1.1.................... moves to amend H.F. No. 1233 as follows:
1.2Delete everything after the enacting clause and insert:


1.6    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 3, is amended to read:
1.7    Subd. 3. MinnesotaCare federal receipts. Receipts received as a result of federal
1.8participation pertaining to administrative costs of the Minnesota health care reform waiver
1.9shall be deposited as nondedicated revenue in the health care access fund. Receipts
1.10received as a result of federal participation pertaining to grants shall be deposited in the
1.11federal fund and shall offset health care access funds for payments to providers. All federal
1.12funding received by Minnesota for implementation and administration of MinnesotaCare
1.13as a basic health program, as authorized in section 1331 of the Affordable Care Act,
1.14Public Law 111-148, as amended by Public Law 111-152, is dedicated to that program and
1.15shall be deposited into the health care access fund. Federal funding that is received for
1.16implementing and administering MinnesotaCare as a basic health program and deposited in
1.17the fund shall be used only for that program to purchase health care coverage for enrollees
1.18and reduce enrollee premiums and cost-sharing or provide additional enrollee benefits.
1.19EFFECTIVE DATE.This section is effective January 1, 2015.

1.20    Sec. 2. Minnesota Statutes 2012, section 254B.04, subdivision 1, is amended to read:
1.21    Subdivision 1. Eligibility. (a) Persons eligible for benefits under Code of Federal
1.22Regulations, title 25, part 20, persons eligible for medical assistance benefits under
1.23sections 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, or who meet
1.24the income standards of section 256B.056, subdivision 4, and persons eligible for general
1.25assistance medical care under section 256D.03, subdivision 3, are entitled to chemical
2.1dependency fund services. State money appropriated for this paragraph must be placed in
2.2a separate account established for this purpose.
2.3Persons with dependent children who are determined to be in need of chemical
2.4dependency treatment pursuant to an assessment under section 626.556, subdivision 10, or
2.5a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
2.6local agency to access needed treatment services. Treatment services must be appropriate
2.7for the individual or family, which may include long-term care treatment or treatment in a
2.8facility that allows the dependent children to stay in the treatment facility. The county
2.9shall pay for out-of-home placement costs, if applicable.
2.10(b) A person not entitled to services under paragraph (a), but with family income
2.11that is less than 215 percent of the federal poverty guidelines for the applicable family
2.12size, shall be eligible to receive chemical dependency fund services within the limit
2.13of funds appropriated for this group for the fiscal year. If notified by the state agency
2.14of limited funds, a county must give preferential treatment to persons with dependent
2.15children who are in need of chemical dependency treatment pursuant to an assessment
2.16under section 626.556, subdivision 10, or a case plan under section 260C.201, subdivision
2.176 , or 260C.212. A county may spend money from its own sources to serve persons under
2.18this paragraph. State money appropriated for this paragraph must be placed in a separate
2.19account established for this purpose.
2.20(c) Persons whose income is between 215 percent and 412 percent of the federal
2.21poverty guidelines for the applicable family size shall be eligible for chemical dependency
2.22services on a sliding fee basis, within the limit of funds appropriated for this group for the
2.23fiscal year. Persons eligible under this paragraph must contribute to the cost of services
2.24according to the sliding fee scale established under subdivision 3. A county may spend
2.25money from its own sources to provide services to persons under this paragraph. State
2.26money appropriated for this paragraph must be placed in a separate account established
2.27for this purpose.

2.28    Sec. 3. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
2.29to read:
2.30    Subd. 35. Federal approval. (a) The commissioner shall seek federal authority
2.31from the U.S. Department of Health and Human Services necessary to operate a health
2.32coverage program for Minnesotans with incomes up to 275 percent of the federal poverty
2.33guidelines (FPG). The proposal shall seek to secure all federal funding available from at
2.34least the following sources:
3.1(1) all premium tax credits and cost-sharing subsidies available under United States
3.2Code, title 26, section 36B, and United States Code, title 42, section 18071, for individuals
3.3with incomes above 133 percent and at or below 275 percent of the federal poverty
3.4guidelines who would otherwise be enrolled in the Minnesota Insurance Marketplace as
3.5defined in Minnesota Statutes, section 62V.02;
3.6(2) Medicaid funding; and
3.7(3) other funding sources identified by the commissioner that support coverage or
3.8care redesign in Minnesota.
3.9(b) Funding received shall be used to design and implement a health coverage
3.10program that creates a single streamlined program and meets the needs of Minnesotans with
3.11incomes up to 275 percent of the federal poverty guidelines. The program must incorporate:
3.12(1) payment reform characteristics included in the health care delivery system and
3.13accountable care organization payment models;
3.14(2) flexibility in benefit set design such that benefits can be targeted to meet enrollee
3.15needs in different income and health status situations and can provide a more seamless
3.16transition from public to private health care coverage;
3.17(3) flexibility in co-payment or premium structures to incent patients to seek
3.18high-quality, low-cost care settings; and
3.19(4) flexibility in premium structures to ease the transition from public to private
3.20health care coverage.
3.21(c) The commissioner shall develop and submit a proposal consistent with the above
3.22criteria and shall seek all federal authority necessary to implement the health coverage
3.23program. In developing the request, the commissioner shall consult with appropriate
3.24stakeholder groups and consumers.
3.25(d) The commissioner is authorized to seek any available waivers or federal
3.26approvals to accomplish the goals under paragraph (b) prior to 2017.
3.27(e) The commissioner shall report progress on implementing this subdivision to the
3.28chairs and ranking minority members of the legislative committees with jurisdiction over
3.29health and human services policy and finance by December 1, 2014.
3.30(f) The commissioner is authorized to accept and expend federal funds that support
3.31the purposes of this subdivision.

3.32    Sec. 4. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
3.33to read:
4.1    Subd. 18. Caretaker relative. "Caretaker relative" means a relative, by blood,
4.2adoption, or marriage, of a child under age 19 with whom the child is living and who
4.3assumes primary responsibility for the child's care.
4.4EFFECTIVE DATE.This section is effective January 1, 2014.

4.5    Sec. 5. Minnesota Statutes 2012, section 256B.02, is amended by adding a subdivision
4.6to read:
4.7    Subd. 19. Insurance affordability program. "Insurance affordability program"
4.8means one of the following programs:
4.9(1) medical assistance under this chapter;
4.10(2) a program that provides advance payments of the premium tax credits established
4.11under section 36B of the Internal Revenue Code or cost-sharing reductions established
4.12under section 1402 of the Affordable Care Act;
4.13(3) MinnesotaCare as defined in chapter 256L; and
4.14(4) a Basic Health Plan as defined in section 1331 of the Affordable Care Act.
4.15EFFECTIVE DATE.This section is effective the day following final enactment.

4.16    Sec. 6. Minnesota Statutes 2012, section 256B.04, subdivision 18, is amended to read:
4.17    Subd. 18. Applications for medical assistance. (a) The state agency may take
4.18 shall accept applications for medical assistance and conduct eligibility determinations for
4.19MinnesotaCare enrollees by telephone, via mail, in-person, online via an Internet Web
4.20site, and through other commonly available electronic means.
4.21    (b) The commissioner of human services shall modify the Minnesota health care
4.22programs application form to add a question asking applicants whether they have ever
4.23served in the United States military.
4.24    (c) For each individual who submits an application or whose eligibility is subject to
4.25renewal or whose eligibility is being redetermined pursuant to a change in circumstances,
4.26if the agency determines the individual is not eligible for medical assistance, the agency
4.27shall determine potential eligibility for other insurance affordability programs.
4.28EFFECTIVE DATE.This section is effective January 1, 2014.

4.29    Sec. 7. Minnesota Statutes 2012, section 256B.055, subdivision 3a, is amended to read:
4.30    Subd. 3a. Families with children. Beginning July 1, 2002, Medical assistance may
4.31be paid for a person who is a child under the age of 18, or age 18 if a full-time student
4.32in a secondary school, or in the equivalent level of vocational or technical training, and
5.1reasonably expected to complete the program before reaching age 19; the parent or
5.2stepparent of a dependent child under the age of 19, including a pregnant woman; or a
5.3caretaker relative of a dependent child under the age of 19.
5.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
5.5approval, whichever is later. The commissioner of human services shall notify the revisor
5.6of statutes when federal approval is obtained.

5.7    Sec. 8. Minnesota Statutes 2012, section 256B.055, subdivision 6, is amended to read:
5.8    Subd. 6. Pregnant women; needy unborn child. Medical assistance may be paid
5.9for a pregnant woman who has written verification of a positive pregnancy test from a
5.10physician or licensed registered nurse, who meets the other eligibility criteria of this
5.11section and whose unborn child would be eligible as a needy child under subdivision 10 if
5.12born and living with the woman. In accordance with Code of Federal Regulations, title
5.1342, section 435.956, the commissioner must accept self-attestation of pregnancy unless
5.14the agency has information that is not reasonably compatible with such attestation. For
5.15purposes of this subdivision, a woman is considered pregnant for 60 days postpartum.
5.16EFFECTIVE DATE.This section is effective January 1, 2014.

5.17    Sec. 9. Minnesota Statutes 2012, section 256B.055, subdivision 10, is amended to read:
5.18    Subd. 10. Infants. Medical assistance may be paid for an infant less than one year
5.19of age, whose mother was eligible for and receiving medical assistance at the time of birth
5.20or who is less than two years of age and is in a family with countable income that is equal
5.21to or less than the income standard established under section 256B.057, subdivision 1.
5.22EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
5.23approval, whichever is later. The commissioner of human services shall notify the revisor
5.24of statutes when federal approval is obtained.

5.25    Sec. 10. Minnesota Statutes 2012, section 256B.055, subdivision 15, is amended to read:
5.26    Subd. 15. Adults without children. Medical assistance may be paid for a person
5.27who is:
5.28(1) at least age 21 and under age 65;
5.29(2) not pregnant;
5.30(3) not entitled to Medicare Part A or enrolled in Medicare Part B under Title XVIII
5.31of the Social Security Act;
6.1(4) not an adult in a family with children as defined in section 256L.01, subdivision
6.23a ; and not otherwise eligible under subdivision 7 as a person who meets the categorical
6.3eligibility requirements of the supplemental security income program;
6.4(5) not enrolled under subdivision 7 as a person who would meet the categorical
6.5eligibility requirements of the supplemental security income program except for excess
6.6income or assets; and
6.7(5) (6) not described in another subdivision of this section.
6.8EFFECTIVE DATE.This section is effective January 1, 2014.

6.9    Sec. 11. Minnesota Statutes 2012, section 256B.055, is amended by adding a
6.10subdivision to read:
6.11    Subd. 17. Adults who were in foster care at the age of 18. Medical assistance may
6.12be paid for a person under 26 years of age who was in foster care under the commissioner's
6.13responsibility on the date of attaining 18 years of age, and who was enrolled in medical
6.14assistance under the state plan or a waiver of the plan while in foster care, in accordance
6.15with section 2004 of the Affordable Care Act.
6.16EFFECTIVE DATE.This section is effective January 1, 2014.

6.17    Sec. 12. Minnesota Statutes 2012, section 256B.056, subdivision 1, is amended to read:
6.18    Subdivision 1. Residency. To be eligible for medical assistance, a person must
6.19reside in Minnesota, or, if absent from the state, be deemed to be a resident of Minnesota,
6.20 in accordance with the rules of the state agency Code of Federal Regulations, title 42,
6.21section 435.403.
6.22EFFECTIVE DATE.This section is effective January 1, 2014.

6.23    Sec. 13. Minnesota Statutes 2012, section 256B.056, subdivision 1c, is amended to read:
6.24    Subd. 1c. Families with children income methodology. (a)(1) [Expired, 1Sp2003
6.25c 14 art 12 s 17]
6.26(2) For applications processed within one calendar month prior to July 1, 2003,
6.27eligibility shall be determined by applying the income standards and methodologies in
6.28effect prior to July 1, 2003, for any months in the six-month budget period before July
6.291, 2003, and the income standards and methodologies in effect on July 1, 2003, for any
6.30months in the six-month budget period on or after that date. The income standards for
6.31each month shall be added together and compared to the applicant's total countable income
6.32for the six-month budget period to determine eligibility.
7.1(3) For children ages one through 18 whose eligibility is determined under section
7.2256B.057, subdivision 2, the following deductions shall be applied to income counted
7.3toward the child's eligibility as allowed under the state's AFDC plan in effect as of July
7.416, 1996: $90 work expense, dependent care, and child support paid under court order.
7.5This clause is effective October 1, 2003.
7.6(b) For families with children whose eligibility is determined using the standard
7.7specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable
7.8earned income shall be disregarded for up to four months and the following deductions
7.9shall be applied to each individual's income counted toward eligibility as allowed under
7.10the state's AFDC plan in effect as of July 16, 1996: dependent care and child support paid
7.11under court order.
7.12(c) If the four-month disregard in paragraph (b) has been applied to the wage
7.13earner's income for four months, the disregard shall not be applied again until the wage
7.14earner's income has not been considered in determining medical assistance eligibility for
7.1512 consecutive months.
7.16(d) The commissioner shall adjust the income standards under this section each July
7.171 by the annual update of the federal poverty guidelines following publication by the
7.18United States Department of Health and Human Services except that the income standards
7.19shall not go below those in effect on July 1, 2009.
7.20(e) For children age 18 or under, annual gifts of $2,000 or less by a tax-exempt
7.21organization to or for the benefit of the child with a life-threatening illness must be
7.22disregarded from income.

7.23    Sec. 14. Minnesota Statutes 2012, section 256B.056, subdivision 3, is amended to read:
7.24    Subd. 3. Asset limitations for certain individuals and families. (a) To be
7.25eligible for medical assistance, a person must not individually own more than $3,000 in
7.26assets, or if a member of a household with two family members, husband and wife, or
7.27parent and child, the household must not own more than $6,000 in assets, plus $200 for
7.28each additional legal dependent. In addition to these maximum amounts, an eligible
7.29individual or family may accrue interest on these amounts, but they must be reduced to the
7.30maximum at the time of an eligibility redetermination. The accumulation of the clothing
7.31and personal needs allowance according to section 256B.35 must also be reduced to the
7.32maximum at the time of the eligibility redetermination. The value of assets that are not
7.33considered in determining eligibility for medical assistance is the value of those assets
7.34excluded under the supplemental security income program for aged, blind, and disabled
7.35persons, with the following exceptions:
8.1(1) household goods and personal effects are not considered;
8.2(2) capital and operating assets of a trade or business that the local agency determines
8.3are necessary to the person's ability to earn an income are not considered;
8.4(3) motor vehicles are excluded to the same extent excluded by the supplemental
8.5security income program;
8.6(4) assets designated as burial expenses are excluded to the same extent excluded by
8.7the supplemental security income program. Burial expenses funded by annuity contracts
8.8or life insurance policies must irrevocably designate the individual's estate as contingent
8.9beneficiary to the extent proceeds are not used for payment of selected burial expenses;
8.10(5) for a person who no longer qualifies as an employed person with a disability due
8.11to loss of earnings, assets allowed while eligible for medical assistance under section
8.12256B.057, subdivision 9 , are not considered for 12 months, beginning with the first month
8.13of ineligibility as an employed person with a disability, to the extent that the person's total
8.14assets remain within the allowed limits of section 256B.057, subdivision 9, paragraph (d);
8.15    (6) when a person enrolled in medical assistance under section 256B.057, subdivision
8.169 , is age 65 or older and has been enrolled during each of the 24 consecutive months
8.17before the person's 65th birthday, the assets owned by the person and the person's spouse
8.18must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph (d),
8.19when determining eligibility for medical assistance under section 256B.055, subdivision
8.207 . The income of a spouse of a person enrolled in medical assistance under section
8.21256B.057, subdivision 9 , during each of the 24 consecutive months before the person's
8.2265th birthday must be disregarded when determining eligibility for medical assistance
8.23under section 256B.055, subdivision 7. Persons eligible under this clause are not subject to
8.24the provisions in section 256B.059. A person whose 65th birthday occurs in 2012 or 2013
8.25is required to have qualified for medical assistance under section 256B.057, subdivision 9,
8.26prior to age 65 for at least 20 months in the 24 months prior to reaching age 65; and
8.27(7) effective July 1, 2009, certain assets owned by American Indians are excluded as
8.28required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
8.29Law 111-5. For purposes of this clause, an American Indian is any person who meets the
8.30definition of Indian according to Code of Federal Regulations, title 42, section 447.50.
8.31(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
8.3215.
8.33EFFECTIVE DATE.This section is effective January 1, 2014.

8.34    Sec. 15. Minnesota Statutes 2012, section 256B.056, subdivision 4, is amended to read:
9.1    Subd. 4. Income. (a) To be eligible for medical assistance, a person eligible under
9.2section 256B.055, subdivisions 7, 7a, and 12, may have income up to 100 percent of
9.3the federal poverty guidelines. Effective January 1, 2000, and each successive January,
9.4recipients of supplemental security income may have an income up to the supplemental
9.5security income standard in effect on that date.
9.6(b) To be eligible for medical assistance, families and children may have an income
9.7up to 133-1/3 percent of the AFDC income standard in effect under the July 16, 1996,
9.8AFDC state plan. Effective July 1, 2000, the base AFDC standard in effect on July 16,
9.91996, shall be increased by three percent.
9.10(c) Effective July 1, 2002 January 1, 2014, to be eligible for medical assistance,
9.11families and children under section 256B.055, subdivision 3a, a parent or caretaker
9.12relative may have an income up to 100 133 percent of the federal poverty guidelines for
9.13the family household size.
9.14(d) To be eligible for medical assistance under section 256B.055, subdivision 15,
9.15a person may have an income up to 75 133 percent of federal poverty guidelines for
9.16the family household size.
9.17(e) In computing income to determine eligibility of persons under paragraphs (a) to
9.18(d) who are not residents of long-term care facilities, the commissioner shall disregard
9.19increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
9.20Veterans aid and attendance benefits and Veterans Administration unusual medical
9.21expense payments are considered income to the recipient To be eligible for medical
9.22assistance under section 256B.055, subdivision 16, a child age 19 to 20 may have an
9.23income up to 133 percent of the federal poverty guidelines for the household size.
9.24(f) To be eligible for medical assistance under section 256B.055, subdivision
9.253a, a child under age 19 may have income up to 275 percent of the federal poverty
9.26guidelines for the household size or an equivalent standard when converted using modified
9.27adjusted gross income methodology as required under the Affordable Care Act. Children
9.28who are enrolled in medical assistance as of December 31, 2013, and are determined
9.29ineligible for medical assistance because of the elimination of income disregards under
9.30modified adjusted gross income methodology as defined in subdivision 1a of this section
9.31remain eligible for medical assistance under the Children's Health Insurance Program
9.32Reauthorization Act of 2009, Public Law 111-3, until the date of their next regularly
9.33scheduled eligibility redetermination as required in section 256B.056, subdivision 7a.
9.34(g) In computing income to determine eligibility of persons under paragraphs (a) to
9.35(f) who are not residents of long-term care facilities, the commissioner shall disregard
9.36increases in income as required by Public Laws 94-566, section 503; 99-272; and 99-509.
10.1For persons eligible under paragraph (a), veteran aid and attendance benefits and Veterans
10.2Administration unusual medical expense payments are considered income to the recipient.
10.3EFFECTIVE DATE.This section is effective January 1, 2014.

10.4    Sec. 16. Minnesota Statutes 2012, section 256B.056, subdivision 5c, is amended to read:
10.5    Subd. 5c. Excess income standard. (a) The excess income standard for families
10.6with children parents and caretaker relatives, pregnant women, infants, and children ages
10.7two through 20 is the standard specified in subdivision 4, paragraph (c).
10.8(b) The excess income standard for a person whose eligibility is based on blindness,
10.9disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
10.10family size. Effective July 1, 2002, the excess income standard for this paragraph shall
10.11equal 75 percent of the federal poverty guidelines.
10.12EFFECTIVE DATE.This section is effective January 1, 2014.

10.13    Sec. 17. Minnesota Statutes 2012, section 256B.056, is amended by adding a
10.14subdivision to read:
10.15    Subd. 7a. Periodic renewal of eligibility. (a) The commissioner shall make an
10.16annual redetermination of eligibility based on information contained in the enrollee's case
10.17file and other information available to the agency, including but not limited to information
10.18accessed through an electronic database, without requiring the enrollee to submit any
10.19information when sufficient data is available for the agency to renew eligibility.
10.20(b) If the commissioner cannot renew eligibility in accordance with paragraph (a),
10.21the commissioner must provide the enrollee with a prepopulated renewal form containing
10.22eligibility information available to the agency and permit the enrollee to submit the form
10.23with any corrections or additional information to the agency and sign the renewal form via
10.24any of the modes of submission specified in section 256B.04, subdivision 18.
10.25(c) An enrollee who is terminated for failure to complete the renewal process may
10.26subsequently submit the renewal form and required information within four months after
10.27the date of termination and have coverage reinstated without a lapse, if otherwise eligible
10.28under this chapter.
10.29(d) Notwithstanding paragraph (a), individuals eligible under subdivision 5 shall be
10.30required to renew eligibility every six months.
10.31EFFECTIVE DATE.This section is effective January 1, 2014.

10.32    Sec. 18. Minnesota Statutes 2012, section 256B.056, subdivision 10, is amended to read:
11.1    Subd. 10. Eligibility verification. (a) The commissioner shall require women who
11.2are applying for the continuation of medical assistance coverage following the end of the
11.360-day postpartum period to update their income and asset information and to submit
11.4any required income or asset verification.
11.5    (b) The commissioner shall determine the eligibility of private-sector health care
11.6coverage for infants less than one year of age eligible under section 256B.055, subdivision
11.710 , or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
11.8if this is determined to be cost-effective.
11.9    (c) The commissioner shall verify assets and income for all applicants, and for all
11.10recipients upon renewal.
11.11    (d) The commissioner shall utilize information obtained through the electronic
11.12service established by the secretary of the United States Department of Health and Human
11.13Services and other available electronic data sources in Code of Federal Regulations, title
11.1442, sections 435.940 to 435.956, to verify eligibility requirements. The commissioner
11.15shall establish standards to define when information obtained electronically is reasonably
11.16compatible with information provided by applicants and enrollees, including use of
11.17self-attestation, to accomplish real-time eligibility determinations and maintain program
11.18integrity.
11.19EFFECTIVE DATE.This section is effective January 1, 2014.

11.20    Sec. 19. Minnesota Statutes 2012, section 256B.057, subdivision 1, is amended to read:
11.21    Subdivision 1. Infants and pregnant women. (a)(1) An infant less than one year
11.22 two years of age or a pregnant woman who has written verification of a positive pregnancy
11.23test from a physician or licensed registered nurse is eligible for medical assistance if the
11.24individual's countable family household income is equal to or less than 275 percent of the
11.25federal poverty guideline for the same family household size or an equivalent standard
11.26when converted using modified adjusted gross income methodology as required under
11.27the Affordable Care Act. For purposes of this subdivision, "countable family income"
11.28means the amount of income considered available using the methodology of the AFDC
11.29program under the state's AFDC plan as of July 16, 1996, as required by the Personal
11.30Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
11.31Law 104-193, except for the earned income disregard and employment deductions.
11.32    (2) For applications processed within one calendar month prior to the effective date,
11.33eligibility shall be determined by applying the income standards and methodologies in
11.34effect prior to the effective date for any months in the six-month budget period before
11.35that date and the income standards and methodologies in effect on the effective date for
12.1any months in the six-month budget period on or after that date. The income standards
12.2for each month shall be added together and compared to the applicant's total countable
12.3income for the six-month budget period to determine eligibility.
12.4    (b)(1) [Expired, 1Sp2003 c 14 art 12 s 19]
12.5    (2) For applications processed within one calendar month prior to July 1, 2003,
12.6eligibility shall be determined by applying the income standards and methodologies in
12.7effect prior to July 1, 2003, for any months in the six-month budget period before July 1,
12.82003, and the income standards and methodologies in effect on the expiration date for any
12.9months in the six-month budget period on or after July 1, 2003. The income standards
12.10for each month shall be added together and compared to the applicant's total countable
12.11income for the six-month budget period to determine eligibility.
12.12    (3) An amount equal to the amount of earned income exceeding 275 percent of
12.13the federal poverty guideline, up to a maximum of the amount by which the combined
12.14total of 185 percent of the federal poverty guideline plus the earned income disregards
12.15and deductions allowed under the state's AFDC plan as of July 16, 1996, as required
12.16by the Personal Responsibility and Work Opportunity Act of 1996 (PRWORA), Public
12.17Law 104-193, exceeds 275 percent of the federal poverty guideline will be deducted for
12.18pregnant women and infants less than one year of age.
12.19    (c) Dependent care and child support paid under court order shall be deducted from
12.20the countable income of pregnant women.
12.21    (d) (b) An infant born to a woman who was eligible for and receiving medical
12.22assistance on the date of the child's birth shall continue to be eligible for medical assistance
12.23without redetermination until the child's first birthday.
12.24EFFECTIVE DATE.This section is effective January 1, 2014.

12.25    Sec. 20. Minnesota Statutes 2012, section 256B.057, subdivision 8, is amended to read:
12.26    Subd. 8. Children under age two. Medical assistance may be paid for a child under
12.27two years of age whose countable family income is above 275 percent of the federal poverty
12.28guidelines for the same size family but less than or equal to 280 percent of the federal
12.29poverty guidelines for the same size family or an equivalent standard when converted using
12.30modified adjusted gross income methodology as required under the Affordable Care Act.
12.31EFFECTIVE DATE.This section is effective January 1, 2014.

12.32    Sec. 21. Minnesota Statutes 2012, section 256B.057, subdivision 10, is amended to read:
13.1    Subd. 10. Certain persons needing treatment for breast or cervical cancer. (a)
13.2Medical assistance may be paid for a person who:
13.3(1) has been screened for breast or cervical cancer by the Minnesota breast and
13.4cervical cancer control program, and program funds have been used to pay for the person's
13.5screening;
13.6(2) according to the person's treating health professional, needs treatment, including
13.7diagnostic services necessary to determine the extent and proper course of treatment, for
13.8breast or cervical cancer, including precancerous conditions and early stage cancer;
13.9(3) meets the income eligibility guidelines for the Minnesota breast and cervical
13.10cancer control program;
13.11(4) is under age 65;
13.12(5) is not otherwise eligible for medical assistance under United States Code, title
13.1342, section 1396a(a)(10)(A)(i); and
13.14(6) is not otherwise covered under creditable coverage, as defined under United
13.15States Code, title 42, section 1396a(aa).
13.16(b) Medical assistance provided for an eligible person under this subdivision shall
13.17be limited to services provided during the period that the person receives treatment for
13.18breast or cervical cancer.
13.19(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance
13.20without meeting the eligibility criteria relating to income and assets in section 256B.056,
13.21subdivisions 1a to 5b 5a.

13.22    Sec. 22. Minnesota Statutes 2012, section 256B.057, is amended by adding a
13.23subdivision to read:
13.24    Subd. 12. Presumptive eligibility determinations made by qualified hospitals.
13.25The commissioner shall establish a process to qualify hospitals that are participating
13.26providers under the medical assistance program to determine presumptive eligibility for
13.27medical assistance for applicants who may have a basis of eligibility using the modified
13.28adjusted gross income methodology as defined in section 256B.056, subdivision 1a,
13.29paragraph (b), clause (1).
13.30EFFECTIVE DATE.This section is effective January 1, 2014.

13.31    Sec. 23. Minnesota Statutes 2012, section 256B.059, subdivision 1, is amended to read:
13.32    Subdivision 1. Definitions. (a) For purposes of this section and sections 256B.058
13.33and 256B.0595, the terms defined in this subdivision have the meanings given them.
13.34    (b) "Community spouse" means the spouse of an institutionalized spouse.
14.1    (c) "Spousal share" means one-half of the total value of all assets, to the extent that
14.2either the institutionalized spouse or the community spouse had an ownership interest at
14.3the time of the first continuous period of institutionalization.
14.4    (d) "Assets otherwise available to the community spouse" means assets individually
14.5or jointly owned by the community spouse, other than assets excluded by subdivision 5,
14.6paragraph (c).
14.7    (e) "Community spouse asset allowance" is the value of assets that can be transferred
14.8under subdivision 3.
14.9    (f) "Institutionalized spouse" means a person who is:
14.10    (1) in a hospital, nursing facility, or intermediate care facility for persons with
14.11developmental disabilities, or receiving home and community-based services under section
14.12256B.0915 , 256B.092, or 256B.49 and is expected to remain in the facility or institution
14.13or receive the home and community-based services for at least 30 consecutive days; and
14.14    (2) married to a person who is not in a hospital, nursing facility, or intermediate
14.15care facility for persons with developmental disabilities, and is not receiving home and
14.16community-based services under section 256B.0915, 256B.092, or 256B.49.
14.17    (g) "For the sole benefit of" means no other individual or entity can benefit in any
14.18way from the assets or income at the time of a transfer or at any time in the future.
14.19    (h) "Continuous period of institutionalization" means a 30-consecutive-day period
14.20of time in which a person is expected to stay in a medical or long-term care facility, or
14.21receive home and community-based services that would qualify for coverage under the
14.22elderly waiver (EW) or alternative care (AC) programs section 256B.0913, 256B.0915,
14.23256B.092, or 256B.49. For a stay in a facility, the 30-consecutive-day period begins
14.24on the date of entry into a medical or long-term care facility. For receipt of home and
14.25community-based services, the 30-consecutive-day period begins on the date that the
14.26following conditions are met:
14.27    (1) the person is receiving services that meet the nursing facility level of care
14.28determined by a long-term care consultation;
14.29    (2) the person has received the long-term care consultation within the past 60 days;
14.30    (3) the services are paid by the EW program under section 256B.0915 or the AC
14.31program under section 256B.0913, 256B.0915, 256B.092, or 256B.49 or would qualify
14.32for payment under the EW or AC programs those sections if the person were otherwise
14.33eligible for either program, and but for the receipt of such services the person would have
14.34resided in a nursing facility; and
14.35    (4) the services are provided by a licensed provider qualified to provide home and
14.36community-based services.
15.1EFFECTIVE DATE.This section is effective January 1, 2014.

15.2    Sec. 24. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
15.3    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
15.4to citizens of the United States, qualified noncitizens as defined in this subdivision, and
15.5other persons residing lawfully in the United States. Citizens or nationals of the United
15.6States must cooperate in obtaining satisfactory documentary evidence of citizenship or
15.7nationality according to the requirements of the federal Deficit Reduction Act of 2005,
15.8Public Law 109-171.
15.9(b) "Qualified noncitizen" means a person who meets one of the following
15.10immigration criteria:
15.11(1) admitted for lawful permanent residence according to United States Code, title 8;
15.12(2) admitted to the United States as a refugee according to United States Code,
15.13title 8, section 1157;
15.14(3) granted asylum according to United States Code, title 8, section 1158;
15.15(4) granted withholding of deportation according to United States Code, title 8,
15.16section 1253(h);
15.17(5) paroled for a period of at least one year according to United States Code, title 8,
15.18section 1182(d)(5);
15.19(6) granted conditional entrant status according to United States Code, title 8,
15.20section 1153(a)(7);
15.21(7) determined to be a battered noncitizen by the United States Attorney General
15.22according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
15.23title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
15.24(8) is a child of a noncitizen determined to be a battered noncitizen by the United
15.25States Attorney General according to the Illegal Immigration Reform and Immigrant
15.26Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
15.27Public Law 104-200; or
15.28(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
15.29Law 96-422, the Refugee Education Assistance Act of 1980.
15.30(c) All qualified noncitizens who were residing in the United States before August
15.3122, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
15.32medical assistance with federal financial participation.
15.33(d) Beginning December 1, 1996, qualified noncitizens who entered the United
15.34States on or after August 22, 1996, and who otherwise meet the eligibility requirements
16.1of this chapter are eligible for medical assistance with federal participation for five years
16.2if they meet one of the following criteria:
16.3(1) refugees admitted to the United States according to United States Code, title 8,
16.4section 1157;
16.5(2) persons granted asylum according to United States Code, title 8, section 1158;
16.6(3) persons granted withholding of deportation according to United States Code,
16.7title 8, section 1253(h);
16.8(4) veterans of the United States armed forces with an honorable discharge for
16.9a reason other than noncitizen status, their spouses and unmarried minor dependent
16.10children; or
16.11(5) persons on active duty in the United States armed forces, other than for training,
16.12their spouses and unmarried minor dependent children.
16.13 Beginning July 1, 2010, children and pregnant women who are noncitizens
16.14described in paragraph (b) or who are lawfully present in the United States as defined
16.15in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
16.16eligibility requirements of this chapter, are eligible for medical assistance with federal
16.17financial participation as provided by the federal Children's Health Insurance Program
16.18Reauthorization Act of 2009, Public Law 111-3.
16.19(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
16.20are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
16.21subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
16.22Code, title 8, section 1101(a)(15).
16.23(f) Payment shall also be made for care and services that are furnished to noncitizens,
16.24regardless of immigration status, who otherwise meet the eligibility requirements of
16.25this chapter, if such care and services are necessary for the treatment of an emergency
16.26medical condition.
16.27(g) For purposes of this subdivision, the term "emergency medical condition" means
16.28a medical condition that meets the requirements of United States Code, title 42, section
16.291396b(v).
16.30(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
16.31of an emergency medical condition are limited to the following:
16.32(i) services delivered in an emergency room or by an ambulance service licensed
16.33under chapter 144E that are directly related to the treatment of an emergency medical
16.34condition;
16.35(ii) services delivered in an inpatient hospital setting following admission from an
16.36emergency room or clinic for an acute emergency condition; and
17.1(iii) follow-up services that are directly related to the original service provided
17.2to treat the emergency medical condition and are covered by the global payment made
17.3to the provider.
17.4    (2) Services for the treatment of emergency medical conditions do not include:
17.5(i) services delivered in an emergency room or inpatient setting to treat a
17.6nonemergency condition;
17.7(ii) organ transplants, stem cell transplants, and related care;
17.8(iii) services for routine prenatal care;
17.9(iv) continuing care, including long-term care, nursing facility services, home health
17.10care, adult day care, day training, or supportive living services;
17.11(v) elective surgery;
17.12(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
17.13part of an emergency room visit;
17.14(vii) preventative health care and family planning services;
17.15(viii) dialysis;
17.16(ix) chemotherapy or therapeutic radiation services;
17.17(x) rehabilitation services;
17.18(xi) physical, occupational, or speech therapy;
17.19(xii) transportation services;
17.20(xiii) case management;
17.21(xiv) prosthetics, orthotics, durable medical equipment, or medical supplies;
17.22(xv) dental services;
17.23(xvi) hospice care;
17.24(xvii) audiology services and hearing aids;
17.25(xviii) podiatry services;
17.26(xix) chiropractic services;
17.27(xx) immunizations;
17.28(xxi) vision services and eyeglasses;
17.29(xxii) waiver services;
17.30(xxiii) individualized education programs; or
17.31(xxiv) chemical dependency treatment.
17.32(i) Beginning July 1, 2009, Pregnant noncitizens who are undocumented,
17.33nonimmigrants, or lawfully present in the United States as defined in Code of Federal
17.34Regulations, title 8, section 103.12, ineligible for federally funded medical assistance
17.35 are not covered by a group health plan or health insurance coverage according to Code
17.36of Federal Regulations, title 42, section 457.310, and who otherwise meet the eligibility
18.1requirements of this chapter, are eligible for medical assistance through the period of
18.2pregnancy, including labor and delivery, and 60 days postpartum, to the extent federal
18.3funds are available under title XXI of the Social Security Act, and the state children's
18.4health insurance program.
18.5(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
18.6services from a nonprofit center established to serve victims of torture and are otherwise
18.7ineligible for medical assistance under this chapter are eligible for medical assistance
18.8without federal financial participation. These individuals are eligible only for the period
18.9during which they are receiving services from the center. Individuals eligible under this
18.10paragraph shall not be required to participate in prepaid medical assistance.
18.11(k) Noncitizens who are lawfully present in the United States as defined in Code
18.12of Federal Regulations, title 8, section 103.12, who are not children or pregnant women
18.13as defined in paragraph (d), and who otherwise meet the eligibility requirements of this
18.14chapter, are eligible for medical assistance without federal financial participation. These
18.15individuals must cooperate with the United States Citizenship and Immigration Services to
18.16pursue any applicable immigration status, including citizenship, that would qualify them
18.17for medical assistance with federal financial participation.
18.18EFFECTIVE DATE.This section is effective January 1, 2014.

18.19    Sec. 25. Minnesota Statutes 2012, section 256B.0755, subdivision 3, is amended to read:
18.20    Subd. 3. Accountability. (a) Health care delivery systems must accept responsibility
18.21for the quality of care based on standards established under subdivision 1, paragraph (b),
18.22clause (10), and the cost of care or utilization of services provided to its enrollees under
18.23subdivision 1, paragraph (b), clause (1).
18.24(b) A health care delivery system may contract and coordinate with providers and
18.25clinics for the delivery of services and shall contract with community health clinics,
18.26federally qualified health centers, community mental health centers or programs, county
18.27agencies, and rural clinics to the extent practicable.
18.28(c) A health care delivery system must demonstrate how its services will be
18.29coordinated with other services affecting its attributed patients' health, quality of care, and
18.30cost of care that are provided by other providers and county agencies in the local service.
18.31The health care delivery system must: (1) document how other providers and counties,
18.32including county-based purchasing plans, will provide services to persons attributed to the
18.33health care delivery system; (2) document how other providers and counties, including
18.34county-based purchasing plans, participated in developing the application; (3) provide
18.35verification that other providers and counties, including county-based purchasing plans,
19.1support the project and are willing to participate; and (4) document how it will address
19.2applicable local needs, priorities, and public health goals.
19.3EFFECTIVE DATE.This section applies to health care delivery system contracts
19.4entered into or renewed on or after July 1, 2013.

19.5    Sec. 26. Minnesota Statutes 2012, section 256B.694, is amended to read:
19.6256B.694 SOLE-SOURCE OR SINGLE-PLAN MANAGED CARE
19.7CONTRACT.
19.8    (a) MS 2010 [Expired, 2008 c 364 s 10]
19.9    (b) The commissioner shall consider, and may approve, contracting on a
19.10single-health plan basis with other county-based purchasing plans, or with other qualified
19.11health plans that have coordination arrangements with counties, to serve persons with
19.12a disability who voluntarily enroll enrolled in state health care programs, in order to
19.13promote better coordination or integration of health care services, social services and
19.14other community-based services, provided that all requirements applicable to health plan
19.15purchasing, including those in section 256B.69, subdivision 23, are satisfied. Nothing in
19.16this paragraph supersedes or modifies the requirements in paragraph (a).

19.17    Sec. 27. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
19.18to read:
19.19    Subd. 1b. Affordable Care Act. "Affordable Care Act" means Public Law 111-148,
19.20as amended by the federal Health Care and Education Reconciliation Act of 2010, Public
19.21Law 111-152, and any amendments to, or regulations or guidance issued under, those acts.

19.22    Sec. 28. Minnesota Statutes 2012, section 256L.01, subdivision 3a, is amended to read:
19.23    Subd. 3a. Family with children. (a) "Family with children" means:
19.24(1) parents and their children residing in the same household; or
19.25(2) grandparents, foster parents, relative caretakers as defined in the medical
19.26assistance program, or legal guardians; and their wards who are children residing in the
19.27same household. "Family" has the meaning given for family and family size as defined
19.28in Code of Federal Regulations, title 26, section 1.36B-1.
19.29(b) The term includes children who are temporarily absent from the household in
19.30settings such as schools, camps, or parenting time with noncustodial parents.
20.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
20.2approval, whichever is later. The commissioner of human services shall notify the revisor
20.3of statutes when federal approval is obtained.

20.4    Sec. 29. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
20.5to read:
20.6    Subd. 4b. Minnesota Insurance Marketplace. "Minnesota Insurance Marketplace"
20.7means the Minnesota Insurance Marketplace as defined in Minnesota Statutes, section
20.862V.02.

20.9    Sec. 30. Minnesota Statutes 2012, section 256L.01, subdivision 5, is amended to read:
20.10    Subd. 5. Income. (a) "Income" has the meaning given for earned and unearned
20.11income for families and children in the medical assistance program, according to the
20.12state's aid to families with dependent children plan in effect as of July 16, 1996. The
20.13definition does not include medical assistance income methodologies and deeming
20.14requirements. The earned income of full-time and part-time students under age 19 is
20.15not counted as income. Public assistance payments and supplemental security income
20.16are not excluded income modified adjusted gross income, as defined in Code of Federal
20.17Regulations, title 26, section 1.36B-1.
20.18(b) For purposes of this subdivision, and unless otherwise specified in this section,
20.19the commissioner shall use reasonable methods to calculate gross earned and unearned
20.20income including, but not limited to, projecting income based on income received within
20.21the past 30 days, the last 90 days, or the last 12 months.
20.22EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
20.23approval, whichever is later. The commissioner of human services shall notify the revisor
20.24of statutes when federal approval is obtained.

20.25    Sec. 31. Minnesota Statutes 2012, section 256L.01, is amended by adding a subdivision
20.26to read:
20.27    Subd. 8. Participating entity. "Participating entity" means a health carrier as
20.28defined in section 62A.011, subdivision 2; a county-based purchasing plan established
20.29under section 256B.692; an accountable care organization or other entity operating a
20.30health care delivery systems demonstration project authorized under section 256B.0755;
20.31an entity operating a county integrated health care delivery network pilot project
20.32authorized under section 256B.0756; or a network of health care providers established to
20.33offer services under MinnesotaCare.
21.1EFFECTIVE DATE.This section is effective January 1, 2015.

21.2    Sec. 32. Minnesota Statutes 2012, section 256L.02, subdivision 2, is amended to read:
21.3    Subd. 2. Commissioner's duties. The commissioner shall establish an office for the
21.4state administration of this plan. The plan shall be used to provide covered health services
21.5for eligible persons. Payment for these services shall be made to all eligible providers
21.6 participating entities under contract with the commissioner. The commissioner shall
21.7adopt rules to administer the MinnesotaCare program. Nothing in this chapter is intended
21.8to violate the requirements of the Affordable Care Act. The commissioner shall not
21.9implement any provision of this chapter if the provision is found to violate the Affordable
21.10Care Act. The commissioner shall establish marketing efforts to encourage potentially
21.11eligible persons to receive information about the program and about other medical care
21.12programs administered or supervised by the Department of Human Services. A toll-free
21.13telephone number and Web site must be used to provide information about medical
21.14programs and to promote access to the covered services.
21.15EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
21.16approval, whichever is later, except that the amendment related to "participating entities"
21.17is effective January 1, 2015. The commissioner of human services shall notify the revisor
21.18when federal approval is obtained.

21.19    Sec. 33. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
21.20to read:
21.21    Subd. 6. Federal approval. (a) The commissioner of human services shall seek
21.22federal approval to implement the MinnesotaCare program under this chapter as a basic
21.23health program. In any agreement with the Centers for Medicare and Medicaid Services
21.24to operate MinnesotaCare as a basic health program, the commissioner shall seek to
21.25include procedures to ensure that federal funding is predictable, stable, and sufficient
21.26to sustain ongoing operation of MinnesotaCare. These procedures must address issues
21.27related to the timing of federal payments, payment reconciliation, enrollee risk adjustment,
21.28and minimization of state financial risk. The commissioner shall consult with the
21.29commissioner of management and budget when developing the proposal for establishing
21.30MinnesotaCare as a basic health program to be submitted to the Centers for Medicare
21.31and Medicaid Services.
21.32(b) The commissioner of human services, in consultation with the commissioner of
21.33management and budget, shall work with the Centers for Medicare and Medicaid Services
21.34to establish a process for reconciliation and adjustment of federal payments that balances
22.1state and federal liability over time. The commissioner of human services shall request that
22.2the secretary of health and human services hold the state, and enrollees, harmless in the
22.3reconciliation process for the first three years, to allow the state to develop a statistically
22.4valid methodology for predicting enrollment trends and their net effect on federal payments.
22.5(c) The commissioner of human services, through December 31, 2015, may modify
22.6the MinnesotaCare program as specified in this chapter, if it is necessary to enhance
22.7health benefits, expand provider access, or reduce cost-sharing and premiums in order
22.8to comply with the terms and conditions of federal approval as a basic health program.
22.9The commissioner may not reduce benefits, impose greater limits on access to providers,
22.10or increase cost-sharing and premiums by enrollees under the authority granted by this
22.11paragraph. If the commissioner modifies the terms and requirements for MinnesotaCare
22.12under this paragraph, the commissioner shall provide the legislature with notice of
22.13implementation of the modifications at least ten working days before notifying enrollees
22.14and participating entities. The costs of any changes to the program necessary to comply
22.15with federal approval shall become part of the program's base funding for purposes of
22.16future budget forecasts.
22.17EFFECTIVE DATE.This section is effective the day following final enactment.

22.18    Sec. 34. Minnesota Statutes 2012, section 256L.02, is amended by adding a subdivision
22.19to read:
22.20    Subd. 7. Coordination with Minnesota Insurance Marketplace. MinnesotaCare
22.21shall be considered a public health care program for purposes of Minnesota Statutes,
22.22chapter 62V.
22.23EFFECTIVE DATE.This section is effective January 1, 2014.

22.24    Sec. 35. Minnesota Statutes 2012, section 256L.03, subdivision 1, is amended to read:
22.25    Subdivision 1. Covered health services. (a) "Covered health services" means the
22.26health services reimbursed under chapter 256B, and all essential health benefits required
22.27under section 1302 of the Affordable Care Act, with the exception of inpatient hospital
22.28services, special education services, private duty nursing services, adult dental care
22.29services other than services covered under section 256B.0625, subdivision 9, orthodontic
22.30services, nonemergency medical transportation services, personal care assistance and case
22.31management services, and nursing home or intermediate care facilities services, inpatient
22.32mental health services, and chemical dependency services.
23.1    (b) No public funds shall be used for coverage of abortion under MinnesotaCare
23.2except where the life of the female would be endangered or substantial and irreversible
23.3impairment of a major bodily function would result if the fetus were carried to term; or
23.4where the pregnancy is the result of rape or incest.
23.5    (c) Covered health services shall be expanded as provided in this section.
23.6EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
23.7approval, whichever is later. The commissioner of human services shall notify the revisor
23.8of statutes when federal approval is obtained.

23.9    Sec. 36. Minnesota Statutes 2012, section 256L.03, subdivision 1a, is amended to read:
23.10    Subd. 1a. Pregnant women and Children; MinnesotaCare health care reform
23.11waiver. Beginning January 1, 1999, Children and pregnant women are eligible for coverage
23.12of all services that are eligible for reimbursement under the medical assistance program
23.13according to chapter 256B, except that abortion services under MinnesotaCare shall be
23.14limited as provided under subdivision 1. Pregnant women and Children are exempt from
23.15the provisions of subdivision 5, regarding co-payments. Pregnant women and Children
23.16who are lawfully residing in the United States but who are not "qualified noncitizens" under
23.17title IV of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
23.18Public Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage
23.19of all services provided under the medical assistance program according to chapter 256B.
23.20EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
23.21approval, whichever is later. The commissioner of human services shall notify the revisor
23.22of statutes when federal approval is obtained.

23.23    Sec. 37. Minnesota Statutes 2012, section 256L.03, subdivision 3, is amended to read:
23.24    Subd. 3. Inpatient hospital services. (a) Covered health services shall include
23.25inpatient hospital services, including inpatient hospital mental health services and inpatient
23.26hospital and residential chemical dependency treatment, subject to those limitations
23.27necessary to coordinate the provision of these services with eligibility under the medical
23.28assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
23.29section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
23.302 , with family gross income that exceeds 200 percent of the federal poverty guidelines or
23.31215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
23.32pregnant, is subject to an annual limit of $10,000.
24.1    (b) Admissions for inpatient hospital services paid for under section 256L.11,
24.2subdivision 3 , must be certified as medically necessary in accordance with Minnesota
24.3Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):
24.4    (1) all admissions must be certified, except those authorized under rules established
24.5under section 254A.03, subdivision 3, or approved under Medicare; and
24.6    (2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
24.7for admissions for which certification is requested more than 30 days after the day of
24.8admission. The hospital may not seek payment from the enrollee for the amount of the
24.9payment reduction under this clause.
24.10EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
24.11approval, whichever is later. The commissioner of human services shall notify the revisor
24.12of statutes when federal approval is obtained.

24.13    Sec. 38. Minnesota Statutes 2012, section 256L.03, is amended by adding a subdivision
24.14to read:
24.15    Subd. 4b. Loss ratio. Health coverage provided through the MinnesotaCare
24.16program must have a medical loss ratio of at least 85 percent, as defined using the loss
24.17ratio methodology described in section 1001 of the Affordable Care Act.
24.18EFFECTIVE DATE.This section is effective January 1, 2015.

24.19    Sec. 39. Minnesota Statutes 2012, section 256L.03, subdivision 5, is amended to read:
24.20    Subd. 5. Cost-sharing. (a) Except as otherwise provided in paragraphs (b) and (c)
24.21 this subdivision, the MinnesotaCare benefit plan shall include the following cost-sharing
24.22requirements for all enrollees:
24.23    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
24.24subject to an annual inpatient out-of-pocket maximum of $1,000 per individual;
24.25    (2) $3 per prescription for adult enrollees;
24.26    (3) $25 for eyeglasses for adult enrollees;
24.27    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
24.28episode of service which is required because of a recipient's symptoms, diagnosis, or
24.29established illness, and which is delivered in an ambulatory setting by a physician or
24.30physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
24.31audiologist, optician, or optometrist;
24.32    (5) $6 for nonemergency visits to a hospital-based emergency room for services
24.33provided through December 31, 2010, and $3.50 effective January 1, 2011; and
25.1(6) a family deductible equal to the maximum amount allowed under Code of
25.2Federal Regulations, title 42, part 447.54.
25.3    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
25.4 families with children under the age of 21.
25.5    (c) Paragraph (a) does not apply to pregnant women and children under the age of 21.
25.6    (d) Paragraph (a), clause (4), does not apply to mental health services.
25.7    (e) Adult enrollees with family gross income that exceeds 200 percent of the federal
25.8poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
25.9and who are not pregnant shall be financially responsible for the coinsurance amount, if
25.10applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.
25.11    (f) (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
25.12or changes from one prepaid health plan to another during a calendar year, any charges
25.13submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
25.14expenses incurred by the enrollee for inpatient services, that were submitted or incurred
25.15prior to enrollment, or prior to the change in health plans, shall be disregarded.
25.16(g) (f) MinnesotaCare reimbursements to fee-for-service providers and payments to
25.17managed care plans or county-based purchasing plans shall not be increased as a result of
25.18the reduction of the co-payments in paragraph (a), clause (5), effective January 1, 2011.
25.19(h) (g) The commissioner, through the contracting process under section 256L.12,
25.20may allow managed care plans and county-based purchasing plans to waive the family
25.21deductible under paragraph (a), clause (6). The value of the family deductible shall not be
25.22included in the capitation payment to managed care plans and county-based purchasing
25.23plans. Managed care plans and county-based purchasing plans shall certify annually to the
25.24commissioner the dollar value of the family deductible.
25.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
25.26approval, whichever is later. The commissioner of human services shall notify the revisor
25.27of statutes when federal approval is obtained.

25.28    Sec. 40. Minnesota Statutes 2012, section 256L.03, subdivision 6, is amended to read:
25.29    Subd. 6. Lien. When the state agency provides, pays for, or becomes liable for
25.30covered health services, the agency shall have a lien for the cost of the covered health
25.31services upon any and all causes of action accruing to the enrollee, or to the enrollee's
25.32legal representatives, as a result of the occurrence that necessitated the payment for the
25.33covered health services. All liens under this section shall be subject to the provisions
25.34of section 256.015. For purposes of this subdivision, "state agency" includes prepaid
25.35health plans participating entities, under contract with the commissioner according to
26.1sections 256B.69, 256D.03, subdivision 4, paragraph (c), and 256L.12; and county-based
26.2purchasing entities under section 256B.692 section 256L.121.
26.3EFFECTIVE DATE.This section is effective January 1, 2015.

26.4    Sec. 41. Minnesota Statutes 2012, section 256L.04, subdivision 1, is amended to read:
26.5    Subdivision 1. Families with children. (a) Families with children with family
26.6income above 133 percent of the federal poverty guidelines and equal to or less than
26.7275 200 percent of the federal poverty guidelines for the applicable family size shall be
26.8eligible for MinnesotaCare according to this section. All other provisions of sections
26.9256L.01 to 256L.18, including the insurance-related barriers to enrollment under section
26.10256L.07, shall apply unless otherwise specified.
26.11    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
26.12if the children are eligible. Children may be enrolled separately without enrollment by
26.13parents. However, if one parent in the household enrolls, both parents must enroll, unless
26.14other insurance is available. If one child from a family is enrolled, all children must
26.15be enrolled, unless other insurance is available. If one spouse in a household enrolls,
26.16the other spouse in the household must also enroll, unless other insurance is available.
26.17Families cannot choose to enroll only certain uninsured members.
26.18    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
26.19to the MinnesotaCare program. These persons are no longer counted in the parental
26.20household and may apply as a separate household.
26.21    (d) Parents are not eligible for MinnesotaCare if their gross income exceeds $57,500.
26.22(e) Children deemed eligible for MinnesotaCare under section 256L.07, subdivision
26.238 , are exempt from the eligibility requirements of this subdivision.
26.24EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
26.25approval, whichever is later. The commissioner of human services shall notify the revisor
26.26of statutes when federal approval is obtained.

26.27    Sec. 42. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
26.28to read:
26.29    Subd. 1c. General requirements. To be eligible for coverage under MinnesotaCare,
26.30a person must meet the eligibility requirements of this section. A person eligible for
26.31MinnesotaCare shall not be treated as a qualified individual under section 1312 of the
26.32Affordable Care Act, and is not eligible for enrollment in a qualified health plan offered
26.33through the health benefit exchange under section 1331 of the Affordable Care Act.
27.1EFFECTIVE DATE.This section is effective January 1, 2015.

27.2    Sec. 43. Minnesota Statutes 2012, section 256L.04, subdivision 7, is amended to read:
27.3    Subd. 7. Single adults and households with no children. (a) The definition of
27.4eligible persons includes all individuals and households families with no children who
27.5have gross family incomes that are above 133 percent and equal to or less than 200 percent
27.6of the federal poverty guidelines for the applicable family size.
27.7    (b) Effective July 1, 2009, the definition of eligible persons includes all individuals
27.8and households with no children who have gross family incomes that are equal to or less
27.9than 250 percent of the federal poverty guidelines.
27.10EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
27.11approval, whichever is later. The commissioner of human services shall notify the revisor
27.12of statutes when federal approval is obtained.

27.13    Sec. 44. Minnesota Statutes 2012, section 256L.04, subdivision 8, is amended to read:
27.14    Subd. 8. Applicants potentially eligible for medical assistance. (a) Individuals
27.15who receive supplemental security income or retirement, survivors, or disability benefits
27.16due to a disability, or other disability-based pension, who qualify under subdivision 7, but
27.17who are potentially eligible for medical assistance without a spenddown shall be allowed
27.18to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
27.19conditions of eligibility. The commissioner shall identify and refer the applications of
27.20such individuals to their county social service agency. The county and the commissioner
27.21shall cooperate to ensure that the individuals obtain medical assistance coverage for any
27.22months for which they are eligible.
27.23(b) The enrollee must cooperate with the county social service agency in determining
27.24medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
27.25cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
27.26from the plan within one calendar month. Persons disenrolled for nonapplication for
27.27medical assistance may not reenroll until they have obtained a medical assistance
27.28eligibility determination. Persons disenrolled for noncooperation with medical assistance
27.29may not reenroll until they have cooperated with the county agency and have obtained a
27.30medical assistance eligibility determination.
27.31(c) Beginning January 1, 2000, counties that choose to become MinnesotaCare
27.32enrollment sites shall consider MinnesotaCare applications to also be applications for
27.33medical assistance. Applicants who are potentially eligible for medical assistance, except
28.1for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
28.2medical assistance.
28.3(d) The commissioner shall redetermine provider payments made under
28.4MinnesotaCare to the appropriate medical assistance payments for those enrollees who
28.5subsequently become eligible for medical assistance.
28.6EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
28.7approval, whichever is later. The commissioner of human services shall notify the revisor
28.8of statutes when federal approval is obtained.

28.9    Sec. 45. Minnesota Statutes 2012, section 256L.04, subdivision 10, is amended to read:
28.10    Subd. 10. Citizenship requirements. (a) Eligibility for MinnesotaCare is limited to
28.11citizens or nationals of the United States, qualified noncitizens, and other persons residing
28.12 and lawfully in the United States present noncitizens as defined in Code of Federal
28.13Regulations, title 8, section 103.12. Undocumented noncitizens and nonimmigrants
28.14 are ineligible for MinnesotaCare. For purposes of this subdivision, a nonimmigrant
28.15is an individual in one or more of the classes listed in United States Code, title 8,
28.16section 1101(a)(15), and an undocumented noncitizen is an individual who resides in the
28.17United States without the approval or acquiescence of the United States Citizenship and
28.18Immigration Services. Families with children who are citizens or nationals of the United
28.19States must cooperate in obtaining satisfactory documentary evidence of citizenship or
28.20nationality according to the requirements of the federal Deficit Reduction Act of 2005,
28.21Public Law 109-171.
28.22(b) Eligible persons include individuals who are lawfully present and ineligible for
28.23medical assistance by reason of immigration status, who have family income equal to or
28.24less than 200 percent of the federal poverty guidelines for the applicable family size.
28.25EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
28.26approval, whichever is later. The commissioner of human services shall notify the revisor
28.27of statutes when federal approval is obtained.

28.28    Sec. 46. Minnesota Statutes 2012, section 256L.04, is amended by adding a subdivision
28.29to read:
28.30    Subd. 14. Coordination with medical assistance. (a) Individuals eligible for
28.31medical assistance under chapter 256B are not eligible for MinnesotaCare under this
28.32section.
29.1(b) The commissioner shall coordinate eligibility and coverage to ensure that
29.2individuals transitioning between medical assistance and MinnesotaCare have seamless
29.3eligibility and access to health care services.
29.4EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
29.5approval, whichever is later. The commissioner of human services shall notify the revisor
29.6of statutes when federal approval is obtained.

29.7    Sec. 47. Minnesota Statutes 2012, section 256L.05, subdivision 1, is amended to read:
29.8    Subdivision 1. Application assistance and information availability. (a) Applicants
29.9may submit applications online, in person, by mail, or by phone in accordance with the
29.10Affordable Care Act, and by any other means by which medical assistance applications
29.11may be submitted. Applicants may submit applications through the Minnesota Insurance
29.12Marketplace or through the MinnesotaCare program. Applications and application
29.13assistance must be made available at provider offices, local human services agencies,
29.14school districts, public and private elementary schools in which 25 percent or more of
29.15the students receive free or reduced price lunches, community health offices, Women,
29.16Infants and Children (WIC) program sites, Head Start program sites, public housing
29.17councils, crisis nurseries, child care centers, early childhood education and preschool
29.18program sites, legal aid offices, and libraries, and at any other locations at which medical
29.19assistance applications must be made available. These sites may accept applications and
29.20forward the forms to the commissioner or local county human services agencies that
29.21choose to participate as an enrollment site. Otherwise, applicants may apply directly to the
29.22commissioner or to participating local county human services agencies.
29.23(b) Application assistance must be available for applicants choosing to file an online
29.24application through the Minnesota Insurance Marketplace.
29.25EFFECTIVE DATE.This section is effective January 1, 2014.

29.26    Sec. 48. Minnesota Statutes 2012, section 256L.05, subdivision 2, is amended to read:
29.27    Subd. 2. Commissioner's duties. The commissioner or county agency shall use
29.28electronic verification through the Minnesota Insurance Marketplace as the primary
29.29method of income verification. If there is a discrepancy between reported income
29.30and electronically verified income, an individual may be required to submit additional
29.31verification to the extent permitted under the Affordable Care Act. In addition, the
29.32commissioner shall perform random audits to verify reported income and eligibility. The
29.33commissioner may execute data sharing arrangements with the Department of Revenue
30.1and any other governmental agency in order to perform income verification related to
30.2eligibility and premium payment under the MinnesotaCare program.
30.3EFFECTIVE DATE.This section is effective January 1, 2014.

30.4    Sec. 49. Minnesota Statutes 2012, section 256L.05, subdivision 3, is amended to read:
30.5    Subd. 3. Effective date of coverage. (a) The effective date of coverage is the
30.6first day of the month following the month in which eligibility is approved and the first
30.7premium payment has been received. As provided in section 256B.057, coverage for
30.8newborns is automatic from the date of birth and must be coordinated with other health
30.9coverage. The effective date of coverage for eligible newly adoptive children added to a
30.10family receiving covered health services is the month of placement. The effective date
30.11of coverage for other new members added to the family is the first day of the month
30.12following the month in which the change is reported. All eligibility criteria must be met
30.13by the family at the time the new family member is added. The income of the new family
30.14member is included with the family's modified adjusted gross income and the adjusted
30.15premium begins in the month the new family member is added.
30.16(b) The initial premium must be received by the last working day of the month for
30.17coverage to begin the first day of the following month.
30.18(c) Benefits are not available until the day following discharge if an enrollee is
30.19hospitalized on the first day of coverage.
30.20(d) (c) Notwithstanding any other law to the contrary, benefits under sections
30.21256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
30.22an eligible person may have coverage and the commissioner shall use cost avoidance
30.23techniques to ensure coordination of any other health coverage for eligible persons. The
30.24commissioner shall identify eligible persons who may have coverage or benefits under
30.25other plans of insurance or who become eligible for medical assistance.
30.26(e) (d) The effective date of coverage for individuals or families who are exempt
30.27from paying premiums under section 256L.15, subdivision 1, paragraph (d), is the first
30.28day of the month following the month in which verification of American Indian status
30.29is received or eligibility is approved, whichever is later.
30.30(f) (e) The effective date of coverage for children eligible under section 256L.07,
30.31subdivision 8, is the first day of the month following the date of termination from foster
30.32care or release from a juvenile residential correctional facility.
31.1EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
31.2approval, whichever is later. The commissioner of human services shall notify the revisor
31.3of statutes when federal approval is obtained.

31.4    Sec. 50. Minnesota Statutes 2012, section 256L.06, subdivision 3, is amended to read:
31.5    Subd. 3. Commissioner's duties and payment. (a) Premiums are dedicated to the
31.6commissioner for MinnesotaCare.
31.7    (b) The commissioner shall develop and implement procedures to: (1) require
31.8enrollees to report changes in income; (2) adjust sliding scale premium payments, based
31.9upon both increases and decreases in enrollee income, at the time the change in income
31.10is reported; and (3) disenroll enrollees from MinnesotaCare for failure to pay required
31.11premiums. Failure to pay includes payment with a dishonored check, a returned automatic
31.12bank withdrawal, or a refused credit card or debit card payment. The commissioner may
31.13demand a guaranteed form of payment, including a cashier's check or a money order, as
31.14the only means to replace a dishonored, returned, or refused payment.
31.15    (c) Premiums are calculated on a calendar month basis and may be paid on a
31.16monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
31.17commissioner of the premium amount required. The commissioner shall inform applicants
31.18and enrollees of these premium payment options. Premium payment is required before
31.19enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
31.20received before noon are credited the same day. Premium payments received after noon
31.21are credited on the next working day.
31.22    (d) Nonpayment of the premium will result in disenrollment from the plan effective
31.23for the calendar month for which the premium was due. Persons disenrolled for
31.24nonpayment or who voluntarily terminate coverage from the program may not reenroll
31.25until four calendar months have elapsed. Persons disenrolled for nonpayment who pay
31.26all past due premiums as well as current premiums due, including premiums due for the
31.27period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively
31.28to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily
31.29terminate coverage from the program may not reenroll for four calendar months unless
31.30the person demonstrates good cause for nonpayment. Good cause does not exist if a
31.31person chooses to pay other family expenses instead of the premium. The commissioner
31.32shall define good cause in rule.
31.33EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
31.34approval, whichever is later. The commissioner of human services shall notify the revisor
31.35of statutes when federal approval is obtained.

32.1    Sec. 51. Minnesota Statutes 2012, section 256L.07, subdivision 1, is amended to read:
32.2    Subdivision 1. General requirements. (a) Children enrolled in the original
32.3children's health plan as of September 30, 1992, children who enrolled in the
32.4MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549,
32.5article 4, section 17, and children who have family gross incomes that are equal to or
32.6less than 200 percent of the federal poverty guidelines are eligible without meeting the
32.7requirements of subdivision 2 and the four-month requirement in subdivision 3, as long as
32.8they maintain continuous coverage in the MinnesotaCare program or medical assistance.
32.9    Parents Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 1,
32.10and individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose
32.11income increases above 275 200 percent of the federal poverty guidelines, are no longer
32.12eligible for the program and shall be disenrolled by the commissioner. Beginning January
32.131, 2008, individuals enrolled in MinnesotaCare under section 256L.04, subdivision
32.147 , whose income increases above 200 percent of the federal poverty guidelines or 250
32.15percent of the federal poverty guidelines on or after July 1, 2009, are no longer eligible for
32.16the program and shall be disenrolled by the commissioner. For persons disenrolled under
32.17this subdivision, MinnesotaCare coverage terminates the last day of the calendar month
32.18following the month in which the commissioner determines that the income of a family or
32.19individual exceeds program income limits.
32.20    (b) Children may remain enrolled in MinnesotaCare if their gross family income as
32.21defined in section 256L.01, subdivision 4, is greater than 275 percent of federal poverty
32.22guidelines. The premium for children remaining eligible under this paragraph shall be the
32.23maximum premium determined under section 256L.15, subdivision 2, paragraph (b).
32.24    (c) Notwithstanding paragraph (a), parents are not eligible for MinnesotaCare if
32.25gross household income exceeds $57,500 for the 12-month period of eligibility.
32.26EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
32.27approval, whichever is later. The commissioner of human services shall notify the revisor
32.28of statutes when federal approval is obtained.

32.29    Sec. 52. Minnesota Statutes 2012, section 256L.07, subdivision 2, is amended to read:
32.30    Subd. 2. Must not have access to employer-subsidized minimum essential
32.31 coverage. (a) To be eligible, a family or individual must not have access to subsidized
32.32health coverage through an employer and must not have had access to employer-subsidized
32.33coverage through a current employer for 18 months prior to application or reapplication.
32.34A family or individual whose employer-subsidized coverage is lost due to an employer
32.35terminating health care coverage as an employee benefit during the previous 18 months is
33.1not eligible that is affordable and provides minimum value as defined in Code of Federal
33.2Regulations, title 26, section 1.36B-2.
33.3(b) This subdivision does not apply to a family or individual who was enrolled
33.4in MinnesotaCare within six months or less of reapplication and who no longer has
33.5employer-subsidized coverage due to the employer terminating health care coverage as an
33.6employee benefit. This subdivision does not apply to children with family gross incomes
33.7that are equal to or less than 200 percent of federal poverty guidelines.
33.8(c) For purposes of this requirement, subsidized health coverage means health
33.9coverage for which the employer pays at least 50 percent of the cost of coverage for
33.10the employee or dependent, or a higher percentage as specified by the commissioner.
33.11Children are eligible for employer-subsidized coverage through either parent, including
33.12the noncustodial parent. The commissioner must treat employer contributions to Internal
33.13Revenue Code Section 125 plans and any other employer benefits intended to pay
33.14health care costs as qualified employer subsidies toward the cost of health coverage for
33.15employees for purposes of this subdivision.
33.16EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
33.17approval, whichever is later. The commissioner of human services shall notify the revisor
33.18of statutes when federal approval is obtained.

33.19    Sec. 53. Minnesota Statutes 2012, section 256L.07, subdivision 3, is amended to read:
33.20    Subd. 3. Other health coverage. (a) Families and individuals enrolled in the
33.21MinnesotaCare program must have no To be eligible, a family must not have minimum
33.22essential health coverage while enrolled, as defined by section 5000A of the Internal
33.23Revenue Code. Children with family gross incomes equal to or greater than 200 percent
33.24of federal poverty guidelines, and adults, must have had no health coverage for at least
33.25four months prior to application and renewal. Children enrolled in the original children's
33.26health plan and children in families with income equal to or less than 200 percent of the
33.27federal poverty guidelines, who have other health insurance, are eligible if the coverage:
33.28(1) lacks two or more of the following:
33.29(i) basic hospital insurance;
33.30(ii) medical-surgical insurance;
33.31(iii) prescription drug coverage;
33.32(iv) dental coverage; or
33.33(v) vision coverage;
33.34(2) requires a deductible of $100 or more per person per year; or
34.1(3) lacks coverage because the child has exceeded the maximum coverage for a
34.2particular diagnosis or the policy excludes a particular diagnosis.
34.3The commissioner may change this eligibility criterion for sliding scale premiums
34.4in order to remain within the limits of available appropriations. The requirement of no
34.5health coverage does not apply to newborns.
34.6(b) Coverage purchased as provided under section 256L.031, subdivision 2, medical
34.7assistance, and the Civilian Health and Medical Program of the Uniformed Service,
34.8CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
34.9part II, chapter 55, are not considered insurance or health coverage for purposes of the
34.10four-month requirement described in this subdivision.
34.11(c) (b) For purposes of this subdivision, an applicant or enrollee who is entitled to
34.12Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
34.13Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered
34.14to have minimum essential health coverage. An applicant or enrollee who is entitled to
34.15premium-free Medicare Part A may not refuse to apply for or enroll in Medicare coverage
34.16to establish eligibility for MinnesotaCare.
34.17(d) Applicants who were recipients of medical assistance within one month of
34.18application must meet the provisions of this subdivision and subdivision 2.
34.19(e) Cost-effective health insurance that was paid for by medical assistance is not
34.20considered health coverage for purposes of the four-month requirement under this
34.21section, except if the insurance continued after medical assistance no longer considered it
34.22cost-effective or after medical assistance closed.
34.23EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.24approval, whichever is later. The commissioner of human services shall notify the revisor
34.25of statutes when federal approval is obtained.

34.26    Sec. 54. Minnesota Statutes 2012, section 256L.09, subdivision 2, is amended to read:
34.27    Subd. 2. Residency requirement. To be eligible for health coverage under the
34.28MinnesotaCare program, pregnant women, individuals, and families with children must
34.29meet the residency requirements as provided by Code of Federal Regulations, title 42,
34.30section 435.403, except that the provisions of section 256B.056, subdivision 1, shall apply
34.31upon receipt of federal approval.
34.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
34.33approval, whichever is later. The commissioner of human services shall notify the revisor
34.34of statutes when federal approval is obtained.

35.1    Sec. 55. Minnesota Statutes 2012, section 256L.11, subdivision 6, is amended to read:
35.2    Subd. 6. Enrollees 18 or older Reimbursement of inpatient hospital services.
35.3Payment by the MinnesotaCare program for inpatient hospital services provided to
35.4MinnesotaCare enrollees eligible under section 256L.04, subdivision 7, or who qualify
35.5under section 256L.04, subdivisions subdivision 1 and 2, with family gross income that
35.6exceeds 175 percent of the federal poverty guidelines and who are not pregnant, who
35.7are 18 years old or older on the date of admission to the inpatient hospital must be in
35.8accordance with paragraphs (a) and (b). Payment for adults who are not pregnant and are
35.9eligible under section 256L.04, subdivisions 1 and 2, and whose incomes are equal to or
35.10less than 175 percent of the federal poverty guidelines, shall be as provided for under
35.11paragraph (c)., shall be at the medical assistance rate minus any co-payment required
35.12under section 256L.03, subdivision 5. The hospital must not seek payment from the
35.13enrollee in addition to the co-payment. The MinnesotaCare payment plus the co-payment
35.14must be treated as payment in full.
35.15(a) If the medical assistance rate minus any co-payment required under section
35.16256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's
35.17benefit limit under section 256L.03, subdivision 3, payment must be the medical
35.18assistance rate minus any co-payment required under section 256L.03, subdivision 4. The
35.19hospital must not seek payment from the enrollee in addition to the co-payment. The
35.20MinnesotaCare payment plus the co-payment must be treated as payment in full.
35.21(b) If the medical assistance rate minus any co-payment required under section
35.22256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit
35.23under section 256L.03, subdivision 3, payment must be the lesser of:
35.24(1) the amount remaining in the enrollee's benefit limit; or
35.25(2) charges submitted for the inpatient hospital services less any co-payment
35.26established under section 256L.03, subdivision 4.
35.27The hospital may seek payment from the enrollee for the amount by which usual and
35.28customary charges exceed the payment under this paragraph. If payment is reduced under
35.29section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the
35.30enrollee for the amount of the reduction.
35.31(c) For admissions occurring on or after July 1, 2011, for single adults and
35.32households without children who are eligible under section 256L.04, subdivision 7, the
35.33commissioner shall pay hospitals directly, up to the medical assistance payment rate,
35.34for inpatient hospital benefits up to the $10,000 annual inpatient benefit limit, minus
35.35any co-payment required under section 256L.03, subdivision 5. Inpatient services paid
36.1directly by the commissioner under this paragraph do not include chemical dependency
36.2hospital-based and residential treatment.
36.3EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
36.4approval, whichever is later. The commissioner of human services shall notify the revisor
36.5of statutes when federal approval is obtained.

36.6    Sec. 56. [256L.121] SERVICE DELIVERY.
36.7    Subdivision 1. Competitive process. The commissioner of human services shall
36.8establish a competitive process for entering into contracts with participating entities for
36.9the offering of standard health plans through MinnesotaCare. Coverage through standard
36.10health plans must be available to enrollees beginning January 1, 2015. Each standard
36.11health plan must cover the health services listed in and meet the requirements of section
36.12256L.03. The competitive process must meet the requirements of section 1331 of the
36.13Affordable Care Act and be designed to ensure enrollee access to high-quality health care
36.14coverage options. The commissioner, to the extent feasible, shall seek to ensure that
36.15enrollees have a choice of coverage from more than one participating entity within a
36.16geographic area. In rural areas other than metropolitan statistical areas, the commissioner
36.17shall use the medical assistance competitive procurement process under section 256B.69,
36.18subdivisions 1 to 32, under which selection of entities is based on criteria related to
36.19provider network access, coordination of health care with other local services, alignment
36.20with local public health goals, and other factors.
36.21    Subd. 2. Other requirements for participating entities. The commissioner shall
36.22require participating entities, as a condition of contract, to document to the commissioner:
36.23(1) the provision of culturally and linguistically appropriate services, including
36.24marketing materials, to MinnesotaCare enrollees; and
36.25(2) the inclusion in provider networks of providers designated as essential
36.26community providers under section 62Q.19.
36.27    Subd. 3. Coordination with state-administered health programs. The
36.28commissioner shall coordinate the administration of the MinnesotaCare program with
36.29medical assistance to maximize efficiency and improve the continuity of care. This
36.30includes, but is not limited to:
36.31(1) establishing geographic areas for MinnesotaCare that are consistent with the
36.32geographic areas of the medical assistance program, within which participating entities
36.33may offer health plans;
36.34(2) requiring, as a condition of participation in MinnesotaCare, participating entities
36.35to also participate in the medical assistance program;
37.1(3) complying with sections 256B.69, subdivision 3a; 256B.692, subdivision 1; and
37.2256B.694, when contracting with MinnesotaCare participating entities;
37.3(4) providing MinnesotaCare enrollees, to the extent possible, with the option to
37.4remain in the same health plan and provider network, if they later become eligible for
37.5medical assistance or coverage through the Minnesota health benefit exchange; and
37.6(5) establishing requirements and criteria for selection that ensure that covered
37.7health care services will be coordinated with local public health services, social services,
37.8long-term care services, mental health services, and other local services affecting
37.9enrollees' health, access, and quality of care.
37.10EFFECTIVE DATE.This section is effective the day following final enactment.

37.11    Sec. 57. Minnesota Statutes 2012, section 256L.15, subdivision 1, is amended to read:
37.12    Subdivision 1. Premium determination. (a) Families with children and individuals
37.13shall pay a premium determined according to subdivision 2.
37.14    (b) Pregnant women and children under age two are exempt from the provisions
37.15of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
37.16for failure to pay premiums. For pregnant women, this exemption continues until the
37.17first day of the month following the 60th day postpartum. Women who remain enrolled
37.18during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
37.19disenrolled on the first of the month following the 60th day postpartum for the penalty
37.20period that otherwise applies under section 256L.06, unless they begin paying premiums.
37.21    (c) (b) Members of the military and their families who meet the eligibility criteria
37.22for MinnesotaCare upon eligibility approval made within 24 months following the end
37.23of the member's tour of active duty shall have their premiums paid by the commissioner.
37.24The effective date of coverage for an individual or family who meets the criteria of this
37.25paragraph shall be the first day of the month following the month in which eligibility is
37.26approved. This exemption applies for 12 months.
37.27(d) (c) Beginning July 1, 2009, American Indians enrolled in MinnesotaCare and
37.28their families shall have their premiums waived by the commissioner in accordance with
37.29section 5006 of the American Recovery and Reinvestment Act of 2009, Public Law 111-5.
37.30An individual must document status as an American Indian, as defined under Code of
37.31Federal Regulations, title 42, section 447.50, to qualify for the waiver of premiums.
37.32EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
37.33approval, whichever is later. The commissioner of human services shall notify the revisor
37.34of statutes when federal approval is obtained.

38.1    Sec. 58. Minnesota Statutes 2012, section 256L.15, subdivision 2, is amended to read:
38.2    Subd. 2. Sliding fee scale; monthly gross individual or family income. (a) The
38.3commissioner shall establish a sliding fee scale to determine the percentage of monthly
38.4gross individual or family income that households at different income levels must pay to
38.5obtain coverage through the MinnesotaCare program. The sliding fee scale must be based
38.6on the enrollee's monthly gross individual or family income. The sliding fee scale must
38.7contain separate tables based on enrollment of one, two, or three or more persons. Until
38.8June 30, 2009, the sliding fee scale begins with a premium of 1.5 percent of monthly gross
38.9individual or family income for individuals or families with incomes below the limits for
38.10the medical assistance program for families and children in effect on January 1, 1999, and
38.11proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and
38.128.8 percent. These percentages are matched to evenly spaced income steps ranging from
38.13the medical assistance income limit for families and children in effect on January 1, 1999,
38.14to 275 percent of the federal poverty guidelines for the applicable family size, up to a
38.15family size of five. The sliding fee scale for a family of five must be used for families of
38.16more than five. The sliding fee scale and percentages are not subject to the provisions of
38.17chapter 14. If a family or individual reports increased income after enrollment, premiums
38.18shall be adjusted at the time the change in income is reported.
38.19    (b) Children in families whose gross income is above 275 percent of the federal
38.20poverty guidelines shall pay the maximum premium. The maximum premium is defined
38.21as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
38.22cases paid the maximum premium, the total revenue would equal the total cost of
38.23MinnesotaCare medical coverage and administration. In this calculation, administrative
38.24costs shall be assumed to equal ten percent of the total. The costs of medical coverage
38.25for pregnant women and children under age two and the enrollees in these groups shall
38.26be excluded from the total. The maximum premium for two enrollees shall be twice the
38.27maximum premium for one, and the maximum premium for three or more enrollees shall
38.28be three times the maximum premium for one.
38.29    (c) (b) Beginning July 1, 2009, MinnesotaCare enrollees shall pay premiums
38.30according to the premium scale specified in paragraph (d) (c) with the exception that
38.31children in families with income at or below 200 percent of the federal poverty guidelines
38.32shall pay no premiums. For purposes of paragraph (d) (c), "minimum" means a monthly
38.33premium of $4.
38.34    (d) (c) The following premium scale is established for individuals and families with
38.35gross family incomes of 275 200 percent of the federal poverty guidelines or less:

39.1	Federal Poverty Guideline Range	Percent of Average Gross Monthly Income
39.2	0-45%	minimum
39.3 39.4	46-54%	$4 or 1.1% of family income, whichever is greater
39.5	55-81%	1.6%
39.6	82-109%	2.2%
39.7	110-136%	2.9%
39.8	137-164%	3.6%
39.9 39.10	165-191 165-200%	4.6%
39.11	192-219%	5.6%
39.12	220-248%	6.5%
39.13	249-275%	7.2%

39.14EFFECTIVE DATE.This section is effective January 1, 2014, or upon federal
39.15approval, whichever is later. The commissioner of human services shall notify the revisor
39.16of statutes when federal approval is obtained.

39.17    Sec. 59. DETERMINATION OF FUNDING ADEQUACY.
39.18The commissioners of revenue and management and budget, in consultation with
39.19the commissioner of human services, shall conduct an assessment of health care taxes,
39.20including the gross premiums tax, the provider tax, and Medicaid surcharges, and their
39.21relationship to the long-term solvency of the health care access fund, as part of the state
39.22revenue and expenditure forecast in November 2013. The commissioners shall determine
39.23the amount of state funding that will be required after December 31, 2019, in addition to
39.24the federal payments made available under section 1331 of the Affordable Care Act, for
39.25the MinnesotaCare program. The commissioners shall evaluate the stability and likelihood
39.26of long-term federal funding for the MinnesotaCare program under section 1331. The
39.27commissioners shall report the results of this assessment to the legislature by January 15,
39.282014, along with recommendations for changes to state revenue for the health care access
39.29fund, if state funding will continue to be required beyond December 31, 2019.

39.30    Sec. 60. STATE-BASED RISK ADJUSTMENT SYSTEM ASSESSMENT.
39.31(a) The commissioners of health, human services, and commerce, and the board of
39.32MNsure, shall study whether Minnesota-based risk adjustment of the individual and small
39.33group insurance market, using either the federal risk adjustment model or a state-based
39.34alternative, can be more cost-effective and perform better than risk adjustment conducted
39.35by federal agencies. The study shall assess the policies, infrastructure, and resources
39.36necessary to satisfy the requirements of Code of Federal Regulations, title 45, section
40.1153, subpart D. The study shall also evaluate the extent to which Minnesota-based risk
40.2adjustment could meet requirements established in Code of Federal Regulations, title
40.345, section 153.330, including:
40.4(1) explaining the variation in health care costs of a given population;
40.5(2) linking risk factors to daily clinical practices and that which is clinically
40.6meaningful to providers;
40.7(3) encouraging favorable behavior among health care market participants and
40.8discouraging unfavorable behavior;
40.9(4) whether risk adjustment factors are relatively easy for stakeholders to understand
40.10and participate in;
40.11(5) providing stable risk scores over time and across health plan products;
40.12(6) minimizing administrative costs;
40.13(7) accounting for risk selection across metal levels;
40.14(8) aligning each of the elements of the methodology; and
40.15(9) can be conducted at a per-member cost equal to or lower than the projected
40.16cost of the federal risk adjustment model.
40.17(b) In conducting the study, and notwithstanding Minnesota Rules, chapter 4653,
40.18and as part of responsibilities under Minnesota Statutes, section 62U.04, subdivision
40.194, paragraph (b), the commissioner of health shall collect from health carriers in the
40.20individual and small group health insurance market, beginning on January 1, 2014, and for
40.21service dates in calendar year 2014, all data required for conducting risk adjustment with
40.22standard risk adjusters such as the Adjusted Clinical Groups or the Hierarchical Condition
40.23Category System, including but not limited to:
40.24(1) an indicator identifying the health plan product under which an enrollee is covered;
40.25(2) an indicator identifying whether an enrollee's policy is an individual or small
40.26group market policy;
40.27(3) an indicator identifying, if applicable, the metal level of an enrollee's health plan
40.28product, and whether the policy is a catastrophic policy; and
40.29(4) additional identified demographic data necessary to link individuals' data across
40.30carriers and insurance affordability programs with 95 percent accuracy. The commissioner
40.31shall not collect more than the last four digits of an individual's social security number.
40.32(c) The commissioner of health shall also asses the extent to which data collected
40.33under paragraph (b) and under Minnesota Statutes, section 62U.04, subdivision 4,
40.34paragraph (a), are sufficient for developing and operating a state alternative risk adjustment
40.35methodology consistent with applicable federal rules by evaluating:
40.36(1) if the data submitted are adequately complete, accurate, and timely;
41.1(2) if the data should be further enriched by nontraditional risk adjusters that help
41.2in better explaining variation in health care costs of a given population and account for
41.3risk selection across metal levels;
41.4(3) whether additional data or identifiers have the potential to strengthen a
41.5Minnesota-based risk adjustment approach; and
41.6(4) what if any changes to the technical infrastructure will be necessary to effectively
41.7perform state-based risk adjustment.
41.8For purposes of this paragraph, the commissioner of health shall have the authority to
41.9use identified data to validate and audit a statistically valid sample of data for each
41.10health carrier in the individual and small group market. In conducting the study, the
41.11commissioners shall contract with entities that do not have an economic interest in the
41.12outcome of Minnesota-based risk adjustment but do have demonstrated expertise in
41.13actuarial science or health economics and demonstrated experience with designing and
41.14implementing risk adjustment models.
41.15(d) The commissioner of human services shall evaluate opportunities to maximize
41.16federal funding under section 1331 of the federal Patient and Protection and Affordable
41.17Care Act, Public Law 111-148, and further defined through amendments to the act and
41.18regulations issued under the act. The commissioner of human services shall make
41.19recommendations on risk adjustment strategies to maximize federal funding to the state
41.20of Minnesota.
41.21(e) The commissioners and board of MNsure shall submit to the legislature by March
41.2215, 2014, an interim report with preliminary findings from the assessment conducted in
41.23paragraphs (c) and (d). The interim report shall include legislative recommendations
41.24for any necessary changes to Minnesota Statutes, section 62Q.03. A final report shall
41.25be submitted by the commissioners and board of MNsure to the legislature by October
41.261, 2015. The final report must include findings from the overall assessment and a
41.27recommendation whether to conduct state-based risk adjustment.
41.28(f) For purposes of this section, the board of MNsure means the board established
41.29under Minnesota Statutes, section 62V.03.

41.30    Sec. 61. REVISOR'S INSTRUCTION.
41.31The revisor shall remove cross-references to the sections repealed in this article
41.32wherever they appear in Minnesota Statutes and Minnesota Rules and make changes
41.33necessary to correct the punctuation, grammar, or structure of the remaining text and
41.34preserve its meaning.

42.1    Sec. 62. REPEALER.
42.2(a) Minnesota Statutes 2012, sections 256L.01, subdivision 4a; 256L.031; 256L.04,
42.3subdivisions 1b, 9, and 10a; 256L.05, subdivision 3b; 256L.07, subdivisions 5, 8, and 9;
42.4256L.11, subdivision 5; and 256L.17, subdivisions 1, 2, 3, 4, and 5, are repealed effective
42.5January 1, 2014.
42.6(b) Minnesota Statutes 2012, section 256L.12, is repealed effective January 1, 2015.


42.9    Section 1. Minnesota Statutes 2012, section 144.0724, subdivision 4, is amended to read:
42.10    Subd. 4. Resident assessment schedule. (a) A facility must conduct and
42.11electronically submit to the commissioner of health case mix assessments that conform
42.12with the assessment schedule defined by Code of Federal Regulations, title 42, section
42.13483.20, and published by the United States Department of Health and Human Services,
42.14Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
42.15Instrument User's Manual, version 3.0, and subsequent updates when issued by the
42.16Centers for Medicare and Medicaid Services. The commissioner of health may substitute
42.17successor manuals or question and answer documents published by the United States
42.18Department of Health and Human Services, Centers for Medicare and Medicaid Services,
42.19to replace or supplement the current version of the manual or document.
42.20(b) The assessments used to determine a case mix classification for reimbursement
42.21include the following:
42.22(1) a new admission assessment must be completed by day 14 following admission;
42.23(2) an annual assessment which must have an assessment reference date (ARD)
42.24within 366 days of the ARD of the last comprehensive assessment;
42.25(3) a significant change assessment must be completed within 14 days of the
42.26identification of a significant change; and
42.27(4) all quarterly assessments must have an assessment reference date (ARD) within
42.2892 days of the ARD of the previous assessment.
42.29(c) In addition to the assessments listed in paragraph (b), the assessments used to
42.30determine nursing facility level of care include the following:
42.31(1) preadmission screening completed under section 256B.0911, subdivision 4a, by a
42.32county, tribe, or managed care organization under contract with the Department of Human
42.33Services 256.975, subdivision 7a, by the Senior LinkAge Line or Disability Linkage Line
42.34or other organization under contract with the Minnesota Board on Aging; and
43.1(2) a nursing facility level of care determination as provided for under section
43.2256B.0911, subdivision 4e, as part of a face-to-face long-term care consultation assessment
43.3completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
43.4managed care organization under contract with the Department of Human Services.

43.5    Sec. 2. Minnesota Statutes 2012, section 144A.351, is amended to read:
43.6144A.351 BALANCING LONG-TERM CARE SERVICES AND SUPPORTS:
43.7REPORT AND STUDY REQUIRED.
43.8    Subdivision 1. Report requirements. The commissioners of health and human
43.9services, with the cooperation of counties and in consultation with stakeholders, including
43.10persons who need or are using long-term care services and supports, lead agencies,
43.11regional entities, senior, disability, and mental health organization representatives, service
43.12providers, and community members shall prepare a report to the legislature by August 15,
43.132013, and biennially thereafter, regarding the status of the full range of long-term care
43.14services and supports for the elderly and children and adults with disabilities and mental
43.15illnesses in Minnesota. The report shall address:
43.16    (1) demographics and need for long-term care services and supports in Minnesota;
43.17    (2) summary of county and regional reports on long-term care gaps, surpluses,
43.18imbalances, and corrective action plans;
43.19    (3) status of long-term care services and related mental health services, housing
43.20options, and supports by county and region including:
43.21    (i) changes in availability of the range of long-term care services and housing options;
43.22    (ii) access problems, including access to the least restrictive and most integrated
43.23services and settings, regarding long-term care services; and
43.24    (iii) comparative measures of long-term care services availability, including serving
43.25people in their home areas near family, and changes over time; and
43.26    (4) recommendations regarding goals for the future of long-term care services and
43.27supports, policy and fiscal changes, and resource development and transition needs.
43.28    Subd. 2. Critical access study. The commissioner shall conduct a onetime study to
43.29assess local capacity and availability of home and community-based services for older
43.30adults, people with disabilities, and people with mental illnesses. The study must assess
43.31critical access at the community level and identify potential strategies to build home and
43.32community-based service capacity in critical access areas. The report shall be submitted
43.33to the legislature no later than August 15, 2015.

43.34    Sec. 3. Minnesota Statutes 2012, section 148E.065, subdivision 4a, is amended to read:
44.1    Subd. 4a. City, county, and state social workers. (a) Beginning July 1, 2016, the
44.2licensure of city, county, and state agency social workers is voluntary, except an individual
44.3who is newly employed by a city or state agency after July 1, 2016, must be licensed
44.4if the individual who provides social work services, as those services are defined in
44.5section 148E.010, subdivision 11, paragraph (b), is presented to the public by any title
44.6incorporating the words "social work" or "social worker."
44.7(b) City, county, and state agencies employing social workers and staff who are
44.8designated to perform mandated duties under sections 256.975, subdivisions 7 to 7c and
44.9256.01, subdivision 24, are not required to employ licensed social workers.

