided in section 256B.057, coverage for
31.21newborns is automatic from the date of birth and must be coordinated with other health
31.22coverage. The effective date of coverage for eligible newly adoptive children added to a
31.23family receiving covered health services is the month of placement. The effective date
31.24of coverage for other new members added to the family is the first day of the month
31.25following the month in which the change is reported. All eligibility criteria must be met
31.26by the family at the time the new family member is added. The income of the new family
31.27member is included with the family's modified adjusted gross income and the adjusted
31.28premium begins in the month the new family member is added.
31.29(b) The initial premium must be received by the last working day of the month for
31.30coverage to begin the first day of the following month.
31.31(c) Benefits are not available until the day following discharge if an enrollee is
31.32hospitalized on the first day of coverage.
32.1(d) (c) Notwithstanding any other law to the contrary, benefits under sections
32.2256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
32.3an eligible person may have coverage and the commissioner shall use cost avoidance
32.4techniques to ensure coordination of any other health coverage for eligible persons. The
32.5commissioner shall identify eligible persons who may have coverage or benefits under
32.6other plans of insurance or who become eligible for medical assistance.
32.7(e) (d) The effective date of coverage for individuals or families who are exempt
32.8from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first
32.9day of the month following the month in which verification of American Indian status
32.10is received or eligibility is approved, whichever is later.
32.11(f) (e) The effective date of coverage for children eligible under section 256L.07,
32.12subdivision 8, is the first day of the month following the date of termination from foster
32.13care or release from a juvenile residential correctional facility.
32.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
32.15approval, whichever is later. The commissioner of human services shall notify the revisor
32.16of statutes when federal approval is obtained.

32.17    Sec. 50. Minnesota Statutes 2012, section 256L.05, subdivision 3c, is amended to read:
32.18    Subd. 3c. Retroactive coverage. Notwithstanding subdivision 3, the effective
32.19date of coverage shall be the first day of the month following termination from medical
32.20assistance for families and individuals who are eligible for MinnesotaCare and who
32.21submitted a written request for retroactive MinnesotaCare coverage with a completed
32.22application within 30 days of the mailing of notification of termination from medical
32.23assistance. The applicant must provide all required verifications within 30 days of the
32.24written request for verification. For retroactive coverage, premiums must be paid in full
32.25for any retroactive month, current month, and next month within 30 days of the premium
32.26billing. General assistance medical care recipients may qualify for retroactive coverage
32.27under this subdivision at six-month renewal.
32.28EFFECTIVE DATE.This section is effective January 1, 2014.

32.29    Sec. 51. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
32.30    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
32.31commissioner for MinnesotaCare.
32.32    (b) The commissioner shall develop and implement procedures to: (1) require
32.33enrollees to report changes in income; (2) adjust sliding scale premium payments, based
33.1upon both increases and decreases in enrollee income, at the time the change in income
33.2is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
33.3premiums. Failure to pay includes payment with a dishonored check, a returned automatic
33.4bank withdrawal, or a refused credit card or debit card payment. The commissioner may
33.5demand a guaranteed form of payment, including a cashier's check or a money order, as
33.6the only means to replace a dishonored, returned, or refused payment.
33.7    (c) Premiums are calculated on a calendar month basis and may be paid on a
33.8monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
33.9commissioner of the premium amount required. The commissioner shall inform applicants
33.10and enrollees of these premium payment options. Premium payment is required before
33.11enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
33.12received before noon are credited the same day. Premium payments received after noon
33.13are credited on the next working day.
33.14    (d) Nonpayment of the premium will result in disenrollment from the plan effective
33.15for the calendar month for which the premium was due. Persons disenrolled for
33.16nonpayment or who voluntarily terminate coverage from the program may not reenroll
33.17until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
33.18all past due premiums as well as current premiums due, including premiums due for the
33.19period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
33.20to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
33.21terminate coverage from the program may not reenroll for four calendar months unless
33.22the person demonstrates good cause for nonpayment. Good cause does not exist if a
33.23person chooses to pay other family expenses instead of the premium. The commissioner
33.24shall define good cause in rule.
33.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.26approval, whichever is later. The commissioner of human services shall notify the revisor
33.27of statutes when federal approval is obtained.

33.28    Sec. 52. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
33.29    Subdivision 1. General requirements. (a) Children enrolled in the original
33.30children's health plan as of September 30, 1992, children who enrolled in the
33.31MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
33.32article 4, section 17, and children who have family gross incomes that are equal to or
33.33less than 200 percent of the federal poverty guidelines are eligible without meeting the
33.34requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
33.35they maintain continuous coverage in the MinnesotaCare program or medical assistance.
34.1    Parents Families and individuals enrolled in MinnesotaCare under section 256L.04,
34.2subdivision 1 , whose income increases above 275 200 percent of the federal poverty
34.3guidelines, are no longer eligible for the program and shall be disenrolled by the
34.4commissioner. Beginning January 1, 2008, Individuals enrolled in MinnesotaCare under
34.5section 256L.04, subdivision 7, whose income increases above 200 percent of the federal
34.6poverty guidelines or 250 percent of the federal poverty guidelines on or after July 1,
34.72009, are no longer eligible for the program and shall be disenrolled by the commissioner.
34.8 For persons disenrolled under this subdivision, MinnesotaCare coverage terminates the
34.9last day of the calendar month following the month in which the commissioner determines
34.10that the income of a family or individual exceeds program income limits.
34.11    (b) Children may remain enrolled in MinnesotaCare if their gross family income as
34.12defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty
34.13guidelines. The premium for children remaining eligible under this paragraph shall be the
34.14maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
34.15    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
34.16gross household income exceeds $57,500 for the 12-month period of eligibility.
34.17EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.18approval, whichever is later. The commissioner of human services shall notify the revisor
34.19of statutes when federal approval is obtained.

34.20    Sec. 53. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
34.21    Subd. 2. Must not have access to employer-subsidized minimum essential
34.22 coverage. (a) To be eligible, a family or individual must not have access to subsidized
34.23health coverage through an employer and must not have had access to employer-subsidized
34.24coverage through a current employer for 18 months prior to application or reapplication.
34.25A family or individual whose employer-subsidized coverage is lost due to an employer
34.26terminating health care coverage as an employee benefit during the previous 18 months is
34.27not eligible that is affordable and provides minimum value as defined in Code of Federal
34.28Regulations, title 26, section 1.36B-2.
34.29(b) This subdivision does not apply to a family or individual who was enrolled
34.30in MinnesotaCare within six months or less of reapplication and who no longer has
34.31employer-subsidized coverage due to the employer terminating health care coverage as an
34.32employee benefit. This subdivision does not apply to children with family gross incomes
34.33that are equal to or less than 200 percent of federal poverty guidelines.
34.34(c) For purposes of this requirement, subsidized health coverage means health
34.35coverage for which the employer pays at least 50 percent of the cost of coverage for
35.1the employee or dependent, or a higher percentage as specified by the commissioner.
35.2Children are eligible for employer-subsidized coverage through either parent, including
35.3the noncustodial parent. The commissioner must treat employer contributions to Internal
35.4Revenue Code Section 125 plans and any other employer benefits intended to pay
35.5health care costs as qualified employer subsidies toward the cost of health coverage for
35.6employees for purposes of this subdivision.
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.07, subdivision 3, is amended to read:
35.11    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
35.12MinnesotaCare program must have no To be eligible, a family or individual must not have
35.13minimum essential health coverage while enrolled, as defined by section 5000A of the
35.14Internal Revenue Code. Children with family gross incomes equal to or greater than 200
35.15percent of federal poverty guidelines, and adults, must have had no health coverage for
35.16at least four months prior to application and renewal. Children enrolled in the original
35.17children's health plan and children in families with income equal to or less than 200
35.18percent of the federal poverty guidelines, who have other health insurance, are eligible if
35.19the coverage:
35.20(1) lacks two or more of the following:
35.21(i) basic hospital insurance;
35.22(ii) medical-surgical insurance;
35.23(iii) prescription drug coverage;
35.24(iv) dental coverage; or
35.25(v) vision coverage;
35.26(2) requires a deductible of $100 or more per person per year; or
35.27(3) lacks coverage because the child has exceeded the maximum coverage for a
35.28particular diagnosis or the policy excludes a particular diagnosis.
35.29The commissioner may change this eligibility criterion for sliding scale premiums
35.30in order to remain within the limits of available appropriations. The requirement of no
35.31health coverage does not apply to newborns.
35.32(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
35.33assistance, and the Civilian Health and Medical Program of the Uniformed Service,
35.34CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
36.1part II, chapter 55, are not considered insurance or health coverage for purposes of the
36.2four-month requirement described in this subdivision.
36.3(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
36.4Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
36.5Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
36.6to have minimum essential health coverage. An applicant or enrollee who is entitled to
36.7premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
36.8to establish eligibility for MinnesotaCare.
36.9(d) Applicants who were recipients of medical assistance within one month of
36.10application must meet the provisions of this subdivision and subdivision 2.
36.11(e) Cost-effective health insurance that was paid for by medical assistance is not
36.12considered health coverage for purposes of the four-month requirement under this
36.13section, except if the insurance continued after medical assistance no longer considered it
36.14cost-effective or after medical assistance closed.
36.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.16approval, whichever is later. The commissioner of human services shall notify the revisor
36.17of statutes when federal approval is obtained.

36.18    Sec. 55. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
36.19    Subd. 2. Residency requirement. To be eligible for health coverage under the
36.20MinnesotaCare program, pregnant women, individuals, and families with children must
36.21meet the residency requirements as provided by Code of Federal Regulations, title 42,
36.22section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply
36.23upon receipt of federal approval.
36.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.25approval, whichever is later. The commissioner of human services shall notify the revisor
36.26of statutes when federal approval is obtained.

36.27    Sec. 56. Minnesota Statutes 2012, section 256L.11, subdivision 1, is amended to read:
36.28    Subdivision 1. Medical assistance rate to be used. (a) Payment to providers
36.29under sections 256L.01 to 256L.11 this chapter shall be at the same rates and conditions
36.30established for medical assistance, except as provided in subdivisions 2 to 6 this section.
36.31(b) Effective for services provided on or after July 1, 2009, total payments for basic
36.32care services shall be reduced by three percent, in accordance with section 256B.766.
37.1Payments made to managed care and county-based purchasing plans shall be reduced for
37.2services provided on or after October 1, 2009, to reflect this reduction.
37.3(c) Effective for services provided on or after July 1, 2009, payment rates for
37.4physician and professional services shall be reduced as described under section 256B.76,
37.5subdivision 1, paragraph (c). Payments made to managed care and county-based
37.6purchasing plans shall be reduced for services provided on or after October 1, 2009,
37.7to reflect this reduction.
37.8EFFECTIVE DATE.This section is effective January 1, 2014.

37.9    Sec. 57. Minnesota Statutes 2012, section 256L.11, subdivision 3, is amended to read:
37.10    Subd. 3. Inpatient hospital services. Inpatient hospital services provided under
37.11section 256L.03, subdivision 3, shall be paid for as provided in subdivisions 4 to 6 at the
37.12medical assistance rate.
37.13EFFECTIVE DATE.This section is effective January 1, 2014.

37.14    Sec. 58. [256L.121] SERVICE DELIVERY.
37.15    Subdivision 1. Competitive process. The commissioner of human services shall
37.16establish a competitive process for entering into contracts with participating entities for
37.17the offering of standard health plans through MinnesotaCare. Coverage through standard
37.18health plans must be available to enrollees beginning January 1, 2015. Each standard health
37.19plan must cover the health services listed in, and meet the requirements of, section 256L.03.
37.20The competitive process must meet the requirements of section 1331 of the Affordable
37.21Care Act and be designed to ensure enrollee access to high-quality health care coverage
37.22options. The commissioner, to the extent feasible, shall seek to ensure that enrollees have
37.23a choice of coverage from more than one participating entity within a geographic area.
37.24    Subd. 2. Other requirements for participating entities. The commissioner shall
37.25require participating entities, as a condition of contract, to document to the commissioner:
37.26(1) the provision of culturally and linguistically appropriate services, including
37.27marketing materials, to MinnesotaCare enrollees; and
37.28(2) the inclusion in provider networks of providers designated as essential
37.29community providers under section 62Q.19.
37.30    Subd. 3. Coordination with state-administered health programs. The
37.31commissioner shall coordinate the administration of the MinnesotaCare program with
37.32medical assistance to maximize efficiency and improve the continuity of care. This
37.33includes, but is not limited to:
38.1(1) establishing geographic areas for MinnesotaCare that are consistent with the
38.2geographic areas of the medical assistance program, within which participating entities
38.3may offer health plans;
38.4(2) requiring, as a condition of participation in MinnesotaCare, participating entities
38.5to also participate in the medical assistance program;
38.6    (3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and
38.7256B.694 when contracting with MinnesotaCare participating entities;
38.8(4) providing MinnesotaCare enrollees, to the extent possible, with the option to
38.9remain in the same health plan and provider network, if they later become eligible for
38.10medical assistance or coverage through the Minnesota Insurance Marketplace and if, in
38.11the case of becoming eligible for medical assistance, the enrollee's MinnesotaCare health
38.12plan is also a medical assistance health plan in the enrollee's county of residence; and
38.13(5) establishing requirements and criteria for selection that ensure that covered
38.14health care services will be coordinated with local public health, social services, long-term
38.15care services, mental health services, and other local services affecting enrollees' health,
38.16access, and quality of care.
38.17EFFECTIVE DATE.This section is effective the day following final enactment.

38.18    Sec. 59. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
38.19    Subdivision 1. Premium determination. (a) Families with children and individuals
38.20shall pay a premium determined according to subdivision 2.
38.21    (b) Pregnant women and children under age two are exempt from the provisions
38.22of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
38.23for failure to pay premiums. For pregnant women, this exemption continues until the
38.24first day of the month following the 60th day postpartum. Women who remain enrolled
38.25during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
38.26disenrolled on the first of the month following the 60th day postpartum for the penalty
38.27period that otherwise applies under section 256L.06, unless they begin paying premiums.
38.28    (c) (b) Members of the military and their families who meet the eligibility criteria
38.29for MinnesotaCare upon eligibility approval made within 24 months following the end
38.30of the member's tour of active duty shall have their premiums paid by the commissioner.
38.31The effective date of coverage for an individual or family who meets the criteria of this
38.32paragraph shall be the first day of the month following the month in which eligibility is
38.33approved. This exemption applies for 12 months.
38.34(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
38.35their families shall have their premiums waived by the commissioner in accordance with
39.1section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
39.2An individual must document status as an American Indian, as defined under Code of
39.3Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
39.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
39.5approval, whichever is later. The commissioner of human services shall notify the revisor
39.6of statutes when federal approval is obtained.

39.7    Sec. 60. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
39.8    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
39.9commissioner shall establish a sliding fee scale to determine the percentage of monthly
39.10 gross individual or family income that households at different income levels must pay to
39.11obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
39.12on the enrollee's monthly gross individual or family income. The sliding fee scale must
39.13contain separate tables based on enrollment of one, two, or three or more persons. Until
39.14June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
39.15individual or family income for individuals or families with incomes below the limits for
39.16the medical assistance program for families and children in effect on January 1, 1999, and
39.17proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
39.188.8 percent. These percentages are matched to evenly spaced income steps ranging from
39.19the medical assistance income limit for families and children in effect on January 1, 1999,
39.20to 275 200 percent of the federal poverty guidelines for the applicable family size, up to a
39.21family size of five. The sliding fee scale for a family of five must be used for families of
39.22more than five. The sliding fee scale and percentages are not subject to the provisions of
39.23chapter 14. If a family or individual reports increased income after enrollment, premiums
39.24shall be adjusted at the time the change in income is reported.
39.25    (b) Children in families whose gross income is above 275 percent of the federal
39.26poverty guidelines shall pay the maximum premium. The maximum premium is defined
39.27as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
39.28cases paid the maximum premium, the total revenue would equal the total cost of
39.29MinnesotaCare medical coverage and administration. In this calculation, administrative
39.30costs shall be assumed to equal ten percent of the total. The costs of medical coverage
39.31for pregnant women and children under age two and the enrollees in these groups shall
39.32be excluded from the total. The maximum premium for two enrollees shall be twice the
39.33maximum premium for one, and the maximum premium for three or more enrollees shall
39.34be three times the maximum premium for one.
40.1    (c) Beginning July 1, 2009, (b) MinnesotaCare enrollees shall pay premiums
40.2according to the premium scale specified in paragraph (d) (c), with the exception that
40.3children in families with income at or below 200 percent of the federal poverty guidelines
40.4shall pay no premiums. For purposes of paragraph (d) (c), "minimum" means a monthly
40.5premium of $4.
40.6    (d) the following premium scale is established for individuals and families with
40.7gross family incomes of 275 percent of the federal poverty guidelines or less:

40.8	Federal Poverty Guideline Range	Percent of Average Gross Monthly Income
40.9	0-45%	minimum
40.10 40.11	46-54%	$4 or 1.1% of family income, whichever is greater
40.12	55-81%	1.6%
40.13	82-109%	2.2%
40.14	110-136%	2.9%
40.15	137-164%	3.6%
40.16	165-191%	4.6%
40.17	192-219%	5.6%
40.18	220-248%	6.5%
40.19	249-275%	7.2%

40.20(c) Effective January 1, 2014, the following premium scale is established for
40.21individuals and families with incomes of 200 percent of federal poverty guidelines or less:

40.22	Federal Poverty Guideline Range	Percent of Average Income
40.23	0-45%	minimum
40.24 40.25	46-54%	$4 or .25% of family income, whichever is greater
40.26	55-81%	.5%
40.27	82-109%	1.0%
40.28	110-136%	1.5%
40.29	137-164%	2.0%
40.30	165-191%	2.5%
40.31	192-200%	3.0%

40.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
40.33approval, whichever is later. The commissioner of human services shall notify the revisor
40.34of statutes when federal approval is obtained.

40.35    Sec. 61. Laws 2013, chapter 1, section 1, the effective date, is amended to read:
40.36EFFECTIVE DATE.This section is effective January 1, 2014 July 1, 2013.

41.1    Sec. 62. DETERMINATION OF FUNDING ADEQUACY FOR
41.2MINNESOTACARE.
41.3The commissioners of revenue and management and budget, in consultation with
41.4the commissioner of human services, shall conduct an assessment of health care taxes,
41.5including the gross premiums tax, the provider tax, and Medicaid surcharges, and their
41.6relationship to the long-term solvency of the health care access fund, as part of the state
41.7revenue and expenditure forecast in November 2013. The commissioners shall determine
41.8the amount of state funding that will be required after December 31, 2019, in addition
41.9to the federal payments made available under section 1331 of the Affordable Care Act,
41.10for the MinnesotaCare program. The commissioners shall evaluate the stability and
41.11likelihood of long-term federal funding for the MinnesotaCare program under section
41.121331. The commissioners shall report the results of this assessment to the chairs and
41.13ranking minority members of the legislative committees with jurisdiction over human
41.14services, finances, and taxes by January 15, 2014, along with recommendations for
41.15changes to state revenue for the health care access fund, if state funding continues to
41.16be required beyond December 31, 2019.

41.17    Sec. 63. REVISOR'S INSTRUCTION.
41.18The revisor shall remove cross-references to the sections repealed in this act
41.19wherever they appear in Minnesota Statutes and Minnesota Rules and make changes
41.20necessary to correct the punctuation, grammar, or structure of the remaining text and
41.21preserve its meaning.

41.22    Sec. 64. REPEALER.
41.23(a) Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.02, subdivision
41.243; 256L.031; 256L.04, subdivisions 1b, 7a, and 9; and 256L.11, subdivisions 2a, 5, and
41.256, are repealed, effective January 1, 2014.
41.26(b) Minnesota Statutes 2012, sections 256L.01, subdivision 3; 256L.03, subdivision
41.274; 256L.04, subdivision 2a; 256L.07, subdivisions 1, 4, 5, 8, and 9; 256L.09, subdivisions
41.281, 4, 5, 6, and 7; 256L.12, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9a, and 9b; and 256L.17,
41.29subdivisions 1, 2, 3, 4, and 5, are repealed effective January 1, 2015.
41.30(c) Minnesota Statutes 2012, sections 256B.055, subdivisions 3, 5, and 10b;
41.31256B.056, subdivision 5b; and 256B.057, subdivisions 1c and 2, are repealed.


42.4    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
42.5    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
42.6electronically submit to the commissioner of health case mix assessments that conform
42.7with the assessment schedule defined by Code of Federal Regulations, title 42, section
42.8483.20, and published by the United States Department of Health and Human Services,
42.9Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
42.10Instrument User's Manual, version 3.0, and subsequent updates when issued by the
42.11Centers for Medicare and Medicaid Services. The commissioner of health may substitute
42.12successor manuals or question and answer documents published by the United States
42.13Department of Health and Human Services, Centers for Medicare and Medicaid Services,
42.14to replace or supplement the current version of the manual or document.
42.15(b) The assessments used to determine a case mix classification for reimbursement
42.16include the following:
42.17(1) a new admission assessment must be completed by day 14 following admission;
42.18(2) an annual assessment which must have an assessment reference date (ARD)
42.19within 366 days of the ARD of the last comprehensive assessment;
42.20(3) a significant change assessment must be completed within 14 days of the
42.21identification of a significant change; and
42.22(4) all quarterly assessments must have an assessment reference date (ARD) within
42.2392 days of the ARD of the previous assessment.
42.24(c) In addition to the assessments listed in paragraph (b), the assessments used to
42.25determine nursing facility level of care include the following:
42.26(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a
42.27county, tribe, or managed care organization under contract with the Department of Human
42.28Services 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line
42.29or other organization under contract with the Minnesota Board on Aging; and
42.30(2) a nursing facility level of care determination as provided for under section
42.31256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
42.32completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
42.33managed care organization under contract with the Department of Human Services.

43.1    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
43.2144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
43.3REPORT AND STUDY REQUIRED.
43.4    Subdivision 1. Report requirements. The commissioners of health and human
43.5services, with the cooperation of counties and in consultation with stakeholders, including
43.6persons who need or are using long-term care services and supports, lead agencies,
43.7regional entities, senior, disability, and mental health organization representatives, service
43.8providers, and community members shall prepare a report to the legislature by August 15,
43.92013, and biennially thereafter, regarding the status of the full range of long-term care
43.10services and supports for the elderly and children and adults with disabilities and mental
43.11illnesses in Minnesota. The report shall address:
43.12    (1) demographics and need for long-term care services and supports in Minnesota;
43.13    (2) summary of county and regional reports on long-term care gaps, surpluses,
43.14imbalances, and corrective action plans;
43.15    (3) status of long-term care services and related mental health services, housing
43.16options, and supports by county and region including:
43.17    (i) changes in availability of the range of long-term care services and housing options;
43.18    (ii) access problems, including access to the least restrictive and most integrated
43.19services and settings, regarding long-term care services; and
43.20    (iii) comparative measures of long-term care services availability, including serving
43.21people in their home areas near family, and changes over time; and
43.22    (4) recommendations regarding goals for the future of long-term care services and
43.23supports, policy and fiscal changes, and resource development and transition needs.
43.24    Subd. 2. Critical access study. The commissioner shall conduct a onetime study to
43.25assess local capacity and availability of home and community-based services for older
43.26adults, people with disabilities, and people with mental illnesses. The study must assess
43.27critical access at the community level and identify potential strategies to build home and
43.28community-based service capacity in critical access areas. The report shall be submitted
43.29to the legislature no later than August 15, 2015.

43.30    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
43.31    Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
43.32licensure of city, county, and state agency social workers is voluntary, except an individual
43.33who is newly employed by a city or state agency after July 1, 2016, must be licensed
43.34if the individual who provides social work services, as those services are defined in
44.1section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title
44.2incorporating the words "social work" or "social worker."
44.3(b) City, county, and state agencies employing social workers and staff who are
44.4designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
44.5256.01, subdivision 24, are not required to employ licensed social workers.

44.6    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
44.7    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
44.82 , the commissioner of human services shall carry out the specific duties in paragraphs (a)
44.9through (cc) (dd):
44.10    (a) Administer and supervise all forms of public assistance provided for by state law
44.11and other welfare activities or services as are vested in the commissioner. Administration
44.12and supervision of human services activities or services includes, but is not limited to,
44.13assuring timely and accurate distribution of benefits, completeness of service, and quality
44.14program management. In addition to administering and supervising human services
44.15activities vested by law in the department, the commissioner shall have the authority to:
44.16    (1) require county agency participation in training and technical assistance programs
44.17to promote compliance with statutes, rules, federal laws, regulations, and policies
44.18governing human services;
44.19    (2) monitor, on an ongoing basis, the performance of county agencies in the
44.20operation and administration of human services, enforce compliance with statutes, rules,
44.21federal laws, regulations, and policies governing welfare services and promote excellence
44.22of administration and program operation;
44.23    (3) develop a quality control program or other monitoring program to review county
44.24performance and accuracy of benefit determinations;
44.25    (4) require county agencies to make an adjustment to the public assistance benefits
44.26issued to any individual consistent with federal law and regulation and state law and rule
44.27and to issue or recover benefits as appropriate;
44.28    (5) delay or deny payment of all or part of the state and federal share of benefits and
44.29administrative reimbursement according to the procedures set forth in section 256.017;
44.30    (6) make contracts with and grants to public and private agencies and organizations,
44.31both profit and nonprofit, and individuals, using appropriated funds; and
44.32    (7) enter into contractual agreements with federally recognized Indian tribes with
44.33a reservation in Minnesota to the extent necessary for the tribe to operate a federally
44.34approved family assistance program or any other program under the supervision of the
44.35commissioner. The commissioner shall consult with the affected county or counties in
45.1the contractual agreement negotiations, if the county or counties wish to be included,
45.2in order to avoid the duplication of county and tribal assistance program services. The
45.3commissioner may establish necessary accounts for the purposes of receiving and
45.4disbursing funds as necessary for the operation of the programs.
45.5    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
45.6regulation, and policy necessary to county agency administration of the programs.
45.7    (c) Administer and supervise all child welfare activities; promote the enforcement of
45.8laws protecting disabled, dependent, neglected and delinquent children, and children born
45.9to mothers who were not married to the children's fathers at the times of the conception
45.10nor at the births of the children; license and supervise child-caring and child-placing
45.11agencies and institutions; supervise the care of children in boarding and foster homes or
45.12in private institutions; and generally perform all functions relating to the field of child
45.13welfare now vested in the State Board of Control.
45.14    (d) Administer and supervise all noninstitutional service to disabled persons,
45.15including those who are visually impaired, hearing impaired, or physically impaired
45.16or otherwise disabled. The commissioner may provide and contract for the care and
45.17treatment of qualified indigent children in facilities other than those located and available
45.18at state hospitals when it is not feasible to provide the service in state hospitals.
45.19    (e) Assist and actively cooperate with other departments, agencies and institutions,
45.20local, state, and federal, by performing services in conformity with the purposes of Laws
45.211939, chapter 431.
45.22    (f) Act as the agent of and cooperate with the federal government in matters of
45.23mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
45.24431, including the administration of any federal funds granted to the state to aid in the
45.25performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
45.26and including the promulgation of rules making uniformly available medical care benefits
45.27to all recipients of public assistance, at such times as the federal government increases its
45.28participation in assistance expenditures for medical care to recipients of public assistance,
45.29the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
45.30    (g) Establish and maintain any administrative units reasonably necessary for the
45.31performance of administrative functions common to all divisions of the department.
45.32    (h) Act as designated guardian of both the estate and the person of all the wards of
45.33the state of Minnesota, whether by operation of law or by an order of court, without any
45.34further act or proceeding whatever, except as to persons committed as developmentally
45.35disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
45.36recognized by the Secretary of the Interior whose interests would be best served by
46.1adoptive placement, the commissioner may contract with a licensed child-placing agency
46.2or a Minnesota tribal social services agency to provide adoption services. A contract
46.3with a licensed child-placing agency must be designed to supplement existing county
46.4efforts and may not replace existing county programs or tribal social services, unless the
46.5replacement is agreed to by the county board and the appropriate exclusive bargaining
46.6representative, tribal governing body, or the commissioner has evidence that child
46.7placements of the county continue to be substantially below that of other counties. Funds
46.8encumbered and obligated under an agreement for a specific child shall remain available
46.9until the terms of the agreement are fulfilled or the agreement is terminated.
46.10    (i) Act as coordinating referral and informational center on requests for service for
46.11newly arrived immigrants coming to Minnesota.
46.12    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
46.13way be construed to be a limitation upon the general transfer of powers herein contained.
46.14    (k) Establish county, regional, or statewide schedules of maximum fees and charges
46.15which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
46.16nursing home care and medicine and medical supplies under all programs of medical
46.17care provided by the state and for congregate living care under the income maintenance
46.18programs.
46.19    (l) Have the authority to conduct and administer experimental projects to test methods
46.20and procedures of administering assistance and services to recipients or potential recipients
46.21of public welfare. To carry out such experimental projects, it is further provided that the
46.22commissioner of human services is authorized to waive the enforcement of existing specific
46.23statutory program requirements, rules, and standards in one or more counties. The order
46.24establishing the waiver shall provide alternative methods and procedures of administration,
46.25shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
46.26in no event shall the duration of a project exceed four years. It is further provided that no
46.27order establishing an experimental project as authorized by the provisions of this section
46.28shall become effective until the following conditions have been met:
46.29    (1) the secretary of health and human services of the United States has agreed, for
46.30the same project, to waive state plan requirements relative to statewide uniformity; and
46.31    (2) a comprehensive plan, including estimated project costs, shall be approved by
46.32the Legislative Advisory Commission and filed with the commissioner of administration.
46.33    (m) According to federal requirements, establish procedures to be followed by
46.34local welfare boards in creating citizen advisory committees, including procedures for
46.35selection of committee members.
47.1    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
47.2control error rates for the aid to families with dependent children program formerly
47.3codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
47.4following manner:
47.5    (1) one-half of the total amount of the disallowance shall be borne by the county
47.6boards responsible for administering the programs. For the medical assistance and the
47.7AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
47.8shared by each county board in the same proportion as that county's expenditures for the
47.9sanctioned program are to the total of all counties' expenditures for the AFDC program
47.10formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
47.11food stamp program, sanctions shall be shared by each county board, with 50 percent of
47.12the sanction being distributed to each county in the same proportion as that county's
47.13administrative costs for food stamps are to the total of all food stamp administrative costs
47.14for all counties, and 50 percent of the sanctions being distributed to each county in the
47.15same proportion as that county's value of food stamp benefits issued are to the total of
47.16all benefits issued for all counties. Each county shall pay its share of the disallowance
47.17to the state of Minnesota. When a county fails to pay the amount due hereunder, the
47.18commissioner may deduct the amount from reimbursement otherwise due the county, or
47.19the attorney general, upon the request of the commissioner, may institute civil action
47.20to recover the amount due; and
47.21    (2) notwithstanding the provisions of clause (1), if the disallowance results from
47.22knowing noncompliance by one or more counties with a specific program instruction, and
47.23that knowing noncompliance is a matter of official county board record, the commissioner
47.24may require payment or recover from the county or counties, in the manner prescribed in
47.25clause (1), an amount equal to the portion of the total disallowance which resulted from the
47.26noncompliance, and may distribute the balance of the disallowance according to clause (1).
47.27    (o) Develop and implement special projects that maximize reimbursements and
47.28result in the recovery of money to the state. For the purpose of recovering state money,
47.29the commissioner may enter into contracts with third parties. Any recoveries that result
47.30from projects or contracts entered into under this paragraph shall be deposited in the
47.31state treasury and credited to a special account until the balance in the account reaches
47.32$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
47.33transferred and credited to the general fund. All money in the account is appropriated to
47.34the commissioner for the purposes of this paragraph.
47.35    (p) Have the authority to make direct payments to facilities providing shelter
47.36to women and their children according to section 256D.05, subdivision 3. Upon
48.1the written request of a shelter facility that has been denied payments under section
48.2256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
48.3a determination within 30 days of the request for review regarding issuance of direct
48.4payments to the shelter facility. Failure to act within 30 days shall be considered a
48.5determination not to issue direct payments.
48.6    (q) Have the authority to establish and enforce the following county reporting
48.7requirements:
48.8    (1) the commissioner shall establish fiscal and statistical reporting requirements
48.9necessary to account for the expenditure of funds allocated to counties for human
48.10services programs. When establishing financial and statistical reporting requirements, the
48.11commissioner shall evaluate all reports, in consultation with the counties, to determine if
48.12the reports can be simplified or the number of reports can be reduced;
48.13    (2) the county board shall submit monthly or quarterly reports to the department
48.14as required by the commissioner. Monthly reports are due no later than 15 working days
48.15after the end of the month. Quarterly reports are due no later than 30 calendar days after
48.16the end of the quarter, unless the commissioner determines that the deadline must be
48.17shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
48.18or risking a loss of federal funding. Only reports that are complete, legible, and in the
48.19required format shall be accepted by the commissioner;
48.20    (3) if the required reports are not received by the deadlines established in clause (2),
48.21the commissioner may delay payments and withhold funds from the county board until
48.22the next reporting period. When the report is needed to account for the use of federal
48.23funds and the late report results in a reduction in federal funding, the commissioner shall
48.24withhold from the county boards with late reports an amount equal to the reduction in
48.25federal funding until full federal funding is received;
48.26    (4) a county board that submits reports that are late, illegible, incomplete, or not
48.27in the required format for two out of three consecutive reporting periods is considered
48.28noncompliant. When a county board is found to be noncompliant, the commissioner
48.29shall notify the county board of the reason the county board is considered noncompliant
48.30and request that the county board develop a corrective action plan stating how the
48.31county board plans to correct the problem. The corrective action plan must be submitted
48.32to the commissioner within 45 days after the date the county board received notice
48.33of noncompliance;
48.34    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
48.35after the date the report was originally due. If the commissioner does not receive a report
48.36by the final deadline, the county board forfeits the funding associated with the report for
49.1that reporting period and the county board must repay any funds associated with the
49.2report received for that reporting period;
49.3    (6) the commissioner may not delay payments, withhold funds, or require repayment
49.4under clause (3) or (5) if the county demonstrates that the commissioner failed to
49.5provide appropriate forms, guidelines, and technical assistance to enable the county to
49.6comply with the requirements. If the county board disagrees with an action taken by the
49.7commissioner under clause (3) or (5), the county board may appeal the action according
49.8to sections 14.57 to 14.69; and
49.9    (7) counties subject to withholding of funds under clause (3) or forfeiture or
49.10repayment of funds under clause (5) shall not reduce or withhold benefits or services to
49.11clients to cover costs incurred due to actions taken by the commissioner under clause
49.12(3) or (5).
49.13    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
49.14federal fiscal disallowances or sanctions are based on a statewide random sample in direct
49.15proportion to each county's claim for that period.
49.16    (s) Be responsible for ensuring the detection, prevention, investigation, and
49.17resolution of fraudulent activities or behavior by applicants, recipients, and other
49.18participants in the human services programs administered by the department.
49.19    (t) Require county agencies to identify overpayments, establish claims, and utilize
49.20all available and cost-beneficial methodologies to collect and recover these overpayments
49.21in the human services programs administered by the department.
49.22    (u) Have the authority to administer a drug rebate program for drugs purchased
49.23pursuant to the prescription drug program established under section 256.955 after the
49.24beneficiary's satisfaction of any deductible established in the program. The commissioner
49.25shall require a rebate agreement from all manufacturers of covered drugs as defined in
49.26section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
49.27or after July 1, 2002, must include rebates for individuals covered under the prescription
49.28drug program who are under 65 years of age. For each drug, the amount of the rebate shall
49.29be equal to the rebate as defined for purposes of the federal rebate program in United
49.30States Code, title 42, section 1396r-8. The manufacturers must provide full payment
49.31within 30 days of receipt of the state invoice for the rebate within the terms and conditions
49.32used for the federal rebate program established pursuant to section 1927 of title XIX of
49.33the Social Security Act. The manufacturers must provide the commissioner with any
49.34information necessary to verify the rebate determined per drug. The rebate program shall
49.35utilize the terms and conditions used for the federal rebate program established pursuant to
49.36section 1927 of title XIX of the Social Security Act.
50.1    (v) Have the authority to administer the federal drug rebate program for drugs
50.2purchased under the medical assistance program as allowed by section 1927 of title XIX
50.3of the Social Security Act and according to the terms and conditions of section 1927.
50.4Rebates shall be collected for all drugs that have been dispensed or administered in an
50.5outpatient setting and that are from manufacturers who have signed a rebate agreement
50.6with the United States Department of Health and Human Services.
50.7    (w) Have the authority to administer a supplemental drug rebate program for drugs
50.8purchased under the medical assistance program. The commissioner may enter into
50.9supplemental rebate contracts with pharmaceutical manufacturers and may require prior
50.10authorization for drugs that are from manufacturers that have not signed a supplemental
50.11rebate contract. Prior authorization of drugs shall be subject to the provisions of section
50.12256B.0625, subdivision 13 .
50.13    (x) Operate the department's communication systems account established in Laws
50.141993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
50.15communication costs necessary for the operation of the programs the commissioner
50.16supervises. A communications account may also be established for each regional
50.17treatment center which operates communications systems. Each account must be used
50.18to manage shared communication costs necessary for the operations of the programs the
50.19commissioner supervises. The commissioner may distribute the costs of operating and
50.20maintaining communication systems to participants in a manner that reflects actual usage.
50.21Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
50.22other costs as determined by the commissioner. Nonprofit organizations and state, county,
50.23and local government agencies involved in the operation of programs the commissioner
50.24supervises may participate in the use of the department's communications technology and
50.25share in the cost of operation. The commissioner may accept on behalf of the state any
50.26gift, bequest, devise or personal property of any kind, or money tendered to the state for
50.27any lawful purpose pertaining to the communication activities of the department. Any
50.28money received for this purpose must be deposited in the department's communication
50.29systems accounts. Money collected by the commissioner for the use of communication
50.30systems must be deposited in the state communication systems account and is appropriated
50.31to the commissioner for purposes of this section.
50.32    (y) Receive any federal matching money that is made available through the medical
50.33assistance program for the consumer satisfaction survey. Any federal money received for
50.34the survey is appropriated to the commissioner for this purpose. The commissioner may
50.35expend the federal money received for the consumer satisfaction survey in either year of
50.36the biennium.
51.1    (z) Designate community information and referral call centers and incorporate
51.2cost reimbursement claims from the designated community information and referral
51.3call centers into the federal cost reimbursement claiming processes of the department
51.4according to federal law, rule, and regulations. Existing information and referral centers
51.5provided by Greater Twin Cities United Way or existing call centers for which Greater
51.6Twin Cities United Way has legal authority to represent, shall be included in these
51.7designations upon review by the commissioner and assurance that these services are
51.8accredited and in compliance with national standards. Any reimbursement is appropriated
51.9to the commissioner and all designated information and referral centers shall receive
51.10payments according to normal department schedules established by the commissioner
51.11upon final approval of allocation methodologies from the United States Department of
51.12Health and Human Services Division of Cost Allocation or other appropriate authorities.
51.13    (aa) Develop recommended standards for foster care homes that address the
51.14components of specialized therapeutic services to be provided by foster care homes with
51.15those services.
51.16    (bb) Authorize the method of payment to or from the department as part of the
51.17human services programs administered by the department. This authorization includes the
51.18receipt or disbursement of funds held by the department in a fiduciary capacity as part of
51.19the human services programs administered by the department.
51.20    (cc) Have the authority to administer a drug rebate program for drugs purchased for
51.21persons eligible for general assistance medical care under section 256D.03, subdivision 3.
51.22For manufacturers that agree to participate in the general assistance medical care rebate
51.23program, the commissioner shall enter into a rebate agreement for covered drugs as
51.24defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
51.25rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
51.26United States Code, title 42, section 1396r-8. The manufacturers must provide payment
51.27within the terms and conditions used for the federal rebate program established under
51.28section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
51.29the terms and conditions used for the federal rebate program established under section
51.301927 of title XIX of the Social Security Act.
51.31    Effective January 1, 2006, drug coverage under general assistance medical care shall
51.32be limited to those prescription drugs that:
51.33    (1) are covered under the medical assistance program as described in section
51.34256B.0625, subdivisions 13 and 13d ; and
51.35    (2) are provided by manufacturers that have fully executed general assistance
51.36medical care rebate agreements with the commissioner and comply with such agreements.
52.1Prescription drug coverage under general assistance medical care shall conform to
52.2coverage under the medical assistance program according to section 256B.0625,
52.3subdivisions 13 to 13g .
52.4    The rebate revenues collected under the drug rebate program are deposited in the
52.5general fund.
52.6(dd) Designate the agencies that operate the Senior LinkAge Line under section
52.7256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
52.8of Minnesota Aging and the Disability Resource Centers under United States Code, title
52.942, section 3001, the Older Americans Act Amendments of 2006, and incorporate cost
52.10reimbursement claims from the designated centers into the federal cost reimbursement
52.11claiming processes of the department according to federal law, rule, and regulations. Any
52.12reimbursement must be appropriated to the commissioner and all Aging and Disability
52.13Resource Center designated agencies shall receive payments of grant funding that supports
52.14the activity and generates the federal financial participation according to Board on Aging
52.15administrative granting mechanisms.

52.16    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
52.17    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
52.18Linkage Line, to which shall serve people with disabilities as the designated Aging and
52.19Disability Resource Center under United States Code, title 42, section 3001, the Older
52.20Americans Act Amendments of 2006, in partnership with the Senior LinkAge Line and
52.21shall serve as Minnesota's neutral access point for statewide disability information and
52.22assistance and must be available during business hours through a statewide toll-free
52.23number and the Internet. The Disability Linkage Line shall:
52.24(1) deliver information and assistance based on national and state standards;
52.25    (2) provide information about state and federal eligibility requirements, benefits,
52.26and service options;
52.27(3) provide benefits and options counseling;
52.28    (4) make referrals to appropriate support entities;
52.29    (5) educate people on their options so they can make well-informed choices and link
52.30them to quality profiles;
52.31    (6) help support the timely resolution of service access and benefit issues;
52.32(7) inform people of their long-term community services and supports;
52.33(8) provide necessary resources and supports that can lead to employment and
52.34increased economic stability of people with disabilities; and
53.1(9) serve as the technical assistance and help center for the Web-based tool,
53.2Minnesota's Disability Benefits 101.org.; and
53.3(10) provide preadmission screening for individuals under 60 years of age using
53.4the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911,
53.5subdivision 4d.

53.6    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
53.7    Subd. 7. Consumer information and assistance and long-term care options
53.8counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
53.9statewide service to aid older Minnesotans and their families in making informed choices
53.10about long-term care options and health care benefits. Language services to persons
53.11with limited English language skills may be made available. The service, known as
53.12Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
53.13Resource Center under United States Code, title 42, section 3001, the Older Americans
53.14Act Amendments of 2006, in partnership with the Disability LinkAge Line under section
53.15256.01, subdivision 24, and must be available during business hours through a statewide
53.16toll-free number and must also be available through the Internet. The Minnesota Board
53.17on Aging shall consult with, and when appropriate work through, the area agencies on
53.18aging to provide and maintain the telephone infrastructure and related support for the
53.19Aging and Disability Resource Center partners that agree by memorandum to access the
53.20infrastructure, including the designated providers of the Senior LinkAge Line and the
53.21Disability Linkage Line.
53.22    (b) The service must provide long-term care options counseling by assisting older
53.23adults, caregivers, and providers in accessing information and options counseling about
53.24choices in long-term care services that are purchased through private providers or available
53.25through public options. The service must:
53.26    (1) develop a comprehensive database that includes detailed listings in both
53.27consumer- and provider-oriented formats;
53.28    (2) make the database accessible on the Internet and through other telecommunication
53.29and media-related tools;
53.30    (3) link callers to interactive long-term care screening tools and make these tools
53.31available through the Internet by integrating the tools with the database;
53.32    (4) develop community education materials with a focus on planning for long-term
53.33care and evaluating independent living, housing, and service options;
53.34    (5) conduct an outreach campaign to assist older adults and their caregivers in
53.35finding information on the Internet and through other means of communication;
54.1    (6) implement a messaging system for overflow callers and respond to these callers
54.2by the next business day;
54.3    (7) link callers with county human services and other providers to receive more
54.4in-depth assistance and consultation related to long-term care options;
54.5    (8) link callers with quality profiles for nursing facilities and other home and
54.6community-based services providers developed by the commissioner commissioners of
54.7health and human services;
54.8    (9) incorporate information about the availability of housing options, as well as
54.9registered housing with services and consumer rights within the MinnesotaHelp.info
54.10network long-term care database to facilitate consumer comparison of services and costs
54.11among housing with services establishments and with other in-home services and to
54.12support financial self-sufficiency as long as possible. Housing with services establishments
54.13and their arranged home care providers shall provide information that will facilitate price
54.14comparisons, including delineation of charges for rent and for services available. The
54.15commissioners of health and human services shall align the data elements required by
54.16section 144G.06, the Uniform Consumer Information Guide, and this section to provide
54.17consumers standardized information and ease of comparison of long-term care options.
54.18The commissioner of human services shall provide the data to the Minnesota Board on
54.19Aging for inclusion in the MinnesotaHelp.info network long-term care database;
54.20(10) provide long-term care options counseling. Long-term care options counselors
54.21shall:
54.22(i) for individuals not eligible for case management under a public program or public
54.23funding source, provide interactive decision support under which consumers, family
54.24members, or other helpers are supported in their deliberations to determine appropriate
54.25long-term care choices in the context of the consumer's needs, preferences, values, and
54.26individual circumstances, including implementing a community support plan;
54.27(ii) provide Web-based educational information and collateral written materials to
54.28familiarize consumers, family members, or other helpers with the long-term care basics,
54.29issues to be considered, and the range of options available in the community;
54.30(iii) provide long-term care futures planning, which means providing assistance to
54.31individuals who anticipate having long-term care needs to develop a plan for the more
54.32distant future; and
54.33(iv) provide expertise in benefits and financing options for long-term care, including
54.34Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
54.35private pay options, and ways to access low or no-cost services or benefits through
54.36volunteer-based or charitable programs;
55.1(11) using risk management and support planning protocols, provide long-term care
55.2options counseling to current residents of nursing homes deemed appropriate for discharge
55.3by the commissioner and older adults who request service after consultation with the
55.4Senior LinkAge Line under clause (12). In order to meet this requirement, The Senior
55.5LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The
55.6Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge
55.7by developing targeting criteria in consultation with the commissioner who shall provide
55.8designated Senior LinkAge Line contact centers with a list of nursing home residents that
55.9meet the criteria as being appropriate for discharge planning via a secure Web portal.
55.10Senior LinkAge Line shall provide these residents, if they indicate a preference to
55.11receive long-term care options counseling, with initial assessment, review of risk factors,
55.12independent living support consultation, or and, if appropriate, a referral to:
55.13(i) long-term care consultation services under section 256B.0911;
55.14(ii) designated care coordinators of contracted entities under section 256B.035 for
55.15persons who are enrolled in a managed care plan; or
55.16(iii) the long-term care consultation team for those who are appropriate eligible
55.17 for relocation service coordination due to high-risk factors or psychological or physical
55.18disability; and
55.19(12) develop referral protocols and processes that will assist certified health care
55.20homes and hospitals to identify at-risk older adults and determine when to refer these
55.21individuals to the Senior LinkAge Line for long-term care options counseling under this
55.22section. The commissioner is directed to work with the commissioner of health to develop
55.23protocols that would comply with the health care home designation criteria and protocols
55.24available at the time of hospital discharge. The commissioner shall keep a record of the
55.25number of people who choose long-term care options counseling as a result of this section.

55.26    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
55.27to read:
55.28    Subd. 7a. Preadmission screening activities related to nursing facility
55.29admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
55.30including certified boarding care facilities, must be screened prior to admission regardless
55.31of income, assets, or funding sources for nursing facility care, except as described in
55.32subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
55.33need for nursing facility level of care as described in section 256B.0911, subdivision
55.344e, and to complete activities required under federal law related to mental illness and
55.35developmental disability as outlined in paragraph (b).
56.1(b) A person who has a diagnosis or possible diagnosis of mental illness or
56.2developmental disability must receive a preadmission screening before admission
56.3regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
56.4the need for further evaluation and specialized services, unless the admission prior to
56.5screening is authorized by the local mental health authority or the local developmental
56.6disabilities case manager, or unless authorized by the county agency according to Public
56.7Law 101-508.
56.8(c) The following criteria apply to the preadmission screening:
56.9(1) requests for preadmission screenings must be submitted via an online form
56.10developed by the commissioner;
56.11(2) the Senior LinkAge Line must use forms and criteria developed by the
56.12commissioner to identify persons who require referral for further evaluation and
56.13determination of the need for specialized services; and
56.14(3) the evaluation and determination of the need for specialized services must be
56.15done by:
56.16(i) a qualified independent mental health professional, for persons with a primary or
56.17secondary diagnosis of a serious mental illness; or
56.18(ii) a qualified developmental disability professional, for persons with a primary or
56.19secondary diagnosis of developmental disability. For purposes of this requirement, a
56.20qualified developmental disability professional must meet the standards for a qualified
56.21developmental disability professional under Code of Federal Regulations, title 42, section
56.22483.430.
56.23(d) The local county mental health authority or the state developmental disability
56.24authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
56.25nursing facility if the individual does not meet the nursing facility level of care criteria or
56.26needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
56.27purposes of this section, "specialized services" for a person with developmental disability
56.28means active treatment as that term is defined under Code of Federal Regulations, title
56.2942, section 483.440(a)(1).
56.30(e) In assessing a person's needs, the screener shall:
56.31(1) use an automated system designated by the commissioner;
56.32(2) consult with care transitions coordinators or physician; and
56.33(3) consider the assessment of the individual's physician.
56.34Other personnel may be included in the level of care determination as deemed
56.35necessary by the screener.
56.36EFFECTIVE DATE.This section is effective October 1, 2013.

57.1    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
57.2to read:
57.3    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
57.4screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
57.5(1) a person who, having entered an acute care facility from a certified nursing
57.6facility, is returning to a certified nursing facility; or
57.7(2) a person transferring from one certified nursing facility in Minnesota to another
57.8certified nursing facility in Minnesota.
57.9(b) Persons who are exempt from preadmission screening for purposes of level of
57.10care determination include:
57.11(1) persons described in paragraph (a);
57.12(2) an individual who has a contractual right to have nursing facility care paid for
57.13indefinitely by the Veterans' Administration;
57.14(3) an individual enrolled in a demonstration project under section 256B.69,
57.15subdivision 8, at the time of application to a nursing facility; and
57.16(4) an individual currently being served under the alternative care program or under
57.17a home and community-based services waiver authorized under section 1915(c) of the
57.18federal Social Security Act.
57.19(c) Persons admitted to a Medicaid-certified nursing facility from the community
57.20on an emergency basis as described in paragraph (d) or from an acute care facility on a
57.21nonworking day must be screened the first working day after admission.
57.22(d) Emergency admission to a nursing facility prior to screening is permitted when
57.23all of the following conditions are met:
57.24(1) a person is admitted from the community to a certified nursing or certified
57.25boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and
57.26older and Disability Linkage Line nonworking hours for under age 60;
57.27(2) a physician has determined that delaying admission until preadmission screening
57.28is completed would adversely affect the person's health and safety;
57.29(3) there is a recent precipitating event that precludes the client from living safely in
57.30the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
57.31inability to continue to provide care;
57.32(4) the attending physician has authorized the emergency placement and has
57.33documented the reason that the emergency placement is recommended; and
57.34(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first
57.35working day following the emergency admission.
58.1Transfer of a patient from an acute care hospital to a nursing facility is not considered
58.2an emergency except for a person who has received hospital services in the following
58.3situations: hospital admission for observation, care in an emergency room without hospital
58.4admission, or following hospital 24-hour bed care and from whom admission is being
58.5sought on a nonworking day.
58.6(e) A nursing facility must provide written information to all persons admitted
58.7regarding the person's right to request and receive long-term care consultation services as
58.8defined in section 256B.0911, subdivision 1a. The information must be provided prior to
58.9the person's discharge from the facility and in a format specified by the commissioner.
58.10EFFECTIVE DATE.This section is effective October 1, 2013.

58.11    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
58.12to read:
58.13    Subd. 7c. Screening requirements. (a) A person may be screened for nursing
58.14facility admission by telephone or in a face-to-face screening interview. The Senior
58.15LinkAge Line shall identify each individual's needs using the following categories:
58.16(1) the person needs no face-to-face long-term care consultation assessment
58.17completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
58.18managed care organization under contract with the Department of Human Services to
58.19determine the need for nursing facility level of care based on information obtained from
58.20other health care professionals;
58.21(2) the person needs an immediate face-to-face long-term care consultation
58.22assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
58.23tribe, or managed care organization under contract with the Department of Human
58.24Services to determine the need for nursing facility level of care and complete activities
58.25required under subdivision 7a; or
58.26(3) the person may be exempt from screening requirements as outlined in subdivision
58.277b, but will need transitional assistance after admission or in-person follow-along after
58.28a return home.
58.29(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities
58.30with only a telephone screening must receive a face-to-face assessment from the long-term
58.31care consultation team member of the county in which the facility is located or from the
58.32recipient's county case manager within 40 calendar days of admission as described in
58.33section 256B.0911, subdivision 4d, paragraph (c).
58.34(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
58.35facility must be screened prior to admission.
59.1(d) Screenings provided by the Senior LinkAge Line must include processes
59.2to identify persons who may require transition assistance described in subdivision 7,
59.3paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
59.4EFFECTIVE DATE.This section is effective October 1, 2013.

59.5    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
59.6to read:
59.7    Subd. 7d. Payment for preadmission screening. Funding for preadmission
59.8screening shall be provided to the Minnesota Board on Aging for the population 60
59.9years of age and older by the Department of Human Services to cover screener salaries
59.10and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota
59.11Board on Aging shall employ, or contract with other agencies to employ, within the limits
59.12of available funding, sufficient personnel to provide preadmission screening and level of
59.13care determination services and shall seek to maximize federal funding for the service as
59.14provided under section 256.01, subdivision 2, paragraph (dd).
59.15EFFECTIVE DATE.This section is effective October 1, 2013.

59.16    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
59.17subdivision to read:
59.18    Subd. 3a. Priority for other grants. The commissioner of health shall give
59.19priority to a grantee selected under subdivision 3 when awarding technology-related
59.20grants, if the grantee is using technology as a part of a proposal, unless that priority
59.21conflicts with existing state or federal guidance related to grant awards by the Department
59.22of Health. The commissioner of transportation shall give priority to a grantee selected
59.23under subdivision 3 when distributing transportation-related funds to create transportation
59.24options for older adults.

59.25    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
59.26subdivision to read:
59.27    Subd. 3b. State waivers. The commissioner of health may waive applicable state
59.28laws and rules on a time-limited basis if the commissioner of health determines that a
59.29participating grantee requires a waiver in order to achieve demonstration project goals.

59.30    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
60.1    Subd. 5. Grant preference. The commissioner of human services shall give
60.2preference when awarding grants under this section to areas where nursing facility
60.3closures have occurred or are occurring or areas with service needs identified by section
60.4144A.351. The commissioner may award grants to the extent grant funds are available
60.5and to the extent applications are approved by the commissioner. Denial of approval of an
60.6application in one year does not preclude submission of an application in a subsequent
60.7year. The maximum grant amount is limited to $750,000.

60.8    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.9subdivision to read:
60.10    Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
60.11subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
60.12(1) an impact assessment focusing on program outcomes, especially those
60.13experienced directly by the person receiving services;
60.14(2) study samples drawn from the population of interest for each project; and
60.15(3) a time series analysis to examine aggregate trends in average monthly
60.16utilization, expenditures, and other outcomes in the targeted populations before and after
60.17implementation of the initiatives.

60.18    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.19subdivision to read:
60.20    Subd. 6. Work, empower, and encourage independence. As provided under
60.21subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
60.22demonstration project to provide navigation, employment supports, and benefits planning
60.23services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
60.24This demonstration shall promote economic stability, increase independence, and reduce
60.25applications for disability benefits while providing a positive impact on the health and
60.26future of participants.

60.27    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.28subdivision to read:
60.29    Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
60.30upon federal approval, the commissioner shall establish a demonstration project to provide
60.31service coordination, outreach, in-reach, tenancy support, and community living assistance
60.32to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
61.1demonstration shall promote housing stability, reduce costly medical interventions, and
61.2increase opportunities for independent community living.

61.3    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
61.4    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
61.5services is to assist persons with long-term or chronic care needs in making care
61.6decisions and selecting support and service options that meet their needs and reflect
61.7their preferences. The availability of, and access to, information and other types of
61.8assistance, including assessment and support planning, is also intended to prevent or delay
61.9institutional placements and to provide access to transition assistance after admission.
61.10Further, the goal of these services is to contain costs associated with unnecessary
61.11institutional admissions. Long-term consultation services must be available to any person
61.12regardless of public program eligibility. The commissioner of human services shall seek
61.13to maximize use of available federal and state funds and establish the broadest program
61.14possible within the funding available.
61.15(b) These services must be coordinated with long-term care options counseling
61.16provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and
61.17section 256.01, subdivision 24. The lead agency providing long-term care consultation
61.18services shall encourage the use of volunteers from families, religious organizations, social
61.19clubs, and similar civic and service organizations to provide community-based services.

61.20    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
61.21read:
61.22    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
61.23    (a) Until additional requirements apply under paragraph (b), "long-term care
61.24consultation services" means:
61.25    (1) intake for and access to assistance in identifying services needed to maintain an
61.26individual in the most inclusive environment;
61.27    (2) providing recommendations for and referrals to cost-effective community
61.28services that are available to the individual;
61.29    (3) development of an individual's person-centered community support plan;
61.30    (4) providing information regarding eligibility for Minnesota health care programs;
61.31    (5) face-to-face long-term care consultation assessments, which may be completed
61.32in a hospital, nursing facility, intermediate care facility for persons with developmental
61.33disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
61.34residence;
62.1    (6) federally mandated preadmission screening activities described under
62.2subdivisions 4a and 4b;
62.3    (7) (6) determination of home and community-based waiver and other service
62.4eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level
62.5of care determination for individuals who need an institutional level of care as determined
62.6under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and
62.7community support plan development, appropriate referrals to obtain necessary diagnostic
62.8information, and including an eligibility determination for consumer-directed community
62.9supports;
62.10    (8) (7) providing recommendations for institutional placement when there are no
62.11cost-effective community services available;
62.12    (9) (8) providing access to assistance to transition people back to community settings
62.13after institutional admission; and
62.14(10) (9) providing information about competitive employment, with or without
62.15supports, for school-age youth and working-age adults and referrals to the Disability
62.16Linkage Line and Disability Benefits 101 to ensure that an informed choice about
62.17competitive employment can be made. For the purposes of this subdivision, "competitive
62.18employment" means work in the competitive labor market that is performed on a full-time
62.19or part-time basis in an integrated setting, and for which an individual is compensated at or
62.20above the minimum wage, but not less than the customary wage and level of benefits paid
62.21by the employer for the same or similar work performed by individuals without disabilities.
62.22(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
62.232c, and 3a, "long-term care consultation services" also means:
62.24(1) service eligibility determination for state plan home care services identified in:
62.25(i) section 256B.0625, subdivisions 7, 19a, and 19c;
62.26(ii) section 256B.0657; or
62.27(iii) consumer support grants under section 256.476;
62.28(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
62.29determination of eligibility for case management services available under sections
62.30256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part
62.319525.0016;
62.32(3) determination of institutional level of care, home and community-based service
62.33waiver, and other service eligibility as required under section 256B.092, determination
62.34of eligibility for family support grants under section 252.32, semi-independent living
62.35services under section 252.275, and day training and habilitation services under section
62.36256B.092 ; and
63.1(4) obtaining necessary diagnostic information to determine eligibility under clauses
63.2(2) and (3).
63.3    (c) "Long-term care options counseling" means the services provided by the linkage
63.4lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and
63.5also includes telephone assistance and follow up once a long-term care consultation
63.6assessment has been completed.
63.7    (d) "Minnesota health care programs" means the medical assistance program under
63.8chapter 256B and the alternative care program under section 256B.0913.
63.9    (e) "Lead agencies" means counties administering or tribes and health plans under
63.10contract with the commissioner to administer long-term care consultation assessment and
63.11support planning services.

63.12    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
63.13read:
63.14    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
63.15services planning, or other assistance intended to support community-based living,
63.16including persons who need assessment in order to determine waiver or alternative care
63.17program eligibility, must be visited by a long-term care consultation team within 20
63.18calendar days after the date on which an assessment was requested or recommended.
63.19Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
63.20applies to an assessment of a person requesting personal care assistance services and
63.21private duty nursing. The commissioner shall provide at least a 90-day notice to lead
63.22agencies prior to the effective date of this requirement. Face-to-face assessments must be
63.23conducted according to paragraphs (b) to (i).
63.24    (b) The lead agency may utilize a team of either the social worker or public health
63.25nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
63.26use certified assessors to conduct the assessment. The consultation team members must
63.27confer regarding the most appropriate care for each individual screened or assessed. For
63.28a person with complex health care needs, a public health or registered nurse from the
63.29team must be consulted.
63.30    (c) The assessment must be comprehensive and include a person-centered assessment
63.31of the health, psychological, functional, environmental, and social needs of referred
63.32individuals and provide information necessary to develop a community support plan that
63.33meets the consumers needs, using an assessment form provided by the commissioner.
63.34    (d) The assessment must be conducted in a face-to-face interview with the person
63.35being assessed and the person's legal representative, and other individuals as requested by
64.1the person, who can provide information on the needs, strengths, and preferences of the
64.2person necessary to develop a community support plan that ensures the person's health and
64.3safety, but who is not a provider of service or has any financial interest in the provision
64.4of services. For persons who are to be assessed for elderly waiver customized living
64.5services under section 256B.0915, with the permission of the person being assessed or
64.6the person's designated or legal representative, the client's current or proposed provider
64.7of services may submit a copy of the provider's nursing assessment or written report
64.8outlining its recommendations regarding the client's care needs. The person conducting
64.9the assessment will notify the provider of the date by which this information is to be
64.10submitted. This information shall be provided to the person conducting the assessment
64.11prior to the assessment.
64.12    (e) If the person chooses to use community-based services, the person or the person's
64.13legal representative must be provided with a written community support plan within 40
64.14calendar days of the assessment visit, regardless of whether the individual is eligible for
64.15Minnesota health care programs. The written community support plan must include:
64.16(1) a summary of assessed needs as defined in paragraphs (c) and (d);
64.17(2) the individual's options and choices to meet identified needs, including all
64.18available options for case management services and providers;
64.19(3) identification of health and safety risks and how those risks will be addressed,
64.20including personal risk management strategies;
64.21(4) referral information; and
64.22(5) informal caregiver supports, if applicable.
64.23For a person determined eligible for state plan home care under subdivision 1a,
64.24paragraph (b), clause (1), the person or person's representative must also receive a copy of
64.25the home care service plan developed by the certified assessor.
64.26(f) A person may request assistance in identifying community supports without
64.27participating in a complete assessment. Upon a request for assistance identifying
64.28community support, the person must be transferred or referred to long-term care options
64.29counseling services available under sections 256.975, subdivision 7, and 256.01,
64.30subdivision 24, for telephone assistance and follow up.
64.31    (g) The person has the right to make the final decision between institutional
64.32placement and community placement after the recommendations have been provided,
64.33except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
64.34    (h) The lead agency must give the person receiving assessment or support planning,
64.35or the person's legal representative, materials, and forms supplied by the commissioner
64.36containing the following information:
65.1    (1) written recommendations for community-based services and consumer-directed
65.2options;
65.3(2) documentation that the most cost-effective alternatives available were offered to
65.4the individual. For purposes of this clause, "cost-effective" means community services and
65.5living arrangements that cost the same as or less than institutional care. For an individual
65.6found to meet eligibility criteria for home and community-based service programs under
65.7section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
65.8approved waiver plan for each program;
65.9(3) the need for and purpose of preadmission screening conducted by long-term care
65.10options counselors according to sections 256.975, subdivisions 7a to 7c, and 256.01,
65.11subdivision 24, if the person selects nursing facility placement. If the individual selects
65.12nursing facility placement, the lead agency shall forward information needed to complete
65.13the level of care determinations and screening for developmental disability and mental
65.14illness collected during the assessment to the long-term care options counselor using forms
65.15provided by the commissioner;
65.16    (4) the role of long-term care consultation assessment and support planning in
65.17eligibility determination for waiver and alternative care programs, and state plan home
65.18care, case management, and other services as defined in subdivision 1a, paragraphs (a),
65.19clause (7), and (b);
65.20    (5) information about Minnesota health care programs;
65.21    (6) the person's freedom to accept or reject the recommendations of the team;
65.22    (7) the person's right to confidentiality under the Minnesota Government Data
65.23Practices Act, chapter 13;
65.24    (8) the certified assessor's decision regarding the person's need for institutional level
65.25of care as determined under criteria established in section 256B.0911, subdivision 4a,
65.26paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services
65.27and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
65.28    (9) the person's right to appeal the certified assessor's decision regarding eligibility
65.29for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
65.30(b), and incorporating the decision regarding the need for institutional level of care or the
65.31lead agency's final decisions regarding public programs eligibility according to section
65.32256.045, subdivision 3 .
65.33    (i) Face-to-face assessment completed as part of eligibility determination for
65.34the alternative care, elderly waiver, community alternatives for disabled individuals,
65.35community alternative care, and brain injury waiver programs under sections 256B.0913,
66.1256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60
66.2calendar days after the date of assessment.
66.3(j) The effective eligibility start date for programs in paragraph (i) can never be
66.4prior to the date of assessment. If an assessment was completed more than 60 days
66.5before the effective waiver or alternative care program eligibility start date, assessment
66.6and support plan information must be updated in a face-to-face visit and documented in
66.7the department's Medicaid Management Information System (MMIS). Notwithstanding
66.8retroactive medical assistance coverage of state plan services, the effective date of
66.9eligibility for programs included in paragraph (i) cannot be prior to the date the most
66.10recent updated assessment is completed.

66.11    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
66.12read:
66.13    Subd. 4d. Preadmission screening of individuals under 65 60 years of age. (a)
66.14It is the policy of the state of Minnesota to ensure that individuals with disabilities or
66.15chronic illness are served in the most integrated setting appropriate to their needs and have
66.16the necessary information to make informed choices about home and community-based
66.17service options.
66.18    (b) Individuals under 65 60 years of age who are admitted to a Medicaid-certified
66.19 nursing facility from a hospital must be screened prior to admission as outlined in
66.20subdivisions 4a through 4c according to the requirements outlined in section 256.975,
66.21subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required
66.22under section 256.01, subdivision 24.
66.23    (c) Individuals under 65 years of age who are admitted to nursing facilities with
66.24only a telephone screening must receive a face-to-face assessment from the long-term
66.25care consultation team member of the county in which the facility is located or from the
66.26recipient's county case manager within 40 calendar days of admission.
66.27    (d) Individuals under 65 years of age who are admitted to a nursing facility
66.28without preadmission screening according to the exemption described in subdivision 4b,
66.29paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
66.30a face-to-face assessment within 40 days of admission.
66.31    (e) (d) At the face-to-face assessment, the long-term care consultation team member
66.32or county case manager must perform the activities required under subdivision 3b.
66.33    (f) (e) For individuals under 21 years of age, a screening interview which
66.34recommends nursing facility admission must be face-to-face and approved by the
66.35commissioner before the individual is admitted to the nursing facility.
67.1    (g) (f) In the event that an individual under 65 60 years of age is admitted to a
67.2nursing facility on an emergency basis, the county Disability Linkage Line must be
67.3notified of the admission on the next working day, and a face-to-face assessment as
67.4described in paragraph (c) must be conducted within 40 calendar days of admission.
67.5    (h) (g) At the face-to-face assessment, the long-term care consultation team member
67.6or the case manager must present information about home and community-based options,
67.7including consumer-directed options, so the individual can make informed choices. If the
67.8individual chooses home and community-based services, the long-term care consultation
67.9team member or case manager must complete a written relocation plan within 20 working
67.10days of the visit. The plan shall describe the services needed to move out of the facility
67.11and a time line for the move which is designed to ensure a smooth transition to the
67.12individual's home and community.
67.13    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive
67.14a face-to-face assessment at least every 12 months to review the person's service choices
67.15and available alternatives unless the individual indicates, in writing, that annual visits are
67.16not desired. In this case, the individual must receive a face-to-face assessment at least
67.17once every 36 months for the same purposes.
67.18    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay
67.19county agencies directly for face-to-face assessments for individuals under 65 years of age
67.20who are being considered for placement or residing in a nursing facility.
67.21(j) Funding for preadmission screening shall be provided to the Disability Linkage
67.22Line for the under 60 population by the Department of Human Services to cover screener
67.23salaries and expenses to provide the services described in subdivisions 7a to 7c. The
67.24Disability Linkage Line shall employ, or contract with other agencies to employ, within
67.25the limits of available funding, sufficient personnel to provide preadmission screening and
67.26level of care determination services and shall seek to maximize federal funding for the
67.27service as provided under section 256.01, subdivision 2, paragraph (dd).
67.28EFFECTIVE DATE.This section is effective October 1, 2013.

67.29    Sec. 21. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
67.30read:
67.31    Subd. 4d. Preadmission screening of individuals under 65 years of age. (a)
67.32It is the policy of the state of Minnesota to ensure that individuals with disabilities or
67.33chronic illness are served in the most integrated setting appropriate to their needs and have
67.34the necessary information to make informed choices about home and community-based
67.35service options.
68.1    (b) Individuals under 65 years of age who are admitted to a nursing facility from a
68.2hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.
68.3    (c) Individuals under 65 years of age who are admitted to nursing facilities with
68.4only a telephone screening must receive a face-to-face assessment from the long-term
68.5care consultation team member of the county in which the facility is located or from the
68.6recipient's county case manager within 40 calendar days of admission.
68.7    (d) Individuals under 65 years of age who are admitted to a nursing facility
68.8without preadmission screening according to the exemption described in subdivision 4b,
68.9paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
68.10a face-to-face assessment within 40 days of admission.
68.11    (e) At the face-to-face assessment, the long-term care consultation team member or
68.12county case manager must perform the activities required under subdivision 3b.
68.13    (f) For individuals under 21 years of age, a screening interview which recommends
68.14nursing facility admission must be face-to-face and approved by the commissioner before
68.15the individual is admitted to the nursing facility.
68.16    (g) In the event that an individual under 65 years of age is admitted to a nursing
68.17facility on an emergency basis, the county must be notified of the admission on the
68.18next working day, and a face-to-face assessment as described in paragraph (c) must be
68.19conducted within 40 calendar days of admission.
68.20    (h) At the face-to-face assessment, the long-term care consultation team member or
68.21the case manager must present information about home and community-based options,
68.22including consumer-directed options, so the individual can make informed choices. If the
68.23individual chooses home and community-based services, the long-term care consultation
68.24team member or case manager must complete a written relocation plan within 20 working
68.25days of the visit. The plan shall describe the services needed to move out of the facility
68.26and a time line for the move which is designed to ensure a smooth transition to the
68.27individual's home and community.
68.28    (i) An individual under 65 years of age residing in a nursing facility shall receive a
68.29face-to-face assessment at least every 12 months to review the person's service choices
68.30and available alternatives unless the individual indicates, in writing, that annual visits are
68.31not desired. In this case, the individual must receive a face-to-face assessment at least
68.32once every 36 months for the same purposes.
68.33    (j) Notwithstanding the provisions of subdivision 6, the commissioner may pay
68.34county agencies directly for face-to-face assessments for individuals under 65 years of age
68.35who are being considered for placement or residing in a nursing facility. Until September
69.130, 2013, payments for individuals under 65 years of age shall be made as described
69.2in this subdivision.

69.3    Sec. 22. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
69.4subdivision to read:
69.5    Subd. 4e. Determination of institutional level of care. The determination of the
69.6need for nursing facility, hospital, and intermediate care facility levels of care must be
69.7made according to criteria developed by the commissioner, and in section 256B.092,
69.8using forms developed by the commissioner. Effective January 1, 2014, for individuals
69.9age 21 and older, the determination of need for nursing facility level of care shall be
69.10based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
69.11determination of the need for nursing facility level of care must be made according to
69.12criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
69.13becomes effective on or after October 1, 2019.

69.14    Sec. 23. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
69.15    Subd. 6. Payment for long-term care consultation services. (a) Until September
69.1630, 2013, payment for long-term care consultation face-to-face assessment shall be made
69.17as described in this subdivision.
69.18    (b) The total payment for each county must be paid monthly by certified nursing
69.19facilities in the county. The monthly amount to be paid by each nursing facility for each
69.20fiscal year must be determined by dividing the county's annual allocation for long-term
69.21care consultation services by 12 to determine the monthly payment and allocating the
69.22monthly payment to each nursing facility based on the number of licensed beds in the
69.23nursing facility. Payments to counties in which there is no certified nursing facility must be
69.24made by increasing the payment rate of the two facilities located nearest to the county seat.
69.25    (b) (c) The commissioner shall include the total annual payment determined under
69.26paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434,
69.27or 256B.441.
69.28    (c) (d) In the event of the layaway, delicensure and decertification, or removal
69.29from layaway of 25 percent or more of the beds in a facility, the commissioner may
69.30adjust the per diem payment amount in paragraph (b) (c) and may adjust the monthly
69.31payment amount in paragraph (a) (b). The effective date of an adjustment made under this
69.32paragraph shall be on or after the first day of the month following the effective date of the
69.33layaway, delicensure and decertification, or removal from layaway.
70.1    (d) (e) Payments for long-term care consultation services are available to the county
70.2or counties to cover staff salaries and expenses to provide the services described in
70.3subdivision 1a. The county shall employ, or contract with other agencies to employ,
70.4within the limits of available funding, sufficient personnel to provide long-term care
70.5consultation services while meeting the state's long-term care outcomes and objectives as
70.6defined in subdivision 1. The county shall be accountable for meeting local objectives
70.7as approved by the commissioner in the biennial home and community-based services
70.8quality assurance plan on a form provided by the commissioner.
70.9    (e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment
70.10of the screening costs under the medical assistance program may not be recovered from
70.11a facility.
70.12    (f) (g) The commissioner of human services shall amend the Minnesota medical
70.13assistance plan to include reimbursement for the local consultation teams.
70.14    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented,
70.15the county may bill, as case management services, assessments, support planning, and
70.16follow-along provided to persons determined to be eligible for case management under
70.17Minnesota health care programs. No individual or family member shall be charged for an
70.18initial assessment or initial support plan development provided under subdivision 3a or 3b.
70.19(h) (i) The commissioner shall develop an alternative payment methodology,
70.20effective on October 1, 2013, for long-term care consultation services that includes
70.21the funding available under this subdivision, and for assessments authorized under
70.22sections 256B.092 and 256B.0659. In developing the new payment methodology, the
70.23commissioner shall consider the maximization of other funding sources, including federal
70.24administrative reimbursement through federal financial participation funding, for all
70.25long-term care consultation and preadmission screening activity. The alternative payment
70.26methodology shall include the use of the appropriate time studies and the state financing
70.27of nonfederal share as part of the state's medical assistance program.

70.28    Sec. 24. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
70.29    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
70.30reimbursement for nursing facilities shall be authorized for a medical assistance recipient
70.31only if a preadmission screening has been conducted prior to admission or the county has
70.32authorized an exemption. Medical assistance reimbursement for nursing facilities shall
70.33not be provided for any recipient who the local screener has determined does not meet the
70.34level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
70.35if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
71.1Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
71.2mental illness is approved by the local mental health authority or an admission for a
71.3recipient with developmental disability is approved by the state developmental disability
71.4authority.
71.5    (b) The nursing facility must not bill a person who is not a medical assistance
71.6recipient for resident days that preceded the date of completion of screening activities
71.7as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing
71.8facility must include unreimbursed resident days in the nursing facility resident day totals
71.9reported to the commissioner.

71.10    Sec. 25. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
71.11    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
71.12    (a) Funding for services under the alternative care program is available to persons who
71.13meet the following criteria:
71.14    (1) the person has been determined by a community assessment under section
71.15256B.0911 to be a person who would require the level of care provided in a nursing
71.16facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for
71.17the provision of services under the alternative care program;
71.18    (2) the person is age 65 or older;
71.19    (3) the person would be eligible for medical assistance within 135 days of admission
71.20to a nursing facility;
71.21    (4) the person is not ineligible for the payment of long-term care services by the
71.22medical assistance program due to an asset transfer penalty under section 256B.0595 or
71.23equity interest in the home exceeding $500,000 as stated in section 256B.056;
71.24    (5) the person needs long-term care services that are not funded through other
71.25state or federal funding, or other health insurance or other third-party insurance such as
71.26long-term care insurance;
71.27    (6) except for individuals described in clause (7), the monthly cost of the alternative
71.28care services funded by the program for this person does not exceed 75 percent of the
71.29monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
71.30does not prohibit the alternative care client from payment for additional services, but in no
71.31case may the cost of additional services purchased under this section exceed the difference
71.32between the client's monthly service limit defined under section 256B.0915, subdivision
71.333 , and the alternative care program monthly service limit defined in this paragraph. If
71.34care-related supplies and equipment or environmental modifications and adaptations are or
71.35will be purchased for an alternative care services recipient, the costs may be prorated on a
72.1monthly basis for up to 12 consecutive months beginning with the month of purchase.
72.2If the monthly cost of a recipient's other alternative care services exceeds the monthly
72.3limit established in this paragraph, the annual cost of the alternative care services shall be
72.4determined. In this event, the annual cost of alternative care services shall not exceed 12
72.5times the monthly limit described in this paragraph;
72.6    (7) for individuals assigned a case mix classification A as described under section
72.7256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
72.8living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
72.9when the dependency score in eating is three or greater as determined by an assessment
72.10performed under section 256B.0911, the monthly cost of alternative care services funded
72.11by the program cannot exceed $593 per month for all new participants enrolled in
72.12the program on or after July 1, 2011. This monthly limit shall be applied to all other
72.13participants who meet this criteria at reassessment. This monthly limit shall be increased
72.14annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly
72.15limit does not prohibit the alternative care client from payment for additional services, but
72.16in no case may the cost of additional services purchased exceed the difference between the
72.17client's monthly service limit defined in this clause and the limit described in clause (6)
72.18for case mix classification A; and
72.19(8) the person is making timely payments of the assessed monthly fee.
72.20A person is ineligible if payment of the fee is over 60 days past due, unless the person
72.21agrees to:
72.22    (i) the appointment of a representative payee;
72.23    (ii) automatic payment from a financial account;
72.24    (iii) the establishment of greater family involvement in the financial management of
72.25payments; or
72.26    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
72.27    The lead agency may extend the client's eligibility as necessary while making
72.28arrangements to facilitate payment of past-due amounts and future premium payments.
72.29Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
72.30reinstated for a period of 30 days.
72.31    (b) Alternative care funding under this subdivision is not available for a person who
72.32is a medical assistance recipient or who would be eligible for medical assistance without a
72.33spenddown or waiver obligation. A person whose initial application for medical assistance
72.34and the elderly waiver program is being processed may be served under the alternative care
72.35program for a period up to 60 days. If the individual is found to be eligible for medical
72.36assistance, medical assistance must be billed for services payable under the federally
73.1approved elderly waiver plan and delivered from the date the individual was found eligible
73.2for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
73.3care funds may not be used to pay for any service the cost of which: (i) is payable by
73.4medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
73.5pay a medical assistance income spenddown for a person who is eligible to participate in the
73.6federally approved elderly waiver program under the special income standard provision.
73.7    (c) Alternative care funding is not available for a person who resides in a licensed
73.8nursing home, certified boarding care home, hospital, or intermediate care facility, except
73.9for case management services which are provided in support of the discharge planning
73.10process for a nursing home resident or certified boarding care home resident to assist with
73.11a relocation process to a community-based setting.
73.12    (d) Alternative care funding is not available for a person whose income is greater
73.13than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
73.14to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
73.15year for which alternative care eligibility is determined, who would be eligible for the
73.16elderly waiver with a waiver obligation.

73.17    Sec. 26. Minnesota Statutes 2012, section 256B.0913, is amended by adding a
73.18subdivision to read:
73.19    Subd. 17. Essential community supports grants. (a) Notwithstanding subdivisions
73.201 to 14, the purpose of the essential community supports grant program is to provide
73.21targeted services to persons age 65 and older who need essential community support, but
73.22whose needs do not meet the level of care required for nursing facility placement under
73.23section 144.0724, subdivision 11.
73.24(b) Essential community supports grants are available not to exceed $400 per person
73.25per month. Essential community supports service grants may be used as authorized within
73.26an authorization period not to exceed 12 months. Grants must be available to a person who:
73.27(1) is age 65 or older;
73.28(2) is not eligible for medical assistance;
73.29(3) would otherwise be financially eligible for the alternative care program under
73.30subdivision 4;
73.31(4) has received a community assessment under section 256B.0911, subdivision 3a
73.32or 3b, and does not require the level of care provided in a nursing facility;
73.33(5) has a community support plan; and
73.34(6) has been determined by a community assessment under section 256B.0911,
73.35subdivision 3a or 3b, to be a person who would require provision of at least one of the
74.1following services, as defined in the approved elderly waiver plan, in order to maintain
74.2their community residence:
74.3(i) caregiver support;
74.4(ii) homemaker support;
74.5(iii) chores; or
74.6(iv) a personal emergency response device or system.
74.7(c) The person receiving any of the essential community supports in this subdivision
74.8must also receive service coordination, not to exceed $600 in a 12-month authorization
74.9period, as part of their community support plan.
74.10(d) A person who has been determined to be eligible for an essential community
74.11supports grant must be reassessed at least annually and continue to meet the criteria in
74.12paragraph (b) to remain eligible for an essential community supports grant.
74.13(e) The commissioner is authorized to use federal matching funds for essential
74.14community supports as necessary and to meet demand for essential community supports
74.15grants as outlined in paragraphs (f) and (g), and that amount of federal funds is
74.16appropriated to the commissioner for this purpose.
74.17(f) Upon federal approval and following a reasonable implementation period
74.18determined by the commissioner, essential community supports are available to an
74.19individual who:
74.20(1) is receiving nursing facility services or home and community-based long-term
74.21services and supports under section 256B.0915 or 256B.49 on the effective date of
74.22implementation of the revised nursing facility level of care under section 144.0724,
74.23subdivision 11;
74.24(2) meets one of the following criteria:
74.25(i) due to the implementation of the revised nursing facility level of care, loses
74.26eligibility for continuing medical assistance payment of nursing facility services at the
74.27first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or
74.28after the effective date of the revised nursing facility level of care criteria under section
74.29144.0724, subdivision 11; or
74.30(ii) due to the implementation of the revised nursing facility level of care, loses
74.31eligibility for continuing medical assistance payment of home and community-based
74.32long-term services and supports under section 256B.0915 or 256B.49 at the first
74.33reassessment required under those sections that occurs on or after the effective date of
74.34implementation of the revised nursing facility level of care under section 144.0724,
74.35subdivision 11;
74.36(3) is not eligible for personal care attendant services; and
75.1(4) has an assessed need for one or more of the supportive services offered under
75.2essential community supports.
75.3Individuals eligible under this paragraph includes individuals who continue to be
75.4eligible for medical assistance state plan benefits and those who are not or are no longer
75.5financially eligible for medical assistance.
75.6(g) Upon federal approval and following a reasonable implementation period
75.7determined by the commissioner, the services available through essential community
75.8supports include the services and grants provided in paragraphs (b) and (c), home-delivered
75.9meals, and community living assistance as defined by the commissioner. These services
75.10are available to all eligible recipients including those outlined in paragraphs (b) and (f).
75.11Recipients are eligible if they have a need for any of these services and meet all other
75.12eligibility criteria.

75.13    Sec. 27. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
75.14    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
75.15shall receive an initial assessment of strengths, informal supports, and need for services
75.16in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
75.17client served under the elderly waiver must be conducted at least every 12 months and at
75.18other times when the case manager determines that there has been significant change in
75.19the client's functioning. This may include instances where the client is discharged from
75.20the hospital. There must be a determination that the client requires nursing facility level
75.21of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and
75.22subsequent assessments to initiate and maintain participation in the waiver program.
75.23(b) Regardless of other assessments identified in section 144.0724, subdivision
75.244, as appropriate to determine nursing facility level of care for purposes of medical
75.25assistance payment for nursing facility services, only face-to-face assessments conducted
75.26according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
75.27level of care determination will be accepted for purposes of initial and ongoing access to
75.28waiver service payment.

75.29    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
75.30subdivision to read:
75.31    Subd. 1a. Home and community-based services for older adults. (a) The purpose
75.32of projects selected by the commissioner of human services under this section is to
75.33make strategic changes in the long-term services and supports system for older adults
75.34including statewide capacity for local service development and technical assistance, and
76.1statewide availability of home and community-based services for older adult services,
76.2caregiver support and respite care services, and other supports in the state of Minnesota.
76.3These projects are intended to create incentives for new and expanded home and
76.4community-based services in Minnesota in order to:
76.5(1) reach older adults early in the progression of their need for long-term services
76.6and supports, providing them with low-cost, high-impact services that will prevent or
76.7delay the use of more costly services;
76.8(2) support older adults to live in the most integrated, least restrictive community
76.9setting;
76.10(3) support the informal caregivers of older adults;
76.11(4) develop and implement strategies to integrate long-term services and supports
76.12with health care services, in order to improve the quality of care and enhance the quality
76.13of life of older adults and their informal caregivers;
76.14(5) ensure cost-effective use of financial and human resources;
76.15(6) build community-based approaches and community commitment to delivering
76.16long-term services and supports for older adults in their own homes;
76.17(7) achieve a broad awareness and use of lower-cost in-home services as an
76.18alternative to nursing homes and other residential services;
76.19(8) strengthen and develop additional home and community-based services and
76.20alternatives to nursing homes and other residential services; and
76.21(9) strengthen programs that use volunteers.
76.22(b) The services provided by these projects are available to older adults who are
76.23eligible for medical assistance and the elderly waiver under section 256B.0915, the
76.24alternative care program under section 256B.0913, or essential community supports grant
76.25under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
76.26services.

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

77.14    Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
77.15subdivision to read:
77.16    Subd. 1c. Eldercare development partnerships. The commissioner of human
77.17services shall select and contract with eldercare development partnerships sufficient to
77.18provide statewide availability of service development and technical assistance using a
77.19request for proposals process. Eldercare development partnerships shall:
77.20(1) develop a local long-term services and supports strategy consistent with state
77.21goals and objectives;
77.22(2) identify and use existing local skills, knowledge, and relationships, and build
77.23on these assets;
77.24(3) coordinate planning for funds to provide services to older adults, including funds
77.25received under Title III of the Older Americans Act, Title XX of the Social Security Act,
77.26and the Local Public Health Act;
77.27(4) target service development and technical assistance where nursing facility
77.28closures have occurred or are occurring or in areas where service needs have been
77.29identified through activities under section 144A.351;
77.30(5) provide sufficient staff for development and technical support in its designated
77.31area; and
77.32(6) designate a single public or nonprofit member of the eldercare development
77.33partnerships to apply grant funding and manage the project.

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

79.17    Sec. 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.439, subdivision 1, is amended to read:
80.18    Subdivision 1. Development and implementation of quality profiles. (a) The
80.19commissioner of human services, in cooperation with the commissioner of health,
80.20shall develop and implement a quality profile system profiles for nursing facilities and,
80.21beginning not later than July 1, 2004 2014, other providers of long-term care services,
80.22except when the quality profile system would duplicate requirements under section
80.23256B.5011 , 256B.5012, or 256B.5013. The system quality profiles must be developed
80.24and implemented to the extent possible without the collection of significant amounts of
80.25new data. To the extent possible, the system using existing data sets maintained by the
80.26commissioners of health and human services to the extent possible. The profiles must
80.27incorporate or be coordinated with information on quality maintained by area agencies on
80.28aging, long-term care trade associations, the ombudsman offices, counties, tribes, health
80.29plans, and other entities and the long-term care database maintained under section 256.975,
80.30subdivision 7. The system profiles must be designed to provide information on quality to:
80.31(1) consumers and their families to facilitate informed choices of service providers;
80.32(2) providers to enable them to measure the results of their quality improvement
80.33efforts and compare quality achievements with other service providers; and
81.1(3) public and private purchasers of long-term care services to enable them to
81.2purchase high-quality care.
81.3(b) The system profiles must be developed in consultation with the long-term care
81.4task force, area agencies on aging, and representatives of consumers, providers, and labor
81.5unions. Within the limits of available appropriations, the commissioners may employ
81.6consultants to assist with this project.

81.7    Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 2, is amended to read:
81.8    Subd. 2. Quality measurement tools. The commissioners shall identify and apply
81.9existing quality measurement tools to:
81.10(1) emphasize quality of care and its relationship to quality of life; and
81.11(2) address the needs of various users of long-term care services, including, but not
81.12limited to, short-stay residents, persons with behavioral problems, persons with dementia,
81.13and persons who are members of minority groups.
81.14    The tools must be identified and applied, to the extent possible, without requiring
81.15providers to supply information beyond current state and federal requirements.

81.16    Sec. 36. Minnesota Statutes 2012, section 256B.439, subdivision 3, is amended to read:
81.17    Subd. 3. Consumer surveys of nursing facilities residents. Following
81.18identification of the quality measurement tool, the commissioners shall conduct surveys
81.19of long-term care service consumers of nursing facilities to develop quality profiles
81.20of providers. To the extent possible, surveys must be conducted face-to-face by state
81.21employees or contractors. At the discretion of the commissioners, surveys may be
81.22conducted by telephone or by provider staff. Surveys must be conducted periodically to
81.23update quality profiles of individual service nursing facilities providers.

81.24    Sec. 37. Minnesota Statutes 2012, section 256B.439, is amended by adding a
81.25subdivision to read:
81.26    Subd. 3a. Home and community-based services report card in cooperation with
81.27the commissioner of health. The profiles developed for home and community-based
81.28services providers under this section shall be incorporated into a report card and
81.29maintained by the Minnesota Board on Aging pursuant to section 256.975, subdivision
81.307, paragraph (b), clause (2), as data becomes available. The commissioner, in
81.31cooperation with the commissioner of health, shall use consumer choice, quality of life,
81.32care approaches, and cost or flexible purchasing categories to organize the consumer
81.33information in the profiles. The final categories used shall include consumer input and
82.1survey data to the extent that it is available through the state agencies. The commissioner
82.2shall develop and disseminate the qualify profiles for a limited number of provider types
82.3initially, and develop quality profiles for additional provider types as measurement tools
82.4are developed and data becomes available. This includes providers of services to older
82.5adults and people with disabilities, regardless of payor source.

82.6    Sec. 38. Minnesota Statutes 2012, section 256B.439, subdivision 4, is amended to read:
82.7    Subd. 4. Dissemination of quality profiles. By July 1, 2003 2014, the
82.8commissioners shall implement a system public awareness effort to disseminate the quality
82.9profiles developed from consumer surveys using the quality measurement tool. Profiles
82.10may be disseminated to through the Senior LinkAge Line and Disability Linkage Line and
82.11to consumers, providers, and purchasers of long-term care services through all feasible
82.12printed and electronic outlets. The commissioners may conduct a public awareness
82.13campaign to inform potential users regarding profile contents and potential uses.

82.14    Sec. 39. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
82.15    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
82.16nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
82.17section 144.122; until September 30, 2013, long-term care consultation fees under
82.18section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
82.19scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
82.20under section 256B.437; or single bed room incentives under section 256B.431,
82.21subdivision 42 ; property taxes and property insurance; and PERA.

82.22    Sec. 40. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
82.23    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
82.24shall calculate a payment rate for external fixed costs.
82.25    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
82.26shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
82.27home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
82.28result of its number of nursing home beds divided by its total number of licensed beds.
82.29    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
82.30shall be the amount of the fee divided by actual resident days.
82.31    (c) The portion related to scholarships shall be determined under section 256B.431,
82.32subdivision 36.
83.1    (d) Until September 30, 2013, the portion related to long-term care consultation shall
83.2be determined according to section 256B.0911, subdivision 6.
83.3    (e) The portion related to development and education of resident and family advisory
83.4councils under section 144A.33 shall be $5 divided by 365.
83.5    (f) The portion related to planned closure rate adjustments shall be as determined
83.6under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
83.7Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
83.8be included in the payment rate for external fixed costs beginning October 1, 2016.
83.9Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
83.10longer be included in the payment rate for external fixed costs beginning on October 1 of
83.11the first year not less than two years after their effective date.
83.12    (g) The portions related to property insurance, real estate taxes, special assessments,
83.13and payments made in lieu of real estate taxes directly identified or allocated to the nursing
83.14facility shall be the actual amounts divided by actual resident days.
83.15    (h) The portion related to the Public Employees Retirement Association shall be
83.16actual costs divided by resident days.
83.17    (i) The single bed room incentives shall be as determined under section 256B.431,
83.18subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
83.19no longer be included in the payment rate for external fixed costs beginning October 1,
83.202016. Single bed room incentives that take effect on or after October 1, 2014, shall no
83.21longer be included in the payment rate for external fixed costs beginning on October 1 of
83.22the first year not less than two years after their effective date.
83.23    (j) The payment rate for external fixed costs shall be the sum of the amounts in
83.24paragraphs (a) to (i).

83.25    Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
83.26    Subd. 12. Informed choice. Persons who are determined likely to require the level
83.27of care provided in a nursing facility as determined under section 256B.0911, subdivision
83.284e, or a hospital shall be informed of the home and community-based support alternatives
83.29to the provision of inpatient hospital services or nursing facility services. Each person
83.30must be given the choice of either institutional or home and community-based services
83.31using the provisions described in section 256B.77, subdivision 2, paragraph (p).

83.32    Sec. 42. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
83.33    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
83.34shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
84.1With the permission of the recipient or the recipient's designated legal representative,
84.2the recipient's current provider of services may submit a written report outlining their
84.3recommendations regarding the recipient's care needs prepared by a direct service
84.4employee with at least 20 hours of service to that client. The person conducting the
84.5assessment or reassessment must notify the provider of the date by which this information
84.6is to be submitted. This information shall be provided to the person conducting the
84.7assessment and the person or the person's legal representative and must be considered
84.8prior to the finalization of the assessment or reassessment.
84.9(b) There must be a determination that the client requires a hospital level of care or a
84.10nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
84.11(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the
84.12waiver program.
84.13(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
84.14appropriate to determine nursing facility level of care for purposes of medical assistance
84.15payment for nursing facility services, only face-to-face assessments conducted according
84.16to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
84.17determination or a nursing facility level of care determination must be accepted for
84.18purposes of initial and ongoing access to waiver services payment.
84.19(d) Recipients who are found eligible for home and community-based services under
84.20this section before their 65th birthday may remain eligible for these services after their
84.2165th birthday if they continue to meet all other eligibility factors.
84.22(e) The commissioner shall develop criteria to identify recipients whose level of
84.23functioning is reasonably expected to improve and reassess these recipients to establish
84.24a baseline assessment. Recipients who meet these criteria must have a comprehensive
84.25transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
84.26reassessed every six months until there has been no significant change in the recipient's
84.27functioning for at least 12 months. After there has been no significant change in the
84.28recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
84.29informal support systems, and need for services shall be conducted at least every 12
84.30months and at other times when there has been a significant change in the recipient's
84.31functioning. Counties, case managers, and service providers are responsible for
84.32conducting these reassessments and shall complete the reassessments out of existing funds.

84.33    Sec. 43. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
84.34    Subdivision 1. Basis and scope. (a) Upon federal approval, the commissioner
84.35shall establish a medical assistance state plan option for the provision of home and
85.1community-based personal assistance service and supports called "community first
85.2services and supports (CFSS)."
85.3(b) CFSS is a participant-controlled method of selecting and providing services
85.4and supports that allows the participant maximum control of the services and supports.
85.5Participants may choose the degree to which they direct and manage their supports by
85.6choosing to have a significant and meaningful role in the management of services and
85.7supports including by directly employing support workers with the necessary supports
85.8to perform that function.
85.9(c) CFSS is available statewide to eligible individuals to assist with accomplishing
85.10activities of daily living (ADLs), instrumental activities of daily living (IADLs), and
85.11health-related procedures and tasks through hands-on assistance to accomplish the task
85.12or constant supervision and cueing to accomplish the task; and to assist with acquiring,
85.13maintaining, and enhancing the skills necessary to accomplish ADLs, IADLs, and
85.14health-related procedures and tasks. CFSS allows payment for certain supports and goods
85.15such as environmental modifications and technology that are intended to replace or
85.16decrease the need for human assistance.
85.17(d) Upon federal approval, CFSS will replace the personal care assistance program
85.18under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
85.19    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
85.20this subdivision have the meanings given.
85.21(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming,
85.22dressing, bathing, mobility, positioning, and transferring.
85.23(c) "Agency-provider model" means a method of CFSS under which a qualified
85.24agency provides services and supports through the agency's own employees and policies.
85.25The agency must allow the participant to have a significant role in the selection and
85.26dismissal of support workers of their choice for the delivery of their specific services
85.27and supports.
85.28(d) "Behavior" means a description of a need for services and supports used to
85.29determine the home care rating and additional service units. The presence of Level I
85.30behavior is used to determine the home care rating. "Level I behavior" means physical
85.31aggression towards self or others or destruction of property that requires the immediate
85.32response of another person. If qualified for a home care rating as described in subdivision
85.338, additional service units can be added as described in subdivision 8, paragraph (f), for
85.34the following behaviors:
85.35(1) Level I behavior;
86.1(2) increased vulnerability due to cognitive deficits or socially inappropriate
86.2behavior; or
86.3(3) increased need for assistance for recipients who are verbally aggressive or
86.4resistive to care so that time needed to perform activities of daily living is increased.
86.5(e) "Complex health-related needs" means an intervention listed in clauses (1) to
86.6(8) that has been ordered by a physician, and is specified in a community support plan,
86.7including:
86.8(1) tube feedings requiring:
86.9(i) a gastrojejunostomy tube; or
86.10(ii) continuous tube feeding lasting longer than 12 hours per day;
86.11(2) wounds described as:
86.12(i) stage III or stage IV;
86.13(ii) multiple wounds;
86.14(iii) requiring sterile or clean dressing changes or a wound vac; or
86.15(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require
86.16specialized care;
86.17(3) parenteral therapy described as:
86.18(i) IV therapy more than two times per week lasting longer than four hours for
86.19each treatment; or
86.20(ii) total parenteral nutrition (TPN) daily;
86.21(4) respiratory interventions, including:
86.22(i) oxygen required more than eight hours per day;
86.23(ii) respiratory vest more than one time per day;
86.24(iii) bronchial drainage treatments more than two times per day;
86.25(iv) sterile or clean suctioning more than six times per day;
86.26(v) dependence on another to apply respiratory ventilation augmentation devices
86.27such as BiPAP and CPAP; and
86.28(vi) ventilator dependence under section 256B.0652;
86.29(5) insertion and maintenance of catheter, including:
86.30(i) sterile catheter changes more than one time per month;
86.31(ii) clean intermittent catheterization, and including self-catheterization more than
86.32six times per day; or
86.33(iii) bladder irrigations;
86.34(6) bowel program more than two times per week requiring more than 30 minutes to
86.35perform each time;
86.36(7) neurological intervention, including:
87.1(i) seizures more than two times per week and requiring significant physical
87.2assistance to maintain safety; or
87.3(ii) swallowing disorders diagnosed by a physician and requiring specialized
87.4assistance from another on a daily basis; and
87.5(8) other congenital or acquired diseases creating a need for significantly increased
87.6direct hands-on assistance and interventions in six to eight activities of daily living.
87.7(f) "Community first services and supports" or "CFSS" means the assistance and
87.8supports program under this section needed for accomplishing activities of daily living,
87.9instrumental activities of daily living, and health-related tasks through hands-on assistance
87.10to complete the task or supervision and cueing to complete the task, or the purchase of
87.11goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for
87.12human assistance.
87.13(g) "Community first services and supports service delivery plan" or "service delivery
87.14plan" means a written summary of the services and supports, that is based on the community
87.15support plan identified in section 256B.0911 and coordinated services and support plan
87.16and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined
87.17by the participant to meet the assessed needs, using a person-centered planning process.
87.18(h) "Critical activities of daily living" means transferring, mobility, eating, and
87.19toileting.
87.20(i) "Dependency" in activities of daily living means a person requires hands-on
87.21assistance or constant supervision and cueing to accomplish one or more of the activities
87.22of daily living every day or on the days during the week that the activity is performed;
87.23however, a child may not be found to be dependent in an activity of daily living if,
87.24because of the child's age, an adult would either perform the activity for the child or assist
87.25the child with the activity. Assistance needed is the assistance appropriate for a typical
87.26child of the same age.
87.27(j) "Extended CFSS" means CFSS services and supports under the agency–provider
87.28model included in a service plan through one of the home and community-based services
87.29waivers authorized under sections 256B.0915; 256B.092, subdivision 5; and 256B.49,
87.30which exceed the amount, duration, and frequency of the state plan CFSS services for
87.31participants.
87.32(k) "Financial management services contractor or vendor" means a qualified
87.33organization having a written contract with the department to provide services necessary to
87.34use the budget model under subdivision 13, that include but are not limited to: participant
87.35education and technical assistance; CFSS service delivery planning and budgeting; billing,
87.36making payments, and monitoring of spending; and assisting the participant in fulfilling
88.1employer-related requirements in accordance with Section 3504 of the IRS code and
88.2the IRS Revenue Procedure 70-6.
88.3(l) "Budget model" means a service delivery method of CFSS that uses an
88.4individualized CFSS service delivery plan and service budget and assistance from the
88.5financial management services contractor to facilitate participant employment of support
88.6workers and the acquisition of supports and goods.
88.7(m) "Health-related procedures and tasks" means procedures and tasks related to
88.8the specific needs of an individual that can be delegated or assigned by a state-licensed
88.9healthcare or behavioral health professional and performed by a support worker.
88.10(n) "Instrumental activities of daily living" means activities related to living
88.11independently in the community, including but not limited to: meal planning, preparation,
88.12and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning;
88.13assistance with medications; managing money; communicating needs, preferences, and
88.14activities; arranging supports; and assistance with traveling around and participating
88.15in the community.
88.16(o) "Legal representative" means parent of a minor, a court-appointed guardian, or
88.17another representative with legal authority to make decisions about services and supports
88.18for the participant. Other representatives with legal authority to make decisions include
88.19but are not limited to a health care agent or an attorney-in-fact authorized through a health
88.20care directive or power of attorney.
88.21(p) "Medication assistance" means providing verbal or visual reminders to take
88.22regularly scheduled medication, and includes any of the following supports listed in clauses
88.23(1) to (3) and other types of assistance, except that a support worker may not determine
88.24medication dose or time for medication or inject medications into veins, muscles, or skin:
88.25(1) under the direction of the participant or the participant's representative, bringing
88.26medications to the participant including medications given through a nebulizer, opening a
88.27container of previously set-up medications, emptying the container into the participant's
88.28hand, opening and giving the medication in the original container to the participant, or
88.29bringing to the participant liquids or food to accompany the medication;
88.30(2) organizing medications as directed by the participant or the participant's
88.31representative; and
88.32(3) providing verbal or visual reminders to perform regularly scheduled medications.
88.33(q) "Participant's representative" means a parent, family member, advocate, or
88.34other adult authorized by the participant to serve as a representative in connection with
88.35the provision of CFSS. This authorization must be in writing or by another method
88.36that clearly indicates the participant's free choice. The participant's representative must
89.1have no financial interest in the provision of any services included in the participant's
89.2service delivery plan and must be capable of providing the support necessary to assist
89.3the participant in the use of CFSS. If through the assessment process described in
89.4subdivision 5 a participant is determined to be in need of a participant's representative, one
89.5must be selected. If the participant is unable to assist in the selection of a participant's
89.6representative, the legal representative shall appoint one. Two persons may be designated
89.7as a participant's representative for reasons such as divided households and court-ordered
89.8custodies. Duties of a participant's representatives may include:
89.9(1) being available while care is provided in a method agreed upon by the participant
89.10or the participant's legal representative and documented in the participant's CFSS service
89.11delivery plan;
89.12(2) monitoring CFSS services to ensure the participant's CFSS service delivery
89.13plan is being followed; and
89.14(3) reviewing and signing CFSS time sheets after services are provided to provide
89.15verification of the CFSS services.
89.16(r) "Person-centered planning process" means a process that is driven by the
89.17participant for discovering and planning services and supports that ensures the participant
89.18makes informed choices and decisions. The person-centered planning process must:
89.19(1) include people chosen by the participant;
89.20(2) provide necessary information and support to ensure that the participant directs
89.21the process to the maximum extent possible, and is enabled to make informed choices
89.22and decisions;
89.23(3) be timely and occur at time and locations of convenience to the participant;
89.24(4) reflect cultural considerations of the participant;
89.25(5) include strategies for solving conflict or disagreement within the process,
89.26including clear conflict-of-interest guidelines for all planning;
89.27(6) offer choices to the participant regarding the services and supports they receive
89.28and from whom;
89.29(7) include a method for the participant to request updates to the plan; and
89.30(8) record the alternative home and community-based settings that were considered
89.31by the participant.
89.32(s) "Shared services" means the provision of CFSS services by the same CFSS
89.33support worker to two or three participants who voluntarily enter into an agreement to
89.34receive services at the same time and in the same setting by the same provider.
89.35(t) "Support specialist" means a professional with the skills and ability to assist the
89.36participant using either the agency provider model under subdivision 11 or the flexible
90.1spending model under subdivision 13, in services including but not limited to assistance
90.2regarding:
90.3(1) the development, implementation, and evaluation of the CFSS service delivery
90.4plan under subdivision 6;
90.5(2) recruitment, training, or supervision, including supervision of health-related
90.6tasks or behavioral supports appropriately delegated by a health care professional, and
90.7evaluation of support workers; and
90.8(3) facilitating the use of informal and community supports, goods, or resources.
90.9(u) "Support worker" means an employee of the agency provider or of the participant
90.10who has direct contact with the participant and provides services as specified within the
90.11participant's service delivery plan.
90.12(v) "Wages and benefits" means the hourly wages and salaries, the employer's
90.13share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
90.14compensation, mileage reimbursement, health and dental insurance, life insurance,
90.15disability insurance, long-term care insurance, uniform allowance, contributions to
90.16employee retirement accounts, or other forms of employee compensation and benefits.
90.17    Subd. 3. Eligibility. (a) CFSS is available to a person who meets one of the
90.18following:
90.19(1) is a recipient of medical assistance as determined under section 256B.055,
90.20256B.056, or 256B.057, subdivisions 5 and 9;
90.21(2) is a recipient of the alternative care program under section 256B.0913;
90.22(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093,
90.23or 256B.49; or
90.24(4) has medical services identified in a participant's individualized education
90.25program and is eligible for services as determined in section 256B.0625, subdivision 26.
90.26(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
90.27meet all of the following:
90.28(1) require assistance and be determined dependent in one activity of daily living or
90.29Level I behavior based on assessment under section 256B.0911;
90.30(2) is not a recipient under the family support grant under section 252.32;
90.31(3) lives in the person's own apartment or home including a family foster care setting
90.32licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a
90.33noncertified boarding care or boarding and lodging establishments under chapter 157.
90.34    Subd. 4. Eligibility for other services. Selection of CFSS by a participant must not
90.35restrict access to other medically necessary care and services furnished under the state
90.36plan medical assistance benefit or other services available through alternative care.
91.1    Subd. 5. Assessment requirements. (a) The assessment of functional need must:
91.2(1) be conducted by a certified assessor according to the criteria established in
91.3section 256B.0911, subdivision 3a;
91.4(2) be conducted face-to-face, initially and at least annually thereafter, or when there
91.5is a significant change in the participant's condition or a change in the need for services
91.6and supports; and
91.7(3) be completed using the format established by the commissioner.
91.8(b) A participant who is residing in a facility may be assessed and choose CFSS for
91.9the purpose of using CFSS to return to the community as described in subdivisions 3
91.10and 7, paragraph (a), clause (5).
91.11(c) The results of the assessment and any recommendations and authorizations for
91.12CFSS must be determined and communicated in writing by the lead agency's certified
91.13assessor as defined in section 256B.0911 to the participant and the agency-provider or
91.14financial management services provider chosen by the participant within 40 calendar days
91.15and must include the participant's right to appeal under section 256.045, subdivision 3.
91.16(d) The lead agency assessor may request a temporary authorization for CFSS
91.17services. Authorization for a temporary level of CFSS services is limited to the time
91.18specified by the commissioner, but shall not exceed 45 days. The level of services
91.19authorized under this provision shall have no bearing on a future authorization.
91.20    Subd. 6. Community first services and support service delivery plan. (a) The
91.21CFSS service delivery plan must be developed, implemented, and evaluated through a
91.22person-centered planning process by the participant, or the participant's representative
91.23or legal representative who may be assisted by a support specialist. The CFSS service
91.24delivery plan must reflect the services and supports that are important to the participant
91.25and for the participant to meet the needs assessed by the certified assessor and identified
91.26in the community support plan under section 256B.0911 or the coordinated services and
91.27support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS
91.28service delivery plan must be reviewed by the participant and the agency-provider or
91.29financial management services contractor at least annually upon reassessment, or when
91.30there is a significant change in the participant's condition, or a change in the need for
91.31services and supports.
91.32(b) The commissioner shall establish the format and criteria for the CFSS service
91.33delivery plan.
91.34(c) The CFSS service delivery plan must be person-centered and:
91.35(1) specify the agency-provider or financial management services contractor selected
91.36by the participant;
92.1(2) reflect the setting in which the participant resides that is chosen by the participant;
92.2(3) reflect the participant's strengths and preferences;
92.3(4) include the means to address the clinical and support needs as identified through
92.4an assessment of functional needs;
92.5(5) include individually identified goals and desired outcomes;
92.6(6) reflect the services and supports, paid and unpaid, that will assist the participant
92.7to achieve identified goals, and the providers of those services and supports, including
92.8natural supports;
92.9(7) identify the amount and frequency of face-to-face supports and amount and
92.10frequency of remote supports and technology that will be used;
92.11(8) identify risk factors and measures in place to minimize them, including
92.12individualized backup plans;
92.13(9) be understandable to the participant and the individuals providing support;
92.14(10) identify the individual or entity responsible for monitoring the plan;
92.15(11) be finalized and agreed to in writing by the participant and signed by all
92.16individuals and providers responsible for its implementation;
92.17(12) be distributed to the participant and other people involved in the plan; and
92.18(13) prevent the provision of unnecessary or inappropriate care.
92.19(d) The total units of agency-provider services or the budget allocation amount for
92.20the budget model include both annual totals and a monthly average amount that cover
92.21the number of months of the service authorization. The amount used each month may
92.22vary, but additional funds must not be provided above the annual service authorization
92.23amount unless a change in condition is assessed and authorized by the certified assessor
92.24and documented in the community support plan, coordinated services and supports plan,
92.25and service delivery plan.
92.26    Subd. 7. Community first services and supports; covered services. Services
92.27and supports covered under CFSS include:
92.28(1) assistance to accomplish activities of daily living (ADLs), instrumental activities
92.29of daily living (IADLs), and health-related procedures and tasks through hands-on
92.30assistance to complete the task or supervision and cueing to complete the task;
92.31(2) assistance to acquire, maintain, or enhance the skills necessary for the participant
92.32to accomplish activities of daily living, instrumental activities of daily living, or
92.33health-related tasks;
92.34(3) expenditures for items, services, supports, environmental modifications, or
92.35goods, including assistive technology. These expenditures must:
92.36(i) relate to a need identified in a participant's CFSS service delivery plan;
93.1(ii) increase independence or substitute for human assistance to the extent that
93.2expenditures would otherwise be made for human assistance for the participant's assessed
93.3needs;
93.4(4) observation and redirection for behavior or symptoms where there is a need for
93.5assistance. A recipient qualifies as having a need for assistance due to behaviors if the
93.6recipient's behavior requires assistance at least four times per week and shows one or
93.7more of the following behaviors:
93.8(i) physical aggression towards self or others, or destruction of property that requires
93.9the immediate response of another person;
93.10(ii) increased vulnerability due to cognitive deficits or socially inappropriate
93.11behavior; or
93.12(iii) increased need for assistance for recipients who are verbally aggressive or
93.13resistive to care so that time needed to perform activities of daily living is increased;
93.14(5) back-up systems or mechanisms, such as the use of pagers or other electronic
93.15devices, to ensure continuity of the participant's services and supports;
93.16(6) transition costs, including:
93.17(i) deposits for rent and utilities;
93.18(ii) first month's rent and utilities;
93.19(iii) bedding;
93.20(iv) basic kitchen supplies;
93.21(v) other necessities, to the extent that these necessities are not otherwise covered
93.22under any other funding that the participant is eligible to receive; and
93.23(vi) other required necessities for an individual to make the transition from a nursing
93.24facility, institution for mental diseases, or intermediate care facility for persons with
93.25developmental disabilities to a community-based home setting where the participant
93.26resides; and
93.27(7) services by a support specialist defined under subdivision 2 that are chosen
93.28by the participant.
93.29    Subd. 8. Determination of CFSS service methodology. (a) All community first
93.30services and supports must be authorized by the commissioner or the commissioner's
93.31designee before services begin, except for the assessments established in section
93.32256B.0911. The authorization for CFSS must be completed as soon as possible following
93.33an assessment but no later than 40 calendar days from the date of the assessment.
93.34(b) The amount of CFSS authorized must be based on the recipient's home care
93.35rating described in subdivision 8, paragraphs (d) and (e), and any additional service units
93.36for which the person qualifies as described in subdivision 8, paragraph (f).
94.1(c) The home care rating shall be determined by the commissioner or the
94.2commissioner's designee based on information submitted to the commissioner identifying
94.3the following for a recipient:
94.4(1) the total number of dependencies of activities of daily living as defined in
94.5subdivision 2, paragraph (b);
94.6(2) the presence of complex health-related needs as defined in subdivision 2,
94.7paragraph (e); and
94.8(3) the presence of Level I behavior as defined in subdivision 2, paragraph (d),
94.9clause (1).
94.10(d) The methodology to determine the total service units for CFSS for each home
94.11care rating is based on the median paid units per day for each home care rating from
94.12fiscal year 2007 data for the PCA program.
94.13(e) Each home care rating is designated by the letters P through Z and EN and has
94.14the following base number of service units assigned:
94.15(i) P home care rating requires Level 1 behavior or one to three dependencies in
94.16ADLs and qualifies one for five service units;
94.17(ii) Q home care rating requires Level 1 behavior and one to three dependencies in
94.18ADLs and qualifies one for six service units;
94.19(iii) R home care rating requires complex health-related needs and one to three
94.20dependencies in ADLs and qualifies one for seven service units;
94.21(iv) S home care rating requires four to six dependencies in ADLs and qualifies
94.22one for ten service units;
94.23(v) T home care rating requires four to six dependencies in ADLs and Level 1
94.24behavior and qualifies one for 11 service units;
94.25(vi) U home care rating requires four to six dependencies in ADLs and a complex
94.26health need and qualifies one for 14 service units;
94.27(vii) V home care rating requires seven to eight dependencies in ADLs and qualifies
94.28one for 17 service units;
94.29(viii) W home care rating requires seven to eight dependencies in ADLs and Level 1
94.30behavior and qualifies one for 20 service units;
94.31(ix) Z home care rating requires seven to eight dependencies in ADLs and a complex
94.32health related need and qualifies one for 30 service units; and
94.33(x) EN home care rating includes ventilator dependency as defined in section
94.34256B.0651, subdivision 1, paragraph (g). Recipients who meet the definition of
94.35ventilator-dependent and the EN home care rating and utilize a combination of CFSS
94.36and other home care services are limited to a total of 96 service units per day for those
95.1services in combination. Additional units may be authorized when a recipient's assessment
95.2indicates a need for two staff to perform activities. Additional time is limited to 16 service
95.3units per day.
95.4(f) Additional service units are provided through the assessment and identification of
95.5the following:
95.6(1) 30 additional minutes per day for a dependency in each critical activity of daily
95.7living as defined in subdivision 2, paragraph (h);
95.8(2) 30 additional minutes per day for each complex health-related function as
95.9defined in subdivision 2, paragraph (e); and
95.10(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2,
95.11paragraph (d).
95.12    Subd. 9. Noncovered services. (a) Services or supports that are not eligible for
95.13payment under this section include those that:
95.14(1) are not authorized by the certified assessor or included in the written service
95.15delivery plan;
95.16(2) are provided prior to the authorization of services and the approval of the written
95.17CFSS service delivery plan;
95.18(3) are duplicative of other paid services in the written service delivery plan;
95.19(4) supplant natural unpaid supports that appropriately meet a need in the service
95.20plan, are provided voluntarily to the participant and are selected by the participant in lieu
95.21of other services and supports;
95.22(5) are not effective means to meet the participant's needs; and
95.23(6) are available through other funding sources, including, but not limited to, funding
95.24through Title IV-E of the Social Security Act.
95.25(b) Additional services, goods, or supports that are not covered include:
95.26(1) those that are not for the direct benefit of the participant, except that services for
95.27caregivers such as training to improve the ability to provide CFSS are considered to directly
95.28benefit the participant if chosen by the participant and approved in the support plan;
95.29(2) any fees incurred by the participant, such as Minnesota health care programs fees
95.30and co-pays, legal fees, or costs related to advocate agencies;
95.31(3) insurance, except for insurance costs related to employee coverage;
95.32(4) room and board costs for the participant with the exception of allowable
95.33transition costs in subdivision 7, clause (6);
95.34(5) services, supports, or goods that are not related to the assessed needs;
96.1(6) special education and related services provided under the Individuals with
96.2Disabilities Education Act and vocational rehabilitation services provided under the
96.3Rehabilitation Act of 1973;
96.4(7) assistive technology devices and assistive technology services other than those
96.5for back-up systems or mechanisms to ensure continuity of service and supports listed in
96.6subdivision 7;
96.7(8) medical supplies and equipment;
96.8(9) environmental modifications, except as specified in subdivision 7;
96.9(10) expenses for travel, lodging, or meals related to training the participant, the
96.10participant's representative, legal representative, or paid or unpaid caregivers that exceed
96.11$500 in a 12-month period;
96.12(11) experimental treatments;
96.13(12) any service or good covered by other medical assistance state plan services,
96.14including prescription and over-the-counter medications, compounds, and solutions and
96.15related fees, including premiums and co-payments;
96.16(13) membership dues or costs, except when the service is necessary and appropriate
96.17to treat a physical condition or to improve or maintain the participant's physical condition.
96.18The condition must be identified in the participant's CFSS plan and monitored by a
96.19physician enrolled in a Minnesota health care program;
96.20(14) vacation expenses other than the cost of direct services;
96.21(15) vehicle maintenance or modifications not related to the disability, health
96.22condition, or physical need; and
96.23(16) tickets and related costs to attend sporting or other recreational or entertainment
96.24events.
96.25    Subd. 10. Provider qualifications and general requirements. (a)
96.26Agency-providers delivering services under the agency-provider model under subdivision
96.2711 or financial management service (FMS) contractors under subdivision 13 shall:
96.28(1) enroll as a medical assistance Minnesota health care programs provider and meet
96.29all applicable provider standards;
96.30(2) comply with medical assistance provider enrollment requirements;
96.31(3) demonstrate compliance with law and policies of CFSS as determined by the
96.32commissioner;
96.33(4) comply with background study requirements under chapter 245C;
96.34(5) verify and maintain records of all services and expenditures by the participant,
96.35including hours worked by support workers and support specialists;
97.1(6) not engage in any agency-initiated direct contact or marketing in person, by
97.2telephone, or other electronic means to potential participants, guardians, family member,
97.3or participants' representatives;
97.4(7) pay support workers and support specialists based upon actual hours of services
97.5provided;
97.6(8) withhold and pay all applicable federal and state payroll taxes;
97.7(9) make arrangements and pay unemployment insurance, taxes, workers'
97.8compensation, liability insurance, and other benefits, if any;
97.9(10) enter into a written agreement with the participant, participant's representative,
97.10or legal representative that assigns roles and responsibilities to be performed before
97.11services, supports, or goods are provided using a format established by the commissioner;
97.12(11) report maltreatment as required under sections 626.556 and 626.557; and
97.13(12) provide the participant with a copy of the service-related rights under
97.14subdivision 19 at the start of services and supports.
97.15(b) The commissioner shall develop policies and procedures designed to ensure
97.16program integrity and fiscal accountability for goods and services provided in this section
97.17in consultation with the implementation council described in subdivision 21.
97.18    Subd. 11. Agency-provider model. (a) The agency-provider model is limited to
97.19the services provided by support workers and support specialists who are employed by
97.20an agency-provider that is licensed according to chapter 245A or meets other criteria
97.21established by the commissioner, including required training.
97.22(b) The agency-provider shall allow the participant to have a significant role in the
97.23selection and dismissal of the support workers for the delivery of the services and supports
97.24specified in the participant's service delivery plan.
97.25(c) A participant may use authorized units of CFSS services as needed within a
97.26service authorization that is not greater than 12 months. Using authorized units in a
97.27flexible manner in either the agency-provider model or the budget model does not increase
97.28the total amount of services and supports authorized for a participant or included in the
97.29participant's service delivery plan.
97.30(d) A participant may share CFSS services. Two or three CFSS participants may
97.31share services at the same time provided by the same support worker.
97.32(e) The agency-provider must use a minimum of 72.5 percent of the revenue
97.33generated by the medical assistance payment for CFSS for support worker wages and
97.34benefits. The agency-provider must document how this requirement is being met. The
97.35revenue generated by the support specialist and the reasonable costs associated with the
97.36support specialist must not be used in making this calculation.
98.1(f) The agency-provider model must be used by individuals who have been restricted
98.2by the Minnesota restricted recipient program under Minnesota Rules, parts 9505.2160
98.3to 9505.2245.
98.4    Subd. 12. Requirements for initial enrollment of CFSS provider agencies. (a)
98.5All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider
98.6agency in a format determined by the commissioner, information and documentation that
98.7includes, but is not limited to, the following:
98.8(1) the CFSS provider agency's current contact information including address,
98.9telephone number, and e-mail address;
98.10(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
98.11provider's payments from Medicaid in the previous year, whichever is less;
98.12(3) proof of fidelity bond coverage in the amount of $20,000;
98.13(4) proof of workers' compensation insurance coverage;
98.14(5) proof of liability insurance;
98.15(6) a description of the CFSS provider agency's organization identifying the names
98.16or all owners, managing employees, staff, board of directors, and the affiliations of the
98.17directors, owners, or staff to other service providers;
98.18(7) a copy of the CFSS provider agency's written policies and procedures including:
98.19hiring of employees; training requirements; service delivery; and employee and consumer
98.20safety including process for notification and resolution of consumer grievances,
98.21identification and prevention of communicable diseases, and employee misconduct;
98.22(8) copies of all other forms the CFSS provider agency uses in the course of daily
98.23business including, but not limited to:
98.24(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from
98.25the standard time sheet for CFSS services approved by the commissioner, and a letter
98.26requesting approval of the CFSS provider agency's nonstandard time sheet;
98.27(ii) the CFSS provider agency's template for the CFSS care plan; and
98.28(iii) the CFSS provider agency's template for the written agreement in subdivision
98.2921 for recipients using the CFSS choice option, if applicable;
98.30(9) a list of all training and classes that the CFSS provider agency requires of its
98.31staff providing CFSS services;
98.32(10) documentation that the CFSS provider agency and staff have successfully
98.33completed all the training required by this section;
98.34(11) documentation of the agency's marketing practices;
98.35(12) disclosure of ownership, leasing, or management of all residential properties
98.36that is used or could be used for providing home care services;
99.1(13) documentation that the agency will use the following percentages of revenue
99.2generated from the medical assistance rate paid for CFSS services for employee personal
99.3care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The
99.4revenue generated by the support specialist and the reasonable costs associated with the
99.5support specialist shall not be used in making this calculation; and
99.6(14) documentation that the agency does not burden recipients' free exercise of their
99.7right to choose service providers by requiring personal care assistants to sign an agreement
99.8not to work with any particular CFSS recipient or for another CFSS provider agency after
99.9leaving the agency and that the agency is not taking action on any such agreements or
99.10requirements regardless of the date signed.
99.11(b) CFSS provider agencies shall provide to the commissioner the information
99.12specified in paragraph (a).
99.13(c) All CFSS provider agencies shall require all employees in management and
99.14supervisory positions and owners of the agency who are active in the day-to-day
99.15management and operations of the agency to complete mandatory training as determined
99.16by the commissioner. Employees in management and supervisory positions and owners
99.17who are active in the day-to-day operations of an agency who have completed the required
99.18training as an employee with a CFSS provider agency do not need to repeat the required
99.19training if they are hired by another agency, if they have completed the training within
99.20the past three years. CFSS provider agency billing staff shall complete training about
99.21CFSS program financial management. Any new owners or employees in management
99.22and supervisory positions involved in the day-to-day operations are required to complete
99.23mandatory training as a requisite of working for the agency. CFSS provider agencies
99.24certified for participation in Medicare as home health agencies are exempt from the
99.25training required in this subdivision.
99.26    Subd. 13. Budget model. (a) Under the budget model participants can exercise
99.27more responsibility and control over the services and supports described and budgeted
99.28within the CFSS service delivery plan. Under this model, participants may use their
99.29budget allocation to:
99.30(1) directly employ support workers;
99.31(2) obtain supports and goods as defined in subdivision 7; and
99.32(3) choose a range of support assistance services from the financial management
99.33services (FMS) contractor related to:
99.34(i) assistance in managing the budget to meet the service delivery plan needs,
99.35consistent with federal and state laws and regulations;
100.1(ii) the employment, training, supervision, and evaluation of workers by the
100.2participant;
100.3(iii) acquisition and payment for supports and goods; and
100.4(iv) evaluation of individual service outcomes as needed for the scope of the
100.5participant's degree of control and responsibility.
100.6(b) Participants who are unable to fulfill any of the functions listed in paragraph (a)
100.7may authorize a legal representative or participant's representative to do so on their behalf.
100.8(c) The FMS contractor shall not provide CFSS services and supports under the
100.9agency-provider service model. The FMS contractor shall provide service functions as
100.10determined by the commissioner that include but are not limited to:
100.11(1) information and consultation about CFSS;
100.12(2) assistance with the development of the service delivery plan and budget model
100.13as requested by the participant;
100.14(3) billing and making payments for budget model expenditures;
100.15(4) assisting participants in fulfilling employer-related requirements according to
100.16Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,
100.17regulation 137036-08, which includes assistance with filing and paying payroll taxes, and
100.18obtaining worker compensation coverage;
100.19(5) data recording and reporting of participant spending; and
100.20(6) other duties established in the contract with the department.
100.21(d) A participant who requests to purchase goods and supports along with support
100.22worker services under the agency-provider model must use the budget model with
100.23a service delivery plan that specifies the amount of services to be authorized to the
100.24agency-provider and the expenditures to be paid by the FMS contractor.
100.25(e) The FMS contractor shall:
100.26(1) not limit or restrict the participant's choice of service or support providers or
100.27service delivery models consistent with any applicable state and federal requirements;
100.28(2) provide the participant and the targeted case manager, if applicable, with a
100.29monthly written summary of the spending for services and supports that were billed
100.30against the spending budget;
100.31(3) be knowledgeable of state and federal employment regulations under the Fair
100.32Labor Standards Act of 1938, and comply with the requirements under the Internal
100.33Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax
100.34Liability for vendor or fiscal employer agent, and any requirements necessary to process
100.35employer and employee deductions, provide appropriate and timely submission of
100.36employer tax liabilities, and maintain documentation to support medical assistance claims;
101.1(4) have current and adequate liability insurance and bonding and sufficient cash
101.2flow as determined by the commissioner and have on staff or under contract a certified
101.3public accountant or an individual with a baccalaureate degree in accounting;
101.4(5) assume fiscal accountability for state funds designated for the program; and
101.5(6) maintain documentation of receipts, invoices, and bills to track all services and
101.6supports expenditures for any goods purchased and maintain time records of support
101.7workers. The documentation and time records must be maintained for a minimum of
101.8five years from the claim date and be available for audit or review upon request by the
101.9commissioner. Claims submitted by the FMS contractor to the commissioner for payment
101.10must correspond with services, amounts, and time periods as authorized in the participant's
101.11spending budget and service plan.
101.12(f) The commissioner of human services shall:
101.13(1) establish rates and payment methodology for the FMS contractor;
101.14(2) identify a process to ensure quality and performance standards for the FMS
101.15contractor and ensure statewide access to FMS contractors; and
101.16(3) establish a uniform protocol for delivering and administering CFSS services
101.17to be used by eligible FMS contractors.
101.18(g) The commissioner of human services shall disenroll or exclude participants from
101.19the budget model and transfer them to the agency-provider model under the following
101.20circumstances that include but are not limited to:
101.21(1) when a participant has been restricted by the Minnesota restricted recipient
101.22program, the participant may be excluded for a specified time period under Minnesota
101.23Rules, parts 9505.2160 to 9505.2245;
101.24(2) when a participant exits the budget model during the participant's service plan
101.25year. Upon transfer, the participant shall not access the budget model for the remainder of
101.26that service plan year; or
101.27(3) when the department determines that the participant or participant's representative
101.28or legal representative cannot manage participant responsibilities under the budget model.
101.29The commissioner must develop policies for determining if a participant is unable to
101.30manage responsibilities under a budget model.
101.31(h) A participant may appeal under section 256.045, subdivision 3, in writing to the
101.32department to contest the department's decision under paragraph (c), clause (3), to remove
101.33or exclude the participant from the budget model.
101.34    Subd. 14. Participant's responsibilities under budget model. (a) A participant
101.35using the budget model must use an FMS contractor or vendor that is under contract with
101.36the department. Upon a determination of eligibility and completion of the assessment and
102.1community support plan, the participant shall choose a FMS contractor from a list of
102.2eligible vendors maintained by the department.
102.3(b) When the participant, participant's representative, or legal representative chooses
102.4to be the employer of the support worker, they are responsible for the hiring and supervision
102.5of the support worker, including, but not limited to, recruiting, interviewing, training, and
102.6discharging the support worker consistent with federal and state laws and regulations.
102.7(c) In addition to the employer responsibilities in paragraph (b), the participant,
102.8participant's representative, or legal representative is responsible for:
102.9(1) tracking the services provided and all expenditures for goods or other supports;
102.10(2) preparing and submitting time sheets, signed by both the participant and support
102.11worker, to the FMS contractor on a regular basis and in a timely manner according to
102.12the FMS contractor's procedures;
102.13(3) notifying the FMS contractor within ten days of any changes in circumstances
102.14affecting the CFSS service plan or in the participant's place of residence including, but
102.15not limited to, any hospitalization of the participant or change in the participant's address,
102.16telephone number, or employment;
102.17(4) notifying the FMS contractor of any changes in the employment status of each
102.18participant support worker; and
102.19(5) reporting any problems resulting from the quality of services rendered by the
102.20support worker to the FMS contractor. If the participant is unable to resolve any problems
102.21resulting from the quality of service rendered by the support worker with the assistance of
102.22the FMS contractor, the participant shall report the situation to the department.
102.23    Subd. 15. Documentation of support services provided. (a) Support services
102.24provided to a participant by a support worker employed by either an agency-provider
102.25or the participant acting as the employer must be documented daily by each support
102.26worker, on a time sheet form approved by the commissioner. All documentation may be
102.27Web-based, electronic, or paper documentation. The completed form must be submitted
102.28on a monthly basis to the provider or the participant and the FMS contractor selected by
102.29the participant to provide assistance with meeting the participant's employer obligations
102.30and kept in the recipient's health record.
102.31(b) The activity documentation must correspond to the written service delivery plan
102.32and be reviewed by the agency provider or the participant and the FMS contractor when
102.33the participant is acting as the employer of the support worker.
102.34(c) The time sheet must be on a form approved by the commissioner documenting
102.35time the support worker provides services in the home. The following criteria must be
102.36included in the time sheet:
103.1(1) full name of the support worker and individual provider number;
103.2(2) provider name and telephone numbers, if an agency-provider is responsible for
103.3delivery services under the written service plan;
103.4(3) full name of the participant;
103.5(4) consecutive dates, including month, day, and year, and arrival and departure
103.6times with a.m. or p.m. notations;
103.7(5) signatures of the participant or the participant's representative;
103.8(6) personal signature of the support worker;
103.9(7) any shared care provided, if applicable;
103.10(8) a statement that it is a federal crime to provide false information on CFSS
103.11billings for medical assistance payments; and
103.12(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
103.13    Subd. 16. Support workers requirements. (a) Support workers shall:
103.14(1) enroll with the department as a support worker after a background study under
103.15chapter 245C has been completed and the support worker has received a notice from the
103.16commissioner that:
103.17(i) the support worker is not disqualified under section 245C.14; or
103.18(ii) is disqualified, but the support worker has received a set-aside of the
103.19disqualification under section 245C.22;
103.20(2) have the ability to effectively communicate with the participant or the
103.21participant's representative;
103.22(3) have the skills and ability to provide the services and supports according to the
103.23person's CFSS service delivery plan and respond appropriately to the participant's needs;
103.24(4) not be a participant of CFSS, unless the support services provided by the support
103.25worker differ from those provided to the support worker;
103.26(5) complete the basic standardized training as determined by the commissioner
103.27before completing enrollment. The training must be available in languages other than
103.28English and to those who need accommodations due to disabilities. Support worker
103.29training must include successful completion of the following training components: basic
103.30first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles
103.31and responsibilities of support workers including information about basic body mechanics,
103.32emergency preparedness, orientation to positive behavioral practices, orientation to
103.33responding to a mental health crisis, fraud issues, time cards and documentation, and an
103.34overview of person-centered planning and self-direction. Upon completion of the training
103.35components, the support worker must pass the certification test to provide assistance
103.36to participants;
104.1(6) complete training and orientation on the participant's individual needs; and
104.2(7) maintain the privacy and confidentiality of the participant, and not independently
104.3determine the medication dose or time for medications for the participant.
104.4(b) The commissioner may deny or terminate a support worker's provider enrollment
104.5and provider number if the support worker:
104.6(1) lacks the skills, knowledge, or ability to adequately or safely perform the
104.7required work;
104.8(2) fails to provide the authorized services required by the participant employer;
104.9(3) has been intoxicated by alcohol or drugs while providing authorized services to
104.10the participant or while in the participant's home;
104.11(4) has manufactured or distributed drugs while providing authorized services to the
104.12participant or while in the participant's home; or
104.13(5) has been excluded as a provider by the commissioner of human services, or the
104.14United States Department of Health and Human Services, Office of Inspector General,
104.15from participation in Medicaid, Medicare, or any other federal health care program.
104.16(c) A support worker may appeal in writing to the commissioner to contest the
104.17decision to terminate the support worker's provider enrollment and provider number.
104.18    Subd. 17. Support specialist requirements and payments. The commissioner
104.19shall develop qualifications, scope of functions, and payment rates and service limits for a
104.20support specialist that may provide additional or specialized assistance necessary to plan,
104.21implement, arrange, augment, or evaluate services and supports.
104.22    Subd. 18. Service unit and budget allocation requirements and limits. (a) For the
104.23agency-provider model, services will be authorized in units of service. The total service
104.24unit amount must be established based upon the assessed need for CFSS services, and must
104.25not exceed the maximum number of units available as determined under subdivision 8.
104.26(b) For the budget model, the budget allocation allowed for services and supports
104.27is established by multiplying the number of units authorized under subdivision 8 by the
104.28payment rate established by the commissioner.
104.29    Subd. 19. Support system. (a) The commissioner shall provide information,
104.30consultation, training, and assistance to ensure the participant is able to manage the
104.31services and supports and budgets, if applicable. This support shall include individual
104.32consultation on how to select and employ workers, manage responsibilities under CFSS,
104.33and evaluate personal outcomes.
104.34(b) The commissioner shall provide assistance with the development of risk
104.35management agreements.
105.1    Subd. 20. Service-related rights. (a) Participants must be provided with adequate
105.2information, counseling, training, and assistance, as needed, to ensure that the participant
105.3is able to choose and manage services, models, and budgets. This support shall include
105.4information regarding:
105.5(1) person-centered planning;
105.6(2) the range and scope of individual choices;
105.7(3) the process for changing plans, services and budgets;
105.8(4) the grievance process;
105.9(5) individual rights;
105.10(6) identifying and assessing appropriate services;
105.11(7) risks and responsibilities; and
105.12(8) risk management.
105.13(b) The commissioner must ensure that the participant has a copy of the most recent
105.14community support plan and service delivery plan.
105.15(c) A participant who appeals a reduction in previously authorized CFSS services
105.16may continue previously authorized services pending an appeal in accordance with section
105.17256.045.
105.18(d) If the units of service or budget allocation for CFSS are reduced, denied, or
105.19terminated, the commissioner must provide notice of the reasons for the reduction in the
105.20participant's notice of denial, termination, or reduction.
105.21(e) If all or part of a service delivery plan is denied approval, the commissioner must
105.22provide a notice that describes the basis of the denial.
105.23    Subd. 21. Development and Implementation Council. The commissioner
105.24shall establish a Development and Implementation Council of which the majority of
105.25members are individuals with disabilities, elderly individuals, and their representatives.
105.26The commissioner shall consult and collaborate with the council when developing and
105.27implementing this section for at least the first five years of operation. The commissioner,
105.28in consultation with the council, shall provide recommendations on how to improve the
105.29quality and integrity of CFSS, reduce the paper documentation required in subdivisions
105.3010, 12, and 15, make use of electronic means of documentation and online reporting in
105.31order to reduce administrative costs and improve training to the legislative chairs of the
105.32health and human services policy and finance committees by February 1, 2014.
105.33    Subd. 22. Quality assurance and risk management system. (a) The commissioner
105.34shall establish quality assurance and risk management measures for use in developing and
105.35implementing CFSS, including those that (1) recognize the roles and responsibilities of
105.36those involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and
106.1budgets based upon a recipient's resources and capabilities. Risk management measures
106.2must include background studies, and backup and emergency plans, including disaster
106.3planning.
106.4(b) The commissioner shall provide ongoing technical assistance and resource and
106.5educational materials for CFSS participants.
106.6(c) Performance assessment measures, such as a participant's satisfaction with the
106.7services and supports, and ongoing monitoring of health and well-being shall be identified
106.8in consultation with the council established in subdivision 21.
106.9(d) Data reporting requirements will be developed in consultation with the council
106.10established in subdivision 21.
106.11    Subd. 23. Commissioner's access. When the commissioner is investigating a
106.12possible overpayment of Medicaid funds, the commissioner must be given immediate
106.13access without prior notice to the agency provider or FMS contractor's office during
106.14regular business hours and to documentation and records related to services provided and
106.15submission of claims for services provided. Denying the commissioner access to records
106.16is cause for immediate suspension of payment and terminating the agency provider's
106.17enrollment according to section 256B.064 or terminating the FMS contract.
106.18    Subd. 24. CFSS agency-providers; background studies. CFSS agency-providers
106.19enrolled to provide personal care assistance services under the medical assistance program
106.20shall comply with the following:
106.21(1) owners who have a five percent interest or more and all managing employees
106.22are subject to a background study as provided in chapter 245C. This applies to currently
106.23enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS
106.24agency-provider. "Managing employee" has the same meaning as Code of Federal
106.25Regulations, title 42, section 455. An organization is barred from enrollment if:
106.26(i) the organization has not initiated background studies on owners managing
106.27employees; or
106.28(ii) the organization has initiated background studies on owners and managing
106.29employees, but the commissioner has sent the organization a notice that an owner or
106.30managing employee of the organization has been disqualified under section 245C.14, and
106.31the owner or managing employee has not received a set-aside of the disqualification
106.32under section 245C.22;
106.33(2) a background study must be initiated and completed for all support specialists; and
106.34(3) a background study must be initiated and completed for all support workers.
106.35EFFECTIVE DATE.This section is effective upon federal approval but no earlier
106.36than January 1, 2014. The service will begin 90 days after federal approval or January 1,
107.12014, whichever is later. The commissioner of human services shall notify the revisor of
107.2statutes when this occurs.