44.10    Sec. 4. Minnesota Statutes 2012, section 256.01, subdivision 2, is amended to read:
44.11    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
44.122 , the commissioner of human services shall carry out the specific duties in paragraphs (a)
44.13through (cc) (dd):
44.14    (a) Administer and supervise all forms of public assistance provided for by state law
44.15and other welfare activities or services as are vested in the commissioner. Administration
44.16and supervision of human services activities or services includes, but is not limited to,
44.17assuring timely and accurate distribution of benefits, completeness of service, and quality
44.18program management. In addition to administering and supervising human services
44.19activities vested by law in the department, the commissioner shall have the authority to:
44.20    (1) require county agency participation in training and technical assistance programs
44.21to promote compliance with statutes, rules, federal laws, regulations, and policies
44.22governing human services;
44.23    (2) monitor, on an ongoing basis, the performance of county agencies in the
44.24operation and administration of human services, enforce compliance with statutes, rules,
44.25federal laws, regulations, and policies governing welfare services and promote excellence
44.26of administration and program operation;
44.27    (3) develop a quality control program or other monitoring program to review county
44.28performance and accuracy of benefit determinations;
44.29    (4) require county agencies to make an adjustment to the public assistance benefits
44.30issued to any individual consistent with federal law and regulation and state law and rule
44.31and to issue or recover benefits as appropriate;
44.32    (5) delay or deny payment of all or part of the state and federal share of benefits and
44.33administrative reimbursement according to the procedures set forth in section 256.017;
44.34    (6) make contracts with and grants to public and private agencies and organizations,
44.35both profit and nonprofit, and individuals, using appropriated funds; and
45.1    (7) enter into contractual agreements with federally recognized Indian tribes with
45.2a reservation in Minnesota to the extent necessary for the tribe to operate a federally
45.3approved family assistance program or any other program under the supervision of the
45.4commissioner. The commissioner shall consult with the affected county or counties in
45.5the contractual agreement negotiations, if the county or counties wish to be included,
45.6in order to avoid the duplication of county and tribal assistance program services. The
45.7commissioner may establish necessary accounts for the purposes of receiving and
45.8disbursing funds as necessary for the operation of the programs.
45.9    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
45.10regulation, and policy necessary to county agency administration of the programs.
45.11    (c) Administer and supervise all child welfare activities; promote the enforcement of
45.12laws protecting disabled, dependent, neglected and delinquent children, and children born
45.13to mothers who were not married to the children's fathers at the times of the conception
45.14nor at the births of the children; license and supervise child-caring and child-placing
45.15agencies and institutions; supervise the care of children in boarding and foster homes or
45.16in private institutions; and generally perform all functions relating to the field of child
45.17welfare now vested in the State Board of Control.
45.18    (d) Administer and supervise all noninstitutional service to disabled persons,
45.19including those who are visually impaired, hearing impaired, or physically impaired
45.20or otherwise disabled. The commissioner may provide and contract for the care and
45.21treatment of qualified indigent children in facilities other than those located and available
45.22at state hospitals when it is not feasible to provide the service in state hospitals.
45.23    (e) Assist and actively cooperate with other departments, agencies and institutions,
45.24local, state, and federal, by performing services in conformity with the purposes of Laws
45.251939, chapter 431.
45.26    (f) Act as the agent of and cooperate with the federal government in matters of
45.27mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
45.28431, including the administration of any federal funds granted to the state to aid in the
45.29performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
45.30and including the promulgation of rules making uniformly available medical care benefits
45.31to all recipients of public assistance, at such times as the federal government increases its
45.32participation in assistance expenditures for medical care to recipients of public assistance,
45.33the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
45.34    (g) Establish and maintain any administrative units reasonably necessary for the
45.35performance of administrative functions common to all divisions of the department.
46.1    (h) Act as designated guardian of both the estate and the person of all the wards of
46.2the state of Minnesota, whether by operation of law or by an order of court, without any
46.3further act or proceeding whatever, except as to persons committed as developmentally
46.4disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
46.5recognized by the Secretary of the Interior whose interests would be best served by
46.6adoptive placement, the commissioner may contract with a licensed child-placing agency
46.7or a Minnesota tribal social services agency to provide adoption services. A contract
46.8with a licensed child-placing agency must be designed to supplement existing county
46.9efforts and may not replace existing county programs or tribal social services, unless the
46.10replacement is agreed to by the county board and the appropriate exclusive bargaining
46.11representative, tribal governing body, or the commissioner has evidence that child
46.12placements of the county continue to be substantially below that of other counties. Funds
46.13encumbered and obligated under an agreement for a specific child shall remain available
46.14until the terms of the agreement are fulfilled or the agreement is terminated.
46.15    (i) Act as coordinating referral and informational center on requests for service for
46.16newly arrived immigrants coming to Minnesota.
46.17    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
46.18way be construed to be a limitation upon the general transfer of powers herein contained.
46.19    (k) Establish county, regional, or statewide schedules of maximum fees and charges
46.20which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
46.21nursing home care and medicine and medical supplies under all programs of medical
46.22care provided by the state and for congregate living care under the income maintenance
46.23programs.
46.24    (l) Have the authority to conduct and administer experimental projects to test methods
46.25and procedures of administering assistance and services to recipients or potential recipients
46.26of public welfare. To carry out such experimental projects, it is further provided that the
46.27commissioner of human services is authorized to waive the enforcement of existing specific
46.28statutory program requirements, rules, and standards in one or more counties. The order
46.29establishing the waiver shall provide alternative methods and procedures of administration,
46.30shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and
46.31in no event shall the duration of a project exceed four years. It is further provided that no
46.32order establishing an experimental project as authorized by the provisions of this section
46.33shall become effective until the following conditions have been met:
46.34    (1) the secretary of health and human services of the United States has agreed, for
46.35the same project, to waive state plan requirements relative to statewide uniformity; and
47.1    (2) a comprehensive plan, including estimated project costs, shall be approved by
47.2the Legislative Advisory Commission and filed with the commissioner of administration.
47.3    (m) According to federal requirements, establish procedures to be followed by
47.4local welfare boards in creating citizen advisory committees, including procedures for
47.5selection of committee members.
47.6    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
47.7control error rates for the aid to families with dependent children program formerly
47.8codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
47.9following manner:
47.10    (1) one-half of the total amount of the disallowance shall be borne by the county
47.11boards responsible for administering the programs. For the medical assistance and the
47.12AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
47.13shared by each county board in the same proportion as that county's expenditures for the
47.14sanctioned program are to the total of all counties' expenditures for the AFDC program
47.15formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
47.16food stamp program, sanctions shall be shared by each county board, with 50 percent of
47.17the sanction being distributed to each county in the same proportion as that county's
47.18administrative costs for food stamps are to the total of all food stamp administrative costs
47.19for all counties, and 50 percent of the sanctions being distributed to each county in the
47.20same proportion as that county's value of food stamp benefits issued are to the total of
47.21all benefits issued for all counties. Each county shall pay its share of the disallowance
47.22to the state of Minnesota. When a county fails to pay the amount due hereunder, the
47.23commissioner may deduct the amount from reimbursement otherwise due the county, or
47.24the attorney general, upon the request of the commissioner, may institute civil action
47.25to recover the amount due; and
47.26    (2) notwithstanding the provisions of clause (1), if the disallowance results from
47.27knowing noncompliance by one or more counties with a specific program instruction, and
47.28that knowing noncompliance is a matter of official county board record, the commissioner
47.29may require payment or recover from the county or counties, in the manner prescribed in
47.30clause (1), an amount equal to the portion of the total disallowance which resulted from the
47.31noncompliance, and may distribute the balance of the disallowance according to clause (1).
47.32    (o) Develop and implement special projects that maximize reimbursements and
47.33result in the recovery of money to the state. For the purpose of recovering state money,
47.34the commissioner may enter into contracts with third parties. Any recoveries that result
47.35from projects or contracts entered into under this paragraph shall be deposited in the
47.36state treasury and credited to a special account until the balance in the account reaches
48.1$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
48.2transferred and credited to the general fund. All money in the account is appropriated to
48.3the commissioner for the purposes of this paragraph.
48.4    (p) Have the authority to make direct payments to facilities providing shelter
48.5to women and their children according to section 256D.05, subdivision 3. Upon
48.6the written request of a shelter facility that has been denied payments under section
48.7256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
48.8a determination within 30 days of the request for review regarding issuance of direct
48.9payments to the shelter facility. Failure to act within 30 days shall be considered a
48.10determination not to issue direct payments.
48.11    (q) Have the authority to establish and enforce the following county reporting
48.12requirements:
48.13    (1) the commissioner shall establish fiscal and statistical reporting requirements
48.14necessary to account for the expenditure of funds allocated to counties for human
48.15services programs. When establishing financial and statistical reporting requirements, the
48.16commissioner shall evaluate all reports, in consultation with the counties, to determine if
48.17the reports can be simplified or the number of reports can be reduced;
48.18    (2) the county board shall submit monthly or quarterly reports to the department
48.19as required by the commissioner. Monthly reports are due no later than 15 working days
48.20after the end of the month. Quarterly reports are due no later than 30 calendar days after
48.21the end of the quarter, unless the commissioner determines that the deadline must be
48.22shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
48.23or risking a loss of federal funding. Only reports that are complete, legible, and in the
48.24required format shall be accepted by the commissioner;
48.25    (3) if the required reports are not received by the deadlines established in clause (2),
48.26the commissioner may delay payments and withhold funds from the county board until
48.27the next reporting period. When the report is needed to account for the use of federal
48.28funds and the late report results in a reduction in federal funding, the commissioner shall
48.29withhold from the county boards with late reports an amount equal to the reduction in
48.30federal funding until full federal funding is received;
48.31    (4) a county board that submits reports that are late, illegible, incomplete, or not
48.32in the required format for two out of three consecutive reporting periods is considered
48.33noncompliant. When a county board is found to be noncompliant, the commissioner
48.34shall notify the county board of the reason the county board is considered noncompliant
48.35and request that the county board develop a corrective action plan stating how the
48.36county board plans to correct the problem. The corrective action plan must be submitted
49.1to the commissioner within 45 days after the date the county board received notice
49.2of noncompliance;
49.3    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
49.4after the date the report was originally due. If the commissioner does not receive a report
49.5by the final deadline, the county board forfeits the funding associated with the report for
49.6that reporting period and the county board must repay any funds associated with the
49.7report received for that reporting period;
49.8    (6) the commissioner may not delay payments, withhold funds, or require repayment
49.9under clause (3) or (5) if the county demonstrates that the commissioner failed to
49.10provide appropriate forms, guidelines, and technical assistance to enable the county to
49.11comply with the requirements. If the county board disagrees with an action taken by the
49.12commissioner under clause (3) or (5), the county board may appeal the action according
49.13to sections 14.57 to 14.69; and
49.14    (7) counties subject to withholding of funds under clause (3) or forfeiture or
49.15repayment of funds under clause (5) shall not reduce or withhold benefits or services to
49.16clients to cover costs incurred due to actions taken by the commissioner under clause
49.17(3) or (5).
49.18    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
49.19federal fiscal disallowances or sanctions are based on a statewide random sample in direct
49.20proportion to each county's claim for that period.
49.21    (s) Be responsible for ensuring the detection, prevention, investigation, and
49.22resolution of fraudulent activities or behavior by applicants, recipients, and other
49.23participants in the human services programs administered by the department.
49.24    (t) Require county agencies to identify overpayments, establish claims, and utilize
49.25all available and cost-beneficial methodologies to collect and recover these overpayments
49.26in the human services programs administered by the department.
49.27    (u) Have the authority to administer a drug rebate program for drugs purchased
49.28pursuant to the prescription drug program established under section 256.955 after the
49.29beneficiary's satisfaction of any deductible established in the program. The commissioner
49.30shall require a rebate agreement from all manufacturers of covered drugs as defined in
49.31section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
49.32or after July 1, 2002, must include rebates for individuals covered under the prescription
49.33drug program who are under 65 years of age. For each drug, the amount of the rebate shall
49.34be equal to the rebate as defined for purposes of the federal rebate program in United
49.35States Code, title 42, section 1396r-8. The manufacturers must provide full payment
49.36within 30 days of receipt of the state invoice for the rebate within the terms and conditions
50.1used for the federal rebate program established pursuant to section 1927 of title XIX of
50.2the Social Security Act. The manufacturers must provide the commissioner with any
50.3information necessary to verify the rebate determined per drug. The rebate program shall
50.4utilize the terms and conditions used for the federal rebate program established pursuant to
50.5section 1927 of title XIX of the Social Security Act.
50.6    (v) Have the authority to administer the federal drug rebate program for drugs
50.7purchased under the medical assistance program as allowed by section 1927 of title XIX
50.8of the Social Security Act and according to the terms and conditions of section 1927.
50.9Rebates shall be collected for all drugs that have been dispensed or administered in an
50.10outpatient setting and that are from manufacturers who have signed a rebate agreement
50.11with the United States Department of Health and Human Services.
50.12    (w) Have the authority to administer a supplemental drug rebate program for drugs
50.13purchased under the medical assistance program. The commissioner may enter into
50.14supplemental rebate contracts with pharmaceutical manufacturers and may require prior
50.15authorization for drugs that are from manufacturers that have not signed a supplemental
50.16rebate contract. Prior authorization of drugs shall be subject to the provisions of section
50.17256B.0625, subdivision 13 .
50.18    (x) Operate the department's communication systems account established in Laws
50.191993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
50.20communication costs necessary for the operation of the programs the commissioner
50.21supervises. A communications account may also be established for each regional
50.22treatment center which operates communications systems. Each account must be used
50.23to manage shared communication costs necessary for the operations of the programs the
50.24commissioner supervises. The commissioner may distribute the costs of operating and
50.25maintaining communication systems to participants in a manner that reflects actual usage.
50.26Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
50.27other costs as determined by the commissioner. Nonprofit organizations and state, county,
50.28and local government agencies involved in the operation of programs the commissioner
50.29supervises may participate in the use of the department's communications technology and
50.30share in the cost of operation. The commissioner may accept on behalf of the state any
50.31gift, bequest, devise or personal property of any kind, or money tendered to the state for
50.32any lawful purpose pertaining to the communication activities of the department. Any
50.33money received for this purpose must be deposited in the department's communication
50.34systems accounts. Money collected by the commissioner for the use of communication
50.35systems must be deposited in the state communication systems account and is appropriated
50.36to the commissioner for purposes of this section.
51.1    (y) Receive any federal matching money that is made available through the medical
51.2assistance program for the consumer satisfaction survey. Any federal money received for
51.3the survey is appropriated to the commissioner for this purpose. The commissioner may
51.4expend the federal money received for the consumer satisfaction survey in either year of
51.5the biennium.
51.6    (z) Designate community information and referral call centers and incorporate
51.7cost reimbursement claims from the designated community information and referral
51.8call centers into the federal cost reimbursement claiming processes of the department
51.9according to federal law, rule, and regulations. Existing information and referral centers
51.10provided by Greater Twin Cities United Way or existing call centers for which Greater
51.11Twin Cities United Way has legal authority to represent, shall be included in these
51.12designations upon review by the commissioner and assurance that these services are
51.13accredited and in compliance with national standards. Any reimbursement is appropriated
51.14to the commissioner and all designated information and referral centers shall receive
51.15payments according to normal department schedules established by the commissioner
51.16upon final approval of allocation methodologies from the United States Department of
51.17Health and Human Services Division of Cost Allocation or other appropriate authorities.
51.18    (aa) Develop recommended standards for foster care homes that address the
51.19components of specialized therapeutic services to be provided by foster care homes with
51.20those services.
51.21    (bb) Authorize the method of payment to or from the department as part of the
51.22human services programs administered by the department. This authorization includes the
51.23receipt or disbursement of funds held by the department in a fiduciary capacity as part of
51.24the human services programs administered by the department.
51.25    (cc) Have the authority to administer a drug rebate program for drugs purchased for
51.26persons eligible for general assistance medical care under section 256D.03, subdivision 3.
51.27For manufacturers that agree to participate in the general assistance medical care rebate
51.28program, the commissioner shall enter into a rebate agreement for covered drugs as
51.29defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
51.30rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
51.31United States Code, title 42, section 1396r-8. The manufacturers must provide payment
51.32within the terms and conditions used for the federal rebate program established under
51.33section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
51.34the terms and conditions used for the federal rebate program established under section
51.351927 of title XIX of the Social Security Act.
52.1    Effective January 1, 2006, drug coverage under general assistance medical care shall
52.2be limited to those prescription drugs that:
52.3    (1) are covered under the medical assistance program as described in section
52.4256B.0625, subdivisions 13 and 13d ; and
52.5    (2) are provided by manufacturers that have fully executed general assistance
52.6medical care rebate agreements with the commissioner and comply with such agreements.
52.7Prescription drug coverage under general assistance medical care shall conform to
52.8coverage under the medical assistance program according to section 256B.0625,
52.9subdivisions 13 to 13g .
52.10    The rebate revenues collected under the drug rebate program are deposited in the
52.11general fund.
52.12(dd) Designate the agencies that operate the Senior LinkAge Line under section
52.13256.975, subdivision 7, and the Disability Linkage Line under subdivision 24 as the state
52.14of Minnesota Aging and the Disability Resource Centers under United States Code, title
52.1542, section 3001, the Older Americans Act Amendments of 2006 and incorporate cost
52.16reimbursement claims from the designated centers into the federal cost reimbursement
52.17claiming processes of the department according to federal law, rule, and regulations. Any
52.18reimbursement must be appropriated to the commissioner and all Aging and Disability
52.19Resource Center designated agencies shall receive payments of grant funding that supports
52.20the activity and generates the federal financial participation according to Board on Aging
52.21administrative granting mechanisms.

52.22    Sec. 5. Minnesota Statutes 2012, section 256.01, subdivision 24, is amended to read:
52.23    Subd. 24. Disability Linkage Line. The commissioner shall establish the Disability
52.24Linkage Line, to who shall serve people with disabilities as the designated Aging and
52.25Disability Resource Center under United States Code, title 42, section 3001, the Older
52.26Americans Act Amendments of 2006 in partnership with the Senior LinkAge Line and
52.27shall serve as Minnesota's neutral access point for statewide disability information and
52.28assistance and must be available during business hours through a statewide toll-free
52.29number and the internet. The Disability Linkage Line shall:
52.30(1) deliver information and assistance based on national and state standards;
52.31    (2) provide information about state and federal eligibility requirements, benefits,
52.32and service options;
52.33(3) provide benefits and options counseling;
52.34    (4) make referrals to appropriate support entities;
53.1    (5) educate people on their options so they can make well-informed choices and link
53.2them to quality profiles;
53.3    (6) help support the timely resolution of service access and benefit issues;
53.4(7) inform people of their long-term community services and supports;
53.5(8) provide necessary resources and supports that can lead to employment and
53.6increased economic stability of people with disabilities; and
53.7(9) serve as the technical assistance and help center for the Web-based tool,
53.8Minnesota's Disability Benefits 101.org.; and
53.9(10) provide preadmission screening for individuals under 60 years of age using
53.10the procedures as defined in section 256.975, subdivisions 7a to 7c, and 256B.0911,
53.11subdivision 4d.

53.12    Sec. 6. Minnesota Statutes 2012, section 256.975, subdivision 7, is amended to read:
53.13    Subd. 7. Consumer information and assistance and long-term care options
53.14counseling; Senior LinkAge Line. (a) The Minnesota Board on Aging shall operate a
53.15statewide service to aid older Minnesotans and their families in making informed choices
53.16about long-term care options and health care benefits. Language services to persons
53.17with limited English language skills may be made available. The service, known as
53.18Senior LinkAge Line, shall serve older adults as the designated Aging and Disability
53.19Resource Center under United States Code, title 42, section 3001, the Older Americans
53.20Act Amendments of 2006 in partnership with the Disability LinkAge Line under section
53.21256.01, subdivision 24, and must be available during business hours through a statewide
53.22toll-free number and must also be available through the Internet. The Minnesota Board
53.23on Aging shall consult with, and when appropriate work through, the area agencies on
53.24aging to provide and maintain the telephony infrastructure and related support for the
53.25Aging and Disability Resource Center partners which agree by memorandum to access
53.26the infrastructure, including the designated providers of the Senior LinkAge Line and the
53.27Disability Linkage Line.
53.28    (b) The service must provide long-term care options counseling by assisting older
53.29adults, caregivers, and providers in accessing information and options counseling about
53.30choices in long-term care services that are purchased through private providers or available
53.31through public options. The service must:
53.32    (1) develop a comprehensive database that includes detailed listings in both
53.33consumer- and provider-oriented formats;
53.34    (2) make the database accessible on the Internet and through other telecommunication
53.35and media-related tools;
54.1    (3) link callers to interactive long-term care screening tools and make these tools
54.2available through the Internet by integrating the tools with the database;
54.3    (4) develop community education materials with a focus on planning for long-term
54.4care and evaluating independent living, housing, and service options;
54.5    (5) conduct an outreach campaign to assist older adults and their caregivers in
54.6finding information on the Internet and through other means of communication;
54.7    (6) implement a messaging system for overflow callers and respond to these callers
54.8by the next business day;
54.9    (7) link callers with county human services and other providers to receive more
54.10in-depth assistance and consultation related to long-term care options;
54.11    (8) link callers with quality profiles for nursing facilities and other home and
54.12community-based services providers developed by the commissioner commissioners of
54.13health and human services;
54.14    (9) incorporate information about the availability of housing options, as well as
54.15registered housing with services and consumer rights within the MinnesotaHelp.info
54.16network long-term care database to facilitate consumer comparison of services and costs
54.17among housing with services establishments and with other in-home services and to
54.18support financial self-sufficiency as long as possible. Housing with services establishments
54.19and their arranged home care providers shall provide information that will facilitate price
54.20comparisons, including delineation of charges for rent and for services available. The
54.21commissioners of health and human services shall align the data elements required by
54.22section 144G.06, the Uniform Consumer Information Guide, and this section to provide
54.23consumers standardized information and ease of comparison of long-term care options.
54.24The commissioner of human services shall provide the data to the Minnesota Board on
54.25Aging for inclusion in the MinnesotaHelp.info network long-term care database;
54.26(10) provide long-term care options counseling. Long-term care options counselors
54.27shall:
54.28(i) for individuals not eligible for case management under a public program or public
54.29funding source, provide interactive decision support under which consumers, family
54.30members, or other helpers are supported in their deliberations to determine appropriate
54.31long-term care choices in the context of the consumer's needs, preferences, values, and
54.32individual circumstances, including implementing a community support plan;
54.33(ii) provide Web-based educational information and collateral written materials to
54.34familiarize consumers, family members, or other helpers with the long-term care basics,
54.35issues to be considered, and the range of options available in the community;
55.1(iii) provide long-term care futures planning, which means providing assistance to
55.2individuals who anticipate having long-term care needs to develop a plan for the more
55.3distant future; and
55.4(iv) provide expertise in benefits and financing options for long-term care, including
55.5Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
55.6private pay options, and ways to access low or no-cost services or benefits through
55.7volunteer-based or charitable programs;
55.8(11) using risk management and support planning protocols, provide long-term care
55.9options counseling to current residents of nursing homes deemed appropriate for discharge
55.10by the commissioner and older adults who request service after consultation with the
55.11Senior LinkAge Line under clause (12). In order to meet this requirement, The Senior
55.12LinkAge Line shall also receive referrals from the residents or staff of nursing homes. The
55.13Senior LinkAge Line shall identify and contact residents deemed appropriate for discharge
55.14by developing targeting criteria in consultation with the commissioner who shall provide
55.15designated Senior LinkAge Line contact centers with a list of nursing home residents that
55.16meet the criteria as being appropriate for discharge planning via a secure Web portal.
55.17Senior LinkAge Line shall provide these residents, if they indicate a preference to
55.18receive long-term care options counseling, with initial assessment, review of risk factors,
55.19independent living support consultation, or and, if appropriate, a referral to:
55.20(i) long-term care consultation services under section 256B.0911;
55.21(ii) designated care coordinators of contracted entities under section 256B.035 for
55.22persons who are enrolled in a managed care plan; or
55.23(iii) the long-term care consultation team for those who are appropriate eligible
55.24 for relocation service coordination due to high-risk factors or psychological or physical
55.25disability; and
55.26(12) develop referral protocols and processes that will assist certified health care
55.27homes and hospitals to identify at-risk older adults and determine when to refer these
55.28individuals to the Senior LinkAge Line for long-term care options counseling under this
55.29section. The commissioner is directed to work with the commissioner of health to develop
55.30protocols that would comply with the health care home designation criteria and protocols
55.31available at the time of hospital discharge. The commissioner shall keep a record of the
55.32number of people who choose long-term care options counseling as a result of this section.

55.33    Sec. 7. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
55.34to read:
56.1    Subd. 7a. Preadmission screening activities related to nursing facility
56.2admissions. (a) All individuals seeking admission to Medicaid certified nursing facilities,
56.3including certified boarding care facilities, must be screened prior to admission regardless
56.4of income, assets, or funding sources for nursing facility care, except as described in
56.5subdivision 7b, paragraphs (a) and (b). The purpose of the screening is to determine the
56.6need for nursing facility level of care as described in section 256B.0911, subdivision
56.74e, and to complete activities required under federal law related to mental illness and
56.8developmental disability as outlined in paragraph (b).
56.9(b) A person who has a diagnosis or possible diagnosis of mental illness or
56.10developmental disability must receive a preadmission screening before admission
56.11regardless of the exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify
56.12the need for further evaluation and specialized services, unless the admission prior to
56.13screening is authorized by the local mental health authority or the local developmental
56.14disabilities case manager, or unless authorized by the county agency according to Public
56.15Law 101-508.
56.16(c) The following criteria apply to the preadmission screening:
56.17(1) requests for preadmission screenings must be submitted via an online form
56.18developed by the commissioner;
56.19(2) the Senior LinkAge Line must use forms and criteria developed by the
56.20commissioner to identify persons who require referral for further evaluation and
56.21determination of the need for specialized services; and
56.22(3) the evaluation and determination of the need for specialized services must be
56.23done by:
56.24(i) a qualified independent mental health professional, for persons with a primary or
56.25secondary diagnosis of a serious mental illness; or
56.26(ii) a qualified developmental disability professional, for persons with a primary or
56.27secondary diagnosis of developmental disability. For purposes of this requirement, a
56.28qualified developmental disability professional must meet the standards for a qualified
56.29developmental disability professional under Code of Federal Regulations, title 42, section
56.30483.430.
56.31(d) The local county mental health authority or the state developmental disability
56.32authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
56.33nursing facility if the individual does not meet the nursing facility level of care criteria or
56.34needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
56.35purposes of this section, "specialized services" for a person with developmental disability
57.1means active treatment as that term is defined under Code of Federal Regulations, title
57.242, section 483.440(a)(1).
57.3(e) In assessing a person's needs, the screener shall:
57.4(1) use an automated system designated by the commissioner;
57.5(2) consult with care transitions coordinators or physician; and
57.6(3) consider the assessment of the individual's physician.
57.7Other personnel may be included in the level of care determination as deemed
57.8necessary by the screener.
57.9EFFECTIVE DATE.This section is effective October 1, 2013.

57.10    Sec. 8. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
57.11to read:
57.12    Subd. 7b. Exemptions and emergency admissions. (a) Exemptions from the federal
57.13screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:
57.14(1) a person who, having entered an acute care facility from a certified nursing
57.15facility, is returning to a certified nursing facility; or
57.16(2) a person transferring from one certified nursing facility in Minnesota to another
57.17certified nursing facility in Minnesota.
57.18(b) Persons who are exempt from preadmission screening for purposes of level of
57.19care determination include:
57.20(1) persons described in paragraph (a);
57.21(2) an individual who has a contractual right to have nursing facility care paid for
57.22indefinitely by the Veterans' Administration;
57.23(3) an individual enrolled in a demonstration project under section 256B.69,
57.24subdivision 8, at the time of application to a nursing facility; and
57.25(4) an individual currently being served under the alternative care program or under
57.26a home and community-based services waiver authorized under section 1915(c) of the
57.27federal Social Security Act.
57.28(c) Persons admitted to a Medicaid-certified nursing facility from the community
57.29on an emergency basis as described in paragraph (d) or from an acute care facility on a
57.30nonworking day must be screened the first working day after admission.
57.31(d) Emergency admission to a nursing facility prior to screening is permitted when
57.32all of the following conditions are met:
57.33(1) a person is admitted from the community to a certified nursing or certified
57.34boarding care facility during Senior LinkAge Line nonworking hours for ages 60 and
57.35older and Disability Linkage Line nonworking hours for under age 60;
58.1(2) a physician has determined that delaying admission until preadmission screening
58.2is completed would adversely affect the person's health and safety;
58.3(3) there is a recent precipitating event that precludes the client from living safely in
58.4the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
58.5inability to continue to provide care;
58.6(4) the attending physician has authorized the emergency placement and has
58.7documented the reason that the emergency placement is recommended; and
58.8(5) the Senior LinkAge Line or Disability Linkage Line is contacted on the first
58.9working day following the emergency admission.
58.10Transfer of a patient from an acute care hospital to a nursing facility is not considered
58.11an emergency except for a person who has received hospital services in the following
58.12situations: hospital admission for observation, care in an emergency room without hospital
58.13admission, or following hospital 24-hour bed care and from whom admission is being
58.14sought on a nonworking day.
58.15(e) A nursing facility must provide written information to all persons admitted
58.16regarding the person's right to request and receive long-term care consultation services as
58.17defined in section 256B.0911, subdivision 1a. The information must be provided prior to
58.18the person's discharge from the facility and in a format specified by the commissioner.
58.19EFFECTIVE DATE.This section is effective October 1, 2013.

58.20    Sec. 9. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
58.21to read:
58.22    Subd. 7c. Screening requirements. (a) A person may be screened for nursing
58.23facility admission by telephone or in a face-to-face screening interview. The Senior
58.24LinkAge Line shall identify each individual's needs using the following categories:
58.25(1) the person needs no face-to-face long-term care consultation assessment
58.26completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or
58.27managed care organization under contract with the Department of Human Services to
58.28determine the need for nursing facility level of care based on information obtained from
58.29other health care professionals;
58.30(2) the person needs an immediate face-to-face long-term care consultation
58.31assessment completed under section 256B.0911, subdivision 3a, 3b, or 4d, by a county,
58.32tribe, or managed care organization under contract with the Department of Human
58.33Services to determine the need for nursing facility level of care and complete activities
58.34required under subdivision 7a; or
59.1(3) the person may be exempt from screening requirements as outlined in subdivision
59.27b, but will need transitional assistance after admission or in-person follow-along after
59.3a return home.
59.4(b) Individuals between the ages of 60 and 64 who are admitted to nursing facilities
59.5with only a telephone screening must receive a face-to-face assessment from the long-term
59.6care consultation team member of the county in which the facility is located or from the
59.7recipient's county case manager within 40 calendar days of admission as described in
59.8section 256B.0911, subdivision 4d, paragraph (c).
59.9(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
59.10facility must be screened prior to admission.
59.11(d) Screenings provided by the Senior LinkAge Line must include processes
59.12to identify persons who may require transition assistance described in subdivision 7,
59.13paragraph (b), clause (12), and section 256B.0911, subdivision 3b.
59.14EFFECTIVE DATE.This section is effective October 1, 2013.

59.15    Sec. 10. Minnesota Statutes 2012, section 256.975, is amended by adding a subdivision
59.16to read:
59.17    Subd. 7d. Payment for preadmission screening. Funding for preadmission
59.18screening shall be provided to the Minnesota Board on Aging for the population 60
59.19years of age and older by the Department of Human Services to cover screener salaries
59.20and expenses to provide the services described in subdivisions 7a to 7c. The Minnesota
59.21Board on Aging shall employ, or contract with other agencies to employ, within the limits
59.22of available funding, sufficient personnel to provide preadmission screening and level of
59.23care determination services and shall seek to maximize federal funding for the service as
59.24provided under section 256.01, subdivision 2, paragraph (dd).
59.25EFFECTIVE DATE.This section is effective October 1, 2013.

59.26    Sec. 11. Minnesota Statutes 2012, section 256.9754, is amended by adding a
59.27subdivision to read:
59.28    Subd. 3a. Priority for other grants. The commissioner of health shall give
59.29priority to a grantee selected under subdivision 3 when awarding technology-related
59.30grants, if the grantee is using technology as a part of a proposal. The commissioner
59.31of transportation shall give priority to a grantee selected under subdivision 3 when
59.32distributing transportation-related funds to create transportation options for older adults.

60.1    Sec. 12. Minnesota Statutes 2012, section 256.9754, is amended by adding a
60.2subdivision to read:
60.3    Subd. 3b. State waivers. The commissioner of health may waive applicable state
60.4laws and rules on a time-limited basis if the commissioner of health determines that a
60.5participating grantee requires a waiver in order to achieve demonstration project goals.

60.6    Sec. 13. Minnesota Statutes 2012, section 256.9754, subdivision 5, is amended to read:
60.7    Subd. 5. Grant preference. The commissioner of human services shall give
60.8preference when awarding grants under this section to areas where nursing facility
60.9closures have occurred or are occurring or areas with service needs identified by section
60.10144A.351. The commissioner may award grants to the extent grant funds are available
60.11and to the extent applications are approved by the commissioner. Denial of approval of an
60.12application in one year does not preclude submission of an application in a subsequent
60.13year. The maximum grant amount is limited to $750,000.

60.14    Sec. 14. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.15subdivision to read:
60.16    Subd. 4a. Evaluation. The commissioner shall evaluate the projects contained in
60.17subdivision 4, paragraphs (f), clauses (2) and (12), and (h). The evaluation must include:
60.18(1) an impact assessment focusing on program outcomes, especially those
60.19experienced directly by the person receiving services;
60.20(2) study samples drawn from the population of interest for each project; and
60.21(3) a time series analysis to examine aggregate trends in average monthly
60.22utilization, expenditures, and other outcomes in the targeted populations before and after
60.23implementation of the initiatives.

60.24    Sec. 15. Minnesota Statutes 2012, section 256B.021, is amended by adding a
60.25subdivision to read:
60.26    Subd. 6. Work, empower, and encourage independence. As provided under
60.27subdivision 4, paragraph (e), upon federal approval, the commissioner shall establish a
60.28demonstration project to provide navigation, employment supports, and benefits planning
60.29services to a targeted group of federally funded Medicaid recipients to begin July 1, 2014.
60.30This demonstration shall promote economic stability, increase independence, and reduce
60.31applications for disability benefits while providing a positive impact on the health and
60.32future of participants.

61.1    Sec. 16. Minnesota Statutes 2012, section 256B.021, is amended by adding a
61.2subdivision to read:
61.3    Subd. 7. Housing stabilization. As provided under subdivision 4, paragraph (e),
61.4upon federal approval, the commissioner shall establish a demonstration project to provide
61.5service coordination, outreach, in-reach, tenancy support, and community living assistance
61.6to a targeted group of federally funded Medicaid recipients to begin January 1, 2014. This
61.7demonstration shall promote housing stability, reduce costly medical interventions, and
61.8increase opportunities for independent community living.

61.9    Sec. 17. Minnesota Statutes 2012, section 256B.0911, subdivision 1, is amended to read:
61.10    Subdivision 1. Purpose and goal. (a) The purpose of long-term care consultation
61.11services is to assist persons with long-term or chronic care needs in making care
61.12decisions and selecting support and service options that meet their needs and reflect
61.13their preferences. The availability of, and access to, information and other types of
61.14assistance, including assessment and support planning, is also intended to prevent or delay
61.15institutional placements and to provide access to transition assistance after admission.
61.16Further, the goal of these services is to contain costs associated with unnecessary
61.17institutional admissions. Long-term consultation services must be available to any person
61.18regardless of public program eligibility. The commissioner of human services shall seek
61.19to maximize use of available federal and state funds and establish the broadest program
61.20possible within the funding available.
61.21(b) These services must be coordinated with long-term care options counseling
61.22provided under subdivision 4d, section 256.975, subdivision subdivisions 7 to 7c, and
61.23section 256.01, subdivision 24. The lead agency providing long-term care consultation
61.24services shall encourage the use of volunteers from families, religious organizations, social
61.25clubs, and similar civic and service organizations to provide community-based services.

61.26    Sec. 18. Minnesota Statutes 2012, section 256B.0911, subdivision 1a, is amended to
61.27read:
61.28    Subd. 1a. Definitions. For purposes of this section, the following definitions apply:
61.29    (a) Until additional requirements apply under paragraph (b), "long-term care
61.30consultation services" means:
61.31    (1) intake for and access to assistance in identifying services needed to maintain an
61.32individual in the most inclusive environment;
61.33    (2) providing recommendations for and referrals to cost-effective community
61.34services that are available to the individual;
62.1    (3) development of an individual's person-centered community support plan;
62.2    (4) providing information regarding eligibility for Minnesota health care programs;
62.3    (5) face-to-face long-term care consultation assessments, which may be completed
62.4in a hospital, nursing facility, intermediate care facility for persons with developmental
62.5disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
62.6residence;
62.7    (6) federally mandated preadmission screening activities described under
62.8subdivisions 4a and 4b;
62.9    (7) (6) determination of home and community-based waiver and other service
62.10eligibility as required under sections 256B.0913, 256B.0915, and 256B.49, including level
62.11of care determination for individuals who need an institutional level of care as determined
62.12under section 256B.0911, subdivision 4a, paragraph (d) 4e, based on assessment and
62.13community support plan development, appropriate referrals to obtain necessary diagnostic
62.14information, and including an eligibility determination for consumer-directed community
62.15supports;
62.16    (8) (7) providing recommendations for institutional placement when there are no
62.17cost-effective community services available;
62.18    (9) (8) providing access to assistance to transition people back to community settings
62.19after institutional admission; and
62.20(10) (9) providing information about competitive employment, with or without
62.21supports, for school-age youth and working-age adults and referrals to the Disability
62.22Linkage Line and Disability Benefits 101 to ensure that an informed choice about
62.23competitive employment can be made. For the purposes of this subdivision, "competitive
62.24employment" means work in the competitive labor market that is performed on a full-time
62.25or part-time basis in an integrated setting, and for which an individual is compensated at or
62.26above the minimum wage, but not less than the customary wage and level of benefits paid
62.27by the employer for the same or similar work performed by individuals without disabilities.
62.28(b) Upon statewide implementation of lead agency requirements in subdivisions 2b,
62.292c, and 3a, "long-term care consultation services" also means:
62.30(1) service eligibility determination for state plan home care services identified in:
62.31(i) section 256B.0625, subdivisions 7, 19a, and 19c;
62.32(ii) section 256B.0657; or
62.33(iii) consumer support grants under section 256.476;
62.34(2) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
62.35determination of eligibility for case management services available under sections
63.1256B.0621, subdivision 2 , paragraph (4), and 256B.0924 and Minnesota Rules, part
63.29525.0016;
63.3(3) determination of institutional level of care, home and community-based service
63.4waiver, and other service eligibility as required under section 256B.092, determination
63.5of eligibility for family support grants under section 252.32, semi-independent living
63.6services under section 252.275, and day training and habilitation services under section
63.7256B.092 ; and
63.8(4) obtaining necessary diagnostic information to determine eligibility under clauses
63.9(2) and (3).
63.10    (c) "Long-term care options counseling" means the services provided by the linkage
63.11lines as mandated by sections 256.01, subdivision 24, and 256.975, subdivision 7, and
63.12also includes telephone assistance and follow up once a long-term care consultation
63.13assessment has been completed.
63.14    (d) "Minnesota health care programs" means the medical assistance program under
63.15chapter 256B and the alternative care program under section 256B.0913.
63.16    (e) "Lead agencies" means counties administering or tribes and health plans under
63.17contract with the commissioner to administer long-term care consultation assessment and
63.18support planning services.

63.19    Sec. 19. Minnesota Statutes 2012, section 256B.0911, subdivision 3a, is amended to
63.20read:
63.21    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
63.22services planning, or other assistance intended to support community-based living,
63.23including persons who need assessment in order to determine waiver or alternative care
63.24program eligibility, must be visited by a long-term care consultation team within 20
63.25calendar days after the date on which an assessment was requested or recommended.
63.26Upon statewide implementation of subdivisions 2b, 2c, and 5, this requirement also
63.27applies to an assessment of a person requesting personal care assistance services and
63.28private duty nursing. The commissioner shall provide at least a 90-day notice to lead
63.29agencies prior to the effective date of this requirement. Face-to-face assessments must be
63.30conducted according to paragraphs (b) to (i).
63.31    (b) The lead agency may utilize a team of either the social worker or public health
63.32nurse, or both. Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall
63.33use certified assessors to conduct the assessment. The consultation team members must
63.34confer regarding the most appropriate care for each individual screened or assessed. For
64.1a person with complex health care needs, a public health or registered nurse from the
64.2team must be consulted.
64.3    (c) The assessment must be comprehensive and include a person-centered assessment
64.4of the health, psychological, functional, environmental, and social needs of referred
64.5individuals and provide information necessary to develop a community support plan that
64.6meets the consumers needs, using an assessment form provided by the commissioner.
64.7    (d) The assessment must be conducted in a face-to-face interview with the person
64.8being assessed and the person's legal representative, and other individuals as requested by
64.9the person, who can provide information on the needs, strengths, and preferences of the
64.10person necessary to develop a community support plan that ensures the person's health and
64.11safety, but who is not a provider of service or has any financial interest in the provision
64.12of services. For persons who are to be assessed for elderly waiver customized living
64.13services under section 256B.0915, with the permission of the person being assessed or
64.14the person's designated or legal representative, the client's current or proposed provider
64.15of services may submit a copy of the provider's nursing assessment or written report
64.16outlining its recommendations regarding the client's care needs. The person conducting
64.17the assessment will notify the provider of the date by which this information is to be
64.18submitted. This information shall be provided to the person conducting the assessment
64.19prior to the assessment.
64.20    (e) If the person chooses to use community-based services, the person or the person's
64.21legal representative must be provided with a written community support plan within 40
64.22calendar days of the assessment visit, regardless of whether the individual is eligible for
64.23Minnesota health care programs. The written community support plan must include:
64.24(1) a summary of assessed needs as defined in paragraphs (c) and (d);
64.25(2) the individual's options and choices to meet identified needs, including all
64.26available options for case management services and providers;
64.27(3) identification of health and safety risks and how those risks will be addressed,
64.28including personal risk management strategies;
64.29(4) referral information; and
64.30(5) informal caregiver supports, if applicable.
64.31For a person determined eligible for state plan home care under subdivision 1a,
64.32paragraph (b), clause (1), the person or person's representative must also receive a copy of
64.33the home care service plan developed by the certified assessor.
64.34(f) A person may request assistance in identifying community supports without
64.35participating in a complete assessment. Upon a request for assistance identifying
64.36community support, the person must be transferred or referred to long-term care options
65.1counseling services available under sections 256.975, subdivision 7, and 256.01,
65.2subdivision 24, for telephone assistance and follow up.
65.3    (g) The person has the right to make the final decision between institutional
65.4placement and community placement after the recommendations have been provided,
65.5except as provided in section 256.975, subdivision 4a, paragraph (c) 7a, paragraph (d).
65.6    (h) The lead agency must give the person receiving assessment or support planning,
65.7or the person's legal representative, materials, and forms supplied by the commissioner
65.8containing the following information:
65.9    (1) written recommendations for community-based services and consumer-directed
65.10options;
65.11(2) documentation that the most cost-effective alternatives available were offered to
65.12the individual. For purposes of this clause, "cost-effective" means community services and
65.13living arrangements that cost the same as or less than institutional care. For an individual
65.14found to meet eligibility criteria for home and community-based service programs under
65.15section 256B.0915 or 256B.49, "cost-effectiveness" has the meaning found in the federally
65.16approved waiver plan for each program;
65.17(3) the need for and purpose of preadmission screening conducted by long-term
65.18care options counselors according to section 256.975, subdivisions 7a to 7c, and section
65.19256.01, subdivision 24, if the person selects nursing facility placement. If the individual
65.20selects nursing facility placement, the lead agency shall forward information needed to
65.21complete the level of care determinations and screening for developmental disability and
65.22mental illness collected during the assessment to the long-term care options counselor
65.23using forms provided by the commissioner;
65.24    (4) the role of long-term care consultation assessment and support planning in
65.25eligibility determination for waiver and alternative care programs, and state plan home
65.26care, case management, and other services as defined in subdivision 1a, paragraphs (a),
65.27clause (7), and (b);
65.28    (5) information about Minnesota health care programs;
65.29    (6) the person's freedom to accept or reject the recommendations of the team;
65.30    (7) the person's right to confidentiality under the Minnesota Government Data
65.31Practices Act, chapter 13;
65.32    (8) the certified assessor's decision regarding the person's need for institutional level
65.33of care as determined under criteria established in section 256B.0911, subdivision 4a,
65.34paragraph (d) 4e, and the certified assessor's decision regarding eligibility for all services
65.35and programs as defined in subdivision 1a, paragraphs (a), clause (7), and (b); and
66.1    (9) the person's right to appeal the certified assessor's decision regarding eligibility
66.2for all services and programs as defined in subdivision 1a, paragraphs (a), clause (7), and
66.3(b), and incorporating the decision regarding the need for institutional level of care or the
66.4lead agency's final decisions regarding public programs eligibility according to section
66.5256.045, subdivision 3 .
66.6    (i) Face-to-face assessment completed as part of eligibility determination for
66.7the alternative care, elderly waiver, community alternatives for disabled individuals,
66.8community alternative care, and brain injury waiver programs under sections 256B.0913,
66.9256B.0915 , and 256B.49 is valid to establish service eligibility for no more than 60
66.10calendar days after the date of assessment.
66.11(j) The effective eligibility start date for programs in paragraph (i) can never be
66.12prior to the date of assessment. If an assessment was completed more than 60 days
66.13before the effective waiver or alternative care program eligibility start date, assessment
66.14and support plan information must be updated in a face-to-face visit and documented in
66.15the department's Medicaid Management Information System (MMIS). Notwithstanding
66.16retroactive medical assistance coverage of state plan services, the effective date of
66.17eligibility for programs included in paragraph (i) cannot be prior to the date the most
66.18recent updated assessment is completed.

66.19    Sec. 20. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to
66.20read:
66.21    Subd. 4d. Preadmission screening of individuals under 65 60 years of age. (a)
66.22It is the policy of the state of Minnesota to ensure that individuals with disabilities or
66.23chronic illness are served in the most integrated setting appropriate to their needs and have
66.24the necessary information to make informed choices about home and community-based
66.25service options.
66.26    (b) Individuals under 65 60 years of age who are admitted to a Medicaid-certified
66.27 nursing facility from a hospital must be screened prior to admission as outlined in
66.28subdivisions 4a through 4c according to the requirements outlined in section 256.975,
66.29subdivisions 7a to 7c. This shall be provided by the Disability Linkage Line as required
66.30under section 256.01, subdivision 24.
66.31    (c) Individuals under 65 years of age who are admitted to nursing facilities with
66.32only a telephone screening must receive a face-to-face assessment from the long-term
66.33care consultation team member of the county in which the facility is located or from the
66.34recipient's county case manager within 40 calendar days of admission.
67.1    (d) Individuals under 65 years of age who are admitted to a nursing facility
67.2without preadmission screening according to the exemption described in subdivision 4b,
67.3paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
67.4a face-to-face assessment within 40 days of admission.
67.5    (e) (d) At the face-to-face assessment, the long-term care consultation team member
67.6or county case manager must perform the activities required under subdivision 3b.
67.7    (f) (e) For individuals under 21 years of age, a screening interview which
67.8recommends nursing facility admission must be face-to-face and approved by the
67.9commissioner before the individual is admitted to the nursing facility.
67.10    (g) (f) In the event that an individual under 65 60 years of age is admitted to a
67.11nursing facility on an emergency basis, the county Disability Linkage Line must be
67.12notified of the admission on the next working day, and a face-to-face assessment as
67.13described in paragraph (c) must be conducted within 40 calendar days of admission.
67.14    (h) (g) At the face-to-face assessment, the long-term care consultation team member
67.15or the case manager must present information about home and community-based options,
67.16including consumer-directed options, so the individual can make informed choices. If the
67.17individual chooses home and community-based services, the long-term care consultation
67.18team member or case manager must complete a written relocation plan within 20 working
67.19days of the visit. The plan shall describe the services needed to move out of the facility
67.20and a time line for the move which is designed to ensure a smooth transition to the
67.21individual's home and community.
67.22    (i) (h) An individual under 65 years of age residing in a nursing facility shall receive
67.23a face-to-face assessment at least every 12 months to review the person's service choices
67.24and available alternatives unless the individual indicates, in writing, that annual visits are
67.25not desired. In this case, the individual must receive a face-to-face assessment at least
67.26once every 36 months for the same purposes.
67.27    (j) (i) Notwithstanding the provisions of subdivision 6, the commissioner may pay
67.28county agencies directly for face-to-face assessments for individuals under 65 years of age
67.29who are being considered for placement or residing in a nursing facility.
67.30(j) Funding for preadmission screening shall be provided to the Disability Linkage
67.31Line for the under 60 population by the Department of Human Services to cover screener
67.32salaries and expenses to provide the services described in subdivisions 7a to 7c. The
67.33Disability Linkage Line shall employ, or contract with other agencies to employ, within
67.34the limits of available funding, sufficient personnel to provide preadmission screening and
67.35level of care determination services and shall seek to maximize federal funding for the
67.36service as provided under section 256.01, subdivision 2, paragraph (dd).
68.1EFFECTIVE DATE.This section is effective October 1, 2013.

68.2    Sec. 21. Minnesota Statutes 2012, section 256B.0911, is amended by adding a
68.3subdivision to read:
68.4    Subd. 4e. Determination of institutional level of care. The determination of the
68.5need for nursing facility, hospital, and intermediate care facility levels of care must be
68.6made according to criteria developed by the commissioner, and in section 256B.092,
68.7using forms developed by the commissioner. Effective January 1, 2014, for individuals
68.8age 21 and older, the determination of need for nursing facility level of care shall be
68.9based on criteria in section 144.0724, subdivision 11. For individuals under age 21, the
68.10determination of the need for nursing facility level of care must be made according to
68.11criteria developed by the commissioner until criteria in section 144.0724, subdivision 11,
68.12becomes effective on or after October 1, 2019.

68.13    Sec. 22. Minnesota Statutes 2012, section 256B.0911, subdivision 7, is amended to read:
68.14    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
68.15reimbursement for nursing facilities shall be authorized for a medical assistance recipient
68.16only if a preadmission screening has been conducted prior to admission or the county has
68.17authorized an exemption. Medical assistance reimbursement for nursing facilities shall
68.18not be provided for any recipient who the local screener has determined does not meet the
68.19level of care criteria for nursing facility placement in section 144.0724, subdivision 11, or,
68.20if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
68.21Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
68.22mental illness is approved by the local mental health authority or an admission for a
68.23recipient with developmental disability is approved by the state developmental disability
68.24authority.
68.25    (b) The nursing facility must not bill a person who is not a medical assistance
68.26recipient for resident days that preceded the date of completion of screening activities
68.27as required under section 256.975, subdivisions 4a, 4b, and 4c 7a to 7c. The nursing
68.28facility must include unreimbursed resident days in the nursing facility resident day totals
68.29reported to the commissioner.

68.30    Sec. 23. Minnesota Statutes 2012, section 256B.0913, subdivision 4, is amended to read:
68.31    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
68.32    (a) Funding for services under the alternative care program is available to persons who
68.33meet the following criteria:
69.1    (1) the person has been determined by a community assessment under section
69.2256B.0911 to be a person who would require the level of care provided in a nursing
69.3facility, as determined under section 256B.0911, subdivision 4a, paragraph (d) 4e, but for
69.4the provision of services under the alternative care program;
69.5    (2) the person is age 65 or older;
69.6    (3) the person would be eligible for medical assistance within 135 days of admission
69.7to a nursing facility;
69.8    (4) the person is not ineligible for the payment of long-term care services by the
69.9medical assistance program due to an asset transfer penalty under section 256B.0595 or
69.10equity interest in the home exceeding $500,000 as stated in section 256B.056;
69.11    (5) the person needs long-term care services that are not funded through other
69.12state or federal funding, or other health insurance or other third-party insurance such as
69.13long-term care insurance;
69.14    (6) except for individuals described in clause (7), the monthly cost of the alternative
69.15care services funded by the program for this person does not exceed 75 percent of the
69.16monthly limit described under section 256B.0915, subdivision 3a. This monthly limit
69.17does not prohibit the alternative care client from payment for additional services, but in no
69.18case may the cost of additional services purchased under this section exceed the difference
69.19between the client's monthly service limit defined under section 256B.0915, subdivision
69.203 , and the alternative care program monthly service limit defined in this paragraph. If
69.21care-related supplies and equipment or environmental modifications and adaptations are or
69.22will be purchased for an alternative care services recipient, the costs may be prorated on a
69.23monthly basis for up to 12 consecutive months beginning with the month of purchase.
69.24If the monthly cost of a recipient's other alternative care services exceeds the monthly
69.25limit established in this paragraph, the annual cost of the alternative care services shall be
69.26determined. In this event, the annual cost of alternative care services shall not exceed 12
69.27times the monthly limit described in this paragraph;
69.28    (7) for individuals assigned a case mix classification A as described under section
69.29256B.0915, subdivision 3a , paragraph (a), with (i) no dependencies in activities of daily
69.30living, or (ii) up to two dependencies in bathing, dressing, grooming, walking, and eating
69.31when the dependency score in eating is three or greater as determined by an assessment
69.32performed under section 256B.0911, the monthly cost of alternative care services funded
69.33by the program cannot exceed $593 per month for all new participants enrolled in
69.34the program on or after July 1, 2011. This monthly limit shall be applied to all other
69.35participants who meet this criteria at reassessment. This monthly limit shall be increased
69.36annually as described in section 256B.0915, subdivision 3a, paragraph (a). This monthly
70.1limit does not prohibit the alternative care client from payment for additional services, but
70.2in no case may the cost of additional services purchased exceed the difference between the
70.3client's monthly service limit defined in this clause and the limit described in clause (6)
70.4for case mix classification A; and
70.5(8) the person is making timely payments of the assessed monthly fee.
70.6A person is ineligible if payment of the fee is over 60 days past due, unless the person
70.7agrees to:
70.8    (i) the appointment of a representative payee;
70.9    (ii) automatic payment from a financial account;
70.10    (iii) the establishment of greater family involvement in the financial management of
70.11payments; or
70.12    (iv) another method acceptable to the lead agency to ensure prompt fee payments.
70.13    The lead agency may extend the client's eligibility as necessary while making
70.14arrangements to facilitate payment of past-due amounts and future premium payments.
70.15Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
70.16reinstated for a period of 30 days.
70.17    (b) Alternative care funding under this subdivision is not available for a person who
70.18is a medical assistance recipient or who would be eligible for medical assistance without a
70.19spenddown or waiver obligation. A person whose initial application for medical assistance
70.20and the elderly waiver program is being processed may be served under the alternative care
70.21program for a period up to 60 days. If the individual is found to be eligible for medical
70.22assistance, medical assistance must be billed for services payable under the federally
70.23approved elderly waiver plan and delivered from the date the individual was found eligible
70.24for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
70.25care funds may not be used to pay for any service the cost of which: (i) is payable by
70.26medical assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to
70.27pay a medical assistance income spenddown for a person who is eligible to participate in the
70.28federally approved elderly waiver program under the special income standard provision.
70.29    (c) Alternative care funding is not available for a person who resides in a licensed
70.30nursing home, certified boarding care home, hospital, or intermediate care facility, except
70.31for case management services which are provided in support of the discharge planning
70.32process for a nursing home resident or certified boarding care home resident to assist with
70.33a relocation process to a community-based setting.
70.34    (d) Alternative care funding is not available for a person whose income is greater
70.35than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
70.36to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
71.1year for which alternative care eligibility is determined, who would be eligible for the
71.2elderly waiver with a waiver obligation.

71.3    Sec. 24. Minnesota Statutes 2012, section 256B.0913, is amended by adding a
71.4subdivision to read:
71.5    Subd. 17. Essential community supports grants. (a) Notwithstanding subdivisions
71.61 to 14, the purpose of the essential community supports grant program is to provide
71.7targeted services to persons age 65 and older who need essential community support, but
71.8whose needs do not meet the level of care required for nursing facility placement under
71.9section 144.0724, subdivision 11.
71.10(b) Essential community supports grants are available not to exceed $400 per person
71.11per month. Essential community supports service grants may be used as authorized within
71.12an authorization period not to exceed 12 months. Grants must be available to a person who:
71.13(1) is age 65 or older;
71.14(2) is not eligible for medical assistance;
71.15(3) would otherwise be financially eligible for the alternative care program under
71.16subdivision 4;
71.17(4) has received a community assessment under section 256B.0911, subdivision 3a
71.18or 3b, and does not require the level of care provided in a nursing facility;
71.19(5) has a community support plan; and
71.20(6) has been determined by a community assessment under section 256B.0911,
71.21subdivision 3a or 3b, to be a person who would require provision of at least one of the
71.22following services, as defined in the approved elderly waiver plan, in order to maintain
71.23their community residence:
71.24(i) caregiver support;
71.25(ii) homemaker support;
71.26(iii) chores; or
71.27(iv) a personal emergency response device or system.
71.28(c) The person receiving any of the essential community supports in this subdivision
71.29must also receive service coordination, not to exceed $600 in a 12-month authorization
71.30period, as part of their community support plan.
71.31(d) A person who has been determined to be eligible for an essential community
71.32supports grant must be reassessed at least annually and continue to meet the criteria in
71.33paragraph (b) to remain eligible for an essential community supports grant.
71.34(e) The commissioner is authorized to use federal matching funds for essential
71.35community supports as necessary and to meet demand for essential community supports
72.1grants as outlined in paragraphs (f) and (g), and that amount of federal funds is
72.2appropriated to the commissioner for this purpose.
72.3(f) Upon federal approval and following a reasonable implementation period
72.4determined by the commissioner, essential community supports are available to an
72.5individual who:
72.6(1) is receiving nursing facility services or home and community-based long-term
72.7services and supports under section 256B.0915 or 256B.49 on the effective date of
72.8implementation of the revised nursing facility level of care under section 144.0724,
72.9subdivision 11;
72.10(2) meets one of the following criteria:
72.11(i) due to the implementation of the revised nursing facility level of care, loses
72.12eligibility for continuing medical assistance payment of nursing facility services at the
72.13first reassessment under section 144.0724, subdivision 11, paragraph (b), that occurs on or
72.14after the effective date of the revised nursing facility level of care criteria under section
72.15144.0724, subdivision 11; or
72.16(ii) due to the implementation of the revised nursing facility level of care, loses
72.17eligibility for continuing medical assistance payment of home and community-based
72.18long-term services and supports under section 256B.0915 or 256B.49 at the first
72.19reassessment required under those sections that occurs on or after the effective date of
72.20implementation of the revised nursing facility level of care under section 144.0724,
72.21subdivision 11;
72.22(3) is not eligible for personal care attendant services; and
72.23(4) has an assessed need for one or more of the supportive services offered under
72.24essential community supports.
72.25Individuals eligible under this paragraph includes individuals who continue to be
72.26eligible for medical assistance state plan benefits and those who are not or are no longer
72.27financially eligible for medical assistance.
72.28(g) Upon federal approval and following a reasonable implementation period
72.29determined by the commissioner, the services available through essential community
72.30supports include the services and grants provided in paragraphs (b) and (c), home-delivered
72.31meals, and community living assistance as defined by the commissioner. These services
72.32are available to all eligible recipients including those outlined in paragraphs (b) and (f).
72.33Recipients are eligible if they have a need for any of these services and meet all other
72.34eligibility criteria.

73.1    Sec. 25. Minnesota Statutes 2012, section 256B.0915, subdivision 3a, is amended to
73.2read:
73.3    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of
73.4waivered services to an individual elderly waiver client except for individuals described in
73.5paragraph paragraphs (b) and (d) shall be the weighted average monthly nursing facility
73.6rate of the case mix resident class to which the elderly waiver client would be assigned
73.7under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance
73.8needs allowance as described in subdivision 1d, paragraph (a), until the first day of the
73.9state fiscal year in which the resident assessment system as described in section 256B.438
73.10for nursing home rate determination is implemented. Effective on the first day of the state
73.11fiscal year in which the resident assessment system as described in section 256B.438 for
73.12nursing home rate determination is implemented and the first day of each subsequent state
73.13fiscal year, the monthly limit for the cost of waivered services to an individual elderly
73.14waiver client shall be the rate of the case mix resident class to which the waiver client
73.15would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on
73.16the last day of the previous state fiscal year, adjusted by any legislatively adopted home
73.17and community-based services percentage rate adjustment.
73.18    (b) The monthly limit for the cost of waivered services to an individual elderly
73.19waiver client assigned to a case mix classification A under paragraph (a) with:
73.20(1) no dependencies in activities of daily living; or
73.21(2) up to two dependencies in bathing, dressing, grooming, walking, and eating
73.22when the dependency score in eating is three or greater as determined by an assessment
73.23performed under section 256B.0911
73.24shall be $1,750 per month effective on July 1, 2011, for all new participants enrolled in
73.25the program on or after July 1, 2011. This monthly limit shall be applied to all other
73.26participants who meet this criteria at reassessment. This monthly limit shall be increased
73.27annually as described in paragraph (a).
73.28(c) If extended medical supplies and equipment or environmental modifications are
73.29or will be purchased for an elderly waiver client, the costs may be prorated for up to
73.3012 consecutive months beginning with the month of purchase. If the monthly cost of a
73.31recipient's waivered services exceeds the monthly limit established in paragraph (a) or
73.32(b), the annual cost of all waivered services shall be determined. In this event, the annual
73.33cost of all waivered services shall not exceed 12 times the monthly limit of waivered
73.34services as described in paragraph (a) or (b).
73.35(d) Effective July 1, 2013, the monthly cost limit of waiver services, including
73.36any necessary home care services described in section 256B.0651, subdivision 2, for
74.1individuals who meet the criteria as ventilator-dependent given in section 256B.0651,
74.2subdivision 1, paragraph (g), shall be the average of the monthly medical assistance
74.3amount established for home care services as described in section 256B.0652, subdivision
74.47, and the annual average contracted amount established by the commissioner for nursing
74.5facility services for ventilator-dependent individuals. This monthly limit shall be increased
74.6annually as described in paragraph (a).

74.7    Sec. 26. Minnesota Statutes 2012, section 256B.0915, is amended by adding a
74.8subdivision to read:
74.9    Subd. 3j. Individual community living support. Upon federal approval, there
74.10is established a new service called individual community living support (ICLS) that is
74.11available on the elderly waiver. ICLS providers may not be the landlord of recipients, nor
74.12have any interest in the recipient's housing. ICLS must be delivered in a single-family
74.13home or apartment where the service recipient or their family owns or rents, as
74.14demonstrated by a lease agreement, and maintains control over the individual unit. Case
74.15managers or care coordinators must develop individual ICLS plans in consultation with
74.16the client using a tool developed by the commissioner. The commissioner shall establish
74.17payment rates and mechanisms to align payments with the type and amount of service
74.18provided, assure statewide uniformity for payment rates, and assure cost-effectiveness.
74.19Licensing standards for ICLS shall be reviewed jointly by the Departments of Health and
74.20Human Services to avoid conflict with provider regulatory standards pursuant to section
74.21144A.43 and chapter 245D.

74.22    Sec. 27. Minnesota Statutes 2012, section 256B.0915, subdivision 5, is amended to read:
74.23    Subd. 5. Assessments and reassessments for waiver clients. (a) Each client
74.24shall receive an initial assessment of strengths, informal supports, and need for services
74.25in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
74.26client served under the elderly waiver must be conducted at least every 12 months and at
74.27other times when the case manager determines that there has been significant change in
74.28the client's functioning. This may include instances where the client is discharged from
74.29the hospital. There must be a determination that the client requires nursing facility level
74.30of care as defined in section 256B.0911, subdivision 4a, paragraph (d) 4e, at initial and
74.31subsequent assessments to initiate and maintain participation in the waiver program.
74.32(b) Regardless of other assessments identified in section 144.0724, subdivision
74.334, as appropriate to determine nursing facility level of care for purposes of medical
74.34assistance payment for nursing facility services, only face-to-face assessments conducted
75.1according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
75.2level of care determination will be accepted for purposes of initial and ongoing access to
75.3waiver service payment.

75.4    Sec. 28. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
75.5subdivision to read:
75.6    Subd. 1a. Home and community-based services for older adults. (a) The purpose
75.7of projects selected by the commissioner of human services under this section is to
75.8make strategic changes in the long-term services and supports system for older adults
75.9including statewide capacity for local service development and technical assistance, and
75.10statewide availability of home and community-based services for older adult services,
75.11caregiver support and respite care services, and other supports in the state of Minnesota.
75.12These projects are intended to create incentives for new and expanded home and
75.13community-based services in Minnesota in order to:
75.14(1) reach older adults early in the progression of their need for long-term services
75.15and supports, providing them with low-cost, high-impact services that will prevent or
75.16delay the use of more costly services;
75.17(2) support older adults to live in the most integrated, least restrictive community
75.18setting;
75.19(3) support the informal caregivers of older adults;
75.20(4) develop and implement strategies to integrate long-term services and supports
75.21with health care services, in order to improve the quality of care and enhance the quality
75.22of life of older adults and their informal caregivers;
75.23(5) ensure cost-effective use of financial and human resources;
75.24(6) build community-based approaches and community commitment to delivering
75.25long-term services and supports for older adults in their own homes;
75.26(7) achieve a broad awareness and use of lower-cost in-home services as an
75.27alternative to nursing homes and other residential services;
75.28(8) strengthen and develop additional home and community-based services and
75.29alternatives to nursing homes and other residential services; and
75.30(9) strengthen programs that use volunteers.
75.31(b) The services provided by these projects are available to older adults who are
75.32eligible for medical assistance and the elderly waiver under section 256B.0915, the
75.33alternative care program under section 256B.0913, or essential community supports grant
75.34under subdivision 14, paragraph (b), and to persons who have their own funds to pay for
75.35services.

76.1    Sec. 29. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
76.2subdivision to read:
76.3    Subd. 1b. Definitions. (a) For purposes of this section, the following terms have
76.4the meanings given.
76.5(b) "Community" means a town; township; city; or targeted neighborhood within a
76.6city; or a consortium of towns, townships, cities, or specific neighborhoods within a city.
76.7(c) "Core home and community-based services provider" means a Faith in Action,
76.8Living at Home Block Nurse, Congregational Nurse, or similar community-based
76.9program governed by a board, the majority of whose members reside within the program's
76.10service area, that organizes and uses volunteers and paid staff to deliver nonmedical
76.11services intended to assist older adults to identify and manage risks and to maintain their
76.12community living and integration in the community.
76.13(d) "Eldercare development partnership" means a team of representatives of county
76.14social service and public health agencies, the area agency on aging, local nursing home
76.15providers, local home care providers, and other appropriate home and community-based
76.16providers in the area agency's planning and service area.
76.17(e) "Long-term services and supports" means any service available under the
76.18elderly waiver program or alternative care grant programs; nursing facility services;
76.19transportation services; caregiver support and respite care services; and other home and
76.20community-based services identified as necessary either to maintain lifestyle choices for
76.21older adults or to support them to remain in their own home.
76.22(f) "Older adult" refers to an individual who is 65 years of age or older.

76.23    Sec. 30. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
76.24subdivision to read:
76.25    Subd. 1c. Eldercare development partnerships. The commissioner of human
76.26services shall select and contract with eldercare development partnerships sufficient to
76.27provide statewide availability of service development and technical assistance using a
76.28request for proposals process. Eldercare development partnerships shall:
76.29(1) develop a local long-term services and supports strategy consistent with state
76.30goals and objectives;
76.31(2) identify and use existing local skills, knowledge and relationships, and build
76.32on these assets;
76.33(3) coordinate planning for funds to provide services to older adults, including funds
76.34received under Title III of the Older Americans Act, Title XX of the Social Security Act,
76.35and the Local Public Health Act;
77.1(4) target service development and technical assistance where nursing facility
77.2closures have occurred or are occurring or in areas where service needs have been
77.3identified through activities under section 144A.351;
77.4(5) provide sufficient staff for development and technical support in its designated
77.5area; and
77.6(6) designate a single public or nonprofit member of the eldercare development
77.7partnerships to apply grant funding and manage the project.

77.8    Sec. 31. Minnesota Statutes 2012, section 256B.0917, subdivision 6, is amended to read:
77.9    Subd. 6. Caregiver support and respite care projects. (a) The commissioner
77.10shall establish up to 36 projects to expand the respite care network in the state and to
77.11support caregivers in their responsibilities for care. The purpose of each project shall
77.12be to availability of caregiver support and respite care services for family and other
77.13caregivers. The commissioner shall use a request for proposals to select nonprofit entities
77.14to administer the projects. Projects shall:
77.15(1) establish a local coordinated network of volunteer and paid respite workers;
77.16(2) coordinate assignment of respite workers care services to clients and care
77.17receivers and assure the health and safety of the client; and caregivers of older adults;
77.18(3) provide training for caregivers and ensure that support groups are available
77.19in the community.
77.20(3) assure the health and safety of the older adults;
77.21(4) identify at-risk caregivers;
77.22(5) provide information, education, and training for caregivers in the designated
77.23community; and
77.24(6) demonstrate the need in the proposed service area particularly where nursing
77.25facility closures have occurred or are occurring or areas with service needs identified
77.26by section 144A.351. Preference must be given for projects that reach underserved
77.27populations.
77.28(b) The caregiver support and respite care funds shall be available to the four to six
77.29local long-term care strategy projects designated in subdivisions 1 to 5.
77.30(c) The commissioner shall publish a notice in the State Register to solicit proposals
77.31from public or private nonprofit agencies for the projects not included in the four to six
77.32local long-term care strategy projects defined in subdivision 2. A county agency may,
77.33alone or in combination with other county agencies, apply for caregiver support and
77.34respite care project funds. A public or nonprofit agency within a designated SAIL project
77.35area may apply for project funds if the agency has a letter of agreement with the county
78.1or counties in which services will be developed, stating the intention of the county or
78.2counties to coordinate their activities with the agency requesting a grant.
78.3(d) The commissioner shall select grantees based on the following criteria (b)
78.4Projects must clearly describe:
78.5(1) the ability of the proposal to demonstrate need in the area served, as evidenced
78.6by a community needs assessment or other demographic data;
78.7(2) the ability of the proposal to clearly describe how the project (1) how they will
78.8achieve the their purpose defined in paragraph (b);
78.9(3) the ability of the proposal to reach underserved populations;
78.10(4) the ability of the proposal to demonstrate community commitment to the project,
78.11as evidenced by letters of support and cooperation as well as formation of a community
78.12task force;
78.13(5) the ability of the proposal to clearly describe (2) the process for recruiting,
78.14training, and retraining volunteers; and
78.15(6) the inclusion in the proposal of the (3) their plan to promote the project in the
78.16designated community, including outreach to persons needing the services.
78.17(e) (c) Funds for all projects under this subdivision may be used to:
78.18(1) hire a coordinator to develop a coordinated network of volunteer and paid respite
78.19care services and assign workers to clients;
78.20(2) recruit and train volunteer providers;
78.21(3) train provide information, training, and education to caregivers;
78.22(4) ensure the development of support groups for caregivers;
78.23(5) (4) advertise the availability of the caregiver support and respite care project; and
78.24(6) (5) purchase equipment to maintain a system of assigning workers to clients.
78.25(f) (d) Project funds may not be used to supplant existing funding sources.

78.26    Sec. 32. Minnesota Statutes 2012, section 256B.0917, is amended by adding a
78.27subdivision to read:
78.28    Subd. 7a. Core home and community-based services. The commissioner shall
78.29select and contract with core home and community-based services providers for projects
78.30to provide services and supports to older adults both with and without family and other
78.31informal caregivers using a request for proposals process. Projects must:
78.32(1) have a credible, public, or private nonprofit sponsor providing ongoing financial
78.33support;
78.34(2) have a specific, clearly defined geographic service area;
79.1(3) use a practice framework designed to identify high-risk older adults and help them
79.2take action to better manage their chronic conditions and maintain their community living;
79.3(4) have a team approach to coordination and care, ensuring that the older adult
79.4participants, their families, and the formal and informal providers are all part of planning
79.5and providing services;
79.6(5) provide information, support services, homemaking services, counseling, and
79.7training for the older adults and family caregivers;
79.8(6) encourage service area or neighborhood residents and local organizations to
79.9collaborate in meeting the needs of older adults in their geographic service areas;
79.10(7) recruit, train, and direct the use of volunteers to provide informal services and
79.11other appropriate support to older adults and their caregivers; and
79.12(8) provide coordination and management of formal and informal services to older
79.13adults and their families using less expensive alternatives.

79.14    Sec. 33. Minnesota Statutes 2012, section 256B.0917, subdivision 13, is amended to
79.15read:
79.16    Subd. 13. Community service grants. The commissioner shall award contracts
79.17for grants to public and private nonprofit agencies to establish services that strengthen
79.18a community's ability to provide a system of home and community-based services
79.19for elderly persons. The commissioner shall use a request for proposal process. The
79.20commissioner shall give preference when awarding grants under this section to areas
79.21where nursing facility closures have occurred or are occurring or to areas with service
79.22needs identified under section 144A.351. The commissioner shall consider grants for:
79.23(1) caregiver support and respite care projects under subdivision 6;
79.24(2) the living-at-home/block nurse grant under subdivisions 7 to 10; and
79.25(3) services identified as needed for community transition.

79.26    Sec. 34. Minnesota Statutes 2012, section 256B.092, is amended by adding a
79.27subdivision to read:
79.28    Subd. 14. Reduce avoidable behavioral crisis emergency room, psychiatric
79.29inpatient hospitalizations, and commitments to institutions. (a) Persons receiving
79.30home and community-based services authorized under this section who have had two
79.31or more admissions within a calendar year to an emergency room, psychiatric unit,
79.32or institution must receive consultation from a mental health professional as defined in
79.33section 245.462, subdivision 18, or a behavioral professional as defined in the home and
80.1community-based services state plan within 30 days of discharge. The mental health
80.2professional or behavioral professional must:
80.3(1) conduct a functional assessment of the crisis incident as defined in section
80.4245D.02, subdivision 11, which led to the hospitalization with the goal of developing
80.5proactive strategies as well as necessary reactive strategies to reduce the likelihood of
80.6future avoidable hospitalizations due to a behavioral crisis;
80.7(2) use the results of the functional assessment to amend the coordinated service and
80.8support plan set forth in section 245D.02, subdivision 4b, to address the potential need
80.9for additional staff training, increased staffing, access to crisis mobility services, mental
80.10health services, use of technology, and crisis stabilization services in section 256B.0624,
80.11subdivision 7; and
80.12(3) identify the need for additional consultation, testing, and mental health crisis
80.13intervention team services as defined in section 245D.02, subdivision 20, psychotropic
80.14medication use and monitoring under section 245D.051, as well as the frequency and
80.15duration of ongoing consultation.
80.16(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
80.17the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

80.18    Sec. 35. Minnesota Statutes 2012, section 256B.439, subdivision 1, is amended to read:
80.19    Subdivision 1. Development and implementation of quality profiles. (a) The
80.20commissioner of human services, in cooperation with the commissioner of health,
80.21shall develop and implement a quality profile system profiles for nursing facilities and,
80.22beginning not later than July 1, 2004 2014, other providers of long-term care services,
80.23except when the quality profile system would duplicate requirements under section
80.24256B.5011 , 256B.5012, or 256B.5013. The system quality profiles must be developed
80.25and implemented to the extent possible without the collection of significant amounts of
80.26new data. To the extent possible, the system using existing data sets maintained by the
80.27commissioners of health and human services to the extent possible. The profiles must
80.28incorporate or be coordinated with information on quality maintained by area agencies on
80.29aging, long-term care trade associations, the ombudsman offices, counties, tribes, health
80.30plans, and other entities and the long-term care database maintained under section 256.975,
80.31subdivision 7. The system profiles must be designed to provide information on quality to:
80.32(1) consumers and their families to facilitate informed choices of service providers;
80.33(2) providers to enable them to measure the results of their quality improvement
80.34efforts 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. 36. 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. 37. 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. 38. 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 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. 39. 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. 40. Minnesota Statutes 2012, section 256B.49, subdivision 12, is amended to read:
82.15    Subd. 12. Informed choice. Persons who are determined likely to require the level
82.16of care provided in a nursing facility as determined under section 256B.0911, subdivision
82.174e, or a hospital shall be informed of the home and community-based support alternatives
82.18to the provision of inpatient hospital services or nursing facility services. Each person
82.19must be given the choice of either institutional or home and community-based services
82.20using the provisions described in section 256B.77, subdivision 2, paragraph (p).

82.21    Sec. 41. Minnesota Statutes 2012, section 256B.49, subdivision 14, is amended to read:
82.22    Subd. 14. Assessment and reassessment. (a) Assessments and reassessments
82.23shall be conducted by certified assessors according to section 256B.0911, subdivision 2b.
82.24With the permission of the recipient or the recipient's designated legal representative,
82.25the recipient's current provider of services may submit a written report outlining their
82.26recommendations regarding the recipient's care needs prepared by a direct service
82.27employee with at least 20 hours of service to that client. The person conducting the
82.28assessment or reassessment must notify the provider of the date by which this information
82.29is to be submitted. This information shall be provided to the person conducting the
82.30assessment and the person or the person's legal representative and must be considered
82.31prior to the finalization of the assessment or reassessment.
82.32(b) There must be a determination that the client requires a hospital level of care or a
82.33nursing facility level of care as defined in section 256B.0911, subdivision 4a, paragraph
83.1(d) 4e, at initial and subsequent assessments to initiate and maintain participation in the
83.2waiver program.
83.3(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
83.4appropriate to determine nursing facility level of care for purposes of medical assistance
83.5payment for nursing facility services, only face-to-face assessments conducted according
83.6to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
83.7determination or a nursing facility level of care determination must be accepted for
83.8purposes of initial and ongoing access to waiver services payment.
83.9(d) Recipients who are found eligible for home and community-based services under
83.10this section before their 65th birthday may remain eligible for these services after their
83.1165th birthday if they continue to meet all other eligibility factors.
83.12(e) The commissioner shall develop criteria to identify recipients whose level of
83.13functioning is reasonably expected to improve and reassess these recipients to establish
83.14a baseline assessment. Recipients who meet these criteria must have a comprehensive
83.15transitional service plan developed under subdivision 15, paragraphs (b) and (c), and be
83.16reassessed every six months until there has been no significant change in the recipient's
83.17functioning for at least 12 months. After there has been no significant change in the
83.18recipient's functioning for at least 12 months, reassessments of the recipient's strengths,
83.19informal support systems, and need for services shall be conducted at least every 12
83.20months and at other times when there has been a significant change in the recipient's
83.21functioning. Counties, case managers, and service providers are responsible for
83.22conducting these reassessments and shall complete the reassessments out of existing funds.

83.23    Sec. 42. Minnesota Statutes 2012, section 256B.49, is amended by adding a
83.24subdivision to read:
83.25    Subd. 25. Reduce avoidable behavioral crisis emergency room, psychiatric
83.26inpatient hospitalizations, and commitments to institutions. (a) Persons receiving
83.27home and community-based services authorized under this section who have two or more
83.28admissions within a calendar year to an emergency room, psychiatric unit, or institution
83.29must receive consultation from a mental health professional as defined in section 245.462,
83.30subdivision 18, or a behavioral professional as defined in the home and community-based
83.31services state plan within 30 days of discharge. The mental health professional or
83.32behavioral professional must:
83.33(1) conduct a functional assessment of the crisis incident as defined in section
83.34245D.02, subdivision 11, which led to the hospitalization with the goal of developing
84.1proactive strategies as well as necessary reactive strategies to reduce the likelihood of
84.2future avoidable hospitalizations due to a behavioral crisis;
84.3(2) use the results of the functional assessment to amend the coordinated service and
84.4support plan in section 245D.02, subdivision 4b, to address the potential need for additional
84.5staff training, increased staffing, access to crisis mobility services, mental health services,
84.6use of technology, and crisis stabilization services in section 256B.0624, subdivision 7; and
84.7(3) identify the need for additional consultation, testing, mental health crisis
84.8intervention team services as defined in section 245D.02, subdivision 20, psychotropic
84.9medication use and monitoring under section 245D.051, as well as the frequency and
84.10duration of ongoing consultation.
84.11(b) For the purposes of this subdivision, "institution" includes, but is not limited to,
84.12the Anoka-Metro Regional Treatment Center and the Minnesota Security Hospital.