107.3    Sec. 44. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
107.4to read:
107.5    Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
107.6negotiate a supplementary service rate under this section for any individual that has been
107.7determined to be eligible for Housing Stability Services as approved by the Centers
107.8for Medicare and Medicaid Services, and who resides in an establishment voluntarily
107.9registered under section 144D.025, as a supportive housing establishment or participates
107.10in the Minnesota supportive housing demonstration program under section 256I.04,
107.11subdivision 3, paragraph (a), clause (4).

107.12    Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
107.13    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
107.14shall immediately make an oral report to the common entry point. The common entry
107.15point may accept electronic reports submitted through a Web-based reporting system
107.16established by the commissioner. Use of a telecommunications device for the deaf or other
107.17similar device shall be considered an oral report. The common entry point may not require
107.18written reports. To the extent possible, the report must be of sufficient content to identify
107.19the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
107.20any evidence of previous maltreatment, the name and address of the reporter, the time,
107.21date, and location of the incident, and any other information that the reporter believes
107.22might be helpful in investigating the suspected maltreatment. A mandated reporter may
107.23disclose not public data, as defined in section 13.02, and medical records under sections
107.24144.291 to 144.298, to the extent necessary to comply with this subdivision.
107.25(b) A boarding care home that is licensed under sections 144.50 to 144.58 and
107.26certified under Title 19 of the Social Security Act, a nursing home that is licensed under
107.27section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a
107.28hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under
107.29Code of Federal Regulations, title 42, section 482.66, may submit a report electronically
107.30to the common entry point instead of submitting an oral report. The report may be a
107.31duplicate of the initial report the facility submits electronically to the commissioner of
107.32health to comply with the reporting requirements under Code of Federal Regulations, title
107.3342, section 483.13. The commissioner of health may modify these reporting requirements
108.1to include items required under paragraph (a) that are not currently included in the
108.2electronic reporting form.
108.3EFFECTIVE DATE.This section is effective July 1, 2014.

108.4    Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
108.5    Subd. 9. Common entry point designation. (a) Each county board shall designate
108.6a common entry point for reports of suspected maltreatment. Two or more county boards
108.7may jointly designate a single The commissioner of human services shall establish a
108.8 common entry point effective July 1, 2014. The common entry point is the unit responsible
108.9for receiving the report of suspected maltreatment under this section.
108.10(b) The common entry point must be available 24 hours per day to take calls from
108.11reporters of suspected maltreatment. The common entry point shall use a standard intake
108.12form that includes:
108.13(1) the time and date of the report;
108.14(2) the name, address, and telephone number of the person reporting;
108.15(3) the time, date, and location of the incident;
108.16(4) the names of the persons involved, including but not limited to, perpetrators,
108.17alleged victims, and witnesses;
108.18(5) whether there was a risk of imminent danger to the alleged victim;
108.19(6) a description of the suspected maltreatment;
108.20(7) the disability, if any, of the alleged victim;
108.21(8) the relationship of the alleged perpetrator to the alleged victim;
108.22(9) whether a facility was involved and, if so, which agency licenses the facility;
108.23(10) any action taken by the common entry point;
108.24(11) whether law enforcement has been notified;
108.25(12) whether the reporter wishes to receive notification of the initial and final
108.26reports; and
108.27(13) if the report is from a facility with an internal reporting procedure, the name,
108.28mailing address, and telephone number of the person who initiated the report internally.
108.29(c) The common entry point is not required to complete each item on the form prior
108.30to dispatching the report to the appropriate lead investigative agency.
108.31(d) The common entry point shall immediately report to a law enforcement agency
108.32any incident in which there is reason to believe a crime has been committed.
108.33(e) If a report is initially made to a law enforcement agency or a lead investigative
108.34agency, those agencies shall take the report on the appropriate common entry point intake
108.35forms and immediately forward a copy to the common entry point.
109.1(f) The common entry point staff must receive training on how to screen and
109.2dispatch reports efficiently and in accordance with this section.
109.3(g) The commissioner of human services shall maintain a centralized database
109.4for the collection of common entry point data, lead investigative agency data including
109.5maltreatment report disposition, and appeals data. The common entry point shall
109.6have access to the centralized database and must log the reports into the database and
109.7immediately identify and locate prior reports of abuse, neglect, or exploitation.
109.8(h) When appropriate, the common entry point staff must refer calls that do not
109.9allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
109.10that might resolve the reporter's concerns.
109.11(i) a common entry point must be operated in a manner that enables the
109.12commissioner of human services to:
109.13(1) track critical steps in the reporting, evaluation, referral, response, disposition,
109.14and investigative process to ensure compliance with all requirements for all reports;
109.15(2) maintain data to facilitate the production of aggregate statistical reports for
109.16monitoring patterns of abuse, neglect, or exploitation;
109.17(3) serve as a resource for the evaluation, management, and planning of preventative
109.18and remedial services for vulnerable adults who have been subject to abuse, neglect,
109.19or exploitation;
109.20(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
109.21of the common entry point; and
109.22(5) track and manage consumer complaints related to the common entry point.
109.23(j) The commissioners of human services and health shall collaborate on the
109.24creation of a system for referring reports to the lead investigative agencies. This system
109.25shall enable the commissioner of human services to track critical steps in the reporting,
109.26evaluation, referral, response, disposition, investigation, notification, determination, and
109.27appeal processes.

109.28    Sec. 47. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
109.29    Subd. 9e. Education requirements. (a) The commissioners of health, human
109.30services, and public safety shall cooperate in the development of a joint program for
109.31education of lead investigative agency investigators in the appropriate techniques for
109.32investigation of complaints of maltreatment. This program must be developed by July
109.331, 1996. The program must include but need not be limited to the following areas: (1)
109.34information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
109.35conclusions based on evidence; (5) interviewing skills, including specialized training to
110.1interview people with unique needs; (6) report writing; (7) coordination and referral
110.2to other necessary agencies such as law enforcement and judicial agencies; (8) human
110.3relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
110.4systems and the appropriate methods for interviewing relatives in the course of the
110.5assessment or investigation; (10) the protective social services that are available to protect
110.6alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
110.7which lead investigative agency investigators and law enforcement workers cooperate in
110.8conducting assessments and investigations in order to avoid duplication of efforts; and
110.9(12) data practices laws and procedures, including provisions for sharing data.
110.10(b) The commissioner of human services shall conduct an outreach campaign to
110.11promote the common entry point for reporting vulnerable adult maltreatment. This
110.12campaign shall use the Internet and other means of communication.
110.13(b) (c) The commissioners of health, human services, and public safety shall offer at
110.14least annual education to others on the requirements of this section, on how this section is
110.15implemented, and investigation techniques.
110.16(c) (d) The commissioner of human services, in coordination with the commissioner
110.17of public safety shall provide training for the common entry point staff as required in this
110.18subdivision and the program courses described in this subdivision, at least four times
110.19per year. At a minimum, the training shall be held twice annually in the seven-county
110.20metropolitan area and twice annually outside the seven-county metropolitan area. The
110.21commissioners shall give priority in the program areas cited in paragraph (a) to persons
110.22currently performing assessments and investigations pursuant to this section.
110.23(d) (e) The commissioner of public safety shall notify in writing law enforcement
110.24personnel of any new requirements under this section. The commissioner of public
110.25safety shall conduct regional training for law enforcement personnel regarding their
110.26responsibility under this section.
110.27(e) (f) Each lead investigative agency investigator must complete the education
110.28program specified by this subdivision within the first 12 months of work as a lead
110.29investigative agency investigator.
110.30A lead investigative agency investigator employed when these requirements take
110.31effect must complete the program within the first year after training is available or as soon
110.32as training is available.
110.33All lead investigative agency investigators having responsibility for investigation
110.34duties under this section must receive a minimum of eight hours of continuing education
110.35or in-service training each year specific to their duties under this section.

111.1    Sec. 48. FEDERAL APPROVAL.
111.2This article is contingent on federal approval.

111.3    Sec. 49. REPEALER.
111.4(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
111.53, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
111.6(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
111.7repealed effective October 1, 2013.


111.11    Section 1. Minnesota Statutes 2012, section 119B.05, subdivision 1, is amended to read:
111.12    Subdivision 1. Eligible participants. Families eligible for child care assistance
111.13under the MFIP child care program are:
111.14    (1) MFIP participants who are employed or in job search and meet the requirements
111.15of section 119B.10;
111.16    (2) persons who are members of transition year families under section 119B.011,
111.17subdivision 20 , and meet the requirements of section 119B.10;
111.18    (3) families who are participating in employment orientation or job search, or
111.19other employment or training activities that are included in an approved employability
111.20development plan under section 256J.95;
111.21    (4) MFIP families who are participating in work job search, job support,
111.22employment, or training activities as required in their employment plan, or in appeals,
111.23hearings, assessments, or orientations according to chapter 256J;
111.24    (5) MFIP families who are participating in social services activities under chapter
111.25256J or mental health treatment as required in their employment plan approved according
111.26to chapter 256J;
111.27    (6) families who are participating in services or activities that are included in an
111.28approved family stabilization plan under section 256J.575;
111.29    (7) MFIP child-only cases under section 256J.88, for up to 20 hours of child care
111.30per child per week under the following conditions: (i) child care will be authorized if the
111.31child's primary caregiver is receiving SSI for a disability related to depression or other
111.32serious mental illness; and (ii) child care will only be authorized for children five years
111.33of age or younger. The child's authorized care under this clause is not conditional based
111.34on the primary caregiver participating in an authorized activity under section 119B.07 or
112.1119B.11. Medical appointments, treatment, or therapy are considered authorized activities
112.2for participants in this category;
112.3    (8) families who are participating in programs as required in tribal contracts under
112.4section 119B.02, subdivision 2, or 256.01, subdivision 2; and
112.5    (8) (9) families who are participating in the transition year extension under section
112.6119B.011, subdivision 20a .

112.7    Sec. 2. Minnesota Statutes 2012, section 119B.13, subdivision 1, is amended to read:
112.8    Subdivision 1. Subsidy restrictions. (a) Beginning October 31, 2011 July 1, 2014,
112.9the maximum rate paid for child care assistance in any county or multicounty region under
112.10the child care fund shall be the rate for like-care arrangements in the county effective July
112.111, 2006 2012, decreased increased by 2.5 two percent.
112.12    (b) Biennially, beginning in 2012, the commissioner shall survey rates charged
112.13by child care providers in Minnesota to determine the 75th percentile for like-care
112.14arrangements in counties. When the commissioner determines that, using the
112.15commissioner's established protocol, the number of providers responding to the survey is
112.16too small to determine the 75th percentile rate for like-care arrangements in a county or
112.17multicounty region, the commissioner may establish the 75th percentile maximum rate
112.18based on like-care arrangements in a county, region, or category that the commissioner
112.19deems to be similar.
112.20    (c) A rate which includes a special needs rate paid under subdivision 3 or under a
112.21school readiness service agreement paid under section 119B.231, may be in excess of the
112.22maximum rate allowed under this subdivision.
112.23    (d) The department shall monitor the effect of this paragraph on provider rates. The
112.24county shall pay the provider's full charges for every child in care up to the maximum
112.25established. The commissioner shall determine the maximum rate for each type of care
112.26on an hourly, full-day, and weekly basis, including special needs and disability care. The
112.27maximum payment to a provider for one day of care must not exceed the daily rate. The
112.28maximum payment to a provider for one week of care must not exceed the weekly rate.
112.29(e) Child care providers receiving reimbursement under this chapter must not be
112.30paid activity fees or an additional amount above the maximum rates for care provided
112.31during nonstandard hours for families receiving assistance.
112.32    (f) When the provider charge is greater than the maximum provider rate allowed,
112.33the parent is responsible for payment of the difference in the rates in addition to any
112.34family co-payment fee.
113.1    (g) All maximum provider rates changes shall be implemented on the Monday
113.2following the effective date of the maximum provider rate.

113.3    Sec. 3. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
113.4    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
113.5must not be reimbursed for more than ten 25 full-day absent days per child, excluding
113.6holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal
113.7nonlicensed family child care providers must not be reimbursed for absent days. If a child
113.8attends for part of the time authorized to be in care in a day, but is absent for part of the
113.9time authorized to be in care in that same day, the absent time must be reimbursed but the
113.10time must not count toward the ten 25 absent day days limit. Child care providers must
113.11only be reimbursed for absent days if the provider has a written policy for child absences
113.12and charges all other families in care for similar absences.
113.13(b) Notwithstanding paragraph (a), children in families may exceed the ten 25 absent
113.14days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school
113.15or general equivalency diploma; and (3) is a student in a school district or another similar
113.16program that provides or arranges for child care, parenting support, social services, career
113.17and employment supports, and academic support to achieve high school graduation, upon
113.18request of the program and approval of the county. If a child attends part of an authorized
113.19day, payment to the provider must be for the full amount of care authorized for that day.
113.20    (c) Child care providers must be reimbursed for up to ten federal or state holidays or
113.21designated holidays per year when the provider charges all families for these days and the
113.22holiday or designated holiday falls on a day when the child is authorized to be in attendance.
113.23Parents may substitute other cultural or religious holidays for the ten recognized state and
113.24federal holidays. Holidays do not count toward the ten 25 absent day days limit.
113.25    (d) A family or child care provider must not be assessed an overpayment for an
113.26absent day payment unless (1) there was an error in the amount of care authorized for the
113.27family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
113.28the family or provider did not timely report a change as required under law.
113.29    (e) The provider and family shall receive notification of the number of absent days
113.30used upon initial provider authorization for a family and ongoing notification of the
113.31number of absent days used as of the date of the notification.

113.32    Sec. 4. Minnesota Statutes 2012, section 245A.07, subdivision 2a, is amended to read:
113.33    Subd. 2a. Immediate suspension expedited hearing. (a) Within five working days
113.34of receipt of the license holder's timely appeal, the commissioner shall request assignment
114.1of an administrative law judge. The request must include a proposed date, time, and place
114.2of a hearing. A hearing must be conducted by an administrative law judge within 30
114.3calendar days of the request for assignment, unless an extension is requested by either
114.4party and granted by the administrative law judge for good cause. The commissioner shall
114.5issue a notice of hearing by certified mail or personal service at least ten working days
114.6before the hearing. The scope of the hearing shall be limited solely to the issue of whether
114.7the temporary immediate suspension should remain in effect pending the commissioner's
114.8final order under section 245A.08, regarding a licensing sanction issued under subdivision
114.93 following the immediate suspension. The burden of proof in expedited hearings under
114.10this subdivision shall be limited to the commissioner's demonstration that reasonable
114.11cause exists to believe that the license holder's actions or failure to comply with applicable
114.12law or rule poses, or if the actions of other individuals or conditions in the program
114.13poses an imminent risk of harm to the health, safety, or rights of persons served by the
114.14program. "Reasonable cause" means there exist specific articulable facts or circumstances
114.15which provide the commissioner with a reasonable suspicion that there is an imminent
114.16risk of harm to the health, safety, or rights of persons served by the program. When the
114.17commissioner has determined there is reasonable cause to order the temporary immediate
114.18suspension of a license based on a violation of safe sleep requirements, as defined in
114.19section 245A.1435, the commissioner is not required to demonstrate that an infant died or
114.20was injured as a result of the safe sleep violations.
114.21    (b) The administrative law judge shall issue findings of fact, conclusions, and a
114.22recommendation within ten working days from the date of hearing. The parties shall have
114.23ten calendar days to submit exceptions to the administrative law judge's report. The
114.24record shall close at the end of the ten-day period for submission of exceptions. The
114.25commissioner's final order shall be issued within ten working days from the close of the
114.26record. Within 90 calendar days after a final order affirming an immediate suspension, the
114.27commissioner shall make a determination regarding whether a final licensing sanction
114.28shall be issued under subdivision 3. The license holder shall continue to be prohibited
114.29from operation of the program during this 90-day period.
114.30    (c) When the final order under paragraph (b) affirms an immediate suspension, and a
114.31final licensing sanction is issued under subdivision 3 and the license holder appeals that
114.32sanction, the license holder continues to be prohibited from operation of the program
114.33pending a final commissioner's order under section 245A.08, subdivision 5, regarding the
114.34final licensing sanction.

115.1    Sec. 5. Minnesota Statutes 2012, section 245A.1435, is amended to read:
115.2245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT
115.3DEATH SYNDROME IN LICENSED PROGRAMS.
115.4    (a) When a license holder is placing an infant to sleep, the license holder must
115.5place the infant on the infant's back, unless the license holder has documentation from
115.6the infant's parent physician directing an alternative sleeping position for the infant. The
115.7parent physician directive must be on a form approved by the commissioner and must
115.8include a statement that the parent or legal guardian has read the information provided by
115.9the Minnesota Sudden Infant Death Center, related to the risk of SIDS and the importance
115.10of placing an infant or child on its back to sleep to reduce the risk of SIDS. remain on file
115.11at the licensed location. An infant who independently rolls onto its stomach after being
115.12placed to sleep on its back may be allowed to remain sleeping on its stomach if the infant
115.13is at least six months of age or the license holder has a signed statement from the parent
115.14indicating that the infant regularly rolls over at home.
115.15(b) The license holder must place the infant in a crib directly on a firm mattress with
115.16a fitted crib sheet that fits tightly on the mattress and overlaps the mattress so it cannot be
115.17dislodged by pulling on the corner of the sheet. The license holder must not place pillows,
115.18quilts, comforters, sheepskin, pillow-like stuffed toys, or other soft products in the crib
115.19with the infant The license holder must place the infant in a crib directly on a firm mattress
115.20with a fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress,
115.21and overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner
115.22of the sheet with reasonable effort. The license holder must not place anything in the crib
115.23with the infant except for the infant's pacifier. The requirements of this section apply to
115.24license holders serving infants up to and including 12 months younger than one year of age.
115.25Licensed child care providers must meet the crib requirements under section 245A.146.
115.26(c) If an infant falls asleep before being placed in a crib, the license holder must
115.27move the infant to a crib as soon as practicable, and must keep the infant within sight of
115.28the license holder until the infant is placed in a crib. When an infant falls asleep while
115.29being held, the license holder must consider the supervision needs of other children in
115.30care when determining how long to hold the infant before placing the infant in a crib to
115.31sleep. The sleeping infant must not be in a position where the airway may be blocked or
115.32with anything covering the infant's face.
115.33(d) Placing a swaddled infant down to sleep in a licensed setting is not recommended
115.34for an infant of any age and is prohibited for any infant who has begun to roll over
115.35independently. However, with the written consent of a parent or guardian according to this
115.36paragraph, a license holder may place the infant who has not yet begun to roll over on its
116.1own down to sleep in a one-piece sleeper equipped with an attached system that fastens
116.2securely only across the upper torso, with no constriction of the hips or legs, to create a
116.3swaddle. Prior to any use of swaddling for sleep by a provider licensed under this chapter,
116.4the license holder must obtain informed written consent for the use of swaddling from the
116.5parent or guardian of the infant on a form provided by the commissioner and prepared in
116.6partnership with the Minnesota Sudden Infant Death Center.

116.7    Sec. 6. Minnesota Statutes 2012, section 245A.144, is amended to read:
116.8245A.144 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
116.9DEATH AND SHAKEN BABY SYNDROME ABUSIVE HEAD TRAUMA FOR
116.10CHILD FOSTER CARE PROVIDERS.
116.11    (a) Licensed child foster care providers that care for infants or children through five
116.12years of age must document that before staff persons and caregivers assist in the care
116.13of infants or children through five years of age, they are instructed on the standards in
116.14section 245A.1435 and receive training on reducing the risk of sudden unexpected infant
116.15death syndrome and shaken baby syndrome for abusive head trauma from shaking infants
116.16and young children. This section does not apply to emergency relative placement under
116.17section 245A.035. The training on reducing the risk of sudden unexpected infant death
116.18syndrome and shaken baby syndrome abusive head trauma may be provided as:
116.19    (1) orientation training to child foster care providers, who care for infants or children
116.20through five years of age, under Minnesota Rules, part 2960.3070, subpart 1; or
116.21    (2) in-service training to child foster care providers, who care for infants or children
116.22through five years of age, under Minnesota Rules, part 2960.3070, subpart 2.
116.23    (b) Training required under this section must be at least one hour in length and must
116.24be completed at least once every five years. At a minimum, the training must address
116.25the risk factors related to sudden unexpected infant death syndrome and shaken baby
116.26syndrome abusive head trauma, means of reducing the risk of sudden unexpected infant
116.27death syndrome and shaken baby syndrome abusive head trauma, and license holder
116.28communication with parents regarding reducing the risk of sudden unexpected infant
116.29death syndrome and shaken baby syndrome abusive head trauma.
116.30    (c) Training for child foster care providers must be approved by the county or
116.31private licensing agency that is responsible for monitoring the child foster care provider
116.32under section 245A.16. The approved training fulfills, in part, training required under
116.33Minnesota Rules, part 2960.3070.

117.1    Sec. 7. Minnesota Statutes 2012, section 245A.1444, is amended to read:
117.2245A.1444 TRAINING ON RISK OF SUDDEN UNEXPECTED INFANT
117.3DEATH SYNDROME AND SHAKEN BABY SYNDROME ABUSIVE HEAD
117.4TRAUMA BY OTHER PROGRAMS.
117.5    A licensed chemical dependency treatment program that serves clients with infants
117.6or children through five years of age, who sleep at the program and a licensed children's
117.7residential facility that serves infants or children through five years of age, must document
117.8that before program staff persons or volunteers assist in the care of infants or children
117.9through five years of age, they are instructed on the standards in section 245A.1435 and
117.10receive training on reducing the risk of sudden unexpected infant death syndrome and
117.11shaken baby syndrome abusive head trauma from shaking infants and young children. The
117.12training conducted under this section may be used to fulfill training requirements under
117.13Minnesota Rules, parts 2960.0100, subpart 3; and 9530.6490, subpart 4, item B.
117.14    This section does not apply to child care centers or family child care programs
117.15governed by sections 245A.40 and 245A.50.

117.16    Sec. 8. [245A.1446] FAMILY CHILD CARE DIAPERING AREA
117.17DISINFECTION.
117.18Notwithstanding Minnesota Rules, part 9502.0435, a family child care provider may
117.19disinfect the diaper changing surface with either a solution of at least two teaspoons
117.20of chlorine bleach to one quart of water or with a surface disinfectant that meets the
117.21following criteria:
117.22(1) the manufacturer's label or instructions state that the product is registered with
117.23the United States Environmental Protection Agency;
117.24(2) the manufacturer's label or instructions state that the disinfectant is effective
117.25against Staphylococcus aureus, Salmonella choleraesuis, and Pseudomonas aeruginosa;
117.26(3) the manufacturer's label or instructions state that the disinfectant is effective with
117.27a ten minute or less contact time;
117.28(4) the disinfectant is clearly labeled by the manufacturer with directions for mixing
117.29and use;
117.30(5) the disinfectant is used only in accordance with the manufacturer's directions; and
117.31(6) the product does not include triclosan or derivatives of triclosan.

117.32    Sec. 9. [245A.147] FAMILY CHILD CARE INFANT SLEEP SUPERVISION
117.33REQUIREMENTS.
118.1    Subdivision 1. In-person checks on infants. (a) License holders that serve infants
118.2are encouraged to monitor sleeping infants by conducting in-person checks on each infant
118.3in their care every 30 minutes.
118.4(b) Upon enrollment of an infant in a family child care program, the license holder is
118.5encouraged to conduct in-person checks on the sleeping infant every 15 minutes, during
118.6the first four months of care.
118.7(c) When an infant has an upper respiratory infection, the license holder is
118.8encouraged to conduct in-person checks on the sleeping infant every 15 minutes
118.9throughout the hours of sleep.
118.10    Subd. 2. Use of audio or visual monitoring devices. In addition to conducting
118.11the in-person checks encouraged under subdivision 1, license holders serving infants are
118.12encouraged to use and maintain an audio or visual monitoring device to monitor each
118.13sleeping infant in care during all hours of sleep.

118.14    Sec. 10. [245A.152] CHILD CARE LICENSE HOLDER INSURANCE.
118.15(a) A license holder must provide a written notice to all parents or guardians of all
118.16children to be accepted for care prior to admission stating whether the license holder has
118.17liability insurance. This notice may be incorporated into and provided on the admission
118.18form used by the license holder.
118.19(b) If the license holder has liability insurance:
118.20(1) the license holder shall inform parents in writing that a current certificate of
118.21coverage for insurance is available for inspection to all parents or guardians of children
118.22receiving services and to all parents seeking services from the family child care program;
118.23(2) the notice must provide the parent or guardian with the date of expiration or
118.24next renewal of the policy; and
118.25(3) upon the expiration date of the policy, the license holder must provide a new
118.26written notice indicating whether the insurance policy has lapsed or whether the license
118.27holder has renewed the policy.
118.28If the policy was renewed, the license holder must provide the new expiration date of the
118.29policy in writing to the parents or guardians.
118.30(c) If the license holder does not have liability insurance, the license holder must
118.31provide an annual notice on a form developed and made available by the commissioner,
118.32to the parents or guardians of children in care indicating that the license holder does not
118.33carry liability insurance.
118.34(d) The license holder must notify all parents and guardians in writing immediately
118.35of any change in insurance status.
119.1(e) The license holder must make available upon request the certificate of liability
119.2insurance to the parents of children in care, to the commissioner, and to county licensing
119.3agents.
119.4(f) The license holder must document, with the signature of the parent or guardian,
119.5that the parent or guardian received the notices required by this section.

119.6    Sec. 11. Minnesota Statutes 2012, section 245A.40, subdivision 5, is amended to read:
119.7    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
119.8 abusive head trauma training. (a) License holders must document that before staff
119.9persons and volunteers care for infants, they are instructed on the standards in section
119.10245A.1435 and receive training on reducing the risk of sudden unexpected infant death
119.11syndrome. In addition, license holders must document that before staff persons care for
119.12infants or children under school age, they receive training on the risk of shaken baby
119.13syndrome abusive head trauma from shaking infants and young children. The training
119.14in this subdivision may be provided as orientation training under subdivision 1 and
119.15in-service training under subdivision 7.
119.16    (b) Sudden unexpected infant death syndrome reduction training required under
119.17this subdivision must be at least one-half hour in length and must be completed at least
119.18once every five years year. At a minimum, the training must address the risk factors
119.19related to sudden unexpected infant death syndrome, means of reducing the risk of sudden
119.20unexpected infant death syndrome in child care, and license holder communication with
119.21parents regarding reducing the risk of sudden unexpected infant death syndrome.
119.22    (c) Shaken baby syndrome Abusive head trauma training under this subdivision
119.23must be at least one-half hour in length and must be completed at least once every five
119.24years year. At a minimum, the training must address the risk factors related to shaken
119.25baby syndrome for shaking infants and young children, means to reduce the risk of shaken
119.26baby syndrome abusive head trauma in child care, and license holder communication with
119.27parents regarding reducing the risk of shaken baby syndrome abusive head trauma.
119.28(d) The commissioner shall make available for viewing a video presentation on the
119.29dangers associated with shaking infants and young children. The video presentation must
119.30be part of the orientation and annual in-service training of licensed child care center
119.31staff persons caring for children under school age. The commissioner shall provide to
119.32child care providers and interested individuals, at cost, copies of a video approved by the
119.33commissioner of health under section 144.574 on the dangers associated with shaking
119.34infants and young children.

120.1    Sec. 12. Minnesota Statutes 2012, section 245A.50, is amended to read:
120.2245A.50 FAMILY CHILD CARE TRAINING REQUIREMENTS.
120.3    Subdivision 1. Initial training. (a) License holders, caregivers, and substitutes must
120.4comply with the training requirements in this section.
120.5    (b) Helpers who assist with care on a regular basis must complete six hours of
120.6training within one year after the date of initial employment.
120.7    Subd. 2. Child growth and development and behavior guidance training. (a) For
120.8purposes of family and group family child care, the license holder and each adult caregiver
120.9who provides care in the licensed setting for more than 30 days in any 12-month period
120.10shall complete and document at least two four hours of child growth and development
120.11and behavior guidance training within the first year of prior to initial licensure, and before
120.12caring for children. For purposes of this subdivision, "child growth and development
120.13training" means training in understanding how children acquire language and develop
120.14physically, cognitively, emotionally, and socially. "Behavior guidance training" means
120.15training in the understanding of the functions of child behavior and strategies for managing
120.16challenging situations. Child growth and development and behavior guidance training
120.17must be repeated annually. Training curriculum shall be developed or approved by the
120.18commissioner of human services by January 1, 2014.
120.19    (b) Notwithstanding paragraph (a), individuals are exempt from this requirement if
120.20they:
120.21    (1) have taken a three-credit course on early childhood development within the
120.22past five years;
120.23    (2) have received a baccalaureate or master's degree in early childhood education or
120.24school-age child care within the past five years;
120.25    (3) are licensed in Minnesota as a prekindergarten teacher, an early childhood
120.26educator, a kindergarten to grade 6 teacher with a prekindergarten specialty, an early
120.27childhood special education teacher, or an elementary teacher with a kindergarten
120.28endorsement; or
120.29    (4) have received a baccalaureate degree with a Montessori certificate within the
120.30past five years.
120.31    Subd. 3. First aid. (a) When children are present in a family child care home
120.32governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person
120.33must be present in the home who has been trained in first aid. The first aid training must
120.34have been provided by an individual approved to provide first aid instruction. First aid
120.35training may be less than eight hours and persons qualified to provide first aid training
121.1include individuals approved as first aid instructors. First aid training must be repeated
121.2every two years.
121.3    (b) A family child care provider is exempt from the first aid training requirements
121.4under this subdivision related to any substitute caregiver who provides less than 30 hours
121.5of care during any 12-month period.
121.6    (c) Video training reviewed and approved by the county licensing agency satisfies
121.7the training requirement of this subdivision.
121.8    Subd. 4. Cardiopulmonary resuscitation. (a) When children are present in a family
121.9child care home governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least
121.10one staff person must be present in the home who has been trained in cardiopulmonary
121.11resuscitation (CPR) and in the treatment of obstructed airways that includes CPR
121.12techniques for infants and children. The CPR training must have been provided by an
121.13individual approved to provide CPR instruction, must be repeated at least once every three
121.14 two years, and must be documented in the staff person's records.
121.15    (b) A family child care provider is exempt from the CPR training requirement in
121.16this subdivision related to any substitute caregiver who provides less than 30 hours of
121.17care during any 12-month period.
121.18    (c) Video training reviewed and approved by the county licensing agency satisfies
121.19the training requirement of this subdivision. Persons providing CPR training must use
121.20CPR training that has been developed:
121.21    (1) by the American Heart Association or the American Red Cross and incorporates
121.22psychomotor skills to support the instruction; or
121.23    (2) using nationally recognized, evidence-based guidelines for CPR training and
121.24incorporates psychomotor skills to support the instruction.
121.25    Subd. 5. Sudden unexpected infant death syndrome and shaken baby syndrome
121.26 abusive head trauma training. (a) License holders must document that before staff
121.27persons, caregivers, and helpers assist in the care of infants, they are instructed on the
121.28standards in section 245A.1435 and receive training on reducing the risk of sudden
121.29unexpected infant death syndrome. In addition, license holders must document that before
121.30staff persons, caregivers, and helpers assist in the care of infants and children under
121.31school age, they receive training on reducing the risk of shaken baby syndrome abusive
121.32head trauma from shaking infants and young children. The training in this subdivision
121.33may be provided as initial training under subdivision 1 or ongoing annual training under
121.34subdivision 7.
121.35    (b) Sudden unexpected infant death syndrome reduction training required under this
121.36subdivision must be at least one-half hour in length and must be completed in person
122.1 at least once every five years two years. On the years when the license holder is not
122.2receiving the in-person training on sudden unexpected infant death reduction, the license
122.3holder must receive sudden unexpected infant death reduction training through a video
122.4of no more than one hour in length developed or approved by the commissioner. At a
122.5minimum, the training must address the risk factors related to sudden unexpected infant
122.6death syndrome, means of reducing the risk of sudden unexpected infant death syndrome
122.7 in child care, and license holder communication with parents regarding reducing the risk
122.8of sudden unexpected infant death syndrome.
122.9    (c) Shaken baby syndrome Abusive head trauma training required under this
122.10subdivision must be at least one-half hour in length and must be completed at least once
122.11every five years year. At a minimum, the training must address the risk factors related
122.12to shaken baby syndrome shaking infants and young children, means of reducing the
122.13risk of shaken baby syndrome abusive head trauma in child care, and license holder
122.14communication with parents regarding reducing the risk of shaken baby syndrome abusive
122.15head trauma.
122.16(d) Training for family and group family child care providers must be developed
122.17by the commissioner in conjunction with the Minnesota Sudden Infant Death Center
122.18and approved by the county licensing agency by the Minnesota Center for Professional
122.19Development.
122.20    (e) The commissioner shall make available for viewing by all licensed child care
122.21providers a video presentation on the dangers associated with shaking infants and young
122.22children. The video presentation shall be part of the initial and ongoing annual training of
122.23licensed child care providers, caregivers, and helpers caring for children under school age.
122.24The commissioner shall provide to child care providers and interested individuals, at cost,
122.25copies of a video approved by the commissioner of health under section 144.574 on the
122.26dangers associated with shaking infants and young children.
122.27    Subd. 6. Child passenger restraint systems; training requirement. (a) A license
122.28holder must comply with all seat belt and child passenger restraint system requirements
122.29under section 169.685.
122.30    (b) Family and group family child care programs licensed by the Department of
122.31Human Services that serve a child or children under nine years of age must document
122.32training that fulfills the requirements in this subdivision.
122.33    (1) Before a license holder, staff person, caregiver, or helper transports a child or
122.34children under age nine in a motor vehicle, the person placing the child or children in a
122.35passenger restraint must satisfactorily complete training on the proper use and installation
123.1of child restraint systems in motor vehicles. Training completed under this subdivision may
123.2be used to meet initial training under subdivision 1 or ongoing training under subdivision 7.
123.3    (2) Training required under this subdivision must be at least one hour in length,
123.4completed at initial training, and repeated at least once every five years. At a minimum,
123.5the training must address the proper use of child restraint systems based on the child's
123.6size, weight, and age, and the proper installation of a car seat or booster seat in the motor
123.7vehicle used by the license holder to transport the child or children.
123.8    (3) Training under this subdivision must be provided by individuals who are certified
123.9and approved by the Department of Public Safety, Office of Traffic Safety. License holders
123.10may obtain a list of certified and approved trainers through the Department of Public
123.11Safety Web site or by contacting the agency.
123.12    (c) Child care providers that only transport school-age children as defined in section
123.13245A.02, subdivision 19 , paragraph (f), in child care buses as defined in section 169.448,
123.14subdivision 1, paragraph (e), are exempt from this subdivision.
123.15    Subd. 7. Training requirements for family and group family child care. For
123.16purposes of family and group family child care, the license holder and each primary
123.17caregiver must complete eight 16 hours of ongoing training each year. For purposes
123.18of this subdivision, a primary caregiver is an adult caregiver who provides services in
123.19the licensed setting for more than 30 days in any 12-month period. Repeat of topical
123.20training requirements in subdivisions 2 to 8 shall count toward the annual 16-hour training
123.21requirement. Additional ongoing training subjects to meet the annual 16-hour training
123.22requirement must be selected from the following areas:
123.23    (1) "child growth and development training" has the meaning given in under
123.24 subdivision 2, paragraph (a);
123.25    (2) "learning environment and curriculum" includes, including training in
123.26establishing an environment and providing activities that provide learning experiences to
123.27meet each child's needs, capabilities, and interests;
123.28    (3) "assessment and planning for individual needs" includes, including training in
123.29observing and assessing what children know and can do in order to provide curriculum
123.30and instruction that addresses their developmental and learning needs, including children
123.31with special needs and bilingual children or children for whom English is not their
123.32primary language;
123.33    (4) "interactions with children" includes, including training in establishing
123.34supportive relationships with children, guiding them as individuals and as part of a group;
124.1    (5) "families and communities" includes, including training in working
124.2collaboratively with families and agencies or organizations to meet children's needs and to
124.3encourage the community's involvement;
124.4    (6) "health, safety, and nutrition" includes, including training in establishing and
124.5maintaining an environment that ensures children's health, safety, and nourishment,
124.6including child abuse, maltreatment, prevention, and reporting; home and fire safety; child
124.7injury prevention; communicable disease prevention and control; first aid; and CPR; and
124.8    (7) "program planning and evaluation" includes, including training in establishing,
124.9implementing, evaluating, and enhancing program operations.; and
124.10(8) behavior guidance, including training in the understanding of the functions of
124.11child behavior and strategies for managing behavior.
124.12    Subd. 8. Other required training requirements. (a) The training required of
124.13family and group family child care providers and staff must include training in the cultural
124.14dynamics of early childhood development and child care. The cultural dynamics and
124.15disabilities training and skills development of child care providers must be designed to
124.16achieve outcomes for providers of child care that include, but are not limited to:
124.17    (1) an understanding and support of the importance of culture and differences in
124.18ability in children's identity development;
124.19    (2) understanding the importance of awareness of cultural differences and
124.20similarities in working with children and their families;
124.21    (3) understanding and support of the needs of families and children with differences
124.22in ability;
124.23    (4) developing skills to help children develop unbiased attitudes about cultural
124.24differences and differences in ability;
124.25    (5) developing skills in culturally appropriate caregiving; and
124.26    (6) developing skills in appropriate caregiving for children of different abilities.
124.27    The commissioner shall approve the curriculum for cultural dynamics and disability
124.28training.
124.29    (b) The provider must meet the training requirement in section 245A.14, subdivision
124.3011 , paragraph (a), clause (4), to be eligible to allow a child cared for at the family child
124.31care or group family child care home to use the swimming pool located at the home.
124.32    Subd. 9. Supervising for safety; training requirement. Effective July 1, 2014,
124.33all family child care license holders and each adult caregiver who provides care in the
124.34licensed family child care home for more than 30 days in any 12-month period shall
124.35complete and document at least six hours approved training on supervising for safety
124.36prior to initial licensure, and before caring for children. At least two hours of training
125.1on supervising for safety must be repeated annually. For purposes of this subdivision,
125.2"supervising for safety" includes supervision basics, supervision outdoors, equipment and
125.3materials, illness, injuries, and disaster preparedness. The commissioner shall develop
125.4the supervising for safety curriculum by January 1, 2014.
125.5    Subd. 10. Approved training. (a) County licensing staff must accept training
125.6approved by the Minnesota Center for Professional Development, including:
125.7(1) face-to-face or classroom training;
125.8(2) online training; and
125.9(3) relationship-based professional development, such as mentoring, coaching,
125.10and consulting.
125.11(b) New and increased training requirements under this section must not be imposed
125.12on providers until the commissioner establishes statewide accessibility to the required
125.13provider training.

125.14    Sec. 13. Minnesota Statutes 2012, section 252.27, subdivision 2a, is amended to read:
125.15    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
125.16child, including a child determined eligible for medical assistance without consideration of
125.17parental income, must contribute to the cost of services used by making monthly payments
125.18on a sliding scale based on income, unless the child is married or has been married, parental
125.19rights have been terminated, or the child's adoption is subsidized according to section
125.20259.67 or through title IV-E of the Social Security Act. The parental contribution is a partial
125.21or full payment for medical services provided for diagnostic, therapeutic, curing, treating,
125.22mitigating, rehabilitation, maintenance, and personal care services as defined in United
125.23States Code, title 26, section 213, needed by the child with a chronic illness or disability.
125.24    (b) For households with adjusted gross income equal to or greater than 100 percent
125.25of federal poverty guidelines, the parental contribution shall be computed by applying the
125.26following schedule of rates to the adjusted gross income of the natural or adoptive parents:
125.27    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
125.28poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
125.29contribution is $4 per month;
125.30    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
125.31poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
125.32the parental contribution shall be determined using a sliding fee scale established by the
125.33commissioner of human services which begins at one percent of adjusted gross income
125.34at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
126.1gross income for those with adjusted gross income up to 545 percent of federal poverty
126.2guidelines;
126.3    (3) if the adjusted gross income is greater than 545 percent of federal poverty
126.4guidelines and less than 675 percent of federal poverty guidelines, the parental
126.5contribution shall be 7.5 percent of adjusted gross income;
126.6    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
126.7poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
126.8contribution shall be determined using a sliding fee scale established by the commissioner
126.9of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
126.10federal poverty guidelines and increases to ten percent of adjusted gross income for those
126.11with adjusted gross income up to 975 percent of federal poverty guidelines; and
126.12    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
126.13poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income.
126.14    If the child lives with the parent, the annual adjusted gross income is reduced by
126.15$2,400 prior to calculating the parental contribution. If the child resides in an institution
126.16specified in section 256B.35, the parent is responsible for the personal needs allowance
126.17specified under that section in addition to the parental contribution determined under this
126.18section. The parental contribution is reduced by any amount required to be paid directly to
126.19the child pursuant to a court order, but only if actually paid.
126.20    (c) The household size to be used in determining the amount of contribution under
126.21paragraph (b) includes natural and adoptive parents and their dependents, including the
126.22child receiving services. Adjustments in the contribution amount due to annual changes
126.23in the federal poverty guidelines shall be implemented on the first day of July following
126.24publication of the changes.
126.25    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
126.26natural or adoptive parents determined according to the previous year's federal tax form,
126.27except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
126.28have been used to purchase a home shall not be counted as income.
126.29    (e) The contribution shall be explained in writing to the parents at the time eligibility
126.30for services is being determined. The contribution shall be made on a monthly basis
126.31effective with the first month in which the child receives services. Annually upon
126.32redetermination or at termination of eligibility, if the contribution exceeded the cost of
126.33services provided, the local agency or the state shall reimburse that excess amount to
126.34the parents, either by direct reimbursement if the parent is no longer required to pay a
126.35contribution, or by a reduction in or waiver of parental fees until the excess amount is
126.36exhausted. All reimbursements must include a notice that the amount reimbursed may be
127.1taxable income if the parent paid for the parent's fees through an employer's health care
127.2flexible spending account under the Internal Revenue Code, section 125, and that the
127.3parent is responsible for paying the taxes owed on the amount reimbursed.
127.4    (f) The monthly contribution amount must be reviewed at least every 12 months;
127.5when there is a change in household size; and when there is a loss of or gain in income
127.6from one month to another in excess of ten percent. The local agency shall mail a written
127.7notice 30 days in advance of the effective date of a change in the contribution amount.
127.8A decrease in the contribution amount is effective in the month that the parent verifies a
127.9reduction in income or change in household size.
127.10    (g) Parents of a minor child who do not live with each other shall each pay the
127.11contribution required under paragraph (a). An amount equal to the annual court-ordered
127.12child support payment actually paid on behalf of the child receiving services shall be
127.13deducted from the adjusted gross income of the parent making the payment prior to
127.14calculating the parental contribution under paragraph (b).
127.15    (h) The contribution under paragraph (b) shall be increased by an additional five
127.16percent if the local agency determines that insurance coverage is available but not
127.17obtained for the child. For purposes of this section, "available" means the insurance is a
127.18benefit of employment for a family member at an annual cost of no more than five percent
127.19of the family's annual income. For purposes of this section, "insurance" means health
127.20and accident insurance coverage, enrollment in a nonprofit health service plan, health
127.21maintenance organization, self-insured plan, or preferred provider organization.
127.22    Parents who have more than one child receiving services shall not be required
127.23to pay more than the amount for the child with the highest expenditures. There shall
127.24be no resource contribution from the parents. The parent shall not be required to pay
127.25a contribution in excess of the cost of the services provided to the child, not counting
127.26payments made to school districts for education-related services. Notice of an increase in
127.27fee payment must be given at least 30 days before the increased fee is due.
127.28    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
127.29in the 12 months prior to July 1:
127.30    (1) the parent applied for insurance for the child;
127.31    (2) the insurer denied insurance;
127.32    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
127.33a complaint or appeal, in writing, to the commissioner of health or the commissioner of
127.34commerce, or litigated the complaint or appeal; and
127.35    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
127.36    For purposes of this section, "insurance" has the meaning given in paragraph (h).
128.1    A parent who has requested a reduction in the contribution amount under this
128.2paragraph shall submit proof in the form and manner prescribed by the commissioner or
128.3county agency, including, but not limited to, the insurer's denial of insurance, the written
128.4letter or complaint of the parents, court documents, and the written response of the insurer
128.5approving insurance. The determinations of the commissioner or county agency under this
128.6paragraph are not rules subject to chapter 14.
128.7(j) Notwithstanding paragraph (b), for the period from July 1, 2010, to June 30,
128.82015, the parental contribution shall be computed by applying the following contribution
128.9schedule to the adjusted gross income of the natural or adoptive parents:
128.10(1) if the adjusted gross income is equal to or greater than 100 percent of federal
128.11poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
128.12contribution is $4 per month;
128.13(2) if the adjusted gross income is equal to or greater than 175 percent of federal
128.14poverty guidelines and less than or equal to 525 percent of federal poverty guidelines,
128.15the parental contribution shall be determined using a sliding fee scale established by the
128.16commissioner of human services which begins at one percent of adjusted gross income
128.17at 175 percent of federal poverty guidelines and increases to eight percent of adjusted
128.18gross income for those with adjusted gross income up to 525 percent of federal poverty
128.19guidelines;
128.20(3) if the adjusted gross income is greater than 525 percent of federal poverty
128.21guidelines and less than 675 percent of federal poverty guidelines, the parental
128.22contribution shall be 9.5 percent of adjusted gross income;
128.23(4) if the adjusted gross income is equal to or greater than 675 percent of federal
128.24poverty guidelines and less than 900 percent of federal poverty guidelines, the parental
128.25contribution shall be determined using a sliding fee scale established by the commissioner
128.26of human services which begins at 9.5 percent of adjusted gross income at 675 percent of
128.27federal poverty guidelines and increases to 12 percent of adjusted gross income for those
128.28with adjusted gross income up to 900 percent of federal poverty guidelines; and
128.29(5) if the adjusted gross income is equal to or greater than 900 percent of federal
128.30poverty guidelines, the parental contribution shall be 13.5 percent of adjusted gross
128.31income. If the child lives with the parent, the annual adjusted gross income is reduced by
128.32$2,400 prior to calculating the parental contribution. If the child resides in an institution
128.33specified in section 256B.35, the parent is responsible for the personal needs allowance
128.34specified under that section in addition to the parental contribution determined under this
128.35section. The parental contribution is reduced by any amount required to be paid directly to
128.36the child pursuant to a court order, but only if actually paid.

129.1    Sec. 14. Minnesota Statutes 2012, section 256.82, subdivision 3, is amended to read:
129.2    Subd. 3. Setting foster care standard rates. The commissioner shall annually
129.3establish minimum standard maintenance rates for foster care maintenance and difficulty
129.4of care payments for all children in foster care. Any increase in rates shall in no case
129.5exceed three percent per annum. The foster care rates in effect on January 1, 2013, shall
129.6remain in effect until December 13, 2015.

129.7    Sec. 15. Minnesota Statutes 2012, section 256J.08, subdivision 24, is amended to read:
129.8    Subd. 24. Disregard. "Disregard" means earned income that is not counted when
129.9determining initial eligibility in the initial income test in section 256J.21, subdivision 3,
129.10 or income that is not counted when determining ongoing eligibility and calculating the
129.11amount of the assistance payment for participants. The commissioner shall determine
129.12the amount of the disregard according to section 256J.24, subdivision 10 for ongoing
129.13eligibility shall be 50 percent of gross earned income.
129.14EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
129.15from the United States Department of Agriculture, whichever is later.

129.16    Sec. 16. Minnesota Statutes 2012, section 256J.21, subdivision 3, is amended to read:
129.17    Subd. 3. Initial income test. The county agency shall determine initial eligibility
129.18by considering all earned and unearned income that is not excluded under subdivision 2.
129.19To be eligible for MFIP, the assistance unit's countable income minus the disregards in
129.20paragraphs (a) and (b) must be below the transitional standard of assistance family wage
129.21level according to section 256J.24 for that size assistance unit.
129.22(a) The initial eligibility determination must disregard the following items:
129.23(1) the employment disregard is 18 percent of the gross earned income whether or
129.24not the member is working full time or part time;
129.25(2) dependent care costs must be deducted from gross earned income for the actual
129.26amount paid for dependent care up to a maximum of $200 per month for each child less
129.27than two years of age, and $175 per month for each child two years of age and older under
129.28this chapter and chapter 119B;
129.29(3) all payments made according to a court order for spousal support or the support
129.30of children not living in the assistance unit's household shall be disregarded from the
129.31income of the person with the legal obligation to pay support, provided that, if there has
129.32been a change in the financial circumstances of the person with the legal obligation to pay
129.33support since the support order was entered, the person with the legal obligation to pay
129.34support has petitioned for a modification of the support order; and
130.1(4) an allocation for the unmet need of an ineligible spouse or an ineligible child
130.2under the age of 21 for whom the caregiver is financially responsible and who lives with
130.3the caregiver according to section 256J.36.
130.4(b) Notwithstanding paragraph (a), when determining initial eligibility for applicant
130.5units when at least one member has received MFIP in this state within four months of
130.6the most recent application for MFIP, apply the disregard as defined in section 256J.08,
130.7subdivision 24 , for all unit members.
130.8After initial eligibility is established, the assistance payment calculation is based on
130.9the monthly income test.
130.10EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
130.11from the United States Department of Agriculture, whichever is later.

130.12    Sec. 17. Minnesota Statutes 2012, section 256J.24, subdivision 5, is amended to read:
130.13    Subd. 5. MFIP transitional standard. The MFIP transitional standard is based
130.14on the number of persons in the assistance unit eligible for both food and cash assistance
130.15unless the restrictions in subdivision 6 on the birth of a child apply. The amount of the
130.16transitional standard is published annually by the Department of Human Services.
130.17EFFECTIVE DATE.This section is effective July 1, 2014.

130.18    Sec. 18. Minnesota Statutes 2012, section 256J.24, subdivision 5a, is amended to read:
130.19    Subd. 5a. Food portion of Adjustments to the MFIP transitional standard. (a)
130.20Effective October 1, 2015, the commissioner shall adjust the MFIP transitional standard as
130.21needed to reflect a onetime increase in the cash portion of 16 percent.
130.22(b) When any adjustments are made in the Supplemental Nutrition Assistance
130.23Program, the commissioner shall adjust the food portion of the MFIP transitional standard
130.24as needed to reflect adjustments to the Supplemental Nutrition Assistance Program. The
130.25commissioner shall publish the transitional standard including a breakdown of the cash
130.26and food portions for an assistance unit of sizes one to ten in the State Register whenever
130.27an adjustment is made.

130.28    Sec. 19. Minnesota Statutes 2012, section 256J.24, subdivision 7, is amended to read:
130.29    Subd. 7. Family wage level. The family wage level is 110 percent of the transitional
130.30standard under subdivision 5 or 6, when applicable, and is the standard used when there is
130.31earned income in the assistance unit. As specified in section 256J.21. If there is earned
130.32income in the assistance unit, earned income is subtracted from the family wage level to
131.1determine the amount of the assistance payment, as specified in section 256J.21. The
131.2assistance payment may not exceed the transitional standard under subdivision 5 or 6,
131.3or the shared household standard under subdivision 9, whichever is applicable, for the
131.4assistance unit.
131.5EFFECTIVE DATE.This section is effective October 1, 2013, or upon approval
131.6from the United States Department of Agriculture, whichever is later.

131.7    Sec. 20. Minnesota Statutes 2012, section 256J.621, is amended to read:
131.8256J.621 WORK PARTICIPATION CASH BENEFITS.
131.9    Subdivision 1. Program characteristics. (a) Effective October 1, 2009, upon
131.10exiting the diversionary work program (DWP) or upon terminating the Minnesota family
131.11investment program with earnings, a participant who is employed may be eligible for work
131.12participation cash benefits of $25 per month to assist in meeting the family's basic needs
131.13as the participant continues to move toward self-sufficiency.
131.14    (b) To be eligible for work participation cash benefits, the participant shall not
131.15receive MFIP or diversionary work program assistance during the month and the
131.16participant or participants must meet the following work requirements:
131.17    (1) if the participant is a single caregiver and has a child under six years of age, the
131.18participant must be employed at least 87 hours per month;
131.19    (2) if the participant is a single caregiver and does not have a child under six years of
131.20age, the participant must be employed at least 130 hours per month; or
131.21    (3) if the household is a two-parent family, at least one of the parents must be
131.22employed 130 hours per month.
131.23    Whenever a participant exits the diversionary work program or is terminated from
131.24MFIP and meets the other criteria in this section, work participation cash benefits are
131.25available for up to 24 consecutive months.
131.26    (c) Expenditures on the program are maintenance of effort state funds under
131.27a separate state program for participants under paragraph (b), clauses (1) and (2).
131.28Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
131.29funds. Months in which a participant receives work participation cash benefits under this
131.30section do not count toward the participant's MFIP 60-month time limit.
131.31    Subd. 2. Program suspension. (a) Effective December 1, 2013, the work
131.32participation cash benefits program shall be suspended.
131.33(b) The commissioner of human services may reinstate the work participation cash
131.34benefits program if the United States Department of Human Services determines that the
132.1state of Minnesota did not meet the federal TANF work participation rate and sends a
132.2notice of penalty to reduce Minnesota's federal TANF block grant authorized under title I
132.3of Public Law 104-193, the Personal Responsibility and Work Opportunity Reconciliation
132.4Act of 1996, and under Public Law 109-171, the Deficit Reduction Act of 2005.
132.5(c) The commissioner shall notify the chairs and ranking minority members of the
132.6legislative committees with jurisdiction over human services policy and finance of the
132.7potential penalty and the commissioner's plans to reinstate the work participation cash
132.8benefit program within 30 days of the date the commissioner receives notification that
132.9the state failed to meet the federal work participation rate.

132.10    Sec. 21. Minnesota Statutes 2012, section 256J.626, subdivision 7, is amended to read:
132.11    Subd. 7. Performance base funds. (a) For the purpose of this section, the following
132.12terms have the meanings given.
132.13(1) "Caseload Reduction Credit" (CRC) means the measure of how much Minnesota
132.14TANF and separate state program caseload has fallen relative to federal fiscal year 2005
132.15based on caseload data from October 1 to September 30.
132.16(2) "TANF participation rate target" means a 50 percent participation rate reduced by
132.17the CRC for the previous year.
132.18(b) (a) For calendar year 2010 2016 and yearly thereafter, each county and tribe will
132.19 must be allocated 95 percent of their initial calendar year allocation. Allocations for
132.20counties and tribes will must be allocated additional funds adjusted based on performance
132.21as follows:
132.22    (1) a county or tribe that achieves the TANF participation rate target or a five
132.23percentage point improvement over the previous year's TANF participation rate under
132.24section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive months for
132.25the most recent year for which the measurements are available, will receive an additional
132.26allocation equal to 2.5 percent of its initial allocation;
132.27    (2) (1) a county or tribe that performs within or above its range of expected
132.28performance on the annualized three-year self-support index under section 256J.751,
132.29subdivision 2 , clause (6), will must receive an additional allocation equal to 2.5 five
132.30percent of its initial allocation; and
132.31    (3) a county or tribe that does not achieve the TANF participation rate target or
132.32a five percentage point improvement over the previous year's TANF participation rate
132.33under section 256J.751, subdivision 2, clause (7), as averaged across 12 consecutive
132.34months for the most recent year for which the measurements are available, will not
133.1receive an additional 2.5 percent of its initial allocation until after negotiating a multiyear
133.2improvement plan with the commissioner; or
133.3    (4) (2) a county or tribe that does not perform within or above performs below its
133.4range of expected performance on the annualized three-year self-support index under
133.5section 256J.751, subdivision 2, clause (6), will not receive an additional allocation equal
133.6to 2.5 percent of its initial allocation until after negotiating for a single year, may receive
133.7an additional allocation of up to five percent of its initial allocation. A county or tribe that
133.8continues to perform below its range of expected performance for two consecutive years
133.9must negotiate a multiyear improvement plan with the commissioner. If no improvement
133.10is shown by the end of the multiyear plan, the commissioner may decrease the county's or
133.11tribe's performance-based funds by up to five percent. The decrease must remain in effect
133.12until the county or tribe performs within or above its range of expected performance.
133.13    (c) (b) For calendar year 2009 2016 and yearly thereafter, performance-based funds
133.14for a federally approved tribal TANF program in which the state and tribe have in place a
133.15contract under section 256.01, addressing consolidated funding, will must be allocated
133.16as follows:
133.17    (1) a tribe that achieves the participation rate approved in its federal TANF plan
133.18using the average of 12 consecutive months for the most recent year for which the
133.19measurements are available, will receive an additional allocation equal to 2.5 percent of
133.20its initial allocation; and
133.21    (2) (1) a tribe that performs within or above its range of expected performance on the
133.22annualized three-year self-support index under section 256J.751, subdivision 2, clause (6),
133.23will must receive an additional allocation equal to 2.5 percent of its initial allocation; or
133.24    (3) a tribe that does not achieve the participation rate approved in its federal TANF
133.25plan using the average of 12 consecutive months for the most recent year for which the
133.26measurements are available, will not receive an additional allocation equal to 2.5 percent
133.27of its initial allocation until after negotiating a multiyear improvement plan with the
133.28commissioner; or
133.29    (4) (2) a tribe that does not perform within or above performs below its range of
133.30expected performance on the annualized three-year self-support index under section
133.31256J.751, subdivision 2 , clause (6), will not receive an additional allocation equal to 2.5
133.32percent until after negotiating for a single year may receive an additional allocation of up
133.33to five percent of its initial allocation. A county or tribe that continues to perform below
133.34its range of expected performance for two consecutive years must negotiate a multiyear
133.35improvement plan with the commissioner. If no improvement is shown by the end of the
133.36multiyear plan, the commissioner may decrease the tribe's performance-based funds by
134.1up to five percent. The decrease must remain in effect until the tribe performs within or
134.2above its range of expected performance.
134.3    (d) (c) Funds remaining unallocated after the performance-based allocations in
134.4paragraph paragraphs (a) and (b) are available to the commissioner for innovation projects
134.5under subdivision 5.
134.6     (1) (d) If available funds are insufficient to meet county and tribal allocations under
134.7paragraph paragraphs (a) and (b), the commissioner may make available for allocation
134.8funds that are unobligated and available from the innovation projects through the end of
134.9the current biennium shall proportionally prorate funds to counties and tribes that qualify
134.10for an additional allocation under paragraphs (a), clause (1), and (b), clause (1).
134.11    (2) If after the application of clause (1) funds remain insufficient to meet county and
134.12tribal allocations under paragraph (b), the commissioner must proportionally reduce the
134.13allocation of each county and tribe with respect to their maximum allocation available
134.14under paragraph (b).

134.15    Sec. 22. [256J.78] TANF DEMONSTRATION PROJECTS OR WAIVER FROM
134.16FEDERAL RULES AND REGULATIONS.
134.17    Subdivision 1. Duties of the commissioner. The commissioner of human services
134.18may pursue TANF demonstration projects or waivers of TANF requirements from the
134.19United States Department of Health and Human Services as needed to allow the state to
134.20build a more results-oriented Minnesota Family Investment Program to better meet the
134.21needs of Minnesota families.
134.22    Subd. 2. Purpose. The purpose of the TANF demonstration projects or waivers is to:
134.23(1) replace the federal TANF process measure and its complex administrative
134.24requirements with state-developed outcomes measures that track adult employment and
134.25exits from MFIP cash assistance;
134.26(2) simplify programmatic and administrative requirements; and
134.27(3) make other policy or programmatic changes that improve the performance of the
134.28program and the outcomes for participants.
134.29    Subd. 3. Report to legislature. The commissioner shall report to the members of
134.30the legislative committees having jurisdiction over human services issues by March 1,
134.312014, regarding the progress of this waiver or demonstration project.
134.32EFFECTIVE DATE.This section is effective the day following final enactment.

135.1    Sec. 23. Minnesota Statutes 2012, section 256K.45, is amended to read:
135.2256K.45 RUNAWAY AND HOMELESS YOUTH ACT.
135.3    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this
135.4section.
135.5(b) "Commissioner" means the commissioner of human services.
135.6(c) "Homeless youth" means a person 21 years of age or younger who is
135.7unaccompanied by a parent or guardian and is without shelter where appropriate care and
135.8supervision are available, whose parent or legal guardian is unable or unwilling to provide
135.9shelter and care, or who lacks a fixed, regular, and adequate nighttime residence. The
135.10following are not fixed, regular, or adequate nighttime residences:
135.11(1) a supervised publicly or privately operated shelter designed to provide temporary
135.12living accommodations;
135.13(2) an institution or a publicly or privately operated shelter designed to provide
135.14temporary living accommodations;
135.15(3) transitional housing;
135.16(4) a temporary placement with a peer, friend, or family member that has not offered
135.17permanent residence, a residential lease, or temporary lodging for more than 30 days; or
135.18(5) a public or private place not designed for, nor ordinarily used as, a regular
135.19sleeping accommodation for human beings.
135.20Homeless youth does not include persons incarcerated or otherwise detained under
135.21federal or state law.
135.22(d) "Youth at risk of homelessness" means a person 21 years of age or younger
135.23whose status or circumstances indicate a significant danger of experiencing homelessness
135.24in the near future. Status or circumstances that indicate a significant danger may include:
135.25(1) youth exiting out-of-home placements; (2) youth who previously were homeless; (3)
135.26youth whose parents or primary caregivers are or were previously homeless; (4) youth
135.27who are exposed to abuse and neglect in their homes; (5) youth who experience conflict
135.28with parents due to chemical or alcohol dependency, mental health disabilities, or other
135.29disabilities; and (6) runaways.
135.30(e) "Runaway" means an unmarried child under the age of 18 years who is absent
135.31from the home of a parent or guardian or other lawful placement without the consent of
135.32the parent, guardian, or lawful custodian.
135.33    Subd. 2. Homeless and runaway youth report. The commissioner shall develop a
135.34 report for homeless youth, youth at risk of homelessness, and runaways. The report shall
135.35include coordination of services as defined under subdivisions 3 to 5 prepare a biennial
135.36report, beginning in February 2015, which provides meaningful information to the
136.1legislative committees having jurisdiction over the issue of homeless youth, that includes,
136.2but is not limited to: (1) a list of the areas of the state with the greatest need for services
136.3and housing for homeless youth, and the level and nature of the needs identified; (2) details
136.4about grants made; (3) the distribution of funds throughout the state based on population
136.5need; (4) follow-up information, if available, on the status of homeless youth and whether
136.6they have stable housing two years after services are provided; and (5) any other outcomes
136.7for populations served to determine the effectiveness of the programs and use of funding.
136.8    Subd. 3. Street and community outreach and drop-in program. Youth drop-in
136.9centers must provide walk-in access to crisis intervention and ongoing supportive services
136.10including one-to-one case management services on a self-referral basis. Street and
136.11community outreach programs must locate, contact, and provide information, referrals,
136.12and services to homeless youth, youth at risk of homelessness, and runaways. Information,
136.13referrals, and services provided may include, but are not limited to:
136.14(1) family reunification services;
136.15(2) conflict resolution or mediation counseling;
136.16(3) assistance in obtaining temporary emergency shelter;
136.17(4) assistance in obtaining food, clothing, medical care, or mental health counseling;
136.18(5) counseling regarding violence, prostitution, substance abuse, sexually transmitted
136.19diseases, and pregnancy;
136.20(6) referrals to other agencies that provide support services to homeless youth,
136.21youth at risk of homelessness, and runaways;
136.22(7) assistance with education, employment, and independent living skills;
136.23(8) aftercare services;
136.24(9) specialized services for highly vulnerable runaways and homeless youth,
136.25including teen parents, emotionally disturbed and mentally ill youth, and sexually
136.26exploited youth; and
136.27(10) homelessness prevention.
136.28    Subd. 4. Emergency shelter program. (a) Emergency shelter programs must
136.29provide homeless youth and runaways with referral and walk-in access to emergency,
136.30short-term residential care. The program shall provide homeless youth and runaways with
136.31safe, dignified shelter, including private shower facilities, beds, and at least one meal each
136.32day; and shall assist a runaway and homeless youth with reunification with the family or
136.33legal guardian when required or appropriate.
136.34(b) The services provided at emergency shelters may include, but are not limited to:
136.35(1) family reunification services;
136.36(2) individual, family, and group counseling;
137.1(3) assistance obtaining clothing;
137.2(4) access to medical and dental care and mental health counseling;
137.3(5) education and employment services;
137.4(6) recreational activities;
137.5(7) advocacy and referral services;
137.6(8) independent living skills training;
137.7(9) aftercare and follow-up services;
137.8(10) transportation; and
137.9(11) homelessness prevention.
137.10    Subd. 5. Supportive housing and transitional living programs. Transitional
137.11living programs must help homeless youth and youth at risk of homelessness to find and
137.12maintain safe, dignified housing. The program may also provide rental assistance and
137.13related supportive services, or refer youth to other organizations or agencies that provide
137.14such services. Services provided may include, but are not limited to:
137.15(1) educational assessment and referrals to educational programs;
137.16(2) career planning, employment, work skill training, and independent living skills
137.17training;
137.18(3) job placement;
137.19(4) budgeting and money management;
137.20(5) assistance in securing housing appropriate to needs and income;
137.21(6) counseling regarding violence, prostitution, substance abuse, sexually transmitted
137.22diseases, and pregnancy;
137.23(7) referral for medical services or chemical dependency treatment;
137.24(8) parenting skills;
137.25(9) self-sufficiency support services or life skill training;
137.26(10) aftercare and follow-up services; and
137.27(11) homelessness prevention.
137.28    Subd. 6. Funding. Any Funds appropriated for this section may be expended on
137.29programs described under subdivisions 3 to 5, technical assistance, and capacity building.
137.30Up to four percent of funds appropriated may be used for the purpose of monitoring and
137.31evaluating runaway and homeless youth programs receiving funding under this section.
137.32Funding shall be directed to meet the greatest need, with a significant share of the funding
137.33focused on homeless youth providers in greater Minnesota to meet the greatest need
137.34on a statewide basis.

137.35    Sec. 24. Minnesota Statutes 2012, section 256M.40, subdivision 1, is amended to read:
138.1    Subdivision 1. Formula. The commissioner shall allocate state funds appropriated
138.2under this chapter to each county board on a calendar year basis in an amount determined
138.3according to the formula in paragraphs (a) to (e).
138.4(a) For calendar years 2011 and 2012, the commissioner shall allocate available
138.5funds to each county in proportion to that county's share in calendar year 2010.
138.6(b) For calendar year 2013 and each calendar year thereafter, the commissioner shall
138.7allocate available funds to each county as follows:
138.8(1) 75 percent must be distributed on the basis of the county share in calendar year
138.92012;
138.10(2) five percent must be distributed on the basis of the number of persons residing in
138.11the county as determined by the most recent data of the state demographer;
138.12(3) ten percent must be distributed on the basis of the number of vulnerable children
138.13that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, and in
138.14the county as determined by the most recent data of the commissioner; and
138.15(4) ten percent must be distributed on the basis of the number of vulnerable adults
138.16that are subjects of reports under section 626.557 in the county as determined by the most
138.17recent data of the commissioner.
138.18(c) For calendar year 2014, the commissioner shall allocate available funds to each
138.19county as follows:
138.20(1) 50 percent must be distributed on the basis of the county share in calendar year
138.212012;
138.22(2) Ten percent must be distributed on the basis of the number of persons residing in
138.23the county as determined by the most recent data of the state demographer;
138.24(3) 20 percent must be distributed on the basis of the number of vulnerable children
138.25that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
138.26county as determined by the most recent data of the commissioner; and
138.27(4) 20 percent must be distributed on the basis of the number of vulnerable adults
138.28that are subjects of reports under section 626.557 in the county as determined by the
138.29most recent data of the commissioner The commissioner is precluded from changing the
138.30formula under this subdivision or recommending a change to the legislature without
138.31public review and input.
138.32(d) For calendar year 2015, the commissioner shall allocate available funds to each
138.33county as follows:
138.34(1) 25 percent must be distributed on the basis of the county share in calendar year
138.352012;
139.1(2) 15 percent must be distributed on the basis of the number of persons residing in
139.2the county as determined by the most recent data of the state demographer;
139.3(3) 30 percent must be distributed on the basis of the number of vulnerable children
139.4that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
139.5county as determined by the most recent data of the commissioner; and
139.6(4) 30 percent must be distributed on the basis of the number of vulnerable adults
139.7that are subjects of reports under section 626.557 in the county as determined by the most
139.8recent data of the commissioner.
139.9(e) For calendar year 2016 and each calendar year thereafter, the commissioner shall
139.10allocate available funds to each county as follows:
139.11(1) 20 percent must be distributed on the basis of the number of persons residing in
139.12the county as determined by the most recent data of the state demographer;
139.13(2) 40 percent must be distributed on the basis of the number of vulnerable children
139.14that are subjects of reports under chapter 260C and sections 626.556 and 626.5561, in the
139.15county as determined by the most recent data of the commissioner; and
139.16(3) 40 percent must be distributed on the basis of the number of vulnerable adults
139.17that are subjects of reports under section 626.557 in the county as determined by the most
139.18recent data of the commissioner.

139.19    Sec. 25. Minnesota Statutes 2012, section 257.85, subdivision 11, is amended to read:
139.20    Subd. 11. Financial considerations. (a) Payment of relative custody assistance
139.21under a relative custody assistance agreement is subject to the availability of state funds
139.22and payments may be reduced or suspended on order of the commissioner if insufficient
139.23funds are available Beginning July 1, 2013, relative custody assistance shall be a forecasted
139.24program, and the commissioner, with the approval of the commissioner of management
139.25and budget, may transfer unencumbered appropriation balances within fiscal years of
139.26each biennium to other forecasted programs of the Department of Human Services. The
139.27commissioner shall inform the chairs and ranking minority members of the senate Health
139.28and Human Services Finance Division and the house of representatives Health and Human
139.29Services Finance Committee quarterly about transfers made under this provision.
139.30(b) Upon receipt from a local agency of a claim for reimbursement, the commissioner
139.31shall reimburse the local agency in an amount equal to 100 percent of the relative custody
139.32assistance payments provided to relative custodians. The local agency may not seek and
139.33the commissioner shall not provide reimbursement for the administrative costs associated
139.34with performing the duties described in subdivision 4.
140.1(c) For the purposes of determining eligibility or payment amounts under MFIP,
140.2relative custody assistance payments shall be excluded in determining the family's
140.3available income.

140.4    Sec. 26. Minnesota Statutes 2012, section 259A.05, subdivision 5, is amended to read:
140.5    Subd. 5. Transfer of funds. The commissioner of human services may transfer
140.6funds into the adoption assistance account when a deficit in the adoption assistance
140.7program occurs Beginning July 1, 2013, adoption assistance shall be a forecasted program
140.8and the commissioner, with the approval of the commissioner of management and budget,
140.9may transfer unencumbered appropriation balances within fiscal years of each biennium to
140.10other forecasted programs of the Department of Human Services. The commissioner shall
140.11inform the chairs and ranking minority members of the senate Health and Human Services
140.12Finance Division and the house of representatives Health and Human Services Finance
140.13Committee quarterly about transfers made under this provision.

140.14    Sec. 27. Minnesota Statutes 2012, section 259A.20, subdivision 4, is amended to read:
140.15    Subd. 4. Reimbursement for special nonmedical expenses. (a) Reimbursement
140.16for special nonmedical expenses is available to children, except those eligible for adoption
140.17assistance based on being an at-risk child.
140.18(b) Reimbursements under this paragraph shall be made only after the adoptive
140.19parent documents that the requested service was denied by the local social service agency,
140.20community agencies, the local school district, the local public health department, the
140.21parent's insurance provider, or the child's program. The denial must be for an eligible
140.22service or qualified item under the program requirements of the applicable agency or
140.23organization.
140.24(c) Reimbursements must be previously authorized, adhere to the requirements and
140.25procedures prescribed by the commissioner, and be limited to:
140.26(1) child care for a child age 12 and younger, or for a child age 13 or 14 who has a
140.27documented disability that requires special instruction for and services by the child care
140.28provider. Child care reimbursements may be made if all available adult caregivers are
140.29employed, unemployed due to a disability as defined in section 259A.01, subdivision 14,
140.30 or attending educational or vocational training programs. Documentation from a qualified
140.31expert that is dated within the last 12 months must be provided to verify the disability. If a
140.32parent is attending an educational or vocational training program, child care reimbursement
140.33is limited to no more than the time necessary to complete the credit requirements for an
140.34associate or baccalaureate degree as determined by the educational institution. Child
141.1care reimbursement is not limited for an adoptive parent completing basic or remedial
141.2education programs needed to prepare for postsecondary education or employment;
141.3(2) respite care provided for the relief of the child's parent up to 504 hours of respite
141.4care annually;
141.5(3) camping up to 14 days per state fiscal year for a child to attend a special needs
141.6camp. The camp must be accredited by the American Camp Association as a special needs
141.7camp in order to be eligible for camp reimbursement;
141.8(4) postadoption counseling to promote the child's integration into the adoptive
141.9family that is provided by the placing agency during the first year following the date of the
141.10adoption decree. Reimbursement is limited to 12 sessions of postadoption counseling;
141.11(5) family counseling that is required to meet the child's special needs.
141.12Reimbursement is limited to the prorated portion of the counseling fees allotted to the
141.13family when the adoptive parent's health insurance or Medicaid pays for the child's
141.14counseling but does not cover counseling for the rest of the family members;
141.15(6) home modifications to accommodate the child's special needs upon which
141.16eligibility for adoption assistance was approved. Reimbursement is limited to once every
141.17five years per child;
141.18(7) vehicle modifications to accommodate the child's special needs upon which
141.19eligibility for adoption assistance was approved. Reimbursement is limited to once every
141.20five years per family; and
141.21(8) burial expenses up to $1,000, if the special needs, upon which eligibility for
141.22adoption assistance was approved, resulted in the death of the child.
141.23(d) The adoptive parent shall submit statements for expenses incurred between July
141.241 and June 30 of a given fiscal year to the state adoption assistance unit within 60 days
141.25after the end of the fiscal year in order for reimbursement to occur.

141.26    Sec. 28. Minnesota Statutes 2012, section 260B.007, subdivision 6, is amended to read:
141.27    Subd. 6. Delinquent child. (a) Except as otherwise provided in paragraphs (b)
141.28and (c), "delinquent child" means a child:
141.29(1) who has violated any state or local law, except as provided in section 260B.225,
141.30subdivision 1 , and except for juvenile offenders as described in subdivisions 16 to 18;
141.31(2) who has violated a federal law or a law of another state and whose case has been
141.32referred to the juvenile court if the violation would be an act of delinquency if committed
141.33in this state or a crime or offense if committed by an adult;
141.34(3) who has escaped from confinement to a state juvenile correctional facility after
141.35being committed to the custody of the commissioner of corrections; or
142.1(4) who has escaped from confinement to a local juvenile correctional facility after
142.2being committed to the facility by the court.
142.3(b) The term delinquent child does not include a child alleged to have committed
142.4murder in the first degree after becoming 16 years of age, but the term delinquent child
142.5does include a child alleged to have committed attempted murder in the first degree.
142.6(c) The term delinquent child does not include a child under the age of 16 years
142.7 alleged to have engaged in conduct which would, if committed by an adult, violate any
142.8federal, state, or local law relating to being hired, offering to be hired, or agreeing to be
142.9hired by another individual to engage in sexual penetration or sexual conduct.
142.10EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
142.11offenses committed on or after that date.

142.12    Sec. 29. Minnesota Statutes 2012, section 260B.007, subdivision 16, is amended to read:
142.13    Subd. 16. Juvenile petty offender; juvenile petty offense. (a) "Juvenile petty
142.14offense" includes a juvenile alcohol offense, a juvenile controlled substance offense,
142.15a violation of section 609.685, or a violation of a local ordinance, which by its terms
142.16prohibits conduct by a child under the age of 18 years which would be lawful conduct if
142.17committed by an adult.
142.18(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also
142.19includes an offense that would be a misdemeanor if committed by an adult.
142.20(c) "Juvenile petty offense" does not include any of the following:
142.21(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242,
142.22609.324 , subdivision 2 or 3, 609.5632, 609.576, 609.66, 609.746, 609.748, 609.79,
142.23or 617.23;
142.24(2) a major traffic offense or an adult court traffic offense, as described in section
142.25260B.225 ;
142.26(3) a misdemeanor-level offense committed by a child whom the juvenile court
142.27previously has found to have committed a misdemeanor, gross misdemeanor, or felony
142.28offense; or
142.29(4) a misdemeanor-level offense committed by a child whom the juvenile court
142.30has found to have committed a misdemeanor-level juvenile petty offense on two or
142.31more prior occasions, unless the county attorney designates the child on the petition
142.32as a juvenile petty offender notwithstanding this prior record. As used in this clause,
142.33"misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that
142.34would have been a juvenile petty offense if it had been committed on or after July 1, 1995.
143.1(d) A child who commits a juvenile petty offense is a "juvenile petty offender." The
143.2term juvenile petty offender does not include a child under the age of 16 years alleged
143.3to have violated any law relating to being hired, offering to be hired, or agreeing to be
143.4hired by another individual to engage in sexual penetration or sexual conduct which, if
143.5committed by an adult, would be a misdemeanor.
143.6EFFECTIVE DATE.This section is effective August 1, 2014, and applies to
143.7offenses committed on or after that date.

143.8    Sec. 30. Minnesota Statutes 2012, section 260C.007, subdivision 6, is amended to read:
143.9    Subd. 6. Child in need of protection or services. "Child in need of protection or
143.10services" means a child who is in need of protection or services because the child:
143.11    (1) is abandoned or without parent, guardian, or custodian;
143.12    (2)(i) has been a victim of physical or sexual abuse as defined in section 626.556,
143.13subdivision 2, (ii) resides with or has resided with a victim of child abuse as defined in
143.14subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
143.15would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or
143.16child abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment
143.17as defined in subdivision 15;
143.18    (3) is without necessary food, clothing, shelter, education, or other required care
143.19for the child's physical or mental health or morals because the child's parent, guardian,
143.20or custodian is unable or unwilling to provide that care;
143.21    (4) is without the special care made necessary by a physical, mental, or emotional
143.22condition because the child's parent, guardian, or custodian is unable or unwilling to
143.23provide that care;
143.24    (5) is medically neglected, which includes, but is not limited to, the withholding of
143.25medically indicated treatment from a disabled infant with a life-threatening condition. The
143.26term "withholding of medically indicated treatment" means the failure to respond to the
143.27infant's life-threatening conditions by providing treatment, including appropriate nutrition,
143.28hydration, and medication which, in the treating physician's or physicians' reasonable
143.29medical judgment, will be most likely to be effective in ameliorating or correcting all
143.30conditions, except that the term does not include the failure to provide treatment other
143.31than appropriate nutrition, hydration, or medication to an infant when, in the treating
143.32physician's or physicians' reasonable medical judgment:
143.33    (i) the infant is chronically and irreversibly comatose;
144.1    (ii) the provision of the treatment would merely prolong dying, not be effective in
144.2ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
144.3futile in terms of the survival of the infant; or
144.4    (iii) the provision of the treatment would be virtually futile in terms of the survival
144.5of the infant and the treatment itself under the circumstances would be inhumane;
144.6    (6) is one whose parent, guardian, or other custodian for good cause desires to be
144.7relieved of the child's care and custody, including a child who entered foster care under a
144.8voluntary placement agreement between the parent and the responsible social services
144.9agency under section 260C.227;
144.10    (7) has been placed for adoption or care in violation of law;
144.11    (8) is without proper parental care because of the emotional, mental, or physical
144.12disability, or state of immaturity of the child's parent, guardian, or other custodian;
144.13    (9) is one whose behavior, condition, or environment is such as to be injurious or
144.14dangerous to the child or others. An injurious or dangerous environment may include, but
144.15is not limited to, the exposure of a child to criminal activity in the child's home;
144.16    (10) is experiencing growth delays, which may be referred to as failure to thrive, that
144.17have been diagnosed by a physician and are due to parental neglect;
144.18    (11) has engaged in prostitution as defined in section 609.321, subdivision 9 is a
144.19sexually exploited youth;
144.20    (12) has committed a delinquent act or a juvenile petty offense before becoming
144.21ten years old;
144.22    (13) is a runaway;
144.23    (14) is a habitual truant;
144.24    (15) has been found incompetent to proceed or has been found not guilty by reason
144.25of mental illness or mental deficiency in connection with a delinquency proceeding, a
144.26certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
144.27proceeding involving a juvenile petty offense; or
144.28(16) has a parent whose parental rights to one or more other children were
144.29involuntarily terminated or whose custodial rights to another child have been involuntarily
144.30transferred to a relative and there is a case plan prepared by the responsible social services
144.31agency documenting a compelling reason why filing the termination of parental rights
144.32petition under section 260C.301, subdivision 3, is not in the best interests of the child; or.
144.33(17) is a sexually exploited youth.
144.34EFFECTIVE DATE.This section is effective August 1, 2014.

144.35    Sec. 31. Minnesota Statutes 2012, section 260C.007, subdivision 31, is amended to read:
145.1    Subd. 31. Sexually exploited youth. "Sexually exploited youth" means an
145.2individual who:
145.3(1) is alleged to have engaged in conduct which would, if committed by an adult,
145.4violate any federal, state, or local law relating to being hired, offering to be hired, or
145.5agreeing to be hired by another individual to engage in sexual penetration or sexual conduct;
145.6(2) is a victim of a crime described in section 609.342, 609.343, 609.344, 609.345,
145.7609.3451 , 609.3453, 609.352, 617.246, or 617.247;
145.8(3) is a victim of a crime described in United States Code, title 18, section 2260;
145.92421; 2422; 2423; 2425; 2425A; or 2256; or
145.10(4) is a sex trafficking victim as defined in section 609.321, subdivision 7b.
145.11EFFECTIVE DATE.This section is effective the day following final enactment.

145.12    Sec. 32. Minnesota Statutes 2012, section 518A.60, is amended to read:
145.13518A.60 COLLECTION; ARREARS ONLY.
145.14(a) Remedies available for the collection and enforcement of support in this chapter
145.15and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
145.16for whom support is owed are emancipated and the obligor owes past support or has an
145.17accumulated arrearage as of the date of the youngest child's emancipation. Child support
145.18arrearages under this section include arrearages for child support, medical support, child
145.19care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
145.20section 518A.41, subdivision 1, paragraph (h).
145.21(b) This section applies retroactively to any support arrearage that accrued on or
145.22before June 3, 1997, and to all arrearages accruing after June 3, 1997.
145.23(c) Past support or pregnancy and confinement expenses ordered for which the
145.24obligor has specific court ordered terms for repayment may not be enforced using
145.25drivers' and occupational or professional license suspension, credit bureau reporting, and
145.26additional income withholding under section 518A.53, subdivision 10, paragraph (a),
145.27unless the obligor fails to comply with the terms of the court order for repayment.
145.28(d) If an arrearage exists at the time a support order would otherwise terminate
145.29and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
145.30arrearage shall be repaid in an amount equal to the current support order until all arrears
145.31have been paid in full, absent a court order to the contrary.
145.32(e) If an arrearage exists according to a support order which fails to establish a
145.33monthly support obligation in a specific dollar amount, the public authority, if it provides
145.34child support services, or the obligee, may establish a payment agreement which shall
146.1equal what the obligor would pay for current support after application of section 518A.34,
146.2plus an additional 20 percent of the current support obligation, until all arrears have been
146.3paid in full. If the obligor fails to enter into or comply with a payment agreement, the
146.4public authority, if it provides child support services, or the obligee, may move the district
146.5court or child support magistrate, if section 484.702 applies, for an order establishing
146.6repayment terms.
146.7(f) If there is no longer a current support order because all of the children of the
146.8order are emancipated, the public authority may discontinue child support services and
146.9close its case under title IV-D of the Social Security Act if:
146.10(1) the arrearage is under $500; or
146.11(2) the arrearage is considered unenforceable by the public authority because there
146.12have been no collections for three years, and all administrative and legal remedies have
146.13been attempted or are determined by the public authority to be ineffective because the
146.14obligor is unable to pay, the obligor has no known income or assets, and there is no
146.15reasonable prospect that the obligor will be able to pay in the foreseeable future.
146.16    (g) At least 60 calendar days before the discontinuation of services under paragraph
146.17(f), the public authority must mail a written notice to the obligee and obligor at the
146.18obligee's and obligor's last known addresses that the public authority intends to close the
146.19child support enforcement case and explaining each party's rights. Seven calendar days
146.20after the first notice is mailed, the public authority must mail a second notice under this
146.21paragraph to the obligee.
146.22    (h) The case must be kept open if the obligee responds before case closure and
146.23provides information that could reasonably lead to collection of arrears. If the case is
146.24closed, the obligee may later request that the case be reopened by completing a new
146.25application for services, if there is a change in circumstances that could reasonably lead to
146.26the collection of arrears.

146.27    Sec. 33. Laws 1998, chapter 407, article 6, section 116, is amended to read:
146.28    Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
146.29    The commissioner of human services shall request and receive approval from the
146.30legislature before adjusting the payment to discontinue the state subsidy to retailers for
146.31electronic benefit transfer transaction costs Supplemental Nutrition Assistance Program
146.32transactions when the federal government discontinues the federal subsidy to the same.

146.33    Sec. 34. DIRECTION TO COMMISSIONERS; INCOME AND ASSET
146.34EXCLUSION.
147.1(a) The commissioner of human services shall not count conditional cash transfers
147.2made to families participating in a family independence demonstration as income or
147.3assets for purposes of determining or redetermining eligibility for child care assistance
147.4programs under Minnesota Statutes, chapter 119B; general assistance under Minnesota
147.5Statutes, chapter 256D; group residential housing under Minnesota Statutes, chapter 256I;
147.6the Minnesota family investment program, work benefit program, or diversionary work
147.7program under Minnesota Statutes, chapter 256J, during the duration of the demonstration.
147.8(b) The commissioner of human services shall not count conditional cash transfers
147.9made to families participating in a family independence demonstration as income or assets
147.10for purposes of determining or redetermining eligibility for medical assistance under
147.11Minnesota Statutes, chapter 256B, and MinnesotaCare under Minnesota Statutes, chapter
147.12256L, except that for enrollees subject to a modified adjusted gross income calculation to
147.13determine eligibility, the conditional cash transfer payments shall be counted as income if
147.14they are included on the enrollee's federal tax return as income, or if the payments can be
147.15taken into account in the month of receipt as a lump sum payment.
147.16(c) The commissioner of the Minnesota Housing Finance Agency shall not count
147.17conditional cash transfers made to families participating in a family independence
147.18demonstration as income or assets for purposes of determining or redetermining eligibility
147.19for housing assistance programs under Minnesota Statutes, section 462A.201, during
147.20the duration of the demonstration.
147.21(d) For the purposes of this section:
147.22(1) "conditional cash transfer" means a payment made to a participant in a family
147.23independence demonstration by a sponsoring organization to incent, support, or facilitate
147.24participation; and
147.25(2) "family independence demonstration" means an initiative sponsored or
147.26cosponsored by a governmental or nongovernmental organization, the goal of which is
147.27to facilitate individualized goal-setting and peer support for cohorts of no more than 12
147.28families each toward the development of financial and nonfinancial assets that enable the
147.29participating families to achieve financial independence.
147.30(e) The citizens league shall provide a report to the legislative committees having
147.31jurisdiction over human services issues by July 1, 2016, informing the legislature on the
147.32progress and outcomes of the demonstration under this section.

147.33    Sec. 35. UNIFORM BENEFITS FOR CHILDREN IN FOSTER CARE,
147.34PERMANENT RELATIVE CARE, AND ADOPTION ASSISTANCE.
148.1Using available resources, the commissioner of human services, in consultation with
148.2representatives of the judicial branch, county human services, and tribes participating in
148.3the American Indian child welfare initiative under Minnesota Statutes, section 256.01,
148.4subdivision 14b, together with other appropriate stakeholders, which might include
148.5communities of color; youth in foster care or those who have aged out of care; kinship
148.6caregivers, foster parents, adoptive parents, foster and adoptive agencies; guardians ad
148.7litem; and experts in permanency, adoption, child development, and the effects of trauma,
148.8and the use of medical assistance home and community-based waivers for persons with
148.9disabilities, shall analyze benefits and services available to children in family foster care
148.10under Minnesota Rules, parts 9560.0650 to 9560.0656, relative custody assistance under
148.11Minnesota Statutes, section 257.85, and adoption assistance under Minnesota Statutes,
148.12chapter 259A. The goal of the analysis is to establish a uniform set of benefits available
148.13to children in foster care, permanent relative care, and adoption so that the benefits
148.14can follow the child rather than being tied to the child's legal status. Included in the
148.15analysis is possible accessing of federal title IV-E through guardianship assistance. The
148.16commissioner shall report findings and conclusions to the chairs and ranking minority
148.17members of the legislative committees and divisions with jurisdiction over health and
148.18human services policy and finance by January 15, 2014, and include draft legislation
148.19establishing uniform benefits.

148.20    Sec. 36. REPEALER.
148.21(a) Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed effective
148.22July 1, 2014.
148.23(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following
148.24final enactment.


148.27    Section 1. Minnesota Statutes 2012, section 245.462, subdivision 20, is amended to read:
148.28    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the brain
148.29or a clinically significant disorder of thought, mood, perception, orientation, memory, or
148.30behavior that is detailed in a diagnostic codes list published by the commissioner, and that
148.31seriously limits a person's capacity to function in primary aspects of daily living such as
148.32personal relations, living arrangements, work, and recreation.
148.33    (b) An "adult with acute mental illness" means an adult who has a mental illness that
148.34is serious enough to require prompt intervention.
149.1    (c) For purposes of case management and community support services, a "person
149.2with serious and persistent mental illness" means an adult who has a mental illness and
149.3meets at least one of the following criteria:
149.4    (1) the adult has undergone two or more episodes of inpatient care for a mental
149.5illness within the preceding 24 months;
149.6    (2) the adult has experienced a continuous psychiatric hospitalization or residential
149.7treatment exceeding six months' duration within the preceding 12 months;
149.8    (3) the adult has been treated by a crisis team two or more times within the preceding
149.924 months;
149.10    (4) the adult:
149.11    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression,
149.12schizoaffective disorder, or borderline personality disorder;
149.13    (ii) indicates a significant impairment in functioning; and
149.14    (iii) has a written opinion from a mental health professional, in the last three years,
149.15stating that the adult is reasonably likely to have future episodes requiring inpatient or
149.16residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
149.17management or community support services are provided;
149.18    (5) the adult has, in the last three years, been committed by a court as a person who is
149.19mentally ill under chapter 253B, or the adult's commitment has been stayed or continued; or
149.20    (6) the adult (i) was eligible under clauses (1) to (5), but the specified time period
149.21has expired or the adult was eligible as a child under section 245.4871, subdivision 6; and
149.22(ii) has a written opinion from a mental health professional, in the last three years, stating
149.23that the adult is reasonably likely to have future episodes requiring inpatient or residential
149.24treatment, of a frequency described in clause (1) or (2), unless ongoing case management
149.25or community support services are provided; or
149.26    (7) the adult was eligible as a child under section 245.4871, subdivision 6, and is
149.27age 21 or younger.

149.28    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
149.29    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
149.30the exception of the placement of a Minnesota specialty treatment facility as defined in
149.31paragraph (c), must be developed under the direction of the county board, or multiple
149.32county boards acting jointly, as the local mental health authority. The planning process
149.33for each pilot shall include, but not be limited to, mental health consumers, families,
149.34advocates, local mental health advisory councils, local and state providers, representatives
149.35of state and local public employee bargaining units, and the department of human services.
150.1As part of the planning process, the county board or boards shall designate a managing
150.2entity responsible for receipt of funds and management of the pilot project.
150.3(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
150.4request for proposal for regions in which a need has been identified for services.
150.5(c) For purposes of this section, Minnesota specialty treatment facility is defined as
150.6an intensive rehabilitative mental health service under section 256B.0622, subdivision 2,
150.7paragraph (b).

150.8    Sec. 3. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
150.9    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
150.10commissioner shall facilitate integration of funds or other resources as needed and
150.11requested by each project. These resources may include:
150.12(1) residential services funds administered under Minnesota Rules, parts 9535.2000
150.13to 9535.3000, in an amount to be determined by mutual agreement between the project's
150.14managing entity and the commissioner of human services after an examination of the
150.15county's historical utilization of facilities located both within and outside of the county
150.16and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
150.17(2) community support services funds administered under Minnesota Rules, parts
150.189535.1700 to 9535.1760;
150.19(3) other mental health special project funds;
150.20(4) medical assistance, general assistance medical care, MinnesotaCare and group
150.21residential housing if requested by the project's managing entity, and if the commissioner
150.22determines this would be consistent with the state's overall health care reform efforts; and
150.23(5) regional treatment center resources consistent with section 246.0136, subdivision
150.241 .; and
150.25(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
150.26participate in mental health specialty treatment services, awarded to providers through
150.27a request for proposal process.
150.28(b) The commissioner shall consider the following criteria in awarding start-up and
150.29implementation grants for the pilot projects:
150.30(1) the ability of the proposed projects to accomplish the objectives described in
150.31subdivision 2;
150.32(2) the size of the target population to be served; and
150.33(3) geographical distribution.
151.1(c) The commissioner shall review overall status of the projects initiatives at least
151.2every two years and recommend any legislative changes needed by January 15 of each
151.3odd-numbered year.
151.4(d) The commissioner may waive administrative rule requirements which are
151.5incompatible with the implementation of the pilot project.
151.6(e) The commissioner may exempt the participating counties from fiscal sanctions
151.7for noncompliance with requirements in laws and rules which are incompatible with the
151.8implementation of the pilot project.
151.9(f) The commissioner may award grants to an entity designated by a county board or
151.10group of county boards to pay for start-up and implementation costs of the pilot project.

151.11    Sec. 4. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
151.12    Subd. 2. General provisions. (a) In the design and implementation of reforms to
151.13the mental health system, the commissioner shall:
151.14    (1) consult with consumers, families, counties, tribes, advocates, providers, and
151.15other stakeholders;
151.16    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
151.17January 15, 2008, recommendations for legislation to update the role of counties and to
151.18clarify the case management roles, functions, and decision-making authority of health
151.19plans and counties, and to clarify county retention of the responsibility for the delivery of
151.20social services as required under subdivision 3, paragraph (a);
151.21    (3) withhold implementation of any recommended changes in case management
151.22roles, functions, and decision-making authority until after the release of the report due
151.23January 15, 2008;
151.24    (4) ensure continuity of care for persons affected by these reforms including
151.25ensuring client choice of provider by requiring broad provider networks and developing
151.26mechanisms to facilitate a smooth transition of service responsibilities;
151.27    (5) provide accountability for the efficient and effective use of public and private
151.28resources in achieving positive outcomes for consumers;
151.29    (6) ensure client access to applicable protections and appeals; and
151.30    (7) make budget transfers necessary to implement the reallocation of services and
151.31client responsibilities between counties and health care programs that do not increase the
151.32state and county costs and efficiently allocate state funds.
151.33    (b) When making transfers under paragraph (a) necessary to implement movement
151.34of responsibility for clients and services between counties and health care programs,
151.35the commissioner, in consultation with counties, shall ensure that any transfer of state
152.1grants to health care programs, including the value of case management transfer grants
152.2under section 256B.0625, subdivision 20, does not exceed the value of the services being
152.3transferred for the latest 12-month period for which data is available. The commissioner
152.4may make quarterly adjustments based on the availability of additional data during the
152.5first four quarters after the transfers first occur. If case management transfer grants under
152.6section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
152.7to repeal, exceeds the value of the services being transferred, the difference becomes an
152.8ongoing part of each county's adult and children's mental health grants under sections
152.9245.4661 , 245.4889, and 256E.12.
152.10    (c) This appropriation is not authorized to be expended after December 31, 2010,
152.11unless approved by the legislature.

152.12    Sec. 5. Minnesota Statutes 2012, section 245.4875, subdivision 8, is amended to read:
152.13    Subd. 8. Transition services. The county board may continue to provide mental
152.14health services as defined in sections 245.487 to 245.4889 to persons over 18 years of
152.15age, but under 21 years of age, if the person was receiving case management or family
152.16community support services prior to age 18, and if one of the following conditions is met:
152.17(1) the person is receiving special education services through the local school
152.18district; or
152.19(2) it is in the best interest of the person to continue services defined in sections
152.20245.487 to 245.4889; or
152.21(3) the person is requesting services and the services are medically necessary.

152.22    Sec. 6. Minnesota Statutes 2012, section 245.4881, subdivision 1, is amended to read:
152.23    Subdivision 1. Availability of case management services. (a) The county board
152.24shall provide case management services for each child with severe emotional disturbance
152.25who is a resident of the county and the child's family who request or consent to the services.
152.26Case management services may be continued must be offered to be provided for a child with
152.27a serious emotional disturbance who is over the age of 18 consistent with section 245.4875,
152.28subdivision 8 , or the child's legal representative, provided the child's service needs can be
152.29met within the children's service system. Before discontinuing case management services
152.30under this subdivision for children between the ages of 17 and 21, a transition plan
152.31must be developed. The transition plan must be developed with the child and, with the
152.32consent of a child age 18 or over, the child's parent, guardian, or legal representative. The
152.33transition plan should include plans for health insurance, housing, education, employment,
153.1and treatment. Staffing ratios must be sufficient to serve the needs of the clients. The case
153.2manager must meet the requirements in section 245.4871, subdivision 4.
153.3(b) Except as permitted by law and the commissioner under demonstration projects,
153.4case management services provided to children with severe emotional disturbance eligible
153.5for medical assistance must be billed to the medical assistance program under sections
153.6256B.02, subdivision 8 , and 256B.0625.
153.7(c) Case management services are eligible for reimbursement under the medical
153.8assistance program. Costs of mentoring, supervision, and continuing education may be
153.9included in the reimbursement rate methodology used for case management services under
153.10the medical assistance program.

153.11    Sec. 7. Minnesota Statutes 2012, section 246.18, subdivision 8, is amended to read:
153.12    Subd. 8. State-operated services account. (a) The state-operated services account is
153.13established in the special revenue fund. Revenue generated by new state-operated services
153.14listed under this section established after July 1, 2010, that are not enterprise activities must
153.15be deposited into the state-operated services account, unless otherwise specified in law:
153.16(1) intensive residential treatment services;
153.17(2) foster care services; and
153.18(3) psychiatric extensive recovery treatment services.
153.19(b) Funds deposited in the state-operated services account are available to the
153.20commissioner of human services for the purposes of:
153.21(1) providing services needed to transition individuals from institutional settings
153.22within state-operated services to the community when those services have no other
153.23adequate funding source;
153.24(2) grants to providers participating in mental health specialty treatment services
153.25under section 245.4661; and
153.26(3) to fund the operation of the Intensive Residential Treatment Service program in
153.27Willmar.

153.28    Sec. 8. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
153.29to read:
153.30    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
153.31to the account in subdivision 8 for noncovered allowable costs of a provider certified and
153.32licensed under section 256B.0622 and operating under section 246.014.

153.33    Sec. 9. Minnesota Statutes 2012, section 253B.10, subdivision 1, is amended to read:
154.1    Subdivision 1. Administrative requirements. (a) When a person is committed,
154.2the court shall issue a warrant or an order committing the patient to the custody of the
154.3head of the treatment facility. The warrant or order shall state that the patient meets the
154.4statutory criteria for civil commitment.
154.5(b) The commissioner shall prioritize patients being admitted from jail or a
154.6correctional institution who are:
154.7(1) ordered confined in a state hospital for an examination under Minnesota Rules of
154.8Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and 20.02, subdivision 2;
154.9(2) under civil commitment for competency treatment and continuing supervision
154.10under Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;
154.11(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
154.12Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
154.13detained in a state hospital or other facility pending completion of the civil commitment
154.14proceedings; or
154.15(4) committed under this chapter to the commissioner after dismissal of the patient's
154.16criminal charges.
154.17Patients described in this paragraph must be admitted to a service operated by the
154.18commissioner within 48 hours. The commitment must be ordered by the court as provided
154.19in section 253B.09, subdivision 1, paragraph (c).
154.20(c) Upon the arrival of a patient at the designated treatment facility, the head of the
154.21facility shall retain the duplicate of the warrant and endorse receipt upon the original
154.22warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment
154.23must be filed in the court of commitment. After arrival, the patient shall be under the
154.24control and custody of the head of the treatment facility.
154.25(d) Copies of the petition for commitment, the court's findings of fact and
154.26conclusions of law, the court order committing the patient, the report of the examiners,
154.27and the prepetition report shall be provided promptly to the treatment facility.

154.28    Sec. 10. Minnesota Statutes 2012, section 254B.13, is amended to read:
154.29254B.13 PILOT PROJECTS; CHEMICAL HEALTH CARE.
154.30    Subdivision 1. Authorization for navigator pilot projects. The commissioner may
154.31approve and implement navigator pilot projects developed under the planning process
154.32required under Laws 2009, chapter 79, article 7, section 26, to provide alternatives to and
154.33enhance coordination of the delivery of chemical health services required under section
154.34254B.03 .
155.1    Subd. 2. Program design and implementation. (a) The commissioner and
155.2counties participating in the navigator pilot projects shall continue to work in partnership
155.3to refine and implement the navigator pilot projects initiated under Laws 2009, chapter
155.479, article 7, section 26.
155.5(b) The commissioner and counties participating in the navigator pilot projects shall
155.6complete the planning phase by June 30, 2010, and, if approved by the commissioner for
155.7implementation, enter into agreements governing the operation of the navigator pilot
155.8projects with implementation scheduled no earlier than July 1, 2010.
155.9    Subd. 2a. Eligibility for navigator pilot program. (a) To be considered for
155.10participation in a navigator pilot program, an individual must:
155.11(1) be a resident of a county with an approved navigator program;
155.12(2) be eligible for consolidated chemical dependency treatment fund services;
155.13(3) be a voluntary participant in the navigator program;
155.14(4) satisfy one of the following items:
155.15(i) have at least one severity rating of three or above in dimension four, five, or six in
155.16a comprehensive assessment under Minnesota Rules, part 9530.6422; or
155.17(ii) have at least one severity rating of two or above in dimension four, five, or six in
155.18a comprehensive assessment under Minnesota Rules, part 9530.6422, and be currently
155.19participating in a Rule 31 treatment program under Minnesota Rules, parts 9530.6405 to
155.209530.6505, or be within 60 days following discharge after participation in a Rule 31
155.21treatment program; and
155.22(5) have had at least two treatment episodes in the past two years, not limited
155.23to episodes reimbursed by the consolidated chemical dependency treatment funds. An
155.24admission to an emergency room, a detoxification program, or a hospital may be substituted
155.25for one treatment episode if it resulted from the individual's substance use disorder.
155.26(b) New eligibility criteria may be added as mutually agreed upon by the
155.27commissioner and participating navigator programs.
155.28    Subd. 3. Program evaluation. The commissioner shall evaluate navigator pilot
155.29projects under this section and report the results of the evaluation to the chairs and
155.30ranking minority members of the legislative committees with jurisdiction over chemical
155.31health issues by January 15, 2014. Evaluation of the navigator pilot projects must be
155.32based on outcome evaluation criteria negotiated with the navigator pilot projects prior
155.33to implementation.
155.34    Subd. 4. Notice of navigator pilot project discontinuation. Each county's
155.35participation in the navigator pilot project may be discontinued for any reason by the county
155.36or the commissioner of human services after 30 days' written notice to the other party.
156.1Any unspent funds held for the exiting county's pro rata share in the special revenue fund
156.2under the authority in subdivision 5, paragraph (d), shall be transferred to the consolidated
156.3chemical dependency treatment fund following discontinuation of the pilot project.
156.4    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in
156.5this chapter, the commissioner may authorize navigator pilot projects to use chemical
156.6dependency treatment funds to pay for nontreatment navigator pilot services:
156.7(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
156.8(a); and
156.9(2) by vendors in addition to those authorized under section 254B.05 when not
156.10providing chemical dependency treatment services.
156.11(b) For purposes of this section, "nontreatment navigator pilot services" include
156.12navigator services, peer support, family engagement and support, housing support, rent
156.13subsidies, supported employment, and independent living skills.
156.14(c) State expenditures for chemical dependency services and nontreatment navigator
156.15pilot services provided by or through the navigator pilot projects must not be greater than
156.16the chemical dependency treatment fund expected share of forecasted expenditures in the
156.17absence of the navigator pilot projects. The commissioner may restructure the schedule of
156.18payments between the state and participating counties under the local agency share and
156.19division of cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to
156.20facilitate the operation of the navigator pilot projects.
156.21(d) To the extent that state fiscal year expenditures within a pilot project are less
156.22than the expected share of forecasted expenditures in the absence of the pilot projects,
156.23the commissioner shall deposit the unexpended funds in a separate account within the
156.24consolidated chemical dependency treatment fund, and make these funds available for
156.25expenditure by the pilot projects the following year. To the extent that treatment and
156.26nontreatment pilot services expenditures within the pilot project exceed the amount
156.27expected in the absence of the pilot projects, the pilot project county or counties are
156.28responsible for the portion of nontreatment pilot services expenditures in excess of the
156.29otherwise expected share of forecasted expenditures.
156.30(e) (d) The commissioner may waive administrative rule requirements that are
156.31incompatible with the implementation of the navigator pilot project, except that any
156.32chemical dependency treatment funded under this section must continue to be provided
156.33by a licensed treatment provider.
156.34(f) (e) The commissioner shall not approve or enter into any agreement related to
156.35navigator pilot projects authorized under this section that puts current or future federal
156.36funding at risk.
157.1(f) The commissioner shall provide participating navigator pilot projects with
157.2transactional data, reports, provider data, and other data generated by county activity to
157.3assess and measure outcomes. This information must be transmitted or made available in
157.4an acceptable form to participating navigator pilot projects at least once every six months
157.5or within a reasonable time following the commissioner's receipt of information from the
157.6counties needed to comply with this paragraph.
157.7    Subd. 6. Duties of county board. The county board, or other county entity that
157.8is approved to administer a navigator pilot project, shall:
157.9(1) administer the navigator pilot project in a manner consistent with the objectives
157.10described in subdivision 2 and the planning process in subdivision 5;
157.11(2) ensure that no one is denied chemical dependency treatment services for which
157.12they would otherwise be eligible under section 254A.03, subdivision 3; and
157.13(3) provide the commissioner with timely and pertinent information as negotiated in
157.14agreements governing operation of the navigator pilot projects.
157.15    Subd. 7. Managed care. An individual who is eligible for the navigator pilot
157.16program under subdivision 2a is excluded from mandatory enrollment in managed care
157.17until these services are included in the health plan's benefit set.
157.18    Subd. 8. Authorization for continuation of navigator pilots. The navigator pilot
157.19projects implemented pursuant to subdivision 1 are authorized to continue operation after
157.20July 1, 2013, under existing agreements governing operation of the pilot projects.
157.21EFFECTIVE DATE.The amendments to subdivisions 1 to 6 and 8 are effective
157.22August 1, 2013. Subdivision 7 is effective July 1, 2013.

157.23    Sec. 11. [254B.14] CONTINUUM OF CARE PILOT PROJECTS; CHEMICAL
157.24HEALTH CARE.
157.25    Subdivision 1. Authorization for continuum of care pilot projects. The
157.26commissioner shall establish chemical dependency continuum of care pilot projects to
157.27begin implementing the measures developed with stakeholder input and identified in the
157.28report completed pursuant to Laws 2012, chapter 247, article 5, section 8. The pilot
157.29projects are intended to improve the effectiveness and efficiency of the service continuum
157.30for chemically dependent individuals in Minnesota while reducing duplication of efforts
157.31and promoting scientifically supported practices.
157.32    Subd. 2. Program implementation. (a) The commissioner, in coordination with
157.33representatives of the Minnesota Association of County Social Service Administrators
157.34and the Minnesota Inter-County Association, shall develop a process for identifying and
157.35selecting interested counties and providers for participation in the continuum of care pilot
158.1projects. There will be three pilot projects; one representing the northern region, one for
158.2the metro region, and one for the southern region. The selection process of counties and
158.3providers must include consideration of population size, geographic distribution, cultural
158.4and racial demographics, and provider accessibility. The commissioner shall identify
158.5counties and providers that are selected for participation in the continuum of care pilot
158.6projects no later than September 30, 2013.
158.7(b) The commissioner and entities participating in the continuum of care pilot
158.8projects shall enter into agreements governing the operation of the continuum of care pilot
158.9projects. The agreements shall identify pilot project outcomes and include timelines for
158.10implementation and beginning operation of the pilot projects.
158.11(c) Entities that are currently participating in the navigator pilot project are
158.12eligible to participate in the continuum of care pilot project subsequent to or instead of
158.13participating in the navigator pilot project.
158.14(d) The commissioner may waive administrative rule requirements that are
158.15incompatible with implementation of the continuum of care pilot projects.
158.16(e) Notwithstanding section 254A.19, the commissioner may designate noncounty
158.17entities to complete chemical use assessments and placement authorizations required
158.18under section 254A.19 and Minnesota Rules, parts 9530.6600 to 9530.6655. Section
158.19254A.19, subdivision 3, is applicable to the continuum of care pilot projects at the
158.20discretion of the commissioner.
158.21    Subd. 3. Program design. (a) The operation of the pilot projects shall include:
158.22(1) new services that are responsive to the chronic nature of substance use disorder;
158.23(2) telehealth services, when appropriate to address barriers to services;
158.24(3) services that assure integration with the mental health delivery system when
158.25appropriate;
158.26(4) services that address the needs of diverse populations; and
158.27(5) an assessment and access process that permits clients to present directly to a
158.28service provider for a substance use disorder assessment and authorization of services.
158.29(b) Prior to implementation of the continuum of care pilot projects, a utilization
158.30review process must be developed and agreed to by the commissioner, participating
158.31counties, and providers. The utilization review process shall be described in the
158.32agreements governing operation of the continuum of care pilot projects.
158.33    Subd. 4. Notice of project discontinuation. Each entity's participation in the
158.34continuum of care pilot project may be discontinued for any reason by the county or the
158.35commissioner after 30 days' written notice to the entity.
159.1    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
159.2chapter, the commissioner may authorize chemical dependency treatment funds to pay for
159.3nontreatment services arranged by continuum of care pilot projects. Individuals who are
159.4currently accessing Rule 31 treatment services are eligible for concurrent participation in
159.5the continuum of care pilot projects.
159.6(b) County expenditures for continuum of care pilot project services shall not
159.7be greater than their expected share of forecasted expenditures in the absence of the
159.8continuum of care pilot projects.
159.9EFFECTIVE DATE.This section is effective August 1, 2013.

159.10    Sec. 12. [256B.0616] MENTAL HEALTH CERTIFIED FAMILY PEER
159.11SPECIALIST.
159.12    Subdivision 1. Scope. Medical assistance covers mental health certified family peer
159.13specialists services, as established in subdivision 2, subject to federal approval, if provided
159.14to recipients who have an emotional disturbance or severe emotional disturbance under
159.15chapter 245, and are provided by a certified family peer specialist who has completed the
159.16training under subdivision 5. A family peer specialist cannot provide services to the
159.17peer specialist's family.
159.18    Subd. 2. Establishment. The commissioner of human services shall establish a
159.19certified family peer specialists program model which:
159.20(1) provides nonclinical family peer support counseling, building on the strengths
159.21of families and helping them achieve desired outcomes;
159.22(2) collaborates with others providing care or support to the family;
159.23(3) provides nonadversarial advocacy;
159.24(4) promotes the individual family culture in the treatment milieu;
159.25(5) links parents to other parents in the community;
159.26(6) offers support and encouragement;
159.27(7) assists parents in developing coping mechanisms and problem-solving skills;
159.28(8) promotes resiliency, self-advocacy, development of natural supports, and
159.29maintenance of skills learned in other support services;
159.30(9) establishes and provides peer led parent support groups; and
159.31(10) increases the child's ability to function better within the child's home, school,
159.32and community by educating parents on community resources, assisting with problem
159.33solving, and educating parents on mental illnesses.
160.1    Subd. 3. Eligibility. Family peer support services may be located in inpatient
160.2hospitalization, partial hospitalization, residential treatment, treatment foster care, day
160.3treatment, children's therapeutic services and supports, or crisis services.
160.4    Subd. 4. Peer support specialist program providers. The commissioner shall
160.5develop a process to certify family peer support specialist programs, in accordance with
160.6the federal guidelines, in order for the program to bill for reimbursable services. Family
160.7peer support programs must operate within an existing mental health community provider
160.8or center.
160.9    Subd. 5. Certified family peer specialist training and certification. The
160.10commissioner shall develop a training and certification process for certified family peer
160.11specialists who must be at least 21 years of age and have a high school diploma or its
160.12equivalent. The candidates must have raised or are currently raising a child with a mental
160.13illness, have had experience navigating the children's mental health system, and must
160.14demonstrate leadership and advocacy skills and a strong dedication to family-driven and
160.15family-focused services. The training curriculum must teach participating family peer
160.16specialists specific skills relevant to providing peer support to other parents. In addition
160.17to initial training and certification, the commissioner shall develop ongoing continuing
160.18educational workshops on pertinent issues related to family peer support counseling.

160.19    Sec. 13. Minnesota Statutes 2012, section 256B.0623, subdivision 2, is amended to read:
160.20    Subd. 2. Definitions. For purposes of this section, the following terms have the
160.21meanings given them.
160.22(a) "Adult rehabilitative mental health services" means mental health services
160.23which are rehabilitative and enable the recipient to develop and enhance psychiatric
160.24stability, social competencies, personal and emotional adjustment, and independent living,
160.25parenting skills, and community skills, when these abilities are impaired by the symptoms
160.26of mental illness. Adult rehabilitative mental health services are also appropriate when
160.27provided to enable a recipient to retain stability and functioning, if the recipient would
160.28be at risk of significant functional decompensation or more restrictive service settings
160.29without these services.
160.30(1) Adult rehabilitative mental health services instruct, assist, and support the
160.31recipient in areas such as: interpersonal communication skills, community resource
160.32utilization and integration skills, crisis assistance, relapse prevention skills, health care
160.33directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking
160.34and nutrition skills, transportation skills, medication education and monitoring, mental
161.1illness symptom management skills, household management skills, employment-related
161.2skills, parenting skills, and transition to community living services.
161.3(2) These services shall be provided to the recipient on a one-to-one basis in the
161.4recipient's home or another community setting or in groups.
161.5(b) "Medication education services" means services provided individually or in
161.6groups which focus on educating the recipient about mental illness and symptoms; the role
161.7and effects of medications in treating symptoms of mental illness; and the side effects of
161.8medications. Medication education is coordinated with medication management services
161.9and does not duplicate it. Medication education services are provided by physicians,
161.10pharmacists, physician's assistants, or registered nurses.
161.11(c) "Transition to community living services" means services which maintain
161.12continuity of contact between the rehabilitation services provider and the recipient and
161.13which facilitate discharge from a hospital, residential treatment program under Minnesota
161.14Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community
161.15living services are not intended to provide other areas of adult rehabilitative mental health
161.16services.

161.17    Sec. 14. Minnesota Statutes 2012, section 256B.0625, subdivision 48, is amended to
161.18read:
161.19    Subd. 48. Psychiatric consultation to primary care practitioners. Effective
161.20January 1, 2006, Medical assistance covers consultation provided by a psychiatrist,
161.21psychologist, or an advanced practice registered nurse certified in psychiatric mental
161.22health via telephone, e-mail, facsimile, or other means of communication to primary care
161.23practitioners, including pediatricians. The need for consultation and the receipt of the
161.24consultation must be documented in the patient record maintained by the primary care
161.25practitioner. If the patient consents, and subject to federal limitations and data privacy
161.26provisions, the consultation may be provided without the patient present.

161.27    Sec. 15. Minnesota Statutes 2012, section 256B.0625, subdivision 56, is amended to
161.28read:
161.29    Subd. 56. Medical service coordination. (a)(1) Medical assistance covers in-reach
161.30community-based service coordination that is performed through a hospital emergency
161.31department as an eligible procedure under a state healthcare program for a frequent user.
161.32A frequent user is defined as an individual who has frequented the hospital emergency
161.33department for services three or more times in the previous four consecutive months.
161.34In-reach community-based service coordination includes navigating services to address a
162.1client's mental health, chemical health, social, economic, and housing needs, or any other
162.2activity targeted at reducing the incidence of emergency room and other nonmedically
162.3necessary health care utilization.
162.4(2) Medical assistance covers in-reach community-based service coordination that
162.5is performed through a hospital emergency department or inpatient psychiatric unit
162.6for a child or young adult up to age 21 with a serious emotional disturbance who has
162.7frequented the hospital emergency room two or more times in the previous consecutive
162.8three months or been admitted to an inpatient psychiatric unit two or more times in the
162.9previous consecutive four months, or is being discharged to a shelter.
162.10    (b) Reimbursement must be made in 15-minute increments and allowed for up to 60
162.11days posthospital discharge based upon the specific identified emergency department visit
162.12or inpatient admitting event. In-reach community-based service coordination shall seek to
162.13connect frequent users with existing covered services available to them, including, but not
162.14limited to, targeted case management, waiver case management, or care coordination in a
162.15health care home. For children and young adults with a serious emotional disturbance,
162.16in-reach community-based service coordination includes navigating and arranging for
162.17community-based services prior to discharge to address a client's mental health, chemical
162.18health, social, educational, family support and housing needs, or any other activity targeted
162.19at reducing multiple incidents of emergency room use, inpatient readmissions, and other
162.20nonmedically necessary health care utilization. In-reach services shall seek to connect
162.21them with existing covered services, including targeted case management, waiver case
162.22management, care coordination in a health care home, children's therapeutic services and
162.23supports, crisis services, and respite care. Eligible in-reach service coordinators must hold
162.24a minimum of a bachelor's degree in social work, public health, corrections, or a related
162.25field. The commissioner shall submit any necessary application for waivers to the Centers
162.26for Medicare and Medicaid Services to implement this subdivision.
162.27    (c)(1) For the purposes of this subdivision, "in-reach community-based service
162.28coordination" means the practice of a community-based worker with training, knowledge,
162.29skills, and ability to access a continuum of services, including housing, transportation,
162.30chemical and mental health treatment, employment, education, and peer support services,
162.31by working with an organization's staff to transition an individual back into the individual's
162.32living environment. In-reach community-based service coordination includes working
162.33with the individual during their discharge and for up to a defined amount of time in the
162.34individual's living environment, reducing the individual's need for readmittance.
162.35    (2) Hospitals utilizing in-reach service coordinators shall report annually to the
162.36commissioner on the number of adults, children, and adolescents served; the postdischarge
163.1services which they accessed; and emergency department/psychiatric hospitalization
163.2readmissions. The commissioner shall ensure that services and payments provided under
163.3in-reach care coordination do not duplicate services or payments provided under section
163.4256B.0753, 256B.0755, or 256B.0625, subdivision 20.

163.5    Sec. 16. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
163.6subdivision to read:
163.7    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
163.8federal approval, whichever is later, medical assistance covers family psychoeducation
163.9services provided to a child up to age 21 with a diagnosed mental health condition when
163.10identified in the child's individual treatment plan and provided by a licensed mental health
163.11professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
163.12clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
163.13has determined it medically necessary to involve family members in the child's care. For
163.14the purposes of this subdivision, "family psychoeducation services" means information
163.15or demonstration provided to an individual or family as part of an individual, family,
163.16multifamily group, or peer group session to explain, educate, and support the child and
163.17family in understanding a child's symptoms of mental illness, the impact on the child's
163.18development, and needed components of treatment and skill development so that the
163.19individual, family, or group can help the child to prevent relapse, prevent the acquisition
163.20of comorbid disorders, and to achieve optimal mental health and long-term resilience.

163.21    Sec. 17. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
163.22subdivision to read:
163.23    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
163.24federal approval, whichever is later, medical assistance covers clinical care consultation
163.25for a person up to age 21 who is diagnosed with a complex mental health condition or a
163.26mental health condition that co-occurs with other complex and chronic conditions, when
163.27described in the person's individual treatment plan and provided by a licensed mental
163.28health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
163.29clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C. For the
163.30purposes of this subdivision, "clinical care consultation" means communication from a
163.31treating mental health professional to other providers or educators not under the clinical
163.32supervision of the treating mental health professional who are working with the same client
163.33to inform, inquire, and instruct regarding the client's symptoms; strategies for effective
164.1engagement, care, and intervention needs; treatment expectations across service settings;
164.2and to direct and coordinate clinical service components provided to the client and family.

164.3    Sec. 18. Minnesota Statutes 2012, section 256B.0943, subdivision 1, is amended to read:
164.4    Subdivision 1. Definitions. For purposes of this section, the following terms have
164.5the meanings given them.
164.6(a) "Children's therapeutic services and supports" means the flexible package of
164.7mental health services for children who require varying therapeutic and rehabilitative
164.8levels of intervention. The services are time-limited interventions that are delivered using
164.9various treatment modalities and combinations of services designed to reach treatment
164.10outcomes identified in the individual treatment plan.
164.11(b) "Clinical supervision" means the overall responsibility of the mental health
164.12professional for the control and direction of individualized treatment planning, service
164.13delivery, and treatment review for each client. A mental health professional who is an
164.14enrolled Minnesota health care program provider accepts full professional responsibility
164.15for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work,
164.16and oversees or directs the supervisee's work.
164.17(c) "County board" means the county board of commissioners or board established
164.18under sections 402.01 to 402.10 or 471.59.
164.19(d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a.
164.20(e) "Culturally competent provider" means a provider who understands and can
164.21utilize to a client's benefit the client's culture when providing services to the client. A
164.22provider may be culturally competent because the provider is of the same cultural or
164.23ethnic group as the client or the provider has developed the knowledge and skills through
164.24training and experience to provide services to culturally diverse clients.
164.25(f) "Day treatment program" for children means a site-based structured program
164.26consisting of group psychotherapy for more than three individuals and other intensive
164.27therapeutic services provided by a multidisciplinary team, under the clinical supervision
164.28of a mental health professional.
164.29(g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision
164.3011 .
164.31(h) "Direct service time" means the time that a mental health professional, mental
164.32health practitioner, or mental health behavioral aide spends face-to-face with a client
164.33and the client's family. Direct service time includes time in which the provider obtains
164.34a client's history or provides service components of children's therapeutic services and
164.35supports. Direct service time does not include time doing work before and after providing
165.1direct services, including scheduling, maintaining clinical records, consulting with others
165.2about the client's mental health status, preparing reports, receiving clinical supervision,
165.3and revising the client's individual treatment plan.
165.4(i) "Direction of mental health behavioral aide" means the activities of a mental
165.5health professional or mental health practitioner in guiding the mental health behavioral
165.6aide in providing services to a client. The direction of a mental health behavioral aide
165.7must be based on the client's individualized treatment plan and meet the requirements in
165.8subdivision 6, paragraph (b), clause (5).
165.9(j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision
165.1015 . For persons at least age 18 but under age 21, mental illness has the meaning given in
165.11section 245.462, subdivision 20, paragraph (a).
165.12(k) "Individual behavioral plan" means a plan of intervention, treatment, and
165.13services for a child written by a mental health professional or mental health practitioner,
165.14under the clinical supervision of a mental health professional, to guide the work of the
165.15mental health behavioral aide.
165.16(l) "Individual treatment plan" has the meaning given in section 245.4871,
165.17subdivision 21 .
165.18(m) "Mental health behavioral aide services" means medically necessary one-on-one
165.19activities performed by a trained paraprofessional to assist a child retain or generalize
165.20psychosocial skills as taught by a mental health professional or mental health practitioner
165.21and as described in the child's individual treatment plan and individual behavior plan.
165.22Activities involve working directly with the child or child's family as provided in
165.23subdivision 9, paragraph (b), clause (4).
165.24(n) "Mental health professional" means an individual as defined in section 245.4871,
165.25subdivision 27 , clauses (1) to (6), or tribal vendor as defined in section 256B.02,
165.26subdivision 7 , paragraph (b).
165.27    (o) "Mental health service plan development" includes:
165.28    (1) the development, review, and revision of a child's individual treatment plan,
165.29as provided in Minnesota Rules, part 9505.0371, subpart 7, including involvement of
165.30the client or client's parents, primary caregiver, or other person authorized to consent to
165.31mental health services for the client, and including arrangement of treatment and support
165.32activities specified in the individual treatment plan; and
165.33    (2) administering standardized outcome measurement instruments, determined
165.34and updated by the commissioner, as periodically needed to evaluate the effectiveness
165.35of treatment for children receiving clinical services and reporting outcome measures,
165.36as required by the commissioner.
166.1(o) (p) "Preschool program" means a day program licensed under Minnesota Rules,
166.2parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and
166.3supports provider to provide a structured treatment program to a child who is at least 33
166.4months old but who has not yet attended the first day of kindergarten.
166.5(p) (q) "Skills training" means individual, family, or group training, delivered
166.6by or under the direction of a mental health professional, designed to facilitate the
166.7acquisition of psychosocial skills that are medically necessary to rehabilitate the child
166.8to an age-appropriate developmental trajectory heretofore disrupted by a psychiatric
166.9illness or to self-monitor, compensate for, cope with, counteract, or replace skills deficits
166.10or maladaptive skills acquired over the course of a psychiatric illness. Skills training
166.11is subject to the following requirements:
166.12(1) a mental health professional or a mental health practitioner must provide skills
166.13training;
166.14(2) the child must always be present during skills training; however, a brief absence
166.15of the child for no more than ten percent of the session unit may be allowed to redirect or
166.16instruct family members;
166.17(3) skills training delivered to children or their families must be targeted to the
166.18specific deficits or maladaptations of the child's mental health disorder and must be
166.19prescribed in the child's individual treatment plan;
166.20(4) skills training delivered to the child's family must teach skills needed by parents
166.21to enhance the child's skill development and to help the child use in daily life the skills
166.22previously taught by a mental health professional or mental health practitioner and to
166.23develop or maintain a home environment that supports the child's progressive use skills;
166.24(5) group skills training may be provided to multiple recipients who, because of the
166.25nature of their emotional, behavioral, or social dysfunction, can derive mutual benefit from
166.26interaction in a group setting, which must be staffed as follows:
166.27(i) one mental health professional or one mental health practitioner under supervision
166.28of a licensed mental health professional must work with a group of four to eight clients; or
166.29(ii) two mental health professionals or two mental health practitioners under
166.30supervision of a licensed mental health professional, or one professional plus one
166.31practitioner must work with a group of nine to 12 clients.

166.32    Sec. 19. Minnesota Statutes 2012, section 256B.0943, subdivision 2, is amended to read:
166.33    Subd. 2. Covered service components of children's therapeutic services and
166.34supports. (a) Subject to federal approval, medical assistance covers medically necessary
166.35children's therapeutic services and supports as defined in this section that an eligible
167.1provider entity certified under subdivision 4 provides to a client eligible under subdivision
167.23.
167.3(b) The service components of children's therapeutic services and supports are:
167.4(1) individual, family, and group psychotherapy;
167.5(2) individual, family, or group skills training provided by a mental health
167.6professional or mental health practitioner;
167.7(3) crisis assistance;
167.8(4) mental health behavioral aide services; and
167.9(5) direction of a mental health behavioral aide.;
167.10(6) mental health service plan development;
167.11(7) clinical care consultation provided by a mental health professional under section
167.12256B.0625, subdivision 62;
167.13(8) family psychoeducation under section 256B.0625, subdivision 61; and
167.14(9) services provided by a family peer specialist under section 256B.0616.
167.15(c) Service components in paragraph (b) may be combined to constitute therapeutic
167.16programs, including day treatment programs and therapeutic preschool programs.

167.17    Sec. 20. Minnesota Statutes 2012, section 256B.0943, subdivision 7, is amended to read:
167.18    Subd. 7. Qualifications of individual and team providers. (a) An individual
167.19or team provider working within the scope of the provider's practice or qualifications
167.20may provide service components of children's therapeutic services and supports that are
167.21identified as medically necessary in a client's individual treatment plan.
167.22(b) An individual provider must be qualified as:
167.23(1) a mental health professional as defined in subdivision 1, paragraph (n); or
167.24(2) a mental health practitioner as defined in section 245.4871, subdivision 26. The
167.25mental health practitioner must work under the clinical supervision of a mental health
167.26professional; or
167.27(3) a mental health behavioral aide working under the clinical supervision of a
167.28mental health professional to implement the rehabilitative mental health services identified
167.29in the client's individual treatment plan and individual behavior plan.
167.30(A) A level I mental health behavioral aide must:
167.31(i) be at least 18 years old;
167.32(ii) have a high school diploma or general equivalency diploma (GED) or two years
167.33of experience as a primary caregiver to a child with severe emotional disturbance within
167.34the previous ten years; and
167.35(iii) meet preservice and continuing education requirements under subdivision 8.
168.1(B) A level II mental health behavioral aide must:
168.2(i) be at least 18 years old;
168.3(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
168.4clinical services in the treatment of mental illness concerning children or adolescents or
168.5complete a certificate program established under subdivision 8a; and
168.6(iii) meet preservice and continuing education requirements in subdivision 8.
168.7(c) A preschool program multidisciplinary team must include at least one mental
168.8health professional and one or more of the following individuals under the clinical
168.9supervision of a mental health professional:
168.10(i) a mental health practitioner; or
168.11(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
168.12qualifications and training standards of a level I mental health behavioral aide.
168.13(d) A day treatment multidisciplinary team must include at least one mental health
168.14professional and one mental health practitioner.

168.15    Sec. 21. Minnesota Statutes 2012, section 256B.0943, is amended by adding a
168.16subdivision to read:
168.17    Subd. 8a. Level II mental health behavioral aide. The commissioner of human
168.18services, in collaboration with the Board of Trustees of the Minnesota State Colleges and
168.19Universities, shall develop a certificate program of not fewer than 11 credits for level II
168.20mental health behavioral aides. The program shall include classroom and field-based
168.21learning. The program components must include, but not be limited to, mental illnesses
168.22in children, parent and family perspectives, skill training, documentation and reporting,
168.23communication skills, and cultural competence.

168.24    Sec. 22. Minnesota Statutes 2012, section 256B.0946, is amended to read:
168.25256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
168.26    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
168.27 upon enactment and subject to federal approval, medical assistance covers medically
168.28necessary intensive treatment services described under paragraph (b) that are provided
168.29by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
168.30who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
168.31to 2960.3340.
168.32(b) Intensive treatment services to children with severe emotional disturbance mental
168.33illness residing in treatment foster care family settings must meet the relevant standards
168.34for mental health services under sections 245.487 to 245.4889. In addition, that comprise
169.1 specific required service components provided in clauses (1) to (5), are reimbursed by
169.2medical assistance must when they meet the following standards:
169.3(1) case management service component must meet the standards in Minnesota
169.4Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
169.5(1) psychotherapy provided by a mental health professional as defined in Minnesota
169.6Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
169.7Rules, part 9505.0371, subpart 5, item C;
169.8(2) psychotherapy, crisis assistance, and skills training components must meet the
169.9 provided according to standards for children's therapeutic services and supports in section
169.10256B.0943 ; and
169.11(3) individual family, and group psychoeducation services under supervision of,
169.12defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
169.13clinical trainee;
169.14(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
169.15health professional or a clinical trainee; and
169.16(5) service delivery payment requirements as provided under subdivision 4.
169.17    Subd. 1a. Definitions. For the purposes of this section, the following terms have
169.18the meanings given them.
169.19(a) "Clinical care consultation" means communication from a treating clinician to
169.20other providers working with the same client to inform, inquire, and instruct regarding
169.21the client's symptoms, strategies for effective engagement, care and intervention needs,
169.22and treatment expectations across service settings, including but not limited to the client's
169.23school, social services, day care, probation, home, primary care, medication prescribers,
169.24disabilities services, and other mental health providers and to direct and coordinate clinical
169.25service components provided to the client and family.
169.26(b) "Clinical supervision" means the documented time a clinical supervisor and
169.27supervisee spend together to discuss the supervisee's work, to review individual client
169.28cases, and for the supervisee's professional development. It includes the documented
169.29oversight and supervision responsibility for planning, implementation, and evaluation of
169.30services for a client's mental health treatment.
169.31(c) "Clinical supervisor" means the mental health professional who is responsible
169.32for clinical supervision.
169.33(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
169.34subpart 5, item C;
170.1(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
170.2including the development of a plan that addresses prevention and intervention strategies
170.3to be used in a potential crisis, but does not include actual crisis intervention.
170.4(f) "Culturally appropriate" means providing mental health services in a manner that
170.5incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
170.6subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
170.7strengths and resources to promote overall wellness.
170.8(g) "Culture" means the distinct ways of living and understanding the world that
170.9are used by a group of people and are transmitted from one generation to another or
170.10adopted by an individual.
170.11(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
170.129505.0370, subpart 11.
170.13(i) "Family" means a person who is identified by the client or the client's parent or
170.14guardian as being important to the client's mental health treatment. Family may include,
170.15but is not limited to, parents, foster parents, children, spouse, committed partners, former
170.16spouses, persons related by blood or adoption, persons who are a part of the client's
170.17permanency plan, or persons who are presently residing together as a family unit.
170.18(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
170.19(k) "Foster family setting" means the foster home in which the license holder resides.
170.20(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
170.219505.0370, subpart 15.
170.22(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
170.239505.0370, subpart 17.
170.24(n) "Mental health professional" has the meaning given in Minnesota Rules, part
170.259505.0370, subpart 18.
170.26(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
170.27subpart 20.
170.28(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
170.29(q) "Psychoeducation services" means information or demonstration provided to
170.30an individual, family, or group to explain, educate, and support the individual, family, or
170.31group in understanding a child's symptoms of mental illness, the impact on the child's
170.32development, and needed components of treatment and skill development so that the
170.33individual, family, or group can help the child to prevent relapse, prevent the acquisition
170.34of comorbid disorders, and to achieve optimal mental health and long-term resilience.
170.35(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
170.36subpart 27.
171.1(s) "Team consultation and treatment planning" means the coordination of treatment
171.2plans and consultation among providers in a group concerning the treatment needs of the
171.3child, including disseminating the child's treatment service schedule to all members of the
171.4service team. Team members must include all mental health professionals working with
171.5the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
171.6and at least two of the following: an individualized education program case manager;
171.7probation agent; children's mental health case manager; child welfare worker, including
171.8adoption or guardianship worker; primary care provider; foster parent; and any other
171.9member of the child's service team.
171.10    Subd. 2. Determination of client eligibility. A client's eligibility to receive
171.11treatment foster care under this section shall be determined by An eligible recipient is an
171.12individual, from birth through age 20, who is currently placed in a foster home licensed
171.13under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
171.14assessment, and an evaluation of level of care needed, and development of an individual
171.15treatment plan, as defined in paragraphs (a) to (c) and (b).
171.16(a) The diagnostic assessment must:
171.17(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
171.18conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
171.19worker that is mental health professional or a clinical trainee;
171.20(2) determine whether or not a child meets the criteria for mental illness, as defined
171.21in Minnesota Rules, part 9505.0370, subpart 20;
171.22(3) document that intensive treatment services are medically necessary within a
171.23foster family setting to ameliorate identified symptoms and functional impairments;
171.24(4) be performed within 180 days prior to before the start of service; and
171.25(2) include current diagnoses on all five axes of the client's current mental health
171.26status;
171.27(3) determine whether or not a child meets the criteria for severe emotional
171.28disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
171.29in section 245.462, subdivision 20; and
171.30(4) be completed annually until age 18. For individuals between age 18 and 21,
171.31unless a client's mental health condition has changed markedly since the client's most
171.32recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
171.33"updating" means a written summary, including current diagnoses on all five axes, by a
171.34mental health professional of the client's current mental status and service needs.
171.35(5) be completed as either a standard or extended diagnostic assessment annually to
171.36determine continued eligibility for the service.
172.1(b) The evaluation of level of care must be conducted by the placing county with
172.2an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
172.3described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
172.4 approved by the commissioner of human services and not subject to the rulemaking
172.5process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
172.6evaluation demonstrates that the child requires intensive intervention without 24-hour
172.7medical monitoring. The commissioner shall update the list of approved level of care
172.8instruments tools annually and publish on the department's Web site.
172.9(c) The individual treatment plan must be:
172.10(1) based on the information in the client's diagnostic assessment;
172.11(2) developed through a child-centered, family driven planning process that identifies
172.12service needs and individualized, planned, and culturally appropriate interventions that
172.13contain specific measurable treatment goals and objectives for the client and treatment
172.14strategies for the client's family and foster family;
172.15(3) reviewed at least once every 90 days and revised; and
172.16(4) signed by the client or, if appropriate, by the client's parent or other person
172.17authorized by statute to consent to mental health services for the client.
172.18    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
172.19intensive children's mental health services in a foster family setting must be certified
172.20by the state and have a service provision contract with a county board or a reservation
172.21tribal council and must be able to demonstrate the ability to provide all of the services
172.22required in this section.
172.23(b) For purposes of this section, a provider agency must have an individual
172.24placement agreement for each recipient and must be a licensed child placing agency, under
172.25Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
172.26(1) a county county-operated entity certified by the state;
172.27(2) an Indian Health Services facility operated by a tribe or tribal organization under
172.28funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
172.29Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
172.30(3) a noncounty entity under contract with a county board.
172.31(c) Certified providers that do not meet the service delivery standards required in
172.32this section shall be subject to a decertification process.
172.33(d) For the purposes of this section, all services delivered to a client must be
172.34provided by a mental health professional or a clinical trainee.
172.35    Subd. 4. Eligible provider responsibilities Service delivery payment
172.36requirements. (a) To be an eligible provider for payment under this section, a provider
173.1must develop and practice written policies and procedures for treatment foster care services
173.2 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
173.3(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
173.4(b) In delivering services under this section, a treatment foster care provider must
173.5ensure that staff caseload size reasonably enables the provider to play an active role in
173.6service planning, monitoring, delivering, and reviewing for discharge planning to meet
173.7the needs of the client, the client's foster family, and the birth family, as specified in each
173.8client's individual treatment plan.
173.9(b) A qualified clinical supervisor, as defined in and performing in compliance with
173.10Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
173.11provision of services described in this section.
173.12(c) Each client receiving treatment services must receive an extended diagnostic
173.13assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
173.1430 days of enrollment in this service unless the client has a previous extended diagnostic
173.15assessment that the client, parent, and mental health professional agree still accurately
173.16describes the client's current mental health functioning.
173.17(d) Each previous and current mental health, school, and physical health treatment
173.18provider must be contacted to request documentation of treatment and assessments that the
173.19eligible client has received and this information must be reviewed and incorporated into
173.20the diagnostic assessment and team consultation and treatment planning review process.
173.21(e) Each client receiving treatment must be assessed for a trauma history and
173.22the client's treatment plan must document how the results of the assessment will be
173.23incorporated into treatment.
173.24(f) Each client receiving treatment services must have an individual treatment plan
173.25that is reviewed, evaluated, and signed every 90 days using the team consultation and
173.26treatment planning process, as defined in subdivision 1a, paragraph (s).
173.27(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
173.28in accordance with the client's individual treatment plan.
173.29(h) Each client must have a crisis assistance plan within ten days of initiating
173.30services and must have access to clinical phone support 24 hours per day, seven days per
173.31week, during the course of treatment, and the crisis plan must demonstrate coordination
173.32with the local or regional mobile crisis intervention team.
173.33(i) Services must be delivered and documented at least three days per week, equaling
173.34at least six hours of treatment per week, unless reduced units of service are specified on
173.35the treatment plan as part of transition or on a discharge plan to another service or level of
173.36care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
174.1(j) Location of service delivery must be in the client's home, day care setting,
174.2school, or other community-based setting that is specified on the client's individualized
174.3treatment plan.
174.4(k) Treatment must be developmentally and culturally appropriate for the client.
174.5(l) Services must be delivered in continual collaboration and consultation with the
174.6client's medical providers and, in particular, with prescribers of psychotropic medications,
174.7including those prescribed on an off-label basis, and members of the service team must be
174.8aware of the medication regimen and potential side effects.
174.9(m) Parents, siblings, foster parents, and members of the child's permanency plan
174.10must be involved in treatment and service delivery unless otherwise noted in the treatment
174.11plan.
174.12(n) Transition planning for the child must be conducted starting with the first
174.13treatment plan and must be addressed throughout treatment to support the child's
174.14permanency plan and postdischarge mental health service needs.
174.15    Subd. 5. Service authorization. The commissioner will administer authorizations
174.16for services under this section in compliance with section 256B.0625, subdivision 25.
174.17    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
174.18under this section and are not eligible for medical assistance payment as components of
174.19intensive treatment in foster care services, but may be billed separately:
174.20(1) treatment foster care services provided in violation of medical assistance policy
174.21in Minnesota Rules, part 9505.0220;
174.22(2) service components of children's therapeutic services and supports
174.23simultaneously provided by more than one treatment foster care provider;
174.24(3) home and community-based waiver services; and
174.25(4) treatment foster care services provided to a child without a level of care
174.26determination according to section 245.4885, subdivision 1.
174.27(1) inpatient psychiatric hospital treatment;
174.28(2) mental health targeted case management;
174.29(3) partial hospitalization;
174.30(4) medication management;
174.31(5) children's mental health day treatment services;
174.32(6) crisis response services under section 256B.0944; and
174.33(7) transportation.
174.34(b) Children receiving intensive treatment in foster care services are not eligible for
174.35medical assistance reimbursement for the following services while receiving intensive
174.36treatment in foster care:
175.1(1) mental health case management services under section 256B.0625, subdivision
175.220 ; and
175.3(2) (1) psychotherapy and skill skills training components of children's therapeutic
175.4services and supports under section 256B.0625, subdivision 35b.;
175.5(2) mental health behavioral aide services as defined in section 256B.0943,
175.6subdivision 1, paragraph (m);
175.7(3) home and community-based waiver services;
175.8(4) mental health residential treatment; and
175.9(5) room and board costs as defined in section 256I.03, subdivision 6.
175.10    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
175.11establish a single daily per-client encounter rate for intensive treatment in foster care
175.12services. The rate must be constructed to cover only eligible services delivered to an
175.13eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

175.14    Sec. 23. Minnesota Statutes 2012, section 256B.761, is amended to read:
175.15256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
175.16(a) Effective for services rendered on or after July 1, 2001, payment for medication
175.17management provided to psychiatric patients, outpatient mental health services, day
175.18treatment services, home-based mental health services, and family community support
175.19services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
175.2050th percentile of 1999 charges.
175.21(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
175.22services provided by an entity that operates: (1) a Medicare-certified comprehensive
175.23outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
175.241993, with at least 33 percent of the clients receiving rehabilitation services in the most
175.25recent calendar year who are medical assistance recipients, will be increased by 38 percent,
175.26when those services are provided within the comprehensive outpatient rehabilitation
175.27facility and provided to residents of nursing facilities owned by the entity.
175.28(c) The commissioner shall establish three levels of payment for mental health
175.29diagnostic assessment, based on three levels of complexity. The aggregate payment under
175.30the tiered rates must not exceed the projected aggregate payments for mental health
175.31diagnostic assessment under the previous single rate. The new rate structure is effective
175.32January 1, 2011, or upon federal approval, whichever is later.
175.33(d) In addition to rate increases otherwise provided, the commissioner may
175.34restructure coverage policy and rates to improve access to adult rehabilitative mental
175.35health services under section 256B.0623 and related mental health support services under
176.1section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
176.22016, the projected state share of increased costs due to this paragraph is transferred
176.3from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
176.4fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
176.5made to managed care plans and county-based purchasing plans under sections 256B.69,
176.6256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.

176.7    Sec. 24. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:
176.8    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
176.9provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
176.10negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
176.11exceed $700 per month, including any legislatively authorized inflationary adjustments,
176.12for a group residential housing provider that:
176.13(1) is located in Hennepin County and has had a group residential housing contract
176.14with the county since June 1996;
176.15(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
176.1626-bed facility; and
176.17(3) serves a chemically dependent clientele, providing 24 hours per day supervision
176.18and limiting a resident's maximum length of stay to 13 months out of a consecutive
176.1924-month period.
176.20(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
176.21supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
176.22per month, including any legislatively authorized inflationary adjustments, of a group
176.23residential provider that:
176.24(1) is located in St. Louis County and has had a group residential housing contract
176.25with the county since 2006;
176.26(2) operates a 62-bed facility; and
176.27(3) serves a chemically dependent adult male clientele, providing 24 hours per
176.28day supervision and limiting a resident's maximum length of stay to 13 months out of
176.29a consecutive 24-month period.
176.30(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
176.31shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
176.32to exceed $700 per month, including any legislatively authorized inflationary adjustments,
176.33for the group residential provider described under paragraphs (a) and (b), not to exceed
176.34an additional 115 beds.

177.1    Sec. 25. CHILD AND ADOLESCENT BEHAVIORAL HEALTH SERVICES.
177.2The commissioner of human services shall, in consultation with children's mental
177.3health community providers, hospitals providing care to children, children's mental health
177.4advocates, and other interested parties, develop recommendations and legislation, if
177.5necessary, for the state-operated child and adolescent behavioral health services facility
177.6to ensure that:
177.7(1) the facility and the services provided meet the needs of children with serious
177.8emotional disturbances, autism spectrum disorders, reactive attachment disorder, PTSD,
177.9serious emotional disturbance co-occurring with a developmental disability, borderline
177.10personality disorder, schizophrenia, fetal alcohol spectrum disorders, brain injuries,
177.11violent tendencies, and complex medical issues;
177.12(2) qualified personnel and staff can be recruited who have specific expertise and
177.13training to treat the children in the facility; and
177.14(3) the treatment provided at the facility is high-quality, effective treatment.

177.15    Sec. 26. PILOT PROVIDER INPUT SURVEY OF PEDIATRIC SERVICES AND
177.16CHILDREN'S MENTAL HEALTH SERVICES.
177.17(a) To assess the efficiency and other operational issues in the management of the
177.18health care delivery system, the commissioner of human services shall initiate a provider
177.19survey. The pilot survey shall consist of an electronic survey of providers of pediatric
177.20home health care services and children's mental health services to identify and measure
177.21issues that arise in dealing with the management of medical assistance. To the maximum
177.22degree possible, existing technology shall be used and interns sought to analyze the results.
177.23(b) The survey questions must focus on seven key business functions provided
177.24by medical assistance contractors: provider inquiries; provider outreach and education;
177.25claims processing; appeals; provider enrollment; medical review; and provider audit and
177.26reimbursement. The commissioner must consider the results of the survey in evaluating
177.27and renewing managed care and fee-for-service management contracts.
177.28(c) The commissioner shall report by January 15, 2014, the results of the survey to
177.29the chairs of the health and human services policy and finance committees and shall
177.30make recommendations on the value of implementing an annual survey with a rotating
177.31list of provider groups as a component of the continuous quality improvement system for
177.32medical assistance.

177.33    Sec. 27. MENTALLY ILL AND DANGEROUS COMMITMENTS
177.34STAKEHOLDERS GROUP.
178.1(a) The commissioner of human services, in consultation with the state court
178.2administrator, shall convene a stakeholder group to develop recommendations for the
178.3legislature that address issues raised in the February 2013 Office of the Legislative
178.4Auditor report on State-Operated Services for persons committed to the commissioner as
178.5mentally ill and dangerous under Minnesota Statutes, section 253B.18. Stakeholders must
178.6include representatives from the Department of Human Services, county human services,
178.7county attorneys, commitment defense attorneys, the ombudsman for mental health and
178.8developmental disabilities, the federal protection and advocacy system, and consumers
178.9and advocates for persons with mental illnesses.
178.10(b) The stakeholder group shall provide recommendations in the following areas:
178.11(1) the role of the special review board, including the scope of authority of the
178.12special review board and the authority of the commissioner to accept or reject special
178.13review board recommendations;
178.14(2) review of special review board decisions by the district court;
178.15(3) annual district court review of commitment, scope of court authority, and
178.16appropriate review criteria;
178.17(4) options, including annual court hearing and review, as alternatives to
178.18indeterminate commitment under Minnesota Statutes, section 253B.18; and
178.19(5) extension of the right to petition the court under Minnesota Statutes,
178.20section 253B.17, to those committed under Minnesota Statutes, section 253B.18.
178.21The commissioner of human services and the state court administrator shall provide
178.22relevant data for the group's consideration in developing these recommendations,
178.23including numbers of proceedings in each category and costs associated with court and
178.24administrative proceedings under Minnesota Statutes, section 253B.18.
178.25(c) By January 15, 2014, the commissioner of human services shall submit the
178.26recommendations of the stakeholder group to the chairs and ranking minority members
178.27of the committees of the legislature with jurisdiction over civil commitment and human
178.28services issues.


178.32    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
178.33subdivision to read:
179.1    Subd. 7b. Child care provider and recipient fraud investigations. Data related
179.2to child care fraud and recipient fraud investigations are governed by section 245E.01,
179.3subdivision 15.

179.4    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
179.5    Subd. 7. Use of data. (a) Except as otherwise provided in subdivision 7a or sections
179.6244.052 and 299C.093, the data provided under this section is private data on individuals
179.7under section 13.02, subdivision 12.
179.8(b) The data may be used only for by law enforcement and corrections agencies for
179.9 law enforcement and corrections purposes.
179.10(c) The commissioner of human services is authorized to have access to the data for:
179.11(1) state-operated services, as defined in section 246.014, are also authorized to
179.12have access to the data for the purposes described in section 246.13, subdivision 2,
179.13paragraph (b); and
179.14(2) purposes of completing background studies under chapter 245C.

179.15    Sec. 3. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision
179.16to read:
179.17    Subd. 4a. Agency background studies. (a) The commissioner shall develop and
179.18implement an electronic process for the regular transfer of new criminal case information
179.19that is added to the Minnesota court information system. The commissioner's system
179.20must include for review only information that relates to individuals who have been the
179.21subject of a background study under this chapter that remain affiliated with the agency
179.22that initiated the background study. For purposes of this paragraph, an individual remains
179.23affiliated with an agency that initiated the background study until the agency informs the
179.24commissioner that the individual is no longer affiliated. When any individual no longer
179.25affiliated according to this paragraph returns to a position requiring a background study
179.26under this chapter, the agency with whom the individual is again affiliated shall initiate
179.27a new background study regardless of the length of time the individual was no longer
179.28affiliated with the agency.
179.29(b) The commissioner shall develop and implement an online system for agencies that
179.30initiate background studies under this chapter to access and maintain records of background
179.31studies initiated by that agency. The system must show all active background study subjects
179.32affiliated with that agency and the status of each individual's background study. Each
179.33agency that initiates background studies must use this system to notify the commissioner
179.34of discontinued affiliation for purposes of the processes required under paragraph (a).

180.1    Sec. 4. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
180.2    Subdivision 1. Background studies conducted by Department of Human
180.3Services. (a) For a background study conducted by the Department of Human Services,
180.4the commissioner shall review:
180.5    (1) information related to names of substantiated perpetrators of maltreatment of
180.6vulnerable adults that has been received by the commissioner as required under section
180.7626.557, subdivision 9c , paragraph (j);
180.8    (2) the commissioner's records relating to the maltreatment of minors in licensed
180.9programs, and from findings of maltreatment of minors as indicated through the social
180.10service information system;
180.11    (3) information from juvenile courts as required in subdivision 4 for individuals
180.12listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
180.13    (4) information from the Bureau of Criminal Apprehension, including information
180.14regarding a background study subject's registration in Minnesota as a predatory offender
180.15under section 243.166;
180.16    (5) except as provided in clause (6), information from the national crime information
180.17system when the commissioner has reasonable cause as defined under section 245C.05,
180.18subdivision 5; and
180.19    (6) for a background study related to a child foster care application for licensure or
180.20adoptions, the commissioner shall also review:
180.21    (i) information from the child abuse and neglect registry for any state in which the
180.22background study subject has resided for the past five years; and
180.23    (ii) information from national crime information databases, when the background
180.24study subject is 18 years of age or older.
180.25    (b) Notwithstanding expungement by a court, the commissioner may consider
180.26information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
180.27received notice of the petition for expungement and the court order for expungement is
180.28directed specifically to the commissioner.
180.29    (c) The commissioner shall also review criminal case information received according
180.30to section 245C.04, subdivision 4a, from the Minnesota court information system that
180.31relates to individuals who have already been studied under this chapter and who remain
180.32affiliated with the agency that initiated the background study.

180.33    Sec. 5. Minnesota Statutes 2012, section 245C.32, subdivision 2, is amended to read:
180.34    Subd. 2. Use. (a) The commissioner may also use these systems and records to
180.35obtain and provide criminal history data from the Bureau of Criminal Apprehension,
181.1criminal history data held by the commissioner, and data about substantiated maltreatment
181.2under section 626.556 or 626.557, for other purposes, provided that:
181.3(1) the background study is specifically authorized in statute; or
181.4(2) the request is made with the informed consent of the subject of the study as
181.5provided in section 13.05, subdivision 4.
181.6(b) An individual making a request under paragraph (a), clause (2), must agree in
181.7writing not to disclose the data to any other individual without the consent of the subject
181.8of the data.
181.9(c) The commissioner may recover the cost of obtaining and providing background
181.10study data by charging the individual or entity requesting the study a fee of no more
181.11than $20 per study. The fees collected under this paragraph are appropriated to the
181.12commissioner for the purpose of conducting background studies.
181.13(d) The commissioner shall recover the cost of obtaining background study data
181.14required under section 524.5-118 through a fee of $100 per study for an individual who
181.15has not lived outside Minnesota for the past ten years, and a fee of $115 for an individual
181.16who has resided outside of Minnesota for any period during the ten years preceding the
181.17background study. The commissioner shall recover, from the individual, any additional
181.18fees charged by other states' licensing agencies that are associated with these data requests.
181.19Fees under subdivision 3 also apply when criminal history data from the National Criminal
181.20Records Repository is required.

181.21    Sec. 6. [245E.01] CHILD CARE PROVIDER AND RECIPIENT FRAUD
181.22INVESTIGATIONS WITHIN THE CHILD CARE ASSISTANCE PROGRAM.
181.23    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in this
181.24subdivision have the meanings given them.
181.25(b) "Applicant" has the meaning given in section 119B.011, subdivision 2.
181.26(c) "Child care assistance program" means any of the assistance programs under
181.27chapter 119B.
181.28(d) "Commissioner" means the commissioner of human services.
181.29(e) "Controlling individual" has the meaning given in section 245A.02, subdivision
181.305a.
181.31(f) "County" means a local county child care assistance program staff or
181.32subcontracted staff, or a county investigator acting on behalf of the commissioner.
181.33(g) "Department" means the Department of Human Services.
181.34(h) "Financial misconduct" or "misconduct" means an entity's or individual's acts or
181.35omissions that result in fraud and abuse or error against the Department of Human Services.
182.1(i) "Identify" means to furnish the full name, current or last known address, phone
182.2number, and e-mail address of the individual or business entity.
182.3(j) "License holder" has the meaning given in section 245A.02, subdivision 9.
182.4(k) "Mail" means the use of any mail service with proof of delivery and receipt.
182.5(l) "Provider" means either a provider as defined in section 119B.011, subdivision
182.619, or a legal unlicensed provider as defined in section 119B.011, subdivision 16.
182.7(m) "Recipient" means a family receiving assistance as defined under section
182.8119B.011, subdivision 13.
182.9(n) "Terminate" means revocation of participation in the child care assistance
182.10program.
182.11    Subd. 2. Investigating provider or recipient financial misconduct. The
182.12department shall investigate alleged or suspected financial misconduct by providers and
182.13errors related to payments issued by the child care assistance program under this chapter.
182.14Recipients, employees, and staff may be investigated when the evidence shows that their
182.15conduct is related to the financial misconduct of a provider, license holder, or controlling
182.16individual.
182.17    Subd. 3. Scope of investigations. (a) The department may contact any person,
182.18agency, organization, or other entity that is necessary to an investigation.
182.19(b) The department may examine or interview any individual, document, or piece of
182.20evidence that may lead to information that is relevant to child care assistance program
182.21benefits, payments, and child care provider authorizations. This includes, but is not
182.22limited to:
182.23(1) child care assistance program payments;
182.24(2) services provided by the program or related to child care assistance program
182.25recipients;
182.26(3) services provided to a provider;
182.27(4) provider financial records of any type;
182.28(5) daily attendance records of the children receiving services from the provider;
182.29(6) billings; and
182.30(7) verification of the credentials of a license holder, controlling individual,
182.31employee, staff person, contractor, subcontractor, and entities under contract with the
182.32provider to provide services or maintain service and the provider's financial records
182.33related to those services.
182.34    Subd. 4. Determination of investigation. After completing its investigation, the
182.35department shall issue one of the following determinations:
182.36(1) no violation of child care assistance requirements occurred;
183.1(2) there is insufficient evidence to show that a violation of child care assistance
183.2requirements occurred;
183.3(3) a preponderance of evidence shows a violation of child care assistance program
183.4law, rule, or policy; or
183.5(4) there exists a credible allegation of fraud.
183.6    Subd. 5. Actions or administrative sanctions. (a) In addition to section 256.98,
183.7after completing the determination under subdivision 4, the department may take one or
183.8more of the actions or sanctions specified in this subdivision.
183.9(b) The department may take the following actions:
183.10(1) refer the investigation to law enforcement or a county attorney for possible
183.11criminal prosecution;
183.12(2) refer relevant information to the department's licensing division, the child care
183.13assistance program, the Department of Education, the federal child and adult care food
183.14program, or appropriate child or adult protection agency;
183.15(3) enter into a settlement agreement with a provider, license holder, controlling
183.16individual, or recipient; or
183.17(4) refer the matter for review by a prosecutorial agency with appropriate jurisdiction
183.18for possible civil action under the Minnesota False Claims Act, chapter 15C.
183.19(c) The department may impose sanctions by:
183.20(1) pursuing administrative disqualification through hearings or waivers;
183.21(2) establishing and seeking monetary recovery or recoupment; or
183.22(3) issuing an order of corrective action that states the practices that are violations of
183.23child care assistance program policies, laws, or regulations, and that they must be corrected.
183.24    Subd. 6. Duty to provide access. (a) A provider, license holder, controlling
183.25individual, employee, staff person, or recipient has an affirmative duty to provide access
183.26upon request to information specified under subdivision 8 or the program facility.
183.27(b) Failure to provide access may result in denial or termination of authorizations for
183.28or payments to a recipient, provider, license holder, or controlling individual in the child
183.29care assistance program.
183.30(c) When a provider fails to provide access, a 15-day notice of denial or termination
183.31must be issued to the provider, which prohibits the provider from participating in the child
183.32care assistance program. Notice must be sent to recipients whose children are under the
183.33provider's care pursuant to Minnesota Rules, part 3400.0185.
183.34(d) If the provider continues to fail to provide access at the expiration of the 15-day
183.35notice period, child care assistance program payments to the provider must be denied
183.36beginning the 16th day following notice of the initial failure or refusal to provide access.
184.1The department may rescind the denial based upon good cause if the provider submits in
184.2writing a good cause basis for having failed or refused to provide access. The writing must
184.3be postmarked no later than the 15th day following the provider's notice of initial failure
184.4to provide access. Additionally, the provider, license holder, or controlling individual
184.5must immediately provide complete, ongoing access to the department. Repeated failures
184.6to provide access must, after the initial failure or for any subsequent failure, result in
184.7termination from participation in the child care assistance program.
184.8(e) The department, at its own expense, may photocopy or otherwise duplicate
184.9records referenced in subdivision 8. Photocopying must be done on the provider's
184.10premises on the day of the request or other mutually agreeable time, unless removal of
184.11records is specifically permitted by the provider. If requested, a provider, license holder,
184.12or controlling individual, or a designee, must assist the investigator in duplicating any
184.13record, including a hard copy or electronically stored data, on the day of the request.
184.14(f) A provider, license holder, controlling individual, employee, or staff person must
184.15grant the department access during the department's normal business hours, and any hours
184.16that the program is operated, to examine the provider's program or the records listed in
184.17subdivision 8. A provider shall make records available at the provider's place of business
184.18on the day for which access is requested, unless the provider and the department both agree
184.19otherwise. The department's normal business hours are 8:00 a.m. to 5:00 p.m., Monday
184.20through Friday, excluding state holidays as defined in section 645.44, subdivision 5.
184.21    Subd. 7. Honest and truthful statements. It shall be unlawful for a provider,
184.22license holder, controlling individual, or recipient to:
184.23(1) falsify, conceal, or cover up by any trick, scheme, or device a material fact;
184.24(2) make any materially false, fictitious, or fraudulent statement or representation; or
184.25(3) make or use any false writing or document knowing the same to contain any
184.26materially false, fictitious, or fraudulent statement or entry related to any child care
184.27assistance program services that the provider, license holder, or controlling individual
184.28supplies or in relation to any child care assistance payments received by a provider, license
184.29holder, or controlling individual or to any fraud investigator or law enforcement officer
184.30conducting a financial misconduct investigation.
184.31    Subd. 8. Record retention. (a) The following records must be maintained,
184.32controlled, and made immediately accessible to license holders, providers, and controlling
184.33individuals. The records must be organized and labeled to correspond to categories that
184.34make them easy to identify so that they can be made available immediately upon request
184.35to an investigator acting on behalf of the commissioner at the provider's place of business:
185.1(1) payroll ledgers, canceled checks, bank deposit slips, and any other accounting
185.2records;
185.3(2) daily attendance records required by and that comply with section 119B.125,
185.4subdivision 6;
185.5(3) billing transmittal forms requesting payments from the child care assistance
185.6program and billing adjustments related to child care assistance program payments;
185.7(4) records identifying all persons, corporations, partnerships, and entities with an
185.8ownership or controlling interest in the provider's child care business;
185.9(5) employee records identifying those persons currently employed by the provider's
185.10child care business or who have been employed by the business at any time within the
185.11previous five years. The records must include each employee's name, hourly and annual
185.12salary, qualifications, position description, job title, and dates of employment. In addition,
185.13employee records that must be made available include the employee's time sheets, current
185.14home address of the employee or last known address of any former employee, and
185.15documentation of background studies required under chapter 119B or 245C;
185.16(6) records related to transportation of children in care, including but not limited to:
185.17(i) the dates and times that transportation is provided to children for transportation to
185.18and from the provider's business location for any purpose. For transportation related to
185.19field trips or locations away from the provider's business location, the names and addresses
185.20of those field trips and locations must also be provided;
185.21(ii) the name, business address, phone number, and Web site address, if any, of the
185.22transportation service utilized; and
185.23(iii) all billing or transportation records related to the transportation.
185.24(b) A provider, license holder, or controlling individual must retain all records
185.25in paragraph (a) for at least six years after the date the record is created. Microfilm or
185.26electronically stored records satisfy the record keeping requirements of this subdivision.
185.27(c) A provider, license holder, or controlling individual who withdraws or is
185.28terminated from the child care assistance program must retain the records required under
185.29this subdivision and make them available to the department on demand.
185.30(d) If the ownership of a provider changes, the transferor, unless otherwise provided
185.31by law or by written agreement with the transferee, is responsible for maintaining,
185.32preserving, and upon request from the department, making available the records related to
185.33the provider that were generated before the date of the transfer. Any written agreement
185.34affecting this provision must be held in the possession of the transferor and transferee.
185.35The written agreement must be provided to the department or county immediately upon
186.1request, and the written agreement must be retained by the transferor and transferee for six
186.2years after the agreement is fully executed.
186.3(e) In the event of an appealed case, the provider must retain all records required in
186.4this subdivision for the duration of the appeal or six years, whichever is longer.
186.5(f) A provider's use of electronic record keeping or electronic signatures is governed
186.6by chapter 325L.
186.7    Subd. 9. Factors regarding imposition of administrative sanctions. (a) The
186.8department shall consider the following factors in determining the administrative sanctions
186.9to be imposed:
186.10(1) nature and extent of financial misconduct;
186.11(2) history of financial misconduct;
186.12(3) actions taken or recommended by other state agencies, other divisions of the
186.13department, and court and administrative decisions;
186.14(4) prior imposition of sanctions;
186.15(5) size and type of provider;
186.16(6) information obtained through an investigation from any source;
186.17(7) convictions or pending criminal charges; and
186.18(8) any other information relevant to the acts or omissions related to the financial
186.19misconduct.
186.20(b) Any single factor under paragraph (a) may be determinative of the department's
186.21decision of whether and what sanctions are imposed.
186.22    Subd. 10. Written notice of department sanction. (a) The department shall give
186.23notice in writing to a person of an administrative sanction that is to be imposed. The notice
186.24shall be sent by mail as defined in subdivision 1, paragraph (k).
186.25(b) The notice shall state:
186.26(1) the factual basis for the department's determination;
186.27(2) the sanction the department intends to take;
186.28(3) the dollar amount of the monetary recovery or recoupment, if any;
186.29(4) how the dollar amount was computed;
186.30(5) the right to dispute the department's determination and to provide evidence;
186.31(6) the right to appeal the department's proposed sanction; and
186.32(7) the option to meet informally with department staff, and to bring additional
186.33documentation or information, to resolve the issues.
186.34(c) In cases of determinations resulting in denial or termination of payments, in
186.35addition to the requirements of paragraph (b), the notice must state:
186.36(1) the length of the denial or termination;
187.1(2) the requirements and procedures for reinstatement; and
187.2(3) the provider's right to submit documents and written arguments against the
187.3denial or termination of payments for review by the department before the effective date
187.4of denial or termination.
187.5(d) The submission of documents and written argument for review by the department
187.6under paragraph (b), clause (5) or (7), or paragraph (c), clause (3), does not stay the
187.7deadline for filing an appeal.
187.8(e) Unless timely appealed, the effective date of the proposed sanction shall be 30
187.9days after the license holder's, provider's, controlling individual's, or recipient's receipt of
187.10the notice. If a timely appeal is made, the proposed sanction shall be delayed pending
187.11the final outcome of the appeal. Implementation of a proposed sanction following the
187.12resolution of a timely appeal may be postponed if, in the opinion of the department, the
187.13delay of sanction is necessary to protect the health or safety of children in care. The
187.14department may consider the economic hardship of a person in implementing the proposed
187.15sanction, but economic hardship shall not be a determinative factor in implementing the
187.16proposed sanction.
187.17(f) Requests for an informal meeting to attempt to resolve issues and requests
187.18for appeals must be sent or delivered to the department's Office of Inspector General,
187.19Financial Fraud and Abuse Division.
187.20    Subd. 11. Appeal of department sanction under this section. (a) If the department
187.21does not pursue a criminal action against a provider, license holder, controlling individual,
187.22or recipient for financial misconduct, but the department imposes an administrative
187.23sanction, any individual or entity against whom the sanction was imposed may appeal the
187.24department's administrative sanction under this section pursuant to section 119B.16 or
187.25256.045 with the additional requirements in clauses (1) to (4). An appeal must specify:
187.26(1) each disputed item, the reason for the dispute, and an estimate of the dollar
187.27amount involved for each disputed item, if appropriate;
187.28(2) the computation that is believed to be correct, if appropriate;
187.29(3) the authority in the statute or rule relied upon for each disputed item; and
187.30(4) the name, address, and phone number of the person at the provider's place of
187.31business with whom contact may be made regarding the appeal.
187.32(b) An appeal is considered timely only if postmarked or received by the
187.33department's Office of Inspector General, Financial Fraud and Abuse Division within 30
187.34days after receiving a notice of department sanction.
188.1(c) Before the appeal hearing, the department may deny or terminate authorizations
188.2or payment to the entity or individual if the department determines that the action is
188.3necessary to protect the public welfare or the interests of the child care assistance program.
188.4    Subd. 12. Consolidated hearings with licensing sanction. If a financial
188.5misconduct sanction has an appeal hearing right and it is timely appealed, and a licensing
188.6sanction exists for which there is an appeal hearing right and the sanction is timely
188.7appealed, and the overpayment recovery action and licensing sanction involve the same
188.8set of facts, the overpayment recovery action and licensing sanction must be consolidated
188.9in the contested case hearing related to the licensing sanction.
188.10    Subd. 13. Grounds for and methods of monetary recovery. (a) The department
188.11may obtain monetary recovery from a provider who has been improperly paid by the
188.12child care assistance program, regardless of whether the error was intentional or county
188.13error. The department does not need to establish a pattern as a precondition of monetary
188.14recovery of erroneous or false billing claims, duplicate billing claims, or billing claims
188.15based on false statements or financial misconduct.
188.16(b) The department shall obtain monetary recovery from providers by the following
188.17means:
188.18(1) permitting voluntary repayment of money, either in lump-sum payment or
188.19installment payments;
188.20(2) using any legal collection process;
188.21(3) deducting or withholding program payments; or
188.22(4) utilizing the means set forth in chapter 16D.
188.23    Subd. 14. Reporting of suspected fraudulent activity. (a) A person who, in
188.24good faith, makes a report of or testifies in any action or proceeding in which financial
188.25misconduct is alleged, and who is not involved in, has not participated in, or has not aided
188.26and abetted, conspired, or colluded in the financial misconduct, shall have immunity from
188.27any liability, civil or criminal, that results by reason of the person's report or testimony.
188.28For the purpose of any proceeding, the good faith of any person reporting or testifying
188.29under this provision shall be presumed.
188.30(b) If a person that is or has been involved in, participated in, aided and abetted,
188.31conspired, or colluded in the financial misconduct reports the financial misconduct,
188.32the department may consider that person's report and assistance in investigating the
188.33misconduct as a mitigating factor in the department's pursuit of civil, criminal, or
188.34administrative remedies.
189.1    Subd. 15. Data privacy. Data of any kind obtained or created in relation to a provider
189.2or recipient investigation under this section is defined, classified, and protected the same as
189.3all other data under section 13.46, and this data has the same classification as licensing data.
189.4    Subd. 16. Monetary recovery; random sample extrapolation. The department is
189.5authorized to calculate the amount of monetary recovery from a provider, license holder, or
189.6controlling individual based upon extrapolation from a statistical random sample of claims
189.7submitted by the provider, license holder, or controlling individual and paid by the child
189.8care assistance program. The department's random sample extrapolation shall constitute a
189.9rebuttable presumption of the accuracy of the calculation of monetary recovery. If the
189.10presumption is not rebutted by the provider, license holder, or controlling individual in the
189.11appeal process, the department shall use the extrapolation as the monetary recovery figure.
189.12The department may use sampling and extrapolation to calculate the amount of monetary
189.13recovery if the claims to be reviewed represent services to 50 or more children in care.
189.14    Subd. 17. Effect of department's monetary penalty determination. Unless
189.15a timely and proper appeal is received by the department's Office of Inspector General,
189.16Financial Fraud and Abuse Division, the department's administrative determination or
189.17sanction shall be considered a final department determination.
189.18    Subd. 18. Office of Inspector General recoveries. Overpayment recoveries
189.19resulting from child care provider fraud investigations initiated by the department's Office
189.20of Inspector General's fraud investigations staff are excluded from the county recovery
189.21provision in section 119B.11, subdivision 3.

189.22    Sec. 7. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
189.23    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
189.24Medicare and Medicaid Services determines that a provider is designated "high-risk," the
189.25commissioner may withhold payment from providers within that category upon initial
189.26enrollment for a 90-day period. The withholding for each provider must begin on the date
189.27of the first submission of a claim.
189.28(b) An enrolled provider that is also licensed by the commissioner under chapter
189.29245A must designate an individual as the entity's compliance officer. The compliance
189.30officer must:
189.31(1) develop policies and procedures to assure adherence to medical assistance laws
189.32and regulations and to prevent inappropriate claims submissions;
189.33(2) train the employees of the provider entity, and any agents or subcontractors of
189.34the provider entity including billers, on the policies and procedures under clause (1);
190.1(3) respond to allegations of improper conduct related to the provision or billing of
190.2medical assistance services, and implement action to remediate any resulting problems;
190.3(4) use evaluation techniques to monitor compliance with medical assistance laws
190.4and regulations;
190.5(5) promptly report to the commissioner any identified violations of medical
190.6assistance laws or regulations; and
190.7    (6) within 60 days of discovery by the provider of a medical assistance
190.8reimbursement overpayment, report the overpayment to the commissioner and make
190.9arrangements with the commissioner for the commissioner's recovery of the overpayment.
190.10The commissioner may require, as a condition of enrollment in medical assistance, that a
190.11provider within a particular industry sector or category establish a compliance program that
190.12contains the core elements established by the Centers for Medicare and Medicaid Services.
190.13(c) The commissioner may revoke the enrollment of an ordering or rendering
190.14provider for a period of not more than one year, if the provider fails to maintain and, upon
190.15request from the commissioner, provide access to documentation relating to written orders
190.16or requests for payment for durable medical equipment, certifications for home health
190.17services, or referrals for other items or services written or ordered by such provider, when
190.18the commissioner has identified a pattern of a lack of documentation. A pattern means a
190.19failure to maintain documentation or provide access to documentation on more than one
190.20occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a
190.21provider under the provisions of section 256B.064.
190.22(d) The commissioner shall terminate or deny the enrollment of any individual or
190.23entity if the individual or entity has been terminated from participation in Medicare or
190.24under the Medicaid program or Children's Health Insurance Program of any other state.
190.25(e) As a condition of enrollment in medical assistance, the commissioner shall
190.26require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
190.27and Medicaid Services or the Minnesota Department of Human Services commissioner
190.28 permit the Centers for Medicare and Medicaid Services, its agents, or its designated
190.29contractors and the state agency, its agents, or its designated contractors to conduct
190.30unannounced on-site inspections of any provider location. The commissioner shall publish
190.31in the Minnesota Health Care Program Provider Manual a list of provider types designated
190.32"limited," "moderate," or "high-risk," based on the criteria and standards used to designate
190.33Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and
190.34criteria are not subject to the requirements of chapter 14. The commissioner's designations
190.35are not subject to administrative appeal.
191.1(f) As a condition of enrollment in medical assistance, the commissioner shall
191.2require that a high-risk provider, or a person with a direct or indirect ownership interest in
191.3the provider of five percent or higher, consent to criminal background checks, including
191.4fingerprinting, when required to do so under state law or by a determination by the
191.5commissioner or the Centers for Medicare and Medicaid Services that a provider is
191.6designated high-risk for fraud, waste, or abuse.
191.7(g) As a condition of enrollment, all durable medical equipment, prosthetics,
191.8orthotics, and supplies (DMEPOS) suppliers operating in Minnesota are required to name
191.9the Department of Human Services, in addition to the Centers for Medicare and Medicaid
191.10Services, as an obligee on all surety performance bonds required pursuant to section
191.114312(a) of the Balanced Budget Act of 1997, Public Law 105-33, amending Social
191.12Security Act, section 1834(a). The performance bond must also allow for recovery of
191.13costs and fees in pursuing a claim on the bond.
191.14(h) The Department of Human Services may require a provider to purchase a
191.15performance surety bond as a condition of initial enrollment, reenrollment, reinstatement,
191.16or continued enrollment if: (1) the provider fails to demonstrate financial viability; (2) the
191.17department determines there is significant evidence of or potential for fraud and abuse
191.18by the provider; or (3) the provider or category of providers is designated high-risk
191.19pursuant to paragraph (a) and Code of Federal Regulations, title 42, section 455.450, or
191.20the department otherwise finds it is in the best interest of the Medicaid program to do so.
191.21The performance bond must be in an amount of $100,000 or ten percent of the provider's
191.22payments from Medicaid during the immediately preceding 12 months, whichever is
191.23greater. The performance bond must name the Department of Human Services as an
191.24obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.
191.25EFFECTIVE DATE.This section is effective the day following final enactment.

191.26    Sec. 8. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
191.27to read:
191.28    Subd. 22. Application fee. (a) The commissioner must collect and retain federally
191.29required nonrefundable application fees to pay for provider screening activities in
191.30accordance with Code of Federal Regulations, title 42, section 455, subpart E. The
191.31enrollment application must be made under the procedures specified by the commissioner,
191.32in the form specified by the commissioner, and accompanied by an application fee
191.33described in paragraph (b), or a request for a hardship exception as described in the
191.34specified procedures. Application fees must be deposited in the provider screening account
191.35in the special revenue fund. Amounts in the provider screening account are appropriated
192.1to the commissioner for costs associated with the provider screening activities required
192.2in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner
192.3shall conduct screening activities as required by Code of Federal Regulations, title 42,
192.4section 455, subpart E, and as otherwise provided by law, to include database checks,
192.5unannounced pre- and postenrollment site visits, fingerprinting, and criminal background
192.6studies. The commissioner must revalidate all providers under this subdivision at least
192.7once every five years.
192.8(b) The application fee under this subdivision is $532 for the calendar year 2013.
192.9For calendar year 2014 and subsequent years, the fee:
192.10(1) is adjusted by the percentage change to the consumer price index for all urban
192.11consumers, United States city average, for the 12-month period ending with June of the
192.12previous year. The resulting fee must be announced in the Federal Register;
192.13(2) is effective from January 1 to December 31 of a calendar year;
192.14(3) is required on the submission of an initial application, an application to establish
192.15a new practice location, an application for reenrollment when the provider is not enrolled
192.16at the time of application of reenrollment, or at revalidation when required by federal
192.17regulation; and
192.18(4) must be in the amount in effect for the calendar year during which the application
192.19for enrollment, new practice location, or reenrollment is being submitted.
192.20(c) The application fee under this subdivision cannot be charged to:
192.21(1) providers who are enrolled in Medicare or who provide documentation of
192.22payment of the fee to, and enrollment with, another state;
192.23(2) providers who are enrolled but are required to submit new applications for
192.24purposes of reenrollment; or
192.25(3) a provider who enrolls as an individual.
192.26EFFECTIVE DATE.This section is effective the day following final enactment.

192.27    Sec. 9. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
192.28    Subd. 1a. Grounds for sanctions against vendors. The commissioner may
192.29impose sanctions against a vendor of medical care for any of the following: (1) fraud,
192.30theft, or abuse in connection with the provision of medical care to recipients of public
192.31assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
192.32not medically necessary; (3) a pattern of making false statements of material facts for
192.33the purpose of obtaining greater compensation than that to which the vendor is legally
192.34entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
192.35agency access during regular business hours to examine all records necessary to disclose
193.1the extent of services provided to program recipients and appropriateness of claims for
193.2payment; (6) failure to repay an overpayment or a fine finally established under this
193.3section; and (7) failure to correct errors in the maintenance of health service or financial
193.4records for which a fine was imposed or after issuance of a warning by the commissioner;
193.5and (8) any reason for which a vendor could be excluded from participation in the
193.6Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
193.7The determination of services not medically necessary may be made by the commissioner
193.8in consultation with a peer advisory task force appointed by the commissioner on the
193.9recommendation of appropriate professional organizations. The task force expires as
193.10provided in section 15.059, subdivision 5.

193.11    Sec. 10. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
193.12    Subd. 1b. Sanctions available. The commissioner may impose the following
193.13sanctions for the conduct described in subdivision 1a: suspension or withholding of
193.14payments to a vendor and suspending or terminating participation in the program, or
193.15imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
193.16this section, the commissioner shall consider the nature, chronicity, or severity of the
193.17conduct and the effect of the conduct on the health and safety of persons served by the
193.18vendor. Regardless of imposition of sanctions, the commissioner may make a referral
193.19to the appropriate state licensing board.

193.20    Sec. 11. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
193.21    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
193.22shall determine any monetary amounts to be recovered and sanctions to be imposed upon
193.23a vendor of medical care under this section. Except as provided in paragraphs (b) and
193.24(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
193.25without prior notice and an opportunity for a hearing, according to chapter 14, on the
193.26commissioner's proposed action, provided that the commissioner may suspend or reduce
193.27payment to a vendor of medical care, except a nursing home or convalescent care facility,
193.28after notice and prior to the hearing if in the commissioner's opinion that action is
193.29necessary to protect the public welfare and the interests of the program.
193.30(b) Except when the commissioner finds good cause not to suspend payments under
193.31Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
193.32withhold or reduce payments to a vendor of medical care without providing advance
193.33notice of such withholding or reduction if either of the following occurs:
194.1(1) the vendor is convicted of a crime involving the conduct described in subdivision
194.21a; or
194.3(2) the commissioner determines there is a credible allegation of fraud for which an
194.4investigation is pending under the program. A credible allegation of fraud is an allegation
194.5which has been verified by the state, from any source, including but not limited to:
194.6(i) fraud hotline complaints;
194.7(ii) claims data mining; and
194.8(iii) patterns identified through provider audits, civil false claims cases, and law
194.9enforcement investigations.
194.10Allegations are considered to be credible when they have an indicia of reliability
194.11and the state agency has reviewed all allegations, facts, and evidence carefully and acts
194.12judiciously on a case-by-case basis.
194.13(c) The commissioner must send notice of the withholding or reduction of payments
194.14under paragraph (b) within five days of taking such action unless requested in writing by a
194.15law enforcement agency to temporarily withhold the notice. The notice must:
194.16(1) state that payments are being withheld according to paragraph (b);
194.17(2) set forth the general allegations as to the nature of the withholding action, but
194.18need not disclose any specific information concerning an ongoing investigation;
194.19(3) except in the case of a conviction for conduct described in subdivision 1a, state
194.20that the withholding is for a temporary period and cite the circumstances under which
194.21withholding will be terminated;
194.22(4) identify the types of claims to which the withholding applies; and
194.23(5) inform the vendor of the right to submit written evidence for consideration by
194.24the commissioner.
194.25The withholding or reduction of payments will not continue after the commissioner
194.26determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
194.27relating to the alleged fraud are completed, unless the commissioner has sent notice of
194.28intention to impose monetary recovery or sanctions under paragraph (a).
194.29(d) The commissioner shall suspend or terminate a vendor's participation in the
194.30program without providing advance notice and an opportunity for a hearing when the
194.31suspension or termination is required because of the vendor's exclusion from participation
194.32in Medicare. Within five days of taking such action, the commissioner must send notice of
194.33the suspension or termination. The notice must:
194.34(1) state that suspension or termination is the result of the vendor's exclusion from
194.35Medicare;
194.36(2) identify the effective date of the suspension or termination; and
195.1(3) inform the vendor of the need to be reinstated to Medicare before reapplying
195.2for participation in the program.
195.3(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
195.4sanction is to be imposed, a vendor may request a contested case, as defined in section
195.514.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
195.6appeal request must be received by the commissioner no later than 30 days after the date
195.7the notification of monetary recovery or sanction was mailed to the vendor. The appeal
195.8request must specify:
195.9(1) each disputed item, the reason for the dispute, and an estimate of the dollar
195.10amount involved for each disputed item;
195.11(2) the computation that the vendor believes is correct;
195.12(3) the authority in statute or rule upon which the vendor relies for each disputed item;
195.13(4) the name and address of the person or entity with whom contacts may be made
195.14regarding the appeal; and
195.15(5) other information required by the commissioner.
195.16(f) The commissioner may order a vendor to forfeit a fine for failure to fully document
195.17services according to standards in this chapter and Minnesota Rules, chapter 9505. The
195.18commissioner may assess fines if specific required components of documentation are
195.19missing. The fine for incomplete documentation shall equal 20 percent of the amount paid
195.20on the claims for reimbursement submitted by the vendor, or up to $5,000, whichever is less.
195.21(g) The vendor shall pay the fine assessed on or before the payment date specified. If
195.22the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
195.23recover the amount of the fine. A timely appeal shall stay payment of the fine until the
195.24commissioner issues a final order.

195.25    Sec. 12. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to
195.26read:
195.27    Subd. 21. Requirements for initial enrollment of personal care assistance
195.28provider agencies. (a) All personal care assistance provider agencies must provide, at the
195.29time of enrollment as a personal care assistance provider agency in a format determined
195.30by the commissioner, information and documentation that includes, but is not limited to,
195.31the following:
195.32    (1) the personal care assistance provider agency's current contact information
195.33including address, telephone number, and e-mail address;
195.34    (2) proof of surety bond coverage in the amount of $50,000 $100,000 or ten percent
195.35of the provider's payments from Medicaid in the previous year, whichever is less more.
196.1The performance bond must be in a form approved by the commissioner, must be renewed
196.2annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;
196.3    (3) proof of fidelity bond coverage in the amount of $20,000;
196.4    (4) proof of workers' compensation insurance coverage;
196.5    (5) proof of liability insurance;
196.6    (6) a description of the personal care assistance provider agency's organization
196.7identifying the names of all owners, managing employees, staff, board of directors, and
196.8the affiliations of the directors, owners, or staff to other service providers;
196.9    (7) a copy of the personal care assistance provider agency's written policies and
196.10procedures including: hiring of employees; training requirements; service delivery;
196.11and employee and consumer safety including process for notification and resolution
196.12of consumer grievances, identification and prevention of communicable diseases, and
196.13employee misconduct;
196.14    (8) copies of all other forms the personal care assistance provider agency uses in
196.15the course of daily business including, but not limited to:
196.16    (i) a copy of the personal care assistance provider agency's time sheet if the time
196.17sheet varies from the standard time sheet for personal care assistance services approved
196.18by the commissioner, and a letter requesting approval of the personal care assistance
196.19provider agency's nonstandard time sheet;
196.20    (ii) the personal care assistance provider agency's template for the personal care
196.21assistance care plan; and
196.22    (iii) the personal care assistance provider agency's template for the written
196.23agreement in subdivision 20 for recipients using the personal care assistance choice
196.24option, if applicable;
196.25    (9) a list of all training and classes that the personal care assistance provider agency
196.26requires of its staff providing personal care assistance services;
196.27    (10) documentation that the personal care assistance provider agency and staff have
196.28successfully completed all the training required by this section;
196.29    (11) documentation of the agency's marketing practices;
196.30    (12) disclosure of ownership, leasing, or management of all residential properties
196.31that is used or could be used for providing home care services;
196.32    (13) documentation that the agency will use the following percentages of revenue
196.33generated from the medical assistance rate paid for personal care assistance services
196.34for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
196.35personal care assistance choice option and 72.5 percent of revenue from other personal
196.36care assistance providers. The revenue generated by the qualified professional and the
197.1reasonable costs associated with the qualified professional shall not be used in making
197.2this calculation; and
197.3    (14) effective May 15, 2010, documentation that the agency does not burden
197.4recipients' free exercise of their right to choose service providers by requiring personal
197.5care assistants to sign an agreement not to work with any particular personal care
197.6assistance recipient or for another personal care assistance provider agency after leaving
197.7the agency and that the agency is not taking action on any such agreements or requirements
197.8regardless of the date signed.
197.9    (b) Personal care assistance provider agencies shall provide the information specified
197.10in paragraph (a) to the commissioner at the time the personal care assistance provider
197.11agency enrolls as a vendor or upon request from the commissioner. The commissioner
197.12shall collect the information specified in paragraph (a) from all personal care assistance
197.13providers beginning July 1, 2009.
197.14    (c) All personal care assistance provider agencies shall require all employees in
197.15management and supervisory positions and owners of the agency who are active in the
197.16day-to-day management and operations of the agency to complete mandatory training
197.17as determined by the commissioner before enrollment of the agency as a provider.
197.18Employees in management and supervisory positions and owners who are active in
197.19the day-to-day operations of an agency who have completed the required training as
197.20an employee with a personal care assistance provider agency do not need to repeat
197.21the required training if they are hired by another agency, if they have completed the
197.22training within the past three years. By September 1, 2010, the required training must
197.23be available with meaningful access according to title VI of the Civil Rights Act and
197.24federal regulations adopted under that law or any guidance from the United States Health
197.25and Human Services Department. The required training must be available online or by
197.26electronic remote connection. The required training must provide for competency testing.
197.27Personal care assistance provider agency billing staff shall complete training about
197.28personal care assistance program financial management. This training is effective July 1,
197.292009. Any personal care assistance provider agency enrolled before that date shall, if it
197.30has not already, complete the provider training within 18 months of July 1, 2009. Any new
197.31owners or employees in management and supervisory positions involved in the day-to-day
197.32operations are required to complete mandatory training as a requisite of working for the
197.33agency. Personal care assistance provider agencies certified for participation in Medicare
197.34as home health agencies are exempt from the training required in this subdivision. When
197.35available, Medicare-certified home health agency owners, supervisors, or managers must
197.36successfully complete the competency test.
198.1EFFECTIVE DATE.This section is effective the day following final enactment.

198.2    Sec. 13. Minnesota Statutes 2012, section 299C.093, is amended to read:
198.3299C.093 DATABASE OF REGISTERED PREDATORY OFFENDERS.
198.4The superintendent of the Bureau of Criminal Apprehension shall maintain a
198.5computerized data system relating to individuals required to register as predatory offenders
198.6under section 243.166. To the degree feasible, the system must include the data required
198.7to be provided under section 243.166, subdivisions 4 and 4a, and indicate the time period
198.8that the person is required to register. The superintendent shall maintain this data in a
198.9manner that ensures that it is readily available to law enforcement agencies. This data is
198.10private data on individuals under section 13.02, subdivision 12, but may be used for law
198.11enforcement and corrections purposes. The commissioner of human services has access
198.12to the data for state-operated services, as defined in section 246.014, are also authorized
198.13to have access to the data for the purposes described in section 246.13, subdivision 2,
198.14paragraph (b), and for purposes of conducting background studies under chapter 245C.

198.15    Sec. 14. Minnesota Statutes 2012, section 524.5-118, subdivision 1, is amended to read:
198.16    Subdivision 1. When required; exception. (a) The court shall require a background
198.17study under this section:
198.18(1) before the appointment of a guardian or conservator, unless a background study
198.19has been done on the person under this section within the previous five two years; and
198.20(2) once every five two years after the appointment, if the person continues to serve
198.21as a guardian or conservator.
198.22(b) The background study must include:
198.23(1) criminal history data from the Bureau of Criminal Apprehension, other criminal
198.24history data held by the commissioner of human services, and data regarding whether the
198.25person has been a perpetrator of substantiated maltreatment of a vulnerable adult and a
198.26 or minor.;
198.27(c) The court shall request a search of the (2) criminal history data from the National
198.28Criminal Records Repository if the proposed guardian or conservator has not resided in
198.29Minnesota for the previous five ten years or if the Bureau of Criminal Apprehension
198.30information received from the commissioner of human services under subdivision 2,
198.31paragraph (b), indicates that the subject is a multistate offender or that the individual's
198.32multistate offender status is undetermined.; and
198.33(3) state licensing agency data if the proposed guardian or conservator has ever been
198.34denied a professional license in the state of Minnesota or elsewhere that is directly related
199.1to the responsibilities of a professional fiduciary, or has ever held a professional license
199.2directly related to the responsibilities of a professional fiduciary that was conditioned,
199.3suspended, revoked, or canceled.
199.4(d) (c) If the guardian or conservator is not an individual, the background study must
199.5be done on all individuals currently employed by the proposed guardian or conservator
199.6who will be responsible for exercising powers and duties under the guardianship or
199.7conservatorship.
199.8(e) (d) If the court determines that it would be in the best interests of the ward or
199.9protected person to appoint a guardian or conservator before the background study can
199.10be completed, the court may make the appointment pending the results of the study,
199.11however, the background study must then be completed as soon as reasonably possible
199.12after appointment, no later than 30 days after appointment.
199.13(f) (e) The fee for conducting a background study for appointment of a professional
199.14guardian or conservator must be paid by the guardian or conservator. In other cases,
199.15the fee must be paid as follows:
199.16(1) if the matter is proceeding in forma pauperis, the fee is an expense for purposes
199.17of section 524.5-502, paragraph (a);
199.18(2) if there is an estate of the ward or protected person, the fee must be paid from
199.19the estate; or
199.20(3) in the case of a guardianship or conservatorship of the person that is not
199.21proceeding in forma pauperis, the court may order that the fee be paid by the guardian or
199.22conservator or by the court.
199.23(g) (f) The requirements of this subdivision do not apply if the guardian or
199.24conservator is:
199.25(1) a state agency or county;
199.26(2) a parent or guardian of a proposed ward or protected person who has a
199.27developmental disability, if the parent or guardian has raised the proposed ward or
199.28protected person in the family home until the time the petition is filed, unless counsel
199.29appointed for the proposed ward or protected person under section 524.5-205, paragraph
199.30(d) ; 524.5-304, paragraph (b); 524.5-405, paragraph (a); or 524.5-406, paragraph (b),
199.31recommends a background study; or
199.32(3) a bank with trust powers, bank and trust company, or trust company, organized
199.33under the laws of any state or of the United States and which is regulated by the
199.34commissioner of commerce or a federal regulator.

200.1    Sec. 15. Minnesota Statutes 2012, section 524.5-118, is amended by adding a
200.2subdivision to read:
200.3    Subd. 2a. Procedure; state licensing agency data. The court shall request
200.4the commissioner of human services to provide the court within 25 working days of
200.5receipt of the request with licensing agency data from Minnesota licensing agencies
200.6that the commissioner determines issue professional licenses directly related to the
200.7responsibilities of a professional fiduciary. The commissioner shall enter into agreements
200.8with these agencies to provide for electronic access to the relevant licensing data by the
200.9commissioner. The data provided by the commissioner to the court shall include, as
200.10applicable, license number and status; original date of issue; last renewal date; expiration
200.11date; date of the denial, condition, suspension, revocation, or cancellation; the name of the
200.12licensing agency that denied, conditioned, suspended, revoked, or canceled the license;
200.13and the basis for denial, condition, suspension, revocation, or cancellation of the license.
200.14If the proposed guardian or conservator has resided in a state other than Minnesota in the
200.15previous ten years, licensing agency data shall also include the licensing agency data
200.16from any other state where the proposed guardian or conservator resided. If the proposed
200.17guardian or conservator has or has had a professional license in another state that is
200.18directly related to the responsibilities of a professional fiduciary, state licensing agency
200.19data shall also include data from the relevant licensing agency of that state.

200.20    Sec. 16. Minnesota Statutes 2012, section 524.5-303, is amended to read:
200.21524.5-303 JUDICIAL APPOINTMENT OF GUARDIAN: PETITION.
200.22(a) An individual or a person interested in the individual's welfare may petition for
200.23a determination of incapacity, in whole or in part, and for the appointment of a limited
200.24or unlimited guardian for the individual.
200.25(b) The petition must set forth the petitioner's name, residence, current address if
200.26different, relationship to the respondent, and interest in the appointment and, to the extent
200.27known, state or contain the following with respect to the respondent and the relief requested:
200.28(1) the respondent's name, age, principal residence, current street address, and, if
200.29different, the address of the dwelling in which it is proposed that the respondent will
200.30reside if the appointment is made;
200.31(2) the name and address of the respondent's:
200.32(i) spouse, or if the respondent has none, an adult with whom the respondent has
200.33resided for more than six months before the filing of the petition; and
201.1(ii) adult children or, if the respondent has none, the respondent's parents and adult
201.2brothers and sisters, or if the respondent has none, at least one of the adults nearest in
201.3kinship to the respondent who can be found;
201.4(3) the name of the administrative head and address of the institution where the
201.5respondent is a patient, resident, or client of any hospital, nursing home, home care
201.6agency, or other institution;
201.7(4) the name and address of any legal representative for the respondent;
201.8(5) the name, address, and telephone number of any person nominated as guardian
201.9by the respondent in any manner permitted by law, including a health care agent nominated
201.10in a health care directive;
201.11(6) the name, address, and telephone number of any proposed guardian and the
201.12reason why the proposed guardian should be selected;
201.13(7) the name and address of any health care agent or proxy appointed pursuant to
201.14a health care directive as defined in section 145C.01, a living will under chapter 145B,
201.15or other similar document executed in another state and enforceable under the laws of
201.16this state;
201.17(8) the reason why guardianship is necessary, including a brief description of the
201.18nature and extent of the respondent's alleged incapacity;
201.19(9) if an unlimited guardianship is requested, the reason why limited guardianship
201.20is inappropriate and, if a limited guardianship is requested, the powers to be granted to
201.21the limited guardian; and
201.22(10) a general statement of the respondent's property with an estimate of its value,
201.23including any insurance or pension, and the source and amount of any other anticipated
201.24income or receipts.
201.25(c) The petition must also set forth the following information regarding the proposed
201.26guardian or any employee of the guardian responsible for exercising powers and duties
201.27under the guardianship:
201.28(1) whether the proposed guardian has ever been removed for cause from serving as
201.29a guardian or conservator and, if so, the case number and court location; and
201.30(2) if the proposed guardian is a professional guardian or conservator, a summary of
201.31the proposed guardian's educational background and relevant work and other experience.;
201.32(3) whether the proposed guardian has ever applied for or held, at any time, any
201.33professional license, and if so, the name of the licensing agency, and as applicable, the
201.34license number and status; whether the license is active or has been denied, conditioned,
201.35suspended, revoked, or canceled; and the basis for the denial, condition, suspension,
201.36revocation, or cancellation of the license;
202.1(4) whether the proposed guardian has ever been found civilly liable in an action
202.2that involved fraud, misrepresentation, material omission, misappropriation, theft, or
202.3conversion, and if so, the case number and court location;
202.4(5) whether the proposed guardian has ever filed for or received protection under the
202.5bankruptcy laws, and if so, the case number and court location;
202.6(6) whether the proposed guardian has any outstanding civil monetary judgments
202.7against the proposed guardian, and if so, the case number, court location, and outstanding
202.8amount owed;
202.9(7) whether an order for protection or harassment restraining order has ever been
202.10issued against the proposed guardian, and if so, the case number and court location; and
202.11(8) whether the proposed guardian has ever been convicted of a crime other than a
202.12petty misdemeanor or traffic offense, and if so, the case number and the crime of which
202.13the guardian was convicted.

202.14    Sec. 17. Minnesota Statutes 2012, section 524.5-316, is amended to read:
202.15524.5-316 REPORTS; MONITORING OF GUARDIANSHIP; COURT
202.16ORDERS.
202.17(a) A guardian shall report to the court in writing on the condition of the ward at least
202.18annually and whenever ordered by the court. A copy of the report must be provided to the
202.19ward and to interested persons of record with the court. A report must state or contain:
202.20(1) the current mental, physical, and social condition of the ward;
202.21(2) the living arrangements for all addresses of the ward during the reporting period;
202.22(3) any restrictions placed on the ward's right to communication and visitation with
202.23persons of the ward's choice and the factual bases for those restrictions;
202.24(4) the medical, educational, vocational, and other services provided to the ward and
202.25the guardian's opinion as to the adequacy of the ward's care;
202.26(5) a recommendation as to the need for continued guardianship and any
202.27recommended changes in the scope of the guardianship;
202.28(6) an address and telephone number where the guardian can be contacted; and
202.29(7) whether the guardian has ever been removed for cause from serving as a guardian
202.30or conservator and, if so, the case number and court location;
202.31(8) any changes occurring that would affect the accuracy of information contained
202.32in the most recent criminal background study of the guardian conducted under section
202.33524.5-118; and
203.1(9) (7) if applicable, the amount of reimbursement for services rendered to the ward
203.2that the guardian received during the previous year that were not reimbursed by county
203.3contract.
203.4(b) A guardian shall report to the court in writing within 30 days of the occurrence of
203.5any of the events listed in this paragraph. The guardian must report any of the occurrences
203.6in this paragraph and follow the same reporting requirements in this paragraph for
203.7any employee of the guardian responsible for exercising powers and duties under the
203.8guardianship. A copy of the report must be provided to the ward and to interested persons
203.9of record with the court. A guardian shall report when:
203.10(1) the guardian is removed for cause from serving as a guardian or conservator, and
203.11if so, the case number and court location;
203.12(2) the guardian has a professional license denied, conditioned, suspended, revoked,
203.13or canceled, and if so, the licensing agency and license number, and the basis for denial,
203.14condition, suspension, revocation, or cancellation of the license;
203.15(3) the guardian is found civilly liable in an action that involves fraud,
203.16misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the
203.17case number and court location;
203.18(4) the guardian files for or receives protection under the bankruptcy laws, and
203.19if so, the case number and court location;
203.20(5) a civil monetary judgment is entered against the guardian, and if so, the case
203.21number, court location, and outstanding amount owed;
203.22(6) the guardian is convicted of a crime other than a petty misdemeanor or traffic
203.23offense, and if so, the case number and court location; or
203.24(7) an order for protection or harassment restraining order is issued against the
203.25guardian, and if so, the case number and court location.
203.26(b) (c) A ward or interested person of record with the court may submit to the court a
203.27written statement disputing statements or conclusions regarding the condition of the ward
203.28or addressing any disciplinary or legal action that are is contained in the report guardian's
203.29reports and may petition the court for an order that is in the best interests of the ward or
203.30for other appropriate relief.
203.31(c) (d) An interested person may notify the court in writing that the interested person
203.32does not wish to receive copies of reports required under this section.
203.33(d) (e) The court may appoint a visitor to review a report, interview the ward or
203.34guardian, and make any other investigation the court directs.
204.1(e) (f) The court shall establish a system for monitoring guardianships, including the
204.2filing and review of annual reports. If an annual report is not filed within 60 days of the
204.3required date, the court shall issue an order to show cause.
204.4(g) If a guardian fails to comply with this section, the court may decline to appoint that
204.5person as a guardian or conservator, or may remove a person as guardian or conservator.

204.6    Sec. 18. Minnesota Statutes 2012, section 524.5-403, is amended to read:
204.7524.5-403 ORIGINAL PETITION FOR APPOINTMENT OR PROTECTIVE
204.8ORDER.
204.9(a) The following may petition for the appointment of a conservator or for any
204.10other appropriate protective order:
204.11(1) the person to be protected;
204.12(2) an individual interested in the estate, affairs, or welfare of the person to be
204.13protected; or
204.14(3) a person who would be adversely affected by lack of effective management of
204.15the property and business affairs of the person to be protected.
204.16(b) The petition must set forth the petitioner's name, residence, current address
204.17if different, relationship to the respondent, and interest in the appointment or other
204.18protective order, and, to the extent known, state or contain the following with respect to
204.19the respondent and the relief requested:
204.20(1) the respondent's name, age, principal residence, current street address, and, if
204.21different, the address of the dwelling where it is proposed that the respondent will reside if
204.22the appointment is made;
204.23(2) if the petition alleges impairment in the respondent's ability to receive and
204.24evaluate information, a brief description of the nature and extent of the respondent's
204.25alleged impairment;
204.26(3) if the petition alleges that the respondent is missing, detained, or unable to
204.27return to the United States, a statement of the relevant circumstances, including the time
204.28and nature of the disappearance or detention and a description of any search or inquiry
204.29concerning the respondent's whereabouts;
204.30(4) the name and address of the respondent's:
204.31(i) spouse, or if the respondent has none, an adult with whom the respondent has
204.32resided for more than six months before the filing of the petition; and
204.33(ii) adult children or, if the respondent has none, the respondent's parents and adult
204.34brothers and sisters or, if the respondent has none, at least one of the adults nearest in
204.35kinship to the respondent who can be found;
205.1(5) the name of the administrative head and address of the institution where the
205.2respondent is a patient, resident, or client of any hospital, nursing home, home care
205.3agency, or other institution;
205.4(6) the name and address of any legal representative for the respondent;
205.5(7) the name and address of any health care agent or proxy appointed pursuant to
205.6a health care directive as defined in section 145C.01, a living will under chapter 145B,
205.7or other similar document executed in another state and enforceable under the laws of
205.8this state;
205.9(8) a general statement of the respondent's property with an estimate of its value,
205.10including any insurance or pension, and the source and amount of other anticipated
205.11income or receipts; and
205.12(9) the reason why a conservatorship or other protective order is in the best interest
205.13of the respondent.
205.14(c) If a conservatorship is requested, the petition must also set forth to the extent
205.15known:
205.16(1) the name, address, and telephone number of any proposed conservator and the
205.17reason why the proposed conservator should be selected;
205.18(2) the name, address, and telephone number of any person nominated as conservator
205.19by the respondent if the respondent has attained 14 years of age; and
205.20(3) the type of conservatorship requested and, if an unlimited conservatorship,
205.21the reason why limited conservatorship is inappropriate or, if a limited conservatorship,
205.22the property to be placed under the conservator's control and any limitation on the
205.23conservator's powers and duties.
205.24(d) The petition must also set forth the following information regarding the proposed
205.25conservator or any employee of the conservator responsible for exercising powers and
205.26duties under the conservatorship:
205.27(1) whether the proposed conservator has ever been removed for cause from serving
205.28as a guardian or conservator and, if so, the case number and court location; and
205.29(2) if the proposed conservator is a professional guardian or conservator, a summary
205.30of the proposed conservator's educational background and relevant work and other
205.31experience.;
205.32(3) whether the proposed conservator has ever applied for or held, at any time, any
205.33professional license, and if so, the name of the licensing agency, and as applicable, the
205.34license number and status; whether the license is active or has been denied, conditioned,
205.35suspended, revoked, or canceled; and the basis for the denial, condition, suspension,
205.36revocation, or cancellation of the license;
206.1(4) whether the proposed conservator has ever been found civilly liable in an action
206.2that involved fraud, misrepresentation, material omission, misappropriation, theft, or
206.3conversion, and if so, the case number and court location;
206.4(5) whether the proposed conservator has ever filed for or received protection under
206.5the bankruptcy laws, and if so, the case number and court location;
206.6(6) whether the proposed conservator has any outstanding civil monetary judgments
206.7against the proposed conservator, and if so, the case number, court location, and
206.8outstanding amount owed;
206.9(7) whether an order for protection or harassment restraining order has ever been
206.10issued against the proposed conservator, and if so, the case number and court location; and
206.11(8) whether the proposed conservator has ever been convicted of a crime other than
206.12a petty misdemeanor or traffic offense, and if so, the case number and the crime of which
206.13the conservator was convicted.

206.14    Sec. 19. Minnesota Statutes 2012, section 524.5-420, is amended to read:
206.15524.5-420 REPORTS; APPOINTMENT OF VISITOR; MONITORING;
206.16COURT ORDERS.
206.17(a) A conservator shall report to the court for administration of the estate annually
206.18unless the court otherwise directs, upon resignation or removal, upon termination of the
206.19conservatorship, and at other times as the court directs. An order, after notice and hearing,
206.20allowing an intermediate report of a conservator adjudicates liabilities concerning the
206.21matters adequately disclosed in the accounting. An order, after notice and hearing, allowing
206.22a final report adjudicates all previously unsettled liabilities relating to the conservatorship.
206.23(b) A report must state or contain a listing of the assets of the estate under the
206.24conservator's control and a listing of the receipts, disbursements, and distributions during
206.25the reporting period.
206.26(c) The report must also state:
206.27(1) an address and telephone number where the conservator can be contacted;.
206.28(2) whether the conservator has ever been removed for cause from serving as a
206.29guardian or conservator and, if so, the case number and court locations; and
206.30(3) any changes occurring that would affect the accuracy of information contained in
206.31the most recent criminal background study of the conservator conducted under section
206.32524.5-118.
206.33(d) A conservator shall report to the court in writing within 30 days of the occurrence
206.34of any of the events listed in this paragraph. The conservator must report any of the
206.35occurrences in this paragraph and follow the same reporting requirements in this paragraph
207.1for any employee of the conservator responsible for exercising powers and duties under
207.2the conservatorship. A copy of the report must be provided to the protected person and to
207.3interested persons of record with the court. A conservator shall report when:
207.4(1) the conservator is removed for cause from serving as a guardian or conservator,
207.5and if so, the case number and court location;
207.6(2) the conservator has a professional license denied, conditioned, suspended,
207.7revoked, or canceled, and if so, the licensing agency and license number, and the basis for
207.8denial, condition, suspension, revocation, or cancellation of the license;
207.9(3) the conservator is found civilly liable in an action that involves fraud,
207.10misrepresentation, material omission, misappropriation, theft, or conversion, and if so, the
207.11case number and court location;
207.12(4) the conservator files for or receives protection under the bankruptcy laws, and
207.13if so, the case number and court location;
207.14(5) a civil monetary judgment is entered against the conservator, and if so, the case
207.15number, court location, and outstanding amount owed;
207.16(6) the conservator is convicted of a crime other than a petty misdemeanor or traffic
207.17offense, and if so, the case number and court location; or
207.18(7) an order for protection or harassment restraining order is issued against the
207.19conservator, and if so, the case number and court location.
207.20(d) (e) A protected person or an interested person of record with the court may
207.21submit to the court a written statement disputing account statements regarding the
207.22administration of the estate or addressing any disciplinary or legal action that are is
207.23 contained in the report reports and may petition the court for any order that is in the best
207.24interests of the protected person and the estate or for other appropriate relief.
207.25(e) (f) An interested person may notify the court in writing that the interested person
207.26does not wish to receive copies of reports required under this section.
207.27(f) (g) The court may appoint a visitor to review a report or plan, interview the
207.28protected person or conservator, and make any other investigation the court directs. In
207.29connection with a report, the court may order a conservator to submit the assets of the
207.30estate to an appropriate examination to be made in a manner the court directs.
207.31(g) (h) The court shall establish a system for monitoring of conservatorships,
207.32including the filing and review of conservators' reports and plans. If an annual report is
207.33not filed within 60 days of the required date, the court shall issue an order to show cause.
207.34(i) If a conservator fails to comply with this section, the court may decline to appoint
207.35that person as a guardian or conservator, or may remove a person as guardian or conservator.

208.1    Sec. 20. INSTRUCTIONS TO THE COMMISSIONER.
208.2    In collaboration with labor organizations, the commissioner of human services shall
208.3develop clear and consistent standards for state-operated services programs to:
208.4    (1) address direct service staffing shortages;
208.5    (2) identify and help resolve workplace safety issues; and
208.6    (3) elevate the use and visibility of performance measures and objectives related to
208.7overtime use.


208.10    Section 1. Minnesota Statutes 2012, section 245.03, subdivision 1, is amended to read:
208.11    Subdivision 1. Establishment. There is created a Department of Human Services.
208.12A commissioner of human services shall be appointed by the governor under the
208.13provisions of section 15.06. The commissioner shall be selected on the basis of ability and
208.14experience in welfare and without regard to political affiliations. The commissioner shall
208.15 may appoint a up to two deputy commissioner commissioners.

208.16    Sec. 2. Minnesota Statutes 2012, section 256.9657, subdivision 3, is amended to read:
208.17    Subd. 3. Surcharge on HMOs and community integrated service networks. (a)
208.18Effective October 1, 1992, each health maintenance organization with a certificate of
208.19authority issued by the commissioner of health under chapter 62D and each community
208.20integrated service network licensed by the commissioner under chapter 62N shall pay to
208.21the commissioner of human services a surcharge equal to six-tenths of one percent of the
208.22total premium revenues of the health maintenance organization or community integrated
208.23service network as reported to the commissioner of health according to the schedule in
208.24subdivision 4.
208.25(b) Effective July 1, 2013, to June 30, 2015, the surcharge under paragraph (a) is
208.26increased to 1.48 percent.
208.27(c) For purposes of this subdivision, total premium revenue means:
208.28(1) premium revenue recognized on a prepaid basis from individuals and groups
208.29for provision of a specified range of health services over a defined period of time which
208.30is normally one month, excluding premiums paid to a health maintenance organization
208.31or community integrated service network from the Federal Employees Health Benefit
208.32Program;
208.33(2) premiums from Medicare wraparound subscribers for health benefits which
208.34supplement Medicare coverage;
209.1(3) Medicare revenue, as a result of an arrangement between a health maintenance
209.2organization or a community integrated service network and the Centers for Medicare
209.3and Medicaid Services of the federal Department of Health and Human Services, for
209.4services to a Medicare beneficiary, excluding Medicare revenue that states are prohibited
209.5from taxing under sections 1854, 1860D-12, and 1876 of title XVIII of the federal Social
209.6Security Act, codified as United States Code, title 42, sections 1395mm, 1395w-112, and
209.71395w-24, respectively, as they may be amended from time to time; and
209.8(4) medical assistance revenue, as a result of an arrangement between a health
209.9maintenance organization or community integrated service network and a Medicaid state
209.10agency, for services to a medical assistance beneficiary.
209.11If advance payments are made under clause (1) or (2) to the health maintenance
209.12organization or community integrated service network for more than one reporting period,
209.13the portion of the payment that has not yet been earned must be treated as a liability.
209.14(c) (d) When a health maintenance organization or community integrated service
209.15network merges or consolidates with or is acquired by another health maintenance
209.16organization or community integrated service network, the surviving corporation or the
209.17new corporation shall be responsible for the annual surcharge originally imposed on
209.18each of the entities or corporations subject to the merger, consolidation, or acquisition,
209.19regardless of whether one of the entities or corporations does not retain a certificate of
209.20authority under chapter 62D or a license under chapter 62N.
209.21(d) (e) Effective July 1 of each year, the surviving corporation's or the new
209.22corporation's surcharge shall be based on the revenues earned in the second previous
209.23calendar year by all of the entities or corporations subject to the merger, consolidation,
209.24or acquisition regardless of whether one of the entities or corporations does not retain a
209.25certificate of authority under chapter 62D or a license under chapter 62N until the total
209.26premium revenues of the surviving corporation include the total premium revenues of all
209.27the merged entities as reported to the commissioner of health.
209.28(e) (f) When a health maintenance organization or community integrated service
209.29network, which is subject to liability for the surcharge under this chapter, transfers,
209.30assigns, sells, leases, or disposes of all or substantially all of its property or assets, liability
209.31for the surcharge imposed by this chapter is imposed on the transferee, assignee, or buyer
209.32of the health maintenance organization or community integrated service network.
209.33(f) (g) In the event a health maintenance organization or community integrated
209.34service network converts its licensure to a different type of entity subject to liability
209.35for the surcharge under this chapter, but survives in the same or substantially similar
209.36form, the surviving entity remains liable for the surcharge regardless of whether one of
210.1the entities or corporations does not retain a certificate of authority under chapter 62D
210.2or a license under chapter 62N.
210.3(g) (h) The surcharge assessed to a health maintenance organization or community
210.4integrated service network ends when the entity ceases providing services for premiums
210.5and the cessation is not connected with a merger, consolidation, acquisition, or conversion.

210.6    Sec. 3. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:
210.7    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
210.8assistance program must not be submitted until the recipient is discharged. However,
210.9the commissioner shall establish monthly interim payments for inpatient hospitals that
210.10have individual patient lengths of stay over 30 days regardless of diagnostic category.
210.11Except as provided in section 256.9693, medical assistance reimbursement for treatment
210.12of mental illness shall be reimbursed based on diagnostic classifications. Individual
210.13hospital payments established under this section and sections 256.9685, 256.9686, and
210.14256.9695 , in addition to third-party and recipient liability, for discharges occurring during
210.15the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
210.16inpatient services paid for the same period of time to the hospital. This payment limitation
210.17shall be calculated separately for medical assistance and general assistance medical
210.18care services. The limitation on general assistance medical care shall be effective for
210.19admissions occurring on or after July 1, 1991. Services that have rates established under
210.20subdivision 11 or 12, must be limited separately from other services. After consulting with
210.21the affected hospitals, the commissioner may consider related hospitals one entity and
210.22may merge the payment rates while maintaining separate provider numbers. The operating
210.23and property base rates per admission or per day shall be derived from the best Medicare
210.24and claims data available when rates are established. The commissioner shall determine
210.25the best Medicare and claims data, taking into consideration variables of recency of the
210.26data, audit disposition, settlement status, and the ability to set rates in a timely manner.
210.27The commissioner shall notify hospitals of payment rates by December 1 of the year
210.28preceding the rate year. The rate setting data must reflect the admissions data used to
210.29establish relative values. Base year changes from 1981 to the base year established for the
210.30rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
210.31to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
210.321. The commissioner may adjust base year cost, relative value, and case mix index data
210.33to exclude the costs of services that have been discontinued by the October 1 of the year
210.34preceding the rate year or that are paid separately from inpatient services. Inpatient stays
210.35that encompass portions of two or more rate years shall have payments established based
211.1on payment rates in effect at the time of admission unless the date of admission preceded
211.2the rate year in effect by six months or more. In this case, operating payment rates for
211.3services rendered during the rate year in effect and established based on the date of
211.4admission shall be adjusted to the rate year in effect by the hospital cost index.
211.5    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
211.6payment, before third-party liability and spenddown, made to hospitals for inpatient
211.7services is reduced by .5 percent from the current statutory rates.
211.8    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
211.9admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
211.10before third-party liability and spenddown, is reduced five percent from the current
211.11statutory rates. Mental health services within diagnosis related groups 424 to 432, and
211.12facilities defined under subdivision 16 are excluded from this paragraph.
211.13    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
211.14fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
211.15inpatient services before third-party liability and spenddown, is reduced 6.0 percent
211.16from the current statutory rates. Mental health services within diagnosis related groups
211.17424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
211.18Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
211.19assistance does not include general assistance medical care. Payments made to managed
211.20care plans shall be reduced for services provided on or after January 1, 2006, to reflect
211.21this reduction.
211.22    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
211.23fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
211.24to hospitals for inpatient services before third-party liability and spenddown, is reduced
211.253.46 percent from the current statutory rates. Mental health services with diagnosis related
211.26groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
211.27paragraph. Payments made to managed care plans shall be reduced for services provided
211.28on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
211.29    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
211.30fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made
211.31to hospitals for inpatient services before third-party liability and spenddown, is reduced
211.321.9 percent from the current statutory rates. Mental health services with diagnosis related
211.33groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
211.34paragraph. Payments made to managed care plans shall be reduced for services provided
211.35on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
212.1    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
212.2for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
212.3inpatient services before third-party liability and spenddown, is reduced 1.79 percent
212.4from the current statutory rates. Mental health services with diagnosis related groups
212.5424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
212.6Payments made to managed care plans shall be reduced for services provided on or after
212.7July 1, 2011, to reflect this reduction.
212.8(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
212.9payment for fee-for-service admissions occurring on or after July 1, 2009, made to
212.10hospitals for inpatient services before third-party liability and spenddown, is reduced
212.11one percent from the current statutory rates. Facilities defined under subdivision 16 are
212.12excluded from this paragraph. Payments made to managed care plans shall be reduced for
212.13services provided on or after October 1, 2009, to reflect this reduction.
212.14(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
212.15payment for fee-for-service admissions occurring on or after July 1, 2011, made to
212.16hospitals for inpatient services before third-party liability and spenddown, is reduced
212.171.96 percent from the current statutory rates. Facilities defined under subdivision 16 are
212.18excluded from this paragraph. Payments made to managed care plans shall be reduced for
212.19services provided on or after January 1, 2011, to reflect this reduction.
212.20(j) For admissions occurring on or after January 1, 2015, the rate for inpatient
212.21hospital services must be increased 1.4 percent from the rate in effect on December 31,
212.222014. Payments made to managed care plans and county-based purchasing plans shall
212.23not be adjusted to reflect payments under this paragraph.

212.24    Sec. 4. Minnesota Statutes 2012, section 256.969, subdivision 29, is amended to read:
212.25    Subd. 29. Reimbursement for the fee increase for the early hearing detection
212.26and intervention program. (a) For admissions occurring on or after July 1, 2010,
212.27payment rates shall be adjusted to include the increase to the fee that is effective on July 1,
212.282010, for the early hearing detection and intervention program recipients under section
212.29144.125, subdivision 1 , that is paid by the hospital for public program recipients. This
212.30payment increase shall be in effect until the increase is fully recognized in the base year
212.31cost under subdivision 2b. This payment shall be included in payments to contracted
212.32managed care organizations.
212.33    (b) For admissions occurring on or after July 1, 2013, payment rates shall be adjusted
212.34to include the increase to the fee that is effective July 1, 2013, for the early hearing detection
212.35and intervention program recipients under section 144.125, subdivision 1, that is paid by
213.1the hospital for public program recipients. This payment increase shall be in effect until
213.2the increase is fully recognized in the base-year cost under subdivision 2b. This payment
213.3shall be included in payments to managed care plans and county-based purchasing plans.

213.4    Sec. 5. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:
213.5    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
213.6inmate of a correctional facility who is conditionally released as authorized under section
213.7241.26 , 244.065, or 631.425, if the individual does not require the security of a public
213.8detention facility and is housed in a halfway house or community correction center, or
213.9under house arrest and monitored by electronic surveillance in a residence approved
213.10by the commissioner of corrections, and if the individual meets the other eligibility
213.11requirements of this chapter.
213.12    (b) An individual who is enrolled in medical assistance, and who is charged with a
213.13crime and incarcerated for less than 12 months shall be suspended from eligibility at the
213.14time of incarceration until the individual is released. Upon release, medical assistance
213.15eligibility is reinstated without reapplication using a reinstatement process and form, if the
213.16individual is otherwise eligible.
213.17    (c) An individual, regardless of age, who is considered an inmate of a public
213.18institution as defined in Code of Federal Regulations, title 42, section 435.1010, and
213.19who meets the eligibility requirements in section 256B.056, is not eligible for medical
213.20assistance, except for covered services received while an inpatient in a medical institution
213.21as defined in Code of Federal Regulations, title 42, section 435.1010. Security issues,
213.22including costs, related to the inpatient treatment of an inmate are the responsibility of the
213.23entity with jurisdiction over the inmate.
213.24EFFECTIVE DATE.This section is effective January 1, 2014.

213.25    Sec. 6. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
213.26    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
213.27to citizens of the United States, qualified noncitizens as defined in this subdivision, and
213.28other persons residing lawfully in the United States. Citizens or nationals of the United
213.29States must cooperate in obtaining satisfactory documentary evidence of citizenship or
213.30nationality according to the requirements of the federal Deficit Reduction Act of 2005,
213.31Public Law 109-171.
213.32(b) "Qualified noncitizen" means a person who meets one of the following
213.33immigration criteria:
213.34(1) admitted for lawful permanent residence according to United States Code, title 8;
214.1(2) admitted to the United States as a refugee according to United States Code,
214.2title 8, section 1157;
214.3(3) granted asylum according to United States Code, title 8, section 1158;
214.4(4) granted withholding of deportation according to United States Code, title 8,
214.5section 1253(h);
214.6(5) paroled for a period of at least one year according to United States Code, title 8,
214.7section 1182(d)(5);
214.8(6) granted conditional entrant status according to United States Code, title 8,
214.9section 1153(a)(7);
214.10(7) determined to be a battered noncitizen by the United States Attorney General
214.11according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
214.12title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
214.13(8) is a child of a noncitizen determined to be a battered noncitizen by the United
214.14States Attorney General according to the Illegal Immigration Reform and Immigrant
214.15Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
214.16Public Law 104-200; or
214.17(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
214.18Law 96-422, the Refugee Education Assistance Act of 1980.
214.19(c) All qualified noncitizens who were residing in the United States before August
214.2022, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
214.21medical assistance with federal financial participation.
214.22(d) Beginning December 1, 1996, qualified noncitizens who entered the United
214.23States on or after August 22, 1996, and who otherwise meet the eligibility requirements
214.24of this chapter are eligible for medical assistance with federal participation for five years
214.25if they meet one of the following criteria:
214.26(1) refugees admitted to the United States according to United States Code, title 8,
214.27section 1157;
214.28(2) persons granted asylum according to United States Code, title 8, section 1158;
214.29(3) persons granted withholding of deportation according to United States Code,
214.30title 8, section 1253(h);
214.31(4) veterans of the United States armed forces with an honorable discharge for
214.32a reason other than noncitizen status, their spouses and unmarried minor dependent
214.33children; or
214.34(5) persons on active duty in the United States armed forces, other than for training,
214.35their spouses and unmarried minor dependent children.
215.1 Beginning July 1, 2010, children and pregnant women who are noncitizens
215.2described in paragraph (b) or who are lawfully present in the United States as defined
215.3in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
215.4eligibility requirements of this chapter, are eligible for medical assistance with federal
215.5financial participation as provided by the federal Children's Health Insurance Program
215.6Reauthorization Act of 2009, Public Law 111-3.
215.7(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
215.8are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
215.9subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
215.10Code, title 8, section 1101(a)(15).
215.11(f) Payment shall also be made for care and services that are furnished to noncitizens,
215.12regardless of immigration status, who otherwise meet the eligibility requirements of
215.13this chapter, if such care and services are necessary for the treatment of an emergency
215.14medical condition.
215.15(g) For purposes of this subdivision, the term "emergency medical condition" means
215.16a medical condition that meets the requirements of United States Code, title 42, section
215.171396b(v).
215.18(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
215.19of an emergency medical condition are limited to the following:
215.20(i) services delivered in an emergency room or by an ambulance service licensed
215.21under chapter 144E that are directly related to the treatment of an emergency medical
215.22condition;
215.23(ii) services delivered in an inpatient hospital setting following admission from an
215.24emergency room or clinic for an acute emergency condition; and
215.25(iii) follow-up services that are directly related to the original service provided
215.26to treat the emergency medical condition and are covered by the global payment made
215.27to the provider.
215.28    (2) Services for the treatment of emergency medical conditions do not include:
215.29(i) services delivered in an emergency room or inpatient setting to treat a
215.30nonemergency condition;
215.31(ii) organ transplants, stem cell transplants, and related care;
215.32(iii) services for routine prenatal care;
215.33(iv) continuing care, including long-term care, nursing facility services, home health
215.34care, adult day care, day training, or supportive living services;
215.35(v) elective surgery;
216.1(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
216.2part of an emergency room visit;
216.3(vii) preventative health care and family planning services;
216.4(viii) dialysis;
216.5(ix) chemotherapy or therapeutic radiation services;
216.6(x) (viii) rehabilitation services;
216.7(xi) (ix) physical, occupational, or speech therapy;
216.8(xii) (x) transportation services;
216.9(xiii) (xi) case management;
216.10(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
216.11(xv) (xiii) dental services;
216.12(xvi) (xiv) hospice care;
216.13(xvii) (xv) audiology services and hearing aids;
216.14(xviii) (xvi) podiatry services;
216.15(xix) (xvii) chiropractic services;
216.16(xx) (xviii) immunizations;
216.17(xxi) (xix) vision services and eyeglasses;
216.18(xxii) (xx) waiver services;
216.19(xxiii) (xxi) individualized education programs; or
216.20(xxiv) (xxii) chemical dependency treatment.
216.21(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
216.22nonimmigrants, or lawfully present in the United States as defined in Code of Federal
216.23Regulations, title 8, section 103.12, are not covered by a group health plan or health
216.24insurance coverage according to Code of Federal Regulations, title 42, section 457.310,
216.25and who otherwise meet the eligibility requirements of this chapter, are eligible for
216.26medical assistance through the period of pregnancy, including labor and delivery, and 60
216.27days postpartum, to the extent federal funds are available under title XXI of the Social
216.28Security Act, and the state children's health insurance program.
216.29(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
216.30services from a nonprofit center established to serve victims of torture and are otherwise
216.31ineligible for medical assistance under this chapter are eligible for medical assistance
216.32without federal financial participation. These individuals are eligible only for the period
216.33during which they are receiving services from the center. Individuals eligible under this
216.34paragraph shall not be required to participate in prepaid medical assistance.
217.1(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
217.2emergency medical conditions under paragraph (f) except where coverage is prohibited
217.3under federal law:
217.4(1) dialysis services provided in a hospital or freestanding dialysis facility; and
217.5(2) surgery and the administration of chemotherapy, radiation, and related services
217.6necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission
217.7and requires surgery, chemotherapy, or radiation treatment.
217.8    (l) The commissioner or its third party medical review agent may authorize payment
217.9for follow-up care and alternative services, including, but not limited to, long-term care
217.10services that would not otherwise be paid for under this subdivision if the commissioner
217.11determines that the services, if provided, will directly prevent a medical emergency from
217.12immediately occurring.

217.13    Sec. 7. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
217.14subdivision to read:
217.15    Subd. 28b. Doula services. Medical assistance covers doula services provided by a
217.16certified doula as defined in section 148.995, subdivision 2, of the mother's choice. For
217.17purposes of this section, "doula services" means childbirth education and support services,
217.18including emotional and physical support provided during pregnancy, labor, birth, and
217.19postpartum.
217.20EFFECTIVE DATE.This section is effective July 1, 2014, or upon federal
217.21approval, whichever is later, and applies to services provided on or after the effective date.

217.22    Sec. 8. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to read:
217.23    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
217.24supplies and equipment. Separate payment outside of the facility's payment rate shall
217.25be made for wheelchairs and wheelchair accessories for recipients who are residents
217.26of intermediate care facilities for the developmentally disabled. Reimbursement for
217.27wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
217.28conditions and limitations as coverage for recipients who do not reside in institutions. A
217.29wheelchair purchased outside of the facility's payment rate is the property of the recipient.
217.30The commissioner may set reimbursement rates for specified categories of medical
217.31supplies at levels below the Medicare payment rate.
217.32(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
217.33must enroll as a Medicare provider.
218.1(c) When necessary to ensure access to durable medical equipment, prosthetics,
218.2orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
218.3enrollment requirement if:
218.4(1) the vendor supplies only one type of durable medical equipment, prosthetic,
218.5orthotic, or medical supply;
218.6(2) the vendor serves ten or fewer medical assistance recipients per year;
218.7(3) the commissioner finds that other vendors are not available to provide same or
218.8similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
218.9(4) the vendor complies with all screening requirements in this chapter and Code of
218.10Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
218.11the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
218.12and Medicaid Services approved national accreditation organization as complying with
218.13the Medicare program's supplier and quality standards and the vendor serves primarily
218.14pediatric patients.
218.15(d) Durable medical equipment means a device or equipment that:
218.16(1) can withstand repeated use;
218.17(2) is generally not useful in the absence of an illness, injury, or disability; and
218.18(3) is provided to correct or accommodate a physiological disorder or physical
218.19condition or is generally used primarily for a medical purpose.
218.20(e) Electronic tablets may be considered durable medical equipment if the electronic
218.21tablet will be used as an augmentative and alternative communication system as defined
218.22under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
218.23must be locked in order to prevent use not related to communication.

218.24    Sec. 9. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
218.25subdivision to read:
218.26    Subd. 31b. Preferred diabetic testing supply program. (a) The commissioner
218.27shall implement a point-of-sale preferred diabetic testing supply program by January 1,
218.282014. Medical assistance coverage for diabetic testing supplies shall conform to the
218.29limitations established under the program. The commissioner may enter into a contract
218.30with a vendor for the purpose of participating in a preferred diabetic testing supply list and
218.31supplemental rebate program. The commissioner shall ensure that any contract meets all
218.32federal requirements and maximizes federal financial participation. The commissioner
218.33shall maintain an accurate and up-to-date list on the department's Web site.
218.34(b) The commissioner may add to, delete from, and otherwise modify the preferred
218.35diabetic testing supply program drug list after consulting with the Drug Formulary
219.1Committee and appropriate medial specialists and providing public notice and the
219.2opportunity for public comment.
219.3(c) The commissioner shall adopt and administer the preferred diabetic testing
219.4supply program as part of the administration of the diabetic testing supply rebate program.
219.5Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply
219.6list may be subject to prior authorization.
219.7(d) All claims for diabetic testing supplies in categories on the preferred diabetic
219.8testing supply list must be submitted by enrolled pharmacy providers using the most
219.9current National Council of Prescription Drug Providers electronic claims standard.
219.10(e) For purposes of this subdivision, "preferred diabetic testing supply list" means a
219.11list of diabetic testing supplies selected by the commissioner, for which prior authorization
219.12is not required.
219.13(f) The commissioner shall seek any federal waivers or approvals necessary to
219.14implement this subdivision.

219.15    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to
219.16read:
219.17    Subd. 39. Childhood immunizations. Providers who administer pediatric vaccines
219.18within the scope of their licensure, and who are enrolled as a medical assistance provider,
219.19must enroll in the pediatric vaccine administration program established by section 13631
219.20of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an
219.21$8.50 fee per dose for administration of the vaccine to children eligible for medical
219.22assistance. Medical assistance does not pay for vaccines that are available at no cost from
219.23the pediatric vaccine administration program.

219.24    Sec. 11. Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to
219.25read:
219.26    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
219.27Medical assistance covers early and periodic screening, diagnosis, and treatment services
219.28(EPSDT). The payment amount for a complete EPSDT screening shall not include charges
219.29for vaccines that are available at no cost to the provider and shall not exceed the rate
219.30established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

219.31    Sec. 12. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
219.32subdivision to read:
220.1    Subd. 61. Payment for multiple services provided on the same day. The
220.2commissioner shall not prohibit payment, including supplemental payments, for mental
220.3health services or dental services provided to a patient by a clinic or health care
220.4professional solely because the mental health or dental services were provided on the same
220.5day as other covered health services furnished by the same provider.

220.6    Sec. 13. Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:
220.7    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
220.8assistance benefit plan shall include the following cost-sharing for all recipients, effective
220.9for services provided on or after September 1, 2011:
220.10    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
220.11of this subdivision, a visit means an episode of service which is required because of
220.12a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
220.13ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
220.14midwife, advanced practice nurse, audiologist, optician, or optometrist;
220.15    (2) $3.50 for nonemergency visits to a hospital-based emergency room, except that
220.16this co-payment shall be increased to $20 upon federal approval;
220.17    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
220.18subject to a $12 per month maximum for prescription drug co-payments. No co-payments
220.19shall apply to antipsychotic drugs when used for the treatment of mental illness;
220.20(4) effective January 1, 2012, a family deductible equal to the maximum amount
220.21allowed under Code of Federal Regulations, title 42, part 447.54; and
220.22    (5) for individuals identified by the commissioner with income at or below 100
220.23percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
220.24percent of family income. For purposes of this paragraph, family income is the total
220.25earned and unearned income of the individual and the individual's spouse, if the spouse is
220.26enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
220.27    (b) Recipients of medical assistance are responsible for all co-payments and
220.28deductibles in this subdivision.
220.29(c) Notwithstanding paragraph (b), the commissioner, through the contracting
220.30process under sections 256B.69 and 256B.692, may allow managed care plans and
220.31county-based purchasing plans to waive the family deductible under paragraph (a),
220.32clause (4). The value of the family deductible shall not be included in the capitation
220.33payment to managed care plans and county-based purchasing plans. Managed care plans
220.34and county-based purchasing plans shall certify annually to the commissioner the dollar
220.35value of the family deductible.
221.1(d) Notwithstanding paragraph (b), the commissioner may shall waive the collection
221.2of the family deductible described under paragraph (a), clause (4), from individuals and
221.3allow long-term care and waivered service providers to assume responsibility for payment.
221.4(e) Notwithstanding paragraph (b), the commissioner, through the contracting
221.5process under section 256B.0756 shall allow the pilot program in Hennepin County to
221.6waive co-payments. The value of the co-payments shall not be included as part of the
221.7payment system for the integrated health care delivery networks under the pilot program.

221.8    Sec. 14. Minnesota Statutes 2012, section 256B.0756, is amended to read:
221.9256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.
221.10(a) The commissioner, upon federal approval of a new waiver request or amendment
221.11of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey
221.12County, or both, to test alternative and innovative integrated health care delivery networks.
221.13(b) Individuals eligible for the pilot program shall be individuals who are eligible for
221.14medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin
221.15County or Ramsey County. The commissioner may identify individuals to be enrolled
221.16in the Hennepin County pilot program by zip code or by whether the individuals would
221.17benefit from an integrated health care delivery network.
221.18(c) Individuals enrolled in the pilot program shall be enrolled in an integrated
221.19health care delivery network in their county of residence. The integrated health care
221.20delivery network in Hennepin County shall be a network, such as an accountable care
221.21organization or a community-based collaborative care network, created by or including
221.22Hennepin County Medical Center. The integrated health care delivery network in Ramsey
221.23County shall be a network, such as an accountable care organization or community-based
221.24collaborative care network, created by or including Regions Hospital.
221.25(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for
221.26Hennepin County and 3,500 enrollees for Ramsey County.
221.27(e) (d) In developing a payment system for the pilot programs, the commissioner
221.28shall establish a total cost of care for the recipients enrolled in the pilot programs that
221.29equals the cost of care that would otherwise be spent for these enrollees in the prepaid
221.30medical assistance program.
221.31(f) Counties may transfer funds necessary to support the nonfederal share of
221.32payments for integrated health care delivery networks in their county. Such transfers per
221.33county shall not exceed 15 percent of the expected expenses for county enrollees.
221.34(g) (e) The commissioner shall apply to the federal government for, or as appropriate,
221.35cooperate with counties, providers, or other entities that are applying for any applicable
222.1grant or demonstration under the Patient Protection and Affordable Health Care Act, Public
222.2Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law
222.3111-152, that would further the purposes of or assist in the creation of an integrated health
222.4care delivery network for the purposes of this subdivision, including, but not limited to, a
222.5global payment demonstration or the community-based collaborative care network grants.

222.6    Sec. 15. Minnesota Statutes 2012, section 256B.196, subdivision 2, is amended to read:
222.7    Subd. 2. Commissioner's duties. (a) For the purposes of this subdivision and
222.8subdivision 3, the commissioner shall determine the fee-for-service outpatient hospital
222.9services upper payment limit for nonstate government hospitals. The commissioner shall
222.10then determine the amount of a supplemental payment to Hennepin County Medical
222.11Center and Regions Hospital for these services that would increase medical assistance
222.12spending in this category to the aggregate upper payment limit for all nonstate government
222.13hospitals in Minnesota. In making this determination, the commissioner shall allot the
222.14available increases between Hennepin County Medical Center and Regions Hospital
222.15based on the ratio of medical assistance fee-for-service outpatient hospital payments to
222.16the two facilities. The commissioner shall adjust this allotment as necessary based on
222.17federal approvals, the amount of intergovernmental transfers received from Hennepin and
222.18Ramsey Counties, and other factors, in order to maximize the additional total payments.
222.19The commissioner shall inform Hennepin County and Ramsey County of the periodic
222.20intergovernmental transfers necessary to match federal Medicaid payments available
222.21under this subdivision in order to make supplementary medical assistance payments to
222.22Hennepin County Medical Center and Regions Hospital equal to an amount that when
222.23combined with existing medical assistance payments to nonstate governmental hospitals
222.24would increase total payments to hospitals in this category for outpatient services to
222.25the aggregate upper payment limit for all hospitals in this category in Minnesota. Upon
222.26receipt of these periodic transfers, the commissioner shall make supplementary payments
222.27to Hennepin County Medical Center and Regions Hospital.
222.28    (b) For the purposes of this subdivision and subdivision 3, the commissioner shall
222.29determine an upper payment limit for physicians and other billing professionals affiliated
222.30with Hennepin County Medical Center and with Regions Hospital. The upper payment
222.31limit shall be based on the average commercial rate or be determined using another method
222.32acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
222.33inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
222.34necessary to match the federal Medicaid payments available under this subdivision in order
222.35to make supplementary payments to physicians and other billing professionals affiliated
223.1with Hennepin County Medical Center and to make supplementary payments to physicians
223.2and other billing professionals affiliated with Regions Hospital through HealthPartners
223.3Medical Group equal to the difference between the established medical assistance
223.4payment for physician and other billing professional services and the upper payment limit.
223.5Upon receipt of these periodic transfers, the commissioner shall make supplementary
223.6payments to physicians and other billing professionals affiliated with Hennepin County
223.7Medical Center and shall make supplementary payments to physicians and other billing
223.8professionals affiliated with Regions Hospital through HealthPartners Medical Group.
223.9    (c) Beginning January 1, 2010, Hennepin County and Ramsey County may make
223.10monthly voluntary intergovernmental transfers to the commissioner in amounts not to
223.11exceed $12,000,000 per year from Hennepin County and $6,000,000 per year from
223.12Ramsey County. The commissioner shall increase the medical assistance capitation
223.13payments to any licensed health plan under contract with the medical assistance program
223.14that agrees to make enhanced payments to Hennepin County Medical Center or Regions
223.15Hospital. The increase shall be in an amount equal to the annual value of the monthly
223.16transfers plus federal financial participation, with each health plan receiving its pro rata
223.17share of the increase based on the pro rata share of medical assistance admissions to
223.18Hennepin County Medical Center and Regions Hospital by those plans. Upon the request
223.19of the commissioner, health plans shall submit individual-level cost data for verification
223.20purposes. The commissioner may ratably reduce these payments on a pro rata basis in
223.21order to satisfy federal requirements for actuarial soundness. If payments are reduced,
223.22transfers shall be reduced accordingly. Any licensed health plan that receives increased
223.23medical assistance capitation payments under the intergovernmental transfer described in
223.24this paragraph shall increase its medical assistance payments to Hennepin County Medical
223.25Center and Regions Hospital by the same amount as the increased payments received in
223.26the capitation payment described in this paragraph.
223.27    (d) For the purposes of this subdivision and subdivision 3, the commissioner shall
223.28determine an upper payment limit for ambulance services affiliated with Hennepin County
223.29Medical Center. The upper payment limit shall be based on the average commercial
223.30rate or be determined using another method acceptable to the Centers for Medicare and
223.31Medicaid Services. The commissioner shall inform Hennepin County of the periodic
223.32intergovernmental transfers necessary to match the federal Medicaid payments available
223.33under this subdivision in order to make supplementary payments to Hennepin County
223.34Medical Center equal to the difference between the established medical assistance
223.35payment for ambulance services and the upper payment limit. Upon receipt of these
224.1periodic transfers, the commissioner shall make supplementary payments to Hennepin
224.2County Medical Center.
224.3    (e) The commissioner shall inform the transferring governmental entities on an
224.4ongoing basis of the need for any changes needed in the intergovernmental transfers in
224.5order to continue the payments under paragraphs (a) to (c) (d), at their maximum level,
224.6including increases in upper payment limits, changes in the federal Medicaid match, and
224.7other factors.
224.8    (e) (f) The payments in paragraphs (a) to (c) (d) shall be implemented independently
224.9of each other, subject to federal approval and to the receipt of transfers under subdivision 3.

224.10    Sec. 16. Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:
224.11    Subd. 5c. Medical education and research fund. (a) The commissioner of human
224.12services shall transfer each year to the medical education and research fund established
224.13under section 62J.692, an amount specified in this subdivision. The commissioner shall
224.14calculate the following:
224.15(1) an amount equal to the reduction in the prepaid medical assistance payments as
224.16specified in this clause. Until January 1, 2002, the county medical assistance capitation
224.17base rate prior to plan specific adjustments and after the regional rate adjustments under
224.18subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
224.19metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
224.20January 1, 2002, the county medical assistance capitation base rate prior to plan specific
224.21adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
224.22metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
224.23facility and elderly waiver payments and demonstration project payments operating
224.24under subdivision 23 are excluded from this reduction. The amount calculated under
224.25this clause shall not be adjusted for periods already paid due to subsequent changes to
224.26the capitation payments;
224.27(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
224.28section;
224.29(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
224.30paid under this section; and
224.31(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
224.32under this section.
224.33(b) This subdivision shall be effective upon approval of a federal waiver which
224.34allows federal financial participation in the medical education and research fund. The
224.35amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount
225.1transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under
225.2paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally
225.3reduce the amount specified under paragraph (a), clause (1).
225.4(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner
225.5shall transfer $21,714,000 each fiscal year to the medical education and research fund.
225.6(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
225.7transfer under paragraph (c), the commissioner shall transfer to the medical education
225.8research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 $43,148,000 in
225.9fiscal year 2014 and thereafter.

225.10    Sec. 17. Minnesota Statutes 2012, section 256B.69, subdivision 31, is amended to read:
225.11    Subd. 31. Payment reduction. (a) Beginning September 1, 2011, the commissioner
225.12shall reduce payments and limit future rate increases paid to managed care plans and
225.13county-based purchasing plans. The limits in paragraphs (a) to (f) shall be achieved
225.14on a statewide aggregate basis by program. The commissioner may use competitive
225.15bidding, payment reductions, or other reductions to achieve the reductions and limits
225.16in this subdivision.
225.17(b) Beginning September 1, 2011, the commissioner shall reduce payments to
225.18managed care plans and county-based purchasing plans as follows:
225.19(1) 2.0 percent for medical assistance elderly basic care. This shall not apply
225.20to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
225.21services;
225.22(2) 2.82 percent for medical assistance families and children;
225.23(3) 10.1 percent for medical assistance adults without children; and
225.24(4) 6.0 percent for MinnesotaCare families and children.
225.25(c) Beginning January 1, 2012, the commissioner shall limit rates paid to managed
225.26care plans and county-based purchasing plans for calendar year 2012 to a percentage of
225.27the rates in effect on August 31, 2011, as follows:
225.28(1) 98 percent for medical assistance elderly basic care. This shall not apply to
225.29Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
225.30services;
225.31(2) 97.18 percent for medical assistance families and children;
225.32(3) 89.9 percent for medical assistance adults without children; and
225.33(4) 94 percent for MinnesotaCare families and children.
226.1(d) Beginning January 1, 2013, to December 31, 2013, the commissioner shall limit
226.2the maximum annual trend increases to rates paid to managed care plans and county-based
226.3purchasing plans as follows:
226.4(1) 7.5 percent for medical assistance elderly basic care. This shall not apply
226.5to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
226.6services;
226.7(2) 5.0 percent for medical assistance special needs basic care;
226.8(3) 2.0 percent for medical assistance families and children;
226.9(4) 3.0 percent for medical assistance adults without children;
226.10(5) 3.0 percent for MinnesotaCare families and children; and
226.11(6) 3.0 percent for MinnesotaCare adults without children.
226.12(e) The commissioner may limit trend increases to less than the maximum.
226.13Beginning July January 1, 2014, the commissioner shall limit the maximum annual trend
226.14increases to rates paid to managed care plans and county-based purchasing plans as
226.15follows for calendar years 2014 and, 2015, 2016, and 2017:
226.16(1) 7.5 6.0 percent for medical assistance elderly basic care. This shall not apply
226.17to Medicare cost-sharing, nursing facility, personal care assistance, and elderly waiver
226.18services;
226.19(2) 5.0 0.5 percent for medical assistance special needs basic care;
226.20(3) 2.0 0.5 percent for medical assistance families and children;
226.21(4) 3.0 0 percent for medical assistance adults without children;
226.22(5) 3.0 percent for MinnesotaCare families and children; and
226.23(6) 4.0 percent for MinnesotaCare adults without children.
226.24The commissioner may limit trend increases to less than the maximum.

226.25    Sec. 18. Minnesota Statutes 2012, section 256B.69, is amended by adding a
226.26subdivision to read:
226.27    Subd. 34. Risk corridors. (a) Effective for services rendered on or after January 1,
226.282014, the commissioner shall establish risk corridors that are actuarially sound for each
226.29managed care plan and each county-based purchasing plan providing services under this
226.30section and section 256B.692. The risk corridors shall be calculated annually based on the
226.31calendar year's net underwriting gain or loss. If the managed care plan or county-based
226.32purchasing plan achieved a net underwriting gain of greater than three percent of
226.33revenue, any excess must be repaid to the commissioner by July 31 of the year following
226.34calculation of the risk corridor year. If the managed care plan or county-based purchasing
226.35plan has incurred a net underwriting loss greater than three percent of total revenue, any
227.1excess must be repaid to the managed care plan or county-based purchasing plan by
227.2the commissioner by July 31 of the year following calculation of the risk corridor year.
227.3Determination of total revenues and net underwriting gain or loss must be based on the
227.4Minnesota supplement report #1 that is filed on April 1 of the year following calculation
227.5of the risk corridor and adjusted for the actual withhold calculation under subdivision 5a
227.6and section 256L.12, subdivision 9. The report must be filed with the commissioner of
227.7health and must be made available on the Department of Health's Web site.
227.8(b) This subdivision shall not apply to the special demonstration projects under
227.9subdivisions 23 and 28.

227.10    Sec. 19. Minnesota Statutes 2012, section 256B.76, subdivision 1, is amended to read:
227.11    Subdivision 1. Physician reimbursement. (a) Effective for services rendered on
227.12or after October 1, 1992, the commissioner shall make payments for physician services
227.13as follows:
227.14    (1) payment for level one Centers for Medicare and Medicaid Services' common
227.15procedural coding system codes titled "office and other outpatient services," "preventive
227.16medicine new and established patient," "delivery, antepartum, and postpartum care,"
227.17"critical care," cesarean delivery and pharmacologic management provided to psychiatric
227.18patients, and level three codes for enhanced services for prenatal high risk, shall be paid
227.19at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
227.2030, 1992. If the rate on any procedure code within these categories is different than the
227.21rate that would have been paid under the methodology in section 256B.74, subdivision 2,
227.22then the larger rate shall be paid;
227.23    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
227.24or (ii) 15.4 percent above the rate in effect on June 30, 1992; and
227.25    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
227.26percentile of 1989, less the percent in aggregate necessary to equal the above increases
227.27except that payment rates for home health agency services shall be the rates in effect
227.28on September 30, 1992.
227.29    (b) Effective for services rendered on or after January 1, 2000, payment rates for
227.30physician and professional services shall be increased by three percent over the rates
227.31in effect on December 31, 1999, except for home health agency and family planning
227.32agency services. The increases in this paragraph shall be implemented January 1, 2000,
227.33for managed care.
227.34(c) Effective for services rendered on or after July 1, 2009, payment rates for
227.35physician and professional services shall be reduced by five percent, except that for the
228.1period July 1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent
228.2for the medical assistance and general assistance medical care programs, over the rates in
228.3effect on June 30, 2009. This reduction and the reductions in paragraph (d) do not apply
228.4to office or other outpatient visits, preventive medicine visits and family planning visits
228.5billed by physicians, advanced practice nurses, or physician assistants in a family planning
228.6agency or in one of the following primary care practices: general practice, general internal
228.7medicine, general pediatrics, general geriatrics, and family medicine. This reduction
228.8and the reductions in paragraph (d) do not apply to federally qualified health centers,
228.9rural health centers, and Indian health services. Effective October 1, 2009, payments
228.10made to managed care plans and county-based purchasing plans under sections 256B.69,
228.11256B.692 , and 256L.12 shall reflect the payment reduction described in this paragraph.
228.12(d) Effective for services rendered on or after July 1, 2010, payment rates for
228.13physician and professional services shall be reduced an additional seven percent over
228.14the five percent reduction in rates described in paragraph (c). This additional reduction
228.15does not apply to physical therapy services, occupational therapy services, and speech
228.16pathology and related services provided on or after July 1, 2010. This additional reduction
228.17does not apply to physician services billed by a psychiatrist or an advanced practice nurse
228.18with a specialty in mental health. Effective October 1, 2010, payments made to managed
228.19care plans and county-based purchasing plans under sections 256B.69, 256B.692, and
228.20256L.12 shall reflect the payment reduction described in this paragraph.
228.21(e) Effective for services rendered on or after September 1, 2011, through June 30,
228.222013, payment rates for physician and professional services shall be reduced three percent
228.23from the rates in effect on August 31, 2011. This reduction does not apply to physical
228.24therapy services, occupational therapy services, and speech pathology and related services.
228.25(f) Effective for services rendered on or after January 1, 2015, payment rates for
228.26physician and professional services, including physical therapy, occupational therapy,
228.27speech pathology, and mental health services shall be increased by five percent from
228.28the rates in effect on December 31, 2014. This increase does not apply to federally
228.29qualified health centers, rural health centers, and Indian health services. Payments made to
228.30managed care plans and county-based purchasing plans shall not be adjusted to reflect
228.31payments under this paragraph.

228.32    Sec. 20. Minnesota Statutes 2012, section 256B.76, subdivision 2, is amended to read:
228.33    Subd. 2. Dental reimbursement. (a) Effective for services rendered on or after
228.34October 1, 1992, the commissioner shall make payments for dental services as follows:
229.1    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
229.2percent above the rate in effect on June 30, 1992; and
229.3    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
229.4percentile of 1989, less the percent in aggregate necessary to equal the above increases.
229.5    (b) Beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
229.6shall be the lower of (1) submitted charge, or (2) 80 percent of median 1997 charges.
229.7    (c) Effective for services rendered on or after January 1, 2000, payment rates for
229.8dental services shall be increased by three percent over the rates in effect on December
229.931, 1999.
229.10    (d) Effective for services provided on or after January 1, 2002, payment for
229.11diagnostic examinations and dental x-rays provided to children under age 21 shall be the
229.12lower of (1) the submitted charge, or (2) 85 percent of median 1999 charges.
229.13    (e) The increases listed in paragraphs (b) and (c) shall be implemented January 1,
229.142000, for managed care.
229.15(f) Effective for dental services rendered on or after October 1, 2010, by a
229.16state-operated dental clinic, payment shall be paid on a reasonable cost basis that is based
229.17on the Medicare principles of reimbursement. This payment shall be effective for services
229.18rendered on or after January 1, 2011, to recipients enrolled in managed care plans or
229.19county-based purchasing plans.
229.20(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics
229.21in paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal
229.22year, a supplemental state payment equal to the difference between the total payments
229.23in paragraph (f) and $1,850,000 shall be paid from the general fund to state-operated
229.24services for the operation of the dental clinics.
229.25(h) If the cost-based payment system for state-operated dental clinics described in
229.26paragraph (f) does not receive federal approval, then state-operated dental clinics shall be
229.27designated as critical access dental providers under subdivision 4, paragraph (b), and shall
229.28receive the critical access dental reimbursement rate as described under subdivision 4,
229.29paragraph (a).
229.30(i) Effective for services rendered on or after September 1, 2011, through June 30,
229.312013, payment rates for dental services shall be reduced by three percent. This reduction
229.32does not apply to state-operated dental clinics in paragraph (f).
229.33(j) Effective for services rendered on or after January 1, 2015, payment rates for
229.34dental services shall be increased by five percent from the rates in effect on December
229.3531, 2014. This increase does not apply to state-operated dental clinics in paragraph
229.36(f), federally qualified health centers, rural health centers, and Indian health services.
230.1Effective January 1, 2015, payments made to managed care plans and county-based
230.2purchasing plans under sections 256B.69, 256B.692, and chapter 256L shall reflect the
230.3payment increase described in this paragraph.

230.4    Sec. 21. Minnesota Statutes 2012, section 256B.76, subdivision 4, is amended to read:
230.5    Subd. 4. Critical access dental providers. (a) Effective for dental services rendered
230.6on or after January 1, 2002, the commissioner shall increase reimbursements to dentists
230.7and dental clinics deemed by the commissioner to be critical access dental providers.
230.8For dental services rendered on or after July 1, 2007, the commissioner shall increase
230.9reimbursement by 30 35 percent above the reimbursement rate that would otherwise be
230.10paid to the critical access dental provider. The commissioner shall pay the managed
230.11care plans and county-based purchasing plans in amounts sufficient to reflect increased
230.12reimbursements to critical access dental providers as approved by the commissioner.
230.13(b) The commissioner shall designate the following dentists and dental clinics as
230.14critical access dental providers:
230.15    (1) nonprofit community clinics that:
230.16(i) have nonprofit status in accordance with chapter 317A;
230.17(ii) have tax exempt status in accordance with the Internal Revenue Code, section
230.18501(c)(3);
230.19(iii) are established to provide oral health services to patients who are low income,
230.20uninsured, have special needs, and are underserved;
230.21(iv) have professional staff familiar with the cultural background of the clinic's
230.22patients;
230.23(v) charge for services on a sliding fee scale designed to provide assistance to
230.24low-income patients based on current poverty income guidelines and family size;
230.25(vi) do not restrict access or services because of a patient's financial limitations
230.26or public assistance status; and
230.27(vii) have free care available as needed;
230.28    (2) federally qualified health centers, rural health clinics, and public health clinics;
230.29    (3) city or county owned and operated hospital-based dental clinics;
230.30(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
230.31accordance with chapter 317A with more than 10,000 patient encounters per year with
230.32patients who are uninsured or covered by medical assistance, general assistance medical
230.33care, or MinnesotaCare; and
230.34(5) a dental clinic owned and operated by the University of Minnesota or the
230.35Minnesota State Colleges and Universities system.; and
231.1(6) private practicing dentists if:
231.2(i) the dentist's office is located within a health professional shortage area as defined
231.3under Code of Federal Regulations, title 42, part 5, and United States Code, title 42,
231.4section 254E;
231.5(ii) more than 50 percent of the dentist's patient encounters per year are with patients
231.6who are uninsured or covered by medical assistance or MinnesotaCare;
231.7(iii) the dentist does not restrict access or services because of a patient's financial
231.8limitations or public assistance status; and
231.9(iv) the level of service provided by the dentist is critical to maintaining adequate
231.10levels of patient access within the service area in which the dentist operates.
231.11    (c) The commissioner may designate a dentist or dental clinic as a critical access
231.12dental provider if the dentist or dental clinic is willing to provide care to patients covered
231.13by medical assistance, general assistance medical care, or MinnesotaCare at a level which
231.14significantly increases access to dental care in the service area.
231.15(d) (c) A designated critical access clinic shall receive the reimbursement rate
231.16specified in paragraph (a) for dental services provided off site at a private dental office if
231.17the following requirements are met:
231.18(1) the designated critical access dental clinic is located within a health professional
231.19shortage area as defined under Code of Federal Regulations, title 42, part 5, and United
231.20States Code, title 42, section 254E, and is located outside the seven-county metropolitan
231.21area;
231.22(2) the designated critical access dental clinic is not able to provide the service
231.23and refers the patient to the off-site dentist;
231.24(3) the service, if provided at the critical access dental clinic, would be reimbursed
231.25at the critical access reimbursement rate;
231.26(4) the dentist and allied dental professionals providing the services off site are
231.27licensed and in good standing under chapter 150A;
231.28(5) the dentist providing the services is enrolled as a medical assistance provider;
231.29(6) the critical access dental clinic submits the claim for services provided off site
231.30and receives the payment for the services; and
231.31(7) the critical access dental clinic maintains dental records for each claim submitted
231.32under this paragraph, including the name of the dentist, the off-site location, and the
231.33license number of the dentist and allied dental professionals providing the services.

231.34    Sec. 22. Minnesota Statutes 2012, section 256B.76, is amended by adding a
231.35subdivision to read:
232.1    Subd. 7. Payment for certain primary care services and immunization
232.2administration. Payment for certain primary care services and immunization
232.3administration services rendered on or after January 1, 2013, through December 31, 2014,
232.4shall be made in accordance with section 1902(a)(13) of the Social Security Act.

232.5    Sec. 23. Minnesota Statutes 2012, section 256B.764, is amended to read:
232.6256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
232.7    (a) Effective for services rendered on or after July 1, 2007, payment rates for family
232.8planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
232.9when these services are provided by a community clinic as defined in section 145.9268,
232.10subdivision 1.
232.11    (b) Effective for services rendered on or after July 1, 2014, payment rates for
232.12family planning services shall be increased by 20 percent over the rates in effect June
232.1330, 2014, when these services are provided by a community clinic as defined in section
232.14145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care
232.15and county-based purchasing plans to reflect this increase, and shall require plans to pass
232.16on the full amount of the rate increase to eligible community clinics, in the form of higher
232.17payment rates for family planning services.

232.18    Sec. 24. Minnesota Statutes 2012, section 256B.766, is amended to read:
232.19256B.766 REIMBURSEMENT FOR BASIC CARE SERVICES.
232.20(a) Effective for services provided on or after July 1, 2009, total payments for basic
232.21care services, shall be reduced by three percent, except that for the period July 1, 2009,
232.22through June 30, 2011, total payments shall be reduced by 4.5 percent for the medical
232.23assistance and general assistance medical care programs, prior to third-party liability and
232.24spenddown calculation. Effective July 1, 2010, the commissioner shall classify physical
232.25therapy services, occupational therapy services, and speech-language pathology and
232.26related services as basic care services. The reduction in this paragraph shall apply to
232.27physical therapy services, occupational therapy services, and speech-language pathology
232.28and related services provided on or after July 1, 2010.
232.29(b) Payments made to managed care plans and county-based purchasing plans shall
232.30be reduced for services provided on or after October 1, 2009, to reflect the reduction
232.31effective July 1, 2009, and payments made to the plans shall be reduced effective October
232.321, 2010, to reflect the reduction effective July 1, 2010.
233.1(c) Effective for services provided on or after September 1, 2011, through June 30,
233.22013, total payments for outpatient hospital facility fees shall be reduced by five percent
233.3from the rates in effect on August 31, 2011.
233.4(d) Effective for services provided on or after September 1, 2011, through June
233.530, 2013, total payments for ambulatory surgery centers facility fees, medical supplies
233.6and durable medical equipment not subject to a volume purchase contract, prosthetics
233.7and orthotics, renal dialysis services, laboratory services, public health nursing services,
233.8physical therapy services, occupational therapy services, speech therapy services,
233.9eyeglasses not subject to a volume purchase contract, hearing aids not subject to a volume
233.10purchase contract, and anesthesia services, and hospice services shall be reduced by three
233.11percent from the rates in effect on August 31, 2011.
233.12(e) Effective for services provided on or after January 1, 2015, payments for
233.13ambulatory surgery centers facility fees, medical supplies and durable medical equipment
233.14not subject to a volume purchase contract, prosthetics and orthotics, hospice services,
233.15renal dialysis services, laboratory services, public health nursing services, eyeglasses
233.16not subject to a volume purchase contract, and hearing aids not subject to a volume
233.17purchase contract shall be increased by three percent. Payments made to managed care
233.18plans and county-based purchasing plans shall not be adjusted to reflect payments under
233.19this paragraph.
233.20(e) (f) This section does not apply to physician and professional services, inpatient
233.21hospital services, family planning services, mental health services, dental services,
233.22prescription drugs, medical transportation, federally qualified health centers, rural health
233.23centers, Indian health services, and Medicare cost-sharing.

233.24    Sec. 25. Laws 2012, chapter 247, article 1, section 28, is amended to read:
233.25    Sec. 28. EMERGENCY MEDICAL ASSISTANCE STUDY.
233.26(a) The commissioner of human services shall convene a work group to develop a
233.27plan to provide coordinated and cost-effective health care and coverage for individuals
233.28who meet eligibility standards for emergency medical assistance and who are ineligible
233.29for other state public programs. The commissioner shall consult with work group shall
233.30consist of representatives of relevant stakeholders in the development of the plan,
233.31including but not limited to safety net hospitals, nonprofit health care coverage programs,
233.32nonprofit community clinics, and counties. The commissioner work group shall consider
233.33the following elements:
233.34(1) strategies to provide individuals with the most appropriate care in the appropriate
233.35setting, utilizing higher quality and lower cost providers;
234.1(2) payment mechanisms to encourage providers to manage the care of these
234.2populations, and to produce lower cost of care and better patient outcomes;
234.3(3) ensure coverage and payment options that address the unique needs of those
234.4needing episodic care, chronic care, and long-term care services;
234.5(4) strategies for coordinating health care and nonhealth care services, and
234.6integrating with existing coverage; and
234.7(5) other issues and strategies to ensure cost-effective and coordinated delivery
234.8of coverage and services.
234.9(b) The commissioner shall submit the plan of the work group to the chairs and
234.10ranking minority members of the legislative committees with jurisdiction over health and
234.11human services policy and financing by January 15 July 15, 2013.
234.12EFFECTIVE DATE.This section is effective the day following final enactment.

234.13    Sec. 26. Laws 2013, chapter 1, section 6, is amended to read:
234.14    Sec. 6. TRANSFER.
234.15(a) The commissioner of management and budget shall transfer from the health care
234.16access fund to the general fund up to $21,319,000 in fiscal year 2014; up to $42,314,000
234.17in fiscal year 2015; up to $56,147,000 in fiscal year 2016; and up to $64,683,000 in fiscal
234.18year 2017.
234.19(b) The commissioner of human services shall determine the difference between the
234.20actual cost to the medical assistance program of adding 19 and 20 year olds and caretaker
234.21populations with income between 100 and 138 percent of the federal poverty guidelines
234.22and the cost of adding those populations that was estimated during the 2013 legislative
234.23session based on the data from the February 2013 forecast.
234.24(c) For each fiscal year from 2014 to 2017, the commissioner of human services shall
234.25certify and report to the commissioner of management and budget the actual cost difference
234.26of adding 19 and 20 year olds and caretaker populations with income between 100 and
234.27138 percent of the federal poverty guidelines, as determined under paragraph (b), by June
234.2830 of each fiscal year. In each fiscal year, the commissioner of management and budget
234.29shall reduce the transfer under paragraph (a) by the amount of the costs certified under
234.30paragraph (b). If, for any fiscal year, the amount of the cost difference determined under
234.31paragraph (b) exceeds the amount of the transfer, the transfer for that year must be zero.

234.32    Sec. 27. 340B PROVIDER PRESCRIPTION DRUGS REIMBURSEMENT
234.33STUDY.
235.1(a) The commissioner of human services shall study and make recommendations on
235.2changes to standardize the medical assistance reimbursement rates for prescription drugs
235.3obtained through the federal 340B Program and dispensed to medical assistance enrollees.
235.4The study must examine the current medical assistance rate 340B providers are receiving
235.5through claims submissions and make recommendations on an overall reimbursement
235.6discount that will pay the same for drugs dispensed through the 340B Program as is paid
235.7for drugs dispensed by non340B providers, taking into consideration any federal rebate.
235.8(b) The commissioner shall consult with 340B providers that would be most
235.9affected by a change in the reimbursement formula, including but not limited to safety net
235.10hospitals, children's hospitals, community health centers, and family planning clinics.
235.11(c) The commissioner shall submit recommendations to the chairs and ranking
235.12minority members of the legislative committees and divisions with jurisdiction over health
235.13and human services policy and finance by January 15, 2014.

235.14    Sec. 28. DENTAL ACCESS AND REIMBURSEMENT REPORT.
235.15    Subdivision 1. Study. (a) The commissioner of human services shall study the
235.16current oral health and dental services delivery system for Minnesota public health
235.17care programs to improve access and ensure cost-effective delivery of services. The
235.18commissioner shall make recommendations on modifying the delivery of services and
235.19reimbursement methods, including modifications to the critical access dental provider
235.20payments under Minnesota Statutes, section 256B.76, subdivision 4.
235.21(b) The commissioner shall consult with dental providers enrolled in Minnesota
235.22health care programs, including providers who serve substantial numbers of low-income
235.23and uninsured patients and are currently receiving enhanced critical access dental provider
235.24payments.
235.25    Subd. 2. Service delivery and reimbursement methods. The recommendations
235.26must address:
235.27(1) targeting state funding and critical access dental payments to improve access
235.28to oral health services for individuals enrolled in Minnesota health care programs who
235.29are not receiving timely and appropriate dental services;
235.30(2) encouraging the use of cost-effective service delivery methods, workforce
235.31innovations, and the delivery of preventive services, including, but not limited to, dental
235.32sealants that will reduce dental disease and future costs of treatment;
235.33(3) improving access in all geographic areas of the state;
235.34(4) encouraging the use of tele-dentistry and mobile dental equipment to serve
235.35underserved patients and communities;
236.1(5) evaluating the use of a single administrator delivery model;
236.2(6) compensating providers for the added costs to providers of serving low-income
236.3and underserved patients and populations who experience the greatest oral health
236.4disparities in terms of incidence of oral health disease and access to and utilization of
236.5needed oral health services;
236.6(7) encouraging coordination of oral health care with other health care services;
236.7(8) preventing overtreatment, fraud, and abuse; and
236.8(9) reducing administrative costs for the state and for dental providers.
236.9    Subd. 3. Report. The commissioner shall submit a report on the recommendations to
236.10the chairs and ranking minority members of the of the legislative committees and divisions
236.11with jurisdiction over health and human services policy and finance by December 15, 2013.


236.14    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 6, is amended to read:
236.15    Subd. 6. Penalties for late or nonsubmission. (a) A facility that fails to complete
236.16or submit an assessment for a RUG-III or RUG-IV classification within seven days of the
236.17time requirements in subdivisions 4 and 5 is subject to a reduced rate for that resident.
236.18The reduced rate shall be the lowest rate for that facility. The reduced rate is effective on
236.19the day of admission for new admission assessments or on the day that the assessment
236.20was due for all other assessments and continues in effect until the first day of the month
236.21following the date of submission of the resident's assessment.
236.22    (b) If loss of revenue due to penalties incurred by a facility for any period of 92 days
236.23are equal to or greater than 1.0 percent of the total operating costs on the facility's most
236.24recent annual statistical and cost report, a facility may apply to the commissioner of
236.25human services for a reduction in the total penalty amount. The commissioner of human
236.26services, in consultation with the commissioner of health, may, at the sole discretion of
236.27the commissioner of human services, limit the penalty for residents covered by medical
236.28assistance to 15 days.

236.29    Sec. 2. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
236.30    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
236.31initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
236.322960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
236.339555.6265, under this chapter for a physical location that will not be the primary residence
236.34of the license holder for the entire period of licensure. If a license is issued during this
237.1moratorium, and the license holder changes the license holder's primary residence away
237.2from the physical location of the foster care license, the commissioner shall revoke the
237.3license according to section 245A.07. Exceptions to the moratorium include:
237.4(1) foster care settings that are required to be registered under chapter 144D;
237.5(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
237.6and determined to be needed by the commissioner under paragraph (b);
237.7(3) new foster care licenses determined to be needed by the commissioner under
237.8paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center,
237.9or; restructuring of state-operated services that limits the capacity of state-operated
237.10facilities;or allowing movement to the community for people who no longer require the
237.11level of care provided in state-operated facilities as provided under section 256B.092,
237.12subdivision 13, or 256B.49, subdivision 24;
237.13(4) new foster care licenses determined to be needed by the commissioner under
237.14paragraph (b) for persons requiring hospital level care; or
237.15(5) new foster care licenses determined to be needed by the commissioner for the
237.16transition of people from personal care assistance to the home and community-based
237.17services.
237.18(b) The commissioner shall determine the need for newly licensed foster care homes
237.19as defined under this subdivision. As part of the determination, the commissioner shall
237.20consider the availability of foster care capacity in the area in which the licensee seeks to
237.21operate, and the recommendation of the local county board. The determination by the
237.22commissioner must be final. A determination of need is not required for a change in
237.23ownership at the same address.
237.24(c) The commissioner shall study the effects of the license moratorium under this
237.25subdivision and shall report back to the legislature by January 15, 2011. This study shall
237.26include, but is not limited to the following:
237.27(1) the overall capacity and utilization of foster care beds where the physical location
237.28is not the primary residence of the license holder prior to and after implementation
237.29of the moratorium;
237.30(2) the overall capacity and utilization of foster care beds where the physical
237.31location is the primary residence of the license holder prior to and after implementation
237.32of the moratorium; and
237.33(3) the number of licensed and occupied ICF/MR beds prior to and after
237.34implementation of the moratorium.
237.35(d) (c) When a foster care recipient moves out of a foster home that is not the primary
237.36residence of the license holder according to section 256B.49, subdivision 15, paragraph
238.1(f), the county shall immediately inform the Department of Human Services Licensing
238.2Division. The department shall decrease the statewide licensed capacity for foster care
238.3settings where the physical location is not the primary residence of the license holder, if
238.4the voluntary changes described in paragraph (f) (e) are not sufficient to meet the savings
238.5required by reductions in licensed bed capacity under Laws 2011, First Special Session
238.6chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide long-term
238.7care residential services capacity within budgetary limits. Implementation of the statewide
238.8licensed capacity reduction shall begin on July 1, 2013. The commissioner shall delicense
238.9up to 128 beds by June 30, 2014, using the needs determination process. Under this
238.10paragraph, the commissioner has the authority to reduce unused licensed capacity of a
238.11current foster care program to accomplish the consolidation or closure of settings. Under
238.12this paragraph, the commissioner has the authority to manage statewide capacity, including
238.13adjusting the capacity available to each county and adjusting statewide available capacity,
238.14to meet the statewide needs identified through the process in paragraph (e). A decreased
238.15licensed capacity according to this paragraph is not subject to appeal under this chapter.
238.16(e) (d) Residential settings that would otherwise be subject to the decreased license
238.17capacity established in paragraph (d) (c) shall be exempt under the following circumstances:
238.18(1) until August 1, 2013, the license holder's beds occupied by residents whose
238.19primary diagnosis is mental illness and the license holder is:
238.20(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
238.21health services (ARMHS) as defined in section 256B.0623;
238.22(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
238.239520.0870;
238.24(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
238.259520.0870; or
238.26(iv) a provider of intensive residential treatment services (IRTS) licensed under
238.27Minnesota Rules, parts 9520.0500 to 9520.0670; or
238.28(2) the license holder's beds occupied by residents whose primary diagnosis is
238.29mental illness and the license holder is certified under the requirements in subdivision 6a.
238.30(f) (e) A resource need determination process, managed at the state level, using the
238.31available reports required by section 144A.351, and other data and information shall
238.32be used to determine where the reduced capacity required under paragraph (d) (c) will
238.33be implemented. The commissioner shall consult with the stakeholders described in
238.34section 144A.351, and employ a variety of methods to improve the state's capacity to
238.35meet long-term care service needs within budgetary limits, including seeking proposals
238.36from service providers or lead agencies to change service type, capacity, or location to
239.1improve services, increase the independence of residents, and better meet needs identified
239.2by the long-term care services reports and statewide data and information. By February
239.31 of each, 2013, and August 1, 2014, and each following year, the commissioner shall
239.4provide information and data on the overall capacity of licensed long-term care services,
239.5actions taken under this subdivision to manage statewide long-term care services and
239.6supports resources, and any recommendations for change to the legislative committees
239.7with jurisdiction over health and human services budget.
239.8    (g) (f) At the time of application and reapplication for licensure, the applicant and the
239.9license holder that are subject to the moratorium or an exclusion established in paragraph
239.10(a) are required to inform the commissioner whether the physical location where the foster
239.11care will be provided is or will be the primary residence of the license holder for the entire
239.12period of licensure. If the primary residence of the applicant or license holder changes, the
239.13applicant or license holder must notify the commissioner immediately. The commissioner
239.14shall print on the foster care license certificate whether or not the physical location is the
239.15primary residence of the license holder.
239.16    (h) (g) License holders of foster care homes identified under paragraph (g) (f) that
239.17are not the primary residence of the license holder and that also provide services in the
239.18foster care home that are covered by a federally approved home and community-based
239.19services waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must
239.20inform the human services licensing division that the license holder provides or intends to
239.21provide these waiver-funded services. These license holders must be considered registered
239.22under section 256B.092, subdivision 11, paragraph (c), and this registration status must
239.23be identified on their license certificates.

239.24    Sec. 3. Minnesota Statutes 2012, section 252.291, is amended by adding a subdivision
239.25to read:
239.26    Subd. 2b. Nicollet County facility project. The commissioner of health shall
239.27certify one additional bed in an intermediate care facility for persons with developmental
239.28disabilities in Nicollet County.