84.13    Sec. 43. [256B.85] COMMUNITY FIRST SERVICES AND SUPPORTS.
84.14    Subdivision 1. Basis and scope. (a) Upon federal approval, the commissioner
84.15shall establish a medical assistance state plan option for the provision of home and
84.16community-based personal assistance service and supports called "community first
84.17services and supports (CFSS)."
84.18(b) CFSS is a participant-controlled method of selecting and providing services
84.19and supports that allows the participant maximum control of the services and supports.
84.20Participants may choose the degree to which they direct and manage their supports by
84.21choosing to have a significant and meaningful role in the management of services and
84.22supports including by directly employing support workers with the necessary supports
84.23to perform that function.
84.24(c) CFSS is available statewide to eligible individuals to assist with accomplishing
84.25activities of daily living (ADLs), instrumental activities of daily living (IADLs), and
84.26health-related procedures and tasks through hands-on assistance to complete the task or
84.27supervision and cueing to complete the task; and to assist with acquiring, maintaining, and
84.28enhancing the skills necessary to accomplish ADLs, IADLs, and health-related procedures
84.29and tasks. CFSS allows payment for certain supports and goods such as environmental
84.30modifications and technology that are intended to replace or decrease the need for human
84.31assistance.
84.32(d) Upon federal approval, CFSS will replace the personal care assistance program
84.33under sections 256.476, 256B.0625, subdivisions 19a and 19c, and 256B.0659.
84.34    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
84.35this subdivision have the meanings given.
85.1(b) "Activities of daily living" or "ADLs" means eating, toileting, grooming,
85.2dressing, bathing, mobility, positioning, and transferring.
85.3(c) "Agency-provider model" means a method of CFSS under which a qualified
85.4agency provides services and supports through the agency's own employees and policies.
85.5The agency must allow the participant to have a significant role in the selection and
85.6dismissal of support workers of their choice for the delivery of their specific services
85.7and supports.
85.8(d) "Behavior" means a category to determine the home care rating and is based on the
85.9criteria in section 256B.0659. "Level I behavior" means physical aggression towards self,
85.10others, or destruction of property that requires the immediate response of another person.
85.11(e) "Complex health-related needs" means a category to determine the home care
85.12rating and is based on the criteria in section 256B.0659.
85.13(f) "Community first services and supports" or "CFSS" means the assistance and
85.14supports program under this section needed for accomplishing activities of daily living,
85.15instrumental activities of daily living, and health-related tasks through hands-on assistance
85.16to complete the task or supervision and cueing to complete the task, or the purchase of
85.17goods as defined in subdivision 7, paragraph (a), clause (2), that replace the need for
85.18human assistance.
85.19(g) "Community first services and supports service delivery plan" or "service delivery
85.20plan" means a written summary of the services and supports, that is based on the community
85.21support plan identified in section 256B.0911 and coordinated services and support plan
85.22and budget identified in section 256B.0915, subdivision 6, if applicable, that is determined
85.23by the participant to meet the assessed needs, using a person-centered planning process.
85.24(h) "Critical activities of daily living" means transferring, mobility, eating, and
85.25toileting.
85.26(i) "Dependency" in activities of daily living means a person requires assistance to
85.27begin and complete one or more of the activities of daily living.
85.28(j) "Financial management services contractor or vendor" means a qualified
85.29organization having a written contract with the department to provide services necessary
85.30to use the flexible spending model under subdivision 13, that include but are not limited
85.31to: participant education and technical assistance; CFSS service delivery planning and
85.32budgeting; billing, making payments, and monitoring of spending; and assisting the
85.33participant in fulfilling employer-related requirements in accordance with Section 3504 of
85.34the IRS code and the IRS Revenue Procedure 70-6.
85.35(k) "Flexible spending model" means a service delivery method of CFSS that uses
85.36an individualized CFSS service delivery plan and service budget and assistance from the
86.1financial management services contractor to facilitate participant employment of support
86.2workers and the acquisition of supports and goods.
86.3(l) "Health-related procedures and tasks" means procedures and tasks related to
86.4the specific needs of an individual that can be delegated or assigned by a state-licensed
86.5healthcare or behavioral health professional and performed by a support worker.
86.6(m) "Instrumental activities of daily living" means activities related to living
86.7independently in the community, including but not limited to: meal planning, preparation,
86.8and cooking; shopping for food, clothing, or other essential items; laundry; housecleaning;
86.9assistance with medications; managing money; communicating needs, preferences, and
86.10activities; arranging supports; and assistance with traveling around and participating
86.11in the community.
86.12(n) "Legal representative" means parent of a minor, a court-appointed guardian, or
86.13another representative with legal authority to make decisions about services and supports
86.14for the participant. Other representatives with legal authority to make decisions include
86.15but are not limited to a health care agent or an attorney-in-fact authorized through a health
86.16care directive or power of attorney.
86.17(o) "Medication assistance" means providing verbal or visual reminders to take
86.18regularly scheduled medication and includes any of the following supports:
86.19(1) under the direction of the participant or the participant's representative, bringing
86.20medications to the participant including medications given through a nebulizer, opening a
86.21container of previously set up medications, emptying the container into the participant's
86.22hand, opening and giving the medication in the original container to the participant, or
86.23bringing to the participant liquids or food to accompany the medication;
86.24(2) organizing medications as directed by the participant or the participant's
86.25representative; and
86.26(3) providing verbal or visual reminders to perform regularly scheduled medications.
86.27(p) "Participant's representative" means a parent, family member, advocate, or
86.28other adult authorized by the participant to serve as a representative in connection with
86.29the provision of CFSS. This authorization must be in writing or by another method
86.30that clearly indicates the participant's free choice. The participant's representative must
86.31have no financial interest in the provision of any services included in the participant's
86.32service delivery plan and must be capable of providing the support necessary to assist
86.33the participant in the use of CFSS. If through the assessment process described in
86.34subdivision 5 a participant is determined to be in need of a participant's representative, one
86.35must be selected. If the participant is unable to assist in the selection of a participant's
86.36representative, the legal representative shall appoint one. Two persons may be designated
87.1as a participant's representative for reasons such as divided households and court-ordered
87.2custodies. Duties of a participant's representatives may include:
87.3(1) being available while care is provided in a method agreed upon by the participant
87.4or the participant's legal representative and documented in the participant's CFSS service
87.5delivery plan;
87.6(2) monitoring CFSS services to ensure the participant's CFSS service delivery
87.7plan is being followed; and
87.8(3) reviewing and signing CFSS time sheets after services are provided to provide
87.9verification of the CFSS services.
87.10(q) "Person-centered planning process" means a process that is driven by the
87.11participant for discovering and planning services and supports that ensures the participant
87.12makes informed choices and decisions. The person-centered planning process must:
87.13(1) include people chosen by the participant;
87.14(2) provide necessary information and support to ensure that the participant directs
87.15the process to the maximum extent possible, and is enabled to make informed choices
87.16and decisions;
87.17(3) be timely and occur at time and locations of convenience to the participant;
87.18(4) reflect cultural considerations of the participant;
87.19(5) include strategies for solving conflict or disagreement within the process,
87.20including clear conflict-of-interest guidelines for all planning;
87.21(6) offers choices to the participant regarding the services and supports they receive
87.22and from whom;
87.23(7) include a method for the participant to request updates to the plan; and
87.24(8) record the alternative home and community-based settings that were considered
87.25by the participant.
87.26(r) "Shared services" means the provision of CFSS services by the same CFSS
87.27support worker to two or three participants who voluntarily enter into an agreement to
87.28receive services at the same time and in the same setting by the same provider.
87.29(s) "Support specialist" means a professional with the skills and ability to assist the
87.30participant using either the agency provider model under subdivision 11 or the flexible
87.31spending model under subdivision 13, in services including, but not limited to assistance
87.32regarding:
87.33(1) the development, implementation, and evaluation of the CFSS service delivery
87.34plan under subdivision 6;
88.1(2) recruitment, training, or supervision, including supervision of health-related
88.2tasks or behavioral supports appropriately delegated by a health care professional, and
88.3evaluation of support workers; and
88.4(3) facilitating the use of informal and community supports, goods, or resources.
88.5(t) "Support worker" means an employee of the agency provider or of the participant
88.6who has direct contact with the participant and provides services as specified within the
88.7participant's service delivery plan.
88.8(u) "Wages and benefits" means the hourly wages and salaries, the employer's
88.9share of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers'
88.10compensation, mileage reimbursement, health and dental insurance, life insurance,
88.11disability insurance, long-term care insurance, uniform allowance, contributions to
88.12employee retirement accounts, or other forms of employee compensation and benefits.
88.13    Subd. 3. Eligibility. (a) CFSS is available to a person who meets one of the
88.14following:
88.15(1) is a recipient of medical assistance as determined under section 256B.055,
88.16256B.056, or 256B.057, subdivisions 5 and 9;
88.17(2) is a recipient of the alternative care program under section 256B.0913;
88.18(3) is a waiver recipient as defined under section 256B.0915, 256B.092, 256B.093,
88.19or 256B.49; or
88.20(4) has medical services identified in a participant's individualized education
88.21program and is eligible for services as determined in section 256B.0625, subdivision 26.
88.22(b) In addition to meeting the eligibility criteria in paragraph (a), a person must also
88.23meet all of the following:
88.24(1) require assistance and be determined dependent in one activity of daily living or
88.25Level I behavior based on assessment under section 256B.0911;
88.26(2) is not a recipient under the family support grant under section 252.32;
88.27(3) lives in the person's own apartment or home including a family foster care setting
88.28licensed under chapter 245A, but not in corporate foster care under chapter 245A; or a
88.29noncertified boarding care or boarding and lodging establishments under chapter 157;
88.30unless transitioning into the community from an institution; and
88.31(4) has not been excluded or disenrolled from the flexible spending model.
88.32(c) The commissioner shall disenroll or exclude participants from the flexible
88.33spending model and transfer them to the agency-provider model under the following
88.34circumstances that include but are not limited to:
88.35(1) when a participant has been restricted by the Minnesota restricted recipient
88.36program, the participant may be excluded for a specified time period;
89.1(2) when a participant exits the flexible spending service delivery model during the
89.2participant's service plan year. Upon transfer, the participant shall not access the flexible
89.3spending model for the remainder of that service plan year; or
89.4(3) when the department determines that the participant or participant's representative
89.5or legal representative cannot manage participant responsibilities under the service
89.6delivery model. The commissioner must develop policies for determining if a participant
89.7is unable to manage responsibilities under a service model.
89.8(d) A participant may appeal in writing to the department to contest the department's
89.9decision under paragraph (c), clause (3), to remove or exclude the participant from the
89.10flexible spending model.
89.11    Subd. 4. Eligibility for other services. Selection of CFSS by a participant must not
89.12restrict access to other medically necessary care and services furnished under the state
89.13plan medical assistance benefit or other services available through alternative care.
89.14    Subd. 5. Assessment requirements. (a) The assessment of functional need must:
89.15(1) be conducted by a certified assessor according to the criteria established in
89.16section 256B.0911;
89.17(2) be conducted face-to-face, initially and at least annually thereafter, or when there
89.18is a significant change in the participant's condition or a change in the need for services
89.19and supports; and
89.20(3) be completed using the format established by the commissioner.
89.21(b) A participant who is residing in a facility may be assessed and choose CFSS for
89.22the purpose of using CFSS to return to the community as described in subdivisions 3
89.23and 7, paragraph (a), clause (5).
89.24(c) The results of the assessment and any recommendations and authorizations for
89.25CFSS must be determined and communicated in writing by the lead agency's certified
89.26assessor as defined in section 256B.0911 to the participant and the agency-provider or
89.27financial management services provider chosen by the participant within 40 calendar days
89.28and must include the participant's right to appeal under section 256.045.
89.29    Subd. 6. Community first services and support service delivery plan. (a) The
89.30CFSS service delivery plan must be developed, implemented, and evaluated through a
89.31person-centered planning process by the participant, or the participant's representative
89.32or legal representative who may be assisted by a support specialist. The CFSS service
89.33delivery plan must reflect the services and supports that are important to the participant
89.34and for the participant to meet the needs assessed by the certified assessor and identified
89.35in the community support plan under section 256B.0911 or the coordinated services and
89.36support plan identified in section 256B.0915, subdivision 6, if applicable. The CFSS
90.1service delivery plan must be reviewed by the participant and the agency-provider or
90.2financial management services contractor at least annually upon reassessment, or when
90.3there is a significant change in the participant's condition, or a change in the need for
90.4services and supports.
90.5(b) The commissioner shall establish the format and criteria for the CFSS service
90.6delivery plan.
90.7(c) The CFSS service delivery plan must be person-centered and:
90.8(1) specify the agency-provider or financial management services contractor selected
90.9by the participant;
90.10(2) reflect the setting in which the participant resides that is chosen by the participant;
90.11(3) reflect the participant's strengths and preferences;
90.12(4) include the means to address the clinical and support needs as identified through
90.13an assessment of functional needs;
90.14(5) include individually identified goals and desired outcomes;
90.15(6) reflect the services and supports, paid and unpaid, that will assist the participant
90.16to achieve identified goals, and the providers of those services and supports, including
90.17natural supports;
90.18(7) identify the amount and frequency of face-to-face supports and amount and
90.19frequency of remote supports and technology that will be used;
90.20(8) identify risk factors and measures in place to minimize them, including
90.21individualized backup plans;
90.22(9) be understandable to the participant and the individuals providing support;
90.23(10) identify the individual or entity responsible for monitoring the plan;
90.24(11) be finalized and agreed to in writing by the participant and signed by all
90.25individuals and providers responsible for its implementation;
90.26(12) be distributed to the participant and other people involved in the plan; and
90.27(13) prevent the provision of unnecessary or inappropriate care.
90.28(d) The total units of agency-provider services or the budget allocation amount for
90.29the flexible spending model include both annual totals and a monthly average amount
90.30that cover the number of months of the service authorization. The amount used each
90.31month may vary, but additional funds must not be provided above the annual service
90.32authorization amount unless a change in condition is assessed and authorized by the
90.33certified assessor and documented in the community support plan, coordinated services
90.34and supports plan, and service delivery plan.
90.35    Subd. 7. Community first services and supports; covered services. Services
90.36and supports covered under CFSS include:
91.1(1) assistance to accomplish activities of daily living (ADLs), instrumental activities
91.2of daily living (IADLs), and health-related procedures and tasks through hands-on
91.3assistance to complete the task or supervision and cueing to complete the task;
91.4(2) assistance to acquire, maintain, or enhance the skills necessary for the participant
91.5to accomplish activities of daily living, instrumental activities of daily living, or
91.6health-related tasks;
91.7(3) expenditures for items, services, supports, environmental modifications, or
91.8goods, including assistive technology. These expenditures must:
91.9(i) relate to a need identified in a participant's CFSS service delivery plan;
91.10(ii) increase independence or substitute for human assistance to the extent that
91.11expenditures would otherwise be made for human assistance for the participant's assessed
91.12needs; and
91.13(iii) fit within the annual limit of the participant's approved service allocation
91.14or budget;
91.15(4) observation and redirection for episodes where there is a need for redirection
91.16due to participant behaviors or intervention needed due to a participant's symptoms. An
91.17assessment of behaviors must meet the criteria in this clause. A recipient qualifies as
91.18having a need for assistance due to behaviors if the recipient's behavior requires assistance
91.19at least four times per week and shows one or more of the following behaviors:
91.20(i) physical aggression towards self or others, or destruction of property that requires
91.21the immediate response of another person;
91.22(ii) increased vulnerability due to cognitive deficits or socially inappropriate
91.23behavior; or
91.24(iii) increased need for assistance for recipients who are verbally aggressive or
91.25resistive to care so that time needed to perform activities of daily living is increased;
91.26(5) back-up systems or mechanisms, such as the use of pagers or other electronic
91.27devices, to ensure continuity of the participant's services and supports;
91.28(6) transition costs, including:
91.29(i) deposits for rent and utilities;
91.30(ii) first month's rent and utilities;
91.31(iii) bedding;
91.32(iv) basic kitchen supplies;
91.33(v) other necessities, to the extent that these necessities are not otherwise covered
91.34under any other funding that the participant is eligible to receive; and
91.35(vi) other required necessities for an individual to make the transition from a nursing
91.36facility, institution for mental diseases, or intermediate care facility for persons with
92.1developmental disabilities to a community-based home setting where the participant
92.2resides; and
92.3(7) services by a support specialist defined under subdivision 2 that are chosen
92.4by the participant.
92.5    Subd. 8. Determination of CFSS service methodology. (a) All community first
92.6services and supports must be authorized by the commissioner or the commissioner's
92.7designee before services begin except for the assessments established in section
92.8256B.0911. The authorization for CFSS must be completed within 30 days after receiving
92.9a complete request.
92.10(b) The amount of CFSS authorized must be based on the recipient's home
92.11care rating. The home care rating shall be determined by the commissioner or the
92.12commissioner's designee based on information submitted to the commissioner identifying
92.13the following for a recipient:
92.14(1) the total number of dependencies of activities of daily living as defined in
92.15subdivision 2;
92.16(2) the presence of complex health-related needs as defined in subdivision 2; and
92.17(3) the presence of Level I behavior as defined in subdivision 2.
92.18(c) For purposes meeting the criteria in paragraph (b), the methodology to determine
92.19the total minutes for CFSS for each home care rating is based on the median paid units
92.20per day for each home care rating from fiscal year 2007 data for the PCA program. Each
92.21home care rating has a base number of minutes assigned. Additional minutes are added
92.22through the assessment and identification of the following:
92.23(1) 30 additional minutes per day for a dependency in each critical activity of daily
92.24living as defined in subdivision 2;
92.25(2) 30 additional minutes per day for each complex health-related function as
92.26defined in subdivision 2; and
92.27(3) 30 additional minutes per day for each behavior issue as defined in subdivision 2.
92.28    Subd. 9. Noncovered services. (a) Services or supports that are not eligible for
92.29payment under this section include those that:
92.30(1) are not authorized by the certified assessor or included in the written service
92.31delivery plan;
92.32(2) are provided prior to the authorization of services and the approval of the written
92.33CFSS service delivery plan;
92.34(3) are duplicative of other paid services in the written service delivery plan;
93.1(4) supplant natural unpaid supports that are provided voluntarily to the participant
93.2and are selected by the participant in lieu of a support worker and appropriately meeting
93.3the participant's needs;
93.4(5) are not effective means to meet the participant's needs; and
93.5(6) are available through other funding sources, including, but not limited to, funding
93.6through Title IV-E of the Social Security Act.
93.7(b) Additional services, goods, or supports that are not covered include:
93.8(1) those that are not for the direct benefit of the participant;
93.9(2) any fees incurred by the participant, such as Minnesota health care programs fees
93.10and co-pays, legal fees, or costs related to advocate agencies;
93.11(3) insurance, except for insurance costs related to employee coverage;
93.12(4) room and board costs for the participant with the exception of allowable
93.13transition costs in subdivision 7, clause (6);
93.14(5) services, supports, or goods that are not related to the assessed needs;
93.15(6) special education and related services provided under the Individuals with
93.16Disabilities Education Act and vocational rehabilitation services provided under the
93.17Rehabilitation Act of 1973;
93.18(7) assistive technology devices and assistive technology services other than those
93.19for back-up systems or mechanisms to ensure continuity of service and supports listed in
93.20subdivision 7;
93.21(8) medical supplies and equipment;
93.22(9) environmental modifications, except as specified in subdivision 7;
93.23(10) expenses for travel, lodging, or meals related to training the participant, the
93.24participant's representative, legal representative, or paid or unpaid caregivers that exceed
93.25$500 in a 12-month period;
93.26(11) experimental treatments;
93.27(12) any service or good covered by other medical assistance state plan services,
93.28including prescription and over-the-counter medications, compounds, and solutions and
93.29related fees, including premiums and co-payments;
93.30(13) membership dues or costs, except when the service is necessary and appropriate
93.31to treat a physical condition or to improve or maintain the participant's physical condition.
93.32The condition must be identified in the participant's CFSS plan and monitored by a
93.33physician enrolled in a Minnesota health care program;
93.34(14) vacation expenses other than the cost of direct services;
93.35(15) vehicle maintenance or modifications not related to the disability, health
93.36condition, or physical need; and
94.1(16) tickets and related costs to attend sporting or other recreational or entertainment
94.2events.
94.3    Subd. 10. Provider qualifications and general requirements. (a)
94.4Agency-providers delivering services under the agency-provider model under subdivision
94.511 or financial management service (FMS) contractors under subdivision 13 shall:
94.6(1) enroll as a medical assistance Minnesota health care programs provider and meet
94.7all applicable provider standards;
94.8(2) comply with medical assistance provider enrollment requirements;
94.9(3) demonstrate compliance with law and policies of CFSS as determined by the
94.10commissioner;
94.11(4) comply with background study requirements under chapter 245C;
94.12(5) verify and maintain records of all services and expenditures by the participant,
94.13including hours worked by support workers and support specialists;
94.14(6) not engage in any agency-initiated direct contact or marketing in person, by
94.15telephone, or other electronic means to potential participants, guardians, family member
94.16or participants' representatives;
94.17(7) pay support workers and support specialists based upon actual hours of services
94.18provided;
94.19(8) withhold and pay all applicable federal and state payroll taxes;
94.20(9) make arrangements and pay unemployment insurance, taxes, workers'
94.21compensation, liability insurance, and other benefits, if any;
94.22(10) enter into a written agreement with the participant, participant's representative,
94.23or legal representative that assigns roles and responsibilities to be performed before
94.24services, supports, or goods are provided using a format established by the commissioner;
94.25(11) report suspected neglect and abuse to the common entry point according to
94.26sections 256B.0651 and 626.557; and
94.27(12) provide the participant with a copy of the service-related rights under
94.28subdivision 19 at the start of services and supports.
94.29(b) The commissioner shall develop policies and procedures designed to ensure
94.30program integrity and fiscal accountability for goods and services provided in this section.
94.31    Subd. 11. Agency-provider model. (a) The agency-provider model is limited to
94.32the services provided by support workers and support specialists who are employed by
94.33an agency-provider that is licensed according to chapter 245A or meets other criteria
94.34established by the commissioner, including required training.
95.1(b) The agency-provider shall allow the participant to retain the ability to have a
95.2significant role in the selection and dismissal of the support workers for the delivery of the
95.3services and supports specified in the service delivery plan.
95.4(c) A participant may use authorized units of CFSS services as needed within
95.5a service authorization that is not greater than 12 months. Using authorized units
95.6agency-provider services or the budget allocation amount for the flexible spending model
95.7flexibly does not increase the total amount of services and supports authorized for a
95.8participant or included in the participant's service delivery plan.
95.9(d) A participant may share CFSS services. Two or three CFSS participants may
95.10share services at the same time provided by the same support worker.
95.11(e) The agency-provider must use a minimum of 72.5 percent of the revenue
95.12generated by the medical assistance payment for CFSS for support worker wages and
95.13benefits. The agency-provider must document how this requirement is being met. The
95.14revenue generated by the support specialist and the reasonable costs associated with the
95.15support specialist must not be used in making this calculation.
95.16(f) The agency-provider model must be used by individuals who have been restricted
95.17by the Minnesota restricted recipient program.
95.18    Subd. 12. Requirements for initial enrollment of CFSS provider agencies. (a)
95.19All CFSS provider agencies must provide, at the time of enrollment as a CFSS provider
95.20agency in a format determined by the commissioner, information and documentation that
95.21includes, but is not limited to, the following:
95.22(1) the CFSS provider agency's current contact information including address,
95.23telephone number, and e-mail address;
95.24(2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
95.25provider's payments from Medicaid in the previous year, whichever is less;
95.26(3) proof of fidelity bond coverage in the amount of $20,000;
95.27(4) proof of workers' compensation insurance coverage;
95.28(5) proof of liability insurance;
95.29(6) a description of the CFSS provider agency's organization identifying the names
95.30or all owners, managing employees, staff, board of directors, and the affiliations of the
95.31directors, owners, or staff to other service providers;
95.32(7) a copy of the CFSS provider agency's written policies and procedures including:
95.33hiring of employees; training requirements; service delivery; and employee and consumer
95.34safety including process for notification and resolution of consumer grievances,
95.35identification and prevention of communicable diseases, and employee misconduct;
96.1(8) copies of all other forms the CFSS provider agency uses in the course of daily
96.2business including, but not limited to:
96.3(i) a copy of the CFSS provider agency's time sheet if the time sheet varies from
96.4the standard time sheet for CFSS services approved by the commissioner, and a letter
96.5requesting approval of the CFSS provider agency's nonstandard time sheet;
96.6(ii) the CFSS provider agency's template for the CFSS care plan; and
96.7(iii) the CFSS provider agency's template for the written agreement in subdivision
96.821 for recipients using the CFSS choice option, if applicable;
96.9(9) a list of all training and classes that the CFSS provider agency requires of its
96.10staff providing CFSS services;
96.11(10) documentation that the CFSS provider agency and staff have successfully
96.12completed all the training required by this section;
96.13(11) documentation of the agency's marketing practices;
96.14(12) disclosure of ownership, leasing, or management of all residential properties
96.15that is used or could be used for providing home care services;
96.16(13) documentation that the agency will use the following percentages of revenue
96.17generated from the medical assistance rate paid for CFSS services for employee personal
96.18care assistant wages and benefits: 72.5 percent of revenue from CFSS providers. The
96.19revenue generated by the support specialist and the reasonable costs associated with the
96.20support specialist shall not be used in making this calculation; and
96.21(14) documentation that the agency does not burden recipients' free exercise of their
96.22right to choose service providers by requiring personal care assistants to sign an agreement
96.23not to work with any particular CFSS recipient or for another CFSS provider agency after
96.24leaving the agency and that the agency is not taking action on any such agreements or
96.25requirements regardless of the date signed.
96.26(b) CFSS provider agencies shall provide the information specified in paragraph
96.27(a) to the commissioner.
96.28(c) All CFSS provider agencies shall require all employees in management and
96.29supervisory positions and owners of the agency who are active in the day-to-day
96.30management and operations of the agency to complete mandatory training as determined
96.31by the commissioner. Employees in management and supervisory positions and owners
96.32who are active in the day-to-day operations of an agency who have completed the required
96.33training as an employee with a CFSS provider agency do not need to repeat the required
96.34training if they are hired by another agency, if they have completed the training within
96.35the past three years. CFSS provider agency billing staff shall complete training about
96.36CFSS program financial management. Any new owners or employees in management
97.1and supervisory positions involved in the day-to-day operations are required to complete
97.2mandatory training as a requisite of working for the agency. CFSS provider agencies
97.3certified for participation in Medicare as home health agencies are exempt from the
97.4training required in this subdivision.
97.5    Subd. 13. Flexible spending model. (a) Under the flexible spending model
97.6participants can exercise more responsibility and control over the services and supports
97.7described and budgeted within the CFSS service delivery plan. Under this model:
97.8(1) participants directly employ support workers;
97.9(2) participants may use a budget allocation to obtain supports and goods as defined
97.10in subdivision 7; and
97.11(3) from the financial management services (FMS) contractor the participant may
97.12choose a range of support assistance services relating to:
97.13(i) planning, budgeting, and management of services and support;
97.14(ii) the participant's employment, training, supervision, and evaluation of workers;
97.15(iii) acquisition and payment for supports and goods; and
97.16(iv) evaluation of individual service outcomes as needed for the scope of the
97.17participant's degree of control and responsibility.
97.18(b) Participants who are unable to fulfill any of the functions listed in paragraph (a)
97.19may authorize a legal representative or participant's representative to do so on their behalf.
97.20(c) The FMS contractor shall not provide CFSS services and supports under the
97.21agency-provider service model. The FMS contractor shall provide service functions as
97.22determined by the commissioner that include but are not limited to:
97.23(1) information and consultation about CFSS;
97.24(2) assistance with the development of the service delivery plan and flexible
97.25spending model as requested by the participant;
97.26(3) billing and making payments for flexible spending model expenditures;
97.27(4) assisting participants in fulfilling employer-related requirements according to
97.28Internal Revenue Code Procedure 70-6, section 3504, Agency Employer Tax Liability,
97.29regulation 137036-08, which includes assistance with filing and paying payroll taxes, and
97.30obtaining worker compensation coverage;
97.31(5) data recording and reporting of participant spending; and
97.32(6) other duties established in the contract with the department.
97.33(d) A participant who requests to purchase goods and supports along with support
97.34worker services under the agency-provider model must use flexible spending model
97.35with a service delivery plan that specifies the amount of services to be authorized to the
97.36agency-provider and the expenditures to be paid by the FMS contractor.
98.1(e) The FMS contractor shall:
98.2(1) not limit or restrict the participant's choice of service or support providers or
98.3service delivery models as authorized by the commissioner;
98.4(2) provide the participant and the targeted case manager, if applicable, with a
98.5monthly written summary of the spending for services and supports that were billed
98.6against the spending budget;
98.7(3) be knowledgeable of state and federal employment regulations under the Fair
98.8Labor Standards Act of 1938, and comply with the requirements under the Internal
98.9Revenue Service Revenue Code Procedure 70-6, Section 35-4, Agency Employer Tax
98.10Liability for vendor or fiscal employer agent, and any requirements necessary to process
98.11employer and employee deductions, provide appropriate and timely submission of
98.12employer tax liabilities, and maintain documentation to support medical assistance claims;
98.13(4) have current and adequate liability insurance and bonding and sufficient cash
98.14flow as determined by the commission and have on staff or under contract a certified
98.15public accountant or an individual with a baccalaureate degree in accounting;
98.16(5) assume fiscal accountability for state funds designated for the program; and
98.17(6) maintain documentation of receipts, invoices, and bills to track all services and
98.18supports expenditures for any goods purchased and maintain time records of support
98.19workers. The documentation and time records must be maintained for a minimum of
98.20five years from the claim date and be available for audit or review upon request by the
98.21commissioner. Claims submitted by the FMS contractor to the commissioner for payment
98.22must correspond with services, amounts, and time periods as authorized in the participant's
98.23spending budget and service plan.
98.24(f) The commissioner of human services shall:
98.25(1) establish rates and payment methodology for the FMS contractor;
98.26(2) identify a process to ensure quality and performance standards for the FMS
98.27contractor and ensure statewide access to FMS contractors; and
98.28(3) establish a uniform protocol for delivering and administering CFSS services
98.29to be used by eligible FMS contractors.
98.30(g) Participants who are disenrolled from the model shall be transferred to the
98.31agency-provider model.
98.32    Subd. 14. Participant's responsibilities under flexible spending model. (a) A
98.33participant using the flexible spending model must use a FMS contractor or vendor that is
98.34under contract with the department. Upon a determination of eligibility and completion of
98.35the assessment and community support plan, the participant shall choose a FMS contractor
98.36from a list of eligible vendors maintained by the department.
99.1(b) When the participant, participant's representative, or legal representative chooses
99.2to be the employer of the support worker, they are responsible for recruiting, interviewing,
99.3hiring, training, scheduling, supervising, and discharging direct support workers.
99.4(c) In addition to the employer responsibilities in paragraph (b), the participant,
99.5participant's representative, or legal representative is responsible for:
99.6(1) tracking the services provided and all expenditures for goods or other supports;
99.7(2) preparing and submitting time sheets, signed by both the participant and support
99.8worker, to the FMS contractor on a regular basis and in a timely manner according to
99.9the FMS contractor's procedures;
99.10(3) notifying the FMS contractor within ten days of any changes in circumstances
99.11affecting the CFSS service plan or in the participant's place of residence including, but
99.12not limited to, any hospitalization of the participant or change in the participant's address,
99.13telephone number, or employment;
99.14(4) notifying the FMS contractor of any changes in the employment status of each
99.15participant support worker; and
99.16(5) reporting any problems resulting from the quality of services rendered by the
99.17support worker to the FMS contractor. If the participant is unable to resolve any problems
99.18resulting from the quality of service rendered by the support worker with the assistance of
99.19the FMS contractor, the participant shall report the situation to the department.
99.20    Subd. 15. Documentation of support services provided. (a) Support services
99.21provided to a participant by a support worker employed by either an agency-provider
99.22or the participant acting as the employer must be documented daily by each support
99.23worker, on a time sheet form approved by the commissioner. All documentation may be
99.24Web-based, electronic, or paper documentation. The completed form must be submitted
99.25on a monthly basis to the provider or the participant and the FMS contractor selected by
99.26the participant to provide assistance with meeting the participant's employer obligations
99.27and kept in the recipient's health record.
99.28(b) The activity documentation must correspond to the written service delivery plan
99.29and be reviewed by the agency provider or the participant and the FMS contractor when
99.30the participant is acting as the employer of the support worker.
99.31(c) The time sheet must be on a form approved by the commissioner documenting
99.32time the support worker provides services in the home. The following criteria must be
99.33included in the time sheet:
99.34(1) full name of the support worker and individual provider number;
99.35(2) provider name and telephone numbers, if an agency-provider is responsible for
99.36delivery services under the written service plan;
100.1(3) full name of the participant;
100.2(4) consecutive dates, including month, day, and year, and arrival and departure
100.3times with a.m. or p.m. notations;
100.4(5) signatures of the participant or the participant's representative;
100.5(6) personal signature of the support worker;
100.6(7) any shared care provided, if applicable;
100.7(8) a statement that it is a federal crime to provide false information on CFSS
100.8billings for medical assistance payments; and
100.9(9) dates and location of recipient stays in a hospital, care facility, or incarceration.
100.10    Subd. 16. Support workers requirements. (a) Support workers shall:
100.11(1) enroll with the department as a support worker after a background study under
100.12chapter 245C has been completed and the support worker has received a notice from the
100.13commissioner that:
100.14(i) the support worker is not disqualified under section 245C.14; or
100.15(ii) is disqualified, but the support worker has received a set-aside of the
100.16disqualification under section 245C.22;
100.17(2) have the ability to effectively communicate with the participant or the
100.18participant's representative;
100.19(3) have the skills and ability to provide the services and supports according to the
100.20person's CFSS service delivery plan and respond appropriately to the participant's needs;
100.21(4) not be a participant of CFSS;
100.22(5) complete the basic standardized training as determined by the commissioner
100.23before completing enrollment. The training must be available in languages other than
100.24English and to those who need accommodations due to disabilities. Support worker
100.25training must include successful completion of the following training components: basic
100.26first aid, vulnerable adult, child maltreatment, OSHA universal precautions, basic roles
100.27and responsibilities of support workers including information about basic body mechanics,
100.28emergency preparedness, orientation to positive behavioral practices, orientation to
100.29responding to a mental health crisis, fraud issues, time cards and documentation, and an
100.30overview of person-centered planning and self-direction. Upon completion of the training
100.31components, the support worker must pass the certification test to provide assistance
100.32to participants;
100.33(6) complete training and orientation on the participant's individual needs; and
100.34(7) maintain the privacy and confidentiality of the participant, and not independently
100.35determine the medication dose or time for medications for the participant.
101.1(b) The commissioner may deny or terminate a support worker's provider enrollment
101.2and provider number if the support worker:
101.3(1) lacks the skills, knowledge, or ability to adequately or safely perform the
101.4required work;
101.5(2) fails to provide the authorized services required by the participant employer;
101.6(3) has been intoxicated by alcohol or drugs while providing authorized services to
101.7the participant or while in the participant's home;
101.8(4) has manufactured or distributed drugs while providing authorized services to the
101.9participant or while in the participant's home; or
101.10(5) has been excluded as a provider by the commissioner of human services, or the
101.11United States Department of Health and Human Services, Office of Inspector General,
101.12from participation in Medicaid, Medicare, or any other federal health care program.
101.13(c) A support worker may appeal in writing to the commissioner to contest the
101.14decision to terminate the support worker's provider enrollment and provider number.
101.15    Subd. 17. Support specialist requirements and payments. The commissioner
101.16shall develop qualifications, scope of functions, and payment rates and service limits for a
101.17support specialist that may provide additional or specialized assistance necessary to plan,
101.18implement, arrange, augment, or evaluate services and supports.
101.19    Subd. 18. Service unit and budget allocation requirements. (a) For the
101.20agency-provider model, services will be authorized in units of service. The total service
101.21unit amount must be established based upon the assessed need for CFSS services, and
101.22must not exceed the maximum number of units available as determined by section
101.23256B.0652, subdivision 6. The unit rate established by the commissioner is used with
101.24assessed units to determine the maximum available CFSS allocation.
101.25(b) For the flexible spending model, services and supports are authorized under
101.26a budget limit.
101.27(c) The maximum available CFSS participant budget allocation shall be established
101.28by multiplying the number of units authorized under subdivision 8 by the payment rate
101.29established by the commissioner.
101.30    Subd. 19. Support system. (a) The commissioner shall provide information,
101.31consultation, training, and assistance to ensure the participant is able to manage the
101.32services and supports and budgets, if applicable. This support shall include individual
101.33consultation on how to select and employ workers, manage responsibilities under CFSS,
101.34and evaluate personal outcomes.
101.35(b) The commissioner shall provide assistance with the development of risk
101.36management agreements.
102.1    Subd. 20. Service-related rights. Participants must be provided with adequate
102.2information, counseling, training, and assistance, as needed, to ensure that the participant
102.3is able to choose and manage services, models, and budgets. This support shall include
102.4information regarding: (1) person-centered planning; (2) the range and scope of individual
102.5choices; (3) the process for changing plans, services and budgets; (4) the grievance
102.6process; (5) individual rights; (6) identifying and assessing appropriate services; (7) risks
102.7and responsibilities; and (8) risk management. A participant who appeals a reduction in
102.8previously authorized CFSS services may continue previously authorized services pending
102.9an appeal under section 256.045. The commissioner must ensure that the participant
102.10has a copy of the most recent service delivery plan that contains a detailed explanation
102.11of which areas of covered CFSS are reduced, and provide notice of the amount of the
102.12budget reduction, and the reasons for the reduction in the participant's notice of denial,
102.13termination, or reduction.
102.14    Subd. 21. Development and Implementation Council. The commissioner
102.15shall establish a Development and Implementation Council of which the majority of
102.16members are individuals with disabilities, elderly individuals, and their representatives.
102.17The commissioner shall consult and collaborate with the council when developing and
102.18implementing this section.
102.19    Subd. 22. Quality assurance and risk management system. (a) The commissioner
102.20shall establish quality assurance and risk management measures for use in developing and
102.21implementing CFSS including those that (1) recognize the roles and responsibilities of those
102.22involved in obtaining CFSS, and (2) ensure the appropriateness of such plans and budgets
102.23based upon a recipient's resources and capabilities. Risk management measures must
102.24include background studies, and backup and emergency plans, including disaster planning.
102.25(b) The commissioner shall provide ongoing technical assistance and resource and
102.26educational materials for CFSS participants.
102.27(c) Performance assessment measures, such as a participant's satisfaction with the
102.28services and supports, and ongoing monitoring of health and well-being shall be identified
102.29in consultation with the council established in subdivision 21.
102.30    Subd. 23. Commissioner's access. When the commissioner is investigating a
102.31possible overpayment of Medicaid funds, the commissioner must be given immediate
102.32access without prior notice to the agency provider or FMS contractor's office during
102.33regular business hours and to documentation and records related to services provided and
102.34submission of claims for services provided. Denying the commissioner access to records
102.35is cause for immediate suspension of payment and terminating the agency provider's
102.36enrollment according to section 256B.064 or terminating the FMS contract.
103.1    Subd. 24. CFSS agency-providers; background studies. CFSS agency-providers
103.2enrolled to provide personal care assistance services under the medical assistance program
103.3shall comply with the following:
103.4(1) owners who have a five percent interest or more and all managing employees
103.5are subject to a background study as provided in chapter 245C. This applies to currently
103.6enrolled CFSS agency-providers and those agencies seeking enrollment as a CFSS
103.7agency-provider. "Managing employee" has the same meaning as Code of Federal
103.8Regulations, title 42, section 455. An organization is barred from enrollment if:
103.9(i) the organization has not initiated background studies on owners managing
103.10employees; or
103.11(ii) the organization has initiated background studies on owners and managing
103.12employees, but the commissioner has sent the organization a notice that an owner or
103.13managing employee of the organization has been disqualified under section 245C.14, and
103.14the owner or managing employee has not received a set-aside of the disqualification
103.15under section 245C.22;
103.16(2) a background study must be initiated and completed for all support specialists; and
103.17(3) a background study must be initiated and completed for all support workers.
103.18EFFECTIVE DATE.This section is effective upon federal approval. The
103.19commissioner of human services shall notify the revisor of statutes when this occurs.

103.20    Sec. 44. Minnesota Statutes 2012, section 256I.05, is amended by adding a subdivision
103.21to read:
103.22    Subd. 1o. Supplementary service rate; exemptions. A county agency shall not
103.23negotiate a supplementary service rate under this section for any individual that has been
103.24determined to be eligible for Housing Stability Services as approved by the Centers
103.25for Medicare and Medicaid Services, and who resides in an establishment voluntarily
103.26registered under section 144D.025, as a supportive housing establishment or participates
103.27in the Minnesota supportive housing demonstration program under section 256I.04,
103.28subdivision 3, paragraph (a), clause (4).

103.29    Sec. 45. Minnesota Statutes 2012, section 626.557, subdivision 4, is amended to read:
103.30    Subd. 4. Reporting. (a) Except as provided in paragraph (b), a mandated reporter
103.31shall immediately make an oral report to the common entry point. The common entry
103.32point may accept electronic reports submitted through a Web-based reporting system
103.33established by the commissioner. Use of a telecommunications device for the deaf or other
103.34similar device shall be considered an oral report. The common entry point may not require
104.1written reports. To the extent possible, the report must be of sufficient content to identify
104.2the vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment,
104.3any evidence of previous maltreatment, the name and address of the reporter, the time,
104.4date, and location of the incident, and any other information that the reporter believes
104.5might be helpful in investigating the suspected maltreatment. A mandated reporter may
104.6disclose not public data, as defined in section 13.02, and medical records under sections
104.7144.291 to 144.298, to the extent necessary to comply with this subdivision.
104.8(b) A boarding care home that is licensed under sections 144.50 to 144.58 and
104.9certified under Title 19 of the Social Security Act, a nursing home that is licensed under
104.10section 144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a
104.11hospital that is licensed under sections 144.50 to 144.58 and has swing beds certified under
104.12Code of Federal Regulations, title 42, section 482.66, may submit a report electronically
104.13to the common entry point instead of submitting an oral report. The report may be a
104.14duplicate of the initial report the facility submits electronically to the commissioner of
104.15health to comply with the reporting requirements under Code of Federal Regulations, title
104.1642, section 483.13. The commissioner of health may modify these reporting requirements
104.17to include items required under paragraph (a) that are not currently included in the
104.18electronic reporting form.
104.19EFFECTIVE DATE.This section is effective July 1, 2014.

104.20    Sec. 46. Minnesota Statutes 2012, section 626.557, subdivision 9, is amended to read:
104.21    Subd. 9. Common entry point designation. (a) Each county board shall designate
104.22a common entry point for reports of suspected maltreatment. Two or more county boards
104.23may jointly designate a single The commissioner of human services shall establish a
104.24 common entry point effective July 1, 2014. The common entry point is the unit responsible
104.25for receiving the report of suspected maltreatment under this section.
104.26(b) The common entry point must be available 24 hours per day to take calls from
104.27reporters of suspected maltreatment. The common entry point shall use a standard intake
104.28form that includes:
104.29(1) the time and date of the report;
104.30(2) the name, address, and telephone number of the person reporting;
104.31(3) the time, date, and location of the incident;
104.32(4) the names of the persons involved, including but not limited to, perpetrators,
104.33alleged victims, and witnesses;
104.34(5) whether there was a risk of imminent danger to the alleged victim;
104.35(6) a description of the suspected maltreatment;
105.1(7) the disability, if any, of the alleged victim;
105.2(8) the relationship of the alleged perpetrator to the alleged victim;
105.3(9) whether a facility was involved and, if so, which agency licenses the facility;
105.4(10) any action taken by the common entry point;
105.5(11) whether law enforcement has been notified;
105.6(12) whether the reporter wishes to receive notification of the initial and final
105.7reports; and
105.8(13) if the report is from a facility with an internal reporting procedure, the name,
105.9mailing address, and telephone number of the person who initiated the report internally.
105.10(c) The common entry point is not required to complete each item on the form prior
105.11to dispatching the report to the appropriate lead investigative agency.
105.12(d) The common entry point shall immediately report to a law enforcement agency
105.13any incident in which there is reason to believe a crime has been committed.
105.14(e) If a report is initially made to a law enforcement agency or a lead investigative
105.15agency, those agencies shall take the report on the appropriate common entry point intake
105.16forms and immediately forward a copy to the common entry point.
105.17(f) The common entry point staff must receive training on how to screen and
105.18dispatch reports efficiently and in accordance with this section.
105.19(g) The commissioner of human services shall maintain a centralized database
105.20for the collection of common entry point data, lead investigative agency data including
105.21maltreatment report disposition, and appeals data. The common entry point shall
105.22have access to the centralized database and must log the reports into the database and
105.23immediately identify and locate prior reports of abuse, neglect, or exploitation.
105.24(h) When appropriate, the common entry point staff must refer calls that do not
105.25allege the abuse, neglect, or exploitation of a vulnerable adult to other organizations
105.26that might resolve the reporter's concerns.
105.27(i) a common entry point must be operated in a manner that enables the
105.28commissioner of human services to:
105.29(1) track critical steps in the reporting, evaluation, referral, response, disposition,
105.30and investigative process to ensure compliance with all requirements for all reports;
105.31(2) maintain data to facilitate the production of aggregate statistical reports for
105.32monitoring patterns of abuse, neglect, or exploitation;
105.33(3) serve as a resource for the evaluation, management, and planning of preventative
105.34and remedial services for vulnerable adults who have been subject to abuse, neglect,
105.35or exploitation;
106.1(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
106.2of the common entry point; and
106.3(5) track and manage consumer complaints related to the common entry point.
106.4(j) The commissioners of human services and health shall collaborate on the
106.5creation of a system for referring reports to the lead investigative agencies. This system
106.6shall enable the commissioner of human services to track critical steps in the reporting,
106.7evaluation, referral, response, disposition, investigation, notification, determination, and
106.8appeal processes.

106.9    Sec. 47. Minnesota Statutes 2012, section 626.557, subdivision 9e, is amended to read:
106.10    Subd. 9e. Education requirements. (a) The commissioners of health, human
106.11services, and public safety shall cooperate in the development of a joint program for
106.12education of lead investigative agency investigators in the appropriate techniques for
106.13investigation of complaints of maltreatment. This program must be developed by July
106.141, 1996. The program must include but need not be limited to the following areas: (1)
106.15information collection and preservation; (2) analysis of facts; (3) levels of evidence; (4)
106.16conclusions based on evidence; (5) interviewing skills, including specialized training to
106.17interview people with unique needs; (6) report writing; (7) coordination and referral
106.18to other necessary agencies such as law enforcement and judicial agencies; (8) human
106.19relations and cultural diversity; (9) the dynamics of adult abuse and neglect within family
106.20systems and the appropriate methods for interviewing relatives in the course of the
106.21assessment or investigation; (10) the protective social services that are available to protect
106.22alleged victims from further abuse, neglect, or financial exploitation; (11) the methods by
106.23which lead investigative agency investigators and law enforcement workers cooperate in
106.24conducting assessments and investigations in order to avoid duplication of efforts; and
106.25(12) data practices laws and procedures, including provisions for sharing data.
106.26(b) The commissioner of human services shall conduct an outreach campaign to
106.27promote the common entry point for reporting vulnerable adult maltreatment. This
106.28campaign shall use the Internet and other means of communication.
106.29(b) (c) The commissioners of health, human services, and public safety shall offer at
106.30least annual education to others on the requirements of this section, on how this section is
106.31implemented, and investigation techniques.
106.32(c) (d) The commissioner of human services, in coordination with the commissioner
106.33of public safety shall provide training for the common entry point staff as required in this
106.34subdivision and the program courses described in this subdivision, at least four times
106.35per year. At a minimum, the training shall be held twice annually in the seven-county
107.1metropolitan area and twice annually outside the seven-county metropolitan area. The
107.2commissioners shall give priority in the program areas cited in paragraph (a) to persons
107.3currently performing assessments and investigations pursuant to this section.
107.4(d) (e) The commissioner of public safety shall notify in writing law enforcement
107.5personnel of any new requirements under this section. The commissioner of public
107.6safety shall conduct regional training for law enforcement personnel regarding their
107.7responsibility under this section.
107.8(e) (f) Each lead investigative agency investigator must complete the education
107.9program specified by this subdivision within the first 12 months of work as a lead
107.10investigative agency investigator.
107.11A lead investigative agency investigator employed when these requirements take
107.12effect must complete the program within the first year after training is available or as soon
107.13as training is available.
107.14All lead investigative agency investigators having responsibility for investigation
107.15duties under this section must receive a minimum of eight hours of continuing education
107.16or in-service training each year specific to their duties under this section.

107.17    Sec. 48. REPEALER.
107.18(a) Minnesota Statutes 2012, sections 245A.655; and 256B.0917, subdivisions 1, 2,
107.193, 4, 5, 7, 8, 9, 10, 11, 12, and 14, are repealed.
107.20(b) Minnesota Statutes 2012, section 256B.0911, subdivisions 4a, 4b, and 4c, are
107.21repealed effective October 1, 2013.

107.22    Sec. 49. EFFECTIVE DATE; CONTINGENT SYSTEMS MODERNIZATION
107.23APPROPRIATION.
107.24    Subdivision 1. Definitions. (a) For the purposes of this section, the terms in this
107.25subdivision have the meanings given.
107.26(b) Unless otherwise indicated, "commissioner" means the commissioner of human
107.27services.
107.28(c) "Contingent systems modernization appropriation" refers to the appropriation in
107.29article 15, section 2.
107.30(d) "Department" means the Department of Human Services.
107.31(e) "Plan" means the plan that outlines how the provisions in this article, and the
107.32contingent appropriation for systems modernization, are implemented once federal action
107.33on Reform 2020 has occurred.
108.1(f) Unless otherwise indicated, "Reform 2020" means the commissioner's request
108.2for any necessary federal approval of provisions in this article that modify or provide
108.3new medical assistance services, or that otherwise modify the federal role in the state's
108.4long-term care system.
108.5    Subd. 2. Intent; effective dates generally. (a) Because the changes contained in
108.6this article generate savings that are contingent on federal approval of Reform 2020,
108.7the legislature has also made an appropriation for systems modernization contingent on
108.8federal approval of Reform 2020. The purpose of this section is to outline how this article
108.9and the contingent systems modernization appropriation in article 15 are implemented if
108.10Reform 2020 is fully, partially, or incrementally approved or denied.
108.11(b) In order for sections 1 to 48 of this article to be effective, the commissioner must
108.12follow the provisions of subdivisions 3 and 4, as applicable, notwithstanding any other
108.13effective dates for those sections.
108.14    Subd. 3. Federal approval. (a) The implementation of this article is contingent
108.15on federal approval.
108.16(b) Upon full or partial approval of the waiver application, the commissioner shall
108.17develop a plan for implementing the provisions in this article that received federal
108.18approval as well as any that do not require federal approval. The plan must:
108.19(1) include fiscal estimates for the 2014-2015 and 2016-2017 biennia;
108.20(2) include the contingent systems modernization appropriation, which cannot
108.21exceed $16,992,000 for the biennium ending June 30, 2015; and
108.22(3) include spending estimates that, with federal administrative reimbursement, do
108.23not exceed the department's net general fund appropriations for the 2014-2015 biennium.
108.24(c) Upon approval by the commissioner of management and budget, the department
108.25may implement the plan.
108.26(d) The commissioner may follow this plan and implement parts of Reform 2020
108.27consistent with federal law if federal approval is denied, received incrementally, or
108.28significantly delayed.
108.29(e) The commissioner must notify the chairs and ranking minority members of the
108.30legislative committees with jurisdiction over health and human services funding of the
108.31plan. The plan must be made publicly available online.
108.32    Subd. 4. Disbursement; implementation. The commissioner of management and
108.33budget shall disburse the appropriations in article 15, section 2, to the commissioner to
108.34allow for implementation of the approved plan and make necessary adjustments in the
108.35accounting system to reflect any modified funding levels. Notwithstanding Minnesota
108.36Statutes, section 16A.11, subdivision 3, paragraph (b), these fiscal estimates must be
109.1considered in establishing the appropriation base for the biennium ending June 30, 2017.
109.2The commissioner of management and budget shall reflect the modified funding levels in
109.3the first fund balance following the approval of the plan.


109.7    Section 1. Minnesota Statutes 2012, section 256B.4912, subdivision 2, is amended to
109.8read:
109.9    Subd. 2. Payment methodologies. (a) The commissioner shall establish, as defined
109.10under section 256B.4913, statewide payment methodologies that meet federal waiver
109.11requirements for home and community-based waiver services for individuals with
109.12disabilities. The payment methodologies must abide by the principles of transparency
109.13and equitability across the state. The methodologies must involve a uniform process of
109.14structuring rates for each service and must promote quality and participant choice.
109.15    (b) As of January 1, 2012, counties shall not implement changes to established
109.16processes for rate-setting methodologies for individuals using components of or data
109.17from research rates.

109.18    Sec. 2. Minnesota Statutes 2012, section 256B.4912, subdivision 3, is amended to read:
109.19    Subd. 3. Payment requirements. The payment methodologies established under
109.20this section shall accommodate:
109.21(1) supervision costs;
109.22(2) staffing patterns staff compensation;
109.23(3) staffing and supervisory patterns;
109.24(3) (4) program-related expenses;
109.25(4) (5) general and administrative expenses; and
109.26(5) (6) consideration of recipient intensity.

109.27    Sec. 3. Minnesota Statutes 2012, section 256B.4913, is amended to read:
109.28256B.4913 PAYMENT METHODOLOGY DEVELOPMENT.
109.29    Subdivision 1. Research period and rates. (a) For the purposes of this
109.30section, "research rate" means a proposed payment rate for the provision of home
109.31and community-based waivered services to meet federal requirements and assess the
109.32implications of changing resources on the provision of services and "research period"
109.33means the time period during which the research rate is being assessed by the commissioner.
110.1    (b) The commissioner shall determine and publish initial frameworks and values to
110.2generate research rates for individuals receiving home and community-based services.
110.3    (c) The initial values issued by the commissioner shall ensure projected spending
110.4for home and community-based services for each service area is equivalent to projected
110.5spending under current law in the most recent expenditure forecast.
110.6    (d) The initial values issued shall be based on the most updated information and cost
110.7data available on supervision, employee-related costs, client programming and supports,
110.8programming planning supports, transportation, administrative overhead, and utilization
110.9costs. These service areas are:
110.10    (1) residential services, defined as corporate foster care, family foster care, residential
110.11care, supported living services, customized living, and 24-hour customized living;
110.12    (2) day program services, defined as adult day care, day training and habilitation,
110.13prevocational services, structured day services, and transportation;
110.14    (3) unit-based services with programming, defined as in-home family support,
110.15independent living services, supported living services, supported employment, behavior
110.16programming, and housing access coordination; and
110.17    (4) unit-based services without programming, defined as respite, personal support,
110.18and night supervision.
110.19    (e) The commissioner shall make available the underlying assessment information,
110.20without any identifying information, and the statistical modeling used to generate the
110.21initial research rate and calculate budget neutrality.
110.22    Subd. 1a. Application. The payment methodologies in this section apply to home
110.23and community-based services waivers under sections 256B.092 and 256B.49. This
110.24section does not change existing waiver policies and procedures.
110.25    Subd. 1b. Definitions. (a) For purposes of this section, the following terms have the
110.26meanings given them, unless the context clearly indicates otherwise.
110.27(b) "Commissioner" means the commissioner of human services.
110.28(c) "Component value" means underlying factors that are part of the cost of providing
110.29services that are built into the waiver rates methodology to calculate service rates.
110.30(d) "Customized living tool" means a methodology for setting service rates which
110.31delineates and documents the amount of each component service included in a recipient's
110.32customized living service plan.
110.33(e) "Disability Waiver Rates System" means a statewide system which establishes
110.34rates that are based on uniform processes and captures the individualized nature of waiver
110.35services and recipient needs.
111.1(f) "Median" means the amount that divides distribution into two equal groups, half
111.2above the median and half below the median.
111.3(g) "Payment" or "rate" means reimbursement to an eligible provider for services
111.4provided to a qualified individual based on an approved service authorization.
111.5(h) "Rates management system" means a Web-based software application that uses
111.6a framework and component values, as determined by the commissioner, to establish
111.7service rates.
111.8(i) "Recipient" means a person receiving home and community-based services
111.9funded under any of the disability waivers.
111.10    Subd. 1c. Applicable services. Applicable services are those authorized under the
111.11state's home and community-based services waivers under sections 256B.092 and 256B.49,
111.12including as defined in the federally approved home and community-based services plan:
111.13(1) 24-hour customized living;
111.14(2) adult day care;
111.15(3) adult day care bath;
111.16(4) behavioral programming;
111.17(5) companion services;
111.18(6) customized living;
111.19(7) day training and habilitation;
111.20(8) housing access coordination;
111.21(9) independent living skills;
111.22(10) in-home family support;
111.23(11) night supervision;
111.24(12) personal support;
111.25(13) prevocational services;
111.26(14) residential care services;
111.27(15) residential support services;
111.28(16) respite services;
111.29(17) structured day services;
111.30(18) supported employment services;
111.31(19) supported living services;
111.32(20) transportation services; and
111.33(21) other services as approved by the federal government in the state home and
111.34community-based services plan.
112.1    Subd. 2. Framework values. (a) The commissioner shall propose legislation with
112.2the specific payment methodology frameworks, process for calculation, and specific
112.3values to populate the frameworks by February 15, 2013.
112.4    (b) The commissioner shall provide underlying data and information used to
112.5formulate the final frameworks and values to the existing stakeholder workgroup by
112.6January 15, 2013.
112.7    (c) The commissioner shall provide recommendations for the final frameworks
112.8and values, and the basis for the recommendations, to the legislative committees with
112.9jurisdiction over health and human services finance by February 15, 2013.
112.10    (d) The commissioner shall review the following topics during the research period
112.11and propose, as necessary, recommendations to address the following research questions:
112.12    (1) underlying differences in the cost to provide services throughout the state;
112.13    (2) a data-driven process for determining labor costs and customizations for staffing
112.14classifications included in each rate framework based on the services performed;
112.15    (3) the allocation of resources previously established under section 256B.501,
112.16subdivision 4b;
112.17    (4) further definition and development of unit-based services;
112.18    (5) the impact of splitting the allocation of resources for unit-based services for those
112.19with programming aspects and those without;
112.20    (6) linking assessment criteria to future assessment processes for determination
112.21of customizations;
112.22    (7) recognition of cost differences in the use of monitoring technology where it is
112.23appropriate to substitute for supervision;
112.24    (8) implications for day services of reimbursement based on a unit rate and a daily
112.25rate;
112.26    (9) a definition of shared and individual staffing for unit-based services;
112.27    (10) the underlying costs of providing transportation associated with day services; and
112.28    (11) an exception process for individuals with exceptional needs that cannot be met
112.29under the initial research rate, and an alternative payment structure for those individuals.
112.30    (e) The commissioner shall develop a comprehensive plan based on information
112.31gathered during the research period that uses statistically reliable and valid assessment
112.32data to refine payment methodologies.
112.33    (f) The commissioner shall make recommendations and provide underlying data and
112.34information used to formulate these research recommendations to the existing stakeholder
112.35workgroup by January 15, 2013.
113.1    Subd. 3. Data collection. (a) The commissioner shall conduct any necessary
113.2research and gather additional data for the further development and refinement of payment
113.3methodology components. These include but are not limited to:
113.4    (1) levels of service utilization and patterns of use;
113.5    (2) staffing patterns for each service;
113.6    (3) profiles of individual service needs; and
113.7    (4) cost factors involved in providing transportation services.
113.8    (b) The commissioner shall provide this information to the existing stakeholder
113.9workgroup by January 15, 2013.
113.10    Subd. 4. Rate stabilization adjustment. Beginning January 1, 2014, the
113.11commissioner shall adjust individual rates determined by the new payment methodology
113.12so that the new rate varies no more than one percent per year from the rate effective
113.13on December 31 of the prior calendar year. This adjustment is made annually and is
113.14effective for three calendar years from the date of implementation. This subdivision
113.15expires January 1, 2017.
113.16    Subd. 4a. Rate stabilization adjustment. (a) The commissioner of human services
113.17shall adjust individual reimbursement rates by no more than 1.0 percent per year effective
113.18January 1, 2014. Rates must be adjusted using the new payment methodology so that the
113.19new unit rate varies no more than 1.0 percent per year from the rate effective December
113.201 of the prior calendar year. This adjustment is made annually for three calendar years
113.21from the date of implementation.
113.22(b) Rate stabilization adjustment applies to services that are authorized in a
113.23recipient's service plan prior to January 1, 2014.
113.24(c) Exemptions shall be made only when there is a significant change in the
113.25recipient's assessed needs which results in a service authorization change. Exemption
113.26adjustments shall be limited to the difference in the authorized framework rate specific to
113.27change in assessed need. Exemptions shall be managed within lead agencies' budgets per
113.28existing allocation procedures which govern county waiver budget allocation.
113.29(d) This subdivision expires January 1, 2017.
113.30    Subd. 5. Stakeholder consultation. The commissioner shall continue consultation
113.31on regular intervals, with the existing stakeholder group established as part of the
113.32rate-setting methodology process and others to gather input, concerns, and data, and
113.33exchange ideas for to assist in the legislative proposals for full implementation of the new
113.34rate payment system and to make pertinent information available to the public through
113.35the department's Web site.
114.1    Subd. 6. Implementation. (a) The commissioner may shall implement changes
114.2no sooner than on January 1, 2014, to payment rates for individuals receiving home and
114.3community-based waivered services after the enactment of legislation that establishes
114.4specific payment methodology frameworks, processes for rate calculations, and specific
114.5values to populate the payment methodology frameworks disability waiver rates system.
114.6(b) Rates shall be determined using component values as provided under this
114.7section. Lead agencies, in consultation with provider agencies, shall enter person-specific
114.8information into a rate management system developed by the commissioner. The rate
114.9management system must calculate rates that lead agencies must use as the basis for
114.10authorizing services on behalf of disability waiver recipients subject to the requirements
114.11of subdivision 4.
114.12(c) On January 1, 2014, all new service authorizations must use the disability waiver
114.13rates system. Beginning January 1, 2014, all renewing individual service plans must use the
114.14disability waiver rates system as reassessment and reauthorization occurs. By December
114.1531, 2014, data for all recipients must be entered into the disability waiver rates system.
114.16(d) Beginning January 1, 2014, through implementation, the commissioner shall
114.17make adjustments to lead agency waiver budgets per the federally approved home and
114.18community-based services waiver plans for people with disabilities as authorized under
114.19sections 256B.092 and 256B.49.
114.20    Subd. 7. Uniform payment methodology. The commissioner shall determine
114.21a uniform methodology to meet the individualized service plan for recipients with
114.22disabilities as funded under the waiver plan for home and community-based services
114.23under sections 256B.092 and 256B.49. The commissioner shall use the component values,
114.24with consideration of recipient needs, to determine the service payment rate under this
114.25section. The payment methodology for customized living, 24-hour customized living, and
114.26residential care services shall be the customized living tool. Revisions to the customized
114.27living tool shall be made to reflect services and activities unique to disability-related
114.28recipient needs.
114.29    Subd. 8. Payments for residential services. (a) Payments for residential support
114.30services as defined in sections 256B.092, subdivision 11, and 256B.49, subdivision 22,
114.31must be calculated as follows:
114.32(1) Determine the number of units of service to meet a recipient's needs.
114.33(2) Personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
114.34national and Minnesota-specific rates or rates derived by the commissioner as provided in
114.35paragraph (c). This is defined as the direct care rate.
115.1(3) For a recipient requiring customization for deaf and hard-of-hearing language
115.2accessibility under subdivision 15, add the customization rate provided in subdivision 15
115.3to the result of clause (2). This is defined as the customized direct care rate.
115.4(4) Multiply the number of residential services direct staff hours by the appropriate
115.5staff wage in paragraph (c) or the customized direct care rate.
115.6(5) Multiply the number of direct staff hours by the product of the supervision
115.7span of control ratio in paragraph (d), clause (1), and the supervision wage in paragraph
115.8(c), clause (5).
115.9(6) Combine the results of clauses (4) and (5), and multiply the result by one plus
115.10the employee vacation, sick, and training allowance ratio in paragraph (d), clause (2).
115.11This is defined as the direct staffing cost.
115.12(7) For employee-related expenses, multiply the direct staffing cost by one plus the
115.13employee-related cost ratio in paragraph (d), clause (3).
115.14(8) For client programming and supports, the commissioner shall add $2,179 per
115.15year adjusted to an hourly rate.
115.16(9) For transportation, if provided, the commissioner shall add $1,680, or $3,000 if
115.17customized for adapted transport per year adjusted to an hourly rate.
115.18(b) The total rate shall be calculated using the following steps:
115.19(1) Subtotal paragraph (a), clauses (7) to (9).
115.20(2) Sum the standard general and administrative rate, the program-related expense
115.21ratio, and the absence and utilization ratio.
115.22(3) Divide the result of clause (1) by one minus the result of clause (2). This is
115.23the total payment amount.
115.24(c)(1) The base wage index is established to determine staffing costs associated with
115.25providing services to individuals receiving home and community-based services. For
115.26purposes of developing and calculating the proposed base wage, Minnesota-specific wages
115.27taken from job descriptions and standard occupational classification (SOC) codes from
115.28the Bureau of Labor Statistics, as defined in the most recent edition of the Occupational
115.29Outlook Handbook, shall be used. The base wage index shall be calculated as provided in
115.30clauses (2) to (5).
115.31(2) The base wage index for residential direct basic care services is:
115.32(i) 50 percent of the median wage for personal and home health aide (SOC code
115.3339-9021);
115.34(ii) 30 percent of the median wage for nursing aide (SOC code 31-1012); and
115.35(iii) 20 percent of the median wage for social and human services aide (SOC code
115.3621-1093).
116.1(3) The base wage index for residential direct care intensive services is:
116.2(i) 20 percent of the median wage for home health aide (SOC code 31-1011);
116.3(ii) 20 percent of the median wage for personal and home health aide (SOC code
116.439-9021);
116.5(iii) 20 percent of the median wage for nursing aide (SOC code 31-1012);
116.6(iv) 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
116.7and
116.8(v) 20 percent of the median wage for social and human services aide (SOC code
116.921-1093).
116.10(4) When residential direct care basic services are provided during normal sleeping
116.11hours, the basic wage is $7.66 per hour, except in a family foster care setting the wage is
116.12$2.80 per hour.
116.13(5) For supervisory staff, the basic wage is $17.43 per hour.
116.14(d) Component values for residential support services, excluding family foster
116.15care, are:
116.16(1) supervisory span of control ratio: 11 percent;
116.17(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
116.18(3) employee-related cost ratio: 23.6 percent;
116.19(4) general administrative support ratio: 13.25 percent;
116.20(5) program-related expense ratio: 1.3 percent; and
116.21(6) absence and utilization factor ratio: 3.9 percent.
116.22(e) Component values for family foster care are:
116.23(1) supervisory span of control ratio: 11 percent;
116.24(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
116.25(3) employee-related cost ratio: 23.6 percent;
116.26(4) general administrative support ratio: 3.3 percent; and
116.27(5) program-related expense ratio: 1.3 percent.
116.28(f) The commissioner shall revise the wage rates in the manner provided in
116.29subdivision 12.
116.30    Subd. 9. Payments for day programs. (a) Payments for services with day
116.31programs, including adult day care, day treatment and habilitation, prevocational services,
116.32and structured day services must be calculated as follows:
116.33(1) Determine the number of units of service to meet a recipient's needs.
116.34(2) Personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
116.35Minnesota-specific rates or rates derived by the commissioner as provided in paragraph (b).
117.1(3) For a recipient requiring customization for deaf and hard-of-hearing language
117.2accessibility under subdivision 15, add the customization rate provided in subdivision 15
117.3to the result of clause (2). This is defined as the customized direct care rate.
117.4(4) Multiply the number of day program direct staff hours by the appropriate staff
117.5wage in paragraph (b) or the customized direct care rate.
117.6(5) Multiply the number of day direct staff hours by the product of the supervision
117.7span of control ratio in paragraph (c), clause (1), and the supervision wage in paragraph
117.8(b), clause (3).
117.9(6) Combine the results of clauses (4) and (5), and multiply the result by one plus
117.10the employee vacation, sick, and training allowance ratio in paragraph (c), clause (2).
117.11This is defined as the direct staffing rate.
117.12(7) For program plan support, multiply the result of clause (6) by one plus the
117.13program plan support ratio in paragraph (c), clause (4).
117.14(8) For employee-related expenses, multiply the result of clause (7) by one plus the
117.15employee-related cost ratio in paragraph (c), clause (3).
117.16(9) For client programming and supports, multiply the result of clause (8) by one
117.17plus the client programming and support ratio in paragraph (c), clause (5).
117.18(10) For program facility costs, add $8.30 per week with consideration of staffing
117.19ratios to meet individual needs.
117.20(11) For adult day bath services, add $7.01 per 15 minute unit.
117.21(12) This is the subtotal rate.
117.22(13) Sum the standard general and administrative rate, the program-related expense
117.23ratio, and the absence and utilization factor ratio.
117.24(14) Divide the result of clause (12) by one minus the result of clause (13). This is
117.25the total payment amount.
117.26(15) For transportation provided as part of day training and habilitation, add a base
117.27of $2.52 plus:
117.28(i) $2.50 for a trip between zero to ten miles without a lift or $7.05 with a lift;
117.29(ii) $7.75 for a trip between 11 and 20 miles without a lift or $22.16 with a lift;
117.30(iii) $17.75 for a trip between 21 and 50 miles without a lift and $50.76 with a lift;
117.31(iv) $25.50 for a trip of 51 miles or more without a lift and $72.93 with a lift; and
117.32(v) divide by six for a shared trip.
117.33(b)(1) The base wage index is established to determine staffing costs associated with
117.34providing services to individuals receiving home and community-based services. For
117.35purposes of developing and calculating the proposed base wage, Minnesota-specific wages
117.36taken from job descriptions and standard occupational classification (SOC) codes from
118.1the Bureau of Labor Statistics, as defined in the most recent edition of the Occupational
118.2Outlook Handbook, shall be used. The base wage index shall be calculated as provided in
118.3clauses (2) and (3).
118.4(2) The base wage index for direct services is:
118.5(i) 20 percent of the median wage for nursing aide (SOC code 31-1012);
118.6(ii) 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
118.7and
118.8(iii) 60 percent of the median wage for social and human services aide (SOC code
118.921-1093).
118.10(3) For supervisory staff, the base wage index is $17.43 per hour.
118.11(c) Component values for day services for all services are:
118.12(1) supervisory span of control ratio: 11 percent;
118.13(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
118.14(3) employee-related cost ratio: 23.6 percent;
118.15(4) program plan support ratio: 5.6 percent;
118.16(5) client programming and support ratio: 10 percent;
118.17(6) general administrative support ratio: 13.25 percent;
118.18(7) program-related expense ratio: 1.8 percent; and
118.19(8) absence and utilization factor ratio: 3.9 percent.
118.20(d) The commissioner shall revise the wage rates in the manner provided in
118.21subdivision 12.
118.22    Subd. 10. Payments for unit-based with program services. (a) Payments for
118.23unit-based with program services, including behavior programming, housing access
118.24coordination, in-home family support, independent living skills training, hourly supported
118.25living services, and supported employment provided to an individual outside of any day or
118.26residential service plan must be calculated as follows, unless the services are authorized
118.27separately under subdivisions 8 and 9:
118.28(1) Determine the number of units of service to meet a recipient's needs.
118.29(2) Personnel hourly wage rate must be based on the 2009 Bureau of Labor Statistics
118.30Minnesota-specific rates or rates derived by the commissioner as provided in paragraph (b).
118.31(3) For a recipient requiring customization for deaf and hard-of-hearing language
118.32accessibility under subdivision 15, add the customization rate provided in subdivision 15
118.33to the result of clause (2). This is defined as the customized direct care rate.
118.34(4) Multiply the number of direct staff hours by the appropriate staff wage in
118.35paragraph (b) or the customized direct care rate.
119.1(5) Multiply the number of direct staff hours by the product of the supervision
119.2span of control ratio in paragraph (c), clause (1), and the supervision wage in paragraph
119.3(b), clause (10).
119.4(6) Combine the results of clauses (4) and (5), and multiply the result by one plus
119.5the employee vacation, sick, and training allowance ratio in paragraph (c), clause (2).
119.6This is defined as the direct staffing rate.
119.7(7) For program plan support, multiply the result of clause (6) by one plus the
119.8program plan supports ratio in paragraph (c), clause (4).
119.9(8) For employee-related expenses, multiply the result of clause (7) by one plus the
119.10employee-related cost ratio in paragraph (c), clause (3).
119.11(9) For client programming and supports, multiply the result of clause (8) by one
119.12plus the client programming and supports ratio in paragraph (c), clause (5).
119.13(10) This is the subtotal rate.
119.14(11) Sum the standard general and administrative rate, the program-related expense
119.15ratio, and the absence and utilization factor ratio.
119.16(12) Divide the result of clause (10) by one minus the result of clause (11). This is
119.17the total payment amount.
119.18(b)(1) The base wage index is established to determine staffing costs associated with
119.19providing services to individuals receiving home and community-based services. For
119.20purposes of developing and calculating the proposed base wage, Minnesota-specific wages
119.21taken from job descriptions and standard occupational classification (SOC) codes from
119.22the Bureau of Labor Statistics, as defined in the most recent edition of the Occupational
119.23Outlook Handbook, shall be used. The base wage index shall be calculated as provided in
119.24clauses (2) to (10).
119.25(2) The base wage index for a behavior program analyst is 100 percent of the median
119.26wage for mental health counselor (SOC code 21-1014).
119.27(3) The base wage index for a behavior program professional is 100 percent of the
119.28median wage for clinical counseling and school psychologist (SOC code 19-3031).
119.29(4) The base wage index for a behavior program specialist is 100 percent of the
119.30median wage for psychiatric technician (SOC code 29-2053).
119.31(5) The base wage index for hourly supportive living services is:
119.32(i) 20 percent of the median wage for nursing aide (SOC code 31-1012);
119.33(ii) 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
119.34and
119.35(iii) 60 percent of the median wage for social and human services aide (SOC code
119.3621-1093).
120.1(6) The base wage index for housing access coordinator services is:
120.2(i) 50 percent of the median wage for community and social services specialist
120.3(SOC code 21-1099); and
120.4(ii) 50 percent of the median wage for social and human services aide (SOC code
120.521-1093).
120.6(7) The base wage index for in-home family support services is:
120.7(i) 20 percent of the median wage for nursing aide (SOC code 31-1012);
120.8(ii) 30 percent of the median wage for community social service specialist (SOC
120.9code 21-1099);
120.10(iii) 40 percent of the median wage for social and human services aide (SOC code
120.1121-1093); and
120.12(iv) ten percent of the median wage for psychiatric technician (SOC code 29-2053).
120.13(8) The base wage index for independent living skills is:
120.14(i) 40 percent of the median wage for community social service specialist (SOC
120.15code 21-1099);
120.16(ii) 50 percent of the median wage for social and human services aide (SOC code
120.1721-1093); and
120.18(iii) ten percent of the median wage for psychiatric technician (SOC code 29-2053).
120.19(9) The base wage index for supported employment services is:
120.20(i) 20 percent of the median wage for nursing aide (SOC code 31-1012);
120.21(ii) 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
120.22and
120.23(iii) 60 percent of the median wage for social and human services aide (SOC code
120.2421-1093).
120.25(10) For a supervisor, the base wage index is $17.43 per hour with the exception of the
120.26supervision of behavior analysts and behavior specialists which shall be $30.75 per hour.
120.27(c) Component values for unit-based with program services are:
120.28(1) supervisory span of control ratio: 11 percent;
120.29(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
120.30(3) employee-related cost ratio: 23.6 percent;
120.31(4) program plan supports ratio: 3.1 percent;
120.32(5) client programming and supports ratio: 8.6 percent;
120.33(6) general administrative support ratio: 13.25 percent;
120.34(7) program-related expense ratio: 6.1 percent; and
120.35(8) absence and utilization factor ratio: 3.9 percent.
121.1(d) The commissioner shall revise the wage rates in the manner provided in
121.2subdivision 12.
121.3    Subd. 11. Payments for unit-based without program services. (a) Payments
121.4for unit-based without program services including night supervision, personal support,
121.5respite, and companion care provided to an individual outside of any day or residential
121.6service plan must be calculated as follows unless the services are authorized separately
121.7under subdivisions 8 and 9:
121.8(1) For all services except respite, determine the number of units of service to meet
121.9a recipient's needs.
121.10(2) Personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
121.11Minnesota-specific rate or rates derived by the commissioner as provided in paragraph (b).
121.12(3) For a recipient requiring customization for deaf and hard-of-hearing language
121.13accessibility under subdivision 15, add the customization rate provided in subdivision 15
121.14to the result of clause (2). This is defined as the customized direct care rate.
121.15(4) Multiply the number of direct staff hours by the appropriate staff wage in
121.16paragraph (b) or the customized direct care rate.
121.17(5) Multiply the number of direct staff hours by the product of the supervision
121.18span of control ratio in paragraph (c), clause (1), and the supervision wage in paragraph
121.19(b), clause (6).
121.20(6) Combine the results of clauses (4) and (5) and multiply the result by one plus
121.21the employee vacation, sick, and training allowance ratio in paragraph (c), clause (2).
121.22This is defined as the direct staffing rate.
121.23(7) For program plan support, multiply the result of clause (6) by one plus the
121.24program plan support ratio in paragraph (c), clause (4).
121.25(8) For employee-related expenses, multiply the result of clause (7) by one plus the
121.26employee-related cost ratio in paragraph (c), clause (3).
121.27(9) For client programming and supports, multiply the result of clause (8) by one
121.28plus the client programming and support ratio in paragraph (c), clause (5).
121.29(10) This is the subtotal rate.
121.30(11) Sum the standard general and administrative rate, the program-related expense
121.31ratio, and the absence and utilization factor ratio.
121.32(12) Divide the result of clause (10) by one minus the result of clause (11). This is
121.33the total payment amount.
121.34(13) For respite services, determine the number of daily units of service to meet an
121.35individual's needs.
122.1(14) Personnel hourly wage rates must be based on the 2009 Bureau of Labor Statistics
122.2Minnesota-specific rate or rates derived by the commissioner as provided in paragraph (b).
122.3(15) For a recipient requiring deaf and hard-of-hearing customization under
122.4subdivision 15, add the customization rate provided in subdivision 15 to the result of
122.5clause (14). This is defined as the customized direct care rate.
122.6(16) Multiply the number of direct staff hours by the appropriate staff wage in
122.7paragraph (b).
122.8(17) Multiply the number of direct staff hours by the product of the supervisory
122.9span of control ratio in paragraph (d), clause (1), and the supervision wage in paragraph
122.10(b), clause (6).
122.11(18) Combine the results of clauses (16) and (17) and multiply the result by one plus
122.12the employee vacation, sick, and training allowance ratio in paragraph (d), clause (2).
122.13This is defined as the direct staffing rate.
122.14(19) For employee-related expenses, multiply the result of clause (18) by one plus
122.15the employee-related cost ratio in paragraph (d), clause (3).
122.16(20) This is the subtotal rate.
122.17(21) Sum the standard general and administrative rate, the program-related expense
122.18ratio, and the absence and utilization factor ratio.
122.19(22) Divide the result of clause (20) by one minus the result of clause (21). This is
122.20the total payment amount.
122.21(b)(1) The base wage index is established to determine staffing costs associated
122.22with providing services to recipients receiving home and community-based services. For
122.23purposes of developing and calculating the proposed base wage, Minnesota-specific wages
122.24taken from job descriptions and standard occupational classification (SOC) codes from
122.25the Bureau of Labor Statistics, as defined in the most recent edition of the Occupational
122.26Outlook Handbook, shall be used. The base wage index shall be calculated as provided in
122.27clauses (2) to (6):
122.28(2) The base wage index for adult companion staff is:
122.29(i) 50 percent of the median wage for personal and home care aide (SOC code
122.3039-9021); and
122.31(ii) 50 percent of the median wage for nursing aides, orderlies, and attendants (SOC
122.32code 31-1012).
122.33(3) The base wage index for night supervision staff is:
122.34(i) 20 percent of the median wage for home health aide (SOC code 31-1011);
122.35(ii) 20 percent of the median wage for personal and home health aide (SOC code
122.3639-9021);
123.1(iii) 20 percent of the median wage for nursing aide (SOC code 31-1012);
123.2(iv) 20 percent of the median wage for psychiatric technician (SOC code 29-2053);
123.3and
123.4(v) 20 percent of the median wage for social and human services aide (SOC code
123.521-1093).
123.6(4) The base wage index for respite staff is:
123.7(i) 50 percent of the median wage for personal and home care aide (SOC code
123.839-9021); and
123.9(ii) 50 percent of the median wage for nursing aides, orderlies, and attendants (SOC
123.10code 31-1012).
123.11(5) The base wage index for personal support staff is:
123.12(i) 50 percent of the median wage for personal and home care aide (SOC code
123.1339-9021); and
123.14(ii) 50 percent of the median wage for nursing aides, orderlies, and attendants (SOC
123.15code 31-1012).
123.16(6) The base wage index for supervisory staff is $17.43 per hour.
123.17(c) Component values for unit-based services without programming except respite
123.18are:
123.19(1) supervisory span of control ratio: 11 percent;
123.20(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
123.21(3) employee-related cost ratio: 23.6 percent;
123.22(4) program plan support ratio: 3.1 percent;
123.23(5) client programming and support ratio: 8.6 percent;
123.24(6) general administrative support ratio: 13.25 percent;
123.25(7) program-related expense ratio: 6.1 percent; and
123.26(8) absence and utilization factor ratio: 3.9 percent.
123.27(d) Component values for unit-based services without programming for respite are:
123.28(1) supervisory span of control ratio: 11 percent;
123.29(2) employee vacation, sick, and training allowance ratio: 8.71 percent;
123.30(3) employee-related cost ratio: 23.6 percent;
123.31(4) general administrative support ratio: 13.25 percent;
123.32(5) program-related expense ratio: 6.1 percent; and
123.33(6) absence and utilization factor ratio: 3.9 percent.
123.34(e) The commissioner shall revise the wage rates in the manner provider in
123.35subdivision 12.
124.1    Subd. 12. Updating or changing payment values. (a) The commissioner shall
124.2develop and implement uniform procedures to refine terms and update or adjust values
124.3used to calculate payment rates in this section. For calendar year 2014, the commissioner
124.4shall use the values, terms, and procedures provided in this section.
124.5(b) The commissioner shall work with stakeholders to assess efficacy of values
124.6and payment rates. The commissioner shall report back to the legislature with proposed
124.7changes for component values and recommendations for revisions on the schedule
124.8provided in paragraphs (c) and (d).
124.9(c) The commissioner shall work with stakeholders to continue refining a
124.10subset of component values, which are to be referred to as interim values, and report
124.11recommendations to the legislature by February 15, 2014. Interim component values are:
124.12transportation rates for day training and habilitation; transportation for adult day, structured
124.13day, and prevocational services; geographic difference factor; day program facility rate;
124.14services where monitoring technology replaces staff time; shared services for independent
124.15living skills training; and supported employment and billing for indirect services.
124.16(d) The commissioner shall report and make recommendations to the legislature on:
124.17February 15, 2015, February 15, 2017, February 15, 2019, and February 15, 2021. After
124.182021, reports shall be provided on a four-year cycle.
124.19(e) The commissioner shall provide a public notice via list serve in October of each
124.20year beginning October 1, 2014. The notice shall contain information detailing legislatively
124.21approved changes in: calculation values including derived wage rates and related employee
124.22and administrative factors; services utilization; county and tribal allocation changes
124.23and; information on adjustments to be made to calculation values and timing of those
124.24adjustment. Information in this notice shall be effective January 1 of the following year.
124.25    Subd. 13. Payment implementation. Upon implementation of the payment
124.26methodologies under this section, those payment rates supersede rates established in county
124.27contracts for recipients receiving waiver services under sections 256B.092 and 256B.49.
124.28    Subd. 14. Transportation. The commissioner shall require that the purchase
124.29of transportation services be cost-effective and be limited to market rates where the
124.30transportation mode is generally available and accessible.
124.31    Subd. 15. Customization of rates for individuals. For persons determined to have
124.32higher needs based on being deaf or hard-of-hearing, the direct care costs must be increased
124.33by an adjustment factor prior to calculating the price under subdivisions 8 to 11. The
124.34customization rate with respect to deaf or hard-of-hearing persons shall be $2.70 per hour
124.35for waiver recipients who meet the respective criteria as determined by the commissioner.
125.1    Subd. 16. Exceptions. (a) In a format prescribed by the commissioner, lead
125.2agencies must identify individuals with exceptional needs that cannot be met under the
125.3disability waiver rate system. The commissioner shall use that information to evaluate
125.4and, if necessary, approve an alternative payment rate for those individuals.
125.5(b) Lead agencies must submit exceptions requests to the state. Requests must
125.6include information specifying: the extraordinary needs of the individual that are not
125.7accounted for in payment methodology; the effort and costs required to meet those needs;
125.8and recommendations from the lead agency regarding the request. Requests must be
125.9reviewed and determinations made by the state. Approved exceptions must be managed
125.10within the lead agencies' budgets.
125.11    Subd. 17. Budget neutrality adjustment. (a) The commissioner shall calculate the
125.12total spending for all home and community-based waiver services under the payments as
125.13defined in subdivisions 8 to 11, and total forecasted spending under current law for the
125.14fiscal year beginning July 1, 2013. If total forecasted spending under subdivisions 8
125.15to 11 is projected to be higher than under current law, the commissioner shall adjust
125.16the rate by the percentage needed to adjust spending in each category to the same level
125.17as projected under current law.
125.18(b) The commissioner shall make any legislatively authorized changes to provider
125.19rates that are beyond subdivision 12 in this subdivision.


125.22    Section 1. Minnesota Statutes 2012, section 245.4661, subdivision 5, is amended to read:
125.23    Subd. 5. Planning for pilot projects. (a) Each local plan for a pilot project, with
125.24the exception of the placement of a Minnesota specialty treatment facility as defined in
125.25paragraph (c), must be developed under the direction of the county board, or multiple
125.26county boards acting jointly, as the local mental health authority. The planning process
125.27for each pilot shall include, but not be limited to, mental health consumers, families,
125.28advocates, local mental health advisory councils, local and state providers, representatives
125.29of state and local public employee bargaining units, and the department of human services.
125.30As part of the planning process, the county board or boards shall designate a managing
125.31entity responsible for receipt of funds and management of the pilot project.
125.32(b) For Minnesota specialty treatment facilities, the commissioner shall issue a
125.33request for proposal for regions in which a need has been identified for services.
126.1(c) For purposes of this section, Minnesota specialty treatment facility is defined as
126.2an intensive rehabilitative mental health service under section 256B.0622, subdivision 2,
126.3paragraph (b).

126.4    Sec. 2. Minnesota Statutes 2012, section 245.4661, subdivision 6, is amended to read:
126.5    Subd. 6. Duties of commissioner. (a) For purposes of the pilot projects, the
126.6commissioner shall facilitate integration of funds or other resources as needed and
126.7requested by each project. These resources may include:
126.8(1) residential services funds administered under Minnesota Rules, parts 9535.2000
126.9to 9535.3000, in an amount to be determined by mutual agreement between the project's
126.10managing entity and the commissioner of human services after an examination of the
126.11county's historical utilization of facilities located both within and outside of the county
126.12and licensed under Minnesota Rules, parts 9520.0500 to 9520.0690;
126.13(2) community support services funds administered under Minnesota Rules, parts
126.149535.1700 to 9535.1760;
126.15(3) other mental health special project funds;
126.16(4) medical assistance, general assistance medical care, MinnesotaCare and group
126.17residential housing if requested by the project's managing entity, and if the commissioner
126.18determines this would be consistent with the state's overall health care reform efforts; and
126.19(5) regional treatment center resources consistent with section 246.0136, subdivision
126.201 .; and
126.21(6) funds transferred from section 246.18, subdivision 8, for grants to providers to
126.22participate in mental health specialty treatment services, awarded to providers through
126.23a request for proposal process.
126.24(b) The commissioner shall consider the following criteria in awarding start-up and
126.25implementation grants for the pilot projects:
126.26(1) the ability of the proposed projects to accomplish the objectives described in
126.27subdivision 2;
126.28(2) the size of the target population to be served; and
126.29(3) geographical distribution.
126.30(c) The commissioner shall review overall status of the projects initiatives at least
126.31every two years and recommend any legislative changes needed by January 15 of each
126.32odd-numbered year.
126.33(d) The commissioner may waive administrative rule requirements which are
126.34incompatible with the implementation of the pilot project.
127.1(e) The commissioner may exempt the participating counties from fiscal sanctions
127.2for noncompliance with requirements in laws and rules which are incompatible with the
127.3implementation of the pilot project.
127.4(f) The commissioner may award grants to an entity designated by a county board or
127.5group of county boards to pay for start-up and implementation costs of the pilot project.

127.6    Sec. 3. Minnesota Statutes 2012, section 245.4682, subdivision 2, is amended to read:
127.7    Subd. 2. General provisions. (a) In the design and implementation of reforms to
127.8the mental health system, the commissioner shall:
127.9    (1) consult with consumers, families, counties, tribes, advocates, providers, and
127.10other stakeholders;
127.11    (2) bring to the legislature, and the State Advisory Council on Mental Health, by
127.12January 15, 2008, recommendations for legislation to update the role of counties and to
127.13clarify the case management roles, functions, and decision-making authority of health
127.14plans and counties, and to clarify county retention of the responsibility for the delivery of
127.15social services as required under subdivision 3, paragraph (a);
127.16    (3) withhold implementation of any recommended changes in case management
127.17roles, functions, and decision-making authority until after the release of the report due
127.18January 15, 2008;
127.19    (4) ensure continuity of care for persons affected by these reforms including
127.20ensuring client choice of provider by requiring broad provider networks and developing
127.21mechanisms to facilitate a smooth transition of service responsibilities;
127.22    (5) provide accountability for the efficient and effective use of public and private
127.23resources in achieving positive outcomes for consumers;
127.24    (6) ensure client access to applicable protections and appeals; and
127.25    (7) make budget transfers necessary to implement the reallocation of services and
127.26client responsibilities between counties and health care programs that do not increase the
127.27state and county costs and efficiently allocate state funds.
127.28    (b) When making transfers under paragraph (a) necessary to implement movement
127.29of responsibility for clients and services between counties and health care programs,
127.30the commissioner, in consultation with counties, shall ensure that any transfer of state
127.31grants to health care programs, including the value of case management transfer grants
127.32under section 256B.0625, subdivision 20, does not exceed the value of the services being
127.33transferred for the latest 12-month period for which data is available. The commissioner
127.34may make quarterly adjustments based on the availability of additional data during the
127.35first four quarters after the transfers first occur. If case management transfer grants under
128.1section 256B.0625, subdivision 20, are repealed and the value, based on the last year prior
128.2to repeal, exceeds the value of the services being transferred, the difference becomes an
128.3ongoing part of each county's adult and children's mental health grants under sections
128.4245.4661 , 245.4889, and 256E.12.
128.5    (c) This appropriation is not authorized to be expended after December 31, 2010,
128.6unless approved by the legislature.

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

128.24    Sec. 5. Minnesota Statutes 2012, section 246.18, is amended by adding a subdivision
128.25to read:
128.26    Subd. 9. Transfers. The commissioner may transfer state mental health grant funds
128.27to the account in subdivision 8 for noncovered allowable costs of a provider certified and
128.28licensed under section 256B.0622, and operating under section 246.014.

128.29    Sec. 6. [254B.14] CHEMICAL HEALTH NAVIGATION PROGRAM.
128.30    Subdivision 1. Establishment; purpose. (a) There is established a state-county
128.31chemical health navigation program. The Department of Human Services and interested
128.32counties shall work in partnership to augment the current chemical health service delivery
129.1system to promote better outcomes for eligible individuals and greater accountability and
129.2productivity in the delivery of state and county funded chemical dependency services.
129.3(b) The navigation program shall allow flexibility for eligible individuals to
129.4timely access needed services as well as to align systems and services to offer the most
129.5appropriate level of chemical health services to eligible individuals.
129.6(c) Chemical health navigation programs must maintain eligibility requirements for
129.7the consolidated chemical dependency treatment fund, continue to meet the requirements
129.8of Minnesota Rules, parts 9530.6405 to 9530.6505 and 9530.6600 to 9530.6655, and must
129.9not put current and future federal funding of chemical health services at risk.
129.10    Subd. 2. Program implementation. (a) Each county's participation in the chemical
129.11health navigation program is voluntary.
129.12(b) The commissioner and each county participating in the chemical health
129.13navigation program shall enter into an agreement governing the operation of the county's
129.14navigation program. Each county shall implement its program within 60 days of the final
129.15agreement with the commissioner.
129.16    Subd. 3. Notice of program discontinuation. Each county's participation in the
129.17chemical health navigation program may be discontinued for any reason by the county or
129.18the commissioner after 30 days' written notice to the other party. Any unspent funds held
129.19for the exiting county's pro rata share in the special revenue fund under the authority in
129.20subdivision 5, paragraph (d), shall be transferred to the consolidated chemical dependency
129.21treatment fund following discontinuation of the program.
129.22    Subd. 4. Eligibility for navigator program. To be considered for participation in
129.23a navigator program, an individual must:
129.24(1) be a resident of a county with an approved navigator program;
129.25(2) be eligible for chemical dependency fund services;
129.26(3) be a voluntary participant in the navigator program;
129.27(4) have at least one severity rating of two or above in dimensions four, five, or six
129.28in a comprehensive assessment under Minnesota Rules, part 9530.6422; and
129.29(5) have had at least two treatment episodes in the past two years, not limited
129.30to episodes reimbursed by the consolidated chemical dependency treatment funds. An
129.31admission to an emergency room, a detoxification program, or a hospital may be substituted
129.32for a treatment episode if it resulted from the individual's substance use disorder.
129.33    Subd. 5. Duties of commissioner. (a) Notwithstanding any other provisions in this
129.34chapter, the commissioner may authorize chemical health navigator programs to use
129.35chemical dependency treatment funds to pay for nontreatment services:
130.1(1) in addition to those authorized under section 254B.03, subdivision 2, paragraph
130.2(a); and
130.3(2) by vendors in addition to those authorized under section 254B.05 when not
130.4providing chemical dependency treatment services.
130.5(b) Participating counties may contract with providers to provide nontreatment
130.6services pursuant to section 256B.69, subdivision 6, paragraph (c).
130.7(c) For the purposes of this section, "nontreatment services" include community-based
130.8navigator services, peer support, family engagement and support, housing support and rent
130.9subsidy for up to 90 days, supported employment, and independent living skills.
130.10(d) State expenditures for chemical dependency services and nontreatment
130.11services provided through the navigator programs must not be greater than the chemical
130.12dependency treatment fund expected share of forecasted expenditures in the absence of
130.13the navigator programs. The commissioner may restructure the schedule of payments
130.14between the state and participating counties under the local agency share and division of
130.15cost provisions under section 254B.03, subdivisions 3 and 4, as necessary to facilitate
130.16the operation of the navigation programs.
130.17(e) To the extent that state fiscal year expenditures within a county's navigator
130.18program are less than the expected share of forecasted expenditures in the absence of the
130.19navigator program, the commissioner shall deposit the unexpended funds in a separate
130.20account within the consolidated chemical dependency treatment fund, and make these
130.21funds available for expenditure by the county for the following year. To the extent that
130.22treatment and nontreatment services expenditures within a county's navigator program
130.23exceed the amount expected in the absence of the navigator program, the county shall be
130.24responsible for the portion of costs for nontreatment services expended in excess of the
130.25otherwise expected share of forecasted expenditures.
130.26(f) The commissioner may waive administrative rule requirements that are
130.27incompatible with the implementation of navigator programs, except that any chemical
130.28dependency treatment funded under this section must continue to be provided by a
130.29licensed treatment provider.
130.30(g) The commissioner shall not approve or enter into any agreement related to
130.31navigator programs authorized under this section that puts current or future federal
130.32funding at risk.
130.33(h) The commissioner shall provide participating counties with transactional data,
130.34reports, provider data, and other data generated by county activity to assess and measure
130.35outcomes. This information must be transmitted to participating counties at least once
130.36every six months.
131.1    Subd. 6. Duties of county board. The county board, or other county entity that is
131.2approved to administer a navigator program, shall:
131.3(1) administer the program in a manner consistent with this section;
131.4(2) ensure that no one is denied chemical dependency treatment services for which
131.5they would otherwise be eligible under section 254A.03, subdivision 3; and
131.6(3) provide the commissioner with timely and pertinent information as negotiated in
131.7the agreement governing operation of the county's navigator program.
131.8    Subd. 7. Managed care. (a) An individual who is eligible for the navigator program
131.9under subdivision 4 is excluded from mandatory enrollment in managed care.
131.10(b) The commissioner shall seek any federal waivers and approvals necessary to
131.11allow managed care organizations to use capitated funds received from the commissioner
131.12to access nontreatment services defined in subdivision 5.
131.13    Subd. 8. Report. The commissioner, in partnership with participating counties,
131.14shall provide an annual report on the achievement of navigator program outcomes to the
131.15legislative committees with jurisdiction over chemical health. The report shall address
131.16qualitative and quantitative outcomes.
131.17EFFECTIVE DATE.This section is effective the day following final enactment.

131.18    Sec. 7. [256.478] HOME AND COMMUNITY-BASED SERVICES
131.19TRANSITIONS GRANTS.
131.20(a) The commissioner shall make available home and community-based services
131.21transition grants to serve individuals who do not meet eligibility criteria for the medical
131.22assistance program under section 256B.056 or 256B.057, but who otherwise meet the
131.23criteria under section 256B.092, subdivision 13, or 256B.49, subdivision 24.
131.24(b) For the purposes of this section, the commissioner has the authority to transfer
131.25funds between the medical assistance account and the home and community-based
131.26services transitions grants account.

131.27    Sec. 8. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
131.28subdivision to read:
131.29    Subd. 61. Family psychoeducation services. Effective July 1, 2013, or upon
131.30federal approval, whichever is later, medical assistance covers family psychoeducation
131.31services provided to a child up to age 21 with a diagnosed mental health condition when
131.32identified in the child's individual treatment plan and provided by a licensed mental health
131.33professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A, or a
131.34clinical trainee, as defined in Minnesota Rules, part 9505.0371, subpart 5, item C, who
132.1has determined it medically necessary to involve family members in the child's care. For
132.2the purposes of this subdivision, "family psychoeducation services" means information
132.3or demonstration provided to an individual or family as part of an individual, family,
132.4multifamily group, or peer group session to explain, educate, and support the child and
132.5family in understanding a child's symptoms of mental illness, the impact on the child's
132.6development, and needed components of treatment and skill development so that the
132.7individual, family, or group can help the child to prevent relapse, prevent the acquisition
132.8of comorbid disorders, and to achieve optimal mental health and long-term resilience.

132.9    Sec. 9. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
132.10subdivision to read:
132.11    Subd. 62. Mental health clinical care consultation. Effective July 1, 2013, or upon
132.12federal approval, whichever is later, medical assistance covers clinical care consultation
132.13for a person up to age 21 who is diagnosed with a complex mental health condition or a
132.14mental health condition that co-occurs with other complex and chronic conditions, when
132.15described in the person's individual treatment plan and provided by a licensed mental
132.16health professional, as defined in Minnesota Rules, part 9505.0371, subpart 5, item A. For
132.17the purposes of this subdivision, "clinical care consultation" means communication from a
132.18treating mental health professional to other providers not under the clinical supervision of
132.19the treating mental health professional who are working with the same client to inform,
132.20inquire, and instruct regarding the client's symptoms; strategies for effective engagement,
132.21care, and intervention needs; and treatment expectations across service settings; and to
132.22direct and coordinate clinical service components provided to the client and family.

132.23    Sec. 10. Minnesota Statutes 2012, section 256B.092, is amended by adding a
132.24subdivision to read:
132.25    Subd. 13. Waiver allocations for transition populations. (a) The commissioner
132.26shall make available additional waiver allocations and additional necessary resources
132.27to assure timely discharges from the Anoka Metro Regional Treatment Center and the
132.28Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
132.29(1) are otherwise eligible for the developmental disabilities waiver under this section;
132.30(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
132.31the Minnesota Security Hospital;
132.32(3) whose discharge would be significantly delayed without the available waiver
132.33allocation; and
132.34(4) who have met treatment objectives and no longer meet hospital level of care.
133.1(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
133.2requirements of the federal approved waiver plan.
133.3(c) Any corporate foster care home developed under this subdivision must be
133.4considered an exception under section 245A.03, subdivision 7, paragraph (a).

133.5    Sec. 11. Minnesota Statutes 2012, section 256B.0946, is amended to read:
133.6256B.0946 INTENSIVE TREATMENT IN FOSTER CARE.
133.7    Subdivision 1. Required covered service components. (a) Effective July 1, 2006,
133.8 upon enactment and subject to federal approval, medical assistance covers medically
133.9necessary intensive treatment services described under paragraph (b) that are provided
133.10by a provider entity eligible under subdivision 3 to a client eligible under subdivision 2
133.11who is placed in a treatment foster home licensed under Minnesota Rules, parts 2960.3000
133.12to 2960.3340.
133.13(b) Intensive treatment services to children with severe emotional disturbance mental
133.14illness residing in treatment foster care family settings must meet the relevant standards
133.15for mental health services under sections 245.487 to 245.4889. In addition, that comprise
133.16 specific required service components provided in clauses (1) to (5), are reimbursed by
133.17medical assistance must when they meet the following standards:
133.18(1) case management service component must meet the standards in Minnesota
133.19Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10;
133.20(1) psychotherapy provided by a mental health professional as defined in Minnesota
133.21Rules, part 9505.0371, subpart 5, item A, or a clinical trainee, as defined in Minnesota
133.22Rules, part 9505.0371, subpart 5, item C;
133.23(2) psychotherapy, crisis assistance, and skills training components must meet the
133.24 provided according to standards for children's therapeutic services and supports in section
133.25256B.0943 ; and
133.26(3) individual family, and group psychoeducation services under supervision of,
133.27defined in subdivision 1a, paragraph (q), provided by a mental health professional. or a
133.28clinical trainee;
133.29(4) clinical care consultation, as defined in subdivision 1a, and provided by a mental
133.30health professional or a clinical trainee; and
133.31(5) service delivery payment requirements as provided under subdivision 4.
133.32    Subd. 1a. Definitions. For the purposes of this section, the following terms have
133.33the meanings given them.
133.34(a) "Clinical care consultation" means communication from a treating clinician to
133.35other providers working with the same client to inform, inquire, and instruct regarding
134.1the client's symptoms, strategies for effective engagement, care and intervention needs,
134.2and treatment expectations across service settings, including but not limited to the client's
134.3school, social services, day care, probation, home, primary care, medication prescribers,
134.4disabilities services, and other mental health providers and to direct and coordinate clinical
134.5service components provided to the client and family.
134.6(b) "Clinical supervision" means the documented time a clinical supervisor and
134.7supervisee spend together to discuss the supervisee's work, to review individual client
134.8cases, and for the supervisee's professional development. It includes the documented
134.9oversight and supervision responsibility for planning, implementation, and evaluation of
134.10services for a client's mental health treatment.
134.11(c) "Clinical supervisor" means the mental health professional who is responsible
134.12for clinical supervision.
134.13(d) "Clinical trainee" has the meaning given in Minnesota Rules, part 9505.0371,
134.14subpart 5, item C;
134.15(e) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a,
134.16including the development of a plan that addresses prevention and intervention strategies
134.17to be used in a potential crisis, but does not include actual crisis intervention.
134.18(f) "Culturally appropriate" means providing mental health services in a manner that
134.19incorporates the child's cultural influences, as defined in Minnesota Rules, part 9505.0370,
134.20subpart 9, into interventions as a way to maximize resiliency factors and utilize cultural
134.21strengths and resources to promote overall wellness.
134.22(g) "Culture" means the distinct ways of living and understanding the world that
134.23are used by a group of people and are transmitted from one generation to another or
134.24adopted by an individual.
134.25(h) "Diagnostic assessment" has the meaning given in Minnesota Rules, part
134.269505.0370, subpart 11.
134.27(i) "Family" means a person who is identified by the client or the client's parent or
134.28guardian as being important to the client's mental health treatment. Family may include,
134.29but is not limited to, parents, foster parents, children, spouse, committed partners, former
134.30spouses, persons related by blood or adoption, persons who are a part of the client's
134.31permanency plan, or persons who are presently residing together as a family unit.
134.32(j) "Foster care" has the meaning given in section 260C.007, subdivision 18.
134.33(k) "Foster family setting" means the foster home in which the license holder resides.
134.34(l) "Individual treatment plan" has the meaning given in Minnesota Rules, part
134.359505.0370, subpart 15.
135.1(m) "Mental health practitioner" has the meaning given in Minnesota Rules, part
135.29505.0370, subpart 17.
135.3(n) "Mental health professional" has the meaning given in Minnesota Rules, part
135.49505.0370, subpart 18.
135.5(o) "Mental illness" has the meaning given in Minnesota Rules, part 9505.0370,
135.6subpart 20.
135.7(p) "Parent" has the meaning given in section 260C.007, subdivision 25.
135.8(q) "Psychoeducation services" means information or demonstration provided to
135.9an individual, family, or group to explain, educate, and support the individual, family, or
135.10group in understanding a child's symptoms of mental illness, the impact on the child's
135.11development, and needed components of treatment and skill development so that the
135.12individual, family, or group can help the child to prevent relapse, prevent the acquisition
135.13of comorbid disorders, and to achieve optimal mental health and long-term resilience.
135.14(r) "Psychotherapy" has the meaning given in Minnesota Rules, part 9505.0370,
135.15subpart 27.
135.16(s) "Team consultation and treatment planning" means the coordination of treatment
135.17plans and consultation among providers in a group concerning the treatment needs of the
135.18child, including disseminating the child's treatment service schedule to all members of the
135.19service team. Team members must include all mental health professionals working with
135.20the child, a parent, the child unless the team lead or parent deem it clinically inappropriate,
135.21and at least two of the following: an individualized education program case manager;
135.22probation agent; children's mental health case manager; child welfare worker, including
135.23adoption or guardianship worker; primary care provider; foster parent; and any other
135.24member of the child's service team.
135.25    Subd. 2. Determination of client eligibility. A client's eligibility to receive
135.26treatment foster care under this section shall be determined by An eligible recipient is an
135.27individual, from birth through age 20, who is currently placed in a foster home licensed
135.28under Minnesota Rules, parts 2960.3000 to 2960.3340, and has received a diagnostic
135.29assessment, and an evaluation of level of care needed, and development of an individual
135.30treatment plan, as defined in paragraphs (a) to (c) and (b).
135.31(a) The diagnostic assessment must:
135.32(1) meet criteria described in Minnesota Rules, part 9505.0372, subpart 1, and be
135.33conducted by a psychiatrist, licensed psychologist, or licensed independent clinical social
135.34worker that is mental health professional or a clinical trainee;
135.35(2) determine whether or not a child meets the criteria for mental illness, as defined
135.36in Minnesota Rules, part 9505.0370, subpart 20;
136.1(3) document that intensive treatment services are medically necessary within a
136.2foster family setting to ameliorate identified symptoms and functional impairments;
136.3(4) be performed within 180 days prior to before the start of service; and
136.4(2) include current diagnoses on all five axes of the client's current mental health
136.5status;
136.6(3) determine whether or not a child meets the criteria for severe emotional
136.7disturbance in section 245.4871, subdivision 6, or for serious and persistent mental illness
136.8in section 245.462, subdivision 20; and
136.9(4) be completed annually until age 18. For individuals between age 18 and 21,
136.10unless a client's mental health condition has changed markedly since the client's most
136.11recent diagnostic assessment, annual updating is necessary. For the purpose of this section,
136.12"updating" means a written summary, including current diagnoses on all five axes, by a
136.13mental health professional of the client's current mental status and service needs.
136.14(5) be completed as either a standard or extended diagnostic assessment annually to
136.15determine continued eligibility for the service.
136.16(b) The evaluation of level of care must be conducted by the placing county with
136.17an instrument, tribe, or case manager in conjunction with the diagnostic assessment as
136.18described by Minnesota Rules, part 9505.0372, subpart 1, item B, using a validated tool
136.19 approved by the commissioner of human services and not subject to the rulemaking
136.20process, consistent with section 245.4885, subdivision 1, paragraph (d), the result of which
136.21evaluation demonstrates that the child requires intensive intervention without 24-hour
136.22medical monitoring. The commissioner shall update the list of approved level of care
136.23instruments tools annually and publish on the department's Web site.
136.24(c) The individual treatment plan must be:
136.25(1) based on the information in the client's diagnostic assessment;
136.26(2) developed through a child-centered, family driven planning process that identifies
136.27service needs and individualized, planned, and culturally appropriate interventions that
136.28contain specific measurable treatment goals and objectives for the client and treatment
136.29strategies for the client's family and foster family;
136.30(3) reviewed at least once every 90 days and revised; and
136.31(4) signed by the client or, if appropriate, by the client's parent or other person
136.32authorized by statute to consent to mental health services for the client.
136.33    Subd. 3. Eligible mental health services providers. (a) Eligible providers for
136.34intensive children's mental health services in a foster family setting must be certified
136.35by the state and have a service provision contract with a county board or a reservation
137.1tribal council and must be able to demonstrate the ability to provide all of the services
137.2required in this section.
137.3(b) For purposes of this section, a provider agency must have an individual
137.4placement agreement for each recipient and must be a licensed child placing agency, under
137.5Minnesota Rules, parts 9543.0010 to 9543.0150, and either be:
137.6(1) a county county-operated entity certified by the state;
137.7(2) an Indian Health Services facility operated by a tribe or tribal organization under
137.8funding authorized by United States Code, title 25, sections 450f to 450n, or title 3 of the
137.9Indian Self-Determination Act, Public Law 93-638, section 638 (facilities or providers); or
137.10(3) a noncounty entity under contract with a county board.
137.11(c) Certified providers that do not meet the service delivery standards required in
137.12this section shall be subject to a decertification process.
137.13(d) For the purposes of this section, all services delivered to a client must be
137.14provided by a mental health professional or a clinical trainee.
137.15    Subd. 4. Eligible provider responsibilities Service delivery payment
137.16requirements. (a) To be an eligible provider for payment under this section, a provider
137.17must develop and practice written policies and procedures for treatment foster care services
137.18 intensive treatment in foster care, consistent with subdivision 1, paragraph (b), clauses (1),
137.19(2), and (3) and comply with the following requirements in paragraphs (b) to (n).
137.20(b) In delivering services under this section, a treatment foster care provider must
137.21ensure that staff caseload size reasonably enables the provider to play an active role in
137.22service planning, monitoring, delivering, and reviewing for discharge planning to meet
137.23the needs of the client, the client's foster family, and the birth family, as specified in each
137.24client's individual treatment plan.
137.25(b) A qualified clinical supervisor, as defined in and performing in compliance with
137.26Minnesota Rules, part 9505.0371, subpart 5, item D, must supervise the treatment and
137.27provision of services described in this section.
137.28(c) Each client receiving treatment services must receive an extended diagnostic
137.29assessment, as described in Minnesota Rules, part 9505.0372, subpart 1, item C, within
137.3030 days of enrollment in this service unless the client has a previous extended diagnostic
137.31assessment that the client, parent, and mental health professional agree still accurately
137.32describes the client's current mental health functioning.
137.33(d) Each previous and current mental health, school, and physical health treatment
137.34provider must be contacted to request documentation of treatment and assessments that the
137.35eligible client has received and this information must be reviewed and incorporated into
137.36the diagnostic assessment and team consultation and treatment planning review process.
138.1(e) Each client receiving treatment must be assessed for a trauma history and
138.2the client's treatment plan must document how the results of the assessment will be
138.3incorporated into treatment.
138.4(f) Each client receiving treatment services must have an individual treatment plan
138.5that is reviewed, evaluated, and signed every 90 days using the team consultation and
138.6treatment planning process, as defined in subdivision 1a, paragraph (s).
138.7(g) Care consultation, as defined in subdivision 1a, paragraph (a), must be provided
138.8in accordance with the client's individual treatment plan.
138.9(h) Each client must have a crisis assistance plan within ten days of initiating
138.10services and must have access to clinical phone support 24 hours per day, seven days per
138.11week, during the course of treatment, and the crisis plan must demonstrate coordination
138.12with the local or regional mobile crisis intervention team.
138.13(i) Services must be delivered and documented at least three days per week, equaling
138.14at least six hours of treatment per week, unless reduced units of service are specified on
138.15the treatment plan as part of transition or on a discharge plan to another service or level of
138.16care. Documentation must comply with Minnesota Rules, parts 9505.2175 and 9505.2197.
138.17(j) Location of service delivery must be in the client's home, day care setting,
138.18school, or other community-based setting that is specified on the client's individualized
138.19treatment plan.
138.20(k) Treatment must be developmentally and culturally appropriate for the client.
138.21(l) Services must be delivered in continual collaboration and consultation with the
138.22client's medical providers and, in particular, with prescribers of psychotropic medications,
138.23including those prescribed on an off-label basis, and members of the service team must be
138.24aware of the medication regimen and potential side effects.
138.25(m) Parents, siblings, foster parents, and members of the child's permanency plan
138.26must be involved in treatment and service delivery unless otherwise noted in the treatment
138.27plan.
138.28(n) Transition planning for the child must be conducted starting with the first
138.29treatment plan and must be addressed throughout treatment to support the child's
138.30permanency plan and postdischarge mental health service needs.
138.31    Subd. 5. Service authorization. The commissioner will administer authorizations
138.32for services under this section in compliance with section 256B.0625, subdivision 25.
138.33    Subd. 6. Excluded services. (a) Services in clauses (1) to (4) (7) are not covered
138.34under this section and are not eligible for medical assistance payment as components of
138.35intensive treatment in foster care services, but may be billed separately:
139.1(1) treatment foster care services provided in violation of medical assistance policy
139.2in Minnesota Rules, part 9505.0220;
139.3(2) service components of children's therapeutic services and supports
139.4simultaneously provided by more than one treatment foster care provider;
139.5(3) home and community-based waiver services; and
139.6(4) treatment foster care services provided to a child without a level of care
139.7determination according to section 245.4885, subdivision 1.
139.8(1) inpatient psychiatric hospital treatment;
139.9(2) mental health targeted case management;
139.10(3) partial hospitalization;
139.11(4) medication management;
139.12(5) children's mental health day treatment services;
139.13(6) crisis response services under section 256B.0944; and
139.14(7) transportation.
139.15(b) Children receiving intensive treatment in foster care services are not eligible for
139.16medical assistance reimbursement for the following services while receiving intensive
139.17treatment in foster care:
139.18(1) mental health case management services under section 256B.0625, subdivision
139.1920 ; and
139.20(2) (1) psychotherapy and skill skills training components of children's therapeutic
139.21services and supports under section 256B.0625, subdivision 35b.;
139.22(2) mental health behavioral aide services as defined in section 256B.0943,
139.23subdivision 1, paragraph (m);
139.24(3) home and community-based waiver services;
139.25(4) mental health residential treatment; and
139.26(5) room and board costs as defined in section 256I.03, subdivision 6.
139.27    Subd. 7. Medical assistance payment and rate setting. The commissioner shall
139.28establish a single daily per-client encounter rate for intensive treatment in foster care
139.29services. The rate must be constructed to cover only eligible services delivered to an
139.30eligible recipient by an eligible provider, as prescribed in subdivision 1, paragraph (b).