239.29    Sec. 4. Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to
239.30read:
239.31    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
239.32shall be the lower of the actual acquisition costs of the drugs or the maximum allowable
239.33cost by the commissioner plus the fixed dispensing fee; or the usual and customary price
239.34charged to the public. The amount of payment basis must be reduced to reflect all discount
240.1amounts applied to the charge by any provider/insurer agreement or contract for submitted
240.2charges to medical assistance programs. The net submitted charge may not be greater
240.3than the patient liability for the service. The pharmacy dispensing fee shall be $3.65,
240.4except that the dispensing fee for intravenous solutions which must be compounded by the
240.5pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30
240.6per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per
240.7bag for total parenteral nutritional products dispensed in quantities greater than one liter.
240.8Actual acquisition cost includes quantity and other special discounts except time and cash
240.9discounts. The actual acquisition cost of a drug shall be estimated by the commissioner at
240.10wholesale acquisition cost plus four percent for independently owned pharmacies located
240.11in a designated rural area within Minnesota, and at wholesale acquisition cost plus two
240.12percent for all other pharmacies. A pharmacy is "independently owned" if it is one of four
240.13or fewer pharmacies under the same ownership nationally. A "designated rural area" means
240.14an area defined as a small rural area or isolated rural area according to the four-category
240.15classification of the Rural Urban Commuting Area system developed for the United States
240.16Health Resources and Services Administration. Wholesale acquisition cost is defined as the
240.17manufacturer's list price for a drug or biological to wholesalers or direct purchasers in the
240.18United States, not including prompt pay or other discounts, rebates, or reductions in price,
240.19for the most recent month for which information is available, as reported in wholesale price
240.20guides or other publications of drug or biological pricing data. The maximum allowable
240.21cost of a multisource drug may be set by the commissioner and it shall be comparable to,
240.22but no higher than, the maximum amount paid by other third-party payors in this state who
240.23have maximum allowable cost programs. Establishment of the amount of payment for
240.24drugs shall not be subject to the requirements of the Administrative Procedure Act.
240.25    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
240.26to pharmacists for legend drug prescriptions dispensed to residents of long-term care
240.27facilities when a unit dose blister card system, approved by the department, is used. Under
240.28this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The
240.29National Drug Code (NDC) from the drug container used to fill the blister card must be
240.30identified on the claim to the department. The unit dose blister card containing the drug
240.31must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that
240.32govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will
240.33be required to credit the department for the actual acquisition cost of all unused drugs that
240.34are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in
240.35a quantity that is less than a 30-day supply.
241.1    (c) Whenever a maximum allowable cost has been set for a multisource drug,
241.2payment shall be the lower of the usual and customary price charged to the public or the
241.3maximum allowable cost established by the commissioner unless prior authorization
241.4for the brand name product has been granted according to the criteria established by
241.5the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the
241.6prescriber has indicated "dispense as written" on the prescription in a manner consistent
241.7with section 151.21, subdivision 2.
241.8    (d) The basis for determining the amount of payment for drugs administered in an
241.9outpatient setting shall be the lower of the usual and customary cost submitted by the
241.10provider or, 106 percent of the average sales price as determined by the United States
241.11Department of Health and Human Services pursuant to title XVIII, section 1847a of the
241.12federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
241.13set by the commissioner. If average sales price is unavailable, the amount of payment
241.14must be lower of the usual and customary cost submitted by the provider or, the wholesale
241.15acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the
241.16commissioner. The payment for drugs administered in an outpatient setting shall be made
241.17to the administering facility or practitioner. A retail or specialty pharmacy dispensing a
241.18drug for administration in an outpatient setting is not eligible for direct reimbursement.
241.19    (e) The commissioner may negotiate lower reimbursement rates for specialty
241.20pharmacy products than the rates specified in paragraph (a). The commissioner may
241.21require individuals enrolled in the health care programs administered by the department
241.22to obtain specialty pharmacy products from providers with whom the commissioner has
241.23negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
241.24used by a small number of recipients or recipients with complex and chronic diseases
241.25that require expensive and challenging drug regimens. Examples of these conditions
241.26include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
241.27C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
241.28of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
241.29biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
241.30that require complex care. The commissioner shall consult with the formulary committee
241.31to develop a list of specialty pharmacy products subject to this paragraph. In consulting
241.32with the formulary committee in developing this list, the commissioner shall take into
241.33consideration the population served by specialty pharmacy products, the current delivery
241.34system and standard of care in the state, and access to care issues. The commissioner shall
241.35have the discretion to adjust the reimbursement rate to prevent access to care issues.
242.1(f) Home infusion therapy services provided by home infusion therapy pharmacies
242.2must be paid at rates according to subdivision 8d.
242.3EFFECTIVE DATE.This section is effective January 1, 2014.

242.4    Sec. 5. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to read:
242.5    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
242.6waivered services to an individual elderly waiver client except for individuals described in
242.7paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility
242.8rate of the case mix resident class to which the elderly waiver client would be assigned
242.9under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance
242.10needs allowance as described in subdivision 1d, paragraph (a), until the first day of the
242.11state fiscal year in which the resident assessment system as described in section 256B.438
242.12for nursing home rate determination is implemented. Effective on the first day of the state
242.13fiscal year in which the resident assessment system as described in section 256B.438 for
242.14nursing home rate determination is implemented and the first day of each subsequent state
242.15fiscal year, the monthly limit for the cost of waivered services to an individual elderly
242.16waiver client shall be the rate of the case mix resident class to which the waiver client
242.17would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on
242.18the last day of the previous state fiscal year, adjusted by any legislatively adopted home
242.19and community-based services percentage rate adjustment.
242.20    (b) The monthly limit for the cost of waivered services to an individual elderly
242.21waiver client assigned to a case mix classification A under paragraph (a) with:
242.22(1) no dependencies in activities of daily living; or
242.23(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
242.24when the dependency score in eating is three or greater as determined by an assessment
242.25performed under section 256B.0911
242.26shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in
242.27the program on or after July 1, 2011. This monthly limit shall be applied to all other
242.28participants who meet this criteria at reassessment. This monthly limit shall be increased
242.29annually as described in paragraph (a).
242.30(c) If extended medical supplies and equipment or environmental modifications are
242.31or will be purchased for an elderly waiver client, the costs may be prorated for up to
242.3212 consecutive months beginning with the month of purchase. If the monthly cost of a
242.33recipient's waivered services exceeds the monthly limit established in paragraph (a) or
242.34(b), the annual cost of all waivered services shall be determined. In this event, the annual
243.1cost of all waivered services shall not exceed 12 times the monthly limit of waivered
243.2services as described in paragraph (a) or (b).
243.3(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
243.4any necessary home care services described in section 256B.0651, subdivision 2, for
243.5individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
243.6subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
243.7amount established for home care services as described in section 256B.0652, subdivision
243.87, and the annual average contracted amount established by the commissioner for nursing
243.9facility services for ventilator-dependent individuals. This monthly limit shall be increased
243.10annually as described in paragraph (a).

243.11    Sec. 6. Minnesota Statutes 2012, section 256B.0915, is amended by adding a
243.12subdivision to read:
243.13    Subd. 3j. Individual community living support. Upon federal approval, there
243.14is established a new service called individual community living support (ICLS) that is
243.15available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor
243.16have any interest in the recipient's housing. ICLS must be delivered in a single-family
243.17home or apartment where the service recipient or their family owns or rents, as
243.18demonstrated by a lease agreement, and maintains control over the individual unit. Case
243.19managers or care coordinators must develop individual ICLS plans in consultation with
243.20the client using a tool developed by the commissioner. The commissioner shall establish
243.21payment rates and mechanisms to align payments with the type and amount of service
243.22provided, assure statewide uniformity for payment rates, and assure cost-effectiveness.
243.23Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and
243.24Human Services to avoid conflict with provider regulatory standards pursuant to section
243.25144A.43 and chapter 245D.

243.26    Sec. 7. Minnesota Statutes 2012, section 256B.0916, is amended by adding a
243.27subdivision to read:
243.28    Subd. 11. Excess spending. County and tribal agencies are responsible for spending
243.29in excess of the allocation made by the commissioner. In the event a county or tribal
243.30agency spends in excess of the allocation made by the commissioner for a given allocation
243.31period, they must submit a corrective action plan to the commissioner. The plan must state
243.32the actions the agency will take to correct their overspending for the year following the
243.33period when the overspending occurred. Failure to correct overspending shall result in
243.34recoupment of spending in excess of the allocation. Nothing in this subdivision shall be
244.1construed as reducing the county's responsibility to offer and make available feasible
244.2home and community-based options to eligible waiver recipients within the resources
244.3allocated to them for that purpose.

244.4    Sec. 8. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
244.5    Subd. 11. Residential support services. (a) Upon federal approval, there is
244.6established a new service called residential support that is available on the community
244.7alternative care, community alternatives for disabled individuals, developmental
244.8disabilities, and brain injury waivers. Existing waiver service descriptions must be
244.9modified to the extent necessary to ensure there is no duplication between other services.
244.10Residential support services must be provided by vendors licensed as a community
244.11residential setting as defined in section 245A.11, subdivision 8.
244.12    (b) Residential support services must meet the following criteria:
244.13    (1) providers of residential support services must own or control the residential site;
244.14    (2) the residential site must not be the primary residence of the license holder;
244.15    (3) the residential site must have a designated program supervisor responsible for
244.16program oversight, development, and implementation of policies and procedures;
244.17    (4) the provider of residential support services must provide supervision, training,
244.18and assistance as described in the person's coordinated service and support plan; and
244.19    (5) the provider of residential support services must meet the requirements of
244.20licensure and additional requirements of the person's coordinated service and support plan.
244.21    (c) Providers of residential support services that meet the definition in paragraph
244.22(a) must be registered using a process determined by the commissioner beginning July
244.231, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts
244.242960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts
244.259555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision
244.267 , paragraph (g) (f), are considered registered under this section.

244.27    Sec. 9. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:
244.28    Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
244.29establish statewide priorities for individuals on the waiting list for developmental
244.30disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
244.31include, but are not limited to, individuals who continue to have a need for waiver services
244.32after they have maximized the use of state plan services and other funding resources,
244.33including natural supports, prior to accessing waiver services, and who meet at least one
244.34of the following criteria:
245.1(1) no longer require the intensity of services provided where they are currently
245.2living; or
245.3(2) make a request to move from an institutional setting.
245.4(b) After the priorities in paragraph (a) are met, priority must also be given to
245.5individuals who meet at least one of the following criteria:
245.6(1) have unstable living situations due to the age, incapacity, or sudden loss of
245.7the primary caregivers;
245.8(2) are moving from an institution due to bed closures;
245.9(3) experience a sudden closure of their current living arrangement;
245.10(4) require protection from confirmed abuse, neglect, or exploitation;
245.11(5) experience a sudden change in need that can no longer be met through state plan
245.12services or other funding resources alone; or
245.13(6) meet other priorities established by the department.
245.14(b) (c) When allocating resources to lead agencies, the commissioner must take into
245.15consideration the number of individuals waiting who meet statewide priorities and the
245.16lead agencies' current use of waiver funds and existing service options. The commissioner
245.17has the authority to transfer funds between counties, groups of counties, and tribes to
245.18accommodate statewide priorities and resource needs while accounting for a necessary
245.19base level reserve amount for each county, group of counties, and tribe.
245.20(c) The commissioner shall evaluate the impact of the use of statewide priorities and
245.21provide recommendations to the legislature on whether to continue the use of statewide
245.22priorities in the November 1, 2011, annual report required by the commissioner in sections
245.23256B.0916, subdivision 7, and 256B.49, subdivision 21.

245.24    Sec. 10. Minnesota Statutes 2012, section 256B.092, is amended by adding a
245.25subdivision to read:
245.26    Subd. 14. Reduce avoidable behavioral crisis emergency room admissions,
245.27psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons
245.28receiving home and community-based services authorized under this section who have
245.29had two or more admissions within a calendar year to an emergency room, psychiatric
245.30unit, or institution must receive consultation from a mental health professional as defined
245.31in section 245.462, subdivision 18, or a behavioral professional as defined in the home
245.32and community-based services state plan within 30 days of discharge. The mental health
245.33professional or behavioral professional must:
245.34(1) conduct a functional assessment of the crisis incident as defined in section
245.35245D.02, subdivision 11, which led to the hospitalization with the goal of developing
246.1proactive strategies as well as necessary reactive strategies to reduce the likelihood of
246.2future avoidable hospitalizations due to a behavioral crisis;
246.3(2) use the results of the functional assessment to amend the coordinated service and
246.4support plan set forth in section 245D.02, subdivision 4b, to address the potential need
246.5for additional staff training, increased staffing, access to crisis mobility services, mental
246.6health services, use of technology, and crisis stabilization services in section 256B.0624,
246.7subdivision 7; and
246.8(3) identify the need for additional consultation, testing, and mental health crisis
246.9intervention team services as defined in section 245D.02, subdivision 20, psychotropic
246.10medication use and monitoring under section 245D.051, and the frequency and duration
246.11of ongoing consultation.
246.12(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
246.13the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

246.14    Sec. 11. Minnesota Statutes 2012, section 256B.095, is amended to read:
246.15256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
246.16    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
246.17disabilities, which includes an alternative quality assurance licensing system for programs,
246.18is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
246.19Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
246.20services provided to persons with developmental disabilities. A county, at its option, may
246.21choose to have all programs for persons with developmental disabilities located within
246.22the county licensed under chapter 245A using standards determined under the alternative
246.23quality assurance licensing system or may continue regulation of these programs under the
246.24licensing system operated by the commissioner. The project expires on June 30, 2014.
246.25    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
246.26participate in the quality assurance system established under paragraph (a). The
246.27commission established under section 256B.0951 may, at its option, allow additional
246.28counties to participate in the system.
246.29    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
246.30may establish a quality assurance system under this section. A new system established
246.31under this section shall have the same rights and duties as the system established
246.32under paragraph (a). A new system shall be governed by a commission under section
246.33256B.0951 . The commissioner shall appoint the initial commission members based
246.34on recommendations from advocates, families, service providers, and counties in the
246.35geographic area included in the new system. Counties that choose to participate in a
247.1new system shall have the duties assigned under section 256B.0952. The new system
247.2shall establish a quality assurance process under section 256B.0953. The provisions of
247.3section 256B.0954 shall apply to a new system established under this paragraph. The
247.4commissioner shall delegate authority to a new system established under this paragraph
247.5according to section 256B.0955.
247.6    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
247.7programs for persons with disabilities and older adults.
247.8(e) Effective July 1, 2013, a provider of service located in a county listed in
247.9paragraph (a) that is a non-opted-in county may opt in to the quality assurance system
247.10provided the county where services are provided indicates its agreement with a county
247.11with a delegation agreement with the Department of Human Services.
247.12EFFECTIVE DATE.This section is effective July 1, 2013.

247.13    Sec. 12. Minnesota Statutes 2012, section 256B.0951, subdivision 1, is amended to read:
247.14    Subdivision 1. Membership. The Quality Assurance Commission is established.
247.15The commission consists of at least 14 but not more than 21 members as follows: at
247.16least three but not more than five members representing advocacy organizations; at
247.17least three but not more than five members representing consumers, families, and their
247.18legal representatives; at least three but not more than five members representing service
247.19providers; at least three but not more than five members representing counties; and the
247.20commissioner of human services or the commissioner's designee. The first commission
247.21shall establish membership guidelines for the transition and recruitment of membership for
247.22the commission's ongoing existence. Members of the commission who do not receive a
247.23salary or wages from an employer for time spent on commission duties may receive a per
247.24diem payment when performing commission duties and functions. All members may be
247.25reimbursed for expenses related to commission activities. Notwithstanding the provisions
247.26of section 15.059, subdivision 5, the commission expires on June 30, 2014.

247.27    Sec. 13. Minnesota Statutes 2012, section 256B.0951, subdivision 4, is amended to read:
247.28    Subd. 4. Commission's authority to recommend variances of licensing
247.29standards. The commission may recommend to the commissioners of human services
247.30and health variances from the standards governing licensure of programs for persons with
247.31developmental disabilities in order to improve the quality of services by implementing
247.32an alternative developmental disabilities licensing system if the commission determines
247.33that the alternative licensing system does not adversely affect the health or safety of
248.1persons being served by the licensed program nor compromise the qualifications of staff
248.2to provide services.

248.3    Sec. 14. Minnesota Statutes 2012, section 256B.0952, subdivision 1, is amended to read:
248.4    Subdivision 1. Notification. Counties or providers shall give notice to the
248.5commission and commissioners of human services and health of intent to join the
248.6alternative quality assurance licensing system. A county or provider choosing to participate
248.7in the alternative quality assurance licensing system commits to participate for three years.

248.8    Sec. 15. Minnesota Statutes 2012, section 256B.0952, subdivision 5, is amended to read:
248.9    Subd. 5. Quality assurance teams. Quality assurance teams shall be comprised
248.10of county staff; providers; consumers, families, and their legal representatives; members
248.11of advocacy organizations; and other involved community members. Team members
248.12must satisfactorily complete the training program approved by the commission and must
248.13demonstrate performance-based competency. Team members are not considered to be
248.14county employees for purposes of workers' compensation, unemployment insurance, or
248.15state retirement laws solely on the basis of participation on a quality assurance team. The
248.16county may pay A per diem may be paid to team members for time spent on alternative
248.17quality assurance process matters. All team members may be reimbursed for expenses
248.18related to their participation in the alternative process.

248.19    Sec. 16. Minnesota Statutes 2012, section 256B.0955, is amended to read:
248.20256B.0955 DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.
248.21(a) Effective July 1, 1998, the commissioner of human services shall delegate
248.22authority to perform licensing functions and activities, in accordance with section
248.23245A.16 , to counties participating in the alternative quality assurance licensing system.
248.24The commissioner shall not license or reimburse a facility, program, or service for persons
248.25with developmental disabilities in a county that participates in the alternative quality
248.26assurance licensing system if the commissioner has received from the appropriate county
248.27notification that the facility, program, or service has been reviewed by a quality assurance
248.28team and has failed to qualify for licensure.
248.29(b) The commissioner may conduct random licensing inspections based on outcomes
248.30adopted under section 256B.0951 at facilities, programs, and services governed by the
248.31alternative quality assurance licensing system. The role of such random inspections shall
248.32be to verify that the alternative quality assurance licensing system protects the safety
249.1and well-being of consumers and maintains the availability of high-quality services for
249.2persons with developmental disabilities.
249.3EFFECTIVE DATE.This section is effective July 1, 2013.

249.4    Sec. 17. Minnesota Statutes 2012, section 256B.097, subdivision 1, is amended to read:
249.5    Subdivision 1. Scope. (a) In order to improve the quality of services provided to
249.6Minnesotans with disabilities and to meet the requirements of the federally approved home
249.7and community-based waivers under section 1915c of the Social Security Act, a State
249.8Quality Assurance, Quality Improvement, and Licensing System for Minnesotans receiving
249.9disability services is enacted. This system is a partnership between the Department of
249.10Human Services and the State Quality Council established under subdivision 3.
249.11    (b) This system is a result of the recommendations from the Department of Human
249.12Services' licensing and alternative quality assurance study mandated under Laws 2005,
249.13First Special Session chapter 4, article 7, section 57, and presented to the legislature
249.14in February 2007.
249.15    (c) The disability services eligible under this section include:
249.16    (1) the home and community-based services waiver programs for persons with
249.17developmental disabilities under section 256B.092, subdivision 4, or section 256B.49,
249.18including brain injuries and services for those who qualify for nursing facility level of care
249.19or hospital facility level of care and any other services licensed under chapter 245D;
249.20    (2) home care services under section 256B.0651;
249.21    (3) family support grants under section 252.32;
249.22    (4) consumer support grants under section 256.476;
249.23    (5) semi-independent living services under section 252.275; and
249.24    (6) services provided through an intermediate care facility for the developmentally
249.25disabled.
249.26    (d) For purposes of this section, the following definitions apply:
249.27    (1) "commissioner" means the commissioner of human services;
249.28    (2) "council" means the State Quality Council under subdivision 3;
249.29    (3) "Quality Assurance Commission" means the commission under section
249.30256B.0951 ; and
249.31    (4) "system" means the State Quality Assurance, Quality Improvement and
249.32Licensing System under this section.

249.33    Sec. 18. Minnesota Statutes 2012, section 256B.097, subdivision 3, is amended to read:
250.1    Subd. 3. State Quality Council. (a) There is hereby created a State Quality
250.2Council which must define regional quality councils, and carry out a community-based,
250.3person-directed quality review component, and a comprehensive system for effective
250.4incident reporting, investigation, analysis, and follow-up.
250.5    (b) By August 1, 2011, the commissioner of human services shall appoint the
250.6members of the initial State Quality Council. Members shall include representatives
250.7from the following groups:
250.8    (1) disability service recipients and their family members;
250.9    (2) during the first two four years of the State Quality Council, there must be at least
250.10three members from the Region 10 stakeholders. As regional quality councils are formed
250.11under subdivision 4, each regional quality council shall appoint one member;
250.12    (3) disability service providers;
250.13    (4) disability advocacy groups; and
250.14    (5) county human services agencies and staff from the Department of Human
250.15Services and Ombudsman for Mental Health and Developmental Disabilities.
250.16    (c) Members of the council who do not receive a salary or wages from an employer
250.17for time spent on council duties may receive a per diem payment when performing council
250.18duties and functions.
250.19    (d) The State Quality Council shall:
250.20    (1) assist the Department of Human Services in fulfilling federally mandated
250.21obligations by monitoring disability service quality and quality assurance and
250.22improvement practices in Minnesota;
250.23    (2) establish state quality improvement priorities with methods for achieving results
250.24and provide an annual report to the legislative committees with jurisdiction over policy
250.25and funding of disability services on the outcomes, improvement priorities, and activities
250.26undertaken by the commission during the previous state fiscal year;
250.27(3) identify issues pertaining to financial and personal risk that impede Minnesotans
250.28with disabilities from optimizing choice of community-based services; and
250.29(4) recommend to the chairs and ranking minority members of the legislative
250.30committees with jurisdiction over human services and civil law by January 15, 2013
250.31 2014, statutory and rule changes related to the findings under clause (3) that promote
250.32individualized service and housing choices balanced with appropriate individualized
250.33protection.
250.34    (e) The State Quality Council, in partnership with the commissioner, shall:
250.35    (1) approve and direct implementation of the community-based, person-directed
250.36system established in this section;
251.1    (2) recommend an appropriate method of funding this system, and determine the
251.2feasibility of the use of Medicaid, licensing fees, as well as other possible funding options;
251.3    (3) approve measurable outcomes in the areas of health and safety, consumer
251.4evaluation, education and training, providers, and systems;
251.5    (4) establish variable licensure periods not to exceed three years based on outcomes
251.6achieved; and
251.7    (5) in cooperation with the Quality Assurance Commission, design a transition plan
251.8for licensed providers from Region 10 into the alternative licensing system by July 1, 2013.
251.9    (f) The State Quality Council shall notify the commissioner of human services that a
251.10facility, program, or service has been reviewed by quality assurance team members under
251.11subdivision 4, paragraph (b), clause (13), and qualifies for a license.
251.12    (g) The State Quality Council, in partnership with the commissioner, shall establish
251.13an ongoing review process for the system. The review shall take into account the
251.14comprehensive nature of the system which is designed to evaluate the broad spectrum of
251.15licensed and unlicensed entities that provide services to persons with disabilities. The
251.16review shall address efficiencies and effectiveness of the system.
251.17    (h) The State Quality Council may recommend to the commissioner certain
251.18variances from the standards governing licensure of programs for persons with disabilities
251.19in order to improve the quality of services so long as the recommended variances do
251.20not adversely affect the health or safety of persons being served or compromise the
251.21qualifications of staff to provide services.
251.22    (i) The safety standards, rights, or procedural protections referenced under
251.23subdivision 2, paragraph (c), shall not be varied. The State Quality Council may make
251.24recommendations to the commissioner or to the legislature in the report required under
251.25paragraph (c) regarding alternatives or modifications to the safety standards, rights, or
251.26procedural protections referenced under subdivision 2, paragraph (c).
251.27    (j) The State Quality Council may hire staff to perform the duties assigned in this
251.28subdivision.

251.29    Sec. 19. Minnesota Statutes 2012, section 256B.431, subdivision 44, is amended to read:
251.30    Subd. 44. Property rate increase increases for a facility in Bloomington effective
251.31November 1, 2010 certain nursing facilities. (a) Notwithstanding any other law to the
251.32contrary, money available for moratorium projects under section 144A.073, subdivision
251.3311 , shall be used, effective November 1, 2010, to fund an approved moratorium exception
251.34project for a nursing facility in Bloomington licensed for 137 beds as of November 1,
251.352010, up to a total property rate adjustment of $19.33.
252.1(b) Effective June 1, 2012, any nursing facility in McLeod County licensed for 110
252.2beds shall have its replacement-cost-new limit under subdivision 17e adjusted to allow
252.3$1,129,463 of a completed construction project to increase the property payment rate.
252.4Notwithstanding any other law to the contrary, money available under section 144A.073,
252.5subdivision 11, after the completion of the moratorium exception approval process in 2013
252.6under section 144A.073, subdivision 3, shall be used to reduce the fiscal impact to the
252.7medical assistance budget for the increase in the replacement-cost-new limit.
252.8(c) Effective July 1, 2012, any nursing facility in Dakota County licensed for
252.961 beds shall have their replacement-cost-new limit under subdivision 17e adjusted to
252.10allow $1,407,624 of a completed construction project to increase their property payment
252.11rate. Effective September 1, 2013, or later, their replacement-cost-new limit under
252.12subdivision 17e shall be adjusted to allow $1,244,599 of a completed construction project
252.13to increase the property payment rate. Notwithstanding any other law to the contrary,
252.14money available under section 144A.073, subdivision 11, after the completion of the
252.15moratorium exception approval process in 2013 under section 144A.073, subdivision 3,
252.16shall be used to reduce the fiscal impact to the medical assistance budget for the increase
252.17in the replacement-cost-new limit.
252.18EFFECTIVE DATE.Paragraph (b) is effective retroactively from June 1, 2012.
252.19Paragraph (c) is effective retroactively from July 1, 2012.

252.20    Sec. 20. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:
252.21    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
252.22have their payment rates determined under this section rather than section 256B.431, the
252.23commissioner shall establish a rate under this subdivision. The nursing facility must enter
252.24into a written contract with the commissioner.
252.25    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
252.26contract under this section is the payment rate the facility would have received under
252.27section 256B.431.
252.28    (c) A nursing facility's case mix payment rates for the second and subsequent years
252.29of a facility's contract under this section are the previous rate year's contract payment
252.30rates plus an inflation adjustment and, for facilities reimbursed under this section or
252.31section 256B.431, an adjustment to include the cost of any increase in Health Department
252.32licensing fees for the facility taking effect on or after July 1, 2001. The index for the
252.33inflation adjustment must be based on the change in the Consumer Price Index-All Items
252.34(United States City average) (CPI-U) forecasted by the commissioner of management and
252.35budget's national economic consultant, as forecasted in the fourth quarter of the calendar
253.1year preceding the rate year. The inflation adjustment must be based on the 12-month
253.2period from the midpoint of the previous rate year to the midpoint of the rate year for
253.3which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
253.42000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
253.5July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall
253.6apply only to the property-related payment rate. For the rate years beginning on October
253.71, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and
253.8October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning
253.9in 2005, adjustment to the property payment rate under this section and section 256B.431
253.10shall be effective on October 1. In determining the amount of the property-related payment
253.11rate adjustment under this paragraph, the commissioner shall determine the proportion of
253.12the facility's rates that are property-related based on the facility's most recent cost report.
253.13    (d) The commissioner shall develop additional incentive-based payments of up to
253.14five percent above a facility's operating payment rate for achieving outcomes specified
253.15in a contract. The commissioner may solicit contract amendments and implement those
253.16which, on a competitive basis, best meet the state's policy objectives. The commissioner
253.17shall limit the amount of any incentive payment and the number of contract amendments
253.18under this paragraph to operate the incentive payments within funds appropriated for this
253.19purpose. The contract amendments may specify various levels of payment for various
253.20levels of performance. Incentive payments to facilities under this paragraph may be in the
253.21form of time-limited rate adjustments or onetime supplemental payments. In establishing
253.22the specified outcomes and related criteria, the commissioner shall consider the following
253.23state policy objectives:
253.24    (1) successful diversion or discharge of residents to the residents' prior home or other
253.25community-based alternatives;
253.26    (2) adoption of new technology to improve quality or efficiency;
253.27    (3) improved quality as measured in the Nursing Home Report Card;
253.28    (4) reduced acute care costs; and
253.29    (5) any additional outcomes proposed by a nursing facility that the commissioner
253.30finds desirable.
253.31    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
253.32take action to come into compliance with existing or pending requirements of the life
253.33safety code provisions or federal regulations governing sprinkler systems must receive
253.34reimbursement for the costs associated with compliance if all of the following conditions
253.35are met:
254.1    (1) the expenses associated with compliance occurred on or after January 1, 2005,
254.2and before December 31, 2008;
254.3    (2) the costs were not otherwise reimbursed under subdivision 4f or section
254.4144A.071 or 144A.073; and
254.5    (3) the total allowable costs reported under this paragraph are less than the minimum
254.6threshold established under section 256B.431, subdivision 15, paragraph (e), and
254.7subdivision 16.
254.8The commissioner shall use money appropriated for this purpose to provide to qualifying
254.9nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
254.102008. Nursing facilities that have spent money or anticipate the need to spend money
254.11to satisfy the most recent life safety code requirements by (1) installing a sprinkler
254.12system or (2) replacing all or portions of an existing sprinkler system may submit to the
254.13commissioner by June 30, 2007, on a form provided by the commissioner the actual
254.14costs of a completed project or the estimated costs, based on a project bid, of a planned
254.15project. The commissioner shall calculate a rate adjustment equal to the allowable
254.16costs of the project divided by the resident days reported for the report year ending
254.17September 30, 2006. If the costs from all projects exceed the appropriation for this
254.18purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
254.19qualifying facilities by reducing the rate adjustment determined for each facility by an
254.20equal percentage. Facilities that used estimated costs when requesting the rate adjustment
254.21shall report to the commissioner by January 31, 2009, on the use of this money on a
254.22form provided by the commissioner. If the nursing facility fails to provide the report, the
254.23commissioner shall recoup the money paid to the facility for this purpose. If the facility
254.24reports expenditures allowable under this subdivision that are less than the amount received
254.25in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

254.26    Sec. 21. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:
254.27    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
254.28services shall calculate the amount of the planned closure rate adjustment available under
254.29subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
254.30(1) the amount available is the net reduction of nursing facility beds multiplied
254.31by $2,080;
254.32(2) the total number of beds in the nursing facility or facilities receiving the planned
254.33closure rate adjustment must be identified;
254.34(3) capacity days are determined by multiplying the number determined under
254.35clause (2) by 365; and
255.1(4) the planned closure rate adjustment is the amount available in clause (1), divided
255.2by capacity days determined under clause (3).
255.3(b) A planned closure rate adjustment under this section is effective on the first day
255.4of the month following completion of closure of the facility designated for closure in
255.5the application and becomes part of the nursing facility's total operating external fixed
255.6 payment rate.
255.7(c) Applicants may use the planned closure rate adjustment to allow for a property
255.8payment for a new nursing facility or an addition to an existing nursing facility or as
255.9an operating payment external fixed rate adjustment. Applications approved under this
255.10subdivision are exempt from other requirements for moratorium exceptions under section
255.11144A.073 , subdivisions 2 and 3.
255.12(d) Upon the request of a closing facility, the commissioner must allow the facility a
255.13closure rate adjustment as provided under section 144A.161, subdivision 10.
255.14(e) A facility that has received a planned closure rate adjustment may reassign it
255.15to another facility that is under the same ownership at any time within three years of its
255.16effective date. The amount of the adjustment shall be computed according to paragraph (a).
255.17(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
255.18the commissioner shall recalculate planned closure rate adjustments for facilities that
255.19delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
255.20bed dollar amount. The recalculated planned closure rate adjustment shall be effective
255.21from the date the per bed dollar amount is increased.
255.22(g) For planned closures approved after June 30, 2009, the commissioner of human
255.23services shall calculate the amount of the planned closure rate adjustment available under
255.24subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
255.25(h) Beginning Between July 16, 2011, and June 30, 2013, the commissioner shall no
255.26longer not accept applications for planned closure rate adjustments under subdivision 3.

255.27    Sec. 22. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
255.28    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
255.29shall calculate a payment rate for external fixed costs.
255.30    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
255.31shall be equal to $8.86 $10.58. For a facility licensed as both a nursing home and a
255.32boarding care home, the portion related to section 256.9657 shall be equal to $8.86
255.33 $10.58 multiplied by the result of its number of nursing home beds divided by its total
255.34number of licensed beds.
256.1    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
256.2shall be the amount of the fee divided by actual resident days.
256.3    (c) The portion related to scholarships shall be determined under section 256B.431,
256.4subdivision 36.
256.5    (d) The portion related to long-term care consultation shall be determined according
256.6to section 256B.0911, subdivision 6.
256.7    (e) The portion related to development and education of resident and family advisory
256.8councils under section 144A.33 shall be $5 divided by 365.
256.9    (f) The portion related to planned closure rate adjustments shall be as determined
256.10under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
256.11Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
256.12be included in the payment rate for external fixed costs beginning October 1, 2016.
256.13Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
256.14longer be included in the payment rate for external fixed costs beginning on October 1 of
256.15the first year not less than two years after their effective date.
256.16    (g) The portions related to property insurance, real estate taxes, special assessments,
256.17and payments made in lieu of real estate taxes directly identified or allocated to the nursing
256.18facility shall be the actual amounts divided by actual resident days.
256.19    (h) The portion related to the Public Employees Retirement Association shall be
256.20actual costs divided by resident days.
256.21    (i) The single bed room incentives shall be as determined under section 256B.431,
256.22subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
256.23no longer be included in the payment rate for external fixed costs beginning October 1,
256.242016. Single bed room incentives that take effect on or after October 1, 2014, shall no
256.25longer be included in the payment rate for external fixed costs beginning on October 1 of
256.26the first year not less than two years after their effective date.
256.27    (j) The payment rate for external fixed costs shall be the sum of the amounts in
256.28paragraphs (a) to (i).
256.29EFFECTIVE DATE.This section is effective June 1, 2013

256.30    Sec. 23. Minnesota Statutes 2012, section 256B.441, subdivision 55, is amended to read:
256.31    Subd. 55. Phase-in of rebased operating payment rates. (a) For the rate years
256.32beginning October 1, 2008, to October 1, 2015, the operating payment rate calculated
256.33under this section shall be phased in by blending the operating rate with the operating
256.34payment rate determined under section 256B.434. For purposes of this subdivision, the
256.35rate to be used that is determined under section 256B.434 shall not include the portion of
257.1the operating payment rate related to performance-based incentive payments under section
257.2256B.434, subdivision 4 , paragraph (d).:
257.3    (1) for the rate year beginning October 1, 2008, the operating payment rate for each
257.4facility shall be 13 percent of the operating payment rate from this section, and 87 percent
257.5of the operating payment rate from section 256B.434.;
257.6    (2) for the rate period from October 1, 2009, to September 30, 2013, no rate
257.7adjustments shall be implemented under this section, but shall be determined under
257.8section 256B.434.;
257.9    (3) for the rate year beginning October 1, 2013, the operating payment rate for each
257.10facility shall be 65 15.4 percent of the operating payment rate from this section, and 35
257.11 84.6 percent of the operating payment rate from section 256B.434.; and
257.12    (4) for the rate year beginning October 1, 2014 2015, the operating payment rate for
257.13each facility shall be 82 24.3 percent of the operating payment rate from this section, and
257.141875.7 percent of the operating payment rate from section 256B.434.
257.15     for the rate year beginning October 1, 2015, the operating payment rate for each
257.16facility shall be the operating payment rate determined under this section. The blending
257.17of operating payment rates under this section shall be performed separately for each
257.18RUG's class.
257.19    (b) For the rate year beginning October 1, 2008, the commissioner shall apply limits
257.20to the operating payment rate increases under paragraph (a) by creating a minimum
257.21percentage increase and a maximum percentage increase.:
257.22    (1) each nursing facility that receives a blended October 1, 2008, operating payment
257.23rate increase under paragraph (a) of less than one percent, when compared to its operating
257.24payment rate on September 30, 2008, computed using rates with RUG's weight of 1.00,
257.25shall receive a rate adjustment of one percent.;
257.26    (2) the commissioner shall determine a maximum percentage increase that will
257.27result in savings equal to the cost of allowing the minimum increase in clause (1). Nursing
257.28facilities with a blended October 1, 2008, operating payment rate increase under paragraph
257.29(a) greater than the maximum percentage increase determined by the commissioner, when
257.30compared to its operating payment rate on September 30, 2008, computed using rates with
257.31a RUG's weight of 1.00, shall receive the maximum percentage increase.;
257.32    (3) nursing facilities with a blended October 1, 2008, operating payment rate
257.33increase under paragraph (a) greater than one percent and less than the maximum
257.34percentage increase determined by the commissioner, when compared to its operating
257.35payment rate on September 30, 2008, computed using rates with a RUG's weight of 1.00,
258.1shall receive the blended October 1, 2008, operating payment rate increase determined
258.2under paragraph (a).; and
258.3    (4) the October 1, 2009, through October 1, 2015, operating payment rate for
258.4facilities receiving the maximum percentage increase determined in clause (2) shall be
258.5the amount determined under paragraph (a) less the difference between the amount
258.6determined under paragraph (a) for October 1, 2008, and the amount allowed under clause
258.7(2). This rate restriction does not apply to rate increases provided in any other section.
258.8    (c) A portion of the funds received under this subdivision that are in excess of
258.9operating payment rates that a facility would have received under section 256B.434, as
258.10determined in accordance with clauses (1) to (3), shall be subject to the requirements in
258.11section 256B.434, subdivision 19, paragraphs (b) to (h).:
258.12    (1) determine the amount of additional funding available to a facility, which shall be
258.13equal to total medical assistance resident days from the most recent reporting year times
258.14the difference between the blended rate determined in paragraph (a) for the rate year being
258.15computed and the blended rate for the prior year.;
258.16    (2) determine the portion of all operating costs, for the most recent reporting year,
258.17that are compensation related. If this value exceeds 75 percent, use 75 percent.;
258.18    (3) subtract the amount determined in clause (2) from 75 percent.; and
258.19    (4) the portion of the fund received under this subdivision that shall be subject to the
258.20requirements in section 256B.434, subdivision 19, paragraphs (b) to (h), shall equal the
258.21amount determined in clause (1) times the amount determined in clause (3).

258.22    Sec. 24. Minnesota Statutes 2012, section 256B.441, subdivision 56, is amended to read:
258.23    Subd. 56. Hold harmless. For the rate years beginning October 1, 2008, to October
258.241, 2016, no nursing facility shall receive an operating cost payment rate less than its
258.25operating cost payment rate under section 256B.434. For rate years beginning between
258.26October 1, 2009, and October 1, 2015, no nursing facility shall receive an operating
258.27payment rate less than its operating payment rate in effect on September 30, 2009. The
258.28comparison of operating payment rates under this section shall be made for a RUG's
258.29rate with a weight of 1.00.

258.30    Sec. 25. Minnesota Statutes 2012, section 256B.441, subdivision 62, is amended to read:
258.31    Subd. 62. Repeal of rebased operating payment rates. Notwithstanding
258.32subdivision 54 or 55, no further steps toward phase-in of rebased operating payment rates
258.33shall be taken, except for subdivision 55, paragraph (a), clauses (3) and (4).

259.1    Sec. 26. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:
259.2    Subd. 11a. Waivered services statewide priorities. (a) The commissioner shall
259.3establish statewide priorities for individuals on the waiting list for community alternative
259.4care, community alternatives for disabled individuals, and brain injury waiver services,
259.5as of January 1, 2010. The statewide priorities must include, but are not limited to,
259.6individuals who continue to have a need for waiver services after they have maximized the
259.7use of state plan services and other funding resources, including natural supports, prior to
259.8accessing waiver services, and who meet at least one of the following criteria:
259.9(1) no longer require the intensity of services provided where they are currently
259.10living; or
259.11(2) make a request to move from an institutional setting.
259.12(b) After the priorities in paragraph (a) are met, priority must also be given to
259.13individuals who meet at least one of the following criteria:
259.14(1) have unstable living situations due to the age, incapacity, or sudden loss of
259.15the primary caregivers;
259.16(2) are moving from an institution due to bed closures;
259.17(3) experience a sudden closure of their current living arrangement;
259.18(4) require protection from confirmed abuse, neglect, or exploitation;
259.19(5) experience a sudden change in need that can no longer be met through state plan
259.20services or other funding resources alone; or
259.21(6) meet other priorities established by the department.
259.22(b) (c) When allocating resources to lead agencies, the commissioner must take into
259.23consideration the number of individuals waiting who meet statewide priorities and the
259.24lead agencies' current use of waiver funds and existing service options. The commissioner
259.25has the authority to transfer funds between counties, groups of counties, and tribes to
259.26accommodate statewide priorities and resource needs while accounting for a necessary
259.27base level reserve amount for each county, group of counties, and tribe.
259.28(c) The commissioner shall evaluate the impact of the use of statewide priorities and
259.29provide recommendations to the legislature on whether to continue the use of statewide
259.30priorities in the November 1, 2011, annual report required by the commissioner in sections
259.31256B.0916, subdivision 7, and 256B.49, subdivision 21.

259.32    Sec. 27. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:
259.33    Subd. 15. Coordinated service and support plan; comprehensive transitional
259.34service plan; maintenance service plan. (a) Each recipient of home and community-based
260.1waivered services shall be provided a copy of the written coordinated service and support
260.2plan which meets the requirements in section 256B.092, subdivision 1b.
260.3(b) In developing the comprehensive transitional service plan, the individual
260.4receiving services, the case manager, and the guardian, if applicable, will identify the
260.5transitional service plan fundamental service outcome and anticipated timeline to achieve
260.6this outcome. Within the first 20 days following a recipient's request for an assessment or
260.7reassessment, the transitional service planning team must be identified. A team leader must
260.8be identified who will be responsible for assigning responsibility and communicating with
260.9team members to ensure implementation of the transition plan and ongoing assessment and
260.10communication process. The team leader should be an individual, such as the case manager
260.11or guardian, who has the opportunity to follow the recipient to the next level of service.
260.12Within ten days following an assessment, a comprehensive transitional service plan
260.13must be developed incorporating elements of a comprehensive functional assessment and
260.14including short-term measurable outcomes and timelines for achievement of and reporting
260.15on these outcomes. Functional milestones must also be identified and reported according
260.16to the timelines agreed upon by the transitional service planning team. In addition, the
260.17comprehensive transitional service plan must identify additional supports that may assist
260.18in the achievement of the fundamental service outcome such as the development of greater
260.19natural community support, increased collaboration among agencies, and technological
260.20supports.
260.21The timelines for reporting on functional milestones will prompt a reassessment of
260.22services provided, the units of services, rates, and appropriate service providers. It is
260.23the responsibility of the transitional service planning team leader to review functional
260.24milestone reporting to determine if the milestones are consistent with observable skills
260.25and that milestone achievement prompts any needed changes to the comprehensive
260.26transitional service plan.
260.27For those whose fundamental transitional service outcome involves the need to
260.28procure housing, a plan for the recipient to seek the resources necessary to secure the least
260.29restrictive housing possible should be incorporated into the plan, including employment
260.30and public supports such as housing access and shelter needy funding.
260.31(c) Counties and other agencies responsible for funding community placement and
260.32ongoing community supportive services are responsible for the implementation of the
260.33comprehensive transitional service plans. Oversight responsibilities include both ensuring
260.34effective transitional service delivery and efficient utilization of funding resources.
260.35(d) Following one year of transitional services, the transitional services planning team
260.36will make a determination as to whether or not the individual receiving services requires
261.1the current level of continuous and consistent support in order to maintain the recipient's
261.2current level of functioning. Recipients who are determined to have not had a significant
261.3change in functioning for 12 months must move from a transitional to a maintenance
261.4service plan. Recipients on a maintenance service plan must be reassessed to determine if
261.5the recipient would benefit from a transitional service plan at least every 12 months and at
261.6other times when there has been a significant change in the recipient's functioning. This
261.7assessment should consider any changes to technological or natural community supports.
261.8(e) When a county is evaluating denials, reductions, or terminations of home and
261.9community-based services under section 256B.49 for an individual, the case manager
261.10shall offer to meet with the individual or the individual's guardian in order to discuss
261.11the prioritization of service needs within the coordinated service and support plan,
261.12comprehensive transitional service plan, or maintenance service plan. The reduction in
261.13the authorized services for an individual due to changes in funding for waivered services
261.14may not exceed the amount needed to ensure medically necessary services to meet the
261.15individual's health, safety, and welfare.
261.16(f) At the time of reassessment, local agency case managers shall assess each recipient
261.17of community alternatives for disabled individuals or brain injury waivered services
261.18currently residing in a licensed adult foster home that is not the primary residence of the
261.19license holder, or in which the license holder is not the primary caregiver, to determine if
261.20that recipient could appropriately be served in a community-living setting. If appropriate
261.21for the recipient, the case manager shall offer the recipient, through a person-centered
261.22planning process, the option to receive alternative housing and service options. In the
261.23event that the recipient chooses to transfer from the adult foster home, the vacated bed
261.24shall not be filled with another recipient of waiver services and group residential housing
261.25and the licensed capacity shall be reduced accordingly, unless the savings required by the
261.26licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7,
261.27sections 1 and 40, paragraph (f), for foster care settings where the physical location is not
261.28the primary residence of the license holder are met through voluntary changes described
261.29in section 245A.03, subdivision 7, paragraph (f) (e), or as provided under paragraph (a),
261.30clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers,
261.31the county agency, with the assistance of the department, shall facilitate a consolidation of
261.32settings or closure. This reassessment process shall be completed by July 1, 2013.

261.33    Sec. 28. Minnesota Statutes 2012, section 256B.49, is amended by adding a
261.34subdivision to read:
262.1    Subd. 25. Reduce avoidable behavioral crisis emergency room admissions,
262.2psychiatric inpatient hospitalizations, and commitments to institutions. (a) Persons
262.3receiving home and community-based services authorized under this section who have
262.4two or more admissions within a calendar year to an emergency room, psychiatric unit,
262.5or institution must receive consultation from a mental health professional as defined in
262.6section 245.462, subdivision 18, or a behavioral professional as defined in the home and
262.7community-based services state plan within 30 days of discharge. The mental health
262.8professional or behavioral professional must:
262.9(1) conduct a functional assessment of the crisis incident as defined in section
262.10245D.02, subdivision 11, which led to the hospitalization with the goal of developing
262.11proactive strategies as well as necessary reactive strategies to reduce the likelihood of
262.12future avoidable hospitalizations due to a behavioral crisis;
262.13(2) use the results of the functional assessment to amend the coordinated service and
262.14support plan in section 245D.02, subdivision 4b, to address the potential need for additional
262.15staff training, increased staffing, access to crisis mobility services, mental health services,
262.16use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
262.17(3) identify the need for additional consultation, testing, mental health crisis
262.18intervention team services as defined in section 245D.02, subdivision 20, psychotropic
262.19medication use and monitoring under section 245D.051, and the frequency and duration
262.20of ongoing consultation.
262.21(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
262.22the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

262.23    Sec. 29. Minnesota Statutes 2012, section 256B.49, is amended by adding a
262.24subdivision to read:
262.25    Subd. 26. Excess allocations. County and tribal agencies will be responsible for
262.26authorizations in excess of the allocation made by the commissioner. In the event a county
262.27or tribal agency authorizes in excess of the allocation made by the commissioner for a
262.28given allocation period, the county or tribal agency must submit a corrective action plan to
262.29the commissioner. The plan must state the actions the agency will take to correct their
262.30overauthorization for the year following the period when the overspending occurred.
262.31Failure to correct overauthorizations shall result in recoupment of authorizations in excess
262.32of the allocation. Nothing in this subdivision shall be construed as reducing the county's
262.33responsibility to offer and make available feasible home and community-based options to
262.34eligible waiver recipients within the resources allocated to them for that purpose.

263.1    Sec. 30. Minnesota Statutes 2012, section 256B.492, is amended to read:
263.2256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
263.3WITH DISABILITIES.
263.4(a) Individuals receiving services under a home and community-based waiver under
263.5section 256B.092 or 256B.49 may receive services in the following settings:
263.6(1) an individual's own home or family home;
263.7(2) a licensed adult foster care setting of up to five people; and
263.8(3) community living settings as defined in section 256B.49, subdivision 23, where
263.9individuals with disabilities may reside in all of the units in a building of four or fewer
263.10units, and no more than the greater of four or 25 percent of the units in a multifamily
263.11building of more than four units, unless required by the Housing Opportunities for Persons
263.12with AIDS Program.
263.13(b) The settings in paragraph (a) must not:
263.14(1) be located in a building that is a publicly or privately operated facility that
263.15provides institutional treatment or custodial care;
263.16(2) be located in a building on the grounds of or adjacent to a public or private
263.17institution;
263.18(3) be a housing complex designed expressly around an individual's diagnosis or
263.19disability, unless required by the Housing Opportunities for Persons with AIDS Program;
263.20(4) be segregated based on a disability, either physically or because of setting
263.21characteristics, from the larger community; and
263.22(5) have the qualities of an institution which include, but are not limited to:
263.23regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
263.24agreed to and documented in the person's individual service plan shall not result in a
263.25residence having the qualities of an institution as long as the restrictions for the person are
263.26not imposed upon others in the same residence and are the least restrictive alternative,
263.27imposed for the shortest possible time to meet the person's needs.
263.28(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
263.29individuals receive services under a home and community-based waiver as of July 1,
263.302012, and the setting does not meet the criteria of this section.
263.31(d) Notwithstanding paragraph (c), a program in Hennepin County established as
263.32part of a Hennepin County demonstration project is qualified for the exception allowed
263.33under paragraph (c).
263.34(e) The commissioner shall submit an amendment to the waiver plan no later than
263.35December 31, 2012.

264.1    Sec. 31. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:
264.2    Subd. 2. Planned closure process needs determination. The commissioner shall
264.3announce and implement a program for planned closure of adult foster care homes. Planned
264.4closure shall be the preferred method for achieving necessary budgetary savings required by
264.5the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph (d)
264.6 (c). If additional closures are required to achieve the necessary savings, the commissioner
264.7shall use the process and priorities in section 245A.03, subdivision 7, paragraph (d) (c).

264.8    Sec. 32. Minnesota Statutes 2012, section 256B.501, is amended by adding a
264.9subdivision to read:
264.10    Subd. 14. Rate adjustment for ICF/DD in Cottonwood County. The
264.11commissioner of health shall decertify three beds in an intermediate care facility for
264.12persons with developmental disabilities with 21 certified beds located in Cottonwood
264.13County. The total payment rate shall be $282.62 per bed, per day.

264.14    Sec. 33. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
264.15subdivision to read:
264.16    Subd. 14. Rate increase effective June 1, 2013. For rate periods beginning on or
264.17after June 1, 2013, the commissioner shall increase the total operating payment rate for
264.18each facility reimbursed under this section by $7.81 per day. The increase shall not be
264.19subject to any annual percentage increase.
264.20EFFECTIVE DATE.This section is effective June 1, 2013.

264.21    Sec. 34. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
264.22subdivision to read:
264.23    Subd. 15. ICF/DD rate increases effective January 1, 2015, and July 1, 2015. (a)
264.24Notwithstanding subdivision 12, for each facility reimbursed under this section, for the rate
264.25period beginning January 1, 2015, the commissioner shall increase operating payments
264.26equal to one percent of the operating payment rates in effect on December 31, 2014.
264.27For the rate period beginning July 1, 2015, the commissioner shall increase operating
264.28payments equal to one percent of the operating payment rates in effect on June 30, 2015.
264.29(b) For each facility, the commissioner shall apply the rate increase based on
264.30occupied beds, using the percentage specified in this subdivision multiplied by the total
264.31payment rate, including the variable rate, but excluding the property-related payment
264.32rate in effect on the preceding date. The total rate increase shall include the adjustment
264.33provided in section 256B.501, subdivision 12.

265.1    Sec. 35. Minnesota Statutes 2012, section 256D.44, subdivision 5, is amended to read:
265.2    Subd. 5. Special needs. In addition to the state standards of assistance established in
265.3subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
265.4Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
265.5center, or a group residential housing facility.
265.6    (a) The county agency shall pay a monthly allowance for medically prescribed
265.7diets if the cost of those additional dietary needs cannot be met through some other
265.8maintenance benefit. The need for special diets or dietary items must be prescribed by
265.9a licensed physician. Costs for special diets shall be determined as percentages of the
265.10allotment for a one-person household under the thrifty food plan as defined by the United
265.11States Department of Agriculture. The types of diets and the percentages of the thrifty
265.12food plan that are covered are as follows:
265.13    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
265.14    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
265.15of thrifty food plan;
265.16    (3) controlled protein diet, less than 40 grams and requires special products, 125
265.17percent of thrifty food plan;
265.18    (4) low cholesterol diet, 25 percent of thrifty food plan;
265.19    (5) high residue diet, 20 percent of thrifty food plan;
265.20    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
265.21    (7) gluten-free diet, 25 percent of thrifty food plan;
265.22    (8) lactose-free diet, 25 percent of thrifty food plan;
265.23    (9) antidumping diet, 15 percent of thrifty food plan;
265.24    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
265.25    (11) ketogenic diet, 25 percent of thrifty food plan.
265.26    (b) Payment for nonrecurring special needs must be allowed for necessary home
265.27repairs or necessary repairs or replacement of household furniture and appliances using
265.28the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
265.29as long as other funding sources are not available.
265.30    (c) A fee for guardian or conservator service is allowed at a reasonable rate
265.31negotiated by the county or approved by the court. This rate shall not exceed five percent
265.32of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
265.33guardian or conservator is a member of the county agency staff, no fee is allowed.
265.34    (d) The county agency shall continue to pay a monthly allowance of $68 for
265.35restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
265.361990, and who eats two or more meals in a restaurant daily. The allowance must continue
266.1until the person has not received Minnesota supplemental aid for one full calendar month
266.2or until the person's living arrangement changes and the person no longer meets the criteria
266.3for the restaurant meal allowance, whichever occurs first.
266.4    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
266.5is allowed for representative payee services provided by an agency that meets the
266.6requirements under SSI regulations to charge a fee for representative payee services. This
266.7special need is available to all recipients of Minnesota supplemental aid regardless of
266.8their living arrangement.
266.9    (f)(1) Notwithstanding the language in this subdivision, an amount equal to the
266.10maximum allotment authorized by the federal Food Stamp Program for a single individual
266.11which is in effect on the first day of July of each year will be added to the standards of
266.12assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify
266.13as shelter needy and are: (i) relocating from an institution, or an adult mental health
266.14residential treatment program under section 256B.0622; (ii) eligible for the self-directed
266.15supports option as defined under section 256B.0657, subdivision 2; or (iii) home and
266.16community-based waiver recipients living in their own home or rented or leased apartment
266.17which is not owned, operated, or controlled by a provider of service not related by blood
266.18or marriage, unless allowed under paragraph (g).
266.19    (2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the
266.20shelter needy benefit under this paragraph is considered a household of one. An eligible
266.21individual who receives this benefit prior to age 65 may continue to receive the benefit
266.22after the age of 65.
266.23    (3) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
266.24exceed 40 percent of the assistance unit's gross income before the application of this
266.25special needs standard. "Gross income" for the purposes of this section is the applicant's or
266.26recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
266.27in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
266.28state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
266.29considered shelter needy for purposes of this paragraph.
266.30(g) Notwithstanding this subdivision, to access housing and services as provided
266.31in paragraph (f), the recipient may choose housing that may be owned, operated, or
266.32controlled by the recipient's service provider. In a multifamily building of more than four
266.33units, the maximum number of units that may be used by recipients of this program shall
266.34be the greater of four units or 25 percent of the units in the building, unless required by the
266.35Housing Opportunities for Persons with AIDS Program. In multifamily buildings of four
266.36or fewer units, all of the units may be used by recipients of this program. When housing is
267.1controlled by the service provider, the individual may choose the individual's own service
267.2provider as provided in section 256B.49, subdivision 23, clause (3). When the housing is
267.3controlled by the service provider, the service provider shall implement a plan with the
267.4recipient to transition the lease to the recipient's name. Within two years of signing the
267.5initial lease, the service provider shall transfer the lease entered into under this subdivision
267.6to the recipient. In the event the landlord denies this transfer, the commissioner may
267.7approve an exception within sufficient time to ensure the continued occupancy by the
267.8recipient. This paragraph expires June 30, 2016.

267.9    Sec. 36. Laws 2011, First Special Session chapter 9, article 7, section 39, subdivision
267.1014, is amended to read:
267.11    Subd. 14. Assessment and reassessment. (a) Assessments of each recipient's
267.12strengths, informal support systems, and need for services shall be completed within 20
267.13working days of the recipient's request as provided in section 256B.0911. Reassessment
267.14of each recipient's strengths, support systems, and need for services shall be conducted
267.15at least every 12 months and at other times when there has been a significant change in
267.16the recipient's functioning.
267.17(b) There must be a determination that the client requires a hospital level of care or a
267.18nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
267.19(d), at initial and subsequent assessments to initiate and maintain participation in the
267.20waiver program.
267.21(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
267.22appropriate to determine nursing facility level of care for purposes of medical assistance
267.23payment for nursing facility services, only face-to-face assessments conducted according
267.24to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
267.25determination or a nursing facility level of care determination must be accepted for
267.26purposes of initial and ongoing access to waiver services payment.
267.27(d) Persons with developmental disabilities who apply for services under the nursing
267.28facility level waiver programs shall be screened for the appropriate level of care according
267.29to section 256B.092.
267.30(e) Recipients who are found eligible for home and community-based services under
267.31this section before their 65th birthday may remain eligible for these services after their
267.3265th birthday if they continue to meet all other eligibility factors.
267.33(f) The commissioner shall develop criteria to identify recipients whose level of
267.34functioning is reasonably expected to improve and reassess these recipients to establish
267.35a baseline assessment. Recipients who meet these criteria must have a comprehensive
268.1transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
268.2reassessed every six months until there has been no significant change in the recipient's
268.3functioning for at least 12 months. After there has been no significant change in the
268.4recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
268.5informal support systems, and need for services shall be conducted at least every 12
268.6months and at other times when there has been a significant change in the recipient's
268.7functioning. Counties, case managers, and service providers are responsible for
268.8conducting these reassessments and shall complete the reassessments out of existing funds.

268.9    Sec. 37. Laws 2012, chapter 247, article 6, section 4, is amended to read:

268.10 268.11

Sec. 4. BOARD OF NURSING HOME ADMINISTRATORS

$

-0-

$

10,000

268.12Administrative Services Unit. This
268.13appropriation is to provide a grant to the
268.14Minnesota Ambulance Association to
268.15coordinate and prepare an assessment of
268.16the extent and costs of uncompensated care
268.17as a direct result of emergency responses
268.18on interstate highways in Minnesota.
268.19The study will collect appropriate
268.20information from medical response units
268.21and ambulance services regulated under
268.22Minnesota Statutes, chapter 144E, and to
268.23the extent possible, firefighting agencies.
268.24In preparing the assessment, the Minnesota
268.25Ambulance Association shall consult with
268.26its membership, the Minnesota Fire Chiefs
268.27Association, the Office of the State Fire
268.28Marshal, and the Emergency Medical
268.29Services Regulatory Board. The findings
268.30of the assessment will be reported to the
268.31chairs and ranking minority members of the
268.32legislative committees with jurisdiction over
268.33health and public safety by January 1, 2013.
268.34 This is a onetime appropriation.

269.1    Sec. 38. DIRECTION TO COMMISSIONER.
269.2    The commissioner of human services shall request authority, in whatever form is
269.3necessary, from the federal Centers for Medicare and Medicaid Services to allow persons
269.4under age 65 participating in the home and community-based services waivers to continue
269.5to use the disregard of the nonassisted spouse's income and assets instead of the spousal
269.6impoverishment provisions under the federal Patient Protection and Affordable Care Act,
269.7Public Law 111-148, section 2404, as amended by the federal Health Care and Education
269.8Reconciliation Act of 2010, Public Law 111-152, and any amendments to, or regulations
269.9or guidance issued under, those acts.

269.10    Sec. 39. RECOMMENDATIONS ON RAISING THE ASSET LIMITS FOR
269.11SENIORS AND PERSONS WITH DISABILITIES.
269.12    The commissioner of human services shall consult with interested stakeholders to
269.13develop recommendations and a request for a federal 1115 demonstration waiver in order
269.14to increase the asset limit for individuals eligible for medical assistance due to disability
269.15or age who are not residing in a nursing facility, intermediate care facility for persons
269.16with developmental disabilities, or other institution whose costs for room and board are
269.17covered by medical assistance or state funds. The recommendations must be provided to
269.18the legislative committees and divisions with jurisdiction over health and human services
269.19policy and finance by February 1, 2014.

269.20    Sec. 40. NURSING HOME LEVEL OF CARE REPORT.
269.21    (a) The commissioner of human services shall report on the impact of the
269.22modification to the nursing facility level of care to be implemented January 1, 2014,
269.23including the following:
269.24    (1) the number of individuals who lose eligibility for home and community-based
269.25services waivers under Minnesota Statutes, sections 256B.0915 and 256B.49, and
269.26alternative care under Minnesota Statutes, section 256B.0913;
269.27    (2) the number of individuals who lose eligibility for medical assistance; and
269.28    (3) for individuals reported under clauses (1) and (2), and to the extent possible:
269.29    (i) their living situation before and after nursing facility level of care implementation;
269.30and
269.31    (ii) the programs or services they received before and after nursing facility level of
269.32care implementation, including, but not limited to, personal care assistant services and
269.33essential community supports.
270.1    (b) The commissioner of human services shall report to the chairs and ranking
270.2minority members of the legislative committees and divisions with jurisdiction over health
270.3and human services policy and finance with the information required under paragraph
270.4(a). A preliminary report shall be submitted on October 1, 2014, and a final report shall
270.5be submitted February 15, 2015.

270.6    Sec. 41. ASSISTIVE TECHNOLOGY EQUIPMENT FOR HOME AND
270.7COMMUNITY-BASED SERVICES WAIVERS FUNDING DEVELOPMENT.
270.8(a) For the purposes of this section, "assistive technology equipment" includes
270.9computer tablets, passive sensors, and other forms of technology allowing increased
270.10safety and independence, and used by those receiving services through a home and
270.11community-based services waiver under Minnesota Statutes, sections 256B.0915,
270.12256B.092, and 256B.49.
270.13(b) The commissioner of human services shall develop recommendations for
270.14assistive technology equipment funding to enable individuals receiving services identified
270.15in paragraph (a) to live in the least restrictive setting possible. In developing the funding,
270.16the commissioner shall examine funding for the following:
270.17(1) an assessment process to match the appropriate assistive technology equipment
270.18with the waiver recipient, including when the recipient's condition changes or progresses;
270.19(2) the use of monitoring services, if applicable, to the assistive technology
270.20equipment identified in clause (1);
270.21(3) the leasing of assistive technology equipment as a possible alternative to
270.22purchasing the equipment; and
270.23(4) ongoing support services, such as technological support.
270.24(c) The commissioner shall provide the chairs and ranking minority members of the
270.25legislative committees and divisions with jurisdiction over health and human services
270.26policy and finance a recommendation for implementing an assistive technology equipment
270.27program as developed in paragraph (b) by February 1, 2014.

270.28    Sec. 42. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JANUARY
270.291, 2015, AND JULY 1, 2015.
270.30(a) The commissioner of human services shall increase reimbursement rates, grants,
270.31allocations, individual limits, and rate limits, as applicable, by one percent for the rate
270.32period beginning January 1, 2015, and by one percent for the rate period beginning July 1,
270.332015, for services rendered on or after those dates. County or tribal contracts for services
271.1specified in this section must be amended to pass through these rate increases within 60
271.2days of the effective date.
271.3(b) The rate changes described in this section must be provided to:
271.4(1) home and community-based waivered services for persons with developmental
271.5disabilities or related conditions, including consumer-directed community supports, under
271.6Minnesota Statutes, section 256B.501;
271.7(2) waivered services under community alternatives for disabled individuals,
271.8including consumer-directed community supports, under Minnesota Statutes, section
271.9256B.49;
271.10(3) community alternative care waivered services, including consumer-directed
271.11community supports, under Minnesota Statutes, section 256B.49;
271.12(4) brain injury waivered services, including consumer-directed community
271.13supports, under Minnesota Statutes, section 256B.49;
271.14(5) home and community-based waivered services for the elderly under Minnesota
271.15Statutes, section 256B.0915;
271.16(6) nursing services and home health services under Minnesota Statutes, section
271.17256B.0625, subdivision 6a;
271.18(7) personal care services and qualified professional supervision of personal care
271.19services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
271.20(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
271.21subdivision 7;
271.22(9) day training and habilitation services for adults with developmental disabilities
271.23or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
271.24additional cost of rate adjustments on day training and habilitation services, provided as a
271.25social service, under Minnesota Statutes, section 256M.60;
271.26(10) alternative care services under Minnesota Statutes, section 256B.0913;
271.27(11) living skills training programs for persons with intractable epilepsy who need
271.28assistance in the transition to independent living under Laws 1988, chapter 689;
271.29(12) semi-independent living services (SILS) under Minnesota Statutes, section
271.30252.275, including SILS funding under county social services grants formerly funded
271.31under Minnesota Statutes, chapter 256I;
271.32(13) consumer support grants under Minnesota Statutes, section 256.476;
271.33(14) family support grants under Minnesota Statutes, section 252.32;
271.34(15) housing access grants under Minnesota Statutes, section 256B.0658;
271.35(16) self-advocacy grants under Laws 2009, chapter 101; and
271.36(17) technology grants under Laws 2009, chapter 79.
272.1(c) A managed care plan receiving state payments for the services in this section
272.2must include these increases in their payments to providers. To implement the rate increase
272.3in this section, capitation rates paid by the commissioner to managed care organizations
272.4under Minnesota Statutes, section 256B.69, shall reflect a one percent increase for the
272.5specified services for the period beginning January 1, 2015.
272.6(d) Counties shall increase the budget for each recipient of consumer-directed
272.7community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).

272.8    Sec. 43. SAFETY NET FOR HOME AND COMMUNITY-BASED SERVICES
272.9WAIVERS.
272.10The commissioner of human services shall submit a request by December 31, 2013,
272.11to the federal government to amend the home and community-based services waivers for
272.12individuals with disabilities authorized under Minnesota Statutes, section 256B.49, to
272.13modify the financial management of the home and community-based services waivers
272.14to provide a state-administered safety net when costs for an individual increase above
272.15an identified threshold. The implementation of the safety net may result in a decreased
272.16allocation for individual counties, tribes, or collaboratives of counties or tribes, but must
272.17not result in a net decreased statewide allocation.

272.18    Sec. 44. SHARED LIVING MODEL.
272.19The commissioner of human services shall develop and promote a shared living model
272.20option for individuals receiving services through the home and community-based services
272.21waivers for individuals with disabilities, authorized under Minnesota Statutes, section
272.22256B.092 or 256B.49, as an option for individuals who require 24-hour assistance. The
272.23option must be a companion model with a limit of one or two individuals receiving support
272.24in the home, planned respite for the caregiver, and the availability of intensive training
272.25and support on the needs of the individual or individuals. Any necessary amendments to
272.26implement the model must be submitted to the federal government by December 31, 2013.

272.27    Sec. 45. MONEY FOLLOWS THE PERSON GRANT.
272.28The commissioner of human services shall submit to the federal government all
272.29necessary waiver amendments to implement the Money Follows the Person federal grant
272.30by December 31, 2013.

272.31    Sec. 46. REPEALER.
273.1Minnesota Statutes 2012, sections 256B.096, subdivisions 1, 2, 3, and 4; and
273.2256B.5012, subdivision 13; and Laws 2011, First Special Session chapter 9, article 7,
273.3section 54, as amended by Laws 2012, chapter 247, article 4, section 42, and Laws 2012,
273.4chapter 298, section 3, are repealed.


273.7    Section 1. Minnesota Statutes 2012, section 13.461, is amended by adding a
273.8subdivision to read:
273.9    Subd. 7c. Human services license holders. Section 245D.095, subdivision 3,
273.10requires certain license holders to protect service recipient records in accordance with
273.11specified provisions of this chapter.

273.12    Sec. 2. Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:
273.13    Subd. 7. Health care facility. "Health care facility" means a hospital or other entity
273.14licensed under sections 144.50 to 144.58, a nursing home licensed to serve adults under
273.15section 144A.02, a home care provider licensed under sections 144A.43 to 144A.47,
273.16an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts
273.179555.5105 to 9555.6265, a community residential setting licensed under chapter 245D, or
273.18a hospice provider licensed under sections 144A.75 to 144A.755.

273.19    Sec. 3. Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:
273.20    Subd. 4b. Health care facility; notice of status. (a) For the purposes of this
273.21subdivision, "health care facility" means a facility:
273.22(1) licensed by the commissioner of health as a hospital, boarding care home or
273.23supervised living facility under sections 144.50 to 144.58, or a nursing home under
273.24chapter 144A;
273.25(2) registered by the commissioner of health as a housing with services establishment
273.26as defined in section 144D.01; or
273.27(3) licensed by the commissioner of human services as a residential facility under
273.28chapter 245A to provide adult foster care, adult mental health treatment, chemical
273.29dependency treatment to adults, or residential services to persons with developmental
273.30 disabilities.
273.31(b) Prior to admission to a health care facility, a person required to register under
273.32this section shall disclose to:
274.1(1) the health care facility employee processing the admission the person's status
274.2as a registered predatory offender under this section; and
274.3(2) the person's corrections agent, or if the person does not have an assigned
274.4corrections agent, the law enforcement authority with whom the person is currently
274.5required to register, that inpatient admission will occur.
274.6(c) A law enforcement authority or corrections agent who receives notice under
274.7paragraph (b) or who knows that a person required to register under this section is
274.8planning to be admitted and receive, or has been admitted and is receiving health care
274.9at a health care facility shall notify the administrator of the facility and deliver a fact
274.10sheet to the administrator containing the following information: (1) name and physical
274.11description of the offender; (2) the offender's conviction history, including the dates of
274.12conviction; (3) the risk level classification assigned to the offender under section 244.052,
274.13if any; and (4) the profile of likely victims.
274.14(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care
274.15facility receives a fact sheet under paragraph (c) that includes a risk level classification for
274.16the offender, and if the facility admits the offender, the facility shall distribute the fact
274.17sheet to all residents at the facility. If the facility determines that distribution to a resident
274.18is not appropriate given the resident's medical, emotional, or mental status, the facility
274.19shall distribute the fact sheet to the patient's next of kin or emergency contact.

274.20    Sec. 4. [245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY
274.21MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
274.22    Subdivision 1. Rules. The commissioner of human services shall, within 24 months
274.23of enactment of this section, adopt rules governing the use of positive support strategies,
274.24safety interventions, and emergency use of manual restraint in facilities and services
274.25licensed under chapter 245D.
274.26    Subd. 2. Data collection. (a) The commissioner shall, with stakeholder input,
274.27develop data collection elements specific to incidents on the use of controlled procedures
274.28with persons receiving services from providers regulated under Minnesota Rules, parts
274.299525.2700 to 9525.2810, and incidents involving persons receiving services from
274.30providers identified to be licensed under chapter 245D effective January 1, 2014. Providers
274.31shall report the data in a format and at a frequency provided by the commissioner of
274.32human services.
274.33(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts
274.349525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures
274.35in a format and at a frequency provided by the commissioner.

275.1    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:
275.2    Subd. 10. Nonresidential program. "Nonresidential program" means care,
275.3supervision, rehabilitation, training or habilitation of a person provided outside the
275.4person's own home and provided for fewer than 24 hours a day, including adult day
275.5care programs; and chemical dependency or chemical abuse programs that are located
275.6in a nursing home or hospital and receive public funds for providing chemical abuse or
275.7chemical dependency treatment services under chapter 254B. Nonresidential programs
275.8include home and community-based services and semi-independent living services for
275.9persons with developmental disabilities or persons age 65 and older that are provided in
275.10or outside of a person's own home under chapter 245D.

275.11    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:
275.12    Subd. 14. Residential program. "Residential program" means a program
275.13that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training,
275.14education, habilitation, or treatment outside a person's own home, including a program
275.15in an intermediate care facility for four or more persons with developmental disabilities;
275.16and chemical dependency or chemical abuse programs that are located in a hospital
275.17or nursing home and receive public funds for providing chemical abuse or chemical
275.18dependency treatment services under chapter 254B. Residential programs include home
275.19and community-based services for persons with developmental disabilities or persons age
275.2065 and older that are provided in or outside of a person's own home under chapter 245D.

275.21    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
275.22    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial
275.23license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,
275.24or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under
275.25this chapter for a physical location that will not be the primary residence of the license
275.26holder for the entire period of licensure. If a license is issued during this moratorium, and
275.27the license holder changes the license holder's primary residence away from the physical
275.28location of the foster care license, the commissioner shall revoke the license according
275.29to section 245A.07. The commissioner shall not issue an initial license for a community
275.30residential setting licensed under chapter 245D. Exceptions to the moratorium include:
275.31(1) foster care settings that are required to be registered under chapter 144D;
275.32(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
275.33community residential setting licenses replacing adult foster care licenses in existence on
275.34December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
276.1(3) new foster care licenses or community residential setting licenses determined to
276.2be needed by the commissioner under paragraph (b) for the closure of a nursing facility,
276.3ICF/MR, or regional treatment center, or restructuring of state-operated services that
276.4limits the capacity of state-operated facilities;
276.5(4) new foster care licenses or community residential setting licenses determined
276.6to be needed by the commissioner under paragraph (b) for persons requiring hospital
276.7level care; or
276.8(5) new foster care licenses or community residential setting licenses determined to
276.9be needed by the commissioner for the transition of people from personal care assistance
276.10to the home and community-based services.
276.11(b) The commissioner shall determine the need for newly licensed foster care
276.12homes or community residential settings as defined under this subdivision. As part of the
276.13determination, the commissioner shall consider the availability of foster care capacity in
276.14the area in which the licensee seeks to operate, and the recommendation of the local
276.15county board. The determination by the commissioner must be final. A determination of
276.16need is not required for a change in ownership at the same address.
276.17(c) The commissioner shall study the effects of the license moratorium under this
276.18subdivision and shall report back to the legislature by January 15, 2011. This study shall
276.19include, but is not limited to the following:
276.20(1) the overall capacity and utilization of foster care beds where the physical location
276.21is not the primary residence of the license holder prior to and after implementation
276.22of the moratorium;
276.23(2) the overall capacity and utilization of foster care beds where the physical
276.24location is the primary residence of the license holder prior to and after implementation
276.25of the moratorium; and
276.26(3) the number of licensed and occupied ICF/MR beds prior to and after
276.27implementation of the moratorium.
276.28(d) When a foster care recipient resident served by the program moves out of a
276.29foster home that is not the primary residence of the license holder according to section
276.30256B.49, subdivision 15 , paragraph (f), or the community residential setting, the county
276.31shall immediately inform the Department of Human Services Licensing Division.
276.32The department shall decrease the statewide licensed capacity for foster care settings
276.33where the physical location is not the primary residence of the license holder, or for
276.34community residential settings, if the voluntary changes described in paragraph (f) are
276.35not sufficient to meet the savings required by reductions in licensed bed capacity under
276.36Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
277.1and maintain statewide long-term care residential services capacity within budgetary
277.2limits. Implementation of the statewide licensed capacity reduction shall begin on July
277.31, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the
277.4needs determination process. Under this paragraph, the commissioner has the authority
277.5to reduce unused licensed capacity of a current foster care program, or the community
277.6residential settings, to accomplish the consolidation or closure of settings. A decreased
277.7licensed capacity according to this paragraph is not subject to appeal under this chapter.
277.8(e) Residential settings that would otherwise be subject to the decreased license
277.9capacity established in paragraph (d) shall be exempt under the following circumstances:
277.10(1) until August 1, 2013, the license holder's beds occupied by residents whose
277.11primary diagnosis is mental illness and the license holder is:
277.12(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
277.13health services (ARMHS) as defined in section 256B.0623;
277.14(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
277.159520.0870;
277.16(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
277.179520.0870; or
277.18(iv) a provider of intensive residential treatment services (IRTS) licensed under
277.19Minnesota Rules, parts 9520.0500 to 9520.0670; or
277.20(2) the license holder is certified under the requirements in subdivision 6a or section
277.21245D.33.
277.22(f) A resource need determination process, managed at the state level, using the
277.23available reports required by section 144A.351, and other data and information shall
277.24be used to determine where the reduced capacity required under paragraph (d) will be
277.25implemented. The commissioner shall consult with the stakeholders described in section
277.26144A.351 , and employ a variety of methods to improve the state's capacity to meet
277.27long-term care service needs within budgetary limits, including seeking proposals from
277.28service providers or lead agencies to change service type, capacity, or location to improve
277.29services, increase the independence of residents, and better meet needs identified by the
277.30long-term care services reports and statewide data and information. By February 1 of each
277.31year, the commissioner shall provide information and data on the overall capacity of
277.32licensed long-term care services, actions taken under this subdivision to manage statewide
277.33long-term care services and supports resources, and any recommendations for change to
277.34the legislative committees with jurisdiction over health and human services budget.
277.35    (g) At the time of application and reapplication for licensure, the applicant and the
277.36license holder that are subject to the moratorium or an exclusion established in paragraph
278.1(a) are required to inform the commissioner whether the physical location where the foster
278.2care will be provided is or will be the primary residence of the license holder for the entire
278.3period of licensure. If the primary residence of the applicant or license holder changes, the
278.4applicant or license holder must notify the commissioner immediately. The commissioner
278.5shall print on the foster care license certificate whether or not the physical location is the
278.6primary residence of the license holder.
278.7    (h) License holders of foster care homes identified under paragraph (g) that are not
278.8the primary residence of the license holder and that also provide services in the foster care
278.9home that are covered by a federally approved home and community-based services
278.10waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the
278.11human services licensing division that the license holder provides or intends to provide
278.12these waiver-funded services. These license holders must be considered registered under
278.13section 256B.092, subdivision 11, paragraph (c), and this registration status must be
278.14identified on their license certificates.

278.15    Sec. 8. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:
278.16    Subd. 8. Excluded providers seeking licensure. Nothing in this section shall
278.17prohibit a program that is excluded from licensure under subdivision 2, paragraph
278.18(a), clause (28) (26), from seeking licensure. The commissioner shall ensure that any
278.19application received from such an excluded provider is processed in the same manner as
278.20all other applications for child care center licensure.

278.21    Sec. 9. Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:
278.22    Subd. 3. Implementation. (a) The commissioner shall implement the
278.23responsibilities of this chapter according to the timelines in paragraphs (b) and (c)
278.24only within the limits of available appropriations or other administrative cost recovery
278.25methodology.
278.26(b) The licensure of home and community-based services according to this section
278.27shall be implemented January 1, 2014. License applications shall be received and
278.28processed on a phased-in schedule as determined by the commissioner beginning July
278.291, 2013. Licenses will be issued thereafter upon the commissioner's determination that
278.30the application is complete according to section 245A.04.
278.31(c) Within the limits of available appropriations or other administrative cost recovery
278.32methodology, implementation of compliance monitoring must be phased in after January
278.331, 2014.
279.1(1) Applicants who do not currently hold a license issued under this chapter 245B
279.2 must receive an initial compliance monitoring visit after 12 months of the effective date of
279.3the initial license for the purpose of providing technical assistance on how to achieve and
279.4maintain compliance with the applicable law or rules governing the provision of home and
279.5community-based services under chapter 245D. If during the review the commissioner
279.6finds that the license holder has failed to achieve compliance with an applicable law or
279.7rule and this failure does not imminently endanger the health, safety, or rights of the
279.8persons served by the program, the commissioner may issue a licensing review report with
279.9recommendations for achieving and maintaining compliance.
279.10(2) Applicants who do currently hold a license issued under this chapter must receive
279.11a compliance monitoring visit after 24 months of the effective date of the initial license.
279.12(d) Nothing in this subdivision shall be construed to limit the commissioner's
279.13authority to suspend or revoke a license or issue a fine at any time under section 245A.07,
279.14or make issue correction orders and make a license conditional for failure to comply with
279.15applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity
279.16of the violation of law or rule and the effect of the violation on the health, safety, or
279.17rights of persons served by the program.

279.18    Sec. 10. Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:
279.19    Subd. 2a. Consolidated contested case hearings. (a) When a denial of a license
279.20under section 245A.05 or a licensing sanction under section 245A.07, subdivision 3, is
279.21based on a disqualification for which reconsideration was requested and which was not
279.22set aside under section 245C.22, the scope of the contested case hearing shall include the
279.23disqualification and the licensing sanction or denial of a license, unless otherwise specified
279.24in this subdivision. When the licensing sanction or denial of a license is based on a
279.25determination of maltreatment under section 626.556 or 626.557, or a disqualification for
279.26serious or recurring maltreatment which was not set aside, the scope of the contested case
279.27hearing shall include the maltreatment determination, disqualification, and the licensing
279.28sanction or denial of a license, unless otherwise specified in this subdivision. In such
279.29cases, a fair hearing under section 256.045 shall not be conducted as provided for in
279.30sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.
279.31    (b) Except for family child care and child foster care, reconsideration of a
279.32maltreatment determination under sections 626.556, subdivision 10i, and 626.557,
279.33subdivision 9d, and reconsideration of a disqualification under section 245C.22, shall
279.34not be conducted when:
280.1    (1) a denial of a license under section 245A.05, or a licensing sanction under section
280.2245A.07 , is based on a determination that the license holder is responsible for maltreatment
280.3or the disqualification of a license holder is based on serious or recurring maltreatment;
280.4    (2) the denial of a license or licensing sanction is issued at the same time as the
280.5maltreatment determination or disqualification; and
280.6    (3) the license holder appeals the maltreatment determination or disqualification,
280.7and denial of a license or licensing sanction. In these cases, a fair hearing shall not be
280.8conducted under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision
280.99d. The scope of the contested case hearing must include the maltreatment determination,
280.10disqualification, and denial of a license or licensing sanction.
280.11    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
280.12determination or disqualification, but does not appeal the denial of a license or a licensing
280.13sanction, reconsideration of the maltreatment determination shall be conducted under
280.14sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
280.15disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
280.16shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
280.17626.557, subdivision 9d .
280.18    (c) In consolidated contested case hearings regarding sanctions issued in family child
280.19care, child foster care, family adult day services, and adult foster care, and community
280.20residential settings, the county attorney shall defend the commissioner's orders in
280.21accordance with section 245A.16, subdivision 4.
280.22    (d) The commissioner's final order under subdivision 5 is the final agency action
280.23on the issue of maltreatment and disqualification, including for purposes of subsequent
280.24background studies under chapter 245C and is the only administrative appeal of the final
280.25agency determination, specifically, including a challenge to the accuracy and completeness
280.26of data under section 13.04.
280.27    (e) When consolidated hearings under this subdivision involve a licensing sanction
280.28based on a previous maltreatment determination for which the commissioner has issued
280.29a final order in an appeal of that determination under section 256.045, or the individual
280.30failed to exercise the right to appeal the previous maltreatment determination under
280.31section 626.556, subdivision 10i, or 626.557, subdivision 9d, the commissioner's order is
280.32conclusive on the issue of maltreatment. In such cases, the scope of the administrative
280.33law judge's review shall be limited to the disqualification and the licensing sanction or
280.34denial of a license. In the case of a denial of a license or a licensing sanction issued to
280.35a facility based on a maltreatment determination regarding an individual who is not the
281.1license holder or a household member, the scope of the administrative law judge's review
281.2includes the maltreatment determination.
281.3    (f) The hearings of all parties may be consolidated into a single contested case
281.4hearing upon consent of all parties and the administrative law judge, if:
281.5    (1) a maltreatment determination or disqualification, which was not set aside under
281.6section 245C.22, is the basis for a denial of a license under section 245A.05 or a licensing
281.7sanction under section 245A.07;
281.8    (2) the disqualified subject is an individual other than the license holder and upon
281.9whom a background study must be conducted under section 245C.03; and
281.10    (3) the individual has a hearing right under section 245C.27.
281.11    (g) When a denial of a license under section 245A.05 or a licensing sanction under
281.12section 245A.07 is based on a disqualification for which reconsideration was requested
281.13and was not set aside under section 245C.22, and the individual otherwise has no hearing
281.14right under section 245C.27, the scope of the administrative law judge's review shall
281.15include the denial or sanction and a determination whether the disqualification should
281.16be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In
281.17determining whether the disqualification should be set aside, the administrative law judge
281.18shall consider the factors under section 245C.22, subdivision 4, to determine whether the
281.19individual poses a risk of harm to any person receiving services from the license holder.
281.20    (h) Notwithstanding section 245C.30, subdivision 5, when a licensing sanction
281.21under section 245A.07 is based on the termination of a variance under section 245C.30,
281.22subdivision 4 , the scope of the administrative law judge's review shall include the sanction
281.23and a determination whether the disqualification should be set aside, unless section
281.24245C.24 prohibits the set-aside of the disqualification. In determining whether the
281.25disqualification should be set aside, the administrative law judge shall consider the factors
281.26under section 245C.22, subdivision 4, to determine whether the individual poses a risk of
281.27harm to any person receiving services from the license holder.

281.28    Sec. 11. Minnesota Statutes 2012, section 245A.10, is amended to read:
281.29245A.10 FEES.
281.30    Subdivision 1. Application or license fee required, programs exempt from fee.
281.31(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
281.32of applications and inspection of programs which are licensed under this chapter.
281.33(b) Except as provided under subdivision 2, no application or license fee shall be
281.34charged for child foster care, adult foster care, or family and group family child care, or
281.35a community residential setting.
282.1    Subd. 2. County fees for background studies and licensing inspections. (a) For
282.2purposes of family and group family child care licensing under this chapter, a county
282.3agency may charge a fee to an applicant or license holder to recover the actual cost of
282.4background studies, but in any case not to exceed $100 annually. A county agency may
282.5also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
282.6license or $100 for a two-year license.
282.7    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
282.8applicant for authorization to recover the actual cost of background studies completed
282.9under section 119B.125, but in any case not to exceed $100 annually.
282.10    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
282.11    (1) in cases of financial hardship;
282.12    (2) if the county has a shortage of providers in the county's area;
282.13    (3) for new providers; or
282.14    (4) for providers who have attained at least 16 hours of training before seeking
282.15initial licensure.
282.16    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
282.17an installment basis for up to one year. If the provider is receiving child care assistance
282.18payments from the state, the provider may have the fees under paragraph (a) or (b)
282.19deducted from the child care assistance payments for up to one year and the state shall
282.20reimburse the county for the county fees collected in this manner.
282.21    (e) For purposes of adult foster care and child foster care licensing, and licensing
282.22the physical plant of a community residential setting, under this chapter, a county agency
282.23may charge a fee to a corporate applicant or corporate license holder to recover the actual
282.24cost of licensing inspections, not to exceed $500 annually.
282.25    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
282.26following circumstances:
282.27(1) in cases of financial hardship;
282.28(2) if the county has a shortage of providers in the county's area; or
282.29(3) for new providers.
282.30    Subd. 3. Application fee for initial license or certification. (a) For fees required
282.31under subdivision 1, an applicant for an initial license or certification issued by the
282.32commissioner shall submit a $500 application fee with each new application required
282.33under this subdivision. An applicant for an initial day services facility license under
282.34chapter 245D shall submit a $250 application fee with each new application. The
282.35application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license
283.1or certification fee that expires on December 31. The commissioner shall not process an
283.2application until the application fee is paid.
283.3(b) Except as provided in clauses (1) to (4) (3), an applicant shall apply for a license
283.4to provide services at a specific location.
283.5(1) For a license to provide residential-based habilitation services to persons with
283.6developmental disabilities under chapter 245B, an applicant shall submit an application
283.7for each county in which the services will be provided. Upon licensure, the license
283.8holder may provide services to persons in that county plus no more than three persons
283.9at any one time in each of up to ten additional counties. A license holder in one county
283.10may not provide services under the home and community-based waiver for persons with
283.11developmental disabilities to more than three people in a second county without holding
283.12a separate license for that second county. Applicants or licensees providing services
283.13under this clause to not more than three persons remain subject to the inspection fees
283.14established in section 245A.10, subdivision 2, for each location. The license issued by
283.15the commissioner must state the name of each additional county where services are being
283.16provided to persons with developmental disabilities. A license holder must notify the
283.17commissioner before making any changes that would alter the license information listed
283.18under section 245A.04, subdivision 7, paragraph (a), including any additional counties
283.19where persons with developmental disabilities are being served. For a license to provide
283.20home and community-based services to persons with disabilities or age 65 and older under
283.21chapter 245D, an applicant shall submit an application to provide services statewide.
283.22(2) For a license to provide supported employment, crisis respite, or
283.23semi-independent living services to persons with developmental disabilities under chapter
283.24245B, an applicant shall submit a single application to provide services statewide.
283.25(3) For a license to provide independent living assistance for youth under section
283.26245A.22 , an applicant shall submit a single application to provide services statewide.
283.27(4) (3) For a license for a private agency to provide foster care or adoption services
283.28under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
283.29application to provide services statewide.
283.30(c) The initial application fee charged under this subdivision does not include the
283.31temporary license surcharge under section 16E.22.
283.32    Subd. 4. License or certification fee for certain programs. (a) Child care centers
283.33shall pay an annual nonrefundable license fee based on the following schedule:

283.34 283.35		Licensed Capacity	Child Care Center License Fee
283.36		1 to 24 persons	$200
283.37		25 to 49 persons	$300
284.1		50 to 74 persons	$400
284.2		75 to 99 persons	$500
284.3		100 to 124 persons	$600
284.4		125 to 149 persons	$700
284.5		150 to 174 persons	$800
284.6		175 to 199 persons	$900
284.7		200 to 224 persons	$1,000
284.8		225 or more persons	$1,100

284.9    (b) A day training and habilitation program serving persons with developmental
284.10disabilities or related conditions shall pay an annual nonrefundable license fee based on
284.11the following schedule:

284.12		Licensed Capacity	License Fee
284.13		1 to 24 persons	$800
284.14		25 to 49 persons	$1,000
284.15		50 to 74 persons	$1,200
284.16		75 to 99 persons	$1,400
284.17		100 to 124 persons	$1,600
284.18		125 to 149 persons	$1,800
284.19		150 or more persons	$2,000

284.20Except as provided in paragraph (c), when a day training and habilitation program
284.21serves more than 50 percent of the same persons in two or more locations in a community,
284.22the day training and habilitation program shall pay a license fee based on the licensed
284.23capacity of the largest facility and the other facility or facilities shall be charged a license
284.24fee based on a licensed capacity of a residential program serving one to 24 persons.
284.25    (c) When a day training and habilitation program serving persons with developmental
284.26disabilities or related conditions seeks a single license allowed under section 245B.07,
284.27subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
284.28capacity for each location.
284.29(d) A program licensed to provide supported employment services to persons
284.30with developmental disabilities under chapter 245B shall pay an annual nonrefundable
284.31license fee of $650.
284.32(e) A program licensed to provide crisis respite services to persons with
284.33developmental disabilities under chapter 245B shall pay an annual nonrefundable license
284.34fee of $700.
284.35(f) A program licensed to provide semi-independent living services to persons
284.36with developmental disabilities under chapter 245B shall pay an annual nonrefundable
284.37license fee of $700.
285.1(g) A program licensed to provide residential-based habilitation services under the
285.2home and community-based waiver for persons with developmental disabilities shall pay
285.3an annual license fee that includes a base rate of $690 plus $60 times the number of clients
285.4served on the first day of July of the current license year.
285.5(h) A residential program certified by the Department of Health as an intermediate
285.6care facility for persons with developmental disabilities (ICF/MR) and a noncertified
285.7residential program licensed to provide health or rehabilitative services for persons
285.8with developmental disabilities shall pay an annual nonrefundable license fee based on
285.9the following schedule:

285.10		Licensed Capacity	License Fee
285.11		1 to 24 persons	$535
285.12		25 to 49 persons	$735
285.13		50 or more persons	$935

285.14(b) A program licensed to provide one or more of the home and community-based
285.15services and supports identified under chapter 245D to persons with disabilities or age
285.1665 and older, shall pay an annual nonrefundable license fee that includes a base rate of
285.17$563, plus $46 times the number of persons served on the last day of June of the current
285.18license year for programs serving ten or more persons. The fee is limited to a maximum of
285.19200 persons, regardless of the actual number of persons served. Programs serving nine
285.20or fewer persons pay only the base rate.
285.21(c) A facility licensed under chapter 245D to provide day services shall pay an
285.22annual nonrefundable license fee of $100.
285.23(i) (d) A chemical dependency treatment program licensed under Minnesota Rules,
285.24parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an
285.25annual nonrefundable license fee based on the following schedule:

285.26		Licensed Capacity	License Fee
285.27		1 to 24 persons	$600
285.28		25 to 49 persons	$800
285.29		50 to 74 persons	$1,000
285.30		75 to 99 persons	$1,200
285.31		100 or more persons	$1,400

285.32(j) (e) A chemical dependency program licensed under Minnesota Rules, parts
285.339530.6510 to 9530.6590, to provide detoxification services shall pay an annual
285.34nonrefundable license fee based on the following schedule:

285.35		Licensed Capacity	License Fee
285.36		1 to 24 persons	$760
286.1		25 to 49 persons	$960
286.2		50 or more persons	$1,160

286.3(k) (f) Except for child foster care, a residential facility licensed under Minnesota
286.4Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
286.5based on the following schedule:

286.6		Licensed Capacity	License Fee
286.7		1 to 24 persons	$1,000
286.8		25 to 49 persons	$1,100
286.9		50 to 74 persons	$1,200
286.10		75 to 99 persons	$1,300
286.11		100 or more persons	$1,400

286.12(l) (g) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
286.139520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
286.14fee based on the following schedule:

286.15		Licensed Capacity	License Fee
286.16		1 to 24 persons	$2,525
286.17		25 or more persons	$2,725

286.18(m) (h) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
286.199570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
286.20license fee based on the following schedule:

286.21		Licensed Capacity	License Fee
286.22		1 to 24 persons	$450
286.23		25 to 49 persons	$650
286.24		50 to 74 persons	$850
286.25		75 to 99 persons	$1,050
286.26		100 or more persons	$1,250

286.27(n) (i) A program licensed to provide independent living assistance for youth under
286.28section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
286.29(o) (j) A private agency licensed to provide foster care and adoption services under
286.30Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
286.31license fee of $875.
286.32(p) (k) A program licensed as an adult day care center licensed under Minnesota
286.33Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based
286.34on the following schedule:

286.35		Licensed Capacity	License Fee
286.36		1 to 24 persons	$500
286.37		25 to 49 persons	$700
287.1		50 to 74 persons	$900
287.2		75 to 99 persons	$1,100
287.3		100 or more persons	$1,300

287.4(q) (l) A program licensed to provide treatment services to persons with sexual
287.5psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
287.69515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
287.7(r) (m) A mental health center or mental health clinic requesting certification for
287.8purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
287.9parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
287.10mental health center or mental health clinic provides services at a primary location with
287.11satellite facilities, the satellite facilities shall be certified with the primary location without
287.12an additional charge.
287.13    Subd. 6. License not issued until license or certification fee is paid. The
287.14commissioner shall not issue a license or certification until the license or certification fee
287.15is paid. The commissioner shall send a bill for the license or certification fee to the billing
287.16address identified by the license holder. If the license holder does not submit the license or
287.17certification fee payment by the due date, the commissioner shall send the license holder
287.18a past due notice. If the license holder fails to pay the license or certification fee by the
287.19due date on the past due notice, the commissioner shall send a final notice to the license
287.20holder informing the license holder that the program license will expire on December 31
287.21unless the license fee is paid before December 31. If a license expires, the program is no
287.22longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2,
287.23must not operate after the expiration date. After a license expires, if the former license
287.24holder wishes to provide licensed services, the former license holder must submit a new
287.25license application and application fee under subdivision 3.
287.26    Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding
287.27section 16A.1285, subdivision 2, related to activities for which the commissioner charges
287.28a fee, the commissioner must plan to fully recover direct expenditures for licensing
287.29activities under this chapter over a five-year period. The commissioner may have
287.30anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
287.31revenues accumulated in previous bienniums.
287.32    Subd. 8. Deposit of license fees. A human services licensing account is created in
287.33the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
287.34be deposited in the human services licensing account and are annually appropriated to the
287.35commissioner for licensing activities authorized under this chapter.
287.36EFFECTIVE DATE.This section is effective July 1, 2013.

288.1    Sec. 12. Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:
288.2    Subd. 2a. Adult foster care and community residential setting license capacity.
288.3(a) The commissioner shall issue adult foster care and community residential setting
288.4 licenses with a maximum licensed capacity of four beds, including nonstaff roomers and
288.5boarders, except that the commissioner may issue a license with a capacity of five beds,
288.6including roomers and boarders, according to paragraphs (b) to (f).
288.7(b) An adult foster care The license holder may have a maximum license capacity
288.8of five if all persons in care are age 55 or over and do not have a serious and persistent
288.9mental illness or a developmental disability.
288.10(c) The commissioner may grant variances to paragraph (b) to allow a foster care
288.11provider facility with a licensed capacity of five persons to admit an individual under the
288.12age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of
288.13the variance is recommended by the county in which the licensed foster care provider
288.14 facility is located.
288.15(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
288.16bed for emergency crisis services for a person with serious and persistent mental illness
288.17or a developmental disability, regardless of age, if the variance complies with section
288.18245A.04, subdivision 9 , and approval of the variance is recommended by the county in
288.19which the licensed foster care provider facility is located.
288.20(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a
288.21fifth bed for respite services, as defined in section 245A.02, for persons with disabilities,
288.22regardless of age, if the variance complies with sections 245A.03, subdivision 7, and
288.23245A.04, subdivision 9 , and approval of the variance is recommended by the county in
288.24which the licensed foster care provider facility is licensed located. Respite care may be
288.25provided under the following conditions:
288.26(1) staffing ratios cannot be reduced below the approved level for the individuals
288.27being served in the home on a permanent basis;
288.28(2) no more than two different individuals can be accepted for respite services in
288.29any calendar month and the total respite days may not exceed 120 days per program in
288.30any calendar year;
288.31(3) the person receiving respite services must have his or her own bedroom, which
288.32could be used for alternative purposes when not used as a respite bedroom, and cannot be
288.33the room of another person who lives in the foster care home facility; and
288.34(4) individuals living in the foster care home facility must be notified when the
288.35variance is approved. The provider must give 60 days' notice in writing to the residents
288.36and their legal representatives prior to accepting the first respite placement. Notice must
289.1be given to residents at least two days prior to service initiation, or as soon as the license
289.2holder is able if they receive notice of the need for respite less than two days prior to
289.3initiation, each time a respite client will be served, unless the requirement for this notice is
289.4waived by the resident or legal guardian.
289.5(f) The commissioner may issue an adult foster care or community residential setting
289.6 license with a capacity of five adults if the fifth bed does not increase the overall statewide
289.7capacity of licensed adult foster care or community residential setting beds in homes that
289.8are not the primary residence of the license holder, as identified in a plan submitted to the
289.9commissioner by the county, when the capacity is recommended by the county licensing
289.10agency of the county in which the facility is located and if the recommendation verifies that:
289.11(1) the facility meets the physical environment requirements in the adult foster
289.12care licensing rule;
289.13(2) the five-bed living arrangement is specified for each resident in the resident's:
289.14(i) individualized plan of care;
289.15(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
289.16(iii) individual resident placement agreement under Minnesota Rules, part
289.179555.5105, subpart 19, if required;
289.18(3) the license holder obtains written and signed informed consent from each
289.19resident or resident's legal representative documenting the resident's informed choice
289.20to remain living in the home and that the resident's refusal to consent would not have
289.21resulted in service termination; and
289.22(4) the facility was licensed for adult foster care before March 1, 2011.
289.23(g) The commissioner shall not issue a new adult foster care license under paragraph
289.24(f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care
289.25license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five
289.26adults if the license holder continues to comply with the requirements in paragraph (f).

289.27    Sec. 13. Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:
289.28    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The
289.29commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
289.30requiring a caregiver to be present in an adult foster care home during normal sleeping
289.31hours to allow for alternative methods of overnight supervision. The commissioner may
289.32grant the variance if the local county licensing agency recommends the variance and the
289.33county recommendation includes documentation verifying that:
290.1    (1) the county has approved the license holder's plan for alternative methods of
290.2providing overnight supervision and determined the plan protects the residents' health,
290.3safety, and rights;
290.4    (2) the license holder has obtained written and signed informed consent from
290.5each resident or each resident's legal representative documenting the resident's or legal
290.6representative's agreement with the alternative method of overnight supervision; and
290.7    (3) the alternative method of providing overnight supervision, which may include
290.8the use of technology, is specified for each resident in the resident's: (i) individualized
290.9plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
290.10required; or (iii) individual resident placement agreement under Minnesota Rules, part
290.119555.5105, subpart 19, if required.
290.12    (b) To be eligible for a variance under paragraph (a), the adult foster care license
290.13holder must not have had a conditional license issued under section 245A.06, or any
290.14other licensing sanction issued under section 245A.07 during the prior 24 months based
290.15on failure to provide adequate supervision, health care services, or resident safety in
290.16the adult foster care home.
290.17    (c) A license holder requesting a variance under this subdivision to utilize
290.18technology as a component of a plan for alternative overnight supervision may request
290.19the commissioner's review in the absence of a county recommendation. Upon receipt of
290.20such a request from a license holder, the commissioner shall review the variance request
290.21with the county.
290.22(d) A variance granted by the commissioner according to this subdivision before
290.23January 1, 2014, to a license holder for an adult foster care home must transfer with the
290.24license when the license converts to a community residential setting license under chapter
290.25245D. The terms and conditions of the variance remain in effect as approved at the time
290.26the variance was granted.

290.27    Sec. 14. Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:
290.28    Subd. 7a. Alternate overnight supervision technology; adult foster care license
290.29 and community residential setting licenses. (a) The commissioner may grant an
290.30applicant or license holder an adult foster care or community residential setting license
290.31for a residence that does not have a caregiver in the residence during normal sleeping
290.32hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, or section
290.33245D.02, subdivision 33b, but uses monitoring technology to alert the license holder
290.34when an incident occurs that may jeopardize the health, safety, or rights of a foster
290.35care recipient. The applicant or license holder must comply with all other requirements
291.1under Minnesota Rules, parts 9555.5105 to 9555.6265, or applicable requirements under
291.2chapter 245D, and the requirements under this subdivision. The license printed by the
291.3commissioner must state in bold and large font:
291.4    (1) that the facility is under electronic monitoring; and
291.5    (2) the telephone number of the county's common entry point for making reports of
291.6suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
291.7(b) Applications for a license under this section must be submitted directly to
291.8the Department of Human Services licensing division. The licensing division must
291.9immediately notify the host county and lead county contract agency and the host county
291.10licensing agency. The licensing division must collaborate with the county licensing
291.11agency in the review of the application and the licensing of the program.
291.12    (c) Before a license is issued by the commissioner, and for the duration of the
291.13license, the applicant or license holder must establish, maintain, and document the
291.14implementation of written policies and procedures addressing the requirements in
291.15paragraphs (d) through (f).
291.16    (d) The applicant or license holder must have policies and procedures that:
291.17    (1) establish characteristics of target populations that will be admitted into the home,
291.18and characteristics of populations that will not be accepted into the home;
291.19    (2) explain the discharge process when a foster care recipient resident served by the
291.20program requires overnight supervision or other services that cannot be provided by the
291.21license holder due to the limited hours that the license holder is on site;
291.22    (3) describe the types of events to which the program will respond with a physical
291.23presence when those events occur in the home during time when staff are not on site, and
291.24how the license holder's response plan meets the requirements in paragraph (e), clause
291.25(1) or (2);
291.26    (4) establish a process for documenting a review of the implementation and
291.27effectiveness of the response protocol for the response required under paragraph (e),
291.28clause (1) or (2). The documentation must include:
291.29    (i) a description of the triggering incident;
291.30    (ii) the date and time of the triggering incident;
291.31    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
291.32    (iv) whether the response met the resident's needs;
291.33    (v) whether the existing policies and response protocols were followed; and
291.34    (vi) whether the existing policies and protocols are adequate or need modification.
291.35    When no physical presence response is completed for a three-month period, the
291.36license holder's written policies and procedures must require a physical presence response
292.1drill to be conducted for which the effectiveness of the response protocol under paragraph
292.2(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
292.3    (5) establish that emergency and nonemergency phone numbers are posted in a
292.4prominent location in a common area of the home where they can be easily observed by a
292.5person responding to an incident who is not otherwise affiliated with the home.
292.6    (e) The license holder must document and include in the license application which
292.7response alternative under clause (1) or (2) is in place for responding to situations that
292.8present a serious risk to the health, safety, or rights of people receiving foster care services
292.9in the home residents served by the program:
292.10    (1) response alternative (1) requires only the technology to provide an electronic
292.11notification or alert to the license holder that an event is underway that requires a response.
292.12Under this alternative, no more than ten minutes will pass before the license holder will be
292.13physically present on site to respond to the situation; or
292.14    (2) response alternative (2) requires the electronic notification and alert system under
292.15alternative (1), but more than ten minutes may pass before the license holder is present on
292.16site to respond to the situation. Under alternative (2), all of the following conditions are met:
292.17    (i) the license holder has a written description of the interactive technological
292.18applications that will assist the license holder in communicating with and assessing the
292.19needs related to the care, health, and safety of the foster care recipients. This interactive
292.20technology must permit the license holder to remotely assess the well being of the foster
292.21care recipient resident served by the program without requiring the initiation of the
292.22foster care recipient. Requiring the foster care recipient to initiate a telephone call does
292.23not meet this requirement;
292.24(ii) the license holder documents how the remote license holder is qualified and
292.25capable of meeting the needs of the foster care recipients and assessing foster care
292.26recipients' needs under item (i) during the absence of the license holder on site;
292.27(iii) the license holder maintains written procedures to dispatch emergency response
292.28personnel to the site in the event of an identified emergency; and
292.29    (iv) each foster care recipient's resident's individualized plan of care, individual
292.30service plan coordinated service and support plan under section sections 256B.0913,
292.31subdivision 8; 256B.0915, subdivision 6; 256B.092, subdivision 1b; and 256B.49,
292.32subdivision 15, if required, or individual resident placement agreement under Minnesota
292.33Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time,
292.34which may be greater than ten minutes, for the license holder to be on site for that foster
292.35care recipient resident.
293.1    (f) Each foster care recipient's resident's placement agreement, individual service
293.2agreement, and plan must clearly state that the adult foster care or community residential
293.3setting license category is a program without the presence of a caregiver in the residence
293.4during normal sleeping hours; the protocols in place for responding to situations that
293.5present a serious risk to the health, safety, or rights of foster care recipients residents
293.6served by the program under paragraph (e), clause (1) or (2); and a signed informed
293.7consent from each foster care recipient resident served by the program or the person's
293.8legal representative documenting the person's or legal representative's agreement with
293.9placement in the program. If electronic monitoring technology is used in the home, the
293.10informed consent form must also explain the following:
293.11    (1) how any electronic monitoring is incorporated into the alternative supervision
293.12system;
293.13    (2) the backup system for any electronic monitoring in times of electrical outages or
293.14other equipment malfunctions;
293.15    (3) how the caregivers or direct support staff are trained on the use of the technology;
293.16    (4) the event types and license holder response times established under paragraph (e);
293.17    (5) how the license holder protects the foster care recipient's each resident's privacy
293.18related to electronic monitoring and related to any electronically recorded data generated
293.19by the monitoring system. A foster care recipient resident served by the program may
293.20not be removed from a program under this subdivision for failure to consent to electronic
293.21monitoring. The consent form must explain where and how the electronically recorded
293.22data is stored, with whom it will be shared, and how long it is retained; and
293.23    (6) the risks and benefits of the alternative overnight supervision system.
293.24    The written explanations under clauses (1) to (6) may be accomplished through
293.25cross-references to other policies and procedures as long as they are explained to the
293.26person giving consent, and the person giving consent is offered a copy.
293.27(g) Nothing in this section requires the applicant or license holder to develop or
293.28maintain separate or duplicative policies, procedures, documentation, consent forms, or
293.29individual plans that may be required for other licensing standards, if the requirements of
293.30this section are incorporated into those documents.
293.31(h) The commissioner may grant variances to the requirements of this section
293.32according to section 245A.04, subdivision 9.
293.33(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
293.34under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
293.35contractors affiliated with the license holder.
294.1(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
294.2remotely determine what action the license holder needs to take to protect the well-being
294.3of the foster care recipient.
294.4(k) The commissioner shall evaluate license applications using the requirements
294.5in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
294.6including a checklist of criteria needed for approval.
294.7(l) To be eligible for a license under paragraph (a), the adult foster care or community
294.8residential setting license holder must not have had a conditional license issued under
294.9section 245A.06 or any licensing sanction under section 245A.07 during the prior 24
294.10months based on failure to provide adequate supervision, health care services, or resident
294.11safety in the adult foster care home or community residential setting.
294.12(m) The commissioner shall review an application for an alternative overnight
294.13supervision license within 60 days of receipt of the application. When the commissioner
294.14receives an application that is incomplete because the applicant failed to submit required
294.15documents or that is substantially deficient because the documents submitted do not meet
294.16licensing requirements, the commissioner shall provide the applicant written notice
294.17that the application is incomplete or substantially deficient. In the written notice to the
294.18applicant, the commissioner shall identify documents that are missing or deficient and
294.19give the applicant 45 days to resubmit a second application that is substantially complete.
294.20An applicant's failure to submit a substantially complete application after receiving
294.21notice from the commissioner is a basis for license denial under section 245A.05. The
294.22commissioner shall complete subsequent review within 30 days.
294.23(n) Once the application is considered complete under paragraph (m), the
294.24commissioner will approve or deny an application for an alternative overnight supervision
294.25license within 60 days.
294.26(o) For the purposes of this subdivision, "supervision" means:
294.27(1) oversight by a caregiver or direct support staff as specified in the individual
294.28resident's place agreement or coordinated service and support plan and awareness of the
294.29resident's needs and activities; and
294.30(2) the presence of a caregiver or direct support staff in a residence during normal
294.31sleeping hours, unless a determination has been made and documented in the individual's
294.32 coordinated service and support plan that the individual does not require the presence of a
294.33caregiver or direct support staff during normal sleeping hours.

294.34    Sec. 15. Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:
295.1    Subd. 7b. Adult foster care data privacy and security. (a) An adult foster care
295.2 or community residential setting license holder who creates, collects, records, maintains,
295.3stores, or discloses any individually identifiable recipient data, whether in an electronic
295.4or any other format, must comply with the privacy and security provisions of applicable
295.5privacy laws and regulations, including:
295.6(1) the federal Health Insurance Portability and Accountability Act of 1996
295.7(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
295.8title 45, part 160, and subparts A and E of part 164; and
295.9(2) the Minnesota Government Data Practices Act as codified in chapter 13.
295.10(b) For purposes of licensure, the license holder shall be monitored for compliance
295.11with the following data privacy and security provisions:
295.12(1) the license holder must control access to data on foster care recipients residents
295.13served by the program according to the definitions of public and private data on individuals
295.14under section 13.02; classification of the data on individuals as private under section
295.1513.46, subdivision 2 ; and control over the collection, storage, use, access, protection,
295.16and contracting related to data according to section 13.05, in which the license holder is
295.17assigned the duties of a government entity;
295.18(2) the license holder must provide each foster care recipient resident served by
295.19the program with a notice that meets the requirements under section 13.04, in which
295.20the license holder is assigned the duties of the government entity, and that meets the
295.21requirements of Code of Federal Regulations, title 45, part 164.52. The notice shall
295.22describe the purpose for collection of the data, and to whom and why it may be disclosed
295.23pursuant to law. The notice must inform the recipient individual that the license holder
295.24uses electronic monitoring and, if applicable, that recording technology is used;
295.25(3) the license holder must not install monitoring cameras in bathrooms;
295.26(4) electronic monitoring cameras must not be concealed from the foster care
295.27recipients residents served by the program; and
295.28(5) electronic video and audio recordings of foster care recipients residents served
295.29by the program shall be stored by the license holder for five days unless: (i) a foster care
295.30recipient resident served by the program or legal representative requests that the recording
295.31be held longer based on a specific report of alleged maltreatment; or (ii) the recording
295.32captures an incident or event of alleged maltreatment under section 626.556 or 626.557 or
295.33a crime under chapter 609. When requested by a recipient resident served by the program
295.34 or when a recording captures an incident or event of alleged maltreatment or a crime, the
295.35license holder must maintain the recording in a secured area for no longer than 30 days
295.36to give the investigating agency an opportunity to make a copy of the recording. The
296.1investigating agency will maintain the electronic video or audio recordings as required in
296.2section 626.557, subdivision 12b.
296.3(c) The commissioner shall develop, and make available to license holders and
296.4county licensing workers, a checklist of the data privacy provisions to be monitored
296.5for purposes of licensure.

296.6    Sec. 16. Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:
296.7    Subd. 8. Community residential setting license. (a) The commissioner shall
296.8establish provider standards for residential support services that integrate service standards
296.9and the residential setting under one license. The commissioner shall propose statutory
296.10language and an implementation plan for licensing requirements for residential support
296.11services to the legislature by January 15, 2012, as a component of the quality outcome
296.12standards recommendations required by Laws 2010, chapter 352, article 1, section 24.
296.13(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
296.14for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105
296.15to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340;
296.16and meeting the provisions of section 256B.092, subdivision 11, paragraph (b) section
296.17245D.02, subdivision 4a, must be required to obtain a community residential setting license.

296.18    Sec. 17. Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:
296.19    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
296.20private agencies that have been designated or licensed by the commissioner to perform
296.21licensing functions and activities under section 245A.04 and background studies for family
296.22child care under chapter 245C; to recommend denial of applicants under section 245A.05;
296.23to issue correction orders, to issue variances, and recommend a conditional license under
296.24section 245A.06, or to recommend suspending or revoking a license or issuing a fine under
296.25section 245A.07, shall comply with rules and directives of the commissioner governing
296.26those functions and with this section. The following variances are excluded from the
296.27delegation of variance authority and may be issued only by the commissioner:
296.28    (1) dual licensure of family child care and child foster care, dual licensure of child
296.29and adult foster care, and adult foster care and family child care;
296.30    (2) adult foster care maximum capacity;
296.31    (3) adult foster care minimum age requirement;
296.32    (4) child foster care maximum age requirement;
296.33    (5) variances regarding disqualified individuals except that county agencies may
296.34issue variances under section 245C.30 regarding disqualified individuals when the county
297.1is responsible for conducting a consolidated reconsideration according to sections 245C.25
297.2and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
297.3and a disqualification based on serious or recurring maltreatment; and
297.4    (6) the required presence of a caregiver in the adult foster care residence during
297.5normal sleeping hours; and
297.6    (7) variances for community residential setting licenses under chapter 245D.
297.7Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency
297.8must not grant a license holder a variance to exceed the maximum allowable family child
297.9care license capacity of 14 children.
297.10    (b) County agencies must report information about disqualification reconsiderations
297.11under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances
297.12granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
297.13prescribed by the commissioner.
297.14    (c) For family day care programs, the commissioner may authorize licensing reviews
297.15every two years after a licensee has had at least one annual review.
297.16    (d) For family adult day services programs, the commissioner may authorize
297.17licensing reviews every two years after a licensee has had at least one annual review.
297.18    (e) A license issued under this section may be issued for up to two years.

297.19    Sec. 18. Minnesota Statutes 2012, section 245D.02, is amended to read:
297.20245D.02 DEFINITIONS.
297.21    Subdivision 1. Scope. The terms used in this chapter have the meanings given
297.22them in this section.
297.23    Subd. 2. Annual and annually. "Annual" and "annually" have the meaning given
297.24in section 245A.02, subdivision 2b.
297.25    Subd. 2a. Authorized representative. "Authorized representative" means a parent,
297.26family member, advocate, or other adult authorized by the person or the person's legal
297.27representative, to serve as a representative in connection with the provision of services
297.28licensed under this chapter. This authorization must be in writing or by another method
297.29that clearly indicates the person's free choice. The authorized representative must have no
297.30financial interest in the provision of any services included in the person's service delivery
297.31plan and must be capable of providing the support necessary to assist the person in the use
297.32of home and community-based services licensed under this chapter.
297.33    Subd. 3. Case manager. "Case manager" means the individual designated
297.34to provide waiver case management services, care coordination, or long-term care
298.1consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
298.2or successor provisions.
298.3    Subd. 3a. Certification. "Certification" means the commissioner's written
298.4authorization for a license holder to provide specialized services based on certification
298.5standards in section 245D.33. The term certification and its derivatives have the same
298.6meaning and may be substituted for the term licensure and its derivatives in this chapter
298.7and chapter 245A.
298.8    Subd. 4. Commissioner. "Commissioner" means the commissioner of the
298.9Department of Human Services or the commissioner's designated representative.
298.10    Subd. 4a. Community residential setting. "Community residential setting" means
298.11a residential program as identified in section 245A.11, subdivision 8, where residential
298.12supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause
298.13(3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant
298.14of the facility licensed according to this chapter, and the license holder does not reside
298.15in the facility.
298.16    Subd. 4b. Coordinated service and support plan. "Coordinated service and support
298.17plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision
298.186; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions.
298.19    Subd. 4c. Coordinated service and support plan addendum. "Coordinated
298.20service and support plan addendum" means the documentation that this chapter requires
298.21of the license holder for each person receiving services.
298.22    Subd. 4d. Corporate foster care. "Corporate foster care" means a child foster
298.23residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340,
298.24or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to
298.259555.6265, where the license holder does not live in the home.
298.26    Subd. 4e. Cultural competence or culturally competent. "Cultural competence"
298.27or "culturally competent" means the ability and the will to respond to the unique needs of
298.28a person that arise from the person's culture and the ability to use the person's culture as a
298.29resource or tool to assist with the intervention and help meet the person's needs.
298.30    Subd. 4f. Day services facility. "Day services facility" means a facility licensed
298.31according to this chapter at which persons receive day services licensed under this chapter
298.32from the license holder's direct support staff for a cumulative total of more than 30 days
298.33within any 12-month period and the license holder is the owner, lessor, or tenant of the
298.34facility.
298.35    Subd. 5. Department. "Department" means the Department of Human Services.
299.1    Subd. 6. Direct contact. "Direct contact" has the meaning given in section 245C.02,
299.2subdivision 11 , and is used interchangeably with the term "direct support service."
299.3    Subd. 6a. Direct support staff or staff. "Direct support staff" or "staff" means
299.4employees of the license holder who have direct contact with persons served by the
299.5program and includes temporary staff or subcontractors, regardless of employer, providing
299.6program services for hire under the control of the license holder who have direct contact
299.7with persons served by the program.
299.8    Subd. 7. Drug. "Drug" has the meaning given in section 151.01, subdivision 5.
299.9    Subd. 8. Emergency. "Emergency" means any event that affects the ordinary
299.10daily operation of the program including, but not limited to, fires, severe weather, natural
299.11disasters, power failures, or other events that threaten the immediate health and safety of
299.12a person receiving services and that require calling 911, emergency evacuation, moving
299.13to an emergency shelter, or temporary closure or relocation of the program to another
299.14facility or service site for more than 24 hours.
299.15    Subd. 8a. Emergency use of manual restraint. "Emergency use of manual
299.16restraint" means using a manual restraint when a person poses an imminent risk of
299.17physical harm to self or others and is the least restrictive intervention that would achieve
299.18safety. Property damage, verbal aggression, or a person's refusal to receive or participate
299.19in treatment or programming on their own, do not constitute an emergency.
299.20    Subd. 8b. Expanded support team. "Expanded support team" means the members
299.21of the support team defined in subdivision 46, and a licensed health or mental health
299.22professional or other licensed, certified, or qualified professionals or consultants working
299.23with the person and included in the team at the request of the person or the person's legal
299.24representative.
299.25    Subd. 8c. Family foster care. "Family foster care" means a child foster family
299.26setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult
299.27foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265,
299.28where the license holder lives in the home.
299.29    Subd. 9. Health services. "Health services" means any service or treatment
299.30consistent with the physical and mental health needs of the person, such as medication
299.31administration and monitoring, medical, dental, nutritional, health monitoring, wellness
299.32education, and exercise.
299.33    Subd. 10. Home and community-based services. "Home and community-based
299.34services" means the services subject to the provisions of this chapter identified in section
299.35245D.03, subdivision 1, and as defined in:
300.1(1) the federal federally approved waiver plans governed by United States Code,
300.2title 42, sections 1396 et seq., or the state's alternative care program according to section
300.3256B.0913, including the waivers for persons with disabilities under section 256B.49,
300.4subdivision 11, including the brain injury (BI) waiver, plan; the community alternative
300.5care (CAC) waiver, plan; the community alternatives for disabled individuals (CADI)
300.6waiver, plan; the developmental disability (DD) waiver, plan under section 256B.092,
300.7subdivision 5; the elderly waiver (EW), and plan under section 256B.0915, subdivision 1;
300.8or successor plans respective to each waiver; or
300.9(2) the alternative care (AC) program under section 256B.0913.
300.10    Subd. 11. Incident. "Incident" means an occurrence that affects the which involves
300.11a person and requires the program to make a response that is not a part of the program's
300.12 ordinary provision of services to a that person, and includes any of the following:
300.13(1) serious injury of a person as determined by section 245.91, subdivision 6;
300.14(2) a person's death;
300.15(3) any medical emergency, unexpected serious illness, or significant unexpected
300.16change in an illness or medical condition, or the mental health status of a person that
300.17requires calling the program to call 911 or a mental health crisis intervention team,
300.18physician treatment, or hospitalization;
300.19(4) any mental health crisis that requires the program to call 911 or a mental health
300.20crisis intervention team;
300.21(5) an act or situation involving a person that requires the program to call 911,
300.22law enforcement, or the fire department;
300.23(4) (6) a person's unauthorized or unexplained absence from a program;
300.24(5) (7) physical aggression conduct by a person receiving services against another
300.25person receiving services that causes physical pain, injury, or persistent emotional distress,
300.26including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting,
300.27pushing, and spitting;:
300.28(i) is so severe, pervasive, or objectively offensive that it substantially interferes with
300.29a person's opportunities to participate in or receive service or support;
300.30(ii) places the person in actual and reasonable fear of harm;
300.31(iii) places the person in actual and reasonable fear of damage to property of the
300.32person; or
300.33(iv) substantially disrupts the orderly operation of the program;
300.34(6) (8) any sexual activity between persons receiving services involving force or
300.35coercion as defined under section 609.341, subdivisions 3 and 14; or
300.36(9) any emergency use of manual restraint as identified in section 245D.061; or
301.1(7) (10) a report of alleged or suspected child or vulnerable adult maltreatment
301.2under section 626.556 or 626.557.
301.3    Subd. 11a. Intermediate care facility for persons with developmental disabilities
301.4or ICF/DD. "Intermediate care facility for persons with developmental disabilities" or
301.5"ICF/DD" means a residential program licensed to serve four or more persons with
301.6developmental disabilities under section 252.28 and chapter 245A and licensed as a
301.7supervised living facility under chapter 144, which together are certified by the Department
301.8of Health as an intermediate care facility for persons with developmental disabilities.
301.9    Subd. 11b. Least restrictive alternative. "Least restrictive alternative" means
301.10the alternative method for providing supports and services that is the least intrusive and
301.11most normalized given the level of supervision and protection required for the person.
301.12This level of supervision and protection allows risk taking to the extent that there is no
301.13reasonable likelihood that serious harm will happen to the person or others.
301.14    Subd. 12. Legal representative. "Legal representative" means the parent of a
301.15person who is under 18 years of age, a court-appointed guardian, or other representative
301.16with legal authority to make decisions about services for a person. Other representatives
301.17with legal authority to make decisions include but are not limited to a health care agent or
301.18an attorney-in-fact authorized through a health care directive or power of attorney.
301.19    Subd. 13. License. "License" has the meaning given in section 245A.02,
301.20subdivision 8 .
301.21    Subd. 14. Licensed health professional. "Licensed health professional" means a
301.22person licensed in Minnesota to practice those professions described in section 214.01,
301.23subdivision 2 .
301.24    Subd. 15. License holder. "License holder" has the meaning given in section
301.25245A.02, subdivision 9 .
301.26    Subd. 16. Medication. "Medication" means a prescription drug or over-the-counter
301.27drug. For purposes of this chapter, "medication" includes dietary supplements.
301.28    Subd. 17. Medication administration. "Medication administration" means
301.29performing the following set of tasks to ensure a person takes both prescription and
301.30over-the-counter medications and treatments according to orders issued by appropriately
301.31licensed professionals, and includes the following:
301.32(1) checking the person's medication record;
301.33(2) preparing the medication for administration;
301.34(3) administering the medication to the person;
301.35(4) documenting the administration of the medication or the reason for not
301.36administering the medication; and
302.1(5) reporting to the prescriber or a nurse any concerns about the medication,
302.2including side effects, adverse reactions, effectiveness, or the person's refusal to take the
302.3medication or the person's self-administration of the medication.
302.4    Subd. 18. Medication assistance. "Medication assistance" means providing verbal
302.5or visual reminders to take regularly scheduled medication, which includes either of
302.6the following:
302.7(1) bringing to the person and opening a container of previously set up medications
302.8and emptying the container into the person's hand or opening and giving the medications
302.9in the original container to the person, or bringing to the person liquids or food to
302.10accompany the medication; or
302.11(2) providing verbal or visual reminders to perform regularly scheduled treatments
302.12and exercises.
302.13    Subd. 19. Medication management. "Medication management" means the
302.14provision of any of the following:
302.15(1) medication-related services to a person;
302.16(2) medication setup;
302.17(3) medication administration;
302.18(4) medication storage and security;
302.19(5) medication documentation and charting;
302.20(6) verification and monitoring of effectiveness of systems to ensure safe medication
302.21handling and administration;
302.22(7) coordination of medication refills;
302.23(8) handling changes to prescriptions and implementation of those changes;
302.24(9) communicating with the pharmacy; or
302.25(10) coordination and communication with prescriber.
302.26For the purposes of this chapter, medication management does not mean "medication
302.27therapy management services" as identified in section 256B.0625, subdivision 13h.
302.28    Subd. 20. Mental health crisis intervention team. "Mental health crisis
302.29intervention team" means a mental health crisis response providers provider as identified
302.30in section 256B.0624, subdivision 2, paragraph (d), for adults, and in section 256B.0944,
302.31subdivision 1 , paragraph (d), for children.
302.32    Subd. 20a. Most integrated setting. "Most integrated setting" means a setting that
302.33enables individuals with disabilities to interact with nondisabled persons to the fullest
302.34extent possible.
303.1    Subd. 21. Over-the-counter drug. "Over-the-counter drug" means a drug that
303.2is not required by federal law to bear the statement "Caution: Federal law prohibits
303.3dispensing without prescription."
303.4    Subd. 21a. Outcome. "Outcome" means the behavior, action, or status attained by
303.5the person that can be observed, measured, and determined reliable and valid.
303.6    Subd. 22. Person. "Person" has the meaning given in section 245A.02, subdivision
303.711 .
303.8    Subd. 23. Person with a disability. "Person with a disability" means a person
303.9determined to have a disability by the commissioner's state medical review team as
303.10identified in section 256B.055, subdivision 7, the Social Security Administration, or
303.11the person is determined to have a developmental disability as defined in Minnesota
303.12Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section
303.13252.27, subdivision 1a .
303.14    Subd. 23a. Physician. "Physician" means a person who is licensed under chapter
303.15147.
303.16    Subd. 24. Prescriber. "Prescriber" means a licensed practitioner as defined in
303.17section 151.01, subdivision 23, person who is authorized under section 148.235; 151.01,
303.18subdivision 23; or 151.37 to prescribe drugs. For the purposes of this chapter, the term
303.19"prescriber" is used interchangeably with "physician."
303.20    Subd. 25. Prescription drug. "Prescription drug" has the meaning given in section
303.21151.01, subdivision 17 16 .
303.22    Subd. 26. Program. "Program" means either the nonresidential or residential
303.23program as defined in section 245A.02, subdivisions 10 and 14.
303.24    Subd. 27. Psychotropic medication. "Psychotropic medication" means any
303.25medication prescribed to treat the symptoms of mental illness that affect thought processes,
303.26mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic
303.27(neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and
303.28stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder.
303.29Other miscellaneous medications are considered to be a psychotropic medication when
303.30they are specifically prescribed to treat a mental illness or to control or alter behavior.
303.31    Subd. 28. Restraint. "Restraint" means physical or mechanical limiting of the free
303.32and normal movement of body or limbs.
303.33    Subd. 29. Seclusion. "Seclusion" means separating a person from others in a way
303.34that prevents social contact and prevents the person from leaving the situation if he or she
303.35chooses the placement of a person alone in a room from which exit is prohibited by a staff
304.1person or a mechanism such as a lock, a device, or an object positioned to hold the door
304.2closed or otherwise prevent the person from leaving the room.
304.3    Subd. 29a. Self-determination. "Self-determination" means the person makes
304.4decisions independently, plans for the person's own future, determines how money is spent
304.5for the person's supports, and takes responsibility for making these decisions. If a person
304.6has a legal representative, the legal representative's decision-making authority is limited to
304.7the scope of authority granted by the court or allowed in the document authorizing the
304.8legal representative to act.
304.9    Subd. 29b. Semi-independent living services. "Semi-independent living services"
304.10has the meaning given in section 252.275.
304.11    Subd. 30. Service. "Service" means care, training, supervision, counseling,
304.12consultation, or medication assistance assigned to the license holder in the coordinated
304.13service and support plan.
304.14    Subd. 31. Service plan. "Service plan" means the individual service plan or
304.15individual care plan identified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
304.16or successor provisions, and includes any support plans or service needs identified as
304.17a result of long-term care consultation, or a support team meeting that includes the
304.18participation of the person, the person's legal representative, and case manager, or assigned
304.19to a license holder through an authorized service agreement.
304.20    Subd. 32. Service site. "Service site" means the location where the service is
304.21provided to the person, including, but not limited to, a facility licensed according to
304.22chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's
304.23own home; or a community-based location.
304.24    Subd. 33. Staff. "Staff" means an employee who will have direct contact with a
304.25person served by the facility, agency, or program.
304.26    Subd. 33a. Supervised living facility. "Supervised living facility" has the meaning
304.27given in Minnesota Rules, part 4665.0100, subpart 10.
304.28    Subd. 33b. Supervision. (a) "Supervision" means:
304.29(1) oversight by direct support staff as specified in the person's coordinated service
304.30and support plan or coordinated service and support plan addendum and awareness of
304.31the person's needs and activities;
304.32(2) responding to situations that present a serious risk to the health, safety, or rights
304.33of the person while services are being provided; and
304.34(3) the presence of direct support staff at a service site while services are being
304.35provided, unless a determination has been made and documented in the person's coordinated
305.1service and support plan or coordinated service and support plan addendum that the person
305.2does not require the presence of direct support staff while services are being provided.
305.3(b) For the purposes of this definition, "while services are being provided," means
305.4any period of time during which the license holder will seek reimbursement for services.
305.5    Subd. 34. Support team. "Support team" means the service planning team
305.6identified in section 256B.49, subdivision 15, or the interdisciplinary team identified in
305.7Minnesota Rules, part 9525.0004, subpart 14.
305.8    Subd. 34a. Time out. "Time out" means removing a person involuntarily from an
305.9ongoing activity to a room, either locked or unlocked, or otherwise separating a person
305.10from others in a way that prevents social contact and prevents the person from leaving
305.11the situation if the person chooses. For the purpose of chapter 245D, "time out" does
305.12not mean voluntary removal or self-removal for the purpose of calming, prevention of
305.13escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out"
305.14does not include a person voluntarily moving from an ongoing activity to an unlocked
305.15room or otherwise separating from a situation or social contact with others if the person
305.16chooses. For the purposes of this definition, "voluntarily" means without being forced,
305.17compelled, or coerced.
305.18    Subd. 35. Unit of government. "Unit of government" means every city, county,
305.19town, school district, other political subdivisions of the state, and any agency of the state
305.20or the United States, and includes any instrumentality of a unit of government.
305.21    Subd. 35a. Treatment. "Treatment" means the provision of care, other than
305.22medications, ordered or prescribed by a licensed health or mental health professional,
305.23provided to a person to cure, rehabilitate, or ease symptoms.
305.24    Subd. 36. Volunteer. "Volunteer" means an individual who, under the direction of the
305.25license holder, provides direct services without pay to a person served by the license holder.
305.26EFFECTIVE DATE.This section is effective January 1, 2014.

305.27    Sec. 19. Minnesota Statutes 2012, section 245D.03, is amended to read:
305.28245D.03 APPLICABILITY AND EFFECT.
305.29    Subdivision 1. Applicability. (a) The commissioner shall regulate the provision of
305.30home and community-based services to persons with disabilities and persons age 65 and
305.31older pursuant to this chapter. The licensing standards in this chapter govern the provision
305.32of the following basic support services: and intensive support services.
305.33(1) housing access coordination as defined under the current BI, CADI, and DD
305.34waiver plans or successor plans;
306.1(2) respite services as defined under the current CADI, BI, CAC, DD, and EW
306.2waiver plans or successor plans when the provider is an individual who is not an employee
306.3of a residential or nonresidential program licensed by the Department of Human Services
306.4or the Department of Health that is otherwise providing the respite service;
306.5(3) behavioral programming as defined under the current BI and CADI waiver
306.6plans or successor plans;
306.7(4) specialist services as defined under the current DD waiver plan or successor plans;
306.8(5) companion services as defined under the current BI, CADI, and EW waiver
306.9plans or successor plans, excluding companion services provided under the Corporation
306.10for National and Community Services Senior Companion Program established under the
306.11Domestic Volunteer Service Act of 1973, Public Law 98-288;
306.12(6) personal support as defined under the current DD waiver plan or successor plans;
306.13(7) 24-hour emergency assistance, on-call and personal emergency response as
306.14defined under the current CADI and DD waiver plans or successor plans;
306.15(8) night supervision services as defined under the current BI waiver plan or
306.16successor plans;
306.17(9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW
306.18waiver plans or successor plans, excluding providers licensed by the Department of Health
306.19under chapter 144A and those providers providing cleaning services only;
306.20(10) independent living skills training as defined under the current BI and CADI
306.21waiver plans or successor plans;
306.22(11) prevocational services as defined under the current BI and CADI waiver plans
306.23or successor plans;
306.24(12) structured day services as defined under the current BI waiver plan or successor
306.25plans; or
306.26(13) supported employment as defined under the current BI and CADI waiver plans
306.27or successor plans.
306.28(b) Basic support services provide the level of assistance, supervision, and care that
306.29is necessary to ensure the health and safety of the person and do not include services that
306.30are specifically directed toward the training, treatment, habilitation, or rehabilitation of
306.31the person. Basic support services include:
306.32(1) in-home and out-of-home respite care services as defined in section 245A.02,
306.33subdivision 15, and under the brain injury, community alternative care, community
306.34alternatives for disabled individuals, developmental disability, and elderly waiver plans;
306.35(2) companion services as defined under the brain injury, community alternatives for
306.36disabled individuals, and elderly waiver plans, excluding companion services provided
307.1under the Corporation for National and Community Services Senior Companion Program
307.2established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
307.3(3) personal support as defined under the developmental disability waiver plan;
307.4(4) 24-hour emergency assistance, personal emergency response as defined under the
307.5community alternatives for disabled individuals and developmental disability waiver plans;
307.6(5) night supervision services as defined under the brain injury waiver plan; and
307.7(6) homemaker services as defined under the community alternatives for disabled
307.8individuals, brain injury, community alternative care, developmental disability, and elderly
307.9waiver plans, excluding providers licensed by the Department of Health under chapter
307.10144A and those providers providing cleaning services only.
307.11(c) Intensive support services provide assistance, supervision, and care that is
307.12necessary to ensure the health and safety of the person and services specifically directed
307.13toward the training, habilitation, or rehabilitation of the person. Intensive support services
307.14include:
307.15(1) intervention services, including:
307.16(i) behavioral support services as defined under the brain injury and community
307.17alternatives for disabled individuals waiver plans;
307.18(ii) in-home or out-of-home crisis respite services as defined under the developmental
307.19disability waiver plan; and
307.20(iii) specialist services as defined under the current developmental disability waiver
307.21plan;
307.22(2) in-home support services, including:
307.23(i) in-home family support and supported living services as defined under the
307.24developmental disability waiver plan;
307.25(ii) independent living services training as defined under the brain injury and
307.26community alternatives for disabled individuals waiver plans; and
307.27(iii) semi-independent living services;
307.28(3) residential supports and services, including:
307.29(i) supported living services as defined under the developmental disability waiver
307.30plan provided in a family or corporate child foster care residence, a family adult foster
307.31care residence, a community residential setting, or a supervised living facility;
307.32(ii) foster care services as defined in the brain injury, community alternative care,
307.33and community alternatives for disabled individuals waiver plans provided in a family or
307.34corporate child foster care residence, a family adult foster care residence, or a community
307.35residential setting; and
308.1(iii) residential services provided in a supervised living facility that is certified by
308.2the Department of Health as an ICF/DD;
308.3(4) day services, including:
308.4(i) structured day services as defined under the brain injury waiver plan;
308.5(ii) day training and habilitation services under sections 252.40 to 252.46, and as
308.6defined under the developmental disability waiver plan; and
308.7(iii) prevocational services as defined under the brain injury and community
308.8alternatives for disabled individuals waiver plans; and
308.9(5) supported employment as defined under the brain injury, developmental
308.10disability, and community alternatives for disabled individuals waiver plans.
308.11    Subd. 2. Relationship to other standards governing home and community-based
308.12services. (a) A license holder governed by this chapter is also subject to the licensure
308.13requirements under chapter 245A.
308.14(b) A license holder concurrently providing child foster care services licensed
308.15according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed
308.16under this chapter is exempt from section 245D.04 as it applies to the person. A corporate
308.17or family child foster care site controlled by a license holder and providing services
308.18governed by this chapter is exempt from compliance with section 245D.04. This exemption
308.19applies to foster care homes where at least one resident is receiving residential supports
308.20and services licensed according to this chapter. This chapter does not apply to corporate or
308.21family child foster care homes that do not provide services licensed under this chapter.
308.22(c) A family adult foster care site controlled by a license holder and providing
308.23services governed by this chapter is exempt from compliance with Minnesota Rules, parts
308.249555.6185; 9555.6225, subpart 8; 9555.6235, item C; 9555.6245; 9555.6255, subpart
308.252; and 9555.6265. These exemptions apply to family adult foster care homes where at
308.26least one resident is receiving residential supports and services licensed according to this
308.27chapter. This chapter does not apply to family adult foster care homes that do not provide
308.28services licensed under this chapter.
308.29(d) A license holder providing services licensed according to this chapter in a
308.30supervised living facility is exempt from compliance with sections 245D.04; 245D.05,
308.31subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
308.32(e) A license holder providing residential services to persons in an ICF/DD is exempt
308.33from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision
308.342, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09,
308.35subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
309.1(c) (f) A license holder concurrently providing home care homemaker services
309.2registered licensed according to sections 144A.43 to 144A.49 to the same person receiving
309.3home management services licensed under this chapter and registered according to chapter
309.4144A is exempt from compliance with section 245D.04 as it applies to the person.
309.5(d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt
309.6from compliance with sections 245A.65, subdivision 2, paragraph (a), and 626.557,
309.7subdivision 14 , paragraph (b).
309.8(e) Notwithstanding section 245D.06, subdivision 5, a license holder providing
309.9structured day, prevocational, or supported employment services under this chapter
309.10and day training and habilitation or supported employment services licensed under
309.11chapter 245B within the same program is exempt from compliance with this chapter
309.12when the license holder notifies the commissioner in writing that the requirements under
309.13chapter 245B will be met for all persons receiving these services from the program. For
309.14the purposes of this paragraph, if the license holder has obtained approval from the
309.15commissioner for an alternative inspection status according to section 245B.031, that
309.16approval will apply to all persons receiving services in the program.
309.17(g) Nothing in this chapter prohibits a license holder from concurrently serving
309.18persons without disabilities or people who are or are not age 65 and older, provided this
309.19chapter's standards are met as well as other relevant standards.
309.20(h) The documentation required under sections 245D.07 and 245D.071 must meet
309.21the individual program plan requirements identified in section 256B.092 or successor
309.22provisions.
309.23    Subd. 3. Variance. If the conditions in section 245A.04, subdivision 9, are met,
309.24the commissioner may grant a variance to any of the requirements in this chapter, except
309.25sections 245D.04, and 245D.10, subdivision 4, paragraph (b) 245D.06, subdivision 4,
309.26paragraph (b), and 245D.061, subdivision 3, or provisions governing data practices and
309.27information rights of persons.
309.28    Subd. 4. License holders with multiple 245D licenses. (a) When a person changes
309.29service from one license to a different license held by the same license holder, the license
309.30holder is exempt from the requirements in section 245D.10, subdivision 4, paragraph (b).
309.31(b) When a staff person begins providing direct service under one or more licenses
309.32held by the same license holder, other than the license for which staff orientation was
309.33initially provided according to section 245D.09, subdivision 4, the license holder is
309.34exempt from those staff orientation requirements, except the staff person must review each
309.35person's service plan and medication administration procedures in accordance with section
309.36245D.09, subdivision 4, paragraph (c), if not previously reviewed by the staff person.
310.1    Subd. 5. Program certification. An applicant or a license holder may apply for
310.2program certification as identified in section 245D.33.
310.3EFFECTIVE DATE.This section is effective January 1, 2014.