139.31    Sec. 12. Minnesota Statutes 2012, section 256B.49, is amended by adding a
139.32subdivision to read:
139.33    Subd. 24. Waiver allocations for transition populations. (a) The commissioner
139.34shall make available additional waiver allocations and additional necessary resources
140.1to assure timely discharges from the Anoka Metro Regional Treatment Center and the
140.2Minnesota Security Hospital in St. Peter for individuals who meet the following criteria:
140.3(1) are otherwise eligible for the brain injury, community alternatives for disabled
140.4individuals, or community alternative care waivers under this section;
140.5(2) who would otherwise remain at the Anoka Metro Regional Treatment Center or
140.6the Minnesota Security Hospital;
140.7(3) whose discharge would be significantly delayed without the available waiver
140.8allocation; and
140.9(4) who have met treatment objectives and no longer meet hospital level of care.
140.10(b) Additional waiver allocations under this subdivision must meet cost-effectiveness
140.11requirements of the federal approved waiver plan.
140.12(c) Any corporate foster care home developed under this subdivision must be
140.13considered an exception under section 245A.03, subdivision 7, paragraph (a).

140.14    Sec. 13. Minnesota Statutes 2012, section 256B.761, is amended to read:
140.15256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.
140.16(a) Effective for services rendered on or after July 1, 2001, payment for medication
140.17management provided to psychiatric patients, outpatient mental health services, day
140.18treatment services, home-based mental health services, and family community support
140.19services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
140.2050th percentile of 1999 charges.
140.21(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
140.22services provided by an entity that operates: (1) a Medicare-certified comprehensive
140.23outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
140.241993, with at least 33 percent of the clients receiving rehabilitation services in the most
140.25recent calendar year who are medical assistance recipients, will be increased by 38 percent,
140.26when those services are provided within the comprehensive outpatient rehabilitation
140.27facility and provided to residents of nursing facilities owned by the entity.
140.28(c) The commissioner shall establish three levels of payment for mental health
140.29diagnostic assessment, based on three levels of complexity. The aggregate payment under
140.30the tiered rates must not exceed the projected aggregate payments for mental health
140.31diagnostic assessment under the previous single rate. The new rate structure is effective
140.32January 1, 2011, or upon federal approval, whichever is later.
140.33(d) In addition to rate increases otherwise provided, the commissioner may
140.34restructure coverage policy and rates to improve access to adult rehabilitative mental
140.35health services under section 256B.0623 and related mental health support services under
141.1section 256B.021, subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and
141.22016, the projected state share of increased costs due to this paragraph is transferred
141.3from adult mental health grants under sections 245.4661 and 256E.12. The transfer for
141.4fiscal year 2016 is a permanent base adjustment for subsequent fiscal years. Payments
141.5made to managed care plans and county-based purchasing plans under sections 256B.69,
141.6256B.692, and 256L.12 shall reflect the rate changes described in this paragraph.


141.9    Section 1. Minnesota Statutes 2012, section 243.166, subdivision 7, is amended to read:
141.10    Subd. 7. Use of data. (a) Except as otherwise provided in subdivision 7a or sections
141.11244.052 and 299C.093, the data provided under this section is private data on individuals
141.12under section 13.02, subdivision 12.
141.13(b) The data may be used only for by law enforcement and corrections agencies for
141.14 law enforcement and corrections purposes.
141.15(c) The commissioner of human services is authorized to have access to the data for:
141.16(1) state-operated services, as defined in section 246.014, are also authorized to
141.17have access to the data for the purposes described in section 246.13, subdivision 2,
141.18paragraph (b); and
141.19(2) purposes of completing background studies under chapter 245C.

141.20    Sec. 2. Minnesota Statutes 2012, section 245C.04, is amended by adding a subdivision
141.21to read:
141.22    Subd. 4a. Agency background studies. (a) The commissioner shall develop
141.23and implement an electronic process for the regular transfer of new criminal history
141.24information that is added to the Minnesota court information system. The commissioner's
141.25system must include for review only information that relates to individuals who have been
141.26the subject of a background study under this chapter that remain affiliated with the agency
141.27that initiated the background study. For purposes of this paragraph, an individual remains
141.28affiliated with an agency that initiated the background study until the agency informs the
141.29commissioner that the individual is no longer affiliated. When any individual no longer
141.30affiliated according to this paragraph returns to a position requiring a background study
141.31under this chapter, the agency with whom the individual is again affiliated shall initiate
141.32a new background study regardless of the length of time the individual was no longer
141.33affiliated with the agency.
142.1(b) The commissioner shall develop and implement an online system for agencies that
142.2initiate background studies under this chapter to access and maintain records of background
142.3studies initiated by that agency. The system must show all active background study subjects
142.4affiliated with that agency and the status of each individual's background study. Each
142.5agency that initiates background studies must use this system to notify the commissioner
142.6of discontinued affiliation for purposes of the processes required under paragraph (a).

142.7    Sec. 3. Minnesota Statutes 2012, section 245C.08, subdivision 1, is amended to read:
142.8    Subdivision 1. Background studies conducted by Department of Human
142.9Services. (a) For a background study conducted by the Department of Human Services,
142.10the commissioner shall review:
142.11    (1) information related to names of substantiated perpetrators of maltreatment of
142.12vulnerable adults that has been received by the commissioner as required under section
142.13626.557, subdivision 9c , paragraph (j);
142.14    (2) the commissioner's records relating to the maltreatment of minors in licensed
142.15programs, and from findings of maltreatment of minors as indicated through the social
142.16service information system;
142.17    (3) information from juvenile courts as required in subdivision 4 for individuals
142.18listed in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;
142.19    (4) information from the Bureau of Criminal Apprehension, including information
142.20regarding a background study subject's registration in Minnesota as a predatory offender
142.21under section 243.166;
142.22    (5) except as provided in clause (6), information from the national crime information
142.23system when the commissioner has reasonable cause as defined under section 245C.05,
142.24subdivision 5; and
142.25    (6) for a background study related to a child foster care application for licensure or
142.26adoptions, the commissioner shall also review:
142.27    (i) information from the child abuse and neglect registry for any state in which the
142.28background study subject has resided for the past five years; and
142.29    (ii) information from national crime information databases, when the background
142.30study subject is 18 years of age or older.
142.31    (b) Notwithstanding expungement by a court, the commissioner may consider
142.32information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
142.33received notice of the petition for expungement and the court order for expungement is
142.34directed specifically to the commissioner.
143.1    (c) The commissioner shall also review criminal history information received
143.2according to section 245C.04, subdivision 4a, from the Minnesota court information
143.3system that relates to individuals who have already been studied under this chapter and
143.4who remain affiliated with the agency that initiated the background study.

143.5    Sec. 4. Minnesota Statutes 2012, section 256B.04, subdivision 21, is amended to read:
143.6    Subd. 21. Provider enrollment. (a) If the commissioner or the Centers for
143.7Medicare and Medicaid Services determines that a provider is designated "high-risk," the
143.8commissioner may withhold payment from providers within that category upon initial
143.9enrollment for a 90-day period. The withholding for each provider must begin on the date
143.10of the first submission of a claim.
143.11(b) An enrolled provider that is also licensed by the commissioner under chapter
143.12245A must designate an individual as the entity's compliance officer. The compliance
143.13officer must:
143.14(1) develop policies and procedures to assure adherence to medical assistance laws
143.15and regulations and to prevent inappropriate claims submissions;
143.16(2) train the employees of the provider entity, and any agents or subcontractors of
143.17the provider entity including billers, on the policies and procedures under clause (1);
143.18(3) respond to allegations of improper conduct related to the provision or billing of
143.19medical assistance services, and implement action to remediate any resulting problems;
143.20(4) use evaluation techniques to monitor compliance with medical assistance laws
143.21and regulations;
143.22(5) promptly report to the commissioner any identified violations of medical
143.23assistance laws or regulations; and
143.24    (6) within 60 days of discovery by the provider of a medical assistance
143.25reimbursement overpayment, report the overpayment to the commissioner and make
143.26arrangements with the commissioner for the commissioner's recovery of the overpayment.
143.27The commissioner may require, as a condition of enrollment in medical assistance, that a
143.28provider within a particular industry sector or category establish a compliance program that
143.29contains the core elements established by the Centers for Medicare and Medicaid Services.
143.30(c) The commissioner may revoke the enrollment of an ordering or rendering
143.31provider for a period of not more than one year, if the provider fails to maintain and, upon
143.32request from the commissioner, provide access to documentation relating to written orders
143.33or requests for payment for durable medical equipment, certifications for home health
143.34services, or referrals for other items or services written or ordered by such provider, when
143.35the commissioner has identified a pattern of a lack of documentation. A pattern means a
144.1failure to maintain documentation or provide access to documentation on more than one
144.2occasion. Nothing in this paragraph limits the authority of the commissioner to sanction a
144.3provider under the provisions of section 256B.064.
144.4(d) The commissioner shall terminate or deny the enrollment of any individual or
144.5entity if the individual or entity has been terminated from participation in Medicare or
144.6under the Medicaid program or Children's Health Insurance Program of any other state.
144.7(e) As a condition of enrollment in medical assistance, the commissioner shall
144.8require that a provider designated "moderate" or "high-risk" by the Centers for Medicare
144.9and Medicaid Services or the Minnesota Department of Human Services commissioner
144.10 permit the Centers for Medicare and Medicaid Services, its agents, or its designated
144.11contractors and the state agency, its agents, or its designated contractors to conduct
144.12unannounced on-site inspections of any provider location. The commissioner shall publish
144.13in the Minnesota Health Care Program Provider Manual a list of provider types designated
144.14"limited," "moderate," or "high-risk," based on the criteria and standards used to designate
144.15Medicare providers in Code of Federal Regulations, title 42, section 424.518. The list and
144.16criteria are not subject to the requirements of chapter 14. The commissioner's designations
144.17are not subject to administrative appeal.
144.18(f) As a condition of enrollment in medical assistance, the commissioner shall
144.19require that a high-risk provider, or a person with a direct or indirect ownership interest in
144.20the provider of five percent or higher, consent to criminal background checks, including
144.21fingerprinting, when required to do so under state law or by a determination by the
144.22commissioner or the Centers for Medicare and Medicaid Services that a provider is
144.23designated high-risk for fraud, waste, or abuse.
144.24(g) As a condition of enrollment, all durable medical equipment, prosthetics,
144.25orthotics, and supplies (DMEPOS) suppliers operating in Minnesota are required to name
144.26the Department of Human Services, in addition to the Centers for Medicare and Medicaid
144.27Services, as an obligee on all surety performance bonds required pursuant to section
144.284312(a) of the Balanced Budget Act of 1997, Public Law 105-33, amending Social
144.29Security Act, section 1834(a). The performance bond must also allow for recovery of
144.30costs and fees in pursuing a claim on the bond.
144.31(h) The Department of Human Services may require a provider to purchase a
144.32performance surety bond as a condition of initial enrollment, reenrollment, reinstatement,
144.33or continued enrollment if: (1) the provider fails to demonstrate financial viability, (2) the
144.34department determines there is significant evidence of or potential for fraud and abuse by
144.35the provider, or (3) the provider or category of providers is designated high-risk pursuant
144.36to paragraph (a) and as per Code of Federal Regulations, title 42, section 455.450, or the
145.1department otherwise finds it is in the best interest of the Medicaid program to do so. The
145.2performance bond must be in an amount of $100,000 or ten percent of the provider's
145.3payments from Medicaid during the immediately preceding 12 months, whichever is
145.4greater. The performance bond must name the Department of Human Services as an
145.5obligee and must allow for recovery of costs and fees in pursuing a claim on the bond.
145.6EFFECTIVE DATE.This section is effective the day following final enactment.

145.7    Sec. 5. Minnesota Statutes 2012, section 256B.04, is amended by adding a subdivision
145.8to read:
145.9    Subd. 22. Application fee. (a) The commissioner must collect and retain federally
145.10required nonrefundable application fees to pay for provider screening activities in
145.11accordance with Code of Federal Regulations, title 42, section 455, subpart E. The
145.12enrollment application must be made under the procedures specified by the commissioner,
145.13in the form specified by the commissioner, and accompanied by an application fee
145.14described in paragraph (b), or a request for a hardship exception as described in the
145.15specified procedures. Application fees must be deposited in the provider screening account
145.16in the special revenue fund. Amounts in the provider screening account are appropriated
145.17to the commissioner for costs associated with the provider screening activities required
145.18in Code of Federal Regulations, title 42, section 455, subpart E. The commissioner
145.19shall conduct screening activities as required by Code of Federal Regulations, title 42,
145.20section 455, subpart E, and as otherwise provided by law, to include database checks,
145.21unannounced pre- and postenrollment site visits, fingerprinting, and criminal background
145.22studies. The commissioner must revalidate all providers under this subdivision at least
145.23once every five years.
145.24(b) The application fee under this subdivision is $532 for the calendar year 2013.
145.25For calendar year 2014 and subsequent years, the fee:
145.26(1) is adjusted by the percentage change to the consumer price index for all urban
145.27consumers, United States city average, for the 12-month period ending with June of the
145.28previous year. The resulting fee must be announced in the Federal Register;
145.29(2) is effective from January 1 to December 31 of a calendar year;
145.30(3) is required on the submission of an initial application, an application to establish
145.31a new practice location, an application for re-enrollment when the provider is not enrolled
145.32at the time of application of re-enrollment, or at revalidation when required by federal
145.33regulation; and
145.34(4) must be in the amount in effect for the calendar year during which the application
145.35for enrollment, new practice location, or re-enrollment is being submitted.
146.1(c) The application fee under this subdivision cannot be charged to:
146.2(1) providers who are enrolled in Medicare or who provide documentation of
146.3payment of the fee to, and enrollment with, another state;
146.4(2) providers who are enrolled but are required to submit new applications for
146.5purposes of re-enrollment; or
146.6(3) a provider who enrolls as an individual.
146.7EFFECTIVE DATE.This section is effective the day following final enactment.

146.8    Sec. 6. Minnesota Statutes 2012, section 256B.064, subdivision 1a, is amended to read:
146.9    Subd. 1a. Grounds for sanctions against vendors. The commissioner may
146.10impose sanctions against a vendor of medical care for any of the following: (1) fraud,
146.11theft, or abuse in connection with the provision of medical care to recipients of public
146.12assistance; (2) a pattern of presentment of false or duplicate claims or claims for services
146.13not medically necessary; (3) a pattern of making false statements of material facts for
146.14the purpose of obtaining greater compensation than that to which the vendor is legally
146.15entitled; (4) suspension or termination as a Medicare vendor; (5) refusal to grant the state
146.16agency access during regular business hours to examine all records necessary to disclose
146.17the extent of services provided to program recipients and appropriateness of claims for
146.18payment; (6) failure to repay an overpayment or a fine finally established under this
146.19section; and (7) failure to correct errors in the maintenance of health service or financial
146.20records for which a fine was imposed or after issuance of a warning by the commissioner;
146.21and (8) any reason for which a vendor could be excluded from participation in the
146.22Medicare program under section 1128, 1128A, or 1866(b)(2) of the Social Security Act.
146.23The determination of services not medically necessary may be made by the commissioner
146.24in consultation with a peer advisory task force appointed by the commissioner on the
146.25recommendation of appropriate professional organizations. The task force expires as
146.26provided in section 15.059, subdivision 5.

146.27    Sec. 7. Minnesota Statutes 2012, section 256B.064, subdivision 1b, is amended to read:
146.28    Subd. 1b. Sanctions available. The commissioner may impose the following
146.29sanctions for the conduct described in subdivision 1a: suspension or withholding of
146.30payments to a vendor and suspending or terminating participation in the program, or
146.31imposition of a fine under subdivision 2, paragraph (f). When imposing sanctions under
146.32this section, the commissioner shall consider the nature, chronicity, or severity of the
146.33conduct and the effect of the conduct on the health and safety of persons served by the
147.1vendor. Regardless of imposition of sanctions, the commissioner may make a referral
147.2to the appropriate state licensing board.

147.3    Sec. 8. Minnesota Statutes 2012, section 256B.064, subdivision 2, is amended to read:
147.4    Subd. 2. Imposition of monetary recovery and sanctions. (a) The commissioner
147.5shall determine any monetary amounts to be recovered and sanctions to be imposed upon
147.6a vendor of medical care under this section. Except as provided in paragraphs (b) and
147.7(d), neither a monetary recovery nor a sanction will be imposed by the commissioner
147.8without prior notice and an opportunity for a hearing, according to chapter 14, on the
147.9commissioner's proposed action, provided that the commissioner may suspend or reduce
147.10payment to a vendor of medical care, except a nursing home or convalescent care facility,
147.11after notice and prior to the hearing if in the commissioner's opinion that action is
147.12necessary to protect the public welfare and the interests of the program.
147.13(b) Except when the commissioner finds good cause not to suspend payments under
147.14Code of Federal Regulations, title 42, section 455.23 (e) or (f), the commissioner shall
147.15withhold or reduce payments to a vendor of medical care without providing advance
147.16notice of such withholding or reduction if either of the following occurs:
147.17(1) the vendor is convicted of a crime involving the conduct described in subdivision
147.181a; or
147.19(2) the commissioner determines there is a credible allegation of fraud for which an
147.20investigation is pending under the program. A credible allegation of fraud is an allegation
147.21which has been verified by the state, from any source, including but not limited to:
147.22(i) fraud hotline complaints;
147.23(ii) claims data mining; and
147.24(iii) patterns identified through provider audits, civil false claims cases, and law
147.25enforcement investigations.
147.26Allegations are considered to be credible when they have an indicia of reliability
147.27and the state agency has reviewed all allegations, facts, and evidence carefully and acts
147.28judiciously on a case-by-case basis.
147.29(c) The commissioner must send notice of the withholding or reduction of payments
147.30under paragraph (b) within five days of taking such action unless requested in writing by a
147.31law enforcement agency to temporarily withhold the notice. The notice must:
147.32(1) state that payments are being withheld according to paragraph (b);
147.33(2) set forth the general allegations as to the nature of the withholding action, but
147.34need not disclose any specific information concerning an ongoing investigation;
148.1(3) except in the case of a conviction for conduct described in subdivision 1a, state
148.2that the withholding is for a temporary period and cite the circumstances under which
148.3withholding will be terminated;
148.4(4) identify the types of claims to which the withholding applies; and
148.5(5) inform the vendor of the right to submit written evidence for consideration by
148.6the commissioner.
148.7The withholding or reduction of payments will not continue after the commissioner
148.8determines there is insufficient evidence of fraud by the vendor, or after legal proceedings
148.9relating to the alleged fraud are completed, unless the commissioner has sent notice of
148.10intention to impose monetary recovery or sanctions under paragraph (a).
148.11(d) The commissioner shall suspend or terminate a vendor's participation in the
148.12program without providing advance notice and an opportunity for a hearing when the
148.13suspension or termination is required because of the vendor's exclusion from participation
148.14in Medicare. Within five days of taking such action, the commissioner must send notice of
148.15the suspension or termination. The notice must:
148.16(1) state that suspension or termination is the result of the vendor's exclusion from
148.17Medicare;
148.18(2) identify the effective date of the suspension or termination; and
148.19(3) inform the vendor of the need to be reinstated to Medicare before reapplying
148.20for participation in the program.
148.21(e) Upon receipt of a notice under paragraph (a) that a monetary recovery or
148.22sanction is to be imposed, a vendor may request a contested case, as defined in section
148.2314.02, subdivision 3 , by filing with the commissioner a written request of appeal. The
148.24appeal request must be received by the commissioner no later than 30 days after the date
148.25the notification of monetary recovery or sanction was mailed to the vendor. The appeal
148.26request must specify:
148.27(1) each disputed item, the reason for the dispute, and an estimate of the dollar
148.28amount involved for each disputed item;
148.29(2) the computation that the vendor believes is correct;
148.30(3) the authority in statute or rule upon which the vendor relies for each disputed item;
148.31(4) the name and address of the person or entity with whom contacts may be made
148.32regarding the appeal; and
148.33(5) other information required by the commissioner.
148.34(f) The commissioner may order a vendor to forfeit a fine for failure to fully
148.35document services according to standards in this chapter and Minnesota Rules, chapter
148.369505. Fines may be assessed when the commissioner has no evidence that services were
149.1not provided and services are partially documented in the health service or financial
149.2record, but specific required components of documentation are missing. The fine for
149.3incomplete documentation shall equal 20 percent of the amount paid on the claims for
149.4reimbursement submitted by the vendor, or up to $5,000, whichever is less.
149.5(g) The vendor shall pay the fine assessed on or before the payment date specified. If
149.6the vendor fails to pay the fine, the commissioner may withhold or reduce payments and
149.7recover the amount of the fine. A timely appeal shall stay payment of the fine until the
149.8commissioner issues a final order.

149.9    Sec. 9. Minnesota Statutes 2012, section 256B.0659, subdivision 21, is amended to read:
149.10    Subd. 21. Requirements for initial enrollment of personal care assistance
149.11provider agencies. (a) All personal care assistance provider agencies must provide, at the
149.12time of enrollment as a personal care assistance provider agency in a format determined
149.13by the commissioner, information and documentation that includes, but is not limited to,
149.14the following:
149.15    (1) the personal care assistance provider agency's current contact information
149.16including address, telephone number, and e-mail address;
149.17    (2) proof of surety bond coverage in the amount of $50,000 $100,000 or ten percent
149.18of the provider's payments from Medicaid in the previous year, whichever is less more.
149.19The performance bond must be in a form approved by the commissioner, must be renewed
149.20annually, and must allow for recovery of costs and fees in pursuing a claim on the bond;
149.21    (3) proof of fidelity bond coverage in the amount of $20,000;
149.22    (4) proof of workers' compensation insurance coverage;
149.23    (5) proof of liability insurance;
149.24    (6) a description of the personal care assistance provider agency's organization
149.25identifying the names of all owners, managing employees, staff, board of directors, and
149.26the affiliations of the directors, owners, or staff to other service providers;
149.27    (7) a copy of the personal care assistance provider agency's written policies and
149.28procedures including: hiring of employees; training requirements; service delivery;
149.29and employee and consumer safety including process for notification and resolution
149.30of consumer grievances, identification and prevention of communicable diseases, and
149.31employee misconduct;
149.32    (8) copies of all other forms the personal care assistance provider agency uses in
149.33the course of daily business including, but not limited to:
149.34    (i) a copy of the personal care assistance provider agency's time sheet if the time
149.35sheet varies from the standard time sheet for personal care assistance services approved
150.1by the commissioner, and a letter requesting approval of the personal care assistance
150.2provider agency's nonstandard time sheet;
150.3    (ii) the personal care assistance provider agency's template for the personal care
150.4assistance care plan; and
150.5    (iii) the personal care assistance provider agency's template for the written
150.6agreement in subdivision 20 for recipients using the personal care assistance choice
150.7option, if applicable;
150.8    (9) a list of all training and classes that the personal care assistance provider agency
150.9requires of its staff providing personal care assistance services;
150.10    (10) documentation that the personal care assistance provider agency and staff have
150.11successfully completed all the training required by this section;
150.12    (11) documentation of the agency's marketing practices;
150.13    (12) disclosure of ownership, leasing, or management of all residential properties
150.14that is used or could be used for providing home care services;
150.15    (13) documentation that the agency will use the following percentages of revenue
150.16generated from the medical assistance rate paid for personal care assistance services
150.17for employee personal care assistant wages and benefits: 72.5 percent of revenue in the
150.18personal care assistance choice option and 72.5 percent of revenue from other personal
150.19care assistance providers. The revenue generated by the qualified professional and the
150.20reasonable costs associated with the qualified professional shall not be used in making
150.21this calculation; and
150.22    (14) effective May 15, 2010, documentation that the agency does not burden
150.23recipients' free exercise of their right to choose service providers by requiring personal
150.24care assistants to sign an agreement not to work with any particular personal care
150.25assistance recipient or for another personal care assistance provider agency after leaving
150.26the agency and that the agency is not taking action on any such agreements or requirements
150.27regardless of the date signed.
150.28    (b) Personal care assistance provider agencies shall provide the information specified
150.29in paragraph (a) to the commissioner at the time the personal care assistance provider
150.30agency enrolls as a vendor or upon request from the commissioner. The commissioner
150.31shall collect the information specified in paragraph (a) from all personal care assistance
150.32providers beginning July 1, 2009.
150.33    (c) All personal care assistance provider agencies shall require all employees in
150.34management and supervisory positions and owners of the agency who are active in the
150.35day-to-day management and operations of the agency to complete mandatory training
150.36as determined by the commissioner before enrollment of the agency as a provider.
151.1Employees in management and supervisory positions and owners who are active in
151.2the day-to-day operations of an agency who have completed the required training as
151.3an employee with a personal care assistance provider agency do not need to repeat
151.4the required training if they are hired by another agency, if they have completed the
151.5training within the past three years. By September 1, 2010, the required training must
151.6be available with meaningful access according to title VI of the Civil Rights Act and
151.7federal regulations adopted under that law or any guidance from the United States Health
151.8and Human Services Department. The required training must be available online or by
151.9electronic remote connection. The required training must provide for competency testing.
151.10Personal care assistance provider agency billing staff shall complete training about
151.11personal care assistance program financial management. This training is effective July 1,
151.122009. Any personal care assistance provider agency enrolled before that date shall, if it
151.13has not already, complete the provider training within 18 months of July 1, 2009. Any new
151.14owners or employees in management and supervisory positions involved in the day-to-day
151.15operations are required to complete mandatory training as a requisite of working for the
151.16agency. Personal care assistance provider agencies certified for participation in Medicare
151.17as home health agencies are exempt from the training required in this subdivision. When
151.18available, Medicare-certified home health agency owners, supervisors, or managers must
151.19successfully complete the competency test.
151.20EFFECTIVE DATE.This section is effective the day following final enactment.


151.23    Section 1. Minnesota Statutes 2012, section 256.9657, subdivision 2, is amended to read:
151.24    Subd. 2. Hospital surcharge. (a) Effective October 1, 1992, each Minnesota
151.25hospital except facilities of the federal Indian Health Service and regional treatment
151.26centers shall pay to the medical assistance account a surcharge equal to 1.4 percent of net
151.27patient revenues excluding net Medicare revenues reported by that provider to the health
151.28care cost information system according to the schedule in subdivision 4.
151.29(b) Effective July 1, 1994, the surcharge under paragraph (a) is increased to 1.56
151.30percent.
151.31(c) Effective July 1, 2013, the surcharge under paragraph (b) is increased to 2.63
151.32percent for all nongovernment-owned hospitals.
151.33(d) Notwithstanding the Medicare cost finding and allowable cost principles, the
151.34hospital surcharge is not an allowable cost for purposes of rate setting under sections
151.35256.9685 to 256.9695.
152.1EFFECTIVE DATE.This section is effective July 1, 2013.

152.2    Sec. 2. Minnesota Statutes 2012, section 256.9685, subdivision 2, is amended to read:
152.3    Subd. 2. Federal requirements. (a) If it is determined that a provision of this
152.4section or section 256.9686, 256.969, or 256.9695 conflicts with existing or future
152.5requirements of the United States government with respect to federal financial participation
152.6in medical assistance, the federal requirements prevail. The commissioner may, in the
152.7aggregate, prospectively and retrospectively, reduce payment rates and payments to avoid
152.8reduced federal financial participation resulting from rates and payments determined by
152.9the commissioner that are in excess of the Medicare upper payment limitations.
152.10(b) For rates and payments determined by the commissioner to be in excess of the
152.11Medicare upper payment limits for the nongovernment-owned limit category, rates and
152.12payments shall be reduced to the limits according to clauses (1) to (4):
152.13(1) rates and payments under section 256.969, subdivision 3a, paragraph (j), shall be
152.14reduced proportionately;
152.15(2) if rates and payments remain above the limit, medical education payments under
152.16section 62J.692, subdivision 8, shall be the first reduction for the government-owned
152.17limit category;
152.18(3) if rates and payments remain above the limit, rates and payments not included
152.19under clause (1) shall be reduced in total; and
152.20(4) the state share of payments under clauses (1) and (2) shall be returned to the
152.21hospital.

152.22    Sec. 3. Minnesota Statutes 2012, section 256.969, subdivision 3a, is amended to read:
152.23    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
152.24assistance program must not be submitted until the recipient is discharged. However,
152.25the commissioner shall establish monthly interim payments for inpatient hospitals that
152.26have individual patient lengths of stay over 30 days regardless of diagnostic category.
152.27Except as provided in section 256.9693, medical assistance reimbursement for treatment
152.28of mental illness shall be reimbursed based on diagnostic classifications. Individual
152.29hospital payments established under this section and sections 256.9685, 256.9686, and
152.30256.9695 , in addition to third-party and recipient liability, for discharges occurring during
152.31the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
152.32inpatient services paid for the same period of time to the hospital. This payment limitation
152.33shall be calculated separately for medical assistance and general assistance medical
152.34care services. The limitation on general assistance medical care shall be effective for
153.1admissions occurring on or after July 1, 1991. Services that have rates established under
153.2subdivision 11 or 12, must be limited separately from other services. After consulting with
153.3the affected hospitals, the commissioner may consider related hospitals one entity and
153.4may merge the payment rates while maintaining separate provider numbers. The operating
153.5and property base rates per admission or per day shall be derived from the best Medicare
153.6and claims data available when rates are established. The commissioner shall determine
153.7the best Medicare and claims data, taking into consideration variables of recency of the
153.8data, audit disposition, settlement status, and the ability to set rates in a timely manner.
153.9The commissioner shall notify hospitals of payment rates by December 1 of the year
153.10preceding the rate year. The rate setting data must reflect the admissions data used to
153.11establish relative values. Base year changes from 1981 to the base year established for the
153.12rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
153.13to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
153.141. The commissioner may adjust base year cost, relative value, and case mix index data
153.15to exclude the costs of services that have been discontinued by the October 1 of the year
153.16preceding the rate year or that are paid separately from inpatient services. Inpatient stays
153.17that encompass portions of two or more rate years shall have payments established based
153.18on payment rates in effect at the time of admission unless the date of admission preceded
153.19the rate year in effect by six months or more. In this case, operating payment rates for
153.20services rendered during the rate year in effect and established based on the date of
153.21admission shall be adjusted to the rate year in effect by the hospital cost index.
153.22    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
153.23payment, before third-party liability and spenddown, made to hospitals for inpatient
153.24services is reduced by .5 percent from the current statutory rates.
153.25    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
153.26admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
153.27before third-party liability and spenddown, is reduced five percent from the current
153.28statutory rates. Mental health services within diagnosis related groups 424 to 432, and
153.29facilities defined under subdivision 16 are excluded from this paragraph.
153.30    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
153.31fee-for-service admissions occurring on or after August 1, 2005, made to hospitals for
153.32inpatient services before third-party liability and spenddown, is reduced 6.0 percent
153.33from the current statutory rates. Mental health services within diagnosis related groups
153.34424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
153.35Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
153.36assistance does not include general assistance medical care. Payments made to managed
154.1care plans shall be reduced for services provided on or after January 1, 2006, to reflect
154.2this reduction.
154.3    (e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
154.4fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
154.5to hospitals for inpatient services before third-party liability and spenddown, is reduced
154.63.46 percent from the current statutory rates. Mental health services with diagnosis related
154.7groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
154.8paragraph. Payments made to managed care plans shall be reduced for services provided
154.9on or after January 1, 2009, through June 30, 2009, to reflect this reduction.
154.10    (f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
154.11fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2011, made
154.12to hospitals for inpatient services before third-party liability and spenddown, is reduced
154.131.9 percent from the current statutory rates. Mental health services with diagnosis related
154.14groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
154.15paragraph. Payments made to managed care plans shall be reduced for services provided
154.16on or after July 1, 2009, through June 30, 2011, to reflect this reduction.
154.17    (g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
154.18for fee-for-service admissions occurring on or after July 1, 2011, made to hospitals for
154.19inpatient services before third-party liability and spenddown, is reduced 1.79 percent
154.20from the current statutory rates. Mental health services with diagnosis related groups
154.21424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
154.22Payments made to managed care plans shall be reduced for services provided on or after
154.23July 1, 2011, to reflect this reduction.
154.24(h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
154.25payment for fee-for-service admissions occurring on or after July 1, 2009, made to
154.26hospitals for inpatient services before third-party liability and spenddown, is reduced
154.27one percent from the current statutory rates. Facilities defined under subdivision 16 are
154.28excluded from this paragraph. Payments made to managed care plans shall be reduced for
154.29services provided on or after October 1, 2009, to reflect this reduction.
154.30(i) In addition to the reductions in paragraphs (b), (c), (d), (g), and (h), the total
154.31payment for fee-for-service admissions occurring on or after July 1, 2011, made to
154.32hospitals for inpatient services before third-party liability and spenddown, is reduced
154.331.96 percent from the current statutory rates. Facilities defined under subdivision 16 are
154.34excluded from this paragraph. Payments made to managed care plans shall be reduced for
154.35services provided on or after January 1, 2011, to reflect this reduction.
155.1(j) In order to offset the rateable reductions provided for in this subdivision, the total
155.2payment rate for medical assistance admissions for nongovernment-owned hospitals
155.3occurring on or after July 1, 2013, made to Minnesota hospitals for inpatient services
155.4before third-party liability and spenddown, shall be increased by 30 percent from the
155.5current statutory rates. The commissioner shall not adjust rates paid to a prepaid health
155.6plan under contract with the commissioner to reflect payments provided in this paragraph.
155.7The commissioner shall adjust rates and payments in excess of the Medicare upper limits
155.8on payments according to section 256.9685, subdivision 2.
155.9EFFECTIVE DATE.This section is effective July 1, 2013.

155.10    Sec. 4. Minnesota Statutes 2012, section 256B.055, subdivision 14, is amended to read:
155.11    Subd. 14. Persons detained by law. (a) Medical assistance may be paid for an
155.12inmate of a correctional facility who is conditionally released as authorized under section
155.13241.26 , 244.065, or 631.425, if the individual does not require the security of a public
155.14detention facility and is housed in a halfway house or community correction center, or
155.15under house arrest and monitored by electronic surveillance in a residence approved
155.16by the commissioner of corrections, and if the individual meets the other eligibility
155.17requirements of this chapter.
155.18    (b) An individual who is enrolled in medical assistance, and who is charged with a
155.19crime and incarcerated for less than 12 months shall be suspended from eligibility at the
155.20time of incarceration until the individual is released. Upon release, medical assistance
155.21eligibility is reinstated without reapplication using a reinstatement process and form, if the
155.22individual is otherwise eligible.
155.23    (c) An individual, regardless of age, who is considered an inmate of a public
155.24institution as defined in Code of Federal Regulations, title 42, section 435.1010, and
155.25who meets the eligibility requirements in section 256B.056, is not eligible for medical
155.26assistance, except for covered services received while an inpatient in a medical institution
155.27as defined in the Code of Federal Regulations, title 42, section 435.1010. Security issues
155.28related to the inpatient treatment of an inmate are the responsibility of the entity with
155.29jurisdiction over the inmate. The non federal share of the cost of the services shall be paid
155.30by the entity with jurisdiction over the inmate.
155.31EFFECTIVE DATE.This section is effective January 1, 2014.

155.32    Sec. 5. Minnesota Statutes 2012, section 256B.06, subdivision 4, is amended to read:
156.1    Subd. 4. Citizenship requirements. (a) Eligibility for medical assistance is limited
156.2to citizens of the United States, qualified noncitizens as defined in this subdivision, and
156.3other persons residing lawfully in the United States. Citizens or nationals of the United
156.4States must cooperate in obtaining satisfactory documentary evidence of citizenship or
156.5nationality according to the requirements of the federal Deficit Reduction Act of 2005,
156.6Public Law 109-171.
156.7(b) "Qualified noncitizen" means a person who meets one of the following
156.8immigration criteria:
156.9(1) admitted for lawful permanent residence according to United States Code, title 8;
156.10(2) admitted to the United States as a refugee according to United States Code,
156.11title 8, section 1157;
156.12(3) granted asylum according to United States Code, title 8, section 1158;
156.13(4) granted withholding of deportation according to United States Code, title 8,
156.14section 1253(h);
156.15(5) paroled for a period of at least one year according to United States Code, title 8,
156.16section 1182(d)(5);
156.17(6) granted conditional entrant status according to United States Code, title 8,
156.18section 1153(a)(7);
156.19(7) determined to be a battered noncitizen by the United States Attorney General
156.20according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
156.21title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;
156.22(8) is a child of a noncitizen determined to be a battered noncitizen by the United
156.23States Attorney General according to the Illegal Immigration Reform and Immigrant
156.24Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
156.25Public Law 104-200; or
156.26(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
156.27Law 96-422, the Refugee Education Assistance Act of 1980.
156.28(c) All qualified noncitizens who were residing in the United States before August
156.2922, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
156.30medical assistance with federal financial participation.
156.31(d) Beginning December 1, 1996, qualified noncitizens who entered the United
156.32States on or after August 22, 1996, and who otherwise meet the eligibility requirements
156.33of this chapter are eligible for medical assistance with federal participation for five years
156.34if they meet one of the following criteria:
156.35(1) refugees admitted to the United States according to United States Code, title 8,
156.36section 1157;
157.1(2) persons granted asylum according to United States Code, title 8, section 1158;
157.2(3) persons granted withholding of deportation according to United States Code,
157.3title 8, section 1253(h);
157.4(4) veterans of the United States armed forces with an honorable discharge for
157.5a reason other than noncitizen status, their spouses and unmarried minor dependent
157.6children; or
157.7(5) persons on active duty in the United States armed forces, other than for training,
157.8their spouses and unmarried minor dependent children.
157.9 Beginning July 1, 2010, children and pregnant women who are noncitizens
157.10described in paragraph (b) or who are lawfully present in the United States as defined
157.11in Code of Federal Regulations, title 8, section 103.12, and who otherwise meet
157.12eligibility requirements of this chapter, are eligible for medical assistance with federal
157.13financial participation as provided by the federal Children's Health Insurance Program
157.14Reauthorization Act of 2009, Public Law 111-3.
157.15(e) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
157.16are eligible for the benefits as provided in paragraphs (f) to (h). For purposes of this
157.17subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
157.18Code, title 8, section 1101(a)(15).
157.19(f) Payment shall also be made for care and services that are furnished to noncitizens,
157.20regardless of immigration status, who otherwise meet the eligibility requirements of
157.21this chapter, if such care and services are necessary for the treatment of an emergency
157.22medical condition.
157.23(g) For purposes of this subdivision, the term "emergency medical condition" means
157.24a medical condition that meets the requirements of United States Code, title 42, section
157.251396b(v).
157.26(h)(1) Notwithstanding paragraph (g), services that are necessary for the treatment
157.27of an emergency medical condition are limited to the following:
157.28(i) services delivered in an emergency room or by an ambulance service licensed
157.29under chapter 144E that are directly related to the treatment of an emergency medical
157.30condition;
157.31(ii) services delivered in an inpatient hospital setting following admission from an
157.32emergency room or clinic for an acute emergency condition; and
157.33(iii) follow-up services that are directly related to the original service provided
157.34to treat the emergency medical condition and are covered by the global payment made
157.35to the provider.
157.36    (2) Services for the treatment of emergency medical conditions do not include:
158.1(i) services delivered in an emergency room or inpatient setting to treat a
158.2nonemergency condition;
158.3(ii) organ transplants, stem cell transplants, and related care;
158.4(iii) services for routine prenatal care;
158.5(iv) continuing care, including long-term care, nursing facility services, home health
158.6care, adult day care, day training, or supportive living services;
158.7(v) elective surgery;
158.8(vi) outpatient prescription drugs, unless the drugs are administered or dispensed as
158.9part of an emergency room visit;
158.10(vii) preventative health care and family planning services;
158.11(viii) dialysis;
158.12(ix) chemotherapy or therapeutic radiation services;
158.13(x) (viii) rehabilitation services;
158.14(xi) (ix) physical, occupational, or speech therapy;
158.15(xii) (x) transportation services;
158.16(xiii) (xi) case management;
158.17(xiv) (xii) prosthetics, orthotics, durable medical equipment, or medical supplies;
158.18(xv) (xiii) dental services;
158.19(xvi) (xiv) hospice care;
158.20(xvii) (xv) audiology services and hearing aids;
158.21(xviii) (xvi) podiatry services;
158.22(xix) (xvii) chiropractic services;
158.23(xx) (xviii) immunizations;
158.24(xxi) (xix) vision services and eyeglasses;
158.25(xxii) (xx) waiver services;
158.26(xxiii) (xxi) individualized education programs; or
158.27(xxiv) (xxii) chemical dependency treatment.
158.28(i) Beginning July 1, 2009, pregnant noncitizens who are undocumented,
158.29nonimmigrants, or lawfully present in the United States as defined in Code of Federal
158.30Regulations, title 8, section 103.12, are not covered by a group health plan or health
158.31insurance coverage according to Code of Federal Regulations, title 42, section 457.310,
158.32and who otherwise meet the eligibility requirements of this chapter, are eligible for
158.33medical assistance through the period of pregnancy, including labor and delivery, and 60
158.34days postpartum, to the extent federal funds are available under title XXI of the Social
158.35Security Act, and the state children's health insurance program.
159.1(j) Beginning October 1, 2003, persons who are receiving care and rehabilitation
159.2services from a nonprofit center established to serve victims of torture and are otherwise
159.3ineligible for medical assistance under this chapter are eligible for medical assistance
159.4without federal financial participation. These individuals are eligible only for the period
159.5during which they are receiving services from the center. Individuals eligible under this
159.6paragraph shall not be required to participate in prepaid medical assistance.
159.7(k) Notwithstanding paragraph (h), clause (2), the following services are covered as
159.8emergency medical conditions under paragraph (f) except where coverage is prohibited
159.9under federal law:
159.10(1) dialysis services provided in a hospital or freestanding dialysis facility; and
159.11(2) surgery and the administration of chemotherapy, radiation, and related services
159.12necessary to treat cancer if the recipient has a cancer diagnosis that is not in remission
159.13and requires surgery, chemotherapy, or radiation treatment.
159.14EFFECTIVE DATE.This section is effective July 1, 2013.

159.15    Sec. 6. Minnesota Statutes 2012, section 256B.0625, subdivision 9, is amended to read:
159.16    Subd. 9. Dental services. (a) Medical assistance covers dental services.
159.17(b) Medical assistance dental coverage for nonpregnant adults is limited to the
159.18following services:
159.19(1) comprehensive exams, limited to once every five years;
159.20(2) periodic exams, limited to one per year;
159.21(3) limited exams;
159.22(4) bitewing x-rays, limited to one per year;
159.23(5) periapical x-rays;
159.24(6) panoramic x-rays, limited to one every five years except (1) when medically
159.25necessary for the diagnosis and follow-up of oral and maxillofacial pathology and trauma
159.26or (2) once every two years for patients who cannot cooperate for intraoral film due to
159.27a developmental disability or medical condition that does not allow for intraoral film
159.28placement;
159.29(7) prophylaxis, limited to one per year;
159.30(8) application of fluoride varnish, limited to one per year;
159.31(9) posterior fillings, all at the amalgam rate;
159.32(10) anterior fillings;
159.33(11) endodontics, limited to root canals on the anterior and premolars only;
159.34(12) removable prostheses, each dental arch limited to one every six years;
160.1(13) oral surgery, limited to extractions, biopsies, and incision and drainage of
160.2abscesses;
160.3(14) palliative treatment and sedative fillings for relief of pain; and
160.4(15) full-mouth debridement, limited to one every five years.
160.5(c) In addition to the services specified in paragraph (b), medical assistance
160.6covers the following services for adults, if provided in an outpatient hospital setting or
160.7freestanding ambulatory surgical center as part of outpatient dental surgery:
160.8(1) periodontics, limited to periodontal scaling and root planing once every two years;
160.9(2) general anesthesia; and
160.10(3) full-mouth survey once every five years.
160.11(d) Medical assistance covers medically necessary dental services for children and
160.12pregnant women. The following guidelines apply:
160.13(1) posterior fillings are paid at the amalgam rate;
160.14(2) application of sealants are covered once every five years per permanent molar for
160.15children only;
160.16(3) application of fluoride varnish is covered once every six months; and
160.17(4) orthodontia is eligible for coverage for children only.
160.18(e) In addition to the services specified in paragraphs (b) and (c), medical assistance
160.19covers the following services for adults:
160.20(1) house calls or extended care facility calls for on-site delivery of covered services;
160.21(2) behavioral management when additional staff time is required to accommodate
160.22behavioral challenges and sedation is not used;
160.23(3) oral or IV sedation, if the covered dental service cannot be performed safely
160.24without it or would otherwise require the service to be performed under general anesthesia
160.25in a hospital or surgical center; and
160.26(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
160.27no more than four times per year.

160.28    Sec. 7. Minnesota Statutes 2012, section 256B.0625, subdivision 13e, is amended to
160.29read:
160.30    Subd. 13e. Payment rates. (a) The basis for determining the amount of payment
160.31shall be the lower of the actual acquisition costs of the drugs or the maximum allowable
160.32cost by the commissioner plus the fixed dispensing fee; or the usual and customary price
160.33charged to the public. The amount of payment basis must be reduced to reflect all discount
160.34amounts applied to the charge by any provider/insurer agreement or contract for submitted
160.35charges to medical assistance programs. The net submitted charge may not be greater
161.1than the patient liability for the service. The pharmacy dispensing fee shall be $3.65,
161.2except that the dispensing fee for intravenous solutions which must be compounded by
161.3the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and
161.4$30 per bag for total parenteral nutritional products dispensed in one liter quantities,
161.5or $44 per bag for total parenteral nutritional products dispensed in quantities greater
161.6than one liter. Actual acquisition cost includes quantity and other special discounts
161.7except time and cash discounts. The actual acquisition cost of a drug shall be estimated
161.8by the commissioner at wholesale acquisition cost plus four percent for independently
161.9owned pharmacies located in a designated rural area within Minnesota, and at wholesale
161.10acquisition cost plus two percent for all other pharmacies. A pharmacy is "independently
161.11owned" if it is one of four or fewer pharmacies under the same ownership nationally.
161.12A "designated rural area" means an area defined as a small rural area or isolated rural
161.13area according to the four-category classification of the Rural Urban Commuting Area
161.14system developed for the United States Health Resources and Services Administration.
161.15The actual acquisition cost of a drug acquired through the federal 340B Drug Pricing
161.16Program shall be estimated by the commissioner at wholesale acquisition cost minus 44
161.17percent. Wholesale acquisition cost is defined as the manufacturer's list price for a drug or
161.18biological to wholesalers or direct purchasers in the United States, not including prompt
161.19pay or other discounts, rebates, or reductions in price, for the most recent month for which
161.20information is available, as reported in wholesale price guides or other publications of
161.21drug or biological pricing data. The maximum allowable cost of a multisource drug may
161.22be set by the commissioner and it shall be comparable to, but no higher than, the maximum
161.23amount paid by other third-party payors in this state who have maximum allowable cost
161.24programs. Establishment of the amount of payment for drugs shall not be subject to the
161.25requirements of the Administrative Procedure Act.
161.26    (b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
161.27to pharmacists for legend drug prescriptions dispensed to residents of long-term care
161.28facilities when a unit dose blister card system, approved by the department, is used. Under
161.29this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The
161.30National Drug Code (NDC) from the drug container used to fill the blister card must be
161.31identified on the claim to the department. The unit dose blister card containing the drug
161.32must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that
161.33govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will
161.34be required to credit the department for the actual acquisition cost of all unused drugs that
161.35are eligible for reuse. The commissioner may permit the drug clozapine to be dispensed in
161.36a quantity that is less than a 30-day supply.
162.1    (c) Whenever a maximum allowable cost has been set for a multisource drug,
162.2payment shall be the lower of the usual and customary price charged to the public or the
162.3maximum allowable cost established by the commissioner unless prior authorization
162.4for the brand name product has been granted according to the criteria established by
162.5the Drug Formulary Committee as required by subdivision 13f, paragraph (a), and the
162.6prescriber has indicated "dispense as written" on the prescription in a manner consistent
162.7with section 151.21, subdivision 2.
162.8    (d) The basis for determining the amount of payment for drugs administered in an
162.9outpatient setting shall be the lower of the usual and customary cost submitted by the
162.10provider or, 106 percent of the average sales price as determined by the United States
162.11Department of Health and Human Services pursuant to title XVIII, section 1847a of the
162.12federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
162.13set by the commissioner. If average sales price is unavailable, the amount of payment
162.14must be lower of the usual and customary cost submitted by the provider or, the wholesale
162.15acquisition cost, the specialty pharmacy rate, or the maximum allowable cost set by the
162.16commissioner. The commissioner shall discount the payment rate for drugs obtained
162.17through the federal 340B Drug Pricing Program by 33 percent. The payment for drugs
162.18administered in an outpatient setting shall be made to the administering facility or
162.19practitioner. A retail or specialty pharmacy dispensing a drug for administration in an
162.20outpatient setting is not eligible for direct reimbursement.
162.21    (e) The commissioner may negotiate lower reimbursement rates for specialty
162.22pharmacy products than the rates specified in paragraph (a). The commissioner may
162.23require individuals enrolled in the health care programs administered by the department
162.24to obtain specialty pharmacy products from providers with whom the commissioner has
162.25negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
162.26used by a small number of recipients or recipients with complex and chronic diseases
162.27that require expensive and challenging drug regimens. Examples of these conditions
162.28include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
162.29C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
162.30of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
162.31biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies
162.32that require complex care. The commissioner shall consult with the formulary committee
162.33to develop a list of specialty pharmacy products subject to this paragraph. In consulting
162.34with the formulary committee in developing this list, the commissioner shall take into
162.35consideration the population served by specialty pharmacy products, the current delivery
163.1system and standard of care in the state, and access to care issues. The commissioner shall
163.2have the discretion to adjust the reimbursement rate to prevent access to care issues.
163.3(f) Home infusion therapy services provided by home infusion therapy pharmacies
163.4must be paid at rates according to subdivision 8d.
163.5EFFECTIVE DATE.This section is effective January 1, 2014.

163.6    Sec. 8. Minnesota Statutes 2012, section 256B.0625, subdivision 31, is amended to read:
163.7    Subd. 31. Medical supplies and equipment. (a) Medical assistance covers medical
163.8supplies and equipment. Separate payment outside of the facility's payment rate shall
163.9be made for wheelchairs and wheelchair accessories for recipients who are residents
163.10of intermediate care facilities for the developmentally disabled. Reimbursement for
163.11wheelchairs and wheelchair accessories for ICF/MR recipients shall be subject to the same
163.12conditions and limitations as coverage for recipients who do not reside in institutions. A
163.13wheelchair purchased outside of the facility's payment rate is the property of the recipient.
163.14The commissioner may set reimbursement rates for specified categories of medical
163.15supplies at levels below the Medicare payment rate.
163.16(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
163.17must enroll as a Medicare provider.
163.18(c) When necessary to ensure access to durable medical equipment, prosthetics,
163.19orthotics, or medical supplies, the commissioner may exempt a vendor from the Medicare
163.20enrollment requirement if:
163.21(1) the vendor supplies only one type of durable medical equipment, prosthetic,
163.22orthotic, or medical supply;
163.23(2) the vendor serves ten or fewer medical assistance recipients per year;
163.24(3) the commissioner finds that other vendors are not available to provide same or
163.25similar durable medical equipment, prosthetics, orthotics, or medical supplies; and
163.26(4) the vendor complies with all screening requirements in this chapter and Code of
163.27Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
163.28the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
163.29and Medicaid Services approved national accreditation organization as complying with
163.30the Medicare program's supplier and quality standards and the vendor serves primarily
163.31pediatric patients.
163.32(d) Durable medical equipment means a device or equipment that:
163.33(1) can withstand repeated use;
163.34(2) is generally not useful in the absence of an illness, injury, or disability; and
164.1(3) is provided to correct or accommodate a physiological disorder or physical
164.2condition or is generally used primarily for a medical purpose.
164.3(e) Electronic tablets may be considered durable medical equipment if the electronic
164.4tablet will be used as an augmentative and alternative communication system as defined
164.5under subdivision 31a, paragraph (a). To be covered by medical assistance, the device
164.6must be locked in order to prevent use not related to communication.

164.7    Sec. 9. Minnesota Statutes 2012, section 256B.0625, is amended by adding a
164.8subdivision to read:
164.9    Subd. 31b. Preferred diabetic testing supply program. (a) The commissioner
164.10shall adopt and implement a point of sale preferred diabetic testing supply program by
164.11January 1, 2014. Medical assistance coverage for diabetic testing supplies shall conform
164.12to the limitations established under the program. The commissioner may enter into a
164.13contract with a vendor for the purpose of participating in a preferred diabetic testing
164.14supply list and supplemental rebate program. The commissioner shall ensure that any
164.15contract meets all federal requirements and maximizes federal financial participation. The
164.16commissioner shall maintain an accurate and up-to-date list on the agency Web site.
164.17(b) The commissioner may add to, delete from, and otherwise modify the preferred
164.18diabetic testing supply program drug list after consulting with the Drug Formulary
164.19Committee and appropriate medial specialists and providing public notice and the
164.20opportunity for public comment.
164.21(c) The commissioner shall adopt and administer the preferred diabetic testing
164.22supply program as part of the administration of the diabetic testing supply rebate program.
164.23Reimbursement for diabetic testing supplies not on the preferred diabetic testing supply
164.24list may be subject to prior authorization.
164.25(d) All claims for diabetic testing supplies in categories on the preferred diabetic
164.26testing supply list must be submitted by enrolled pharmacy providers using the most
164.27current National Council of Prescription Drug Providers electronic claims standard.
164.28(e) For purposes of this subdivision, "preferred diabetic testing supply list" means a
164.29list of diabetic testing supplies selected by the commissioner, for which prior authorization
164.30is not required.
164.31(f) The commissioner shall seek any federal waivers or approvals necessary to
164.32implement this subdivision.

164.33    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 39, is amended to
164.34read:
165.1    Subd. 39. Childhood immunizations. Providers who administer pediatric vaccines
165.2within the scope of their licensure, and who are enrolled as a medical assistance provider,
165.3must enroll in the pediatric vaccine administration program established by section 13631
165.4of the Omnibus Budget Reconciliation Act of 1993. Medical assistance shall pay an
165.5$8.50 fee per dose for administration of the vaccine to children eligible for medical
165.6assistance. Medical assistance does not pay for vaccines that are available at no cost from
165.7the pediatric vaccine administration program.

165.8    Sec. 11. Minnesota Statutes 2012, section 256B.0625, subdivision 58, is amended to
165.9read:
165.10    Subd. 58. Early and periodic screening, diagnosis, and treatment services.
165.11Medical assistance covers early and periodic screening, diagnosis, and treatment services
165.12(EPSDT). The payment amount for a complete EPSDT screening shall not include charges
165.13for vaccines that are available at no cost to the provider and shall not exceed the rate
165.14established per Minnesota Rules, part 9505.0445, item M, effective October 1, 2010.

165.15    Sec. 12. Minnesota Statutes 2012, section 256B.0631, subdivision 1, is amended to read:
165.16    Subdivision 1. Cost-sharing. (a) Except as provided in subdivision 2, the medical
165.17assistance benefit plan shall include the following cost-sharing for all recipients, effective
165.18for services provided on or after September 1, 2011:
165.19    (1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes
165.20of this subdivision, a visit means an episode of service which is required because of
165.21a recipient's symptoms, diagnosis, or established illness, and which is delivered in an
165.22ambulatory setting by a physician or physician ancillary, chiropractor, podiatrist, nurse
165.23midwife, advanced practice nurse, audiologist, optician, or optometrist;
165.24    (2) $3.50 for nonemergency visits to a hospital-based emergency room, except that
165.25this co-payment shall be increased to $20 upon federal approval;
165.26    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
165.27subject to a $12 per month maximum for prescription drug co-payments. No co-payments
165.28shall apply to antipsychotic drugs when used for the treatment of mental illness;
165.29(4) effective January 1, 2012, a family deductible equal to the maximum amount
165.30allowed under Code of Federal Regulations, title 42, part 447.54; and
165.31    (5) for individuals identified by the commissioner with income at or below 100
165.32percent of the federal poverty guidelines, total monthly cost-sharing must not exceed five
165.33percent of family income. For purposes of this paragraph, family income is the total
166.1earned and unearned income of the individual and the individual's spouse, if the spouse is
166.2enrolled in medical assistance and also subject to the five percent limit on cost-sharing.
166.3    (b) Recipients of medical assistance are responsible for all co-payments and
166.4deductibles in this subdivision.
166.5(c) Notwithstanding paragraph (b), the commissioner, through the contracting
166.6process under sections 256B.69 and 256B.692, may allow managed care plans and
166.7county-based purchasing plans to waive the family deductible under paragraph (a),
166.8clause (4). The value of the family deductible shall not be included in the capitation
166.9payment to managed care plans and county-based purchasing plans. Managed care plans
166.10and county-based purchasing plans shall certify annually to the commissioner the dollar
166.11value of the family deductible.
166.12(d) Notwithstanding paragraph (b), the commissioner may waive the collection of
166.13the family deductible described under paragraph (a), clause (4), from individuals and
166.14allow long-term care and waivered service providers to assume responsibility for payment.
166.15(e) Notwithstanding paragraph (b), the commissioner, through the contracting
166.16process under section 256B.0756 shall allow the pilot program in Hennepin County to
166.17waive co-payments. The value of the co-payments shall not be included in the capitation
166.18amount to the managed care organization.

166.19    Sec. 13. Minnesota Statutes 2012, section 256B.0756, is amended to read:
166.20256B.0756 HENNEPIN AND RAMSEY COUNTIES PILOT PROGRAM.
166.21(a) The commissioner, upon federal approval of a new waiver request or amendment
166.22of an existing demonstration, may establish a pilot program in Hennepin County or Ramsey
166.23County, or both, to test alternative and innovative integrated health care delivery networks.
166.24(b) Individuals eligible for the pilot program shall be individuals who are eligible for
166.25medical assistance under section 256B.055, subdivision 15, and who reside in Hennepin
166.26County or Ramsey County. The commissioner may identify individuals to be enrolled in
166.27the Hennepin County pilot program based on zip code in Hennepin County or whether the
166.28individuals would benefit from an integrated health care delivery network.
166.29(c) Individuals enrolled in the pilot program shall be enrolled in an integrated
166.30health care delivery network in their county of residence. The integrated health care
166.31delivery network in Hennepin County shall be a network, such as an accountable care
166.32organization or a community-based collaborative care network, created by or including
166.33Hennepin County Medical Center. The integrated health care delivery network in Ramsey
166.34County shall be a network, such as an accountable care organization or community-based
166.35collaborative care network, created by or including Regions Hospital.
167.1(d) The commissioner shall cap pilot program enrollment at 7,000 enrollees for
167.2Hennepin County and 3,500 enrollees for Ramsey County.
167.3(e) (d) In developing a payment system for the pilot programs, the commissioner
167.4shall establish a total cost of care for the recipients enrolled in the pilot programs that
167.5equals the cost of care that would otherwise be spent for these enrollees in the prepaid
167.6medical assistance program.
167.7(f) Counties may transfer funds necessary to support the nonfederal share of
167.8payments for integrated health care delivery networks in their county. Such transfers per
167.9county shall not exceed 15 percent of the expected expenses for county enrollees.
167.10(g) (e) The commissioner shall apply to the federal government for, or as appropriate,
167.11cooperate with counties, providers, or other entities that are applying for any applicable
167.12grant or demonstration under the Patient Protection and Affordable Health Care Act, Public
167.13Law 111-148, or the Health Care and Education Reconciliation Act of 2010, Public Law
167.14111-152, that would further the purposes of or assist in the creation of an integrated health
167.15care delivery network for the purposes of this subdivision, including, but not limited to, a
167.16global payment demonstration or the community-based collaborative care network grants.

167.17    Sec. 14. Minnesota Statutes 2012, section 256B.69, subdivision 5c, is amended to read:
167.18    Subd. 5c. Medical education and research fund. (a) The commissioner of human
167.19services shall transfer each year to the medical education and research fund established
167.20under section 62J.692, an amount specified in this subdivision. The commissioner shall
167.21calculate the following:
167.22(1) an amount equal to the reduction in the prepaid medical assistance payments as
167.23specified in this clause. Until January 1, 2002, the county medical assistance capitation
167.24base rate prior to plan specific adjustments and after the regional rate adjustments under
167.25subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining
167.26metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after
167.27January 1, 2002, the county medical assistance capitation base rate prior to plan specific
167.28adjustments is reduced 6.3 percent for Hennepin County, two percent for the remaining
167.29metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing
167.30facility and elderly waiver payments and demonstration project payments operating
167.31under subdivision 23 are excluded from this reduction. The amount calculated under
167.32this clause shall not be adjusted for periods already paid due to subsequent changes to
167.33the capitation payments;
167.34(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this
167.35section;
168.1(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
168.2paid under this section; and
168.3(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
168.4under this section.
168.5(b) This subdivision shall be effective upon approval of a federal waiver which
168.6allows federal financial participation in the medical education and research fund. The
168.7amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount
168.8transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under
168.9paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally
168.10reduce the amount specified under paragraph (a), clause (1).
168.11(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner
168.12shall transfer $21,714,000 each fiscal year to the medical education and research fund.
168.13(d) Beginning September 1, 2011, of the amount in paragraph (a), following the
168.14transfer under paragraph (c), the commissioner shall transfer to the medical education
168.15research fund $23,936,000 in fiscal years 2012 and 2013 and $36,744,000 $49,552,000 in
168.16fiscal year 2014 and thereafter.

168.17    Sec. 15. Minnesota Statutes 2012, section 256B.76, is amended by adding a
168.18subdivision to read:
168.19    Subd. 7. Payment for certain primary care services and immunization
168.20administration. Payment for certain primary care services and immunization
168.21administration services rendered on or after January 1, 2013, through December 31, 2014,
168.22shall be made in accordance with section 1902(a)(13) of the Social Security Act.

168.23    Sec. 16. Minnesota Statutes 2012, section 256B.764, is amended to read:
168.24256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
168.25    (a) Effective for services rendered on or after July 1, 2007, payment rates for family
168.26planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
168.27when these services are provided by a community clinic as defined in section 145.9268,
168.28subdivision 1.
168.29    (b) Effective for services rendered on or after July 1, 2013, payment rates for
168.30family planning services shall be increased by 20 percent over the rates in effect June
168.3130, 2013, when these services are provided by a community clinic as defined in section
168.32145.9268, subdivision 1. The commissioner shall adjust capitation rates to managed care
168.33and county-based purchasing plans to reflect this increase, and shall require plans to pass
169.1on the full amount of the rate increase to eligible community clinics, in the form of higher
169.2payment rates for family planning services.
169.3EFFECTIVE DATE.This section is effective July 1, 2013.


169.6    Section 1. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
169.7    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an
169.8initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
169.92960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
169.109555.6265, under this chapter for a physical location that will not be the primary residence
169.11of the license holder for the entire period of licensure. If a license is issued during this
169.12moratorium, and the license holder changes the license holder's primary residence away
169.13from the physical location of the foster care license, the commissioner shall revoke the
169.14license according to section 245A.07. Exceptions to the moratorium include:
169.15(1) foster care settings that are required to be registered under chapter 144D;
169.16(2) foster care licenses replacing foster care licenses in existence on May 15, 2009,
169.17and determined to be needed by the commissioner under paragraph (b);
169.18(3) new foster care licenses determined to be needed by the commissioner under
169.19paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center, or
169.20restructuring of state-operated services that limits the capacity of state-operated facilities;
169.21(4) new foster care licenses determined to be needed by the commissioner under
169.22paragraph (b) for persons requiring hospital level care; or
169.23(5) new foster care licenses determined to be needed by the commissioner for the
169.24transition of people from personal care assistance to the home and community-based
169.25services.
169.26(b) The commissioner shall determine the need for newly licensed foster care homes
169.27as defined under this subdivision. As part of the determination, the commissioner shall
169.28consider the availability of foster care capacity in the area in which the licensee seeks to
169.29operate, and the recommendation of the local county board. The determination by the
169.30commissioner must be final. A determination of need is not required for a change in
169.31ownership at the same address.
169.32(c) The commissioner shall study the effects of the license moratorium under this
169.33subdivision and shall report back to the legislature by January 15, 2011. This study shall
169.34include, but is not limited to the following:
170.1(1) the overall capacity and utilization of foster care beds where the physical location
170.2is not the primary residence of the license holder prior to and after implementation
170.3of the moratorium;
170.4(2) the overall capacity and utilization of foster care beds where the physical
170.5location is the primary residence of the license holder prior to and after implementation
170.6of the moratorium; and
170.7(3) the number of licensed and occupied ICF/MR beds prior to and after
170.8implementation of the moratorium.
170.9(d) (c) When a foster care recipient moves out of a foster home that is not the
170.10primary residence of the license holder according to section 256B.49, subdivision 15,
170.11paragraph (f), the county shall immediately inform the Department of Human Services
170.12Licensing Division. The department shall decrease the statewide licensed capacity for
170.13foster care settings where the physical location is not the primary residence of the license
170.14holder, if the voluntary changes described in paragraph (f) (e) are not sufficient to meet the
170.15savings required by reductions in licensed bed capacity under Laws 2011, First Special
170.16Session chapter 9, article 7, sections 1 and 40, paragraph (f), and maintain statewide
170.17long-term care residential services capacity within budgetary limits. Implementation of
170.18the statewide licensed capacity reduction shall begin on July 1, 2013. The commissioner
170.19shall delicense up to 128 beds by June 30, 2014, using the needs determination process.
170.20Under this paragraph, the commissioner has the authority to reduce unused licensed
170.21capacity of a current foster care program to accomplish the consolidation or closure of
170.22settings. A decreased licensed capacity according to this paragraph is not subject to appeal
170.23under this chapter.
170.24(e) (d) Residential settings that would otherwise be subject to the decreased license
170.25capacity established in paragraph (d) (c) shall be exempt under the following circumstances:
170.26(1) until August 1, 2013, the license holder's beds occupied by residents whose
170.27primary diagnosis is mental illness and the license holder is:
170.28(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
170.29health services (ARMHS) as defined in section 256B.0623;
170.30(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
170.319520.0870;
170.32(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
170.339520.0870; or
170.34(iv) a provider of intensive residential treatment services (IRTS) licensed under
170.35Minnesota Rules, parts 9520.0500 to 9520.0670; or
170.36(2) the license holder is certified under the requirements in subdivision 6a.
171.1(f) (e) A resource need determination process, managed at the state level, using the
171.2available reports required by section 144A.351, and other data and information shall
171.3be used to determine where the reduced capacity required under paragraph (d) (c) will
171.4be implemented. The commissioner shall consult with the stakeholders described in
171.5section 144A.351, and employ a variety of methods to improve the state's capacity to
171.6meet long-term care service needs within budgetary limits, including seeking proposals
171.7from service providers or lead agencies to change service type, capacity, or location to
171.8improve services, increase the independence of residents, and better meet needs identified
171.9by the long-term care services reports and statewide data and information. By February
171.101 of each 2013 and August 1 of 2014 and each following year, the commissioner shall
171.11provide information and data on the overall capacity of licensed long-term care services,
171.12actions taken under this subdivision to manage statewide long-term care services and
171.13supports resources, and any recommendations for change to the legislative committees
171.14with jurisdiction over health and human services budget.
171.15    (g) (f) At the time of application and reapplication for licensure, the applicant and the
171.16license holder that are subject to the moratorium or an exclusion established in paragraph
171.17(a) are required to inform the commissioner whether the physical location where the foster
171.18care will be provided is or will be the primary residence of the license holder for the entire
171.19period of licensure. If the primary residence of the applicant or license holder changes, the
171.20applicant or license holder must notify the commissioner immediately. The commissioner
171.21shall print on the foster care license certificate whether or not the physical location is the
171.22primary residence of the license holder.
171.23    (h) (g) License holders of foster care homes identified under paragraph (g) (f) that
171.24are not the primary residence of the license holder and that also provide services in the
171.25foster care home that are covered by a federally approved home and community-based
171.26services waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must
171.27inform the human services licensing division that the license holder provides or intends to
171.28provide these waiver-funded services. These license holders must be considered registered
171.29under section 256B.092, subdivision 11, paragraph (c), and this registration status must
171.30be identified on their license certificates.

171.31    Sec. 2. Minnesota Statutes 2012, section 256.9657, subdivision 3a, is amended to read:
171.32    Subd. 3a. ICF/MR ICF/DD license surcharge. (a) Effective July 1, 2003, each
171.33non-state-operated facility as defined under section 256B.501, subdivision 1, shall pay
171.34to the commissioner an annual surcharge according to the schedule in subdivision 4,
171.35paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of
172.1licensed beds is reduced, the surcharge shall be based on the number of remaining licensed
172.2beds the second month following the receipt of timely notice by the commissioner of
172.3human services that beds have been delicensed. The facility must notify the commissioner
172.4of health in writing when beds are delicensed. The commissioner of health must notify
172.5the commissioner of human services within ten working days after receiving written
172.6notification. If the notification is received by the commissioner of human services by
172.7the 15th of the month, the invoice for the second following month must be reduced to
172.8recognize the delicensing of beds. The commissioner may reduce, and may subsequently
172.9restore, the surcharge under this subdivision based on the commissioner's determination of
172.10a permissible surcharge.
172.11(b) Effective July 1, 2013, the surcharge under paragraph (a) is increased to $3,717
172.12per licensed bed.
172.13EFFECTIVE DATE.This section is effective July 1, 2013.

172.14    Sec. 3. Minnesota Statutes 2012, section 256B.0911, subdivision 4d, is amended to read:
172.15    Subd. 4d. Preadmission screening of individuals under 65 years of age. (a)
172.16It is the policy of the state of Minnesota to ensure that individuals with disabilities or
172.17chronic illness are served in the most integrated setting appropriate to their needs and have
172.18the necessary information to make informed choices about home and community-based
172.19service options.
172.20    (b) Individuals under 65 years of age who are admitted to a nursing facility from a
172.21hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.
172.22    (c) Individuals under 65 years of age who are admitted to nursing facilities with
172.23only a telephone screening must receive a face-to-face assessment from the long-term
172.24care consultation team member of the county in which the facility is located or from the
172.25recipient's county case manager within 40 calendar days of admission.
172.26    (d) Individuals under 65 years of age who are admitted to a nursing facility
172.27without preadmission screening according to the exemption described in subdivision 4b,
172.28paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive
172.29a face-to-face assessment within 40 days of admission.
172.30    (e) At the face-to-face assessment, the long-term care consultation team member or
172.31county case manager must perform the activities required under subdivision 3b.
172.32    (f) For individuals under 21 years of age, a screening interview which recommends
172.33nursing facility admission must be face-to-face and approved by the commissioner before
172.34the individual is admitted to the nursing facility.
173.1    (g) In the event that an individual under 65 years of age is admitted to a nursing
173.2facility on an emergency basis, the county must be notified of the admission on the
173.3next working day, and a face-to-face assessment as described in paragraph (c) must be
173.4conducted within 40 calendar days of admission.
173.5    (h) At the face-to-face assessment, the long-term care consultation team member or
173.6the case manager must present information about home and community-based options,
173.7including consumer-directed options, so the individual can make informed choices. If the
173.8individual chooses home and community-based services, the long-term care consultation
173.9team member or case manager must complete a written relocation plan within 20 working
173.10days of the visit. The plan shall describe the services needed to move out of the facility
173.11and a time line for the move which is designed to ensure a smooth transition to the
173.12individual's home and community.
173.13    (i) An individual under 65 years of age residing in a nursing facility shall receive a
173.14face-to-face assessment at least every 12 months to review the person's service choices
173.15and available alternatives unless the individual indicates, in writing, that annual visits are
173.16not desired. In this case, the individual must receive a face-to-face assessment at least
173.17once every 36 months for the same purposes.
173.18    (j) Notwithstanding the provisions of subdivision 6, the commissioner may pay
173.19county agencies directly for face-to-face assessments for individuals under 65 years of age
173.20who are being considered for placement or residing in a nursing facility. Until September
173.2130, 2013, payments for individuals under 65 years of age shall be made as described
173.22in this subdivision.

173.23    Sec. 4. Minnesota Statutes 2012, section 256B.0911, subdivision 6, is amended to read:
173.24    Subd. 6. Payment for long-term care consultation services. (a) Until September
173.2530, 2013, payment for long-term care consultation face-to-face assessment shall be made
173.26as described in this subdivision.
173.27    (b) The total payment for each county must be paid monthly by certified nursing
173.28facilities in the county. The monthly amount to be paid by each nursing facility for each
173.29fiscal year must be determined by dividing the county's annual allocation for long-term
173.30care consultation services by 12 to determine the monthly payment and allocating the
173.31monthly payment to each nursing facility based on the number of licensed beds in the
173.32nursing facility. Payments to counties in which there is no certified nursing facility must be
173.33made by increasing the payment rate of the two facilities located nearest to the county seat.
174.1    (b) (c) The commissioner shall include the total annual payment determined under
174.2paragraph (a) for each nursing facility reimbursed under section 256B.431, 256B.434,
174.3or 256B.441.
174.4    (c) (d) In the event of the layaway, delicensure and decertification, or removal from
174.5layaway of 25 percent or more of the beds in a facility, the commissioner may adjust the
174.6per diem payment amount in paragraph (b) (c) and may adjust the monthly payment
174.7amount in paragraph (a). The effective date of an adjustment made under this paragraph
174.8shall be on or after the first day of the month following the effective date of the layaway,
174.9delicensure and decertification, or removal from layaway.
174.10    (d) (e) Payments for long-term care consultation services are available to the county
174.11or counties to cover staff salaries and expenses to provide the services described in
174.12subdivision 1a. The county shall employ, or contract with other agencies to employ,
174.13within the limits of available funding, sufficient personnel to provide long-term care
174.14consultation services while meeting the state's long-term care outcomes and objectives as
174.15defined in subdivision 1. The county shall be accountable for meeting local objectives
174.16as approved by the commissioner in the biennial home and community-based services
174.17quality assurance plan on a form provided by the commissioner.
174.18    (e) (f) Notwithstanding section 256B.0641, overpayments attributable to payment
174.19of the screening costs under the medical assistance program may not be recovered from
174.20a facility.
174.21    (f) (g) The commissioner of human services shall amend the Minnesota medical
174.22assistance plan to include reimbursement for the local consultation teams.
174.23    (g) (h) Until the alternative payment methodology in paragraph (h) (i) is implemented,
174.24the county may bill, as case management services, assessments, support planning, and
174.25follow-along provided to persons determined to be eligible for case management under
174.26Minnesota health care programs. No individual or family member shall be charged for an
174.27initial assessment or initial support plan development provided under subdivision 3a or 3b.
174.28(h) (i) The commissioner shall develop an alternative payment methodology,
174.29effective on October 1, 2013, for long-term care consultation services that includes
174.30the funding available under this subdivision, and for assessments authorized under
174.31sections 256B.092 and 256B.0659. In developing the new payment methodology, the
174.32commissioner shall consider the maximization of other funding sources, including federal
174.33administrative reimbursement through federal financial participation funding, for all
174.34long-term care consultation and preadmission screening activity. The alternative payment
174.35methodology shall include the use of the appropriate time studies and the state financing
174.36of nonfederal share as part of the state's medical assistance program.

175.1    Sec. 5. Minnesota Statutes 2012, section 256B.0916, is amended by adding a
175.2subdivision to read:
175.3    Subd. 11. Excess spending. County and tribal agencies are responsible for spending
175.4in excess of the allocation made by the commissioner. In the event a county or tribal
175.5agency spends in excess of the allocation made by the commissioner for a given allocation
175.6period, they must submit a corrective action plan to the commissioner. The plan must state
175.7the actions the agency will take to correct their overspending for the year following the
175.8period when the overspending occurred. Failure to correct overspending shall result in
175.9recoupment of spending in excess of the allocation. Nothing in this subdivision shall be
175.10construed as reducing the county's responsibility to offer and make available feasible
175.11home and community-based options to eligible waiver recipients within the resources
175.12allocated to them for that purpose.

175.13    Sec. 6. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
175.14    Subd. 11. Residential support services. (a) Upon federal approval, there is
175.15established a new service called residential support that is available on the community
175.16alternative care, community alternatives for disabled individuals, developmental
175.17disabilities, and brain injury waivers. Existing waiver service descriptions must be
175.18modified to the extent necessary to ensure there is no duplication between other services.
175.19Residential support services must be provided by vendors licensed as a community
175.20residential setting as defined in section 245A.11, subdivision 8.
175.21    (b) Residential support services must meet the following criteria:
175.22    (1) providers of residential support services must own or control the residential site;
175.23    (2) the residential site must not be the primary residence of the license holder;
175.24    (3) the residential site must have a designated program supervisor responsible for
175.25program oversight, development, and implementation of policies and procedures;
175.26    (4) the provider of residential support services must provide supervision, training,
175.27and assistance as described in the person's coordinated service and support plan; and
175.28    (5) the provider of residential support services must meet the requirements of
175.29licensure and additional requirements of the person's coordinated service and support plan.
175.30    (c) Providers of residential support services that meet the definition in paragraph
175.31(a) must be registered using a process determined by the commissioner beginning July
175.321, 2009. Providers licensed to provide child foster care under Minnesota Rules, parts
175.332960.3000 to 2960.3340, or adult foster care licensed under Minnesota Rules, parts
175.349555.5105 to 9555.6265, and that meet the requirements in section 245A.03, subdivision
175.357 , paragraph (g) (f), are considered registered under this section.

176.1    Sec. 7. Minnesota Statutes 2012, section 256B.092, subdivision 12, is amended to read:
176.2    Subd. 12. Waivered services statewide priorities. (a) The commissioner shall
176.3establish statewide priorities for individuals on the waiting list for developmental
176.4disabilities (DD) waiver services, as of January 1, 2010. The statewide priorities must
176.5include, but are not limited to, individuals who continue to have a need for waiver services
176.6after they have maximized the use of state plan services and other funding resources,
176.7including natural supports, prior to accessing waiver services, and who meet at least one
176.8of the following criteria:
176.9(1) have unstable living situations due to the age, incapacity, or sudden loss of
176.10the primary caregivers;
176.11(2) are moving from an institution due to bed closures;
176.12(3) experience a sudden closure of their current living arrangement;
176.13(4) require protection from confirmed abuse, neglect, or exploitation;
176.14(5) experience a sudden change in need that can no longer be met through state plan
176.15services or other funding resources alone; or
176.16(6) meet other priorities established by the department.
176.17(b) When allocating resources to lead agencies, the commissioner must take into
176.18consideration the number of individuals waiting who meet statewide priorities and the
176.19lead agencies' current use of waiver funds and existing service options. The commissioner
176.20has the authority to transfer funds between counties, groups of counties, and tribes to
176.21accommodate statewide priorities and resource needs while accounting for a necessary
176.22base level reserve amount for each county, group of counties, and tribe.
176.23(c) The commissioner shall evaluate the impact of the use of statewide priorities and
176.24provide recommendations to the legislature on whether to continue the use of statewide
176.25priorities in the November 1, 2011, annual report required by the commissioner in sections
176.26256B.0916, subdivision 7, and 256B.49, subdivision 21.

176.27    Sec. 8. [256B.0949] AUTISM EARLY INTENSIVE INTERVENTION BENEFIT.
176.28    Subdivision 1. Purpose. This section creates a new benefit available under the
176.29medical assistance state plan 1915(i) option to provide early intensive intervention to a
176.30child with an autism spectrum disorder diagnosis. This benefit must provide coverage for
176.31the comprehensive, multidisciplinary diagnostic assessment, ongoing progress evaluation,
176.32and medically necessary treatment of autism spectrum disorder. This option must be
176.33available upon federal approval, but not earlier than March 1, 2014.
176.34    Subd. 2. Definitions. (a) For the purposes of this section, the terms defined in
176.35this subdivision have the meanings given.
177.1(b) "Autism spectrum disorder diagnosis" is defined by diagnostic code 299 in the
177.2Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
177.3(c) "Child" means a person under the age of 18.
177.4(d) "Early intensive intervention benefit" means autism treatment options based in
177.5behavioral and developmental science, which may include modalities such as applied
177.6behavioral analysis, developmental treatment approaches, and naturalistic and parent
177.7training models.
177.8(e) "Commissioner" means the commissioner of human services, unless otherwise
177.9specified.
177.10(f) "Generalizable" means goals or gains that are observed in a variety of activities
177.11with different people, such as providers, family members, other adults, and children and
177.12in different environments including, but not limited to, clinics, homes, schools, and the
177.13community.
177.14    Subd. 3. Initial eligibility. (a) This benefit is available to a child receiving medical
177.15assistance who has an autism spectrum disorder diagnosis and who meets the criteria for
177.16medically necessary early intensive intervention services.
177.17(b) A comprehensive diagnosis must be based upon current DSM criteria including
177.18direct observations and parental or caregiver reports. The comprehensive diagnosis
177.19must reflect both medical and mental health input as provided by a licensed health care
177.20professional and a licensed mental health professional.
177.21(c) Additional diagnostic assessments may be provided as needed by professionals
177.22who are licensed experts in the fields of medicine, speech and language, psychology,
177.23occupational therapy, and physical therapy.
177.24(d) Special education assessments may also be considered in the diagnostic
177.25assessment.
177.26(e) The multidisciplinary diagnostic assessment must lead to an individualized
177.27treatment plan.
177.28    Subd. 4. Treatment plan. (a) Each child's treatment plan must be family centered,
177.29culturally sensitive, and individualized based on the child's needs and developmental
177.30status. The treatment plan must specify developmentally appropriate, functional,
177.31generalizable goals, treatment modality, intensity, and setting. Treatment must be overseen
177.32by a licensed health care or mental health professional with expertise and training in
177.33autism and child development.
177.34(b) A functional assessment must identify the child's developmental skills, needs,
177.35and capacities based on direct observation of the child. It may include, but is not limited
177.36to, input provided by the child's special education teacher.
178.1(c) An assessment of parental or caregiver resilience and ability to participate in
178.2therapy must be conducted to determine the nature and level of parental or caregiver
178.3involvement and training.
178.4(d) The treatment plan must be submitted to the commissioner for approval in a
178.5manner determined by the commissioner for this purpose.
178.6(e) The commissioner must authorize services consistent with approved treatment
178.7plans.
178.8    Subd. 5. Ongoing eligibility. A child receiving this benefit must receive an
178.9independent progress evaluation by a licensed mental health professional every six
178.10months, or more frequently as determined by the commissioner, to determine if progress is
178.11being made toward achieving generalizable gains and meeting functional goals contained
178.12in the treatment plan. The progress evaluation must determine if the treatment plan
178.13needs modification. This progress evaluation must include the treating provider's report,
178.14parental or caregiver input, and an independent observation of the child. For children
178.15participating in special education, the observation component of this progress evaluation
178.16may be performed by the child's special education teacher. Progress evaluations must be
178.17submitted to the commissioner in a manner determined by the commissioner for this
178.18purpose. A child who continues to achieve generalizable gains and treatment goals as
178.19contained in the treatment plan is eligible to continue receiving this benefit.
178.20    Subd. 6. Refining the benefit with stakeholders. The commissioner must develop
178.21the implementation details of the benefit in consultation with stakeholders and consider
178.22recommendations from the Health Services Advisory Council, the Autism Spectrum
178.23Disorder Advisory Council, and the Interagency Task Force of the Departments of Health,
178.24Education, and Human Services. The commissioner must release these details for a 30-day
178.25public comment period prior to submission to the federal government for approval. The
178.26implementation details include, but are not limited to, the following:
178.27(1) defining the qualifications, standards, and roles of the treatment team;
178.28(2) developing initial, uniform parameters for multidisciplinary diagnostic
178.29assessment and progress evaluation standards;
178.30(3) developing an effective and consistent process for assessing parent and caregiver
178.31resilience and capacity to participate in the child's early intervention treatment;
178.32(4) forming a collaborative process in which professionals have opportunities to
178.33collectively inform diagnostic assessment and progress evaluation processes and standards
178.34and to support quality improvement of early intensive intervention services;
178.35(5) coordination with and interaction of this benefit with other services provided by
178.36the Departments of Human Services and Education; and
179.1(6) ongoing evaluation of and research regarding the program and treatment
179.2modalities provided to children under this benefit.
179.3    Subd. 7. Revision of treatment options. The commissioner may revise covered
179.4treatment options as needed to ensure consistency with evolving evidence.
179.5    Subd. 8. Coordination between agencies. The commissioners of human services
179.6and education must coordinate diagnostic and educational assessment, service delivery,
179.7and progress evaluations across health and education sectors.

179.8    Sec. 9. Minnesota Statutes 2012, section 256B.434, subdivision 4, is amended to read:
179.9    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
179.10have their payment rates determined under this section rather than section 256B.431, the
179.11commissioner shall establish a rate under this subdivision. The nursing facility must enter
179.12into a written contract with the commissioner.
179.13    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
179.14contract under this section is the payment rate the facility would have received under
179.15section 256B.431.
179.16    (c) A nursing facility's case mix payment rates for the second and subsequent years
179.17of a facility's contract under this section are the previous rate year's contract payment
179.18rates plus an inflation adjustment and, for facilities reimbursed under this section or
179.19section 256B.431, an adjustment to include the cost of any increase in Health Department
179.20licensing fees for the facility taking effect on or after July 1, 2001. The index for the
179.21inflation adjustment must be based on the change in the Consumer Price Index-All Items
179.22(United States City average) (CPI-U) forecasted by the commissioner of management and
179.23budget's national economic consultant, as forecasted in the fourth quarter of the calendar
179.24year preceding the rate year. The inflation adjustment must be based on the 12-month
179.25period from the midpoint of the previous rate year to the midpoint of the rate year for
179.26which the rate is being determined. For the rate years beginning on July 1, 1999, July 1,
179.272000, July 1, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006,
179.28July 1, 2007, July 1, 2008, October 1, 2009, and October 1, 2010, this paragraph shall
179.29apply only to the property-related payment rate. For the rate years beginning on October
179.301, 2011, and October 1, 2012, October 1, 2013, October 1, 2014, October 1, 2015, and
179.31October 1, 2016, the rate adjustment under this paragraph shall be suspended. Beginning
179.32in 2005, adjustment to the property payment rate under this section and section 256B.431
179.33shall be effective on October 1. In determining the amount of the property-related payment
179.34rate adjustment under this paragraph, the commissioner shall determine the proportion of
179.35the facility's rates that are property-related based on the facility's most recent cost report.
180.1    (d) The commissioner shall develop additional incentive-based payments of up to
180.2five percent above a facility's operating payment rate for achieving outcomes specified
180.3in a contract. The commissioner may solicit contract amendments and implement those
180.4which, on a competitive basis, best meet the state's policy objectives. The commissioner
180.5shall limit the amount of any incentive payment and the number of contract amendments
180.6under this paragraph to operate the incentive payments within funds appropriated for this
180.7purpose. The contract amendments may specify various levels of payment for various
180.8levels of performance. Incentive payments to facilities under this paragraph may be in the
180.9form of time-limited rate adjustments or onetime supplemental payments. In establishing
180.10the specified outcomes and related criteria, the commissioner shall consider the following
180.11state policy objectives:
180.12    (1) successful diversion or discharge of residents to the residents' prior home or other
180.13community-based alternatives;
180.14    (2) adoption of new technology to improve quality or efficiency;
180.15    (3) improved quality as measured in the Nursing Home Report Card;
180.16    (4) reduced acute care costs; and
180.17    (5) any additional outcomes proposed by a nursing facility that the commissioner
180.18finds desirable.
180.19    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
180.20take action to come into compliance with existing or pending requirements of the life
180.21safety code provisions or federal regulations governing sprinkler systems must receive
180.22reimbursement for the costs associated with compliance if all of the following conditions
180.23are met:
180.24    (1) the expenses associated with compliance occurred on or after January 1, 2005,
180.25and before December 31, 2008;
180.26    (2) the costs were not otherwise reimbursed under subdivision 4f or section
180.27144A.071 or 144A.073; and
180.28    (3) the total allowable costs reported under this paragraph are less than the minimum
180.29threshold established under section 256B.431, subdivision 15, paragraph (e), and
180.30subdivision 16.
180.31The commissioner shall use money appropriated for this purpose to provide to qualifying
180.32nursing facilities a rate adjustment beginning October 1, 2007, and ending September 30,
180.332008. Nursing facilities that have spent money or anticipate the need to spend money
180.34to satisfy the most recent life safety code requirements by (1) installing a sprinkler
180.35system or (2) replacing all or portions of an existing sprinkler system may submit to the
180.36commissioner by June 30, 2007, on a form provided by the commissioner the actual
181.1costs of a completed project or the estimated costs, based on a project bid, of a planned
181.2project. The commissioner shall calculate a rate adjustment equal to the allowable
181.3costs of the project divided by the resident days reported for the report year ending
181.4September 30, 2006. If the costs from all projects exceed the appropriation for this
181.5purpose, the commissioner shall allocate the money appropriated on a pro rata basis to the
181.6qualifying facilities by reducing the rate adjustment determined for each facility by an
181.7equal percentage. Facilities that used estimated costs when requesting the rate adjustment
181.8shall report to the commissioner by January 31, 2009, on the use of this money on a
181.9form provided by the commissioner. If the nursing facility fails to provide the report, the
181.10commissioner shall recoup the money paid to the facility for this purpose. If the facility
181.11reports expenditures allowable under this subdivision that are less than the amount received
181.12in the facility's annualized rate adjustment, the commissioner shall recoup the difference.

181.13    Sec. 10. Minnesota Statutes 2012, section 256B.434, is amended by adding a
181.14subdivision to read:
181.15    Subd. 19a. Nursing facility rate adjustments beginning October 1, 2013. (a)
181.16For the rate year beginning October 1, 2013, the commissioner shall make available to
181.17each nursing facility reimbursed under this section a two percent operating payment
181.18rate increase.
181.19(b) Seventy-five percent of the money resulting from the rate adjustment under
181.20paragraph (a) must be used for increases in compensation-related costs for employees
181.21directly employed by the nursing facility on or after the effective date of the rate
181.22adjustment, except:
181.23(1) the administrator;
181.24(2) persons employed in the central office of a corporation that has an ownership
181.25interest in the nursing facility or exercises control over the nursing facility; and
181.26(3) persons paid by the nursing facility under a management contract.
181.27(c) The commissioner shall allow as compensation-related costs all costs for:
181.28(1) wages and salaries;
181.29(2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
181.30compensation;
181.31(3) the employer's share of health and dental insurance, life insurance, disability
181.32insurance, long-term care insurance, uniform allowance, and pensions; and
181.33(4) other benefits provided and workforce needs including the recruiting and training
181.34of employees, subject to the approval of the commissioner.
182.1(d) The portion of the rate adjustment under paragraph (a) that is not subject to the
182.2requirements of paragraph (b) shall be provided to nursing facilities effective October 1.
182.3Nursing facilities may apply for the portion of the rate adjustment under paragraph (a)
182.4that is subject to the requirements in paragraph (b). The application must be submitted
182.5to the commissioner within six months of the effective date of the rate adjustment, and
182.6the nursing facility must provide additional information required by the commissioner
182.7within nine months of the effective date of the rate adjustment. The commissioner must
182.8respond to all applications within three weeks of receipt. The commissioner may waive
182.9the deadlines in this paragraph under extraordinary circumstances, to be determined at the
182.10sole discretion of the commissioner. The application must contain:
182.11(1) an estimate of the amounts of money that must be used as specified in paragraph
182.12(b);
182.13(2) a detailed distribution plan specifying the allowable compensation-related and
182.14wage increases the nursing facility will implement to use the funds available in clause (1);
182.15(3) a description of how the nursing facility will notify eligible employees of
182.16the contents of the approved application, which must provide for giving each eligible
182.17employee a copy of the approved application, excluding the information required in clause
182.18(1), or posting a copy of the approved application, excluding the information required in
182.19clause (1), for a period of at least six weeks in an area of the nursing facility to which all
182.20eligible employees have access; and
182.21(4) instructions for employees who believe they have not received the
182.22compensation-related or wage increases specified in clause (2), as approved by the
182.23commissioner, and which must include a mailing address, e-mail address, and the
182.24telephone number that may be used by the employee to contact the commissioner or the
182.25commissioner's representative.
182.26(e) For the October 1, 2013, rate increase, the commissioner shall ensure that cost
182.27increases in distribution plans under paragraph (d), clause (2), that may be included in
182.28approved applications, comply with the following requirements:
182.29(1) a portion of the costs resulting from tenure-related wage or salary increases
182.30may be considered to be allowable wage increases, according to formulas that the
182.31commissioner shall provide, where employee retention is above the average statewide
182.32rate of retention of direct care employees;
182.33(2) the annualized amount of increases in costs for the employer's share of health
182.34and dental insurance, life insurance, disability insurance, and workers' compensation
182.35shall be allowable compensation-related increases if they are effective on or after April
182.361, 2013, and prior to April 1, 2014; and
183.1(3) for nursing facilities in which employees are represented by an exclusive
183.2bargaining representative, the commissioner shall approve the application only upon
183.3receipt of a letter of acceptance of the distribution plan, in regard to members of the
183.4bargaining unit, signed by the exclusive bargaining agent and dated after May 25, 2013.
183.5Upon receipt of the letter of acceptance, the commissioner shall deem all requirements of
183.6this provision as having been met in regard to the members of the bargaining unit.
183.7(f) The commissioner shall review applications received under paragraph (e) and
183.8shall provide the portion of the rate adjustment under paragraph (b) if the requirements
183.9of this statute have been met. The rate adjustment shall be effective October 1.
183.10Notwithstanding paragraph (a), if the approved application distributes less money than is
183.11available, the amount of the rate adjustment shall be reduced so that the amount of money
183.12made available is equal to the amount to be distributed.
183.13(g) The increase in this subdivision shall be applied as a total percentage to
183.14operating rates effective September 30, 2013, except that they shall not increase any
183.15performance-based incentive payments under section 256B.434, subdivision 4, paragraph
183.16(d), awarded prior to the effective date of the rate adjustment. Facilities receiving equitable
183.17cost-sharing for publicly owned nursing facilities program rate adjustments under section
183.18256B.441, subdivision 55a, must have rate increases under this paragraph computed based
183.19on rates in effect before the increases given under section 256B.441, subdivision 55a.

183.20    Sec. 11. Minnesota Statutes 2012, section 256B.437, subdivision 6, is amended to read:
183.21    Subd. 6. Planned closure rate adjustment. (a) The commissioner of human
183.22services shall calculate the amount of the planned closure rate adjustment available under
183.23subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):
183.24(1) the amount available is the net reduction of nursing facility beds multiplied
183.25by $2,080;
183.26(2) the total number of beds in the nursing facility or facilities receiving the planned
183.27closure rate adjustment must be identified;
183.28(3) capacity days are determined by multiplying the number determined under
183.29clause (2) by 365; and
183.30(4) the planned closure rate adjustment is the amount available in clause (1), divided
183.31by capacity days determined under clause (3).
183.32(b) A planned closure rate adjustment under this section is effective on the first day
183.33of the month following completion of closure of the facility designated for closure in
183.34the application and becomes part of the nursing facility's total operating external fixed
183.35 payment rate.
184.1(c) Applicants may use the planned closure rate adjustment to allow for a property
184.2payment for a new nursing facility or an addition to an existing nursing facility or as
184.3an operating payment external fixed rate adjustment. Applications approved under this
184.4subdivision are exempt from other requirements for moratorium exceptions under section
184.5144A.073 , subdivisions 2 and 3.
184.6(d) Upon the request of a closing facility, the commissioner must allow the facility a
184.7closure rate adjustment as provided under section 144A.161, subdivision 10.
184.8(e) A facility that has received a planned closure rate adjustment may reassign it
184.9to another facility that is under the same ownership at any time within three years of its
184.10effective date. The amount of the adjustment shall be computed according to paragraph (a).
184.11(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
184.12the commissioner shall recalculate planned closure rate adjustments for facilities that
184.13delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
184.14bed dollar amount. The recalculated planned closure rate adjustment shall be effective
184.15from the date the per bed dollar amount is increased.
184.16(g) For planned closures approved after June 30, 2009, the commissioner of human
184.17services shall calculate the amount of the planned closure rate adjustment available under
184.18subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
184.19(h) Beginning Between July 16, 2011, and June 30, 2013, the commissioner shall no
184.20longer not accept applications for planned closure rate adjustments under subdivision 3.

184.21    Sec. 12. Minnesota Statutes 2012, section 256B.441, subdivision 13, is amended to read:
184.22    Subd. 13. External fixed costs. "External fixed costs" means costs related to the
184.23nursing home surcharge under section 256.9657, subdivision 1; licensure fees under
184.24section 144.122; until September 30, 2013, long-term care consultation fees under
184.25section 256B.0911, subdivision 6; family advisory council fee under section 144A.33;
184.26scholarships under section 256B.431, subdivision 36; planned closure rate adjustments
184.27under section 256B.437; or single bed room incentives under section 256B.431,
184.28subdivision 42 ; property taxes and property insurance; and PERA.

184.29    Sec. 13. Minnesota Statutes 2012, section 256B.441, subdivision 53, is amended to read:
184.30    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
184.31shall calculate a payment rate for external fixed costs.
184.32    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
184.33shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
185.1home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
185.2result of its number of nursing home beds divided by its total number of licensed beds.
185.3    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
185.4shall be the amount of the fee divided by actual resident days.
185.5    (c) The portion related to scholarships shall be determined under section 256B.431,
185.6subdivision 36.
185.7    (d) Until September 30, 2013, the portion related to long-term care consultation shall
185.8be determined according to section 256B.0911, subdivision 6.
185.9    (e) The portion related to development and education of resident and family advisory
185.10councils under section 144A.33 shall be $5 divided by 365.
185.11    (f) The portion related to planned closure rate adjustments shall be as determined
185.12under section 256B.437, subdivision 6, and Minnesota Statutes 2010, section 256B.436.
185.13Planned closure rate adjustments that take effect before October 1, 2014, shall no longer
185.14be included in the payment rate for external fixed costs beginning October 1, 2016.
185.15Planned closure rate adjustments that take effect on or after October 1, 2014, shall no
185.16longer be included in the payment rate for external fixed costs beginning on October 1 of
185.17the first year not less than two years after their effective date.
185.18    (g) The portions related to property insurance, real estate taxes, special assessments,
185.19and payments made in lieu of real estate taxes directly identified or allocated to the nursing
185.20facility shall be the actual amounts divided by actual resident days.
185.21    (h) The portion related to the Public Employees Retirement Association shall be
185.22actual costs divided by resident days.
185.23    (i) The single bed room incentives shall be as determined under section 256B.431,
185.24subdivision 42. Single bed room incentives that take effect before October 1, 2014, shall
185.25no longer be included in the payment rate for external fixed costs beginning October 1,
185.262016. Single bed room incentives that take effect on or after October 1, 2014, shall no
185.27longer be included in the payment rate for external fixed costs beginning on October 1 of
185.28the first year not less than two years after their effective date.
185.29    (j) The payment rate for external fixed costs shall be the sum of the amounts in
185.30paragraphs (a) to (i).

185.31    Sec. 14. Minnesota Statutes 2012, section 256B.49, subdivision 11a, is amended to read:
185.32    Subd. 11a. Waivered services statewide priorities. (a) The commissioner shall
185.33establish statewide priorities for individuals on the waiting list for community alternative
185.34care, community alternatives for disabled individuals, and brain injury waiver services,
185.35as of January 1, 2010. The statewide priorities must include, but are not limited to,
186.1individuals who continue to have a need for waiver services after they have maximized the
186.2use of state plan services and other funding resources, including natural supports, prior to
186.3accessing waiver services, and who meet at least one of the following criteria:
186.4(1) have unstable living situations due to the age, incapacity, or sudden loss of
186.5the primary caregivers;
186.6(2) are moving from an institution due to bed closures;
186.7(3) experience a sudden closure of their current living arrangement;
186.8(4) require protection from confirmed abuse, neglect, or exploitation;
186.9(5) experience a sudden change in need that can no longer be met through state plan
186.10services or other funding resources alone; or
186.11(6) meet other priorities established by the department.
186.12(b) When allocating resources to lead agencies, the commissioner must take into
186.13consideration the number of individuals waiting who meet statewide priorities and the
186.14lead agencies' current use of waiver funds and existing service options. The commissioner
186.15has the authority to transfer funds between counties, groups of counties, and tribes to
186.16accommodate statewide priorities and resource needs while accounting for a necessary
186.17base level reserve amount for each county, group of counties, and tribe.
186.18(c) The commissioner shall evaluate the impact of the use of statewide priorities and
186.19provide recommendations to the legislature on whether to continue the use of statewide
186.20priorities in the November 1, 2011, annual report required by the commissioner in sections
186.21256B.0916, subdivision 7, and 256B.49, subdivision 21.

186.22    Sec. 15. Minnesota Statutes 2012, section 256B.49, subdivision 15, is amended to read:
186.23    Subd. 15. Coordinated service and support plan; comprehensive transitional
186.24service plan; maintenance service plan. (a) Each recipient of home and community-based
186.25waivered services shall be provided a copy of the written coordinated service and support
186.26plan which meets the requirements in section 256B.092, subdivision 1b.
186.27(b) In developing the comprehensive transitional service plan, the individual
186.28receiving services, the case manager, and the guardian, if applicable, will identify the
186.29transitional service plan fundamental service outcome and anticipated timeline to achieve
186.30this outcome. Within the first 20 days following a recipient's request for an assessment or
186.31reassessment, the transitional service planning team must be identified. A team leader must
186.32be identified who will be responsible for assigning responsibility and communicating with
186.33team members to ensure implementation of the transition plan and ongoing assessment and
186.34communication process. The team leader should be an individual, such as the case manager
186.35or guardian, who has the opportunity to follow the recipient to the next level of service.
187.1Within ten days following an assessment, a comprehensive transitional service plan
187.2must be developed incorporating elements of a comprehensive functional assessment and
187.3including short-term measurable outcomes and timelines for achievement of and reporting
187.4on these outcomes. Functional milestones must also be identified and reported according
187.5to the timelines agreed upon by the transitional service planning team. In addition, the
187.6comprehensive transitional service plan must identify additional supports that may assist
187.7in the achievement of the fundamental service outcome such as the development of greater
187.8natural community support, increased collaboration among agencies, and technological
187.9supports.
187.10The timelines for reporting on functional milestones will prompt a reassessment of
187.11services provided, the units of services, rates, and appropriate service providers. It is
187.12the responsibility of the transitional service planning team leader to review functional
187.13milestone reporting to determine if the milestones are consistent with observable skills
187.14and that milestone achievement prompts any needed changes to the comprehensive
187.15transitional service plan.
187.16For those whose fundamental transitional service outcome involves the need to
187.17procure housing, a plan for the recipient to seek the resources necessary to secure the least
187.18restrictive housing possible should be incorporated into the plan, including employment
187.19and public supports such as housing access and shelter needy funding.
187.20(c) Counties and other agencies responsible for funding community placement and
187.21ongoing community supportive services are responsible for the implementation of the
187.22comprehensive transitional service plans. Oversight responsibilities include both ensuring
187.23effective transitional service delivery and efficient utilization of funding resources.
187.24(d) Following one year of transitional services, the transitional services planning team
187.25will make a determination as to whether or not the individual receiving services requires
187.26the current level of continuous and consistent support in order to maintain the recipient's
187.27current level of functioning. Recipients who are determined to have not had a significant
187.28change in functioning for 12 months must move from a transitional to a maintenance
187.29service plan. Recipients on a maintenance service plan must be reassessed to determine if
187.30the recipient would benefit from a transitional service plan at least every 12 months and at
187.31other times when there has been a significant change in the recipient's functioning. This
187.32assessment should consider any changes to technological or natural community supports.
187.33(e) When a county is evaluating denials, reductions, or terminations of home and
187.34community-based services under section 256B.49 for an individual, the case manager
187.35shall offer to meet with the individual or the individual's guardian in order to discuss
187.36the prioritization of service needs within the coordinated service and support plan,
188.1comprehensive transitional service plan, or maintenance service plan. The reduction in
188.2the authorized services for an individual due to changes in funding for waivered services
188.3may not exceed the amount needed to ensure medically necessary services to meet the
188.4individual's health, safety, and welfare.
188.5(f) At the time of reassessment, local agency case managers shall assess each recipient
188.6of community alternatives for disabled individuals or brain injury waivered services
188.7currently residing in a licensed adult foster home that is not the primary residence of the
188.8license holder, or in which the license holder is not the primary caregiver, to determine if
188.9that recipient could appropriately be served in a community-living setting. If appropriate
188.10for the recipient, the case manager shall offer the recipient, through a person-centered
188.11planning process, the option to receive alternative housing and service options. In the
188.12event that the recipient chooses to transfer from the adult foster home, the vacated bed
188.13shall not be filled with another recipient of waiver services and group residential housing
188.14and the licensed capacity shall be reduced accordingly, unless the savings required by the
188.15licensed bed closure reductions under Laws 2011, First Special Session chapter 9, article 7,
188.16sections 1 and 40, paragraph (f), for foster care settings where the physical location is not
188.17the primary residence of the license holder are met through voluntary changes described
188.18in section 245A.03, subdivision 7, paragraph (f) (e), or as provided under paragraph (a),
188.19clauses (3) and (4). If the adult foster home becomes no longer viable due to these transfers,
188.20the county agency, with the assistance of the department, shall facilitate a consolidation of
188.21settings or closure. This reassessment process shall be completed by July 1, 2013.

188.22    Sec. 16. Minnesota Statutes 2012, section 256B.49, is amended by adding a
188.23subdivision to read:
188.24    Subd. 25. Excess allocations. County and tribal agencies will be responsible for
188.25authorizations in excess of the allocation made by the commissioner. In the event a county
188.26or tribal agency authorizes in excess of the allocation made by the commissioner for a
188.27given allocation period, they must submit a corrective action plan to the commissioner.
188.28The plan must state the actions the agency will take to correct their over-authorization for
188.29the year following the period when the over-authorization occurred. Failure to correct
188.30over-authorizations shall result in recoupment of authorizations in excess of the allocation.
188.31Nothing in this subdivision shall be construed as reducing the county's responsibility to
188.32offer and make available feasible home and community-based options to eligible waiver
188.33recipients within the resources allocated to them for that purpose.

188.34    Sec. 17. Minnesota Statutes 2012, section 256B.492, is amended to read:
189.1256B.492 HOME AND COMMUNITY-BASED SETTINGS FOR PEOPLE
189.2WITH DISABILITIES.
189.3(a) Individuals receiving services under a home and community-based waiver under
189.4section 256B.092 or 256B.49 may receive services in the following settings:
189.5(1) an individual's own home or family home;
189.6(2) a licensed adult foster care setting of up to five people; and
189.7(3) community living settings as defined in section 256B.49, subdivision 23, where
189.8individuals with disabilities may reside in all of the units in a building of four or fewer
189.9units, and no more than the greater of four or 25 percent of the units in a multifamily
189.10building of more than four units, unless required by the Housing Opportunities for Persons
189.11with AIDS program.
189.12(b) The settings in paragraph (a) must not:
189.13(1) be located in a building that is a publicly or privately operated facility that
189.14provides institutional treatment or custodial care;
189.15(2) be located in a building on the grounds of or adjacent to a public or private
189.16institution;
189.17(3) be a housing complex designed expressly around an individual's diagnosis or
189.18disability, unless required by the Housing Opportunities for Persons with AIDS program;
189.19(4) be segregated based on a disability, either physically or because of setting
189.20characteristics, from the larger community; and
189.21(5) have the qualities of an institution which include, but are not limited to:
189.22regimented meal and sleep times, limitations on visitors, and lack of privacy. Restrictions
189.23agreed to and documented in the person's individual service plan shall not result in a
189.24residence having the qualities of an institution as long as the restrictions for the person are
189.25not imposed upon others in the same residence and are the least restrictive alternative,
189.26imposed for the shortest possible time to meet the person's needs.
189.27(c) The provisions of paragraphs (a) and (b) do not apply to any setting in which
189.28individuals receive services under a home and community-based waiver as of July 1,
189.292012, and the setting does not meet the criteria of this section.
189.30(d) Notwithstanding paragraph (c), a program in Hennepin County established as
189.31part of a Hennepin County demonstration project is qualified for the exception allowed
189.32under paragraph (c).
189.33(e) The commissioner shall submit an amendment to the waiver plan no later than
189.34December 31, 2012.

189.35    Sec. 18. Minnesota Statutes 2012, section 256B.493, subdivision 2, is amended to read:
190.1    Subd. 2. Planned closure process needs determination. The commissioner shall
190.2announce and implement a program for planned closure of adult foster care homes. Planned
190.3closure shall be the preferred method for achieving necessary budgetary savings required by
190.4the licensed bed closure budget reduction in section 245A.03, subdivision 7, paragraph (d)
190.5 (c). If additional closures are required to achieve the necessary savings, the commissioner
190.6shall use the process and priorities in section 245A.03, subdivision 7, paragraph (d) (c).

190.7    Sec. 19. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
190.8subdivision to read:
190.9    Subd. 14. Rate increase effective June 1, 2013. For rate periods beginning on or
190.10after June 1, 2013, the commissioner shall increase the total operating payment rate for
190.11each facility reimbursed under this section by $7.81 per day. The increase shall not be
190.12subject to any annual percentage increase.
190.13EFFECTIVE DATE.This section is effective June 1, 2013.

190.14    Sec. 20. Minnesota Statutes 2012, section 256B.5012, is amended by adding a
190.15subdivision to read:
190.16    Subd. 15. ICF/DD rate increases effective July 1, 2013. (a) Notwithstanding
190.17subdivision 12, for each facility reimbursed under this section, for the rate period
190.18beginning July 1, 2013, the commissioner shall increase operating payments equal to two
190.19percent of the operating payment rates in effect on June 30, 2013.
190.20(b) For each facility, the commissioner shall apply the rate increase based on
190.21occupied beds, using the percentage specified in this subdivision multiplied by the total
190.22payment rate, including the variable rate, but excluding the property-related payment
190.23rate in effect on the preceding date. The total rate increase shall include the adjustment
190.24provided in section 256B.501, subdivision 12.

190.25    Sec. 21. Laws 2011, First Special Session chapter 9, article 10, section 3, subdivision
190.263, as amended by Laws 2012, chapter 247, article 4, section 43, is amended to read:

190.27

Subd. 3.Forecasted Programs

190.28The amounts that may be spent from this
190.29appropriation for each purpose are as follows:

190.30

(a) MFIP/DWP Grants

191.1	Appropriations by Fund
191.2	General	84,680,000	91,978,000
191.3	Federal TANF	84,425,000	75,417,000

191.4

(b) MFIP Child Care Assistance Grants

55,456,000

30,923,000

191.5

(c) General Assistance Grants

49,192,000

46,938,000

191.6General Assistance Standard. The
191.7commissioner shall set the monthly standard
191.8of assistance for general assistance units
191.9consisting of an adult recipient who is
191.10childless and unmarried or living apart
191.11from parents or a legal guardian at $203.
191.12The commissioner may reduce this amount
191.13according to Laws 1997, chapter 85, article
191.143, section 54.
191.15Emergency General Assistance. The
191.16amount appropriated for emergency general
191.17assistance funds is limited to no more than
191.18$6,689,812 in fiscal year 2012 and $6,729,812
191.19in fiscal year 2013. Funds to counties shall
191.20be allocated by the commissioner using the
191.21allocation method specified in Minnesota
191.22Statutes, section 256D.06.

191.23

(d) Minnesota Supplemental Aid Grants

38,095,000

39,120,000

191.24

(e) Group Residential Housing Grants

121,080,000

129,238,000

191.25

(f) MinnesotaCare Grants

295,046,000

317,272,000

191.26This appropriation is from the health care
191.27access fund.

191.28

(g) Medical Assistance Grants

4,501,582,000

4,437,282,000

191.29Managed Care Incentive Payments. The
191.30commissioner shall not make managed care
191.31incentive payments for expanding preventive
191.32services during fiscal years beginning July 1,
191.332011, and July 1, 2012.
192.1Reduction of Rates for Congregate
192.2Living for Individuals with Lower Needs.
192.3Beginning October 1, 2011, lead agencies
192.4must reduce rates in effect on January 1, 2011,
192.5by ten percent for individuals with lower
192.6needs living in foster care settings where the
192.7license holder does not share the residence
192.8with recipients on the CADI and DD waivers
192.9and customized living settings for CADI.
192.10Lead agencies shall consult with providers to
192.11review individual service plans and identify
192.12changes or modifications to reduce the
192.13utilization of services while maintaining the
192.14health and safety of the individual receiving
192.15services. Lead agencies must adjust contracts
192.16within 60 days of the effective date. If
192.17federal waiver approval is obtained under
192.18the long-term care realignment waiver
192.19application submitted on February 13,
192.202012, and federal financial participation is
192.21authorized for the alternative care program,
192.22the commissioner shall adjust this payment
192.23rate reduction from ten to five percent for
192.24services rendered on or after July 1, 2012, or
192.25the first day of the month following federal
192.26approval, whichever is later. Effective
192.27August 1, 2013, this provision does not apply
192.28to individuals whose primary diagnosis is
192.29mental illness and who are living in foster
192.30care settings where the license holder is
192.31also (1) a provider of assertive community
192.32treatment (ACT) or adult rehabilitative
192.33mental health services (ARMHS) as defined
192.34in Minnesota Statutes, section 256B.0623;
192.35(2) a mental health center or mental health
192.36clinic certified under Minnesota Rules, parts
193.19520.0750 to 9520.0870; or (3) a provider
193.2of intensive residential treatment services
193.3(IRTS) licensed under Minnesota Rules,
193.4parts 9520.0500 to 9520.0670.
193.5Reduction of Lead Agency Waiver
193.6Allocations to Implement Rate Reductions
193.7for Congregate Living for Individuals
193.8with Lower Needs. Beginning October 1,
193.92011, the commissioner shall reduce lead
193.10agency waiver allocations to implement the
193.11reduction of rates for individuals with lower
193.12needs living in foster care settings where the
193.13license holder does not share the residence
193.14with recipients on the CADI and DD waivers
193.15and customized living settings for CADI.
193.16Reduce customized living and 24-hour
193.17customized living component rates.
193.18Effective July 1, 2011, the commissioner
193.19shall reduce elderly waiver customized living
193.20and 24-hour customized living component
193.21service spending by five percent through
193.22reductions in component rates and service
193.23rate limits. The commissioner shall adjust
193.24the elderly waiver capitation payment
193.25rates for managed care organizations paid
193.26under Minnesota Statutes, section 256B.69,
193.27subdivisions 6a and 23, to reflect reductions
193.28in component spending for customized living
193.29services and 24-hour customized living
193.30services under Minnesota Statutes, section
193.31256B.0915, subdivisions 3e and 3h, for the
193.32contract period beginning January 1, 2012.
193.33To implement the reduction specified in
193.34this provision, capitation rates paid by the
193.35commissioner to managed care organizations
193.36under Minnesota Statutes, section 256B.69,
194.1shall reflect a ten percent reduction for the
194.2specified services for the period January 1,
194.32012, to June 30, 2012, and a five percent
194.4reduction for those services on or after July
194.51, 2012.
194.6Limit Growth in the Developmental
194.7Disability Waiver. The commissioner
194.8shall limit growth in the developmental
194.9disability waiver to six diversion allocations
194.10per month beginning July 1, 2011, through
194.11June 30, 2013, and 15 diversion allocations
194.12per month beginning July 1, 2013, through
194.13June 30, 2015. Waiver allocations shall
194.14be targeted to individuals who meet the
194.15priorities for accessing waiver services
194.16identified in Minnesota Statutes, 256B.092,
194.17subdivision 12 . The limits do not include
194.18conversions from intermediate care facilities
194.19for persons with developmental disabilities.
194.20Notwithstanding any contrary provisions in
194.21this article, this paragraph expires June 30,
194.222015.
194.23Limit Growth in the Community
194.24Alternatives for Disabled Individuals
194.25Waiver. The commissioner shall limit
194.26growth in the community alternatives for
194.27disabled individuals waiver to 60 allocations
194.28per month beginning July 1, 2011, through
194.29June 30, 2013, and 85 allocations per
194.30month beginning July 1, 2013, through
194.31June 30, 2015. Waiver allocations must
194.32be targeted to individuals who meet the
194.33priorities for accessing waiver services
194.34identified in Minnesota Statutes, section
194.35256B.49, subdivision 11a . The limits include
194.36conversions and diversions, unless the
195.1commissioner has approved a plan to convert
195.2funding due to the closure or downsizing
195.3of a residential facility or nursing facility
195.4to serve directly affected individuals on
195.5the community alternatives for disabled
195.6individuals waiver. Notwithstanding any
195.7contrary provisions in this article, this
195.8paragraph expires June 30, 2015.
195.9Personal Care Assistance Relative
195.10Care. The commissioner shall adjust the
195.11capitation payment rates for managed care
195.12organizations paid under Minnesota Statutes,
195.13section 256B.69, to reflect the rate reductions
195.14for personal care assistance provided by
195.15a relative pursuant to Minnesota Statutes,
195.16section 256B.0659, subdivision 11. This rate
195.17reduction is effective July 1, 2013.

195.18

(h) Alternative Care Grants

46,421,000

46,035,000

195.19Alternative Care Transfer. Any money
195.20allocated to the alternative care program that
195.21is not spent for the purposes indicated does
195.22not cancel but shall be transferred to the
195.23medical assistance account.

195.24

(i) Chemical Dependency Entitlement Grants

94,675,000

93,298,000

195.25EFFECTIVE DATE.This section is effective August 1, 2013.

195.26    Sec. 22. RECOMMENDATIONS FOR CONCENTRATION LIMITS ON HOME
195.27AND COMMUNITY-BASED SETTINGS.
195.28The commissioner of human services shall consult with the Minnesota Olmstead
195.29subcabinet, advocates, providers, and city representatives to develop recommendations
195.30on concentration limits on home and community-based settings, as defined in
195.31Minnesota Statutes, section 256B.492, as well as any other exceptions to the definition.
195.32The recommendations must be consistent with Minnesota's Olmstead plan. The
195.33recommendations and proposed legislation must be submitted to the chairs and ranking
196.1minority members of the legislative committees with jurisdiction over health and human
196.2services policy and finance by February 1, 2014.

196.3    Sec. 23. PROVIDER RATE AND GRANT INCREASES EFFECTIVE JULY
196.41, 2013.
196.5(a) The commissioner of human services shall increase reimbursement rates, grants,
196.6allocations, individual limits, and rate limits, as applicable, by two percent for the rate
196.7period beginning July 1, 2013, for services rendered on or after those dates. County or
196.8tribal contracts for services specified in this section must be amended to pass through
196.9these rate increases within 60 days of the effective date.
196.10(b) The rate changes described in this section must be provided to:
196.11(1) home and community-based waivered services for persons with developmental
196.12disabilities or related conditions, including consumer-directed community supports, under
196.13Minnesota Statutes, section 256B.501;
196.14(2) waivered services under community alternatives for disabled individuals,
196.15including consumer-directed community supports, under Minnesota Statutes, section
196.16256B.49;
196.17(3) community alternative care waivered services, including consumer-directed
196.18community supports, under Minnesota Statutes, section 256B.49;
196.19(4) traumatic brain injury waivered services, including consumer-directed
196.20community supports, under Minnesota Statutes, section 256B.49;
196.21(5) home and community-based waivered services for the elderly under Minnesota
196.22Statutes, section 256B.0915;
196.23(6) nursing services and home health services under Minnesota Statutes, section
196.24256B.0625, subdivision 6a;
196.25(7) personal care services and qualified professional supervision of personal care
196.26services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
196.27(8) private duty nursing services under Minnesota Statutes, section 256B.0625,
196.28subdivision 7;
196.29(9) day training and habilitation services for adults with developmental disabilities
196.30or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
196.31additional cost of rate adjustments on day training and habilitation services, provided as a
196.32social service, under Minnesota Statutes, section 256M.60;
196.33(10) alternative care services under Minnesota Statutes, section 256B.0913;
196.34(11) living skills training programs for persons with intractable epilepsy who need
196.35assistance in the transition to independent living under Laws 1988, chapter 689;
197.1(12) semi-independent living services (SILS) under Minnesota Statutes, section
197.2252.275, including SILS funding under county social services grants formerly funded
197.3under Minnesota Statutes, chapter 256I;
197.4(13) consumer support grants under Minnesota Statutes, section 256.476;
197.5(14) family support grants under Minnesota Statutes, section 252.32;
197.6(15) housing access grants under Minnesota Statutes, section 256B.0658;
197.7(16) self-advocacy grants under Laws 2009, chapter 101; and
197.8(17) technology grants under Laws 2009, chapter 79.
197.9(c) A managed care plan receiving state payments for the services in this section
197.10must include these increases in their payments to providers. To implement the rate increase
197.11in this section, capitation rates paid by the commissioner to managed care organizations
197.12under Minnesota Statutes, section 256B.69, shall reflect a two percent increase for the
197.13specified services for the period beginning July 1, 2013.
197.14(d) Counties shall increase the budget for each recipient of consumer-directed
197.15community supports by the amounts in paragraph (a) on the effective dates in paragraph (a).

197.16    Sec. 24. REPEALER.
197.17Minnesota Statutes 2012, section 256B.5012, subdivision 13, and Laws 2011, First
197.18Special Session chapter 9, article 7, section 54, as amended by Laws 2012, chapter 247,
197.19article 4, section 42, and Laws 2012, chapter 298, section 3, are repealed.


197.22    Section 1. Minnesota Statutes 2012, section 145C.01, subdivision 7, is amended to read:
197.23    Subd. 7. Health care facility. "Health care facility" means a hospital or other entity
197.24licensed under sections 144.50 to 144.58, a nursing home licensed to serve adults under
197.25section 144A.02, a home care provider licensed under sections 144A.43 to 144A.47,
197.26an adult foster care provider licensed under chapter 245A and Minnesota Rules, parts
197.279555.5105 to 9555.6265, a community residential setting licensed under chapter 245D, or
197.28a hospice provider licensed under sections 144A.75 to 144A.755.

197.29    Sec. 2. Minnesota Statutes 2012, section 243.166, subdivision 4b, is amended to read:
197.30    Subd. 4b. Health care facility; notice of status. (a) For the purposes of this
197.31subdivision, "health care facility" means a facility:
198.1(1) licensed by the commissioner of health as a hospital, boarding care home or
198.2supervised living facility under sections 144.50 to 144.58, or a nursing home under
198.3chapter 144A;
198.4(2) registered by the commissioner of health as a housing with services establishment
198.5as defined in section 144D.01; or
198.6(3) licensed by the commissioner of human services as a residential facility under
198.7chapter 245A to provide adult foster care, adult mental health treatment, chemical
198.8dependency treatment to adults, or residential services to persons with developmental
198.9 disabilities.
198.10(b) Prior to admission to a health care facility, a person required to register under
198.11this section shall disclose to:
198.12(1) the health care facility employee processing the admission the person's status
198.13as a registered predatory offender under this section; and
198.14(2) the person's corrections agent, or if the person does not have an assigned
198.15corrections agent, the law enforcement authority with whom the person is currently
198.16required to register, that inpatient admission will occur.
198.17(c) A law enforcement authority or corrections agent who receives notice under
198.18paragraph (b) or who knows that a person required to register under this section is
198.19planning to be admitted and receive, or has been admitted and is receiving health care
198.20at a health care facility shall notify the administrator of the facility and deliver a fact
198.21sheet to the administrator containing the following information: (1) name and physical
198.22description of the offender; (2) the offender's conviction history, including the dates of
198.23conviction; (3) the risk level classification assigned to the offender under section 244.052,
198.24if any; and (4) the profile of likely victims.
198.25(d) Except for a hospital licensed under sections 144.50 to 144.58, if a health care
198.26facility receives a fact sheet under paragraph (c) that includes a risk level classification for
198.27the offender, and if the facility admits the offender, the facility shall distribute the fact
198.28sheet to all residents at the facility. If the facility determines that distribution to a resident
198.29is not appropriate given the resident's medical, emotional, or mental status, the facility
198.30shall distribute the fact sheet to the patient's next of kin or emergency contact.

198.31    Sec. 3. [245.8251] POSITIVE SUPPORT STRATEGIES AND EMERGENCY
198.32MANUAL RESTRAINT; LICENSED FACILITIES AND PROGRAMS.
198.33    Subdivision 1. Rules. The commissioner of human services shall, within 24 months
198.34of enactment of this section, adopt rules governing the use of positive support strategies,
199.1safety interventions, and emergency use of manual restraint in facilities and services
199.2licensed under chapter 245D.
199.3    Subd. 2. Data collection. (a) The commissioner shall, with stakeholder input,
199.4develop data collection elements specific to incidents on the use of controlled procedures
199.5with persons receiving services from providers regulated under Minnesota Rules, parts
199.69525.2700 to 9525.2810, and incidents involving persons receiving services from
199.7providers identified to be licensed under chapter 245D effective January 1, 2014. Providers
199.8shall report the data in a format and at a frequency provided by the commissioner of
199.9human services.
199.10(b) Beginning July 1, 2013, providers regulated under Minnesota Rules, parts
199.119525.2700 to 9525.2810, shall submit data regarding the use of all controlled procedures
199.12in a format and at a frequency provided by the commissioner.

199.13    Sec. 4. Minnesota Statutes 2012, section 245A.02, subdivision 10, is amended to read:
199.14    Subd. 10. Nonresidential program. "Nonresidential program" means care,
199.15supervision, rehabilitation, training or habilitation of a person provided outside the
199.16person's own home and provided for fewer than 24 hours a day, including adult day
199.17care programs; and chemical dependency or chemical abuse programs that are located
199.18in a nursing home or hospital and receive public funds for providing chemical abuse or
199.19chemical dependency treatment services under chapter 254B. Nonresidential programs
199.20include home and community-based services and semi-independent living services for
199.21persons with developmental disabilities or persons age 65 and older that are provided in
199.22or outside of a person's own home under chapter 245D.

199.23    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 14, is amended to read:
199.24    Subd. 14. Residential program. "Residential program" means a program
199.25that provides 24-hour-a-day care, supervision, food, lodging, rehabilitation, training,
199.26education, habilitation, or treatment outside a person's own home, including a program
199.27in an intermediate care facility for four or more persons with developmental disabilities;
199.28and chemical dependency or chemical abuse programs that are located in a hospital
199.29or nursing home and receive public funds for providing chemical abuse or chemical
199.30dependency treatment services under chapter 254B. Residential programs include home
199.31and community-based services for persons with developmental disabilities or persons age
199.3265 and older that are provided in or outside of a person's own home under chapter 245D.

199.33    Sec. 6. Minnesota Statutes 2012, section 245A.03, subdivision 7, is amended to read:
200.1    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial
200.2license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,
200.3or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under
200.4this chapter for a physical location that will not be the primary residence of the license
200.5holder for the entire period of licensure. If a license is issued during this moratorium, and
200.6the license holder changes the license holder's primary residence away from the physical
200.7location of the foster care license, the commissioner shall revoke the license according
200.8to section 245A.07. The commissioner shall not issue an initial license for a community
200.9residential setting licensed under chapter 245D. Exceptions to the moratorium include:
200.10(1) foster care settings that are required to be registered under chapter 144D;
200.11(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
200.12community residential setting licenses replacing adult foster care licenses in existence on
200.13December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
200.14(3) new foster care licenses or community residential setting licenses determined to
200.15be needed by the commissioner under paragraph (b) for the closure of a nursing facility,
200.16ICF/MR, or regional treatment center, or restructuring of state-operated services that
200.17limits the capacity of state-operated facilities;
200.18(4) new foster care licenses or community residential setting licenses determined
200.19to be needed by the commissioner under paragraph (b) for persons requiring hospital
200.20level care; or
200.21(5) new foster care licenses or community residential setting licenses determined to
200.22be needed by the commissioner for the transition of people from personal care assistance
200.23to the home and community-based services.
200.24(b) The commissioner shall determine the need for newly licensed foster care
200.25homes or community residential settings as defined under this subdivision. As part of the
200.26determination, the commissioner shall consider the availability of foster care capacity in
200.27the area in which the licensee seeks to operate, and the recommendation of the local
200.28county board. The determination by the commissioner must be final. A determination of
200.29need is not required for a change in ownership at the same address.
200.30(c) The commissioner shall study the effects of the license moratorium under this
200.31subdivision and shall report back to the legislature by January 15, 2011. This study shall
200.32include, but is not limited to the following:
200.33(1) the overall capacity and utilization of foster care beds where the physical location
200.34is not the primary residence of the license holder prior to and after implementation
200.35of the moratorium;
201.1(2) the overall capacity and utilization of foster care beds where the physical
201.2location is the primary residence of the license holder prior to and after implementation
201.3of the moratorium; and
201.4(3) the number of licensed and occupied ICF/MR beds prior to and after
201.5implementation of the moratorium.
201.6(d) When a foster care recipient resident served by the program moves out of a
201.7foster home that is not the primary residence of the license holder according to section
201.8256B.49, subdivision 15 , paragraph (f), or the community residential setting, the county
201.9shall immediately inform the Department of Human Services Licensing Division.
201.10The department shall decrease the statewide licensed capacity for foster care settings
201.11where the physical location is not the primary residence of the license holder, or for
201.12community residential settings, if the voluntary changes described in paragraph (f) are
201.13not sufficient to meet the savings required by reductions in licensed bed capacity under
201.14Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
201.15and maintain statewide long-term care residential services capacity within budgetary
201.16limits. Implementation of the statewide licensed capacity reduction shall begin on July
201.171, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the
201.18needs determination process. Under this paragraph, the commissioner has the authority
201.19to reduce unused licensed capacity of a current foster care program, or the community
201.20residential settings, to accomplish the consolidation or closure of settings. A decreased
201.21licensed capacity according to this paragraph is not subject to appeal under this chapter.
201.22(e) Residential settings that would otherwise be subject to the decreased license
201.23capacity established in paragraph (d) shall be exempt under the following circumstances:
201.24(1) until August 1, 2013, the license holder's beds occupied by residents whose
201.25primary diagnosis is mental illness and the license holder is:
201.26(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
201.27health services (ARMHS) as defined in section 256B.0623;
201.28(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
201.299520.0870;
201.30(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
201.319520.0870; or
201.32(iv) a provider of intensive residential treatment services (IRTS) licensed under
201.33Minnesota Rules, parts 9520.0500 to 9520.0670; or
201.34(2) the license holder is certified under the requirements in subdivision 6a or section
201.35245D.33.
202.1(f) A resource need determination process, managed at the state level, using the
202.2available reports required by section 144A.351, and other data and information shall
202.3be used to determine where the reduced capacity required under paragraph (d) will be
202.4implemented. The commissioner shall consult with the stakeholders described in section
202.5144A.351 , and employ a variety of methods to improve the state's capacity to meet
202.6long-term care service needs within budgetary limits, including seeking proposals from
202.7service providers or lead agencies to change service type, capacity, or location to improve
202.8services, increase the independence of residents, and better meet needs identified by the
202.9long-term care services reports and statewide data and information. By February 1 of each
202.10year, the commissioner shall provide information and data on the overall capacity of
202.11licensed long-term care services, actions taken under this subdivision to manage statewide
202.12long-term care services and supports resources, and any recommendations for change to
202.13the legislative committees with jurisdiction over health and human services budget.
202.14    (g) At the time of application and reapplication for licensure, the applicant and the
202.15license holder that are subject to the moratorium or an exclusion established in paragraph
202.16(a) are required to inform the commissioner whether the physical location where the foster
202.17care will be provided is or will be the primary residence of the license holder for the entire
202.18period of licensure. If the primary residence of the applicant or license holder changes, the
202.19applicant or license holder must notify the commissioner immediately. The commissioner
202.20shall print on the foster care license certificate whether or not the physical location is the
202.21primary residence of the license holder.
202.22    (h) License holders of foster care homes identified under paragraph (g) that are not
202.23the primary residence of the license holder and that also provide services in the foster care
202.24home that are covered by a federally approved home and community-based services
202.25waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the
202.26human services licensing division that the license holder provides or intends to provide
202.27these waiver-funded services. These license holders must be considered registered under
202.28section 256B.092, subdivision 11, paragraph (c), and this registration status must be
202.29identified on their license certificates.

202.30    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 8, is amended to read:
202.31    Subd. 8. Excluded providers seeking licensure. Nothing in this section shall
202.32prohibit a program that is excluded from licensure under subdivision 2, paragraph
202.33(a), clause (28) (26), from seeking licensure. The commissioner shall ensure that any
202.34application received from such an excluded provider is processed in the same manner as
202.35all other applications for child care center licensure.

203.1    Sec. 8. Minnesota Statutes 2012, section 245A.042, subdivision 3, is amended to read:
203.2    Subd. 3. Implementation. (a) The commissioner shall implement the
203.3responsibilities of this chapter according to the timelines in paragraphs (b) and (c)
203.4only within the limits of available appropriations or other administrative cost recovery
203.5methodology.
203.6(b) The licensure of home and community-based services according to this section
203.7shall be implemented January 1, 2014. License applications shall be received and
203.8processed on a phased-in schedule as determined by the commissioner beginning July
203.91, 2013. Licenses will be issued thereafter upon the commissioner's determination that
203.10the application is complete according to section 245A.04.
203.11(c) Within the limits of available appropriations or other administrative cost recovery
203.12methodology, implementation of compliance monitoring must be phased in after January
203.131, 2014.
203.14(1) Applicants who do not currently hold a license issued under this chapter 245B
203.15 must receive an initial compliance monitoring visit after 12 months of the effective date of
203.16the initial license for the purpose of providing technical assistance on how to achieve and
203.17maintain compliance with the applicable law or rules governing the provision of home and
203.18community-based services under chapter 245D. If during the review the commissioner
203.19finds that the license holder has failed to achieve compliance with an applicable law or
203.20rule and this failure does not imminently endanger the health, safety, or rights of the
203.21persons served by the program, the commissioner may issue a licensing review report with
203.22recommendations for achieving and maintaining compliance.
203.23(2) Applicants who do currently hold a license issued under this chapter must receive
203.24a compliance monitoring visit after 24 months of the effective date of the initial license.
203.25(d) Nothing in this subdivision shall be construed to limit the commissioner's
203.26authority to suspend or revoke a license or issue a fine at any time under section 245A.07,
203.27or make issue correction orders and make a license conditional for failure to comply with
203.28applicable laws or rules under section 245A.06, based on the nature, chronicity, or severity
203.29of the violation of law or rule and the effect of the violation on the health, safety, or
203.30rights of persons served by the program.

203.31    Sec. 9. Minnesota Statutes 2012, section 245A.08, subdivision 2a, is amended to read:
203.32    Subd. 2a. Consolidated contested case hearings. (a) When a denial of a license
203.33under section 245A.05 or a licensing sanction under section 245A.07, subdivision 3, is
203.34based on a disqualification for which reconsideration was requested and which was not
203.35set aside under section 245C.22, the scope of the contested case hearing shall include the
204.1disqualification and the licensing sanction or denial of a license, unless otherwise specified
204.2in this subdivision. When the licensing sanction or denial of a license is based on a
204.3determination of maltreatment under section 626.556 or 626.557, or a disqualification for
204.4serious or recurring maltreatment which was not set aside, the scope of the contested case
204.5hearing shall include the maltreatment determination, disqualification, and the licensing
204.6sanction or denial of a license, unless otherwise specified in this subdivision. In such
204.7cases, a fair hearing under section 256.045 shall not be conducted as provided for in
204.8sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision 9d.
204.9    (b) Except for family child care and child foster care, reconsideration of a
204.10maltreatment determination under sections 626.556, subdivision 10i, and 626.557,
204.11subdivision 9d, and reconsideration of a disqualification under section 245C.22, shall
204.12not be conducted when:
204.13    (1) a denial of a license under section 245A.05, or a licensing sanction under section
204.14245A.07 , is based on a determination that the license holder is responsible for maltreatment
204.15or the disqualification of a license holder is based on serious or recurring maltreatment;
204.16    (2) the denial of a license or licensing sanction is issued at the same time as the
204.17maltreatment determination or disqualification; and
204.18    (3) the license holder appeals the maltreatment determination or disqualification,
204.19and denial of a license or licensing sanction. In these cases, a fair hearing shall not be
204.20conducted under sections 245C.27, 626.556, subdivision 10i, and 626.557, subdivision
204.219d. The scope of the contested case hearing must include the maltreatment determination,
204.22disqualification, and denial of a license or licensing sanction.
204.23    Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
204.24determination or disqualification, but does not appeal the denial of a license or a licensing
204.25sanction, reconsideration of the maltreatment determination shall be conducted under
204.26sections 626.556, subdivision 10i, and 626.557, subdivision 9d, and reconsideration of the
204.27disqualification shall be conducted under section 245C.22. In such cases, a fair hearing
204.28shall also be conducted as provided under sections 245C.27, 626.556, subdivision 10i, and
204.29626.557, subdivision 9d .
204.30    (c) In consolidated contested case hearings regarding sanctions issued in family child
204.31care, child foster care, family adult day services, and adult foster care, and community
204.32residential settings, the county attorney shall defend the commissioner's orders in
204.33accordance with section 245A.16, subdivision 4.
204.34    (d) The commissioner's final order under subdivision 5 is the final agency action
204.35on the issue of maltreatment and disqualification, including for purposes of subsequent
204.36background studies under chapter 245C and is the only administrative appeal of the final
205.1agency determination, specifically, including a challenge to the accuracy and completeness
205.2of data under section 13.04.
205.3    (e) When consolidated hearings under this subdivision involve a licensing sanction
205.4based on a previous maltreatment determination for which the commissioner has issued
205.5a final order in an appeal of that determination under section 256.045, or the individual
205.6failed to exercise the right to appeal the previous maltreatment determination under
205.7section 626.556, subdivision 10i, or 626.557, subdivision 9d, the commissioner's order is
205.8conclusive on the issue of maltreatment. In such cases, the scope of the administrative
205.9law judge's review shall be limited to the disqualification and the licensing sanction or
205.10denial of a license. In the case of a denial of a license or a licensing sanction issued to
205.11a facility based on a maltreatment determination regarding an individual who is not the
205.12license holder or a household member, the scope of the administrative law judge's review
205.13includes the maltreatment determination.
205.14    (f) The hearings of all parties may be consolidated into a single contested case
205.15hearing upon consent of all parties and the administrative law judge, if:
205.16    (1) a maltreatment determination or disqualification, which was not set aside under
205.17section 245C.22, is the basis for a denial of a license under section 245A.05 or a licensing
205.18sanction under section 245A.07;
205.19    (2) the disqualified subject is an individual other than the license holder and upon
205.20whom a background study must be conducted under section 245C.03; and
205.21    (3) the individual has a hearing right under section 245C.27.
205.22    (g) When a denial of a license under section 245A.05 or a licensing sanction under
205.23section 245A.07 is based on a disqualification for which reconsideration was requested
205.24and was not set aside under section 245C.22, and the individual otherwise has no hearing
205.25right under section 245C.27, the scope of the administrative law judge's review shall
205.26include the denial or sanction and a determination whether the disqualification should
205.27be set aside, unless section 245C.24 prohibits the set-aside of the disqualification. In
205.28determining whether the disqualification should be set aside, the administrative law judge
205.29shall consider the factors under section 245C.22, subdivision 4, to determine whether the
205.30individual poses a risk of harm to any person receiving services from the license holder.
205.31    (h) Notwithstanding section 245C.30, subdivision 5, when a licensing sanction
205.32under section 245A.07 is based on the termination of a variance under section 245C.30,
205.33subdivision 4 , the scope of the administrative law judge's review shall include the sanction
205.34and a determination whether the disqualification should be set aside, unless section
205.35245C.24 prohibits the set-aside of the disqualification. In determining whether the
205.36disqualification should be set aside, the administrative law judge shall consider the factors
206.1under section 245C.22, subdivision 4, to determine whether the individual poses a risk of
206.2harm to any person receiving services from the license holder.

206.3    Sec. 10. Minnesota Statutes 2012, section 245A.10, is amended to read:
206.4245A.10 FEES.
206.5    Subdivision 1. Application or license fee required, programs exempt from fee.
206.6(a) Unless exempt under paragraph (b), the commissioner shall charge a fee for evaluation
206.7of applications and inspection of programs which are licensed under this chapter.
206.8(b) Except as provided under subdivision 2, no application or license fee shall be
206.9charged for child foster care, adult foster care, or family and group family child care, or
206.10a community residential setting.
206.11    Subd. 2. County fees for background studies and licensing inspections. (a) For
206.12purposes of family and group family child care licensing under this chapter, a county
206.13agency may charge a fee to an applicant or license holder to recover the actual cost of
206.14background studies, but in any case not to exceed $100 annually. A county agency may
206.15also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
206.16license or $100 for a two-year license.
206.17    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
206.18applicant for authorization to recover the actual cost of background studies completed
206.19under section 119B.125, but in any case not to exceed $100 annually.
206.20    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
206.21    (1) in cases of financial hardship;
206.22    (2) if the county has a shortage of providers in the county's area;
206.23    (3) for new providers; or
206.24    (4) for providers who have attained at least 16 hours of training before seeking
206.25initial licensure.
206.26    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
206.27an installment basis for up to one year. If the provider is receiving child care assistance
206.28payments from the state, the provider may have the fees under paragraph (a) or (b)
206.29deducted from the child care assistance payments for up to one year and the state shall
206.30reimburse the county for the county fees collected in this manner.
206.31    (e) For purposes of adult foster care and child foster care licensing, and licensing
206.32the physical plant of a community residential setting, under this chapter, a county agency
206.33may charge a fee to a corporate applicant or corporate license holder to recover the actual
206.34cost of licensing inspections, not to exceed $500 annually.
207.1    (f) Counties may elect to reduce or waive the fees in paragraph (e) under the
207.2following circumstances:
207.3(1) in cases of financial hardship;
207.4(2) if the county has a shortage of providers in the county's area; or
207.5(3) for new providers.
207.6    Subd. 3. Application fee for initial license or certification. (a) For fees required
207.7under subdivision 1, an applicant for an initial license or certification issued by the
207.8commissioner shall submit a $500 application fee with each new application required
207.9under this subdivision. An applicant for an initial day services facility license under
207.10chapter 245D shall submit a $250 application fee with each new application. The
207.11application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license
207.12or certification fee that expires on December 31. The commissioner shall not process an
207.13application until the application fee is paid.
207.14(b) Except as provided in clauses (1) to (4) (3), an applicant shall apply for a license
207.15to provide services at a specific location.
207.16(1) For a license to provide residential-based habilitation services to persons with
207.17developmental disabilities under chapter 245B, an applicant shall submit an application
207.18for each county in which the services will be provided. Upon licensure, the license
207.19holder may provide services to persons in that county plus no more than three persons
207.20at any one time in each of up to ten additional counties. A license holder in one county
207.21may not provide services under the home and community-based waiver for persons with
207.22developmental disabilities to more than three people in a second county without holding
207.23a separate license for that second county. Applicants or licensees providing services
207.24under this clause to not more than three persons remain subject to the inspection fees
207.25established in section 245A.10, subdivision 2, for each location. The license issued by
207.26the commissioner must state the name of each additional county where services are being
207.27provided to persons with developmental disabilities. A license holder must notify the
207.28commissioner before making any changes that would alter the license information listed
207.29under section 245A.04, subdivision 7, paragraph (a), including any additional counties
207.30where persons with developmental disabilities are being served. For a license to provide
207.31home and community-based services to persons with disabilities or age 65 and older under
207.32chapter 245D, an applicant shall submit an application to provide services statewide.
207.33(2) For a license to provide supported employment, crisis respite, or
207.34semi-independent living services to persons with developmental disabilities under chapter
207.35245B, an applicant shall submit a single application to provide services statewide.
208.1(3) For a license to provide independent living assistance for youth under section
208.2245A.22 , an applicant shall submit a single application to provide services statewide.
208.3(4) (3) For a license for a private agency to provide foster care or adoption services
208.4under Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single
208.5application to provide services statewide.
208.6(c) The initial application fee charged under this subdivision does not include the
208.7temporary license surcharge under section 16E.22.
208.8    Subd. 4. License or certification fee for certain programs. (a) Child care centers
208.9shall pay an annual nonrefundable license fee based on the following schedule:

208.10 208.11		Licensed Capacity	Child Care Center License Fee
208.12		1 to 24 persons	$200
208.13		25 to 49 persons	$300
208.14		50 to 74 persons	$400
208.15		75 to 99 persons	$500
208.16		100 to 124 persons	$600
208.17		125 to 149 persons	$700
208.18		150 to 174 persons	$800
208.19		175 to 199 persons	$900
208.20		200 to 224 persons	$1,000
208.21		225 or more persons	$1,100

208.22    (b) A day training and habilitation program serving persons with developmental
208.23disabilities or related conditions shall pay an annual nonrefundable license fee based on
208.24the following schedule:

208.25		Licensed Capacity	License Fee
208.26		1 to 24 persons	$800
208.27		25 to 49 persons	$1,000
208.28		50 to 74 persons	$1,200
208.29		75 to 99 persons	$1,400
208.30		100 to 124 persons	$1,600
208.31		125 to 149 persons	$1,800
208.32		150 or more persons	$2,000

208.33Except as provided in paragraph (c), when a day training and habilitation program
208.34serves more than 50 percent of the same persons in two or more locations in a community,
208.35the day training and habilitation program shall pay a license fee based on the licensed
208.36capacity of the largest facility and the other facility or facilities shall be charged a license
208.37fee based on a licensed capacity of a residential program serving one to 24 persons.
208.38    (c) When a day training and habilitation program serving persons with developmental
208.39disabilities or related conditions seeks a single license allowed under section 245B.07,
209.1subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
209.2capacity for each location.
209.3(d) A program licensed to provide supported employment services to persons
209.4with developmental disabilities under chapter 245B shall pay an annual nonrefundable
209.5license fee of $650.
209.6(e) A program licensed to provide crisis respite services to persons with
209.7developmental disabilities under chapter 245B shall pay an annual nonrefundable license
209.8fee of $700.
209.9(f) A program licensed to provide semi-independent living services to persons
209.10with developmental disabilities under chapter 245B shall pay an annual nonrefundable
209.11license fee of $700.
209.12(g) A program licensed to provide residential-based habilitation services under the
209.13home and community-based waiver for persons with developmental disabilities shall pay
209.14an annual license fee that includes a base rate of $690 plus $60 times the number of clients
209.15served on the first day of July of the current license year.
209.16(h) A residential program certified by the Department of Health as an intermediate
209.17care facility for persons with developmental disabilities (ICF/MR) and a noncertified
209.18residential program licensed to provide health or rehabilitative services for persons
209.19with developmental disabilities shall pay an annual nonrefundable license fee based on
209.20the following schedule:

209.21		Licensed Capacity	License Fee
209.22		1 to 24 persons	$535
209.23		25 to 49 persons	$735
209.24		50 or more persons	$935

209.25(b) A program licensed to provide one or more of the home and community-based
209.26services and supports identified under chapter 245D to persons with disabilities or age
209.2765 and older, shall pay an annual nonrefundable license fee that includes a base rate of
209.28$1,125, plus $92 times the number of persons served on the last day of June of the current
209.29license year for programs serving ten or more persons. The fee is limited to a maximum of
209.30200 persons, regardless of the actual number of persons served. Programs serving nine
209.31or fewer persons pay only the base rate.
209.32(c) A facility licensed under chapter 245D to provide day services shall pay an
209.33annual nonrefundable license fee of $100.
209.34(i) (d) A chemical dependency treatment program licensed under Minnesota Rules,
209.35parts 9530.6405 to 9530.6505, to provide chemical dependency treatment shall pay an
209.36annual nonrefundable license fee based on the following schedule:

210.1		Licensed Capacity	License Fee
210.2		1 to 24 persons	$600
210.3		25 to 49 persons	$800
210.4		50 to 74 persons	$1,000
210.5		75 to 99 persons	$1,200
210.6		100 or more persons	$1,400

210.7(j) (e) A chemical dependency program licensed under Minnesota Rules, parts
210.89530.6510 to 9530.6590, to provide detoxification services shall pay an annual
210.9nonrefundable license fee based on the following schedule:

210.10		Licensed Capacity	License Fee
210.11		1 to 24 persons	$760
210.12		25 to 49 persons	$960
210.13		50 or more persons	$1,160

210.14(k) (f) Except for child foster care, a residential facility licensed under Minnesota
210.15Rules, chapter 2960, to serve children shall pay an annual nonrefundable license fee
210.16based on the following schedule:

210.17		Licensed Capacity	License Fee
210.18		1 to 24 persons	$1,000
210.19		25 to 49 persons	$1,100
210.20		50 to 74 persons	$1,200
210.21		75 to 99 persons	$1,300
210.22		100 or more persons	$1,400

210.23(l) (g) A residential facility licensed under Minnesota Rules, parts 9520.0500 to
210.249520.0670, to serve persons with mental illness shall pay an annual nonrefundable license
210.25fee based on the following schedule:

210.26		Licensed Capacity	License Fee
210.27		1 to 24 persons	$2,525
210.28		25 or more persons	$2,725

210.29(m) (h) A residential facility licensed under Minnesota Rules, parts 9570.2000 to
210.309570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
210.31license fee based on the following schedule:

210.32		Licensed Capacity	License Fee
210.33		1 to 24 persons	$450
210.34		25 to 49 persons	$650
210.35		50 to 74 persons	$850
210.36		75 to 99 persons	$1,050
210.37		100 or more persons	$1,250

211.1(n) (i) A program licensed to provide independent living assistance for youth under
211.2section 245A.22 shall pay an annual nonrefundable license fee of $1,500.
211.3(o) (j) A private agency licensed to provide foster care and adoption services under
211.4Minnesota Rules, parts 9545.0755 to 9545.0845, shall pay an annual nonrefundable
211.5license fee of $875.
211.6(p) (k) A program licensed as an adult day care center licensed under Minnesota
211.7Rules, parts 9555.9600 to 9555.9730, shall pay an annual nonrefundable license fee based
211.8on the following schedule:

211.9		Licensed Capacity	License Fee
211.10		1 to 24 persons	$500
211.11		25 to 49 persons	$700
211.12		50 to 74 persons	$900
211.13		75 to 99 persons	$1,100
211.14		100 or more persons	$1,300

211.15(q) (l) A program licensed to provide treatment services to persons with sexual
211.16psychopathic personalities or sexually dangerous persons under Minnesota Rules, parts
211.179515.3000 to 9515.3110, shall pay an annual nonrefundable license fee of $20,000.
211.18(r) (m) A mental health center or mental health clinic requesting certification for
211.19purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
211.20parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,550 per year. If the
211.21mental health center or mental health clinic provides services at a primary location with
211.22satellite facilities, the satellite facilities shall be certified with the primary location without
211.23an additional charge.
211.24    Subd. 6. License not issued until license or certification fee is paid. The
211.25commissioner shall not issue a license or certification until the license or certification fee
211.26is paid. The commissioner shall send a bill for the license or certification fee to the billing
211.27address identified by the license holder. If the license holder does not submit the license or
211.28certification fee payment by the due date, the commissioner shall send the license holder
211.29a past due notice. If the license holder fails to pay the license or certification fee by the
211.30due date on the past due notice, the commissioner shall send a final notice to the license
211.31holder informing the license holder that the program license will expire on December 31
211.32unless the license fee is paid before December 31. If a license expires, the program is no
211.33longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2,
211.34must not operate after the expiration date. After a license expires, if the former license
211.35holder wishes to provide licensed services, the former license holder must submit a new
211.36license application and application fee under subdivision 3.
212.1    Subd. 7. Human services licensing fees to recover expenditures. Notwithstanding
212.2section 16A.1285, subdivision 2, related to activities for which the commissioner charges
212.3a fee, the commissioner must plan to fully recover direct expenditures for licensing
212.4activities under this chapter over a five-year period. The commissioner may have
212.5anticipated expenditures in excess of anticipated revenues in a biennium by using surplus
212.6revenues accumulated in previous bienniums.
212.7    Subd. 8. Deposit of license fees. A human services licensing account is created in
212.8the state government special revenue fund. Fees collected under subdivisions 3 and 4 must
212.9be deposited in the human services licensing account and are annually appropriated to the
212.10commissioner for licensing activities authorized under this chapter.
212.11EFFECTIVE DATE.This section is effective July 1, 2013.

212.12    Sec. 11. Minnesota Statutes 2012, section 245A.11, subdivision 2a, is amended to read:
212.13    Subd. 2a. Adult foster care and community residential setting license capacity.
212.14(a) The commissioner shall issue adult foster care and community residential setting
212.15 licenses with a maximum licensed capacity of four beds, including nonstaff roomers and
212.16boarders, except that the commissioner may issue a license with a capacity of five beds,
212.17including roomers and boarders, according to paragraphs (b) to (f).
212.18(b) An adult foster care The license holder may have a maximum license capacity
212.19of five if all persons in care are age 55 or over and do not have a serious and persistent
212.20mental illness or a developmental disability.
212.21(c) The commissioner may grant variances to paragraph (b) to allow a foster care
212.22provider facility with a licensed capacity of five persons to admit an individual under the
212.23age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of
212.24the variance is recommended by the county in which the licensed foster care provider
212.25 facility is located.
212.26(d) The commissioner may grant variances to paragraph (b) to allow the use of a fifth
212.27bed for emergency crisis services for a person with serious and persistent mental illness
212.28or a developmental disability, regardless of age, if the variance complies with section
212.29245A.04, subdivision 9 , and approval of the variance is recommended by the county in
212.30which the licensed foster care provider facility is located.
212.31(e) The commissioner may grant a variance to paragraph (b) to allow for the use of a
212.32fifth bed for respite services, as defined in section 245A.02, for persons with disabilities,
212.33regardless of age, if the variance complies with sections 245A.03, subdivision 7, and
212.34245A.04, subdivision 9 , and approval of the variance is recommended by the county in
213.1which the licensed foster care provider facility is licensed located. Respite care may be
213.2provided under the following conditions:
213.3(1) staffing ratios cannot be reduced below the approved level for the individuals
213.4being served in the home on a permanent basis;
213.5(2) no more than two different individuals can be accepted for respite services in
213.6any calendar month and the total respite days may not exceed 120 days per program in
213.7any calendar year;
213.8(3) the person receiving respite services must have his or her own bedroom, which
213.9could be used for alternative purposes when not used as a respite bedroom, and cannot be
213.10the room of another person who lives in the foster care home facility; and
213.11(4) individuals living in the foster care home facility must be notified when the
213.12variance is approved. The provider must give 60 days' notice in writing to the residents
213.13and their legal representatives prior to accepting the first respite placement. Notice must
213.14be given to residents at least two days prior to service initiation, or as soon as the license
213.15holder is able if they receive notice of the need for respite less than two days prior to
213.16initiation, each time a respite client will be served, unless the requirement for this notice is
213.17waived by the resident or legal guardian.
213.18(f) The commissioner may issue an adult foster care or community residential setting
213.19 license with a capacity of five adults if the fifth bed does not increase the overall statewide
213.20capacity of licensed adult foster care or community residential setting beds in homes that
213.21are not the primary residence of the license holder, as identified in a plan submitted to the
213.22commissioner by the county, when the capacity is recommended by the county licensing
213.23agency of the county in which the facility is located and if the recommendation verifies that:
213.24(1) the facility meets the physical environment requirements in the adult foster
213.25care licensing rule;
213.26(2) the five-bed living arrangement is specified for each resident in the resident's:
213.27(i) individualized plan of care;
213.28(ii) individual service plan under section 256B.092, subdivision 1b, if required; or
213.29(iii) individual resident placement agreement under Minnesota Rules, part
213.309555.5105, subpart 19, if required;
213.31(3) the license holder obtains written and signed informed consent from each
213.32resident or resident's legal representative documenting the resident's informed choice
213.33to remain living in the home and that the resident's refusal to consent would not have
213.34resulted in service termination; and
213.35(4) the facility was licensed for adult foster care before March 1, 2011.
214.1(g) The commissioner shall not issue a new adult foster care license under paragraph
214.2(f) after June 30, 2016. The commissioner shall allow a facility with an adult foster care
214.3license issued under paragraph (f) before June 30, 2016, to continue with a capacity of five
214.4adults if the license holder continues to comply with the requirements in paragraph (f).

214.5    Sec. 12. Minnesota Statutes 2012, section 245A.11, subdivision 7, is amended to read:
214.6    Subd. 7. Adult foster care; variance for alternate overnight supervision. (a) The
214.7commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
214.8requiring a caregiver to be present in an adult foster care home during normal sleeping
214.9hours to allow for alternative methods of overnight supervision. The commissioner may
214.10grant the variance if the local county licensing agency recommends the variance and the
214.11county recommendation includes documentation verifying that:
214.12    (1) the county has approved the license holder's plan for alternative methods of
214.13providing overnight supervision and determined the plan protects the residents' health,
214.14safety, and rights;
214.15    (2) the license holder has obtained written and signed informed consent from
214.16each resident or each resident's legal representative documenting the resident's or legal
214.17representative's agreement with the alternative method of overnight supervision; and
214.18    (3) the alternative method of providing overnight supervision, which may include
214.19the use of technology, is specified for each resident in the resident's: (i) individualized
214.20plan of care; (ii) individual service plan under section 256B.092, subdivision 1b, if
214.21required; or (iii) individual resident placement agreement under Minnesota Rules, part
214.229555.5105, subpart 19, if required.
214.23    (b) To be eligible for a variance under paragraph (a), the adult foster care license
214.24holder must not have had a conditional license issued under section 245A.06, or any
214.25other licensing sanction issued under section 245A.07 during the prior 24 months based
214.26on failure to provide adequate supervision, health care services, or resident safety in
214.27the adult foster care home.
214.28    (c) A license holder requesting a variance under this subdivision to utilize
214.29technology as a component of a plan for alternative overnight supervision may request
214.30the commissioner's review in the absence of a county recommendation. Upon receipt of
214.31such a request from a license holder, the commissioner shall review the variance request
214.32with the county.
214.33(d) A variance granted by the commissioner according to this subdivision before
214.34January 1, 2014, to a license holder for an adult foster care home must transfer with the
214.35license when the license converts to a community residential setting license under chapter
215.1245D. The terms and conditions of the variance remain in effect as approved at the time
215.2the variance was granted.

215.3    Sec. 13. Minnesota Statutes 2012, section 245A.11, subdivision 7a, is amended to read:
215.4    Subd. 7a. Alternate overnight supervision technology; adult foster care license
215.5 and community residential setting licenses. (a) The commissioner may grant an
215.6applicant or license holder an adult foster care or community residential setting license
215.7for a residence that does not have a caregiver in the residence during normal sleeping
215.8hours as required under Minnesota Rules, part 9555.5105, subpart 37, item B, or section
215.9245D.02, subdivision 33b, but uses monitoring technology to alert the license holder
215.10when an incident occurs that may jeopardize the health, safety, or rights of a foster
215.11care recipient. The applicant or license holder must comply with all other requirements
215.12under Minnesota Rules, parts 9555.5105 to 9555.6265, or applicable requirements under
215.13chapter 245D, and the requirements under this subdivision. The license printed by the
215.14commissioner must state in bold and large font:
215.15    (1) that the facility is under electronic monitoring; and
215.16    (2) the telephone number of the county's common entry point for making reports of
215.17suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.
215.18(b) Applications for a license under this section must be submitted directly to
215.19the Department of Human Services licensing division. The licensing division must
215.20immediately notify the host county and lead county contract agency and the host county
215.21licensing agency. The licensing division must collaborate with the county licensing
215.22agency in the review of the application and the licensing of the program.
215.23    (c) Before a license is issued by the commissioner, and for the duration of the
215.24license, the applicant or license holder must establish, maintain, and document the
215.25implementation of written policies and procedures addressing the requirements in
215.26paragraphs (d) through (f).
215.27    (d) The applicant or license holder must have policies and procedures that:
215.28    (1) establish characteristics of target populations that will be admitted into the home,
215.29and characteristics of populations that will not be accepted into the home;
215.30    (2) explain the discharge process when a foster care recipient resident served by the
215.31program requires overnight supervision or other services that cannot be provided by the
215.32license holder due to the limited hours that the license holder is on site;
215.33    (3) describe the types of events to which the program will respond with a physical
215.34presence when those events occur in the home during time when staff are not on site, and
216.1how the license holder's response plan meets the requirements in paragraph (e), clause
216.2(1) or (2);
216.3    (4) establish a process for documenting a review of the implementation and
216.4effectiveness of the response protocol for the response required under paragraph (e),
216.5clause (1) or (2). The documentation must include:
216.6    (i) a description of the triggering incident;
216.7    (ii) the date and time of the triggering incident;
216.8    (iii) the time of the response or responses under paragraph (e), clause (1) or (2);
216.9    (iv) whether the response met the resident's needs;
216.10    (v) whether the existing policies and response protocols were followed; and
216.11    (vi) whether the existing policies and protocols are adequate or need modification.
216.12    When no physical presence response is completed for a three-month period, the
216.13license holder's written policies and procedures must require a physical presence response
216.14drill to be conducted for which the effectiveness of the response protocol under paragraph
216.15(e), clause (1) or (2), will be reviewed and documented as required under this clause; and
216.16    (5) establish that emergency and nonemergency phone numbers are posted in a
216.17prominent location in a common area of the home where they can be easily observed by a
216.18person responding to an incident who is not otherwise affiliated with the home.
216.19    (e) The license holder must document and include in the license application which
216.20response alternative under clause (1) or (2) is in place for responding to situations that
216.21present a serious risk to the health, safety, or rights of people receiving foster care services
216.22in the home residents served by the program:
216.23    (1) response alternative (1) requires only the technology to provide an electronic
216.24notification or alert to the license holder that an event is underway that requires a response.
216.25Under this alternative, no more than ten minutes will pass before the license holder will be
216.26physically present on site to respond to the situation; or
216.27    (2) response alternative (2) requires the electronic notification and alert system under
216.28alternative (1), but more than ten minutes may pass before the license holder is present on
216.29site to respond to the situation. Under alternative (2), all of the following conditions are met:
216.30    (i) the license holder has a written description of the interactive technological
216.31applications that will assist the license holder in communicating with and assessing the
216.32needs related to the care, health, and safety of the foster care recipients. This interactive
216.33technology must permit the license holder to remotely assess the well being of the foster
216.34care recipient resident served by the program without requiring the initiation of the
216.35foster care recipient. Requiring the foster care recipient to initiate a telephone call does
216.36not meet this requirement;
217.1(ii) the license holder documents how the remote license holder is qualified and
217.2capable of meeting the needs of the foster care recipients and assessing foster care
217.3recipients' needs under item (i) during the absence of the license holder on site;
217.4(iii) the license holder maintains written procedures to dispatch emergency response
217.5personnel to the site in the event of an identified emergency; and
217.6    (iv) each foster care recipient's resident's individualized plan of care, individual
217.7service plan coordinated service and support plan under section sections 256B.0913,
217.8subdivision 8; 256B.0915, subdivision 6; 256B.092, subdivision 1b; and 256B.49,
217.9subdivision 15, if required, or individual resident placement agreement under Minnesota
217.10Rules, part 9555.5105, subpart 19, if required, identifies the maximum response time,
217.11which may be greater than ten minutes, for the license holder to be on site for that foster
217.12care recipient resident.
217.13    (f) Each foster care recipient's resident's placement agreement, individual service
217.14agreement, and plan must clearly state that the adult foster care or community residential
217.15setting license category is a program without the presence of a caregiver in the residence
217.16during normal sleeping hours; the protocols in place for responding to situations that
217.17present a serious risk to the health, safety, or rights of foster care recipients residents
217.18served by the program under paragraph (e), clause (1) or (2); and a signed informed
217.19consent from each foster care recipient resident served by the program or the person's
217.20legal representative documenting the person's or legal representative's agreement with
217.21placement in the program. If electronic monitoring technology is used in the home, the
217.22informed consent form must also explain the following:
217.23    (1) how any electronic monitoring is incorporated into the alternative supervision
217.24system;
217.25    (2) the backup system for any electronic monitoring in times of electrical outages or
217.26other equipment malfunctions;
217.27    (3) how the caregivers or direct support staff are trained on the use of the technology;
217.28    (4) the event types and license holder response times established under paragraph (e);
217.29    (5) how the license holder protects the foster care recipient's each resident's privacy
217.30related to electronic monitoring and related to any electronically recorded data generated
217.31by the monitoring system. A foster care recipient resident served by the program may
217.32not be removed from a program under this subdivision for failure to consent to electronic
217.33monitoring. The consent form must explain where and how the electronically recorded
217.34data is stored, with whom it will be shared, and how long it is retained; and
217.35    (6) the risks and benefits of the alternative overnight supervision system.
218.1    The written explanations under clauses (1) to (6) may be accomplished through
218.2cross-references to other policies and procedures as long as they are explained to the
218.3person giving consent, and the person giving consent is offered a copy.
218.4(g) Nothing in this section requires the applicant or license holder to develop or
218.5maintain separate or duplicative policies, procedures, documentation, consent forms, or
218.6individual plans that may be required for other licensing standards, if the requirements of
218.7this section are incorporated into those documents.
218.8(h) The commissioner may grant variances to the requirements of this section
218.9according to section 245A.04, subdivision 9.
218.10(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
218.11under section 245A.2, subdivision 9, and additionally includes all staff, volunteers, and
218.12contractors affiliated with the license holder.
218.13(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to
218.14remotely determine what action the license holder needs to take to protect the well-being
218.15of the foster care recipient.
218.16(k) The commissioner shall evaluate license applications using the requirements
218.17in paragraphs (d) to (f). The commissioner shall provide detailed application forms,
218.18including a checklist of criteria needed for approval.
218.19(l) To be eligible for a license under paragraph (a), the adult foster care or community
218.20residential setting license holder must not have had a conditional license issued under
218.21section 245A.06 or any licensing sanction under section 245A.07 during the prior 24
218.22months based on failure to provide adequate supervision, health care services, or resident
218.23safety in the adult foster care home or community residential setting.
218.24(m) The commissioner shall review an application for an alternative overnight
218.25supervision license within 60 days of receipt of the application. When the commissioner
218.26receives an application that is incomplete because the applicant failed to submit required
218.27documents or that is substantially deficient because the documents submitted do not meet
218.28licensing requirements, the commissioner shall provide the applicant written notice
218.29that the application is incomplete or substantially deficient. In the written notice to the
218.30applicant, the commissioner shall identify documents that are missing or deficient and
218.31give the applicant 45 days to resubmit a second application that is substantially complete.
218.32An applicant's failure to submit a substantially complete application after receiving
218.33notice from the commissioner is a basis for license denial under section 245A.05. The
218.34commissioner shall complete subsequent review within 30 days.
219.1(n) Once the application is considered complete under paragraph (m), the
219.2commissioner will approve or deny an application for an alternative overnight supervision
219.3license within 60 days.
219.4(o) For the purposes of this subdivision, "supervision" means:
219.5(1) oversight by a caregiver or direct support staff as specified in the individual
219.6resident's place agreement or coordinated service and support plan and awareness of the
219.7resident's needs and activities; and
219.8(2) the presence of a caregiver or direct support staff in a residence during normal
219.9sleeping hours, unless a determination has been made and documented in the individual's
219.10 coordinated service and support plan that the individual does not require the presence of a
219.11caregiver or direct support staff during normal sleeping hours.

219.12    Sec. 14. Minnesota Statutes 2012, section 245A.11, subdivision 7b, is amended to read:
219.13    Subd. 7b. Adult foster care data privacy and security. (a) An adult foster care
219.14 or community residential setting license holder who creates, collects, records, maintains,
219.15stores, or discloses any individually identifiable recipient data, whether in an electronic
219.16or any other format, must comply with the privacy and security provisions of applicable
219.17privacy laws and regulations, including:
219.18(1) the federal Health Insurance Portability and Accountability Act of 1996
219.19(HIPAA), Public Law 104-1; and the HIPAA Privacy Rule, Code of Federal Regulations,
219.20title 45, part 160, and subparts A and E of part 164; and
219.21(2) the Minnesota Government Data Practices Act as codified in chapter 13.
219.22(b) For purposes of licensure, the license holder shall be monitored for compliance
219.23with the following data privacy and security provisions:
219.24(1) the license holder must control access to data on foster care recipients residents
219.25served by the program according to the definitions of public and private data on individuals
219.26under section 13.02; classification of the data on individuals as private under section
219.2713.46, subdivision 2 ; and control over the collection, storage, use, access, protection,
219.28and contracting related to data according to section 13.05, in which the license holder is
219.29assigned the duties of a government entity;
219.30(2) the license holder must provide each foster care recipient resident served by
219.31the program with a notice that meets the requirements under section 13.04, in which
219.32the license holder is assigned the duties of the government entity, and that meets the
219.33requirements of Code of Federal Regulations, title 45, part 164.52. The notice shall
219.34describe the purpose for collection of the data, and to whom and why it may be disclosed
220.1pursuant to law. The notice must inform the recipient individual that the license holder
220.2uses electronic monitoring and, if applicable, that recording technology is used;
220.3(3) the license holder must not install monitoring cameras in bathrooms;
220.4(4) electronic monitoring cameras must not be concealed from the foster care
220.5recipients residents served by the program; and
220.6(5) electronic video and audio recordings of foster care recipients residents served
220.7by the program shall be stored by the license holder for five days unless: (i) a foster care
220.8recipient resident served by the program or legal representative requests that the recording
220.9be held longer based on a specific report of alleged maltreatment; or (ii) the recording
220.10captures an incident or event of alleged maltreatment under section 626.556 or 626.557 or
220.11a crime under chapter 609. When requested by a recipient resident served by the program
220.12 or when a recording captures an incident or event of alleged maltreatment or a crime, the
220.13license holder must maintain the recording in a secured area for no longer than 30 days
220.14to give the investigating agency an opportunity to make a copy of the recording. The
220.15investigating agency will maintain the electronic video or audio recordings as required in
220.16section 626.557, subdivision 12b.
220.17(c) The commissioner shall develop, and make available to license holders and
220.18county licensing workers, a checklist of the data privacy provisions to be monitored
220.19for purposes of licensure.

220.20    Sec. 15. Minnesota Statutes 2012, section 245A.11, subdivision 8, is amended to read:
220.21    Subd. 8. Community residential setting license. (a) The commissioner shall
220.22establish provider standards for residential support services that integrate service standards
220.23and the residential setting under one license. The commissioner shall propose statutory
220.24language and an implementation plan for licensing requirements for residential support
220.25services to the legislature by January 15, 2012, as a component of the quality outcome
220.26standards recommendations required by Laws 2010, chapter 352, article 1, section 24.
220.27(b) Providers licensed under chapter 245B, and providing, contracting, or arranging
220.28for services in settings licensed as adult foster care under Minnesota Rules, parts 9555.5105
220.29to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to 2960.3340;
220.30and meeting the provisions of section 256B.092, subdivision 11, paragraph (b) section
220.31245D.02, subdivision 4a, must be required to obtain a community residential setting license.

220.32    Sec. 16. Minnesota Statutes 2012, section 245A.16, subdivision 1, is amended to read:
220.33    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
220.34private agencies that have been designated or licensed by the commissioner to perform
221.1licensing functions and activities under section 245A.04 and background studies for family
221.2child care under chapter 245C; to recommend denial of applicants under section 245A.05;
221.3to issue correction orders, to issue variances, and recommend a conditional license under
221.4section 245A.06, or to recommend suspending or revoking a license or issuing a fine under
221.5section 245A.07, shall comply with rules and directives of the commissioner governing
221.6those functions and with this section. The following variances are excluded from the
221.7delegation of variance authority and may be issued only by the commissioner:
221.8    (1) dual licensure of family child care and child foster care, dual licensure of child
221.9and adult foster care, and adult foster care and family child care;
221.10    (2) adult foster care maximum capacity;
221.11    (3) adult foster care minimum age requirement;
221.12    (4) child foster care maximum age requirement;
221.13    (5) variances regarding disqualified individuals except that county agencies may
221.14issue variances under section 245C.30 regarding disqualified individuals when the county
221.15is responsible for conducting a consolidated reconsideration according to sections 245C.25
221.16and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
221.17and a disqualification based on serious or recurring maltreatment; and
221.18    (6) the required presence of a caregiver in the adult foster care residence during
221.19normal sleeping hours; and
221.20    (7) variances for community residential setting licenses under chapter 245D.
221.21Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency
221.22must not grant a license holder a variance to exceed the maximum allowable family child
221.23care license capacity of 14 children.
221.24    (b) County agencies must report information about disqualification reconsiderations
221.25under sections 245C.25 and 245C.27, subdivision 2, paragraphs (a) and (b), and variances
221.26granted under paragraph (a), clause (5), to the commissioner at least monthly in a format
221.27prescribed by the commissioner.
221.28    (c) For family day care programs, the commissioner may authorize licensing reviews
221.29every two years after a licensee has had at least one annual review.
221.30    (d) For family adult day services programs, the commissioner may authorize
221.31licensing reviews every two years after a licensee has had at least one annual review.
221.32    (e) A license issued under this section may be issued for up to two years.

221.33    Sec. 17. Minnesota Statutes 2012, section 245D.02, is amended to read:
221.34245D.02 DEFINITIONS.
222.1    Subdivision 1. Scope. The terms used in this chapter have the meanings given
222.2them in this section.
222.3    Subd. 2. Annual and annually. "Annual" and "annually" have the meaning given
222.4in section 245A.02, subdivision 2b.
222.5    Subd. 2a. Authorized representative. "Authorized representative" means a parent,
222.6family member, advocate, or other adult authorized by the person or the person's legal
222.7representative, to serve as a representative in connection with the provision of services
222.8licensed under this chapter. This authorization must be in writing or by another method
222.9that clearly indicates the person's free choice. The authorized representative must have no
222.10financial interest in the provision of any services included in the person's service delivery
222.11plan and must be capable of providing the support necessary to assist the person in the use
222.12of home and community-based services licensed under this chapter.
222.13    Subd. 3. Case manager. "Case manager" means the individual designated
222.14to provide waiver case management services, care coordination, or long-term care
222.15consultation, as specified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
222.16or successor provisions.
222.17    Subd. 3a. Certification. "Certification" means the commissioner's written
222.18authorization for a license holder to provide specialized services based on certification
222.19standards in section 245D.33. The term certification and its derivatives have the same
222.20meaning and may be substituted for the term licensure and its derivatives in this chapter
222.21and chapter 245A.
222.22    Subd. 4. Commissioner. "Commissioner" means the commissioner of the
222.23Department of Human Services or the commissioner's designated representative.
222.24    Subd. 4a. Community residential setting. "Community residential setting" means
222.25a residential program as identified in section 245A.11, subdivision 8, where residential
222.26supports and services identified in section 245D.03, subdivision 1, paragraph (c), clause
222.27(3), items (i) and (ii), are provided and the license holder is the owner, lessor, or tenant
222.28of the facility licensed according to this chapter, and the license holder does not reside
222.29in the facility.
222.30    Subd. 4b. Coordinated service and support plan. "Coordinated service and support
222.31plan" has the meaning given in sections 256B.0913, subdivision 8; 256B.0915, subdivision
222.326; 256B.092, subdivision 1b; and 256B.49, subdivision 15, or successor provisions.
222.33    Subd. 4c. Coordinated service and support plan addendum. "Coordinated
222.34service and support plan addendum" means the documentation that this chapter requires
222.35of the license holder for each person receiving services.
223.1    Subd. 4d. Corporate foster care. "Corporate foster care" means a child foster
223.2residence setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340,
223.3or an adult foster care home licensed according to Minnesota Rules, parts 9555.5105 to
223.49555.6265, where the license holder does not live in the home.
223.5    Subd. 4e. Cultural competence or culturally competent. "Cultural competence"
223.6or "culturally competent" means the ability and the will to respond to the unique needs of
223.7a person that arise from the person's culture and the ability to use the person's culture as a
223.8resource or tool to assist with the intervention and help meet the person's needs.
223.9    Subd. 4f. Day services facility. "Day services facility" means a facility licensed
223.10according to this chapter at which persons receive day services licensed under this chapter
223.11from the license holder's direct support staff for a cumulative total of more than 30 days
223.12within any 12-month period and the license holder is the owner, lessor, or tenant of the
223.13facility.
223.14    Subd. 5. Department. "Department" means the Department of Human Services.
223.15    Subd. 6. Direct contact. "Direct contact" has the meaning given in section 245C.02,
223.16subdivision 11 , and is used interchangeably with the term "direct support service."
223.17    Subd. 6a. Direct support staff or staff. "Direct support staff" or "staff" means
223.18employees of the license holder who have direct contact with persons served by the
223.19program and includes temporary staff or subcontractors, regardless of employer, providing
223.20program services for hire under the control of the license holder who have direct contact
223.21with persons served by the program.
223.22    Subd. 7. Drug. "Drug" has the meaning given in section 151.01, subdivision 5.
223.23    Subd. 8. Emergency. "Emergency" means any event that affects the ordinary
223.24daily operation of the program including, but not limited to, fires, severe weather, natural
223.25disasters, power failures, or other events that threaten the immediate health and safety of
223.26a person receiving services and that require calling 911, emergency evacuation, moving
223.27to an emergency shelter, or temporary closure or relocation of the program to another
223.28facility or service site for more than 24 hours.
223.29    Subd. 8a. Emergency use of manual restraint. "Emergency use of manual
223.30restraint" means using a manual restraint when a person poses an imminent risk of
223.31physical harm to self or others and is the least restrictive intervention that would achieve
223.32safety. Property damage, verbal aggression, or a person's refusal to receive or participate
223.33in treatment or programming on their own, do not constitute an emergency.
223.34    Subd. 8b. Expanded support team. "Expanded support team" means the members
223.35of the support team defined in subdivision 46, and a licensed health or mental health
223.36professional or other licensed, certified, or qualified professionals or consultants working
224.1with the person and included in the team at the request of the person or the person's legal
224.2representative.
224.3    Subd. 8c. Family foster care. "Family foster care" means a child foster family
224.4setting licensed according to Minnesota Rules, parts 2960.0010 to 2960.3340, or an adult
224.5foster care home licensed according to Minnesota Rules, parts 9555.5105 to 9555.6265,
224.6where the license holder lives in the home.
224.7    Subd. 9. Health services. "Health services" means any service or treatment
224.8consistent with the physical and mental health needs of the person, such as medication
224.9administration and monitoring, medical, dental, nutritional, health monitoring, wellness
224.10education, and exercise.
224.11    Subd. 10. Home and community-based services. "Home and community-based
224.12services" means the services subject to the provisions of this chapter identified in section
224.13245D.03, subdivision 1, and as defined in:
224.14(1) the federal federally approved waiver plans governed by United States Code,
224.15title 42, sections 1396 et seq., or the state's alternative care program according to section
224.16256B.0913, including the waivers for persons with disabilities under section 256B.49,
224.17subdivision 11, including the brain injury (BI) waiver, plan; the community alternative
224.18care (CAC) waiver, plan; the community alternatives for disabled individuals (CADI)
224.19waiver, plan; the developmental disability (DD) waiver, plan under section 256B.092,
224.20subdivision 5; the elderly waiver (EW), and plan under section 256B.0915, subdivision 1;
224.21or successor plans respective to each waiver; or
224.22(2) the alternative care (AC) program under section 256B.0913.
224.23    Subd. 11. Incident. "Incident" means an occurrence that affects the which involves
224.24a person and requires the program to make a response that is not a part of the program's
224.25 ordinary provision of services to a that person, and includes any of the following:
224.26(1) serious injury of a person as determined by section 245.91, subdivision 6;
224.27(2) a person's death;
224.28(3) any medical emergency, unexpected serious illness, or significant unexpected
224.29change in an illness or medical condition, or the mental health status of a person that
224.30requires calling the program to call 911 or a mental health crisis intervention team,
224.31physician treatment, or hospitalization;
224.32(4) any mental health crisis that requires the program to call 911 or a mental health
224.33crisis intervention team;
224.34(5) an act or situation involving a person that requires the program to call 911,
224.35law enforcement, or the fire department;
224.36(4) (6) a person's unauthorized or unexplained absence from a program;
225.1(5) (7) physical aggression conduct by a person receiving services against another
225.2person receiving services that causes physical pain, injury, or persistent emotional distress,
225.3including, but not limited to, hitting, slapping, kicking, scratching, pinching, biting,
225.4pushing, and spitting;:
225.5(i) is so severe, pervasive, or objectively offensive that it substantially interferes with
225.6a person's opportunities to participate in or receive service or support;
225.7(ii) places the person in actual and reasonable fear of harm;
225.8(iii) places the person in actual and reasonable fear of damage to property of the
225.9person; or
225.10(iv) substantially disrupts the orderly operation of the program;
225.11(6) (8) any sexual activity between persons receiving services involving force or
225.12coercion as defined under section 609.341, subdivisions 3 and 14; or
225.13(9) any emergency use of manual restraint as identified in section 245D.061; or
225.14(7) (10) a report of alleged or suspected child or vulnerable adult maltreatment
225.15under section 626.556 or 626.557.
225.16    Subd. 11a. Intermediate care facility for persons with developmental disabilities
225.17or ICF/DD. "Intermediate care facility for persons with developmental disabilities" or
225.18"ICF/DD" means a residential program licensed to serve four or more persons with
225.19developmental disabilities under section 252.28 and chapter 245A and licensed as a
225.20supervised living facility under chapter 144, which together are certified by the Department
225.21of Health as an intermediate care facility for persons with developmental disabilities.
225.22    Subd. 11b. Least restrictive alternative. "Least restrictive alternative" means
225.23the alternative method for providing supports and services that is the least intrusive and
225.24most normalized given the level of supervision and protection required for the person.
225.25This level of supervision and protection allows risk taking to the extent that there is no
225.26reasonable likelihood that serious harm will happen to the person or others.
225.27    Subd. 12. Legal representative. "Legal representative" means the parent of a
225.28person who is under 18 years of age, a court-appointed guardian, or other representative
225.29with legal authority to make decisions about services for a person. Other representatives
225.30with legal authority to make decisions include but are not limited to a health care agent or
225.31an attorney-in-fact authorized through a health care directive or power of attorney.
225.32    Subd. 13. License. "License" has the meaning given in section 245A.02,
225.33subdivision 8 .
225.34    Subd. 14. Licensed health professional. "Licensed health professional" means a
225.35person licensed in Minnesota to practice those professions described in section 214.01,
225.36subdivision 2 .
226.1    Subd. 15. License holder. "License holder" has the meaning given in section
226.2245A.02, subdivision 9 .
226.3    Subd. 16. Medication. "Medication" means a prescription drug or over-the-counter
226.4drug. For purposes of this chapter, "medication" includes dietary supplements.
226.5    Subd. 17. Medication administration. "Medication administration" means
226.6performing the following set of tasks to ensure a person takes both prescription and
226.7over-the-counter medications and treatments according to orders issued by appropriately
226.8licensed professionals, and includes the following:
226.9(1) checking the person's medication record;
226.10(2) preparing the medication for administration;
226.11(3) administering the medication to the person;
226.12(4) documenting the administration of the medication or the reason for not
226.13administering the medication; and
226.14(5) reporting to the prescriber or a nurse any concerns about the medication,
226.15including side effects, adverse reactions, effectiveness, or the person's refusal to take the
226.16medication or the person's self-administration of the medication.
226.17    Subd. 18. Medication assistance. "Medication assistance" means providing verbal
226.18or visual reminders to take regularly scheduled medication, which includes either of
226.19the following:
226.20(1) bringing to the person and opening a container of previously set up medications
226.21and emptying the container into the person's hand or opening and giving the medications
226.22in the original container to the person, or bringing to the person liquids or food to
226.23accompany the medication; or
226.24(2) providing verbal or visual reminders to perform regularly scheduled treatments
226.25and exercises.
226.26    Subd. 19. Medication management. "Medication management" means the
226.27provision of any of the following:
226.28(1) medication-related services to a person;
226.29(2) medication setup;
226.30(3) medication administration;
226.31(4) medication storage and security;
226.32(5) medication documentation and charting;
226.33(6) verification and monitoring of effectiveness of systems to ensure safe medication
226.34handling and administration;
226.35(7) coordination of medication refills;
226.36(8) handling changes to prescriptions and implementation of those changes;
227.1(9) communicating with the pharmacy; or
227.2(10) coordination and communication with prescriber.
227.3For the purposes of this chapter, medication management does not mean "medication
227.4therapy management services" as identified in section 256B.0625, subdivision 13h.
227.5    Subd. 20. Mental health crisis intervention team. "Mental health crisis
227.6intervention team" means a mental health crisis response providers provider as identified
227.7in section 256B.0624, subdivision 2, paragraph (d), for adults, and in section 256B.0944,
227.8subdivision 1 , paragraph (d), for children.
227.9    Subd. 20a. Most integrated setting. "Most integrated setting" means a setting that
227.10enables individuals with disabilities to interact with nondisabled persons to the fullest
227.11extent possible.
227.12    Subd. 21. Over-the-counter drug. "Over-the-counter drug" means a drug that
227.13is not required by federal law to bear the statement "Caution: Federal law prohibits
227.14dispensing without prescription."
227.15    Subd. 21a. Outcome. "Outcome" means the behavior, action, or status attained by
227.16the person that can be observed, measured, and determined reliable and valid.
227.17    Subd. 22. Person. "Person" has the meaning given in section 245A.02, subdivision
227.1811 .
227.19    Subd. 23. Person with a disability. "Person with a disability" means a person
227.20determined to have a disability by the commissioner's state medical review team as
227.21identified in section 256B.055, subdivision 7, the Social Security Administration, or
227.22the person is determined to have a developmental disability as defined in Minnesota
227.23Rules, part 9525.0016, subpart 2, item B, or a related condition as defined in section
227.24252.27, subdivision 1a .
227.25    Subd. 23a. Physician. "Physician" means a person who is licensed under chapter
227.26147.
227.27    Subd. 24. Prescriber. "Prescriber" means a licensed practitioner as defined in
227.28section 151.01, subdivision 23, person who is authorized under section sections 148.235;
227.29151.01, subdivision 23; or 151.37 to prescribe drugs. For the purposes of this chapter, the
227.30term "prescriber" is used interchangeably with "physician."
227.31    Subd. 25. Prescription drug. "Prescription drug" has the meaning given in section
227.32151.01, subdivision 17 16 .
227.33    Subd. 26. Program. "Program" means either the nonresidential or residential
227.34program as defined in section 245A.02, subdivisions 10 and 14.
227.35    Subd. 27. Psychotropic medication. "Psychotropic medication" means any
227.36medication prescribed to treat the symptoms of mental illness that affect thought processes,
228.1mood, sleep, or behavior. The major classes of psychotropic medication are antipsychotic
228.2(neuroleptic), antidepressant, antianxiety, mood stabilizers, anticonvulsants, and
228.3stimulants and nonstimulants for the treatment of attention deficit/hyperactivity disorder.
228.4Other miscellaneous medications are considered to be a psychotropic medication when
228.5they are specifically prescribed to treat a mental illness or to control or alter behavior.
228.6    Subd. 28. Restraint. "Restraint" means physical or mechanical limiting of the free
228.7and normal movement of body or limbs.
228.8    Subd. 29. Seclusion. "Seclusion" means separating a person from others in a way
228.9that prevents social contact and prevents the person from leaving the situation if he or she
228.10chooses the placement of a person alone in a room from which exit is prohibited by a staff
228.11person or a mechanism such as a lock, a device, or an object positioned to hold the door
228.12closed or otherwise prevent the person from leaving the room.
228.13    Subd. 29a. Self-determination. "Self-determination" means the person makes
228.14decisions independently, plans for the person's own future, determines how money is spent
228.15for the person's supports, and takes responsibility for making these decisions. If a person
228.16has a legal representative, the legal representative's decision-making authority is limited to
228.17the scope of authority granted by the court or allowed in the document authorizing the
228.18legal representative to act.
228.19    Subd. 29b. Semi-independent living services. "Semi-independent living services"
228.20has the meaning given in section 252.275.
228.21    Subd. 30. Service. "Service" means care, training, supervision, counseling,
228.22consultation, or medication assistance assigned to the license holder in the coordinated
228.23service and support plan.
228.24    Subd. 31. Service plan. "Service plan" means the individual service plan or
228.25individual care plan identified in sections 256B.0913, 256B.0915, 256B.092, and 256B.49,
228.26or successor provisions, and includes any support plans or service needs identified as
228.27a result of long-term care consultation, or a support team meeting that includes the
228.28participation of the person, the person's legal representative, and case manager, or assigned
228.29to a license holder through an authorized service agreement.
228.30    Subd. 32. Service site. "Service site" means the location where the service is
228.31provided to the person, including, but not limited to, a facility licensed according to
228.32chapter 245A; a location where the license holder is the owner, lessor, or tenant; a person's
228.33own home; or a community-based location.
228.34    Subd. 33. Staff. "Staff" means an employee who will have direct contact with a
228.35person served by the facility, agency, or program.
229.1    Subd. 33a. Supervised living facility. "Supervised living facility" has the meaning
229.2given in Minnesota Rules, part 4665.0100, subpart 10.
229.3    Subd. 33b. Supervision. (a) "Supervision" means:
229.4(1) oversight by direct support staff as specified in the person's coordinated service
229.5and support plan or coordinated service and support plan addendum and awareness of
229.6the person's needs and activities;
229.7(2) responding to situations that present a serious risk to the health, safety, or rights
229.8of the person while services are being provided; and
229.9(3) the presence of direct support staff at a service site while services are being
229.10provided, unless a determination has been made and documented in the person's coordinated
229.11service and support plan or coordinated service and support plan addendum that the person
229.12does not require the presence of direct support staff while services are being provided.
229.13(b) For the purposes of this definition, "while services are being provided," means
229.14any period of time during which the license holder will seek reimbursement for services.
229.15    Subd. 34. Support team. "Support team" means the service planning team
229.16identified in section 256B.49, subdivision 15, or the interdisciplinary team identified in
229.17Minnesota Rules, part 9525.0004, subpart 14.
229.18    Subd. 34a. Time out. "Time out" means removing a person involuntarily from an
229.19ongoing activity to a room, either locked or unlocked, or otherwise separating a person
229.20from others in a way that prevents social contact and prevents the person from leaving
229.21the situation if the person chooses. For the purpose of chapter 245D, "time out" does
229.22not mean voluntary removal or self-removal for the purpose of calming, prevention of
229.23escalation, or de-escalation of behavior for a period of up to 15 minutes. "Time out"
229.24does not include a person voluntarily moving from an ongoing activity to an unlocked
229.25room or otherwise separating from a situation or social contact with others if the person
229.26chooses. For the purposes of this definition, "voluntarily" means without being forced,
229.27compelled, or coerced.
229.28    Subd. 35. Unit of government. "Unit of government" means every city, county,
229.29town, school district, other political subdivisions of the state, and any agency of the state
229.30or the United States, and includes any instrumentality of a unit of government.
229.31    Subd. 35a. Treatment. "Treatment" means the provision of care, other than
229.32medications, ordered or prescribed by a licensed health or mental health professional,
229.33provided to a person to cure, rehabilitate, or ease symptoms.
229.34    Subd. 36. Volunteer. "Volunteer" means an individual who, under the direction of the
229.35license holder, provides direct services without pay to a person served by the license holder.
229.36EFFECTIVE DATE.This section is effective January 1, 2014.