310.4    Sec. 20. Minnesota Statutes 2012, section 245D.04, is amended to read:
310.5245D.04 SERVICE RECIPIENT RIGHTS.
310.6    Subdivision 1. License holder responsibility for individual rights of persons
310.7served by the program. The license holder must:
310.8(1) provide each person or each person's legal representative with a written notice
310.9that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of
310.10those rights within five working days of service initiation and annually thereafter;
310.11(2) make reasonable accommodations to provide this information in other formats
310.12or languages as needed to facilitate understanding of the rights by the person and the
310.13person's legal representative, if any;
310.14(3) maintain documentation of the person's or the person's legal representative's
310.15receipt of a copy and an explanation of the rights; and
310.16(4) ensure the exercise and protection of the person's rights in the services provided
310.17by the license holder and as authorized in the coordinated service and support plan.
310.18    Subd. 2. Service-related rights. A person's service-related rights include the right to:
310.19(1) participate in the development and evaluation of the services provided to the
310.20person;
310.21(2) have services and supports identified in the coordinated service and support plan
310.22and the coordinated service and support plan addendum provided in a manner that respects
310.23and takes into consideration the person's preferences according to the requirements in
310.24sections 245D.07 and 245D.071;
310.25(3) refuse or terminate services and be informed of the consequences of refusing
310.26or terminating services;
310.27(4) know, in advance, limits to the services available from the license holder,
310.28including the license holder's knowledge, skill, and ability to meet the person's service and
310.29support needs based on the information required in section 245D.031, subdivision 2;
310.30(5) know conditions and terms governing the provision of services, including the
310.31license holder's admission criteria and policies and procedures related to temporary
310.32service suspension and service termination;
310.33(6) a coordinated transfer to ensure continuity of care when there will be a change
310.34in the provider;
311.1(7) know what the charges are for services, regardless of who will be paying for the
311.2services, and be notified of changes in those charges;
311.3(7) (8) know, in advance, whether services are covered by insurance, government
311.4funding, or other sources, and be told of any charges the person or other private party
311.5may have to pay; and
311.6(8) (9) receive services from an individual who is competent and trained, who has
311.7professional certification or licensure, as required, and who meets additional qualifications
311.8identified in the person's coordinated service and support plan. or coordinated service and
311.9support plan addendum.
311.10    Subd. 3. Protection-related rights. (a) A person's protection-related rights include
311.11the right to:
311.12(1) have personal, financial, service, health, and medical information kept private,
311.13and be advised of disclosure of this information by the license holder;
311.14(2) access records and recorded information about the person in accordance with
311.15applicable state and federal law, regulation, or rule;
311.16(3) be free from maltreatment;
311.17(4) be free from restraint, time out, or seclusion used for a purpose other than except
311.18for emergency use of manual restraint to protect the person from imminent danger to self
311.19or others according to the requirements in section 245D.06;
311.20(5) receive services in a clean and safe environment when the license holder is the
311.21owner, lessor, or tenant of the service site;
311.22(6) be treated with courtesy and respect and receive respectful treatment of the
311.23person's property;
311.24(7) reasonable observance of cultural and ethnic practice and religion;
311.25(8) be free from bias and harassment regarding race, gender, age, disability,
311.26spirituality, and sexual orientation;
311.27(9) be informed of and use the license holder's grievance policy and procedures,
311.28including knowing how to contact persons responsible for addressing problems and to
311.29appeal under section 256.045;
311.30(10) know the name, telephone number, and the Web site, e-mail, and street
311.31addresses of protection and advocacy services, including the appropriate state-appointed
311.32ombudsman, and a brief description of how to file a complaint with these offices;
311.33(11) assert these rights personally, or have them asserted by the person's family,
311.34authorized representative, or legal representative, without retaliation;
311.35(12) give or withhold written informed consent to participate in any research or
311.36experimental treatment;
312.1(13) associate with other persons of the person's choice;
312.2(14) personal privacy; and
312.3(15) engage in chosen activities.
312.4(b) For a person residing in a residential site licensed according to chapter 245A,
312.5or where the license holder is the owner, lessor, or tenant of the residential service site,
312.6protection-related rights also include the right to:
312.7(1) have daily, private access to and use of a non-coin-operated telephone for local
312.8calls and long-distance calls made collect or paid for by the person;
312.9(2) receive and send, without interference, uncensored, unopened mail or electronic
312.10correspondence or communication; and
312.11(3) have use of and free access to common areas in the residence; and
312.12(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious
312.13advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including
312.14privacy in the person's bedroom.
312.15(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a),
312.16clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure
312.17the health, safety, and well-being of the person. Any restriction of those rights must be
312.18documented in the person's coordinated service and support plan for the person and or
312.19coordinated service and support plan addendum. The restriction must be implemented
312.20in the least restrictive alternative manner necessary to protect the person and provide
312.21support to reduce or eliminate the need for the restriction in the most integrated setting
312.22and inclusive manner. The documentation must include the following information:
312.23(1) the justification for the restriction based on an assessment of the person's
312.24vulnerability related to exercising the right without restriction;
312.25(2) the objective measures set as conditions for ending the restriction;
312.26(3) a schedule for reviewing the need for the restriction based on the conditions for
312.27ending the restriction to occur, at a minimum, every three months for persons who do not
312.28have a legal representative and annually for persons who do have a legal representative
312.29 semiannually from the date of initial approval, at a minimum, or more frequently if
312.30requested by the person, the person's legal representative, if any, and case manager; and
312.31(4) signed and dated approval for the restriction from the person, or the person's
312.32legal representative, if any. A restriction may be implemented only when the required
312.33approval has been obtained. Approval may be withdrawn at any time. If approval is
312.34withdrawn, the right must be immediately and fully restored.
312.35EFFECTIVE DATE.This section is effective January 1, 2014.

313.1    Sec. 21. Minnesota Statutes 2012, section 245D.05, is amended to read:
313.2245D.05 HEALTH SERVICES.
313.3    Subdivision 1. Health needs. (a) The license holder is responsible for providing
313.4 meeting health services service needs assigned in the coordinated service and support plan
313.5and or the coordinated service and support plan addendum, consistent with the person's
313.6health needs. The license holder is responsible for promptly notifying the person or
313.7 the person's legal representative, if any, and the case manager of changes in a person's
313.8physical and mental health needs affecting assigned health services service needs assigned
313.9to the license holder in the coordinated service and support plan or the coordinated service
313.10and support plan addendum, when discovered by the license holder, unless the license
313.11holder has reason to know the change has already been reported. The license holder
313.12must document when the notice is provided.
313.13(b) When assigned in the service plan, If responsibility for meeting the person's
313.14health service needs has been assigned to the license holder in the coordinated service and
313.15support plan or the coordinated service and support plan addendum, the license holder is
313.16required to must maintain documentation on how the person's health needs will be met,
313.17including a description of the procedures the license holder will follow in order to:
313.18(1) provide medication administration, assistance or medication assistance, or
313.19medication management administration according to this chapter;
313.20(2) monitor health conditions according to written instructions from the person's
313.21physician or a licensed health professional;
313.22(3) assist with or coordinate medical, dental, and other health service appointments; or
313.23(4) use medical equipment, devices, or adaptive aides or technology safely and
313.24correctly according to written instructions from the person's physician or a licensed
313.25health professional.
313.26    Subd. 1a. Medication setup. For the purposes of this subdivision, "medication
313.27setup" means the arranging of medications according to instructions from the pharmacy,
313.28the prescriber, or a licensed nurse, for later administration when the license holder
313.29is assigned responsibility for medication assistance or medication administration in
313.30the coordinated service and support plan or the coordinated service and support plan
313.31addendum. A prescription label or the prescriber's written or electronically recorded order
313.32for the prescription is sufficient to constitute written instructions from the prescriber. The
313.33license holder must document in the person's medication administration record: dates
313.34of setup, name of medication, quantity of dose, times to be administered, and route of
313.35administration at time of setup; and, when the person will be away from home, to whom
313.36the medications were given.
314.1    Subd. 1b. Medication assistance. If responsibility for medication assistance
314.2is assigned to the license holder in the coordinated service and support plan or the
314.3coordinated service and support plan addendum, the license holder must ensure that
314.4the requirements of subdivision 2, paragraph (b), have been met when staff provides
314.5medication assistance to enable a person to self-administer medication or treatment when
314.6the person is capable of directing the person's own care, or when the person's legal
314.7representative is present and able to direct care for the person. For the purposes of this
314.8subdivision, "medication assistance" means any of the following:
314.9(1) bringing to the person and opening a container of previously set up medications,
314.10emptying the container into the person's hand, or opening and giving the medications in
314.11the original container to the person;
314.12(2) bringing to the person liquids or food to accompany the medication; or
314.13(3) providing reminders to take regularly scheduled medication or perform regularly
314.14scheduled treatments and exercises.
314.15    Subd. 2. Medication administration. (a) If responsibility for medication
314.16administration is assigned to the license holder in the coordinated service and support plan
314.17or the coordinated service and support plan addendum, the license holder must implement
314.18the following medication administration procedures to ensure a person takes medications
314.19and treatments as prescribed:
314.20(1) checking the person's medication record;
314.21(2) preparing the medication as necessary;
314.22(3) administering the medication or treatment to the person;
314.23(4) documenting the administration of the medication or treatment or the reason for
314.24not administering the medication or treatment; and
314.25(5) reporting to the prescriber or a nurse any concerns about the medication or
314.26treatment, including side effects, effectiveness, or a pattern of the person refusing to
314.27take the medication or treatment as prescribed. Adverse reactions must be immediately
314.28reported to the prescriber or a nurse.
314.29(b)(1) The license holder must ensure that the following criteria requirements in
314.30clauses (2) to (4) have been met before staff that is not a licensed health professional
314.31administers administering medication or treatment:.
314.32(1) (2) The license holder must obtain written authorization has been obtained from
314.33the person or the person's legal representative to administer medication or treatment
314.34orders; and must obtain reauthorization annually as needed. If the person or the person's
314.35legal representative refuses to authorize the license holder to administer medication, the
315.1medication must not be administered. The refusal to authorize medication administration
315.2must be reported to the prescriber as expediently as possible.
315.3(2) (3) The staff person has completed responsible for administering the medication
315.4or treatment must complete medication administration training according to section
315.5245D.09, subdivision 4 , paragraph 4a, paragraphs (a) and (c), clause (2); and, as applicable
315.6to the person, paragraph (d).
315.7(3) The medication or treatment will be administered under administration
315.8procedures established for the person in consultation with a licensed health professional.
315.9written instruction from the person's physician may constitute the medication
315.10administration procedures. A prescription label or the prescriber's order for the
315.11prescription is sufficient to constitute written instructions from the prescriber. A licensed
315.12health professional may delegate medication administration procedures.
315.13(4) For a license holder providing intensive support services, the medication or
315.14treatment must be administered according to the license holder's medication administration
315.15policy and procedures as required under section 245D.11, subdivision 2, clause (3).
315.16(b) (c) The license holder must ensure the following information is documented in
315.17the person's medication administration record:
315.18(1) the information on the current prescription label or the prescriber's current written
315.19or electronically recorded order or prescription that includes directions for the person's
315.20name, description of the medication or treatment to be provided, and the frequency and
315.21other information needed to safely and correctly administering administer the medication
315.22or treatment to ensure effectiveness;
315.23(2) information on any discomforts, risks, or other side effects that are reasonable to
315.24expect, and any contraindications to its use. This information must be readily available
315.25to all staff administering the medication;
315.26(3) the possible consequences if the medication or treatment is not taken or
315.27administered as directed;
315.28(4) instruction from the prescriber on when and to whom to report the following:
315.29(i) if the a dose of medication or treatment is not administered or treatment is not
315.30performed as prescribed, whether by error by the staff or the person or by refusal by
315.31the person; and
315.32(ii) the occurrence of possible adverse reactions to the medication or treatment;
315.33(5) notation of any occurrence of a dose of medication not being administered or
315.34treatment not performed as prescribed, whether by error by the staff or the person or by
315.35refusal by the person, or of adverse reactions, and when and to whom the report was
315.36made; and
316.1(6) notation of when a medication or treatment is started, administered, changed, or
316.2discontinued.
316.3(c) The license holder must ensure that the information maintained in the medication
316.4administration record is current and is regularly reviewed with the person or the person's
316.5legal representative and the staff administering the medication to identify medication
316.6administration issues or errors. At a minimum, the review must be conducted every three
316.7months or more often if requested by the person or the person's legal representative.
316.8Based on the review, the license holder must develop and implement a plan to correct
316.9medication administration issues or errors. If issues or concerns are identified related to
316.10the medication itself, the license holder must report those as required under subdivision 4.
316.11    Subd. 3. Medication assistance. The license holder must ensure that the
316.12requirements of subdivision 2, paragraph (a), have been met when staff provides assistance
316.13to enable a person to self-administer medication when the person is capable of directing
316.14the person's own care, or when the person's legal representative is present and able to
316.15direct care for the person.
316.16    Subd. 4. Reviewing and reporting medication and treatment issues. The
316.17following medication administration issues must be reported to the person or the person's
316.18legal representative and case manager as they occur or following timelines established
316.19in the person's service plan or as requested in writing by the person or the person's legal
316.20representative, or the case manager: (a) When assigned responsibility for medication
316.21administration, the license holder must ensure that the information maintained in
316.22the medication administration record is current and is regularly reviewed to identify
316.23medication administration errors. At a minimum, the review must be conducted every
316.24three months, or more frequently as directed in the coordinated service and support plan
316.25or coordinated service and support plan addendum or as requested by the person or the
316.26person's legal representative. Based on the review, the license holder must develop and
316.27implement a plan to correct patterns of medication administration errors when identified.
316.28(b) If assigned responsibility for medication assistance or medication administration,
316.29the license holder must report the following to the person's legal representative and case
316.30manager as they occur or as otherwise directed in the coordinated service and support plan
316.31or the coordinated service and support plan addendum:
316.32(1) any reports made to the person's physician or prescriber required under
316.33subdivision 2, paragraph (b) (c), clause (4);
316.34(2) a person's refusal or failure to take or receive medication or treatment as
316.35prescribed; or
316.36(3) concerns about a person's self-administration of medication or treatment.
317.1    Subd. 5. Injectable medications. Injectable medications may be administered
317.2according to a prescriber's order and written instructions when one of the following
317.3conditions has been met:
317.4(1) a registered nurse or licensed practical nurse will administer the subcutaneous or
317.5intramuscular injection;
317.6(2) a supervising registered nurse with a physician's order has delegated the
317.7administration of subcutaneous injectable medication to an unlicensed staff member
317.8and has provided the necessary training; or
317.9(3) there is an agreement signed by the license holder, the prescriber, and the
317.10person or the person's legal representative specifying what subcutaneous injections may
317.11be given, when, how, and that the prescriber must retain responsibility for the license
317.12holder's giving the injections. A copy of the agreement must be placed in the person's
317.13service recipient record.
317.14Only licensed health professionals are allowed to administer psychotropic
317.15medications by injection.
317.16EFFECTIVE DATE.This section is effective January 1, 2014.

317.17    Sec. 22. [245D.051] PSYCHOTROPIC MEDICATION USE AND
317.18MONITORING.
317.19    Subdivision 1. Conditions for psychotropic medication administration. (a)
317.20When a person is prescribed a psychotropic medication and the license holder is assigned
317.21responsibility for administration of the medication in the person's coordinated service
317.22and support plan or the coordinated service and support plan addendum, the license
317.23holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05,
317.24subdivision 2, are met.
317.25(b) Use of the medication must be included in the person's coordinated service and
317.26support plan or in the coordinated service and support plan addendum and based on a
317.27prescriber's current written or electronically recorded prescription.
317.28(c) The license holder must develop, implement, and maintain the following
317.29documentation in the person's coordinated service and support plan addendum according
317.30to the requirements in sections 245D.07 and 245D.071:
317.31(1) a description of the target symptoms that the psychotropic medication is to
317.32alleviate; and
317.33(2) documentation methods the license holder will use to monitor and measure
317.34changes in the target symptoms that are to be alleviated by the psychotropic medication if
317.35required by the prescriber. The license holder must collect and report on medication and
318.1symptom-related data as instructed by the prescriber. The license holder must provide
318.2the monitoring data to the expanded support team for review every three months, or as
318.3otherwise requested by the person or the person's legal representative.
318.4For the purposes of this section, "target symptom" refers to any perceptible
318.5diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic
318.6and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or
318.7successive editions that has been identified for alleviation.
318.8(d) If a person is prescribed a psychotropic medication, monitoring the use of the
318.9psychotropic medication must be assigned to the license holder in the coordinated service
318.10and support plan or the coordinated service and support plan addendum. The assigned
318.11license holder must monitor the psychotropic medication as required by this section.
318.12    Subd. 2. Refusal to authorize psychotropic medication. If the person or the
318.13person's legal representative refuses to authorize the administration of a psychotropic
318.14medication as ordered by the prescriber, the license holder must follow the requirement
318.15in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal
318.16to the prescriber, the license holder must follow any directives or orders given by the
318.17prescriber. A court order must be obtained to override the refusal. Refusal to authorize
318.18administration of a specific psychotropic medication is not grounds for service termination
318.19and does not constitute an emergency. A decision to terminate services must be reached in
318.20compliance with section 245D.10, subdivision 3.
318.21EFFECTIVE DATE.This section is effective January 1, 2014.

318.22    Sec. 23. Minnesota Statutes 2012, section 245D.06, is amended to read:
318.23245D.06 PROTECTION STANDARDS.
318.24    Subdivision 1. Incident response and reporting. (a) The license holder must
318.25respond to all incidents under section 245D.02, subdivision 11, that occur while providing
318.26services to protect the health and safety of and minimize risk of harm to the person.
318.27(b) The license holder must maintain information about and report incidents to the
318.28person's legal representative or designated emergency contact and case manager within 24
318.29hours of an incident occurring while services are being provided, or within 24 hours of
318.30discovery or receipt of information that an incident occurred, unless the license holder
318.31has reason to know that the incident has already been reported, or as otherwise directed
318.32in a person's coordinated service and support plan or coordinated service and support
318.33plan addendum. An incident of suspected or alleged maltreatment must be reported as
319.1required under paragraph (d), and an incident of serious injury or death must be reported
319.2as required under paragraph (e).
319.3(c) When the incident involves more than one person, the license holder must not
319.4disclose personally identifiable information about any other person when making the report
319.5to each person and case manager unless the license holder has the consent of the person.
319.6(d) Within 24 hours of reporting maltreatment as required under section 626.556
319.7or 626.557, the license holder must inform the case manager of the report unless there is
319.8reason to believe that the case manager is involved in the suspected maltreatment. The
319.9license holder must disclose the nature of the activity or occurrence reported and the
319.10agency that received the report.
319.11(e) The license holder must report the death or serious injury of the person to the legal
319.12representative, if any, and case manager, as required in paragraph (b) and to the Department
319.13of Human Services Licensing Division, and the Office of Ombudsman for Mental Health
319.14and Developmental Disabilities as required under section 245.94, subdivision 2a, within
319.1524 hours of the death, or receipt of information that the death occurred, unless the license
319.16holder has reason to know that the death has already been reported.
319.17(f) When a death or serious injury occurs in a facility certified as an intermediate
319.18care facility for persons with developmental disabilities, the death or serious injury must
319.19be reported to the Department of Health, Office of Health Facility Complaints, and the
319.20Office of Ombudsman for Mental Health and Developmental Disabilities, as required
319.21under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
319.22know that the death has already been reported.
319.23(f) (g) The license holder must conduct a an internal review of incident reports of
319.24deaths and serious injuries that occurred while services were being provided and that
319.25were not reported by the program as alleged or suspected maltreatment, for identification
319.26of incident patterns, and implementation of corrective action as necessary to reduce
319.27occurrences. The review must include an evaluation of whether related policies and
319.28procedures were followed, whether the policies and procedures were adequate, whether
319.29there is a need for additional staff training, whether the reported event is similar to past
319.30events with the persons or the services involved, and whether there is a need for corrective
319.31action by the license holder to protect the health and safety of persons receiving services.
319.32Based on the results of this review, the license holder must develop, document, and
319.33implement a corrective action plan designed to correct current lapses and prevent future
319.34lapses in performance by staff or the license holder, if any.
319.35(h) The license holder must verbally report the emergency use of manual restraint of
319.36a person as required in paragraph (b), within 24 hours of the occurrence. The license holder
320.1must ensure the written report and internal review of all incident reports of the emergency
320.2use of manual restraints are completed according to the requirements in section 245D.061.
320.3    Subd. 2. Environment and safety. The license holder must:
320.4(1) ensure the following when the license holder is the owner, lessor, or tenant
320.5of the an unlicensed service site:
320.6(i) the service site is a safe and hazard-free environment;
320.7(ii) doors are locked or toxic substances or dangerous items normally accessible are
320.8inaccessible to persons served by the program are stored in locked cabinets, drawers, or
320.9containers only to protect the safety of a person receiving services and not as a substitute
320.10for staff supervision or interactions with a person who is receiving services. If doors are
320.11locked or toxic substances or dangerous items normally accessible to persons served by the
320.12program are stored in locked cabinets, drawers, or containers are made inaccessible, the
320.13license holder must justify and document how this determination was made in consultation
320.14with the person or person's legal representative, and how access will otherwise be provided
320.15to the person and all other affected persons receiving services; and document an assessment
320.16of the physical plant, its environment, and its population identifying the risk factors which
320.17require toxic substances or dangerous items to be inaccessible and a statement of specific
320.18measures to be taken to minimize the safety risk to persons receiving services;
320.19(iii) doors are locked from the inside to prevent a person from exiting only when
320.20necessary to protect the safety of a person receiving services and not as a substitute for
320.21staff supervision or interactions with the person. If doors are locked from the inside, the
320.22license holder must document an assessment of the physical plant, the environment and
320.23the population served, identifying the risk factors which require the use of locked doors,
320.24and a statement of specific measures to be taken to minimize the safety risk to persons
320.25receiving services at the service site; and
320.26(iii) (iv) a staff person is available on site who is trained in basic first aid and, when
320.27required in a person's coordinated service and support plan or coordinated service and
320.28support plan addendum, cardiopulmonary resuscitation, "CPR," whenever persons are
320.29present and staff are required to be at the site to provide direct service. The CPR training
320.30must include in-person instruction, hands-on practice, and an observed skills assessment
320.31under the direct supervision of a CPR instructor;
320.32(2) maintain equipment, vehicles, supplies, and materials owned or leased by the
320.33license holder in good condition when used to provide services;
320.34(3) follow procedures to ensure safe transportation, handling, and transfers of the
320.35person and any equipment used by the person, when the license holder is responsible for
320.36transportation of a person or a person's equipment;
321.1(4) be prepared for emergencies and follow emergency response procedures to
321.2ensure the person's safety in an emergency; and
321.3(5) follow universal precautions and sanitary practices, including hand washing, for
321.4infection prevention and control, and to prevent communicable diseases.
321.5    Subd. 3. Compliance with fire and safety codes. When services are provided at a
321.6 service site licensed according to chapter 245A or where the license holder is the owner,
321.7lessor, or tenant of the service site, the license holder must document compliance with
321.8applicable building codes, fire and safety codes, health rules, and zoning ordinances, or
321.9document that an appropriate waiver has been granted.
321.10    Subd. 4. Funds and property. (a) Whenever the license holder assists a person
321.11with the safekeeping of funds or other property according to section 245A.04, subdivision
321.1213 , the license holder must have obtain written authorization to do so from the person or
321.13the person's legal representative and the case manager. Authorization must be obtained
321.14within five working days of service initiation and renewed annually thereafter. At the time
321.15initial authorization is obtained, the license holder must survey, document, and implement
321.16the preferences of the person or the person's legal representative and the case manager
321.17for frequency of receiving a statement that itemizes receipts and disbursements of funds
321.18or other property. The license holder must document changes to these preferences when
321.19they are requested.
321.20(b) A license holder or staff person may not accept powers-of-attorney from a
321.21person receiving services from the license holder for any purpose, and may not accept an
321.22appointment as guardian or conservator of a person receiving services from the license
321.23holder. This does not apply to license holders that are Minnesota counties or other
321.24units of government or to staff persons employed by license holders who were acting
321.25as power-of-attorney, guardian, or conservator attorney-in-fact for specific individuals
321.26prior to April 23, 2012 implementation of this chapter. The license holder must maintain
321.27documentation of the power-of-attorney, guardianship, or conservatorship in the service
321.28recipient record.
321.29(c) Upon the transfer or death of a person, any funds or other property of the person
321.30must be surrendered to the person or the person's legal representative, or given to the
321.31executor or administrator of the estate in exchange for an itemized receipt.
321.32    Subd. 5. Prohibitions. (a) The license holder is prohibited from using psychotropic
321.33medication chemical restraints, mechanical restraint practices, manual restraints, time out,
321.34or seclusion as a substitute for adequate staffing, for a behavioral or therapeutic program
321.35to reduce or eliminate behavior, as punishment, or for staff convenience, or for any reason
321.36other than as prescribed.
322.1(b) The license holder is prohibited from using restraints or seclusion under any
322.2circumstance, unless the commissioner has approved a variance request from the license
322.3holder that allows for the emergency use of restraints and seclusion according to terms
322.4and conditions approved in the variance. Applicants and license holders who have
322.5reason to believe they may be serving an individual who will need emergency use of
322.6restraints or seclusion may request a variance on the application or reapplication, and
322.7the commissioner shall automatically review the request for a variance as part of the
322.8application or reapplication process. License holders may also request the variance any
322.9time after issuance of a license. In the event a license holder uses restraint or seclusion for
322.10any reason without first obtaining a variance as required, the license holder must report
322.11the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the
322.12occurrence and request the required variance.
322.13(b) For the purposes of this subdivision, "chemical restraint" means the
322.14administration of a drug or medication to control the person's behavior or restrict the
322.15person's freedom of movement and is not a standard treatment of dosage for the person's
322.16medical or psychological condition.
322.17(c) For the purposes of this subdivision, "mechanical restraint practice" means the
322.18use of any adaptive equipment or safety device to control the person's behavior or restrict
322.19the person's freedom of movement and not as ordered by a licensed health professional.
322.20Mechanical restraint practices include, but are not limited to, the use of bed rails or similar
322.21devices on a bed to prevent the person from getting out of bed, chairs that prevent a person
322.22from rising, or placing a person in a wheelchair so close to a wall that the wall prevents
322.23the person from rising. Wrist bands or devices on clothing that trigger electronic alarms to
322.24warn staff that a person is leaving a room or area do not, in and of themselves, restrict
322.25freedom of movement and should not be considered restraints.
322.26(d) A license holder must not use manual restraints, time out, or seclusion under any
322.27circumstance, except for emergency use of manual restraints according to the requirements
322.28in section 245D.061 or the use of controlled procedures with a person with a developmental
322.29disability as governed by Minnesota Rules, parts 9525.2700 to 9525.2810, or its successor
322.30provisions. License holders implementing nonemergency use of manual restraint, or any
322.31other programmatic use of mechanical restraint, time out, or seclusion with persons who
322.32do not have a developmental disability that is not subject to the requirements of Minnesota
322.33Rules, parts 9525.2700 to 9525.2810, must submit a variance request to the commissioner
322.34for continued use of the procedure within three months of implementation of this chapter.
322.35EFFECTIVE DATE.This section is effective January 1, 2014.

323.1    Sec. 24. [245D.061] EMERGENCY USE OF MANUAL RESTRAINTS.
323.2    Subdivision 1. Standards for emergency use of manual restraints. Except
323.3for the emergency use of controlled procedures with a person with a developmental
323.4disability as governed by Minnesota Rules, part 9525.2770, or its successor provisions,
323.5the license holder must ensure that emergency use of manual restraints complies with the
323.6requirements of this chapter and the license holder's policy and procedures as required
323.7under subdivision 10.
323.8    Subd. 2. Definitions. (a) The terms used in this section have the meaning given
323.9them in this subdivision.
323.10(b) "Manual restraint" means physical intervention intended to hold a person
323.11immobile or limit a person's voluntary movement by using body contact as the only source
323.12of physical restraint.
323.13(c) "Mechanical restraint" means the use of devices, materials, or equipment attached
323.14or adjacent to the person's body, or the use of practices which restrict freedom of movement
323.15or normal access to one's body or body parts, or limits a person's voluntary movement
323.16or holds a person immobile as an intervention precipitated by a person's behavior. The
323.17term does apply to mechanical restraint used to prevent injury with persons who engage in
323.18self-injurious behaviors, such as head-banging, gouging, or other actions resulting in tissue
323.19damage that have caused or could cause medical problems resulting from the self-injury.
323.20    Subd. 3. Conditions for emergency use of manual restraint. Emergency use of
323.21manual restraint must meet the following conditions:
323.22(1) immediate intervention must be needed to protect the person or others from
323.23imminent risk of physical harm; and
323.24(2) the type of manual restraint used must be the least restrictive intervention to
323.25eliminate the immediate risk of harm and effectively achieve safety. The manual restraint
323.26must end when the threat of harm ends.
323.27    Subd. 4. Permitted instructional techniques and therapeutic conduct. (a) Use of
323.28physical contact as therapeutic conduct or as an instructional technique as identified in
323.29paragraphs (b) and (c), is permitted and is not subject to the requirements of this section
323.30when such use is addressed in a person's coordinated service and support plan addendum
323.31and the required conditions have been met. For the purposes of this subdivision,
323.32"therapeutic conduct" has the meaning given in section 626.5572, subdivision 20.
323.33(b) Physical contact or instructional techniques must use the least restrictive
323.34alternative possible to meet the needs of the person and may be used:
323.35(1) to calm or comfort a person by holding that person with no resistance from
323.36that person;
324.1(2) to protect a person known to be at risk of injury due to frequent falls as a result of
324.2a medical condition; or
324.3(3) to position a person with physical disabilities in a manner specified in the
324.4person's coordinated service and support plan addendum.
324.5(c) Restraint may be used as therapeutic conduct:
324.6(1) to allow a licensed health care professional to safely conduct a medical
324.7examination or to provide medical treatment ordered by a licensed health care professional
324.8to a person necessary to promote healing or recovery from an acute, meaning short-term,
324.9medical condition;
324.10(2) to facilitate the person's completion of a task or response when the person does
324.11not resist or the person's resistance is minimal in intensity and duration;
324.12(3) to briefly block or redirect a person's limbs or body without holding the person
324.13or limiting the person's movement to interrupt the person's behavior that may result in
324.14injury to self or others; or
324.15(4) to assist in the safe evacuation of a person in the event of an emergency or to
324.16redirect a person who is at imminent risk of harm in a dangerous situation.
324.17(d) A plan for using restraint as therapeutic conduct must be developed according to
324.18the requirements in sections 245D.07 and 245D.071, and must include methods to reduce
324.19or eliminate the use of and need for restraint.
324.20    Subd. 5. Restrictions when implementing emergency use of manual restraint.
324.21(a) Emergency use of manual restraint procedures must not:
324.22(1) be implemented with a child in a manner that constitutes sexual abuse, neglect,
324.23physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
324.24(2) be implemented with an adult in a manner that constitutes abuse or neglect as
324.25defined in section 626.5572, subdivisions 2 and 17;
324.26(3) be implemented in a manner that violates a person's rights and protections
324.27identified in section 245D.04;
324.28(4) restrict a person's normal access to a nutritious diet, drinking water, adequate
324.29ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping
324.30conditions, or necessary clothing, or to any protection required by state licensing standards
324.31and federal regulations governing the program;
324.32(5) deny the person visitation or ordinary contact with legal counsel, a legal
324.33representative, or next of kin;
324.34(6) be used as a substitute for adequate staffing, for the convenience of staff, as
324.35punishment, or as a consequence if the person refuses to participate in the treatment
324.36or services provided by the program; or
325.1(7) use prone restraint. For the purposes of this section, "prone restraint" means use
325.2of manual restraint that places a person in a face-down position. This does not include
325.3brief physical holding of a person who, during an emergency use of manual restraint, rolls
325.4into a prone position, and the person is restored to a standing, sitting, or side-lying position
325.5as quickly as possible. Applying back or chest pressure while a person is in the prone or
325.6supine position or face-up is prohibited.
325.7    Subd. 6. Monitoring emergency use of manual restraint. The license holder shall
325.8monitor a person's health and safety during an emergency use of a manual restraint. Staff
325.9monitoring the procedure must not be the staff implementing the procedure when possible.
325.10The license holder shall complete a monitoring form, approved by the commissioner, for
325.11each incident involving the emergency use of a manual restraint.
325.12    Subd. 7. Reporting emergency use of manual restraint incident. (a) Within
325.13three calendar days after an emergency use of a manual restraint, the staff person who
325.14implemented the emergency use must report in writing to the designated coordinator the
325.15following information about the emergency use:
325.16(1) the staff and persons receiving services who were involved in the incident
325.17leading up to the emergency use of manual restraint;
325.18(2) a description of the physical and social environment, including who was present
325.19before and during the incident leading up to the emergency use of manual restraint;
325.20(3) a description of what less restrictive alternative measures were attempted to
325.21de-escalate the incident and maintain safety before the manual restraint was implemented
325.22that identifies when, how, and how long the alternative measures were attempted before
325.23manual restraint was implemented;
325.24(4) a description of the mental, physical, and emotional condition of the person who
325.25was restrained, and other persons involved in the incident leading up to, during, and
325.26following the manual restraint;
325.27(5) whether there was any injury to the person who was restrained or other persons
325.28involved in the incident, including staff, before or as a result of the use of manual
325.29restraint; and
325.30(6) whether there was an attempt to debrief with the staff, and, if not contraindicated,
325.31with the person who was restrained and other persons who were involved in or who
325.32witnessed the restraint, following the incident and the outcome of the debriefing. If the
325.33debriefing was not conducted at the time the incident report was made, the report should
325.34identify whether a debriefing is planned.
326.1(b) Each single incident of emergency use of manual restraint must be reported
326.2separately. For the purposes of this subdivision, an incident of emergency use of manual
326.3restraint is a single incident when the following conditions have been met:
326.4(1) after implementing the manual restraint, staff attempt to release the person at the
326.5moment staff believe the person's conduct no longer poses an imminent risk of physical
326.6harm to self or others and less restrictive strategies can be implemented to maintain safety;
326.7(2) upon the attempt to release the restraint, the person's behavior immediately
326.8re-escalates; and
326.9(3) staff must immediately reimplement the restraint in order to maintain safety.
326.10    Subd. 8. Internal review of emergency use of manual restraint. (a) Within five
326.11working days of the emergency use of manual restraint, the license holder must complete
326.12an internal review of each report of emergency use of manual restraint. The review must
326.13include an evaluation of whether:
326.14(1) the person's service and support strategies developed according to sections
326.15245D.07 and 245D.071 need to be revised;
326.16(2) related policies and procedures were followed;
326.17(3) the policies and procedures were adequate;
326.18(4) there is a need for additional staff training;
326.19(5) the reported event is similar to past events with the persons, staff, or the services
326.20involved; and
326.21(6) there is a need for corrective action by the license holder to protect the health
326.22and safety of persons.
326.23(b) Based on the results of the internal review, the license holder must develop,
326.24document, and implement a corrective action plan for the program designed to correct
326.25current lapses and prevent future lapses in performance by individuals or the license
326.26holder, if any. The corrective action plan, if any, must be implemented within 30 days of
326.27the internal review being completed.
326.28    Subd. 9. Expanded support team review. Within five working days after the
326.29completion of the internal review required in subdivision 8, the license holder must consult
326.30with the expanded support team following the emergency use of manual restraint to:
326.31(1) discuss the incident reported in subdivision 7, to define the antecedent or event
326.32that gave rise to the behavior resulting in the manual restraint and identify the perceived
326.33function the behavior served; and
326.34(2) determine whether the person's coordinated service and support plan addendum
326.35needs to be revised according to sections 245D.07 and 245D.071 to positively and
327.1effectively help the person maintain stability and to reduce or eliminate future occurrences
327.2requiring emergency use of manual restraint.
327.3    Subd. 10. Emergency use of manual restraints policy and procedures. The
327.4license holder must develop, document, and implement a policy and procedures that
327.5promote service recipient rights and protect health and safety during the emergency use of
327.6manual restraints. The policy and procedures must comply with the requirements of this
327.7section and must specify the following:
327.8(1) a description of the positive support strategies and techniques staff must use to
327.9attempt to de-escalate a person's behavior before it poses an imminent risk of physical
327.10harm to self or others;
327.11(2) a description of the types of manual restraints the license holder allows staff to
327.12use on an emergency basis, if any. If the license holder will not allow the emergency use
327.13of manual restraint, the policy and procedure must identify the alternative measures the
327.14license holder will require staff to use when a person's conduct poses an imminent risk of
327.15physical harm to self or others and less restrictive strategies would not achieve safety;
327.16(3) instructions for safe and correct implementation of the allowed manual restraint
327.17procedures;
327.18(4) the training that staff must complete and the timelines for completion, before they
327.19may implement an emergency use of manual restraint. In addition to the training on this
327.20policy and procedure and the orientation and annual training required in section 245D.09,
327.21subdivision 4, the training for emergency use of manual restraint must incorporate the
327.22following subjects:
327.23(i) alternatives to manual restraint procedures, including techniques to identify
327.24events and environmental factors that may escalate conduct that poses an imminent risk of
327.25physical harm to self or others;
327.26(ii) de-escalation methods, positive support strategies, and how to avoid power
327.27struggles;
327.28(iii) simulated experiences of administering and receiving manual restraint
327.29procedures allowed by the license holder on an emergency basis;
327.30(iv) how to properly identify thresholds for implementing and ceasing restrictive
327.31procedures;
327.32(v) how to recognize, monitor, and respond to the person's physical signs of distress,
327.33including positional asphyxia;
327.34(vi) the physiological and psychological impact on the person and the staff when
327.35restrictive procedures are used;
327.36(vii) the communicative intent of behaviors; and
328.1(viii) relationship building;
328.2(5) the procedures and forms to be used to monitor the emergency use of manual
328.3restraints, including what must be monitored and the frequency of monitoring per
328.4each incident of emergency use of manual restraint, and the person or position who is
328.5responsible for monitoring the use;
328.6(6) the instructions, forms, and timelines required for completing and submitting an
328.7incident report by the person or persons who implemented the manual restraint; and
328.8(7) the procedures and timelines for conducting the internal review and the expanded
328.9support team review, and the person or position responsible for completing the reviews and
328.10who is responsible for ensuring that corrective action is taken or the person's coordinated
328.11service and support plan addendum is revised, when determined necessary.
328.12EFFECTIVE DATE.This section is effective January 1, 2014.

328.13    Sec. 25. Minnesota Statutes 2012, section 245D.07, is amended to read:
328.14245D.07 SERVICE NEEDS PLANNING AND DELIVERY.
328.15    Subdivision 1. Provision of services. The license holder must provide services as
328.16specified assigned in the coordinated service and support plan and assigned to the license
328.17holder. The provision of services must comply with the requirements of this chapter and
328.18the federal waiver plans.
328.19    Subd. 1a. Person-centered planning and service delivery. (a) The license holder
328.20must provide services in response to the person's identified needs, interests, preferences,
328.21and desired outcomes as specified in the coordinated service and support plan, the
328.22coordinated service and support plan addendum, and in compliance with the requirements
328.23of this chapter. License holders providing intensive support services must also provide
328.24outcome-based services according to the requirements in section 245D.071.
328.25(b) Services must be provided in a manner that supports the person's preferences,
328.26daily needs, and activities and accomplishment of the person's personal goals and service
328.27outcomes, consistent with the principles of:
328.28(1) person-centered service planning and delivery that:
328.29(i) identifies and supports what is important to the person as well as what is
328.30important for the person, including preferences for when, how, and by whom direct
328.31support service is provided;
328.32(ii) uses that information to identify outcomes the person desires; and
328.33(iii) respects each person's history, dignity, and cultural background;
328.34(2) self-determination that supports and provides:
329.1(i) opportunities for the development and exercise of functional and age-appropriate
329.2skills, decision making and choice, personal advocacy, and communication; and
329.3(ii) the affirmation and protection of each person's civil and legal rights;
329.4(3) providing the most integrated setting and inclusive service delivery that supports,
329.5promotes, and allows:
329.6(i) inclusion and participation in the person's community as desired by the person
329.7in a manner that enables the person to interact with nondisabled persons to the fullest
329.8extent possible and supports the person in developing and maintaining a role as a valued
329.9community member;
329.10(ii) opportunities for self-sufficiency as well as developing and maintaining social
329.11relationships and natural supports; and
329.12(iii) a balance between risk and opportunity, meaning the least restrictive supports or
329.13interventions necessary are provided in the most integrated settings in the most inclusive
329.14manner possible to support the person to engage in activities of the person's own choosing
329.15that may otherwise present a risk to the person's health, safety, or rights.
329.16    Subd. 2. Service planning requirements for basic support services. (a) License
329.17holders providing basic support services must meet the requirements of this subdivision.
329.18(b) Within 15 days of service initiation the license holder must complete a
329.19preliminary coordinated service and support plan addendum based on the coordinated
329.20service and support plan.
329.21(c) Within 60 days of service initiation the license holder must review and revise as
329.22needed the preliminary coordinated service and support plan addendum to document the
329.23services that will be provided including how, when, and by whom services will be provided,
329.24and the person responsible for overseeing the delivery and coordination of services.
329.25(d) The license holder must participate in service planning and support team
329.26meetings related to for the person following stated timelines established in the person's
329.27 coordinated service and support plan or as requested by the support team, the person, or
329.28the person's legal representative, the support team or the expanded support team.
329.29    Subd. 3. Reports. The license holder must provide written reports regarding the
329.30person's progress or status as requested by the person, the person's legal representative, the
329.31case manager, or the team.
329.32EFFECTIVE DATE.This section is effective January 1, 2014.

329.33    Sec. 26. [245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE
329.34SUPPORT SERVICES.
330.1    Subdivision 1. Requirements for intensive support services. A license holder
330.2providing intensive support services identified in section 245D.03, subdivision 1,
330.3paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1
330.4and 3, and this section.
330.5    Subd. 2. Abuse prevention. Prior to or upon initiating services, the license holder
330.6must develop, document, and implement an abuse prevention plan according to section
330.7245A.65, subdivision 2.
330.8    Subd. 3. Assessment and initial service planning. (a) Within 15 days of service
330.9initiation the license holder must complete a preliminary coordinated service and support
330.10plan addendum based on the coordinated service and support plan.
330.11(b) Within 45 days of service initiation the license holder must meet with the person,
330.12the person's legal representative, the case manager, and other members of the support team
330.13or expanded support team to assess and determine the following based on the person's
330.14coordinated service and support plan and the requirements in subdivision 4 and section
330.15245D.07, subdivision 1a:
330.16(1) the scope of the services to be provided to support the person's daily needs
330.17and activities;
330.18(2) the person's desired outcomes and the supports necessary to accomplish the
330.19person's desired outcomes;
330.20(3) the person's preferences for how services and supports are provided;
330.21(4) whether the current service setting is the most integrated setting available and
330.22appropriate for the person; and
330.23(5) how services must be coordinated across other providers licensed under this
330.24chapter serving the same person to ensure continuity of care for the person.
330.25(c) Within the scope of services, the license holder must, at a minimum, assess
330.26the following areas:
330.27(1) the person's ability to self-manage health and medical needs to maintain or
330.28improve physical, mental, and emotional well-being, including, when applicable, allergies,
330.29seizures, choking, special dietary needs, chronic medical conditions, self-administration
330.30of medication or treatment orders, preventative screening, and medical and dental
330.31appointments;
330.32(2) the person's ability to self-manage personal safety to avoid injury or accident in
330.33the service setting, including, when applicable, risk of falling, mobility, regulating water
330.34temperature, community survival skills, water safety skills, and sensory disabilities; and
330.35(3) the person's ability to self-manage symptoms or behavior that may otherwise
330.36result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to
331.1(7), suspension or termination of services by the license holder, or other symptoms
331.2or behaviors that may jeopardize the health and safety of the person or others. The
331.3assessments must produce information about the person that is descriptive of the person's
331.4overall strengths, functional skills and abilities, and behaviors or symptoms.
331.5    Subd. 4. Service outcomes and supports. (a) Within ten working days of the
331.645-day meeting, the license holder must develop and document the service outcomes and
331.7supports based on the assessments completed under subdivision 3 and the requirements
331.8in section 245D.07, subdivision 1a. The outcomes and supports must be included in the
331.9coordinated service and support plan addendum.
331.10(b) The license holder must document the supports and methods to be implemented
331.11to support the accomplishment of outcomes related to acquiring, retaining, or improving
331.12skills. The documentation must include:
331.13(1) the methods or actions that will be used to support the person and to accomplish
331.14the service outcomes, including information about:
331.15(i) any changes or modifications to the physical and social environments necessary
331.16when the service supports are provided;
331.17(ii) any equipment and materials required; and
331.18(iii) techniques that are consistent with the person's communication mode and
331.19learning style;
331.20(2) the measurable and observable criteria for identifying when the desired outcome
331.21has been achieved and how data will be collected;
331.22(3) the projected starting date for implementing the supports and methods and
331.23the date by which progress towards accomplishing the outcomes will be reviewed and
331.24evaluated; and
331.25(4) the names of the staff or position responsible for implementing the supports
331.26and methods.
331.27(c) Within 20 working days of the 45-day meeting, the license holder must obtain
331.28dated signatures from the person or the person's legal representative and case manager
331.29to document completion and approval of the assessment and coordinated service and
331.30support plan addendum.
331.31    Subd. 5. Progress reviews. (a) The license holder must give the person or the
331.32person's legal representative and case manager an opportunity to participate in the ongoing
331.33review and development of the methods used to support the person and accomplish
331.34outcomes identified in subdivisions 3 and 4. The license holder, in coordination with
331.35the person's support team or expanded support team, must meet with the person, the
331.36person's legal representative, and the case manager, and participate in progress review
332.1meetings following stated timelines established in the person's coordinated service and
332.2support plan or coordinated service and support plan addendum or within 30 days of a
332.3written request by the person, the person's legal representative, or the case manager,
332.4at a minimum of once per year.
332.5(b) The license holder must summarize the person's progress toward achieving the
332.6identified outcomes and make recommendations and identify the rationale for changing,
332.7continuing, or discontinuing implementation of supports and methods identified in
332.8subdivision 4 in a written report sent to the person or the person's legal representative
332.9and case manager five working days prior to the review meeting, unless the person, the
332.10person's legal representative, or the case manager request to receive the report at the
332.11time of the meeting.
332.12(c) Within ten working days of the progress review meeting, the license holder
332.13must obtain dated signatures from the person or the person's legal representative and
332.14the case manager to document approval of any changes to the coordinated service and
332.15support plan addendum.
332.16EFFECTIVE DATE.This section is effective January 1, 2014.

332.17    Sec. 27. [245D.081] PROGRAM COORDINATION, EVALUATION, AND
332.18OVERSIGHT.
332.19    Subdivision 1. Program coordination and evaluation. (a) The license holder
332.20is responsible for:
332.21(1) coordination of service delivery and evaluation for each person served by the
332.22program as identified in subdivision 2; and
332.23(2) program management and oversight that includes evaluation of the program
332.24quality and program improvement for services provided by the license holder as identified
332.25in subdivision 3.
332.26(b) The same person may perform the functions in paragraph (a) if the work and
332.27education qualifications are met in subdivisions 2 and 3.
332.28    Subd. 2. Coordination and evaluation of individual service delivery. (a) Delivery
332.29and evaluation of services provided by the license holder must be coordinated by a
332.30designated staff person. The designated coordinator must provide supervision, support,
332.31and evaluation of activities that include:
332.32(1) oversight of the license holder's responsibilities assigned in the person's
332.33coordinated service and support plan and the coordinated service and support plan
332.34addendum;
333.1(2) taking the action necessary to facilitate the accomplishment of the outcomes
333.2according to the requirements in section 245D.07;
333.3(3) instruction and assistance to direct support staff implementing the coordinated
333.4service and support plan and the service outcomes, including direct observation of service
333.5delivery sufficient to assess staff competency; and
333.6(4) evaluation of the effectiveness of service delivery, methodologies, and progress on
333.7the person's outcomes based on the measurable and observable criteria for identifying when
333.8the desired outcome has been achieved according to the requirements in section 245D.07.
333.9(b) The license holder must ensure that the designated coordinator is competent to
333.10perform the required duties identified in paragraph (a) through education and training in
333.11human services and disability-related fields, and work experience in providing direct care
333.12services and supports to persons with disabilities. The designated coordinator must have
333.13the skills and ability necessary to develop effective plans and to design and use data
333.14systems to measure effectiveness of services and supports. The license holder must verify
333.15and document competence according to the requirements in section 245D.09, subdivision
333.163. The designated coordinator must minimally have:
333.17(1) a baccalaureate degree in a field related to human services, and one year of
333.18full-time work experience providing direct care services to persons with disabilities or
333.19persons age 65 and older;
333.20(2) an associate degree in a field related to human services, and two years of
333.21full-time work experience providing direct care services to persons with disabilities or
333.22persons age 65 and older;
333.23(3) a diploma in a field related to human services from an accredited postsecondary
333.24institution and three years of full-time work experience providing direct care services to
333.25persons with disabilities or persons age 65 and older; or
333.26(4) a minimum of 50 hours of education and training related to human services
333.27and disabilities; and
333.28(5) four years of full-time work experience providing direct care services to persons
333.29with disabilities or persons age 65 and older under the supervision of a staff person who
333.30meets the qualifications identified in clauses (1) to (3).
333.31    Subd. 3. Program management and oversight. (a) The license holder must
333.32designate a managerial staff person or persons to provide program management and
333.33oversight of the services provided by the license holder. The designated manager is
333.34responsible for the following:
333.35(1) maintaining a current understanding of the licensing requirements sufficient to
333.36ensure compliance throughout the program as identified in section 245A.04, subdivision
334.11, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21,
334.2paragraph (b);
334.3(2) ensuring the duties of the designated coordinator are fulfilled according to the
334.4requirements in subdivision 2;
334.5(3) ensuring the program implements corrective action identified as necessary
334.6by the program following review of incident and emergency reports according to the
334.7requirements in section 245D.11, subdivision 2, clause (7). An internal review of
334.8incident reports of alleged or suspected maltreatment must be conducted according to the
334.9requirements in section 245A.65, subdivision 1, paragraph (b);
334.10(4) evaluation of satisfaction of persons served by the program, the person's legal
334.11representative, if any, and the case manager, with the service delivery and progress
334.12towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and
334.13ensuring and protecting each person's rights as identified in section 245D.04;
334.14(5) ensuring staff competency requirements are met according to the requirements in
334.15section 245D.09, subdivision 3, and ensuring staff orientation and training is provided
334.16according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
334.17(6) ensuring corrective action is taken when ordered by the commissioner and that
334.18the terms and condition of the license and any variances are met; and
334.19(7) evaluating the information identified in clauses (1) to (6) to develop, document,
334.20and implement ongoing program improvements.
334.21(b) The designated manager must be competent to perform the duties as required and
334.22must minimally meet the education and training requirements identified in subdivision
334.232, paragraph (b), and have a minimum of three years of supervisory level experience in
334.24a program providing direct support services to persons with disabilities or persons age
334.2565 and older.
334.26EFFECTIVE DATE.This section is effective January 1, 2014.

334.27    Sec. 28. Minnesota Statutes 2012, section 245D.09, is amended to read:
334.28245D.09 STAFFING STANDARDS.
334.29    Subdivision 1. Staffing requirements. The license holder must provide the level of
334.30 direct service support staff sufficient supervision, assistance, and training necessary:
334.31(1) to ensure the health, safety, and protection of rights of each person; and
334.32(2) to be able to implement the responsibilities assigned to the license holder in each
334.33person's coordinated service and support plan or identified in the coordinated service and
334.34support plan addendum, according to the requirements of this chapter.
335.1    Subd. 2. Supervision of staff having direct contact. Except for a license holder
335.2who is the sole direct service support staff, the license holder must provide adequate
335.3supervision of staff providing direct service support to ensure the health, safety, and
335.4protection of rights of each person and implementation of the responsibilities assigned to
335.5the license holder in each person's service plan coordinated service and support plan or
335.6coordinated service and support plan addendum.
335.7    Subd. 3. Staff qualifications. (a) The license holder must ensure that staff is
335.8 providing direct support, or staff who have responsibilities related to supervising or
335.9managing the provision of direct support service, are competent as demonstrated through
335.10 skills and knowledge training, experience, and education to meet the person's needs
335.11and additional requirements as written in the coordinated service and support plan or
335.12coordinated service and support plan addendum, or when otherwise required by the case
335.13manager or the federal waiver plan. The license holder must verify and maintain evidence
335.14of staff competency, including documentation of:
335.15(1) education and experience qualifications relevant to the job responsibilities
335.16assigned to the staff and the needs of the general population of persons served by the
335.17program, including a valid degree and transcript, or a current license, registration, or
335.18certification, when a degree or licensure, registration, or certification is required by this
335.19chapter or in the coordinated service and support plan or coordinated service and support
335.20plan addendum;
335.21(2) completion of required demonstrated competency in the orientation and training
335.22 areas required under this chapter, including and when applicable, completion of continuing
335.23education required to maintain professional licensure, registration, or certification
335.24requirements. Competency in these areas is determined by the license holder through
335.25knowledge testing and observed skill assessment conducted by the trainer or instructor; and
335.26(3) except for a license holder who is the sole direct service support staff, periodic
335.27 performance evaluations completed by the license holder of the direct service support staff
335.28person's ability to perform the job functions based on direct observation.
335.29(b) Staff under 18 years of age may not perform overnight duties or administer
335.30medication.
335.31    Subd. 4. Orientation to program requirements. (a) Except for a license holder
335.32who does not supervise any direct service support staff, within 90 days of hiring direct
335.33service staff 60 days of hire, unless stated otherwise, the license holder must provide
335.34and ensure completion of 30 hours of orientation for direct support staff that combines
335.35supervised on-the-job training with review of and instruction on in the following areas:
335.36(1) the job description and how to complete specific job functions, including:
336.1(i) responding to and reporting incidents as required under section 245D.06,
336.2subdivision 1; and
336.3(ii) following safety practices established by the license holder and as required in
336.4section 245D.06, subdivision 2;
336.5(2) the license holder's current policies and procedures required under this chapter,
336.6including their location and access, and staff responsibilities related to implementation
336.7of those policies and procedures;
336.8(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the
336.9federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff
336.10responsibilities related to complying with data privacy practices;
336.11(4) the service recipient rights under section 245D.04, and staff responsibilities
336.12related to ensuring the exercise and protection of those rights according to the requirements
336.13in section 245D.04;
336.14(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment
336.15reporting and service planning for children and vulnerable adults, and staff responsibilities
336.16related to protecting persons from maltreatment and reporting maltreatment. This
336.17orientation must be provided within 72 hours of first providing direct contact services and
336.18annually thereafter according to section 245A.65, subdivision 3;
336.19(6) what constitutes use of restraints, seclusion, and psychotropic medications,
336.20and staff responsibilities related to the prohibitions of their use the principles of
336.21person-centered service planning and delivery as identified in section 245D.07, subdivision
336.221a, and how they apply to direct support service provided by the staff person; and
336.23(7) other topics as determined necessary in the person's coordinated service and
336.24support plan by the case manager or other areas identified by the license holder.
336.25(b) License holders who provide direct service themselves must complete the
336.26orientation required in paragraph (a), clauses (3) to (7).
336.27    Subd. 4a. Orientation to individual service recipient needs. (c) (a) Before
336.28providing having unsupervised direct service to contact with a person served by the
336.29program, or for whom the staff person has not previously provided direct service support,
336.30or any time the plans or procedures identified in clauses (1) and (2) paragraphs (b) to
336.31(f) are revised, the staff person must review and receive instruction on the following
336.32as it relates requirements in paragraphs (b) to (f) as they relate to the staff person's job
336.33functions for that person:.
336.34(b) Training and competency evaluations must include the following:
337.1(1) appropriate and safe techniques in personal hygiene and grooming, including
337.2hair care, bathing, care of teeth, gums, oral prosthetic devices, and other activities of daily
337.3living (ADLs) as defined under section 256B.0659, subdivision 1;
337.4(2) an understanding of what constitutes a healthy diet according to data from the
337.5Centers for Disease Control and Prevention and the skills necessary to prepare that diet;
337.6(3) skills necessary to provide appropriate support in instrumental activities of daily
337.7living (IADLs) as defined under section 256B.0659, subdivision 1; and
337.8(4) demonstrated competence in providing first aid.
337.9(1) (c) The staff person must review and receive instruction on the person's
337.10 coordinated service and support plan or coordinated service and support plan addendum as
337.11it relates to the responsibilities assigned to the license holder, and when applicable, the
337.12person's individual abuse prevention plan according to section 245A.65, to achieve and
337.13demonstrate an understanding of the person as a unique individual, and how to implement
337.14those plans; and.
337.15(2) (d) The staff person must review and receive instruction on medication
337.16administration procedures established for the person when medication administration is
337.17 assigned to the license holder according to section 245D.05, subdivision 1, paragraph
337.18(b). Unlicensed staff may administer medications only after successful completion of a
337.19medication administration training, from a training curriculum developed by a registered
337.20nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse
337.21practitioner, physician's assistant, or physician incorporating. The training curriculum
337.22must incorporate an observed skill assessment conducted by the trainer to ensure staff
337.23demonstrate the ability to safely and correctly follow medication procedures.
337.24Medication administration must be taught by a registered nurse, clinical nurse
337.25specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of
337.26service initiation or any time thereafter, the person has or develops a health care condition
337.27that affects the service options available to the person because the condition requires:
337.28(i) (1) specialized or intensive medical or nursing supervision; and
337.29(ii) (2) nonmedical service providers to adapt their services to accommodate the
337.30health and safety needs of the person; and.
337.31(iii) necessary training in order to meet the health service needs of the person as
337.32determined by the person's physician.
337.33(e) The staff person must review and receive instruction on the safe and correct
337.34operation of medical equipment used by the person to sustain life, including but not
337.35limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided
337.36by a licensed health care professional or a manufacturer's representative and incorporate
338.1an observed skill assessment to ensure staff demonstrate the ability to safely and correctly
338.2operate the equipment according to the treatment orders and the manufacturer's instructions.
338.3(f) The staff person must review and receive instruction on what constitutes use of
338.4restraints, time out, and seclusion, including chemical restraint, and staff responsibilities
338.5related to the prohibitions of their use according to the requirements in section 245D.06,
338.6subdivision 5, why such procedures are not effective for reducing or eliminating symptoms
338.7or undesired behavior and why they are not safe, and the safe and correct use of manual
338.8restraint on an emergency basis according to the requirements in section 245D.061.
338.9(g) In the event of an emergency service initiation, the license holder must ensure
338.10the training required in this subdivision occurs within 72 hours of the direct support staff
338.11person first having unsupervised contact with the person receiving services. The license
338.12holder must document the reason for the unplanned or emergency service initiation and
338.13maintain the documentation in the person's service recipient record.
338.14(h) License holders who provide direct support services themselves must complete
338.15the orientation required in subdivision 4, clauses (3) to (7).
338.16    Subd. 5. Annual training. (a) A license holder must provide annual training
338.17to direct service support staff on the topics identified in subdivision 4, paragraph (a),
338.18 clauses (3) to (6) (7), and subdivision 4a. A license holder must provide a minimum of 24
338.19hours of annual training to direct service staff with fewer than five years of documented
338.20experience and 12 hours of annual training to direct service staff with five or more years
338.21of documented experience in topics described in subdivisions 4 and 4a, paragraphs (a)
338.22to (h). Training on relevant topics received from sources other than the license holder
338.23may count toward training requirements.
338.24(b) A license holder providing behavioral programming, specialist services, personal
338.25support, 24-hour emergency assistance, night supervision, independent living skills,
338.26structured day, prevocational, or supported employment services must provide a minimum
338.27of eight hours of annual training to direct service staff that addresses:
338.28(1) topics related to the general health, safety, and service needs of the population
338.29served by the license holder; and
338.30(2) other areas identified by the license holder or in the person's current service plan.
338.31Training on relevant topics received from sources other than the license holder
338.32may count toward training requirements.
338.33(c) When the license holder is the owner, lessor, or tenant of the service site and
338.34whenever a person receiving services is present at the site, the license holder must have
338.35a staff person available on site who is trained in basic first aid and, when required in a
338.36person's service plan, cardiopulmonary resuscitation.
339.1    Subd. 5a. Alternative sources of training. Orientation or training received by the
339.2staff person from sources other than the license holder in the same subjects as identified
339.3in subdivision 4 may count toward the orientation and annual training requirements if
339.4received in the 12-month period before the staff person's date of hire. The license holder
339.5must maintain documentation of the training received from other sources and of each staff
339.6person's competency in the required area according to the requirements in subdivision 3.
339.7    Subd. 6. Subcontractors and temporary staff. If the license holder uses a
339.8subcontractor or temporary staff to perform services licensed under this chapter on the
339.9license holder's behalf, the license holder must ensure that the subcontractor or temporary
339.10staff meets and maintains compliance with all requirements under this chapter that apply
339.11to the services to be provided, including training, orientation, and supervision necessary
339.12to fulfill their responsibilities. The license holder must ensure that a background study
339.13has been completed according to the requirements in sections 245C.03, subdivision 1,
339.14and 245C.04. Subcontractors and temporary staff hired by the license holder must meet
339.15the Minnesota licensing requirements applicable to the disciplines in which they are
339.16providing services. The license holder must maintain documentation that the applicable
339.17requirements have been met.
339.18    Subd. 7. Volunteers. The license holder must ensure that volunteers who provide
339.19direct support services to persons served by the program receive the training, orientation,
339.20and supervision necessary to fulfill their responsibilities. The license holder must ensure
339.21that a background study has been completed according to the requirements in sections
339.22245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation
339.23that the applicable requirements have been met.
339.24    Subd. 8. Staff orientation and training plan. The license holder must develop
339.25a staff orientation and training plan documenting when and how compliance with
339.26subdivisions 4, 4a, and 5 will be met.
339.27EFFECTIVE DATE.This section is effective January 1, 2014.

339.28    Sec. 29. [245D.091] INTERVENTION SERVICES.
339.29    Subdivision 1. Licensure requirements. An individual meeting the staff
339.30qualification requirements of this section who is an employee of a program licensed
339.31according to this chapter and providing behavioral support services, specialist services,
339.32or crisis respite services is not required to hold a separate license under this chapter.
339.33An individual meeting the staff qualifications of this section who is not providing these
339.34services as an employee of a program licensed according to this chapter must obtain a
339.35license according to this chapter.
340.1    Subd. 2. Behavior professional qualifications. A behavior professional, as defined
340.2in the brain injury and community alternatives for disabled individuals waiver plans or
340.3successor plans, must have competencies in areas related to:
340.4(1) ethical considerations;
340.5(2) functional assessment;
340.6(3) functional analysis;
340.7(4) measurement of behavior and interpretation of data;
340.8(5) selecting intervention outcomes and strategies;
340.9(6) behavior reduction and elimination strategies that promote least restrictive
340.10approved alternatives;
340.11(7) data collection;
340.12(8) staff and caregiver training;
340.13(9) support plan monitoring;
340.14(10) co-occurring mental disorders or neuro-cognitive disorder;
340.15(11) demonstrated expertise with populations being served; and
340.16(12) must be a:
340.17(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the
340.18Board of Psychology competencies in the above identified areas;
340.19(ii) clinical social worker licensed as an independent clinical social worker under
340.20chapter 148D, or a person with a master's degree in social work from an accredited college
340.21or university, with at least 4,000 hours of post-master's supervised experience in the
340.22delivery of clinical services in the areas identified in clauses (1) to (11);
340.23(iii) physician licensed under chapter 147 and certified by the American Board
340.24of Psychiatry and Neurology or eligible for board certification in psychiatry with
340.25competencies in the areas identified in clauses (1) to (11);
340.26(iv) licensed professional clinical counselor licensed under sections 148B.29 to
340.27148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery
340.28of clinical services who has demonstrated competencies in the areas identified in clauses
340.29(1) to (11);
340.30(v) person with a master's degree from an accredited college or university in one
340.31of the behavioral sciences or related fields, with at least 4,000 hours of post-master's
340.32supervised experience in the delivery of clinical services with demonstrated competencies
340.33in the areas identified in clauses (1) to (11); or
340.34(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is
340.35certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
340.36mental health nursing by a national nurse certification organization, or who has a master's
341.1degree in nursing or one of the behavioral sciences or related fields from an accredited
341.2college or university or its equivalent, with at least 4,000 hours of post-master's supervised
341.3experience in the delivery of clinical services.
341.4    Subd. 3. Behavior analyst qualifications. (a) A behavior analyst, as defined in
341.5the brain injury and community alternatives for disabled individuals waiver plans or
341.6successor plans, must:
341.7(1) have obtained a baccalaureate degree, master's degree, or PhD in a social services
341.8discipline; or
341.9(2) meet the qualifications of a mental health practitioner as defined in section
341.10245.462, subdivision 17.
341.11(b) In addition, a behavior analyst must:
341.12(1) have four years of supervised experience working with individuals who exhibit
341.13challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder;
341.14(2) have received ten hours of instruction in functional assessment and functional
341.15analysis;
341.16(3) have received 20 hours of instruction in the understanding of the function of
341.17behavior;
341.18(4) have received ten hours of instruction on design of positive practices behavior
341.19support strategies;
341.20(5) have received 20 hours of instruction on the use of behavior reduction approved
341.21strategies used only in combination with behavior positive practices strategies;
341.22(6) be determined by a behavior professional to have the training and prerequisite
341.23skills required to provide positive practice strategies as well as behavior reduction
341.24approved and permitted intervention to the person who receives behavioral support; and
341.25(7) be under the direct supervision of a behavior professional.
341.26    Subd. 4. Behavior specialist qualifications. (a) A behavior specialist, as defined
341.27in the brain injury and community alternatives for disabled individuals waiver plans or
341.28successor plans, must meet the following qualifications:
341.29(1) have an associate's degree in a social services discipline; or
341.30(2) have two years of supervised experience working with individuals who exhibit
341.31challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder.
341.32(b) In addition, a behavior specialist must:
341.33(1) have received a minimum of four hours of training in functional assessment;
341.34(2) have received 20 hours of instruction in the understanding of the function of
341.35behavior;
342.1(3) have received ten hours of instruction on design of positive practices behavioral
342.2support strategies;
342.3(4) be determined by a behavior professional to have the training and prerequisite
342.4skills required to provide positive practices strategies as well as behavior reduction
342.5approved intervention to the person who receives behavioral support; and
342.6(5) be under the direct supervision of a behavior professional.
342.7    Subd. 5. Specialist services qualifications. An individual providing specialist
342.8services, as defined in the developmental disabilities waiver plan or successor plan, must
342.9have:
342.10(1) the specific experience and skills required of the specialist to meet the needs of
342.11the person identified by the person's service planning team; and
342.12(2) the qualifications of the specialist identified in the person's coordinated service
342.13and support plan.
342.14EFFECTIVE DATE.This section is effective January 1, 2014.

342.15    Sec. 30. [245D.095] RECORD REQUIREMENTS.
342.16    Subdivision 1. Record-keeping systems. The license holder must ensure that the
342.17content and format of service recipient, personnel, and program records are uniform and
342.18legible according to the requirements of this chapter.
342.19    Subd. 2. Admission and discharge register. The license holder must keep a written
342.20or electronic register, listing in chronological order the dates and names of all persons
342.21served by the program who have been admitted, discharged, or transferred, including
342.22service terminations initiated by the license holder and deaths.
342.23    Subd. 3. Service recipient record. (a) The license holder must maintain a record of
342.24current services provided to each person on the premises where the services are provided
342.25or coordinated. When the services are provided in a licensed facility, the records must
342.26be maintained at the facility, otherwise the records must be maintained at the license
342.27holder's program office. The license holder must protect service recipient records against
342.28loss, tampering, or unauthorized disclosure according to the requirements in sections
342.2913.01 to 13.10 and 13.46.
342.30(b) The license holder must maintain the following information for each person:
342.31(1) an admission form signed by the person or the person's legal representative
342.32that includes:
342.33(i) identifying information, including the person's name, date of birth, address,
342.34and telephone number; and
343.1(ii) the name, address, and telephone number of the person's legal representative, if
343.2any, and a primary emergency contact, the case manager, and family members or others as
343.3identified by the person or case manager;
343.4(2) service information, including service initiation information, verification of the
343.5person's eligibility for services, documentation verifying that services have been provided
343.6as identified in the coordinated service and support plan or coordinated service and support
343.7plan addendum according to paragraph (a), and date of admission or readmission;
343.8(3) health information, including medical history, special dietary needs, and
343.9allergies, and when the license holder is assigned responsibility for meeting the person's
343.10health service needs according to section 245D.05:
343.11(i) current orders for medication, treatments, or medical equipment and a signed
343.12authorization from the person or the person's legal representative to administer or assist in
343.13administering the medication or treatments, if applicable;
343.14(ii) a signed statement authorizing the license holder to act in a medical emergency
343.15when the person's legal representative, if any, cannot be reached or is delayed in arriving;
343.16(iii) medication administration procedures;
343.17(iv) a medication administration record documenting the implementation of the
343.18medication administration procedures, and the medication administration record reviews,
343.19including any agreements for administration of injectable medications by the license
343.20holder according to the requirements in section 245D.05; and
343.21(v) a medical appointment schedule when the license holder is assigned
343.22responsibility for assisting with medical appointments;
343.23(4) the person's current coordinated service and support plan or that portion of the
343.24plan assigned to the license holder;
343.25(5) copies of the individual abuse prevention plan and assessments as required under
343.26section 245D.071, subdivisions 2 and 3;
343.27(6) a record of other service providers serving the person when the person's
343.28coordinated service and support plan or coordinated service and support plan addendum
343.29identifies the need for coordination between the service providers, that includes a contact
343.30person and telephone numbers, services being provided, and names of staff responsible for
343.31coordination;
343.32(7) documentation of orientation to service recipient rights according to section
343.33245D.04, subdivision 1, and maltreatment reporting policies and procedures according to
343.34section 245A.65, subdivision 1, paragraph (c);
343.35(8) copies of authorizations to handle a person's funds, according to section 245D.06,
343.36subdivision 4, paragraph (a);
344.1(9) documentation of complaints received and grievance resolution;
344.2(10) incident reports involving the person, required under section 245D.06,
344.3subdivision 1;
344.4(11) copies of written reports regarding the person's status when requested according
344.5to section 245D.07, subdivision 3, progress review reports as required under section
344.6245D.071, subdivision 5, progress or daily log notes that are recorded by the program,
344.7and reports received from other agencies involved in providing services or care to the
344.8person; and
344.9(12) discharge summary, including service termination notice and related
344.10documentation, when applicable.
344.11    Subd. 4. Access to service recipient records. The license holder must ensure that
344.12the following people have access to the information in subdivision 1 in accordance with
344.13applicable state and federal laws, regulations, or rules:
344.14(1) the person, the person's legal representative, and anyone properly authorized
344.15by the person;
344.16(2) the person's case manager;
344.17(3) staff providing services to the person unless the information is not relevant to
344.18carrying out the coordinated service and support plan or coordinated service and support
344.19plan addendum; and
344.20(4) the county child or adult foster care licensor, when services are also licensed as
344.21child or adult foster care.
344.22    Subd. 5. Personnel records. (a) The license holder must maintain a personnel
344.23record of each employee to document and verify staff qualifications, orientation, and
344.24training. The personnel record must include:
344.25(1) the employee's date of hire, completed application, an acknowledgement signed
344.26by the employee that job duties were reviewed with the employee and the employee
344.27understands those duties, and documentation that the employee meets the position
344.28requirements as determined by the license holder;
344.29 (2) documentation of staff qualifications, orientation, training, and performance
344.30evaluations as required under section 245D.09, subdivisions 3 to 5, including the date
344.31the training was completed, the number of hours per subject area, and the name of the
344.32trainer or instructor; and
344.33(3) a completed background study as required under chapter 245C.
344.34(b) For employees hired after January 1, 2014, the license holder must maintain
344.35documentation in the personnel record or elsewhere, sufficient to determine the date of the
345.1employee's first supervised direct contact with a person served by the program, and the
345.2date of first unsupervised direct contact with a person served by the program.
345.3EFFECTIVE DATE.This section is effective January 1, 2014.

345.4    Sec. 31. Minnesota Statutes 2012, section 245D.10, is amended to read:
345.5245D.10 POLICIES AND PROCEDURES.
345.6    Subdivision 1. Policy and procedure requirements. The A license holder
345.7 providing either basic or intensive supports and services must establish, enforce, and
345.8maintain policies and procedures as required in this chapter, chapter 245A, and other
345.9applicable state and federal laws and regulations governing the provision of home and
345.10community-based services licensed according to this chapter.
345.11    Subd. 2. Grievances. The license holder must establish policies and procedures
345.12that provide promote service recipient rights by providing a simple complaint process for
345.13persons served by the program and their authorized representatives to bring a grievance that:
345.14(1) provides staff assistance with the complaint process when requested, and the
345.15addresses and telephone numbers of outside agencies to assist the person;
345.16(2) allows the person to bring the complaint to the highest level of authority in the
345.17program if the grievance cannot be resolved by other staff members, and that provides
345.18the name, address, and telephone number of that person;
345.19(3) requires the license holder to promptly respond to all complaints affecting a
345.20person's health and safety. For all other complaints, the license holder must provide an
345.21initial response within 14 calendar days of receipt of the complaint. All complaints must
345.22be resolved within 30 calendar days of receipt or the license holder must document the
345.23reason for the delay and a plan for resolution;
345.24(4) requires a complaint review that includes an evaluation of whether:
345.25(i) related policies and procedures were followed and adequate;
345.26(ii) there is a need for additional staff training;
345.27(iii) the complaint is similar to past complaints with the persons, staff, or services
345.28involved; and
345.29(iv) there is a need for corrective action by the license holder to protect the health
345.30and safety of persons receiving services;
345.31(5) based on the review in clause (4), requires the license holder to develop,
345.32document, and implement a corrective action plan designed to correct current lapses and
345.33prevent future lapses in performance by staff or the license holder, if any;
346.1(6) provides a written summary of the complaint and a notice of the complaint
346.2resolution to the person and case manager that:
346.3(i) identifies the nature of the complaint and the date it was received;
346.4(ii) includes the results of the complaint review;
346.5(iii) identifies the complaint resolution, including any corrective action; and
346.6(7) requires that the complaint summary and resolution notice be maintained in the
346.7service recipient record.
346.8    Subd. 3. Service suspension and service termination. (a) The license holder must
346.9establish policies and procedures for temporary service suspension and service termination
346.10that promote continuity of care and service coordination with the person and the case
346.11manager and with other licensed caregivers, if any, who also provide support to the person.
346.12(b) The policy must include the following requirements:
346.13(1) the license holder must notify the person or the person's legal representative and
346.14case manager in writing of the intended termination or temporary service suspension, and
346.15the person's right to seek a temporary order staying the termination of service according to
346.16the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
346.17(2) notice of the proposed termination of services, including those situations
346.18that began with a temporary service suspension, must be given at least 60 days before
346.19the proposed termination is to become effective when a license holder is providing
346.20independent living skills training, structured day, prevocational or supported employment
346.21services to the person intensive supports and services identified in section 245D.03,
346.22subdivision 1, paragraph (c), and 30 days prior to termination for all other services
346.23licensed under this chapter;
346.24(3) the license holder must provide information requested by the person or case
346.25manager when services are temporarily suspended or upon notice of termination;
346.26(4) prior to giving notice of service termination or temporary service suspension,
346.27the license holder must document actions taken to minimize or eliminate the need for
346.28service suspension or termination;
346.29(5) during the temporary service suspension or service termination notice period,
346.30the license holder will work with the appropriate county agency to develop reasonable
346.31alternatives to protect the person and others;
346.32(6) the license holder must maintain information about the service suspension or
346.33termination, including the written termination notice, in the service recipient record; and
346.34(7) the license holder must restrict temporary service suspension to situations in
346.35which the person's behavior causes immediate and serious danger to the health and safety
347.1of the person or others conduct poses an imminent risk of physical harm to self or others
347.2and less restrictive or positive support strategies would not achieve safety.
347.3    Subd. 4. Availability of current written policies and procedures. (a) The license
347.4holder must review and update, as needed, the written policies and procedures required
347.5under this chapter.
347.6(b)(1) The license holder must inform the person and case manager of the policies
347.7and procedures affecting a person's rights under section 245D.04, and provide copies of
347.8those policies and procedures, within five working days of service initiation.
347.9(2) If a license holder only provides basic services and supports, this includes the:
347.10(i) grievance policy and procedure required under subdivision 2; and
347.11(ii) service suspension and termination policy and procedure required under
347.12subdivision 3.
347.13(3) For all other license holders this includes the:
347.14(i) policies and procedures in clause (2);
347.15(ii) emergency use of manual restraints policy and procedure required under
347.16subdivision 3a; and
347.17(iii) data privacy requirements under section 245D.11, subdivision 3.
347.18(c) The license holder must provide a written notice to all persons or their legal
347.19representatives and case managers at least 30 days before implementing any revised
347.20policies and procedures procedural revisions to policies affecting a person's service-related
347.21or protection-related rights under section 245D.04 and maltreatment reporting policies and
347.22procedures. The notice must explain the revision that was made and include a copy of the
347.23revised policy and procedure. The license holder must document the reason reasonable
347.24cause for not providing the notice at least 30 days before implementing the revisions.
347.25(d) Before implementing revisions to required policies and procedures, the license
347.26holder must inform all employees of the revisions and provide training on implementation
347.27of the revised policies and procedures.
347.28(e) The license holder must annually notify all persons, or their legal representatives,
347.29and case managers of any procedural revisions to policies required under this chapter,
347.30other than those in paragraph (c). Upon request, the license holder must provide the
347.31person, or the person's legal representative, and case manager with copies of the revised
347.32policies and procedures.
347.33EFFECTIVE DATE.This section is effective January 1, 2014.

347.34    Sec. 32. [245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT
347.35SERVICES.
348.1    Subdivision 1. Policy and procedure requirements. A license holder providing
348.2intensive support services as identified in section 245D.03, subdivision 1, paragraph (c),
348.3must establish, enforce, and maintain policies and procedures as required in this section.
348.4    Subd. 2. Health and safety. The license holder must establish policies and
348.5procedures that promote health and safety by ensuring:
348.6(1) use of universal precautions and sanitary practices in compliance with section
348.7245D.06, subdivision 2, clause (5);
348.8(2) if the license holder operates a residential program, health service coordination
348.9and care according to the requirements in section 245D.05, subdivision 1;
348.10(3) safe medication assistance and administration according to the requirements
348.11in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in
348.12consultation with a registered nurse, nurse practitioner, physician's assistant, or medical
348.13doctor and require completion of medication administration training according to the
348.14requirements in section 245D.09, subdivision 4a, paragraph (c). Medication assistance
348.15and administration includes, but is not limited to:
348.16(i) providing medication-related services for a person;
348.17(ii) medication setup;
348.18(iii) medication administration;
348.19(iv) medication storage and security;
348.20(v) medication documentation and charting;
348.21(vi) verification and monitoring of effectiveness of systems to ensure safe medication
348.22handling and administration;
348.23(vii) coordination of medication refills;
348.24(viii) handling changes to prescriptions and implementation of those changes;
348.25(ix) communicating with the pharmacy; and
348.26(x) coordination and communication with prescriber;
348.27(4) safe transportation, when the license holder is responsible for transportation of
348.28persons, with provisions for handling emergency situations according to the requirements
348.29in section 245D.06, subdivision 2, clauses (2) to (4);
348.30(5) a plan for ensuring the safety of persons served by the program in emergencies as
348.31defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies
348.32to the license holder. A license holder with a community residential setting or a day service
348.33facility license must ensure the policy and procedures comply with the requirements in
348.34section 245D.22, subdivision 4;
349.1(6) a plan for responding to all incidents as defined in section 245D.02, subdivision
349.211; and reporting all incidents required to be reported according to section 245D.06,
349.3subdivision 1. The plan must:
349.4(i) provide the contact information of a source of emergency medical care and
349.5transportation; and
349.6(ii) require staff to first call 911 when the staff believes a medical emergency may be
349.7life threatening, or to call the mental health crisis intervention team when the person is
349.8experiencing a mental health crisis; and
349.9(7) a procedure for the review of incidents and emergencies to identify trends or
349.10patterns, and corrective action if needed. The license holder must establish and maintain
349.11a record-keeping system for the incident and emergency reports. Each incident and
349.12emergency report file must contain a written summary of the incident. The license holder
349.13must conduct a review of incident reports for identification of incident patterns, and
349.14implementation of corrective action as necessary to reduce occurrences. Each incident
349.15report must include:
349.16(i) the name of the person or persons involved in the incident. It is not necessary
349.17to identify all persons affected by or involved in an emergency unless the emergency
349.18resulted in an incident;
349.19(ii) the date, time, and location of the incident or emergency;
349.20(iii) a description of the incident or emergency;
349.21(iv) a description of the response to the incident or emergency and whether a person's
349.22coordinated service and support plan addendum or program policies and procedures were
349.23implemented as applicable;
349.24(v) the name of the staff person or persons who responded to the incident or
349.25emergency; and
349.26(vi) the determination of whether corrective action is necessary based on the results
349.27of the review.
349.28    Subd. 3. Data privacy. The license holder must establish policies and procedures that
349.29promote service recipient rights by ensuring data privacy according to the requirements in:
349.30(1) the Minnesota Government Data Practices Act, section 13.46, and all other
349.31applicable Minnesota laws and rules in handling all data related to the services provided;
349.32and
349.33(2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the
349.34extent that the license holder performs a function or activity involving the use of protected
349.35health information as defined under Code of Federal Regulations, title 45, section 164.501,
349.36including, but not limited to, providing health care services; health care claims processing
350.1or administration; data analysis, processing, or administration; utilization review; quality
350.2assurance; billing; benefit management; practice management; repricing; or as otherwise
350.3provided by Code of Federal Regulations, title 45, section 160.103. The license holder
350.4must comply with the Health Insurance Portability and Accountability Act of 1996 and
350.5its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164,
350.6and all applicable requirements.
350.7    Subd. 4. Admission criteria. The license holder must establish policies and
350.8procedures that promote continuity of care by ensuring that admission or service initiation
350.9criteria:
350.10(1) is consistent with the license holder's registration information identified in the
350.11requirements in section 245D.031, subdivision 2, and with the service-related rights
350.12identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8);
350.13(2) identifies the criteria to be applied in determining whether the license holder
350.14can develop services to meet the needs specified in the person's coordinated service and
350.15support plan;
350.16(3) requires a license holder providing services in a health care facility to comply
350.17with the requirements in section 243.166, subdivision 4b, to provide notification to
350.18residents when a registered predatory offender is admitted into the program or to a
350.19potential admission when the facility was already serving a registered predatory offender.
350.20For purposes of this clause, "health care facility" means a facility licensed by the
350.21commissioner as a residential facility under chapter 245A to provide adult foster care or
350.22residential services to persons with disabilities; and
350.23(4) requires that when a person or the person's legal representative requests services
350.24from the license holder, a refusal to admit the person must be based on an evaluation of
350.25the person's assessed needs and the license holder's lack of capacity to meet the needs of
350.26the person. The license holder must not refuse to admit a person based solely on the
350.27type of residential services the person is receiving, or solely on the person's severity of
350.28disability, orthopedic or neurological handicaps, sight or hearing impairments, lack of
350.29communication skills, physical disabilities, toilet habits, behavioral disorders, or past
350.30failure to make progress. Documentation of the basis for refusal must be provided to the
350.31person or the person's legal representative and case manager upon request.
350.32EFFECTIVE DATE.This section is effective January 1, 2014.

350.33    Sec. 33. [245D.21] FACILITY LICENSURE REQUIREMENTS AND
350.34APPLICATION PROCESS.
351.1    Subdivision 1. Community residential settings and day service facilities. For
351.2purposes of this section, "facility" means both a community residential setting and day
351.3service facility and the physical plant.
351.4    Subd. 2. Inspections and code compliance. (a) Physical plants must comply with
351.5applicable state and local fire, health, building, and zoning codes.
351.6(b)(1) The facility must be inspected by a fire marshal or their delegate within
351.712 months before initial licensure to verify that it meets the applicable occupancy
351.8requirements as defined in the State Fire Code and that the facility complies with the fire
351.9safety standards for that occupancy code contained in the State Fire Code.
351.10(2) The fire marshal inspection of a community residential setting must verify the
351.11residence is a dwelling unit within a residential occupancy as defined in section 9.117 of
351.12the State Fire Code. A home safety checklist, approved by the commissioner, must be
351.13completed for a community residential setting by the license holder and the commissioner
351.14before the satellite license is reissued.
351.15(3) The facility shall be inspected according to the facility capacity specified on the
351.16initial application form.
351.17(4) If the commissioner has reasonable cause to believe that a potentially hazardous
351.18condition may be present or the licensed capacity is increased, the commissioner shall
351.19request a subsequent inspection and written report by a fire marshal to verify the absence
351.20of hazard.
351.21(5) Any condition cited by a fire marshal, building official, or health authority as
351.22hazardous or creating an immediate danger of fire or threat to health and safety must be
351.23corrected before a license is issued by the department, and for community residential
351.24settings, before a license is reissued.
351.25(c) The facility must maintain in a permanent file the reports of health, fire, and
351.26other safety inspections.
351.27(d) The facility's plumbing, ventilation, heating, cooling, lighting, and other
351.28fixtures and equipment, including elevators or food service, if provided, must conform to
351.29applicable health, sanitation, and safety codes and regulations.
351.30EFFECTIVE DATE.This section is effective January 1, 2014.

351.31    Sec. 34. [245D.22] FACILITY SANITATION AND HEALTH.
351.32    Subdivision 1. General maintenance. The license holder must maintain the interior
351.33and exterior of buildings, structures, or enclosures used by the facility, including walls,
351.34floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a
351.35sanitary and safe condition. The facility must be clean and free from accumulations of
352.1dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must
352.2correct building and equipment deterioration, safety hazards, and unsanitary conditions.
352.3    Subd. 2. Hazards and toxic substances. The license holder must ensure that
352.4service sites owned or leased by the license holder are free from hazards that would
352.5threaten the health or safety of a person receiving services by ensuring the requirements
352.6in paragraphs (a) to (g) are met.
352.7(a) Chemicals, detergents, and other hazardous or toxic substances must not be
352.8stored with food products or in any way that poses a hazard to persons receiving services.
352.9(b) The license holder must install handrails and nonslip surfaces on interior and
352.10exterior runways, stairways, and ramps according to the applicable building code.
352.11(c) If there are elevators in the facility, the license holder must have elevators
352.12inspected each year. The date of the inspection, any repairs needed, and the date the
352.13necessary repairs were made must be documented.
352.14(d) The license holder must keep stairways, ramps, and corridors free of obstructions.
352.15(e) Outside property must be free from debris and safety hazards. Exterior stairs and
352.16walkways must be kept free of ice and snow.
352.17(f) Heating, ventilation, air conditioning units, and other hot surfaces and moving
352.18parts of machinery must be shielded or enclosed.
352.19(g) Use of dangerous items or equipment by persons served by the program must be
352.20allowed in accordance with the person's coordinated service and support plan addendum
352.21or the program abuse prevention plan, if not addressed in the coordinated service and
352.22support plan addendum.
352.23    Subd. 3. Storage and disposal of medication. Schedule II controlled substances in
352.24the facility that are named in section 152.02, subdivision 3, must be stored in a locked
352.25storage area permitting access only by persons and staff authorized to administer the
352.26medication. This must be incorporated into the license holder's medication administration
352.27policy and procedures required under section 245D.11, subdivision 2, clause (3).
352.28Medications must be disposed of according to the Environmental Protection Agency
352.29recommendations.
352.30    Subd. 4. First aid must be available on site. (a) A staff person trained in first
352.31aid must be available on site and, when required in a person's coordinated service and
352.32support plan or coordinated service and support plan addendum, be able to provide
352.33cardiopulmonary resuscitation, whenever persons are present and staff are required to be
352.34at the site to provide direct service. The CPR training must include in-person instruction,
352.35hands-on practice, and an observed skills assessment under the direct supervision of a
352.36CPR instructor.
353.1(b) A facility must have first aid kits readily available for use by, and that meet
353.2the needs of, persons receiving services and staff. At a minimum, the first aid kit must
353.3be equipped with accessible first aid supplies including bandages, sterile compresses,
353.4scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap,
353.5adhesive tape, and first aid manual.
353.6    Subd. 5. Emergencies. (a) The license holder must have a written plan for
353.7responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the
353.8safety of persons served in the facility. The plan must include:
353.9(1) procedures for emergency evacuation and emergency sheltering, including:
353.10(i) how to report a fire or other emergency;
353.11(ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive
353.12procedures or equipment to assist with the safe evacuation of persons with physical or
353.13sensory disabilities; and
353.14(iii) instructions on closing off the fire area, using fire extinguishers, and activating
353.15and responding to alarm systems;
353.16(2) a floor plan that identifies:
353.17(i) the location of fire extinguishers;
353.18(ii) the location of audible or visual alarm systems, including but not limited to
353.19manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and
353.20sprinkler systems;
353.21(iii) the location of exits, primary and secondary evacuation routes, and accessible
353.22egress routes, if any; and
353.23(iv) the location of emergency shelter within the facility;
353.24(3) a site plan that identifies:
353.25(i) designated assembly points outside the facility;
353.26(ii) the locations of fire hydrants; and
353.27(iii) the routes of fire department access;
353.28(4) the responsibilities each staff person must assume in case of emergency;
353.29(5) procedures for conducting quarterly drills each year and recording the date of
353.30each drill in the file of emergency plans;
353.31(6) procedures for relocation or service suspension when services are interrupted
353.32for more than 24 hours;
353.33(7) for a community residential setting with three or more dwelling units, a floor
353.34plan that identifies the location of enclosed exit stairs; and
353.35(8) an emergency escape plan for each resident.
353.36(b) The license holder must:
354.1(1) maintain a log of quarterly fire drills on file in the facility;
354.2(2) provide an emergency response plan that is readily available to staff and persons
354.3receiving services;
354.4(3) inform each person of a designated area within the facility where the person
354.5should go for emergency shelter during severe weather and the designated assembly points
354.6outside the facility; and
354.7(4) maintain emergency contact information for persons served at the facility that
354.8can be readily accessed in an emergency.
354.9    Subd. 6. Emergency equipment. The facility must have a flashlight and a portable
354.10radio or television set that do not require electricity and can be used if a power failure
354.11occurs.
354.12    Subd. 7. Telephone and posted numbers. A facility must have a non-coin operated
354.13telephone that is readily accessible. A list of emergency numbers must be posted in a
354.14prominent location. When an area has a 911 number or a mental health crisis intervention
354.15team number, both numbers must be posted and the emergency number listed must be
354.16911. In areas of the state without a 911 number, the numbers listed must be those of the
354.17local fire department, police department, emergency transportation, and poison control
354.18center. The names and telephone numbers of each person's representative, physician, and
354.19dentist must be readily available.
354.20EFFECTIVE DATE.This section is effective January 1, 2014.

354.21    Sec. 35. [245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE
354.22LICENSURE REQUIREMENTS AND APPLICATION PROCESS.
354.23    Subdivision 1. Separate satellite license required for separate sites. (a) A license
354.24holder providing residential support services must obtain a separate satellite license for
354.25each community residential setting located at separate addresses when the community
354.26residential settings are to be operated by the same license holder. For purposes of this
354.27chapter, a community residential setting is a satellite of the home and community-based
354.28services license.
354.29(b) Community residential settings are permitted single-family use homes. After a
354.30license has been issued, the commissioner shall notify the local municipality where the
354.31residence is located of the approved license.
354.32    Subd. 2. Notification to local agency. The license holder must notify the local
354.33agency within 24 hours of the onset of changes in a residence resulting from construction,
354.34remodeling, or damages requiring repairs that require a building permit or may affect a
354.35licensing requirement in this chapter.
355.1    Subd. 3. Alternate overnight supervision. A license holder granted an alternate
355.2overnight supervision technology adult foster care license according to section 245A.11,
355.3subdivision 7a, that converts to a community residential setting satellite license according
355.4to this chapter, must retain that designation.
355.5EFFECTIVE DATE.This section is effective January 1, 2014.

355.6    Sec. 36. [245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL
355.7PLANT AND ENVIRONMENT.
355.8    Subdivision 1. Occupancy. The residence must meet the definition of a dwelling
355.9unit in a residential occupancy.
355.10    Subd. 2. Common area requirements. The living area must be provided with an
355.11adequate number of furnishings for the usual functions of daily living and social activities.
355.12The dining area must be furnished to accommodate meals shared by all persons living in
355.13the residence. These furnishings must be in good repair and functional to meet the daily
355.14needs of the persons living in the residence.
355.15    Subd. 3. Bedrooms. (a) People receiving services must mutually consent, in
355.16writing, to sharing a bedroom with one another. No more than two people receiving
355.17services may share one bedroom.
355.18(b) A single occupancy bedroom must have at least 80 square feet of floor space with
355.19a 7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor
355.20space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and
355.21other habitable rooms by floor to ceiling walls containing no openings except doorways
355.22and must not serve as a corridor to another room used in daily living.
355.23(c) A person's personal possessions and items for the person's own use are the only
355.24items permitted to be stored in a person's bedroom.
355.25(d) Unless otherwise documented through assessment as a safety concern for the
355.26person, each person must be provided with the following furnishings:
355.27(1) a separate bed of proper size and height for the convenience and comfort of the
355.28person, with a clean mattress in good repair;
355.29(2) clean bedding appropriate for the season for each person;
355.30(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal
355.31possessions and clothing; and
355.32(4) a mirror for grooming.
355.33(e) When possible, a person must be allowed to have items of furniture that the
355.34person personally owns in the bedroom, unless doing so would interfere with safety
355.35precautions, violate a building or fire code, or interfere with another person's use of the
356.1bedroom. A person may choose not to have a cabinet, dresser, shelves, or a mirror in the
356.2bedroom, as otherwise required under paragraph (d), clause (3) or (4). A person may
356.3choose to use a mattress other than an innerspring mattress and may choose not to have
356.4the mattress on a mattress frame or support. If a person chooses not to have a piece of
356.5required furniture, the license holder must document this choice and is not required to
356.6provide the item. If a person chooses to use a mattress other than an innerspring mattress
356.7or chooses not to have a mattress frame or support, the license holder must document this
356.8choice and allow the alternative desired by the person.
356.9(f) A person must be allowed to bring personal possessions into the bedroom
356.10and other designated storage space, if such space is available, in the residence. The
356.11person must be allowed to accumulate possessions to the extent the residence is able to
356.12accommodate them, unless doing so is contraindicated for the person's physical or mental
356.13health, would interfere with safety precautions or another person's use of the bedroom, or
356.14would violate a building or fire code. The license holder must allow for locked storage
356.15of personal items. Any restriction on the possession or locked storage of personal items,
356.16including requiring a person to use a lock provided by the license holder, must comply
356.17with section 245D.04, subdivision 3, paragraph (c), and allow the person to be present if
356.18and when the license holder opens the lock.
356.19EFFECTIVE DATE.This section is effective January 1, 2014.

356.20    Sec. 37. [245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND
356.21WATER.
356.22    Subdivision 1. Water. Potable water from privately owned wells must be tested
356.23annually by a Department of Health-certified laboratory for coliform bacteria and nitrate
356.24nitrogens to verify safety. The health authority may require retesting and corrective
356.25measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in
356.26the event of flooding or an incident which may put the well at risk of contamination. To
356.27prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.
356.28    Subd. 2. Food. Food served must meet any special dietary needs of a person as
356.29prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day
356.30must be served or made available to persons, and nutritious snacks must be available
356.31between meals.
356.32    Subd. 3. Food safety. Food must be obtained, handled, and properly stored to
356.33prevent contamination, spoilage, or a threat to the health of a person.
356.34EFFECTIVE DATE.This section is effective January 1, 2014.

357.1    Sec. 38. [245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION
357.2AND HEALTH.
357.3    Subdivision 1. Goods provided by the license holder. Individual clean bed linens
357.4appropriate for the season and the person's comfort, including towels and wash cloths,
357.5must be available for each person. Usual or customary goods for the operation of a
357.6residence which are communally used by all persons receiving services living in the
357.7residence must be provided by the license holder, including household items for meal
357.8preparation, cleaning supplies to maintain the cleanliness of the residence, window
357.9coverings on windows for privacy, toilet paper, and hand soap.
357.10    Subd. 2. Personal items. Personal health and hygiene items must be stored in a
357.11safe and sanitary manner.
357.12    Subd. 3. Pets and service animals. Pets and service animals housed within
357.13the residence must be immunized and maintained in good health as required by local
357.14ordinances and state law. The license holder must ensure that the person and the person's
357.15representative are notified before admission of the presence of pets in the residence.
357.16    Subd. 4. Smoking in the residence. License holders must comply with the
357.17requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when
357.18smoking is permitted in the residence.
357.19    Subd. 5. Weapons. Weapons and ammunition must be stored separately in locked
357.20areas that are inaccessible to a person receiving services. For purposes of this subdivision,
357.21"weapons" means firearms and other instruments or devices designed for and capable of
357.22producing bodily harm.
357.23EFFECTIVE DATE.This section is effective January 1, 2014.

357.24    Sec. 39. [245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE
357.25REQUIREMENTS AND APPLICATION PROCESS.
357.26Except for day service facilities on the same or adjoining lot, the license holder
357.27providing day services must apply for a separate license for each facility-based service
357.28site when the license holder is the owner, lessor, or tenant of the service site at which
357.29persons receive day services and the license holder's employees who provide day services
357.30are present for a cumulative total of more than 30 days within any 12-month period. For
357.31purposes of this chapter, a day services facility license is a satellite license of the day
357.32services program. A day services program may operate multiple licensed day service
357.33facilities in one or more counties in the state. For the purposes of this section, "adjoining
357.34lot" means day services facilities that are next door to or across the street from one another.
358.1EFFECTIVE DATE.This section is effective January 1, 2014.

358.2    Sec. 40. [245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND
358.3SPACE REQUIREMENTS.
358.4    Subdivision 1. Facility capacity and useable space requirements. (a) The facility
358.5capacity of each day service facility must be determined by the amount of primary space
358.6available, the scheduling of activities at other service sites, and the space requirements of
358.7all persons receiving services at the facility, not just the licensed services. The facility
358.8capacity must specify the maximum number of persons that may receive services on
358.9site at any one time.
358.10(b) When a facility is located in a multifunctional organization, the facility may
358.11share common space with the multifunctional organization if the required available
358.12primary space for use by persons receiving day services is maintained while the facility is
358.13operating. The license holder must comply at all times with all applicable fire and safety
358.14codes under section 245A.04, subdivision 2a, and adequate supervision requirements
358.15under section 245D.31 for all persons receiving day services.
358.16(c) A day services facility must have a minimum of 40 square feet of primary space
358.17available for each person receiving services who is present at the site at any one time.
358.18Primary space does not include:
358.19(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms,
358.20and kitchens;
358.21(2) floor areas beneath stationary equipment; or
358.22(3) any space occupied by persons associated with the multifunctional organization
358.23while persons receiving day services are using common space.
358.24    Subd. 2. Individual personal articles. Each person must be provided space in a
358.25closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own
358.26use while receiving services at the facility, unless doing so would interfere with safety
358.27precautions, another person's work space, or violate a building or fire code.
358.28EFFECTIVE DATE.This section is effective January 1, 2014.

358.29    Sec. 41. [245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY
358.30REQUIREMENTS.
358.31    Subdivision 1. Refrigeration. If the license holder provides refrigeration at service
358.32sites owned or leased by the license holder for storing perishable foods and perishable
358.33portions of bag lunches, whether the foods are supplied by the license holder or the
359.1persons receiving services, the refrigeration must have a temperature of 40 degrees
359.2Fahrenheit or less.
359.3    Subd. 2. Drinking water. Drinking water must be available to all persons
359.4receiving services. If a person is unable to request or obtain drinking water, it must be
359.5provided according to that person's individual needs. Drinking water must be provided in
359.6single-service containers or from drinking fountains accessible to all persons.
359.7    Subd. 3. Individuals who become ill during the day. There must be an area in
359.8which a person receiving services can rest if:
359.9(1) the person becomes ill during the day;
359.10(2) the person does not live in a licensed residential site;
359.11(3) the person requires supervision; and
359.12(4) there is not a caretaker immediately available. Supervision must be provided
359.13until the caretaker arrives to bring the person home.
359.14    Subd. 4. Safety procedures. The license holder must establish general written
359.15safety procedures that include criteria for selecting, training, and supervising persons who
359.16work with hazardous machinery, tools, or substances. Safety procedures specific to each
359.17person's activities must be explained and be available in writing to all staff members
359.18and persons receiving services.
359.19EFFECTIVE DATE.This section is effective January 1, 2014.

359.20    Sec. 42. [245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND
359.21FACILITY COVERAGE.
359.22    Subdivision 1. Scope. This section applies only to facility-based day services.
359.23    Subd. 2. Factors. (a) The number of direct support service staff members that a
359.24license holder must have on duty at the facility at a given time to meet the minimum
359.25staffing requirements established in this section varies according to:
359.26(1) the number of persons who are enrolled and receiving direct support services
359.27at that given time;
359.28(2) the staff ratio requirement established under subdivision 3 for each person who
359.29is present; and
359.30(3) whether the conditions described in subdivision 8 exist and warrant additional
359.31staffing beyond the number determined to be needed under subdivision 7.
359.32(b) The commissioner must consider the factors in paragraph (a) in determining a
359.33license holder's compliance with the staffing requirements and must further consider
359.34whether the staff ratio requirement established under subdivision 3 for each person
359.35receiving services accurately reflects the person's need for staff time.
360.1    Subd. 3. Staff ratio requirement for each person receiving services. The case
360.2manager, in consultation with the interdisciplinary team, must determine at least once each
360.3year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving
360.4services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio
360.5assigned each person and the documentation of how the ratio was arrived at must be kept
360.6in each person's individual service plan. Documentation must include an assessment of the
360.7person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard
360.8assessment form required by the commissioner.
360.9    Subd. 4. Person requiring staff ratio of one to four. A person must be assigned a
360.10staff ratio requirement of one to four if:
360.11(1) on a daily basis the person requires total care and monitoring or constant
360.12hand-over-hand physical guidance to successfully complete at least three of the following
360.13activities: toileting, communicating basic needs, eating, ambulating; or is not capable of
360.14taking appropriate action for self-preservation under emergency conditions; or
360.15(2) the person engages in conduct that poses an imminent risk of physical harm to
360.16self or others at a documented level of frequency, intensity, or duration requiring frequent
360.17daily ongoing intervention and monitoring as established in the person's coordinated
360.18service and support plan or coordinated service and support plan addendum.
360.19    Subd. 5. Person requiring staff ratio of one to eight. A person must be assigned a
360.20staff ratio requirement of one to eight if:
360.21(1) the person does not meet the requirements in subdivision 4; and
360.22(2) on a daily basis the person requires verbal prompts or spot checks and minimal
360.23or no physical assistance to successfully complete at least four of the following activities:
360.24toileting, communicating basic needs, eating, ambulating, or taking appropriate action for
360.25self-preservation under emergency conditions.
360.26    Subd. 6. Person requiring staff ratio of one to six. A person who does not have
360.27any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio
360.28requirement of one to six.
360.29    Subd. 7. Determining number of direct support service staff required. The
360.30minimum number of direct support service staff members required at any one time to
360.31meet the combined staff ratio requirements of the persons present at that time can be
360.32determined by the following steps:
360.33(1) assign to each person in attendance the three-digit decimal below that corresponds
360.34to the staff ratio requirement assigned to that person. A staff ratio requirement of one to
360.35four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio
360.36requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100;
361.1(2) add all of the three-digit decimals (one three-digit decimal for every person in
361.2attendance) assigned in clause (1);
361.3(3) when the sum in clause (2) falls between two whole numbers, round off the sum
361.4to the larger of the two whole numbers; and
361.5(4) the larger of the two whole numbers in clause (3) equals the number of direct
361.6support service staff members needed to meet the staff ratio requirements of the persons
361.7in attendance.
361.8    Subd. 8. Staff to be included in calculating minimum staffing requirement.
361.9Only staff providing direct support must be counted as staff members in calculating
361.10the staff-to-participant ratio. A volunteer may be counted as a direct support staff in
361.11calculating the staff to participant ratio if the volunteer meets the same standards and
361.12requirements as paid staff. No person receiving services must be counted as or be
361.13substituted for a staff member in calculating the staff-to-participant ratio.
361.14    Subd. 9. Conditions requiring additional direct support staff. The license holder
361.15must increase the number of direct support staff members present at any one time beyond
361.16the number arrived at in subdivision 4 if necessary when any one or combination of the
361.17following circumstances can be documented by the commissioner as existing:
361.18(1) the health and safety needs of the persons receiving services cannot be met by
361.19the number of staff members available under the staffing pattern in effect even though the
361.20number has been accurately calculated under subdivision 7; or
361.21(2) the person's conduct frequently presents an imminent risk of physical harm to
361.22self or others.
361.23    Subd. 10. Supervision requirements. (a) At no time must one direct support
361.24staff member be assigned responsibility for supervision and training of more than ten
361.25persons receiving supervision and training, except as otherwise stated in each person's risk
361.26management plan.
361.27(b) In the temporary absence of the director or a supervisor, a direct support staff
361.28member must be designated to supervise the center.
361.29    Subd. 11. Multifunctional programs. A multifunctional program may count other
361.30employees of the organization besides direct support staff of the day service facility in
361.31calculating the staff-to-participant ratio if the employee is assigned to the day services
361.32facility for a specified amount of time, during which the employee is not assigned to
361.33another organization or program.
361.34EFFECTIVE DATE.This section is effective January 1, 2014.

361.35    Sec. 43. [245D.32] ALTERNATIVE LICENSING INSPECTIONS.
362.1    Subdivision 1. Eligibility for an alternative licensing inspection. (a) A license
362.2holder providing services licensed under this chapter, with a qualifying accreditation and
362.3meeting the eligibility criteria in paragraphs (b) and (c), may request approval for an
362.4alternative licensing inspection when all services provided under the license holder's
362.5license are accredited. A license holder with a qualifying accreditation and meeting
362.6the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative
362.7licensing inspection for individual community residential settings or day services facilities
362.8licensed under this chapter.
362.9(b) In order to be eligible for an alternative licensing inspection, the program must
362.10have had at least one inspection by the commissioner following issuance of the initial
362.11license. For programs operating a day services facility, each facility must have had at least
362.12one on-site inspection by the commissioner following issuance of the initial license.
362.13(c) In order to be eligible for an alternative licensing inspection, the program must
362.14have been in substantial and consistent compliance at the time of the last licensing
362.15inspection and during the current licensing period. For purposes of this section,
362.16"substantial and consistent compliance" means:
362.17(1) the license holder's license was not made conditional, suspended, or revoked;
362.18(2) there have been no substantiated allegations of maltreatment against the license
362.19holder;
362.20(3) there were no program deficiencies identified that would jeopardize the health,
362.21safety, or rights of persons being served; and
362.22(4) the license holder maintained substantial compliance with the other requirements
362.23of chapters 245A and 245C and other applicable laws and rules.
362.24(d) For the purposes of this section, the license holder's license includes services
362.25licensed under this chapter that were previously licensed under chapter 245B until
362.26December 31, 2013.
362.27    Subd. 2. Qualifying accreditation. The commissioner must accept a three-year
362.28accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF)
362.29as a qualifying accreditation.
362.30    Subd. 3. Request for approval of an alternative inspection status. (a) A request
362.31for an alternative inspection must be made on the forms and in the manner prescribed
362.32by the commissioner. When submitting the request, the license holder must submit all
362.33documentation issued by the accrediting body verifying that the license holder has obtained
362.34and maintained the qualifying accreditation and has complied with recommendations
362.35or requirements from the accrediting body during the period of accreditation. Based
363.1on the request and the additional required materials, the commissioner may approve
363.2an alternative inspection status.
363.3(b) The commissioner must notify the license holder in writing that the request for
363.4an alternative inspection status has been approved. Approval must be granted until the
363.5end of the qualifying accreditation period.
363.6(c) The license holder must submit a written request for approval to be renewed
363.7one month before the end of the current approval period according to the requirements
363.8in paragraph (a). If the license holder does not submit a request to renew approval as
363.9required, the commissioner must conduct a licensing inspection.
363.10    Subd. 4. Programs approved for alternative licensing inspection; deemed
363.11compliance licensing requirements. (a) A license holder approved for alternative
363.12licensing inspection under this section is required to maintain compliance with all
363.13licensing standards according to this chapter.
363.14(b) A license holder approved for alternative licensing inspection under this section
363.15must be deemed to be in compliance with all the requirements of this chapter, and the
363.16commissioner must not perform routine licensing inspections.
363.17(c) Upon receipt of a complaint regarding the services of a license holder approved
363.18for alternative licensing inspection under this section, the commissioner must investigate
363.19the complaint and may take any action as provided under section 245A.06 or 245A.07.
363.20    Subd. 5. Investigations of alleged or suspected maltreatment. Nothing in this
363.21section changes the commissioner's responsibilities to investigate alleged or suspected
363.22maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557.
363.23    Subd. 6. Termination or denial of subsequent approval. Following approval of
363.24an alternative licensing inspection, the commissioner may terminate or deny subsequent
363.25approval of an alternative licensing inspection if the commissioner determines that:
363.26(1) the license holder has not maintained the qualifying accreditation;
363.27(2) the commissioner has substantiated maltreatment for which the license holder or
363.28facility is determined to be responsible during the qualifying accreditation period; or
363.29(3) during the qualifying accreditation period, the license holder has been issued
363.30an order for conditional license, fine, suspension, or license revocation that has not been
363.31reversed upon appeal.
363.32    Subd. 7. Appeals. The commissioner's decision that the conditions for approval for
363.33an alternative licensing inspection have not been met is final and not subject to appeal
363.34under the provisions of chapter 14.
364.1    Subd. 8. Commissioner's programs. Home and community-based services licensed
364.2under this chapter for which the commissioner is the license holder with a qualifying
364.3accreditation are excluded from being approved for an alternative licensing inspection.
364.4EFFECTIVE DATE.This section is effective January 1, 2014.

364.5    Sec. 44. [245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS.
364.6(a) The commissioner of human services shall issue a mental health certification
364.7for services licensed under this chapter when a license holder is determined to have met
364.8the requirements under paragraph (b). This certification is voluntary for license holders.
364.9The certification shall be printed on the license and identified on the commissioner's
364.10public Web site.
364.11(b) The requirements for certification are:
364.12(1) all staff have received at least seven hours of annual training covering all of
364.13the following topics:
364.14(i) mental health diagnoses;
364.15(ii) mental health crisis response and de-escalation techniques;
364.16(iii) recovery from mental illness;
364.17(iv) treatment options, including evidence-based practices;
364.18(v) medications and their side effects;
364.19(vi) co-occurring substance abuse and health conditions; and
364.20(vii) community resources;
364.21(2) a mental health professional, as defined in section 245.462, subdivision 18, or a
364.22mental health practitioner as defined in section 245.462, subdivision 17, is available
364.23for consultation and assistance;
364.24(3) there is a plan and protocol in place to address a mental health crisis; and
364.25(4) each person's individual service and support plan identifies who is providing
364.26clinical services and their contact information, and includes an individual crisis prevention
364.27and management plan developed with the person.
364.28(c) License holders seeking certification under this section must request this
364.29certification on forms and in the manner prescribed by the commissioner.
364.30(d) If the commissioner finds that the license holder has failed to comply with the
364.31certification requirements under paragraph (b), the commissioner may issue a correction
364.32order and an order of conditional license in accordance with section 245A.06 or may
364.33issue a sanction in accordance with section 245A.07, including and up to removal of
364.34the certification.
365.1(e) A denial of the certification or the removal of the certification based on a
365.2determination that the requirements under paragraph (b) have not been met is not subject to
365.3appeal. A license holder that has been denied a certification or that has had a certification
365.4removed may again request certification when the license holder is in compliance with the
365.5requirements of paragraph (b).
365.6EFFECTIVE DATE.This section is effective January 1, 2014.

365.7    Sec. 45. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
365.8    Subd. 11. Residential support services. (a) Upon federal approval, there is
365.9established a new service called residential support that is available on the community
365.10alternative care, community alternatives for disabled individuals, developmental
365.11disabilities, and brain injury waivers. Existing waiver service descriptions must be
365.12modified to the extent necessary to ensure there is no duplication between other services.
365.13Residential support services must be provided by vendors licensed as a community
365.14residential setting as defined in section 245A.11, subdivision 8, a foster care setting
365.15licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care
365.16setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
365.17    (b) Residential support services must meet the following criteria:
365.18    (1) providers of residential support services must own or control the residential site;
365.19    (2) the residential site must not be the primary residence of the license holder;
365.20    (3) (1) the residential site must have a designated program supervisor person
365.21 responsible for program management, oversight, development, and implementation of
365.22policies and procedures;
365.23    (4) (2) the provider of residential support services must provide supervision, training,
365.24and assistance as described in the person's coordinated service and support plan; and
365.25    (5) (3) the provider of residential support services must meet the requirements of
365.26licensure and additional requirements of the person's coordinated service and support plan.
365.27    (c) Providers of residential support services that meet the definition in paragraph (a)
365.28must be registered using a process determined by the commissioner beginning July 1, 2009
365.29 must be licensed according to chapter 245D. Providers licensed to provide child foster care
365.30under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under
365.31Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section
365.32245A.03, subdivision 7 , paragraph (g), are considered registered under this section.

365.33    Sec. 46. Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:
366.1    Subdivision 1. Provider qualifications. (a) For the home and community-based
366.2waivers providing services to seniors and individuals with disabilities under sections
366.3256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
366.4(1) agreements with enrolled waiver service providers to ensure providers meet
366.5Minnesota health care program requirements;
366.6(2) regular reviews of provider qualifications, and including requests of proof of
366.7documentation; and
366.8(3) processes to gather the necessary information to determine provider qualifications.
366.9    (b) Beginning July 1, 2012, staff that provide direct contact, as defined in section
366.10245C.02, subdivision 11 , for services specified in the federally approved waiver plans
366.11must meet the requirements of chapter 245C prior to providing waiver services and as
366.12part of ongoing enrollment. Upon federal approval, this requirement must also apply to
366.13consumer-directed community supports.
366.14    (c) Beginning January 1, 2014, service owners and managerial officials overseeing
366.15the management or policies of services that provide direct contact as specified in the
366.16federally approved waiver plans must meet the requirements of chapter 245C prior to
366.17reenrollment or, for new providers, prior to initial enrollment if they have not already done
366.18so as a part of service licensure requirements.

366.19    Sec. 47. Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:
366.20    Subd. 7. Applicant and license holder training. An applicant or license holder
366.21for the home and community-based waivers providing services to seniors and individuals
366.22with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 that is
366.23not enrolled as a Minnesota health care program home and community-based services
366.24waiver provider at the time of application must ensure that at least one controlling
366.25individual completes a onetime training on the requirements for providing home and
366.26community-based services from a qualified source as determined by the commissioner,
366.27before a provider is enrolled or license is issued. Within six months of enrollment, a newly
366.28enrolled home and community-based waiver service provider must ensure that at least one
366.29controlling individual has completed training on waiver and related program billing.

366.30    Sec. 48. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
366.31subdivision to read:
366.32    Subd. 8. Data on use of emergency use of manual restraint. Beginning July 1,
366.332013, facilities and services to be licensed under chapter 245D shall submit data regarding
367.1the use of emergency use of manual restraint as identified in section 245D.061 in a format
367.2and at a frequency identified by the commissioner.

367.3    Sec. 49. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
367.4subdivision to read:
367.5    Subd. 9. Definitions. (a) For the purposes of this section, the following terms
367.6have the meanings given them.
367.7(b) "Controlling individual" means a public body, governmental agency, business
367.8entity, officer, owner, or managerial official whose responsibilities include the direction of
367.9the management or policies of a program.
367.10(c) "Managerial official" means an individual who has decision-making authority
367.11related to the operation of the program and responsibility for the ongoing management of
367.12or direction of the policies, services, or employees of the program.
367.13(d) "Owner" means an individual who has direct or indirect ownership interest in
367.14a corporation or partnership, or business association enrolling with the Department of
367.15Human Services as a provider of waiver services.

367.16    Sec. 50. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
367.17subdivision to read:
367.18    Subd. 10. Enrollment requirements. All home and community-based waiver
367.19providers must provide, at the time of enrollment and within 30 days of a request, in a
367.20format determined by the commissioner, information and documentation that includes, but
367.21is not limited to, the following:
367.22(1) proof of surety bond coverage in the amount of $50,000 or ten percent of the
367.23provider's payments from Medicaid in the previous calendar year, whichever is greater;
367.24(2) proof of fidelity bond coverage in the amount of $20,000; and
367.25(3) proof of liability insurance.

367.26    Sec. 51. Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:
367.27    Subd. 9a. Evaluation and referral of reports made to common entry point unit.
367.28    The common entry point must screen the reports of alleged or suspected maltreatment for
367.29immediate risk and make all necessary referrals as follows:
367.30    (1) if the common entry point determines that there is an immediate need for
367.31adult protective services, the common entry point agency shall immediately notify the
367.32appropriate county agency;
368.1    (2) if the report contains suspected criminal activity against a vulnerable adult, the
368.2common entry point shall immediately notify the appropriate law enforcement agency;
368.3    (3) the common entry point shall refer all reports of alleged or suspected
368.4maltreatment to the appropriate lead investigative agency as soon as possible, but in any
368.5event no longer than two working days; and
368.6    (4) if the report involves services licensed by the Department of Human Services
368.7and subject to chapter 245D, the common entry point shall refer the report to the county as
368.8the lead agency according to clause (3), but shall also notify the Department of Human
368.9Services of the report; and
368.10    (5) (4) if the report contains information about a suspicious death, the common
368.11entry point shall immediately notify the appropriate law enforcement agencies, the local
368.12medical examiner, and the ombudsman for mental health and developmental disabilities
368.13established under section 245.92. Law enforcement agencies shall coordinate with the
368.14local medical examiner and the ombudsman as provided by law.

368.15    Sec. 52. Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:
368.16    Subd. 13. Lead investigative agency. "Lead investigative agency" is the primary
368.17administrative agency responsible for investigating reports made under section 626.557.
368.18(a) The Department of Health is the lead investigative agency for facilities or
368.19services licensed or required to be licensed as hospitals, home care providers, nursing
368.20homes, boarding care homes, hospice providers, residential facilities that are also federally
368.21certified as intermediate care facilities that serve people with developmental disabilities,
368.22or any other facility or service not listed in this subdivision that is licensed or required to
368.23be licensed by the Department of Health for the care of vulnerable adults. "Home care
368.24provider" has the meaning provided in section 144A.43, subdivision 4, and applies when
368.25care or services are delivered in the vulnerable adult's home, whether a private home or a
368.26housing with services establishment registered under chapter 144D, including those that
368.27offer assisted living services under chapter 144G.
368.28(b) Except as provided under paragraph (c), for services licensed according to
368.29chapter 245D, The Department of Human Services is the lead investigative agency for
368.30facilities or services licensed or required to be licensed as adult day care, adult foster care,
368.31programs for people with developmental disabilities, family adult day services, mental
368.32health programs, mental health clinics, chemical dependency programs, the Minnesota
368.33sex offender program, or any other facility or service not listed in this subdivision that is
368.34licensed or required to be licensed by the Department of Human Services.
369.1(c) The county social service agency or its designee is the lead investigative agency
369.2for all other reports, including, but not limited to, reports involving vulnerable adults
369.3receiving services from a personal care provider organization under section 256B.0659,
369.4or receiving home and community-based services licensed by the Department of Human
369.5Services and subject to chapter 245D.

369.6    Sec. 53. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
369.7AND COMMUNITY-BASED SERVICES.
369.8(a) The Department of Health Compliance Monitoring Division and the Department
369.9of Human Services Licensing Division shall jointly develop an integrated licensing system
369.10for providers of both home care services subject to licensure under Minnesota Statutes,
369.11chapter 144A, and for home and community-based services subject to licensure under
369.12Minnesota Statutes, chapter 245D. The integrated licensing system shall:
369.13(1) require only one license of any provider of services under Minnesota Statutes,
369.14sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
369.15(2) promote quality services that recognize a person's individual needs and protect
369.16the person's health, safety, rights, and well-being;
369.17(3) promote provider accountability through application requirements, compliance
369.18inspections, investigations, and enforcement actions;
369.19(4) reference other applicable requirements in existing state and federal laws,
369.20including the federal Affordable Care Act;
369.21(5) establish internal procedures to facilitate ongoing communications between the
369.22agencies and with providers and services recipients about the regulatory activities;
369.23(6) create a link between the agency Web sites so that providers and the public can
369.24access the same information regardless of which Web site is accessed initially; and
369.25(7) collect data on identified outcome measures as necessary for the agencies to
369.26report to the Centers for Medicare and Medicaid Services.
369.27(b) The joint recommendations for legislative changes to implement the integrated
369.28licensing system are due to the legislature by February 15, 2014.
369.29(c) Before implementation of the integrated licensing system, providers licensed as
369.30home care providers under Minnesota Statutes, chapter 144A, may also provide home
369.31and community-based services subject to licensure under Minnesota Statutes, chapter
369.32245D, without obtaining a home and community-based services license under Minnesota
369.33Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
369.34apply to these providers:
370.1(1) the provider must comply with all requirements under Minnesota Statutes, chapter
370.2245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
370.3(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
370.4enforced by the Department of Health under the enforcement authority set forth in
370.5Minnesota Statutes, section 144A.475; and
370.6(3) the Department of Health will provide information to the Department of Human
370.7Services about each provider licensed under this section, including the provider's license
370.8application, licensing documents, inspections, information about complaints received, and
370.9investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

370.10    Sec. 54. REPEALER.
370.11(a) Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031;
370.12245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and
370.13245B.08, are repealed effective January 1, 2014.
370.14(b) Minnesota Statutes 2012, section 245D.08, is repealed.


370.17    Section 1. Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:
370.18    Subd. 5. Specific purchases. The solicitation process described in this chapter is
370.19not required for acquisition of the following:
370.20(1) merchandise for resale purchased under policies determined by the commissioner;
370.21(2) farm and garden products which, as determined by the commissioner, may be
370.22purchased at the prevailing market price on the date of sale;
370.23(3) goods and services from the Minnesota correctional facilities;
370.24(4) goods and services from rehabilitation facilities and extended employment
370.25providers that are certified by the commissioner of employment and economic
370.26development, and day training and habilitation services licensed under sections 245B.01
370.27to 245B.08 chapter 245D;
370.28(5) goods and services for use by a community-based facility operated by the
370.29commissioner of human services;
370.30(6) goods purchased at auction or when submitting a sealed bid at auction provided
370.31that before authorizing such an action, the commissioner consult with the requesting
370.32agency to determine a fair and reasonable value for the goods considering factors
370.33including, but not limited to, costs associated with submitting a bid, travel, transportation,
370.34and storage. This fair and reasonable value must represent the limit of the state's bid;
371.1(7) utility services where no competition exists or where rates are fixed by law or
371.2ordinance; and
371.3(8) goods and services from Minnesota sex offender program facilities.
371.4EFFECTIVE DATE.This section is effective January 1, 2014.

371.5    Sec. 2. Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:
371.6    Subdivision 1. Service contracts. The commissioner of administration shall
371.7ensure that a portion of all contracts for janitorial services; document imaging;
371.8document shredding; and mailing, collating, and sorting services be awarded by the
371.9state to rehabilitation programs and extended employment providers that are certified
371.10by the commissioner of employment and economic development, and day training and
371.11habilitation services licensed under sections 245B.01 to 245B.08 chapter 245D. The
371.12amount of each contract awarded under this section may exceed the estimated fair market
371.13price as determined by the commissioner for the same goods and services by up to six
371.14percent. The aggregate value of the contracts awarded to eligible providers under this
371.15section in any given year must exceed 19 percent of the total value of all contracts for
371.16janitorial services; document imaging; document shredding; and mailing, collating, and
371.17sorting services entered into in the same year. For the 19 percent requirement to be
371.18applicable in any given year, the contract amounts proposed by eligible providers must be
371.19within six percent of the estimated fair market price for at least 19 percent of the contracts
371.20awarded for the corresponding service area.
371.21EFFECTIVE DATE.This section is effective January 1, 2014.

371.22    Sec. 3. Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:
371.23    Subd. 4. Housing with services establishment or establishment. (a) "Housing
371.24with services establishment" or "establishment" means:
371.25(1) an establishment providing sleeping accommodations to one or more adult
371.26residents, at least 80 percent of which are 55 years of age or older, and offering or
371.27providing, for a fee, one or more regularly scheduled health-related services or two or
371.28more regularly scheduled supportive services, whether offered or provided directly by the
371.29establishment or by another entity arranged for by the establishment; or
371.30(2) an establishment that registers under section 144D.025.
371.31(b) Housing with services establishment does not include:
371.32(1) a nursing home licensed under chapter 144A;
372.1(2) a hospital, certified boarding care home, or supervised living facility licensed
372.2under sections 144.50 to 144.56;
372.3(3) a board and lodging establishment licensed under chapter 157 and Minnesota
372.4Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660,
372.5or 9530.4100 to 9530.4450, or under chapter 245B 245D;
372.6(4) a board and lodging establishment which serves as a shelter for battered women
372.7or other similar purpose;
372.8(5) a family adult foster care home licensed by the Department of Human Services;
372.9(6) private homes in which the residents are related by kinship, law, or affinity with
372.10the providers of services;
372.11(7) residential settings for persons with developmental disabilities in which the
372.12services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable
372.13successor rules or laws;
372.14(8) a home-sharing arrangement such as when an elderly or disabled person or
372.15single-parent family makes lodging in a private residence available to another person
372.16in exchange for services or rent, or both;
372.17(9) a duly organized condominium, cooperative, common interest community, or
372.18owners' association of the foregoing where at least 80 percent of the units that comprise the
372.19condominium, cooperative, or common interest community are occupied by individuals
372.20who are the owners, members, or shareholders of the units; or
372.21(10) services for persons with developmental disabilities that are provided under
372.22a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until
372.23January 1, 1998, or under chapter 245B 245D.
372.24EFFECTIVE DATE.This section is effective January 1, 2014.

372.25    Sec. 4. Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:
372.26    Subdivision 1. Applicability. (a) The operating standards for special transportation
372.27service adopted under this section do not apply to special transportation provided by:
372.28(1) a common carrier operating on fixed routes and schedules;
372.29(2) a volunteer driver using a private automobile;
372.30(3) a school bus as defined in section 169.011, subdivision 71; or
372.31(4) an emergency ambulance regulated under chapter 144.
372.32(b) The operating standards adopted under this section only apply to providers
372.33of special transportation service who receive grants or other financial assistance from
372.34either the state or the federal government, or both, to provide or assist in providing that
372.35service; except that the operating standards adopted under this section do not apply
373.1to any nursing home licensed under section 144A.02, to any board and care facility
373.2licensed under section 144.50, or to any day training and habilitation services, day care,
373.3or group home facility licensed under sections 245A.01 to 245A.19 unless the facility or
373.4program provides transportation to nonresidents on a regular basis and the facility receives
373.5reimbursement, other than per diem payments, for that service under rules promulgated
373.6by the commissioner of human services.
373.7(c) Notwithstanding paragraph (b), the operating standards adopted under this
373.8section do not apply to any vendor of services licensed under chapter 245B 245D that
373.9provides transportation services to consumers or residents of other vendors licensed under
373.10chapter 245B 245D and transports 15 or fewer persons, including consumers or residents
373.11and the driver.
373.12EFFECTIVE DATE.This section is effective January 1, 2014.

373.13    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:
373.14    Subdivision 1. Scope. The terms used in this chapter and chapter 245B have the
373.15meanings given them in this section.
373.16EFFECTIVE DATE.This section is effective January 1, 2014.

373.17    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:
373.18    Subd. 9. License holder. "License holder" means an individual, corporation,
373.19partnership, voluntary association, or other organization that is legally responsible for the
373.20operation of the program, has been granted a license by the commissioner under this chapter
373.21or chapter 245B 245D and the rules of the commissioner, and is a controlling individual.
373.22EFFECTIVE DATE.This section is effective January 1, 2014.

373.23    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:
373.24    Subd. 9. Permitted services by an individual who is related. Notwithstanding
373.25subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a
373.26person receiving supported living services may provide licensed services to that person if:
373.27(1) the person who receives supported living services received these services in a
373.28residential site on July 1, 2005;
373.29(2) the services under clause (1) were provided in a corporate foster care setting for
373.30adults and were funded by the developmental disabilities home and community-based
373.31services waiver defined in section 256B.092;
374.1(3) the individual who is related obtains and maintains both a license under chapter
374.2245B 245D and an adult foster care license under Minnesota Rules, parts 9555.5105
374.3to 9555.6265; and
374.4(4) the individual who is related is not the guardian of the person receiving supported
374.5living services.
374.6EFFECTIVE DATE.This section is effective January 1, 2014.

374.7    Sec. 8. Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:
374.8    Subd. 13. Funds and property; other requirements. (a) A license holder must
374.9ensure that persons served by the program retain the use and availability of personal funds
374.10or property unless restrictions are justified in the person's individual plan. This subdivision
374.11does not apply to programs governed by the provisions in section 245B.07, subdivision 10.
374.12(b) The license holder must ensure separation of funds of persons served by the
374.13program from funds of the license holder, the program, or program staff.
374.14(c) Whenever the license holder assists a person served by the program with the
374.15safekeeping of funds or other property, the license holder must:
374.16(1) immediately document receipt and disbursement of the person's funds or other
374.17property at the time of receipt or disbursement, including the person's signature, or the
374.18signature of the conservator or payee; and
374.19(2) return to the person upon the person's request, funds and property in the license
374.20holder's possession subject to restrictions in the person's treatment plan, as soon as
374.21possible, but no later than three working days after the date of request.
374.22(d) License holders and program staff must not:
374.23(1) borrow money from a person served by the program;
374.24(2) purchase personal items from a person served by the program;
374.25(3) sell merchandise or personal services to a person served by the program;
374.26(4) require a person served by the program to purchase items for which the license
374.27holder is eligible for reimbursement; or
374.28(5) use funds of persons served by the program to purchase items for which the
374.29facility is already receiving public or private payments.
374.30EFFECTIVE DATE.This section is effective January 1, 2014.

374.31    Sec. 9. Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:
374.32    Subd. 3. License suspension, revocation, or fine. (a) The commissioner may
374.33suspend or revoke a license, or impose a fine if:
375.1(1) a license holder fails to comply fully with applicable laws or rules;
375.2(2) a license holder, a controlling individual, or an individual living in the household
375.3where the licensed services are provided or is otherwise subject to a background study has
375.4a disqualification which has not been set aside under section 245C.22;
375.5(3) a license holder knowingly withholds relevant information from or gives false
375.6or misleading information to the commissioner in connection with an application for
375.7a license, in connection with the background study status of an individual, during an
375.8investigation, or regarding compliance with applicable laws or rules; or
375.9(4) after July 1, 2012, and upon request by the commissioner, a license holder fails
375.10to submit the information required of an applicant under section 245A.04, subdivision 1,
375.11paragraph (f) or (g).
375.12A license holder who has had a license suspended, revoked, or has been ordered
375.13to pay a fine must be given notice of the action by certified mail or personal service. If
375.14mailed, the notice must be mailed to the address shown on the application or the last
375.15known address of the license holder. The notice must state the reasons the license was
375.16suspended, revoked, or a fine was ordered.
375.17    (b) If the license was suspended or revoked, the notice must inform the license
375.18holder of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
375.191400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
375.20a license. The appeal of an order suspending or revoking a license must be made in writing
375.21by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
375.22the commissioner within ten calendar days after the license holder receives notice that the
375.23license has been suspended or revoked. If a request is made by personal service, it must be
375.24received by the commissioner within ten calendar days after the license holder received
375.25the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits
375.26a timely appeal of an order suspending or revoking a license, the license holder may
375.27continue to operate the program as provided in section 245A.04, subdivision 7, paragraphs
375.28(g) and (h), until the commissioner issues a final order on the suspension or revocation.
375.29    (c)(1) If the license holder was ordered to pay a fine, the notice must inform the
375.30license holder of the responsibility for payment of fines and the right to a contested case
375.31hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal
375.32of an order to pay a fine must be made in writing by certified mail or personal service. If
375.33mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
375.34days after the license holder receives notice that the fine has been ordered. If a request is
375.35made by personal service, it must be received by the commissioner within ten calendar
375.36days after the license holder received the order.
376.1    (2) The license holder shall pay the fines assessed on or before the payment date
376.2specified. If the license holder fails to fully comply with the order, the commissioner
376.3may issue a second fine or suspend the license until the license holder complies. If the
376.4license holder receives state funds, the state, county, or municipal agencies or departments
376.5responsible for administering the funds shall withhold payments and recover any payments
376.6made while the license is suspended for failure to pay a fine. A timely appeal shall stay
376.7payment of the fine until the commissioner issues a final order.
376.8    (3) A license holder shall promptly notify the commissioner of human services,
376.9in writing, when a violation specified in the order to forfeit a fine is corrected. If upon
376.10reinspection the commissioner determines that a violation has not been corrected as
376.11indicated by the order to forfeit a fine, the commissioner may issue a second fine. The
376.12commissioner shall notify the license holder by certified mail or personal service that a
376.13second fine has been assessed. The license holder may appeal the second fine as provided
376.14under this subdivision.
376.15    (4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for
376.16each determination of maltreatment of a child under section 626.556 or the maltreatment
376.17of a vulnerable adult under section 626.557 for which the license holder is determined
376.18responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i),
376.19or 626.557, subdivision 9c, paragraph (c); the license holder shall forfeit $200 for each
376.20occurrence of a violation of law or rule governing matters of health, safety, or supervision,
376.21including but not limited to the provision of adequate staff-to-child or adult ratios, and
376.22failure to comply with background study requirements under chapter 245C; and the license
376.23holder shall forfeit $100 for each occurrence of a violation of law or rule other than
376.24those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence"
376.25means each violation identified in the commissioner's fine order. Fines assessed against a
376.26license holder that holds a license to provide the residential-based habilitation home and
376.27community-based services, as defined under identified in section 245B.02, subdivision
376.2820 245D.03, subdivision 1, and a community residential setting or day services facility
376.29license to provide foster care under chapter 245D where the services are provided, may be
376.30assessed against both licenses for the same occurrence, but the combined amount of the
376.31fines shall not exceed the amount specified in this clause for that occurrence.
376.32    (5) When a fine has been assessed, the license holder may not avoid payment by
376.33closing, selling, or otherwise transferring the licensed program to a third party. In such an
376.34event, the license holder will be personally liable for payment. In the case of a corporation,
376.35each controlling individual is personally and jointly liable for payment.
377.1(d) Except for background study violations involving the failure to comply with an
377.2order to immediately remove an individual or an order to provide continuous, direct
377.3supervision, the commissioner shall not issue a fine under paragraph (c) relating to a
377.4background study violation to a license holder who self-corrects a background study
377.5violation before the commissioner discovers the violation. A license holder who has
377.6previously exercised the provisions of this paragraph to avoid a fine for a background
377.7study violation may not avoid a fine for a subsequent background study violation unless at
377.8least 365 days have passed since the license holder self-corrected the earlier background
377.9study violation.
377.10EFFECTIVE DATE.This section is effective January 1, 2014.