230.1    Sec. 18. Minnesota Statutes 2012, section 245D.03, is amended to read:
230.2245D.03 APPLICABILITY AND EFFECT.
230.3    Subdivision 1. Applicability. (a) The commissioner shall regulate the provision of
230.4home and community-based services to persons with disabilities and persons age 65 and
230.5older pursuant to this chapter. The licensing standards in this chapter govern the provision
230.6of the following basic support services: and intensive support services.
230.7(1) housing access coordination as defined under the current BI, CADI, and DD
230.8waiver plans or successor plans;
230.9(2) respite services as defined under the current CADI, BI, CAC, DD, and EW
230.10waiver plans or successor plans when the provider is an individual who is not an employee
230.11of a residential or nonresidential program licensed by the Department of Human Services
230.12or the Department of Health that is otherwise providing the respite service;
230.13(3) behavioral programming as defined under the current BI and CADI waiver
230.14plans or successor plans;
230.15(4) specialist services as defined under the current DD waiver plan or successor plans;
230.16(5) companion services as defined under the current BI, CADI, and EW waiver
230.17plans or successor plans, excluding companion services provided under the Corporation
230.18for National and Community Services Senior Companion Program established under the
230.19Domestic Volunteer Service Act of 1973, Public Law 98-288;
230.20(6) personal support as defined under the current DD waiver plan or successor plans;
230.21(7) 24-hour emergency assistance, on-call and personal emergency response as
230.22defined under the current CADI and DD waiver plans or successor plans;
230.23(8) night supervision services as defined under the current BI waiver plan or
230.24successor plans;
230.25(9) homemaker services as defined under the current CADI, BI, CAC, DD, and EW
230.26waiver plans or successor plans, excluding providers licensed by the Department of Health
230.27under chapter 144A and those providers providing cleaning services only;
230.28(10) independent living skills training as defined under the current BI and CADI
230.29waiver plans or successor plans;
230.30(11) prevocational services as defined under the current BI and CADI waiver plans
230.31or successor plans;
230.32(12) structured day services as defined under the current BI waiver plan or successor
230.33plans; or
230.34(13) supported employment as defined under the current BI and CADI waiver plans
230.35or successor plans.
231.1(b) Basic support services provide the level of assistance, supervision, and care that
231.2is necessary to ensure the health and safety of the person and do not include services that
231.3are specifically directed toward the training, treatment, habilitation, or rehabilitation of
231.4the person. Basic support services include:
231.5(1) in-home and out-of-home respite care services as defined in section 245A.02,
231.6subdivision 15, and under the brain injury, community alternative care, community
231.7alternatives for disabled individuals, developmental disability, and elderly waiver plans;
231.8(2) companion services as defined under the brain injury, community alternatives for
231.9disabled individuals, and elderly waiver plans, excluding companion services provided
231.10under the Corporation for National and Community Services Senior Companion Program
231.11established under the Domestic Volunteer Service Act of 1973, Public Law 98-288;
231.12(3) personal support as defined under the developmental disability waiver plan;
231.13(4) 24-hour emergency assistance, personal emergency response as defined under the
231.14community alternatives for disabled individuals and developmental disability waiver plans;
231.15(5) night supervision services as defined under the brain injury waiver plan; and
231.16(6) homemaker services as defined under the community alternatives for disabled
231.17individuals, brain injury, community alternative care, developmental disability, and elderly
231.18waiver plans, excluding providers licensed by the Department of Health under chapter
231.19144A and those providers providing cleaning services only.
231.20(c) Intensive support services provide assistance, supervision, and care that is
231.21necessary to ensure the health and safety of the person and services specifically directed
231.22toward the training, habilitation, or rehabilitation of the person. Intensive support services
231.23include:
231.24(1) intervention services, including:
231.25(i) behavioral support services as defined under the brain injury and community
231.26alternatives for disabled individuals waiver plans;
231.27(ii) in-home or out-of-home crisis respite services as defined under the developmental
231.28disability waiver plan; and
231.29(iii) specialist services as defined under the current developmental disability waiver
231.30plan;
231.31(2) in-home support services, including:
231.32(i) in-home family support and supported living services as defined under the
231.33developmental disability waiver plan;
231.34(ii) independent living services training as defined under the brain injury and
231.35community alternatives for disabled individuals waiver plans; and
231.36(iii) semi-independent living services;
232.1(3) residential supports and services, including:
232.2(i) supported living services as defined under the developmental disability waiver
232.3plan provided in a family or corporate child foster care residence, a family adult foster
232.4care residence, a community residential setting, or a supervised living facility;
232.5(ii) foster care services as defined in the brain injury, community alternative care,
232.6and community alternatives for disabled individuals waiver plans provided in a family or
232.7corporate child foster care residence, a family adult foster care residence, or a community
232.8residential setting; and
232.9(iii) residential services provided in a supervised living facility that is certified by
232.10the Department of Health as an ICF/DD;
232.11(4) day services, including:
232.12(i) structured day services as defined under the brain injury waiver plan;
232.13(ii) day training and habilitation services under sections 252.40 to 252.46, and as
232.14defined under the developmental disability waiver plan; and
232.15(iii) prevocational services as defined under the brain injury and community
232.16alternatives for disabled individuals waiver plans; and
232.17(5) supported employment as defined under the brain injury, developmental
232.18disability, and community alternatives for disabled individuals waiver plans.
232.19    Subd. 2. Relationship to other standards governing home and community-based
232.20services. (a) A license holder governed by this chapter is also subject to the licensure
232.21requirements under chapter 245A.
232.22(b) A license holder concurrently providing child foster care services licensed
232.23according to Minnesota Rules, chapter 2960, to the same person receiving a service licensed
232.24under this chapter is exempt from section 245D.04 as it applies to the person. A corporate
232.25or family child foster care site controlled by a license holder and providing services
232.26governed by this chapter is exempt from compliance with section 245D.04. This exemption
232.27applies to foster care homes where at least one resident is receiving residential supports
232.28and services licensed according to this chapter. This chapter does not apply to corporate or
232.29family child foster care homes that do not provide services licensed under this chapter.
232.30(c) A family adult foster care site controlled by a license holder and providing
232.31services governed by this chapter is exempt from compliance with Minnesota Rules, parts
232.329555.6185; 9555.6225, subpart 8; 9555.6235, item C; 9555.6245; 9555.6255, subpart
232.332; and 9555.6265. These exemptions apply to family adult foster care homes where at
232.34least one resident is receiving residential supports and services licensed according to this
232.35chapter. This chapter does not apply to family adult foster care homes that do not provide
232.36services licensed under this chapter.
233.1(d) A license holder providing services licensed according to this chapter in a
233.2supervised living facility is exempt from compliance with sections 245D.04; 245D.05,
233.3subdivision 2; and 245D.06, subdivision 2, clauses (1), (4), and (5).
233.4(e) A license holder providing residential services to persons in an ICF/DD is exempt
233.5from compliance with sections 245D.04; 245D.05, subdivision 1b; 245D.06, subdivision
233.62, clauses (4) and (5); 245D.071, subdivisions 4 and 5; 245D.081, subdivision 2; 245D.09,
233.7subdivision 7; 245D.095, subdivision 2; and 245D.11, subdivision 3.
233.8(c) (f) A license holder concurrently providing home care homemaker services
233.9registered licensed according to sections 144A.43 to 144A.49 to the same person receiving
233.10home management services licensed under this chapter and registered according to chapter
233.11144A is exempt from compliance with section 245D.04 as it applies to the person.
233.12(d) A license holder identified in subdivision 1, clauses (1), (5), and (9), is exempt
233.13from compliance with sections 245A.65, subdivision 2, paragraph (a), and 626.557,
233.14subdivision 14 , paragraph (b).
233.15(e) Notwithstanding section 245D.06, subdivision 5, a license holder providing
233.16structured day, prevocational, or supported employment services under this chapter
233.17and day training and habilitation or supported employment services licensed under
233.18chapter 245B within the same program is exempt from compliance with this chapter
233.19when the license holder notifies the commissioner in writing that the requirements under
233.20chapter 245B will be met for all persons receiving these services from the program. For
233.21the purposes of this paragraph, if the license holder has obtained approval from the
233.22commissioner for an alternative inspection status according to section 245B.031, that
233.23approval will apply to all persons receiving services in the program.
233.24(g) Nothing in this chapter prohibits a license holder from concurrently serving
233.25persons without disabilities or people who are or are not age 65 and older, provided this
233.26chapter's standards are met as well as other relevant standards.
233.27(h) The documentation required under sections 245D.07 and 245D.071 must meet
233.28the individual program plan requirements identified in section 256B.092 or successor
233.29provisions.
233.30    Subd. 3. Variance. If the conditions in section 245A.04, subdivision 9, are met,
233.31the commissioner may grant a variance to any of the requirements in this chapter, except
233.32sections 245D.04, and 245D.10, subdivision 4, paragraph (b) 245D.06, subdivision 4,
233.33paragraph (b), and 245D.061, subdivision 3, or provisions governing data practices and
233.34information rights of persons.
234.1    Subd. 4. License holders with multiple 245D licenses. (a) When a person changes
234.2service from one license to a different license held by the same license holder, the license
234.3holder is exempt from the requirements in section 245D.10, subdivision 4, paragraph (b).
234.4(b) When a staff person begins providing direct service under one or more licenses
234.5held by the same license holder, other than the license for which staff orientation was
234.6initially provided according to section 245D.09, subdivision 4, the license holder is
234.7exempt from those staff orientation requirements, except the staff person must review each
234.8person's service plan and medication administration procedures in accordance with section
234.9245D.09, subdivision 4, paragraph (c), if not previously reviewed by the staff person.
234.10    Subd. 5. Program certification. An applicant or a license holder may apply for
234.11program certification as identified in section 245D.33.
234.12EFFECTIVE DATE.This section is effective January 1, 2014.

234.13    Sec. 19. Minnesota Statutes 2012, section 245D.04, is amended to read:
234.14245D.04 SERVICE RECIPIENT RIGHTS.
234.15    Subdivision 1. License holder responsibility for individual rights of persons
234.16served by the program. The license holder must:
234.17(1) provide each person or each person's legal representative with a written notice
234.18that identifies the service recipient rights in subdivisions 2 and 3, and an explanation of
234.19those rights within five working days of service initiation and annually thereafter;
234.20(2) make reasonable accommodations to provide this information in other formats
234.21or languages as needed to facilitate understanding of the rights by the person and the
234.22person's legal representative, if any;
234.23(3) maintain documentation of the person's or the person's legal representative's
234.24receipt of a copy and an explanation of the rights; and
234.25(4) ensure the exercise and protection of the person's rights in the services provided
234.26by the license holder and as authorized in the coordinated service and support plan.
234.27    Subd. 2. Service-related rights. A person's service-related rights include the right to:
234.28(1) participate in the development and evaluation of the services provided to the
234.29person;
234.30(2) have services and supports identified in the coordinated service and support plan
234.31and the coordinated service and support plan addendum provided in a manner that respects
234.32and takes into consideration the person's preferences according to the requirements in
234.33sections 245D.07 and 245D.071;
235.1(3) refuse or terminate services and be informed of the consequences of refusing
235.2or terminating services;
235.3(4) know, in advance, limits to the services available from the license holder,
235.4including the license holder's knowledge, skill, and ability to meet the person's service and
235.5support needs based on the information required in section 245D.031, subdivision 2;
235.6(5) know conditions and terms governing the provision of services, including the
235.7license holder's admission criteria and policies and procedures related to temporary
235.8service suspension and service termination;
235.9(6) a coordinated transfer to ensure continuity of care when there will be a change
235.10in the provider;
235.11(7) know what the charges are for services, regardless of who will be paying for the
235.12services, and be notified of changes in those charges;
235.13(7) (8) know, in advance, whether services are covered by insurance, government
235.14funding, or other sources, and be told of any charges the person or other private party
235.15may have to pay; and
235.16(8) (9) receive services from an individual who is competent and trained, who has
235.17professional certification or licensure, as required, and who meets additional qualifications
235.18identified in the person's coordinated service and support plan. or coordinated service and
235.19support plan addendum.
235.20    Subd. 3. Protection-related rights. (a) A person's protection-related rights include
235.21the right to:
235.22(1) have personal, financial, service, health, and medical information kept private,
235.23and be advised of disclosure of this information by the license holder;
235.24(2) access records and recorded information about the person in accordance with
235.25applicable state and federal law, regulation, or rule;
235.26(3) be free from maltreatment;
235.27(4) be free from restraint, time out, or seclusion used for a purpose other than except
235.28for emergency use of manual restraint to protect the person from imminent danger to self
235.29or others according to the requirements in section 245D.06;
235.30(5) receive services in a clean and safe environment when the license holder is the
235.31owner, lessor, or tenant of the service site;
235.32(6) be treated with courtesy and respect and receive respectful treatment of the
235.33person's property;
235.34(7) reasonable observance of cultural and ethnic practice and religion;
235.35(8) be free from bias and harassment regarding race, gender, age, disability,
235.36spirituality, and sexual orientation;
236.1(9) be informed of and use the license holder's grievance policy and procedures,
236.2including knowing how to contact persons responsible for addressing problems and to
236.3appeal under section 256.045;
236.4(10) know the name, telephone number, and the Web site, e-mail, and street
236.5addresses of protection and advocacy services, including the appropriate state-appointed
236.6ombudsman, and a brief description of how to file a complaint with these offices;
236.7(11) assert these rights personally, or have them asserted by the person's family,
236.8authorized representative, or legal representative, without retaliation;
236.9(12) give or withhold written informed consent to participate in any research or
236.10experimental treatment;
236.11(13) associate with other persons of the person's choice;
236.12(14) personal privacy; and
236.13(15) engage in chosen activities.
236.14(b) For a person residing in a residential site licensed according to chapter 245A,
236.15or where the license holder is the owner, lessor, or tenant of the residential service site,
236.16protection-related rights also include the right to:
236.17(1) have daily, private access to and use of a non-coin-operated telephone for local
236.18calls and long-distance calls made collect or paid for by the person;
236.19(2) receive and send, without interference, uncensored, unopened mail or electronic
236.20correspondence or communication; and
236.21(3) have use of and free access to common areas in the residence; and
236.22(4) privacy for visits with the person's spouse, next of kin, legal counsel, religious
236.23advisor, or others, in accordance with section 363A.09 of the Human Rights Act, including
236.24privacy in the person's bedroom.
236.25(c) Restriction of a person's rights under subdivision 2, clause (10), or paragraph (a),
236.26clauses (13) to (15), or paragraph (b) is allowed only if determined necessary to ensure
236.27the health, safety, and well-being of the person. Any restriction of those rights must be
236.28documented in the person's coordinated service and support plan for the person and or
236.29coordinated service and support plan addendum. The restriction must be implemented
236.30in the least restrictive alternative manner necessary to protect the person and provide
236.31support to reduce or eliminate the need for the restriction in the most integrated setting
236.32and inclusive manner. The documentation must include the following information:
236.33(1) the justification for the restriction based on an assessment of the person's
236.34vulnerability related to exercising the right without restriction;
236.35(2) the objective measures set as conditions for ending the restriction;
237.1(3) a schedule for reviewing the need for the restriction based on the conditions for
237.2ending the restriction to occur, at a minimum, every three months for persons who do not
237.3have a legal representative and annually for persons who do have a legal representative
237.4 semiannually from the date of initial approval, at a minimum, or more frequently if
237.5requested by the person, the person's legal representative, if any, and case manager; and
237.6(4) signed and dated approval for the restriction from the person, or the person's
237.7legal representative, if any. A restriction may be implemented only when the required
237.8approval has been obtained. Approval may be withdrawn at any time. If approval is
237.9withdrawn, the right must be immediately and fully restored.
237.10EFFECTIVE DATE.This section is effective January 1, 2014.

237.11    Sec. 20. Minnesota Statutes 2012, section 245D.05, is amended to read:
237.12245D.05 HEALTH SERVICES.
237.13    Subdivision 1. Health needs. (a) The license holder is responsible for providing
237.14 meeting health services service needs assigned in the coordinated service and support plan
237.15and or the coordinated service and support plan addendum, consistent with the person's
237.16health needs. The license holder is responsible for promptly notifying the person or
237.17 the person's legal representative, if any, and the case manager of changes in a person's
237.18physical and mental health needs affecting assigned health services service needs assigned
237.19to the license holder in the coordinated service and support plan or the coordinated service
237.20and support plan addendum, when discovered by the license holder, unless the license
237.21holder has reason to know the change has already been reported. The license holder
237.22must document when the notice is provided.
237.23(b) When assigned in the service plan, If responsibility for meeting the person's
237.24health service needs has been assigned to the license holder in the coordinated service and
237.25support plan or the coordinated service and support plan addendum, the license holder is
237.26required to must maintain documentation on how the person's health needs will be met,
237.27including a description of the procedures the license holder will follow in order to:
237.28(1) provide medication administration, assistance or medication assistance, or
237.29medication management administration according to this chapter;
237.30(2) monitor health conditions according to written instructions from the person's
237.31physician or a licensed health professional;
237.32(3) assist with or coordinate medical, dental, and other health service appointments; or
238.1(4) use medical equipment, devices, or adaptive aides or technology safely and
238.2correctly according to written instructions from the person's physician or a licensed
238.3health professional.
238.4    Subd. 1a. Medication setup. For the purposes of this subdivision, "medication
238.5setup" means the arranging of medications according to instructions from the pharmacy,
238.6the prescriber, or a licensed nurse, for later administration when the license holder
238.7is assigned responsibility for medication assistance or medication administration in
238.8the coordinated service and support plan or the coordinated service and support plan
238.9addendum. A prescription label or the prescriber's written or electronically recorded order
238.10for the prescription is sufficient to constitute written instructions from the prescriber. The
238.11license holder must document in the person's medication administration record: dates
238.12of setup, name of medication, quantity of dose, times to be administered, and route of
238.13administration at time of setup; and, when the person will be away from home, to whom
238.14the medications were given.
238.15    Subd. 1b. Medication assistance. If responsibility for medication assistance
238.16is assigned to the license holder in the coordinated service and support plan or the
238.17coordinated service and support plan addendum, the license holder must ensure that
238.18the requirements of subdivision 2, paragraph (b), have been met when staff provides
238.19medication assistance to enable a person to self-administer medication or treatment when
238.20the person is capable of directing the person's own care, or when the person's legal
238.21representative is present and able to direct care for the person. For the purposes of this
238.22subdivision, "medication assistance" means any of the following:
238.23(1) bringing to the person and opening a container of previously set up medications,
238.24emptying the container into the person's hand, or opening and giving the medications in
238.25the original container to the person;
238.26(2) bringing to the person liquids or food to accompany the medication; or
238.27(3) providing reminders to take regularly scheduled medication or perform regularly
238.28scheduled treatments and exercises.
238.29    Subd. 2. Medication administration. (a) If responsibility for medication
238.30administration is assigned to the license holder in the coordinated service and support plan
238.31or the coordinated service and support plan addendum, the license holder must implement
238.32the following medication administration procedures to ensure a person takes medications
238.33and treatments as prescribed:
238.34(1) checking the person's medication record;
238.35(2) preparing the medication as necessary;
238.36(3) administering the medication or treatment to the person;
239.1(4) documenting the administration of the medication or treatment or the reason for
239.2not administering the medication or treatment; and
239.3(5) reporting to the prescriber or a nurse any concerns about the medication or
239.4treatment, including side effects, effectiveness, or a pattern of the person refusing to
239.5take the medication or treatment as prescribed. Adverse reactions must be immediately
239.6reported to the prescriber or a nurse.
239.7(b)(1) The license holder must ensure that the following criteria requirements in
239.8clauses (2) to (4) have been met before staff that is not a licensed health professional
239.9administers administering medication or treatment:.
239.10(1) (2) The license holder must obtain written authorization has been obtained from
239.11the person or the person's legal representative to administer medication or treatment
239.12orders; and must obtain reauthorization annually as needed. If the person or the person's
239.13legal representative refuses to authorize the license holder to administer medication, the
239.14medication must not be administered. The refusal to authorize medication administration
239.15must be reported to the prescriber as expediently as possible.
239.16(2) (3) The staff person has completed responsible for administering the medication
239.17or treatment must complete medication administration training according to section
239.18245D.09, subdivision 4 , paragraph 4a, paragraphs (a) and (c), clause (2); and, as applicable
239.19to the person, paragraph (d).
239.20(3) The medication or treatment will be administered under administration
239.21procedures established for the person in consultation with a licensed health professional.
239.22written instruction from the person's physician may constitute the medication
239.23administration procedures. A prescription label or the prescriber's order for the
239.24prescription is sufficient to constitute written instructions from the prescriber. A licensed
239.25health professional may delegate medication administration procedures.
239.26(4) For a license holder providing intensive support services, the medication or
239.27treatment must be administered according to the license holder's medication administration
239.28policy and procedures as required under section 245D.11, subdivision 2, clause (3).
239.29(b) (c) The license holder must ensure the following information is documented in
239.30the person's medication administration record:
239.31(1) the information on the current prescription label or the prescriber's current written
239.32or electronically recorded order or prescription that includes directions for the person's
239.33name, description of the medication or treatment to be provided, and the frequency and
239.34other information needed to safely and correctly administering administer the medication
239.35or treatment to ensure effectiveness;
240.1(2) information on any discomforts, risks, or other side effects that are reasonable to
240.2expect, and any contraindications to its use. This information must be readily available
240.3to all staff administering the medication;
240.4(3) the possible consequences if the medication or treatment is not taken or
240.5administered as directed;
240.6(4) instruction from the prescriber on when and to whom to report the following:
240.7(i) if the a dose of medication or treatment is not administered or treatment is not
240.8performed as prescribed, whether by error by the staff or the person or by refusal by
240.9the person; and
240.10(ii) the occurrence of possible adverse reactions to the medication or treatment;
240.11(5) notation of any occurrence of a dose of medication not being administered or
240.12treatment not performed as prescribed, whether by error by the staff or the person or by
240.13refusal by the person, or of adverse reactions, and when and to whom the report was
240.14made; and
240.15(6) notation of when a medication or treatment is started, administered, changed, or
240.16discontinued.
240.17(c) The license holder must ensure that the information maintained in the medication
240.18administration record is current and is regularly reviewed with the person or the person's
240.19legal representative and the staff administering the medication to identify medication
240.20administration issues or errors. At a minimum, the review must be conducted every three
240.21months or more often if requested by the person or the person's legal representative.
240.22Based on the review, the license holder must develop and implement a plan to correct
240.23medication administration issues or errors. If issues or concerns are identified related to
240.24the medication itself, the license holder must report those as required under subdivision 4.
240.25    Subd. 3. Medication assistance. The license holder must ensure that the
240.26requirements of subdivision 2, paragraph (a), have been met when staff provides assistance
240.27to enable a person to self-administer medication when the person is capable of directing
240.28the person's own care, or when the person's legal representative is present and able to
240.29direct care for the person.
240.30    Subd. 4. Reviewing and reporting medication and treatment issues. The
240.31following medication administration issues must be reported to the person or the person's
240.32legal representative and case manager as they occur or following timelines established
240.33in the person's service plan or as requested in writing by the person or the person's legal
240.34representative, or the case manager: (a) When assigned responsibility for medication
240.35administration, the license holder must ensure that the information maintained in
240.36the medication administration record is current and is regularly reviewed to identify
241.1medication administration errors. At a minimum, the review must be conducted every
241.2three months, or more frequently as directed in the coordinated service and support plan
241.3or coordinated service and support plan addendum or as requested by the person or the
241.4person's legal representative. Based on the review, the license holder must develop and
241.5implement a plan to correct patterns of medication administration errors when identified.
241.6(b) If assigned responsibility for medication assistance or medication administration,
241.7the license holder must report the following to the person's legal representative and case
241.8manager as they occur or as otherwise directed in the coordinated service and support plan
241.9or the coordinated service and support plan addendum:
241.10(1) any reports made to the person's physician or prescriber required under
241.11subdivision 2, paragraph (b) (c), clause (4);
241.12(2) a person's refusal or failure to take or receive medication or treatment as
241.13prescribed; or
241.14(3) concerns about a person's self-administration of medication or treatment.
241.15    Subd. 5. Injectable medications. Injectable medications may be administered
241.16according to a prescriber's order and written instructions when one of the following
241.17conditions has been met:
241.18(1) a registered nurse or licensed practical nurse will administer the subcutaneous or
241.19intramuscular injection;
241.20(2) a supervising registered nurse with a physician's order has delegated the
241.21administration of subcutaneous injectable medication to an unlicensed staff member
241.22and has provided the necessary training; or
241.23(3) there is an agreement signed by the license holder, the prescriber, and the
241.24person or the person's legal representative specifying what subcutaneous injections may
241.25be given, when, how, and that the prescriber must retain responsibility for the license
241.26holder's giving the injections. A copy of the agreement must be placed in the person's
241.27service recipient record.
241.28Only licensed health professionals are allowed to administer psychotropic
241.29medications by injection.
241.30EFFECTIVE DATE.This section is effective January 1, 2014.

241.31    Sec. 21. [245D.051] PSYCHOTROPIC MEDICATION USE AND
241.32MONITORING.
241.33    Subdivision 1. Conditions for psychotropic medication administration. (a)
241.34When a person is prescribed a psychotropic medication and the license holder is assigned
241.35responsibility for administration of the medication in the person's coordinated service
242.1and support plan or the coordinated service and support plan addendum, the license
242.2holder must ensure that the requirements in paragraphs (b) to (d) and section 245D.05,
242.3subdivision 2, are met.
242.4(b) Use of the medication must be included in the person's coordinated service and
242.5support plan or in the coordinated service and support plan addendum and based on a
242.6prescriber's current written or electronically recorded prescription.
242.7(c) The license holder must develop, implement, and maintain the following
242.8documentation in the person's coordinated service and support plan addendum according
242.9to the requirements in sections 245D.07 and 245D.071:
242.10(1) a description of the target symptoms that the psychotropic medication is to
242.11alleviate; and
242.12(2) documentation methods the license holder will use to monitor and measure
242.13changes in the target symptoms that are to be alleviated by the psychotropic medication if
242.14required by the prescriber. The license holder must collect and report on medication and
242.15symptom-related data as instructed by the prescriber. The license holder must provide
242.16the monitoring data to the expanded support team for review every three months, or as
242.17otherwise requested by the person or the person's legal representative.
242.18For the purposes of this section, "target symptom" refers to any perceptible
242.19diagnostic criteria for a person's diagnosed mental disorder as defined by the Diagnostic
242.20and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) or
242.21successive editions that has been identified for alleviation.
242.22(d) If a person is prescribed a psychotropic medication, monitoring the use of the
242.23psychotropic medication must be assigned to the license holder in the coordinated service
242.24and support plan or the coordinated service and support plan addendum. The assigned
242.25license holder must monitor the psychotropic medication as required by this section.
242.26    Subd. 2. Refusal to authorize psychotropic medication. If the person or the
242.27person's legal representative refuses to authorize the administration of a psychotropic
242.28medication as ordered by the prescriber, the license holder must follow the requirement
242.29in section 245D.05, subdivision 2, paragraph (b), clause (2). After reporting the refusal
242.30to the prescriber, the license holder must follow any directives or orders given by the
242.31prescriber. A court order must be obtained to override the refusal. Refusal to authorize
242.32administration of a specific psychotropic medication is not grounds for service termination
242.33and does not constitute an emergency. A decision to terminate services must be reached in
242.34compliance with section 245D.10, subdivision 3.
242.35EFFECTIVE DATE.This section is effective January 1, 2014.

243.1    Sec. 22. Minnesota Statutes 2012, section 245D.06, is amended to read:
243.2245D.06 PROTECTION STANDARDS.
243.3    Subdivision 1. Incident response and reporting. (a) The license holder must
243.4respond to all incidents under section 245D.02, subdivision 11, that occur while providing
243.5services to protect the health and safety of and minimize risk of harm to the person.
243.6(b) The license holder must maintain information about and report incidents to the
243.7person's legal representative or designated emergency contact and case manager within 24
243.8hours of an incident occurring while services are being provided, or within 24 hours of
243.9discovery or receipt of information that an incident occurred, unless the license holder
243.10has reason to know that the incident has already been reported, or as otherwise directed
243.11in a person's coordinated service and support plan or coordinated service and support
243.12plan addendum. An incident of suspected or alleged maltreatment must be reported as
243.13required under paragraph (d), and an incident of serious injury or death must be reported
243.14as required under paragraph (e).
243.15(c) When the incident involves more than one person, the license holder must not
243.16disclose personally identifiable information about any other person when making the report
243.17to each person and case manager unless the license holder has the consent of the person.
243.18(d) Within 24 hours of reporting maltreatment as required under section 626.556
243.19or 626.557, the license holder must inform the case manager of the report unless there is
243.20reason to believe that the case manager is involved in the suspected maltreatment. The
243.21license holder must disclose the nature of the activity or occurrence reported and the
243.22agency that received the report.
243.23(e) The license holder must report the death or serious injury of the person to the legal
243.24representative, if any, and case manager, as required in paragraph (b) and to the Department
243.25of Human Services Licensing Division, and the Office of Ombudsman for Mental Health
243.26and Developmental Disabilities as required under section 245.94, subdivision 2a, within
243.2724 hours of the death, or receipt of information that the death occurred, unless the license
243.28holder has reason to know that the death has already been reported.
243.29(f) When a death or serious injury occurs in a facility certified as an intermediate
243.30care facility for persons with developmental disabilities, the death or serious injury must
243.31be reported to the Department of Health, Office of Health Facility Complaints, and the
243.32Office of Ombudsman for Mental Health and Developmental Disabilities, as required
243.33under sections 245.91 and 245.94, subdivision 2a, unless the license holder has reason to
243.34know that the death has already been reported.
243.35(f) (g) The license holder must conduct a an internal review of incident reports of
243.36deaths and serious injuries that occurred while services were being provided and that
244.1were not reported by the program as alleged or suspected maltreatment, for identification
244.2of incident patterns, and implementation of corrective action as necessary to reduce
244.3occurrences. The review must include an evaluation of whether related policies and
244.4procedures were followed, whether the policies and procedures were adequate, whether
244.5there is a need for additional staff training, whether the reported event is similar to past
244.6events with the persons or the services involved, and whether there is a need for corrective
244.7action by the license holder to protect the health and safety of persons receiving services.
244.8Based on the results of this review, the license holder must develop, document, and
244.9implement a corrective action plan designed to correct current lapses and prevent future
244.10lapses in performance by staff or the license holder, if any.
244.11(h) The license holder must verbally report the emergency use of manual restraint of
244.12a person as required in paragraph (b), within 24 hours of the occurrence. The license holder
244.13must ensure the written report and internal review of all incident reports of the emergency
244.14use of manual restraints are completed according to the requirements in section 245D.061.
244.15    Subd. 2. Environment and safety. The license holder must:
244.16(1) ensure the following when the license holder is the owner, lessor, or tenant
244.17of the an unlicensed service site:
244.18(i) the service site is a safe and hazard-free environment;
244.19(ii) doors are locked or toxic substances or dangerous items normally accessible are
244.20inaccessible to persons served by the program are stored in locked cabinets, drawers, or
244.21containers only to protect the safety of a person receiving services and not as a substitute
244.22for staff supervision or interactions with a person who is receiving services. If doors are
244.23locked or toxic substances or dangerous items normally accessible to persons served by the
244.24program are stored in locked cabinets, drawers, or containers are made inaccessible, the
244.25license holder must justify and document how this determination was made in consultation
244.26with the person or person's legal representative, and how access will otherwise be provided
244.27to the person and all other affected persons receiving services; and document an assessment
244.28of the physical plant, its environment, and its population identifying the risk factors which
244.29require toxic substances or dangerous items to be inaccessible and a statement of specific
244.30measures to be taken to minimize the safety risk to persons receiving services;
244.31(iii) doors are locked from the inside to prevent a person from exiting only when
244.32necessary to protect the safety of a person receiving services and not as a substitute for
244.33staff supervision or interactions with the person. If doors are locked from the inside, the
244.34license holder must document an assessment of the physical plant, the environment and
244.35the population served, identifying the risk factors which require the use of locked doors,
245.1and a statement of specific measures to be taken to minimize the safety risk to persons
245.2receiving services at the service site; and
245.3(iii) (iv) a staff person is available on site who is trained in basic first aid and, when
245.4required in a person's coordinated service and support plan or coordinated service and
245.5support plan addendum, cardiopulmonary resuscitation, whenever persons are present and
245.6staff are required to be at the site to provide direct service. The training must include
245.7in-person instruction, hands-on practice, and an observed skills assessment under the
245.8direct supervision of a first aid instructor;
245.9(2) maintain equipment, vehicles, supplies, and materials owned or leased by the
245.10license holder in good condition when used to provide services;
245.11(3) follow procedures to ensure safe transportation, handling, and transfers of the
245.12person and any equipment used by the person, when the license holder is responsible for
245.13transportation of a person or a person's equipment;
245.14(4) be prepared for emergencies and follow emergency response procedures to
245.15ensure the person's safety in an emergency; and
245.16(5) follow universal precautions and sanitary practices, including hand washing, for
245.17infection prevention and control, and to prevent communicable diseases.
245.18    Subd. 3. Compliance with fire and safety codes. When services are provided at a
245.19 service site licensed according to chapter 245A or where the license holder is the owner,
245.20lessor, or tenant of the service site, the license holder must document compliance with
245.21applicable building codes, fire and safety codes, health rules, and zoning ordinances, or
245.22document that an appropriate waiver has been granted.
245.23    Subd. 4. Funds and property. (a) Whenever the license holder assists a person
245.24with the safekeeping of funds or other property according to section 245A.04, subdivision
245.2513 , the license holder must have obtain written authorization to do so from the person or
245.26the person's legal representative and the case manager. Authorization must be obtained
245.27within five working days of service initiation and renewed annually thereafter. At the time
245.28initial authorization is obtained, the license holder must survey, document, and implement
245.29the preferences of the person or the person's legal representative and the case manager
245.30for frequency of receiving a statement that itemizes receipts and disbursements of funds
245.31or other property. The license holder must document changes to these preferences when
245.32they are requested.
245.33(b) A license holder or staff person may not accept powers-of-attorney from a
245.34person receiving services from the license holder for any purpose, and may not accept an
245.35appointment as guardian or conservator of a person receiving services from the license
245.36holder. This does not apply to license holders that are Minnesota counties or other
246.1units of government or to staff persons employed by license holders who were acting
246.2as power-of-attorney, guardian, or conservator attorney-in-fact for specific individuals
246.3prior to April 23, 2012 implementation of this chapter. The license holder must maintain
246.4documentation of the power-of-attorney, guardianship, or conservatorship in the service
246.5recipient record.
246.6(c) Upon the transfer or death of a person, any funds or other property of the person
246.7must be surrendered to the person or the person's legal representative, or given to the
246.8executor or administrator of the estate in exchange for an itemized receipt.
246.9    Subd. 5. Prohibitions. (a) The license holder is prohibited from using psychotropic
246.10medication chemical restraints, mechanical restraint practices, manual restraints, time out,
246.11or seclusion as a substitute for adequate staffing, for a behavioral or therapeutic program
246.12to reduce or eliminate behavior, as punishment, or for staff convenience, or for any reason
246.13other than as prescribed.
246.14(b) The license holder is prohibited from using restraints or seclusion under any
246.15circumstance, unless the commissioner has approved a variance request from the license
246.16holder that allows for the emergency use of restraints and seclusion according to terms
246.17and conditions approved in the variance. Applicants and license holders who have
246.18reason to believe they may be serving an individual who will need emergency use of
246.19restraints or seclusion may request a variance on the application or reapplication, and
246.20the commissioner shall automatically review the request for a variance as part of the
246.21application or reapplication process. License holders may also request the variance any
246.22time after issuance of a license. In the event a license holder uses restraint or seclusion for
246.23any reason without first obtaining a variance as required, the license holder must report
246.24the unauthorized use of restraint or seclusion to the commissioner within 24 hours of the
246.25occurrence and request the required variance.
246.26(b) For the purposes of this subdivision, "chemical restraint" means the
246.27administration of a drug or medication to control the person's behavior or restrict the
246.28person's freedom of movement and is not a standard treatment of dosage for the person's
246.29medical or psychological condition.
246.30(c) For the purposes of this subdivision, "mechanical restraint practice" means the
246.31use of any adaptive equipment or safety device to control the person's behavior or restrict
246.32the person's freedom of movement and not as ordered by a licensed health professional.
246.33Mechanical restraint practices include, but are not limited to, the use of bed rails or similar
246.34devices on a bed to prevent the person from getting out of bed, chairs that prevent a person
246.35from rising, or placing a person in a wheelchair so close to a wall that the wall prevents
246.36the person from rising. Wrist bands or devices on clothing that trigger electronic alarms to
247.1warn staff that a person is leaving a room or area do not, in and of themselves, restrict
247.2freedom of movement and should not be considered restraints.
247.3(d) A license holder must not use manual restraints, time out, or seclusion under any
247.4circumstance, except for emergency use of manual restraints according to the requirements
247.5in section 245D.061 or the use of controlled procedures with a person with a developmental
247.6disability as governed by Minnesota Rules, parts 9525.2700 to 9525.2810, or its successor
247.7provisions. License holders implementing nonemergency use of manual restraint, or any
247.8other programmatic use of mechanical restraint, time out, or seclusion with persons who
247.9do not have a developmental disability that is not subject to the requirements of Minnesota
247.10Rules, parts 9525.2700 to 9525.2810, must submit a variance request to the commissioner
247.11for continued use of the procedure within three months of implementation of this chapter.
247.12EFFECTIVE DATE.This section is effective January 1, 2014.

247.13    Sec. 23. [245D.061] EMERGENCY USE OF MANUAL RESTRAINTS.
247.14    Subdivision 1. Standards for emergency use of manual restraints. Except
247.15for the emergency use of controlled procedures with a person with a developmental
247.16disability as governed by Minnesota Rules, part 9525.2770, or its successor provisions,
247.17the license holder must ensure that emergency use of manual restraints complies with the
247.18requirements of this chapter and the license holder's policy and procedures as required
247.19under subdivision 10.
247.20    Subd. 2. Definitions. (a) The terms used in this section have the meaning given
247.21them in this subdivision.
247.22(b) "Manual restraint" means physical intervention intended to hold a person
247.23immobile or limit a person's voluntary movement by using body contact as the only source
247.24of physical restraint.
247.25(c) "Mechanical restraint" means the use of devices, materials, or equipment attached
247.26or adjacent to the person's body, or the use of practices which restrict freedom of movement
247.27or normal access to one's body or body parts, or limits a person's voluntary movement
247.28or holds a person immobile as an intervention precipitated by a person's behavior. The
247.29term does apply to mechanical restraint used to prevent injury with persons who engage in
247.30self-injurious behaviors, such as head-banging, gouging, or other actions resulting in tissue
247.31damage that have caused or could cause medical problems resulting from the self-injury.
247.32    Subd. 3. Conditions for emergency use of manual restraint. Emergency use of
247.33manual restraint must meet the following conditions:
247.34(1) immediate intervention must be needed to protect the person or others from
247.35imminent risk of physical harm; and
248.1(2) the type of manual restraint used must be the least restrictive intervention to
248.2eliminate the immediate risk of harm and effectively achieve safety. The manual restraint
248.3must end when the threat of harm ends.
248.4    Subd. 4. Permitted instructional techniques and therapeutic conduct. (a) Use of
248.5physical contact as therapeutic conduct or as an instructional technique as identified in
248.6paragraphs (b) and (c), is permitted and is not subject to the requirements of this section
248.7when such use is addressed in a person's coordinated service and support plan addendum
248.8and the required conditions have been met. For the purposes of this subdivision,
248.9"therapeutic conduct" has the meaning given in section 626.5572, subdivision 20.
248.10(b) Physical contact or instructional techniques must use the least restrictive
248.11alternative possible to meet the needs of the person and may be used:
248.12(1) to calm or comfort a person by holding that person with no resistance from
248.13that person;
248.14(2) to protect a person known to be at risk of injury due to frequent falls as a result of
248.15a medical condition; or
248.16(3) to position a person with physical disabilities in a manner specified in the
248.17person's coordinated service and support plan addendum.
248.18(c) Restraint may be used as therapeutic conduct:
248.19(1) to allow a licensed health care professional to safely conduct a medical
248.20examination or to provide medical treatment ordered by a licensed health care professional
248.21to a person necessary to promote healing or recovery from an acute, meaning short-term,
248.22medical condition;
248.23(2) to facilitate the person's completion of a task or response when the person does
248.24not resist or the person's resistance is minimal in intensity and duration;
248.25(3) to briefly block or redirect a person's limbs or body without holding the person
248.26or limiting the person's movement to interrupt the person's behavior that may result in
248.27injury to self or others; or
248.28(4) to assist in the safe evacuation of a person in the event of an emergency or to
248.29redirect a person who is at imminent risk of harm in a dangerous situation.
248.30(d) A plan for using restraint as therapeutic conduct must be developed according to
248.31the requirements in sections 245D.07 and 245D.071, and must include methods to reduce
248.32or eliminate the use of and need for restraint.
248.33    Subd. 5. Restrictions when implementing emergency use of manual restraint.
248.34(a) Emergency use of manual restraint procedures must not:
248.35(1) be implemented with a child in a manner that constitutes sexual abuse, neglect,
248.36physical abuse, or mental injury, as defined in section 626.556, subdivision 2;
249.1(2) be implemented with an adult in a manner that constitutes abuse or neglect as
249.2defined in section 626.5572, subdivisions 2 and 17;
249.3(3) be implemented in a manner that violates a person's rights and protections
249.4identified in section 245D.04;
249.5(4) restrict a person's normal access to a nutritious diet, drinking water, adequate
249.6ventilation, necessary medical care, ordinary hygiene facilities, normal sleeping
249.7conditions, or necessary clothing, or to any protection required by state licensing standards
249.8and federal regulations governing the program;
249.9(5) deny the person visitation or ordinary contact with legal counsel, a legal
249.10representative, or next of kin;
249.11(6) be used as a substitute for adequate staffing, for the convenience of staff, as
249.12punishment, or as a consequence if the person refuses to participate in the treatment
249.13or services provided by the program; or
249.14(7) use prone restraint. For the purposes of this section, "prone restraint" means use
249.15of manual restraint that places a person in a face-down position. This does not include
249.16brief physical holding of a person who, during an emergency use of manual restraint, rolls
249.17into a prone position, and the person is restored to a standing, sitting, or side-lying position
249.18as quickly as possible. Applying back or chest pressure while a person is in the prone or
249.19supine position or face-up is prohibited.
249.20    Subd. 6. Monitoring emergency use of manual restraint. The license holder shall
249.21monitor a person's health and safety during an emergency use of a manual restraint. Staff
249.22monitoring the procedure must not be the staff implementing the procedure when possible.
249.23The license holder shall complete a monitoring form, approved by the commissioner, for
249.24each incident involving the emergency use of a manual restraint.
249.25    Subd. 7. Reporting emergency use of manual restraint incident. (a) Within
249.26three calendar days after an emergency use of a manual restraint, the staff person who
249.27implemented the emergency use must report in writing to the designated coordinator the
249.28following information about the emergency use:
249.29(1) the staff and persons receiving services who were involved in the incident
249.30leading up to the emergency use of manual restraint;
249.31(2) a description of the physical and social environment, including who was present
249.32before and during the incident leading up to the emergency use of manual restraint;
249.33(3) a description of what less restrictive alternative measures were attempted to
249.34de-escalate the incident and maintain safety before the manual restraint was implemented
249.35that identifies when, how, and how long the alternative measures were attempted before
249.36manual restraint was implemented;
250.1(4) a description of the mental, physical, and emotional condition of the person who
250.2was restrained, and other persons involved in the incident leading up to, during, and
250.3following the manual restraint;
250.4(5) whether there was any injury to the person who was restrained or other persons
250.5involved in the incident, including staff, before or as a result of the use of manual
250.6restraint; and
250.7(6) whether there was an attempt to debrief with the staff, and, if not contraindicated,
250.8with the person who was restrained and other persons who were involved in or who
250.9witnessed the restraint, following the incident and the outcome of the debriefing. If the
250.10debriefing was not conducted at the time the incident report was made, the report should
250.11identify whether a debriefing is planned.
250.12(b) Each single incident of emergency use of manual restraint must be reported
250.13separately. For the purposes of this subdivision, an incident of emergency use of manual
250.14restraint is a single incident when the following conditions have been met:
250.15(1) after implementing the manual restraint, staff attempt to release the person at the
250.16moment staff believe the person's conduct no longer poses an imminent risk of physical
250.17harm to self or others and less restrictive strategies can be implemented to maintain safety;
250.18(2) upon the attempt to release the restraint, the person's behavior immediately
250.19re-escalates; and
250.20(3) staff must immediately reimplement the restraint in order to maintain safety.
250.21    Subd. 8. Internal review of emergency use of manual restraint. (a) Within five
250.22working days of the emergency use of manual restraint, the license holder must complete
250.23an internal review of each report of emergency use of manual restraint. The review must
250.24include an evaluation of whether:
250.25(1) the person's service and support strategies developed according to sections
250.26245D.07 and 245D.071 need to be revised;
250.27(2) related policies and procedures were followed;
250.28(3) the policies and procedures were adequate;
250.29(4) there is a need for additional staff training;
250.30(5) the reported event is similar to past events with the persons, staff, or the services
250.31involved; and
250.32(6) there is a need for corrective action by the license holder to protect the health
250.33and safety of persons.
250.34(b) Based on the results of the internal review, the license holder must develop,
250.35document, and implement a corrective action plan for the program designed to correct
250.36current lapses and prevent future lapses in performance by individuals or the license
251.1holder, if any. The corrective action plan, if any, must be implemented within 30 days of
251.2the internal review being completed.
251.3    Subd. 9. Expanded support team review. (a) Within five working days after the
251.4completion of the internal review required in subdivision 8, the license holder must consult
251.5with the expanded support team following the emergency use of manual restraint to:
251.6(1) discuss the incident reported in subdivision 7, to define the antecedent or event
251.7that gave rise to the behavior resulting in the manual restraint and identify the perceived
251.8function the behavior served; and
251.9(2) determine whether the person's coordinated service and support plan addendum
251.10needs to be revised according to sections 245D.07 and 245D.071 to positively and
251.11effectively help the person maintain stability and to reduce or eliminate future occurrences
251.12requiring emergency use of manual restraint.
251.13    Subd. 10. Emergency use of manual restraints policy and procedures. The
251.14license holder must develop, document, and implement a policy and procedures that
251.15promote service recipient rights and protect health and safety during the emergency use of
251.16manual restraints. The policy and procedures must comply with the requirements of this
251.17section and must specify the following:
251.18(1) a description of the positive support strategies and techniques staff must use to
251.19attempt to de-escalate a person's behavior before it poses an imminent risk of physical
251.20harm to self or others;
251.21(2) a description of the types of manual restraints the license holder allows staff to
251.22use on an emergency basis, if any. If the license holder will not allow the emergency use
251.23of manual restraint, the policy and procedure must identify the alternative measures the
251.24license holder will require staff to use when a person's conduct poses an imminent risk of
251.25physical harm to self or others and less restrictive strategies would not achieve safety;
251.26(3) instructions for safe and correct implementation of the allowed manual restraint
251.27procedures;
251.28(4) the training that staff must complete and the timelines for completion, before they
251.29may implement an emergency use of manual restraint. In addition to the training on this
251.30policy and procedure and the orientation and annual training required in section 245D.09,
251.31subdivision 4, the training for emergency use of manual restraint must incorporate the
251.32following subjects:
251.33(i) alternatives to manual restraint procedures, including techniques to identify
251.34events and environmental factors that may escalate conduct that poses an imminent risk of
251.35physical harm to self or others;
252.1(ii) de-escalation methods, positive support strategies, and how to avoid power
252.2struggles;
252.3(iii) simulated experiences of administering and receiving manual restraint
252.4procedures allowed by the license holder on an emergency basis;
252.5(iv) how to properly identify thresholds for implementing and ceasing restrictive
252.6procedures;
252.7(v) how to recognize, monitor, and respond to the person's physical signs of distress,
252.8including positional asphyxia;
252.9(vi) the physiological and psychological impact on the person and the staff when
252.10restrictive procedures are used;
252.11(vii) the communicative intent of behaviors; and
252.12(viii) relationship building;
252.13(5) the procedures and forms to be used to monitor the emergency use of manual
252.14restraints, including what must be monitored and the frequency of monitoring per
252.15each incident of emergency use of manual restraint, and the person or position who is
252.16responsible for monitoring the use;
252.17(6) the instructions, forms, and timelines required for completing and submitting an
252.18incident report by the person or persons who implemented the manual restraint; and
252.19(7) the procedures and timelines for conducting the internal review and the expanded
252.20support team review, and the person or position responsible for completing the reviews and
252.21who is responsible for ensuring that corrective action is taken or the person's coordinated
252.22service and support plan addendum is revised, when determined necessary.
252.23EFFECTIVE DATE.This section is effective January 1, 2014.

252.24    Sec. 24. Minnesota Statutes 2012, section 245D.07, is amended to read:
252.25245D.07 SERVICE NEEDS PLANNING AND DELIVERY.
252.26    Subdivision 1. Provision of services. The license holder must provide services as
252.27specified assigned in the coordinated service and support plan and assigned to the license
252.28holder. The provision of services must comply with the requirements of this chapter and
252.29the federal waiver plans.
252.30    Subd. 1a. Person-centered planning and service delivery. (a) The license holder
252.31must provide services in response to the person's identified needs, interests, preferences,
252.32and desired outcomes as specified in the coordinated service and support plan, the
252.33coordinated service and support plan addendum, and in compliance with the requirements
253.1of this chapter. License holders providing intensive support services must also provide
253.2outcome-based services according to the requirements in section 245D.071.
253.3(b) Services must be provided in a manner that supports the person's preferences,
253.4daily needs, and activities and accomplishment of the person's personal goals and service
253.5outcomes, consistent with the principles of:
253.6(1) person-centered service planning and delivery that:
253.7(i) identifies and supports what is important to the person as well as what is
253.8important for the person, including preferences for when, how, and by whom direct
253.9support service is provided;
253.10(ii) uses that information to identify outcomes the person desires; and
253.11(iii) respects each person's history, dignity, and cultural background;
253.12(2) self-determination that supports and provides:
253.13(i) opportunities for the development and exercise of functional and age-appropriate
253.14skills, decision making and choice, personal advocacy, and communication; and
253.15(ii) the affirmation and protection of each person's civil and legal rights;
253.16(3) providing the most integrated setting and inclusive service delivery that supports,
253.17promotes, and allows:
253.18(i) inclusion and participation in the person's community as desired by the person
253.19in a manner that enables the person to interact with nondisabled persons to the fullest
253.20extent possible and supports the person in developing and maintaining a role as a valued
253.21community member;
253.22(ii) opportunities for self-sufficiency as well as developing and maintaining social
253.23relationships and natural supports; and
253.24(iii) a balance between risk and opportunity, meaning the least restrictive supports or
253.25interventions necessary are provided in the most integrated settings in the most inclusive
253.26manner possible to support the person to engage in activities of the person's own choosing
253.27that may otherwise present a risk to the person's health, safety, or rights.
253.28    Subd. 2. Service planning requirements for basic support services. (a) License
253.29holders providing basic support services must meet the requirements of this subdivision.
253.30(b) Within 15 days of service initiation the license holder must complete a
253.31preliminary coordinated service and support plan addendum based on the coordinated
253.32service and support plan.
253.33(c) Within 60 days of service initiation the license holder must review and revise as
253.34needed the preliminary coordinated service and support plan addendum to document the
253.35services that will be provided including how, when, and by whom services will be provided,
253.36and the person responsible for overseeing the delivery and coordination of services.
254.1(d) The license holder must participate in service planning and support team
254.2meetings related to for the person following stated timelines established in the person's
254.3 coordinated service and support plan or as requested by the support team, the person, or
254.4the person's legal representative, the support team or the expanded support team.
254.5    Subd. 3. Reports. The license holder must provide written reports regarding the
254.6person's progress or status as requested by the person, the person's legal representative, the
254.7case manager, or the team.
254.8EFFECTIVE DATE.This section is effective January 1, 2014.

254.9    Sec. 25. [245D.071] SERVICE PLANNING AND DELIVERY; INTENSIVE
254.10SUPPORT SERVICES.
254.11    Subdivision 1. Requirements for intensive support services. A license holder
254.12providing intensive support services identified in section 245D.03, subdivision 1,
254.13paragraph (c), must comply with the requirements in section 245D.07, subdivisions 1
254.14and 3, and this section.
254.15    Subd. 2. Abuse prevention. Prior to or upon initiating services, the license holder
254.16must develop, document, and implement an abuse prevention plan according to section
254.17245A.65, subdivision 2.
254.18    Subd. 3. Assessment and initial service planning. (a) Within 15 days of service
254.19initiation the license holder must complete a preliminary coordinated service and support
254.20plan addendum based on the coordinated service and support plan.
254.21(b) Within 45 days of service initiation the license holder must meet with the person,
254.22the person's legal representative, the case manager, and other members of the support team
254.23or expanded support team to assess and determine the following based on the person's
254.24coordinated service and support plan and the requirements in subdivision 4 and section
254.25245D.07, subdivision 1a:
254.26(1) the scope of the services to be provided to support the person's daily needs
254.27and activities;
254.28(2) the person's desired outcomes and the supports necessary to accomplish the
254.29person's desired outcomes;
254.30(3) the person's preferences for how services and supports are provided;
254.31(4) whether the current service setting is the most integrated setting available and
254.32appropriate for the person; and
254.33(5) how services must be coordinated across other providers licensed under this
254.34chapter serving the same person to ensure continuity of care for the person.
255.1(c) Within the scope of services, the license holder must, at a minimum, assess
255.2the following areas:
255.3(1) the person's ability to self-manage health and medical needs to maintain or
255.4improve physical, mental, and emotional well-being, including, when applicable, allergies,
255.5seizures, choking, special dietary needs, chronic medical conditions, self-administration
255.6of medication or treatment orders, preventative screening, and medical and dental
255.7appointments;
255.8(2) the person's ability to self-manage personal safety to avoid injury or accident in
255.9the service setting, including, when applicable, risk of falling, mobility, regulating water
255.10temperature, community survival skills, water safety skills, and sensory disabilities; and
255.11(3) the person's ability to self-manage symptoms or behavior that may otherwise
255.12result in an incident as defined in section 245D.02, subdivision 11, clauses (4) to
255.13(7), suspension or termination of services by the license holder, or other symptoms
255.14or behaviors that may jeopardize the health and safety of the person or others. The
255.15assessments must produce information about the person that is descriptive of the person's
255.16overall strengths, functional skills and abilities, and behaviors or symptoms.
255.17    Subd. 4. Service outcomes and supports. (a) Within ten working days of the
255.1845-day meeting, the license holder must develop and document the service outcomes and
255.19supports based on the assessments completed under subdivision 3 and the requirements
255.20in section 245D.07, subdivision 1a. The outcomes and supports must be included in the
255.21coordinated service and support plan addendum.
255.22(b) The license holder must document the supports and methods to be implemented
255.23to support the accomplishment of outcomes related to acquiring, retaining, or improving
255.24skills. The documentation must include:
255.25(1) the methods or actions that will be used to support the person and to accomplish
255.26the service outcomes, including information about:
255.27(i) any changes or modifications to the physical and social environments necessary
255.28when the service supports are provided;
255.29(ii) any equipment and materials required; and
255.30(iii) techniques that are consistent with the person's communication mode and
255.31learning style;
255.32(2) the measurable and observable criteria for identifying when the desired outcome
255.33has been achieved and how data will be collected;
255.34(3) the projected starting date for implementing the supports and methods and
255.35the date by which progress towards accomplishing the outcomes will be reviewed and
255.36evaluated; and
256.1(4) the names of the staff or position responsible for implementing the supports
256.2and methods.
256.3(c) Within 20 working days of the 45-day meeting, the license holder must obtain
256.4dated signatures from the person or the person's legal representative and case manager
256.5to document completion and approval of the assessment and coordinated service and
256.6support plan addendum.
256.7    Subd. 5. Progress reviews. (a) The license holder must give the person or the
256.8person's legal representative and case manager an opportunity to participate in the ongoing
256.9review and development of the methods used to support the person and accomplish
256.10outcomes identified in subdivisions 3 and 4. The license holder, in coordination with
256.11the person's support team or expanded support team, must meet with the person, the
256.12person's legal representative, and the case manager, and participate in progress review
256.13meetings following stated timelines established in the person's coordinated service and
256.14support plan or coordinated service and support plan addendum or within 30 days of a
256.15written request by the person, the person's legal representative, or the case manager,
256.16at a minimum of once per year.
256.17(b) The license holder must summarize the person's progress toward achieving the
256.18identified outcomes and make recommendations and identify the rationale for changing,
256.19continuing, or discontinuing implementation of supports and methods identified in
256.20subdivision 4 in a written report sent to the person or the person's legal representative
256.21and case manager five working days prior to the review meeting, unless the person, the
256.22person's legal representative, or the case manager request to receive the report at the
256.23time of the meeting.
256.24(c) Within ten working days of the progress review meeting, the license holder
256.25must obtain dated signatures from the person or the person's legal representative and
256.26the case manager to document approval of any changes to the coordinated service and
256.27support plan addendum.
256.28EFFECTIVE DATE.This section is effective January 1, 2014.

256.29    Sec. 26. [245D.081] PROGRAM COORDINATION, EVALUATION, AND
256.30OVERSIGHT.
256.31    Subdivision 1. Program coordination and evaluation. (a) The license holder
256.32is responsible for:
256.33(1) coordination of service delivery and evaluation for each person served by the
256.34program as identified in subdivision 2; and
257.1(2) program management and oversight that includes evaluation of the program
257.2quality and program improvement for services provided by the license holder as identified
257.3in subdivision 3.
257.4(b) The same person may perform the functions in paragraph (a) if the work and
257.5education qualifications are met in subdivisions 2 and 3.
257.6    Subd. 2. Coordination and evaluation of individual service delivery. (a) Delivery
257.7and evaluation of services provided by the license holder must be coordinated by a
257.8designated staff person. The designated coordinator must provide supervision, support,
257.9and evaluation of activities that include:
257.10(1) oversight of the license holder's responsibilities assigned in the person's
257.11coordinated service and support plan and the coordinated service and support plan
257.12addendum;
257.13(2) taking the action necessary to facilitate the accomplishment of the outcomes
257.14according to the requirements in section 245D.07;
257.15(3) instruction and assistance to direct support staff implementing the coordinated
257.16service and support plan and the service outcomes, including direct observation of service
257.17delivery sufficient to assess staff competency; and
257.18(4) evaluation of the effectiveness of service delivery, methodologies, and progress on
257.19the person's outcomes based on the measurable and observable criteria for identifying when
257.20the desired outcome has been achieved according to the requirements in section 245D.07.
257.21(b) The license holder must ensure that the designated coordinator is competent to
257.22perform the required duties identified in paragraph (a) through education and training in
257.23human services and disability-related fields, and work experience in providing direct care
257.24services and supports to persons with disabilities. The designated coordinator must have
257.25the skills and ability necessary to develop effective plans and to design and use data
257.26systems to measure effectiveness of services and supports. The license holder must verify
257.27and document competence according to the requirements in section 245D.09, subdivision
257.283. The designated coordinator must minimally have:
257.29(1) a baccalaureate degree in a field related to human services, and one year of
257.30full-time work experience providing direct care services to persons with disabilities or
257.31persons age 65 and older;
257.32(2) an associate degree in a field related to human services, and two years of
257.33full-time work experience providing direct care services to persons with disabilities or
257.34persons age 65 and older;
258.1(3) a diploma in a field related to human services from an accredited postsecondary
258.2institution and three years of full-time work experience providing direct care services to
258.3persons with disabilities or persons age 65 and older; or
258.4(4) a minimum of 50 hours of education and training related to human services
258.5and disabilities, and
258.6four years of full-time work experience providing direct care services to persons
258.7with disabilities or persons age 65 and older under the supervision of a staff person who
258.8meets the qualifications identified in clauses (1) to (3).
258.9    Subd. 3. Program management and oversight. (a) The license holder must
258.10designate a managerial staff person or persons to provide program management and
258.11oversight of the services provided by the license holder. The designated manager is
258.12responsible for the following:
258.13(1) maintaining a current understanding of the licensing requirements sufficient to
258.14ensure compliance throughout the program as identified in section 245A.04, subdivision
258.151, paragraph (e), and when applicable, as identified in section 256B.04, subdivision 21,
258.16paragraph (b);
258.17(2) ensuring the duties of the designated coordinator are fulfilled according to the
258.18requirements in subdivision 2;
258.19(3) ensuring the program implements corrective action identified as necessary
258.20by the program following review of incident and emergency reports according to the
258.21requirements in section 245D.11, subdivision 2, clause (7). An internal review of
258.22incident reports of alleged or suspected maltreatment must be conducted according to the
258.23requirements in section 245A.65, subdivision 1, paragraph (b);
258.24(4) evaluation of satisfaction of persons served by the program, the person's legal
258.25representative, if any, and the case manager, with the service delivery and progress
258.26towards accomplishing outcomes identified in sections 245D.07 and 245D.071, and
258.27ensuring and protecting each person's rights as identified in section 245D.04;
258.28(5) ensuring staff competency requirements are met according to the requirements in
258.29section 245D.09, subdivision 3, and ensuring staff orientation and training is provided
258.30according to the requirements in section 245D.09, subdivisions 4, 4a, and 5;
258.31(6) ensuring corrective action is taken when ordered by the commissioner and that
258.32the terms and condition of the license and any variances are met; and
258.33(7) evaluating the information identified in clauses (1) to (6) to develop, document,
258.34and implement ongoing program improvements.
258.35(b) The designated manager must be competent to perform the duties as required and
258.36must minimally meet the education and training requirements identified in subdivision
259.12, paragraph (b), and have a minimum of three years of supervisory level experience in
259.2a program providing direct support services to persons with disabilities or persons age
259.365 and older.
259.4EFFECTIVE DATE.This section is effective January 1, 2014.

259.5    Sec. 27. Minnesota Statutes 2012, section 245D.09, is amended to read:
259.6245D.09 STAFFING STANDARDS.
259.7    Subdivision 1. Staffing requirements. The license holder must provide the level of
259.8 direct service support staff sufficient supervision, assistance, and training necessary:
259.9(1) to ensure the health, safety, and protection of rights of each person; and
259.10(2) to be able to implement the responsibilities assigned to the license holder in each
259.11person's coordinated service and support plan or identified in the coordinated service and
259.12support plan addendum, according to the requirements of this chapter.
259.13    Subd. 2. Supervision of staff having direct contact. Except for a license holder
259.14who is the sole direct service support staff, the license holder must provide adequate
259.15supervision of staff providing direct service support to ensure the health, safety, and
259.16protection of rights of each person and implementation of the responsibilities assigned to
259.17the license holder in each person's service plan coordinated service and support plan or
259.18coordinated service and support plan addendum.
259.19    Subd. 3. Staff qualifications. (a) The license holder must ensure that staff providing
259.20direct support, or staff who have responsibilities related to supervising or managing the
259.21provision of direct support service, is competent as demonstrated through skills and
259.22knowledge training, experience, and education to meet the person's needs and additional
259.23requirements as written in the coordinated service and support plan or coordinated
259.24service and support plan addendum, or when otherwise required by the case manager or
259.25the federal waiver plan. The license holder must verify and maintain evidence of staff
259.26competency, including documentation of:
259.27(1) education and experience qualifications relevant to the job responsibilities
259.28assigned to the staff and the needs of the general population of persons served by the
259.29program, including a valid degree and transcript, or a current license, registration, or
259.30certification, when a degree or licensure, registration, or certification is required by this
259.31chapter or in the coordinated service and support plan or coordinated service and support
259.32plan addendum;
259.33(2) completion of required demonstrated competency in the orientation and training
259.34 areas required under this chapter, including and when applicable, completion of continuing
260.1education required to maintain professional licensure, registration, or certification
260.2requirements. Competency in these areas is determined by the license holder through
260.3knowledge testing and observed skill assessment conducted by the trainer or instructor; and
260.4(3) except for a license holder who is the sole direct service support staff, periodic
260.5 performance evaluations completed by the license holder of the direct service support staff
260.6person's ability to perform the job functions based on direct observation.
260.7(b) Staff under 18 years of age may not perform overnight duties or administer
260.8medication.
260.9    Subd. 4. Orientation to program requirements. (a) Except for a license holder
260.10who does not supervise any direct service support staff, within 90 days of hiring direct
260.11service staff 60 days of hire, unless stated otherwise, the license holder must provide
260.12and ensure completion of orientation for direct support staff that combines supervised
260.13on-the-job training with review of and instruction on in the following areas:
260.14(1) the job description and how to complete specific job functions, including:
260.15(i) responding to and reporting incidents as required under section 245D.06,
260.16subdivision 1; and
260.17(ii) following safety practices established by the license holder and as required in
260.18section 245D.06, subdivision 2;
260.19(2) the license holder's current policies and procedures required under this chapter,
260.20including their location and access, and staff responsibilities related to implementation
260.21of those policies and procedures;
260.22(3) data privacy requirements according to sections 13.01 to 13.10 and 13.46, the
260.23federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), and staff
260.24responsibilities related to complying with data privacy practices;
260.25(4) the service recipient rights under section 245D.04, and staff responsibilities
260.26related to ensuring the exercise and protection of those rights according to the requirements
260.27in section 245D.04;
260.28(5) sections 245A.65, 245A.66, 626.556, and 626.557, governing maltreatment
260.29reporting and service planning for children and vulnerable adults, and staff responsibilities
260.30related to protecting persons from maltreatment and reporting maltreatment. This
260.31orientation must be provided within 72 hours of first providing direct contact services and
260.32annually thereafter according to section 245A.65, subdivision 3;
260.33(6) what constitutes use of restraints, seclusion, and psychotropic medications,
260.34and staff responsibilities related to the prohibitions of their use the principles of
260.35person-centered service planning and delivery as identified in section 245D.07, subdivision
260.361a, and how they apply to direct support service provided by the staff person; and
261.1(7) other topics as determined necessary in the person's coordinated service and
261.2support plan by the case manager or other areas identified by the license holder.
261.3(b) License holders who provide direct service themselves must complete the
261.4orientation required in paragraph (a), clauses (3) to (7).
261.5    Subd. 4a. Orientation to individual service recipient needs. (c) (a) Before
261.6providing having unsupervised direct service to contact with a person served by the
261.7program, or for whom the staff person has not previously provided direct service support,
261.8or any time the plans or procedures identified in clauses (1) and (2) paragraphs (b) to
261.9(e) are revised, the staff person must review and receive instruction on the following
261.10as it relates requirements in paragraphs (b) to (e) as they relate to the staff person's job
261.11functions for that person:.
261.12(1) (b) The staff person must review and receive instruction on the person's
261.13 coordinated service and support plan or coordinated service and support plan addendum as
261.14it relates to the responsibilities assigned to the license holder, and when applicable, the
261.15person's individual abuse prevention plan according to section 245A.65, to achieve and
261.16demonstrate an understanding of the person as a unique individual, and how to implement
261.17those plans; and.
261.18(2) (c) The staff person must review and receive instruction on medication
261.19administration procedures established for the person when medication administration is
261.20 assigned to the license holder according to section 245D.05, subdivision 1, paragraph
261.21(b). Unlicensed staff may administer medications only after successful completion of a
261.22medication administration training, from a training curriculum developed by a registered
261.23nurse, clinical nurse specialist in psychiatric and mental health nursing, certified nurse
261.24practitioner, physician's assistant, or physician incorporating. The training curriculum
261.25must incorporate an observed skill assessment conducted by the trainer to ensure staff
261.26demonstrate the ability to safely and correctly follow medication procedures.
261.27Medication administration must be taught by a registered nurse, clinical nurse
261.28specialist, certified nurse practitioner, physician's assistant, or physician if, at the time of
261.29service initiation or any time thereafter, the person has or develops a health care condition
261.30that affects the service options available to the person because the condition requires:
261.31(i) (1) specialized or intensive medical or nursing supervision; and
261.32(ii) (2) nonmedical service providers to adapt their services to accommodate the
261.33health and safety needs of the person; and.
261.34(iii) necessary training in order to meet the health service needs of the person as
261.35determined by the person's physician.
262.1(d) The staff person must review and receive instruction on the safe and correct
262.2operation of medical equipment used by the person to sustain life, including but not
262.3limited to ventilators, feeding tubes, or endotracheal tubes. The training must be provided
262.4by a licensed health care professional or a manufacturer's representative and incorporate
262.5an observed skill assessment to ensure staff demonstrate the ability to safely and correctly
262.6operate the equipment according to the treatment orders and the manufacturer's instructions.
262.7(e) The staff person must review and receive instruction on what constitutes use of
262.8restraints, time out, and seclusion, including chemical restraint, and staff responsibilities
262.9related to the prohibitions of their use according to the requirements in section 245D.06,
262.10subdivision 5, why such procedures are not effective for reducing or eliminating symptoms
262.11or undesired behavior and why they are not safe, and the safe and correct use of manual
262.12restraint on an emergency basis according to the requirements in section 245D.061.
262.13(f) In the event of an emergency service initiation, the license holder must ensure
262.14the training required in this subdivision occurs within 72 hours of the direct support staff
262.15person first having unsupervised contact with the person receiving services. The license
262.16holder must document the reason for the unplanned or emergency service initiation and
262.17maintain the documentation in the person's service recipient record.
262.18(g) License holders who provide direct support services themselves must complete
262.19the orientation required in subdivision 4, clauses (3) to (7).
262.20    Subd. 5. Annual training. (a) A license holder must provide annual training to
262.21direct service support staff on the topics identified in subdivision 4, paragraph (a), clauses
262.22(3) to (6) (7). Training on relevant topics received from sources other than the license
262.23holder may count toward training requirements.
262.24(b) A license holder providing behavioral programming, specialist services, personal
262.25support, 24-hour emergency assistance, night supervision, independent living skills,
262.26structured day, prevocational, or supported employment services must provide a minimum
262.27of eight hours of annual training to direct service staff that addresses:
262.28(1) topics related to the general health, safety, and service needs of the population
262.29served by the license holder; and
262.30(2) other areas identified by the license holder or in the person's current service plan.
262.31Training on relevant topics received from sources other than the license holder
262.32may count toward training requirements.
262.33(c) When the license holder is the owner, lessor, or tenant of the service site and
262.34whenever a person receiving services is present at the site, the license holder must have
262.35a staff person available on site who is trained in basic first aid and, when required in a
262.36person's service plan, cardiopulmonary resuscitation.
263.1    Subd. 5a. Alternative sources of training. Orientation or training received by the
263.2staff person from sources other than the license holder in the same subjects as identified
263.3in subdivision 4 may count toward the orientation and annual training requirements if
263.4received in the 12-month period before the staff person's date of hire. The license holder
263.5must maintain documentation of the training received from other sources and of each staff
263.6person's competency in the required area according to the requirements in subdivision 3.
263.7    Subd. 6. Subcontractors and temporary staff. If the license holder uses a
263.8subcontractor or temporary staff to perform services licensed under this chapter on the
263.9license holder's behalf, the license holder must ensure that the subcontractor or temporary
263.10staff meets and maintains compliance with all requirements under this chapter that apply
263.11to the services to be provided, including training, orientation, and supervision necessary
263.12to fulfill their responsibilities. The license holder must ensure that a background study
263.13has been completed according to the requirements in sections 245C.03, subdivision 1,
263.14and 245C.04. Subcontractors and temporary staff hired by the license holder must meet
263.15the Minnesota licensing requirements applicable to the disciplines in which they are
263.16providing services. The license holder must maintain documentation that the applicable
263.17requirements have been met.
263.18    Subd. 7. Volunteers. The license holder must ensure that volunteers who provide
263.19direct support services to persons served by the program receive the training, orientation,
263.20and supervision necessary to fulfill their responsibilities. The license holder must ensure
263.21that a background study has been completed according to the requirements in sections
263.22245C.03, subdivision 1, and 245C.04. The license holder must maintain documentation
263.23that the applicable requirements have been met.
263.24    Subd. 8. Staff orientation and training plan. The license holder must develop
263.25a staff orientation and training plan documenting when and how compliance with
263.26subdivisions 4, 4a, and 5 will be met.
263.27EFFECTIVE DATE.This section is effective January 1, 2014.

263.28    Sec. 28. [245D.091] INTERVENTION SERVICES.
263.29    Subdivision 1. Licensure requirements. An individual meeting the staff
263.30qualification requirements of this section who is an employee of a program licensed
263.31according to this chapter and providing behavioral support services, specialist services,
263.32or crisis respite services is not required to hold a separate license under this chapter.
263.33An individual meeting the staff qualifications of this section who is not providing these
263.34services as an employee of a program licensed according to this chapter must obtain a
263.35license according to this chapter.
264.1    Subd. 2. Behavior professional qualifications. A behavior professional, as defined
264.2in the brain injury and community alternatives for disabled individuals waiver plans or
264.3successor plans, must have competencies in areas related to:
264.4(1) ethical considerations;
264.5(2) functional assessment;
264.6(3) functional analysis;
264.7(4) measurement of behavior and interpretation of data;
264.8(5) selecting intervention outcomes and strategies;
264.9(6) behavior reduction and elimination strategies that promote least restrictive
264.10approved alternatives;
264.11(7) data collection;
264.12(8) staff and caregiver training;
264.13(9) support plan monitoring;
264.14(10) co-occurring mental disorders or neuro-cognitive disorder;
264.15(11) demonstrated expertise with populations being served; and
264.16(12) must be a:
264.17(i) psychologist licensed under sections 148.88 to 148.98, who has stated to the
264.18Board of Psychology competencies in the above identified areas;
264.19(ii) clinical social worker licensed as an independent clinical social worker under
264.20chapter 148D, or a person with a master's degree in social work from an accredited college
264.21or university, with at least 4,000 hours of post-master's supervised experience in the
264.22delivery of clinical services in the areas identified in clauses (1) to (11);
264.23(iii) physician licensed under chapter 147 and certified by the American Board
264.24of Psychiatry and Neurology or eligible for board certification in psychiatry with
264.25competencies in the areas identified in clauses (1) to (11);
264.26(iv) licensed professional clinical counselor licensed under sections 148B.29 to
264.27148B.39 with at least 4,000 hours of post-master's supervised experience in the delivery
264.28of clinical services who has demonstrated competencies in the areas identified in clauses
264.29(1) to (11);
264.30(v) person with a master's degree from an accredited college or university in one
264.31of the behavioral sciences or related fields, with at least 4,000 hours of post-master's
264.32supervised experience in the delivery of clinical services with demonstrated competencies
264.33in the areas identified in clauses (1) to (11); or
264.34(vi) registered nurse who is licensed under sections 148.171 to 148.285, and who is
264.35certified as a clinical specialist or as a nurse practitioner in adult or family psychiatric and
264.36mental health nursing by a national nurse certification organization, or who has a master's
265.1degree in nursing or one of the behavioral sciences or related fields from an accredited
265.2college or university or its equivalent, with at least 4,000 hours of post-master's supervised
265.3experience in the delivery of clinical services.
265.4    Subd. 3. Behavior analyst qualifications. (a) A behavior analyst, as defined in
265.5the brain injury and community alternatives for disabled individuals waiver plans or
265.6successor plans, must:
265.7(1) have obtained a baccalaureate degree, master's degree, or a PhD in a social
265.8services discipline; or
265.9(2) meet the qualifications of a mental health practitioner as defined in section
265.10245.462, subdivision 17.
265.11(b) In addition, a behavior analyst must:
265.12(1) have four years of supervised experience working with individuals who exhibit
265.13challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder;
265.14(2) have received ten hours of instruction in functional assessment and functional
265.15analysis;
265.16(3) have received 20 hours of instruction in the understanding of the function of
265.17behavior;
265.18(4) have received ten hours of instruction on design of positive practices behavior
265.19support strategies;
265.20(5) have received 20 hours of instruction on the use of behavior reduction approved
265.21strategies used only in combination with behavior positive practices strategies;
265.22(6) be determined by a behavior professional to have the training and prerequisite
265.23skills required to provide positive practice strategies as well as behavior reduction
265.24approved and permitted intervention to the person who receives behavioral support; and
265.25(7) be under the direct supervision of a behavior professional.
265.26    Subd. 4. Behavior specialist qualifications. (a) A behavior specialist, as defined
265.27in the brain injury and community alternatives for disabled individuals waiver plans or
265.28successor plans, must meet the following qualifications:
265.29(1) have an associate's degree in a social services discipline; or
265.30(2) have two years of supervised experience working with individuals who exhibit
265.31challenging behaviors as well as co-occurring mental disorders or neuro-cognitive disorder.
265.32(b) In addition, a behavior specialist must:
265.33(1) have received a minimum of four hours of training in functional assessment;
265.34(2) have received 20 hours of instruction in the understanding of the function of
265.35behavior;
266.1(3) have received ten hours of instruction on design of positive practices behavioral
266.2support strategies;
266.3(4) be determined by a behavior professional to have the training and prerequisite
266.4skills required to provide positive practices strategies as well as behavior reduction
266.5approved intervention to the person who receives behavioral support; and
266.6(5) be under the direct supervision of a behavior professional.
266.7    Subd. 5. Specialist services qualifications. An individual providing specialist
266.8services, as defined in the developmental disabilities waiver plan or successor plan, must
266.9have:
266.10(1) the specific experience and skills required of the specialist to meet the needs of
266.11the person identified by the person's service planning team; and
266.12(2) the qualifications of the specialist identified in the person's coordinated service
266.13and support plan.
266.14EFFECTIVE DATE.This section is effective January 1, 2014.

266.15    Sec. 29. [245D.095] RECORD REQUIREMENTS.
266.16    Subdivision 1. Record-keeping systems. The license holder must ensure that the
266.17content and format of service recipient, personnel, and program records are uniform and
266.18legible according to the requirements of this chapter.
266.19    Subd. 2. Admission and discharge register. The license holder must keep a written
266.20or electronic register, listing in chronological order the dates and names of all persons
266.21served by the program who have been admitted, discharged, or transferred, including
266.22service terminations initiated by the license holder and deaths.
266.23    Subd. 3. Service recipient record. (a) The license holder must maintain a record of
266.24current services provided to each person on the premises where the services are provided
266.25or coordinated. When the services are provided in a licensed facility, the records must
266.26be maintained at the facility, otherwise the records must be maintained at the license
266.27holder's program office. The license holder must protect service recipient records against
266.28loss, tampering, or unauthorized disclosure according to the requirements in sections
266.2913.01 to 13.10 and 13.46.
266.30(b) The license holder must maintain the following information for each person:
266.31(1) an admission form signed by the person or the person's legal representative
266.32that includes:
266.33(i) identifying information, including the person's name, date of birth, address,
266.34and telephone number; and
267.1(ii) the name, address, and telephone number of the person's legal representative, if
267.2any, and a primary emergency contact, the case manager, and family members or others as
267.3identified by the person or case manager;
267.4(2) service information, including service initiation information, verification of the
267.5person's eligibility for services, documentation verifying that services have been provided
267.6as identified in the coordinated service and support plan or coordinated service and support
267.7plan addendum according to paragraph (a), and date of admission or readmission;
267.8(3) health information, including medical history, special dietary needs, and
267.9allergies, and when the license holder is assigned responsibility for meeting the person's
267.10health service needs according to section 245D.05:
267.11(i) current orders for medication, treatments, or medical equipment and a signed
267.12authorization from the person or the person's legal representative to administer or assist in
267.13administering the medication or treatments, if applicable;
267.14(ii) a signed statement authorizing the license holder to act in a medical emergency
267.15when the person's legal representative, if any, cannot be reached or is delayed in arriving;
267.16(iii) medication administration procedures;
267.17(iv) a medication administration record documenting the implementation of the
267.18medication administration procedures, the medication administration record reviews, and
267.19including any agreements for administration of injectable medications by the license
267.20holder according to the requirements in section 245D.05; and
267.21(v) a medical appointment schedule when the license holder is assigned
267.22responsibility for assisting with medical appointments;
267.23(4) the person's current coordinated service and support plan or that portion of the
267.24plan assigned to the license holder;
267.25(5) copies of the individual abuse prevention plan and assessments as required under
267.26section 245D.071, subdivisions 2 and 3;
267.27(6) a record of other service providers serving the person when the person's
267.28coordinated service and support plan or coordinated service and support plan addendum
267.29identifies the need for coordination between the service providers, that includes a contact
267.30person and telephone numbers, services being provided, and names of staff responsible for
267.31coordination;
267.32(7) documentation of orientation to service recipient rights according to section
267.33245D.04, subdivision 1, and maltreatment reporting policies and procedures according to
267.34section 245A.65, subdivision 1, paragraph (c);
267.35(8) copies of authorizations to handle a person's funds, according to section 245D.06,
267.36subdivision 4, paragraph (a);
268.1(9) documentation of complaints received and grievance resolution;
268.2(10) incident reports involving the person, required under section 245D.06,
268.3subdivision 1;
268.4(11) copies of written reports regarding the person's status when requested according
268.5to section 245D.07, subdivision 3, progress review reports as required under section
268.6245D.071, subdivision 5, progress or daily log notes that are recorded by the program,
268.7and reports received from other agencies involved in providing services or care to the
268.8person; and
268.9(12) discharge summary, including service termination notice and related
268.10documentation, when applicable.
268.11    Subd. 4. Access to service recipient records. The license holder must ensure that
268.12the following people have access to the information in subdivision 1 in accordance with
268.13applicable state and federal law, regulation, or rule:
268.14(1) the person, the person's legal representative, and anyone properly authorized
268.15by the person;
268.16(2) the person's case manager;
268.17(3) staff providing services to the person unless the information is not relevant to
268.18carrying out the coordinated service and support plan or coordinated service and support
268.19plan addendum; and
268.20(4) the county child or adult foster care licensor, when services are also licensed as
268.21child or adult foster care.
268.22    Subd. 5. Personnel records. (a) The license holder must maintain a personnel
268.23record of each employee to document and verify staff qualifications, orientation, and
268.24training. The personnel record must include:
268.25(1) the employee's date of hire, completed application, an acknowledgement signed
268.26by the employee that job duties were reviewed with the employee and the employee
268.27understands those duties, and documentation that the employee meets the position
268.28requirements as determined by the license holder;
268.29 (2) documentation of staff qualifications, orientation, training, and performance
268.30evaluations as required under section 245D.09, subdivisions 3 to 5, including the date
268.31the training was completed, the number of hours per subject area, and the name of the
268.32trainer or instructor; and
268.33(3) a completed background study as required under chapter 245C.
268.34(b) For employees hired after January 1, 2014, the license holder must maintain
268.35documentation in the personnel record or elsewhere, sufficient to determine the date of the
269.1employee's first supervised direct contact with a person served by the program, and the
269.2date of first unsupervised direct contact with a person served by the program.
269.3EFFECTIVE DATE.This section is effective January 1, 2014.

269.4    Sec. 30. Minnesota Statutes 2012, section 245D.10, is amended to read:
269.5245D.10 POLICIES AND PROCEDURES.
269.6    Subdivision 1. Policy and procedure requirements. The A license holder
269.7 providing either basic or intensive supports and services must establish, enforce, and
269.8maintain policies and procedures as required in this chapter, chapter 245A, and other
269.9applicable state and federal laws and regulations governing the provision of home and
269.10community-based services licensed according to this chapter.
269.11    Subd. 2. Grievances. The license holder must establish policies and procedures
269.12that provide promote service recipient rights by providing a simple complaint process for
269.13persons served by the program and their authorized representatives to bring a grievance that:
269.14(1) provides staff assistance with the complaint process when requested, and the
269.15addresses and telephone numbers of outside agencies to assist the person;
269.16(2) allows the person to bring the complaint to the highest level of authority in the
269.17program if the grievance cannot be resolved by other staff members, and that provides
269.18the name, address, and telephone number of that person;
269.19(3) requires the license holder to promptly respond to all complaints affecting a
269.20person's health and safety. For all other complaints, the license holder must provide an
269.21initial response within 14 calendar days of receipt of the complaint. All complaints must
269.22be resolved within 30 calendar days of receipt or the license holder must document the
269.23reason for the delay and a plan for resolution;
269.24(4) requires a complaint review that includes an evaluation of whether:
269.25(i) related policies and procedures were followed and adequate;
269.26(ii) there is a need for additional staff training;
269.27(iii) the complaint is similar to past complaints with the persons, staff, or services
269.28involved; and
269.29(iv) there is a need for corrective action by the license holder to protect the health
269.30and safety of persons receiving services;
269.31(5) based on the review in clause (4), requires the license holder to develop,
269.32document, and implement a corrective action plan designed to correct current lapses and
269.33prevent future lapses in performance by staff or the license holder, if any;
270.1(6) provides a written summary of the complaint and a notice of the complaint
270.2resolution to the person and case manager that:
270.3(i) identifies the nature of the complaint and the date it was received;
270.4(ii) includes the results of the complaint review;
270.5(iii) identifies the complaint resolution, including any corrective action; and
270.6(7) requires that the complaint summary and resolution notice be maintained in the
270.7service recipient record.
270.8    Subd. 3. Service suspension and service termination. (a) The license holder must
270.9establish policies and procedures for temporary service suspension and service termination
270.10that promote continuity of care and service coordination with the person and the case
270.11manager and with other licensed caregivers, if any, who also provide support to the person.
270.12(b) The policy must include the following requirements:
270.13(1) the license holder must notify the person or the person's legal representative and
270.14case manager in writing of the intended termination or temporary service suspension, and
270.15the person's right to seek a temporary order staying the termination of service according to
270.16the procedures in section 256.045, subdivision 4a, or 6, paragraph (c);
270.17(2) notice of the proposed termination of services, including those situations
270.18that began with a temporary service suspension, must be given at least 60 days before
270.19the proposed termination is to become effective when a license holder is providing
270.20independent living skills training, structured day, prevocational or supported employment
270.21services to the person intensive supports and services identified in section 245D.03,
270.22subdivision 1, paragraph (c), and 30 days prior to termination for all other services
270.23licensed under this chapter;
270.24(3) the license holder must provide information requested by the person or case
270.25manager when services are temporarily suspended or upon notice of termination;
270.26(4) prior to giving notice of service termination or temporary service suspension,
270.27the license holder must document actions taken to minimize or eliminate the need for
270.28service suspension or termination;
270.29(5) during the temporary service suspension or service termination notice period,
270.30the license holder will work with the appropriate county agency to develop reasonable
270.31alternatives to protect the person and others;
270.32(6) the license holder must maintain information about the service suspension or
270.33termination, including the written termination notice, in the service recipient record; and
270.34(7) the license holder must restrict temporary service suspension to situations in
270.35which the person's behavior causes immediate and serious danger to the health and safety
271.1of the person or others conduct poses an imminent risk of physical harm to self or others
271.2and less restrictive or positive support strategies would not achieve safety.
271.3    Subd. 4. Availability of current written policies and procedures. (a) The license
271.4holder must review and update, as needed, the written policies and procedures required
271.5under this chapter.
271.6(b)(1) The license holder must inform the person and case manager of the policies
271.7and procedures affecting a person's rights under section 245D.04, and provide copies of
271.8those policies and procedures, within five working days of service initiation.
271.9(2) If a license holder only provides basic services and supports, this includes the:
271.10(i) grievance policy and procedure required under subdivision 2; and
271.11(ii) service suspension and termination policy and procedure required under
271.12subdivision 3.
271.13(3) For all other license holders this includes the:
271.14(i) policies and procedures in clause (2);
271.15(ii) emergency use of manual restraints policy and procedure required under
271.16subdivision 3a; and
271.17(iii) data privacy requirements under section 245D.11, subdivision 3.
271.18(c) The license holder must provide a written notice at least 30 days before
271.19implementing any revised policies and procedures procedural revisions to policies
271.20 affecting a person's service-related or protection-related rights under section 245D.04 and
271.21maltreatment reporting policies and procedures. The notice must explain the revision that
271.22was made and include a copy of the revised policy and procedure. The license holder
271.23must document the reason reasonable cause for not providing the notice at least 30 days
271.24before implementing the revisions.
271.25(d) Before implementing revisions to required policies and procedures, the license
271.26holder must inform all employees of the revisions and provide training on implementation
271.27of the revised policies and procedures.
271.28(e) The license holder must annually notify all persons, or their legal representatives,
271.29and case managers of any procedural revisions to policies required under this chapter,
271.30other than those in paragraph (c). Upon request, the license holder must provide the
271.31person, or the person's legal representative, and case manager with copies of the revised
271.32policies and procedures.
271.33EFFECTIVE DATE.This section is effective January 1, 2014.

271.34    Sec. 31. [245D.11] POLICIES AND PROCEDURES; INTENSIVE SUPPORT
271.35SERVICES.
272.1    Subdivision 1. Policy and procedure requirements. A license holder providing
272.2intensive support services as identified in section 245D.03, subdivision 1, paragraph (c),
272.3must establish, enforce, and maintain policies and procedures as required in this section.
272.4    Subd. 2. Health and safety. The license holder must establish policies and
272.5procedures that promote health and safety by ensuring:
272.6(1) use of universal precautions and sanitary practices in compliance with section
272.7245D.06, subdivision 2, clause (5);
272.8(2) if the license holder operates a residential program, health service coordination
272.9and care according to the requirements in section 245D.05, subdivision 1;
272.10(3) safe medication assistance and administration according to the requirements
272.11in sections 245D.05, subdivisions 1a, 2, and 5, and 245D.051, that are established in
272.12consultation with a registered nurse, nurse practitioner, physician's assistant, or medical
272.13doctor and require completion of medication administration training according to the
272.14requirements in section 245D.09, subdivision 4a, paragraph (c). Medication assistance
272.15and administration includes, but is not limited to:
272.16(i) providing medication-related services for a person;
272.17(ii) medication setup;
272.18(iii) medication administration;
272.19(iv) medication storage and security;
272.20(v) medication documentation and charting;
272.21(vi) verification and monitoring of effectiveness of systems to ensure safe medication
272.22handling and administration;
272.23(vii) coordination of medication refills;
272.24(viii) handling changes to prescriptions and implementation of those changes;
272.25(ix) communicating with the pharmacy; and
272.26(x) coordination and communication with prescriber;
272.27(4) safe transportation, when the license holder is responsible for transportation of
272.28persons, with provisions for handling emergency situations according to the requirements
272.29in section 245D.06, subdivision 2, clauses (2) to (4);
272.30(5) a plan for ensuring the safety of persons served by the program in emergencies as
272.31defined in section 245D.02, subdivision 8, and procedures for staff to report emergencies
272.32to the license holder. A license holder with a community residential setting or a day service
272.33facility license must ensure the policy and procedures comply with the requirements in
272.34section 245D.22, subdivision 4;
273.1(6) a plan for responding to all incidents as defined in section 245D.02, subdivision
273.211; and reporting all incidents required to be reported according to section 245D.06,
273.3subdivision 1. The plan must:
273.4(i) provide the contact information of a source of emergency medical care and
273.5transportation; and
273.6(ii) require staff to first call 911 when the staff believes a medical emergency may be
273.7life threatening, or to call the mental health crisis intervention team when the person is
273.8experiencing a mental health crisis; and
273.9(7) a procedure for the review of incidents and emergencies to identify trends or
273.10patterns, and corrective action if needed. The license holder must establish and maintain
273.11a record-keeping system for the incident and emergency reports. Each incident and
273.12emergency report file must contain a written summary of the incident. The license holder
273.13must conduct a review of incident reports for identification of incident patterns, and
273.14implementation of corrective action as necessary to reduce occurrences. Each incident
273.15report must include:
273.16(i) the name of the person or persons involved in the incident. It is not necessary
273.17to identify all persons affected by or involved in an emergency unless the emergency
273.18resulted in an incident;
273.19(ii) the date, time, and location of the incident or emergency;
273.20(iii) a description of the incident or emergency;
273.21(iv) a description of the response to the incident or emergency and whether a person's
273.22coordinated service and support plan addendum or program policies and procedures were
273.23implemented as applicable;
273.24(v) the name of the staff person or persons who responded to the incident or
273.25emergency; and
273.26(vi) the determination of whether corrective action is necessary based on the results
273.27of the review.
273.28    Subd. 3. Data privacy. The license holder must establish policies and procedures that
273.29promote service recipient rights by ensuring data privacy according to the requirements in:
273.30(1) the Minnesota Government Data Practices Act, section 13.46, and all other
273.31applicable Minnesota laws and rules in handling all data related to the services provided;
273.32and
273.33(2) the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to the
273.34extent that the license holder performs a function or activity involving the use of protected
273.35health information as defined under Code of Federal Regulations, title 45, section 164.501,
273.36including, but not limited to, providing health care services; health care claims processing
274.1or administration; data analysis, processing, or administration; utilization review; quality
274.2assurance; billing; benefit management; practice management; repricing; or as otherwise
274.3provided by Code of Federal Regulations, title 45, section 160.103. The license holder
274.4must comply with the Health Insurance Portability and Accountability Act of 1996 and
274.5its implementing regulations, Code of Federal Regulations, title 45, parts 160 to 164,
274.6and all applicable requirements.
274.7    Subd. 4. Admission criteria. The license holder must establish policies and
274.8procedures that promote continuity of care by ensuring that admission or service initiation
274.9criteria:
274.10(1) is consistent with the license holder's registration information identified in the
274.11requirements in section 245D.031, subdivision 2, and with the service-related rights
274.12identified in section 245D.04, subdivisions 2, clauses (4) to (7), and 3, clause (8);
274.13(2) identifies the criteria to be applied in determining whether the license holder
274.14can develop services to meet the needs specified in the person's coordinated service and
274.15support plan;
274.16(3) requires a license holder providing services in a health care facility to comply
274.17with the requirements in section 243.166, subdivision 4b, to provide notification to
274.18residents when a registered predatory offender is admitted into the program or to a
274.19potential admission when the facility was already serving a registered predatory offender.
274.20For purposes of this clause, "health care facility" means a facility licensed by the
274.21commissioner as a residential facility under chapter 245A to provide adult foster care or
274.22residential services to persons with disabilities; and
274.23(4) requires that when a person or the person's legal representative requests services
274.24from the license holder, a refusal to admit the person must be based on an evaluation of
274.25the person's assessed needs and the license holder's lack of capacity to meet the needs of
274.26the person. The license holder must not refuse to admit a person based solely on the
274.27type of residential services the person is receiving, or solely on the person's severity of
274.28disability, orthopedic or neurological handicaps, sight or hearing impairments, lack of
274.29communication skills, physical disabilities, toilet habits, behavioral disorders, or past
274.30failure to make progress. Documentation of the basis for refusal must be provided to the
274.31person or the person's legal representative and case manager upon request.
274.32EFFECTIVE DATE.This section is effective January 1, 2014.

274.33    Sec. 32. [245D.21] FACILITY LICENSURE REQUIREMENTS AND
274.34APPLICATION PROCESS.
275.1    Subdivision 1. Community residential settings and day service facilities. For
275.2purposes of this section, "facility" means both a community residential setting and day
275.3service facility and the physical plant.
275.4    Subd. 2. Inspections and code compliance. (a) Physical plants must comply with
275.5applicable state and local fire, health, building, and zoning codes.
275.6(b)(1) The facility must be inspected by a fire marshal or their delegate within
275.712 months before initial licensure to verify that it meets the applicable occupancy
275.8requirements as defined in the State Fire Code and that the facility complies with the fire
275.9safety standards for that occupancy code contained in the State Fire Code.
275.10(2) The fire marshal inspection of a community residential setting must verify the
275.11residence is a dwelling unit within a residential occupancy as defined in section 9.117 of
275.12the State Fire Code. A home safety checklist, approved by the commissioner, must be
275.13completed for a community residential setting by the license holder and the commissioner
275.14before the satellite license is reissued.
275.15(3) The facility shall be inspected according to the facility capacity specified on the
275.16initial application form.
275.17(4) If the commissioner has reasonable cause to believe that a potentially hazardous
275.18condition may be present or the licensed capacity is increased, the commissioner shall
275.19request a subsequent inspection and written report by a fire marshal to verify the absence
275.20of hazard.
275.21(5) Any condition cited by a fire marshal, building official, or health authority as
275.22hazardous or creating an immediate danger of fire or threat to health and safety must be
275.23corrected before a license is issued by the department, and for community residential
275.24settings, before a license is reissued.
275.25(c) The facility must maintain in a permanent file the reports of health, fire, and
275.26other safety inspections.
275.27(d) The facility's plumbing, ventilation, heating, cooling, lighting, and other
275.28fixtures and equipment, including elevators or food service, if provided, must conform to
275.29applicable health, sanitation, and safety codes and regulations.
275.30EFFECTIVE DATE.This section is effective January 1, 2014.

275.31    Sec. 33. [245D.22] FACILITY SANITATION AND HEALTH.
275.32    Subdivision 1. General maintenance. The license holder must maintain the interior
275.33and exterior of buildings, structures, or enclosures used by the facility, including walls,
275.34floors, ceilings, registers, fixtures, equipment, and furnishings in good repair and in a
275.35sanitary and safe condition. The facility must be clean and free from accumulations of
276.1dirt, grease, garbage, peeling paint, mold, vermin, and insects. The license holder must
276.2correct building and equipment deterioration, safety hazards, and unsanitary conditions.
276.3    Subd. 2. Hazards and toxic substances. (a) The license holder must ensure that
276.4service sites owned or leased by the license holder are free from hazards that would
276.5threaten the health or safety of a person receiving services by ensuring the requirements
276.6in paragraphs (b) to (h) are met.
276.7(b) Chemicals, detergents, and other hazardous or toxic substances must not be
276.8stored with food products or in any way that poses a hazard to persons receiving services.
276.9(c) The license holder must install handrails and nonslip surfaces on interior and
276.10exterior runways, stairways, and ramps according to the applicable building code.
276.11(d) If there are elevators in the facility, the license holder must have elevators
276.12inspected each year. The date of the inspection, any repairs needed, and the date the
276.13necessary repairs were made must be documented.
276.14(e) The license holder must keep stairways, ramps, and corridors free of obstructions.
276.15(f) Outside property must be free from debris and safety hazards. Exterior stairs and
276.16walkways must be kept free of ice and snow.
276.17(g) Heating, ventilation, air conditioning units, and other hot surfaces and moving
276.18parts of machinery must be shielded or enclosed.
276.19(h) Use of dangerous items or equipment by persons served by the program must be
276.20allowed in accordance with the person's coordinated service and support plan addendum
276.21or the program abuse prevention plan, if not addressed in the coordinated service and
276.22support plan addendum.
276.23    Subd. 3. Storage and disposal of medication. Schedule II controlled substances in
276.24the facility that are named in section 152.02, subdivision 3, must be stored in a locked
276.25storage area permitting access only by persons and staff authorized to administer the
276.26medication. This must be incorporated into the license holder's medication administration
276.27policy and procedures required under section 245D.11, subdivision 2, clause (3).
276.28Medications must be disposed of according to the Environmental Protection Agency
276.29recommendations.
276.30    Subd. 4. First aid must be available on site. (a) A staff person trained in first aid
276.31must be available on site and, when required in a person's coordinated service and support
276.32plan or coordinated service and support plan addendum, cardiopulmonary resuscitation,
276.33whenever persons are present and staff are required to be at the site to provide direct
276.34service. The training must include in-person instruction, hands-on practice, and an
276.35observed skills assessment under the direct supervision of a first aid instructor.
277.1(b) A facility must have first aid kits readily available for use by, and that meets
277.2the needs of, persons receiving services and staff. At a minimum, the first aid kit must
277.3be equipped with accessible first aid supplies including bandages, sterile compresses,
277.4scissors, an ice bag or cold pack, an oral or surface thermometer, mild liquid soap,
277.5adhesive tape, and first aid manual.
277.6    Subd. 5. Emergencies. (a) The license holder must have a written plan for
277.7responding to emergencies as defined in section 245D.02, subdivision 8, to ensure the
277.8safety of persons served in the facility. The plan must include:
277.9(1) procedures for emergency evacuation and emergency sheltering, including:
277.10(i) how to report a fire or other emergency;
277.11(ii) procedures to notify, relocate, and evacuate occupants, including use of adaptive
277.12procedures or equipment to assist with the safe evacuation of persons with physical or
277.13sensory disabilities; and
277.14(iii) instructions on closing off the fire area, using fire extinguishers, and activating
277.15and responding to alarm systems;
277.16(2) a floor plan that identifies:
277.17(i) the location of fire extinguishers;
277.18(ii) the location of audible or visual alarm systems, including but not limited to
277.19manual fire alarm boxes, smoke detectors, fire alarm enunciators and controls, and
277.20sprinkler systems;
277.21(iii) the location of exits, primary and secondary evacuation routes, and accessible
277.22egress routes, if any; and
277.23(iv) the location of emergency shelter within the facility;
277.24(3) a site plan that identifies:
277.25(i) designated assembly points outside the facility;
277.26(ii) the locations of fire hydrants; and
277.27(iii) the routes of fire department access;
277.28(4) the responsibilities each staff person must assume in case of emergency;
277.29(5) procedures for conducting quarterly drills each year and recording the date of
277.30each drill in the file of emergency plans;
277.31(6) procedures for relocation or service suspension when services are interrupted
277.32for more than 24 hours;
277.33(7) for a community residential setting with three or more dwelling units, a floor
277.34plan that identifies the location of enclosed exit stairs; and
277.35(8) an emergency escape plan for each resident.
277.36(b) The license holder must:
278.1(1) maintain a log of quarterly fire drills on file in the facility;
278.2(2) provide an emergency response plan that is readily available to staff and persons
278.3receiving services;
278.4(3) inform each person of a designated area within the facility where the person
278.5should go to for emergency shelter during severe weather and the designated assembly
278.6points outside the facility; and
278.7(4) maintain emergency contact information for persons served at the facility that
278.8can be readily accessed in an emergency.
278.9    Subd. 6. Emergency equipment. The facility must have a flashlight and a portable
278.10radio or television set that do not require electricity and can be used if a power failure
278.11occurs.
278.12    Subd. 7. Telephone and posted numbers. A facility must have a non-coin operated
278.13telephone that is readily accessible. A list of emergency numbers must be posted in a
278.14prominent location. When an area has a 911 number or a mental health crisis intervention
278.15team number, both numbers must be posted and the emergency number listed must be
278.16911. In areas of the state without a 911 number, the numbers listed must be those of the
278.17local fire department, police department, emergency transportation, and poison control
278.18center. The names and telephone numbers of each person's representative, physician, and
278.19dentist must be readily available.
278.20EFFECTIVE DATE.This section is effective January 1, 2014.

278.21    Sec. 34. [245D.23] COMMUNITY RESIDENTIAL SETTINGS; SATELLITE
278.22LICENSURE REQUIREMENTS AND APPLICATION PROCESS.
278.23    Subdivision 1. Separate satellite license required for separate sites. (a) A license
278.24holder providing residential support services must obtain a separate satellite license for
278.25each community residential setting located at separate addresses when the community
278.26residential settings are to be operated by the same license holder. For purposes of this
278.27chapter, a community residential setting is a satellite of the home and community-based
278.28services license.
278.29(b) Community residential settings are permitted single-family use homes. After a
278.30license has been issued, the commissioner shall notify the local municipality where the
278.31residence is located of the approved license.
278.32    Subd. 2. Notification to local agency. The license holder must notify the local
278.33agency within 24 hours of the onset of changes in a residence resulting from construction,
278.34remodeling, or damages requiring repairs that require a building permit or may affect a
278.35licensing requirement in this chapter.
279.1    Subd. 3. Alternate overnight supervision. A license holder granted an alternate
279.2overnight supervision technology adult foster care license according to section 245A.11,
279.3subdivision 7a, that converts to a community residential setting satellite license according
279.4to this chapter must retain that designation.
279.5EFFECTIVE DATE.This section is effective January 1, 2014.

279.6    Sec. 35. [245D.24] COMMUNITY RESIDENTIAL SETTINGS; PHYSICAL
279.7PLANT AND ENVIRONMENT.
279.8    Subdivision 1. Occupancy. The residence must meet the definition of a dwelling
279.9unit in a residential occupancy.
279.10    Subd. 2. Common area requirements. The living area must be provided with an
279.11adequate number of furnishings for the usual functions of daily living and social activities.
279.12The dining area must be furnished to accommodate meals shared by all persons living in
279.13the residence. These furnishings must be in good repair and functional to meet the daily
279.14needs of the persons living in the residence.
279.15    Subd. 3. Bedrooms. (a) People receiving services must mutually consent, in
279.16writing, to sharing a bedroom with one another. No more than two people receiving
279.17services may share one bedroom.
279.18(b) A single occupancy bedroom must have at least 80 square feet of floor space with
279.19a 7-1/2 foot ceiling. A double occupancy room must have at least 120 square feet of floor
279.20space with a 7-1/2 foot ceiling. Bedrooms must be separated from halls, corridors, and
279.21other habitable rooms by floor to ceiling walls containing no openings except doorways
279.22and must not serve as a corridor to another room used in daily living.
279.23(c) A person's personal possessions and items for the person's own use are the only
279.24items permitted to be stored in a person's bedroom.
279.25(d) Unless otherwise documented through assessment as a safety concern for the
279.26person, each person must be provided with the following furnishings:
279.27(1) a separate bed of proper size and height for the convenience and comfort of the
279.28person, with a clean mattress in good repair;
279.29(2) clean bedding appropriate for the season for each person;
279.30(3) an individual cabinet, or dresser, shelves, and a closet, for storage of personal
279.31possessions and clothing; and
279.32(4) a mirror for grooming.
279.33(e) When possible, a person must be allowed to have items of furniture that the
279.34person personally owns in the bedroom, unless doing so would interfere with safety
279.35precautions, violate a building or fire code, or interfere with another person's use of the
280.1bedroom. A person may choose to not have a cabinet, dresser, shelves, or a mirror in the
280.2bedroom, as otherwise required under paragraph (d), clause (3) or (4). A person may
280.3choose to use a mattress other than an innerspring mattress and may choose to not have
280.4the mattress on a mattress frame or support. If a person chooses not to have a piece of
280.5required furniture, the license holder must document this choice and is not required to
280.6provide the item. If a person chooses to use a mattress other than an innerspring mattress
280.7or chooses to not have a mattress frame or support, the license holder must document this
280.8choice and allow the alternative desired by the person.
280.9(f) A person must be allowed to bring personal possessions into the bedroom
280.10and other designated storage space, if such space is available, in the residence. The
280.11person must be allowed to accumulate possessions to the extent the residence is able to
280.12accommodate them, unless doing so is contraindicated for the person's physical or mental
280.13health, would interfere with safety precautions or another person's use of the bedroom, or
280.14would violate a building or fire code. The license holder must allow for locked storage
280.15of personal items. Any restriction on the possession or locked storage of personal items,
280.16including requiring a person to use a lock provided by the license holder, must comply
280.17with section 245D.04, subdivision 3, paragraph (c), and allow the person to be present if
280.18and when the license holder opens the lock.
280.19EFFECTIVE DATE.This section is effective January 1, 2014.

280.20    Sec. 36. [245D.25] COMMUNITY RESIDENTIAL SETTINGS; FOOD AND
280.21WATER.
280.22    Subdivision 1. Water. Potable water from privately owned wells must be tested
280.23annually by a Department of Health-certified laboratory for coliform bacteria and nitrate
280.24nitrogens to verify safety. The health authority may require retesting and corrective
280.25measures if results exceed state water standards in Minnesota Rules, chapter 4720, or in
280.26the event of a flooding or incident which may put the well at risk of contamination. To
280.27prevent scalding, the water temperature of faucets must not exceed 120 degrees Fahrenheit.
280.28    Subd. 2. Food. Food served must meet any special dietary needs of a person as
280.29prescribed by the person's physician or dietitian. Three nutritionally balanced meals a day
280.30must be served or made available to persons, and nutritious snacks must be available
280.31between meals.
280.32    Subd. 3. Food safety. Food must be obtained, handled, and properly stored to
280.33prevent contamination, spoilage, or a threat to the health of a person.
280.34EFFECTIVE DATE.This section is effective January 1, 2014.

281.1    Sec. 37. [245D.26] COMMUNITY RESIDENTIAL SETTINGS; SANITATION
281.2AND HEALTH.
281.3    Subdivision 1. Goods provided by the license holder. Individual clean bed linens
281.4appropriate for the season and the person's comfort, including towels and wash cloths,
281.5must be available for each person. Usual or customary goods for the operation of a
281.6residence which are communally used by all persons receiving services living in the
281.7residence must be provided by the license holder, including household items for meal
281.8preparation, cleaning supplies to maintain the cleanliness of the residence, window
281.9coverings on windows for privacy, toilet paper, and hand soap.
281.10    Subd. 2. Personal items. Personal health and hygiene items must be stored in a
281.11safe and sanitary manner.
281.12    Subd. 3. Pets and service animals. Pets and service animals housed within
281.13the residence must be immunized and maintained in good health as required by local
281.14ordinances and state law. The license holder must ensure that the person and the person's
281.15representative is notified before admission of the presence of pets in the residence.
281.16    Subd. 4. Smoking in the residence. License holders must comply with the
281.17requirements of the Minnesota Clean Indoor Air Act, sections 144.411 to 144.417, when
281.18smoking is permitted in the residence.
281.19    Subd. 5. Weapons. Weapons and ammunition must be stored separately in locked
281.20areas that are inaccessible to a person receiving services. For purposes of this subdivision,
281.21"weapons" means firearms and other instruments or devices designed for and capable of
281.22producing bodily harm.
281.23EFFECTIVE DATE.This section is effective January 1, 2014.

281.24    Sec. 38. [245D.27] DAY SERVICES FACILITIES; SATELLITE LICENSURE
281.25REQUIREMENTS AND APPLICATION PROCESS.
281.26Except for day service facilities on the same or adjoining lot, the license holder
281.27providing day services must apply for a separate license for each facility-based service
281.28site when the license holder is the owner, lessor, or tenant of the service site at which
281.29persons receive day services and the license holder's employees who provide day services
281.30are present for a cumulative total of more than 30 days within any 12-month period. For
281.31purposes of this chapter, a day services facility license is a satellite license of the day
281.32services program. A day services program may operate multiple licensed day service
281.33facilities in one or more counties in the state. For the purposes of this section, "adjoining
281.34lot" means day services facilities that are next door to or across the street from one another.
282.1EFFECTIVE DATE.This section is effective January 1, 2014.

282.2    Sec. 39. [245D.28] DAY SERVICES FACILITIES; PHYSICAL PLANT AND
282.3SPACE REQUIREMENTS.
282.4    Subdivision 1. Facility capacity and useable space requirements. (a) The facility
282.5capacity of each day service facility must be determined by the amount of primary space
282.6available, the scheduling of activities at other service sites, and the space requirements of
282.7all persons receiving services at the facility, not just the licensed services. The facility
282.8capacity must specify the maximum number of persons that may receive services on
282.9site at any one time.
282.10(b) When a facility is located in a multifunctional organization, the facility may
282.11share common space with the multifunctional organization if the required available
282.12primary space for use by persons receiving day services is maintained while the facility is
282.13operating. The license holder must comply at all times with all applicable fire and safety
282.14codes under section 245A.04, subdivision 2a, and adequate supervision requirements
282.15under section 245D.31 for all persons receiving day services.
282.16(c) A day services facility must have a minimum of 40 square feet of primary space
282.17available for each person who is present at the site at any one time. Primary space does
282.18not include:
282.19(1) common areas, such as hallways, stairways, closets, utility areas, bathrooms,
282.20and kitchens;
282.21(2) floor areas beneath stationary equipment; or
282.22(3) any space occupied by persons associated with the multifunctional organization
282.23while persons receiving day services are using common space.
282.24    Subd. 2. Individual personal articles. Each person must be provided space in a
282.25closet, cabinet, on a shelf, or a coat hook for storage of personal items for the person's own
282.26use while receiving services at the facility, unless doing so would interfere with safety
282.27precautions, another person's work space, or violate a building or fire code.
282.28EFFECTIVE DATE.This section is effective January 1, 2014.

282.29    Sec. 40. [245D.29] DAY SERVICES FACILITIES; HEALTH AND SAFETY
282.30REQUIREMENTS.
282.31    Subdivision 1. Refrigeration. If the license holder provides refrigeration at service
282.32sites owned or leased by the license holder for storing perishable foods and perishable
282.33portions of bag lunches, whether the foods are supplied by the license holder or the
283.1persons receiving services, the refrigeration must have a temperature of 40 degrees
283.2Fahrenheit or less.
283.3    Subd. 2. Drinking water. Drinking water must be available to all persons
283.4receiving services. If a person is unable to request or obtain drinking water, it must be
283.5provided according to that person's individual needs. Drinking water must be provided in
283.6single-service containers or from drinking fountains accessible to all persons.
283.7    Subd. 3. Individuals who become ill during the day. There must be an area in
283.8which a person receiving services can rest if:
283.9(1) the person becomes ill during the day;
283.10(2) the person does not live in a licensed residential site;
283.11(3) the person requires supervision; and
283.12(4) there is not a caretaker immediately available. Supervision must be provided
283.13until the caretaker arrives to bring the person home.
283.14    Subd. 4. Safety procedures. The license holder must establish general written
283.15safety procedures that include criteria for selecting, training, and supervising persons who
283.16work with hazardous machinery, tools, or substances. Safety procedures specific to each
283.17person's activities must be explained and be available in writing to all staff members
283.18and persons receiving services.
283.19EFFECTIVE DATE.This section is effective January 1, 2014.

283.20    Sec. 41. [245D.31] DAY SERVICES FACILITIES; STAFF RATIO AND
283.21FACILITY COVERAGE.
283.22    Subdivision 1. Scope. This section applies only to facility-based day services.
283.23    Subd. 2. Factors. (a) The number of direct support service staff members that a
283.24license holder must have on duty at the facility at a given time to meet the minimum
283.25staffing requirements established in this section varies according to:
283.26(1) the number of persons who are enrolled and receiving direct support services
283.27at that given time;
283.28(2) the staff ratio requirement established under subdivision 3 for each person who
283.29is present; and
283.30(3) whether the conditions described in subdivision 8 exist and warrant additional
283.31staffing beyond the number determined to be needed under subdivision 7.
283.32(b) The commissioner must consider the factors in paragraph (a) in determining a
283.33license holder's compliance with the staffing requirements and must further consider
283.34whether the staff ratio requirement established under subdivision 3 for each person
283.35receiving services accurately reflects the person's need for staff time.
284.1    Subd. 3. Staff ratio requirement for each person receiving services. The case
284.2manager, in consultation with the interdisciplinary team, must determine at least once each
284.3year which of the ratios in subdivisions 4, 5, and 6 is appropriate for each person receiving
284.4services on the basis of the characteristics described in subdivisions 4, 5, and 6. The ratio
284.5assigned each person and the documentation of how the ratio was arrived at must be kept
284.6in each person's individual service plan. Documentation must include an assessment of the
284.7person with respect to the characteristics in subdivisions 4, 5, and 6 recorded on a standard
284.8assessment form required by the commissioner.
284.9    Subd. 4. Person requiring staff ratio of one to four. A person must be assigned a
284.10staff ratio requirement of one to four if:
284.11(1) on a daily basis the person requires total care and monitoring or constant
284.12hand-over-hand physical guidance to successfully complete at least three of the following
284.13activities: toileting, communicating basic needs, eating, ambulating; or is not capable of
284.14taking appropriate action for self-preservation under emergency conditions; or
284.15(2) the person engages in conduct that poses an imminent risk of physical harm to
284.16self or others at a documented level of frequency, intensity, or duration requiring frequent
284.17daily ongoing intervention and monitoring as established in the person's coordinated
284.18service and support plan or coordinated service and support plan addendum.
284.19    Subd. 5. Person requiring staff ratio of one to eight. A person must be assigned a
284.20staff ratio requirement of one to eight if:
284.21(1) the person does not meet the requirements in subdivision 4; and
284.22(2) on a daily basis the person requires verbal prompts or spot checks and minimal
284.23or no physical assistance to successfully complete at least four of the following activities:
284.24toileting, communicating basic needs, eating, ambulating, or taking appropriate action for
284.25self-preservation under emergency conditions.
284.26    Subd. 6. Person requiring staff ratio of one to six. A person who does not have
284.27any of the characteristics described in subdivision 4 or 5 must be assigned a staff ratio
284.28requirement of one to six.
284.29    Subd. 7. Determining number of direct support service staff required. The
284.30minimum number of direct support service staff members required at any one time to
284.31meet the combined staff ratio requirements of the persons present at that time can be
284.32determined by the following steps:
284.33(1) assign each person in attendance the three-digit decimal below that corresponds
284.34to the staff ratio requirement assigned to that person. A staff ratio requirement of one to
284.35four equals 0.250. A staff ratio requirement of one to eight equals 0.125. A staff ratio
284.36requirement of one to six equals 0.166. A staff ratio requirement of one to ten equals 0.100;
285.1(2) add all of the three-digit decimals (one three-digit decimal for every person in
285.2attendance) assigned in clause (1);
285.3(3) when the sum in clause (2) falls between two whole numbers, round off the sum
285.4to the larger of the two whole numbers; and
285.5(4) the larger of the two whole numbers in clause (3) equals the number of direct
285.6support service staff members needed to meet the staff ratio requirements of the persons
285.7in attendance.
285.8    Subd. 8. Staff to be included in calculating minimum staffing requirement. Only
285.9direct support staff must be counted as staff members in calculating the staff to participant
285.10ratio. A volunteer may be counted as a direct support staff in calculating the staff to
285.11participant ratio if the volunteer meets the same standards and requirements as paid staff.
285.12No person receiving services must be counted as or be substituted for a staff member in
285.13calculating the staff to participant ratio.
285.14    Subd. 9. Conditions requiring additional direct support staff. The license holder
285.15must increase the number of direct support staff members present at any one time beyond
285.16the number arrived at in subdivision 4 if necessary when any one or combination of the
285.17following circumstances can be documented by the commissioner as existing:
285.18(1) the health and safety needs of the persons receiving services cannot be met by
285.19the number of staff members available under the staffing pattern in effect even though the
285.20number has been accurately calculated under subdivision 7; or
285.21(2) the person's conduct frequently presents an imminent risk of physical harm to
285.22self or others.
285.23    Subd. 10. Supervision requirements. (a) At no time must one direct support
285.24staff member be assigned responsibility for supervision and training of more than ten
285.25persons receiving supervision and training, except as otherwise stated in each person's risk
285.26management plan.
285.27(b) In the temporary absence of the director or a supervisor, a direct support staff
285.28member must be designated to supervise the center.
285.29    Subd. 11. Multifunctional programs. A multifunctional program may count other
285.30employees of the organization besides direct support staff of the day service facility in
285.31calculating the staff to participant ratio if the employee is assigned to the day services
285.32facility for a specified amount of time, during which the employee is not assigned to
285.33another organization or program.
285.34EFFECTIVE DATE.This section is effective January 1, 2014.

285.35    Sec. 42. [245D.32] ALTERNATIVE LICENSING INSPECTIONS.
286.1    Subdivision 1. Eligibility for an alternative licensing inspection. (a) A license
286.2holder providing services licensed under this chapter, with a qualifying accreditation and
286.3meeting the eligibility criteria in paragraphs (b) and (c) may request approval for an
286.4alternative licensing inspection when all services provided under the license holder's
286.5license are accredited. A license holder with a qualifying accreditation and meeting
286.6the eligibility criteria in paragraphs (b) and (c) may request approval for an alternative
286.7licensing inspection for individual community residential settings or day services facilities
286.8licensed under this chapter.
286.9(b) In order to be eligible for an alternative licensing inspection, the program must
286.10have had at least one inspection by the commissioner following issuance of the initial
286.11license. For programs operating a day services facility, each facility must have had at least
286.12one on-site inspection by the commissioner following issuance of the initial license.
286.13(c) In order to be eligible for an alternative licensing inspection, the program must
286.14have been in "substantial and consistent compliance" at the time of the last licensing
286.15inspection and during the current licensing period. For purposes of this section, substantial
286.16and consistent compliance means:
286.17(1) the license holder's license was not made conditional, suspended, or revoked;
286.18(2) there have been no substantiated allegations of maltreatment against the license
286.19holder;
286.20(3) there were no program deficiencies identified that would jeopardize the health,
286.21safety, or rights of persons being served; and
286.22(4) the license holder maintained substantial compliance with the other requirements
286.23of chapters 245A and 245C and other applicable laws and rules.
286.24(d) For the purposes of this section, the license holder's license includes services
286.25licensed under this chapter that were previously licensed under chapter 245B until
286.26December 31, 2013.
286.27    Subd. 2. Qualifying accreditation. The commissioner must accept a three-year
286.28accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF)
286.29as a qualifying accreditation.
286.30    Subd. 3. Request for approval of an alternative inspection status. (a) A request
286.31for an alternative inspection must be made on the forms and in the manner prescribed
286.32by the commissioner. When submitting the request, the license holder must submit all
286.33documentation issued by the accrediting body verifying that the license holder has obtained
286.34and maintained the qualifying accreditation and has complied with recommendations
286.35or requirements from the accrediting body during the period of accreditation. Based
287.1on the request and the additional required materials, the commissioner may approve
287.2an alternative inspection status.
287.3(b) The commissioner must notify the license holder in writing that the request for
287.4an alternative inspection status has been approved. Approval must be granted until the
287.5end of the qualifying accreditation period.
287.6(c) The license holder must submit a written request for approval to be renewed
287.7one month before the end of the current approval period according to the requirements
287.8in paragraph (a). If the license holder does not submit a request to renew approval as
287.9required, the commissioner must conduct a licensing inspection.
287.10    Subd. 4. Programs approved for alternative licensing inspection; deemed
287.11compliance licensing requirements. (a) A license holder approved for alternative
287.12licensing inspection under this section is required to maintain compliance with all
287.13licensing standards according to this chapter.
287.14(b) A license holder approved for alternative licensing inspection under this section
287.15must be deemed to be in compliance with all the requirements of this chapter, and the
287.16commissioner must not perform routine licensing inspections.
287.17(c) Upon receipt of a complaint regarding the services of a license holder approved
287.18for alternative licensing inspection under this section, the commissioner must investigate
287.19the complaint and may take any action as provided under section 245A.06 or 245A.07.
287.20    Subd. 5. Investigations of alleged or suspected maltreatment. Nothing in this
287.21section changes the commissioner's responsibilities to investigate alleged or suspected
287.22maltreatment of a minor under section 626.556 or a vulnerable adult under section 626.557.
287.23    Subd. 6. Termination or denial of subsequent approval. Following approval of
287.24an alternative licensing inspection, the commissioner may terminate or deny subsequent
287.25approval of an alternative licensing inspection if the commissioner determines that:
287.26(1) the license holder has not maintained the qualifying accreditation;
287.27(2) the commissioner has substantiated maltreatment for which the license holder or
287.28facility is determined to be responsible during the qualifying accreditation period; or
287.29(3) during the qualifying accreditation period, the license holder has been issued
287.30an order for conditional license, fine, suspension, or license revocation that has not been
287.31reversed upon appeal.
287.32    Subd. 7. Appeals. The commissioner's decision that the conditions for approval for
287.33an alternative licensing inspection have not been met is final and not subject to appeal
287.34under the provisions of chapter 14.
288.1    Subd. 8. Commissioner's programs. Home and community-based services licensed
288.2under this chapter for which the commissioner is the license holder with a qualifying
288.3accreditation are excluded from being approved for an alternative licensing inspection.
288.4EFFECTIVE DATE.This section is effective January 1, 2014.

288.5    Sec. 43. [245D.33] ADULT MENTAL HEALTH CERTIFICATION STANDARDS.
288.6(a) The commissioner of human services shall issue a mental health certification
288.7for services licensed under this chapter, when a license holder is determined to have met
288.8the requirements under paragraph (b). This certification is voluntary for license holders.
288.9The certification shall be printed on the license and identified on the commissioner's
288.10public Web site.
288.11(b) The requirements for certification are:
288.12(1) all staff have received at least seven hours of annual training covering all of
288.13the following topics:
288.14(i) mental health diagnoses;
288.15(ii) mental health crisis response and de-escalation techniques;
288.16(iii) recovery from mental illness;
288.17(iv) treatment options, including evidence-based practices;
288.18(v) medications and their side effects;
288.19(vi) co-occurring substance abuse and health conditions; and
288.20(vii) community resources;
288.21(2) a mental health professional, as defined in section 245.462, subdivision 18, or a
288.22mental health practitioner as defined in section 245.462, subdivision 17, is available
288.23for consultation and assistance;
288.24(3) there is a plan and protocol in place to address a mental health crisis; and
288.25(4) each person's individual service and support plan identifies who is providing
288.26clinical services and their contact information, and includes an individual crisis prevention
288.27and management plan developed with the person.
288.28(c) License holders seeking certification under this section must request this
288.29certification on forms and in the manner prescribed by the commissioner.
288.30(d) If the commissioner finds that the license holder has failed to comply with the
288.31certification requirements under paragraph (b), the commissioner may issue a correction
288.32order and an order of conditional license in accordance with section 245A.06 or may
288.33issue a sanction in accordance with section 245A.07, including and up to removal of
288.34the certification.
289.1(e) A denial of the certification or the removal of the certification based on a
289.2determination that the requirements under paragraph (b) have not been met is not subject to
289.3appeal. A license holder that has been denied a certification or that has had a certification
289.4removed may again request certification when the license holder is in compliance with the
289.5requirements of paragraph (b).
289.6EFFECTIVE DATE.This section is effective January 1, 2014.

289.7    Sec. 44. Minnesota Statutes 2012, section 256B.092, subdivision 11, is amended to read:
289.8    Subd. 11. Residential support services. (a) Upon federal approval, there is
289.9established a new service called residential support that is available on the community
289.10alternative care, community alternatives for disabled individuals, developmental
289.11disabilities, and brain injury waivers. Existing waiver service descriptions must be
289.12modified to the extent necessary to ensure there is no duplication between other services.
289.13Residential support services must be provided by vendors licensed as a community
289.14residential setting as defined in section 245A.11, subdivision 8, a foster care setting
289.15licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or an adult foster care
289.16setting licensed under Minnesota Rules, parts 9555.5105 to 9555.6265.
289.17    (b) Residential support services must meet the following criteria:
289.18    (1) providers of residential support services must own or control the residential site;
289.19    (2) the residential site must not be the primary residence of the license holder;
289.20    (3) (1) the residential site must have a designated program supervisor person
289.21 responsible for program management, oversight, development, and implementation of
289.22policies and procedures;
289.23    (4) (2) the provider of residential support services must provide supervision, training,
289.24and assistance as described in the person's coordinated service and support plan; and
289.25    (5) (3) the provider of residential support services must meet the requirements of
289.26licensure and additional requirements of the person's coordinated service and support plan.
289.27    (c) Providers of residential support services that meet the definition in paragraph (a)
289.28must be registered using a process determined by the commissioner beginning July 1, 2009
289.29 must be licensed according to chapter 245D. Providers licensed to provide child foster care
289.30under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult foster care licensed under
289.31Minnesota Rules, parts 9555.5105 to 9555.6265, and that meet the requirements in section
289.32245A.03, subdivision 7 , paragraph (g), are considered registered under this section.

289.33    Sec. 45. Minnesota Statutes 2012, section 256B.4912, subdivision 1, is amended to read:
290.1    Subdivision 1. Provider qualifications. (a) For the home and community-based
290.2waivers providing services to seniors and individuals with disabilities under sections
290.3256B.0913, 256B.0915, 256B.092, and 256B.49, the commissioner shall establish:
290.4(1) agreements with enrolled waiver service providers to ensure providers meet
290.5Minnesota health care program requirements;
290.6(2) regular reviews of provider qualifications, and including requests of proof of
290.7documentation; and
290.8(3) processes to gather the necessary information to determine provider qualifications.
290.9    (b) Beginning July 1, 2012, staff that provide direct contact, as defined in section
290.10245C.02, subdivision 11 , for services specified in the federally approved waiver plans
290.11must meet the requirements of chapter 245C prior to providing waiver services and as
290.12part of ongoing enrollment. Upon federal approval, this requirement must also apply to
290.13consumer-directed community supports.
290.14    (c) Beginning January 1, 2014, service owners and managerial officials overseeing
290.15the management or policies of services that provide direct contact as specified in the
290.16federally approved waiver plans must meet the requirements of chapter 245C prior to
290.17reenrollment or, for new providers, prior to initial enrollment if they have not already done
290.18so as a part of service licensure requirements.

290.19    Sec. 46. Minnesota Statutes 2012, section 256B.4912, subdivision 7, is amended to read:
290.20    Subd. 7. Applicant and license holder training. An applicant or license holder
290.21for the home and community-based waivers providing services to seniors and individuals
290.22with disabilities under sections 256B.0913, 256B.0915, 256B.092, and 256B.49 that is
290.23not enrolled as a Minnesota health care program home and community-based services
290.24waiver provider at the time of application must ensure that at least one controlling
290.25individual completes a onetime training on the requirements for providing home and
290.26community-based services from a qualified source as determined by the commissioner,
290.27before a provider is enrolled or license is issued. Within six months of enrollment, a newly
290.28enrolled home and community-based waiver service provider must ensure that at least one
290.29controlling individual has completed training on waiver and related program billing.

290.30    Sec. 47. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
290.31subdivision to read:
290.32    Subd. 8. Data on use of emergency use of manual restraint. Beginning July 1,
290.332013, facilities and services to be licensed under chapter 245D shall submit data regarding
291.1the use of emergency use of manual restraint as identified in section 245D.061 in a format
291.2and at a frequency identified by the commissioner.

291.3    Sec. 48. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
291.4subdivision to read:
291.5    Subd. 9. Definitions. (a) For the purposes of this section the following terms have
291.6the meanings given them.
291.7(b) "Controlling individual" means a public body, governmental agency, business
291.8entity, officer, owner, or managerial official whose responsibilities include the direction of
291.9the management or policies of a program.
291.10(c) "Managerial official" means an individual who has decision-making authority
291.11related to the operation of the program and responsibility for the ongoing management of
291.12or direction of the policies, services, or employees of the program.
291.13(d) "Owner" means an individual who has direct or indirect ownership interest in
291.14a corporation or partnership, or business association enrolling with the Department of
291.15Human Services as a provider of waiver services.

291.16    Sec. 49. Minnesota Statutes 2012, section 256B.4912, is amended by adding a
291.17subdivision to read:
291.18    Subd. 10. Enrollment requirements. All home and community-based waiver
291.19providers must provide, at the time of enrollment and within 30 days of a request, in a
291.20format determined by the commissioner, information and documentation that includes, but
291.21is not limited to, the following:
291.22(1) proof of surety bond coverage in the amount of $50,000 or ten percent of the
291.23provider's payments from Medicaid in the previous calendar year, whichever is greater;
291.24(2) proof of fidelity bond coverage in the amount of $20,000; and
291.25(3) proof of liability insurance.

291.26    Sec. 50. Minnesota Statutes 2012, section 626.557, subdivision 9a, is amended to read:
291.27    Subd. 9a. Evaluation and referral of reports made to common entry point unit.
291.28    The common entry point must screen the reports of alleged or suspected maltreatment for
291.29immediate risk and make all necessary referrals as follows:
291.30    (1) if the common entry point determines that there is an immediate need for
291.31adult protective services, the common entry point agency shall immediately notify the
291.32appropriate county agency;
292.1    (2) if the report contains suspected criminal activity against a vulnerable adult, the
292.2common entry point shall immediately notify the appropriate law enforcement agency;
292.3    (3) the common entry point shall refer all reports of alleged or suspected
292.4maltreatment to the appropriate lead investigative agency as soon as possible, but in any
292.5event no longer than two working days; and
292.6    (4) if the report involves services licensed by the Department of Human Services
292.7and subject to chapter 245D, the common entry point shall refer the report to the county as
292.8the lead agency according to clause (3), but shall also notify the Department of Human
292.9Services of the report; and
292.10    (5) (4) if the report contains information about a suspicious death, the common
292.11entry point shall immediately notify the appropriate law enforcement agencies, the local
292.12medical examiner, and the ombudsman for mental health and developmental disabilities
292.13established under section 245.92. Law enforcement agencies shall coordinate with the
292.14local medical examiner and the ombudsman as provided by law.

292.15    Sec. 51. Minnesota Statutes 2012, section 626.5572, subdivision 13, is amended to read:
292.16    Subd. 13. Lead investigative agency. "Lead investigative agency" is the primary
292.17administrative agency responsible for investigating reports made under section 626.557.
292.18(a) The Department of Health is the lead investigative agency for facilities or
292.19services licensed or required to be licensed as hospitals, home care providers, nursing
292.20homes, boarding care homes, hospice providers, residential facilities that are also federally
292.21certified as intermediate care facilities that serve people with developmental disabilities,
292.22or any other facility or service not listed in this subdivision that is licensed or required to
292.23be licensed by the Department of Health for the care of vulnerable adults. "Home care
292.24provider" has the meaning provided in section 144A.43, subdivision 4, and applies when
292.25care or services are delivered in the vulnerable adult's home, whether a private home or a
292.26housing with services establishment registered under chapter 144D, including those that
292.27offer assisted living services under chapter 144G.
292.28(b) Except as provided under paragraph (c), for services licensed according to
292.29chapter 245D, The Department of Human Services is the lead investigative agency for
292.30facilities or services licensed or required to be licensed as adult day care, adult foster care,
292.31programs for people with developmental disabilities, family adult day services, mental
292.32health programs, mental health clinics, chemical dependency programs, the Minnesota
292.33sex offender program, or any other facility or service not listed in this subdivision that is
292.34licensed or required to be licensed by the Department of Human Services.
293.1(c) The county social service agency or its designee is the lead investigative agency
293.2for all other reports, including, but not limited to, reports involving vulnerable adults
293.3receiving services from a personal care provider organization under section 256B.0659,
293.4or receiving home and community-based services licensed by the Department of Human
293.5Services and subject to chapter 245D.

293.6    Sec. 52. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
293.7AND COMMUNITY-BASED SERVICES.
293.8(a) The Department of Health Compliance Monitoring Division and the Department
293.9of Human Services Licensing Division shall jointly develop an integrated licensing system
293.10for providers of both home care services subject to licensure under Minnesota Statutes,
293.11chapter 144A, and for home and community-based services subject to licensure under
293.12Minnesota Statutes, chapter 245D. The integrated licensing system shall:
293.13(1) require only one license of any provider of services under Minnesota Statutes,
293.14sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
293.15(2) promote quality services that recognize a person's individual needs and protect
293.16the person's health, safety, rights, and well-being;
293.17(3) promote provider accountability through application requirements, compliance
293.18inspections, investigations, and enforcement actions;
293.19(4) reference other applicable requirements in existing state and federal laws,
293.20including the federal Affordable Care Act;
293.21(5) establish internal procedures to facilitate ongoing communications between the
293.22agencies, and with providers and services recipients about the regulatory activities;
293.23(6) create a link between the agency Web sites so that providers and the public can
293.24access the same information regardless of which Web site is accessed initially; and
293.25(7) collect data on identified outcome measures as necessary for the agencies to
293.26report to the Centers for Medicare and Medicaid Services.
293.27(b) The joint recommendations for legislative changes to implement the integrated
293.28licensing system are due to the legislature by February 15, 2014.
293.29(c) Before implementation of the integrated licensing system, providers licensed as
293.30home care providers under Minnesota Statutes, chapter 144A, may also provide home
293.31and community-based services subject to licensure under Minnesota Statutes, chapter
293.32245D, without obtaining a home and community-based services license under Minnesota
293.33Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
293.34apply to these providers:
294.1(1) the provider must comply with all requirements under Minnesota Statutes, chapter
294.2245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
294.3(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
294.4enforced by the Department of Health under the enforcement authority set forth in
294.5Minnesota Statutes, section 144A.475; and
294.6(3) the Department of Health will provide information to the Department of Human
294.7Services about each provider licensed under this section, including the provider's license
294.8application, licensing documents, inspections, information about complaints received, and
294.9investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

294.10    Sec. 53. REPEALER.
294.11(a) Minnesota Statutes 2012, sections 245B.01; 245B.02; 245B.03; 245B.031;
294.12245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, and 7; 245B.055; 245B.06; 245B.07; and
294.13245B.08, are repealed effective January 1, 2014.
294.14(b) Minnesota Statutes 2012, section 245D.08, is repealed.


294.17    Section 1. Minnesota Statutes 2012, section 16C.10, subdivision 5, is amended to read:
294.18    Subd. 5. Specific purchases. The solicitation process described in this chapter is
294.19not required for acquisition of the following:
294.20(1) merchandise for resale purchased under policies determined by the commissioner;
294.21(2) farm and garden products which, as determined by the commissioner, may be
294.22purchased at the prevailing market price on the date of sale;
294.23(3) goods and services from the Minnesota correctional facilities;
294.24(4) goods and services from rehabilitation facilities and extended employment
294.25providers that are certified by the commissioner of employment and economic
294.26development, and day training and habilitation services licensed under sections 245B.01
294.27to 245B.08 chapter 245D;
294.28(5) goods and services for use by a community-based facility operated by the
294.29commissioner of human services;
294.30(6) goods purchased at auction or when submitting a sealed bid at auction provided
294.31that before authorizing such an action, the commissioner consult with the requesting
294.32agency to determine a fair and reasonable value for the goods considering factors
294.33including, but not limited to, costs associated with submitting a bid, travel, transportation,
294.34and storage. This fair and reasonable value must represent the limit of the state's bid;
295.1(7) utility services where no competition exists or where rates are fixed by law or
295.2ordinance; and
295.3(8) goods and services from Minnesota sex offender program facilities.
295.4EFFECTIVE DATE.This section is effective January 1, 2014.

295.5    Sec. 2. Minnesota Statutes 2012, section 16C.155, subdivision 1, is amended to read:
295.6    Subdivision 1. Service contracts. The commissioner of administration shall
295.7ensure that a portion of all contracts for janitorial services; document imaging;
295.8document shredding; and mailing, collating, and sorting services be awarded by the
295.9state to rehabilitation programs and extended employment providers that are certified
295.10by the commissioner of employment and economic development, and day training and
295.11habilitation services licensed under sections 245B.01 to 245B.08 chapter 245D. The
295.12amount of each contract awarded under this section may exceed the estimated fair market
295.13price as determined by the commissioner for the same goods and services by up to six
295.14percent. The aggregate value of the contracts awarded to eligible providers under this
295.15section in any given year must exceed 19 percent of the total value of all contracts for
295.16janitorial services; document imaging; document shredding; and mailing, collating, and
295.17sorting services entered into in the same year. For the 19 percent requirement to be
295.18applicable in any given year, the contract amounts proposed by eligible providers must be
295.19within six percent of the estimated fair market price for at least 19 percent of the contracts
295.20awarded for the corresponding service area.
295.21EFFECTIVE DATE.This section is effective January 1, 2014.

295.22    Sec. 3. Minnesota Statutes 2012, section 144D.01, subdivision 4, is amended to read:
295.23    Subd. 4. Housing with services establishment or establishment. (a) "Housing
295.24with services establishment" or "establishment" means:
295.25(1) an establishment providing sleeping accommodations to one or more adult
295.26residents, at least 80 percent of which are 55 years of age or older, and offering or
295.27providing, for a fee, one or more regularly scheduled health-related services or two or
295.28more regularly scheduled supportive services, whether offered or provided directly by the
295.29establishment or by another entity arranged for by the establishment; or
295.30(2) an establishment that registers under section 144D.025.
295.31(b) Housing with services establishment does not include:
295.32(1) a nursing home licensed under chapter 144A;
296.1(2) a hospital, certified boarding care home, or supervised living facility licensed
296.2under sections 144.50 to 144.56;
296.3(3) a board and lodging establishment licensed under chapter 157 and Minnesota
296.4Rules, parts 9520.0500 to 9520.0670, 9525.0215 to 9525.0355, 9525.0500 to 9525.0660,
296.5or 9530.4100 to 9530.4450, or under chapter 245B 245D;
296.6(4) a board and lodging establishment which serves as a shelter for battered women
296.7or other similar purpose;
296.8(5) a family adult foster care home licensed by the Department of Human Services;
296.9(6) private homes in which the residents are related by kinship, law, or affinity with
296.10the providers of services;
296.11(7) residential settings for persons with developmental disabilities in which the
296.12services are licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or applicable
296.13successor rules or laws;
296.14(8) a home-sharing arrangement such as when an elderly or disabled person or
296.15single-parent family makes lodging in a private residence available to another person
296.16in exchange for services or rent, or both;
296.17(9) a duly organized condominium, cooperative, common interest community, or
296.18owners' association of the foregoing where at least 80 percent of the units that comprise the
296.19condominium, cooperative, or common interest community are occupied by individuals
296.20who are the owners, members, or shareholders of the units; or
296.21(10) services for persons with developmental disabilities that are provided under
296.22a license according to Minnesota Rules, parts 9525.2000 to 9525.2140 in effect until
296.23January 1, 1998, or under chapter 245B 245D.
296.24EFFECTIVE DATE.This section is effective January 1, 2014.

296.25    Sec. 4. Minnesota Statutes 2012, section 174.30, subdivision 1, is amended to read:
296.26    Subdivision 1. Applicability. (a) The operating standards for special transportation
296.27service adopted under this section do not apply to special transportation provided by:
296.28(1) a common carrier operating on fixed routes and schedules;
296.29(2) a volunteer driver using a private automobile;
296.30(3) a school bus as defined in section 169.011, subdivision 71; or
296.31(4) an emergency ambulance regulated under chapter 144.
296.32(b) The operating standards adopted under this section only apply to providers
296.33of special transportation service who receive grants or other financial assistance from
296.34either the state or the federal government, or both, to provide or assist in providing that
296.35service; except that the operating standards adopted under this section do not apply
297.1to any nursing home licensed under section 144A.02, to any board and care facility
297.2licensed under section 144.50, or to any day training and habilitation services, day care,
297.3or group home facility licensed under sections 245A.01 to 245A.19 unless the facility or
297.4program provides transportation to nonresidents on a regular basis and the facility receives
297.5reimbursement, other than per diem payments, for that service under rules promulgated
297.6by the commissioner of human services.
297.7(c) Notwithstanding paragraph (b), the operating standards adopted under this
297.8section do not apply to any vendor of services licensed under chapter 245B 245D that
297.9provides transportation services to consumers or residents of other vendors licensed under
297.10chapter 245B 245D and transports 15 or fewer persons, including consumers or residents
297.11and the driver.
297.12EFFECTIVE DATE.This section is effective January 1, 2014.

297.13    Sec. 5. Minnesota Statutes 2012, section 245A.02, subdivision 1, is amended to read:
297.14    Subdivision 1. Scope. The terms used in this chapter and chapter 245B have the
297.15meanings given them in this section.
297.16EFFECTIVE DATE.This section is effective January 1, 2014.

297.17    Sec. 6. Minnesota Statutes 2012, section 245A.02, subdivision 9, is amended to read:
297.18    Subd. 9. License holder. "License holder" means an individual, corporation,
297.19partnership, voluntary association, or other organization that is legally responsible for the
297.20operation of the program, has been granted a license by the commissioner under this chapter
297.21or chapter 245B 245D and the rules of the commissioner, and is a controlling individual.
297.22EFFECTIVE DATE.This section is effective January 1, 2014.

297.23    Sec. 7. Minnesota Statutes 2012, section 245A.03, subdivision 9, is amended to read:
297.24    Subd. 9. Permitted services by an individual who is related. Notwithstanding
297.25subdivision 2, paragraph (a), clause (1), and subdivision 7, an individual who is related to a
297.26person receiving supported living services may provide licensed services to that person if:
297.27(1) the person who receives supported living services received these services in a
297.28residential site on July 1, 2005;
297.29(2) the services under clause (1) were provided in a corporate foster care setting for
297.30adults and were funded by the developmental disabilities home and community-based
297.31services waiver defined in section 256B.092;
298.1(3) the individual who is related obtains and maintains both a license under chapter
298.2245B 245D and an adult foster care license under Minnesota Rules, parts 9555.5105
298.3to 9555.6265; and
298.4(4) the individual who is related is not the guardian of the person receiving supported
298.5living services.
298.6EFFECTIVE DATE.This section is effective January 1, 2014.

298.7    Sec. 8. Minnesota Statutes 2012, section 245A.04, subdivision 13, is amended to read:
298.8    Subd. 13. Funds and property; other requirements. (a) A license holder must
298.9ensure that persons served by the program retain the use and availability of personal funds
298.10or property unless restrictions are justified in the person's individual plan. This subdivision
298.11does not apply to programs governed by the provisions in section 245B.07, subdivision 10.
298.12(b) The license holder must ensure separation of funds of persons served by the
298.13program from funds of the license holder, the program, or program staff.
298.14(c) Whenever the license holder assists a person served by the program with the
298.15safekeeping of funds or other property, the license holder must:
298.16(1) immediately document receipt and disbursement of the person's funds or other
298.17property at the time of receipt or disbursement, including the person's signature, or the
298.18signature of the conservator or payee; and
298.19(2) return to the person upon the person's request, funds and property in the license
298.20holder's possession subject to restrictions in the person's treatment plan, as soon as
298.21possible, but no later than three working days after the date of request.
298.22(d) License holders and program staff must not:
298.23(1) borrow money from a person served by the program;
298.24(2) purchase personal items from a person served by the program;
298.25(3) sell merchandise or personal services to a person served by the program;
298.26(4) require a person served by the program to purchase items for which the license
298.27holder is eligible for reimbursement; or
298.28(5) use funds of persons served by the program to purchase items for which the
298.29facility is already receiving public or private payments.
298.30EFFECTIVE DATE.This section is effective January 1, 2014.

298.31    Sec. 9. Minnesota Statutes 2012, section 245A.07, subdivision 3, is amended to read:
298.32    Subd. 3. License suspension, revocation, or fine. (a) The commissioner may
298.33suspend or revoke a license, or impose a fine if:
299.1(1) a license holder fails to comply fully with applicable laws or rules;
299.2(2) a license holder, a controlling individual, or an individual living in the household
299.3where the licensed services are provided or is otherwise subject to a background study has
299.4a disqualification which has not been set aside under section 245C.22;
299.5(3) a license holder knowingly withholds relevant information from or gives false
299.6or misleading information to the commissioner in connection with an application for
299.7a license, in connection with the background study status of an individual, during an
299.8investigation, or regarding compliance with applicable laws or rules; or
299.9(4) after July 1, 2012, and upon request by the commissioner, a license holder fails
299.10to submit the information required of an applicant under section 245A.04, subdivision 1,
299.11paragraph (f) or (g).
299.12A license holder who has had a license suspended, revoked, or has been ordered
299.13to pay a fine must be given notice of the action by certified mail or personal service. If
299.14mailed, the notice must be mailed to the address shown on the application or the last
299.15known address of the license holder. The notice must state the reasons the license was
299.16suspended, revoked, or a fine was ordered.
299.17    (b) If the license was suspended or revoked, the notice must inform the license
299.18holder of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
299.191400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
299.20a license. The appeal of an order suspending or revoking a license must be made in writing
299.21by certified mail or personal service. If mailed, the appeal must be postmarked and sent to
299.22the commissioner within ten calendar days after the license holder receives notice that the
299.23license has been suspended or revoked. If a request is made by personal service, it must be
299.24received by the commissioner within ten calendar days after the license holder received
299.25the order. Except as provided in subdivision 2a, paragraph (c), if a license holder submits
299.26a timely appeal of an order suspending or revoking a license, the license holder may
299.27continue to operate the program as provided in section 245A.04, subdivision 7, paragraphs
299.28(g) and (h), until the commissioner issues a final order on the suspension or revocation.
299.29    (c)(1) If the license holder was ordered to pay a fine, the notice must inform the
299.30license holder of the responsibility for payment of fines and the right to a contested case
299.31hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal
299.32of an order to pay a fine must be made in writing by certified mail or personal service. If
299.33mailed, the appeal must be postmarked and sent to the commissioner within ten calendar
299.34days after the license holder receives notice that the fine has been ordered. If a request is
299.35made by personal service, it must be received by the commissioner within ten calendar
299.36days after the license holder received the order.
300.1    (2) The license holder shall pay the fines assessed on or before the payment date
300.2specified. If the license holder fails to fully comply with the order, the commissioner
300.3may issue a second fine or suspend the license until the license holder complies. If the
300.4license holder receives state funds, the state, county, or municipal agencies or departments
300.5responsible for administering the funds shall withhold payments and recover any payments
300.6made while the license is suspended for failure to pay a fine. A timely appeal shall stay
300.7payment of the fine until the commissioner issues a final order.
300.8    (3) A license holder shall promptly notify the commissioner of human services,
300.9in writing, when a violation specified in the order to forfeit a fine is corrected. If upon
300.10reinspection the commissioner determines that a violation has not been corrected as
300.11indicated by the order to forfeit a fine, the commissioner may issue a second fine. The
300.12commissioner shall notify the license holder by certified mail or personal service that a
300.13second fine has been assessed. The license holder may appeal the second fine as provided
300.14under this subdivision.
300.15    (4) Fines shall be assessed as follows: the license holder shall forfeit $1,000 for
300.16each determination of maltreatment of a child under section 626.556 or the maltreatment
300.17of a vulnerable adult under section 626.557 for which the license holder is determined
300.18responsible for the maltreatment under section 626.556, subdivision 10e, paragraph (i),
300.19or 626.557, subdivision 9c, paragraph (c); the license holder shall forfeit $200 for each
300.20occurrence of a violation of law or rule governing matters of health, safety, or supervision,
300.21including but not limited to the provision of adequate staff-to-child or adult ratios, and
300.22failure to comply with background study requirements under chapter 245C; and the license
300.23holder shall forfeit $100 for each occurrence of a violation of law or rule other than
300.24those subject to a $1,000 or $200 fine above. For purposes of this section, "occurrence"
300.25means each violation identified in the commissioner's fine order. Fines assessed against a
300.26license holder that holds a license to provide the residential-based habilitation home and
300.27community-based services, as defined under identified in section 245B.02, subdivision
300.2820 245D.03, subdivision 1, and a community residential setting or day services facility
300.29license to provide foster care under chapter 245D where the services are provided, may be
300.30assessed against both licenses for the same occurrence, but the combined amount of the
300.31fines shall not exceed the amount specified in this clause for that occurrence.
300.32    (5) When a fine has been assessed, the license holder may not avoid payment by
300.33closing, selling, or otherwise transferring the licensed program to a third party. In such an
300.34event, the license holder will be personally liable for payment. In the case of a corporation,
300.35each controlling individual is personally and jointly liable for payment.
301.1(d) Except for background study violations involving the failure to comply with an
301.2order to immediately remove an individual or an order to provide continuous, direct
301.3supervision, the commissioner shall not issue a fine under paragraph (c) relating to a
301.4background study violation to a license holder who self-corrects a background study
301.5violation before the commissioner discovers the violation. A license holder who has
301.6previously exercised the provisions of this paragraph to avoid a fine for a background
301.7study violation may not avoid a fine for a subsequent background study violation unless at
301.8least 365 days have passed since the license holder self-corrected the earlier background
301.9study violation.
301.10EFFECTIVE DATE.This section is effective January 1, 2014.

301.11    Sec. 10. Minnesota Statutes 2012, section 256B.0625, subdivision 19c, is amended to
301.12read:
301.13    Subd. 19c. Personal care. Medical assistance covers personal care assistance
301.14services provided by an individual who is qualified to provide the services according to
301.15subdivision 19a and sections 256B.0651 to 256B.0656, provided in accordance with a
301.16plan, and supervised by a qualified professional.
301.17"Qualified professional" means a mental health professional as defined in section
301.18245.462, subdivision 18 , clauses (1) to (6), or 245.4871, subdivision 27, clauses (1) to (6);
301.19or a registered nurse as defined in sections 148.171 to 148.285, a licensed social worker
301.20as defined in sections 148E.010 and 148E.055, or a qualified developmental disabilities
301.21specialist under section 245B.07, subdivision 4 designated coordinator under section
301.22245D.081, subdivision 2. The qualified professional shall perform the duties required in
301.23section 256B.0659.
301.24EFFECTIVE DATE.This section is effective January 1, 2014.

301.25    Sec. 11. Minnesota Statutes 2012, section 256B.5011, subdivision 2, is amended to read:
301.26    Subd. 2. Contract provisions. (a) The service contract with each intermediate
301.27care facility must include provisions for:
301.28(1) modifying payments when significant changes occur in the needs of the
301.29consumers;
301.30(2) appropriate and necessary statistical information required by the commissioner;
301.31(3) annual aggregate facility financial information; and
301.32(4) additional requirements for intermediate care facilities not meeting the standards
301.33set forth in the service contract.
302.1(b) The commissioner of human services and the commissioner of health, in
302.2consultation with representatives from counties, advocacy organizations, and the provider
302.3community, shall review the consolidated standards under chapter 245B and the home and
302.4community-based services standards under chapter 245D and the supervised living facility
302.5rule under Minnesota Rules, chapter 4665, to determine what provisions in Minnesota
302.6Rules, chapter 4665, may be waived by the commissioner of health for intermediate care
302.7facilities in order to enable facilities to implement the performance measures in their
302.8contract and provide quality services to residents without a duplication of or increase in
302.9regulatory requirements.
302.10EFFECTIVE DATE.This section is effective January 1, 2014.

302.11    Sec. 12. Minnesota Statutes 2012, section 471.59, subdivision 1, is amended to read:
302.12    Subdivision 1. Agreement. Two or more governmental units, by agreement entered
302.13into through action of their governing bodies, may jointly or cooperatively exercise
302.14any power common to the contracting parties or any similar powers, including those
302.15which are the same except for the territorial limits within which they may be exercised.
302.16The agreement may provide for the exercise of such powers by one or more of the
302.17participating governmental units on behalf of the other participating units. The term
302.18"governmental unit" as used in this section includes every city, county, town, school
302.19district, independent nonprofit firefighting corporation, other political subdivision of
302.20this or another state, another state, federally recognized Indian tribe, the University
302.21of Minnesota, the Minnesota Historical Society, nonprofit hospitals licensed under
302.22sections 144.50 to 144.56, rehabilitation facilities and extended employment providers
302.23that are certified by the commissioner of employment and economic development, day
302.24training and habilitation services licensed under sections 245B.01 to 245B.08, day and
302.25supported employment services licensed under chapter 245D, and any agency of the state
302.26of Minnesota or the United States, and includes any instrumentality of a governmental
302.27unit. For the purpose of this section, an instrumentality of a governmental unit means an
302.28instrumentality having independent policy-making and appropriating authority.
302.29EFFECTIVE DATE.This section is effective January 1, 2014.

302.30    Sec. 13. Minnesota Statutes 2012, section 626.556, subdivision 2, is amended to read:
302.31    Subd. 2. Definitions. As used in this section, the following terms have the meanings
302.32given them unless the specific content indicates otherwise:
303.1    (a) "Family assessment" means a comprehensive assessment of child safety, risk
303.2of subsequent child maltreatment, and family strengths and needs that is applied to a
303.3child maltreatment report that does not allege substantial child endangerment. Family
303.4assessment does not include a determination as to whether child maltreatment occurred
303.5but does determine the need for services to address the safety of family members and the
303.6risk of subsequent maltreatment.
303.7    (b) "Investigation" means fact gathering related to the current safety of a child
303.8and the risk of subsequent maltreatment that determines whether child maltreatment
303.9occurred and whether child protective services are needed. An investigation must be used
303.10when reports involve substantial child endangerment, and for reports of maltreatment in
303.11facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
303.12144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
303.1313, and 124D.10; or in a nonlicensed personal care provider association as defined in
303.14sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
303.15    (c) "Substantial child endangerment" means a person responsible for a child's care,
303.16and in the case of sexual abuse includes a person who has a significant relationship to the
303.17child as defined in section 609.341, or a person in a position of authority as defined in
303.18section 609.341, who by act or omission commits or attempts to commit an act against a
303.19child under their care that constitutes any of the following:
303.20    (1) egregious harm as defined in section 260C.007, subdivision 14;
303.21    (2) sexual abuse as defined in paragraph (d);
303.22    (3) abandonment under section 260C.301, subdivision 2;
303.23    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
303.24child's physical or mental health, including a growth delay, which may be referred to as
303.25failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
303.26    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
303.27609.195 ;
303.28    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
303.29    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
303.30609.223 ;
303.31    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
303.32    (9) criminal sexual conduct under sections 609.342 to 609.3451;
303.33    (10) solicitation of children to engage in sexual conduct under section 609.352;
303.34    (11) malicious punishment or neglect or endangerment of a child under section
303.35609.377 or 609.378;
303.36    (12) use of a minor in sexual performance under section 617.246; or
304.1    (13) parental behavior, status, or condition which mandates that the county attorney
304.2file a termination of parental rights petition under section 260C.301, subdivision 3,
304.3paragraph (a).
304.4    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
304.5child's care, by a person who has a significant relationship to the child, as defined in
304.6section 609.341, or by a person in a position of authority, as defined in section 609.341,
304.7subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
304.8conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
304.9609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
304.10in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
304.11abuse also includes any act which involves a minor which constitutes a violation of
304.12prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
304.13threatened sexual abuse which includes the status of a parent or household member
304.14who has committed a violation which requires registration as an offender under section
304.15243.166, subdivision 1b, paragraph (a) or (b), or required registration under section
304.16243.166, subdivision 1b, paragraph (a) or (b).
304.17    (e) "Person responsible for the child's care" means (1) an individual functioning
304.18within the family unit and having responsibilities for the care of the child such as a
304.19parent, guardian, or other person having similar care responsibilities, or (2) an individual
304.20functioning outside the family unit and having responsibilities for the care of the child
304.21such as a teacher, school administrator, other school employees or agents, or other lawful
304.22custodian of a child having either full-time or short-term care responsibilities including,
304.23but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
304.24and coaching.
304.25    (f) "Neglect" means the commission or omission of any of the acts specified under
304.26clauses (1) to (9), other than by accidental means:
304.27    (1) failure by a person responsible for a child's care to supply a child with necessary
304.28food, clothing, shelter, health, medical, or other care required for the child's physical or
304.29mental health when reasonably able to do so;
304.30    (2) failure to protect a child from conditions or actions that seriously endanger the
304.31child's physical or mental health when reasonably able to do so, including a growth delay,
304.32which may be referred to as a failure to thrive, that has been diagnosed by a physician and
304.33is due to parental neglect;
304.34    (3) failure to provide for necessary supervision or child care arrangements
304.35appropriate for a child after considering factors as the child's age, mental ability, physical
305.1condition, length of absence, or environment, when the child is unable to care for the
305.2child's own basic needs or safety, or the basic needs or safety of another child in their care;
305.3    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
305.4260C.163, subdivision 11 , which does not include a parent's refusal to provide the parent's
305.5child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
305.6    (5) nothing in this section shall be construed to mean that a child is neglected solely
305.7because the child's parent, guardian, or other person responsible for the child's care in
305.8good faith selects and depends upon spiritual means or prayer for treatment or care of
305.9disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
305.10or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
305.11if a lack of medical care may cause serious danger to the child's health. This section does
305.12not impose upon persons, not otherwise legally responsible for providing a child with
305.13necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
305.14    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
305.15subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
305.16symptoms in the child at birth, results of a toxicology test performed on the mother at
305.17delivery or the child at birth, medical effects or developmental delays during the child's
305.18first year of life that medically indicate prenatal exposure to a controlled substance, or the
305.19presence of a fetal alcohol spectrum disorder;
305.20    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
305.21    (8) chronic and severe use of alcohol or a controlled substance by a parent or
305.22person responsible for the care of the child that adversely affects the child's basic needs
305.23and safety; or
305.24    (9) emotional harm from a pattern of behavior which contributes to impaired
305.25emotional functioning of the child which may be demonstrated by a substantial and
305.26observable effect in the child's behavior, emotional response, or cognition that is not
305.27within the normal range for the child's age and stage of development, with due regard to
305.28the child's culture.
305.29    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
305.30inflicted by a person responsible for the child's care on a child other than by accidental
305.31means, or any physical or mental injury that cannot reasonably be explained by the child's
305.32history of injuries, or any aversive or deprivation procedures, or regulated interventions,
305.33that have not been authorized under section 121A.67 or 245.825.
305.34    Abuse does not include reasonable and moderate physical discipline of a child
305.35administered by a parent or legal guardian which does not result in an injury. Abuse does
305.36not include the use of reasonable force by a teacher, principal, or school employee as
306.1allowed by section 121A.582. Actions which are not reasonable and moderate include,
306.2but are not limited to, any of the following that are done in anger or without regard to the
306.3safety of the child:
306.4    (1) throwing, kicking, burning, biting, or cutting a child;
306.5    (2) striking a child with a closed fist;
306.6    (3) shaking a child under age three;
306.7    (4) striking or other actions which result in any nonaccidental injury to a child
306.8under 18 months of age;
306.9    (5) unreasonable interference with a child's breathing;
306.10    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
306.11    (7) striking a child under age one on the face or head;
306.12    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
306.13substances which were not prescribed for the child by a practitioner, in order to control or
306.14punish the child; or other substances that substantially affect the child's behavior, motor
306.15coordination, or judgment or that results in sickness or internal injury, or subjects the
306.16child to medical procedures that would be unnecessary if the child were not exposed
306.17to the substances;
306.18    (9) unreasonable physical confinement or restraint not permitted under section
306.19609.379 , including but not limited to tying, caging, or chaining; or
306.20    (10) in a school facility or school zone, an act by a person responsible for the child's
306.21care that is a violation under section 121A.58.
306.22    (h) "Report" means any report received by the local welfare agency, police
306.23department, county sheriff, or agency responsible for assessing or investigating
306.24maltreatment pursuant to this section.
306.25    (i) "Facility" means:
306.26    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
306.27sanitarium, or other facility or institution required to be licensed under sections 144.50 to
306.28144.58 , 241.021, or 245A.01 to 245A.16, or chapter 245B 245D;
306.29    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
306.30124D.10 ; or
306.31    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
306.32subdivision 16, and 256B.0625, subdivision 19a.
306.33    (j) "Operator" means an operator or agency as defined in section 245A.02.
306.34    (k) "Commissioner" means the commissioner of human services.
307.1    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
307.2not limited to employee assistance counseling and the provision of guardian ad litem and
307.3parenting time expeditor services.
307.4    (m) "Mental injury" means an injury to the psychological capacity or emotional
307.5stability of a child as evidenced by an observable or substantial impairment in the child's
307.6ability to function within a normal range of performance and behavior with due regard to
307.7the child's culture.
307.8    (n) "Threatened injury" means a statement, overt act, condition, or status that
307.9represents a substantial risk of physical or sexual abuse or mental injury. Threatened
307.10injury includes, but is not limited to, exposing a child to a person responsible for the
307.11child's care, as defined in paragraph (e), clause (1), who has:
307.12    (1) subjected a child to, or failed to protect a child from, an overt act or condition
307.13that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
307.14similar law of another jurisdiction;
307.15    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
307.16(4), or a similar law of another jurisdiction;
307.17    (3) committed an act that has resulted in an involuntary termination of parental rights
307.18under section 260C.301, or a similar law of another jurisdiction; or
307.19    (4) committed an act that has resulted in the involuntary transfer of permanent
307.20legal and physical custody of a child to a relative under Minnesota Statutes 2010, section
307.21260C.201, subdivision 11 , paragraph (d), clause (1), section 260C.515, subdivision 4, or a
307.22similar law of another jurisdiction.
307.23A child is the subject of a report of threatened injury when the responsible social
307.24services agency receives birth match data under paragraph (o) from the Department of
307.25Human Services.
307.26(o) Upon receiving data under section 144.225, subdivision 2b, contained in a
307.27birth record or recognition of parentage identifying a child who is subject to threatened
307.28injury under paragraph (n), the Department of Human Services shall send the data to the
307.29responsible social services agency. The data is known as "birth match" data. Unless the
307.30responsible social services agency has already begun an investigation or assessment of the
307.31report due to the birth of the child or execution of the recognition of parentage and the
307.32parent's previous history with child protection, the agency shall accept the birth match
307.33data as a report under this section. The agency may use either a family assessment or
307.34investigation to determine whether the child is safe. All of the provisions of this section
307.35apply. If the child is determined to be safe, the agency shall consult with the county
307.36attorney to determine the appropriateness of filing a petition alleging the child is in need
308.1of protection or services under section 260C.007, subdivision 6, clause (16), in order to
308.2deliver needed services. If the child is determined not to be safe, the agency and the county
308.3attorney shall take appropriate action as required under section 260C.301, subdivision 3.
308.4    (p) Persons who conduct assessments or investigations under this section shall take
308.5into account accepted child-rearing practices of the culture in which a child participates
308.6and accepted teacher discipline practices, which are not injurious to the child's health,
308.7welfare, and safety.
308.8    (q) "Accidental" means a sudden, not reasonably foreseeable, and unexpected
308.9occurrence or event which:
308.10    (1) is not likely to occur and could not have been prevented by exercise of due
308.11care; and
308.12    (2) if occurring while a child is receiving services from a facility, happens when the
308.13facility and the employee or person providing services in the facility are in compliance
308.14with the laws and rules relevant to the occurrence or event.
308.15(r) "Nonmaltreatment mistake" means:
308.16(1) at the time of the incident, the individual was performing duties identified in the
308.17center's child care program plan required under Minnesota Rules, part 9503.0045;
308.18(2) the individual has not been determined responsible for a similar incident that
308.19resulted in a finding of maltreatment for at least seven years;
308.20(3) the individual has not been determined to have committed a similar
308.21nonmaltreatment mistake under this paragraph for at least four years;
308.22(4) any injury to a child resulting from the incident, if treated, is treated only with
308.23remedies that are available over the counter, whether ordered by a medical professional or
308.24not; and
308.25(5) except for the period when the incident occurred, the facility and the individual
308.26providing services were both in compliance with all licensing requirements relevant to the
308.27incident.
308.28This definition only applies to child care centers licensed under Minnesota
308.29Rules, chapter 9503. If clauses (1) to (5) apply, rather than making a determination of
308.30substantiated maltreatment by the individual, the commissioner of human services shall
308.31determine that a nonmaltreatment mistake was made by the individual.
308.32EFFECTIVE DATE.This section is effective January 1, 2014.

308.33    Sec. 14. Minnesota Statutes 2012, section 626.556, subdivision 3, is amended to read:
308.34    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
308.35to believe a child is being neglected or physically or sexually abused, as defined in
309.1subdivision 2, or has been neglected or physically or sexually abused within the preceding
309.2three years, shall immediately report the information to the local welfare agency, agency
309.3responsible for assessing or investigating the report, police department, or the county
309.4sheriff if the person is:
309.5    (1) a professional or professional's delegate who is engaged in the practice of
309.6the healing arts, social services, hospital administration, psychological or psychiatric
309.7treatment, child care, education, correctional supervision, probation and correctional
309.8services, or law enforcement; or
309.9    (2) employed as a member of the clergy and received the information while
309.10engaged in ministerial duties, provided that a member of the clergy is not required by
309.11this subdivision to report information that is otherwise privileged under section 595.02,
309.12subdivision 1 , paragraph (c).
309.13    The police department or the county sheriff, upon receiving a report, shall
309.14immediately notify the local welfare agency or agency responsible for assessing or
309.15investigating the report, orally and in writing. The local welfare agency, or agency
309.16responsible for assessing or investigating the report, upon receiving a report, shall
309.17immediately notify the local police department or the county sheriff orally and in writing.
309.18The county sheriff and the head of every local welfare agency, agency responsible
309.19for assessing or investigating reports, and police department shall each designate a
309.20person within their agency, department, or office who is responsible for ensuring that
309.21the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
309.22this subdivision shall be construed to require more than one report from any institution,
309.23facility, school, or agency.
309.24    (b) Any person may voluntarily report to the local welfare agency, agency responsible
309.25for assessing or investigating the report, police department, or the county sheriff if the
309.26person knows, has reason to believe, or suspects a child is being or has been neglected or
309.27subjected to physical or sexual abuse. The police department or the county sheriff, upon
309.28receiving a report, shall immediately notify the local welfare agency or agency responsible
309.29for assessing or investigating the report, orally and in writing. The local welfare agency or
309.30agency responsible for assessing or investigating the report, upon receiving a report, shall
309.31immediately notify the local police department or the county sheriff orally and in writing.
309.32    (c) A person mandated to report physical or sexual child abuse or neglect occurring
309.33within a licensed facility shall report the information to the agency responsible for
309.34licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
309.35chapter 245B 245D; or a nonlicensed personal care provider organization as defined in
309.36sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. A health or corrections
310.1agency receiving a report may request the local welfare agency to provide assistance
310.2pursuant to subdivisions 10, 10a, and 10b. A board or other entity whose licensees
310.3perform work within a school facility, upon receiving a complaint of alleged maltreatment,
310.4shall provide information about the circumstances of the alleged maltreatment to the
310.5commissioner of education. Section 13.03, subdivision 4, applies to data received by the
310.6commissioner of education from a licensing entity.
310.7    (d) Any person mandated to report shall receive a summary of the disposition of
310.8any report made by that reporter, including whether the case has been opened for child
310.9protection or other services, or if a referral has been made to a community organization,
310.10unless release would be detrimental to the best interests of the child. Any person who is
310.11not mandated to report shall, upon request to the local welfare agency, receive a concise
310.12summary of the disposition of any report made by that reporter, unless release would be
310.13detrimental to the best interests of the child.
310.14    (e) For purposes of this section, "immediately" means as soon as possible but in
310.15no event longer than 24 hours.
310.16EFFECTIVE DATE.This section is effective January 1, 2014.

310.17    Sec. 15. Minnesota Statutes 2012, section 626.556, subdivision 10d, is amended to read:
310.18    Subd. 10d. Notification of neglect or abuse in facility. (a) When a report is
310.19received that alleges neglect, physical abuse, sexual abuse, or maltreatment of a child while
310.20in the care of a licensed or unlicensed day care facility, residential facility, agency, hospital,
310.21sanitarium, or other facility or institution required to be licensed according to sections
310.22144.50 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B 245D, or a school as
310.23defined in sections 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed
310.24personal care provider organization as defined in section 256B.04, subdivision 16, and
310.25256B.0625, subdivision 19a , the commissioner of the agency responsible for assessing
310.26or investigating the report or local welfare agency investigating the report shall provide
310.27the following information to the parent, guardian, or legal custodian of a child alleged to
310.28have been neglected, physically abused, sexually abused, or the victim of maltreatment
310.29of a child in the facility: the name of the facility; the fact that a report alleging neglect,
310.30physical abuse, sexual abuse, or maltreatment of a child in the facility has been received;
310.31the nature of the alleged neglect, physical abuse, sexual abuse, or maltreatment of a child
310.32in the facility; that the agency is conducting an assessment or investigation; any protective
310.33or corrective measures being taken pending the outcome of the investigation; and that a
310.34written memorandum will be provided when the investigation is completed.
311.1(b) The commissioner of the agency responsible for assessing or investigating the
311.2report or local welfare agency may also provide the information in paragraph (a) to the
311.3parent, guardian, or legal custodian of any other child in the facility if the investigative
311.4agency knows or has reason to believe the alleged neglect, physical abuse, sexual
311.5abuse, or maltreatment of a child in the facility has occurred. In determining whether
311.6to exercise this authority, the commissioner of the agency responsible for assessing
311.7or investigating the report or local welfare agency shall consider the seriousness of the
311.8alleged neglect, physical abuse, sexual abuse, or maltreatment of a child in the facility; the
311.9number of children allegedly neglected, physically abused, sexually abused, or victims of
311.10maltreatment of a child in the facility; the number of alleged perpetrators; and the length
311.11of the investigation. The facility shall be notified whenever this discretion is exercised.
311.12(c) When the commissioner of the agency responsible for assessing or investigating
311.13the report or local welfare agency has completed its investigation, every parent, guardian,
311.14or legal custodian previously notified of the investigation by the commissioner or
311.15local welfare agency shall be provided with the following information in a written
311.16memorandum: the name of the facility investigated; the nature of the alleged neglect,
311.17physical abuse, sexual abuse, or maltreatment of a child in the facility; the investigator's
311.18name; a summary of the investigation findings; a statement whether maltreatment was
311.19found; and the protective or corrective measures that are being or will be taken. The
311.20memorandum shall be written in a manner that protects the identity of the reporter and
311.21the child and shall not contain the name, or to the extent possible, reveal the identity of
311.22the alleged perpetrator or of those interviewed during the investigation. If maltreatment
311.23is determined to exist, the commissioner or local welfare agency shall also provide the
311.24written memorandum to the parent, guardian, or legal custodian of each child in the facility
311.25who had contact with the individual responsible for the maltreatment. When the facility is
311.26the responsible party for maltreatment, the commissioner or local welfare agency shall also
311.27provide the written memorandum to the parent, guardian, or legal custodian of each child
311.28who received services in the population of the facility where the maltreatment occurred.
311.29This notification must be provided to the parent, guardian, or legal custodian of each child
311.30receiving services from the time the maltreatment occurred until either the individual
311.31responsible for maltreatment is no longer in contact with a child or children in the facility
311.32or the conclusion of the investigation. In the case of maltreatment within a school facility,
311.33as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10, the commissioner
311.34of education need not provide notification to parents, guardians, or legal custodians of
311.35each child in the facility, but shall, within ten days after the investigation is completed,
311.36provide written notification to the parent, guardian, or legal custodian of any student
312.1alleged to have been maltreated. The commissioner of education may notify the parent,
312.2guardian, or legal custodian of any student involved as a witness to alleged maltreatment.
312.3EFFECTIVE DATE.This section is effective January 1, 2014.

312.4    Sec. 16. REPEALER.
312.5Minnesota Statutes 2012, section 256B.49, subdivision 16a, is repealed effective
312.6January 1, 2014.


312.9    Section 1. Minnesota Statutes 2012, section 119B.13, subdivision 7, is amended to read:
312.10    Subd. 7. Absent days. (a) Licensed child care providers and license-exempt centers
312.11must not be reimbursed for more than ten 25 full-day absent days per child, excluding
312.12holidays, in a fiscal year, or for more than ten consecutive full-day absent days. Legal
312.13nonlicensed family child care providers must not be reimbursed for absent days. If a child
312.14attends for part of the time authorized to be in care in a day, but is absent for part of the
312.15time authorized to be in care in that same day, the absent time must be reimbursed but
312.16the time must not count toward the ten absent day days limit. Child care providers must
312.17only be reimbursed for absent days if the provider has a written policy for child absences
312.18and charges all other families in care for similar absences.
312.19(b) Notwithstanding paragraph (a), children with documented medical conditions
312.20that cause more frequent absences may exceed the 25 absent days limit, or ten consecutive
312.21full-day absent days limit. Absences due to a documented medical condition of a parent
312.22or sibling who lives in the same residence as the child receiving child care assistance
312.23do not count against the absent days limit in a fiscal year. Documentation of medical
312.24conditions must be on the forms and submitted according to the timelines established by
312.25the commissioner. A public health nurse or school nurse may verify the illness in lieu of
312.26a medical practitioner. If a provider sends a child home early due to a medical reason,
312.27including, but not limited to, fever or contagious illness, the child care center director or
312.28lead teacher may verify the illness in lieu of a medical practitioner.
312.29(b) (c) Notwithstanding paragraph (a), children in families may exceed the ten absent
312.30days limit if at least one parent: (1) is under the age of 21; (2) does not have a high school
312.31or general equivalency diploma; and (3) is a student in a school district or another similar
312.32program that provides or arranges for child care, parenting support, social services, career
312.33and employment supports, and academic support to achieve high school graduation, upon
313.1request of the program and approval of the county. If a child attends part of an authorized
313.2day, payment to the provider must be for the full amount of care authorized for that day.
313.3    (c) (d) Child care providers must be reimbursed for up to ten federal or state holidays
313.4or designated holidays per year when the provider charges all families for these days and the
313.5holiday or designated holiday falls on a day when the child is authorized to be in attendance.
313.6Parents may substitute other cultural or religious holidays for the ten recognized state and
313.7federal holidays. Holidays do not count toward the ten absent day days limit.
313.8    (d) (e) A family or child care provider must not be assessed an overpayment for an
313.9absent day payment unless (1) there was an error in the amount of care authorized for the
313.10family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
313.11the family or provider did not timely report a change as required under law.
313.12    (e) (f) The provider and family shall receive notification of the number of absent
313.13days used upon initial provider authorization for a family and ongoing notification of the
313.14number of absent days used as of the date of the notification.
313.15(g) For purposes of this subdivision, "absent days limit" means 25 full-day absent
313.16days per child, excluding holidays, in a fiscal year; and ten consecutive full-day absent days.

313.17    Sec. 2. [214.075] HEALTH-RELATED LICENSING BOARDS; CRIMINAL
313.18BACKGROUND CHECKS.
313.19    Subdivision 1. Applications. (a) By January 1, 2018, each health-related licensing
313.20board, as defined in section 214.01, subdivision 2, shall require applicants for initial
313.21licensure, licensure by endorsement, or reinstatement or other relicensure after a lapse
313.22in licensure, as defined by the individual health-related licensing boards to submit to
313.23a criminal history records check of state data completed by the Bureau of Criminal
313.24Apprehension (BCA) and a national criminal history records check, including a search of
313.25the records of the Federal Bureau of Investigation (FBI).
313.26(b) An applicant must complete a criminal background check if more than one year
313.27has elapsed since the applicant last submitted a background check to the board.
313.28    Subd. 2. Investigations. If a health-related licensing board has reasonable cause
313.29to believe a licensee has been charged with or convicted of a crime in this or any other
313.30jurisdiction, the health-related licensing board may require the licensee to submit to a
313.31criminal history records check of state data completed by the BCA and a national criminal
313.32history records check, including a search of the records of the FBI.
313.33    Subd. 3. Consent form; fees; fingerprints. In order to effectuate the federal
313.34and state level, fingerprint-based criminal background check, the applicant or licensee
313.35must submit a completed criminal history records check consent form and a full set of
314.1fingerprints to the respective health-related licensing board or a designee in the manner
314.2and form specified by the board. The applicant or licensee is responsible for all fees
314.3associated with preparation of the fingerprints, the criminal records check consent form,
314.4and the criminal background check. The fees for the criminal records background check
314.5shall be set by the BCA and the FBI and are not refundable.
314.6    Subd. 4. Refusal to consent. (a) The health-related licensing boards shall not issue
314.7a license to any applicant who refuses to consent to a criminal background check or fails
314.8to submit fingerprints within 90 days after submission of an application for licensure. Any
314.9fees paid by the applicant to the board shall be forfeited if the applicant refuses to consent
314.10to the criminal background check or fails to submit the required fingerprints.
314.11(b) The failure of a licensee to submit to a criminal background check as provided in
314.12subdivision 3 is grounds for disciplinary action by the respective health licensing board.
314.13    Subd. 5. Submission of fingerprints to BCA. The health-related licensing board
314.14or designee shall submit applicant or licensee fingerprints to the BCA. The BCA shall
314.15perform a check for state criminal justice information and shall forward the applicant's
314.16or licensee's fingerprints to the FBI to perform a check for national criminal justice
314.17information regarding the applicant or licensee. The BCA shall report to the board the
314.18results of the state and national criminal justice information checks.
314.19    Subd. 6. Alternatives to fingerprint-based criminal background checks. The
314.20health-related licensing board may require an alternative method of criminal history
314.21checks for an applicant or licensee who has submitted at least three sets of fingerprints in
314.22accordance with this section that have been unreadable by the BCA or FBI.
314.23    Subd. 7. Opportunity to challenge accuracy of report. Prior to taking disciplinary
314.24action against an applicant or a licensee based on a criminal conviction, the health-related
314.25licensing board shall provide the applicant or licensee an opportunity to complete or
314.26challenge the accuracy of the criminal history information reported to the board. The
314.27applicant or licensee shall have 30 calendar days following notice from the board of the
314.28intent to deny licensure or take disciplinary action to request an opportunity to correct or
314.29complete the record prior to the board taking disciplinary action based on the information
314.30reported to the board. The board shall provide the applicant up to 180 days to challenge
314.31the accuracy or completeness of the report with the agency responsible for the record. This
314.32subdivision does not affect the right of the subject of the data to contest the accuracy or
314.33completeness under section 13.04, subdivision 4.
314.34    Subd. 8. Instructions to the board; plans. The health-related licensing boards, in
314.35collaboration with the commissioner of human services and the BCA, shall establish a
314.36plan for completing criminal background checks of all licensees who were licensed before
315.1the effective date requirement under subdivision 1. The plan must seek to minimize
315.2duplication of requirements for background checks of licensed health professionals. The
315.3plan for background checks of current licensees shall be developed no later than January
315.41, 2017, and may be contingent upon the implementation of a system by the BCA or FBI
315.5in which any new crimes that an applicant or licensee commits after an initial background
315.6check are flagged in the BCA's or FBI's database and reported back to the board. The plan
315.7shall include recommendations for any necessary statutory changes.