377.11    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to
377.12read:
377.13    Subd. 19c. Personal care. Medical assistance covers personal care assistance
377.14services provided by an individual who is qualified to provide the services according to
377.15subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a
377.16plan, and supervised by a qualified professional.
377.17"Qualified professional" means a mental health professional as defined in section
377.18245.462, subdivision 18 , clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6);
377.19or a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker
377.20as defined in sections 148E.010 and 148E.055, or a qualified developmental disabilities
377.21specialist under section 245B.07, subdivision 4 designated coordinator under section
377.22245D.081, subdivision 2. The qualified professional shall perform the duties required in
377.23section 256B.0659.
377.24EFFECTIVE DATE.This section is effective January 1, 2014.

377.25    Sec. 11. Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:
377.26    Subd. 2. Contract provisions. (a) The service contract with each intermediate
377.27care facility must include provisions for:
377.28(1) modifying payments when significant changes occur in the needs of the
377.29consumers;
377.30(2) appropriate and necessary statistical information required by the commissioner;
377.31(3) annual aggregate facility financial information; and
377.32(4) additional requirements for intermediate care facilities not meeting the standards
377.33set forth in the service contract.
378.1(b) The commissioner of human services and the commissioner of health, in
378.2consultation with representatives from counties, advocacy organizations, and the provider
378.3community, shall review the consolidated standards under chapter 245B and the home and
378.4community-based services standards under chapter 245D and the supervised living facility
378.5rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota
378.6Rules, chapter 4665, may be waived by the commissioner of health for intermediate care
378.7facilities in order to enable facilities to implement the performance measures in their
378.8contract and provide quality services to residents without a duplication of or increase in
378.9regulatory requirements.
378.10EFFECTIVE DATE.This section is effective January 1, 2014.

378.11    Sec. 12. Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:
378.12    Subdivision 1. Agreement. Two or more governmental units, by agreement entered
378.13into through action of their governing bodies, may jointly or cooperatively exercise
378.14any power common to the contracting parties or any similar powers, including those
378.15which are the same except for the territorial limits within which they may be exercised.
378.16The agreement may provide for the exercise of such powers by one or more of the
378.17participating governmental units on behalf of the other participating units. The term
378.18"governmental unit" as used in this section includes every city, county, town, school
378.19district, independent nonprofit firefighting corporation, other political subdivision of
378.20this or another state, another state, federally recognized Indian tribe, the University
378.21of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under
378.22sections 144.50 to 144.56, rehabilitation facilities and extended employment providers
378.23that are certified by the commissioner of employment and economic development, day
378.24training and habilitation services licensed under sections 245B.01 to 245B.08, day and
378.25supported employment services licensed under chapter 245D, and any agency of the state
378.26of Minnesota or the United States, and includes any instrumentality of a governmental
378.27unit. For the purpose of this section, an instrumentality of a governmental unit means an
378.28instrumentality having independent policy-making and appropriating authority.
378.29EFFECTIVE DATE.This section is effective January 1, 2014.

378.30    Sec. 13. Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:
378.31    Subd. 2. Definitions. As used in this section, the following terms have the meanings
378.32given them unless the specific content indicates otherwise:
379.1    (a) "Family assessment" means a comprehensive assessment of child safety, risk
379.2of subsequent child maltreatment, and family strengths and needs that is applied to a
379.3child maltreatment report that does not allege substantial child endangerment. Family
379.4assessment does not include a determination as to whether child maltreatment occurred
379.5but does determine the need for services to address the safety of family members and the
379.6risk of subsequent maltreatment.
379.7    (b) "Investigation" means fact gathering related to the current safety of a child
379.8and the risk of subsequent maltreatment that determines whether child maltreatment
379.9occurred and whether child protective services are needed. An investigation must be used
379.10when reports involve substantial child endangerment, and for reports of maltreatment in
379.11facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
379.12144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
379.1313, and 124D.10; or in a nonlicensed personal care provider association as defined in
379.14sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
379.15    (c) "Substantial child endangerment" means a person responsible for a child's care,
379.16and in the case of sexual abuse includes a person who has a significant relationship to the
379.17child as defined in section 609.341, or a person in a position of authority as defined in
379.18section 609.341, who by act or omission commits or attempts to commit an act against a
379.19child under their care that constitutes any of the following:
379.20    (1) egregious harm as defined in section 260C.007, subdivision 14;
379.21    (2) sexual abuse as defined in paragraph (d);
379.22    (3) abandonment under section 260C.301, subdivision 2;
379.23    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
379.24child's physical or mental health, including a growth delay, which may be referred to as
379.25failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
379.26    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
379.27609.195 ;
379.28    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
379.29    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
379.30609.223 ;
379.31    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
379.32    (9) criminal sexual conduct under sections 609.342 to 609.3451;
379.33    (10) solicitation of children to engage in sexual conduct under section 609.352;
379.34    (11) malicious punishment or neglect or endangerment of a child under section
379.35609.377 or 609.378;
379.36    (12) use of a minor in sexual performance under section 617.246; or
380.1    (13) parental behavior, status, or condition which mandates that the county attorney
380.2file a termination of parental rights petition under section 260C.301, subdivision 3,
380.3paragraph (a).
380.4    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
380.5child's care, by a person who has a significant relationship to the child, as defined in
380.6section 609.341, or by a person in a position of authority, as defined in section 609.341,
380.7subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
380.8conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
380.9609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
380.10in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
380.11abuse also includes any act which involves a minor which constitutes a violation of
380.12prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
380.13threatened sexual abuse which includes the status of a parent or household member
380.14who has committed a violation which requires registration as an offender under section
380.15243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
380.16243.166, subdivision 1b, paragraph (a) or (b).
380.17    (e) "Person responsible for the child's care" means (1) an individual functioning
380.18within the family unit and having responsibilities for the care of the child such as a
380.19parent, guardian, or other person having similar care responsibilities, or (2) an individual
380.20functioning outside the family unit and having responsibilities for the care of the child
380.21such as a teacher, school administrator, other school employees or agents, or other lawful
380.22custodian of a child having either full-time or short-term care responsibilities including,
380.23but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
380.24and coaching.
380.25    (f) "Neglect" means the commission or omission of any of the acts specified under
380.26clauses (1) to (9), other than by accidental means:
380.27    (1) failure by a person responsible for a child's care to supply a child with necessary
380.28food, clothing, shelter, health, medical, or other care required for the child's physical or
380.29mental health when reasonably able to do so;
380.30    (2) failure to protect a child from conditions or actions that seriously endanger the
380.31child's physical or mental health when reasonably able to do so, including a growth delay,
380.32which may be referred to as a failure to thrive, that has been diagnosed by a physician and
380.33is due to parental neglect;
380.34    (3) failure to provide for necessary supervision or child care arrangements
380.35appropriate for a child after considering factors as the child's age, mental ability, physical
381.1condition, length of absence, or environment, when the child is unable to care for the
381.2child's own basic needs or safety, or the basic needs or safety of another child in their care;
381.3    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
381.4260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's
381.5child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
381.6    (5) nothing in this section shall be construed to mean that a child is neglected solely
381.7because the child's parent, guardian, or other person responsible for the child's care in
381.8good faith selects and depends upon spiritual means or prayer for treatment or care of
381.9disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
381.10or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
381.11if a lack of medical care may cause serious danger to the child's health. This section does
381.12not impose upon persons, not otherwise legally responsible for providing a child with
381.13necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
381.14    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
381.15subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
381.16symptoms in the child at birth, results of a toxicology test performed on the mother at
381.17delivery or the child at birth, medical effects or developmental delays during the child's
381.18first year of life that medically indicate prenatal exposure to a controlled substance, or the
381.19presence of a fetal alcohol spectrum disorder;
381.20    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
381.21    (8) chronic and severe use of alcohol or a controlled substance by a parent or
381.22person responsible for the care of the child that adversely affects the child's basic needs
381.23and safety; or
381.24    (9) emotional harm from a pattern of behavior which contributes to impaired
381.25emotional functioning of the child which may be demonstrated by a substantial and
381.26observable effect in the child's behavior, emotional response, or cognition that is not
381.27within the normal range for the child's age and stage of development, with due regard to
381.28the child's culture.
381.29    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
381.30inflicted by a person responsible for the child's care on a child other than by accidental
381.31means, or any physical or mental injury that cannot reasonably be explained by the child's
381.32history of injuries, or any aversive or deprivation procedures, or regulated interventions,
381.33that have not been authorized under section 121A.67 or 245.825.
381.34    Abuse does not include reasonable and moderate physical discipline of a child
381.35administered by a parent or legal guardian which does not result in an injury. Abuse does
381.36not include the use of reasonable force by a teacher, principal, or school employee as
382.1allowed by section 121A.582. Actions which are not reasonable and moderate include,
382.2but are not limited to, any of the following that are done in anger or without regard to the
382.3safety of the child:
382.4    (1) throwing, kicking, burning, biting, or cutting a child;
382.5    (2) striking a child with a closed fist;
382.6    (3) shaking a child under age three;
382.7    (4) striking or other actions which result in any nonaccidental injury to a child
382.8under 18 months of age;
382.9    (5) unreasonable interference with a child's breathing;
382.10    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
382.11    (7) striking a child under age one on the face or head;
382.12    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
382.13substances which were not prescribed for the child by a practitioner, in order to control or
382.14punish the child; or other substances that substantially affect the child's behavior, motor
382.15coordination, or judgment or that results in sickness or internal injury, or subjects the
382.16child to medical procedures that would be unnecessary if the child were not exposed
382.17to the substances;
382.18    (9) unreasonable physical confinement or restraint not permitted under section
382.19609.379 , including but not limited to tying, caging, or chaining; or
382.20    (10) in a school facility or school zone, an act by a person responsible for the child's
382.21care that is a violation under section 121A.58.
382.22    (h) "Report" means any report received by the local welfare agency, police
382.23department, county sheriff, or agency responsible for assessing or investigating
382.24maltreatment pursuant to this section.
382.25    (i) "Facility" means:
382.26    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
382.27sanitarium, or other facility or institution required to be licensed under sections 144.50 to
382.28144.58 , 241.021, or 245A.01 to 245A.16, or chapter 245B 245D;
382.29    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
382.30124D.10 ; or
382.31    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
382.32subdivision 16, and 256B.0625, subdivision 19a.
382.33    (j) "Operator" means an operator or agency as defined in section 245A.02.
382.34    (k) "Commissioner" means the commissioner of human services.
383.1    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
383.2not limited to employee assistance counseling and the provision of guardian ad litem and
383.3parenting time expeditor services.
383.4    (m) "Mental injury" means an injury to the psychological capacity or emotional
383.5stability of a child as evidenced by an observable or substantial impairment in the child's
383.6ability to function within a normal range of performance and behavior with due regard to
383.7the child's culture.
383.8    (n) "Threatened injury" means a statement, overt act, condition, or status that
383.9represents a substantial risk of physical or sexual abuse or mental injury. Threatened
383.10injury includes, but is not limited to, exposing a child to a person responsible for the
383.11child's care, as defined in paragraph (e), clause (1), who has:
383.12    (1) subjected a child to, or failed to protect a child from, an overt act or condition
383.13that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
383.14similar law of another jurisdiction;
383.15    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
383.16(4), or a similar law of another jurisdiction;
383.17    (3) committed an act that has resulted in an involuntary termination of parental rights
383.18under section 260C.301, or a similar law of another jurisdiction; or
383.19    (4) committed an act that has resulted in the involuntary transfer of permanent
383.20legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
383.21260C.201, subdivision 11 , paragraph (d), clause (1), section 260C.515, subdivision 4, or a
383.22similar law of another jurisdiction.
383.23A child is the subject of a report of threatened injury when the responsible social
383.24services agency receives birth match data under paragraph (o) from the Department of
383.25Human Services.
383.26(o) Upon receiving data under section 144.225, subdivision 2b, contained in a
383.27birth record or recognition of parentage identifying a child who is subject to threatened
383.28injury under paragraph (n), the Department of Human Services shall send the data to the
383.29responsible social services agency. The data is known as "birth match" data. Unless the
383.30responsible social services agency has already begun an investigation or assessment of the
383.31report due to the birth of the child or execution of the recognition of parentage and the
383.32parent's previous history with child protection, the agency shall accept the birth match
383.33data as a report under this section. The agency may use either a family assessment or
383.34investigation to determine whether the child is safe. All of the provisions of this section
383.35apply. If the child is determined to be safe, the agency shall consult with the county
383.36attorney to determine the appropriateness of filing a petition alleging the child is in need
384.1of protection or services under section 260C.007, subdivision 6, clause (16), in order to
384.2deliver needed services. If the child is determined not to be safe, the agency and the county
384.3attorney shall take appropriate action as required under section 260C.301, subdivision 3.
384.4    (p) Persons who conduct assessments or investigations under this section shall take
384.5into account accepted child-rearing practices of the culture in which a child participates
384.6and accepted teacher discipline practices, which are not injurious to the child's health,
384.7welfare, and safety.
384.8    (q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
384.9occurrence or event which:
384.10    (1) is not likely to occur and could not have been prevented by exercise of due
384.11care; and
384.12    (2) if occurring while a child is receiving services from a facility, happens when the
384.13facility and the employee or person providing services in the facility are in compliance
384.14with the laws and rules relevant to the occurrence or event.
384.15(r) "Nonmaltreatment mistake" means:
384.16(1) at the time of the incident, the individual was performing duties identified in the
384.17center's child care program plan required under Minnesota Rules, part 9503.0045;
384.18(2) the individual has not been determined responsible for a similar incident that
384.19resulted in a finding of maltreatment for at least seven years;
384.20(3) the individual has not been determined to have committed a similar
384.21nonmaltreatment mistake under this paragraph for at least four years;
384.22(4) any injury to a child resulting from the incident, if treated, is treated only with
384.23remedies that are available over the counter, whether ordered by a medical professional or
384.24not; and
384.25(5) except for the period when the incident occurred, the facility and the individual
384.26providing services were both in compliance with all licensing requirements relevant to the
384.27incident.
384.28This definition only applies to child care centers licensed under Minnesota
384.29Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
384.30substantiated maltreatment by the individual, the commissioner of human services shall
384.31determine that a nonmaltreatment mistake was made by the individual.
384.32EFFECTIVE DATE.This section is effective January 1, 2014.

384.33    Sec. 14. Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:
384.34    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
384.35to believe a child is being neglected or physically or sexually abused, as defined in
385.1subdivision 2, or has been neglected or physically or sexually abused within the preceding
385.2three years, shall immediately report the information to the local welfare agency, agency
385.3responsible for assessing or investigating the report, police department, or the county
385.4sheriff if the person is:
385.5    (1) a professional or professional's delegate who is engaged in the practice of
385.6the healing arts, social services, hospital administration, psychological or psychiatric
385.7treatment, child care, education, correctional supervision, probation and correctional
385.8services, or law enforcement; or
385.9    (2) employed as a member of the clergy and received the information while
385.10engaged in ministerial duties, provided that a member of the clergy is not required by
385.11this subdivision to report information that is otherwise privileged under section 595.02,
385.12subdivision 1 , paragraph (c).
385.13    The police department or the county sheriff, upon receiving a report, shall
385.14immediately notify the local welfare agency or agency responsible for assessing or
385.15investigating the report, orally and in writing. The local welfare agency, or agency
385.16responsible for assessing or investigating the report, upon receiving a report, shall
385.17immediately notify the local police department or the county sheriff orally and in writing.
385.18The county sheriff and the head of every local welfare agency, agency responsible
385.19for assessing or investigating reports, and police department shall each designate a
385.20person within their agency, department, or office who is responsible for ensuring that
385.21the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
385.22this subdivision shall be construed to require more than one report from any institution,
385.23facility, school, or agency.
385.24    (b) Any person may voluntarily report to the local welfare agency, agency responsible
385.25for assessing or investigating the report, police department, or the county sheriff if the
385.26person knows, has reason to believe, or suspects a child is being or has been neglected or
385.27subjected to physical or sexual abuse. The police department or the county sheriff, upon
385.28receiving a report, shall immediately notify the local welfare agency or agency responsible
385.29for assessing or investigating the report, orally and in writing. The local welfare agency or
385.30agency responsible for assessing or investigating the report, upon receiving a report, shall
385.31immediately notify the local police department or the county sheriff orally and in writing.
385.32    (c) A person mandated to report physical or sexual child abuse or neglect occurring
385.33within a licensed facility shall report the information to the agency responsible for
385.34licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
385.35chapter 245B 245D; or a nonlicensed personal care provider organization as defined in
385.36sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections
386.1agency receiving a report may request the local welfare agency to provide assistance
386.2pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees
386.3perform work within a school facility, upon receiving a complaint of alleged maltreatment,
386.4shall provide information about the circumstances of the alleged maltreatment to the
386.5commissioner of education. Section 13.03, subdivision 4, applies to data received by the
386.6commissioner of education from a licensing entity.
386.7    (d) Any person mandated to report shall receive a summary of the disposition of
386.8any report made by that reporter, including whether the case has been opened for child
386.9protection or other services, or if a referral has been made to a community organization,
386.10unless release would be detrimental to the best interests of the child. Any person who is
386.11not mandated to report shall, upon request to the local welfare agency, receive a concise
386.12summary of the disposition of any report made by that reporter, unless release would be
386.13detrimental to the best interests of the child.
386.14    (e) For purposes of this section, "immediately" means as soon as possible but in
386.15no event longer than 24 hours.
386.16EFFECTIVE DATE.This section is effective January 1, 2014.

386.17    Sec. 15. Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:
386.18    Subd. 10d. Notification of neglect or abuse in facility. (a) When a report is
386.19received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while
386.20in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
386.21sanitarium, or other facility or institution required to be licensed according to sections
386.22144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B 245D, or a school as
386.23defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed
386.24personal care provider organization as defined in section 256B.04, subdivision 16, and
386.25256B.0625, subdivision 19a , the commissioner of the agency responsible for assessing
386.26or investigating the report or local welfare agency investigating the report shall provide
386.27the following information to the parent, guardian, or legal custodian of a child alleged to
386.28have been neglected, physically abused, sexually abused, or the victim of maltreatment
386.29of a child in the facility: the name of the facility; the fact that a report alleging neglect,
386.30physical abuse, sexual abuse, or maltreatment of a child in the facility has been received;
386.31the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child
386.32in the facility; that the agency is conducting an assessment or investigation; any protective
386.33or corrective measures being taken pending the outcome of the investigation; and that a
386.34written memorandum will be provided when the investigation is completed.
387.1(b) The commissioner of the agency responsible for assessing or investigating the
387.2report or local welfare agency may also provide the information in paragraph (a) to the
387.3parent, guardian, or legal custodian of any other child in the facility if the investigative
387.4agency knows or has reason to believe the alleged neglect, physical abuse, sexual
387.5abuse, or maltreatment of a child in the facility has occurred. In determining whether
387.6to exercise this authority, the commissioner of the agency responsible for assessing
387.7or investigating the report or local welfare agency shall consider the seriousness of the
387.8alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the
387.9number of children allegedly neglected, physically abused, sexually abused, or victims of
387.10maltreatment of a child in the facility; the number of alleged perpetrators; and the length
387.11of the investigation. The facility shall be notified whenever this discretion is exercised.
387.12(c) When the commissioner of the agency responsible for assessing or investigating
387.13the report or local welfare agency has completed its investigation, every parent, guardian,
387.14or legal custodian previously notified of the investigation by the commissioner or
387.15local welfare agency shall be provided with the following information in a written
387.16memorandum: the name of the facility investigated; the nature of the alleged neglect,
387.17physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's
387.18name; a summary of the investigation findings; a statement whether maltreatment was
387.19found; and the protective or corrective measures that are being or will be taken. The
387.20memorandum shall be written in a manner that protects the identity of the reporter and
387.21the child and shall not contain the name, or to the extent possible, reveal the identity of
387.22the alleged perpetrator or of those interviewed during the investigation. If maltreatment
387.23is determined to exist, the commissioner or local welfare agency shall also provide the
387.24written memorandum to the parent, guardian, or legal custodian of each child in the facility
387.25who had contact with the individual responsible for the maltreatment. When the facility is
387.26the responsible party for maltreatment, the commissioner or local welfare agency shall also
387.27provide the written memorandum to the parent, guardian, or legal custodian of each child
387.28who received services in the population of the facility where the maltreatment occurred.
387.29This notification must be provided to the parent, guardian, or legal custodian of each child
387.30receiving services from the time the maltreatment occurred until either the individual
387.31responsible for maltreatment is no longer in contact with a child or children in the facility
387.32or the conclusion of the investigation. In the case of maltreatment within a school facility,
387.33as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10, the commissioner
387.34of education need not provide notification to parents, guardians, or legal custodians of
387.35each child in the facility, but shall, within ten days after the investigation is completed,
387.36provide written notification to the parent, guardian, or legal custodian of any student
388.1alleged to have been maltreated. The commissioner of education may notify the parent,
388.2guardian, or legal custodian of any student involved as a witness to alleged maltreatment.
388.3EFFECTIVE DATE.This section is effective January 1, 2014.

388.4    Sec. 16. REPEALER.
388.5Minnesota Statutes 2012, section 256B.49, subdivision 16a, is repealed effective
388.6January 1, 2014.


388.9    Section 1. Minnesota Statutes 2012, section 13.411, subdivision 7, is amended to read:
388.10    Subd. 7. Examining and licensing boards. (a) Health licensing boards. Data
388.11held by health licensing boards are classified under sections 214.10, subdivision 8, and
388.12214.25, subdivision 1 .
388.13(b) Combined boards data. Data held by licensing boards participating in a health
388.14professional services program are classified under sections 214.34 and 214.35.
388.15(c) Criminal background checks. Criminal history record information obtained by
388.16a health-related licensing board is classified under section 214.075, subdivision 7.

388.17    Sec. 2. Minnesota Statutes 2012, section 148B.17, subdivision 2, is amended to read:
388.18    Subd. 2. Licensure and application fees. Nonrefundable licensure and application
388.19fees charged established by the board are as follows shall not exceed the following amounts:
388.20(1) application fee for national examination is $220 $110;
388.21(2) application fee for Licensed Marriage and Family Therapist (LMFT) state
388.22examination is $110;
388.23(3) initial LMFT license fee is prorated, but cannot exceed $125;
388.24(4) annual renewal fee for LMFT license is $125;
388.25(5) late fee for initial Licensed Associate Marriage and Family Therapist LAMFT
388.26 LMFT license renewal is $50;
388.27(6) application fee for LMFT licensure by reciprocity is $340 $220;
388.28(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT)
388.29license is $75;
388.30(8) annual renewal fee for LAMFT license is $75;
388.31(9) late fee for LAMFT renewal is $50 $25;
388.32(10) fee for reinstatement of license is $150; and
389.1(11) fee for emeritus status is $125.

389.2    Sec. 3. Minnesota Statutes 2012, section 151.01, subdivision 27, is amended to read:
389.3    Subd. 27. Practice of pharmacy. "Practice of pharmacy" means:
389.4    (1) interpretation and evaluation of prescription drug orders;
389.5    (2) compounding, labeling, and dispensing drugs and devices (except labeling by
389.6a manufacturer or packager of nonprescription drugs or commercially packaged legend
389.7drugs and devices);
389.8    (3) participation in clinical interpretations and monitoring of drug therapy for
389.9assurance of safe and effective use of drugs;
389.10    (4) participation in drug and therapeutic device selection; drug administration for first
389.11dosage and medical emergencies; drug regimen reviews; and drug or drug-related research;
389.12    (5) participation in administration of influenza vaccines to all eligible individuals ten
389.13years of age and older and all other vaccines to patients 18 years of age and older under
389.14standing orders from a physician licensed under chapter 147 or by written protocol with a
389.15physician licensed under chapter 147 provided that:
389.16    (i) the standing orders or protocol include, at a minimum, the name, dosage, and
389.17route of each vaccine that may be given, the patient population to whom the vaccine may
389.18be given, contraindications and precautions to the vaccine, the procedure for handling an
389.19adverse reaction, the name and signature of the physician, the address of the physician, a
389.20phone number at which the physician can be contacted, and the date and time period for
389.21which the standing orders or protocol are valid;
389.22    (i) (ii) the pharmacist is trained in has successfully completed a program approved
389.23by the American Accreditation Council of Pharmaceutical for Pharmacy Education,
389.24specifically for the administration of immunizations, or graduated from a college of
389.25pharmacy in 2001 or thereafter; and a program approved according to rules adopted by
389.26the board;
389.27    (iii) the pharmacist completes continuing education concerning the administration of
389.28immunizations, as required by Minnesota Rules;
389.29    (iv) the pharmacist has a current cardiopulmonary resuscitation certificate;
389.30    (ii) (v) the pharmacist reports the administration of the immunization to the patient's
389.31primary physician or clinic or to the Minnesota Immunization Information Connection;
389.32    (vi) the pharmacist complies with guidelines for vaccines and immunizations
389.33established by the federal Advisory Committee on Immunization Practices (ACIP), except
389.34that a pharmacist does not need to comply with those guidelines if administering a vaccine
389.35pursuant to a valid, patient-specific order issued by a physician licensed under chapter 147
390.1when the order is consistent with United States Food and Drug Administration-approved
390.2labeling of the vaccine; and
390.3    (vii) the pharmacist complies with Centers for Disease Control and Prevention
390.4guidelines relating to immunization schedules, vaccine storage and handling, and vaccine
390.5administration and documentation;
390.6    (6) participation in the practice of managing drug therapy and modifying drug
390.7therapy, according to section 151.21, subdivision 1, according to a written protocol
390.8between the specific pharmacist and the individual dentist, optometrist, physician,
390.9podiatrist, or veterinarian who is responsible for the patient's care and authorized to
390.10independently prescribe drugs. Any significant changes in drug therapy must be reported
390.11by the pharmacist to the patient's medical record;
390.12    (7) participation in the storage of drugs and the maintenance of records;
390.13    (8) responsibility for participation in patient counseling on therapeutic values,
390.14content, hazards, and uses of drugs and devices; and
390.15    (9) offering or performing those acts, services, operations, or transactions necessary
390.16in the conduct, operation, management, and control of a pharmacy.

390.17    Sec. 4. Minnesota Statutes 2012, section 151.19, subdivision 1, is amended to read:
390.18    Subdivision 1. Pharmacy registration licensure requirements. The board shall
390.19require and provide for the annual registration of every pharmacy now or hereafter doing
390.20business within this state. Upon the payment of any applicable fee specified in section
390.21151.065, the board shall issue a registration certificate in such form as it may prescribe to
390.22such persons as may be qualified by law to conduct a pharmacy. Such certificate shall
390.23be displayed in a conspicuous place in the pharmacy for which it is issued and expire on
390.24the 30th day of June following the date of issue. It shall be unlawful for any person to
390.25conduct a pharmacy unless such certificate has been issued to the person by the board. (a)
390.26No person shall operate a pharmacy without first obtaining a license from the board and
390.27paying any applicable fee specified in section 151.065. The license shall be displayed in a
390.28conspicuous place in the pharmacy for which it is issued and expires on June 30 following
390.29the date of issue. It is unlawful for any person to operate a pharmacy unless the license
390.30has been issued to the person by the board.
390.31    (b) Application for a pharmacy license under this section shall be made in a manner
390.32specified by the board.
390.33    (c) No license shall be issued or renewed for a pharmacy located within the state
390.34unless the applicant agrees to operate the pharmacy in a manner prescribed by federal and
390.35state law and according to rules adopted by the board. No license shall be issued for a
391.1pharmacy located outside of the state unless the applicant agrees to operate the pharmacy
391.2in a manner prescribed by federal law and, when dispensing medications for residents of
391.3this state, the laws of this state, and Minnesota Rules.
391.4    (d) No license shall be issued or renewed for a pharmacy that is required to be
391.5licensed or registered by the state in which it is physically located unless the applicant
391.6supplies the board with proof of such licensure or registration.
391.7    (e) The board shall require a separate license for each pharmacy located within
391.8the state and for each pharmacy located outside of the state at which any portion of the
391.9dispensing process occurs for drugs dispensed to residents of this state.
391.10    (f) The board shall not issue an initial or renewed license for a pharmacy unless the
391.11pharmacy passes an inspection conducted by an authorized representative of the board. In
391.12the case of a pharmacy located outside of the state, the board may require the applicant to
391.13pay the cost of the inspection, in addition to the license fee in section 151.065, unless the
391.14applicant furnishes the board with a report, issued by the appropriate regulatory agency of
391.15the state in which the facility is located, of an inspection that has occurred within the 24
391.16months immediately preceding receipt of the license application by the board. The board
391.17may deny licensure unless the applicant submits documentation satisfactory to the board
391.18that any deficiencies noted in an inspection report have been corrected.
391.19    (g) The board shall not issue an initial or renewed license for a pharmacy located
391.20outside of the state unless the applicant discloses and certifies:
391.21    (1) the location, names, and titles of all principal corporate officers and all
391.22pharmacists who are involved in dispensing drugs to residents of this state;
391.23    (2) that it maintains its records of drugs dispensed to residents of this state so that the
391.24records are readily retrievable from the records of other drugs dispensed;
391.25    (3) that it agrees to cooperate with, and provide information to, the board concerning
391.26matters related to dispensing drugs to residents of this state;
391.27    (4) that, during its regular hours of operation, but no less than six days per week, for
391.28a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate
391.29communication between patients in this state and a pharmacist at the pharmacy who has
391.30access to the patients' records; the toll-free number must be disclosed on the label affixed
391.31to each container of drugs dispensed to residents of this state; and
391.32    (5) that, upon request of a resident of a long-term care facility located in this
391.33state, the resident's authorized representative, or a contract pharmacy or licensed health
391.34care facility acting on behalf of the resident, the pharmacy will dispense medications
391.35prescribed for the resident in unit-dose packaging or, alternatively, comply with section
391.36151.415, subdivision 5.

392.1    Sec. 5. Minnesota Statutes 2012, section 151.19, subdivision 3, is amended to read:
392.2    Subd. 3. Sale of federally restricted medical gases. The board shall require and
392.3provide for the annual registration of every person or establishment not licensed as a
392.4pharmacy or a practitioner engaged in the retail sale or distribution of federally restricted
392.5medical gases. Upon the payment of any applicable fee specified in section 151.065, the
392.6board shall issue a registration certificate in such form as it may prescribe to those persons
392.7or places that may be qualified to sell or distribute federally restricted medical gases. The
392.8certificate shall be displayed in a conspicuous place in the business for which it is issued
392.9and expire on the date set by the board. It is unlawful for a person to sell or distribute
392.10federally restricted medical gases unless a certificate has been issued to that person by the
392.11board. (a) A person or establishment not licensed as a pharmacy or a practitioner shall not
392.12engage in the retail sale or distribution of federally restricted medical gases without first
392.13obtaining a registration from the board and paying the applicable fee specified in section
392.14151.065. The registration shall be displayed in a conspicuous place in the business for
392.15which it is issued and expires on the date set by the board. It is unlawful for a person to
392.16sell or distribute federally restricted medical gases unless a certificate has been issued to
392.17that person by the board.
392.18    (b) Application for a medical gas distributor registration under this section shall be
392.19made in a manner specified by the board.
392.20    (c) No registration shall be issued or renewed for a medical gas distributor located
392.21within the state unless the applicant agrees to operate in a manner prescribed by federal
392.22and state law and according to the rules adopted by the board. No license shall be issued
392.23for a medical gas distributor located outside of the state unless the applicant agrees to
392.24operate in a manner prescribed by federal law and, when distributing medical gases for
392.25residents of this state, the laws of this state and Minnesota Rules.
392.26    (d) No registration shall be issued or renewed for a medical gas distributor that is
392.27required to be licensed or registered by the state in which it is physically located unless the
392.28applicant supplies the board with proof of the licensure or registration. The board may, by
392.29rule, establish standards for the registration of a medical gas distributor that is not required
392.30to be licensed or registered by the state in which it is physically located.
392.31    (e) The board shall require a separate registration for each medical gas distributor
392.32located within the state and for each facility located outside of the state from which
392.33medical gases are distributed to residents of this state.
392.34    (f) The board shall not issue an initial or renewed registration for a medical gas
392.35distributor unless the medical gas distributor passes an inspection conducted by an
392.36authorized representative of the board. In the case of a medical gas distributor located
393.1outside of the state, the board may require the applicant to pay the cost of the inspection,
393.2in addition to the license fee in section 151.065, unless the applicant furnishes the board
393.3with a report, issued by the appropriate regulatory agency of the state in which the facility
393.4is located, of an inspection that has occurred within the 24 months immediately preceding
393.5receipt of the license application by the board. The board may deny licensure unless the
393.6applicant submits documentation satisfactory to the board that any deficiencies noted in
393.7an inspection report have been corrected.

393.8    Sec. 6. [151.252] LICENSING OF DRUG MANUFACTURERS; FEES;
393.9PROHIBITIONS.
393.10    Subdivision 1. Requirements. (a) No person shall act as a manufacturer without
393.11first obtaining a license from the board and paying any applicable fee specified in section
393.12151.065.
393.13    (b) Application for a manufacturer license under this section shall be made in a
393.14manner specified by the board.
393.15    (c) No license shall be issued or renewed for a manufacturer unless the applicant
393.16agrees to operate in a manner prescribed by federal and state law and according to
393.17Minnesota Rules.
393.18    (d) No license shall be issued or renewed for a manufacturer that is required to
393.19be registered pursuant to United State Code, title 21, section 360, unless the applicant
393.20supplies the board with proof of registration. The board may establish by rule the
393.21standards for licensure of manufacturers that are not required to be registered under United
393.22States Code, title 21, section 360.
393.23    (e) No license shall be issued or renewed for a manufacturer that is required to be
393.24licensed or registered by the state in which it is physically located unless the applicant
393.25supplies the board with proof of licensure or registration. The board may establish, by
393.26rule, standards for the licensure of a manufacturer that is not required to be licensed or
393.27registered by the state in which it is physically located.
393.28    (f) The board shall require a separate license for each facility located within the state
393.29at which manufacturing occurs and for each facility located outside of the state at which
393.30drugs that are shipped into the state are manufactured.
393.31    (g) The board shall not issue an initial or renewed license for a manufacturing
393.32facility unless the facility passes an inspection conducted by an authorized representative
393.33of the board. In the case of a manufacturing facility located outside of the state, the board
393.34may require the applicant to pay the cost of the inspection, in addition to the license fee
393.35in section 151.065, unless the applicant furnishes the board with a report, issued by the
394.1appropriate regulatory agency of the state in which the facility is located or by the United
394.2States Food and Drug Administration, of an inspection that has occurred within the 24
394.3months immediately preceding receipt of the license application by the board. The board
394.4may deny licensure unless the applicant submits documentation satisfactory to the board
394.5that any deficiencies noted in an inspection report have been corrected.
394.6    Subd. 2. Prohibition. It is unlawful for any person engaged in manufacturing to sell
394.7legend drugs to anyone located in this state except as provided in this chapter.

394.8    Sec. 7. Minnesota Statutes 2012, section 151.26, subdivision 1, is amended to read:
394.9    Subdivision 1. Generally. Nothing in this chapter shall subject a person duly
394.10licensed in this state to practice medicine, dentistry, or veterinary medicine, to inspection
394.11by the State Board of Pharmacy, nor prevent the person from administering drugs,
394.12medicines, chemicals, or poisons in the person's practice, nor prevent a duly licensed
394.13practitioner from furnishing to a patient properly packaged and labeled drugs, medicines,
394.14chemicals, or poisons as may be considered appropriate in the treatment of such patient;
394.15unless the person is engaged in the dispensing, sale, or distribution of drugs and the board
394.16provides reasonable notice of an inspection.
394.17    Except for the provisions of section 151.37, nothing in this chapter applies to or
394.18interferes with the dispensing, in its original package and at no charge to the patient, of
394.19a legend drug, other than a controlled substance, that was packaged by a manufacturer
394.20and provided to the dispenser for distribution dispensing as a professional sample, so
394.21long as the sample is prepared and distributed pursuant to Code of Federal Regulations,
394.22title 21, section 203, subpart D.
394.23    Nothing in this chapter shall prevent the sale of drugs, medicines, chemicals, or
394.24poisons at wholesale to licensed physicians, dentists and veterinarians for use in their
394.25practice, nor to hospitals for use therein.
394.26    Nothing in this chapter shall prevent the sale of drugs, chemicals, or poisons either
394.27at wholesale or retail for use for commercial purposes, or in the arts, nor interfere with the
394.28sale of insecticides, as defined in Minnesota Statutes 1974, section 24.069, and nothing in
394.29this chapter shall prevent the sale of common household preparations and other drugs,
394.30chemicals, and poisons sold exclusively for use for nonmedicinal purposes.
394.31    Nothing in this chapter shall apply to or interfere with the vending or retailing
394.32of any nonprescription medicine or drug not otherwise prohibited by statute which is
394.33prepackaged, fully prepared by the manufacturer or producer for use by the consumer, and
394.34labeled in accordance with the requirements of the state or federal Food and Drug Act; nor
394.35to the manufacture, wholesaling, vending, or retailing of flavoring extracts, toilet articles,
395.1cosmetics, perfumes, spices, and other commonly used household articles of a chemical
395.2nature, for use for nonmedicinal purposes. Nothing in this chapter shall prevent the sale of
395.3drugs or medicines by licensed pharmacists at a discount to persons over 65 years of age.

395.4    Sec. 8. Minnesota Statutes 2012, section 151.37, subdivision 4, is amended to read:
395.5    Subd. 4. Research. (a) Any qualified person may use legend drugs in the course
395.6of a bona fide research project, but cannot administer or dispense such drugs to human
395.7beings unless such drugs are prescribed, dispensed, and administered by a person lawfully
395.8authorized to do so.
395.9    (b) Drugs may be dispensed or distributed by a pharmacy licensed by the board for
395.10use by, or administration to, patients enrolled in a bona fide research study that is being
395.11conducted pursuant to either an investigational new drug application approved by the
395.12United States Food and Drug Administration or that has been approved by an institutional
395.13review board. For the purposes of this subdivision only:
395.14    (1) a prescription drug order is not required for a pharmacy to dispense a research
395.15drug, unless the study protocol requires the pharmacy to receive such an order;
395.16    (2) notwithstanding the prescription labeling requirements found in this chapter or
395.17the rules promulgated by the board, a research drug may be labeled as required by the
395.18study protocol; and
395.19    (3) dispensing and distribution of research drugs by pharmacies shall not be
395.20considered compounding, manufacturing, or wholesaling under this chapter.
395.21    (c) An entity that is under contract to a federal agency for the purpose of distributing
395.22drugs for bona fide research studies is exempt from the drug wholesaler licensing
395.23requirements of this chapter. Any other entity is exempt from the drug wholesaler
395.24licensing requirements of this chapter if the board finds that the entity is licensed or
395.25registered according to the laws of the state in which it is physically located and it is
395.26distributing drugs for use by, or administration to, patients enrolled in a bona fide research
395.27study that is being conducted pursuant to either an investigational new drug application
395.28approved by the United States Food and Drug Administration or that has been approved
395.29by an institutional review board.
395.30EFFECTIVE DATE.This section is effective the day following final enactment.

395.31    Sec. 9. Minnesota Statutes 2012, section 151.47, subdivision 1, is amended to read:
395.32    Subdivision 1. Requirements. (a) All wholesale drug distributors are subject to the
395.33requirements in paragraphs (a) to (f) of this subdivision.
396.1    (a) (b) No person or distribution outlet shall act as a wholesale drug distributor
396.2without first obtaining a license from the board and paying any applicable fee specified
396.3in section 151.065.
396.4    (c) Application for a wholesale drug distributor license under this section shall be
396.5made in a manner specified by the board.
396.6    (b) (d) No license shall be issued or renewed for a wholesale drug distributor to
396.7operate unless the applicant agrees to operate in a manner prescribed by federal and state
396.8law and according to the rules adopted by the board.
396.9    (c) The board may require a separate license for each facility directly or indirectly
396.10owned or operated by the same business entity within the state, or for a parent entity
396.11with divisions, subsidiaries, or affiliate companies within the state, when operations
396.12are conducted at more than one location and joint ownership and control exists among
396.13all the entities.
396.14    (e) No license may be issued or renewed for a drug wholesale distributor that is
396.15required to be licensed or registered by the state in which it is physically located unless
396.16the applicant supplies the board with proof of licensure or registration. The board may
396.17establish, by rule, standards for the licensure of a drug wholesale distributor that is not
396.18required to be licensed or registered by the state in which it is physically located.
396.19    (f) The board shall require a separate license for each drug wholesale distributor
396.20facility located within the state and for each drug wholesale distributor facility located
396.21outside of the state from which drugs are shipped into the state or to which drugs are
396.22reverse distributed.
396.23    (g) The board shall not issue an initial or renewed license for a drug wholesale
396.24distributor facility unless the facility passes an inspection conducted by an authorized
396.25representative of the board. In the case of a drug wholesale distributor facility located
396.26outside of the state, the board may require the applicant to pay the cost of the inspection,
396.27in addition to the license fee in section 151.065, unless the applicant furnishes the board
396.28with a report, issued by the appropriate regulatory agency of the state in which the facility
396.29is located, of an inspection that has occurred within the 24 months immediately preceding
396.30receipt of the license application by the board. The board may deny licensure unless the
396.31applicant submits documentation satisfactory to the board that any deficiencies noted in
396.32an inspection report have been corrected.
396.33    (d) (h) As a condition for receiving and retaining a wholesale drug distributor license
396.34issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has
396.35and will continuously maintain:
396.36    (1) adequate storage conditions and facilities;
397.1    (2) minimum liability and other insurance as may be required under any applicable
397.2federal or state law;
397.3    (3) a viable security system that includes an after hours central alarm, or comparable
397.4entry detection capability; restricted access to the premises; comprehensive employment
397.5applicant screening; and safeguards against all forms of employee theft;
397.6    (4) a system of records describing all wholesale drug distributor activities set forth
397.7in section 151.44 for at least the most recent two-year period, which shall be reasonably
397.8accessible as defined by board regulations in any inspection authorized by the board;
397.9    (5) principals and persons, including officers, directors, primary shareholders,
397.10and key management executives, who must at all times demonstrate and maintain their
397.11capability of conducting business in conformity with sound financial practices as well
397.12as state and federal law;
397.13    (6) complete, updated information, to be provided to the board as a condition for
397.14obtaining and retaining a license, about each wholesale drug distributor to be licensed,
397.15including all pertinent corporate licensee information, if applicable, or other ownership,
397.16principal, key personnel, and facilities information found to be necessary by the board;
397.17    (7) written policies and procedures that assure reasonable wholesale drug distributor
397.18preparation for, protection against, and handling of any facility security or operation
397.19problems, including, but not limited to, those caused by natural disaster or government
397.20emergency, inventory inaccuracies or product shipping and receiving, outdated product
397.21or other unauthorized product control, appropriate disposition of returned goods, and
397.22product recalls;
397.23    (8) sufficient inspection procedures for all incoming and outgoing product
397.24shipments; and
397.25    (9) operations in compliance with all federal requirements applicable to wholesale
397.26drug distribution.
397.27    (e) (i) An agent or employee of any licensed wholesale drug distributor need not
397.28seek licensure under this section.
397.29    (f) A wholesale drug distributor shall file with the board an annual report, in a
397.30form and on the date prescribed by the board, identifying all payments, honoraria,
397.31reimbursement or other compensation authorized under section 151.461, clauses (3) to
397.32(5), paid to practitioners in Minnesota during the preceding calendar year. The report
397.33shall identify the nature and value of any payments totaling $100 or more, to a particular
397.34practitioner during the year, and shall identify the practitioner. Reports filed under this
397.35provision are public data.

398.1    Sec. 10. Minnesota Statutes 2012, section 151.47, is amended by adding a subdivision
398.2to read:
398.3    Subd. 3. Prohibition. It is unlawful for any person engaged in wholesale drug
398.4distribution to sell drugs to anyone located within the state or to receive drugs in reverse
398.5distribution from anyone located within the state except as provided in this chapter.

398.6    Sec. 11. Minnesota Statutes 2012, section 151.49, is amended to read:
398.7151.49 LICENSE RENEWAL APPLICATION PROCEDURES.
398.8    Application blanks or notices for renewal of a license required by sections 151.42
398.9to 151.51 shall be mailed or otherwise provided to each licensee on or before the first
398.10day of the month prior to the month in which the license expires and, if application for
398.11renewal of the license with the required fee and supporting documents is not made before
398.12the expiration date, the existing license or renewal shall lapse and become null and void
398.13upon the date of expiration.

398.14    Sec. 12. Minnesota Statutes 2012, section 152.126, is amended to read:
398.15152.126 CONTROLLED SUBSTANCES PRESCRIPTION ELECTRONIC
398.16REPORTING SYSTEM PRESCRIPTION MONITORING PROGRAM.
398.17    Subdivision 1. Definitions. (a) For purposes of this section, the terms defined in
398.18this subdivision have the meanings given.
398.19    (a) (b) "Board" means the Minnesota State Board of Pharmacy established under
398.20chapter 151.
398.21    (b) (c) "Controlled substances" means those substances listed in section 152.02,
398.22subdivisions 3 to 5 6, and those substances defined by the board pursuant to section
398.23152.02, subdivisions 7 , 8, and 12. For the purpose of this section only, "controlled
398.24substances" includes tramadol and butalbital.
398.25    (c) (d) "Dispense" or "dispensing" has the meaning given in section 151.01,
398.26subdivision 30 . Dispensing does not include the direct administering of a controlled
398.27substance to a patient by a licensed health care professional.
398.28    (d) (e) "Dispenser" means a person authorized by law to dispense a controlled
398.29substance, pursuant to a valid prescription. For the purposes of this section, a dispenser does
398.30not include a licensed hospital pharmacy that distributes controlled substances for inpatient
398.31hospital care or a veterinarian who is dispensing prescriptions under section 156.18.
398.32    (e) (f) "Prescriber" means a licensed health care professional who is authorized to
398.33prescribe a controlled substance under section 152.12, subdivision 1.
398.34    (f) (g) "Prescription" has the meaning given in section 151.01, subdivision 16.
399.1    Subd. 1a. Treatment of intractable pain. This section is not intended to limit or
399.2interfere with the legitimate prescribing of controlled substances for pain. No prescriber
399.3shall be subject to disciplinary action by a health-related licensing board for prescribing a
399.4controlled substance according to the provisions of section 152.125.
399.5    Subd. 2. Prescription electronic reporting system. (a) The board shall establish
399.6by January 1, 2010, an electronic system for reporting the information required under
399.7subdivision 4 for all controlled substances dispensed within the state.
399.8    (b) The board may contract with a vendor for the purpose of obtaining technical
399.9assistance in the design, implementation, operation, and maintenance of the electronic
399.10reporting system.
399.11    Subd. 3. Prescription Electronic Reporting Monitoring Program Advisory
399.12Committee. (a) The board shall convene an advisory committee. The committee must
399.13include at least one representative of:
399.14    (1) the Department of Health;
399.15    (2) the Department of Human Services;
399.16    (3) each health-related licensing board that licenses prescribers;
399.17    (4) a professional medical association, which may include an association of pain
399.18management and chemical dependency specialists;
399.19    (5) a professional pharmacy association;
399.20    (6) a professional nursing association;
399.21    (7) a professional dental association;
399.22    (8) a consumer privacy or security advocate; and
399.23    (9) a consumer or patient rights organization; and
399.24    (10) an association of medical examiners and coroners.
399.25    (b) The advisory committee shall advise the board on the development and operation
399.26of the electronic reporting system prescription monitoring program, including, but not
399.27limited to:
399.28    (1) technical standards for electronic prescription drug reporting;
399.29    (2) proper analysis and interpretation of prescription monitoring data; and
399.30    (3) an evaluation process for the program.
399.31    Subd. 4. Reporting requirements; notice. (a) Each dispenser must submit the
399.32following data to the board or its designated vendor, subject to the notice required under
399.33paragraph (d):
399.34    (1) name of the prescriber;
399.35    (2) national provider identifier of the prescriber;
399.36    (3) name of the dispenser;
400.1    (4) national provider identifier of the dispenser;
400.2    (5) prescription number;
400.3    (6) name of the patient for whom the prescription was written;
400.4    (7) address of the patient for whom the prescription was written;
400.5    (8) date of birth of the patient for whom the prescription was written;
400.6    (9) date the prescription was written;
400.7    (10) date the prescription was filled;
400.8    (11) name and strength of the controlled substance;
400.9    (12) quantity of controlled substance prescribed;
400.10    (13) quantity of controlled substance dispensed; and
400.11    (14) number of days supply.
400.12    (b) The dispenser must submit the required information by a procedure and in a
400.13format established by the board. The board may allow dispensers to omit data listed in this
400.14subdivision or may require the submission of data not listed in this subdivision provided
400.15the omission or submission is necessary for the purpose of complying with the electronic
400.16reporting or data transmission standards of the American Society for Automation in
400.17Pharmacy, the National Council on Prescription Drug Programs, or other relevant national
400.18standard-setting body.
400.19    (c) A dispenser is not required to submit this data for those controlled substance
400.20prescriptions dispensed for:
400.21    (1) individuals residing in licensed skilled nursing or intermediate care facilities;
400.22    (2) individuals receiving assisted living services under chapter 144G or through a
400.23medical assistance home and community-based waiver;
400.24    (3) individuals receiving medication intravenously;
400.25    (4) individuals receiving hospice and other palliative or end-of-life care; and
400.26    (5) individuals receiving services from a home care provider regulated under
400.27chapter 144A. individuals residing in a health care facility as defined in section 151.58,
400.28subdivision 2, paragraph (b), when a drug is distributed through the use of an automated
400.29drug distribution system according to section 151.58; and
400.30    (2) individuals receiving a drug sample that was packaged by a manufacturer and
400.31provided to the dispenser for dispensing as a professional sample pursuant to Code of
400.32Federal Regulations, title 21, section 203, subpart D.
400.33    (d) A dispenser must not submit data under this subdivision unless provide a
400.34conspicuous notice of the reporting requirements of this section is given to the patient for
400.35whom the prescription was written.
401.1    Subd. 5. Use of data by board. (a) The board shall develop and maintain a database
401.2of the data reported under subdivision 4. The board shall maintain data that could identify
401.3an individual prescriber or dispenser in encrypted form. The database may be used by
401.4permissible users identified under subdivision 6 for the identification of:
401.5    (1) individuals receiving prescriptions for controlled substances from prescribers
401.6who subsequently obtain controlled substances from dispensers in quantities or with a
401.7frequency inconsistent with generally recognized standards of use for those controlled
401.8substances, including standards accepted by national and international pain management
401.9associations; and
401.10    (2) individuals presenting forged or otherwise false or altered prescriptions for
401.11controlled substances to dispensers.
401.12    (b) No permissible user identified under subdivision 6 may access the database
401.13for the sole purpose of identifying prescribers of controlled substances for unusual or
401.14excessive prescribing patterns without a valid search warrant or court order.
401.15    (c) No personnel of a state or federal occupational licensing board or agency may
401.16access the database for the purpose of obtaining information to be used to initiate or
401.17substantiate a disciplinary action against a prescriber.
401.18    (d) Data reported under subdivision 4 shall be retained by the board in the an active
401.19 database for a 12-month period, and shall be removed from the active database no later
401.20than 12 months from the last day of the month during which the data was received. The
401.21board may transfer the data into a database that may only be used by the authorized staff
401.22of the board for the purposes of administering, operating, and maintaining the prescription
401.23monitoring program and conducting trend analyses and other studies as necessary to
401.24evaluate the effectiveness of the program. No data that can be used to identify an
401.25individual may be transferred into this database.
401.26    Subd. 6. Access to reporting system data. (a) Except as indicated in this
401.27subdivision, the data submitted to the board under subdivision 4 is private data on
401.28individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
401.29    (b) Except as specified in subdivision 5, the following persons shall be considered
401.30permissible users and may access the data submitted under subdivision 4 in the same or
401.31similar manner, and for the same or similar purposes, as those persons who are authorized
401.32to access similar private data on individuals under federal and state law:
401.33    (1) a prescriber or an agent or employee of the prescriber to whom the prescriber has
401.34delegated the task of accessing the data, to the extent the information relates specifically to
401.35a current patient, to whom the prescriber is prescribing or considering prescribing any
401.36controlled substance or to whom the prescriber is providing other medical treatment for
402.1which access to the data may be necessary and with the provision that the prescriber remains
402.2responsible for the use or misuse of data accessed by a delegated agent or employee;
402.3    (2) a dispenser or an agent or employee of the dispenser to whom the dispenser has
402.4delegated the task of accessing the data, to the extent the information relates specifically
402.5to a current patient to whom that dispenser is dispensing or considering dispensing any
402.6controlled substance or to whom the dispenser is providing other pharmaceutical care for
402.7which access to the data may be necessary and with the provision that the dispenser remains
402.8responsible for the use or misuse of data accessed by a delegated agent or employee;
402.9    (3) a licensed pharmacist who is providing pharmaceutical care for which access to
402.10the data may be necessary or when consulted by a prescriber who is requesting data in
402.11accordance with clause (1);
402.12    (3) (4) an individual who is the recipient of a controlled substance prescription for
402.13which data was submitted under subdivision 4, or a guardian of the individual, parent or
402.14guardian of a minor, or health care agent of the individual acting under a health care
402.15directive under chapter 145C;
402.16    (4) (5) personnel of the board specifically assigned to conduct a bona fide
402.17investigation of a specific licensee;
402.18    (5) (6) personnel of the board engaged in the collection of controlled substance
402.19prescription information as part of the assigned duties and responsibilities under this
402.20section;
402.21    (6) (7) authorized personnel of a vendor under contract with the board who are
402.22engaged in the design, implementation, operation, and maintenance of the electronic
402.23reporting system prescription monitoring program as part of the assigned duties and
402.24responsibilities of their employment, provided that access to data is limited to the
402.25minimum amount necessary to carry out such duties and responsibilities;
402.26    (7) (8) federal, state, and local law enforcement authorities acting pursuant to a
402.27valid search warrant; and
402.28    (8) (9) personnel of the medical assistance program Minnesota health care programs
402.29 assigned to use the data collected under this section to identify and manage recipients
402.30whose usage of controlled substances may warrant restriction to a single primary care
402.31physician provider, a single outpatient pharmacy, or and a single hospital; and
402.32    (10) a coroner or medical examiner, or an agent or employee of the coroner or
402.33medical examiner to whom the coroner or medical examiner has delegated the task of
402.34accessing the data, conducting an investigation pursuant to section 390.11, and with the
402.35provision that the coroner or medical examiner remains responsible for the use or misuse
402.36of data accessed by a delegated agent or employee.
403.1    For purposes of clause (3) (4), access by an individual includes persons in the
403.2definition of an individual under section 13.02.
403.3    (c) Any permissible user identified in paragraph (b), who directly accesses
403.4the data electronically, shall implement and maintain a comprehensive information
403.5security program that contains administrative, technical, and physical safeguards that
403.6are appropriate to the user's size and complexity, and the sensitivity of the personal
403.7information obtained. The permissible user shall identify reasonably foreseeable internal
403.8and external risks to the security, confidentiality, and integrity of personal information
403.9that could result in the unauthorized disclosure, misuse, or other compromise of the
403.10information and assess the sufficiency of any safeguards in place to control the risks.
403.11    (d) The board shall not release data submitted under this section unless it is provided
403.12with evidence, satisfactory to the board, that the person requesting the information is
403.13entitled to receive the data.
403.14    (e) The board shall not release the name of a prescriber without the written consent
403.15of the prescriber or a valid search warrant or court order. The board shall provide a
403.16mechanism for a prescriber to submit to the board a signed consent authorizing the release
403.17of the prescriber's name when data containing the prescriber's name is requested.
403.18    (f) The board shall maintain a log of all persons who access the data for a period of
403.19at least five years and shall ensure that any permissible user complies with paragraph (c)
403.20prior to attaining direct access to the data.
403.21    (g) (f) Section 13.05, subdivision 6, shall apply to any contract the board enters into
403.22pursuant to subdivision 2. A vendor shall not use data collected under this section for
403.23any purpose not specified in this section.
403.24    (g) The board may participate in an interstate prescription monitoring program data
403.25exchange system provided that permissible users in other states may have access to the data
403.26only as allowed under this section and that section 13.05, subdivision 6, shall apply to any
403.27contract or memorandum of understanding that the board enters into under this paragraph.
403.28    Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to
403.29the board as required under this section is subject to disciplinary action by the appropriate
403.30health-related licensing board.
403.31    (b) A prescriber or dispenser authorized to access the data who knowingly discloses
403.32the data in violation of state or federal laws relating to the privacy of health care data
403.33shall be subject to disciplinary action by the appropriate health-related licensing board,
403.34and appropriate civil penalties.
403.35    Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription
403.36electronic reporting system to determine if the system is negatively impacting appropriate
404.1prescribing practices of controlled substances. The board may contract with a vendor to
404.2design and conduct the evaluation.
404.3    (b) The board shall submit the evaluation of the system to the legislature by July
404.415, 2011.
404.5    Subd. 9. Immunity from liability; no requirement to obtain information. (a) A
404.6pharmacist, prescriber, or other dispenser making a report to the program in good faith
404.7under this section is immune from any civil, criminal, or administrative liability, which
404.8might otherwise be incurred or imposed as a result of the report, or on the basis that the
404.9pharmacist or prescriber did or did not seek or obtain or use information from the program.
404.10    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
404.11to obtain information about a patient from the program, and the pharmacist, prescriber,
404.12or other dispenser, if acting in good faith, is immune from any civil, criminal, or
404.13administrative liability that might otherwise be incurred or imposed for requesting,
404.14receiving, or using information from the program.
404.15    Subd. 10. Funding. (a) The board may seek grants and private funds from nonprofit
404.16charitable foundations, the federal government, and other sources to fund the enhancement
404.17and ongoing operations of the prescription electronic reporting system monitoring
404.18program established under this section. Any funds received shall be appropriated to the
404.19board for this purpose. The board may not expend funds to enhance the program in a way
404.20that conflicts with this section without seeking approval from the legislature.
404.21    (b) Notwithstanding any other section, the administrative services unit for the
404.22health-related licensing boards shall apportion between the Board of Medical Practice, the
404.23Board of Nursing, the Board of Dentistry, the Board of Podiatric Medicine, the Board of
404.24Optometry, the Board of Veterinary Medicine, and the Board of Pharmacy an amount to
404.25be paid through fees by each respective board. The amount apportioned to each board
404.26shall equal each board's share of the annual appropriation to the Board of Pharmacy
404.27from the state government special revenue fund for operating the prescription electronic
404.28reporting system monitoring program under this section. Each board's apportioned share
404.29shall be based on the number of prescribers or dispensers that each board identified in
404.30this paragraph licenses as a percentage of the total number of prescribers and dispensers
404.31licensed collectively by these boards. Each respective board may adjust the fees that the
404.32boards are required to collect to compensate for the amount apportioned to each board by
404.33the administrative services unit.

404.34    Sec. 13. [214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL
404.35BACKGROUND CHECKS.
405.1    Subdivision 1. Applications. (a) By January 1, 2018, each health-related licensing
405.2board, as defined in section 214.01, subdivision 2, shall require applicants for initial
405.3licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse
405.4in licensure, as defined by the individual health-related licensing boards, to submit to
405.5a criminal history records check of state data completed by the Bureau of Criminal
405.6Apprehension (BCA) and a national criminal history records check, including a search of
405.7the records of the Federal Bureau of Investigation (FBI).
405.8(b) An applicant must complete a criminal background check if more than one year
405.9has elapsed since the applicant last submitted a background check to the board.
405.10    Subd. 2. Investigations. If a health-related licensing board has reasonable cause
405.11to believe a licensee has been charged with or convicted of a crime in this or any other
405.12jurisdiction, the health-related licensing board may require the licensee to submit to a
405.13criminal history records check of state data completed by the BCA and a national criminal
405.14history records check, including a search of the records of the FBI.
405.15    Subd. 3. Consent form; fees; fingerprints. (a) In order to effectuate the federal
405.16and state level, fingerprint-based criminal background check, the applicant or licensee
405.17must submit a completed criminal history records check consent form and a full set of
405.18fingerprints to the respective health-related licensing board or a designee in the manner
405.19and form specified by the board.
405.20(b) The applicant or licensee is responsible for all fees associated with preparation of
405.21the fingerprints, the criminal records check consent form, and the criminal background
405.22check. The fees for the criminal records background check shall be set by the BCA and
405.23the FBI and are not refundable. The fees shall be submitted to the respective health-related
405.24licensing board by the applicant or licensee as prescribed by the respective board.
405.25    (c) All fees received by the health-related licensing boards under this subdivision
405.26shall be deposited in a dedicated account in the special revenue fund and are appropriated
405.27to the Board of Nursing Home Administrators for the administrative services unit to pay
405.28for the criminal background checks conducted by the Bureau of Criminal Apprehension
405.29and Federal Bureau of Investigation.
405.30    Subd. 4. Refusal to consent. (a) The health-related licensing boards shall not issue
405.31a license to any applicant who refuses to consent to a criminal background check or fails
405.32to submit fingerprints within 90 days after submission of an application for licensure. Any
405.33fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent
405.34to the criminal background check or fails to submit the required fingerprints.
405.35(b) The failure of a licensee to submit to a criminal background check as provided in
405.36subdivision 3 is grounds for disciplinary action by the respective health licensing board.
406.1    Subd. 5. Submission of fingerprints to the Bureau of Criminal Apprehension.
406.2The health-related licensing board or designee shall submit applicant or licensee
406.3fingerprints to the BCA. The BCA shall perform a check for state criminal justice
406.4information and shall forward the applicant's or licensee's fingerprints to the FBI to
406.5perform a check for national criminal justice information regarding the applicant or
406.6licensee. The BCA shall report to the board the results of the state and national criminal
406.7justice information checks.
406.8    Subd. 6. Alternatives to fingerprint-based criminal background checks. The
406.9health-related licensing board may require an alternative method of criminal history
406.10checks for an applicant or licensee who has submitted at least three sets of fingerprints in
406.11accordance with this section that have been unreadable by the BCA or the FBI.
406.12    Subd. 7. Data practices. Criminal history record information obtained by the
406.13health-related licensing board under this section is private data on individuals under
406.14section 13.02, subdivision 12.
406.15    Subd. 8. Opportunity to challenge accuracy of report. Prior to taking disciplinary
406.16action against an applicant or a licensee based on a criminal conviction, the health-related
406.17licensing board shall provide the applicant or the licensee an opportunity to complete or
406.18challenge the accuracy of the criminal history information reported to the board. The
406.19applicant or licensee shall have 30 calendar days following notice from the board of
406.20the intent to deny licensure or to take disciplinary action to request an opportunity to
406.21correct or complete the record prior to the board taking disciplinary action based on the
406.22information reported to the board. The board shall provide the applicant up to 180 days to
406.23challenge the accuracy or completeness of the report with the agency responsible for the
406.24record. This subdivision does not affect the right of the subject of the data to contest the
406.25accuracy or completeness under section 13.04, subdivision 4.
406.26    Subd. 9. Instructions to the board; plans. The health-related licensing boards, in
406.27collaboration with the commissioner of human services and the BCA, shall establish a
406.28plan for completing criminal background checks of all licensees who were licensed before
406.29the effective date requirement under subdivision 1. The plan must seek to minimize
406.30duplication of requirements for background checks of licensed health professionals. The
406.31plan for background checks of current licensees shall be developed no later than January
406.321, 2017, and may be contingent upon the implementation of a system by the BCA or FBI
406.33in which any new crimes that an applicant or licensee commits after an initial background
406.34check are flagged in the BCA's or FBI's database and reported back to the board. The plan
406.35shall include recommendations for any necessary statutory changes.

407.1    Sec. 14. Minnesota Statutes 2012, section 214.12, is amended by adding a subdivision
407.2to read:
407.3    Subd. 4. Parental depression. The health-related licensing boards that regulate
407.4professions that serve caregivers at risk of depression, or their children, including
407.5behavioral health and therapy, chiropractic, marriage and family therapy, medical practice,
407.6nursing, psychology, and social work, shall provide educational materials to licensees on
407.7the subject of parental depression and its potential effects on children if unaddressed,
407.8including how to:
407.9(1) screen mothers for depression;
407.10(2) identify children who are affected by their mother's depression; and
407.11(3) provide treatment or referral information on needed services.

407.12    Sec. 15. Minnesota Statutes 2012, section 214.40, subdivision 1, is amended to read:
407.13    Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this
407.14section.
407.15(b) "Administrative services unit" means the administrative services unit for the
407.16health-related licensing boards.
407.17(c) "Charitable organization" means a charitable organization within the meaning of
407.18section 501(c)(3) of the Internal Revenue Code that has as a purpose the sponsorship or
407.19support of programs designed to improve the quality, awareness, and availability of health
407.20care services and that serves as a funding mechanism for providing those services.
407.21(d) "Health care facility or organization" means a health care facility licensed under
407.22chapter 144 or 144A, or a charitable organization.
407.23(e) "Health care provider" means a physician licensed under chapter 147, physician
407.24assistant registered licensed and practicing under chapter 147A, nurse licensed and
407.25registered to practice under chapter 148, or dentist or, dental hygienist, or dental therapist
407.26 licensed under chapter 150A, or an advanced dental therapist licensed and certified under
407.27chapter 150A.
407.28(f) "Health care services" means health promotion, health monitoring, health
407.29education, diagnosis, treatment, minor surgical procedures, the administration of local
407.30anesthesia for the stitching of wounds, and primary dental services, including preventive,
407.31diagnostic, restorative, and emergency treatment. Health care services do not include the
407.32administration of general anesthesia or surgical procedures other than minor surgical
407.33procedures.
407.34(g) "Medical professional liability insurance" means medical malpractice insurance
407.35as defined in section 62F.03.
408.1EFFECTIVE DATE.This section is effective the day following final enactment.

408.2    Sec. 16. INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO
408.3CRIMINAL BACKGROUND CHECKS.
408.4(a) If the Department of Health is not reviewed by the Sunset Advisory Commission
408.5according to the schedule in Minnesota Statutes, section 3D.21, the commissioner
408.6of health, as the regulator for occupational therapy practitioners, speech-language
408.7pathologists, audiologists, and hearing instrument dispensers, shall require applicants
408.8for licensure or renewal to submit to a criminal history records check as required under
408.9Minnesota Statutes, section 214.075, for other health-related licensed occupations
408.10regulated by the health-related licensing boards.
408.11(b) Any statutory changes necessary to include the commissioner of health to
408.12Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota
408.13Statutes, section 214.075, subdivision 9.

408.14    Sec. 17. REPEALER.
408.15Minnesota Statutes 2012, sections 151.19, subdivision 2; 151.25; 151.45; 151.47,
408.16subdivision 2; and 151.48, are repealed.


408.19    Section 1. Minnesota Statutes 2012, section 13.381, subdivision 2, is amended to read:
408.20    Subd. 2. Health occupations data. (a) Health-related licensees and registrants.
408.21The collection, analysis, reporting, and use of data on individuals licensed or registered by
408.22the commissioner of health or health-related licensing boards are governed by sections
408.23144.051, subdivision 2 subdivisions 2 to 6 , and 144.052.
408.24(b) Health services personnel. Data collected by the commissioner of health for the
408.25database on health services personnel are classified under section 144.1485.

408.26    Sec. 2. Minnesota Statutes 2012, section 13.381, subdivision 10, is amended to read:
408.27    Subd. 10. Home care and hospice provider. Data regarding a home care provider
408.28under sections 144A.43 to 144A.47 are governed by section 144A.45. Data regarding
408.29home care provider background studies are governed by section 144A.476, subdivision 1.
408.30Data regarding a hospice provider under sections 144A.75 to 144A.755 are governed by
408.31sections 144A.752 and 144A.754.

409.1    Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
409.2to read:
409.3    Subd. 3. Data classification; private data. For providers regulated pursuant to
409.4sections 144A.43 to 144A.482, the following data collected, created, or maintained by
409.5the commissioner are classified as private data on individuals as defined in section 13.02,
409.6subdivision 12:
409.7(1) data submitted by or on behalf of applicants for licenses prior to issuance of
409.8the license;
409.9(2) the identity of complainants who have made reports concerning licensees or
409.10applicants unless the complainant consents to the disclosure;
409.11(3) the identity of individuals who provide information as part of surveys and
409.12investigations;
409.13(4) Social Security numbers; and
409.14(5) health record data.

409.15    Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
409.16to read:
409.17    Subd. 4. Data classification; public data. For providers regulated pursuant to
409.18sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
409.19commissioner are public:
409.20(1) all application data on licensees, license numbers, license status;
409.21(2) licensing information about licenses previously held under this chapter;
409.22(3) correction orders, including information about compliance with the order and
409.23whether the fine was paid;
409.24(4) final enforcement actions pursuant to chapter 14;
409.25(5) orders for hearing, findings of fact and conclusions of law; and
409.26(6) when the licensee and department agree to resolve the matter without a hearing,
409.27the agreement and specific reasons for the agreement are public data.

409.28    Sec. 5. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
409.29to read:
409.30    Subd. 5. Data classification; confidential data. For providers regulated pursuant to
409.31sections 144A.43 to 144A.482, the following data collected, created, or maintained by
409.32the Department of Health are classified as confidential data on individuals as defined in
409.33section 13.02, subdivision 3: active investigative data relating to the investigation of
410.1potential violations of law by a licensee including data from the survey process before the
410.2correction order is issued by the department.

410.3    Sec. 6. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
410.4to read:
410.5    Subd. 6. Release of private or confidential data. For providers regulated pursuant
410.6to sections 144A.43 to 144A.482, the department may release private or confidential data,
410.7except Social Security numbers, to the appropriate state, federal, or local agency and law
410.8enforcement office to facilitate investigative or enforcement efforts or further the public
410.9health protective process. Types of offices include Adult Protective Services, Office of the
410.10Ombudsmen for Long-Term Care and Office of the Ombudsmen for Mental Health and
410.11Developmental Disabilities, health licensing boards, the Department of Human Services,
410.12county or city attorney's offices, police, and local or county public health offices.

410.13    Sec. 7. Minnesota Statutes 2012, section 144A.43, is amended to read:
410.14144A.43 DEFINITIONS.
410.15    Subdivision 1. Applicability. The definitions in this section apply to sections
410.16144.699, subdivision 2 , and 144A.43 to 144A.47 144A.482.
410.17    Subd. 1a. Agent. "Agent" means the person upon whom all notices and orders shall
410.18be served and who is authorized to accept service of notices and orders on behalf of
410.19the home care provider.
410.20    Subd. 1b. Applicant. "Applicant" means an individual, organization, association,
410.21corporation, unit of government, or other entity that applies for a temporary license,
410.22license, or renewal of their home care provider license under section 144A.472.
410.23    Subd. 1c. Client. "Client" means a person to whom home care services are provided.
410.24    Subd. 1d. Client record. "Client record" means all records that document
410.25information about the home care services provided to the client by the home care provider.
410.26    Subd. 1e. Client representative. "Client representative" means a person who,
410.27because of the client's needs, makes decisions about the client's care on behalf of the
410.28client. A client representative may be a guardian, health care agent, family member, or
410.29other agent of the client. Nothing in this section expands or diminishes the rights of
410.30persons to act on behalf of clients under other law.
410.31    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
410.32    Subd. 2a. Controlled substance. "Controlled substance" has the meaning given
410.33in section 152.01, subdivision 4.
410.34    Subd. 2b. Department. "Department" means the Minnesota Department of Health.
411.1    Subd. 2c. Dietary supplement. "Dietary supplement" means a product taken by
411.2mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary
411.3ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and
411.4substances such as enzymes, organ tissue, glandulars, or metabolites.
411.5    Subd. 2d. Dietitian. "Dietitian" is a person licensed under sections 148.621 to
411.6148.633.
411.7    Subd. 2e. Dietetics or nutrition practice. "Dietetics or nutrition practice" is
411.8performed by a licensed dietitian or licensed nutritionist and includes the activities of
411.9assessment, setting priorities and objectives, providing nutrition counseling, developing
411.10and implementing nutrition care services, and evaluating and maintaining appropriate
411.11standards of quality of nutrition care under sections 148.621 to 148.633.
411.12    Subd. 3. Home care service. "Home care service" means any of the following
411.13services when delivered in a place of residence to the home of a person whose illness,
411.14disability, or physical condition creates a need for the service:
411.15(1) nursing services, including the services of a home health aide;
411.16(2) personal care services not included under sections 148.171 to 148.285;
411.17(3) physical therapy;
411.18(4) speech therapy;
411.19(5) respiratory therapy;
411.20(6) occupational therapy;
411.21(7) nutritional services;
411.22(8) home management services when provided to a person who is unable to perform
411.23these activities due to illness, disability, or physical condition. Home management
411.24services include at least two of the following services: housekeeping, meal preparation,
411.25and shopping;
411.26(9) medical social services;
411.27(10) the provision of medical supplies and equipment when accompanied by the
411.28provision of a home care service; and
411.29(11) other similar medical services and health-related support services identified by
411.30the commissioner in rule.
411.31"Home care service" does not include the following activities conducted by the
411.32commissioner of health or a board of health as defined in section 145A.02, subdivision 2:
411.33communicable disease investigations or testing; administering or monitoring a prescribed
411.34therapy necessary to control or prevent a communicable disease; or the monitoring
411.35of an individual's compliance with a health directive as defined in section 144.4172,
411.36subdivision 6 .
412.1(1) assistive tasks as defined in section 144A.471, subdivision 6, provided by
412.2unlicensed personnel;
412.3(2) services provided by a registered nurse or licensed practical nurse, physical
412.4therapist, respiratory therapist, occupational therapist, speech-language pathologist,
412.5dietitian or nutritionist, or social worker;
412.6(3) medication and treatment management services; or
412.7(4) the provision of durable medical equipment services when provided with any of
412.8the home care services listed in clauses (1) to (3).
412.9    Subd. 3a. Hands-on-assistance. "Hands-on-assistance" means physical help by
412.10another person without which the client is not able to perform the activity.
412.11    Subd. 3b. Home. "Home" means the client's temporary or permanent place of
412.12residence.
412.13    Subd. 4. Home care provider. "Home care provider" means an individual,
412.14organization, association, corporation, unit of government, or other entity that is regularly
412.15engaged in the delivery of at least one home care service, directly or by contractual
412.16arrangement, of home care services in a client's home for a fee and who has a valid current
412.17temporary license or license issued under sections 144A.43 to 144A.482. At least one
412.18home care service must be provided directly, although additional home care services may
412.19be provided by contractual arrangements. "Home care provider" does not include:
412.20(1) any home care or nursing services conducted by and for the adherents of any
412.21recognized church or religious denomination for the purpose of providing care and
412.22services for those who depend upon spiritual means, through prayer alone, for healing;
412.23(2) an individual who only provides services to a relative;
412.24(3) an individual not connected with a home care provider who provides assistance
412.25with home management services or personal care needs if the assistance is provided
412.26primarily as a contribution and not as a business;
412.27(4) an individual not connected with a home care provider who shares housing with
412.28and provides primarily housekeeping or homemaking services to an elderly or disabled
412.29person in return for free or reduced-cost housing;
412.30(5) an individual or agency providing home-delivered meal services;
412.31(6) an agency providing senior companion services and other older American
412.32volunteer programs established under the Domestic Volunteer Service Act of 1973,
412.33Public Law 98-288;
412.34(7) an employee of a nursing home licensed under this chapter or an employee of a
412.35boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
413.1emergency calls from individuals residing in a residential setting that is attached to or
413.2located on property contiguous to the nursing home or boarding care home;
413.3(8) a member of a professional corporation organized under chapter 319B that does
413.4not regularly offer or provide home care services as defined in subdivision 3;
413.5(9) the following organizations established to provide medical or surgical services
413.6that do not regularly offer or provide home care services as defined in subdivision 3:
413.7a business trust organized under sections 318.01 to 318.04, a nonprofit corporation
413.8organized under chapter 317A, a partnership organized under chapter 323, or any other
413.9entity determined by the commissioner;
413.10(10) an individual or agency that provides medical supplies or durable medical
413.11equipment, except when the provision of supplies or equipment is accompanied by a
413.12home care service;
413.13(11) an individual licensed under chapter 147; or
413.14(12) an individual who provides home care services to a person with a developmental
413.15disability who lives in a place of residence with a family, foster family, or primary caregiver.
413.16    Subd. 5. Medication reminder. "Medication reminder" means providing a verbal
413.17or visual reminder to a client to take medication. This includes bringing the medication
413.18to the client and providing liquids or nutrition to accompany medication that a client is
413.19self-administering.
413.20    Subd. 6. License. "License" means a basic or comprehensive home care license
413.21issued by the commissioner to a home care provider.
413.22    Subd. 7. Licensed health professional. "Licensed health professional" means a
413.23person, other than a registered nurse or licensed practical nurse, who provides home care
413.24services within the scope of practice of the person's health occupation license, registration,
413.25or certification as regulated and who is licensed by the appropriate Minnesota state board
413.26or agency.
413.27    Subd. 8. Licensee. "Licensee" means a home care provider that is licensed under
413.28this chapter.
413.29    Subd. 9. Managerial official. "Managerial official" means an administrator,
413.30director, officer, trustee, or employee of a home care provider, however designated, who
413.31has the authority to establish or control business policy.
413.32    Subd. 10. Medication. "Medication" means a prescription or over-the-counter drug.
413.33For purposes of this chapter only, medication includes dietary supplements.
413.34    Subd. 11. Medication administration. "Medication administration" means
413.35performing a set of tasks to ensure a client takes medications, and includes the following:
413.36(1) checking the client's medication record;
414.1(2) preparing the medication as necessary;
414.2(3) administering the medication to the client;
414.3(4) documenting the administration or reason for not administering the medication;
414.4and
414.5(5) reporting to a nurse any concerns about the medication, the client, or the client's
414.6refusal to take the medication.
414.7    Subd. 12. Medication management. "Medication management" means the
414.8provision of any of the following medication-related services to a client:
414.9(1) performing medication setup;
414.10(2) administering medication;
414.11(3) storing and securing medications;
414.12(4) documenting medication activities;
414.13(5) verifying and monitoring effectiveness of systems to ensure safe handling and
414.14administration;
414.15(6) coordinating refills;
414.16(7) handling and implementing changes to prescriptions;
414.17(8) communicating with the pharmacy about the client's medications; and
414.18(9) coordinating and communicating with the prescriber.
414.19    Subd. 13. Medication setup. "Medication setup" means arranging medications by a
414.20nurse, pharmacy, or authorized prescriber for later administration by the client or by
414.21comprehensive home care staff.
414.22    Subd. 14. Nurse. "Nurse" means a person who is licensed under sections 148.171 to
414.23148.285.
414.24    Subd. 15. Occupational therapist. "Occupational therapist" means a person who is
414.25licensed under sections 148.6401 to 148.6450.
414.26    Subd. 16. Over-the-counter drug. "Over-the-counter drug" means a drug that is
414.27not required by federal law to bear the symbol "Rx only."
414.28    Subd. 17. Owner. "Owner" means a proprietor, general partner, limited partner who
414.29has five percent or more of equity interest in a limited partnership, a person who owns or
414.30controls voting stock in a corporation in an amount equal to or greater than five percent of
414.31the shares issued and outstanding, or a corporation that owns equity interest in a licensee
414.32or applicant for a license.
414.33    Subd. 18. Pharmacist. "Pharmacist" has the meaning given in section 151.01,
414.34subdivision 3.
414.35    Subd. 19. Physical therapist. "Physical therapist" means a person who is licensed
414.36under sections 148.65 to 148.78.
415.1    Subd. 20. Physician. "Physician" means a person who is licensed under chapter 147.
415.2    Subd. 21. Prescriber. "Prescriber" means a person who is authorized by sections
415.3148.235; 151.01, subdivision 23; and 151.37, to prescribe prescription drugs.
415.4    Subd. 22. Prescription. "Prescription" has the meaning given in section 151.01,
415.5subdivision 16.
415.6    Subd. 23. Regularly scheduled. "Regularly scheduled" means ordered or planned
415.7to be completed at predetermined times or according to a predetermined routine.
415.8    Subd. 24. Reminder. "Reminder" means providing a verbal or visual reminder
415.9to a client.
415.10    Subd. 25. Respiratory therapist. "Respiratory therapist" means a person who
415.11is licensed under chapter 147C.
415.12    Subd. 26. Revenues. "Revenues" means all money received by a licensee derived
415.13from the provisions of home care services, including fees for services and appropriations
415.14of public money for home care services.
415.15    Subd. 27. Service plan. "Service plan" means the written plan between the client or
415.16client's representative and the temporary licensee or licensee about the services that will
415.17be provided to the client.
415.18    Subd. 28. Social worker. "Social worker" means a person who is licensed under
415.19chapter 148D or 148E.
415.20    Subd. 29. Speech language pathologist. "Speech language pathologist" has the
415.21meaning given in section 148.512.
415.22    Subd. 30. Standby assistance. "Standby assistance" means the presence of another
415.23person within arm's reach to minimize the risk of injury while performing daily activities
415.24through physical intervention or cuing.
415.25    Subd. 31. Substantial compliance. "Substantial compliance" means complying
415.26with the requirements in this chapter sufficiently to prevent unacceptable health or safety
415.27risks to the home care client.
415.28    Subd. 32. Survey. "Survey" means an inspection of a licensee or applicant for
415.29licensure for compliance with this chapter.
415.30    Subd. 33. Surveyor. "Surveyor" means a staff person of the department authorized
415.31to conduct surveys of home care providers and applicants.
415.32    Subd. 34. Temporary license. "Temporary license" means the initial basic or
415.33comprehensive home care license the department issues after approval of a complete
415.34written application and before the department completes the temporary license survey and
415.35determines that the temporary licensee is in substantial compliance.
416.1    Subd. 35. Treatment or therapy. "Treatment" or "therapy" means the provision
416.2of care, other than medications, ordered or prescribed by a licensed health professional
416.3provided to a client to cure, rehabilitate, or ease symptoms.
416.4    Subd. 36. Unit of government. "Unit of government" means every city, county,
416.5town, school district, other political subdivisions of the state, and any agency of the state
416.6or federal government, which includes any instrumentality of a unit of government.
416.7    Subd. 37. Unlicensed personnel. "Unlicensed personnel" are individuals not
416.8otherwise licensed or certified by a governmental health board or agency who provide
416.9home care services in the client's home.
416.10    Subd. 38. Verbal. "Verbal" means oral and not in writing.

416.11    Sec. 8. Minnesota Statutes 2012, section 144A.44, is amended to read:
416.12144A.44 HOME CARE BILL OF RIGHTS.
416.13    Subdivision 1. Statement of rights. A person who receives home care services
416.14has these rights:
416.15(1) the right to receive written information about rights in advance of before
416.16receiving care or during the initial evaluation visit before the initiation of treatment
416.17 services, including what to do if rights are violated;
416.18(2) the right to receive care and services according to a suitable and up-to-date plan,
416.19and subject to accepted health care, medical or nursing standards, to take an active part
416.20in creating and changing the plan developing, modifying, and evaluating care the plan
416.21 and services;
416.22(3) the right to be told in advance of before receiving care about the services that will
416.23be provided, the disciplines that will furnish care the type and disciplines of staff who will
416.24be providing the services, the frequency of visits proposed to be furnished, other choices
416.25that are available for addressing home care needs, and the consequences of these choices
416.26including the potential consequences of refusing these services;
416.27(4) the right to be told in advance of any change recommended changes by the
416.28provider in the service plan of care and to take an active part in any change decisions
416.29about changes to the service plan;
416.30(5) the right to refuse services or treatment;
416.31(6) the right to know, in advance before receiving services or during the initial
416.32visit, any limits to the services available from a home care provider, and the provider's
416.33grounds for a termination of services;
417.1(7) the right to know in advance of receiving care whether the services are covered
417.2by health insurance, medical assistance, or other health programs, the charges for services
417.3that will not be covered by Medicare, and the charges that the individual may have to pay;
417.4(8) (7) the right to know be told before services are initiated what the provider
417.5charges are for the services, no matter who will be paying the bill and if known, to what
417.6extent payment may be expected from health insurance, public programs or other sources,
417.7and what charges the client may be responsible for paying;
417.8(9) (8) the right to know that there may be other services available in the community,
417.9including other home care services and providers, and to know where to go for find
417.10 information about these services;
417.11(10) (9) the right to choose freely among available providers and to change providers
417.12after services have begun, within the limits of health insurance, long-term care insurance,
417.13medical assistance, or other health programs;
417.14(11) (10) the right to have personal, financial, and medical information kept private,
417.15and to be advised of the provider's policies and procedures regarding disclosure of such
417.16information;
417.17(12) (11) the right to be allowed access to the client's own records and written
417.18information from those records in accordance with sections 144.291 to 144.298;
417.19(13) (12) the right to be served by people who are properly trained and competent
417.20to perform their duties;
417.21(14) (13) the right to be treated with courtesy and respect, and to have the patient's
417.22 client's property treated with respect;
417.23(15) (14) the right to be free from physical and verbal abuse, neglect, financial
417.24exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and
417.25the Maltreatment of Minors Act;
417.26(16) (15) the right to reasonable, advance notice of changes in services or charges,
417.27including;
417.28(16) the right to know the provider's reason for termination of services;
417.29(17) the right to at least ten days' advance notice of the termination of a service by a
417.30provider, except in cases where:
417.31(i) the recipient of services client engages in conduct that significantly alters the
417.32conditions of employment as specified in the employment contract between terms of
417.33the service plan with the home care provider and the individual providing home care
417.34services, or creates;
417.35(ii) the client, person who lives with the client, or others create an abusive or unsafe
417.36work environment for the individual person providing home care services; or
418.1(ii) (iii) an emergency for the informal caregiver or a significant change in the
418.2recipient's client's condition has resulted in service needs that exceed the current service
418.3provider agreement plan and that cannot be safely met by the home care provider;
418.4(17) (18) the right to a coordinated transfer when there will be a change in the
418.5provider of services;
418.6(18) (19) the right to voice grievances regarding treatment or care that is complain
418.7about services that are provided, or fails to be, furnished, or regarding fail to be provided,
418.8and the lack of courtesy or respect to the patient client or the patient's client's property;
418.9(19) (20) the right to know how to contact an individual associated with the home
418.10care provider who is responsible for handling problems and to have the home care provider
418.11investigate and attempt to resolve the grievance or complaint;
418.12(20) (21) the right to know the name and address of the state or county agency to
418.13contact for additional information or assistance; and
418.14(21) (22) the right to assert these rights personally, or have them asserted by
418.15the patient's family or guardian when the patient has been judged incompetent, client's
418.16representative or by anyone on behalf of the client, without retaliation.
418.17    Subd. 2. Interpretation and enforcement of rights. These rights are established
418.18for the benefit of persons clients who receive home care services. "Home care services"
418.19means home care services as defined in section 144A.43, subdivision 3, and unlicensed
418.20personal care assistance services, including services covered by medical assistance under
418.21section 256B.0625, subdivision 19a. All home care providers, including those exempted
418.22under section 144A.471, must comply with this section. The commissioner shall enforce
418.23this section and the home care bill of rights requirement against home care providers
418.24exempt from licensure in the same manner as for licensees. A home care provider may
418.25not request or require a person client to surrender any of these rights as a condition of
418.26receiving services. A guardian or conservator or, when there is no guardian or conservator,
418.27a designated person, may seek to enforce these rights. This statement of rights does not
418.28replace or diminish other rights and liberties that may exist relative to persons clients
418.29 receiving home care services, persons providing home care services, or providers licensed
418.30under Laws 1987, chapter 378. A copy of these rights must be provided to an individual
418.31at the time home care services, including personal care assistance services, are initiated.
418.32The copy shall also contain the address and phone number of the Office of Health Facility
418.33Complaints and the Office of Ombudsman for Long-Term Care and a brief statement
418.34describing how to file a complaint with these offices. Information about how to contact
418.35the Office of Ombudsman for Long-Term Care shall be included in notices of change in
419.1client fees and in notices where home care providers initiate transfer or discontinuation of
419.2services sections 144A.43 to 144A.482.

419.3    Sec. 9. Minnesota Statutes 2012, section 144A.45, is amended to read:
419.4144A.45 REGULATION OF HOME CARE SERVICES.
419.5    Subdivision 1. Rules Regulations. The commissioner shall adopt rules for the
419.6regulation of regulate home care providers pursuant to sections 144A.43 to 144A.47
419.7 144A.482. The rules regulations shall include the following:
419.8    (1) provisions to assure, to the extent possible, the health, safety and well-being,
419.9and appropriate treatment of persons who receive home care services while respecting
419.10clients' autonomy and choice;
419.11    (2) requirements that home care providers furnish the commissioner with specified
419.12information necessary to implement sections 144A.43 to 144A.47 144A.482;
419.13    (3) standards of training of home care provider personnel, which may vary according
419.14to the nature of the services provided or the health status of the consumer;
419.15(4) standards for provision of home care services;
419.16    (4) (5) standards for medication management which may vary according to the
419.17nature of the services provided, the setting in which the services are provided, or the
419.18status of the consumer. Medication management includes the central storage, handling,
419.19distribution, and administration of medications;
419.20    (5) (6) standards for supervision of home care services requiring supervision by a
419.21registered nurse or other appropriate health care professional which must occur on site
419.22at least every 62 days, or more frequently if indicated by a clinical assessment, and in
419.23accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a
419.24person performing home care aide tasks for a class B licensee providing paraprofessional
419.25services does not require nursing supervision;
419.26    (6) (7) standards for client evaluation or assessment which may vary according to
419.27the nature of the services provided or the status of the consumer;
419.28    (7) (8) requirements for the involvement of a consumer's physician client's health
419.29care provider, the documentation of physicians' health care providers' orders, if required,
419.30and the consumer's treatment client's service plan, and;
419.31(9) the maintenance of accurate, current clinical client records;
419.32    (8) (10) the establishment of different classes basic and comprehensive levels of
419.33licenses for different types of providers and different standards and requirements for
419.34different kinds of home care based on services provided; and
420.1    (9) operating procedures required to implement (11) provisions to enforce these
420.2regulations and the home care bill of rights.
420.3    Subd. 1a. Home care aide tasks. Notwithstanding the provisions of Minnesota
420.4Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
420.5toileting, transfers, and ambulation if the client is ambulatory and if the client has no
420.6serious acute illness or infectious disease.
420.7    Subd. 1b. Home health aide qualifications. Notwithstanding the provisions of
420.8Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks
420.9if the person maintains current registration as a nursing assistant on the Minnesota nursing
420.10assistant registry. Maintaining current registration on the Minnesota nursing assistant
420.11registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110,
420.12subpart 3.
420.13    Subd. 2. Regulatory functions. (a) The commissioner shall:
420.14(1) evaluate, monitor, and license, survey, and monitor without advance notice, home
420.15care providers in accordance with sections 144A.45 to 144A.47 144A.43 to 144A.482;
420.16(2) inspect the office and records of a provider during regular business hours without
420.17advance notice to the home care provider;
420.18(2) survey every temporary licensee within one year of the temporary license issuance
420.19date subject to the temporary licensee providing home care services to a client or clients;
420.20(3) survey all licensed home care providers on an interval that will promote the
420.21health and safety of clients;
420.22(3) (4) with the consent of the consumer client, visit the home where services are
420.23being provided;
420.24(4) (5) issue correction orders and assess civil penalties in accordance with section
420.25144.653, subdivisions 5 to 8 , for violations of sections 144A.43 to 144A.47 or the rules
420.26adopted under those sections 144A.482;
420.27(5) (6) take action as authorized in section 144A.46, subdivision 3 144A.475; and
420.28(6) (7) take other action reasonably required to accomplish the purposes of sections
420.29144A.43 to 144A.47 144A.482.
420.30(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the
420.31commissioner shall comply with the applicable requirements of section 144.122, the
420.32Government Data Practices Act, and the Administrative Procedure Act.
420.33    Subd. 4. Medicaid reimbursement. Notwithstanding the provisions of section
420.34256B.37 or state plan requirements to the contrary, certification by the federal Medicare
420.35program must not be a requirement of Medicaid payment for services delivered under
420.36section 144A.4605.
421.1    Subd. 5. Home care providers; services for Alzheimer's disease or related
421.2disorder. (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets
421.3or otherwise promotes services for persons with Alzheimer's disease or related disorders,
421.4the facility's direct care staff and their supervisors must be trained in dementia care.
421.5(b) Areas of required training include:
421.6(1) an explanation of Alzheimer's disease and related disorders;
421.7(2) assistance with activities of daily living;
421.8(3) problem solving with challenging behaviors; and
421.9(4) communication skills.
421.10(c) The licensee shall provide to consumers in written or electronic form a
421.11description of the training program, the categories of employees trained, the frequency
421.12of training, and the basic topics covered.

421.13    Sec. 10. [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.
421.14    Subdivision 1. License required. A home care provider may not open, operate,
421.15manage, conduct, maintain, or advertise itself as a home care provider or provide home
421.16care services in Minnesota without a temporary or current home care provider license
421.17issued by the commissioner of health.
421.18    Subd. 2. Determination of direct home care service. "Direct home care service"
421.19means a home care service provided to a client by the home care provider or its employees,
421.20and not by contract. Factors that must be considered in determining whether an individual
421.21or a business entity provides at least one home care service directly include, but are not
421.22limited to, whether the individual or business entity:
421.23    (1) has the right to control, and does control, the types of services provided;
421.24(2) has the right to control, and does control, when and how the services are provided;
421.25    (3) establishes the charges;
421.26(4) collects fees from the clients or receives payment from third-party payers on
421.27the clients' behalf;
421.28(5) pays individuals providing services compensation on an hourly, weekly, or
421.29similar basis;
421.30(6) treats the individuals providing services as employees for the purposes of payroll
421.31taxes and workers' compensation insurance; and
421.32(7) holds itself out as a provider of home care services or acts in a manner that
421.33leads clients or potential clients to believe that it is a home care provider providing home
421.34care services.
421.35    None of the factors listed in this subdivision is solely determinative.
422.1    Subd. 3. Determination of regularly engaged. "Regularly engaged" means
422.2providing, or offering to provide, home care services as a regular part of a business. The
422.3following factors must be considered by the commissioner in determining whether an
422.4individual or a business entity is regularly engaged in providing home care services:
422.5    (1) whether the individual or business entity states or otherwise promotes that the
422.6individual or business entity provides home care services;
422.7    (2) whether persons receiving home care services constitute a substantial part of the
422.8individual's or the business entity's clientele; and
422.9(3) whether the home care services provided are other than occasional or incidental
422.10to the provision of services other than home care services.
422.11    None of the factors listed in this subdivision is solely determinative.
422.12    Subd. 4. Penalties for operating without license. A person involved in the
422.13management, operation, or control of a home care provider that operates without an
422.14appropriate license is guilty of a misdemeanor. This section does not apply to a person
422.15who has no legal authority to affect or change decisions related to the management,
422.16operation, or control of a home care provider.
422.17    Subd. 5. Basic and comprehensive levels of licensure. An applicant seeking
422.18to become a home care provider must apply for either a basic or comprehensive home
422.19care license.
422.20    Subd. 6. Basic home care license provider. Home care services that can be
422.21provided with a basic home care license are assistive tasks provided by licensed or
422.22unlicensed personnel that include:
422.23(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting,
422.24and bathing;
422.25(2) providing standby assistance;
422.26(3) providing verbal or visual reminders to the client to take regularly scheduled
422.27medication which includes bringing the client previously set-up medication, medication in
422.28original containers, or liquid or food to accompany the medication;
422.29(4) providing verbal or visual reminders to the client to perform regularly scheduled
422.30treatments and exercises;
422.31(5) preparing modified diets ordered by a licensed health professional; and
422.32(6) assisting with laundry, housekeeping, meal preparation, shopping, or other
422.33household chores and services if the provider is also providing at least one of the activities
422.34in clauses (1) to (5)
423.1    Subd. 7. Comprehensive home care license provider. Home care services that
423.2may be provided with a comprehensive home care license include any of the basic home
423.3care services listed in subdivision 6, and one or more of the following:
423.4(1) services of an advanced practice nurse, registered nurse, licensed practical
423.5nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
423.6pathologist, dietitian or nutritionist, or social worker;
423.7(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a
423.8licensed health professional within the person's scope of practice;
423.9(3) medication management services;
423.10(4) hands-on assistance with transfers and mobility;
423.11(5) assisting clients with eating when the clients have complicating eating problems
423.12as identified in the client record or through an assessment such as difficulty swallowing,
423.13recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
423.14instruments to be fed; or
423.15(6) providing other complex or specialty health care services.
423.16    Subd. 8. Exemptions from home care services licensure. (a) Except as otherwise
423.17provided in this chapter, home care services that are provided by the state, counties, or
423.18other units of government must be licensed under this chapter.
423.19(b) An exemption under this subdivision does not excuse the exempted individual or
423.20organization from complying with applicable provisions of the home care bill of rights
423.21in section 144A.44. The following individuals or organizations are exempt from the
423.22requirement to obtain a home care provider license:
423.23(1) an individual or organization that offers, provides, or arranges for personal care
423.24assistance services under the medical assistance program as authorized under sections
423.25256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;
423.26(2) a provider that is licensed by the commissioner of human services to provide
423.27semi-independent living services for persons with developmental disabilities under section
423.28252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
423.29(3) a provider that is licensed by the commissioner of human services to provide
423.30home and community-based services for persons with developmental disabilities under
423.31section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
423.32(4) an individual or organization that provides only home management services, if
423.33the individual or organization is registered under section 144A.482; or
423.34(5) an individual who is licensed in this state as a nurse, dietitian, social worker,
423.35occupational therapist, physical therapist, or speech-language pathologist who provides
424.1health care services in the home independently and not through any contractual or
424.2employment relationship with a home care provider or other organization.
424.3    Subd. 9. Exclusions from home care licensure. The following are excluded from
424.4home care licensure and are not required to provide the home care bill of rights:
424.5(1) an individual or business entity providing only coordination of home care that
424.6includes one or more of the following:
424.7(i) determination of whether a client needs home care services, or assisting a client
424.8in determining what services are needed;
424.9(ii) referral of clients to a home care provider;
424.10(iii) administration of payments for home care services; or
424.11(iv) administration of a health care home established under section 256B.0751;
424.12(2) an individual who is not an employee of a licensed home care provider if the
424.13individual:
424.14(i) only provides services as an independent contractor to one or more licensed
424.15home care providers;
424.16(ii) provides no services under direct agreements or contracts with clients; and
424.17(iii) is contractually bound to perform services in compliance with the contracting
424.18home care provider's policies and service plans;
424.19(3) a business that provides staff to home care providers, such as a temporary
424.20employment agency, if the business:
424.21(i) only provides staff under contract to licensed or exempt providers;
424.22(ii) provides no services under direct agreements with clients; and
424.23(iii) is contractually bound to perform services under the contracting home care
424.24provider's direction and supervision;
424.25(4) any home care services conducted by and for the adherents of any recognized
424.26church or religious denomination for its members through spiritual means, or by prayer
424.27for healing;
424.28(5) an individual who only provides home care services to a relative;
424.29(6) an individual not connected with a home care provider that provides assistance
424.30with basic home care needs if the assistance is provided primarily as a contribution and
424.31not as a business;
424.32(7) an individual not connected with a home care provider that shares housing with
424.33and provides primarily housekeeping or homemaking services to an elderly or disabled
424.34person in return for free or reduced-cost housing;
424.35(8) an individual or provider providing home-delivered meal services;
425.1(9) an individual providing senior companion services and other Older American
425.2Volunteer Programs (OAVP) established under the Domestic Volunteer Service Act of
425.31973, United States Code, title 42, chapter 66;
425.4(10) an employee of a nursing home licensed under this chapter or an employee of a
425.5boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
425.6emergency calls from individuals residing in a residential setting that is attached to or
425.7located on property contiguous to the nursing home or boarding care home;
425.8(11) a member of a professional corporation organized under chapter 319B that
425.9does not regularly offer or provide home care services as defined in section 144A.43,
425.10subdivision 3;
425.11(12) the following organizations established to provide medical or surgical services
425.12that do not regularly offer or provide home care services as defined in section 144A.43,
425.13subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
425.14corporation organized under chapter 317A, a partnership organized under chapter 323, or
425.15any other entity determined by the commissioner;
425.16(13) an individual or agency that provides medical supplies or durable medical
425.17equipment, except when the provision of supplies or equipment is accompanied by a
425.18home care service;
425.19(14) a physician licensed under chapter 147;
425.20(15) an individual who provides home care services to a person with a developmental
425.21disability who lives in a place of residence with a family, foster family, or primary caregiver;
425.22(16) a business that only provides services that are primarily instructional and not
425.23medical services or health-related support services;
425.24(17) an individual who performs basic home care services for no more than 14 hours
425.25each calendar week to no more than one client;
425.26(18) an individual or business licensed as hospice as defined in sections 144A.75 to
425.27144A.755 who is not providing home care services independent of hospice service;
425.28(19) activities conducted by the commissioner of health or a board of health as
425.29defined in section 145A.02, subdivision 2, including communicable disease investigations
425.30or testing; or
425.31(20) administering or monitoring a prescribed therapy necessary to control or
425.32prevent a communicable disease, or the monitoring of an individual's compliance with a
425.33health directive as defined in section 144.4172, subdivision 6.

425.34    Sec. 11. [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION
425.35AND RENEWAL.
426.1    Subdivision 1. License applications. Each application for a home care provider
426.2license must include information sufficient to show that the applicant meets the
426.3requirements of licensure, including:
426.4    (1) the applicant's name, e-mail address, physical address, and mailing address,
426.5including the name of the county in which the applicant resides and has a principal
426.6place of business;
426.7(2) the initial license fee in the amount specified in subdivision 7;
426.8(3) e-mail address, physical address, mailing address, and telephone number of the
426.9principal administrative office;
426.10(4) e-mail address, physical address, mailing address, and telephone number of
426.11each branch office, if any;
426.12(5) names, e-mail and mailing addresses, and telephone numbers of all owners
426.13and managerial officials;
426.14(6) documentation of compliance with the background study requirements of section
426.15144A.476 for all persons involved in the management, operation, or control of the home
426.16care provider;
426.17(7) documentation of a background study as required by section 144.057 for any
426.18individual seeking employment, paid or volunteer, with the home care provider;
426.19(8) evidence of workers' compensation coverage as required by sections 176.181
426.20and 176.182;
426.21(9) documentation of liability coverage, if the provider has it;
426.22(10) identification of the license level the provider is seeking;
426.23(11) documentation that identifies the managerial official who is in charge of
426.24day-to-day operations and attestation that the person has reviewed and understands the
426.25home care provider regulations;
426.26(12) documentation that the applicant has designated one or more owners,
426.27managerial officials, or employees as an agent or agents, which shall not affect the legal
426.28responsibility of any other owner or managerial official under this chapter;
426.29(13) the signature of the officer or managing agent on behalf of an entity, corporation,
426.30association, or unit of government;
426.31(14) verification that the applicant has the following policies and procedures in place
426.32so that if a license is issued, the applicant will implement the policies and procedures
426.33and keep them current:
426.34    (i) requirements in sections 626.556, reporting of maltreatment of minors, and
426.35626.557, reporting of maltreatment of vulnerable adults;
426.36(ii) conducting and handling background studies on employees;
427.1(iii) orientation, training, and competency evaluations of home care staff, and a
427.2process for evaluating staff performance;
427.3(iv) handling complaints from clients, family members, or client representatives
427.4regarding staff or services provided by staff;
427.5(v) conducting initial evaluation of clients' needs and the providers' ability to provide
427.6those services;
427.7(vi) conducting initial and ongoing client evaluations and assessments and how
427.8changes in a client's condition are identified, managed, and communicated to staff and
427.9other health care providers as appropriate;
427.10(vii) orientation to and implementation of the home care client bill of rights;
427.11(viii) infection control practices;
427.12(ix) reminders for medications, treatments, or exercises, if provided; and
427.13(x) conducting appropriate screenings, or documentation of prior screenings, to
427.14show that staff are free of tuberculosis, consistent with current United States Centers for
427.15Disease Control standards; and
427.16(15) other information required by the department.
427.17    Subd. 2. Comprehensive home care license applications. In addition to the
427.18information and fee required in subdivision 1, applicants applying for a comprehensive
427.19home care license must also provide verification that the applicant has the following
427.20policies and procedures in place so that if a license is issued, the applicant will implement
427.21the policies and procedures in this subdivision and keep them current:
427.22(1) conducting initial and ongoing assessments of the client's needs by a registered
427.23nurse or appropriate licensed health professional, including how changes in the client's
427.24conditions are identified, managed, and communicated to staff and other health care
427.25providers, as appropriate;
427.26(2) ensuring that nurses and licensed health professionals have current and valid
427.27licenses to practice;
427.28(3) medication and treatment management;
427.29(4) delegation of home care tasks by registered nurses or licensed health professionals;
427.30(5) supervision of registered nurses and licensed health professionals; and
427.31(6) supervision of unlicensed personnel performing delegated home care tasks.
427.32    Subd. 3. License renewal. (a) Except as provided in section 144A.475, a license
427.33may be renewed for a period of one year if the licensee satisfies the following:
427.34(1) submits an application for renewal in the format provided by the commissioner
427.35at least 30 days before expiration of the license;
427.36(2) submits the renewal fee in the amount specified in subdivision 7;
428.1(3) has provided home care services within the past 12 months;
428.2(4) complies with sections 144A.43 to 144A.4799;
428.3(5) provides information sufficient to show that the applicant meets the requirements
428.4of licensure, including items required under subdivision 1;
428.5(6) provides verification that all policies under subdivision 1 are current; and
428.6(7) provides any other information deemed necessary by the commissioner.
428.7(b) A renewal applicant who holds a comprehensive home care license must also
428.8provide verification that policies listed under subdivision 2 are current.
428.9    Subd. 4. Multiple units. Multiple units or branches of a licensee must be separately
428.10licensed if the commissioner determines that the units cannot adequately share supervision
428.11and administration of services from the main office.
428.12    Subd. 5. Transfers prohibited; changes in ownership. Any home care license
428.13issued by the commissioner may not be transferred to another party. Before acquiring
428.14ownership of a home care provider business, a prospective applicant must apply for a
428.15new temporary license. A change of ownership is a transfer of operational control to
428.16a different business entity, and includes:
428.17(1) transfer of the business to a different or new corporation;
428.18(2) in the case of a partnership, the dissolution or termination of the partnership under
428.19chapter 323A, with the business continuing by a successor partnership or other entity;
428.20(3) relinquishment of control of the provider to another party, including to a contract
428.21management firm that is not under the control of the owner of the business' assets;
428.22(4) transfer of the business by a sole proprietor to another party or entity; or
428.23(5) in the case of a privately held corporation, the change in ownership or control of
428.2450 percent or more of the outstanding voting stock.
428.25    Subd. 6. Notification of changes of information. The temporary licensee or
428.26licensee shall notify the commissioner in writing within ten working days after any
428.27change in the information required in subdivision 1, except the information required in
428.28subdivision 1, clause (5), is required at the time of license renewal.
428.29    Subd. 7. Fees; application, change of ownership, and renewal. (a) An applicant
428.30seeking a temporary home care licensure must submit the following application fee to the
428.31commissioner along with a completed application:
428.32(1) basic home care provider, $2,100; or
428.33(2) comprehensive home care provider, $4,200.
428.34(b) A home care provider who is filing a change of ownership as required under
428.35subdivision 5 must submit the following application fee to the commissioner, along with
428.36the documentation required for the change of ownership:
429.1(1) basic home care provider, $2,100; or
429.2(2) comprehensive home care provider, $4,200.
429.3(c) A home care provider who is seeking to renew the provider's license shall pay a
429.4fee to the commissioner based on revenues derived from the provision of home care
429.5services during the calendar year prior to the year in which the application is submitted,
429.6according to the following schedule:
429.7License Renewal Fee

429.8	Provider Annual Revenue		Fee
429.9	greater than $1,500,000		$6,625
429.10 429.11	greater than $1,275,000 and no more than $1,500,000		$5,797
429.12 429.13	greater than $1,100,000 and no more than $1,275,000		$4,969
429.14 429.15	greater than $950,000 and no more than $1,100,000		$4,141
429.16 429.17	greater than $850,000 and no more than $950,000		$3,727
429.18 429.19	greater than $750,000 and no more than $850,000		$3,313
429.20 429.21	greater than $650,000 and no more than $750,000		$2,898
429.22 429.23	greater than $550,000 and no more than $650,000		$2,485
429.24 429.25	greater than $450,000 and no more than $550,000		$2,070
429.26 429.27	greater than $350,000 and no more than $450,000		$1,656
429.28 429.29	greater than $250,000 and no more than $350,000		$1,242
429.30 429.31	greater than $100,000 and no more than $250,000		$828
429.32 429.33	greater than $50,000 and no more than $100,000		$500
429.34 429.35	greater than $25,000 and no more than $50,000		$400
429.36	no more than $25,000		$200

429.37(d) If requested, the home care provider shall provide the commissioner information
429.38to verify the provider's annual revenues or other information as needed, including copies
429.39of documents submitted to the Department of Revenue.
429.40(e) At each annual renewal, a home care provider may elect to pay the highest
429.41renewal fee for its license category, and not provide annual revenue information to the
429.42commissioner.
430.1(f) A temporary license or license applicant, or temporary licensee or licensee that
430.2knowingly provides the commissioner incorrect revenue amounts for the purpose of
430.3paying a lower license fee, shall be subject to a civil penalty in the amount of double the
430.4fee the provider should have paid.
430.5(g) Fees and penalties collected under this section shall be deposited in the state
430.6treasury and credited to the special state government revenue fund.

430.7    Sec. 12. [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE
430.8RENEWAL.
430.9    Subdivision 1. Temporary license and renewal of license. (a) The department
430.10shall review each application to determine the applicant's knowledge of and compliance
430.11with Minnesota home care regulations. Before granting a temporary license or renewing a
430.12license, the commissioner may further evaluate the applicant or licensee by requesting
430.13additional information or documentation or by conducting an on-site survey of the
430.14applicant to determine compliance with sections 144A.43 to 144A.482.
430.15(b) Within 14 calendar days after receiving an application for a license,
430.16the commissioner shall acknowledge receipt of the application in writing. The
430.17acknowledgment must indicate whether the application appears to be complete or whether
430.18additional information is required before the application will be considered complete.
430.19(c) Within 90 days after receiving a complete application, the commissioner shall
430.20issue a temporary license, renew the license, or deny the license.
430.21(d) The commissioner shall issue a license that contains the home care provider's
430.22name, address, license level, expiration date of the license, and unique license number. All
430.23licenses are valid for one year from the date of issuance.
430.24    Subd. 2. Temporary license. (a) For new license applicants, the commissioner
430.25shall issue a temporary license for either the basic or comprehensive home care level. A
430.26temporary license is effective for one year from the date of issuance. Temporary licensees
430.27must comply with sections 144A.43 to 144A.482.
430.28(b) During the temporary license year, the commissioner shall survey the temporary
430.29licensee after the commissioner is notified or has evidence that the temporary licensee
430.30is providing home care services.
430.31(c) Within five days of beginning the provision of services, the temporary
430.32licensee must notify the commissioner that it is serving clients. The notification to the
430.33commissioner may be mailed or e-mailed to the commissioner at the address provided by
430.34the commissioner. If the temporary licensee does not provide home care services during
431.1the temporary license year, then the temporary license expires at the end of the year and
431.2the applicant must reapply for a temporary home care license.
431.3(d) A temporary licensee may request a change in the level of licensure prior to
431.4being surveyed and granted a license by notifying the commissioner in writing and
431.5providing additional documentation or materials required to update or complete the
431.6changed temporary license application. The applicant must pay the difference between the
431.7application fees when changing from the basic to the comprehensive level of licensure.
431.8No refund will be made if the provider chooses to change the license application to the
431.9basic level.
431.10(e) If the temporary licensee notifies the commissioner that the licensee has clients
431.11within 45 days prior to the temporary license expiration, the commissioner may extend the
431.12temporary license for up to 60 days in order to allow the commissioner to complete the
431.13on-site survey required under this section and follow-up survey visits.
431.14    Subd. 3. Temporary licensee survey. (a) If the temporary licensee is in substantial
431.15compliance with the survey, the commissioner shall issue either a basic or comprehensive
431.16home care license. If the temporary licensee is not in substantial compliance with the
431.17survey, the commissioner shall not issue a basic or comprehensive license and there will
431.18be no contested hearing right under chapter 14.
431.19(b) If the temporary licensee whose basic or comprehensive license has been denied
431.20disagrees with the conclusions of the commissioner, then the licensee may request a
431.21reconsideration by the commissioner or commissioner's designee. The reconsideration
431.22request process will be conducted internally by the commissioner or commissioner's
431.23designee, and chapter 14 does not apply.
431.24(c) The temporary licensee requesting reconsideration must make the request in
431.25writing and must list and describe the reasons why the licensee disagrees with the decision
431.26to deny the basic or comprehensive home care license.
431.27(d) A temporary licensee whose license is denied must comply with the requirements
431.28for notification and transfer of clients in section 144A.475, subdivision 5.

431.29    Sec. 13. [144A.474] SURVEYS AND INVESTIGATIONS.
431.30    Subdivision 1. Surveys. The commissioner shall conduct surveys of each home
431.31care provider. By June 30, 2016, the commissioner shall conduct a survey of home care
431.32providers on a frequency of at least once every three years. Survey frequency may be
431.33based on the license level, the provider's compliance history, number of clients served,
431.34or other factors as determined by the department deemed necessary to ensure the health,
431.35safety, and welfare of clients and compliance with the law.
432.1    Subd. 2. Types of home care surveys. (a) "Initial full survey" is the survey
432.2conducted of a new temporary licensee after the department is notified or has evidence that
432.3the licensee is providing home care services to determine if the provider is in compliance
432.4with home care requirements. Initial surveys must be completed within 14 months after
432.5the department's issuance of a temporary basic or comprehensive license.
432.6(b) "Core survey" means periodic inspection of home care providers to determine
432.7ongoing compliance with the home care requirements focusing on the essential health and
432.8safety requirements. Core surveys are available to licensed home care providers who have
432.9been licensed for three years, and been surveyed at least once in the past three years,
432.10with the latest survey having no widespread violation or violations beyond Level 1 as
432.11provided in subdivision 11. Providers must also have not had any substantiated licensing
432.12complaints, substantiated complaints against the agency under the Vulnerable Adults
432.13Act or Maltreatment of Minors Act, or an enforcement action as authorized in section
432.14144A.475 in the past three years. The core survey for basic license level providers will
432.15review compliance in the following areas:
432.16(1) reporting of maltreatment;
432.17(2) orientation to and implementation of home care client bill of rights;
432.18(3) statement of home care services;
432.19(4) initial evaluation of clients and initiation of services;
432.20(5) basic license level client review and monitoring;
432.21(6) service plan implementation and changes to the service plan;
432.22(7) client complaint and investigative process;
432.23(8) competency of unlicensed personnel; and
432.24(9) infection control.
432.25For comprehensive license level providers, the core survey will include everything
432.26in the basic license level core survey plus these areas:
432.27(1) assessment, monitoring, and reassessments of clients; and
432.28(2) medication, treatment, and therapy management.
432.29(c) "Full survey" means the periodic inspection of home care providers to determine
432.30ongoing compliance with the home care requirements that cover the core survey areas and
432.31all the legal requirements for home care providers. A full survey will be conducted for
432.32all temporary licensees, providers who do not meet the requirements needed for a core
432.33survey, and when a surveyor identifies unacceptable client health or safety risks during a
432.34core survey. A full survey will include all the tasks identified as part of the core survey
432.35and any additional review deemed necessary by the department, including additional
432.36observation, interviewing, or records review of additional clients and staff.
433.1(d) "Follow-up surveys" are conducted to determine if a home care provider has
433.2corrected deficient issues and systems identified during a core survey, full survey, or
433.3complaint investigation. Follow-up surveys may be conducted via phone, e-mail, fax,
433.4mail, or on-site reviews. Follow-up surveys, other than complaint surveys, shall be
433.5concluded with an exit conference and written information provided on the process for
433.6requesting a reconsideration of the survey results.
433.7(e) Upon receiving information alleging that a home care provider has violated or
433.8is currently violating a requirement of sections 144A.43 to 144A.482, the commissioner
433.9shall investigate the complaint according to sections 144A.51 to 144A.54.
433.10    Subd. 3. Survey process. The survey process for core surveys shall include the
433.11following as applicable to the particular licensee and setting surveyed:
433.12(1) presurvey review of pertinent documents and notification to the ombudsman
433.13for long-term care;
433.14(2) an entrance conference with available staff;
433.15(3) communication with managerial officials or the RN in charge, if available, and
433.16ongoing communication with key staff throughout the survey regarding information
433.17needed by the surveyor, clarifications regarding home care requirements, and applicable
433.18standards of practice;
433.19(4) presentation of written contact information to the provider about the survey staff
433.20conducting the survey, the supervisor, and the process for requesting a reconsideration of
433.21the survey results;
433.22(5) a brief tour of a sampling of the housing with services establishments in which
433.23the provider is providing home care services;
433.24(6) a sample selection of home care clients;
433.25(7) information gathering through client and staff observations, client and staff
433.26interviews, and reviews of records, policies, procedures, practices, and other agency
433.27information;
433.28(8) interviews of client's family members, if available, with client's consent when the
433.29client can legally give consent;
433.30(9) except for complaint surveys conducted by the Office of Health Facilities
433.31Complaints, an on-site exit conference with preliminary findings shared and discussed
433.32with the provider, documentation that an exit conference occurred, and written information
433.33on the process for requesting a reconsideration of the survey results; and
433.34(10) postsurvey analysis of findings and formulation of survey results, including
433.35correction orders when applicable.
434.1    Subd. 4. Scheduling surveys. Surveys and investigations shall be conducted
434.2without advance notice to home care providers. Surveyors may contact the home care
434.3provider on the day of a survey to arrange for someone to be available at the survey site.
434.4The contact does not constitute advance notice.
434.5    Subd. 5. Information provided by home care provider. The home care provider
434.6shall provide accurate and truthful information to the department during a survey,
434.7investigation, or other licensing activities.
434.8    Subd. 6. Providing client records. Upon request of a surveyor, home care providers
434.9shall provide a list of current and past clients or client representatives that includes
434.10addresses and telephone numbers and any other information requested about the services
434.11to clients within a reasonable period of time.
434.12    Subd. 7. Contacting and visiting clients. Surveyors may contact or visit a home
434.13care provider's clients to gather information without notice to the home care provider.
434.14Before visiting a client, a surveyor shall obtain the client's or client's representative's
434.15permission by telephone, mail, or in person. Surveyors shall inform all clients or client's
434.16representatives of their right to decline permission for a visit.
434.17    Subd. 8. Correction orders. (a) A correction order may be issued whenever the
434.18commissioner finds upon survey or during a complaint investigation that a home care
434.19provider, managerial official, or an employee of the provider is not in compliance with
434.20sections 144A.43 to 144A.482. The correction order shall cite the specific statute and
434.21document areas of noncompliance and the time allowed for correction.
434.22(b) The commissioner shall mail copies of any correction order to the last known
434.23address of the home care provider. A copy of each correction order and copies of any
434.24documentation supplied to the commissioner shall be kept on file by the home care
434.25provider, and public documents shall be made available for viewing by any person upon
434.26request. Copies may be kept electronically.
434.27(c) By the correction order date, the home care provider must document in the
434.28provider's records any action taken to comply with the correction order. The commissioner
434.29may request a copy of this documentation and the home care provider's action to respond
434.30to the correction order in future surveys, upon a complaint investigation, and as otherwise
434.31needed.
434.32    Subd. 9. Follow-up surveys. For providers that have Level III or Level IV
434.33violations or any violations determined to be widespread, the department shall conduct a
434.34follow-up survey within 90 calendar days of the survey. When conducting a follow-up
434.35survey, the surveyor will focus on whether the previous violations have been corrected and
434.36may also address any new violations that are observed while evaluating the corrections
435.1that have been made. If a new violation is identified on a follow-up survey, no fine will be
435.2imposed unless it is not corrected on the next follow-up survey.
435.3    Subd. 10. Performance incentive. A licensee is eligible for a performance
435.4incentive if there are no violations identified in a core or full survey. The performance
435.5incentive is a ten percent discount on the licensee's next home care renewal license fee.
435.6    Subd. 11. Fines. (a) Fines and enforcement actions under this subdivision may be
435.7assessed based on the level and scope of the violations described in paragraph (c) as follows:
435.8(1) Level I, no fines or enforcement;
435.9(2) Level II, fines ranging from $0 to $500, in addition to any of the enforcement
435.10mechanisms authorized in section 144A.475 for widespread violations;
435.11(3) Level III, fines ranging from $500 to $1,000, in addition to any of the
435.12enforcement mechanisms authorized in section 144A.475; and
435.13(4) Level IV, fines ranging from $1,000 to $5,000, in addition to any of the
435.14enforcement mechanisms authorized in section 144A.475.
435.15(b) Correction orders for violations will be categorized by both level and scope as
435.16follows, and fines will be assessed accordingly:
435.17(1) level of violation:
435.18(i) Level I, a violation that has no potential to cause more than a minimal impact on
435.19the client and does not affect health or safety;
435.20(ii) Level II, a violation that did not harm the client's health or safety, but had the
435.21potential to have harmed a client's health or safety, but not likely to cause serious injury,
435.22impairment, or death;
435.23(iii) Level III, a violation that harmed a client's health or safety, not including serious
435.24injury, impairment, or death, or a violation that has the potential to lead to serious injury,
435.25impairment, or death; and
435.26(iv) Level IV, a violation that results in serious injury, impairment or death.
435.27(2) scope of violation:
435.28(i) isolated, when one or a limited number of clients are affected, or one or a limited
435.29number of staff are involved, or the situation has occurred only occasionally;
435.30(ii) pattern, when more than a limited number of clients are affected, more than a
435.31limited number of staff are involved, or the situation has had repeated occurrences but
435.32is not found to be pervasive; or
435.33(iii) widespread; when problems are pervasive or represent a systemic failure that
435.34has affected or has the potential to affect a large portion or all of the clients.
435.35(c) If the commissioner finds that the applicant or a home care provider required
435.36to be licensed under sections 144A.43 to 144A.482 has not corrected violations by the
436.1date specified in the correction order or conditional license resulting from a survey or
436.2complaint investigation, the commissioner may impose a fine. A notice of noncompliance
436.3with a correction order must be mailed to the applicant's or provider's last known address.
436.4The noncompliance notice must list the violations not corrected.
436.5(d) The license holder must pay the fines assessed on or before the payment date
436.6specified. If the license holder fails to fully comply with the order, the commissioner
436.7may issue a second fine or suspend the license until the license holder complies by
436.8paying the fine. A timely appeal shall stay payment of the fine until the commissioner
436.9issues a final order.
436.10(e) A license holder shall promptly notify the commissioner in writing when a
436.11violation specified in the order is corrected. If upon reinspection, the commissioner
436.12determines that a violation has not been corrected as indicated by the order, the
436.13commissioner may issue a second fine. The commissioner shall notify the license holder by
436.14mail to the last known address in the licensing record that a second fine has been assessed.
436.15The license holder may appeal the second fine as provided under this subdivision.
436.16(f) A home care provider that has been assessed a fine under this subdivision has a
436.17right to a reconsideration or a hearing under this section and chapter 14.
436.18(g) When a fine has been assessed, the license holder may not avoid payment by
436.19closing, selling, or otherwise transferring the licensed program to a third party. In such an
436.20event, the license holder shall be liable for payment of the fine.
436.21(h) In addition to any fine imposed under this section, the commissioner may assess
436.22costs related to an investigation that results in a final order assessing a fine or other
436.23enforcement action authorized by this chapter.
436.24(i) Fines collected under this subdivision shall be deposited in the state government
436.25special revenue fund and credited to an account separate from the revenue collected under
436.26section 144A.472. Subject to an appropriation by the legislature, the revenue from the
436.27fines collected may be used by the commissioner for special projects to improve home care
436.28in Minnesota as recommended by the advisory council established in section 144A.4799.
436.29    Subd. 12. Reconsideration. (a) The commissioner shall make available to home
436.30care providers a correction order reconsideration process. This process may be used
436.31to challenge the correction order issued, including the level and scope described in
436.32subdivision 11, and any fine assessed. During the correction order reconsideration
436.33request, the issuance of the correction orders under reconsideration are not stayed, but
436.34the department will post information on the Web site with the correction order that the
436.35licensee has requested a reconsideration review and that the review is pending.
437.1(b) A licensed home care provider may request from the commissioner, in writing,
437.2a correction order reconsideration regarding any correction order issued to the provider.
437.3The correction order reconsideration shall not be reviewed by any surveyor, investigator,
437.4or supervisor that participated in the writing or reviewing of the correction order being
437.5disputed. The correction order reconsiderations may be conducted in person by telephone,
437.6by another electronic form, or in writing, as determined by the commissioner. The
437.7commissioner shall respond in writing to the request from a home care provider for
437.8a correction order reconsideration within 60 days of the date the provider requests a
437.9reconsideration. The commissioner's response shall identify the commissioner's decision
437.10regarding each citation challenged by the home care provider.
437.11(c) The findings of a correction order reconsideration process shall be one or more of
437.12the following:
437.13(1) supported in full: the correction order is supported in full, with no deletion of
437.14findings to the citation;
437.15(2) supported in substance: the correction order is supported, but one or more
437.16findings are deleted or modified without any change in the citation;
437.17 (3) correction order cited an incorrect home care licensing requirement: the correction
437.18order is amended by changing the correction order to the appropriate statutory reference;
437.19(4) correction order was issued under an incorrect citation: the correction order is
437.20amended to be issued under the more appropriate correction order citation;
437.21(5) the correction order is rescinded;
437.22(6) fine is amended: it is determined the fine assigned to the correction order was
437.23applied incorrectly; or
437.24(7) the level or scope of the citation is modified based on the reconsideration.
437.25(d) If the correction order findings are changed by the commissioner, the
437.26commissioner shall update the correction order on the Web site accordingly.
437.27    Subd. 13. Home care surveyor training. Before conducting a home care survey,
437.28each home care surveyor must receive training on the following topics:
437.29(1) Minnesota home care licensure requirements;
437.30(2) Minnesota home care client bill of rights;
437.31(3) Minnesota Vulnerable Adults Act and Reporting of Maltreatment of Minors;
437.32(4) principles of documentation;
437.33(5) survey protocol and processes;
437.34(6) Offices of the Ombudsman roles;
437.35(7) Office of Health Facility Complaints;
437.36(8) Minnesota landlord and tenant, and housing with services laws;
438.1(9) types of payors for home care services; and
438.2(10) Minnesota Nurse Practice Act for nurse surveyors.
438.3Materials used for this training will be posted on the Department of Health Web
438.4site. Requisite understanding of these topics will be reviewed as part of the quality
438.5improvement plan in section 30.

438.6    Sec. 14. [144A.475] ENFORCEMENT.
438.7    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a temporary
438.8license or refuse to renew a license, may suspend or revoke a license, or may impose a
438.9conditional license if the home care provider or owner or managerial official of the home
438.10care provider:
438.11(1) is in violation of, or during the term of the license has violated, any of the
438.12requirements in sections 144A.471 to 144A.482;
438.13(2) permits, aids, or abets the commission of any illegal act in the provision of
438.14home care;
438.15(3) performs any act detrimental to the health, safety, and welfare of a client;
438.16(4) obtains the license by fraud or misrepresentation;
438.17(5) knowingly made or makes a false statement of a material fact in the application
438.18for a license or in any other record or report required by this chapter;
438.19(6) denies representatives of the department access to any part of the home care
438.20provider's books, records, files, or employees;
438.21(7) interferes with or impedes a representative of the department in contacting the
438.22home care provider's clients;
438.23(8) interferes with or impedes a representative of the department in the enforcement
438.24of this chapter or has failed to fully cooperate with an inspection, survey, or investigation
438.25by the department;
438.26(9) destroys or makes unavailable any records or other evidence relating to the home
438.27care provider's compliance with this chapter;
438.28(10) refuses to initiate a background study under section 144.057 or 245A.04;
438.29(11) fails to timely pay any fines assessed by the department;
438.30(12) violates any local, city, or township ordinance relating to home care services;
438.31(13) has repeated incidents of personnel performing services beyond their
438.32competency level; or
438.33(14) has operated beyond the scope of the home care provider's license level.
438.34    (b) A violation by a contractor providing the home care services of the home care
438.35provider is a violation by the home care provider.
439.1    Subd. 2. Terms to suspension or conditional license. A suspension or conditional
439.2license designation may include terms that must be completed or met before a suspension
439.3or conditional license designation is lifted. A conditional license designation may include
439.4restrictions or conditions that are imposed on the provider. Terms for a suspension or
439.5conditional license may include one or more of the following and the scope of each will be
439.6determined by the commissioner:
439.7(1) requiring a consultant to review, evaluate, and make recommended changes to
439.8the home care provider's practices and submit reports to the commissioner at the cost of
439.9the home care provider;
439.10(2) requiring supervision of the home care provider or staff practices at the cost
439.11of the home care provider by an unrelated person who has sufficient knowledge and
439.12qualifications to oversee the practices and who will submit reports to the commissioner;
439.13(3) requiring the home care provider or employees to obtain training at the cost of
439.14the home care provider;
439.15(4) requiring the home care provider to submit reports to the commissioner;
439.16(5) prohibiting the home care provider from taking any new clients for a period
439.17of time; or
439.18(6) any other action reasonably required to accomplish the purpose of this
439.19subdivision and section 144A.45, subdivision 2.
439.20    Subd. 3. Notice. Prior to any suspension, revocation, or refusal to renew a license,
439.21the home care provider shall be entitled to notice and a hearing as provided by sections
439.2214.57 to 14.69. In addition to any other remedy provided by law, the commissioner may,
439.23without a prior contested case hearing, temporarily suspend a license or prohibit delivery
439.24of services by a provider for not more than 90 days if the commissioner determines that
439.25the health or safety of a consumer is in imminent danger, provided:
439.26(1) advance notice is given to the home care provider;
439.27(2) after notice, the home care provider fails to correct the problem;
439.28(3) the commissioner has reason to believe that other administrative remedies are not
439.29likely to be effective; and
439.30(4) there is an opportunity for a contested case hearing within the 90 days.
439.31    Subd. 4. Time limits for appeals. To appeal the assessment of civil penalties
439.32under section 144A.45, subdivision 2, clause (5), and an action against a license under
439.33this section, a provider must request a hearing no later than 15 days after the provider
439.34receives notice of the action.
439.35    Subd. 5. Plan required. (a) The process of suspending or revoking a license
439.36must include a plan for transferring affected clients to other providers by the home care
440.1provider, which will be monitored by the commissioner. Within three business days of
440.2being notified of the final revocation or suspension action, the home care provider shall
440.3provide the commissioner, the lead agencies as defined in section 256B.0911, and the
440.4ombudsman for long-term care with the following information:
440.5(1) a list of all clients, including full names and all contact information on file;
440.6(2) a list of each client's representative or emergency contact person, including full
440.7names and all contact information on file;
440.8(3) the location or current residence of each client;
440.9(4) the payor sources for each client, including payor source identification numbers;
440.10and
440.11(5) for each client, a copy of the client's service plan, and a list of the types of
440.12services being provided.
440.13(b) The revocation or suspension notification requirement is satisfied by mailing the
440.14notice to the address in the license record. The home care provider shall cooperate with
440.15the commissioner and the lead agencies during the process of transferring care of clients to
440.16qualified providers. Within three business days of being notified of the final revocation or
440.17suspension action, the home care provider must notify and disclose to each of the home
440.18care provider's clients, or the client's representative or emergency contact persons, that
440.19the commissioner is taking action against the home care provider's license by providing a
440.20copy of the revocation or suspension notice issued by the commissioner.
440.21    Subd. 6. Owners and managerial officials; refusal to grant license. (a) The owner
440.22and managerial officials of a home care provider whose Minnesota license has not been
440.23renewed or that has been revoked because of noncompliance with applicable laws or rules
440.24shall not be eligible to apply for and shall not be granted a home care license, including
440.25other licenses under this chapter, or be given status as an enrolled personal care assistance
440.26provider agency or personal care assistant by the Department of Human Services under
440.27section 256B.0659 for five years following the effective date of the nonrenewal or
440.28revocation. If the owner and managerial officials already have enrollment status, their
440.29enrollment will be terminated by the Department of Human Services.
440.30(b) The commissioner shall not issue a license to a home care provider for five
440.31years following the effective date of license nonrenewal or revocation if the owner or
440.32managerial official, including any individual who was an owner or managerial official
440.33of another home care provider, had a Minnesota license that was not renewed or was
440.34revoked as described in paragraph (a).
440.35(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall
440.36suspend or revoke, the license of any home care provider that includes any individual
441.1as an owner or managerial official who was an owner or managerial official of a home
441.2care provider whose Minnesota license was not renewed or was revoked as described in
441.3paragraph (a) for five years following the effective date of the nonrenewal or revocation.
441.4(d) The commissioner shall notify the home care provider 30 days in advance of
441.5the date of nonrenewal, suspension, or revocation of the license. Within ten days after
441.6the receipt of the notification, the home care provider may request, in writing, that the
441.7commissioner stay the nonrenewal, revocation, or suspension of the license. The home
441.8care provider shall specify the reasons for requesting the stay; the steps that will be taken
441.9to attain or maintain compliance with the licensure laws and regulations; any limits on the
441.10authority or responsibility of the owners or managerial officials whose actions resulted in
441.11the notice of nonrenewal, revocation, or suspension; and any other information to establish
441.12that the continuing affiliation with these individuals will not jeopardize client health, safety,
441.13or well-being. The commissioner shall determine whether the stay will be granted within
441.1430 days of receiving the provider's request. The commissioner may propose additional
441.15restrictions or limitations on the provider's license and require that the granting of the stay
441.16be contingent upon compliance with those provisions. The commissioner shall take into
441.17consideration the following factors when determining whether the stay should be granted:
441.18(1) the threat that continued involvement of the owners and managerial officials with
441.19the home care provider poses to client health, safety, and well-being;
441.20(2) the compliance history of the home care provider; and
441.21(3) the appropriateness of any limits suggested by the home care provider.
441.22    If the commissioner grants the stay, the order shall include any restrictions or
441.23limitation on the provider's license. The failure of the provider to comply with any
441.24restrictions or limitations shall result in the immediate removal of the stay and the
441.25commissioner shall take immediate action to suspend, revoke, or not renew the license.
441.26    Subd. 7. Request for hearing. A request for a hearing must be in writing and must:
441.27(1) be mailed or delivered to the department or the commissioner's designee;
441.28(2) contain a brief and plain statement describing every matter or issue contested; and
441.29(3) contain a brief and plain statement of any new matter that the applicant or home
441.30care provider believes constitutes a defense or mitigating factor.
441.31    Subd. 8. Informal conference. At any time, the applicant or home care provider
441.32and the commissioner may hold an informal conference to exchange information, clarify
441.33issues, or resolve issues.
441.34    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the
441.35commissioner may bring an action in district court to enjoin a person who is involved in
441.36the management, operation, or control of a home care provider or an employee of the
442.1home care provider from illegally engaging in activities regulated by sections 144A.43 to
442.2144A.482. The commissioner may bring an action under this subdivision in the district
442.3court in Ramsey County or in the district in which a home care provider is providing
442.4services. The court may grant a temporary restraining order in the proceeding if continued
442.5activity by the person who is involved in the management, operation, or control of a home
442.6care provider, or by an employee of the home care provider, would create an imminent
442.7risk of harm to a recipient of home care services.
442.8    Subd. 10. Subpoena. In matters pending before the commissioner under sections
442.9144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance
442.10of witnesses and the production of all necessary papers, books, records, documents, and
442.11other evidentiary material. If a person fails or refuses to comply with a subpoena or
442.12order of the commissioner to appear or testify regarding any matter about which the
442.13person may be lawfully questioned or to produce any papers, books, records, documents,
442.14or evidentiary materials in the matter to be heard, the commissioner may apply to the
442.15district court in any district, and the court shall order the person to comply with the
442.16commissioner's order or subpoena. The commissioner of health may administer oaths to
442.17witnesses or take their affirmation. Depositions may be taken in or outside the state in the
442.18manner provided by law for the taking of depositions in civil actions. A subpoena or other
442.19process or paper may be served on a named person anywhere in the state by an officer
442.20authorized to serve subpoenas in civil actions, with the same fees and mileage and in the
442.21same manner as prescribed by law for a process issued out of a district court. A person
442.22subpoenaed under this subdivision shall receive the same fees, mileage, and other costs
442.23that are paid in proceedings in district court.

442.24    Sec. 15. [144A.476] BACKGROUND STUDIES.
442.25    Subdivision 1. Prior criminal convictions; owner and managerial officials. (a)
442.26Before the commissioner issues a temporary license or renews a license, an owner or
442.27managerial official is required to complete a background study under section 144.057. No
442.28person may be involved in the management, operation, or control of a home care provider
442.29if the person has been disqualified under chapter 245C. If an individual is disqualified
442.30under section 144.057 or chapter 245C, the individual may request reconsideration of
442.31the disqualification. If the individual requests reconsideration and the commissioner
442.32sets aside or rescinds the disqualification, the individual is eligible to be involved in the
442.33management, operation, or control of the provider. If an individual has a disqualification
442.34under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's
443.1disqualification is barred from a set aside, and the individual must not be involved in the
443.2management, operation, or control of the provider.
443.3(b) For purposes of this section, owners of a home care provider subject to the
443.4background check requirement are those individuals whose ownership interest provides
443.5sufficient authority or control to affect or change decisions related to the operation of the
443.6home care provider. An owner includes a sole proprietor, a general partner, or any other
443.7individual whose individual ownership interest can affect the management and direction
443.8of the policies of the home care provider.
443.9(c) For the purposes of this section, managerial officials subject to the background
443.10check requirement are individuals who provide direct contact as defined in section
443.11245C.02, subdivision 11, or individuals who have the responsibility for the ongoing
443.12management or direction of the policies, services, or employees of the home care provider.
443.13Data collected under this subdivision shall be classified as private data on individuals as
443.14defined in section 13.02, subdivision 12.
443.15(d) The department shall not issue any license if the applicant, owner, or managerial
443.16official has been unsuccessful in having a background study disqualification set aside
443.17under section 144.057 and chapter 245C; if the owner or managerial official, as an owner
443.18or managerial official of another home care provider, was substantially responsible for
443.19the other home care provider's failure to substantially comply with sections 144A.43 to
443.20144A.482; or if an owner that has ceased doing business, either individually or as an
443.21owner of a home care provider, was issued a correction order for failing to assist clients in
443.22violation of this chapter.
443.23    Subd. 2. Employees, contractors, and volunteers. (a) Employees, contractors,
443.24and volunteers of a home care provider are subject to the background study required by
443.25section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall
443.26be construed to prohibit a home care provider from requiring self-disclosure of criminal
443.27conviction information.
443.28(b) Termination of an employee in good faith reliance on information or records
443.29obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not
443.30subject the home care provider to civil liability or liability for unemployment benefits.

443.31    Sec. 16. [144A.477] COMPLIANCE.
443.32    Subdivision 1. Medicare-certified providers; coordination of surveys. If feasible,
443.33the commissioner shall survey licensees to determine compliance with this chapter at the
443.34same time as surveys for certification for Medicare if Medicare certification is based on
443.35compliance with the federal conditions of participation and on survey and enforcement
444.1by the Department of Health as agent for the United States Department of Health and
444.2Human Services.
444.3    Subd. 2. Medicare-certified providers; equivalent requirements. For home care
444.4providers licensed to provide comprehensive home care services that are also certified for
444.5participation in Medicare as a home health agency under Code of Federal Regulations,
444.6title 42, part 484, the following state licensure regulations are considered equivalent to
444.7the federal requirements:
444.8(1) quality management, section 144A.479, subdivision 3;
444.9(2) personnel records, section 144A.479, subdivision 7;
444.10(3) acceptance of clients, section 144A.4791, subdivision 4;
444.11(4) referrals, section 144A.4791, subdivision 5;
444.12(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792,
444.13subdivisions 2 and 3;
444.14(6) individualized monitoring and reassessment, sections 144A.4791, subdivision
444.158, and 144A.4792, subdivisions 2 and 3;
444.16(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792,
444.17subdivision 5, and 144A.4793, subdivision 3;
444.18(8) client complaint and investigation process, section 144A.4791, subdivision 11;
444.19(9) prescription orders, section 144A.4792, subdivisions 13 to 16;
444.20(10) client records, section 144A.4794, subdivisions 1 to 3;
444.21(11) qualifications for unlicensed personnel performing delegated tasks, section
444.22144A.4795;
444.23(12) training and competency staff, section 144A.4795;
444.24(13) training and competency for unlicensed personnel, section 144A.4795,
444.25subdivision 7;
444.26(14) delegation of home care services, section 144A.4795, subdivision 4;
444.27(15) availability of contact person, section 144A.4797, subdivision 1; and
444.28(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.
444.29Violations of the requirements in clauses (1) to (16) may lead to enforcement actions
444.30under section 144A.474.

444.31    Sec. 17. [144A.478] INNOVATION VARIANCE.
444.32    Subdivision 1. Definition. For purposes of this section, "innovation variance"
444.33means a specified alternative to a requirement of this chapter. An innovation variance may
444.34be granted to allow a home care provider to offer home care services of a type or in a
444.35manner that is innovative, will not impair the services provided, will not adversely affect
445.1the health, safety, or welfare of the clients, and is likely to improve the services provided.
445.2The innovative variance cannot change any of the client's rights under section 144A.44.
445.3    Subd. 2. Conditions. The commissioner may impose conditions on the granting of
445.4an innovation variance that the commissioner considers necessary.
445.5    Subd. 3. Duration and renewal. The commissioner may limit the duration of any
445.6innovation variance and may renew a limited innovation variance.
445.7    Subd. 4. Applications; innovation variance. An application for innovation
445.8variance from the requirements of this chapter may be made at any time, must be made in
445.9writing to the commissioner, and must specify the following:
445.10(1) the statute or law from which the innovation variance is requested;
445.11(2) the time period for which the innovation variance is requested;
445.12(3) the specific alternative action that the licensee proposes;
445.13(4) the reasons for the request; and
445.14(5) justification that an innovation variance will not impair the services provided;
445.15will not adversely affect the health, safety, or welfare of clients; and is likely to improve
445.16the services provided.
445.17The commissioner may require additional information from the home care provider before
445.18acting on the request.
445.19    Subd. 5. Grants and denials. The commissioner shall grant or deny each request
445.20for an innovation variance in writing within 45 days of receipt of a complete request.
445.21Notice of a denial shall contain the reasons for the denial. The terms of a requested
445.22innovation variance may be modified upon agreement between the commissioner and
445.23the home care provider.
445.24    Subd. 6. Violation of innovation variances. A failure to comply with the terms of
445.25an innovation variance shall be deemed to be a violation of this chapter.
445.26    Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or
445.27deny renewal of an innovation variance if:
445.28(1) it is determined that the innovation variance is adversely affecting the health,
445.29safety, or welfare of the licensee's clients;
445.30(2) the home care provider has failed to comply with the terms of the innovation
445.31variance;
445.32(3) the home care provider notifies the commissioner in writing that it wishes to
445.33relinquish the innovation variance and be subject to the statute previously varied; or
445.34(4) the revocation or denial is required by a change in law.

446.1    Sec. 18. [144A.479] HOME CARE PROVIDER RESPONSIBILITIES;
446.2BUSINESS OPERATION.
446.3    Subdivision 1. Display of license. The original current license must be displayed
446.4in the home care provider's principal business office and copies must be displayed in
446.5any branch office. The home care provider must provide a copy of the license to any
446.6person who requests it.
446.7    Subd. 2. Advertising. Home care providers shall not use false, fraudulent,
446.8or misleading advertising in the marketing of services. For purposes of this section,
446.9advertising includes any verbal, written, or electronic means of communicating to
446.10potential clients about the availability, nature, or terms of home care services.
446.11    Subd. 3. Quality management. The home care provider shall engage in quality
446.12management appropriate to the size of the home care provider and relevant to the type
446.13of services the home care provider provides. The quality management activity means
446.14evaluating the quality of care by periodically reviewing client services, complaints made,
446.15and other issues that have occurred and determining whether changes in services, staffing,
446.16or other procedures need to be made in order to ensure safe and competent services to
446.17clients. Documentation about quality management activity must be available for two
446.18years. Information about quality management must be available to the commissioner at
446.19the time of the survey, investigation, or renewal.
446.20    Subd. 4. Provider restrictions. (a) This subdivision does not apply to licensees
446.21that are Minnesota counties or other units of government.
446.22(b) A home care provider or staff cannot accept powers-of-attorney from clients for
446.23any purpose, and may not accept appointments as guardians or conservators of clients.
446.24(c) A home care provider cannot serve as a client's representative.
446.25    Subd. 5. Handling of client's finances and property. (a) A home care provider
446.26may assist clients with household budgeting, including paying bills and purchasing
446.27household goods, but may not otherwise manage a client's property. A home care provider
446.28must provide a client with receipts for all transactions and purchases paid with the client's
446.29funds. When receipts are not available, the transaction or purchase must be documented.
446.30A home care provider must maintain records of all such transactions.
446.31(b) A home care provider or staff may not borrow a client's funds or personal or
446.32real property, nor in any way convert a client's property to the home care provider's or
446.33staff's possession.
446.34(c) Nothing in this section precludes a home care provider or staff from accepting
446.35gifts of minimal value, or precludes the acceptance of donations or bequests made to a
447.1home care provider that are exempt from income tax under section 501(c) of the Internal
447.2Revenue Code of 1986.
447.3    Subd. 6. Reporting maltreatment of vulnerable adults and minors. (a) All
447.4home care providers must comply with requirements for the reporting of maltreatment
447.5of minors in section 626.556 and the requirements for the reporting of maltreatment
447.6of vulnerable adults in section 626.557. Home care providers must report suspected
447.7maltreatment of minors and vulnerable adults to the common entry point. Each home
447.8care provider must establish and implement a written procedure to ensure that all cases
447.9of suspected maltreatment are reported.
447.10(b) Each home care provider must develop and implement an individual abuse
447.11prevention plan for each vulnerable minor or adult for whom home care services are
447.12provided by a home care provider. The plan shall contain an individualized review or
447.13assessment of the person's susceptibility to abuse by another individual, including other
447.14vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors;
447.15and statements of the specific measures to be taken to minimize the risk of abuse to that
447.16person and other vulnerable adults or minors. For purposes of the abuse prevention plan,
447.17the term abuse includes self-abuse.
447.18    Subd. 7. Employee records. The home care provider must maintain current records
447.19of each paid employee, regularly scheduled volunteers providing home care services,
447.20and each individual contractor providing home care services. The records must include
447.21the following information:
447.22(1) evidence of current professional licensure, registration, or certification, if
447.23licensure, registration, or certification is required by this statute, or other rules;
447.24(2) records of orientation, required annual training and infection control training,
447.25and competency evaluations;
447.26(3) current job description, including qualifications, responsibilities, and
447.27identification of staff providing supervision;
447.28(4) documentation of annual performance reviews which identify areas of
447.29improvement needed and training needs;
447.30(5) for individuals providing home care services, verification that required health
447.31screenings under section 144A.4798 have taken place and the dates of those screenings; and
447.32(6) documentation of the background study as required under section 144.057.
447.33Each employee record must be retained for at least three years after a paid employee,
447.34home care volunteer, or contractor ceases to be employed by or under contract with the
447.35home care provider. If a home care provider ceases operation, employee records must be
447.36maintained for three years.

448.1    Sec. 19. [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH
448.2RESPECT TO CLIENTS.
448.3    Subdivision 1. Home care bill of rights; notification to client. (a) The home care
448.4provider shall make all reasonable efforts to provide the client or the client's representative
448.5a written notice of the rights under section 144A.44 before the initiation of services. The
448.6home care provider shall make all reasonable efforts to provide the notice in a language
448.7the client or client's representative understands. If a written version is not effective or
448.8available, the notice may be provided verbally.
448.9(b) In addition to the text of the home care bill of rights in section 144A.44,
448.10subdivision 1, the notice shall also contain the following statement describing how to file
448.11a complaint with these offices.
448.12"If you have a complaint about the provider or the person providing your
448.13home care services, you may call, write, or visit the Office of Health Facility
448.14Complaints, Minnesota Department of Health. You may also contact the Office of
448.15Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health
448.16and Developmental Disabilities."
448.17The statement should include the telephone number, Web site address, e-mail
448.18address, mailing address, and street address of the Office of Health Facility Complaints at
448.19the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care,
448.20and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
448.21statement should also include the home care provider's name, address, e-mail, telephone
448.22number, and name or title of the person at the provider to whom problems or complaints
448.23may be directed. It must also include a statement that the home care provider will not
448.24retaliate because of a complaint.
448.25(c) The home care provider shall obtain written acknowledgment of the client's
448.26receipt of the home care bill of rights or shall document why an acknowledgment cannot
448.27be obtained. The acknowledgment may be obtained from the client or the client's
448.28representative. Acknowledgment of receipt shall be retained in the client's record.
448.29    Subd. 2. Notice of services for dementia, Alzheimer's disease, or related
448.30disorders. The home care provider that provides services to clients with dementia shall
448.31provide in written or electronic form, to clients and families or other persons who request
448.32it, a description of the training program and related training it provides, including the
448.33categories of employees trained, the frequency of training, and the basic topics covered.
448.34This information satisfies the disclosure requirements in section 325F.72, subdivision
448.352, clause (4).
449.1    Subd. 3. Statement of home care services. Prior to the initiation of services,
449.2a home care provider must provide to the client or the client's representative a written
449.3statement which identifies if they have a basic or comprehensive home care license, the
449.4services they are authorized to provide, and which services they cannot provide under the
449.5scope of their license. The home care provider shall obtain written acknowledgment
449.6from the clients that they have provided the statement or must document why they could
449.7not obtain the acknowledgment.
449.8    Subd. 4. Acceptance of clients. No home care provider may accept a person as a
449.9client unless the home care provider has staff, sufficient in qualifications, competency,
449.10and numbers, to adequately provide the services agreed to in the service plan and that
449.11are within the provider's scope of practice.
449.12    Subd. 5. Referrals. If a home care provider reasonably believes that a client is in
449.13need of another medical or health service, including a licensed health professional, or
449.14social service provider, the home care provider shall:
449.15(1) determine the client's preferences with respect to obtaining the service; and
449.16(2) inform the client of resources available, if known, to assist the client in obtaining
449.17services.
449.18    Subd. 6. Initiation of services. When a provider initiates services and the
449.19individualized review or assessment required in subdivisions 7 and 8 has not been
449.20completed, the provider must complete a temporary plan and agreement with the client for
449.21services.
449.22    Subd. 7. Basic individualized client review and monitoring. (a) When services
449.23being provided are basic home care services, an individualized initial review of the client's
449.24needs and preferences must be conducted at the client's residence with the client or client's
449.25representative. This initial review must be completed within 30 days after the initiation of
449.26the home care services.
449.27(b) Client monitoring and review must be conducted as needed based on changes
449.28in the needs of the client and cannot exceed 90 days from the date of the last review.
449.29The monitoring and review may be conducted at the client's residence or through the
449.30utilization of telecommunication methods based on practice standards that meet the
449.31individual client's needs.
449.32    Subd. 8. Comprehensive assessment, monitoring, and reassessment. (a) When
449.33the services being provided are comprehensive home care services, an individualized
449.34initial assessment must be conducted in-person by a registered nurse. When the services
449.35are provided by other licensed health professionals, the assessment must be conducted by
450.1the appropriate health professional. This initial assessment must be completed within five
450.2days after initiation of home care services.
450.3(b) Client monitoring and reassessment must be conducted in the client's home no
450.4more than 14 days after initiation of services.
450.5(c) Ongoing client monitoring and reassessment must be conducted as needed based
450.6on changes in the needs of the client and cannot exceed 90 days from the last date of the
450.7assessment. The monitoring and reassessment may be conducted at the client's residence
450.8or through the utilization of telecommunication methods based on practice standards that
450.9meet the individual client's needs.
450.10    Subd. 9. Service plan, implementation, and revisions to service plan. (a) No later
450.11than 14 days after the initiation of services, a home care provider shall finalize a current
450.12written service plan.
450.13(b) The service plan and any revisions must include a signature or other
450.14authentication by the home care provider and by the client or the client's representative
450.15documenting agreement on the services to be provided. The service plan must be revised,
450.16if needed, based on client review or reassessment under subdivisions 7 and 8. The provider
450.17must provide information to the client about changes to the provider's fee for services and
450.18how to contact the Office of the Ombudsman for Long-Term Care.
450.19(c) The home care provider must implement and provide all services required by
450.20the current service plan.
450.21(d) The service plan and revised service plan must be entered into the client's record,
450.22including notice of a change in a client's fees when applicable.
450.23(e) Staff providing home care services must be informed of the current written
450.24service plan.
450.25(f) The service plan must include:
450.26(1) a description of the home care services to be provided, the fees for services, and
450.27the frequency of each service, according to the client's current review or assessment and
450.28client preferences;
450.29(2) the identification of the staff or categories of staff who will provide the services;
450.30(3) the schedule and methods of monitoring reviews or assessments of the client;
450.31(4) the frequency of sessions of supervision of staff and type of personnel who
450.32will supervise staff; and
450.33(5) a contingency plan that includes:
450.34(i) the action to be taken by the home care provider and by the client or client's
450.35representative if the scheduled service cannot be provided;
451.1(ii) information and method for a client or client's representative to contact the
451.2home care provider;
451.3(iii) names and contact information of persons the client wishes to have notified
451.4in an emergency or if there is a significant adverse change in the client's condition,
451.5including identification of and information as to who has authority to sign for the client in
451.6an emergency; and
451.7(iv) the circumstances in which emergency medical services are not to be summoned
451.8consistent with chapters 145B and 145C, and declarations made by the client under those
451.9chapters.
451.10    Subd. 10. Termination of service plan. (a) If a home care provider terminates a
451.11service plan with a client, and the client continues to need home care services, the home
451.12care provider shall provide the client and the client's representative, if any, with a written
451.13notice of termination which includes the following information:
451.14(1) the effective date of termination;
451.15(2) the reason for termination;
451.16(3) a list of known licensed home care providers in the client's immediate geographic
451.17area;
451.18(4) a statement that the home care provider will participate in a coordinated transfer
451.19of care of the client to another home care provider, health care provider, or caregiver, as
451.20required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
451.21(5) the name and contact information of a person employed by the home care
451.22provider with whom the client may discuss the notice of termination; and
451.23(6) if applicable, a statement that the notice of termination of home care services
451.24does not constitute notice of termination of the housing with services contract with a
451.25housing with services establishment.
451.26(b) When the home care provider voluntarily discontinues services to all clients, the
451.27home care provider must notify the commissioner, lead agencies, and the ombudsman for
451.28long-term care about its clients and comply with the requirements in this subdivision.
451.29    Subd. 11. Client complaint and investigative process. (a) The home care
451.30provider must have a written policy and system for receiving, investigating, reporting,
451.31and attempting to resolve complaints from its clients or clients' representatives. The
451.32policy should clearly identify the process by which clients may file a complaint or concern
451.33about home care services and an explicit statement that the home care provider will not
451.34discriminate or retaliate against a client for expressing concerns or complaints. A home
451.35care provider must have a process in place to conduct investigations of complaints made
451.36by the client or the client's representative about the services in the client's plan that are or
452.1are not being provided or other items covered in the client's home care bill of rights. This
452.2complaint system must provide reasonable accommodations for any special needs of the
452.3client or client's representative if requested.
452.4(b) The home care provider must document the complaint, name of the client,
452.5investigation, and resolution of each complaint filed. The home care provider must
452.6maintain a record of all activities regarding complaints received, including the date the
452.7complaint was received, and the home care provider's investigation and resolution of the
452.8complaint. This complaint record must be kept for each event for at least two years after
452.9the date of entry and must be available to the commissioner for review.
452.10(c) The required complaint system must provide for written notice to each client or
452.11client's representative that includes:
452.12(1) the client's right to complain to the home care provider about the services received;
452.13(2) the name or title of the person or persons with the home care provider to contact
452.14with complaints;
452.15(3) the method of submitting a complaint to the home care provider; and
452.16(4) a statement that the provider is prohibited against retaliation according to
452.17paragraph (d).
452.18(d) A home care provider must not take any action that negatively affects a client
452.19in retaliation for a complaint made or a concern expressed by the client or the client's
452.20representative.
452.21    Subd. 12. Disaster planning and emergency preparedness plan. The home care
452.22provider must have a written plan of action to facilitate the management of the client's care
452.23and services in response to a natural disaster, such as flood and storms, or other emergencies
452.24that may disrupt the home care provider's ability to provide care or services. The licensee
452.25must provide adequate orientation and training of staff on emergency preparedness.
452.26    Subd. 13. Request for discontinuation of life-sustaining treatment. (a) If a
452.27client, family member, or other caregiver of the client requests that an employee or other
452.28agent of the home care provider discontinue a life-sustaining treatment, the employee or
452.29agent receiving the request:
452.30(1) shall take no action to discontinue the treatment; and
452.31(2) shall promptly inform their supervisor or other agent of the home care provider
452.32of the client's request.
452.33(b) Upon being informed of a request for termination of treatment, the home care
452.34provider shall promptly:
452.35(1) inform the client that the request will be made known to the physician who
452.36ordered the client's treatment;
453.1(2) inform the physician of the client's request; and
453.2(3) work with the client and the client's physician to comply with the provisions of
453.3the Health Care Directive Act in chapter 145C.
453.4(c) This section does not require the home care provider to discontinue treatment,
453.5except as may be required by law or court order.
453.6(d) This section does not diminish the rights of clients to control their treatments,
453.7refuse services, or terminate their relationships with the home care provider.
453.8(e) This section shall be construed in a manner consistent with chapter 145B or
453.9145C, whichever applies, and declarations made by clients under those chapters.

453.10    Sec. 20. [144A.4792] MEDICATION MANAGEMENT.
453.11    Subdivision 1. Medication management services; comprehensive home care
453.12license. (a) This subdivision applies only to home care providers with a comprehensive
453.13home care license that provides medication management services to clients. Medication
453.14management services may not be provided by a home care provider that has a basic
453.15home care license.
453.16(b) A comprehensive home care provider who provides medication management
453.17services must develop, implement, and maintain current written medication management
453.18policies and procedures. The policies and procedures must be developed under the
453.19supervision and direction of a registered nurse, licensed health professional, or pharmacist
453.20consistent with current practice standards and guidelines.
453.21(c) The written policies and procedures must address requesting and receiving
453.22prescriptions for medications; preparing and giving medications; verifying that
453.23prescription drugs are administered as prescribed; documenting medication management
453.24activities; controlling and storing medications; monitoring and evaluating medication use;
453.25resolving medication errors; communicating with the prescriber, pharmacist, client, and
453.26client representative, if any; disposing of unused medications; and educating clients and
453.27client representatives about medications. When controlled substances are being managed,
453.28the policies and procedures must also identify how the provider will ensure security and
453.29accountability for the overall management, control, and disposition of those substances in
453.30compliance with state and federal regulations and with subdivision 22.
453.31    Subd. 2. Provision of medication management services. (a) For each client who
453.32requests medication management services, the comprehensive home care provider shall,
453.33prior to providing medication management services, have a registered nurse, licensed
453.34health professional, or authorized prescriber under section 151.37 conduct an assessment
453.35to determine what medication management services will be provided and how the services
454.1will be provided. This assessment must be conducted face-to-face with the client. The
454.2assessment must include an identification and review of all medications the client is known
454.3to be taking. The review and identification must include indications for medications, side
454.4effects, contraindications, allergic or adverse reactions, and actions to address these issues.
454.5(b) The assessment must identify interventions needed in management of
454.6medications to prevent diversion of medication by the client or others who may have
454.7access to the medications. Diversion of medications means the misuse, theft, or illegal
454.8or improper disposition of medications.
454.9    Subd. 3. Individualized medication monitoring and reassessment. The
454.10comprehensive home care provider must monitor and reassess the client's medication
454.11management services as needed under subdivision 14 when the client presents with
454.12symptoms or other issues that may be medication-related and, at a minimum, annually.
454.13    Subd. 4. Client refusal. The home care provider must document in the client's
454.14record any refusal for an assessment for medication management by the client. The
454.15provider must discuss with the client the possible consequences of the client's refusal and
454.16document the discussion in the client's record.
454.17    Subd. 5. Individualized medication management plan. (a) For each client
454.18receiving medication management services, the comprehensive home care provider must
454.19prepare and include in the service plan a written statement of the medication management
454.20services that will be provided to the client. The provider must develop and maintain a
454.21current individualized medication management record for each client based on the client's
454.22assessment that contains the following:
454.23(1) a statement describing the medication management services that will be provided;
454.24(2) a description of storage of medications based on the client's needs and
454.25preferences, risk of diversion, and consistent with the manufacturer's directions;
454.26(3) documentation of specific client instructions relating to the administration
454.27of medications;
454.28(4) identification of persons responsible for monitoring medication supplies and
454.29ensuring that medication refills are ordered on a timely basis;
454.30(5) identification of medication management tasks that may be delegated to
454.31unlicensed personnel;
454.32(6) procedures for staff notifying a registered nurse or appropriate licensed health
454.33professional when a problem arises with medication management services; and
454.34(7) any client-specific requirements relating to documenting medication
454.35administration, verification that all medications are administered as prescribed, and
454.36monitoring of medication use to prevent possible complications or adverse reactions.
455.1(b) The medication management record must be current and updated when there are
455.2any changes.
455.3    Subd. 6. Administration of medication. Medications may be administered by a
455.4nurse, physician, or other licensed health practitioner authorized to administer medications
455.5or by unlicensed personnel who have been delegated medication administration tasks by
455.6a registered nurse.
455.7    Subd. 7. Delegation of medication administration. When administration of
455.8medications is delegated to unlicensed personnel, the comprehensive home care provider
455.9must ensure that the registered nurse has:
455.10(1) instructed the unlicensed personnel in the proper methods to administer the
455.11medications, and the unlicensed personnel has demonstrated ability to competently follow
455.12the procedures;
455.13(2) specified, in writing, specific instructions for each client and documented those
455.14instructions in the client's records; and
455.15(3) communicated with the unlicensed personnel about the individual needs of
455.16the client.
455.17    Subd. 8. Documentation of administration of medications. Each medication
455.18administered by comprehensive home care provider staff must be documented in the
455.19client's record. The documentation must include the signature and title of the person
455.20who administered the medication. The documentation must include the medication
455.21name, dosage, date and time administered, and method and route of administration. The
455.22staff must document the reason why medication administration was not completed as
455.23prescribed and document any follow-up procedures that were provided to meet the client's
455.24needs when medication was not administered as prescribed and in compliance with the
455.25client's medication management plan.
455.26    Subd. 9. Documentation of medication set up. Documentation of dates of
455.27medication set up, name of medication, quantity of dose, times to be administered, route
455.28of administration, and name of person completing medication set up must be done at
455.29time of set up.
455.30    Subd. 10. Medications management for clients who will be away from home.
455.31(a) A home care provider that is providing medication management services to the client
455.32and controls the client's access to the medications must develop and implement policies
455.33and procedures for giving accurate and current medications to clients for planned or
455.34unplanned times away from home according to the client's individualized medication
455.35management plan.
455.36The policy and procedures must state that:
456.1(1) for planned time away, the medications must be obtained from the pharmacy or
456.2set up by the registered nurse according to appropriate state and federal laws and nursing
456.3standards of practice;
456.4(2) for unplanned time away, when the pharmacy is not able to provide the
456.5medications, a licensed nurse or unlicensed personnel shall give the client or the client's
456.6representative medications in amounts and dosages needed for the length of the anticipated
456.7absence, not to exceed 120 hours;
456.8(3) the client, or the client's representative, must be provided written information
456.9on medications, including any special instructions for administering or handling the
456.10medications, including controlled substances;
456.11(4) the medications must be placed in a medication container or containers
456.12appropriate to the provider's medication system and must be labeled with the client's name
456.13and the dates and times that the medications are scheduled; and
456.14(5) the client or client's representative must be provided in writing the home care
456.15provider's name and information on how to contact them.
456.16(b) For unplanned time away when the licensed nurse is not available, the registered
456.17nurse may delegate this task to unlicensed personnel if:
456.18(1) the registered nurse has trained and determined the unlicensed staff to be
456.19competent to follow the procedures for giving medications to clients;
456.20(2) the registered nurse has developed written procedures for the unlicensed
456.21personnel, including any special instructions or procedures regarding controlled substances
456.22that are prescribed for the client. The procedures must address:
456.23(i) the type of container or containers to be used for the medications appropriate to
456.24the provider's medication system;
456.25(ii) how the container or containers must be labeled;
456.26(iii) the written information about the medications to be given to the client or the
456.27client' s representative;
456.28(iv) how the unlicensed staff will document in the client's record that medications
456.29have been given to the client or the client's responsible person, including documenting the
456.30date the medications were given to the client or the client's responsible person and who
456.31received the medications, the person who gave the medications to the client, the number of
456.32medications that were given to the client, and other required information;
456.33(v) how the registered nurse will be notified that medications have been given to
456.34the client or the client's responsible person and whether the registered nurse needs to
456.35be contacted before the medications are given to the client or the client's responsible
456.36person; and
457.1(vi) a review by the registered nurse of the completion of this task to verify that this
457.2task was completed accurately by the unlicensed personnel.
457.3    Subd. 11. Prescribed and nonprescribed medication. The comprehensive home
457.4care provider must determine whether it will require a prescription for all medications it
457.5manages. The comprehensive home care provider must inform the client or the client's
457.6representative whether the comprehensive home care provider requires a prescription
457.7for all over-the-counter and dietary supplements before the comprehensive home care
457.8provider will agree to manage those medications.
457.9    Subd. 12. Medications; over-the-counter; dietary supplements not prescribed.
457.10A comprehensive home care provider providing medication management services for
457.11over-the-counter drugs or dietary supplements must retain those items in the original labeled
457.12container with directions for use prior to setting up for immediate or later administration.
457.13The provider must verify that the medications are up-to-date and stored as appropriate.
457.14    Subd. 13. Prescriptions. There must be a current written or electronically recorded
457.15prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed
457.16medications that the comprehensive home care provider is managing for the client.
457.17    Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least
457.18every 12 months or more frequently as indicated by the assessment in subdivision 2.
457.19Prescriptions for controlled substances must comply with chapter 152.
457.20    Subd. 15. Verbal prescription orders. Verbal prescription orders from an
457.21authorized prescriber must be received by a nurse or pharmacist. The order must be
457.22handled according to Minnesota Rules, part 6800.6200.
457.23    Subd. 16. Written or electronic prescription. When a written or electronic
457.24prescription is received, it must be communicated to the registered nurse in charge and
457.25recorded or placed in the client's record.
457.26    Subd. 17. Records confidential. A prescription or order received verbally, in
457.27writing, or electronically must be kept according to sections 144.291 to 144.298 and
457.28144A.44.
457.29    Subd. 18. Medications provided by client or family members. When the
457.30comprehensive home care provider is aware of any medications or dietary supplements
457.31that are being used by the client and are not included in the assessment for medication
457.32management services, the staff must advise the registered nurse and document that in
457.33the client's record.
457.34    Subd. 19. Storage of drugs. A comprehensive home care provider providing
457.35storage of medications outside of the client's private living space must store all prescription
458.1drugs in securely locked and substantially constructed compartments according to the
458.2manufacturer's directions and permit only authorized personnel to have access.
458.3    Subd. 20. Prescription drugs. A prescription drug, prior to being set up for
458.4immediate or later administration, must be kept in the original container in which it was
458.5dispensed by the pharmacy bearing the original prescription label with legible information
458.6including the expiration or beyond-use date of a time-dated drug.
458.7    Subd. 21. Prohibitions. No prescription drug supply for one client may be used or
458.8saved for use by anyone other than the client.
458.9    Subd. 22. Disposition of drugs. (a) Any current medications being managed by the
458.10comprehensive home care provider must be given to the client or the client's representative
458.11when the client's service plan ends or medication management services are no longer part
458.12of the service plan. Medications that have been stored in the client's private living space
458.13for a client that is deceased or that have been discontinued or that have expired may be
458.14given to the client or the client's representative for disposal.
458.15(b) The comprehensive home care provider will dispose of any medications
458.16remaining with the comprehensive home care provider that are discontinued or expired or
458.17upon the termination of the service contract or the client's death according to state and
458.18federal regulations for disposition of drugs and controlled substances.
458.19(c) Upon disposition, the comprehensive home care provider must document in the
458.20client's record the disposition of the medications including the medication's name, strength,
458.21prescription number as applicable, quantity, to whom the medications were given, date of
458.22disposition, and names of staff and other individuals involved in the disposition.
458.23    Subd. 23. Loss or spillage. (a) Comprehensive home care providers providing
458.24medication management must develop and implement procedures for loss or spillage of all
458.25controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must
458.26require that when a spillage of a controlled substance occurs, a notation must be made
458.27in the client's record explaining the spillage and the actions taken. The notation must
458.28be signed by the person responsible for the spillage and include verification that any
458.29contaminated substance was disposed of according to state or federal regulations.
458.30(b) The procedures must require the comprehensive home care provider of
458.31medication management to investigate any known loss or unaccounted for prescription
458.32drugs and take appropriate action required under state or federal regulations and document
458.33the investigation in required records.

458.34    Sec. 21. [144A.4793] TREATMENT AND THERAPY MANAGEMENT
458.35SERVICES.
459.1    Subdivision 1. Providers with a comprehensive home care license. This section
459.2applies only to home care providers with a comprehensive home care license that provide
459.3treatment or therapy management services to clients. Treatment or therapy management
459.4services cannot be provided by a home care provider that has a basic home care license.
459.5    Subd. 2. Policies and procedures. (a) A comprehensive home care provider who
459.6provides treatment and therapy management services must develop, implement, and
459.7maintain up-to-date written treatment or therapy management policies and procedures.
459.8The policies and procedures must be developed under the supervision and direction of
459.9a registered nurse or appropriate licensed health professional consistent with current
459.10practice standards and guidelines.
459.11(b) The written policies and procedures must address requesting and receiving
459.12orders or prescriptions for treatments or therapies, providing the treatment or therapy,
459.13documenting of treatment or therapy activities, educating and communicating with clients
459.14about treatments or therapy they are receiving, monitoring and evaluating the treatment
459.15and therapy, and communicating with the prescriber.
459.16    Subd. 3. Individualized treatment or therapy management plan. For each
459.17client receiving management of ordered or prescribed treatments or therapy services, the
459.18comprehensive home care provider must prepare and include in the service plan a written
459.19statement of the treatment or therapy services that will be provided to the client. The
459.20provider must also develop and maintain a current individualized treatment and therapy
459.21management record for each client that contains at least the following:
459.22(1) a statement of the type of services that will be provided;
459.23(2) documentation of specific client instructions relating to the treatments or therapy
459.24administration;
459.25(3) identification of treatment or therapy tasks that will be delegated to unlicensed
459.26personnel;
459.27(4) procedures for notifying a registered nurse or appropriate licensed health
459.28professional when a problem arises with treatments or therapy services; and
459.29(5) any client-specific requirements relating to documentation of treatment and
459.30therapy received, verification that all treatments and therapy was administered as
459.31prescribed, and monitoring of treatment or therapy to prevent possible complications or
459.32adverse reactions. The treatment or therapy management record must be current and
459.33updated when there are any changes.
459.34    Subd. 4. Administration of treatments and therapy. Ordered or prescribed
459.35treatments or therapies must be administered by a nurse, physician, or other licensed health
459.36professional authorized to perform the treatment or therapy, or may be delegated or assigned
460.1to unlicensed personnel by the licensed health professional according to the appropriate
460.2practice standards for delegation or assignment. When administration of a treatment or
460.3therapy is delegated or assigned to unlicensed personnel, the home care provider must
460.4ensure that the registered nurse or authorized licensed health professional has:
460.5(1) instructed the unlicensed personnel in the proper methods with respect to each
460.6client and has demonstrated their ability to competently follow the procedures;
460.7(2) specified, in writing, specific instructions for each client and documented those
460.8instructions in the client's record; and
460.9(3) communicated with the unlicensed personnel about the individual needs of
460.10the client.
460.11    Subd. 5. Documentation of administration of treatments and therapies. Each
460.12treatment or therapy administered by a comprehensive home care provider must be
460.13documented in the client's record. The documentation must include the signature and title
460.14of the person who administered the treatment or therapy and must include the date and
460.15time of administration. When treatment or therapies are not administered as ordered or
460.16prescribed, the provider must document the reason why it was not administered and any
460.17follow-up procedures that were provided to meet the client's needs.
460.18    Subd. 6. Orders or prescriptions. There must be an up-to-date written or
460.19electronically recorded order or prescription for all treatments and therapies. The order
460.20must contain the name of the client, description of the treatment or therapy to be provided,
460.21and the frequency and other information needed to administer the treatment or therapy.

460.22    Sec. 22. [144A.4794] CLIENT RECORD REQUIREMENTS.
460.23    Subdivision 1. Client record. (a) The home care provider must maintain records
460.24for each client to whom it is providing services. Entries in the client records must be
460.25current, legible, permanently recorded, dated, and authenticated with the name and title
460.26of the person making the entry.
460.27(b) Client records, whether written or electronic, must be protected against loss,
460.28tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
460.29relevant federal and state laws. The home care provider shall establish and implement
460.30written procedures to control use, storage, and security of client's records and establish
460.31criteria for release of client information.
460.32(c) The home care provider may not disclose to any other person any personal,
460.33financial, medical, or other information about the client, except:
460.34(1) as may be required by law;
461.1(2) to employees or contractors of the home care provider, another home care
461.2provider, other health care practitioner or provider, or inpatient facility needing
461.3information in order to provide services to the client, but only such information that
461.4is necessary for the provision of services;
461.5(3) to persons authorized in writing by the client or the client's representative to
461.6receive the information, including third-party payers; and
461.7(4) to representatives of the commissioner authorized to survey or investigate home
461.8care providers under this chapter or federal laws.
461.9    Subd. 2. Access to records. The home care provider must ensure that the
461.10appropriate records are readily available to employees or contractors authorized to access
461.11the records. Client records must be maintained in a manner that allows for timely access,
461.12printing, or transmission of the records.
461.13    Subd. 3. Contents of client record. Contents of a client record include the
461.14following for each client:
461.15(1) identifying information, including the client's name, date of birth, address, and
461.16telephone number;
461.17(2) the name, address, and telephone number of an emergency contact, family
461.18members, client's representative, if any, or others as identified;
461.19(3) names, addresses, and telephone numbers of the client's health and medical
461.20service providers and other home care providers, if known;
461.21(4) health information, including medical history, allergies, and when the provider
461.22is managing medications, treatments or therapies that require documentation, and other
461.23relevant health records;
461.24(5) client's advance directives, if any;
461.25(6) the home care provider's current and previous assessments and service plans;
461.26(7) all records of communications pertinent to the client's home care services;
461.27(8) documentation of significant changes in the client's status and actions taken in
461.28response to the needs of the client including reporting to the appropriate supervisor or
461.29health care professional;
461.30(9) documentation of incidents involving the client and actions taken in response
461.31to the needs of the client including reporting to the appropriate supervisor or health
461.32care professional;
461.33(10) documentation that services have been provided as identified in the service plan;
461.34(11) documentation that the client has received and reviewed the home care bill
461.35of rights;
462.1(12) documentation that the client has been provided the statement of disclosure on
462.2limitations of services under section 144A.4791, subdivision 3;
462.3(13) documentation of complaints received and resolution;
462.4(14) discharge summary, including service termination notice and related
462.5documentation, when applicable; and
462.6(15) other documentation required under this chapter and relevant to the client's
462.7services or status.
462.8    Subd. 4. Transfer of client records. If a client transfers to another home care
462.9provider or other health care practitioner or provider, or is admitted to an inpatient facility,
462.10the home care provider, upon request of the client or the client's representative, shall take
462.11steps to ensure a coordinated transfer including sending a copy or summary of the client's
462.12record to the new home care provider, facility, or the client, as appropriate.
462.13    Subd. 5. Record retention. Following the client's discharge or termination of
462.14services, a home care provider must retain a client's record for at least five years, or as
462.15otherwise required by state or federal regulations. Arrangements must be made for secure
462.16storage and retrieval of client records if the home care provider ceases business.

462.17    Sec. 23. [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.
462.18    Subdivision 1. Qualifications, training, and competency. All staff providing
462.19home care services must be trained and competent in the provision of home care services
462.20consistent with current practice standards appropriate to the client's needs.
462.21    Subd. 2. Licensed health professionals and nurses. (a) Licensed health
462.22professionals and nurses providing home care services as an employee of a licensed home
462.23care provider must possess current Minnesota license or registration to practice.
462.24(b) Licensed health professionals and registered nurses must be competent in
462.25assessing client needs, planning appropriate home care services to meet client needs,
462.26implementing services, and supervising staff if assigned.
462.27(c) Nothing in this section limits or expands the rights of nurses or licensed health
462.28professionals to provide services within the scope of their licenses or registrations, as
462.29provided by law.
462.30    Subd. 3. Unlicensed personnel. (a) Unlicensed personnel providing basic home
462.31care services must have:
462.32(1) successfully completed a training and competency evaluation appropriate to
462.33the services provided by the home care provider and the topics listed in subdivision 7,
462.34paragraph (b); or
463.1(2) demonstrated competency by satisfactorily completing a written or oral test on
463.2the tasks the unlicensed personnel will perform and in the topics listed in subdivision
463.37, paragraph (b); and successfully demonstrate competency of topics in subdivision 7,
463.4paragraph (b), clauses (5), (7), and (8), by a practical skills test.
463.5Unlicensed personnel providing home care services for a basic home care provider may
463.6not perform delegated nursing or therapy tasks.
463.7(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive
463.8home care provider must have:
463.9(1) successfully completed training and demonstrated competency by successfully
463.10completing a written or oral test of the topics in subdivision 7, paragraphs (b) and (c), and
463.11a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5) and (7),
463.12and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform; or
463.13(2) satisfy the current requirements of Medicare for training or competency of home
463.14health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
463.15section 483 or section 484.36; or
463.16(3) before April 19, 1993, completed a training course for nursing assistants that was
463.17approved by the commissioner.
463.18(c) Unlicensed personnel performing therapy or treatment tasks delegated or
463.19assigned by a licensed health professional must meet the requirements for delegated
463.20tasks in subdivision 4 and any other training or competency requirements within the
463.21licensed health professional scope of practice relating to delegation or assignment of tasks
463.22to unlicensed personnel.
463.23    Subd. 4. Delegation of home care tasks. A registered nurse or licensed health
463.24professional may delegate tasks only to staff that are competent and possess the knowledge
463.25and skills consistent with the complexity of the tasks and according to the appropriate
463.26Minnesota Practice Act. The comprehensive home care provider must establish and
463.27implement a system to communicate up-to-date information to the registered nurse or
463.28licensed health professional regarding the current available staff and their competency so
463.29the registered nurse or licensed health professional has sufficient information to determine
463.30the appropriateness of delegating tasks to meet individual client needs and preferences.
463.31    Subd. 5. Individual contractors. When a home care provider contracts with an
463.32individual contractor excluded from licensure under section 144A.471 to provide home
463.33care services, the contractor must meet the same requirements required by this section for
463.34personnel employed by the home care provider.
463.35    Subd. 6. Temporary staff. When a home care provider contracts with a temporary
463.36staffing agency excluded from licensure under section 144A.471, those individuals must
464.1meet the same requirements required by this section for personnel employed by the home
464.2care provider and shall be treated as if they are staff of the home care provider.
464.3    Subd. 7. Requirements for instructors, training content, and competency
464.4evaluations for unlicensed personnel. (a) Instructors and competency evaluators must
464.5meet the following requirements:
464.6(1) training and competency evaluations of unlicensed personnel providing basic
464.7home care services must be conducted by individuals with work experience and training in
464.8providing home care services listed in section 144A.471, subdivisions 6 and 7; and
464.9(2) training and competency evaluations of unlicensed personnel providing
464.10comprehensive home care services must be conducted by a registered nurse, or another
464.11instructor may provide training in conjunction with the registered nurse. If the home care
464.12provider is providing services by licensed health professionals only, then that specific
464.13training and competency evaluation may be conducted by the licensed health professionals
464.14as appropriate.
464.15(b) Training and competency evaluations for all unlicensed personnel must include
464.16the following:
464.17(1) documentation requirements for all services provided;
464.18(2) reports of changes in the client's condition to the supervisor designated by the
464.19home care provider;
464.20(3) basic infection control, including blood-borne pathogens;
464.21(4) maintenance of a clean and safe environment;
464.22(5) appropriate and safe techniques in personal hygiene and grooming, including:
464.23(i) hair care and bathing;
464.24(ii) care of teeth, gums, and oral prosthetic devices;
464.25(iii) care and use of hearing aids; and
464.26(iv) dressing and assisting with toileting;
464.27(6) training on the prevention of falls for providers working with the elderly or
464.28individuals at risk of falls;
464.29(7) standby assistance techniques and how to perform them;
464.30(8) medication, exercise, and treatment reminders;
464.31(9) basic nutrition, meal preparation, food safety, and assistance with eating;
464.32(10) preparation of modified diets as ordered by a licensed health professional;
464.33(11) communication skills that include preserving the dignity of the client and
464.34showing respect for the client and the client's preferences, cultural background, and family;
464.35(12) awareness of confidentiality and privacy;
465.1(13) understanding appropriate boundaries between staff and clients and the client's
465.2family;
465.3(14) procedures to utilize in handling various emergency situations; and
465.4(15) awareness of commonly used health technology equipment and assistive devices.
465.5(c) In addition to paragraph (b), training and competency evaluation for unlicensed
465.6personnel providing comprehensive home care services must include:
465.7(1) observation, reporting, and documenting of client status;
465.8(2) basic knowledge of body functioning and changes in body functioning, injuries,
465.9or other observed changes that must be reported to appropriate personnel;
465.10(3) reading and recording temperature, pulse, and respirations of the client;
465.11(4) recognizing physical, emotional, cognitive, and developmental needs of the client;
465.12(5) safe transfer techniques and ambulation;
465.13(6) range of motioning and positioning; and
465.14(7) administering medications or treatments as required.
465.15(d) When the registered nurse or licensed health professional delegates tasks, they
465.16must ensure that prior to the delegation the unlicensed personnel is trained in the proper
465.17methods to perform the tasks or procedures for each client and are able to demonstrate
465.18the ability to competently follow the procedures and perform the tasks. If an unlicensed
465.19personnel has not regularly performed the delegated home care task for a period of 24
465.20consecutive months, the unlicensed personnel must demonstrate competency in the task
465.21to the registered nurse or appropriate licensed health professional. The registered nurse
465.22or licensed health professional must document instructions for the delegated tasks in
465.23the client's record.

465.24    Sec. 24. [144A.4796] ORIENTATION AND ANNUAL TRAINING
465.25REQUIREMENTS.
465.26    Subdivision 1. Orientation of staff and supervisors to home care. All staff
465.27providing and supervising direct home care services must complete an orientation to home
465.28care licensing requirements and regulations before providing home care services to clients.
465.29The orientation may be incorporated into the training required under subdivision 6. The
465.30orientation need only be completed once for each staff person and is not transferable
465.31to another home care provider.
465.32    Subd. 2. Content. The orientation must contain the following topics:
465.33    (1) an overview of sections 144A.43 to 144A.4798;
465.34(2) introduction and review of all the provider's policies and procedures related to
465.35the provision of home care services;
466.1(3) handling of emergencies and use of emergency services;
466.2(4) compliance with and reporting the maltreatment of minors or vulnerable adults
466.3under sections 626.556 and 626.557;
466.4(5) home care bill of rights, under section 144A.44;
466.5(6) handling of clients' complaints, reporting of complaints, and where to report
466.6complaints including information on the Office of Health Facility Complaints and the
466.7Common Entry Point;
466.8(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
466.9Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
466.10Ombudsman at the Department of Human Services, county managed care advocates,
466.11or other relevant advocacy services; and
466.12(8) review of the types of home care services the employee will be providing and
466.13the provider's scope of licensure.
466.14    Subd. 3. Verification and documentation of orientation. Each home care provider
466.15shall retain evidence in the employee record of each staff person having completed the
466.16orientation required by this section.
466.17    Subd. 4. Orientation to client. Staff providing home care services must be oriented
466.18specifically to each individual client and the services to be provided. This orientation may
466.19be provided in person, orally, in writing, or electronically.
466.20    Subd. 5. Training required relating to Alzheimer's disease and related disorders.
466.21For home care providers that provide services for persons with Alzheimer's or related
466.22disorders, all direct care staff and supervisors working with these clients must receive
466.23training that includes a current explanation of Alzheimer's disease and related disorders,
466.24effective approaches to use to problem solve when working with a client's challenging
466.25behaviors, and how to communicate with clients who have Alzheimer's or related disorders.
466.26    Subd. 6. Required annual training. All staff that perform direct home care
466.27services must complete at least eight hours of annual training for each 12 months of
466.28employment. The training may be obtained from the home care provider or another source
466.29and must include topics relevant to the provision of home care services. The annual
466.30training must include:
466.31(1) training on reporting of maltreatment of minors under section 626.556 and
466.32maltreatment of vulnerable adults under section 626.557, whichever is applicable to the
466.33services provided;
466.34(2) review of the home care bill of rights in section 144A.44;
466.35(3) review of infection control techniques used in the home and implementation of
466.36infection control standards including a review of hand washing techniques; the need for
467.1and use of protective gloves, gowns, and masks; appropriate disposal of contaminated
467.2materials and equipment, such as dressings, needles, syringes, and razor blades;
467.3disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of
467.4communicable diseases; and
467.5(4) review of the provider's policies and procedures relating to the provision of home
467.6care services and how to implement those policies and procedures.
467.7    Subd. 7. Documentation. A home care provider must retain documentation in the
467.8employee records of the staff that have satisfied the orientation and training requirements
467.9of this section.

467.10    Sec. 25. [144A.4797] PROVISION OF SERVICES.
467.11    Subdivision 1. Availability of contact person to staff. (a) A home care provider
467.12with a basic home care license must have a person available to staff for consultation on
467.13items relating to the provision of services or about the client.
467.14(b) A home care provider with a comprehensive home care license must have a
467.15registered nurse available for consultation to staff performing delegated nursing tasks
467.16and must have an appropriate licensed health professional available if performing other
467.17delegated services such as therapies.
467.18(c) The appropriate contact person must be readily available either in person, by
467.19telephone, or by other means to the staff at times when the staff is providing services.
467.20    Subd. 2. Supervision of staff; basic home care services. (a) Staff who perform
467.21basic home care services must be supervised periodically where the services are being
467.22provided to verify that the work is being performed competently and to identify problems
467.23and solutions to address issues relating to the staff's ability to provide the services. The
467.24supervision of the unlicensed personnel must be done by staff of the home care provider
467.25having the authority, skills, and ability to provide the supervision of unlicensed personnel
467.26and who can implement changes as needed, and train staff.
467.27(b) Supervision includes direct observation of unlicensed personnel while they
467.28are providing the services and may also include indirect methods of gaining input such
467.29as gathering feedback from the client. Supervisory review of staff must be provided at a
467.30frequency based on the staff person's competency and performance.
467.31(c) For an individual who is licensed as a home care provider, this section does
467.32not apply.
467.33    Subd. 3. Supervision of staff performing delegated nursing or therapy home
467.34care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must
467.35be supervised by an appropriately licensed health professional or a registered nurse
468.1periodically where the services are being provided to verify that the work is being
468.2performed competently and to identify problems and solutions related to the staff person's
468.3ability to perform the tasks. Supervision of staff performing medication or treatment
468.4administration shall be provided by a registered nurse or appropriately licensed health
468.5professional and must include observation of the staff administering the medication or
468.6treatment and the interaction with the client.
468.7(b) The direct supervision of staff performing delegated tasks must be provided
468.8within 30 days after the individual begins working for the home care provider and
468.9thereafter as needed based on performance. This requirement also applies to staff who
468.10have not performed delegated tasks for one year or longer.
468.11    Subd. 4. Documentation. A home care provider must retain documentation of
468.12supervision activities in the personnel records.
468.13    Subd. 5. Exemption. This section does not apply to an individual licensed under
468.14sections 144A.43 to 144A.4799.

468.15    Sec. 26. [144A.4798] EMPLOYEE HEALTH STATUS.
468.16    Subdivision 1. Tuberculosis (TB) prevention and control. A home care provider
468.17must establish and maintain a TB prevention and control program based on the most
468.18current guidelines issued by the Centers for Disease Control and Prevention (CDC).
468.19Components of a TB prevention and control program include screening all staff providing
468.20home care services, both paid and unpaid, at the time of hire for active TB disease and
468.21latent TB infection, and developing and implementing a written TB infection control plan.
468.22The commissioner shall make the most recent CDC standards available to home care
468.23providers on the department's Web site.
468.24    Subd. 2. Communicable diseases. A home care provider must follow
468.25current federal or state guidelines for prevention, control, and reporting of human
468.26immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
468.27communicable diseases as defined in Minnesota Rules, part 4605.7040.

468.28    Sec. 27. [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE
468.29PROVIDER ADVISORY COUNCIL.
468.30    Subdivision 1. Membership. The commissioner of health shall appoint eight
468.31persons to a home care provider advisory council consisting of the following:
468.32(1) three public members as defined in section 214.02 who shall be either persons
468.33who are currently receiving home care services or have family members receiving home
469.1care services, or persons who have family members who have received home care services
469.2within five years of the application date;
469.3(2) three Minnesota home care licensees representing basic and comprehensive
469.4levels of licensure who may be a managerial official, an administrator, a supervising
469.5registered nurse, or an unlicensed personnel performing home care tasks;
469.6(3) one member representing the Minnesota Board of Nursing; and
469.7(4) one member representing the ombudsman for long-term care.
469.8    Subd. 2. Organizations and meetings. The advisory council shall be organized
469.9and administered under section 15.059 with per diems and costs paid within the limits of
469.10available appropriations. Meetings will be held quarterly and hosted by the department.
469.11Subcommittees may be developed as necessary by the commissioner. Advisory council
469.12meetings are subject to the Open Meeting Law under chapter 13D.
469.13    Subd. 3. Duties. At the commissioner's request, the advisory council shall provide
469.14advice regarding regulations of Department of Health licensed home care providers in
469.15this chapter such as:
469.16(1) advice to the commissioner regarding community standards for home care
469.17practices;
469.18(2) advice to the commissioner on enforcement of licensing standards and whether
469.19certain disciplinary actions are appropriate;
469.20(3) advice to the commissioner about ways of distributing information to licensees
469.21and consumers of home care;
469.22(4) advice to the commissioner about training standards;
469.23(5) identify emerging issues and opportunities in the home care field, including the
469.24use of technology in home and telehealth capabilities; and
469.25(6) perform other duties as directed by the commissioner.

469.26    Sec. 28. [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR
469.27NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.
469.28    Subdivision 1. Temporary home care licenses and changes of ownership. (a)
469.29Beginning January 1, 2014, all temporary license applicants must apply for either a
469.30temporary basic or comprehensive home care license.
469.31(b) Temporary home care licenses issued beginning January 1, 2014, will be
469.32issued according to the provisions in sections 144A.43 to 144A.4799 and fees in section
469.33144A.472 and will be required to comply with this chapter.
469.34(c) No temporary licenses will be accepted or issued between December 1, 2013,
469.35and December 31, 2013.
470.1(d) Beginning October 1, 2013, changes in ownership applications will require
470.2payment of the new fees listed in section 144A.472. Providers who are providing
470.3nursing, delegated nursing, or professional health care services, must submit the fee for
470.4comprehensive home care providers, and all other providers must submit the fee for basic
470.5home care providers as provided in section 144A.472. Change of ownership applicants will
470.6be issued a new home care license based on the licensure law in effect on June 30, 2013.
470.7    Subd. 2. Current home care licensees with licenses prior to July 1, 2013. (a)
470.8Beginning July 1, 2014, department licensed home care providers must apply for either
470.9the basic or comprehensive home care license on their regularly scheduled renewal date.
470.10(b) By June 30, 2015, all home care providers must either have a basic or
470.11comprehensive home care license or temporary license.
470.12    Subd. 3. Renewal and change of ownership application of home care licensure
470.13during transition period. Renewal and change of ownership applications of home care
470.14licenses issued beginning July 1, 2014, will be issued according to sections 144A.43
470.15to 144A.4799, and upon license renewal or issuance of a new license for a change of
470.16ownership, providers must comply with sections 144A.43 to 144A.4799. Prior to renewal,
470.17providers must comply with the home care licensure law in effect on June 30, 2013.
470.18The fees charged for licenses renewed between July 1, 2014, and June 30, 2016,
470.19shall be the lesser of 200 percent or $1,000, except where the 200 percent or $1,000
470.20increase exceeds the actual renewal fee charged, with a maximum renewal fee of $6,625.
470.21For fiscal year 2014 only the fees for providers with revenues greater than $25,000
470.22and no more than $100,000 will be $313 and for providers with revenues no more than
470.23$25,000 the fee will be $125.
470.24The license renewal fee schedule in section 144A.472 will be effective July 1, 2016.

470.25    Sec. 29. [144A.482] REGISTRATION OF HOME MANAGEMENT
470.26PROVIDERS.
470.27(a) For purposes of this section, a home management provider is an individual or
470.28organization that provides at least two of the following services: housekeeping, meal
470.29preparation, and shopping, to a person who is unable to perform these activities due to
470.30illness, disability, or physical condition.
470.31(b) A person or organization that provides only home management services may not
470.32operate in the state without a current certificate of registration issued by the commissioner
470.33of health. To obtain a certificate of registration, the person or organization must annually
470.34submit to the commissioner the name, mailing and physical address, e-mail address, and
470.35telephone number of the individual or organization and a signed statement declaring that
471.1the individual or organization is aware that the home care bill of rights applies to their
471.2clients and that the person or organization will comply with the home care bill of rights
471.3provisions contained in section 144A.44. An individual or organization applying for a
471.4certificate must also provide the name, business address, and telephone number of each of
471.5the individuals responsible for the management or direction of the organization.
471.6(c) The commissioner shall charge an annual registration fee of $20 for individuals
471.7and $50 for organizations. The registration fee shall be deposited in the state treasury and
471.8credited to the state government special revenue fund.
471.9(d) A home care provider that provides home management services and other home
471.10care services must be licensed, but licensure requirements other than the home care bill of
471.11rights do not apply to those employees or volunteers who provide only home management
471.12services to clients who do not receive any other home care services from the provider.
471.13A licensed home care provider need not be registered as a home management service
471.14provider, but must provide an orientation on the home care bill of rights to its employees
471.15or volunteers who provide home management services.
471.16(e) An individual who provides home management services under this section must,
471.17within 120 days after beginning to provide services, attend an orientation session approved
471.18by the commissioner that provides training on the home care bill of rights and an orientation
471.19on the aging process and the needs and concerns of elderly and disabled persons.
471.20(f) The commissioner may suspend or revoke a provider's certificate of registration
471.21or assess fines for violation of the home care bill of rights. Any fine assessed for a
471.22violation of the home care bill of rights by a provider registered under this section shall be
471.23in the amount established in the licensure rules for home care providers. As a condition
471.24of registration, a provider must cooperate fully with any investigation conducted by the
471.25commissioner, including providing specific information requested by the commissioner on
471.26clients served and the employees and volunteers who provide services. Fines collected
471.27under this paragraph shall be deposited in the state treasury and credited to the fund
471.28specified in the statute or rule in which the penalty was established.
471.29(g) The commissioner may use any of the powers granted in sections 144A.43 to
471.30144A.4799 to administer the registration system and enforce the home care bill of rights
471.31under this section.

471.32    Sec. 30. AGENCY QUALITY IMPROVEMENT PROGRAM.
471.33    Subdivision 1. Annual legislative report on home care licensing. The
471.34commissioner shall establish a quality improvement program for the home care survey
471.35and home care complaint investigation processes. The commissioner shall submit to the
472.1legislature an annual report, beginning October 1, 2015, and each October 1 thereafter.
472.2Each report will review the previous state fiscal year of home care licensing and regulatory
472.3activities. The report must include, but is not limited to, an analysis of:
472.4(1) the number of FTE's in the Compliance Monitoring Division, including the
472.5Office of Health Facilities Complaint units assigned to home care licensing, survey,
472.6investigation, and enforcement process;
472.7(2) numbers of and descriptive information about licenses issued, complaints
472.8received and investigated, including allegations made and correction orders issued,
472.9surveys completed and timelines, correction order reconsiderations, and results;
472.10(3) descriptions of emerging trends in home care provision and areas of concern
472.11identified by the department in its regulation of home care providers;
472.12(4) information and data regarding performance improvement projects underway
472.13and planned by the commissioner in the area of home care surveys; and
472.14(5) work of the Department of Health Home Care Advisory Council.
472.15    Subd. 2. Study of correction order appeal process. Starting July 1, 2015, the
472.16commissioner shall study whether to add a correction order appeal process conducted by
472.17an independent reviewer, such as an administrative law judge or other office, and submit a
472.18report to the legislature by February 1, 2016. The commissioner shall review home care
472.19regulatory systems in other states as part of that study. The commissioner shall consult
472.20with the home care providers and representatives.

472.21    Sec. 31. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
472.22AND COMMUNITY-BASED SERVICES.
472.23(a) The Department of Health Compliance Monitoring Division and the Department
472.24of Human Services Licensing Division shall jointly develop an integrated licensing system
472.25for providers of both home care services subject to licensure under Minnesota Statutes,
472.26chapter 144A, and for home and community-based services subject to licensure under
472.27Minnesota Statutes, chapter 245D. The integrated licensing system shall:
472.28(1) require only one license of any provider of services under Minnesota Statutes,
472.29sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
472.30(2) promote quality services that recognize a person's individual needs and protect
472.31the person's health, safety, rights, and well-being;
472.32(3) promote provider accountability through application requirements, compliance
472.33inspections, investigations, and enforcement actions;
472.34(4) reference other applicable requirements in existing state and federal laws,
472.35including the federal Affordable Care Act;
473.1(5) establish internal procedures to facilitate ongoing communications between the
473.2agencies, and with providers and services recipients about the regulatory activities;
473.3(6) create a link between the agency Web sites so that providers and the public can
473.4access the same information regardless of which Web site is accessed initially; and
473.5(7) collect data on identified outcome measures as necessary for the agencies to
473.6report to the Centers for Medicare and Medicaid Services.
473.7(b) The joint recommendations for legislative changes to implement the integrated
473.8licensing system are due to the legislature by February 15, 2014.
473.9(c) Before implementation of the integrated licensing system, providers licensed as
473.10home care providers under Minnesota Statutes, chapter 144A, may also provide home
473.11and community-based services subject to licensure under Minnesota Statutes, chapter
473.12245D, without obtaining a home and community-based services license under Minnesota
473.13Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
473.14apply to these providers:
473.15(1) the provider must comply with all requirements under Minnesota Statutes, chapter
473.16245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
473.17(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
473.18enforced by the Department of Health under the enforcement authority set forth in
473.19Minnesota Statutes, section 144A.475; and
473.20(3) the Department of Health will provide information to the Department of Human
473.21Services about each provider licensed under this section, including the provider's license
473.22application, licensing documents, inspections, information about complaints received, and
473.23investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

473.24    Sec. 32. STUDY OF CORRECTION ORDER APPEAL PROCESS.
473.25Beginning July 1, 2015, the commissioner of health shall study whether to use
473.26a correction order appeal process conducted by an independent reviewer, such as
473.27an administrative law judge or other office. The commissioner shall review home
473.28care regulatory systems in other states and consult with the home care providers and
473.29representatives. By February 1, 2016, the commissioner shall submit a report to the chairs
473.30and ranking minority members of the committees of the legislature with jurisdiction over
473.31health and human services and judiciary issues with any recommendations regarding
473.32an independent appeal process.

473.33    Sec. 33. REPEALER.
473.34(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.
474.1(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
474.24668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040;
474.34668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
474.44668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170;
474.54668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240;
474.64668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830;
474.74668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
474.84669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.

474.9    Sec. 34. EFFECTIVE DATE.
474.10Sections 1 to 30 are effective the day following final enactment.


474.13    Section 1. Minnesota Statutes 2012, section 62J.692, subdivision 1, is amended to read:
474.14    Subdivision 1. Definitions. For purposes of this section, the following definitions
474.15apply:
474.16    (a) "Accredited clinical training" means the clinical training provided by a medical
474.17education program that is accredited through an organization recognized by the Department
474.18of Education, the Centers for Medicare and Medicaid Services, or another national body
474.19who reviews the accrediting organizations for multiple disciplines and whose standards
474.20for recognizing accrediting organizations are reviewed and approved by the commissioner
474.21of health in consultation with the Medical Education and Research Advisory Committee.
474.22    (b) "Commissioner" means the commissioner of health.
474.23    (c) "Clinical medical education program" means the accredited clinical training of
474.24physicians (medical students and residents), doctor of pharmacy practitioners, doctors
474.25of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
474.26registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
474.27 physician assistants, dental therapists and advanced dental therapists, psychologists,
474.28clinical social workers, community paramedics, and community health workers.
474.29    (d) "Sponsoring institution" means a hospital, school, or consortium located in
474.30Minnesota that sponsors and maintains primary organizational and financial responsibility
474.31for a clinical medical education program in Minnesota and which is accountable to the
474.32accrediting body.
474.33    (e) "Teaching institution" means a hospital, medical center, clinic, or other
474.34organization that conducts a clinical medical education program in Minnesota.
475.1    (f) "Trainee" means a student or resident involved in a clinical medical education
475.2program.
475.3    (g) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
475.4equivalent counts, that are at training sites located in Minnesota with currently active
475.5medical assistance enrollment status and a National Provider Identification (NPI) number
475.6where training occurs in either an inpatient or ambulatory patient care setting and where
475.7the training is funded, in part, by patient care revenues. Training that occurs in nursing
475.8facility settings is not eligible for funding under this section.

475.9    Sec. 2. Minnesota Statutes 2012, section 62J.692, subdivision 3, is amended to read:
475.10    Subd. 3. Application process. (a) A clinical medical education program conducted
475.11in Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners,
475.12dentists, chiropractors, or physician assistants is, dental therapists and advanced dental
475.13therapists, psychologists, clinical social workers, community paramedics, or community
475.14health workers are eligible for funds under subdivision 4 if the program:
475.15(1) is funded, in part, by patient care revenues;
475.16(2) occurs in patient care settings that face increased financial pressure as a result
475.17of competition with nonteaching patient care entities; and
475.18(3) emphasizes primary care or specialties that are in undersupply in Minnesota.
475.19(b) A clinical medical education program for advanced practice nursing is eligible for
475.20funds under subdivision 4 if the program meets the eligibility requirements in paragraph
475.21(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health
475.22Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges
475.23and Universities system or members of the Minnesota Private College Council.
475.24(c) Applications must be submitted to the commissioner by a sponsoring institution
475.25on behalf of an eligible clinical medical education program and must be received by
475.26October 31 of each year for distribution in the following year. An application for funds
475.27must contain the following information:
475.28(1) the official name and address of the sponsoring institution and the official
475.29name and site address of the clinical medical education programs on whose behalf the
475.30sponsoring institution is applying;
475.31(2) the name, title, and business address of those persons responsible for
475.32administering the funds;
475.33(3) for each clinical medical education program for which funds are being sought;
475.34the type and specialty orientation of trainees in the program; the name, site address, and
475.35medical assistance provider number and national provider identification number of each
476.1training site used in the program; the federal tax identification number of each training site
476.2used in the program, where available; the total number of trainees at each training site; and
476.3the total number of eligible trainee FTEs at each site; and
476.4(4) other supporting information the commissioner deems necessary to determine
476.5program eligibility based on the criteria in paragraphs (a) and (b) and to ensure the
476.6equitable distribution of funds.
476.7(d) An application must include the information specified in clauses (1) to (3) for
476.8each clinical medical education program on an annual basis for three consecutive years.
476.9After that time, an application must include the information specified in clauses (1) to (3)
476.10when requested, at the discretion of the commissioner:
476.11(1) audited clinical training costs per trainee for each clinical medical education
476.12program when available or estimates of clinical training costs based on audited financial
476.13data;
476.14(2) a description of current sources of funding for clinical medical education costs,
476.15including a description and dollar amount of all state and federal financial support,
476.16including Medicare direct and indirect payments; and
476.17(3) other revenue received for the purposes of clinical training.
476.18(e) An applicant that does not provide information requested by the commissioner
476.19shall not be eligible for funds for the current funding cycle.

476.20    Sec. 3. Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:
476.21    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute the
476.22available medical education funds to all qualifying applicants based on a distribution
476.23formula that reflects a summation of two factors:
476.24    (1) a public program volume factor, which is determined by the total volume of
476.25public program revenue received by each training site as a percentage of all public
476.26program revenue received by all training sites in the fund pool; and
476.27    (2) a supplemental public program volume factor, which is determined by providing
476.28a supplemental payment of 20 percent of each training site's grant to training sites whose
476.29public program revenue accounted for at least 0.98 percent of the total public program
476.30revenue received by all eligible training sites. Grants to training sites whose public
476.31program revenue accounted for less than 0.98 percent of the total public program revenue
476.32received by all eligible training sites shall be reduced by an amount equal to the total
476.33value of the supplemental payment.
476.34    Public program revenue for the distribution formula includes revenue from medical
476.35assistance, prepaid medical assistance, general assistance medical care, and prepaid
477.1general assistance medical care. Training sites that receive no public program revenue
477.2are ineligible for funds available under this subdivision. For purposes of determining
477.3training-site level grants to be distributed under paragraph (a), total statewide average
477.4costs per trainee for medical residents is based on audited clinical training costs per trainee
477.5in primary care clinical medical education programs for medical residents. Total statewide
477.6average costs per trainee for dental residents is based on audited clinical training costs
477.7per trainee in clinical medical education programs for dental students. Total statewide
477.8average costs per trainee for pharmacy residents is based on audited clinical training costs
477.9per trainee in clinical medical education programs for pharmacy students. Training sites
477.10whose training site level grant is less than $1,000 $5,000, based on the formula described
477.11in this paragraph, or that train fewer than 0.1 FTE eligible trainees, are ineligible for
477.12funds available under this subdivision. No training sites shall receive a grant per FTE
477.13trainee that is in excess of the 95th percentile grant per FTE across all eligible training
477.14sites; grants in excess of this amount will be redistributed to other eligible sites based on
477.15the formula described in this paragraph.
477.16    (b) Funds distributed shall not be used to displace current funding appropriations
477.17from federal or state sources.
477.18    (c) Funds shall be distributed to the sponsoring institutions indicating the amount
477.19to be distributed to each of the sponsor's clinical medical education programs based on
477.20the criteria in this subdivision and in accordance with the commissioner's approval letter.
477.21Each clinical medical education program must distribute funds allocated under paragraph
477.22(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
477.23institutions, which are accredited through an organization recognized by the Department
477.24of Education or the Centers for Medicare and Medicaid Services, may contract directly
477.25with training sites to provide clinical training. To ensure the quality of clinical training,
477.26those accredited sponsoring institutions must:
477.27    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
477.28training conducted at sites; and
477.29    (2) take necessary action if the contract requirements are not met. Action may include
477.30the withholding of payments under this section or the removal of students from the site.
477.31    (d) Use of funds is limited to expenses related to clinical training program costs for
477.32eligible programs.
477.33    (e) Any funds not distributed in accordance with the commissioner's approval letter
477.34must be returned to the medical education and research fund within 30 days of receiving
477.35notice from the commissioner. The commissioner shall distribute returned funds to the
477.36appropriate training sites in accordance with the commissioner's approval letter.
478.1    (e) (f) A maximum of $150,000 of the funds dedicated to the commissioner
478.2under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
478.3administrative expenses associated with implementing this section.

478.4    Sec. 4. Minnesota Statutes 2012, section 62J.692, subdivision 5, is amended to read:
478.5    Subd. 5. Report. (a) Sponsoring institutions receiving funds under this section
478.6must sign and submit a medical education grant verification report (GVR) to verify that
478.7the correct grant amount was forwarded to each eligible training site. If the sponsoring
478.8institution fails to submit the GVR by the stated deadline, or to request and meet
478.9the deadline for an extension, the sponsoring institution is required to return the full
478.10amount of funds received to the commissioner within 30 days of receiving notice from
478.11the commissioner. The commissioner shall distribute returned funds to the appropriate
478.12training sites in accordance with the commissioner's approval letter.
478.13    (b) The reports must provide verification of the distribution of the funds and must
478.14include:
478.15    (1) the total number of eligible trainee FTEs in each clinical medical education
478.16program;
478.17    (2) the name of each funded program and, for each program, the dollar amount
478.18distributed to each training site and a training site expenditure report;
478.19    (3) documentation of any discrepancies between the initial grant distribution notice
478.20included in the commissioner's approval letter and the actual distribution;
478.21    (4) a statement by the sponsoring institution stating that the completed grant
478.22verification report is valid and accurate; and
478.23    (5) other information the commissioner, with advice from the advisory committee,
478.24 deems appropriate to evaluate the effectiveness of the use of funds for medical education.
478.25    (c) By February 15 of Each year, the commissioner, with advice from the
478.26advisory committee, shall provide an annual summary report to the legislature on the
478.27implementation of this section.

478.28    Sec. 5. Minnesota Statutes 2012, section 62J.692, subdivision 7a, is amended to read:
478.29    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
478.30shall award grants to teaching institutions and clinical training sites for projects that
478.31increase dental access for underserved populations and promote innovative clinical
478.32training of dental professionals.
478.33(b) $1,000,000 of the funds dedicated to the commissioner under section 297F.10,
478.34subdivision 1, clause (2), plus any federal financial participation on these funds, shall
479.1be distributed by the commissioner for primary care development grants pursuant to
479.2paragraph (c).
479.3(c) The commissioner shall award grants to teaching institutions and clinical training
479.4sites for projects that increase the supply and availability of primary care providers for
479.5public program enrollees, improve access for underserved and rural populations, and
479.6promote interdisciplinary and team training of primary care providers and related personnel.
479.7(d) In awarding the grants, the commissioner, in consultation with the commissioner
479.8of human services, shall consider the following:
479.9(1) potential to successfully increase access to an underserved population;
479.10(2) the long-term viability of the project to improve access beyond the period
479.11of initial funding;
479.12(3) evidence of collaboration between the applicant and local communities;
479.13(4) the efficiency in the use of the funding; and
479.14(5) the priority level of the project in relation to state clinical education, access,
479.15and workforce goals.
479.16(b) (e) The commissioner shall periodically evaluate the priorities in awarding the
479.17innovations grants in order to ensure that the priorities meet the changing workforce
479.18needs of the state.

479.19    Sec. 6. Minnesota Statutes 2012, section 62J.692, subdivision 9, is amended to read:
479.20    Subd. 9. Review of eligible providers. The commissioner and the Medical
479.21Education and Research Costs Advisory Committee may review provider groups included
479.22in the definition of a clinical medical education program to assure that the distribution
479.23of the funds continue to be consistent with the purpose of this section. The results of
479.24any such reviews must be reported to the chairs and ranking minority members of the
479.25legislative committees with jurisdiction over health care policy and finance.

479.26    Sec. 7. Minnesota Statutes 2012, section 62J.692, is amended by adding a subdivision
479.27to read:
479.28    Subd. 11. Distribution of funds. If federal approval is not received for the formula
479.29described in subdivision 4, paragraph (a), 100 percent of available medical education
479.30and research funds shall be distributed based on a distribution formula that reflects as
479.31summation of two factors:
479.32(1) a public program volume factor, that is determined by the total volume of public
479.33program revenue received by each training site as a percentage of all public program
479.34revenue received by all training sites in the fund pool; and
480.1(2) a supplemental public program volume factor, that is determined by providing a
480.2supplemental payment of 20 percent of each training site's grant to training sites whose
480.3public program revenue accounted for a least 0.98 percent of the total public program
480.4revenue received by all eligible training sites. Grants to training sites whose public
480.5program revenue accounted for less than 0.98 percent of the total public program revenue
480.6received by all eligible training sites shall be reduced by an amount equal to the total
480.7value of the supplemental payment.

480.8    Sec. 8. Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:
480.9    Subdivision 1. Designation. (a) The commissioner shall designate essential
480.10community providers. The criteria for essential community provider designation shall be
480.11the following:
480.12(1) a demonstrated ability to integrate applicable supportive and stabilizing services
480.13with medical care for uninsured persons and high-risk and special needs populations,
480.14underserved, and other special needs populations; and
480.15(2) a commitment to serve low-income and underserved populations by meeting the
480.16following requirements:
480.17(i) has nonprofit status in accordance with chapter 317A;
480.18(ii) has tax-exempt status in accordance with the Internal Revenue Service Code,
480.19section 501(c)(3);
480.20(iii) charges for services on a sliding fee schedule based on current poverty income
480.21guidelines; and
480.22(iv) does not restrict access or services because of a client's financial limitation;
480.23(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
480.24hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
480.25government, an Indian health service unit, or a community health board as defined in
480.26chapter 145A;
480.27(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
480.28bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
480.29conditions;
480.30(5) a sole community hospital. For these rural hospitals, the essential community
480.31provider designation applies to all health services provided, including both inpatient and
480.32outpatient services. For purposes of this section, "sole community hospital" means a
480.33rural hospital that:
480.34(i) is eligible to be classified as a sole community hospital according to Code
480.35of Federal Regulations, title 42, section 412.92, or is located in a community with a
481.1population of less than 5,000 and located more than 25 miles from a like hospital currently
481.2providing acute short-term services;
481.3(ii) has experienced net operating income losses in two of the previous three
481.4most recent consecutive hospital fiscal years for which audited financial information is
481.5available; and
481.6(iii) consists of 40 or fewer licensed beds; or
481.7(6) a birth center licensed under section 144.615; or
481.8(7) a hospital or affiliated specialty clinic that:
481.9(i) serves patients who are predominately under the age of 21;
481.10(ii) provides intensive specialty pediatric services that are only routinely provided
481.11in less than five hospitals in the state; and
481.12(iii) serves children from at least half the counties in the state.
481.13(b) Prior to designation, the commissioner shall publish the names of all applicants
481.14in the State Register. The public shall have 30 days from the date of publication to submit
481.15written comments to the commissioner on the application. No designation shall be made
481.16by the commissioner until the 30-day period has expired.
481.17(c) The commissioner may designate an eligible provider as an essential community
481.18provider for all the services offered by that provider or for specific services designated by
481.19the commissioner.
481.20(d) For the purpose of this subdivision, supportive and stabilizing services include at
481.21a minimum, transportation, child care, cultural, and linguistic services where appropriate.

481.22    Sec. 9. Minnesota Statutes 2012, section 103I.005, is amended by adding a subdivision
481.23to read:
481.24    Subd. 1a. Bored geothermal heat exchanger. "Bored geothermal heat exchanger"
481.25means an earth-coupled heating or cooling device consisting of a sealed closed-loop
481.26piping system installed in a boring in the ground to transfer heat to or from the surrounding
481.27earth with no discharge.

481.28    Sec. 10. Minnesota Statutes 2012, section 103I.521, is amended to read:
481.29103I.521 FEES DEPOSITED WITH COMMISSIONER OF MANAGEMENT
481.30AND BUDGET.
481.31Unless otherwise specified, fees collected for licenses or registration by the
481.32commissioner under this chapter shall be deposited in the state treasury and credited to
481.33the state government special revenue fund.

482.1    Sec. 11. Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:
482.2    Subdivision 1. Who must pay. Except for the limitation contained in this section,
482.3the commissioner of health shall charge a handling fee may enter into a contractual
482.4agreement to recover costs incurred for analysis for diagnostic purposes for each specimen
482.5submitted to the Department of Health for analysis for diagnostic purposes by any hospital,
482.6private laboratory, private clinic, or physician. No fee shall be charged to any entity which
482.7receives direct or indirect financial assistance from state or federal funds administered by
482.8the Department of Health, including any public health department, nonprofit community
482.9clinic, sexually transmitted disease clinic, or similar entity. No fee will be charged The
482.10commissioner shall not charge for any biological materials submitted to the Department
482.11of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
482.12materials requested by the department to gather information for disease prevention or
482.13control purposes. The commissioner of health may establish other exceptions to the
482.14handling fee as may be necessary to protect the public's health. All fees collected pursuant
482.15to this section shall be deposited in the state treasury and credited to the state government
482.16special revenue fund. Funds generated in a contractual agreement made pursuant to this
482.17section shall be deposited in a special account and are appropriated to the commissioner
482.18for purposes of providing the services specified in the contracts. All such contractual
482.19agreements shall be processed in accordance with the provisions of chapter 16C.
482.20EFFECTIVE DATE.This section is effective July 1, 2014.

482.21    Sec. 12. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:
482.22    Subdivision 1. Duty to perform testing. (a) It is the duty of (1) the administrative
482.23officer or other person in charge of each institution caring for infants 28 days or less
482.24of age, (2) the person required in pursuance of the provisions of section 144.215, to
482.25register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
482.26birth, to arrange to have administered to every infant or child in its care tests for heritable
482.27and congenital disorders according to subdivision 2 and rules prescribed by the state
482.28commissioner of health.
482.29    (b) Testing and the, recording and of test results, reporting of test results, and
482.30follow-up of infants with heritable congenital disorders, including hearing loss detected
482.31through the early hearing detection and intervention program in section 144.966, shall be
482.32performed at the times and in the manner prescribed by the commissioner of health. The
482.33commissioner shall charge a fee so that the total of fees collected will approximate the
482.34costs of conducting the tests and implementing and maintaining a system to follow-up
483.1infants with heritable or congenital disorders, including hearing loss detected through the
483.2early hearing detection and intervention program under section 144.966.
483.3    (c) The fee is $101 per specimen. Effective July 1, 2010, the fee shall be increased
483.4to $106 to support the newborn screening program, including tests administered under
483.5this section and section 144.966, shall be $135 per specimen. The increased fee amount
483.6shall be deposited in the general fund. Costs associated with capital expenditures and
483.7the development of new procedures may be prorated over a three-year period when
483.8calculating the amount of the fees. This fee amount shall be deposited in the state treasury
483.9and credited to the state government special revenue fund.
483.10(d) The fee to offset the cost of the support services provided under section 144.966,
483.11subdivision 3a, shall be $15 per specimen. This fee shall be deposited in the state treasury
483.12and credited to the general fund.

483.13    Sec. 13. [144.1251] NEWBORN SCREENING FOR CRITICAL CONGENITAL
483.14HEART DISEASE (CCHD).
483.15    Subdivision 1. Required testing and reporting. (a) Each licensed hospital or
483.16state-licensed birthing center or facility that provides maternity and newborn care services
483.17shall provide screening for congenital heart disease to all newborns prior to discharge
483.18using pulse oximetry screening. The screening must occur after the infant is 24 hours old,
483.19before discharge from the nursery. If discharge occurs before the infant is 24 hours old,
483.20the screening must occur as close as possible to the time of discharge.
483.21(b) For premature infants (less than 36 weeks of gestation) and infants admitted to a
483.22higher-level nursery (special care or intensive care), pulse oximetry must be performed
483.23when medically appropriate prior to discharge.
483.24(c) Results of the screening must be reported to the Department of Health.
483.25    Subd. 2. Implementation. The Department of Health shall:
483.26(1) communicate the screening protocol requirements;
483.27(2) make information and forms available to the hospitals, birthing centers, and other
483.28facilities that are required to provide the screening, health care providers who provide
483.29prenatal care and care to newborns, and expectant parents and parents of newborns. The
483.30information and forms must include screening protocol and reporting requirements and
483.31parental options;
483.32(3) provide training to ensure compliance with and appropriate implementation of
483.33the screening;
484.1(4) establish the mechanism for the required data collection and reporting of
484.2screening and follow-up diagnostic results to the Department of Health according to the
484.3Department of Health's recommendations;
484.4(5) coordinate the implementation of universal standardized screening;
484.5(6) act as a resource for providers as the screening program is implemented, and in
484.6consultation with the Advisory Committee on Heritable and Congenital Disorders, develop
484.7and implement policies for early medical and developmental intervention services and
484.8long-term follow-up services for children and their families identified with a CCHD; and
484.9(7) comply with sections 144.125 to 144.128.

484.10    Sec. 14. Minnesota Statutes 2012, section 144.212, is amended to read:
484.11144.212 DEFINITIONS.
484.12    Subdivision 1. Scope. As used in sections 144.211 to 144.227, the following terms
484.13have the meanings given.
484.14    Subd. 1a. Amendment. "Amendment" means completion or correction of made
484.15to certification items on a vital record. after a certification has been issued or more
484.16than one year after the event, whichever occurs first, that does not result in a sealed or
484.17replaced record.
484.18    Subd. 1b. Authorized representative. "Authorized representative" means an agent
484.19designated in a written and witnessed statement signed by the subject of the record or
484.20other qualified applicant.
484.21    Subd. 1c. Certification item. "Certification item" means all individual items
484.22appearing on a certificate of birth and the demographic and legal items on a certificate
484.23of death.
484.24    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
484.25    Subd. 2a. Correction. "Correction" means a change made to a noncertification
484.26item, including information collected for medical and statistical purposes. A correction
484.27also means a change to a certification item within one year of the event provided that no
484.28certification, whether paper or electronic, has been issued.
484.29    Subd. 2b. Court of competent jurisdiction. "Court of competent jurisdiction"
484.30means a court within the United States with jurisdiction over the individual and such other
484.31individuals that the court deems necessary.
484.32    Subd. 2a 2c. Delayed registration. "Delayed registration" means registration of a
484.33record of birth or death filed one or more years after the date of birth or death.
485.1    Subd. 2d. Disclosure. "Disclosure" means to make available or make known
485.2personally identifiable information contained in a vital record, by any means of
485.3communication.
485.4    Subd. 3. File. "File" means to present a vital record or report for registration to the
485.5Office of the State Registrar Vital Records and to have the vital record or report accepted
485.6for registration by the Office of the State Registrar Vital Records.
485.7    Subd. 4. Final disposition. "Final disposition" means the burial, interment,
485.8cremation, removal from the state, or other authorized disposition of a dead body or
485.9dead fetus.
485.10    Subd. 4a. Institution. "Institution" means a public or private establishment that:
485.11(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment;
485.12or
485.13(2) provides nursing, custodial, or domiciliary care, or to which persons are
485.14committed by law.
485.15    Subd. 4b. Legal representative. "Legal representative" means a licensed attorney
485.16representing an individual.
485.17    Subd. 4c. Local issuance office. "Local issuance office" means a county
485.18governmental office authorized by the state registrar to issue certified birth and death
485.19records.
485.20    Subd. 4d. Record. "Record" means a report of a vital event that has been registered
485.21by the state registrar.
485.22    Subd. 5. Registration. "Registration" means the process by which vital records
485.23are completed, filed, and incorporated into the official records of the Office of the State
485.24Registrar.
485.25    Subd. 6. State registrar. "State registrar" means the commissioner of health or a
485.26designee.
485.27    Subd. 7. System of vital statistics. "System of vital statistics" includes the
485.28registration, collection, preservation, amendment, verification, maintenance of the security
485.29and integrity of, and certification of vital records, the collection of other reports required
485.30by sections 144.211 to 144.227, and related activities including the tabulation, analysis,
485.31publication, and dissemination of vital statistics.
485.32    Subd. 7a. Verification. "Verification" means a confirmation of the information on a
485.33vital record based on the facts contained in a certification.
485.34    Subd. 8. Vital record. "Vital record" means a record or report of birth, stillbirth,
485.35death, marriage, dissolution and annulment, and data related thereto. The birth record is
485.36not a medical record of the mother or the child.
486.1    Subd. 9. Vital statistics. "Vital statistics" means the data derived from records and
486.2reports of birth, death, fetal death, induced abortion, marriage, dissolution and annulment,
486.3and related reports.
486.4    Subd. 10. Local registrar. "Local registrar" means an individual designated under
486.5section 144.214, subdivision 1, to perform the duties of a local registrar.
486.6    Subd. 11. Consent to disclosure. "Consent to disclosure" means an affidavit filed
486.7with the state registrar which sets forth the following information:
486.8(1) the current name and address of the affiant;
486.9(2) any previous name by which the affiant was known;
486.10(3) the original and adopted names, if known, of the adopted child whose original
486.11birth record is to be disclosed;
486.12(4) the place and date of birth of the adopted child;
486.13(5) the biological relationship of the affiant to the adopted child; and
486.14(6) the affiant's consent to disclosure of information from the original birth record of
486.15the adopted child.

486.16    Sec. 15. Minnesota Statutes 2012, section 144.213, is amended to read:
486.17144.213 OFFICE OF THE STATE REGISTRAR VITAL RECORDS.
486.18    Subdivision 1. Creation; state registrar; Office of Vital Records. The
486.19commissioner shall establish an Office of the State Registrar Vital Records under the
486.20supervision of the state registrar. The commissioner shall furnish to local registrars the
486.21forms necessary for correct reporting of vital statistics, and shall instruct the local registrars
486.22in the collection and compilation of the data. The commissioner shall promulgate rules for
486.23the collection, filing, and registering of vital statistics information by the state and local
486.24registrars registrar, physicians, morticians, and others. Except as otherwise provided in
486.25sections 144.211 to 144.227, rules previously promulgated by the commissioner relating to
486.26the collection, filing and registering of vital statistics shall remain in effect until repealed,
486.27modified or superseded by a rule promulgated by the commissioner.
486.28    Subd. 2. General duties. (a) The state registrar shall coordinate the work of
486.29local registrars to maintain a statewide system of vital statistics. The state registrar is
486.30responsible for the administration and enforcement of sections 144.211 to 144.227, and
486.31shall supervise local registrars in the enforcement of sections 144.211 to 144.227 and the
486.32rules promulgated thereunder. Local issuance offices that fail to comply with the statutes
486.33or rules or to properly train employees may have their issuance privileges and access to
486.34the vital records system revoked.
487.1(b) To preserve vital records the state registrar is authorized to prepare typewritten,
487.2photographic, electronic or other reproductions of original records and files in the Office
487.3of Vital Records. The reproductions when certified by the state registrar shall be accepted
487.4as the original records.
487.5(c) The state registrar shall also:
487.6(1) establish, designate, and eliminate offices in the state to aid in the efficient
487.7issuance of vital records;
487.8(2) direct the activities of all persons engaged in activities pertaining to the operation
487.9of the system of vital statistics;
487.10(3) develop and conduct training programs to promote uniformity of policy and
487.11procedures throughout the state in matters pertaining to the system of vital statistics; and
487.12(4) prescribe, furnish, and distribute all forms required by sections 144.211 to
487.13144.227 and any rules adopted under these sections, and prescribe other means for the
487.14transmission of data, including electronic submission, that will accomplish the purpose of
487.15complete, accurate, and timely reporting and registration.
487.16    Subd. 3. Record keeping. To preserve vital records the state registrar is authorized
487.17to prepare typewritten, photographic, electronic or other reproductions of original records
487.18and files in the Office of the State Registrar. The reproductions when certified by the state
487.19or local registrar shall be accepted as the original records.

487.20    Sec. 16. [144.2131] SECURITY OF VITAL RECORDS SYSTEM.
487.21The state registrar shall:
487.22(1) authenticate all users of the system of vital statistics and document that all users
487.23require access based on their official duties;
487.24(2) authorize authenticated users of the system of vital statistics to access specific
487.25components of the vital statistics systems necessary for their official roles and duties;
487.26(3) establish separation of duties between staff roles that may be susceptible to fraud
487.27or misuse and routinely perform audits of staff work for the purposes of identifying fraud
487.28or misuse within the vital statistics system;
487.29(4) require that authenticated and authorized users of the system of vital
487.30statistics maintain a specified level of training related to security and provide written
487.31acknowledgment of security procedures and penalties;
487.32(5) validate data submitted for registration through site visits or with independent
487.33sources outside the registration system at a frequency specified by the state registrar to
487.34maximize the integrity of the data collected;
488.1(6) protect personally identifiable information and maintain systems pursuant to
488.2applicable state and federal laws;
488.3(7) accept a report of death if the decedent was born in Minnesota or if the decedent
488.4was a resident of Minnesota from the United States Department of Defense or the United
488.5States Department of State when the death of a United States citizen occurs outside the
488.6United States;
488.7(8) match death records registered in Minnesota and death records provided from
488.8other jurisdictions to live birth records in Minnesota;
488.9(9) match death records received from the United States Department of Defense
488.10or the United States Department of State for deaths of United States citizens occurring
488.11outside the United States to live birth records in Minnesota;
488.12(10) work with law enforcement to initiate and provide evidence for active fraud
488.13investigations;
488.14(11) provide secure workplace, storage, and technology environments that have
488.15limited role-based access;
488.16(12) maintain overt, covert, and forensic security measures for certifications,
488.17verifications, and automated systems that are part of the vital statistics system; and
488.18(13) comply with applicable state and federal laws and rules associated with
488.19information technology systems and related information security requirements.

488.20    Sec. 17. Minnesota Statutes 2012, section 144.215, subdivision 3, is amended to read:
488.21    Subd. 3. Father's name; child's name. In any case in which paternity of a child is
488.22determined by a court of competent jurisdiction, a declaration of parentage is executed
488.23under section 257.34, or a recognition of parentage is executed under section 257.75, the
488.24name of the father shall be entered on the birth record. If the order of the court declares
488.25the name of the child, it shall also be entered on the birth record. If the order of the court
488.26does not declare the name of the child, or there is no court order, then upon the request of
488.27both parents in writing, the surname of the child shall be defined by both parents.

488.28    Sec. 18. Minnesota Statutes 2012, section 144.215, subdivision 4, is amended to read:
488.29    Subd. 4. Social Security number registration. (a) Parents of a child born within
488.30this state shall give the parents' Social Security numbers to the Office of the State Registrar
488.31 Vital Records at the time of filing the birth record, but the numbers shall not appear on
488.32the certified record.
488.33(b) The Social Security numbers are classified as private data, as defined in section
488.3413.02, subdivision 12, on individuals, but the Office of the State Registrar Vital Records
489.1 shall provide a Social Security number to the public authority responsible for child support
489.2services upon request by the public authority for use in the establishment of parentage and
489.3the enforcement of child support obligations.

489.4    Sec. 19. Minnesota Statutes 2012, section 144.216, subdivision 1, is amended to read:
489.5    Subdivision 1. Reporting a foundling. Whoever finds a live born infant of unknown
489.6parentage shall report within five days to the Office of the State Registrar Vital Records
489.7 such information as the commissioner may by rule require to identify the foundling.

489.8    Sec. 20. Minnesota Statutes 2012, section 144.217, subdivision 2, is amended to read:
489.9    Subd. 2. Court petition. If a delayed record of birth is rejected under subdivision
489.101, a person may petition the appropriate court in the county in which the birth allegedly
489.11occurred for an order establishing a record of the date and place of the birth and the
489.12parentage of the person whose birth is to be registered. The petition shall state:
489.13(1) that the person for whom a delayed record of birth is sought was born in this state;
489.14(2) that no record of birth can be found in the Office of the State Registrar Vital
489.15Records;
489.16(3) that diligent efforts by the petitioner have failed to obtain the evidence required
489.17in subdivision 1;
489.18(4) that the state registrar has refused to register a delayed record of birth; and
489.19(5) other information as may be required by the court.

489.20    Sec. 21. Minnesota Statutes 2012, section 144.218, subdivision 5, is amended to read:
489.21    Subd. 5. Replacement of vital records. Upon the order of a court of this state, upon
489.22the request of a court of another state, upon the filing of a declaration of parentage under
489.23section 257.34, or upon the filing of a recognition of parentage with a the state registrar, a
489.24replacement birth record must be registered consistent with the findings of the court, the
489.25declaration of parentage, or the recognition of parentage.

489.26    Sec. 22. [144.2181] AMENDMENT AND CORRECTION OF VITAL RECORDS.
489.27(a) A vital record registered under sections 144.212 to 144.227 may be amended
489.28or corrected only according to sections 144.212 to 144.227 and rules adopted by the
489.29commissioner of health to protect the integrity and accuracy of vital records.
489.30(b)(1) A vital record that is amended under this section shall indicate that it has been
489.31amended, except as otherwise provided in this section or by rule.
490.1(2) Electronic documentation shall be maintained by the state registrar that
490.2identifies the evidence upon which the amendment or correction was based, the date
490.3of the amendment or correction, and the identity of the authorized person making the
490.4amendment or correction.
490.5(c) Upon receipt of a certified copy of an order of a court of competent jurisdiction
490.6changing the name of a person whose birth is registered in Minnesota and upon request of
490.7such person if 18 years of age or older or having the status of emancipated minor, the state
490.8registrar shall amend the birth record to show the new name. If the person is a minor or
490.9an incapacitated person then a parent, guardian, or legal representative of the minor or
490.10incapacitated person may make the request.
490.11(d) When an applicant does not submit the minimum documentation required for
490.12amending a vital record or when the state registrar has cause to question the validity
490.13or completeness of the applicant's statements or the documentary evidence, and the
490.14deficiencies are not corrected, the state registrar shall not amend the vital record. The
490.15state registrar shall advise the applicant of the reason for this action and shall further
490.16advise the applicant of the right of appeal to a court with competent jurisdiction over
490.17the Department of Health.

490.18    Sec. 23. Minnesota Statutes 2012, section 144.225, subdivision 1, is amended to read:
490.19    Subdivision 1. Public information; access to vital records. Except as otherwise
490.20provided for in this section and section 144.2252, information contained in vital records
490.21shall be public information. Physical access to vital records shall be subject to the
490.22supervision and regulation of the state and local registrars registrar and their employees
490.23pursuant to rules promulgated by the commissioner in order to protect vital records from
490.24loss, mutilation or destruction and to prevent improper disclosure of vital records which
490.25are confidential or private data on individuals, as defined in section 13.02, subdivisions
490.263 and 12.

490.27    Sec. 24. Minnesota Statutes 2012, section 144.225, subdivision 4, is amended to read:
490.28    Subd. 4. Access to records for research purposes. The state registrar may permit
490.29persons performing medical research access to the information restricted in subdivision
490.302 or 2a if those persons agree in writing not to disclose private or confidential data on
490.31individuals.

490.32    Sec. 25. Minnesota Statutes 2012, section 144.225, subdivision 7, is amended to read:
491.1    Subd. 7. Certified birth or death record. (a) The state or local registrar or local
491.2issuance office shall issue a certified birth or death record or a statement of no vital record
491.3found to an individual upon the individual's proper completion of an attestation provided
491.4by the commissioner and payment of the required fee:
491.5    (1) to a person who has a tangible interest in the requested vital record. A person
491.6who has a tangible interest is:
491.7    (i) the subject of the vital record;
491.8    (ii) a child of the subject;
491.9    (iii) the spouse of the subject;
491.10    (iv) a parent of the subject;
491.11    (v) the grandparent or grandchild of the subject;
491.12    (vi) if the requested record is a death record, a sibling of the subject;
491.13    (vii) the party responsible for filing the vital record;
491.14    (viii) the legal custodian, guardian or conservator, or health care agent of the subject;
491.15    (ix) a personal representative, by sworn affidavit of the fact that the certified copy is
491.16required for administration of the estate;
491.17    (x) a successor of the subject, as defined in section 524.1-201, if the subject is
491.18deceased, by sworn affidavit of the fact that the certified copy is required for administration
491.19of the estate;
491.20    (xi) if the requested record is a death record, a trustee of a trust by sworn affidavit of
491.21the fact that the certified copy is needed for the proper administration of the trust;
491.22    (xii) a person or entity who demonstrates that a certified vital record is necessary for
491.23the determination or protection of a personal or property right, pursuant to rules adopted
491.24by the commissioner; or
491.25    (xiii) adoption agencies in order to complete confidential postadoption searches as
491.26required by section 259.83;
491.27    (2) to any local, state, or federal governmental agency upon request if the certified
491.28vital record is necessary for the governmental agency to perform its authorized duties.
491.29An authorized governmental agency includes the Department of Human Services, the
491.30Department of Revenue, and the United States Citizenship and Immigration Services;
491.31    (3) to an attorney upon evidence of the attorney's license;
491.32    (4) pursuant to a court order issued by a court of competent jurisdiction. For
491.33purposes of this section, a subpoena does not constitute a court order; or
491.34    (5) to a representative authorized by a person under clauses (1) to (4).
491.35    (b) The state or local registrar or local issuance office shall also issue a certified
491.36death record to an individual described in paragraph (a), clause (1), items (ii) to (viii), if,
492.1on behalf of the individual, a licensed mortician furnishes the registrar with a properly
492.2completed attestation in the form provided by the commissioner within 180 days of the
492.3time of death of the subject of the death record. This paragraph is not subject to the
492.4requirements specified in Minnesota Rules, part 4601.2600, subpart 5, item B.

492.5    Sec. 26. Minnesota Statutes 2012, section 144.225, subdivision 8, is amended to read:
492.6    Subd. 8. Standardized format for certified birth and death records. No later than
492.7July 1, 2000, The commissioner shall develop maintain a standardized format for certified
492.8birth records and death records issued by the state and local registrars registrar and local
492.9issuance offices. The format shall incorporate security features in accordance with this
492.10section. The standardized format must be implemented on a statewide basis by July 1, 2001.

492.11    Sec. 27. Minnesota Statutes 2012, section 144.226, is amended to read:
492.12144.226 FEES.
492.13    Subdivision 1. Which services are for fee. The fees for the following services shall
492.14be the following or an amount prescribed by rule of the commissioner:
492.15(a) The fee for the issuance of a certified vital record, a search for a vital record that
492.16cannot be issued, or a certification that the vital record cannot be found is $9. No fee shall be
492.17charged for a certified birth, stillbirth, or death record that is reissued within one year of the
492.18original issue, if an amendment is made to the vital record and if the previously issued vital
492.19record is surrendered. The fee is payable at the time of application and is nonrefundable.
492.20(b) The fee for processing a request for the replacement of a birth record for
492.21all events, except when filing a recognition of parentage pursuant to section 257.73,
492.22subdivision 1 , is $40. The fee is payable at the time of application and is nonrefundable.
492.23(c) The fee for reviewing and processing a request for the filing of a delayed
492.24registration of birth, stillbirth, or death is $40. The fee is payable at the time of application
492.25and is nonrefundable. This fee includes one subsequent review of the request if the request
492.26is not acceptable upon the initial receipt.
492.27(d) The fee for reviewing and processing a request for the amendment of any vital
492.28record when requested more than 45 days after the filing of the vital record is $40. No fee
492.29shall be charged for an amendment requested within 45 days after the filing of the vital
492.30record. The fee is payable at the time of application and is nonrefundable. This fee includes
492.31one subsequent review of the request if the request is not acceptable upon the initial receipt.
492.32(e) The fee for reviewing and processing a request for the verification of information
492.33from vital records is $9 when the applicant furnishes the specific information to locate
492.34the vital record. When the applicant does not furnish specific information, the fee is
493.1$20 per hour for staff time expended. Specific information includes the correct date of
493.2the event and the correct name of the registrant subject of the record. Fees charged shall
493.3approximate the costs incurred in searching and copying the vital records. The fee is
493.4payable at the time of application and is nonrefundable.
493.5(f) The fee for reviewing and processing a request for the issuance of a copy of any
493.6document on file pertaining to a vital record or statement that a related document cannot
493.7be found is $9. The fee is payable at the time of application and is nonrefundable.
493.8    Subd. 2. Fees to state government special revenue fund. Fees collected under
493.9this section by the state registrar shall be deposited in the state treasury and credited to
493.10the state government special revenue fund.
493.11    Subd. 3. Birth record surcharge. (a) In addition to any fee prescribed under
493.12subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
493.13stillbirth record and for a certification that the vital record cannot be found. The local or
493.14 state registrar or local issuance office shall forward this amount to the commissioner of
493.15management and budget for deposit into the account for the children's trust fund for the
493.16prevention of child abuse established under section 256E.22. This surcharge shall not be
493.17charged under those circumstances in which no fee for a certified birth or stillbirth record
493.18is permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of
493.19management and budget that the assets in that fund exceed $20,000,000, this surcharge
493.20shall be discontinued.
493.21(b) In addition to any fee prescribed under subdivision 1, there shall be a
493.22nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
493.23or local issuance office shall forward this amount to the commissioner of management and
493.24budget for deposit in the general fund. This surcharge shall not be charged under those
493.25circumstances in which no fee for a certified birth record is permitted under subdivision 1,
493.26paragraph (a).
493.27    Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
493.28subdivision 1, there is a nonrefundable surcharge of $2 $4 for each certified and
493.29noncertified birth, stillbirth, or death record, and for a certification that the record cannot
493.30be found. The local issuance office or state registrar shall forward this amount to the
493.31commissioner of management and budget to be deposited into the state government special
493.32revenue fund. This surcharge shall not be charged under those circumstances in which no
493.33fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).
493.34(b) Effective August 1, 2005, the surcharge in paragraph (a) is $4.
493.35    Subd. 5. Electronic verification. A fee for the electronic verification or electronic
493.36certification of a vital event, when the information being verified or certified is obtained
494.1from a certified birth or death record, shall be established through contractual or
494.2interagency agreements with interested local, state, or federal government agencies.
494.3    Subd. 6. Alternative payment methods. Notwithstanding subdivision 1, alternative
494.4payment methods may be approved and implemented by the state registrar or a local
494.5registrar issuance office.

494.6    Sec. 28. [144.492] DEFINITIONS.
494.7    Subdivision 1. Applicability. For the purposes of sections 144.492 to 144.494, the
494.8terms defined in this section have the meanings given them.
494.9    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
494.10    Subd. 3. Joint commission. "Joint commission" means the independent,
494.11not-for-profit organization that accredits and certifies health care organizations and
494.12programs in the United States.
494.13    Subd. 4. Stroke. "Stroke" means the sudden death of brain cells in a localized
494.14area due to inadequate blood flow.

494.15    Sec. 29. [144.493] CRITERIA.
494.16    Subdivision 1. Comprehensive stroke center. A hospital meets the criteria for a
494.17comprehensive stroke center if the hospital has been certified as a comprehensive stroke
494.18center by the joint commission or another nationally recognized accreditation entity.
494.19    Subd. 2. Primary stroke center. A hospital meets the criteria for a primary stroke
494.20center if the hospital has been certified as a primary stroke center by the joint commission
494.21or another nationally recognized accreditation entity.
494.22    Subd. 3. Acute stroke ready hospital. A hospital meets the criteria for an acute
494.23stroke ready hospital if the hospital has the following elements of an acute stroke ready
494.24hospital:
494.25(1) an acute stroke team available or on-call 24 hours a days, seven days a week;
494.26(2) written stroke protocols, including triage, stabilization of vital functions, initial
494.27diagnostic tests, and use of medications;
494.28(3) a written plan and letter of cooperation with emergency medical services regarding
494.29triage and communication that are consistent with regional patient care procedures;
494.30(4) emergency department personnel who are trained in diagnosing and treating
494.31acute stroke;
494.32(5) the capacity to complete basic laboratory tests, electrocardiograms, and chest
494.33x-rays 24 hours a day, seven days a week;
495.1(6) the capacity to perform and interpret brain injury imaging studies 24 hours a
495.2days, seven days a week;
495.3(7) written protocols that detail available emergent therapies and reflect current
495.4treatment guidelines, which include performance measures and are revised at least annually;
495.5(8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan;
495.6(9) transfer protocols and agreements for stroke patients; and
495.7(10) a designated medical director with experience and expertise in acute stroke care.

495.8    Sec. 30. [144.494] DESIGNATING STROKE HOSPITALS.
495.9    Subdivision 1. Naming privileges. Unless it has been designated a stroke hospital
495.10by the commissioner, the joint commission, or another nationally recognized accreditation
495.11entity, no hospital shall use the term "stroke center" or "stroke hospital" in its name or its
495.12advertising or shall otherwise indicate it has stroke treatment capabilities.
495.13    Subd. 2. Designation. A hospital that voluntarily meets the criteria for a
495.14comprehensive stroke center, primary stroke center, or acute stroke ready hospital may
495.15apply to the commissioner for designation, and upon the commissioner's review and
495.16approval of the application, shall be designated as a comprehensive stroke center, a
495.17primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital
495.18loses its certification as a comprehensive stroke center or primary stroke center from
495.19the joint commission or other nationally recognized accreditation entity, its Minnesota
495.20designation will be immediately withdrawn. Prior to the expiration of the three-year
495.21designation, a hospital seeking to remain part of the voluntary acute stroke system may
495.22reapply to the commissioner for designation.

495.23    Sec. 31. [144.554] HEALTH FACILITIES CONSTRUCTION PLAN
495.24SUBMITTAL AND FEES.
495.25For hospitals, nursing homes, boarding care homes, residential hospices, supervised
495.26living facilities, freestanding outpatient surgical centers, and end-stage renal disease
495.27facilities, the commissioner shall collect a fee for the review and approval of architectural,
495.28mechanical, and electrical plans and specifications submitted before construction begins
495.29for each project relative to construction of new buildings, additions to existing buildings,
495.30or for remodeling or alterations of existing buildings. All fees collected in this section
495.31shall be deposited in the state treasury and credited to the state government special revenue
495.32fund. Fees must be paid at the time of submission of final plans for review and are not
495.33refundable. The fee is calculated as follows:

496.1	Construction project total estimated cost	Fee
496.2	$0 - $10,000	$30
496.3	$10,001 - $50,000	$150
496.4	$50,001 - $100,000	$300
496.5	$100,001 - $150,000	$450
496.6	$150,001 - $200,000	$600
496.7	$200,001 - $250,000	$750
496.8	$250,001 - $300,000	$900
496.9	$300,001 - $350,000	$1,050
496.10	$350,001 - $400,000	$1,200
496.11	$400,001 - $450,000	$1,350
496.12	$450,001 - $500,000	$1,500
496.13	$500,001 - $550,000	$1,650
496.14	$550,001 - $600,000	$1,800
496.15	$600,001 - $650,000	$1,950
496.16	$650,001 - $700,000	$2,100
496.17	$700,001 - $750,000	$2,250
496.18	$750,001 - $800,000	$2,400
496.19	$800,001 - $850,000	$2,550
496.20	$850,001 - $900,000	$2,700
496.21	$900,001 - $950,000	$2,850
496.22	$950,001 - $1,000,000	$3,000
496.23	$1,000,001 - $1,050,000	$3,150
496.24	$1,050,001 - $1,100,000	$3,300
496.25	$1,100,001 - $1,150,000	$3,450
496.26	$1,150,001 - $1,200,000	$3,600
496.27	$1,200,001 - $1,250,000	$3,750
496.28	$1,250,001 - $1,300,000	$3,900
496.29	$1,300,001 - $1,350,000	$4,050
496.30	$1,350,001 - $1,400,000	$4,200
496.31	$1,400,001 - $1,450,000	$4,350
496.32	$1,450,001 - $1,500,000	$4,500
496.33	$1,500,001 and over	$4,800

496.34    Sec. 32. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:
496.35    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
496.36commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
496.37to advise and assist the Department of Health and the Department of Education in:
496.38    (1) developing protocols and timelines for screening, rescreening, and diagnostic
496.39audiological assessment and early medical, audiological, and educational intervention
496.40services for children who are deaf or hard-of-hearing;
497.1    (2) designing protocols for tracking children from birth through age three that may
497.2have passed newborn screening but are at risk for delayed or late onset of permanent
497.3hearing loss;
497.4    (3) designing a technical assistance program to support facilities implementing the
497.5screening program and facilities conducting rescreening and diagnostic audiological
497.6assessment;
497.7    (4) designing implementation and evaluation of a system of follow-up and tracking;
497.8and
497.9    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
497.10culturally appropriate services for children with a confirmed hearing loss and their families.
497.11    (b) The commissioner of health shall appoint at least one member from each of the
497.12following groups with no less than two of the members being deaf or hard-of-hearing:
497.13    (1) a representative from a consumer organization representing culturally deaf
497.14persons;
497.15    (2) a parent with a child with hearing loss representing a parent organization;
497.16    (3) a consumer from an organization representing oral communication options;
497.17    (4) a consumer from an organization representing cued speech communication
497.18options;
497.19    (5) an audiologist who has experience in evaluation and intervention of infants
497.20and young children;
497.21    (6) a speech-language pathologist who has experience in evaluation and intervention
497.22of infants and young children;
497.23    (7) two primary care providers who have experience in the care of infants and young
497.24children, one of which shall be a pediatrician;
497.25    (8) a representative from the early hearing detection intervention teams;
497.26    (9) a representative from the Department of Education resource center for the deaf
497.27and hard-of-hearing or the representative's designee;
497.28    (10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing
497.29Minnesotans;
497.30    (11) a representative from the Department of Human Services Deaf and
497.31Hard-of-Hearing Services Division;
497.32    (12) one or more of the Part C coordinators from the Department of Education, the
497.33Department of Health, or the Department of Human Services or the department's designees;
497.34    (13) the Department of Health early hearing detection and intervention coordinators;
497.35    (14) two birth hospital representatives from one rural and one urban hospital;
497.36    (15) a pediatric geneticist;
498.1    (16) an otolaryngologist;
498.2    (17) a representative from the Newborn Screening Advisory Committee under
498.3this subdivision; and
498.4    (18) a representative of the Department of Education regional low-incidence
498.5facilitators.
498.6The commissioner must complete the appointments required under this subdivision by
498.7September 1, 2007.
498.8    (c) The Department of Health member shall chair the first meeting of the committee.
498.9At the first meeting, the committee shall elect a chair from its membership. The committee
498.10shall meet at the call of the chair, at least four times a year. The committee shall adopt
498.11written bylaws to govern its activities. The Department of Health shall provide technical
498.12and administrative support services as required by the committee. These services shall
498.13include technical support from individuals qualified to administer infant hearing screening,
498.14rescreening, and diagnostic audiological assessments.
498.15    Members of the committee shall receive no compensation for their service, but
498.16shall be reimbursed as provided in section 15.059 for expenses incurred as a result of
498.17their duties as members of the committee.
498.18    (d) This subdivision expires June 30, 2013 2019.

498.19    Sec. 33. Minnesota Statutes 2012, section 144.966, subdivision 3a, is amended to read:
498.20    Subd. 3a. Support services to families. (a) The commissioner shall contract with a
498.21nonprofit organization to provide support and assistance to families with children who are
498.22deaf or have a hearing loss. The family support provided must include:
498.23    (1) direct hearing loss specific parent-to-parent assistance and unbiased information
498.24on communication, educational, and medical options; and
498.25    (2) individualized deaf or hard-of-hearing mentors who provide education, including
498.26instruction in American Sign Language as an available option.
498.27The commissioner shall give preference to a nonprofit organization that has the ability to
498.28provide these services throughout the state.
498.29    (b) Family participation in the support and assistance services is voluntary.

498.30    Sec. 34. Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:
498.31    Subd. 3. Annual fees. (a) An application for accreditation under subdivision 6 must
498.32be accompanied by the annual fees specified in this subdivision. The annual fees include:
498.33(1) base accreditation fee, $1,500 $600;
498.34(2) sample preparation techniques fee, $200 per technique;
499.1(3) an administrative fee for laboratories located outside this state, $3,750 $2,000; and
499.2(4) test category fees.
499.3(b) For the programs in subdivision 3a, the commissioner may accredit laboratories
499.4for fields of testing under the categories listed in clauses (1) to (10) upon completion of
499.5the application requirements provided by subdivision 6 and receipt of the fees for each
499.6category under each program that accreditation is requested. The categories offered and
499.7related fees include:
499.8(1) microbiology, $450 $200;
499.9(2) inorganics, $450 $200;
499.10(3) metals, $1,000 $500;
499.11(4) volatile organics, $1,300 $1,000;
499.12(5) other organics, $1,300 $1,000;
499.13(6) radiochemistry, $1,500 $750;
499.14(7) emerging contaminants, $1,500 $1,000;
499.15(8) agricultural contaminants, $1,250 $1,000;
499.16(9) toxicity (bioassay), $1,000 $500; and
499.17(10) physical characterization, $250.
499.18(c) The total annual fee includes the base fee, the sample preparation techniques
499.19fees, the test category fees per program, and, when applicable, an administrative fee for
499.20out-of-state laboratories.
499.21EFFECTIVE DATE.This section is effective the day following final enactment.

499.22    Sec. 35. Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:
499.23    Subd. 5. State government special revenue fund. Fees collected by the
499.24commissioner under this section must be deposited in the state treasury and credited to
499.25the state government special revenue fund.
499.26EFFECTIVE DATE.This section is effective the day following final enactment.

499.27    Sec. 36. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
499.28to read:
499.29    Subd. 10. Establishing a selection committee. (a) The commissioner shall
499.30establish a selection committee for the purpose of recommending approval of qualified
499.31laboratory assessors and assessment bodies. Committee members shall demonstrate
499.32competence in assessment practices. The committee shall initially consist of seven
499.33members appointed by the commissioner as follows:
500.1(1) one member from a municipal laboratory accredited by the commissioner;
500.2(2) one member from an industrial treatment laboratory accredited by the
500.3commissioner;
500.4(3) one member from a commercial laboratory located in this state and accredited by
500.5the commissioner;
500.6(4) one member from a commercial laboratory located outside the state and
500.7accredited by the commissioner;
500.8(5) one member from a nongovernmental client of environmental laboratories;
500.9(6) one member from a professional organization with a demonstrated interest in
500.10environmental laboratory data and accreditation; and
500.11(7) one employee of the laboratory accreditation program administered by the
500.12department.
500.13(b) Committee appointments begin on January 1 and end on December 31 of the
500.14same year.
500.15(c) The commissioner shall appoint persons to fill vacant committee positions,
500.16expand the total number of appointed positions, or change the designated positions upon
500.17the advice of the committee.
500.18(d) The commissioner shall rescind the appointment of a selection committee
500.19member for sufficient cause as the commissioner determines, such as:
500.20(1) neglect of duty;
500.21(2) failure to notify the commissioner of a real or perceived conflict of interest;
500.22(3) nonconformance with committee procedures;
500.23(4) failure to demonstrate competence in assessment practices; or
500.24(5) official misconduct.
500.25(e) Members of the selection committee shall be compensated according to the
500.26provisions in section 15.059, subdivision 3.

500.27    Sec. 37. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
500.28to read:
500.29    Subd. 11. Activities of the selection committee. (a) The selection committee
500.30shall determine assessor and assessment body application requirements, the frequency
500.31of application submittal, and the application review schedule. The commissioner shall
500.32publish the application requirements and procedures on the accreditation program Web site.
500.33(b) In its selection process, the committee shall ensure its application requirements
500.34and review process:
500.35(1) meet the standards implemented in subdivision 2a;
501.1(2) ensure assessors have demonstrated competence in technical disciplines offered
501.2for accreditation by the commissioner; and
501.3(3) consider any history of repeated nonconformance or complaints regarding
501.4assessors or assessment bodies.
501.5(c) The selection committee shall consider an application received from qualified
501.6applicants and shall supply a list of recommended assessors and assessment bodies to
501.7the commissioner of health no later than 90 days after the commissioner notifies the
501.8committee of the need for review of applications.

501.9    Sec. 38. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
501.10to read:
501.11    Subd. 12. Commissioner approval of assessors and scheduling of assessments.
501.12(a) The commissioner shall approve assessors who:
501.13(1) are employed by the commissioner for the purpose of accrediting laboratories
501.14and demonstrate competence in assessment practices for environmental laboratories; or
501.15(2) are employed by a state or federal agency with established agreements for
501.16mutual assistance or recognition with the commissioner and demonstrate competence in
501.17assessment practices for environmental laboratories.
501.18(b) The commissioner may approve other assessors or assessment bodies who are
501.19recommended by the selection committee according to subdivision 11, paragraph (c). The
501.20commissioner shall publish the list of assessors and assessment bodies approved from the
501.21recommendations.
501.22(c) The commissioner shall rescind approval for an assessor or assessment body for
501.23sufficient cause as the commissioner determines, such as:
501.24(1) failure to meet the minimum qualifications for performing assessments;
501.25(2) lack of availability;
501.26(3) nonconformance with the applicable laws, rules, standards, policies, and
501.27procedures;
501.28(4) misrepresentation of application information regarding qualifications and
501.29training; or
501.30(5) excessive cost to perform the assessment activities.

501.31    Sec. 39. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
501.32to read:
501.33    Subd. 13. Laboratory requirements for assessor selection and scheduling
501.34assessments. (a) A laboratory accredited or seeking accreditation that requires an
502.1assessment by the commissioner must select an assessor, group of assessors, or an
502.2assessment body from the published list specified in subdivision 12, paragraph (b). An
502.3accredited laboratory must complete an assessment and make all corrective actions at least
502.4once every 24 months. Unless the commissioner grants interim accreditation, a laboratory
502.5seeking accreditation must complete an assessment and make all corrective actions
502.6prior to, but no earlier than, 18 months prior to the date the application is submitted to
502.7the commissioner.
502.8(b) A laboratory shall not select the same assessor more than twice in succession
502.9for assessments of the same facility unless the laboratory receives written approval
502.10from the commissioner for the selection. The laboratory must supply a written request
502.11to the commissioner for approval and must justify the reason for the request and provide
502.12the alternate options considered.
502.13(c) A laboratory must select assessors appropriate to the size and scope of the
502.14laboratory's application or existing accreditation.
502.15(d) A laboratory must enter into its own contract for direct payment of the assessors
502.16or assessment body. The contract must authorize the assessor, assessment body, or
502.17subcontractors to release all records to the commissioner regarding the assessment activity,
502.18when the assessment is performed in compliance with this statute.
502.19(e) A laboratory must agree to permit other assessors as selected by the commissioner
502.20to participate in the assessment activities.
502.21(f) If the laboratory determines no approved assessor is available to perform
502.22the assessment, the laboratory must notify the commissioner in writing and provide a
502.23justification for the determination. If the commissioner confirms no approved assessor
502.24is available, the commissioner may designate an alternate assessor from those approved
502.25in subdivision 12, paragraph (a), or the commissioner may delay the assessment until
502.26an assessor is available. If an approved alternate assessor performs the assessment, the
502.27commissioner may collect fees equivalent to the cost of performing the assessment
502.28activities.
502.29(g) Fees collected under this section are deposited in a special account and are
502.30annually appropriated to the commissioner for the purpose of performing assessment
502.31activities.
502.32EFFECTIVE DATE.This section is effective the day following final enactment.

502.33    Sec. 40. Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:
502.34    Subd. 4. Administrative penalty orders. (a) The commissioner may issue an
502.35order requiring violations to be corrected and administratively assessing monetary
503.1penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The
503.2procedures in section 144.991 must be followed when issuing administrative penalty
503.3orders. Except in the case of repeated or serious violations, the penalty assessed in the
503.4order must be forgiven if the person who is subject to the order demonstrates in writing
503.5to the commissioner before the 31st day after receiving the order that the person has
503.6corrected the violation or has developed a corrective plan acceptable to the commissioner.
503.7The maximum amount of an administrative penalty order is $10,000 for each violator for
503.8all violations by that violator identified in an inspection or review of compliance.
503.9(b) Notwithstanding paragraph (a), the commissioner may issue to a large public
503.10water supply, serving a population of more than 10,000 persons, an administrative penalty
503.11order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000
503.12for each violation of sections 144.381 to 144.385 and rules adopted thereunder.
503.13(c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead
503.14firm or person performing regulated lead work, an administrative penalty order imposing a
503.15penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of
503.16sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from
503.17monetary penalties in this section shall be deposited in the state treasury and credited to
503.18the state government special revenue fund.

503.19    Sec. 41. Minnesota Statutes 2012, section 145.906, is amended to read:
503.20145.906 POSTPARTUM DEPRESSION EDUCATION AND INFORMATION.
503.21(a) The commissioner of health shall work with health care facilities, licensed health
503.22and mental health care professionals, the women, infants, and children (WIC) program,
503.23mental health advocates, consumers, and families in the state to develop materials and
503.24information about postpartum depression, including treatment resources, and develop
503.25policies and procedures to comply with this section.
503.26(b) Physicians, traditional midwives, and other licensed health care professionals
503.27providing prenatal care to women must have available to women and their families
503.28information about postpartum depression.
503.29(c) Hospitals and other health care facilities in the state must provide departing new
503.30mothers and fathers and other family members, as appropriate, with written information
503.31about postpartum depression, including its symptoms, methods of coping with the illness,
503.32and treatment resources.
503.33(d) Information about postpartum depression, including its symptoms, potential
503.34impact on families, and treatment resources, must be available at WIC sites.
504.1(e) The commissioner of health, in collaboration with the commissioner of human
504.2services and to the extent authorized by the federal Centers for Disease Control and
504.3Prevention, shall review the materials and information related to postpartum depression to
504.4determine their effectiveness in transmitting the information in a way that reduces racial
504.5health disparities as reported in surveys of maternal attitudes and experiences before,
504.6during, and after pregnancy, including those conducted by the commissioner of health. The
504.7commissioner shall implement changes to reduce racial health disparities in the information
504.8reviewed, as needed, and ensure that women of color are receiving the information.

504.9    Sec. 42. [145.907] MATERNAL DEPRESSION; DEFINITION.
504.10"Maternal depression" means depression or other perinatal mood or anxiety disorder
504.11experienced by a woman during pregnancy or during the first year following the birth of
504.12her child.

504.13    Sec. 43. Minnesota Statutes 2012, section 145.986, is amended to read:
504.14145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.
504.15    Subdivision 1. Grants to local communities Purpose. The purpose of the statewide
504.16health improvement program is to:
504.17(1) address the top three leading preventable causes of illness and death: tobacco use
504.18and exposure, poor diet, and lack of regular physical activity;
504.19(2) promote the development, availability, and use of evidence-based, community
504.20level, comprehensive strategies to create healthy communities; and
504.21(3) measure the impact of the evidence-based, community health improvement
504.22practices which over time work to contain health care costs and reduce chronic diseases.
504.23    Subd. 1a. Grants to local communities. (a) Beginning July 1, 2009, the
504.24commissioner of health shall award competitive grants to community health boards
504.25established pursuant to section 145A.09 and tribal governments to convene, coordinate,
504.26and implement evidence-based strategies targeted at reducing the percentage of
504.27Minnesotans who are obese or overweight and to reduce the use of tobacco.
504.28    (b) Grantee activities shall:
504.29    (1) be based on scientific evidence;
504.30    (2) be based on community input;
504.31    (3) address behavior change at the individual, community, and systems levels;
504.32    (4) occur in community, school, worksite, and health care settings; and
504.33    (5) be focused on policy, systems, and environmental changes that support healthy
504.34behaviors.; and
505.1(6) address the health disparities and inequities that exist in the grantee's community.
505.2    (c) To receive a grant under this section, community health boards and tribal
505.3governments must submit proposals to the commissioner. A local match of ten percent
505.4of the total funding allocation is required. This local match may include funds donated
505.5by community partners.
505.6    (d) In order to receive a grant, community health boards and tribal governments
505.7must submit a health improvement plan to the commissioner of health for approval. The
505.8commissioner may require the plan to identify a community leadership team, community
505.9partners, and a community action plan that includes an assessment of area strengths and
505.10needs, proposed action strategies, technical assistance needs, and a staffing plan.
505.11    (e) The grant recipient must implement the health improvement plan, evaluate the
505.12effectiveness of the interventions strategies, and modify or discontinue interventions
505.13 strategies found to be ineffective.
505.14    (f) By January 15, 2011, the commissioner of health shall recommend whether any
505.15funding should be distributed to community health boards and tribal governments based
505.16on health disparities demonstrated in the populations served.
505.17    (g) (f) Grant recipients shall report their activities and their progress toward the
505.18outcomes established under subdivision 2 to the commissioner in a format and at a time
505.19specified by the commissioner.
505.20    (h) (g) All grant recipients shall be held accountable for making progress toward
505.21the measurable outcomes established in subdivision 2. The commissioner shall require a
505.22corrective action plan and may reduce the funding level of grant recipients that do not
505.23make adequate progress toward the measurable outcomes.
505.24(h) Notwithstanding paragraph (a), the commissioner may award funding to
505.25convene, coordinate, and implement evidence-based strategies targeted at reducing other
505.26risk factors, aside from tobacco use and exposure, poor diet, and lack of regular physical
505.27activity, that are associated with chronic disease and may impact public health. The
505.28commissioner shall develop a criteria and procedures to allocate funding under this section.
505.29    Subd. 2. Outcomes. (a) The commissioner shall set measurable outcomes to meet
505.30the goals specified in subdivision 1, and annually review the progress of grant recipients
505.31in meeting the outcomes.
505.32    (b) The commissioner shall measure current public health status, using existing
505.33measures and data collection systems when available, to determine baseline data against
505.34which progress shall be monitored.
505.35    Subd. 3. Technical assistance and oversight. (a) The commissioner shall provide
505.36content expertise, technical expertise, and training to grant recipients and advice on
506.1evidence-based strategies, including those based on populations and types of communities
506.2served. The commissioner shall ensure that the statewide health improvement program
506.3meets the outcomes established under subdivision 2 by conducting a comprehensive
506.4statewide evaluation and assisting grant recipients to modify or discontinue interventions
506.5found to be ineffective.
506.6(b) For the purposes of carrying out the grant program under this section, including
506.7for administrative purposes, the commissioner shall award contracts to appropriate entities
506.8to assist in training and provide technical assistance to grantees.
506.9(c) Contracts awarded under paragraph (b) may be used to provide technical
506.10assistance and training in the areas of:
506.11(1) community engagement and capacity building;
506.12(2) tribal support;
506.13(3) community asset building and risk behavior reduction;
506.14(4) legal;
506.15(5) communications;
506.16(6) community, school, health care, work site, and other site-specific strategies; and
506.17(7) health equity.
506.18    Subd. 4. Evaluation. (a) Using the outcome measures established in subdivision 3,
506.19the commissioner shall conduct a biennial evaluation of the statewide health improvement
506.20program funded under this section. Grant recipients shall cooperate with the commissioner
506.21in the evaluation and provide the commissioner with the information necessary to conduct
506.22the evaluation.
506.23(b) Grant recipients will collect, monitor, and submit to the Department of Health
506.24baseline and annual data and provide information to improve the quality and impact of
506.25community health improvement strategies.
506.26(c) For the purposes of carrying out the grant program under this section, including
506.27for administrative purposes, the commissioner shall award contracts to appropriate entities
506.28to assist in designing and implementing evaluation systems.
506.29(d) Contracts awarded under paragraph (c) may be used to:
506.30(1) develop grantee monitoring and reporting systems to track grantee progress,
506.31including aggregated and disaggregated data;
506.32(2) manage, analyze, and report program evaluation data results; and
506.33(3) utilize innovative support tools to analyze and predict the impact of prevention
506.34strategies on health outcomes and state health care costs over time.
506.35    Subd. 5. Report. The commissioner shall submit a biennial report to the legislature
506.36on the statewide health improvement program funded under this section. These reports
507.1 The report must include information on each grant recipients recipient, including the
507.2activities that were conducted by the grantee using grant funds, evaluation data, and
507.3outcome measures, if available. the grantee's progress toward achieving the measurable
507.4outcomes established under subdivision 2, and the data provided to the commissioner by
507.5the grantee to measure these outcomes for grant activities. The commissioner shall provide
507.6information on grants in which a corrective action plan was required under subdivision
507.71a, the types of plan action, and the progress that has been made toward meeting the
507.8measurable outcomes. In addition, the commissioner shall provide recommendations
507.9on future areas of focus for health improvement. These reports are due by January 15
507.10of every other year, beginning in 2010. In the report due on January 15, 2010, the
507.11commissioner shall include recommendations on a sustainable funding source for the
507.12statewide health improvement program other than the health care access fund In the report
507.13due on January 15, 2014, the commissioner shall include a description of the contracts
507.14awarded under subdivision 4, paragraph (c), and the monitoring and evaluation systems
507.15that were designed and implemented under these contracts.
507.16    Subd. 6. Supplantation of existing funds. Community health boards and tribal
507.17governments must use funds received under this section to develop new programs, expand
507.18current programs that work to reduce the percentage of Minnesotans who are obese or
507.19overweight or who use tobacco, or replace discontinued state or federal funds previously
507.20used to reduce the percentage of Minnesotans who are obese or overweight or who use
507.21tobacco. Funds must not be used to supplant current state or local funding to community
507.22health boards or tribal governments used to reduce the percentage of Minnesotans who are
507.23obese or overweight or to reduce tobacco use.

507.24    Sec. 44. Minnesota Statutes 2012, section 145A.17, subdivision 1, is amended to read:
507.25    Subdivision 1. Establishment; goals. The commissioner shall establish a program
507.26to fund family home visiting programs designed to foster healthy beginnings, improve
507.27pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce
507.28juvenile delinquency, promote positive parenting and resiliency in children, and promote
507.29family health and economic self-sufficiency for children and families. The commissioner
507.30shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
507.31professionals and paraprofessionals from the fields of public health nursing, social work,
507.32and early childhood education. A program funded under this section must serve families
507.33at or below 200 percent of the federal poverty guidelines, and other families determined
507.34to be at risk, including but not limited to being at risk for child abuse, child neglect, or
508.1juvenile delinquency. Programs must begin prenatally whenever possible and must be
508.2targeted to families with:
508.3    (1) adolescent parents;
508.4    (2) a history of alcohol or other drug abuse;
508.5    (3) a history of child abuse, domestic abuse, or other types of violence;
508.6    (4) a history of domestic abuse, rape, or other forms of victimization;
508.7    (5) reduced cognitive functioning;
508.8    (6) a lack of knowledge of child growth and development stages;
508.9    (7) low resiliency to adversities and environmental stresses;
508.10    (8) insufficient financial resources to meet family needs;
508.11    (9) a history of homelessness;
508.12    (10) a risk of long-term welfare dependence or family instability due to employment
508.13barriers; or
508.14(11) a serious mental health disorder, including maternal depression as defined in
508.15section 145.907; or
508.16    (11) (12) other risk factors as determined by the commissioner.

508.17    Sec. 45. Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:
508.18    Subd. 1a. Alkaline hydrolysis. "Alkaline hydrolysis" means the reduction of a dead
508.19human body to essential elements through exposure to a combination of heat and alkaline
508.20hydrolysis and the repositioning or movement of the body during the process to facilitate
508.21reduction, a water-based dissolution process using alkaline chemicals, heat, agitation, and
508.22pressure to accelerate natural decomposition; the processing of the hydrolyzed remains
508.23after removal from the alkaline hydrolysis chamber, vessel; placement of the processed
508.24remains in a hydrolyzed remains container,; and release of the hydrolyzed remains to an
508.25appropriate party. Alkaline hydrolysis is a form of final disposition.

508.26    Sec. 46. Minnesota Statutes 2012, section 149A.02, is amended by adding a
508.27subdivision to read:
508.28    Subd. 1b. Alkaline hydrolysis container. "Alkaline hydrolysis container" means a
508.29hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily
508.30fluids that encases the body and into which a dead human body is placed prior to insertion
508.31into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or
508.32biodegradable alternative containers or caskets.

509.1    Sec. 47. Minnesota Statutes 2012, section 149A.02, is amended by adding a
509.2subdivision to read:
509.3    Subd. 1c. Alkaline hydrolysis facility. "Alkaline hydrolysis facility" means a
509.4building or structure containing one or more alkaline hydrolysis vessels for the alkaline
509.5hydrolysis of dead human bodies.

509.6    Sec. 48. Minnesota Statutes 2012, section 149A.02, is amended by adding a
509.7subdivision to read:
509.8    Subd. 1d. Alkaline hydrolysis vessel. "Alkaline hydrolysis vessel" means the
509.9container in which the alkaline hydrolysis of a dead human body is performed.

509.10    Sec. 49. Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:
509.11    Subd. 2. Alternative container. "Alternative container" means a nonmetal
509.12receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed
509.13for the encasement of dead human bodies and is made of hydrolyzable or biodegradable
509.14materials, corrugated cardboard, fiberboard, pressed-wood, or other like materials.

509.15    Sec. 50. Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:
509.16    Subd. 3. Arrangements for disposition. "Arrangements for disposition" means
509.17any action normally taken by a funeral provider in anticipation of or preparation for the
509.18entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

509.19    Sec. 51. Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:
509.20    Subd. 4. Cash advance item. "Cash advance item" means any item of service
509.21or merchandise described to a purchaser as a "cash advance," "accommodation," "cash
509.22disbursement," or similar term. A cash advance item is also any item obtained from a
509.23third party and paid for by the funeral provider on the purchaser's behalf. Cash advance
509.24items include, but are not limited to, cemetery, alkaline hydrolysis, or crematory services,
509.25pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary
509.26notices, gratuities, and death records.

509.27    Sec. 52. Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:
509.28    Subd. 5. Casket. "Casket" means a rigid container which is designed for the
509.29encasement of a dead human body and is usually constructed of hydrolyzable or
509.30biodegradable materials, wood, metal, fiberglass, plastic, or like material, and ornamented
509.31and lined with fabric.

510.1    Sec. 53. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.2subdivision to read:
510.3    Subd. 12a. Crypt. "Crypt" means a space in a mausoleum of sufficient size, used or
510.4intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.

510.5    Sec. 54. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.6subdivision to read:
510.7    Subd. 12b. Direct alkaline hydrolysis. "Direct alkaline hydrolysis" means a
510.8final disposition of a dead human body by alkaline hydrolysis, without formal viewing,
510.9visitation, or ceremony with the body present.

510.10    Sec. 55. Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:
510.11    Subd. 16. Final disposition. "Final disposition" means the acts leading to and the
510.12entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

510.13    Sec. 56. Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:
510.14    Subd. 23. Funeral services. "Funeral services" means any services which may
510.15be used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis,
510.16cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral
510.17ceremony or the final disposition of dead human bodies.

510.18    Sec. 57. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.19subdivision to read:
510.20    Subd. 24a. Holding facility. "Holding facility" means a secure enclosed room or
510.21confined area within a funeral establishment, crematory, or alkaline hydrolysis facility
510.22used for temporary storage of human remains awaiting final disposition.

510.23    Sec. 58. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.24subdivision to read:
510.25    Subd. 24b. Hydrolyzed remains. "Hydrolyzed remains" means the remains of a
510.26dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not
510.27include pacemakers, prostheses, or similar foreign materials.

510.28    Sec. 59. Minnesota Statutes 2012, section 149A.02, is amended by adding a
510.29subdivision to read:
511.1    Subd. 24c. Hydrolyzed remains container. "Hydrolyzed remains container" means
511.2a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a
511.3hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage
511.4jewelry.

511.5    Sec. 60. Minnesota Statutes 2012, section 149A.02, is amended by adding a
511.6subdivision to read:
511.7    Subd. 26a. Inurnment. "Inurnment" means placing hydrolyzed or cremated remains
511.8in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.

511.9    Sec. 61. Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:
511.10    Subd. 27. Licensee. "Licensee" means any person or entity that has been issued
511.11a license to practice mortuary science, to operate a funeral establishment, to operate an
511.12alkaline hydrolysis facility, or to operate a crematory by the Minnesota commissioner
511.13of health.

511.14    Sec. 62. Minnesota Statutes 2012, section 149A.02, is amended by adding a
511.15subdivision to read:
511.16    Subd. 30a. Niche. "Niche" means a space in a columbarium used, or intended to be
511.17used, for the placement of hydrolyzed or cremated remains.

511.18    Sec. 63. Minnesota Statutes 2012, section 149A.02, is amended by adding a
511.19subdivision to read:
511.20    Subd. 32a. Placement. "Placement" means the placing of a container holding
511.21hydrolyzed or cremated remains in a crypt, vault, or niche.

511.22    Sec. 64. Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:
511.23    Subd. 34. Preparation of the body. "Preparation of the body" means placement of
511.24the body into an appropriate cremation or alkaline hydrolysis container, embalming of
511.25the body or such items of care as washing, disinfecting, shaving, positioning of features,
511.26restorative procedures, application of cosmetics, dressing, and casketing.

511.27    Sec. 65. Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:
511.28    Subd. 35. Processing. "Processing" means the removal of foreign objects, drying or
511.29cooling, and the reduction of the hydrolyzed or cremated remains by mechanical means
512.1including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance
512.2appropriate for final disposition.

512.3    Sec. 66. Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:
512.4    Subd. 37. Public transportation. "Public transportation" means all manner of
512.5transportation via common carrier available to the general public including airlines, buses,
512.6railroads, and ships. For purposes of this chapter, a livery service providing transportation
512.7to private funeral establishments, alkaline hydrolysis facilities, or crematories is not public
512.8transportation.

512.9    Sec. 67. Minnesota Statutes 2012, section 149A.02, is amended by adding a
512.10subdivision to read:
512.11    Subd. 37c. Scattering. "Scattering" means the authorized dispersal of hydrolyzed
512.12or cremated remains in a defined area of a dedicated cemetery or in areas where no local
512.13prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable
512.14to the public, are not in a container, and that the person who has control over disposition
512.15of the hydrolyzed or cremated remains has obtained written permission of the property
512.16owner or governing agency to scatter on the property.

512.17    Sec. 68. Minnesota Statutes 2012, section 149A.02, is amended by adding a
512.18subdivision to read:
512.19    Subd. 41. Vault. "Vault" means a space in a mausoleum of sufficient size, used or
512.20intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.
512.21Vault may also mean a sealed and lined casket enclosure.

512.22    Sec. 69. Minnesota Statutes 2012, section 149A.03, is amended to read:
512.23149A.03 DUTIES OF COMMISSIONER.
512.24    The commissioner shall:
512.25    (1) enforce all laws and adopt and enforce rules relating to the:
512.26    (i) removal, preparation, transportation, arrangements for disposition, and final
512.27disposition of dead human bodies;
512.28    (ii) licensure and professional conduct of funeral directors, morticians, interns,
512.29practicum students, and clinical students;
512.30    (iii) licensing and operation of a funeral establishment; and
512.31(iv) licensing and operation of an alkaline hydrolysis facility; and
512.32    (iv) (v) licensing and operation of a crematory;
513.1    (2) provide copies of the requirements for licensure and permits to all applicants;
513.2    (3) administer examinations and issue licenses and permits to qualified persons
513.3and other legal entities;
513.4    (4) maintain a record of the name and location of all current licensees and interns;
513.5    (5) perform periodic compliance reviews and premise inspections of licensees;
513.6    (6) accept and investigate complaints relating to conduct governed by this chapter;
513.7    (7) maintain a record of all current preneed arrangement trust accounts;
513.8    (8) maintain a schedule of application, examination, permit, and licensure fees,
513.9initial and renewal, sufficient to cover all necessary operating expenses;
513.10    (9) educate the public about the existence and content of the laws and rules for
513.11mortuary science licensing and the removal, preparation, transportation, arrangements
513.12for disposition, and final disposition of dead human bodies to enable consumers to file
513.13complaints against licensees and others who may have violated those laws or rules;
513.14    (10) evaluate the laws, rules, and procedures regulating the practice of mortuary
513.15science in order to refine the standards for licensing and to improve the regulatory and
513.16enforcement methods used; and
513.17    (11) initiate proceedings to address and remedy deficiencies and inconsistencies in
513.18the laws, rules, or procedures governing the practice of mortuary science and the removal,
513.19preparation, transportation, arrangements for disposition, and final disposition of dead
513.20human bodies.

513.21    Sec. 70. [149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS
513.22FACILITY.
513.23    Subdivision 1. License requirement. Except as provided in section 149A.01,
513.24subdivision 3, a place or premise shall not be maintained, managed, or operated which
513.25is devoted to or used in the holding and alkaline hydrolysis of a dead human body
513.26without possessing a valid license to operate an alkaline hydrolysis facility issued by the
513.27commissioner of health.
513.28    Subd. 2. Requirements for an alkaline hydrolysis facility. (a) An alkaline
513.29hydrolysis facility licensed under this section must consist of:
513.30(1) a building or structure that complies with applicable local and state building
513.31codes, zoning laws and ordinances, wastewater management and environmental standards,
513.32containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead
513.33human bodies;
513.34(2) a method approved by the commissioner of health to dry the hydrolyzed remains
513.35and which is located within the licensed facility;
514.1(3) a means approved by the commissioner of health for refrigeration of dead human
514.2bodies awaiting alkaline hydrolysis;
514.3(4) an appropriate means of processing hydrolyzed remains to a granulated
514.4appearance appropriate for final disposition; and
514.5(5) an appropriate holding facility for dead human bodies awaiting alkaline
514.6hydrolysis.
514.7(b) An alkaline hydrolysis facility licensed under this section may also contain a
514.8display room for funeral goods.
514.9    Subd. 3. Application procedure; documentation; initial inspection. An
514.10application to license and operate an alkaline hydrolysis facility shall be submitted to the
514.11commissioner of health. A completed application includes:
514.12(1) a completed application form, as provided by the commissioner;
514.13(2) proof of business form and ownership;
514.14(3) proof of liability insurance coverage or other financial documentation, as
514.15determined by the commissioner, that demonstrates the applicant's ability to respond in
514.16damages for liability arising from the ownership, maintenance management, or operation
514.17of an alkaline hydrolysis facility; and
514.18(4) copies of wastewater and other environmental regulatory permits and
514.19environmental regulatory licenses necessary to conduct operations.
514.20Upon receipt of the application and appropriate fee, the commissioner shall review and
514.21verify all information. Upon completion of the verification process and resolution of any
514.22deficiencies in the application information, the commissioner shall conduct an initial
514.23inspection of the premises to be licensed. After the inspection and resolution of any
514.24deficiencies found and any reinspections as may be necessary, the commissioner shall
514.25make a determination, based on all the information available, to grant or deny licensure. If
514.26the commissioner's determination is to grant the license, the applicant shall be notified and
514.27the license shall issue and remain valid for a period prescribed on the license, but not to
514.28exceed one calendar year from the date of issuance of the license. If the commissioner's
514.29determination is to deny the license, the commissioner must notify the applicant in writing
514.30of the denial and provide the specific reason for denial.
514.31    Subd. 4. Nontransferability of license. A license to operate an alkaline hydrolysis
514.32facility is not assignable or transferable and shall not be valid for any entity other than the
514.33one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the
514.34location identified on the license. A 50 percent or more change in ownership or location of
514.35the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall
514.36be required of two or more persons or other legal entities operating from the same location.
515.1    Subd. 5. Display of license. Each license to operate an alkaline hydrolysis
515.2facility must be conspicuously displayed in the alkaline hydrolysis facility at all times.
515.3Conspicuous display means in a location where a member of the general public within the
515.4alkaline hydrolysis facility will be able to observe and read the license.
515.5    Subd. 6. Period of licensure. All licenses to operate an alkaline hydrolysis facility
515.6issued by the commissioner are valid for a period of one calendar year beginning on July 1
515.7and ending on June 30, regardless of the date of issuance.
515.8    Subd. 7. Reporting changes in license information. Any change of license
515.9information must be reported to the commissioner, on forms provided by the
515.10commissioner, no later than 30 calendar days after the change occurs. Failure to report
515.11changes is grounds for disciplinary action.
515.12    Subd. 8. Notification to the commissioner. If the licensee is operating under a
515.13wastewater or an environmental permit or license that is subsequently revoked, denied,
515.14or terminated, the licensee shall notify the commissioner.
515.15    Subd. 9. Application information. All information submitted to the commissioner
515.16for a license to operate an alkaline hydrolysis facility is classified as licensing data under
515.17section 13.41, subdivision 5.

515.18    Sec. 71. [149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE
515.19HYDROLYSIS FACILITY.
515.20    Subdivision 1. Renewal required. All licenses to operate an alkaline hydrolysis
515.21facility issued by the commissioner expire on June 30 following the date of issuance of the
515.22license and must be renewed to remain valid.
515.23    Subd. 2. Renewal procedure and documentation. Licensees who wish to renew
515.24their licenses must submit to the commissioner a completed renewal application no later
515.25than June 30 following the date the license was issued. A completed renewal application
515.26includes:
515.27(1) a completed renewal application form, as provided by the commissioner; and
515.28(2) proof of liability insurance coverage or other financial documentation, as
515.29determined by the commissioner, that demonstrates the applicant's ability to respond in
515.30damages for liability arising from the ownership, maintenance, management, or operation
515.31of an alkaline hydrolysis facility.
515.32Upon receipt of the completed renewal application, the commissioner shall review and
515.33verify the information. Upon completion of the verification process and resolution of
515.34any deficiencies in the renewal application information, the commissioner shall make a
515.35determination, based on all the information available, to reissue or refuse to reissue the
516.1license. If the commissioner's determination is to reissue the license, the applicant shall
516.2be notified and the license shall issue and remain valid for a period prescribed on the
516.3license, but not to exceed one calendar year from the date of issuance of the license. If
516.4the commissioner's determination is to refuse to reissue the license, section 149A.09,
516.5subdivision 2, applies.
516.6    Subd. 3. Penalty for late filing. Renewal applications received after the expiration
516.7date of a license will result in the assessment of a late filing penalty. The late filing penalty
516.8must be paid before the reissuance of the license and received by the commissioner no
516.9later than 31 calendar days after the expiration date of the license.
516.10    Subd. 4. Lapse of license. Licenses to operate alkaline hydrolysis facilities
516.11shall automatically lapse when a completed renewal application is not received by the
516.12commissioner within 31 calendar days after the expiration date of a license, or a late
516.13filing penalty assessed under subdivision 3 is not received by the commissioner within 31
516.14calendar days after the expiration of a license.
516.15    Subd. 5. Effect of lapse of license. Upon the lapse of a license, the person to whom
516.16the license was issued is no longer licensed to operate an alkaline hydrolysis facility in
516.17Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed
516.18license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue
516.19any additional lawful remedies as justified by the case.
516.20    Subd. 6. Restoration of lapsed license. The commissioner may restore a lapsed
516.21license upon receipt and review of a completed renewal application, receipt of the late
516.22filing penalty, and reinspection of the premises, provided that the receipt is made within
516.23one calendar year from the expiration date of the lapsed license and the cease and desist
516.24order issued by the commissioner has not been violated. If a lapsed license is not restored
516.25within one calendar year from the expiration date of the lapsed license, the holder of the
516.26lapsed license cannot be relicensed until the requirements in section 149A.54 are met.
516.27    Subd. 7. Reporting changes in license information. Any change of license
516.28information must be reported to the commissioner, on forms provided by the
516.29commissioner, no later than 30 calendar days after the change occurs. Failure to report
516.30changes is grounds for disciplinary action.
516.31    Subd. 8. Application information. All information submitted to the commissioner
516.32by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is
516.33classified as licensing data under section 13.41, subdivision 5.

516.34    Sec. 72. Minnesota Statutes 2012, section 149A.65, is amended by adding a
516.35subdivision to read:
517.1    Subd. 6. Alkaline hydrolysis facilities. The initial and renewal fee for an alkaline
517.2hydrolysis facility is $300. The late fee charge for a license renewal is $25.

517.3    Sec. 73. Minnesota Statutes 2012, section 149A.65, is amended by adding a
517.4subdivision to read:
517.5    Subd. 7. State government special revenue fund. Fees collected by the
517.6commissioner under this section must be deposited in the state treasury and credited to
517.7the state government special revenue fund.

517.8    Sec. 74. Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:
517.9    Subdivision 1. Use of titles. Only a person holding a valid license to practice
517.10mortuary science issued by the commissioner may use the title of mortician, funeral
517.11director, or any other title implying that the licensee is engaged in the business or practice
517.12of mortuary science. Only the holder of a valid license to operate an alkaline hydrolysis
517.13facility issued by the commissioner may use the title of alkaline hydrolysis facility, water
517.14cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or
517.15any other title, word, or term implying that the licensee operates an alkaline hydrolysis
517.16facility. Only the holder of a valid license to operate a funeral establishment issued by the
517.17commissioner may use the title of funeral home, funeral chapel, funeral service, or any
517.18other title, word, or term implying that the licensee is engaged in the business or practice
517.19of mortuary science. Only the holder of a valid license to operate a crematory issued by
517.20the commissioner may use the title of crematory, crematorium, green-cremation, or any
517.21other title, word, or term implying that the licensee operates a crematory or crematorium.

517.22    Sec. 75. Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:
517.23    Subd. 2. Business location. A funeral establishment, alkaline hydrolysis facility, or
517.24crematory shall not do business in a location that is not licensed as a funeral establishment,
517.25alkaline hydrolysis facility, or crematory and shall not advertise a service that is available
517.26from an unlicensed location.

517.27    Sec. 76. Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:
517.28    Subd. 3. Advertising. No licensee, clinical student, practicum student, or intern
517.29shall publish or disseminate false, misleading, or deceptive advertising. False, misleading,
517.30or deceptive advertising includes, but is not limited to:
518.1    (1) identifying, by using the names or pictures of, persons who are not licensed to
518.2practice mortuary science in a way that leads the public to believe that those persons will
518.3provide mortuary science services;
518.4    (2) using any name other than the names under which the funeral establishment,
518.5alkaline hydrolysis facility, or crematory is known to or licensed by the commissioner;
518.6    (3) using a surname not directly, actively, or presently associated with a licensed
518.7funeral establishment, alkaline hydrolysis facility, or crematory, unless the surname had
518.8been previously and continuously used by the licensed funeral establishment, alkaline
518.9hydrolysis facility, or crematory; and
518.10    (4) using a founding or establishing date or total years of service not directly or
518.11continuously related to a name under which the funeral establishment, alkaline hydrolysis
518.12facility, or crematory is currently or was previously licensed.
518.13    Any advertising or other printed material that contains the names or pictures of
518.14persons affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory
518.15shall state the position held by the persons and shall identify each person who is licensed
518.16or unlicensed under this chapter.

518.17    Sec. 77. Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:
518.18    Subd. 5. Reimbursement prohibited. No licensee, clinical student, practicum
518.19student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other
518.20reimbursement in consideration for recommending or causing a dead human body to
518.21be disposed of by a specific body donation program, funeral establishment, alkaline
518.22hydrolysis facility, crematory, mausoleum, or cemetery.

518.23    Sec. 78. Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:
518.24    Subd. 2. Preventive requirements. (a) To prevent unfair or deceptive acts or
518.25practices, the requirements of this subdivision must be met.
518.26    (b) Funeral providers must tell persons who ask by telephone about the funeral
518.27provider's offerings or prices any accurate information from the price lists described in
518.28paragraphs (c) to (e) and any other readily available information that reasonably answers
518.29the questions asked.
518.30    (c) Funeral providers must make available for viewing to people who inquire in
518.31person about the offerings or prices of funeral goods or burial site goods, separate printed
518.32or typewritten price lists using a ten-point font or larger. Each funeral provider must have a
518.33separate price list for each of the following types of goods that are sold or offered for sale:
518.34    (1) caskets;
519.1    (2) alternative containers;
519.2    (3) outer burial containers;
519.3(4) alkaline hydrolysis containers;
519.4    (4) (5) cremation containers;
519.5(6) hydrolyzed remains containers;
519.6    (5) (7) cremated remains containers;
519.7    (6) (8) markers; and
519.8    (7) (9) headstones.
519.9    (d) Each separate price list must contain the name of the funeral provider's place
519.10of business, address, and telephone number and a caption describing the list as a price
519.11list for one of the types of funeral goods or burial site goods described in paragraph (c),
519.12clauses (1) to (7) (9). The funeral provider must offer the list upon beginning discussion
519.13of, but in any event before showing, the specific funeral goods or burial site goods and
519.14must provide a photocopy of the price list, for retention, if so asked by the consumer. The
519.15list must contain, at least, the retail prices of all the specific funeral goods and burial site
519.16goods offered which do not require special ordering, enough information to identify each,
519.17and the effective date for the price list. However, funeral providers are not required to
519.18make a specific price list available if the funeral providers place the information required
519.19by this paragraph on the general price list described in paragraph (e).
519.20    (e) Funeral providers must give a printed price list, for retention, to persons who
519.21inquire in person about the funeral goods, funeral services, burial site goods, or burial site
519.22services or prices offered by the funeral provider. The funeral provider must give the list
519.23upon beginning discussion of either the prices of or the overall type of funeral service or
519.24disposition or specific funeral goods, funeral services, burial site goods, or burial site
519.25services offered by the provider. This requirement applies whether the discussion takes
519.26place in the funeral establishment or elsewhere. However, when the deceased is removed
519.27for transportation to the funeral establishment, an in-person request for authorization to
519.28embalm does not, by itself, trigger the requirement to offer the general price list. If the
519.29provider, in making an in-person request for authorization to embalm, discloses that
519.30embalming is not required by law except in certain special cases, the provider is not
519.31required to offer the general price list. Any other discussion during that time about prices
519.32or the selection of funeral goods, funeral services, burial site goods, or burial site services
519.33triggers the requirement to give the consumer a general price list. The general price list
519.34must contain the following information:
519.35    (1) the name, address, and telephone number of the funeral provider's place of
519.36business;
520.1    (2) a caption describing the list as a "general price list";
520.2    (3) the effective date for the price list;
520.3    (4) the retail prices, in any order, expressed either as a flat fee or as the prices per
520.4hour, mile, or other unit of computation, and other information described as follows:
520.5    (i) forwarding of remains to another funeral establishment, together with a list of
520.6the services provided for any quoted price;
520.7    (ii) receiving remains from another funeral establishment, together with a list of
520.8the services provided for any quoted price;
520.9    (iii) separate prices for each alkaline hydrolysis or cremation offered by the funeral
520.10provider, with the price including an alternative container or alkaline hydrolysis or
520.11cremation container, any alkaline hydrolysis or crematory charges, and a description of the
520.12services and container included in the price, where applicable, and the price of alkaline
520.13hydrolysis or cremation where the purchaser provides the container;
520.14    (iv) separate prices for each immediate burial offered by the funeral provider,
520.15including a casket or alternative container, and a description of the services and container
520.16included in that price, and the price of immediate burial where the purchaser provides the
520.17casket or alternative container;
520.18    (v) transfer of remains to the funeral establishment or other location;
520.19    (vi) embalming;
520.20    (vii) other preparation of the body;
520.21    (viii) use of facilities, equipment, or staff for viewing;
520.22    (ix) use of facilities, equipment, or staff for funeral ceremony;
520.23    (x) use of facilities, equipment, or staff for memorial service;
520.24    (xi) use of equipment or staff for graveside service;
520.25    (xii) hearse or funeral coach;
520.26    (xiii) limousine; and
520.27    (xiv) separate prices for all cemetery-specific goods and services, including all goods
520.28and services associated with interment and burial site goods and services and excluding
520.29markers and headstones;
520.30    (5) the price range for the caskets offered by the funeral provider, together with the
520.31statement "A complete price list will be provided at the funeral establishment or casket
520.32sale location." or the prices of individual caskets, as disclosed in the manner described
520.33in paragraphs (c) and (d);
520.34    (6) the price range for the alternative containers offered by the funeral provider,
520.35together with the statement "A complete price list will be provided at the funeral
521.1establishment or alternative container sale location." or the prices of individual alternative
521.2containers, as disclosed in the manner described in paragraphs (c) and (d);
521.3    (7) the price range for the outer burial containers offered by the funeral provider,
521.4together with the statement "A complete price list will be provided at the funeral
521.5establishment or outer burial container sale location." or the prices of individual outer
521.6burial containers, as disclosed in the manner described in paragraphs (c) and (d);
521.7(8) the price range for the alkaline hydrolysis container offered by the funeral
521.8provider, together with the statement: "A complete price list will be provided at the funeral
521.9establishment or alkaline hydrolysis container sale location.", or the prices of individual
521.10alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c)
521.11and (d);
521.12(9) the price range for the hydrolyzed remains container offered by the funeral
521.13provider, together with the statement: "A complete price list will be provided at the
521.14funeral establishment or hydrolyzed remains container sale location.", or the prices
521.15of individual hydrolyzed remains container, as disclosed in the manner described in
521.16paragraphs (c) and (d);
521.17    (8) (10) the price range for the cremation containers offered by the funeral provider,
521.18together with the statement "A complete price list will be provided at the funeral
521.19establishment or cremation container sale location." or the prices of individual cremation
521.20containers and cremated remains containers, as disclosed in the manner described in
521.21paragraphs (c) and (d);
521.22    (9) (11) the price range for the cremated remains containers offered by the funeral
521.23provider, together with the statement, "A complete price list will be provided at the funeral
521.24establishment or cremation cremated remains container sale location," or the prices of
521.25individual cremation containers as disclosed in the manner described in paragraphs (c)
521.26and (d);
521.27    (10) (12) the price for the basic services of funeral provider and staff, together with a
521.28list of the principal basic services provided for any quoted price and, if the charge cannot
521.29be declined by the purchaser, the statement "This fee for our basic services will be added
521.30to the total cost of the funeral arrangements you select. (This fee is already included in
521.31our charges for alkaline hydrolysis, direct cremations, immediate burials, and forwarding
521.32or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted
521.33price shall include all charges for the recovery of unallocated funeral provider overhead,
521.34and funeral providers may include in the required disclosure the phrase "and overhead"
521.35after the word "services." This services fee is the only funeral provider fee for services,
522.1facilities, or unallocated overhead permitted by this subdivision to be nondeclinable,
522.2unless otherwise required by law;
522.3    (11) (13) the price range for the markers and headstones offered by the funeral
522.4provider, together with the statement "A complete price list will be provided at the funeral
522.5establishment or marker or headstone sale location." or the prices of individual markers
522.6and headstones, as disclosed in the manner described in paragraphs (c) and (d); and
522.7    (12) (14) any package priced funerals offered must be listed in addition to and
522.8following the information required in this paragraph (e) and must clearly state the funeral
522.9goods and services being offered, the price being charged for those goods and services,
522.10and the discounted savings.
522.11    (f) Funeral providers must give an itemized written statement, for retention, to each
522.12consumer who arranges an at-need funeral or other disposition of human remains at the
522.13conclusion of the discussion of the arrangements. The itemized written statement must be
522.14signed by the consumer selecting the goods and services as required in section 149A.80.
522.15If the statement is provided by a funeral establishment, the statement must be signed by
522.16the licensed funeral director or mortician planning the arrangements. If the statement is
522.17provided by any other funeral provider, the statement must be signed by an authorized
522.18agent of the funeral provider. The statement must list the funeral goods, funeral services,
522.19burial site goods, or burial site services selected by that consumer and the prices to be paid
522.20for each item, specifically itemized cash advance items (these prices must be given to the
522.21extent then known or reasonably ascertainable if the prices are not known or reasonably
522.22ascertainable, a good faith estimate shall be given and a written statement of the actual
522.23charges shall be provided before the final bill is paid), and the total cost of goods and
522.24services selected. At the conclusion of an at-need arrangement, the funeral provider is
522.25required to give the consumer a copy of the signed itemized written contract that must
522.26contain the information required in this paragraph.
522.27    (g) Upon receiving actual notice of the death of an individual with whom a funeral
522.28provider has entered a preneed funeral agreement, the funeral provider must provide
522.29a copy of all preneed funeral agreement documents to the person who controls final
522.30disposition of the human remains or to the designee of the person controlling disposition.
522.31The person controlling final disposition shall be provided with these documents at the time
522.32of the person's first in-person contact with the funeral provider, if the first contact occurs
522.33in person at a funeral establishment, alkaline hydrolysis facility, crematory, or other place
522.34of business of the funeral provider. If the contact occurs by other means or at another
522.35location, the documents must be provided within 24 hours of the first contact.

523.1    Sec. 79. Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:
523.2    Subd. 4. Casket, alternate container, alkaline hydrolysis containers, and
523.3cremation container sales; records; required disclosures. Any funeral provider who
523.4sells or offers to sell a casket, alternate container, alkaline hydrolysis container, hydrolyzed
523.5remains container, or cremation container, or cremated remains container to the public
523.6must maintain a record of each sale that includes the name of the purchaser, the purchaser's
523.7mailing address, the name of the decedent, the date of the decedent's death, and the place
523.8of death. These records shall be open to inspection by the regulatory agency. Any funeral
523.9provider selling a casket, alternate container, or cremation container to the public, and not
523.10having charge of the final disposition of the dead human body, shall provide a copy of the
523.11statutes and rules controlling the removal, preparation, transportation, arrangements for
523.12disposition, and final disposition of a dead human body. This subdivision does not apply to
523.13morticians, funeral directors, funeral establishments, crematories, or wholesale distributors
523.14of caskets, alternate containers, alkaline hydrolysis containers, or cremation containers.

523.15    Sec. 80. Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:
523.16    Subd. 3. Casket for alkaline hydrolysis or cremation provisions; deceptive acts
523.17or practices. In selling or offering to sell funeral goods or funeral services to the public, it
523.18is a deceptive act or practice for a funeral provider to represent that a casket is required for
523.19alkaline hydrolysis or cremations by state or local law or otherwise.

523.20    Sec. 81. Minnesota Statutes 2012, section 149A.72, is amended by adding a
523.21subdivision to read:
523.22    Subd. 3a. Casket for alkaline hydrolysis provision; preventive measures. To
523.23prevent deceptive acts or practices, funeral providers must place the following disclosure
523.24in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota
523.25law does not require you to purchase a casket for alkaline hydrolysis. If you want to
523.26arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline
523.27hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant
523.28to leakage of bodily fluids that encases the body and into which a dead human body is
523.29placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide
523.30are (specify containers provided)." This disclosure is required only if the funeral provider
523.31arranges alkaline hydrolysis.

523.32    Sec. 82. Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:
524.1    Subd. 9. Deceptive acts or practices. In selling or offering to sell funeral goods,
524.2funeral services, burial site goods, or burial site services to the public, it is a deceptive act
524.3or practice for a funeral provider to represent that federal, state, or local laws, or particular
524.4cemeteries, alkaline hydrolysis facilities, or crematories, require the purchase of any funeral
524.5goods, funeral services, burial site goods, or burial site services when that is not the case.

524.6    Sec. 83. Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:
524.7    Subdivision 1. Casket for alkaline hydrolysis or cremation provisions; deceptive
524.8acts or practices. In selling or offering to sell funeral goods, funeral services, burial site
524.9goods, or burial site services to the public, it is a deceptive act or practice for a funeral
524.10provider to require that a casket be purchased for alkaline hydrolysis or cremation.

524.11    Sec. 84. Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:
524.12    Subd. 2. Casket for alkaline hydrolysis or cremation; preventive requirements.
524.13To prevent unfair or deceptive acts or practices, if funeral providers arrange for alkaline
524.14hydrolysis or cremations, they must make a an alkaline hydrolysis container or cremation
524.15container available for alkaline hydrolysis or cremations.

524.16    Sec. 85. Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:
524.17    Subd. 4. Required purchases of funeral goods or services; preventive
524.18requirements. To prevent unfair or deceptive acts or practices, funeral providers must
524.19place the following disclosure in the general price list, immediately above the prices
524.20required by section 149A.71, subdivision 2, paragraph (e), clauses (4) to (10): "The goods
524.21and services shown below are those we can provide to our customers. You may choose
524.22only the items you desire. If legal or other requirements mean that you must buy any items
524.23you did not specifically ask for, we will explain the reason in writing on the statement we
524.24provide describing the funeral goods, funeral services, burial site goods, and burial site
524.25services you selected." However, if the charge for "services of funeral director and staff"
524.26cannot be declined by the purchaser, the statement shall include the sentence "However,
524.27any funeral arrangements you select will include a charge for our basic services." between
524.28the second and third sentences of the sentences specified in this subdivision. The statement
524.29may include the phrase "and overhead" after the word "services" if the fee includes a
524.30charge for the recovery of unallocated funeral overhead. If the funeral provider does
524.31not include this disclosure statement, then the following disclosure statement must be
524.32placed in the statement of funeral goods, funeral services, burial site goods, and burial site
524.33services selected, as described in section 149A.71, subdivision 2, paragraph (f): "Charges
525.1are only for those items that you selected or that are required. If we are required by law or
525.2by a cemetery, alkaline hydrolysis facility, or crematory to use any items, we will explain
525.3the reasons in writing below." A funeral provider is not in violation of this subdivision by
525.4failing to comply with a request for a combination of goods or services which would be
525.5impossible, impractical, or excessively burdensome to provide.

525.6    Sec. 86. Minnesota Statutes 2012, section 149A.74, is amended to read:
525.7149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.
525.8    Subdivision 1. Services provided without prior approval; deceptive acts or
525.9practices. In selling or offering to sell funeral goods or funeral services to the public, it
525.10is a deceptive act or practice for any funeral provider to embalm a dead human body
525.11unless state or local law or regulation requires embalming in the particular circumstances
525.12regardless of any funeral choice which might be made, or prior approval for embalming
525.13has been obtained from an individual legally authorized to make such a decision. In
525.14seeking approval to embalm, the funeral provider must disclose that embalming is not
525.15required by law except in certain circumstances; that a fee will be charged if a funeral
525.16is selected which requires embalming, such as a funeral with viewing; and that no
525.17embalming fee will be charged if the family selects a service which does not require
525.18embalming, such as direct alkaline hydrolysis, direct cremation, or immediate burial.
525.19    Subd. 2. Services provided without prior approval; preventive requirement.
525.20To prevent unfair or deceptive acts or practices, funeral providers must include on
525.21the itemized statement of funeral goods or services, as described in section 149A.71,
525.22subdivision 2 , paragraph (f), the statement "If you selected a funeral that may require
525.23embalming, such as a funeral with viewing, you may have to pay for embalming. You do
525.24not have to pay for embalming you did not approve if you selected arrangements such
525.25as direct alkaline hydrolysis, direct cremation, or immediate burial. If we charged for
525.26embalming, we will explain why below."

525.27    Sec. 87. Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:
525.28    Subd. 9. Embalmed Bodies awaiting final disposition. All embalmed bodies
525.29awaiting final disposition shall be kept in an appropriate holding facility or preparation
525.30and embalming room. The holding facility must be secure from access by anyone except
525.31the authorized personnel of the funeral establishment, preserve the dignity and integrity of
525.32the body, and protect the health and safety of the personnel of the funeral establishment.

525.33    Sec. 88. Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:
526.1    Subd. 3. Disposition permit. A disposition permit is required before a body can
526.2be buried, entombed, alkaline hydrolyzed, or cremated. No disposition permit shall be
526.3issued until a fact of death record has been completed and filed with the local or state
526.4registrar of vital statistics.

526.5    Sec. 89. Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:
526.6    Subd. 6. Conveyances permitted for transportation. A dead human body may be
526.7transported by means of private vehicle or private aircraft, provided that the body must be
526.8encased in an appropriate container, that meets the following standards:
526.9    (1) promotes respect for and preserves the dignity of the dead human body;
526.10    (2) shields the body from being viewed from outside of the conveyance;
526.11    (3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket,
526.12alternative container, alkaline hydrolysis container, or cremation container in a horizontal
526.13position;
526.14    (4) is designed to permit loading and unloading of the body without excessive tilting
526.15of the cot, stretcher, rigid tray, casket, alternative container, alkaline hydrolysis container,
526.16 or cremation container; and
526.17    (5) if used for the transportation of more than one dead human body at one time,
526.18the vehicle must be designed so that a body or container does not rest directly on top of
526.19another body or container and that each body or container is secured to prevent the body
526.20or container from excessive movement within the conveyance.
526.21    A vehicle that is a dignified conveyance and was specified for use by the deceased
526.22or by the family of the deceased may be used to transport the body to the place of final
526.23disposition.

526.24    Sec. 90. Minnesota Statutes 2012, section 149A.94, is amended to read:
526.25149A.94 FINAL DISPOSITION.
526.26    Subdivision 1. Generally. Every dead human body lying within the state, except
526.27unclaimed bodies delivered for dissection by the medical examiner, those delivered for
526.28anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through
526.29the state for the purpose of disposition elsewhere; and the remains of any dead human
526.30body after dissection or anatomical study, shall be decently buried, or entombed in a
526.31public or private cemetery, alkaline hydrolyzed or cremated, within a reasonable time
526.32after death. Where final disposition of a body will not be accomplished within 72 hours
526.33following death or release of the body by a competent authority with jurisdiction over the
526.34body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body
527.1may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry
527.2ice for a period that exceeds four calendar days, from the time of death or release of the
527.3body from the coroner or medical examiner.
527.4    Subd. 3. Permit required. No dead human body shall be buried, entombed, or
527.5cremated without a disposition permit. The disposition permit must be filed with the person
527.6in charge of the place of final disposition. Where a dead human body will be transported out
527.7of this state for final disposition, the body must be accompanied by a certificate of removal.
527.8    Subd. 4. Alkaline hydrolysis or cremation. Inurnment of alkaline hydrolyzed or
527.9cremated remains and release to an appropriate party is considered final disposition and no
527.10further permits or authorizations are required for transportation, interment, entombment, or
527.11placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

527.12    Sec. 91. [149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE
527.13HYDROLYSIS.
527.14    Subdivision 1. License required. A dead human body may only be hydrolyzed in
527.15this state at an alkaline hydrolysis facility licensed by the commissioner of health.
527.16    Subd. 2. General requirements. Any building to be used as an alkaline hydrolysis
527.17facility must comply with all applicable local and state building codes, zoning laws and
527.18ordinances, wastewater management regulations, and environmental statutes, rules, and
527.19standards. An alkaline hydrolysis facility must have, on site, a purpose built human
527.20alkaline hydrolysis system approved by the commissioner of health, a system approved by
527.21the commissioner of health for drying the hydrolyzed remains, a motorized mechanical
527.22device approved by the commissioner of health for processing hydrolyzed remains and
527.23must have in the building a holding facility approved by the commissioner of health for
527.24the retention of dead human bodies awaiting alkaline hydrolysis. The holding facility
527.25must be secure from access by anyone except the authorized personnel of the alkaline
527.26hydrolysis facility, preserve the dignity of the remains, and protect the health and safety of
527.27the alkaline hydrolysis facility personnel.
527.28    Subd. 3. Lighting and ventilation. The room where the alkaline hydrolysis vessel
527.29is located and the room where the chemical storage takes place shall be properly lit and
527.30ventilated with an exhaust fan that provides at least 12 air changes per hour.
527.31    Subd. 4. Plumbing connections. All plumbing fixtures, water supply lines,
527.32plumbing vents, and waste drains shall be properly vented and connected pursuant to the
527.33Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a
527.34functional sink with hot and cold running water.
528.1    Subd. 5. Flooring, walls, ceiling, doors, and windows. The room where the
528.2alkaline hydrolysis vessel is located and the room where the chemical storage takes place
528.3shall have nonporous flooring, so that a sanitary condition is provided. The walls and
528.4ceiling of the room where the alkaline hydrolysis vessel is located and the room where
528.5the chemical storage takes place shall run from floor to ceiling and be covered with tile,
528.6or by plaster or sheetrock painted with washable paint or other appropriate material so
528.7that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be
528.8constructed to prevent odors from entering any other part of the building. All windows
528.9or other openings to the outside must be screened and all windows must be treated in a
528.10manner that prevents viewing into the room where the alkaline hydrolysis vessel is located
528.11and the room where the chemical storage takes place. A viewing window for authorized
528.12family members or their designees is not a violation of this subdivision.
528.13    Subd. 6. Equipment and supplies. The alkaline hydrolysis facility must have a
528.14functional emergency eye wash and quick drench shower.
528.15    Subd. 7. Access and privacy. (a) The room where the alkaline hydrolysis vessel is
528.16located and the room where the chemical storage takes place must be private and have no
528.17general passageway through it. The room shall, at all times, be secure from the entrance of
528.18unauthorized persons. Authorized persons are:
528.19(1) licensed morticians;
528.20(2) registered interns or students as described in section 149A.91, subdivision 6;
528.21(3) public officials or representatives in the discharge of their official duties;
528.22(4) trained alkaline hydrolysis facility operators; and
528.23(5) the persons with the right to control the dead human body as defined in section
528.24149A.80, subdivision 2, and their designees.
528.25    (b) Each door allowing ingress or egress shall carry a sign that indicates that the
528.26room is private and access is limited. All authorized persons who are present in or enter
528.27the room where the alkaline hydrolysis vessel is located while a body is being prepared for
528.28final disposition must be attired according to all applicable state and federal regulations
528.29regarding the control of infectious disease and occupational and workplace health and
528.30safety.
528.31    Subd. 8. Sanitary conditions and permitted use. The room where the alkaline
528.32hydrolysis vessel is located and the room where the chemical storage takes place and all
528.33fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies
528.34stored or used in the room must be maintained in a clean and sanitary condition at all times.
529.1    Subd. 9. Boiler use. When a boiler is required by the manufacturer of the alkaline
529.2hydrolysis vessel for its operation, all state and local regulations for that boiler must be
529.3followed.
529.4    Subd. 10. Occupational and workplace safety. All applicable provisions of state
529.5and federal regulations regarding exposure to workplace hazards and accidents shall be
529.6followed in order to protect the health and safety of all authorized persons at the alkaline
529.7hydrolysis facility.
529.8    Subd. 11. Licensed personnel. A licensed alkaline hydrolysis facility must employ
529.9a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body.
529.10It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for
529.11all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for
529.12compliance with this chapter and other applicable state and federal regulations regarding
529.13occupational and workplace health and safety.
529.14    Subd. 12. Authorization to hydrolyze required. No alkaline hydrolysis facility
529.15shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part
529.16without receiving written authorization to do so from the person or persons who have the
529.17legal right to control disposition as described in section 149A.80 or the person's legal
529.18designee. The written authorization must include:
529.19(1) the name of the deceased and the date of death of the deceased;
529.20(2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body;
529.21(3) the name, address, telephone number, relationship to the deceased, and signature
529.22of the person or persons with legal right to control final disposition or a legal designee;
529.23(4) directions for the disposition of any nonhydrolyzed materials or items recovered
529.24from the alkaline hydrolysis vessel;
529.25(5) acknowledgment that the hydrolyzed remains will be dried and mechanically
529.26reduced to a granulated appearance and placed in an appropriate container and
529.27authorization to place any hydrolyzed remains that a selected urn or container will not
529.28accommodate into a temporary container;
529.29(6) acknowledgment that, even with the exercise of reasonable care, it is not possible
529.30to recover all particles of the hydrolyzed remains and that some particles may inadvertently
529.31become commingled with particles of other hydrolyzed remains that remain in the alkaline
529.32hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains;
529.33(7) directions for the ultimate disposition of the hydrolyzed remains; and
529.34(8) a statement that includes, but is not limited to, the following information:
529.35"During the alkaline hydrolysis process, chemical dissolution using heat, water, and an
529.36alkaline solution is used to chemically break down the human tissue and the hydrolyzable
530.1alkaline hydrolysis container. After the process is complete, the liquid effluent solution
530.2contains the chemical by-products of the alkaline hydrolysis process except for the
530.3deceased's bone fragments. The solution is cooled and released according to local
530.4environmental regulations. A water rinse is applied to the hydrolyzed remains which are
530.5then dried and processed to facilitate inurnment or scattering."
530.6    Subd. 13. Limitation of liability. A licensed alkaline hydrolysis facility acting in
530.7good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an
530.8authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from
530.9civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis
530.10facility.
530.11    Subd. 14. Acceptance of delivery of body. (a) No dead human body shall be
530.12accepted for final disposition by alkaline hydrolysis unless:
530.13(1) encased in an appropriate alkaline hydrolysis container;
530.14(2) accompanied by a disposition permit issued pursuant to section 149A.93,
530.15subdivision 3, including a photocopy of the completed death record or a signed release
530.16authorizing alkaline hydrolysis of the body received from the coroner or medical
530.17examiner; and
530.18(3) accompanied by an alkaline hydrolysis authorization that complies with
530.19subdivision 12.
530.20    (b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline
530.21hydrolysis container where there is:
530.22(1) evidence of leakage of fluids from the alkaline hydrolysis container;
530.23(2) a known dispute concerning hydrolysis of the body delivered;
530.24(3) a reasonable basis for questioning any of the representations made on the written
530.25authorization to hydrolyze; or
530.26(4) any other lawful reason.
530.27    Subd. 15. Bodies awaiting hydrolysis. A dead human body must be hydrolyzed
530.28within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of
530.29the body.
530.30    Subd. 16. Handling of alkaline hydrolysis containers for dead human bodies.
530.31All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for
530.32dead human bodies shall use universal precautions and otherwise exercise all reasonable
530.33precautions to minimize the risk of transmitting any communicable disease from the body.
530.34No dead human body shall be removed from the container in which it is delivered.
530.35    Subd. 17. Identification of body. All licensed alkaline hydrolysis facilities shall
530.36develop, implement, and maintain an identification procedure whereby dead human
531.1bodes can be identified from the time the alkaline hydrolysis facility accepts delivery
531.2of the remains until the hydrolyzed remains are released to an authorized party. After
531.3hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the
531.4hydrolyzed remains container before the hydrolyzed remains are released from the alkaline
531.5hydrolysis facility. Each identification disk, tab, or label shall have a number that shall
531.6be recorded on all paperwork regarding the decedent. This procedure shall be designed
531.7to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains
531.8are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the
531.9inability to individually identify the hydrolyzed remains is a violation of this subdivision.
531.10    Subd. 18. Alkaline hydrolysis vessel for human remains. A licensed alkaline
531.11hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains
531.12in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for
531.13infectious disease control.
531.14    Subd. 19. Alkaline hydrolysis procedures; privacy. The final disposition of
531.15dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is
531.16written authorization from the person with the legal right to control the disposition,
531.17only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline
531.18hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting
531.19alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline
531.20hydrolysis vessel, or being processed and placed in a hydrolyzed remains container.
531.21    Subd. 20. Alkaline hydrolysis procedures; commingling of hydrolyzed remains
531.22prohibited. Except with the express written permission of the person with the legal right
531.23to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one
531.24dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce
531.25a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have
531.26been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze
531.27a dead human body and other human remains at the same time and in the same alkaline
531.28hydrolysis vessel. This section does not apply where commingling of human remains
531.29during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental
531.30and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is
531.31not a violation of this subdivision.
531.32    Subd. 21. Alkaline hydrolysis procedures; removal from alkaline hydrolysis
531.33vessel. Upon completion of the alkaline hydrolysis process, reasonable efforts shall be
531.34made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed
531.35remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be
531.36made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed
532.1human remains and dispose of these materials in a lawful manner, by the alkaline
532.2hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate
532.3container to be transported to the processing area.
532.4    Subd. 22. Drying device or mechanical processor procedures; commingling of
532.5hydrolyzed remains prohibited. Except with the express written permission of the
532.6person with the legal right to control the final disposition or otherwise provided by
532.7law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed
532.8human remains of more than one body at a time in the same drying device or mechanical
532.9processor, or introduce the hydrolyzed human remains of a second body into a drying
532.10device or mechanical processor until processing of any preceding hydrolyzed human
532.11remains has been terminated and reasonable efforts have been employed to remove all
532.12fragments of the preceding hydrolyzed remains. The fact that there is incidental and
532.13unavoidable residue in the drying device, the mechanical processor, or any container used
532.14in a prior alkaline hydrolysis process, is not a violation of this provision.
532.15    Subd. 23. Alkaline hydrolysis procedures; processing hydrolyzed remains. The
532.16hydrolyzed human remains shall be dried and then reduced by a motorized mechanical
532.17device to a granulated appearance appropriate for final disposition and placed in an
532.18alkaline hydrolysis remains container along with the appropriate identifying disk, tab,
532.19or permanent label. Processing must take place within the licensed alkaline hydrolysis
532.20facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they
532.21can be identified, may be removed prior to processing the hydrolyzed remains, only by
532.22staff licensed or registered by the commissioner of health; however, any dental gold and
532.23silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains
532.24container unless otherwise directed by the person or persons having the right to control the
532.25final disposition. Every person who removes or possesses dental gold or silver, jewelry,
532.26or mementos from any hydrolyzed remains without specific written permission of the
532.27person or persons having the right to control those remains is guilty of a misdemeanor.
532.28The fact that residue and any unavoidable dental gold or dental silver, or other precious
532.29metals remain in the alkaline hydrolysis vessel or other equipment or any container used
532.30in a prior hydrolysis is not a violation of this section.
532.31    Subd. 24. Alkaline hydrolysis procedures; container of insufficient capacity.
532.32If a hydrolyzed remains container is of insufficient capacity to accommodate all
532.33hydrolyzed remains of a given dead human body, subject to directives provided in the
532.34written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess
532.35hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the
532.36second container, in a manner so as not to be easily detached through incidental contact, to
533.1the primary alkaline hydrolysis remains container. The secondary container shall contain a
533.2duplicate of the identification disk, tab, or permanent label that was placed in the primary
533.3container and all paperwork regarding the given body shall include a notation that the
533.4hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature
533.5hydrolyzed remains containers are not subject to the requirements of this subdivision.
533.6    Subd. 25. Disposition procedures; commingling of hydrolyzed remains
533.7prohibited. No hydrolyzed remains shall be disposed of or scattered in a manner or in
533.8a location where the hydrolyzed remains are commingled with those of another person
533.9without the express written permission of the person with the legal right to control
533.10disposition or as otherwise provided by law. This subdivision does not apply to the
533.11scattering or burial of hydrolyzed remains at sea or in a body of water from individual
533.12containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to
533.13the disposal in a dedicated cemetery of accumulated residue removed from an alkaline
533.14hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members
533.15of the same family in a common container designed for the hydrolyzed remains of more
533.16than one body, or to the inurnment in a container or interment in a space that has been
533.17previously designated, at the time of sale or purchase, as being intended for the inurnment
533.18or interment of the hydrolyzed remains of more than one person.
533.19    Subd. 26. Alkaline hydrolysis procedures; disposition of accumulated residue.
533.20Every alkaline hydrolysis facility shall provide for the removal and disposition in a
533.21dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel,
533.22drying device, mechanical processor, container, or other equipment used in alkaline
533.23hydrolysis. Disposition of accumulated residue shall be according to the regulations of the
533.24dedicated cemetery and any applicable local ordinances.
533.25    Subd. 27. Alkaline hydrolysis procedures; release of hydrolyzed remains.
533.26Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be
533.27released according to the instructions given on the written authorization to hydrolyze. If
533.28the hydrolyzed remains are to be shipped, they must be securely packaged and transported
533.29by a method which has an internal tracing system available and which provides for a
533.30receipt signed by the person accepting delivery. Where there is a dispute over release
533.31or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit
533.32the hydrolyzed remains with a court of competent jurisdiction pending resolution of the
533.33dispute or retain the hydrolyzed remains until the person with the legal right to control
533.34disposition presents satisfactory indication that the dispute is resolved.
533.35    Subd. 28. Unclaimed hydrolyzed remains. If, after 30 calendar days following
533.36the inurnment, the hydrolyzed remains are not claimed or disposed of according to the
534.1written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment
534.2may give written notice, by certified mail, to the person with the legal right to control
534.3the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and
534.4requesting further release directions. Should the hydrolyzed remains be unclaimed 120
534.5calendar days following the mailing of the written notification, the alkaline hydrolysis
534.6facility or funeral establishment may dispose of the hydrolyzed remains in any lawful
534.7manner deemed appropriate.
534.8    Subd. 29. Required records. Every alkaline hydrolysis facility shall create and
534.9maintain on its premises or other business location in Minnesota an accurate record of
534.10every hydrolyzation provided. The record shall include all of the following information
534.11for each hydrolyzation:
534.12(1) the name of the person or funeral establishment delivering the body for alkaline
534.13hydrolysis;
534.14(2) the name of the deceased and the identification number assigned to the body;
534.15(3) the date of acceptance of delivery;
534.16(4) the names of the alkaline hydrolysis vessel, drying device, and mechanical
534.17processor operator;
534.18(5) the time and date that the body was placed in and removed from the alkaline
534.19hydrolysis vessel;
534.20(6) the time and date that processing and inurnment of the hydrolyzed remains
534.21was completed;
534.22(7) the time, date, and manner of release of the hydrolyzed remains;
534.23(8) the name and address of the person who signed the authorization to hydrolyze;
534.24(9) all supporting documentation, including any transit or disposition permits, a
534.25photocopy of the death record, and the authorization to hydrolyze; and
534.26(10) the type of alkaline hydrolysis container.
534.27    Subd. 30. Retention of records. Records required under subdivision 29 shall be
534.28maintained for a period of three calendar years after the release of the hydrolyzed remains.
534.29Following this period and subject to any other laws requiring retention of records, the
534.30alkaline hydrolysis facility may then place the records in storage or reduce them to
534.31microfilm, microfiche, laser disc, or any other method that can produce an accurate
534.32reproduction of the original record, for retention for a period of ten calendar years from
534.33the date of release of the hydrolyzed remains. At the end of this period and subject to any
534.34other laws requiring retention of records, the alkaline hydrolysis facility may destroy
534.35the records by shredding, incineration, or any other manner that protects the privacy of
534.36the individuals identified.

535.1    Sec. 92. Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:
535.2    Subd. 9. Hydrolyzed and cremated remains. Subject to section 149A.95,
535.3subdivision 16 , inurnment of the hydrolyzed or cremated remains and release to an
535.4appropriate party is considered final disposition and no further permits or authorizations
535.5are required for disinterment, transportation, or placement of the hydrolyzed or cremated
535.6remains.

535.7    Sec. 93. Minnesota Statutes 2012, section 257.75, subdivision 7, is amended to read:
535.8    Subd. 7. Hospital and Department of Health; recognition form. Hospitals that
535.9provide obstetric services and the state registrar of vital statistics shall distribute the
535.10educational materials and recognition of parentage forms prepared by the commissioner of
535.11human services to new parents, shall assist parents in understanding the recognition of
535.12parentage form, including following the provisions for notice under subdivision 5, shall
535.13provide notary services for parents who complete the recognition of parentage form, and
535.14shall timely file the completed recognition of parentage form with the Office of the State
535.15Registrar of Vital Statistics Records unless otherwise instructed by the Office of the State
535.16Registrar of Vital Statistics Records. On and after January 1, 1994, hospitals may not
535.17distribute the declaration of parentage forms.

535.18    Sec. 94. Minnesota Statutes 2012, section 260C.635, subdivision 1, is amended to read:
535.19    Subdivision 1. Legal effect. (a) Upon adoption, the adopted child becomes the legal
535.20child of the adopting parent and the adopting parent becomes the legal parent of the child
535.21with all the rights and duties between them of a birth parent and child.
535.22(b) The child shall inherit from the adoptive parent and the adoptive parent's
535.23relatives the same as though the child were the birth child of the parent, and in case of the
535.24child's death intestate, the adoptive parent and the adoptive parent's relatives shall inherit
535.25the child's estate as if the child had been the adoptive parent's birth child.
535.26(c) After a decree of adoption is entered, the birth parents or previous legal parents
535.27of the child shall be relieved of all parental responsibilities for the child except child
535.28support that has accrued to the date of the order for guardianship to the commissioner
535.29which continues to be due and owing. The child's birth or previous legal parent shall not
535.30exercise or have any rights over the adopted child or the adopted child's property, person,
535.31privacy, or reputation.
535.32(d) The adopted child shall not owe the birth parents or the birth parent's relatives
535.33any legal duty nor shall the adopted child inherit from the birth parents or kindred unless
535.34otherwise provided for in a will of the birth parent or kindred.
536.1    (e) Upon adoption, the court shall complete a certificate of adoption form and mail
536.2the form to the Office of the State Registrar Vital Records at the Minnesota Department
536.3of Health. Upon receiving the certificate of adoption, the state registrar shall register a
536.4replacement vital record in the new name of the adopted child as required under section
536.5144.218 .

536.6    Sec. 95. Minnesota Statutes 2012, section 517.001, is amended to read:
536.7517.001 DEFINITION.
536.8As used in this chapter, "local registrar" has the meaning given in section 144.212,
536.9subdivision 10 means an individual designated by the county board of commissioners to
536.10register marriages.

536.11    Sec. 96. FUNERAL ESTABLISHMENTS; BRANCH LOCATIONS.
536.12    The commissioner of health shall review the statutory requirements for preparation
536.13and embalming rooms and develop legislation with input from stakeholders that provides
536.14appropriate health and safety protection for funeral home locations where deceased bodies
536.15are present, but are branch locations associated through a majority ownership of a licensed
536.16funeral establishment that meets the requirements of Minnesota Statutes, sections 149A.50
536.17and 149A.92, subdivisions 2 to 10. The review shall include consideration of distance
536.18between the main location and branch, and other health and safety issues.

536.19    Sec. 97. REVISOR'S INSTRUCTION.
536.20The revisor shall substitute the term "vertical heat exchangers" or "vertical
536.21heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat
536.22exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions
536.232 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208,
536.24subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3.

536.25    Sec. 98. REPEALER.
536.26(a) Minnesota Statutes 2012, sections 62J.693; 103I.005, subdivision 20; 149A.025;
536.27149A.20, subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45,
536.28subdivision 6; 149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a;
536.29149A.53, subdivision 9; and 485.14, are repealed.
536.30(b) Minnesota Statutes 2012, section 144.123, subdivision 2, is repealed effective
536.31July 1, 2014.


537.4    Section 1. Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to
537.5read:
537.6    Subd. 2. Payment methodologies. (a) The commissioner shall establish, as defined
537.7under section 256B.4914, statewide payment methodologies that meet federal waiver
537.8requirements for home and community-based waiver services for individuals with
537.9disabilities. The payment methodologies must abide by the principles of transparency
537.10and equitability across the state. The methodologies must involve a uniform process of
537.11structuring rates for each service and must promote quality and participant choice.
537.12    (b) As of January 1, 2012, counties shall not implement changes to established
537.13processes for rate-setting methodologies for individuals using components of or data
537.14from research rates.

537.15    Sec. 2. Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:
537.16    Subd. 3. Payment requirements. The payment methodologies established under
537.17this section shall accommodate:
537.18(1) supervision costs;
537.19(2) staffing patterns staff compensation;
537.20(3) staffing and supervisory patterns;
537.21(3) (4) program-related expenses;
537.22(4) (5) general and administrative expenses; and
537.23(5) (6) consideration of recipient intensity.

537.24    Sec. 3. Minnesota Statutes 2012, section 256B.4913, is amended by adding a
537.25subdivision to read:
537.26    Subd. 4a. Rate stabilization adjustment. (a) The commissioner of human services
537.27shall adjust individual reimbursement rates by no more than 1.0 percent per year effective
537.28January 1, 2016. Rates determined under section 256B.4914 must be adjusted so that
537.29the unit rate varies no more than 1.0 percent per year from the rate effective December
537.301 of the prior calendar year. This adjustment is made annually for three calendar years
537.31from the date of implementation.
537.32(b) Rate stabilization adjustment applies to services that are authorized in a
537.33recipient's service plan prior to January 1, 2016.
538.1(c) Exemptions shall be made only when there is a significant change in the
538.2recipient's assessed needs that results in a service authorization change. Exemption
538.3adjustments shall be limited to the difference in the authorized framework rate specific to
538.4change in assessed need. Exemptions shall be managed within lead agencies' budgets per
538.5existing allocation procedures.
538.6(d) This subdivision expires January 1, 2019.

538.7    Sec. 4. Minnesota Statutes 2012, section 256B.4913, subdivision 5, is amended to read:
538.8    Subd. 5. Stakeholder consultation. The commissioner shall continue consultation
538.9on regular intervals with the existing stakeholder group established as part of the
538.10rate-setting methodology process and others, to gather input, concerns, and data, and
538.11exchange ideas for the legislative proposals for to assist in the full implementation of
538.12 the new rate payment system and to make pertinent information available to the public
538.13through the department's Web site.

538.14    Sec. 5. Minnesota Statutes 2012, section 256B.4913, subdivision 6, is amended to read:
538.15    Subd. 6. Implementation. (a) The commissioner may shall implement changes
538.16no sooner than on January 1, 2014, to payment rates for individuals receiving home and
538.17community-based waivered services after the enactment of legislation that establishes
538.18specific payment methodology frameworks, processes for rate calculations, and specific
538.19values to populate the payment methodology frameworks disability waiver rates system.
538.20(b) On January 1, 2014, all new service authorizations must use the disability waiver
538.21rates system. Beginning January 1, 2014, all renewing individual service plans must use the
538.22disability waiver rates system as reassessment and reauthorization occurs. By December
538.2331, 2014, data for all recipients must be entered into the disability waiver rates system.

538.24    Sec. 6. [256B.4914] HOME AND COMMUNITY-BASED SERVICES WAIVERS;
538.25RATE SETTING.
538.26    Subdivision 1. Application. The payment methodologies in this section apply to
538.27home and community-based services waivers under sections 256B.092 and 256B.49. This
538.28section does not change existing waiver policies and procedures.
538.29    Subd. 2. Definitions. (a) For purposes of this section, the following terms have the
538.30meanings given them, unless the context clearly indicates otherwise.
538.31(b) "Commissioner" means the commissioner of human services.
538.32(c) "Component value" means underlying factors that are part of the cost of providing
538.33services that are built into the waiver rates methodology to calculate service rates.
539.1(d) "Customized living tool" means a methodology for setting service rates that
539.2delineates and documents the amount of each component service included in a recipient's
539.3customized living service plan.
539.4(e) "Disability waiver rates system" means a statewide system that establishes rates
539.5that are based on uniform processes and captures the individualized nature of waiver
539.6services and recipient needs.
539.7(f) "Lead agency" means a county, partnership of counties, or tribal agency charged
539.8with administering waivered services under sections 256B.092 and 256B.49.
539.9(g) "Median" means the amount that divides distribution into two equal groups,
539.10one-half above the median and one-half below the median.
539.11(h) "Payment or rate" means reimbursement to an eligible provider for services
539.12provided to a qualified individual based on an approved service authorization.
539.13(i) "Rates management system" means a Web-based software application that uses
539.14a framework and component values, as determined by the commissioner, to establish
539.15service rates.
539.16(j) "Recipient" means a person receiving home and community-based services
539.17funded under any of the disability waivers.
539.18    Subd. 3. Applicable services. Applicable services are those authorized under
539.19the state's home and community-based services waivers under sections 256B.092 and
539.20256B.49, including the following, as defined in the federally approved home and
539.21community-based services plan:
539.22(1) 24 hour customized living;
539.23(2) adult day care;
539.24(3) adult day care bath;
539.25(4) behavioral programming;
539.26(5) companion services;
539.27(6) customized living;
539.28(7) day training and habilitation;
539.29(8) housing access coordination;
539.30(9) independent living skills;
539.31(10) in-home family support;
539.32(11) night supervision;
539.33(12) personal support;
539.34(13) prevocational services;
539.35(14) residential care services;
539.36(15) residential support services;
540.1(16) respite services;
540.2(17) structured day services;
540.3(18) supported employment services;
540.4(19) supported living services;
540.5(20) transportation services; and
540.6(21) other services as approved by the federal government in the state home and
540.7community-based services plan.
540.8    Subd. 4. Data collection for rate determination. (a) Rates for all applicable home
540.9and community-based waivered services, including rate exceptions under subdivision 12,
540.10are set via the rates management system.
540.11(b) Only data and information in the rates management system may be used to
540.12calculate an individual's rate.
540.13(c) Service providers, with information from the community support plan, shall enter
540.14values and information needed to calculate an individual's rate into the rates management
540.15system. These values and information include:
540.16(1) shared staffing hours;
540.17(2) individual staffing hours;
540.18(3) staffing ratios;
540.19(4) information to document variable levels of service qualification for variable
540.20levels of reimbursement in each framework;
540.21(5) shared or individualized arrangements for unit-based services, including the
540.22staffing ratio; and
540.23(6) number of trips and miles for transportation services.
540.24(d) Updates to individual data shall include:
540.25(1) data for each individual that is updated annually when renewing service plans; and
540.26(2) requests by individuals or lead agencies to update a rate whenever there is a
540.27change in an individual's service needs, with accompanying documentation.
540.28(e) Lead agencies shall review and approve values to calculate the final payment rate
540.29for each individual. Lead agencies must notify the individual and the service provider
540.30of the final agreed-upon values and rate. If a value used was mistakenly or erroneously
540.31entered and used to calculate a rate, a provider may petition lead agencies to correct it.
540.32Lead agencies must respond to these requests.
540.33    Subd. 5. Base wage index and standard component values. (a) The base wage
540.34index is established to determine staffing costs associated with providing services to
540.35individuals receiving home and community-based services. For purposes of developing
540.36and calculating the proposed base wage, Minnesota-specific wages taken from job
541.1descriptions and standard occupational classification (SOC) codes from the Bureau of
541.2Labor Statistics as defined in the most recent edition of the Occupational Handbook shall
541.3be used. The base wage index shall be calculated as follows:
541.4(1) for residential direct-care basic staff, 50 percent of the median wage for personal
541.5and home health aide (SOC code 39-9021); 30 percent of the median wage for nursing
541.6aide (SOC code 31-1012); and 20 percent of the median wage for social and human
541.7services aide (SOC code 21-1093);
541.8(2) for residential direct-care intensive staff, 20 percent of the median wage for home
541.9health aide (SOC code 31-1011); 20 percent of the median wage for personal and home
541.10health aide (SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code
541.1121-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
541.12and 20 percent of the median wage for social and human services aide (SOC code 21-1093);
541.13(3) for day services, 20 percent of the median wage for nursing aide (SOC code
541.1431-1012); 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
541.15and 60 percent of the median wage for social and human services code (SOC code 21-1093);
541.16(4) for residential asleep-overnight staff, the wage will be $7.66 per hour, except in
541.17a family foster care setting, the wage is $2.80 per hour;
541.18(5) for behavior program analyst staff, 100 percent of the median wage for mental
541.19health counselors (SOC code 21-1014);
541.20(6) for behavior program professional staff, 100 percent of the median wage for
541.21clinical counseling and school psychologist (SOC code 19-3031);
541.22(7) for behavior program specialist staff, 100 percent of the median wage for
541.23psychiatric technicians (SOC code 29-2053);
541.24(8) for supportive living services staff, 20 percent of the median wage for nursing
541.25aide (SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
541.26code 29-2053); and 60 percent of the median wage for social and human services aide
541.27(SOC code 21-1093);
541.28(9) for housing access coordination staff, 50 percent of the median wage for
541.29community and social services specialist (SOC code 21-1099); and 50 percent of the
541.30median wage for social and human services aide (SOC code 21-1093);
541.31(10) for in-home family support staff, 20 percent of the median wage for nursing
541.32aide (SOC code 31-1012); 30 percent of community social service specialist (SOC code
541.3321-1099); 40 percent of the median wage for social and human services aide (SOC code
541.3421-1093); and ten percent of the median wage for psychiatric technician (SOC code
541.3529-2053);
542.1(11) for independent living skills staff, 40 percent of the median wage for community
542.2social service specialist (SOC code 21-1099); 50 percent of the median wage for social
542.3and human services aide (SOC code 21-1093); and ten percent of the median wage for
542.4psychiatric technician (SOC code 29-2053);
542.5(12) for supported employment staff, 20 percent of the median wage for nursing aide
542.6(SOC code 31-1012); 20 percent of the median wage for psychiatric technician (SOC
542.7code 29-2053); and 60 percent of the median wage for social and human services aide
542.8(SOC code 21-1093);
542.9(13) for adult companion staff, 50 percent of the median wage for personal and home
542.10care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
542.11orderlies, and attendants (SOC code 31-1012);
542.12(14) for night supervision staff, 20 percent of the median wage for home health aide
542.13(SOC code 31-1011); 20 percent of the median wage for personal and home health aide
542.14(SOC code 39-9021); 20 percent of the median wage for nursing aide (SOC code 31-1012);
542.1520 percent of the median wage for psychiatric technician (SOC code 29-2053); and 20
542.16percent of the median wage for social and human services aide (SOC code 21-1093);
542.17(15) for respite staff, 50 percent of the median wage for personal and home care aide
542.18(SOC code 39-9021); and 50 percent of the median wage for nursing aides, orderlies, and
542.19attendants (SOC code 31-1012);
542.20(16) for personal support staff, 50 percent of the median wage for personal and home
542.21care aide (SOC code 39-9021); and 50 percent of the median wage for nursing aides,
542.22orderlies, and attendants (SOC code 31-1012); and
542.23(17) for supervisory staff, the basic wage is $17.43 per hour with exception of the
542.24supervisor of behavior analyst and behavior specialists, which shall be $30.75 per hour.
542.25(b) Component values for residential support services, excluding family foster
542.26care, are:
542.27(1) supervisory span of control ratio: 11 percent;
542.28(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
542.29(3) employee-related cost ratio: 23.6 percent;
542.30(4) general administrative support ratio: 13.25 percent;
542.31(5) program-related expense ratio: 1.3 percent; and
542.32(6) absence and utilization factor ratio: 3.9 percent.
542.33(c) Component values for family foster care are:
542.34(1) supervisory span of control ratio: 11 percent;
542.35(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
542.36(3) employee-related cost ratio: 23.6 percent;
543.1(4) general administrative support ratio: 3.3 percent; and
543.2(5) program-related expense ratio: 1.3 percent.
543.3(d) Component values for day services for all services are:
543.4(1) supervisory span of control ratio: 11 percent;
543.5(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
543.6(3) employee-related cost ratio: 23.6 percent;
543.7(4) program plan support ratio: 5.6 percent;
543.8(5) client programming and support ratio: ten percent;
543.9(6) general administrative support ratio: 13.25 percent;
543.10(7) program-related expense ratio: 1.8 percent; and
543.11(8) absence and utilization factor ratio: 3.9 percent.
543.12(e) Component values for unit-based with program services are:
543.13(1) supervisory span of control ratio: 11 percent;
543.14(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
543.15(3) employee-related cost ratio: 23.6 percent;
543.16(4) program plan supports ratio: 3.1 percent;
543.17(5) client programming and supports ratio: 8.6 percent;
543.18(6) general administrative support ratio: 13.25 percent;
543.19(7) program-related expense ratio: 6.1 percent; and
543.20(8) absence and utilization factor ratio: 3.9 percent.
543.21(f) Component values for unit-based services without programming except respite
543.22are:
543.23(1) supervisory span of control ratio: 11 percent;
543.24(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
543.25(3) employee-related cost ratio: 23.6 percent;
543.26(4) program plan support ratio: 3.1 percent;
543.27(5) client programming and support ratio: 8.6 percent;
543.28(6) general administrative support ratio: 13.25 percent;
543.29(7) program-related expense ratio: 6.1 percent; and
543.30(8) absence and utilization factor ratio: 3.9 percent.
543.31(g) Component values for unit-based services without programming for respite are:
543.32(1) supervisory span of control ratio: 11 percent;
543.33(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
543.34(3) employee-related cost ratio: 23.6 percent;
543.35(4) general administrative support ratio: 13.25 percent;
543.36(5) program-related expense ratio: 6.1 percent; and
544.1(6) absence and utilization factor ratio: 3.9 percent.
544.2(h) On July 1, 2017, the commissioner shall update the base wage index in paragraph
544.3(b) based on the wage data by standard occupational code (SOC) from the Bureau of
544.4Labor Statistics available on December 31, 2016. The commissioner shall publish these
544.5updated values and load them into the rate management system. This adjustment occurs
544.6every five years. For adjustments in 2021 and beyond, the commissioner shall use the data
544.7available on December 31 of the calendar year five years prior.
544.8(i) On July 1, 2017, the commissioner shall update the framework components in
544.9paragraph (c) for changes in the Consumer Price Index. The commissioner will adjust
544.10these values higher or lower by the percentage change in the Consumer Price Index-All
544.11Items, United States city average (CPI-U) from January 1, 2014, to January 1, 2017. The
544.12commissioner shall publish these updated values and load them into the rate management
544.13system. This adjustment occurs every five years. For adjustments in 2021 and beyond, the
544.14commissioner shall use the data available on January 1 of the calendar year four years
544.15prior and January 1 of the current calendar year.
544.16    Subd. 6. Payments for residential support services. (a) Payments for residential
544.17support services, as defined in sections 256B.092, subdivision 11, and 256B.49,
544.18subdivision 22, must be calculated as follows:
544.19(1) determine the number of units of service to meet a recipient's needs;
544.20(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
544.21national and Minnesota-specific rates or rates derived by the commissioner as provided
544.22in subdivision 5. This is defined as the direct-care rate;
544.23(3) for a recipient requiring customization for deaf and hard-of-hearing language
544.24accessibility under subdivision 12, add the customization rate provided in subdivision 12
544.25to the result of clause (2). This is defined as the customized direct-care rate;
544.26(4) multiply the number of residential services direct staff hours by the appropriate
544.27staff wage in subdivision 5, paragraph (a), or the customized direct-care rate;
544.28(5) multiply the number of direct staff hours by the product of the supervision span
544.29of control ratio in subdivision 5, paragraph (b), clause (1), and the appropriate supervision
544.30wage in subdivision 5, paragraph (a), clause (17);
544.31(6) combine the results of clauses (4) and (5), and multiply the result by one plus
544.32the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (b),
544.33clause (2). This is defined as the direct staffing cost;
544.34(7) for employee-related expenses, multiply the direct staffing cost by one plus the
544.35employee-related cost ratio in subdivision 5, paragraph (b), clause (3);
544.36(8) for client programming and supports, the commissioner shall add $2,179; and
545.1(9) for transportation, if provided, the commissioner shall add $1,680, or $3,000 if
545.2customized for adapted transport, per year.
545.3(b) The total rate shall be calculated using the following steps:
545.4(1) subtotal paragraph (a), clauses (7) to (9);
545.5(2) sum the standard general and administrative rate, the program-related expense
545.6ratio, and the absence and utilization ratio; and
545.7(3) divide the result of clause (1) by one minus the result of clause (2). This is
545.8the total payment amount.
545.9    Subd. 7. Payments for day programs. Payments for services with day programs
545.10including adult day care, day treatment and habilitation, prevocational services, and
545.11structured day services must be calculated as follows:
545.12(1) determine the number of units of service to meet a recipient's needs;
545.13(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
545.14Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
545.15(3) for a recipient requiring customization for deaf and hard-of-hearing language
545.16accessibility under subdivision 12, add the customization rate provided in subdivision 12
545.17to the result of clause (2). This is defined as the customized direct-care rate;
545.18(4) multiply the number of day program direct staff hours by the appropriate staff
545.19wage in subdivision 5, paragraph (a), or the customized direct-care rate;
545.20(5) multiply the number of day direct staff hours by the product of the supervision
545.21span of control ratio in subdivision 5, paragraph (d), clause (1), and the appropriate
545.22supervision wage in subdivision 5, paragraph (a), clause (17);
545.23(6) combine the results of clauses (4) and (5), and multiply the result by one plus
545.24the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (d),
545.25clause (2). This is defined as the direct staffing rate;
545.26(7) for program plan support, multiply the result of clause (6) by one plus the
545.27program plan support ratio in subdivision 5, paragraph (d), clause (4);
545.28(8) for employee-related expenses, multiply the result of clause (7) by one plus the
545.29employee-related cost ratio in subdivision 5, paragraph (d), clause (3);
545.30(9) for client programming and supports, multiply the result of clause (8) by one plus
545.31the client programming and support ratio in subdivision 5, paragraph (d), clause (5);
545.32(10) for program facility costs, add $8.30 per week with consideration of staffing
545.33ratios to meet individual needs;
545.34(11) for adult day bath services, add $7.01 per 15 minute unit;
545.35(12) this is the subtotal rate;
546.1(13) sum the standard general and administrative rate, the program-related expense
546.2ratio, and the absence and utilization factor ratio;
546.3(14) divide the result of clause (12) by one minus the result of clause (13). This is
546.4the total payment amount;
546.5(15) for transportation provided as part of day training and habilitation for an
546.6individual who does not require a lift, add:
546.7(i) $10.50 for a trip between zero and ten miles for a nonshared ride in a vehicle
546.8without a lift, $8.83 for a shared ride in a vehicle without a lift, and $9.25 for a shared
546.9ride in a vehicle with a lift;
546.10(ii) $15.75 for a trip between 11 and 20 miles for a nonshared ride in a vehicle
546.11without a lift, $10.58 for a shared ride in a vehicle without a lift, and $11.88 for a shared
546.12ride in a vehicle with a lift;
546.13(iii) $25.75 for a trip between 21 and 50 miles for a nonshared ride in a vehicle
546.14without a lift, $13.92 for a shared ride in a vehicle without a lift, and $16.88 for a shared
546.15ride in a vehicle with a lift; or
546.16(iv) $33.50 for a trip of 51 miles or more for a nonshared ride in a vehicle without a
546.17lift, $16.50 for a shared ride in a vehicle without a lift. and $20.75 for a shared ride in a
546.18vehicle with a lift;
546.19(16) for transportation provide as part of day training and habilitation for an
546.20individual who does require a lift, add:
546.21(i) $19.05 for a trip between zero and ten miles for a nonshared ride in a vehicle with
546.22a lift, and $15.05 for a shared ride in a vehicle with a lift;
546.23(ii) $32.16 for a trip between 11 and 20 miles for a nonshared ride in a vehicle with a
546.24lift, and $28.16 for a shared ride in a vehicle with a lift;
546.25(iii) $58.76 for a trip between 21 and 50 miles for a nonshared ride in a vehicle with
546.26a lift, and $58.76 for a shared ride in a vehicle with a lift; or
546.27(iv) $80.93 for a trip of 51 miles or more for a nonshared ride in a vehicle with a
546.28lift, and $80.93 for a shared ride in a vehicle with a lift.
546.29    Subd. 8. Payments for unit-based services with programming. Payments for
546.30unit-based with program services, including behavior programming, housing access
546.31coordination, in-home family support, independent living skills training, hourly supported
546.32living services, and supported employment provided to an individual outside of any day or
546.33residential service plan must be calculated as follows, unless the services are authorized
546.34separately under subdivision 6 or 7:
546.35(1) determine the number of units of service to meet a recipient's needs;
547.1(2) personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
547.2Minnesota-specific rates or rates derived by the commissioner as provided in subdivision 5;
547.3(3) for a recipient requiring customization for deaf and hard-of-hearing language
547.4accessibility under subdivision 12, add the customization rate provided in subdivision 12
547.5to the result of clause (2). This is defined as the customized direct-care rate;
547.6(4) multiply the number of direct staff hours by the appropriate staff wage in
547.7subdivision 5, paragraph (a), or the customized direct care rate;
547.8(5) multiply the number of direct staff hours by the product of the supervision span
547.9of control ratio in subdivision 5, paragraph (e), clause (1), and the appropriate supervision
547.10wage in subdivision 5, paragraph (a), clause (17);
547.11(6) combine the results of clauses (4) and (5), and multiply the result by one plus
547.12the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (e),
547.13clause (2). This is defined as the direct staffing rate;
547.14(7) for program plan support, multiply the result of clause (6) by one plus the
547.15program plan supports ratio in subdivision 5, paragraph (e), clause (4);
547.16(8) for employee-related expenses, multiply the result of clause (7) by one plus the
547.17employee-related cost ratio in subdivision 5, paragraph (e), clause (3);
547.18(9) for client programming and supports, multiply the result of clause (8) by one plus
547.19the client programming and supports ratio in subdivision 5, paragraph (e), clause (5);
547.20(10) this is the subtotal rate;
547.21(11) sum the standard general and administrative rate, the program-related expense
547.22ratio, and the absence and utilization factor ratio; and
547.23(12) divide the result of clause (10) by one minus the result of clause (11). This is
547.24the total payment amount.
547.25    Subd. 9. Payments for unit-based services without programming. Payments
547.26for unit-based without program services, including night supervision, personal support,
547.27respite, and companion care provided to an individual outside of any day or residential
547.28service plan must be calculated as follows unless the services are authorized separately
547.29under subdivision 6 or 7:
547.30(1) for all services except respite, determine the number of units of service to meet
547.31a recipient's needs;
547.32(2) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
547.33Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
547.34(3) for a recipient requiring customization for deaf and hard-of-hearing language
547.35accessibility under subdivision 12, add the customization rate provided in subdivision 12
547.36to the result of clause (2). This is defined as the customized direct care rate;
548.1(4) multiply the number of direct staff hours by the appropriate staff wage in
548.2subdivision 5 or the customized direct care rate;
548.3(5) multiply the number of direct staff hours by the product of the supervision span
548.4of control ratio in subdivision 5, paragraph (f), clause (1), and the appropriate supervision
548.5wage in subdivision 5, paragraph (a), clause (17);
548.6(6) combine the results of clauses (4) and (5), and multiply the result by one plus
548.7the employee vacation, sick, and training allowance ratio in, subdivision 5, paragraph (f),
548.8clause (2). This is defined as the direct staffing rate;
548.9(7) for program plan support, multiply the result of clause (6) by one plus the
548.10program plan support ratio in subdivision 5, paragraph (f), clause (4);
548.11(8) for employee-related expenses, multiply the result of clause (7) by one plus the
548.12employee-related cost ratio in subdivision 5, paragraph (f), clause (3);
548.13(9) for client programming and supports, multiply the result of clause (8) by one plus
548.14the client programming and support ratio in subdivision 5, paragraph (f), clause (5);
548.15(10) this is the subtotal rate;
548.16(11) sum the standard general and administrative rate, the program-related expense
548.17ratio, and the absence and utilization factor ratio;
548.18(12) divide the result of clause (10) by one minus the result of clause (11). This is
548.19the total payment amount;
548.20(13) for respite services, determine the number of daily units of service to meet an
548.21individual's needs;
548.22(14) personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
548.23Minnesota-specific rate or rates derived by the commissioner as provided in subdivision 5;
548.24(15) for a recipient requiring deaf and hard-of-hearing customization under
548.25subdivision 12, add the customization rate provided in subdivision 12 to the result of
548.26clause (14). This is defined as the customized direct care rate;
548.27(16) multiply the number of direct staff hours by the appropriate staff wage in
548.28subdivision 5, paragraph (a);
548.29(17) multiply the number of direct staff hours by the product of the supervisory span
548.30of control ratio in subdivision 5, paragraph (g), clause (1), and the appropriate supervision
548.31wage in subdivision 5, paragraph (a), clause (17);
548.32(18) combine the results of clauses (16) and (17), and multiply the result by one plus
548.33the employee vacation, sick, and training allowance ratio in subdivision 5, paragraph (g),
548.34clause (2). This is defined as the direct staffing rate;
548.35(19) for employee-related expenses, multiply the result of clause (18) by one plus
548.36the employee-related cost ratio in subdivision 5, paragraph (g), clause (3).
549.1(20) this is the subtotal rate;
549.2(21) sum the standard general and administrative rate, the program-related expense
549.3ratio, and the absence and utilization factor ratio; and
549.4(22) divide the result of clause (20) by one minus the result of clause (21). This is
549.5the total payment amount.
549.6    Subd. 10. Updating payment values and additional information. (a) The
549.7commissioner shall develop and implement uniform procedures to refine terms and update
549.8or adjust values used to calculate payment rates in this section. For calendar year 2014,
549.9the commissioner shall use the values, terms, and procedures provided in this section.
549.10(b) The commissioner shall work with stakeholders to assess efficacy of values
549.11and payment rates. The commissioner shall report back to the legislature with proposed
549.12changes for component values and recommendations for revisions on the schedule
549.13provided in paragraphs (c) and (d).
549.14(c) The commissioner shall work with stakeholders to continue refining a
549.15subset of component values, which are to be referred to as interim values, and report
549.16recommendations to the legislature by February 15, 2014. Interim component values are:
549.17transportation rates for day training and habilitation; transportation for adult day, structured
549.18day, and prevocational services; geographic difference factor; day program facility rate;
549.19services where monitoring technology replaces staff time; shared services for independent
549.20living skills training; and supported employment and billing for indirect services.
549.21(d) The commissioner shall report and make recommendations to the legislature on:
549.22February 15, 2015; February 15, 2017; February 15, 2019; and February 15, 2021. After
549.232021 reports shall be provided on a four-year cycle.
549.24(e) The commissioner shall provide a public notice via LISTSERV in October of
549.25each year beginning October 1, 2014. The notice shall contain information detailing
549.26legislatively approved changes in: calculation values, including derived wage rates
549.27and related employee and administrative factors; services utilization; county and tribal
549.28allocation changes; and information on adjustments to be made to calculation values
549.29and timing of those adjustments. Information in this notice shall be effective January
549.301 of the following year.
549.31    Subd. 11. Payment implementation. Upon implementation of the payment
549.32methodologies under this section, those payment rates supersede rates established in county
549.33contracts for recipients receiving waiver services under section 256B.092 or 256B.49.
549.34    Subd. 12. Customization of rates for individuals. (a) For persons determined to
549.35have higher needs based on being deaf or hard-of-hearing, the direct-care costs must be
549.36increased by an adjustment factor prior to calculating the rate under subdivisions 6, 7, 8,
550.1and 9. The customization rate with respect to deaf or hard-of-hearing persons shall be
550.2$2.50 per hour for waiver recipients who meet the respective criteria as determined by
550.3the commissioner.
550.4(b) For the purposes of this section, "deaf or hard-of-hearing" means:
550.5(1) the person has a developmental disability and an assessment score which
550.6indicates a hearing impairment that is severe or that the person has no useful hearing;
550.7(2) the person has a developmental disability and an expressive communications
550.8score that indicates the person uses single signs or gestures, uses an augmentative
550.9communication aid, or does not have functional communication, or the person's expressive
550.10communications is unknown; and
550.11(3) the person has a developmental disability and a communication score which
550.12indicates the person comprehends signs, gestures and modeling prompts or does not
550.13comprehend verbal, visual or gestural communication or that the person's receptive
550.14communication score is unknown; or
550.15(4) the person receives long-term care services and has an assessment score that
550.16indicates they hear only very loud sounds, have no useful hearing, or a determination
550.17cannot be made; and the person receives long-term care services and has an assessment
550.18that indicates the person communicates needs with sign language, symbol board, written
550.19messages, gestures or an interpreter; communicates with inappropriate content, makes
550.20garbled sounds or displays echolalia, or does not communicate needs.
550.21    Subd. 13. Transportation. The commissioner shall require that the purchase
550.22of transportation services be cost-effective and be limited to market rates where the
550.23transportation mode is generally available and accessible.
550.24    Subd. 14. Exceptions. (a) In a format prescribed by the commissioner, lead
550.25agencies must identify individuals with exceptional needs that cannot be met under the
550.26disability waiver rate system. The commissioner shall use that information to evaluate
550.27and, if necessary, approve an alternative payment rate for those individuals.
550.28(b) Lead agencies must submit exceptions requests to the state.
550.29(c) An application for a rate exception may be submitted for the following criteria:
550.30(1) an individual has service needs that cannot be met through additional units
550.31of service; or
550.32(2) an individual's rate determined under subdivisions 6, 7, 8, and 9 results in an
550.33individual being discharged.
550.34(d) Exception requests will include the following information:
550.35(1) the service needs required by each individual that are not accounted for in
550.36subdivisions 6, 7, 8, and 9;
551.1(2) the service rate requested and the difference from the rate determined in
551.2subdivisions 6, 7, 8, and 9;
551.3(3) a basis for the underlying costs used for the rate exception and any accompanying
551.4documentation;
551.5(4) the duration of the rate exception; and
551.6(5) any contingencies for approval.
551.7(e) Approved rate exceptions shall be managed within lead agency allocations under
551.8sections 256B.092 and 256B.49.
551.9(f) Individual disability waiver recipients may request that a lead agency submit an
551.10exceptions request. A lead agency that denies such a request shall notify the individual
551.11waiver recipient of its decision and the reasons for denying the request in writing no later
551.12than 30 days after the individual's request has been made.
551.13(g) The commissioner shall determine whether to approve or deny an exception
551.14request no more than 30 days after receiving the request. If the commissioner denies the
551.15request, the commissioner shall notify the lead agency and the individual disability waiver
551.16recipient in writing of the reasons for the denial.
551.17(h) The individual disability waiver recipient may appeal any denial of an exception
551.18request by either the lead agency or the commissioner, pursuant to sections 256.045 and
551.19256.0451. When the denial of an exception request results in the proposed demission of a
551.20waiver recipient from a residential or day habilitation program, the commissioner shall
551.21issue a temporary stay of demission, when requested by the disability waiver recipient,
551.22consistent with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c).
551.23The temporary stay shall remain in effect until the lead agency can provide an informed
551.24choice of appropriate, alternative services to the disability waiver.
551.25(i) Providers may petition lead agencies to update values that were entered
551.26incorrectly or erroneously into the rate management system, based on past service level
551.27discussions and determination in subdivision 4, without applying for a rate exception.
551.28    Subd. 15. County or tribal allocations. (a) Upon implementation of the disability
551.29waiver rates management system on January 1, 2014, the commissioner shall establish
551.30a method of tracking and reporting the fiscal impact of the disability waiver rates
551.31management system on individual lead agencies.
551.32(b) Beginning January 1, 2014, and continuing through full implementation on
551.33December 31, 2017, the commissioner shall make annual adjustments to lead agencies'
551.34home and community-based waivered service budget allocations to adjust for rate
551.35differences and the resulting impact on county allocations upon implementation of the
551.36disability waiver rates system.
552.1    Subd. 16. Budget neutrality adjustment. The commissioner shall calculate the
552.2total spending for all home and community-based waiver services under the payments as
552.3defined in subdivisions 6, 7, 8, and 9 for all recipients as of July 1, 2013, and compare it to
552.4spending for services defined for subdivisions 6, 7, 8, and 9 under current law. If spending
552.5for services in one particular subdivision differs, there will be a percentage adjustment
552.6to increase or decrease individual rates for the services defined in each subdivision so
552.7aggregate spending matches projections under current law.
552.8    Subd. 17. Implementation. (a) On January 1, 2014, the commissioner shall fully
552.9implement the calculation of rates for waivered services under sections 256B.092 and
552.10256B.49 without additional legislative approval.
552.11(b) The commissioner shall phase in the application of rates determined in
552.12subdivisions 6 to 9 for two years.
552.13(c) The commissioner shall preserve rates in effect on December 31, 2013, for
552.14the two-year period.
552.15(d) The commissioner shall calculate and measure the difference in cost per
552.16individual using the historical rate and the rates under subdivisions 6 to 9 for all existing
552.17individuals. This measurement shall occur statewide, and for individuals in every county.
552.18The commissioner shall provide the results of this analysis by county for calendar year
552.192014 to the legislative committees and divisions with jurisdiction over health and human
552.20services finance by February 15, 2015.
552.21(e) The commissioner shall calculate the average rate per unit for each service by
552.22county. For individuals enrolled after January 1, 2014, individuals will receive the higher
552.23of the rate produced under subdivisions 6 to 9, or the by-county average rate.
552.24(f) On January 1, 2016, the rates determined in subdivisions 6 to 9 shall be applied.

552.25    Sec. 7. REPEALER.
552.26Minnesota Statutes 2012, section 256B.4913, subdivisions 1, 2, 3, and 4, is repealed.

552.29

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

552.30The sums shown in the columns marked "Appropriations" are appropriated to the
552.31agencies and for the purposes specified in this article. The appropriations are from the
552.32general fund, or another named fund, and are available for the fiscal years indicated
552.33for each purpose. The figures "2014" and "2015" used in this article mean that the
552.34appropriations listed under them are available for the fiscal year ending June 30, 2014, or
553.1June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
553.2year 2015. "The biennium" is fiscal years 2014 and 2015.

553.3				APPROPRIATIONS
553.4				Available for the Year
553.5				Ending June 30
553.6					2014		2015

553.7 553.8

Sec. 2. COMMISSIONER OF HUMAN SERVICES

553.9

Subdivision 1.Total Appropriation

$

6,411,182,000

$

6,392,303,000

553.10	Appropriations by Fund
553.11		2014	2015
553.12	General	5,807,515,000	5,831,770,000
553.13 553.14	State Government Special Revenue	3,815,000	4,915,000
553.15	Health Care Access	340,047,000	298,915,000
553.16	Federal TANF	257,915,000	254,813,000
553.17	Lottery Prize Fund	1,890,000	1,890,000

553.18Receipts for Systems Projects.
553.19Appropriations and federal receipts for
553.20information systems projects for MAXIS,
553.21PRISM, MMIS, and SSIS must be deposited
553.22in the state system account authorized
553.23in Minnesota Statutes, section 256.014.
553.24Money appropriated for computer projects
553.25approved by the commissioner of Minnesota
553.26information technology services, funded
553.27by the legislature, and approved by the
553.28commissioner of management and budget,
553.29may be transferred from one project to
553.30another and from development to operations
553.31as the commissioner of human services
553.32considers necessary. Any unexpended
553.33balance in the appropriation for these
553.34projects does not cancel but is available for
553.35ongoing development and operations.
553.36Nonfederal Share Transfers. The
553.37nonfederal share of activities for which
554.1federal administrative reimbursement is
554.2appropriated to the commissioner may be
554.3transferred to the special revenue fund.
554.4ARRA Supplemental Nutrition Assistance
554.5Benefit Increases. The funds provided for
554.6food support benefit increases under the
554.7Supplemental Nutrition Assistance Program
554.8provisions of the American Recovery and
554.9Reinvestment Act (ARRA) of 2009 must be
554.10used for benefit increases beginning July 1,
554.112009.
554.12Supplemental Nutrition Assistance
554.13Program Employment and Training.
554.14(1) Notwithstanding Minnesota Statutes,
554.15sections 256D.051, subdivisions 1a, 6b,
554.16and 6c, and 256J.626, federal Supplemental
554.17Nutrition Assistance employment and
554.18training funds received as reimbursement of
554.19MFIP consolidated fund grant expenditures
554.20for diversionary work program participants
554.21and child care assistance program
554.22expenditures must be deposited in the general
554.23fund. The amount of funds must be limited to
554.24$4,900,000 per year in fiscal years 2014 and
554.252015, and to $4,400,000 per year in fiscal
554.26years 2016 and 2017, contingent on approval
554.27by the federal Food and Nutrition Service.
554.28(2) Consistent with the receipt of the federal
554.29funds, the commissioner may adjust the
554.30level of working family credit expenditures
554.31claimed as TANF maintenance of effort.
554.32Notwithstanding any contrary provision in
554.33this article, this rider expires June 30, 2017.
554.34TANF Maintenance of Effort. (a) In order
554.35to meet the basic maintenance of effort
555.1(MOE) requirements of the TANF block grant
555.2specified under Code of Federal Regulations,
555.3title 45, section 263.1, the commissioner may
555.4only report nonfederal money expended for
555.5allowable activities listed in the following
555.6clauses as TANF/MOE expenditures:
555.7(1) MFIP cash, diversionary work program,
555.8and food assistance benefits under Minnesota
555.9Statutes, chapter 256J;
555.10(2) the child care assistance programs
555.11under Minnesota Statutes, sections 119B.03
555.12and 119B.05, and county child care
555.13administrative costs under Minnesota
555.14Statutes, section 119B.15;
555.15(3) state and county MFIP administrative
555.16costs under Minnesota Statutes, chapters
555.17256J and 256K;
555.18(4) state, county, and tribal MFIP
555.19employment services under Minnesota
555.20Statutes, chapters 256J and 256K;
555.21(5) expenditures made on behalf of legal
555.22noncitizen MFIP recipients who qualify for
555.23the MinnesotaCare program under Minnesota
555.24Statutes, chapter 256L;
555.25(6) qualifying working family credit
555.26expenditures under Minnesota Statutes,
555.27section 290.0671;
555.28(7) qualifying Minnesota education credit
555.29expenditures under Minnesota Statutes,
555.30section 290.0674; and
555.31(8) qualifying Head Start expenditures under
555.32Minnesota Statutes, section 119A.50.
555.33(b) The commissioner shall ensure that
555.34sufficient qualified nonfederal expenditures
556.1are made each year to meet the state's
556.2TANF/MOE requirements. For the activities
556.3listed in paragraph (a), clauses (2) to
556.4(8), the commissioner may only report
556.5expenditures that are excluded from the
556.6definition of assistance under Code of
556.7Federal Regulations, title 45, section 260.31.
556.8(c) For fiscal years beginning with state fiscal
556.9year 2003, the commissioner shall ensure
556.10that the maintenance of effort used by the
556.11commissioner of management and budget
556.12for the February and November forecasts
556.13required under Minnesota Statutes, section
556.1416A.103, contains expenditures under
556.15paragraph (a), clause (1), equal to at least 16
556.16percent of the total required under Code of
556.17Federal Regulations, title 45, section 263.1.
556.18(d) The requirement in Minnesota Statutes,
556.19section 256.011, subdivision 3, that federal
556.20grants or aids secured or obtained under that
556.21subdivision be used to reduce any direct
556.22appropriations provided by law, do not apply
556.23if the grants or aids are federal TANF funds.
556.24(e) For the federal fiscal years beginning on
556.25or after October 1, 2007, the commissioner
556.26may not claim an amount of TANF/MOE in
556.27excess of the 75 percent standard in Code
556.28of Federal Regulations, title 45, section
556.29263.1(a)(2), except:
556.30(1) to the extent necessary to meet the 80
556.31percent standard under Code of Federal
556.32Regulations, title 45, section 263.1(a)(1),
556.33if it is determined by the commissioner
556.34that the state will not meet the TANF work
556.35participation target rate for the current year;
557.1(2) to provide any additional amounts
557.2under Code of Federal Regulations, title 45,
557.3section 264.5, that relate to replacement of
557.4TANF funds due to the operation of TANF
557.5penalties; and
557.6(3) to provide any additional amounts that
557.7may contribute to avoiding or reducing
557.8TANF work participation penalties through
557.9the operation of the excess MOE provisions
557.10of Code of Federal Regulations, title 45,
557.11section 261.43(a)(2).
557.12For the purposes of clauses (1) to (3),
557.13the commissioner may supplement the
557.14MOE claim with working family credit
557.15expenditures or other qualified expenditures
557.16to the extent such expenditures are otherwise
557.17available after considering the expenditures
557.18allowed in this subdivision and subdivisions
557.192 and 3.
557.20(f) Notwithstanding any contrary provision
557.21in this article, paragraphs (a) to (e) expire
557.22June 30, 2017.
557.23Working Family Credit Expenditures
557.24as TANF/MOE. The commissioner may
557.25claim as TANF maintenance of effort up to
557.26$6,707,000 per year of working family credit
557.27expenditures in each fiscal year.

557.28 557.29

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

557.30The commissioner may count the following
557.31amounts of working family credit
557.32expenditures as TANF/MOE:
557.33(1) fiscal year 2014, $45,196,000;
557.34(2) fiscal year 2015, $41,885,000;
558.1(3) fiscal year 2016, $8,869,000; and
558.2(4) fiscal year 2017, $11,181,000.

558.3 558.4

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

558.5(a) The following TANF fund amounts
558.6are appropriated to the commissioner for
558.7purposes of MFIP/transition year child care
558.8assistance under Minnesota Statutes, section
558.9119B.05:
558.10(1) fiscal year 2014; $14,020,000; and
558.11(2) fiscal year 2015, $14,020,000.
558.12(b) The commissioner shall authorize the
558.13transfer of sufficient TANF funds to the
558.14federal child care and development fund to
558.15meet this appropriation and shall ensure that
558.16all transferred funds are expended according
558.17to federal child care and development fund
558.18regulations.

558.19

Subd. 4.Central Office

558.20The amounts that may be spent from this
558.21appropriation for each purpose are as follows:

558.22

(a) Operations

558.23	Appropriations by Fund
558.24	General	88,876,000	91,189,000
558.25 558.26	State Government Special Revenue	3,690,000	4,790,000
558.27	Health Care Access	13,177,000	13,004,000
558.28	Federal TANF	100,000	100,000

558.29DHS Receipt Center Accounting. The
558.30commissioner is authorized to transfer
558.31appropriations to, and account for DHS
558.32receipt center operations in, the special
558.33revenue fund.
559.1Administrative Recovery; Set-Aside. The
559.2commissioner may invoice local entities
559.3through the SWIFT accounting system as an
559.4alternative means to recover the actual cost
559.5of administering the following provisions:
559.6(1) Minnesota Statutes, section 125A.744,
559.7subdivision 3;
559.8(2) Minnesota Statutes, section 245.495,
559.9paragraph (b);
559.10(3) Minnesota Statutes, section 256B.0625,
559.11subdivision 20, paragraph (k);
559.12(4) Minnesota Statutes, section 256B.0924,
559.13subdivision 6, paragraph (g);
559.14(5) Minnesota Statutes, section 256B.0945,
559.15subdivision 4, paragraph (d); and
559.16(6) Minnesota Statutes, section 256F.10,
559.17subdivision 6, paragraph (b).
559.18Systems Modernization. The following
559.19amounts are appropriated for transfer to
559.20the state systems account authorized in
559.21Minnesota Statutes, section 256.014:
559.22(1) $1,825,000 in fiscal year 2014 and
559.23$2,502,000 in fiscal year 2015 is for the
559.24state share of Medicaid-allocated costs of
559.25the health insurance exchange information
559.26technology and operational structure. The
559.27funding base is $3,222,000 in fiscal year 2016
559.28and $3,037,000 in fiscal year 2017 but shall
559.29not be included in the base thereafter; and
559.30(2) $1,000,000 in fiscal year 2014 and
559.31$2,000,000 in fiscal year 2015 are for the
559.32modernization and streamlining of agency
559.33eligibility and child support systems. The
559.34funding base is $2,000,000 in fiscal year
560.12016 and $2,000,000 in fiscal year 2017 but
560.2shall not be included in the base thereafter.
560.3The unexpended balance of the $1,000,000
560.4appropriation in fiscal year 2014 and the
560.5$2,000,000 appropriation in fiscal year 2015
560.6must be transferred from the Department of
560.7Human Services state systems account to
560.8the Office of Enterprise Technology when
560.9the Office of Enterprise Technology has
560.10negotiated a federally approved internal
560.11service fund rates and billing process with
560.12sufficient internal accounting controls to
560.13properly maximize federal reimbursement
560.14to Minnesota for human services system
560.15modernization projects, but not later than
560.16June 30, 2015.
560.17If contingent funding is fully or partially
560.18disbursed under article.., section .., and
560.19transferred to the state systems account, the
560.20unexpended balance of that appropriation
560.21must be transferred to the Office of Enterprise
560.22Technology in accordance with this clause.
560.23Contingent funding must not exceed
560.24$14,297,000 for the biennium.
560.25Base Adjustment. The general fund base
560.26is increased by $646,000 in fiscal year 2016
560.27and $461,000 in fiscal year 2017. The health
560.28access fund base is decreased by $551,000 in
560.29fiscal years 2016 and 2017.

560.30

(b) Children and Families

560.31	Appropriations by Fund
560.32	General	7,569,000	7,519,000
560.33	Federal TANF	2,282,000	2,282,000

560.34Financial Institution Data Match and
560.35Payment of Fees. The commissioner is
561.1authorized to allocate up to $310,000 each
561.2year in fiscal years 2014 and 2015 from the
561.3PRISM special revenue account to make
561.4payments to financial institutions in exchange
561.5for performing data matches between account
561.6information held by financial institutions
561.7and the public authority's database of child
561.8support obligors as authorized by Minnesota
561.9Statutes, section 13B.06, subdivision 7.

561.10

(c) Health Care

561.11	Appropriations by Fund
561.12	General	13,643,000	13,227,000
561.13	Health Care Access	24,602,000	26,728,000

561.14Base Adjustment. The general fund base
561.15is decreased by $86,000 in fiscal year 2016
561.16and by $86,000 in fiscal year 2017. The
561.17health care access fund base is increased
561.18by $7,956,000 in fiscal year 2016 and by
561.19$6,354,000 in fiscal year 2017.

561.20

(d) Continuing Care

561.21	Appropriations by Fund
561.22	General	17,361,000	17,426,000
561.23 561.24	State Government Special Revenue	125,000	125,000

561.25Base Adjustment. The general fund base is
561.26decreased by $1,000 in fiscal year 2016 and
561.27by $1,000 in fiscal year 2017.

561.28

(e) Chemical and Mental Health

561.29	Appropriations by Fund
561.30	General	4,313,000	4,179,000
561.31	Lottery Prize Fund	157,000	157,000

561.32

Subd. 5.Forecasted Programs

561.33The amounts that may be spent from this
561.34appropriation for each purpose are as follows:

562.1

(a) MFIP/DWP

562.2	Appropriations by Fund
562.3	General	73,742,000	79,302,000
562.4	Federal TANF	80,342,000	76,851,000

562.5

(b) MFIP Child Care Assistance

62,030,000

64,731,000

562.6

(c) General Assistance

54,787,000

56,068,000

562.7General Assistance Standard. The
562.8commissioner shall set the monthly standard
562.9of assistance for general assistance units
562.10consisting of an adult recipient who is
562.11childless and unmarried or living apart
562.12from parents or a legal guardian at $203.
562.13The commissioner may reduce this amount
562.14according to Laws 1997, chapter 85, article
562.153, section 54.
562.16Emergency General Assistance. The
562.17amount appropriated for emergency general
562.18assistance funds is limited to no more
562.19than $6,729,812 in fiscal year 2014 and
562.20$6,729,812 in fiscal year 2015. Funds
562.21to counties shall be allocated by the
562.22commissioner using the allocation method in
562.23Minnesota Statutes, section 256D.06.

562.24

(d) MN Supplemental Assistance

38,646,000

39,821,000

562.25

(e) Group Residential Housing

140,447,000

149,984,000

562.26

(f) MinnesotaCare

299,290,000

257,020,000

562.27This appropriation is from the health care
562.28access fund.

562.29

(g) Medical Assistance

4,609,672,000

4,615,440,000

562.30Medical Eligibility for Inmates in Medical
562.31Institutions. The commissioner of human
562.32services shall execute an interagency
562.33agreement with the commissioner of
563.1corrections to recover the medical assistance
563.2cost attributable to medical assistance
563.3eligibility for inmates of public institutions
563.4admitted to hospitals on an inpatient basis.
563.5The amount that must be recovered from
563.6the Department of Corrections shall include
563.7all state medical assistance costs, including
563.8administrative costs, attributable to inmates
563.9under state and county jurisdiction admitted
563.10to hospitals on an inpatient basis.
563.11Support Services for Deaf and
563.12Hard-of-Hearing. $121,000 in fiscal
563.13year 2014 and $141,000 in fiscal year 2015;
563.14and $10,000 in fiscal year 2014 and $13,000
563.15in fiscal year 2015 are from the health care
563.16access fund for the hospital reimbursement
563.17increase in Minnesota Statutes, section
563.18256.969, subdivision 29, paragraph (b).

563.19

(h) Alternative Care

47,058,000

47,078,000

563.20Alternative Care Transfer. Any money
563.21allocated to the alternative care program that
563.22is not spent for the purposes indicated does
563.23not cancel but shall be transferred to the
563.24medical assistance account.

563.25

(i) CD Treatment Fund

81,440,000

74,875,000

563.26Balance Transfer. The commissioner must
563.27transfer $18,188,000 from the consolidated
563.28chemical dependency treatment fund to the
563.29general fund by September 30, 2013.

563.30

Subd. 6.Grant Programs

563.31The amounts that may be spent from this
563.32appropriation for each purpose are as follows:

563.33

(a) Support Services Grants

564.1	Appropriations by Fund
564.2	General	11,333,000	11,133,000
564.3	Federal TANF	94,611,000	94,611,000

564.4Paid Work Experience. $1,159,000 in fiscal
564.5year 2014, and $1,009,000 in fiscal year
564.62015 is from the general fund for paid work
564.7experience for long-term MFIP recipients.
564.8Paid work includes full and partial wage
564.9subsidies and other related services such as
564.10job development, marketing, preworksite
564.11training, job coaching, and postplacement
564.12services. Unexpended funds for fiscal year
564.132014 do not cancel but are available for this
564.14purpose in fiscal year 2015.
564.15Work Study Funding for MFIP
564.16Participants. $250,000 each year is from
564.17the general fund to pilot work study jobs for
564.18MFIP recipients in approved postsecondary
564.19education programs. This is a onetime
564.20appropriation. Unexpended funds for fiscal
564.21year 2014 do not cancel but are available for
564.22this purpose in fiscal year 2015.
564.23Base Adjustment. The general fund base is
564.24decreased by $2,418,000 in fiscal years 2016
564.25and 2017.

564.26 564.27

(b) Basic Sliding Fee Child Care Assistance Grants

39,039,000

40,391,000

564.28

(c) Child Care Development Grants

1,487,000

1,487,000

564.29

(d) Child Support Enforcement Grants

50,000

50,000

564.30Federal Child Support Demonstration
564.31Grants. Federal administrative
564.32reimbursement resulting from the federal
564.33child support grant expenditures authorized
564.34under United States Code, title 42, section
565.11315, is appropriated to the commissioner
565.2for this activity.

565.3

(e) Children's Services Grants

565.4	Appropriations by Fund
565.5	General	49,810,000	50,260,000
565.6	Federal TANF	140,000	140,000

565.7Adoption Assistance and Relative Custody
565.8Assistance. The commissioner may transfer
565.9unencumbered appropriation balances for
565.10adoption assistance and relative custody
565.11assistance between fiscal years and between
565.12programs.
565.13Title IV-E Adoption Assistance. Additional
565.14federal reimbursements to the state as a result
565.15of the Fostering Connections to Success
565.16and Increasing Adoptions Act's expanded
565.17eligibility for Title IV-E adoption assistance
565.18are appropriated for postadoption services,
565.19including a parent-to-parent support network.
565.20Privatized Adoption Grants. Federal
565.21reimbursement for privatized adoption grant
565.22and foster care recruitment grant expenditures
565.23is appropriated to the commissioner for
565.24adoption grants and foster care and adoption
565.25administrative purposes.
565.26Adoption Assistance Incentive Grants.
565.27 Federal funds available during fiscal years
565.282014 and 2015 for adoption incentive grants
565.29are appropriated for postadoption services,
565.30including a parent-to-parent support network.
565.31Base Adjustment. The general fund base is
565.32decreased by $466,000 in fiscal year 2016
565.33and by $822,000 in fiscal year 2017.

565.34

(f) Child and Community Service Grants

53,301,000

53,301,000

566.1

(g) Child and Economic Support Grants

20,972,000

20,973,000

566.2Minnesota Food Assistance Program.
566.3Unexpended funds for the Minnesota food
566.4assistance program for fiscal year 2014 do
566.5not cancel but are available for this purpose
566.6in fiscal year 2015.
566.7Family Assets for Independence. $250,000
566.8each year is for the Family Assets for
566.9Independence Minnesota program. This
566.10appropriation is available in either year of the
566.11biennium and may be transferred between
566.12fiscal years.
566.13Food Shelf Programs. $500,000 in fiscal
566.14year 2014 and $500,000 in fiscal year
566.152015 are for food shelf programs under
566.16Minnesota Statutes, section 256E.34. If the
566.17appropriation for either year is insufficient,
566.18the appropriation for the other year is
566.19available for it.
566.20Homeless Youth Act. $4,000,000 is for
566.21purposes of Minnesota Statutes, section
566.22256K.45.
566.23Safe Harbor Shelter and Housing.
566.24$2,000,000 in fiscal year 2014 and
566.25$2,000,000 in fiscal year 2015 is for a safe
566.26harbor shelter and housing fund for housing
566.27and supportive services for youth who are
566.28sexually exploited.

566.29

(h) Health Care Grants

566.30	Appropriations by Fund
566.31	General	190,000	190,000
566.32	Health Care Access	2,228,000	1,413,000

566.33Emergency Medical Assistance Referral
566.34and Assistance Grants. (a) The
567.1commissioner of human services shall
567.2award grants to nonprofit programs that
567.3provide immigration legal services based
567.4on indigency to provide legal services for
567.5immigration assistance to individuals with
567.6emergency medical conditions or complex
567.7and chronic health conditions who are not
567.8currently eligible for medical assistance
567.9or other public health care programs, but
567.10who may meet eligibility requirements with
567.11immigration assistance.
567.12(b) The grantees, in collaboration with
567.13hospitals and safety net providers, shall
567.14provide referral assistance to connect
567.15individuals identified in paragraph (a) with
567.16alternative resources and services to assist in
567.17meeting their health care needs. $100,000
567.18is appropriated in fiscal year 2014 and
567.19$100,000 in fiscal year 2015. This is a
567.20onetime appropriation.
567.21(c) The programs receiving grants under
567.22paragraph (a) must report to the commissioner
567.23of human services the number of individuals
567.24who were provided immigration assistance
567.25under the grants and who were eventually
567.26determined to be eligible for medical
567.27assistance or another public health care
567.28program due to this assistance. The
567.29commissioner shall report this information to
567.30the chairs and ranking minority members of
567.31the legislative committees with jurisdiction
567.32over human services policy and finance by
567.33January 1, 2015.
567.34Base Adjustment. The general fund is
567.35decreased by $100,000 in fiscal year 2016
568.1and $100,000 in fiscal year 2017. The health
568.2care access fund is decreased by $1,223,000
568.3in fiscal years 2016 and 2017.

568.4

(i) Aging and Adult Services Grants

22,043,000

22,910,000

568.5Base Adjustment. The general fund is
568.6increased by $5,000 in fiscal year 2016 and
568.7$5,000 in fiscal year 2017.

568.8

(j) Deaf and Hard-of-Hearing Grants

1,767,000

1,767,000

568.9

(k) Disabilities Grants

17,844,000

17,426,000

568.10Advocating Change Together. $310,000 in
568.11fiscal year 2014 is for a grant to Advocating
568.12Change Together (ACT) to maintain and
568.13promote services for persons with intellectual
568.14and developmental disabilities throughout
568.15the state. Of this appropriation:
568.16(1) $120,000 is for direct costs associated
568.17with the delivery and evaluation of
568.18peer-to-peer training programs administered
568.19throughout the state, focusing on education,
568.20employment, housing, transportation, and
568.21voting;
568.22(2) $100,000 is for delivery of statewide
568.23conferences focusing on leadership and
568.24skill development within the disability
568.25community; and
568.26(3) $90,000 is for administrative and general
568.27operating costs associated with managing
568.28or maintaining facilities, program delivery,
568.29staff, and technology. This is a onetime
568.30appropriation.
568.31Base Adjustment. The general fund base
568.32is increased by $448,000 in fiscal year 2016
568.33and by $470,000 in fiscal year 2017.

569.1

(l) Adult Mental Health Grants

569.2	Appropriations by Fund
569.3	General	70,777,000	69,108,000
569.4	Health Care Access	750,000	750,000
569.5	Lottery Prize	1,733,000	1,733,000

569.6Problem Gambling. $225,000 in fiscal year
569.72014 and $225,000 in fiscal year 2015 is
569.8appropriated from the lottery prize fund for a
569.9grant to the state affiliate recognized by the
569.10National Council on Problem Gambling. The
569.11affiliate must provide services to increase
569.12public awareness of problem gambling,
569.13education and training for individuals and
569.14organizations providing effective treatment
569.15services to problem gamblers and their
569.16families, and research relating to problem
569.17gambling.
569.18Funding Usage. Up to 75 percent of a fiscal
569.19year's appropriations for adult mental health
569.20grants may be used to fund allocations in that
569.21portion of the fiscal year ending December
569.2231.
569.23Base Adjustment. The general fund base is
569.24decreased by $4,197,000 in fiscal year 2016
569.25and by $4,197,000 in fiscal year 2017.

569.26

(m) Child Mental Health Grants

15,233,000

15,234,000

569.27Mental Health First Aid Training. $45,000
569.28for the biennium ending June 30, 2015, is
569.29to train teachers, social service personnel,
569.30law enforcement, and others who come into
569.31contact with children with mental illnesses,
569.32in children and adolescents mental health
569.33first aid training.
570.1Funding Usage. Up to 75 percent of a fiscal
570.2year's appropriation for child mental health
570.3grants may be used to fund allocations in that
570.4portion of the fiscal year ending December
570.531.

570.6

(n) CD Treatment Support Grants

1,996,000

1,636,000

570.7SBIRT Training. $300,000 each year is
570.8for grants to train primary care clinicians to
570.9provide substance abuse brief intervention
570.10and referral to treatment (SBIRT). This is a
570.11onetime appropriation.
570.12Fetal Alcohol Syndrome Grant. (a)
570.13$360,000 is appropriated in fiscal year 2014
570.14to the commissioner of human services for
570.15a grant to the Minnesota Organization on
570.16Fetal Alcohol Syndrome (MOFAS). This is a
570.17onetime appropriation.
570.18(b) Grant money must be used to reduce the
570.19incidence of FASD and other prenatal drug
570.20related effects in children in Minnesota by
570.21identifying and serving pregnant women
570.22suspected of or known to use or abuse
570.23alcohol or other drugs. The grant recipient
570.24must provide intensive services to chemically
570.25dependent women in order to increase
570.26positive birth outcomes and report to the
570.27commissioner necessary data to prepare
570.28the required report to the legislature. The
570.29organization may retain two percent of the
570.30grant money for administrative costs.
570.31(c) A grant recipient must report to the
570.32commissioner of human services annually
570.33by January 15 on the services and programs
570.34funded by the appropriation. The report must
570.35include measurable outcomes, including
571.1the number of pregnant women served and
571.2toxic-free babies born in the previous year.
571.3Base Adjustment. The general fund base is
571.4decreased by $300,000 in fiscal year 2016
571.5and $300,000 in fiscal year 2017.

571.6

Subd. 7.State-Operated Services

571.7Transfer Authority Related to
571.8State-Operated Services. Money
571.9appropriated for state-operated services
571.10may be transferred between fiscal years
571.11of the biennium with the approval of the
571.12commissioner of management and budget.
571.13The amounts that may be spent from the
571.14appropriation for each purpose are as follows:

571.15

(a) SOS Mental Health

115,738,000

115,738,000

571.16Dedicated Receipts Available. Of the
571.17revenue received under Minnesota Statutes,
571.18section 246.18, subdivision 8, paragraph
571.19(a), $1,000,000 each year is available for
571.20the purposes of paragraph (b), clause (1),
571.21of that subdivision, $1,000,000 each year
571.22is available to transfer to the adult mental
571.23health budget activity for the purposes of
571.24paragraph (b), clause (2), of that subdivision,
571.25and up to $2,713,000 each year is available
571.26for the purposes of paragraph (b), clause (3),
571.27of that subdivision.

571.28

(b) SOS MN Security Hospital

69,582,000

69,582,000

571.29

Subd. 8.Sex Offender Program

76,769,000

79,745,000

571.30Transfer Authority Related to Minnesota
571.31Sex Offender Program. Money
571.32appropriated for the Minnesota sex offender
571.33program may be transferred between fiscal
572.1years of the biennium with the approval of the
572.2commissioner of management and budget.

572.3

Subd. 9.Technical Activities

80,440,000

80,829,000

572.4This appropriation is from the federal TANF
572.5fund.
572.6Base Adjustment. The federal TANF fund
572.7base is increased by $278,000 in fiscal year
572.82016 and increased by $651,000 in fiscal
572.9year 2017.

572.10

Subd. 10.Transfer.

572.11

Sec. 3. COMMISSIONER OF HEALTH

572.12

Subdivision 1.Total Appropriation

$

158,912,000

$

155,115,000

572.13	Appropriations by Fund
572.14		2014	2015
572.15	General	79,476,000	74,256,000
572.16 572.17	State Government Special Revenue	48,680,000	50,703,000
572.18	Health Care Access	18,743,000	18,143,000
572.19	Federal TANF	11,713,000	11,713,000
572.20	Special Revenue	300,000	300,000

572.21The amounts that may be spent for each
572.22purpose are specified in the following
572.23subdivisions.

572.24

Subd. 2.Health Improvement

572.25	Appropriations by Fund
572.26	General	52,864,000	47,644,000
572.27 572.28	State Government Special Revenue	1,033,000	1,033,000
572.29	Health Care Access	9,219,000	9,219,000
572.30	Federal TANF	11,713,000	11,713,000

572.31Statewide Health Improvement Program.
572.32$7,500,000 in fiscal year 2014 and
572.33$7,500,000 in fiscal year 2015 is from the
572.34health care access fund for the statewide
573.1health improvement program under
573.2Minnesota Statutes, section 145.986.
573.3Of the appropriation in fiscal year 2014,
573.4$10,000 is for the commissioner of
573.5management and budget to develop and
573.6implement a return on taxpayer investment
573.7(ROTI) methodology and practice related
573.8to the state health improvement program.
573.9In developing the methodology, the
573.10commissioner shall assess ROTI initiatives
573.11in other states, design implications for
573.12Minnesota, and identify one or more
573.13Minnesota institutions of higher education
573.14capable of providing rigorous and consistent
573.15nonpartisan institutional support for ROTI.
573.16The commissioner shall consult with
573.17representatives of other state agencies,
573.18counties, legislative staff, Minnesota
573.19institutions of higher education, and other
573.20stakeholders in developing the methodology.
573.21The commissioner shall report the results to
573.22the chairs and ranking minority members of
573.23the legislative committees and divisions with
573.24jurisdiction over health and human services,
573.25taxes, and finance by March 15, 2015.
573.26Statewide Cancer Surveillance System. Of
573.27the general fund appropriation, $350,000 in
573.28fiscal year 2014 and $350,000 in fiscal year
573.292015 is to develop and implement a new
573.30cancer reporting system under Minnesota
573.31Statutes, sections 144.671 to 144.69. Any
573.32information technology development or
573.33support costs necessary for the cancer
573.34surveillance system must be incorporated
573.35into the agency's service level agreement and
573.36paid to the Office of Enterprise Technology.
574.1Minnesota Poison Information Center.
574.2 $250,000 in fiscal year 2014 and $250,000
574.3in fiscal year 2015 from the general fund
574.4is for regional poison information centers
574.5according to Minnesota Statutes, section
574.6145.93.
574.7Text Message Suicide Prevention Program.
574.8 $1,500,000 for the biennium ending June 30,
574.92015, is for a grant to a nonprofit organization
574.10to establish and implement a statewide text
574.11message suicide prevention program. The
574.12program shall implement a suicide prevention
574.13counseling text line designed to use text
574.14messaging to connect with crisis counselors
574.15and to obtain emergency information and
574.16referrals to local resources in the local
574.17community. The program shall include
574.18training within schools and communities to
574.19encourage the use of the program.
574.20Support Services for Deaf and
574.21Hard-of-Hearing. (a) $365,000 in fiscal
574.22year 2014 and $349,000 in fiscal year 2015
574.23are for providing support services to families
574.24as required under Minnesota Statutes, section
574.25144.966, subdivision 3a.
574.26(b) $164,000 in fiscal year 2014 and $156,000
574.27in fiscal year 2015 are for home-based
574.28education in American Sign Language for
574.29families with children who are deaf or have
574.30hearing loss, as required under Minnesota
574.31Statutes, section 144.966, subdivision 3a.
574.32Reproductive Health Strategic Plan to
574.33Reduce Health Disparities for Somali
574.34Women. To the extent funds are available
574.35for fiscal years 2014 and 2015 for grants
575.1provided pursuant to Minnesota Statutes,
575.2section 145.928, the commissioner
575.3shall provide a grant to a Somali-based
575.4organization located in the metropolitan area
575.5to develop a reproductive health strategic
575.6plan to eliminate reproductive health
575.7disparities for Somali women. The plan shall
575.8develop initiatives to provide educational
575.9and information resources to health care
575.10providers, community organizations, and
575.11Somali women to ensure effective interaction
575.12with Somali culture and western medicine
575.13and the delivery of appropriate health care
575.14services, and the achievement of better health
575.15outcomes for Somali women. The plan must
575.16engage health care providers, the Somali
575.17community, and Somali health-centered
575.18organizations. The commissioner shall
575.19submit a report to the chairs and ranking
575.20minority members of the senate and house
575.21committees with jurisdiction over health
575.22policy on the strategic plan developed under
575.23this grant for eliminating reproductive health
575.24disparities for Somali women. The report
575.25must be submitted by February 15, 2014.
575.26TANF Appropriations. (1) $1,156,000 of
575.27the TANF funds is appropriated each year of
575.28the biennium to the commissioner for family
575.29planning grants under Minnesota Statutes,
575.30section 145.925.
575.31(2) $3,579,000 of the TANF funds is
575.32appropriated each year of the biennium to
575.33the commissioner for home visiting and
575.34nutritional services listed under Minnesota
575.35Statutes, section 145.882, subdivision 7,
575.36clauses (6) and (7). Funds must be distributed
576.1to community health boards according to
576.2Minnesota Statutes, section 145A.131,
576.3subdivision 1.
576.4(3) $2,000,000 of the TANF funds is
576.5appropriated each year of the biennium to
576.6the commissioner for decreasing racial and
576.7ethnic disparities in infant mortality rates
576.8under Minnesota Statutes, section 145.928,
576.9subdivision 7.
576.10(4) $4,978,000 of the TANF funds is
576.11appropriated each year of the biennium to the
576.12commissioner for the family home visiting
576.13grant program according to Minnesota
576.14Statutes, section 145A.17. $4,000,000 of the
576.15funding must be distributed to community
576.16health boards according to Minnesota
576.17Statutes, section 145A.131, subdivision 1.
576.18$978,000 of the funding must be distributed
576.19to tribal governments based on Minnesota
576.20Statutes, section 145A.14, subdivision 2a.
576.21(5) The commissioner may use up to 6.23
576.22percent of the funds appropriated each fiscal
576.23year to conduct the ongoing evaluations
576.24required under Minnesota Statutes, section
576.25145A.17, subdivision 7, and training and
576.26technical assistance as required under
576.27Minnesota Statutes, section 145A.17,
576.28subdivisions 4 and 5.
576.29TANF Carryforward. Any unexpended
576.30balance of the TANF appropriation in the
576.31first year of the biennium does not cancel but
576.32is available for the second year.

576.33

Subd. 3.Policy Quality and Compliance

576.34	Appropriations by Fund
576.35	General	9,391,000	9,391,000
577.1 577.2	State Government Special Revenue	14,434,000	16,454,000
577.3	Health Care Access	9,524,000	8,924,000

577.4Base Level Adjustment. The state
577.5government special revenue fund base shall
577.6be reduced by $2,000 in fiscal year 2017. The
577.7health care access base shall be increased by
577.8$600,000 in fiscal year 2016 and decreased
577.9by $600,000 in fiscal year 2017.

577.10

Subd. 4.Health Protection

577.11	Appropriations by Fund
577.12	General	9,449,000	9,449,000
577.13 577.14	State Government Special Revenue	33,213,000	33,216,000
577.15	Special Revenue	300,000	300,000

577.16Infectious Disease Laboratory. Of the
577.17general fund appropriation, $200,000 in
577.18fiscal year 2014 and $200,000 in fiscal year
577.192015 are to monitor infectious disease trends
577.20and investigate infectious disease outbreaks.
577.21Surveillance for Elevated Blood Lead
577.22Levels. Of the general fund appropriation,
577.23$100,000 in fiscal year 2014 and $100,000
577.24in fiscal year 2015 are for the blood lead
577.25surveillance system under Minnesota
577.26Statutes, section 144.9502.
577.27Base Level Adjustment. The state
577.28government special revenue base is increased
577.29by $6,000 in fiscal year 2016 and by $13,000
577.30in fiscal year 2017.

577.31

Subd. 5.Administrative Support Services

7,772,000

7,772,000

577.32Regional Support for Local Public Health
577.33Departments. $350,000 in fiscal year
577.342014 and $350,000 in fiscal year 2015 is
578.1for regional staff who provide specialized
578.2expertise to local public health departments.

578.3

Sec. 4. HEALTH-RELATED BOARDS

578.4

Subdivision 1.Total Appropriation

$

17,335,000

$

17,285,000

578.5This appropriation is from the state
578.6government special revenue fund.
578.7The amounts that may be spent for each
578.8purpose are specified in the following
578.9subdivisions.

578.10

Subd. 2.Board of Chiropractic Examiners

470,000

470,000

578.11

Subd. 3.Board of Dentistry

1,820,000

1,820,000

578.12Health Professional Services Program. Of
578.13this appropriation, $704,000 in fiscal year
578.142014 and $704,000 in fiscal year 2015 from
578.15the state government special revenue fund are
578.16for the health professional services program.

578.17 578.18

Subd. 4.Board of Dietetic and Nutrition Practice

111,000

111,000

578.19 578.20

Subd. 5.Board of Marriage and Family Therapy

168,000

168,000

578.21

Subd. 6.Board of Medical Practice

3,867,000

3,867,000

578.22

Subd. 7.Board of Nursing

3,637,000

3,637,000

578.23 578.24

Subd. 8.Board of Nursing Home Administrators

1,632,000

1,582,000

578.25Administrative Services Unit - Operating
578.26Costs. Of this appropriation, $676,000
578.27in fiscal year 2014 and $626,000 in
578.28fiscal year 2015 are for operating costs
578.29of the administrative services unit. The
578.30administrative services unit may receive
578.31and expend reimbursements for services
578.32performed by other agencies.
579.1Administrative Services Unit - Volunteer
579.2Health Care Provider Program. Of this
579.3appropriation, $150,000 in fiscal year 2014
579.4and $150,000 in fiscal year 2015 are to pay
579.5for medical professional liability coverage
579.6required under Minnesota Statutes, section
579.7214.40.
579.8Administrative Services Unit - Contested
579.9Cases and Other Legal Proceedings. Of
579.10this appropriation, $200,000 in fiscal year
579.112014 and $200,000 in fiscal year 2015 are
579.12for costs of contested case hearings and other
579.13unanticipated costs of legal proceedings
579.14involving health-related boards funded
579.15under this section. Upon certification of a
579.16health-related board to the administrative
579.17services unit that the costs will be incurred
579.18and that there is insufficient money available
579.19to pay for the costs out of money currently
579.20available to that board, the administrative
579.21services unit is authorized to transfer money
579.22from this appropriation to the board for
579.23payment of those costs with the approval
579.24of the commissioner of management and
579.25budget.

579.26

Subd. 9.Board of Optometry

107,000

107,000

579.27

Subd. 10.Board of Pharmacy

2,555,000

2,555,000

579.28Prescription Electronic Reporting. Of
579.29this appropriation, $356,000 in fiscal year
579.302014 and $356,000 in fiscal year 2015 from
579.31the state government special revenue fund
579.32are to the board to operate the prescription
579.33monitoring program in Minnesota Statutes,
579.34section 152.126.

579.35

Subd. 11.Board of Physical Therapy

346,000

346,000

580.1

Subd. 12.Board of Podiatry

76,000

76,000

580.2

Subd. 13.Board of Psychology

847,000

847,000

580.3

Subd. 14.Board of Social Work

1,054,000

1,054,000

580.4

Subd. 15.Board of Veterinary Medicine

230,000

230,000

580.5 580.6

Subd. 16.Board of Behavioral Health and Therapy

415,000

415,000

580.7 580.8

Sec. 5. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

2,741,000

$

2,741,000

580.9Regional Grants. $585,000 in fiscal year
580.102014 and $585,000 in fiscal year 2015 are
580.11for regional emergency medical services
580.12programs, to be distributed equally to the
580.13eight emergency medical service regions.
580.14Cooper/Sams Volunteer Ambulance
580.15Program. $700,000 in fiscal year 2014 and
580.16$700,000 in fiscal year 2015 are for the
580.17Cooper/Sams volunteer ambulance program
580.18under Minnesota Statutes, section 144E.40.
580.19(a) Of this amount, $611,000 in fiscal year
580.202014 and $611,000 in fiscal year 2015
580.21are for the ambulance service personnel
580.22longevity award and incentive program under
580.23Minnesota Statutes, section 144E.40.
580.24(b) Of this amount, $89,000 in fiscal year
580.252014 and $89,000 in fiscal year 2015 are
580.26for the operations of the ambulance service
580.27personnel longevity award and incentive
580.28program under Minnesota Statutes, section
580.29144E.40.
580.30Ambulance Training Grant. $361,000 in
580.31fiscal year 2014 and $361,000 in fiscal year
580.322015 are for training grants.
581.1EMSRB Board Operations. $1,095,000 in
581.2fiscal year 2014 and $1,095,000 in fiscal year
581.32015 are for operations.

581.4

Sec. 6. COUNCIL ON DISABILITY

$

614,000

$

614,000

581.5 581.6 581.7

Sec. 7. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,654,000

$

1,654,000

581.8

Sec. 8. OMBUDSPERSON FOR FAMILIES

$

333,000

$

334,000

581.9    Sec. 9. Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:
581.10    Subd. 34. Federal administrative reimbursement dedicated. Federal
581.11administrative reimbursement resulting from the following activities is appropriated to the
581.12commissioner for the designated purposes:
581.13(1) reimbursement for the Minnesota senior health options project; and
581.14(2) reimbursement related to prior authorization and inpatient admission certification
581.15by a professional review organization. A portion of these funds must be used for activities
581.16to decrease unnecessary pharmaceutical costs in medical assistance.; and
581.17(3) reimbursement resulting from the federal child support grant expenditures
581.18authorized under United States Code, title 42, section 1315.

581.19    Sec. 10. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
581.20to read:
581.21    Subd. 35. Federal reimbursement for privatized adoption grants. Federal
581.22reimbursement for privatized adoption grant and foster care recruitment grant expenditures
581.23is appropriated to the commissioner for adoption grants and foster care and adoption
581.24administrative purposes.

581.25    Sec. 11. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
581.26to read:
581.27    Subd. 36. DHS receipt center accounting. The commissioner may transfer
581.28appropriations to, and account for DHS receipt center operations in, the special revenue
581.29fund.

581.30    Sec. 12. TRANSFERS AND ADJUSTMENTS.
582.1(a) The appropriation in subdivision 5, paragraph (g), includes up to $53,391,000
582.2in fiscal year 2014; $216,637,000 in fiscal year 2015; $261,660,000 in fiscal year 2016;
582.3and $279,984,000 in fiscal year 2017, for medical assistance eligibility and administration
582.4changes related to:
582.5(1) eligibility for children age two to 18 with income up to 275 percent of the federal
582.6poverty guidelines;
582.7(2) eligibility for pregnant women with income up to 275 percent of the federal
582.8poverty guidelines;
582.9(3) Affordable Care Act enrollment and renewal processes, including elimination
582.10of six-month renewals, ex parte eligibility reviews, preprinted renewal forms, changes
582.11in verification requirements, and other changes in the eligibility determination and
582.12enrollment and renewal process;
582.13(4) automatic eligibility for children who turn 18 in foster care until they reach age 26;
582.14(5) eligibility related to spousal impoverishment provisions for waiver recipients; and
582.15(6) presumptive eligibility determinations by hospitals.
582.16(b) The commissioner of the Department of Human Services shall determine the
582.17difference between the actual costs to the medical assistance program attributable to
582.18the program changes in paragraph (a), clauses (1) to (6), and the costs of paragraph (a),
582.19clauses (1) to (6), that were estimated during the 2013 legislative session based on data
582.20from the 2013 February forecast. The costs in this paragraph must be calculated between
582.21beginning January 1, 2014, and June 30, 2017.
582.22(c) For each fiscal year from 2014 to 2017, the commissioner of human services
582.23shall certify the actual cost differences to the medical assistance program determined
582.24under paragraph (b), and report the costs to the commissioner of management and budget
582.25by June 30 of each fiscal year. In each fiscal year, the commissioner of management
582.26and budget shall reduce the transfer from the health care access fund under section 3
582.27by the amounts determined in paragraph (b). If for any fiscal year the amount of the
582.28cost difference determined under paragraph (b) exceeds the amount of the transfer under
582.29section 14, the transfer for that year must be zero.
582.30(d) This section expires on January 1, 2018.

582.31    Sec. 13. HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND
582.32FOR MINNESOTACARE POPULATIONS.
582.33(a) The commissioner of Minnesota management and budget shall transfer from the
582.34health care access fund to the general fund $53,391,000 in fiscal year 2014; $216,637,000
583.1in fiscal year 2015; $261,660,000 in fiscal year 2016; and $279,984,000 in fiscal year
583.22017, for medical assistance changes in section 12.
583.3(b) This section expires on January 1, 2018.

583.4    Sec. 14. HEALTH CARE ACCESS FUND TRANSFER TO GENERAL FUND.
583.5(a) The commissioner of Minnesota management and budget shall transfer from the
583.6health care access fund to the general fund $143,027,000 in fiscal year 2014; $14,631,000
583.7in fiscal year 2015; $48,371,000 in fiscal year 2016; and $32,325,000 in fiscal year 2017.
583.8For each fiscal year, the commissioner must reduce the amount of the transfer under this
583.9section according to section 12, paragraph (c).
583.10(b) This section expires on January 1, 2018.

583.11    Sec. 15. TRANSFERS.
583.12    Subdivision 1. Grants. The commissioner of human services, with the approval of
583.13the commissioner of management and budget, may transfer unencumbered appropriation
583.14balances for the biennium ending June 30, 2015, within fiscal years among the MFIP,
583.15general assistance, general assistance medical care under Minnesota Statutes 2009
583.16Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP
583.17child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental
583.18aid, group residential housing programs, the entitlement portion of the chemical
583.19dependency consolidated treatment fund, and between fiscal years of the biennium. The
583.20commissioner shall inform the chairs and ranking minority members of the senate Health
583.21and Human Services Finance Division and the house of representatives Health and Human
583.22Services Finance Committee quarterly about transfers made under this provision.
583.23    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
583.24money may be transferred within the Departments of Human Services and Health as the
583.25commissioners consider necessary, with the advance approval of the commissioner of
583.26management and budget. The commissioner shall inform the chairs and ranking minority
583.27members of the senate Health and Human Services Finance Division and the house of
583.28representatives Health and Human Services Finance Committee quarterly about transfers
583.29made under this provision.

583.30    Sec. 16. INDIRECT COSTS NOT TO FUND PROGRAMS.
583.31The commissioners of health and human services shall not use indirect cost
583.32allocations to pay for the operational costs of any program for which they are responsible.

584.1    Sec. 17. EXPIRATION OF UNCODIFIED LANGUAGE.
584.2All uncodified language contained in this article expires on June 30, 2015, unless a
584.3different expiration date is explicit.

584.4    Sec. 18. EFFECTIVE DATE.
584.5This article is effective July 1, 2013, unless a different effective date is specified.

584.8

Section 1. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

584.9The sums shown in the columns marked "Appropriations" are appropriated to the
584.10agencies and for the purposes specified in this article. The appropriations are from the
584.11general fund, or another named fund, and are available for the fiscal years indicated
584.12for each purpose. The figures "2014" and "2015" used in this article mean that the
584.13appropriations listed under them are available for the fiscal year ending June 30, 2014, or
584.14June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
584.15year 2015. "The biennium" is fiscal years 2014 and 2015.

584.16				APPROPRIATIONS
584.17				Available for the Year
584.18				Ending June 30
584.19					2014		2015

584.20 584.21

Sec. 2. COMMISSIONER OF HUMAN SERVICES

584.22

Subdivision 1.Total Appropriation

817,000

895,000

584.23

Subd. 2.Central Office

584.24The amounts that may be spent from this
584.25appropriation for each purpose are as follows:

584.26

(a) Operations

4,688,000

11,643,000

584.27Base Adjustment. The general fund base is
584.28decreased by $11,056,000 in fiscal year 2016
584.29and $11,056,000 in fiscal year 2017.

584.30

(b) Continuing Care

2,334,000

2,556,000

585.1Base Adjustment. The general fund base is
585.2decreased by $2,000 in fiscal year 2016 and
585.3by $27,000,000 in fiscal year 2017.

585.4

(c) Group Residential Housing

(1,166,000)

(8,602,000)

585.5

(d) Medical Assistance

(2,647,000)

(2,627,000)

585.6

(e) Alternative Care

(7,386,000)

(6,851,000)

585.7

(f) Child and Community Service Grants

3,000,000

3,000,000

585.8

(g) Aging and Adult Services Grants

1,430,000

1,237,000

585.9Gaps Analysis. In fiscal year 2014, and
585.10in each even-numbered year thereafter,
585.11$435,000 is appropriated to conduct an
585.12analysis of gaps in long-term care services
585.13under Minnesota Statutes, section 144A.351.
585.14This is a biennial appropriation. The base is
585.15increased by $435,000 in fiscal year 2016.
585.16Notwithstanding any contrary provisions in
585.17this article, this provision does not expire.
585.18Base Adjustment. The general fund base is
585.19increased by $597,000 in fiscal year 2016,
585.20and by $100,000 in fiscal year 2017.

585.21

(h) Disabilities Grants

(564,000)

(539,000)

585.22Base Adjustment. The general fund base is
585.23increased by $25,000 in fiscal year 2016 and
585.24by $25,000 in fiscal year 2017.

585.25    Sec. 3. FEDERAL APPROVAL.
585.26(a) The implementation of this article is contingent on federal approval.
585.27(b) Upon full or partial approval of the waiver application, the commissioner of
585.28human services shall submit to the commissioner of management and budget a plan for
585.29implementing the provisions in this article that received federal approval as well as any
585.30provisions that do not require federal approval. The plan must:
585.31(1) include fiscal estimates that, with federal administrative reimbursement, do
585.32not increase the general fund appropriations to the commissioner of human services in
585.33fiscal years 2014 and 2015; and
586.1(2) include a fiscal estimate for the systems modernization appropriation, which
586.2cannot exceed $14,297,000 for the biennium ending June 30, 2015.
586.3(c) Upon approval by the commissioner of management and budget, the
586.4commissioner of human services may implement the plan.
586.5(d) The commissioner of management and budget must notify the chairs and ranking
586.6minority members of the legislative committees with jurisdiction over health and human
586.7services finance when the plan is approved. The plan must be made publicly available.

586.8    Sec. 4. IMPLEMENTATION OF REFORM 2020 CONTINGENT PROVISIONS
586.9AND ADJUSTMENTS TO APPROPRIATIONS AND PLANNING ESTIMATES.
586.10Upon approval of the plan in section 3, the commissioner of management and
586.11budget shall make necessary adjustments to the appropriations in this article to reflect the
586.12effective date of federal approval. The adjustments must include the nondedicated revenue
586.13attributable to the provisions of this article and the related planning estimates for fiscal
586.14years 2016 and 2017 must reflect the revised fiscal estimates attributable to the provisions
586.15in this article. The revised appropriations for fiscal years 2014 and 2015 shall be included
586.16in the forecast and must not increase the appropriations to the commissioner of human
586.17services for fiscal years 2014 and 2015. If the adjustments to the planning estimates for
586.18fiscal years 2016 and 2017 result in increased general fund expenditure estimates for
586.19the commissioner of human services attributable to the provisions in this article, when
586.20compared to the planning estimates attributable to the provision in this article made in the
586.21February 2013 forecast, none of the provisions in this article shall be implemented.

586.24 586.25

Section 1. COMMISSIONER OF HUMAN SERVICES

586.26

Subdivision 1.Total Appropriation

$

(161,031,000)

586.27	Appropriations by Fund
586.28		2013
586.29	General Fund	(158,668,000)
586.30	Health Care Access	(7,179,000)
586.31	TANF	4,816,000

586.32	Subd. 2.Forecasted Programs
586.33	(a) MFIP/DWP Grants

587.1	Appropriations by Fund
587.2	General Fund	(8,211,000)
587.3	TANF	4,399,000

587.4

(b) MFIP Child Care Assistance Grants

10,113,000

587.5

(c) General Assistance Grants

3,230,000

587.6

(d) Minnesota Supplemental Aid Grants

(1,008,000)

587.7

(e) Group Residential Housing Grants

(5,423,000)

587.8

(f) MinnesotaCare Grants

(7,179,000)

587.9This appropriation is from the health care
587.10access fund.

587.11

(g) Medical Assistance Grants

(159,733,000)

587.12

(h) Alternative Care Grants

-0-

587.13

(i) CD Entitlement Grants

2,364,000

587.14

Subd. 3.Technical Activities

417,000

587.15This appropriation is from the TANF fund.
587.16EFFECTIVE DATE.This section is effective the day following final enactment.