315.8    Sec. 3. Minnesota Statutes 2012, section 246.54, is amended to read:
315.9246.54 LIABILITY OF COUNTY; REIMBURSEMENT.
315.10    Subdivision 1. County portion for cost of care. (a) Except for chemical
315.11dependency services provided under sections 254B.01 to 254B.09, the client's county
315.12shall pay to the state of Minnesota a portion of the cost of care provided in a regional
315.13treatment center or a state nursing facility to a client legally settled in that county. A
315.14county's payment shall be made from the county's own sources of revenue and payments
315.15shall equal a percentage of the cost of care, as determined by the commissioner, for each
315.16day, or the portion thereof, that the client spends at a regional treatment center or a state
315.17nursing facility according to the following schedule:
315.18    (1) zero percent for the first 30 days;
315.19    (2) 20 percent for days 31 to 60; and
315.20    (3) 50 75 percent for any days over 60.
315.21    (b) The increase in the county portion for cost of care under paragraph (a), clause
315.22(3), shall be imposed when the treatment facility has determined that it is clinically
315.23appropriate for the client to be discharged.
315.24    (c) If payments received by the state under sections 246.50 to 246.53 exceed 80
315.25percent of the cost of care for days 31 to 60, or 50 25 percent for days over 60, the county
315.26shall be responsible for paying the state only the remaining amount. The county shall
315.27not be entitled to reimbursement from the client, the client's estate, or from the client's
315.28relatives, except as provided in section 246.53.
315.29    Subd. 2. Exceptions. (a) Subdivision 1 does not apply to services provided at the
315.30Minnesota Security Hospital or the Minnesota extended treatment options program. For
315.31services at these facilities the Minnesota Security Hospital, a county's payment shall be
315.32made from the county's own sources of revenue and payments shall be paid as follows:.
315.33Excluding the state-operated forensic transition service, payments to the state from the
315.34county shall equal ten percent of the cost of care, as determined by the commissioner, for
315.35each day, or the portion thereof, that the client spends at the facility. For the state-operated
316.1forensic transition service, payments to the state from the county shall equal 50 percent of
316.2the cost of care, as determined by the commissioner, for each day, or the portion thereof,
316.3that the client spends in the program. If payments received by the state under sections
316.4246.50 to 246.53 for services provided at the Minnesota Security Hospital, excluding the
316.5state-operated forensic transition service, exceed 90 percent of the cost of care, the county
316.6shall be responsible for paying the state only the remaining amount. If payments received
316.7by the state under sections 246.50 to 246.53 for the state-operated forensic transition service
316.8exceed 50 percent of the cost of care, the county shall be responsible for paying the state
316.9only the remaining amount. The county shall not be entitled to reimbursement from the
316.10client, the client's estate, or from the client's relatives, except as provided in section 246.53.
316.11    (b) Regardless of the facility to which the client is committed, subdivision 1 does
316.12not apply to the following individuals:
316.13    (1) clients who are committed as mentally ill and dangerous under section 253B.02,
316.14subdivision 17;
316.15    (2) (1) clients who are committed as sexual psychopathic personalities under section
316.16253B.02, subdivision 18b ; and
316.17    (3) (2) clients who are committed as sexually dangerous persons under section
316.18253B.02 , subdivision 18c.
316.19    For each of the individuals in clauses (1) to (3), the payment by the county to the state
316.20shall equal ten percent of the cost of care for each day as determined by the commissioner.

316.21    Sec. 4. [256.999] CULTURAL AND ETHNIC COMMUNITIES LEADERSHIP
316.22COUNCIL.
316.23    Subdivision 1. Establishment; purpose. There is hereby established the Cultural
316.24and Ethnic Communities Leadership Council for the Department of Human Services. The
316.25purpose of the council is to advise the commissioner of human services on reducing
316.26disparities that affect racial and ethnic groups.
316.27    Subd. 2. Members. (a) The council must consist of no fewer than 15 and no more
316.28than 25 members appointed by the commissioner of human services, in consultation with
316.29county, tribal, cultural, and ethnic communities; diverse program participants; and parent
316.30representatives from these communities. The commissioner shall direct the development
316.31of guidelines defining the membership of the council; setting out definitions; and
316.32developing duties of the commissioner, the council, and council members regarding racial
316.33and ethnic disparities reduction. The guidelines must be developed in consultation with:
316.34(1) the chairs of relevant committees; and
317.1(2) county, tribal, and cultural communities and program participants from these
317.2communities.
317.3(b) Members must be appointed to allow for representation of the following groups:
317.4(1) racial and ethnic minority groups;
317.5(2) tribal service providers;
317.6(3) culturally and linguistically specific advocacy groups and service providers;
317.7(4) human services program participants;
317.8(5) public and private institutions;
317.9(6) parents of human services program participants;
317.10(7) members of the faith community;
317.11(8) Department of Human Services employees;
317.12(9) chairs of relevant legislative committees; and
317.13(10) any other group the commissioner deems appropriate to facilitate the goals
317.14and duties of the council.
317.15(c) Each member of the council must be appointed to either a one-year or two-year
317.16term. The commissioner shall appoint one member as chair.
317.17(d) Notwithstanding section 15.059, members of the council shall receive no
317.18compensation for their services.
317.19    Subd. 3. Duties of commissioner. (a) The commissioner of human services or the
317.20commissioner's designee shall:
317.21(1) maintain the council established in this section;
317.22(2) supervise and coordinate policies for persons from racial, ethnic, cultural,
317.23linguistic, and tribal communities who experience disparities in access and outcomes;
317.24(3) identify human services rules or statutes affecting persons from racial, ethnic,
317.25cultural, linguistic, and tribal communities that may need to be revised;
317.26(4) investigate and implement cost-effective models of service delivery such as
317.27careful adaptation of clinically proven services that constitute one strategy for increasing
317.28the number of culturally relevant services available to currently underserved populations;
317.29(5) based on recommendations of the council, review identified department
317.30policies that maintain racial, ethnic, cultural, linguistic, and tribal disparities, and make
317.31adjustments to ensure those disparities are not perpetuated; and
317.32(6) based on recommendations of the council, submit legislation to reduce disparities
317.33affecting racial and ethnic groups, increase access to programs, and promote better
317.34outcomes.
318.1(b) The commissioner of human services or the commissioner's designee shall
318.2consult with the council and receive recommendations from the council when meeting
318.3the requirements of this section.
318.4    Subd. 4. Duties of council. The Cultural and Ethnic Communities Leadership
318.5Council shall:
318.6(1) recommend to the commissioner for review identified policies in the Department
318.7of Human Services that maintain racial, ethnic, cultural, linguistic, and tribal disparities;
318.8(2) identify issues regarding disparities by engaging diverse populations in human
318.9services programs;
318.10(3) engage in mutual learning essential for achieving human services parity and
318.11optimal wellness for service recipients;
318.12(4) raise awareness about human services disparities to the legislature and media;
318.13(5) provide technical assistance and consultation support to counties, private
318.14nonprofit agencies, and other service providers to build their capacity to provide equitable
318.15human services for persons from racial, ethnic, cultural, linguistic, and tribal communities
318.16who experience disparities in access and outcomes;
318.17(6) provide technical assistance to promote statewide development of culturally
318.18and linguistically appropriate, accessible, and cost-effective human services and related
318.19policies;
318.20(7) provide training and outreach to facilitate access to culturally and linguistically
318.21appropriate, accessible, and cost-effective human services to prevent disparities;
318.22(8) facilitate culturally appropriate and culturally sensitive admissions, continued
318.23services, discharges, and utilization review for human services agencies and institutions;
318.24(9) form work groups to help carry out the duties of the council that include, but are
318.25not limited to, persons who provide and receive services and representatives of advocacy
318.26groups, and provide the work groups with clear guidelines, standardized parameters, and
318.27tasks for the work groups to accomplish; and
318.28(10) promote information-sharing in the human services community and statewide.
318.29    Subd. 5. Duties of council members. The members of the council shall:
318.30(1) attend and participate in scheduled meetings and be prepared by reviewing
318.31meeting notes;
318.32(2) maintain open communication channels with respective constituencies;
318.33(3) identify and communicate issues and risks that could impact the timely
318.34completion of tasks;
318.35(4) collaborate on disparity reduction efforts;
319.1(5) communicate updates of the council's work progress and status on the
319.2Department of Human Services Web site; and
319.3(6) participate in any activities the council or chair deem appropriate and necessary
319.4to facilitate the goals and duties of the council.
319.5    Subd. 6. Expiration. Notwithstanding section 15.059, the council does not expire
319.6unless directed by the commissioner.

319.7    Sec. 5. Minnesota Statutes 2012, section 256I.05, subdivision 1e, is amended to read:
319.8    Subd. 1e. Supplementary rate for certain facilities. (a) Notwithstanding the
319.9provisions of subdivisions 1a and 1c, beginning July 1, 2005, a county agency shall
319.10negotiate a supplementary rate in addition to the rate specified in subdivision 1, not to
319.11exceed $700 per month, including any legislatively authorized inflationary adjustments,
319.12for a group residential housing provider that:
319.13(1) is located in Hennepin County and has had a group residential housing contract
319.14with the county since June 1996;
319.15(2) operates in three separate locations a 75-bed facility, a 50-bed facility, and a
319.1626-bed facility; and
319.17(3) serves a chemically dependent clientele, providing 24 hours per day supervision
319.18and limiting a resident's maximum length of stay to 13 months out of a consecutive
319.1924-month period.
319.20(b) Notwithstanding subdivisions 1a and 1c, a county agency shall negotiate a
319.21supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
319.22per month, including any legislatively authorized inflationary adjustments, of a group
319.23residential provider that:
319.24(1) is located in St. Louis County and has had a group residential housing contract
319.25with the county since 2006;
319.26(2) operates a 62-bed facility; and
319.27(3) serves a chemically dependent adult male clientele, providing 24 hours per
319.28day supervision and limiting a resident's maximum length of stay to 13 months out of
319.29a consecutive 24-month period.
319.30(c) Notwithstanding subdivisions 1a and 1c, beginning July 1, 2013, a county agency
319.31shall negotiate a supplementary rate in addition to the rate specified in subdivision 1, not
319.32to exceed $700 per month, including any legislatively authorized inflationary adjustments,
319.33for the group residential provider described under paragraphs (a) and (b), not to exceed
319.34an additional 115 beds.

320.1    Sec. 6. Laws 1998, chapter 407, article 6, section 116, is amended to read:
320.2    Sec. 116. EBT TRANSACTION COSTS; APPROVAL FROM LEGISLATURE.
320.3    The commissioner of human services shall request and receive approval from the
320.4legislature before adjusting the payment to not subsidize retailers for electronic benefit
320.5transfer transaction costs Supplemental Nutrition Assistance Program transactions.
320.6EFFECTIVE DATE.This section is effective 30 days after the commissioner
320.7notifies retailers of the termination of their agreement with the state. The commissioner of
320.8human services must notify the revisor of statutes of that date.

320.9    Sec. 7. INCLUSION OF OTHER HEALTH-RELATED OCCUPATIONS TO
320.10CRIMINAL BACKGROUND CHECKS.
320.11(a) If the Department of Health is not reviewed by the Sunset Advisory Commission
320.12according to the schedule in Minnesota Statutes, section 3D.21, the commissioner
320.13of health, as the regulator for occupational therapy practitioners, speech-language
320.14pathologists, audiologists, and hearing instrument dispensers, shall require applicants
320.15for licensure or renewal to submit to a criminal history records check as required under
320.16Minnesota Statutes, section 214.075, for other health-related licensed occupations
320.17regulated by the health-related licensing boards.
320.18(b) Any statutory changes necessary to include the commissioner of health to
320.19Minnesota Statutes, section 214.075, shall be included in the plan required in Minnesota
320.20Statutes, section 214.075, subdivision 8.

320.21    Sec. 8. REPEALER.
320.22Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed.


320.25    Section 1. Minnesota Statutes 2012, section 144.051, is amended by adding a
320.26subdivision to read:
320.27    Subd. 3. Data classification; private data. For providers regulated pursuant to
320.28sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
320.29commissioner are classified as "private data" as defined in section 13.02, subdivision 12:
320.30(1) data submitted by or on behalf of applicants for licenses prior to issuance of
320.31the license;
320.32(2) the identity of complainants who have made reports concerning licensees or
320.33applicants unless the complainant consents to the disclosure;
321.1(3) the identity of individuals who provide information as part of surveys and
321.2investigations;
321.3(4) Social Security numbers; and
321.4(5) health record data.

321.5    Sec. 2. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
321.6to read:
321.7    Subd. 4. Data classification; public data. For providers regulated pursuant to
321.8sections 144A.43 to 144A.482, the following data collected, created, or maintained by the
321.9commissioner are classified as "public data" as defined in section 13.02, subdivision 15:
321.10(1) all application data on licensees, license numbers, license status;
321.11(2) licensing information about licenses previously held under this chapter;
321.12(3) correction orders, including information about compliance with the order and
321.13whether the fine was paid;
321.14(4) final enforcement actions pursuant to chapter 14;
321.15(5) orders for hearing, findings of fact and conclusions of law; and
321.16(6) when the licensee and department agree to resolve the matter without a hearing,
321.17the agreement and specific reasons for the agreement are public data.

321.18    Sec. 3. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
321.19to read:
321.20    Subd. 5. Data classification; confidential data. For providers regulated pursuant to
321.21sections 144A.43 to 144A.482, the following data collected, created, or maintained by
321.22the Department of Health are classified as "confidential data" as defined in section 13.02,
321.23subdivision 3: active investigative data relating to the investigation of potential violations
321.24of law by licensee including data from the survey process before the correction order is
321.25issued by the department.

321.26    Sec. 4. Minnesota Statutes 2012, section 144.051, is amended by adding a subdivision
321.27to read:
321.28    Subd. 6. Release of private or confidential data. For providers regulated pursuant
321.29to sections 144A.43 to 144A.482, the department may release private or confidential
321.30data, except Social Security numbers, to the appropriate state, federal, or local agency
321.31and law enforcement office to enhance investigative or enforcement efforts or further
321.32public health protective process. Types of offices include, but are not limited to, Adult
321.33Protective Services, Office of the Ombudsmen for Long-Term Care and Office of the
322.1Ombudsmen for Mental Health and Developmental Disabilities, the health licensing
322.2boards, Department of Human Services, county or city attorney's offices, police, and local
322.3or county public health offices.

322.4    Sec. 5. Minnesota Statutes 2012, section 144A.43, is amended to read:
322.5144A.43 DEFINITIONS.
322.6    Subdivision 1. Applicability. The definitions in this section apply to sections
322.7144.699, subdivision 2 , and 144A.43 to 144A.47 144A.482.
322.8    Subd. 1a. Agent. "Agent" means the person upon whom all notices and orders shall
322.9be served and who is authorized to accept service of notices and orders on behalf of
322.10the home care provider.
322.11    Subd. 1b. Applicant. "Applicant" means an individual, organization, association,
322.12corporation, unit of government, or other entity that applies for a temporary license,
322.13license, or renewal of their home care provider license under section 144A.472.
322.14    Subd. 1c. Client. "Client" means a person to whom home care services are provided.
322.15    Subd. 1d. Client record. "Client record" means all records that document
322.16information about the home care services provided to the client by the home care provider.
322.17    Subd. 1e. Client representative. "Client representative" means a person who,
322.18because of the client's needs, makes decisions about the client's care on behalf of the
322.19client. A client representative may be a guardian, health care agent, family member, or
322.20other agent of the client. Nothing in this section expands or diminishes the rights of
322.21persons to act on behalf of clients under other law.
322.22    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
322.23    Subd. 2a. Controlled substance. "Controlled substance" has the meaning given
322.24in section 152.01, subdivision 4.
322.25    Subd. 2b. Department. "Department" means the Minnesota Department of Health.
322.26    Subd. 2c. Dietary supplement. "Dietary supplement" means a product taken by
322.27mouth that contains a "dietary ingredient" intended to supplement the diet. Dietary
322.28ingredients may include vitamins, minerals, herbs or other botanicals, amino acids, and
322.29substances such as enzymes, organ tissue, glandulars, or metabolites.
322.30    Subd. 2d. Dietician. "Dietitian" is a person licensed under sections 148.621 to
322.31148.633.
322.32    Subd. 2e. Dietetics or nutrition practice. "Dietetics or nutrition practice" is
322.33performed by a licensed dietician or licensed nutritionist and includes the activities of
322.34assessment, setting priorities and objectives, providing nutrition counseling, developing
323.1and implementing nutrition care services, and evaluating and maintaining appropriate
323.2standards of quality of nutrition care under sections 148.621 to 148.633.
323.3    Subd. 3. Home care service. "Home care service" means any of the following
323.4services when delivered in a place of residence to the home of a person whose illness,
323.5disability, or physical condition creates a need for the service:
323.6(1) nursing services, including the services of a home health aide;
323.7(2) personal care services not included under sections 148.171 to 148.285;
323.8(3) physical therapy;
323.9(4) speech therapy;
323.10(5) respiratory therapy;
323.11(6) occupational therapy;
323.12(7) nutritional services;
323.13(8) home management services when provided to a person who is unable to perform
323.14these activities due to illness, disability, or physical condition. Home management
323.15services include at least two of the following services: housekeeping, meal preparation,
323.16and shopping;
323.17(9) medical social services;
323.18(10) the provision of medical supplies and equipment when accompanied by the
323.19provision of a home care service; and
323.20(11) other similar medical services and health-related support services identified by
323.21the commissioner in rule.
323.22"Home care service" does not include the following activities conducted by the
323.23commissioner of health or a board of health as defined in section 145A.02, subdivision 2:
323.24communicable disease investigations or testing; administering or monitoring a prescribed
323.25therapy necessary to control or prevent a communicable disease; or the monitoring
323.26of an individual's compliance with a health directive as defined in section 144.4172,
323.27subdivision 6 .
323.28(1) assistive tasks provided by unlicensed personnel;
323.29(2) services provided by a registered nurse or licensed practical nurse, physical
323.30therapist, respiratory therapist, occupational therapist, speech-language pathologist,
323.31dietitian or nutritionist, or social worker;
323.32(3) medication and treatment management services; or
323.33(4) the provision of durable medical equipment services when provided with any of
323.34the home care services listed in clauses (1) to (3).
323.35    Subd. 3a. Hands-on-assistance. "Hands-on-assistance" means physical help by
323.36another person without which the client is not able to perform the activity.
324.1    Subd. 3b. Home. "Home" means the client's temporary or permanent place of
324.2residence.
324.3    Subd. 4. Home care provider. "Home care provider" means an individual,
324.4organization, association, corporation, unit of government, or other entity that is regularly
324.5engaged in the delivery of at least one home care service, directly or by contractual
324.6arrangement, of home care services in a client's home for a fee and who has a valid current
324.7temporary license or license issued under sections 144A.43 to 144A.482. At least one
324.8home care service must be provided directly, although additional home care services may
324.9be provided by contractual arrangements. "Home care provider" does not include:
324.10(1) any home care or nursing services conducted by and for the adherents of any
324.11recognized church or religious denomination for the purpose of providing care and
324.12services for those who depend upon spiritual means, through prayer alone, for healing;
324.13(2) an individual who only provides services to a relative;
324.14(3) an individual not connected with a home care provider who provides assistance
324.15with home management services or personal care needs if the assistance is provided
324.16primarily as a contribution and not as a business;
324.17(4) an individual not connected with a home care provider who shares housing with
324.18and provides primarily housekeeping or homemaking services to an elderly or disabled
324.19person in return for free or reduced-cost housing;
324.20(5) an individual or agency providing home-delivered meal services;
324.21(6) an agency providing senior companion services and other older American
324.22volunteer programs established under the Domestic Volunteer Service Act of 1973,
324.23Public Law 98-288;
324.24(7) an employee of a nursing home licensed under this chapter or an employee of a
324.25boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
324.26emergency calls from individuals residing in a residential setting that is attached to or
324.27located on property contiguous to the nursing home or boarding care home;
324.28(8) a member of a professional corporation organized under chapter 319B that does
324.29not regularly offer or provide home care services as defined in subdivision 3;
324.30(9) the following organizations established to provide medical or surgical services
324.31that do not regularly offer or provide home care services as defined in subdivision 3:
324.32a business trust organized under sections 318.01 to 318.04, a nonprofit corporation
324.33organized under chapter 317A, a partnership organized under chapter 323, or any other
324.34entity determined by the commissioner;
325.1(10) an individual or agency that provides medical supplies or durable medical
325.2equipment, except when the provision of supplies or equipment is accompanied by a
325.3home care service;
325.4(11) an individual licensed under chapter 147; or
325.5(12) an individual who provides home care services to a person with a developmental
325.6disability who lives in a place of residence with a family, foster family, or primary caregiver.
325.7    Subd. 5. Medication reminder. "Medication reminder" means providing a verbal
325.8or visual reminder to a client to take medication. This includes bringing the medication
325.9to the client and providing liquids or nutrition to accompany medication that a client is
325.10self-administering.
325.11    Subd. 6. License. "License" means a basic or comprehensive home care license
325.12issued by the commissioner to a home care provider.
325.13    Subd. 7. Licensed health professional. "Licensed health professional" means a
325.14person, other than a registered nurse or licensed practical nurse, who provides home care
325.15services within the scope of practice of the person's health occupation license, registration,
325.16or certification as regulated and who is licensed by the appropriate Minnesota state board
325.17or agency.
325.18    Subd. 8. Licensee. "Licensee" means a home care provider that is licensed under
325.19this chapter.
325.20    Subd. 9. Managerial official. "Managerial official" means an administrator,
325.21director, officer, trustee, or employee of a home care provider, however designated, who
325.22has the authority to establish or control business policy.
325.23    Subd. 10. Medication. "Medication" means a prescription or over-the-counter drug.
325.24For purposes of this chapter only, medication includes dietary supplements.
325.25    Subd. 11. Medication administration. "Medication administration" means
325.26performing a set of tasks to ensure a client takes medications, and includes the following:
325.27(1) checking the client's medication record;
325.28(2) preparing the medication as necessary;
325.29(3) administering the medication to the client;
325.30(4) documenting the administration or reason for not administering the medication;
325.31and
325.32(5) reporting to a nurse any concerns about the medication, the client, or the client's
325.33refusal to take the medication.
325.34    Subd. 12. Medication management. "Medication management" means the
325.35provision of any of the following medication-related services to a client:
325.36(1) performing medication setup;
326.1(2) administering medication;
326.2(3) storing and securing medications;
326.3(4) documenting medication activities;
326.4(5) verifying and monitoring effectiveness of systems to ensure safe handling and
326.5administration;
326.6(6) coordinating refills;
326.7(7) handling and implementing changes to prescriptions;
326.8(8) communicating with the pharmacy about the client's medications; and
326.9(9) coordinating and communicating with the prescriber.
326.10    Subd. 13. Medication setup. "Medication setup" means arranging medications by a
326.11nurse, pharmacy, or authorized prescriber for later administration by the client or by
326.12comprehensive home care staff.
326.13    Subd. 14. Nurse. "Nurse" means a person who is licensed under sections 148.171 to
326.14148.285.
326.15    Subd. 15. Occupational therapist. "Occupational therapist" means a person who is
326.16licensed under sections 148.6401 to 148.6450.
326.17    Subd. 16. Over-the-counter drug. "Over-the-counter drug" means a drug that is
326.18not required by federal law to bear the symbol "Rx only."
326.19    Subd. 17. Owner. "Owner" means a proprietor, general partner, limited partner who
326.20has five percent or more of equity interest in a limited partnership, a person who owns or
326.21controls voting stock in a corporation in an amount equal to or greater than five percent of
326.22the shares issued and outstanding, or a corporation that owns equity interest in a licensee
326.23or applicant for a license.
326.24    Subd. 18. Pharmacist. "Pharmacist" has the meaning given in section 151.01,
326.25subdivision 3.
326.26    Subd. 19. Physical therapist. "Physical therapist" means a person who is licensed
326.27under sections 148.65 to 148.78.
326.28    Subd. 20. Physician. "Physician" means a person who is licensed under chapter 147.
326.29    Subd. 21. Prescriber. "Prescriber" means a person who is authorized by sections
326.30148.235; 151.01, subdivision 23; and 151.37, to prescribe prescription drugs.
326.31    Subd. 22. Prescription. "Prescription" has the meaning given in section 151.01,
326.32subdivision 16.
326.33    Subd. 23. Regularly scheduled. "Regularly scheduled" means ordered or planned
326.34to be completed at predetermined times or according to a predetermined routine.
326.35    Subd. 24. Reminder. "Reminder" means providing a verbal or visual reminder
326.36to a client.
327.1    Subd. 25. Respiratory therapist. "Respiratory therapist" means a person who
327.2is licensed under chapter 147C.
327.3    Subd. 26. Revenues. "Revenues" means all money or the value of property or
327.4services received by a registrant and derived from the provision of home care services,
327.5including fees for services, grants, bequests, gifts, donations, appropriations of public
327.6money, and earned interest or dividends.
327.7    Subd. 27. Service plan. "Service plan" means the written plan between the client or
327.8client's representative and the temporary licensee or licensee about the services that will
327.9be provided to the client.
327.10    Subd. 28. Social worker. "Social worker" means a person who is licensed under
327.11chapter 148D or 148E.
327.12    Subd. 29. Speech language pathologist. "Speech language pathologist" has the
327.13meaning given in section 148.512.
327.14    Subd. 30. Standby assistance. "Standby assistance" means the presence of another
327.15person within arm's reach to minimize the risk of injury while performing daily activities
327.16through physical intervention or cuing.
327.17    Subd. 31. Substantial compliance. "Substantial compliance" means complying
327.18with the requirements in this chapter sufficiently to prevent unacceptable health or safety
327.19risks to the home care client.
327.20    Subd. 32. Survey. "Survey" means an inspection of a licensee or applicant for
327.21licensure for compliance with this chapter.
327.22    Subd. 33. Surveyor. "Surveyor" means a staff person of the department authorized
327.23to conduct surveys of home care providers and applicants.
327.24    Subd. 34. Temporary license. "Temporary license" means the initial basic or
327.25comprehensive home care license the department issues after approval of a complete
327.26written application and before the department completes the temporary license survey and
327.27determines that the temporary licensee is in substantial compliance.
327.28    Subd. 35. Treatment or therapy. "Treatment" or "therapy" means the provision
327.29of care, other than medications, ordered or prescribed by a licensed health professional
327.30provided to a client to cure, rehabilitate, or ease symptoms.
327.31    Subd. 36. Unit of government. "Unit of government" means every city, county,
327.32town, school district, other political subdivisions of the state, and any agency of the state
327.33or federal government, which includes any instrumentality of a unit of government.
327.34    Subd. 37. Unlicensed personnel. "Unlicensed personnel" are individuals not
327.35otherwise licensed or certified by a governmental health board or agency who provide
327.36home care services in the client's home.
328.1    Subd. 38. Verbal. "Verbal" means oral and not in writing.

328.2    Sec. 6. Minnesota Statutes 2012, section 144A.44, is amended to read:
328.3144A.44 HOME CARE BILL OF RIGHTS.
328.4    Subdivision 1. Statement of rights. A person who receives home care services
328.5has these rights:
328.6(1) the right to receive written information about rights in advance of before
328.7receiving care or during the initial evaluation visit before the initiation of treatment
328.8 services, including what to do if rights are violated;
328.9(2) the right to receive care and services according to a suitable and up-to-date plan,
328.10and subject to accepted health care, medical or nursing standards, to take an active part
328.11in creating and changing the plan developing, modifying, and evaluating care the plan
328.12 and services;
328.13(3) the right to be told in advance of before receiving care about the services that will
328.14be provided, the disciplines that will furnish care the type and disciplines of staff who will
328.15be providing the services, the frequency of visits proposed to be furnished, other choices
328.16that are available for addressing home care needs, and the consequences of these choices
328.17including the potential consequences of refusing these services;
328.18(4) the right to be told in advance of any change recommended changes by the
328.19provider in the service plan of care and to take an active part in any change decisions
328.20about changes to the service plan;
328.21(5) the right to refuse services or treatment;
328.22(6) the right to know, in advance before receiving services or during the initial
328.23visit, any limits to the services available from a home care provider, and the provider's
328.24grounds for a termination of services;
328.25(7) the right to know in advance of receiving care whether the services are covered
328.26by health insurance, medical assistance, or other health programs, the charges for services
328.27that will not be covered by Medicare, and the charges that the individual may have to pay;
328.28(8) (7) the right to know be told before services are initiated what the provider
328.29charges are for the services, no matter who will be paying the bill and if known to what
328.30extent payment may be expected from health insurance, public programs or other sources,
328.31and what charges the client may be responsible for paying;
328.32(9) (8) the right to know that there may be other services available in the community,
328.33including other home care services and providers, and to know where to go for find
328.34 information about these services;
329.1(10) (9) the right to choose freely among available providers and to change providers
329.2after services have begun, within the limits of health insurance, long-term care insurance,
329.3medical assistance, or other health programs;
329.4(11) (10) the right to have personal, financial, and medical information kept private,
329.5and to be advised of the provider's policies and procedures regarding disclosure of such
329.6information;
329.7(12) (11) the right to be allowed access to the client's own records and written
329.8information from those records in accordance with sections 144.291 to 144.298;
329.9(13) (12) the right to be served by people who are properly trained and competent
329.10to perform their duties;
329.11(14) (13) the right to be treated with courtesy and respect, and to have the patient's
329.12 client's property treated with respect;
329.13(15) (14) the right to be free from physical and verbal abuse, neglect, financial
329.14exploitation, and all forms of maltreatment covered under the Vulnerable Adults Act and
329.15the Maltreatment of Minors Act;
329.16(16) (15) the right to reasonable, advance notice of changes in services or charges,
329.17including;
329.18(16) the right to know the provider's reason for termination of services;
329.19(17) the right to at least ten days' advance notice of the termination of a service by a
329.20provider, except in cases where:
329.21(i) the recipient of services client engages in conduct that significantly alters the
329.22conditions of employment as specified in the employment contract between terms of
329.23the service plan with the home care provider and the individual providing home care
329.24services, or creates;
329.25(ii) the client, person who lives with the client, or others create an abusive or unsafe
329.26work environment for the individual person providing home care services; or
329.27(ii) (iii) an emergency for the informal caregiver or a significant change in the
329.28recipient's client's condition has resulted in service needs that exceed the current service
329.29provider agreement plan and that cannot be safely met by the home care provider;
329.30(17) (18) the right to a coordinated transfer when there will be a change in the
329.31provider of services;
329.32(18) (19) the right to voice grievances regarding treatment or care that is complain
329.33about services that are provided, or fails to be, furnished, or regarding fail to be provided,
329.34and the lack of courtesy or respect to the patient client or the patient's client's property;
330.1(19) (20) the right to know how to contact an individual associated with the home
330.2care provider who is responsible for handling problems and to have the home care provider
330.3investigate and attempt to resolve the grievance or complaint;
330.4(20) (21) the right to know the name and address of the state or county agency to
330.5contact for additional information or assistance; and
330.6(21) (22) the right to assert these rights personally, or have them asserted by
330.7the patient's family or guardian when the patient has been judged incompetent, client's
330.8representative or by anyone on behalf of the client, without retaliation.
330.9    Subd. 2. Interpretation and enforcement of rights. These rights are established
330.10for the benefit of persons clients who receive home care services. "Home care services"
330.11means home care services as defined in section 144A.43, subdivision 3, and unlicensed
330.12personal care assistance services, including services covered by medical assistance under
330.13section 256B.0625, subdivision 19a. All home care providers, including those exempted
330.14under section 144A.471, must comply with this section. The commissioner shall enforce
330.15this section and the home care bill of rights requirement against home care providers
330.16exempt from licensure in the same manner as for licensees. A home care provider may
330.17not request or require a person client to surrender any of these rights as a condition of
330.18receiving services. A guardian or conservator or, when there is no guardian or conservator,
330.19a designated person, may seek to enforce these rights. This statement of rights does not
330.20replace or diminish other rights and liberties that may exist relative to persons clients
330.21 receiving home care services, persons providing home care services, or providers licensed
330.22under Laws 1987, chapter 378. A copy of these rights must be provided to an individual
330.23at the time home care services, including personal care assistance services, are initiated.
330.24The copy shall also contain the address and phone number of the Office of Health Facility
330.25Complaints and the Office of Ombudsman for Long-Term Care and a brief statement
330.26describing how to file a complaint with these offices. Information about how to contact
330.27the Office of Ombudsman for Long-Term Care shall be included in notices of change in
330.28client fees and in notices where home care providers initiate transfer or discontinuation of
330.29services sections 144A.43 to 144A.482.

330.30    Sec. 7. Minnesota Statutes 2012, section 144A.45, is amended to read:
330.31144A.45 REGULATION OF HOME CARE SERVICES.
330.32    Subdivision 1. Rules Regulations. The commissioner shall adopt rules for the
330.33regulation of regulate home care providers pursuant to sections 144A.43 to 144A.47
330.34 144A.482. The rules regulations shall include the following:
331.1    (1) provisions to assure, to the extent possible, the health, safety and well-being,
331.2and appropriate treatment of persons who receive home care services while respecting
331.3clients' autonomy and choice;
331.4    (2) requirements that home care providers furnish the commissioner with specified
331.5information necessary to implement sections 144A.43 to 144A.47 144A.482;
331.6    (3) standards of training of home care provider personnel, which may vary according
331.7to the nature of the services provided or the health status of the consumer;
331.8(4) standards for provision of home care services;
331.9    (4) (5) standards for medication management which may vary according to the
331.10nature of the services provided, the setting in which the services are provided, or the
331.11status of the consumer. Medication management includes the central storage, handling,
331.12distribution, and administration of medications;
331.13    (5) (6) standards for supervision of home care services requiring supervision by a
331.14registered nurse or other appropriate health care professional which must occur on site
331.15at least every 62 days, or more frequently if indicated by a clinical assessment, and in
331.16accordance with sections 148.171 to 148.285 and rules adopted thereunder, except that a
331.17person performing home care aide tasks for a class B licensee providing paraprofessional
331.18services does not require nursing supervision;
331.19    (6) (7) standards for client evaluation or assessment which may vary according to
331.20the nature of the services provided or the status of the consumer;
331.21    (7) (8) requirements for the involvement of a consumer's physician client's health
331.22care provider, the documentation of physicians' health care providers' orders, if required,
331.23and the consumer's treatment client's service plan, and;
331.24(9) the maintenance of accurate, current clinical client records;
331.25    (8) (10) the establishment of different classes basic and comprehensive levels of
331.26licenses for different types of providers and different standards and requirements for
331.27different kinds of home care based on services provided; and
331.28    (9) operating procedures required to implement (11) provisions to enforce these
331.29regulations and the home care bill of rights.
331.30    Subd. 1a. Home care aide tasks. Notwithstanding the provisions of Minnesota
331.31Rules, part 4668.0110, subpart 1, item E, home care aide tasks also include assisting
331.32toileting, transfers, and ambulation if the client is ambulatory and if the client has no
331.33serious acute illness or infectious disease.
331.34    Subd. 1b. Home health aide qualifications. Notwithstanding the provisions of
331.35Minnesota Rules, part 4668.0100, subpart 5, a person may perform home health aide tasks
331.36if the person maintains current registration as a nursing assistant on the Minnesota nursing
332.1assistant registry. Maintaining current registration on the Minnesota nursing assistant
332.2registry satisfies the documentation requirements of Minnesota Rules, part 4668.0110,
332.3subpart 3.
332.4    Subd. 2. Regulatory functions. (a) The commissioner shall:
332.5(1) evaluate, monitor, and license, survey, and monitor without advance notice, home
332.6care providers in accordance with sections 144A.45 to 144A.47 144A.43 to 144A.482;
332.7(2) inspect the office and records of a provider during regular business hours without
332.8advance notice to the home care provider;
332.9(2) survey every temporary licensee within one year of the temporary license issuance
332.10date subject to the temporary licensee providing home care services to a client or clients;
332.11(3) survey all licensed home care providers on an interval that will promote the
332.12health and safety of clients;
332.13(3) (4) with the consent of the consumer client, visit the home where services are
332.14being provided;
332.15(4) (5) issue correction orders and assess civil penalties in accordance with section
332.16144.653, subdivisions 5 to 8 , for violations of sections 144A.43 to 144A.47 or the rules
332.17adopted under those sections 144A.482;
332.18(5) (6) take action as authorized in section 144A.46, subdivision 3 144A.475; and
332.19(6) (7) take other action reasonably required to accomplish the purposes of sections
332.20144A.43 to 144A.47 144A.482.
332.21(b) In the exercise of the authority granted in sections 144A.43 to 144A.47, the
332.22commissioner shall comply with the applicable requirements of section 144.122, the
332.23Government Data Practices Act, and the Administrative Procedure Act.
332.24    Subd. 4. Medicaid reimbursement. Notwithstanding the provisions of section
332.25256B.37 or state plan requirements to the contrary, certification by the federal Medicare
332.26program must not be a requirement of Medicaid payment for services delivered under
332.27section 144A.4605.
332.28    Subd. 5. Home care providers; services for Alzheimer's disease or related
332.29disorder. (a) If a home care provider licensed under section 144A.46 or 144A.4605 markets
332.30or otherwise promotes services for persons with Alzheimer's disease or related disorders,
332.31the facility's direct care staff and their supervisors must be trained in dementia care.
332.32(b) Areas of required training include:
332.33(1) an explanation of Alzheimer's disease and related disorders;
332.34(2) assistance with activities of daily living;
332.35(3) problem solving with challenging behaviors; and
332.36(4) communication skills.
333.1(c) The licensee shall provide to consumers in written or electronic form a
333.2description of the training program, the categories of employees trained, the frequency
333.3of training, and the basic topics covered.

333.4    Sec. 8. [144A.471] HOME CARE PROVIDER AND HOME CARE SERVICES.
333.5    Subdivision 1. License required. A home care provider may not open, operate,
333.6manage, conduct, maintain, or advertise itself as a home care provider or provide home
333.7care services in Minnesota without a temporary or current home care provider license
333.8issued by the commissioner of health.
333.9    Subd. 2. Determination of direct home care service. "Direct home care service"
333.10means a home care service provided to a client by the home care provider or its employees,
333.11and not by contract. Factors that must be considered in determining whether an individual
333.12or a business entity provides at least one home care service directly include, but are not
333.13limited to, whether the individual or business entity:
333.14    (1) has the right to control, and does control, the types of services provided;
333.15(2) has the right to control, and does control, when and how the services are provided;
333.16    (3) establishes the charges;
333.17(4) collects fees from the clients or receives payment from third-party payers on
333.18the clients' behalf;
333.19(5) pays individuals providing services compensation on an hourly, weekly, or
333.20similar basis;
333.21(6) treats the individuals providing services as employees for the purposes of payroll
333.22taxes and workers' compensation insurance; and
333.23(7) holds itself out as a provider of home care services or acts in a manner that
333.24leads clients or potential clients to believe that it is a home care provider providing home
333.25care services.
333.26    None of the factors listed in this subdivision is solely determinative.
333.27    Subd. 3. Determination of regularly engaged. "Regularly engaged" means
333.28providing, or offering to provide, home care services as a regular part of a business. The
333.29following factors must be considered by the commissioner in determining whether an
333.30individual or a business entity is regularly engaged in providing home care services:
333.31    (1) whether the individual or business entity states or otherwise promotes that the
333.32individual or business entity provides home care services;
333.33    (2) whether persons receiving home care services constitute a substantial part of the
333.34individual's or the business entity's clientele; and
334.1(3) whether the home care services provided are other than occasional or incidental
334.2to the provision of services other than home care services.
334.3    None of the factors listed in this subdivision is solely determinative.
334.4    Subd. 4. Penalties for operating without license. A person involved in the
334.5management, operation, or control of a home care provider that operates without an
334.6appropriate license is guilty of a misdemeanor. This section does not apply to a person
334.7who has no legal authority to affect or change decisions related to the management,
334.8operation, or control of a home care provider.
334.9    Subd. 5. Basic and comprehensive levels of licensure. An applicant seeking
334.10to become a home care provider must apply for either a basic or comprehensive home
334.11care license.
334.12    Subd. 6. Basic home care license provider. Home care services that can be
334.13provided with a basic home care license are assistive tasks provided by licensed or
334.14unlicensed personnel that include:
334.15(1) assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting,
334.16and bathing;
334.17(2) providing standby assistance;
334.18(3) providing verbal or visual reminders to the client to take regularly scheduled
334.19medication which includes bringing the client previously set-up medication, medication in
334.20original containers, or liquid or food to accompany the medication;
334.21(4) providing verbal or visual reminders to the client to perform regularly scheduled
334.22treatments and exercises;
334.23(5) preparing modified diets ordered by a licensed health professional; and
334.24(6) assisting with laundry, housekeeping, meal preparation, shopping, or other
334.25household chores and services if the provider is also providing at least one of the activities
334.26in clauses (1) to (5)
334.27    Subd. 7. Comprehensive home care license provider. Home care services that
334.28may be provided with a comprehensive home care license include any of the basic home
334.29care services listed in subdivision 6, and one or more of the following:
334.30(1) services of an advanced practice nurse, registered nurse, licensed practical
334.31nurse, physical therapist, respiratory therapist, occupational therapist, speech-language
334.32pathologist, dietician or nutritionist, or social worker;
334.33(2) tasks delegated to unlicensed personnel by a registered nurse or assigned by a
334.34licensed health professional within the person's scope of practice;
334.35(3) medication management services;
334.36(4) hands-on assistance with transfers and mobility;
335.1(5) assisting clients with eating when the clients have complicating eating problems
335.2as identified in the client record or through an assessment such as difficulty swallowing,
335.3recurrent lung aspirations, or requiring the use of a tube or parenteral or intravenous
335.4instruments to be fed; or
335.5(6) providing other complex or specialty health care services.
335.6    Subd. 8. Exemptions from home care services licensure. (a) Except as otherwise
335.7provided in this chapter, home care services that are provided by the state, counties, or
335.8other units of government must be licensed under this chapter.
335.9(b) An exemption under this subdivision does not excuse the exempted individual or
335.10organization from complying with applicable provisions of the home care bill of rights
335.11in section 144A.44. The following individuals or organizations are exempt from the
335.12requirement to obtain a home care provider license:
335.13(1) an individual or organization that offers, provides, or arranges for personal care
335.14assistance services under the medical assistance program as authorized under sections
335.15256B.04, subdivision 16; 256B.0625, subdivision 19a; and 256B.0659;
335.16(2) a provider that is licensed by the commissioner of human services to provide
335.17semi-independent living services for persons with developmental disabilities under section
335.18252.275 and Minnesota Rules, parts 9525.0900 to 9525.1020;
335.19(3) a provider that is licensed by the commissioner of human services to provide
335.20home and community-based services for persons with developmental disabilities under
335.21section 256B.092 and Minnesota Rules, parts 9525.1800 to 9525.1930;
335.22(4) an individual or organization that provides only home management services, if
335.23the individual or organization is registered under section 144A.482; or
335.24(5) an individual who is licensed in this state as a nurse, dietitian, social worker,
335.25occupational therapist, physical therapist, or speech-language pathologist who provides
335.26health care services in the home independently and not through any contractual or
335.27employment relationship with a home care provider or other organization.
335.28    Subd. 9. Exclusions from home care licensure. The following are excluded from
335.29home care licensure and are not required to provide the home care bill of rights:
335.30(1) an individual or business entity providing only coordination of home care that
335.31includes one or more of the following:
335.32(i) determination of whether a client needs home care services, or assisting a client
335.33in determining what services are needed;
335.34(ii) referral of clients to a home care provider;
335.35(iii) administration of payments for home care services; or
335.36(iv) administration of a health care home established under section 256B.0751;
336.1(2) an individual who is not an employee of a licensed home care provider if the
336.2individual:
336.3(i) only provides services as an independent contractor to one or more licensed
336.4home care providers;
336.5(ii) provides no services under direct agreements or contracts with clients; and
336.6(iii) is contractually bound to perform services in compliance with the contracting
336.7home care provider's policies and service plans;
336.8(3) a business that provides staff to home care providers, such as a temporary
336.9employment agency, if the business:
336.10(i) only provides staff under contract to licensed or exempt providers;
336.11(ii) provides no services under direct agreements with clients; and
336.12(iii) is contractually bound to perform services under the contracting home care
336.13provider's direction and supervision;
336.14(4) any home care services conducted by and for the adherents of any recognized
336.15church or religious denomination for its members through spiritual means, or by prayer
336.16for healing;
336.17(5) an individual who only provides home care services to a relative;
336.18(6) an individual not connected with a home care provider that provides assistance
336.19with basic home care needs if the assistance is provided primarily as a contribution and
336.20not as a business;
336.21(7) an individual not connected with a home care provider that shares housing with
336.22and provides primarily housekeeping or homemaking services to an elderly or disabled
336.23person in return for free or reduced-cost housing;
336.24(8) an individual or provider providing home-delivered meal services;
336.25(9) an individual providing senior companion services and other Older American
336.26Volunteer Programs (OAVP) established under the Domestic Volunteer Service Act of
336.271973, United States Code, title 42, chapter 66;
336.28(10) an employee of a nursing home licensed under this chapter or an employee of a
336.29boarding care home licensed under sections 144.50 to 144.56 who responds to occasional
336.30emergency calls from individuals residing in a residential setting that is attached to or
336.31located on property contiguous to the nursing home or boarding care home;
336.32(11) a member of a professional corporation organized under chapter 319B that
336.33does not regularly offer or provide home care services as defined in section 144A.43,
336.34subdivision 3;
336.35(12) the following organizations established to provide medical or surgical services
336.36that do not regularly offer or provide home care services as defined in section 144A.43,
337.1subdivision 3: a business trust organized under sections 318.01 to 318.04, a nonprofit
337.2corporation organized under chapter 317A, a partnership organized under chapter 323, or
337.3any other entity determined by the commissioner;
337.4(13) an individual or agency that provides medical supplies or durable medical
337.5equipment, except when the provision of supplies or equipment is accompanied by a
337.6home care service;
337.7(14) a physician licensed under chapter 147;
337.8(15) an individual who provides home care services to a person with a developmental
337.9disability who lives in a place of residence with a family, foster family, or primary caregiver;
337.10(16) a business that only provides services that are primarily instructional and not
337.11medical services or health-related support services;
337.12(17) an individual who performs basic home care services for no more than 14 hours
337.13each calendar week to no more than one client;
337.14(18) an individual or business licensed as hospice as defined in sections 144A.75 to
337.15144A.755 who is not providing home care services independent of hospice service;
337.16(19) activities conducted by the commissioner of health or a board of health as
337.17defined in section 145A.02, subdivision 2, including communicable disease investigations
337.18or testing; or
337.19(20) administering or monitoring a prescribed therapy necessary to control or
337.20prevent a communicable disease, or the monitoring of an individual's compliance with a
337.21health directive as defined in section 144.4172, subdivision 6.

337.22    Sec. 9. [144A.472] HOME CARE PROVIDER LICENSE; APPLICATION AND
337.23RENEWAL.
337.24    Subdivision 1. License applications. Each application for a home care provider
337.25license must include information sufficient to show that the applicant meets the
337.26requirements of licensure, including:
337.27    (1) the applicant's name, e-mail address, physical address, and mailing address,
337.28including the name of the county in which the applicant resides and has a principal
337.29place of business;
337.30(2) the initial license fee in the amount specified in subdivision 7;
337.31(3) e-mail address, physical address, mailing address, and telephone number of the
337.32principal administrative office;
337.33(4) e-mail address, physical address, mailing address, and telephone number of
337.34each branch office, if any;
338.1(5) names, e-mail and mailing addresses, and telephone numbers of all owners
338.2and managerial officials;
338.3(6) documentation of compliance with the background study requirements of section
338.4144A.476 for all persons involved in the management, operation, or control of the home
338.5care provider;
338.6(7) documentation of a background study as required by section 144.057 for any
338.7individual seeking employment, paid or volunteer, with the home care provider;
338.8(8) evidence of workers' compensation coverage as required by sections 176.181
338.9and 176.182;
338.10(9) documentation of liability coverage, if the provider has it;
338.11(10) identification of the license level the provider is seeking;
338.12(11) documentation that identifies the managerial official who is in charge of
338.13day-to-day operations and attestation that the person has reviewed and understands the
338.14home care provider regulations;
338.15(12) documentation that the applicant has designated one or more owners,
338.16managerial officials, or employees as an agent or agents, which shall not affect the legal
338.17responsibility of any other owner or managerial official under this chapter;
338.18(13) the signature of the officer or managing agent on behalf of an entity, corporation,
338.19association, or unit of government;
338.20(14) verification that the applicant has the following policies and procedures in place
338.21so that if a license is issued, the applicant will implement the policies and procedures
338.22and keep them current:
338.23    (i) requirements in sections 626.556, reporting of maltreatment of minors, and
338.24626.557, reporting of maltreatment of vulnerable adults;
338.25(ii) conducting and handling background studies on employees;
338.26(iii) orientation, training, and competency evaluations of home care staff, and a
338.27process for evaluating staff performance;
338.28(iv) handling complaints from clients, family members, or client representatives
338.29regarding staff or services provided by staff;
338.30(v) conducting initial evaluation of clients' needs and the providers' ability to provide
338.31those services;
338.32(vi) conducting initial and ongoing client evaluations and assessments and how
338.33changes in a client's condition are identified, managed, and communicated to staff and
338.34other health care providers as appropriate;
338.35(vii) orientation to and implementation of the home care client bill of rights;
338.36(viii) infection control practices;
339.1(ix) reminders for medications, treatments, or exercises, if provided; and
339.2(x) conducting appropriate screenings, or documentation of prior screenings, to
339.3show that staff are free of tuberculosis, consistent with current United States Centers for
339.4Disease Control standards; and
339.5(15) other information required by the department.
339.6    Subd. 2. Comprehensive home care license applications. In addition to the
339.7information and fee required in subdivision 1, applicants applying for a comprehensive
339.8home care license must also provide verification that the applicant has the following
339.9policies and procedures in place so that if a license is issued, the applicant will implement
339.10the policies and procedures in this subdivision and keep them current:
339.11(1) conducting initial and ongoing assessments of the client's needs by a registered
339.12nurse or appropriate licensed health professional, including how changes in the client's
339.13conditions are identified, managed, and communicated to staff and other health care
339.14providers, as appropriate;
339.15(2) ensuring that nurses and licensed health professionals have current and valid
339.16licenses to practice;
339.17(3) medication and treatment management;
339.18(4) delegation of home care tasks by registered nurses or licensed health professionals;
339.19(5) supervision of registered nurses and licensed health professionals; and
339.20(6) supervision of unlicensed personnel performing delegated home care tasks.
339.21    Subd. 3. License renewal. (a) Except as provided in section 144A.475, a license
339.22may be renewed for a period of one year if the licensee satisfies the following:
339.23(1) submits an application for renewal in the format provided by the commissioner
339.24at least 30 days before expiration of the license;
339.25(2) submits the renewal fee in the amount specified in subdivision 7;
339.26(3) has provided home care services within the past 12 months;
339.27(4) complies with sections 144A.43 to 144A.4799;
339.28(5) provides information sufficient to show that the applicant meets the requirements
339.29of licensure, including items required under subdivision 1;
339.30(6) provides verification that all policies under subdivision 1, are current; and
339.31(7) provides any other information deemed necessary by the commissioner.
339.32(b) A renewal applicant who holds a comprehensive home care license must also
339.33provide verification that policies listed under subdivision 2 are current.
339.34    Subd. 4. Multiple units. Multiple units or branches of a licensee must be separately
339.35licensed if the commissioner determines that the units cannot adequately share supervision
339.36and administration of services from the main office.
340.1    Subd. 5. Transfers prohibited; changes in ownership. Any home care license
340.2issued by the commissioner may not be transferred to another party. Before acquiring
340.3ownership of a home care provider business, a prospective applicant must apply for a
340.4new temporary license. A change of ownership is a transfer of operational control to
340.5a different business entity, and includes:
340.6(1) transfer of the business to a different or new corporation;
340.7(2) in the case of a partnership, the dissolution or termination of the partnership under
340.8chapter 323A, with the business continuing by a successor partnership or other entity;
340.9(3) relinquishment of control of the provider to another party, including to a contract
340.10management firm that is not under the control of the owner of the business' assets;
340.11(4) transfer of the business by a sole proprietor to another party or entity; or
340.12(5) in the case of a privately held corporation, the change in ownership or control of
340.1350 percent or more of the outstanding voting stock.
340.14    Subd. 6. Notification of changes of information. The temporary licensee or
340.15licensee shall notify the commissioner in writing within ten working days after any
340.16change in the information required in subdivision 1, except the information required in
340.17subdivision 1, clause (5), is required at the time of license renewal.
340.18    Subd. 7. Fees; application, change of ownership, and renewal. (a) An initial
340.19applicant seeking initial temporary home care licensure must submit the following
340.20application fee to the commissioner along with a completed application:
340.21(1) basic home care provider, $2,100; or
340.22(2) comprehensive home care provider, $4,200.
340.23(b) A home care provider who is filing a change of ownership as required under
340.24subdivision 5 must submit the following application fee to the commissioner, along with
340.25the documentation required for the change of ownership:
340.26(1) basic home care provider, $2,100; or
340.27(2) comprehensive home care provider, $4,200.
340.28(c) A home care provider who is seeking to renew the provider's license shall pay a
340.29fee to the commissioner based on revenues derived from the provision of home care
340.30services during the calendar year prior to the year in which the application is submitted,
340.31according to the following schedule:
340.32License Renewal Fee

340.33	Provider Annual Revenue	Fee
340.34	greater than $1,500,000	$6,625
340.35 340.36	greater than $1,275,000 and no more than $1,500,000	$5,797
341.1 341.2	greater than $1,100,000 and no more than $1,275,000	$4,969
341.3 341.4	greater than $950,000 and no more than $1,100,000	$4,141
341.5 341.6	greater than $850,000 and no more than $950,000	$3,727
341.7 341.8	greater than $750,000 and no more than $850,000	$3,313
341.9 341.10	greater than $650,000 and no more than $750,000	$2,898
341.11 341.12	greater than $550,000 and no more than $650,000	$2,485
341.13 341.14	greater than $450,000 and no more than $550,000	$2,070
341.15 341.16	greater than $350,000 and no more than $450,000	$1,656
341.17 341.18	greater than $250,000 and no more than $350,000	$1,242
341.19 341.20	greater than $100,000 and no more than $250,000	$828
341.21	greater than $25,000 and no more than $100,000	$414
341.22	no more than $25,000	$166

341.23(d) If requested, the home care provider shall provide the commissioner information
341.24to verify the provider's annual revenues or other information as needed, including copies
341.25of documents submitted to the Department of Revenue.
341.26(e) A temporary license or license applicant, or temporary licensee or licensee that
341.27knowingly provides the commissioner incorrect revenue amounts for the purpose of
341.28paying a lower license fee, shall be subject to a civil penalty in the amount of double the
341.29fee the provider should have paid.
341.30(f) Fees and penalties collected under this section shall be deposited in the state
341.31treasury and credited to the special state government revenue fund.

341.32    Sec. 10. [144A.473] ISSUANCE OF TEMPORARY LICENSE AND LICENSE
341.33RENEWAL.
341.34    Subdivision 1. Temporary license and renewal of license. (a) The department
341.35shall review each application to determine the applicant's knowledge of and compliance
341.36with Minnesota home care regulations. Before granting a temporary license or renewing a
341.37license, the commissioner may further evaluate the applicant or licensee by requesting
341.38additional information or documentation or by conducting an on-site survey of the
341.39applicant to determine compliance with sections 144A.43 to 144A.482.
341.40(b) Within 14 calendar days after receiving an application for a license,
341.41the commissioner shall acknowledge receipt of the application in writing. The
342.1acknowledgment must indicate whether the application appears to be complete or whether
342.2additional information is required before the application will be considered complete.
342.3(c) Within 90 days after receiving a complete application, the commissioner shall
342.4issue a temporary license, renew the license, or deny the license.
342.5(d) The commissioner shall issue a license that contains the home care provider's
342.6name, address, license level, expiration date of the license, and unique license number. All
342.7licenses are valid for one year from the date of issuance.
342.8    Subd. 2. Temporary license. (a) For new license applicants, the commissioner
342.9shall issue a temporary license for either the basic or comprehensive home care level. A
342.10temporary license is effective for one year from the date of issuance. Temporary licensees
342.11must comply with sections 144A.43 to 144A.482.
342.12(b) During the temporary license year, the commissioner shall survey the temporary
342.13licensee after the commissioner is notified or has evidence that the temporary licensee
342.14is providing home care services.
342.15(c) Within five days of beginning the provision of services, the temporary
342.16licensee must notify the commissioner that it is serving clients. The notification to the
342.17commissioner may be mailed or e-mailed to the commissioner at the address provided by
342.18the commissioner. If the temporary licensee does not provide home care services during
342.19the temporary license year, then the temporary license expires at the end of the year and
342.20the applicant must reapply for a temporary home care license.
342.21(d) A temporary licensee may request a change in the level of licensure prior to
342.22being surveyed and granted a license by notifying the commissioner in writing and
342.23providing additional documentation or materials required to update or complete the
342.24changed temporary license application. The applicant must pay the difference between the
342.25application fees when changing from the basic to the comprehensive level of licensure.
342.26No refund will be made if the provider chooses to change the license application to the
342.27basic level.
342.28(e) If the temporary licensee notifies the commissioner that the licensee has clients
342.29within 45 days prior to the temporary license expiration, the commissioner may extend the
342.30temporary license for up to 60 days in order to allow the commissioner to complete the
342.31on-site survey required under this section and follow-up survey visits.
342.32    Subd. 3. Temporary licensee survey. (a) If the temporary licensee is in substantial
342.33compliance with the survey, the commissioner shall issue either a basic or comprehensive
342.34home care license. If the temporary licensee is not in substantial compliance with the
342.35survey, the commissioner shall not issue a basic or comprehensive license and there will
342.36be no contested hearing right under chapter 14.
343.1(b) If the temporary licensee whose basic or comprehensive license has been denied
343.2disagrees with the conclusions of the commissioner, then the licensee may request a
343.3reconsideration by the commissioner or commissioner's designee. The reconsideration
343.4request process will be conducted internally by the commissioner or commissioner's
343.5designee, and chapter 14 does not apply.
343.6(c) The temporary licensee requesting reconsideration must make the request in
343.7writing and must list and describe the reasons why the licensee disagrees with the decision
343.8to deny the basic or comprehensive home care license.
343.9(d) A temporary licensee whose license is denied must comply with the requirements
343.10for notification and transfer of clients in section 144A.475, subdivision 5.

343.11    Sec. 11. [144A.474] SURVEYS AND INVESTIGATIONS.
343.12    Subdivision 1. Surveys. The commissioner shall conduct surveys of each home care
343.13provider. Survey frequency may be based on the license level, the provider's compliance
343.14history, number of clients served, or other factors as determined by the department deemed
343.15necessary to ensure the health, safety, and welfare of clients and compliance with the law.
343.16    Subd. 2. Scheduling surveys. Surveys and investigations shall be conducted
343.17without advance notice to home care providers. Surveyors may contact the home care
343.18provider on the day of a survey to arrange for someone to be available at the survey site.
343.19The contact does not constitute advance notice.
343.20    Subd. 3. Information provided by home care provider. The home care provider
343.21shall provide accurate and truthful information to the department during a survey,
343.22investigation, or other licensing activities.
343.23    Subd. 4. Providing client records. Upon request of a surveyor, home care providers
343.24shall provide a list of current and past clients or client representatives that includes
343.25addresses and telephone numbers and any other information requested about the services
343.26to clients within a reasonable period of time.
343.27    Subd. 5. Contacting and visiting clients. Surveyors may contact or visit a home
343.28care provider's clients to gather information without notice to the home care provider.
343.29Before visiting a client, a surveyor shall obtain the client's or client's representative's
343.30permission by telephone, mail, or in person. Surveyors shall inform all clients or client's
343.31representatives of their right to decline permission for a visit.
343.32    Subd. 6. Complaint investigations. Upon receiving information alleging that
343.33a home care provider has violated or is currently violating a requirement of sections
343.34144A.43 to 144A.482, 626.556, and 626.557, the commissioner shall investigate the
343.35complaint according to sections 144A.51 to 144A.54.
344.1    Subd. 7. Correction orders. (a) A correction order may be issued whenever the
344.2commissioner finds upon survey or during a complaint investigation that a home care
344.3provider, a controlling person, or an employee of the provider is not in compliance with
344.4sections 144A.43 to 144A.482, 626.556, or 626.557. The correction order shall cite the
344.5specific rule or statute and document areas of noncompliance and the time allowed for
344.6correction.
344.7(b) The commissioner shall mail copies of any correction order to the last known
344.8address of the home care provider. A copy of each correction order and copies of any
344.9documentation supplied to the commissioner shall be kept on file by the home care
344.10provider, and public documents shall be made available for viewing by any person upon
344.11request. Copies may be kept electronically.
344.12(c) By the correction order date, the home care provider must document in the
344.13provider's records any action taken to comply with the correction order. The commissioner
344.14may request a copy of this documentation and the home care provider's action to respond
344.15to the correction order in future surveys, upon a complaint investigation, and as otherwise
344.16needed.
344.17    Subd. 8. Reconsideration of survey findings. (a) If the applicant or licensee
344.18believes that the contents of the commissioner's order for correction are in error, the
344.19applicant or license holder may ask the commissioner to reconsider the parts of the
344.20correction order that are alleged to be in error. The request for reconsideration must be
344.21made in writing and must be postmarked and sent to the commissioner within 20 calendar
344.22days after receipt of the correction order by the applicant or license holder, and:
344.23(1) specify the parts of the correction order that are alleged to be in error;
344.24(2) explain why they are in error; and
344.25(3) include documentation to support the allegation of error.
344.26(b) A request for reconsideration does not stay any provisions or requirements of the
344.27correction order. The commissioner's disposition of a request for reconsideration is final
344.28and not subject to appeal under chapter 14.
344.29    Subd. 9. Fines. (a) The commissioner may assess fines according to this subdivision.
344.30(b) In addition to any enforcement action authorized under this chapter, the
344.31commissioner may assess a licensed home care provider a fine from $1,000 to $10,000 for
344.32any of the following violations:
344.33(1) failure to report maltreatment of a child under section 626.556 or the
344.34maltreatment of a vulnerable adult under section 626.557;
344.35(2) failure to establish and implement procedures for reporting suspected
344.36maltreatment under section 144A.479, subdivision 6, paragraph (a);
345.1(3) failure to complete and implement an abuse prevention plan under section
345.2144.479, subdivision 6, paragraph (b);
345.3(4) an act, omission, or practice that results in a client's illness, injury, or death or
345.4places the client at imminent risk including physical abuse, sexual abuse, questionable or
345.5wrongful death, serious unexplained injuries, or serious medical emergency;
345.6(5) failure to obtain background check clearance or exemption for direct care staff
345.7prior to provision of services;
345.8(6) willful violation of state licensing laws and regulations; and
345.9(7) violation of employee health status guidance relating to control of infectious
345.10diseases such as tuberculosis.
345.11(c) If the commissioner finds that the applicant or a home care provider required to
345.12be licensed under sections 144A.43 to 144A.482 has not corrected violations identified
345.13in a survey or complaint investigation that were specified in the correction order or
345.14conditional license, the commissioner may impose a fine. A notice of noncompliance with
345.15a correction order must be mailed to the applicant's or provider's last known address. The
345.16noncompliance notice must list the violations not corrected.
345.17(d) Fines under this subdivision may be assessed according to paragraph (b), or
345.18the commissioner may assess a fine other than those identified in paragraph (b) from
345.19$500 to $2,000 per violation when the provider has failed to correct an order relating to
345.20violation of state licensing laws.
345.21(e) The license holder must pay the fines assessed on or before the payment date
345.22specified. If the license holder fails to fully comply with the order, the commissioner may
345.23issue a second fine or suspend the license until the license holder complies by paying the
345.24fine. If the license holder receives state funds, the state, county, or municipal agencies or
345.25departments responsible for administering the funds shall withhold payments and recover
345.26any payments made while the license is suspended for failure to pay a fine. A timely
345.27appeal shall stay payment of the fine until the commissioner issues a final order.
345.28(f) A license holder shall promptly notify the commissioner in writing, including
345.29by e-mail, when a violation specified in the order to forfeit a fine is corrected. If upon
345.30reinspection the commissioner determines that a violation has not been corrected as
345.31indicated by the order to forfeit a fine, the commissioner may issue a second fine. The
345.32commissioner shall notify the license holder by mail to the last known address in the
345.33licensing record that a second fine has been assessed. The license holder may appeal the
345.34second fine as provided under this subdivision.
345.35(g) A home care provider that has been assessed a fine under this subdivision has a
345.36right to a hearing under this section and chapter 14.
346.1(h) When a fine has been assessed, the license holder may not avoid payment by
346.2closing, selling, or otherwise transferring the licensed program to a third party. In such an
346.3event, the license holder shall be personally liable for payment of the fine. In the case
346.4of a corporation, each controlling individual is personally and jointly liable for payment
346.5of the fine.
346.6(i) In addition to any fine imposed under this section, the commissioner may assess
346.7costs related to an investigation that results in a final order assessing a fine or other
346.8enforcement action authorized by this chapter.
346.9(j) Fines collected under this subdivision shall be deposited in the state government
346.10special revenue fund and credited to an account separate from the revenue collected under
346.11section 144A.472. Subject to an appropriation by the legislature, the revenue from the
346.12fines collected may be used by the commissioner for special projects to improve home care
346.13regulations as recommended by the advisory council established in section 144A.4799.

346.14    Sec. 12. [144A.475] ENFORCEMENT.
346.15    Subdivision 1. Conditions. (a) The commissioner may refuse to grant a temporary
346.16license, renew a license, suspend or revoke a license, or impose a conditional license if the
346.17home care provider or owner or managerial official of the home care provider:
346.18(1) is in violation of, or during the term of the license has violated, any of the
346.19requirements in sections 144A.471 to 144A.482;
346.20(2) permits, aids, or abets the commission of any illegal act in the provision of
346.21home care;
346.22(3) performs any act detrimental to the health, safety, and welfare of a client;
346.23(4) obtains the license by fraud or misrepresentation;
346.24(5) knowingly made or makes a false statement of a material fact in the application
346.25for a license or in any other record or report required by this chapter;
346.26(6) denies representatives of the department access to any part of the home care
346.27provider's books, records, files, or employees;
346.28(7) interferes with or impedes a representative of the department in contacting the
346.29home care provider's clients;
346.30(8) interferes with or impedes a representative of the department in the enforcement
346.31of this chapter or has failed to fully cooperate with an inspection, survey, or investigation
346.32by the department;
346.33(9) destroys or makes unavailable any records or other evidence relating to the home
346.34care provider's compliance with this chapter;
346.35(10) refuses to initiate a background study under section 144.057 or 245A.04;
347.1(11) fails to timely pay any fines assessed by the department;
347.2(12) violates any local, city, or township ordinance relating to home care services;
347.3(13) has repeated incidents of personnel performing services beyond their
347.4competency level; or
347.5(14) has operated beyond the scope of the home care provider's license level.
347.6    (b) A violation by a contractor providing the home care services of the home care
347.7provider is a violation by the home care provider.
347.8    Subd. 2. Terms to suspension or conditional license. A suspension or conditional
347.9license designation may include terms that must be completed or met before a suspension
347.10or conditional license designation is lifted. A conditional license designation may include
347.11restrictions or conditions that are imposed on the provider. Terms for a suspension or
347.12conditional license may include one or more of the following and the scope of each will be
347.13determined by the commissioner:
347.14(1) requiring a consultant to review, evaluate, and make recommended changes to
347.15the home care provider's practices and submit reports to the commissioner at the cost of
347.16the home care provider;
347.17(2) requiring supervision of the home care provider or staff practices at the cost
347.18of the home care provider by an unrelated person who has sufficient knowledge and
347.19qualifications to oversee the practices and who will submit reports to the commissioner;
347.20(3) requiring the home care provider or employees to obtain training at the cost of
347.21the home care provider;
347.22(4) requiring the home care provider to submit reports to the commissioner;
347.23(5) prohibiting the home care provider from taking any new clients for a period
347.24of time; or
347.25(6) any other action reasonably required to accomplish the purpose of this
347.26subdivision and section 144A.45, subdivision 2.
347.27    Subd. 3. Notice. Prior to any suspension, revocation, or refusal to renew a license,
347.28the home care provider shall be entitled to notice and a hearing as provided by sections
347.2914.57 to 14.69. In addition to any other remedy provided by law, the commissioner may,
347.30without a prior contested case hearing, temporarily suspend a license or prohibit delivery
347.31of services by a provider for not more than 90 days if the commissioner determines that
347.32the health or safety of a consumer is in imminent danger, provided:
347.33(1) advance notice is given to the home care provider;
347.34(2) after notice, the home care provider fails to correct the problem;
347.35(3) the commissioner has reason to believe that other administrative remedies are not
347.36likely to be effective; and
348.1(4) there is an opportunity for a contested case hearing within the 90 days.
348.2    Subd. 4. Time limits for appeals. To appeal the assessment of civil penalties
348.3under section 144A.45, subdivision 2, clause (5), and an action against a license under
348.4this section, a provider must request a hearing no later than 15 days after the provider
348.5receives notice of the action.
348.6    Subd. 5. Plan required. (a) The process of suspending or revoking a license
348.7must include a plan for transferring affected clients to other providers by the home care
348.8provider, which will be monitored by the commissioner. Within three business days of
348.9being notified of the final revocation or suspension action, the home care provider shall
348.10provide the commissioner, the lead agencies as defined in section 256B.0911, and the
348.11ombudsman for long-term care with the following information:
348.12(1) a list of all clients, including full names and all contact information on file;
348.13(2) a list of each client's representative or emergency contact person, including full
348.14names and all contact information on file;
348.15(3) the location or current residence of each client;
348.16(4) the payor sources for each client, including payor source identification numbers;
348.17and
348.18(5) for each client, a copy of the client's service plan, and a list of the types of
348.19services being provided.
348.20(b) The revocation or suspension notification requirement is satisfied by mailing the
348.21notice to the address in the license record. The home care provider shall cooperate with
348.22the commissioner and the lead agencies during the process of transferring care of clients to
348.23qualified providers. Within three business days of being notified of the final revocation or
348.24suspension action, the home care provider must notify and disclose to each of the home
348.25care provider's clients, or the client's representative or emergency contact persons, that
348.26the commissioner is taking action against the home care provider's license by providing a
348.27copy of the revocation or suspension notice issued by the commissioner.
348.28    Subd. 6. Owners and managerial officials; refusal to grant license. (a) The
348.29owner and managerial officials of a home care provider whose Minnesota license has not
348.30been renewed or that has been revoked because of noncompliance with applicable laws or
348.31rules shall not be eligible to apply for nor will be granted a home care license, including
348.32other licenses under this chapter, or be given status as an enrolled personal care assistance
348.33provider agency or personal care assistant by the Department of Human Services under
348.34section 256B.0659 for five years following the effective date of the nonrenewal or
348.35revocation. If the owner and managerial officials already have enrollment status, their
348.36enrollment will be terminated by the Department of Human Services.
349.1(b) The commissioner shall not issue a license to a home care provider for five
349.2years following the effective date of license nonrenewal or revocation if the owner or
349.3managerial official, including any individual who was an owner or managerial official
349.4of another home care provider, had a Minnesota license that was not renewed or was
349.5revoked as described in paragraph (a).
349.6(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall
349.7suspend or revoke, the license of any home care provider that includes any individual
349.8as an owner or managerial official who was an owner or managerial official of a home
349.9care provider whose Minnesota license was not renewed or was revoked as described in
349.10paragraph (a) for five years following the effective date of the nonrenewal or revocation.
349.11(d) The commissioner shall notify the home care provider 30 days in advance of
349.12the date of nonrenewal, suspension, or revocation of the license. Within ten days after
349.13the receipt of the notification, the home care provider may request, in writing, that the
349.14commissioner stay the nonrenewal, revocation, or suspension of the license. The home
349.15care provider shall specify the reasons for requesting the stay; the steps that will be taken
349.16to attain or maintain compliance with the licensure laws and regulations; any limits on the
349.17authority or responsibility of the owners or managerial officials whose actions resulted in
349.18the notice of nonrenewal, revocation, or suspension; and any other information to establish
349.19that the continuing affiliation with these individuals will not jeopardize client health, safety,
349.20or well-being. The commissioner shall determine whether the stay will be granted within
349.2130 days of receiving the provider's request. The commissioner may propose additional
349.22restrictions or limitations on the provider's license and require that the granting of the stay
349.23be contingent upon compliance with those provisions. The commissioner shall take into
349.24consideration the following factors when determining whether the stay should be granted:
349.25(1) the threat that continued involvement of the owners and managerial officials with
349.26the home care provider poses to client health, safety, and well-being;
349.27(2) the compliance history of the home care provider; and
349.28(3) the appropriateness of any limits suggested by the home care provider.
349.29    If the commissioner grants the stay, the order shall include any restrictions or
349.30limitation on the provider's license. The failure of the provider to comply with any
349.31restrictions or limitations shall result in the immediate removal of the stay and the
349.32commissioner shall take immediate action to suspend, revoke, or not renew the license.
349.33    Subd. 7. Request for hearing. A request for a hearing must be in writing and must:
349.34(1) be mailed or delivered to the department or the commissioner's designee;
349.35(2) contain a brief and plain statement describing every matter or issue contested; and
350.1(3) contain a brief and plain statement of any new matter that the applicant or home
350.2care provider believes constitutes a defense or mitigating factor.
350.3    Subd. 8. Informal conference. At any time, the applicant or home care provider
350.4and the commissioner may hold an informal conference to exchange information, clarify
350.5issues, or resolve issues.
350.6    Subd. 9. Injunctive relief. In addition to any other remedy provided by law, the
350.7commissioner may bring an action in district court to enjoin a person who is involved in
350.8the management, operation, or control of a home care provider or an employee of the
350.9home care provider from illegally engaging in activities regulated by sections 144A.43 to
350.10144A.482. The commissioner may bring an action under this subdivision in the district
350.11court in Ramsey County or in the district in which a home care provider is providing
350.12services. The court may grant a temporary restraining order in the proceeding if continued
350.13activity by the person who is involved in the management, operation, or control of a home
350.14care provider, or by an employee of the home care provider, would create an imminent
350.15risk of harm to a recipient of home care services.
350.16    Subd. 10. Subpoena. In matters pending before the commissioner under sections
350.17144A.43 to 144A.482, the commissioner may issue subpoenas and compel the attendance
350.18of witnesses and the production of all necessary papers, books, records, documents, and
350.19other evidentiary material. If a person fails or refuses to comply with a subpoena or
350.20order of the commissioner to appear or testify regarding any matter about which the
350.21person may be lawfully questioned or to produce any papers, books, records, documents,
350.22or evidentiary materials in the matter to be heard, the commissioner may apply to the
350.23district court in any district, and the court shall order the person to comply with the
350.24commissioner's order or subpoena. The commissioner of health may administer oaths to
350.25witnesses or take their affirmation. Depositions may be taken in or outside the state in the
350.26manner provided by law for the taking of depositions in civil actions. A subpoena or other
350.27process or paper may be served on a named person anywhere in the state by an officer
350.28authorized to serve subpoenas in civil actions, with the same fees and mileage and in the
350.29same manner as prescribed by law for a process issued out of a district court. A person
350.30subpoenaed under this subdivision shall receive the same fees, mileage, and other costs
350.31that are paid in proceedings in district court.

350.32    Sec. 13. [144A.476] BACKGROUND STUDIES.
350.33    Subdivision 1. Prior criminal convictions; owner and managerial officials. (a)
350.34Before the commissioner issues a temporary license or renews a license, an owner or
350.35managerial official is required to complete a background study under section 144.057. No
351.1person may be involved in the management, operation, or control of a home care provider
351.2if the person has been disqualified under chapter 245C. If an individual is disqualified
351.3under section 144.056 or chapter 245C, the individual may request reconsideration of
351.4the disqualification. If the individual requests reconsideration and the commissioner
351.5sets aside or rescinds the disqualification, the individual is eligible to be involved in the
351.6management, operation, or control of the provider. If an individual has a disqualification
351.7under section 245C.15, subdivision 1, and the disqualification is affirmed, the individual's
351.8disqualification is barred from a set aside, and the individual must not be involved in the
351.9management, operation, or control of the provider.
351.10(b) For purposes of this section, owners of a home care provider subject to the
351.11background check requirement are those individuals whose ownership interest provides
351.12sufficient authority or control to affect or change decisions related to the operation of the
351.13home care provider. An owner includes a sole proprietor, a general partner, or any other
351.14individual whose individual ownership interest can affect the management and direction
351.15of the policies of the home care provider.
351.16(c) For the purposes of this section, managerial officials subject to the background
351.17check requirement are individuals who provide direct contact as defined in section 245C.02,
351.18subdivision 11, or individuals who have the responsibility for the ongoing management or
351.19direction of the policies, services, or employees of the home care provider. Data collected
351.20under this subdivision shall be classified as private data under section 13.02, subdivision 12.
351.21(d) The department shall not issue any license if the applicant or owner or managerial
351.22official has been unsuccessful in having a background study disqualification set aside
351.23under section 144.057 and chapter 245C; if the owner or managerial official, as an owner
351.24or managerial official of another home care provider, was substantially responsible for
351.25the other home care provider's failure to substantially comply with sections 144A.43 to
351.26144A.482; or if an owner that has ceased doing business, either individually or as an
351.27owner of a home care provider, was issued a correction order for failing to assist clients in
351.28violation of this chapter.
351.29    Subd. 2. Employees, contractors, and volunteers. (a) Employees, contractors,
351.30and volunteers of a home care provider are subject to the background study required by
351.31section 144.057, and may be disqualified under chapter 245C. Nothing in this section shall
351.32be construed to prohibit a home care provider from requiring self-disclosure of criminal
351.33conviction information.
351.34(b) Termination of an employee in good faith reliance on information or records
351.35obtained under paragraph (a) or subdivision 1, regarding a confirmed conviction does not
351.36subject the home care provider to civil liability or liability for unemployment benefits.

352.1    Sec. 14. [144A.477] COMPLIANCE.
352.2    Subdivision 1. Medicare-certified providers; coordination of surveys. If feasible,
352.3the commissioner shall survey licensees to determine compliance with this chapter at the
352.4same time as surveys for certification for Medicare if Medicare certification is based on
352.5compliance with the federal conditions of participation and on survey and enforcement
352.6by the Department of Health as agent for the United States Department of Health and
352.7Human Services.
352.8    Subd. 2. Medicare-certified providers; equivalent requirements. For home care
352.9providers licensed to provide comprehensive home care services that are also certified for
352.10participation in Medicare as a home health agency under Code of Federal Regulations,
352.11title 42, part 484, the following state licensure regulations are considered equivalent to
352.12the federal requirements:
352.13(1) quality management, section 144A.479, subdivision 3;
352.14(2) personnel records, section 144A.479, subdivision 7;
352.15(3) acceptance of clients, section 144A.4791, subdivision 4;
352.16(4) referrals, section 144A.4791, subdivision 5;
352.17(5) client assessment, sections 144A.4791, subdivision 8, and 144A.4792,
352.18subdivisions 2 and 3;
352.19(6) individualized monitoring and reassessment, sections 144A.4791, subdivision
352.208, and 144A.4792, subdivisions 2 and 3;
352.21(7) individualized service plan, sections 144A.4791, subdivision 9, 144A.4792,
352.22subdivision 5, and 144A.4793, subdivision 3;
352.23(8) client complaint and investigation process, section 144A.4791, subdivision 11;
352.24(9) prescription orders, section 144A.4792, subdivisions 13 to 16;
352.25(10) client records, section 144A.4794, subdivisions 1 to 3;
352.26(11) qualifications for unlicensed personnel performing delegated tasks, section
352.27144A.4795;
352.28(12) training and competency staff, section 144A.4795;
352.29(13) training and competency for unlicensed personnel, section 144A.4795,
352.30subdivision 7;
352.31(14) delegation of home care services, section 144A.4795, subdivision 4;
352.32(15) availability of contact person, section 144A.4797, subdivision 1; and
352.33(16) supervision of staff, section 144A.4797, subdivisions 2 and 3.
352.34Violations of requirements in clauses (1) to (16) may lead to enforcement actions
352.35under section 144A.474.

353.1    Sec. 15. [144A.478] INNOVATION VARIANCE.
353.2    Subdivision 1. Definition. For purposes of this section, "innovation variance"
353.3means a specified alternative to a requirement of this chapter. An innovation variance
353.4may be granted to allow a home care provider to offer home care services of a type or
353.5in a manner that is innovative, will not impair the services provided, will not adversely
353.6affect the health, safety, or welfare of the clients, and is likely to improve the services
353.7provided. The innovative variance cannot change any of the client's rights under section
353.8144A.44, home care bill of rights.
353.9    Subd. 2. Conditions. The commissioner may impose conditions on the granting of
353.10an innovation variance that the commissioner considers necessary.
353.11    Subd. 3. Duration and renewal. The commissioner may limit the duration of any
353.12innovation variance and may renew a limited innovation variance.
353.13    Subd. 4. Applications; innovation variance. An application for innovation
353.14variance from the requirements of this chapter may be made at any time, must be made in
353.15writing to the commissioner, and must specify the following:
353.16(1) the statute or law from which the innovation variance is requested;
353.17(2) the time period for which the innovation variance is requested;
353.18(3) the specific alternative action that the licensee proposes;
353.19(4) the reasons for the request; and
353.20(5) justification that an innovation variance will not impair the services provided,
353.21will not adversely affect the health, safety, or welfare of clients, and is likely to improve
353.22the services provided.
353.23The commissioner may require additional information from the home care provider before
353.24acting on the request.
353.25    Subd. 5. Grants and denials. The commissioner shall grant or deny each request
353.26for an innovation variance in writing within 45 days of receipt of a complete request.
353.27Notice of a denial shall contain the reasons for the denial. The terms of a requested
353.28innovation variance may be modified upon agreement between the commissioner and
353.29the home care provider.
353.30    Subd. 6. Violation of innovation variances. A failure to comply with the terms of
353.31an innovation variance shall be deemed to be a violation of this chapter.
353.32    Subd. 7. Revocation or denial of renewal. The commissioner shall revoke or
353.33deny renewal of an innovation variance if:
353.34(1) it is determined that the innovation variance is adversely affecting the health,
353.35safety, or welfare of the licensee's clients;
354.1(2) the home care provider has failed to comply with the terms of the innovation
354.2variance;
354.3(3) the home care provider notifies the commissioner in writing that it wishes to
354.4relinquish the innovation variance and be subject to the statute previously varied; or
354.5(4) the revocation or denial is required by a change in law.

354.6    Sec. 16. [144A.479] HOME CARE PROVIDER RESPONSIBILITIES;
354.7BUSINESS OPERATION.
354.8    Subdivision 1. Display of license. The original current license must be displayed
354.9in the home care providers' principal business office and copies must be displayed in
354.10any branch office. The home care provider must provide a copy of the license to any
354.11person who requests it.
354.12    Subd. 2. Advertising. Home care providers shall not use false, fraudulent,
354.13or misleading advertising in the marketing of services. For purposes of this section,
354.14advertising includes any verbal, written, or electronic means of communicating to
354.15potential clients about the availability, nature, or terms of home care services.
354.16    Subd. 3. Quality management. The home care provider shall engage in quality
354.17management appropriate to the size of the home care provider and relevant to the type
354.18of services the home care provider provides. The quality management activity means
354.19evaluating the quality of care by periodically reviewing client services, complaints made,
354.20and other issues that have occurred and determining whether changes in services, staffing,
354.21or other procedures need to be made in order to ensure safe and competent services to
354.22clients. Documentation about quality management activity must be available for two
354.23years. Information about quality management must be available to the commissioner at
354.24the time of the survey, investigation, or renewal.
354.25    Subd. 4. Provider restrictions. (a) This subdivision does not apply to licensees
354.26that are Minnesota counties or other units of government.
354.27(b) A home care provider or staff cannot accept powers-of-attorney from clients for
354.28any purpose, and may not accept appointments as guardians or conservators of clients.
354.29(c) A home care provider cannot serve as a client's representative.
354.30    Subd. 5. Handling of client's finances and property. (a) A home care provider
354.31may assist clients with household budgeting, including paying bills and purchasing
354.32household goods, but may not otherwise manage a client's property. A home care provider
354.33must provide a client with receipts for all transactions and purchases paid with the clients'
354.34funds. When receipts are not available, the transaction or purchase must be documented.
354.35A home care provider must maintain records of all such transactions.
355.1(b) A home care provider or staff may not borrow a client's funds or personal or
355.2real property, nor in any way convert a client's property to the home care provider's or
355.3staff's possession.
355.4(c) Nothing in this section precludes a home care provider or staff from accepting
355.5gifts of minimal value, or precludes the acceptance of donations or bequests made to a
355.6home care provider that are exempt from income tax under section 501(c) of the Internal
355.7Revenue Code of 1986.
355.8    Subd. 6. Reporting maltreatment of vulnerable adults and minors. (a) All
355.9home care providers must comply with requirements for the reporting of maltreatment
355.10of minors in section 626.556 and the requirements for the reporting of maltreatment
355.11of vulnerable adults in section 626.557. Home care providers must report suspected
355.12maltreatment of minors and vulnerable adults to the common entry point. Each home
355.13care provider must establish and implement a written procedure to ensure that all cases
355.14of suspected maltreatment are reported.
355.15(b) Each home care provider must develop and implement an individual abuse
355.16prevention plan for each vulnerable minor or adult for whom home care services are
355.17provided by a home care provider. The plan shall contain an individualized review or
355.18assessment of the person's susceptibility to abuse by another individual, including other
355.19vulnerable adults or minors; the person's risk of abusing other vulnerable adults or minors;
355.20and statements of the specific measures to be taken to minimize the risk of abuse to that
355.21person and other vulnerable adults or minors. For purposes of the abuse prevention plan,
355.22the term abuse includes self-abuse.
355.23    Subd. 7. Employee records. The home care provider must maintain current records
355.24of each paid employee, regularly scheduled volunteers providing home care services, and
355.25of each individual contractor providing home care services. The records must include
355.26the following information:
355.27(1) evidence of current professional licensure, registration, or certification, if
355.28licensure, registration, or certification is required by this statute, or other rules;
355.29(2) records of orientation, required annual training and infection control training,
355.30and competency evaluations;
355.31(3) current job description, including qualifications, responsibilities, and
355.32identification of staff providing supervision;
355.33(4) documentation of annual performance reviews which identify areas of
355.34improvement needed and training needs;
355.35(5) for individuals providing home care services, verification that required health
355.36screenings under section 144A.4798 have taken place and the dates of those screenings; and
356.1(6) documentation of the background study as required under section 144.057.
356.2Each employee record must be retained for at least three years after a paid employee,
356.3home care volunteer, or contractor ceases to be employed by or under contract with the
356.4home care provider. If a home care provider ceases operation, employee records must be
356.5maintained for three years.

356.6    Sec. 17. [144A.4791] HOME CARE PROVIDER RESPONSIBILITIES WITH
356.7RESPECT TO CLIENTS.
356.8    Subdivision 1. Home care bill of rights; notification to client. (a) The home
356.9care provider shall provide the client or the client's representative a written notice of the
356.10rights under section 144A.44 in a language that the client or the client's representative
356.11can understand before the initiation of services to that client. If a written version is not
356.12available, the home care bill of rights must be communicated to the client or client's
356.13representative in a language they can understand.
356.14(b) In addition to the text of the home care bill of rights in section 144A.44,
356.15subdivision 1, the notice shall also contain the following statement describing how to file
356.16a complaint with these offices.
356.17"If you have a complaint about the provider or the person providing your
356.18home care services, you may call, write, or visit the Office of Health Facility
356.19Complaints, Minnesota Department of Health. You may also contact the Office of
356.20Ombudsman for Long-Term Care or the Office of Ombudsman for Mental Health
356.21and Developmental Disabilities."
356.22The statement should include the telephone number, Web site address, e-mail
356.23address, mailing address, and street address of the Office of Health Facility Complaints at
356.24the Minnesota Department of Health, the Office of the Ombudsman for Long-Term Care,
356.25and the Office of the Ombudsman for Mental Health and Developmental Disabilities. The
356.26statement should also include the home care provider's name, address, e-mail, telephone
356.27number, and name or title of the person at the provider to whom problems or complaints
356.28may be directed. It must also include a statement that the home care provider will not
356.29retaliate because of a complaint.
356.30(c) The home care provider shall obtain written acknowledgment of the client's
356.31receipt of the home care bill of rights or shall document why an acknowledgment cannot
356.32be obtained. The acknowledgment may be obtained from the client or the client's
356.33representative. Acknowledgment of receipt shall be retained in the client's record.
356.34    Subd. 2. Notice of services for dementia, Alzheimer's disease, or related
356.35disorders. The home care provider that provides services to clients with dementia shall
357.1provide in written or electronic form, to clients and families or other persons who request
357.2it, a description of the training program and related training it provides, including the
357.3categories of employees trained, the frequency of training, and the basic topics covered.
357.4This information satisfies the disclosure requirements in section 325F.72, subdivision
357.52, clause (4).
357.6    Subd. 3. Statement of home care services. Prior to the initiation of services,
357.7a home care provider must provide to the client or the client's representative a written
357.8statement which identifies if they have a basic or comprehensive home care license, the
357.9services they are authorized to provide, and which services they cannot provide under the
357.10scope of their license. The home care provider shall obtain written acknowledgment
357.11from the clients that they have provided the statement or must document why they could
357.12not obtain the acknowledgment.
357.13    Subd. 4. Acceptance of clients. No home care provider may accept a person as a
357.14client unless the home care provider has staff, sufficient in qualifications, competency,
357.15and numbers, to adequately provide the services agreed to in the service plan and that
357.16are within the provider's scope of practice.
357.17    Subd. 5. Referrals. If a home care provider reasonably believes that a client is in
357.18need of another medical or health service, including a licensed health professional, or
357.19social service provider, the home care provider shall:
357.20(1) determine the client's preferences with respect to obtaining the service; and
357.21(2) inform the client of resources available, if known, to assist the client in obtaining
357.22services.
357.23    Subd. 6. Initiation of services. When a provider initiates services and the
357.24individualized review or assessment required in subdivisions 7 and 8 has not been
357.25completed, the provider must complete a temporary plan and agreement with the client for
357.26services.
357.27    Subd. 7. Basic individualized client review and monitoring. (a) When services
357.28being provided are basic home care services, an individualized initial review of the client's
357.29needs and preferences must be conducted at the client's residence with the client or client's
357.30representative. This initial review must be completed within 30 days after the initiation of
357.31the home care services.
357.32(b) Client monitoring and review must be conducted as needed based on changes
357.33in the needs of the client and cannot exceed 90 days from the date of the last review.
357.34The monitoring and review may be conducted at the client's residence or through the
357.35utilization of telecommunication methods based on practice standards that meet the
357.36individual client's needs.
358.1    Subd. 8. Comprehensive assessment, monitoring, and reassessment. (a) When
358.2the services being provided are comprehensive home care services, an individualized
358.3initial assessment must be conducted in-person by a registered nurse. When the services
358.4are provided by other licensed health professionals, the assessment must be conducted by
358.5the appropriate health professional. This initial assessment must be completed within five
358.6days after initiation of home care services.
358.7(b) Client monitoring and reassessment must be conducted in the client's home no
358.8more than 14 days after initiation of services.
358.9(c) Ongoing client monitoring and reassessment must be conducted as needed based
358.10on changes in the needs of the client and cannot exceed 90 days from the last date of the
358.11assessment. The monitoring and reassessment may be conducted at the client's residence
358.12or through the utilization of telecommunication methods based on practice standards that
358.13meet the individual client's needs.
358.14    Subd. 9. Service plan, implementation, and revisions to service plan. (a) No later
358.15than 14 days after the initiation of services, a home care provider shall finalize a current
358.16written service plan.
358.17(b) The service plan and any revisions must include a signature or other
358.18authentication by the home care provider and by the client or the client's representative
358.19documenting agreement on the services to be provided. The service plan must be revised,
358.20if needed, based on client review or reassessment under subdivisions 7 and 8. The provider
358.21must provide information to the client about changes to the provider's fee for services and
358.22how to contact the Office of the Ombudsman for Long-Term Care.
358.23(c) The home care provider must implement and provide all services required by
358.24the current service plan.
358.25(d) The service plan and revised service plan must be entered into the client's record,
358.26including notice of a change in a client's fees when applicable.
358.27(e) Staff providing home care services must be informed of the current written
358.28service plan.
358.29(f) The service plan must include:
358.30(1) a description of the home care services to be provided, the fees for services, and
358.31the frequency of each service, according to the client's current review or assessment and
358.32client preferences;
358.33(2) the identification of the staff or categories of staff who will provide the services;
358.34(3) the schedule and methods of monitoring reviews or assessments of the client;
358.35(4) the frequency of sessions of supervision of staff and type of personnel who
358.36will supervise staff; and
359.1(5) a contingency plan that includes:
359.2(i) the action to be taken by the home care provider and by the client or client's
359.3representative if the scheduled service cannot be provided;
359.4(ii) information and method for a client or client's representative to contact the
359.5home care provider;
359.6(iii) names and contact information of persons the client wishes to have notified
359.7in an emergency or if there is a significant adverse change in the client's condition,
359.8including identification of and information as to who has authority to sign for the client in
359.9an emergency; and
359.10(iv) the circumstances in which emergency medical services are not to be summoned
359.11consistent with chapters 145B and 145C, and declarations made by the client under those
359.12chapters.
359.13    Subd. 10. Termination of service plan. (a) If a home care provider terminates a
359.14service plan with a client, and the client continues to need home care services, the home
359.15care provider shall provide the client and the client's representative, if any, with a written
359.16notice of termination which includes the following information:
359.17(1) the effective date of termination;
359.18(2) the reason for termination;
359.19(3) a list of known licensed home care providers in the client's immediate geographic
359.20area;
359.21(4) a statement that the home care provider will participate in a coordinated transfer
359.22of care of the client to another home care provider, health care provider, or caregiver, as
359.23required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);
359.24(5) the name and contact information of a person employed by the home care
359.25provider with whom the client may discuss the notice of termination; and
359.26(6) if applicable, a statement that the notice of termination of home care services
359.27does not constitute notice of termination of the housing with services contract with a
359.28housing with services establishment.
359.29(b) When the home care provider voluntarily discontinues services to all clients, the
359.30home care provider must notify the commissioner, lead agencies, and the ombudsman for
359.31long-term care about its clients and comply with the requirements in this subdivision.
359.32    Subd. 11. Client complaint and investigative process. (a) The home care
359.33provider must have a written policy and system for receiving, investigating, reporting,
359.34and attempting to resolve complaints from its clients or clients' representatives. The
359.35policy should clearly identify the process by which clients may file a complaint or concern
359.36about home care services and an explicit statement that the home care provider will not
360.1discriminate or retaliate against a client for expressing concerns or complaints. A home
360.2care provider must have a process in place to conduct investigations of complaints made
360.3by the client or the client's representative about the services in the client's plan that are or
360.4are not being provided or other items covered in the client's home care bill of rights. This
360.5complaint system must provide reasonable accommodations for any special needs of the
360.6client or client's representative if requested.
360.7(b) The home care provider must document the complaint, name of the client,
360.8investigation, and resolution of each complaint filed. The home care provider must
360.9maintain a record of all activities regarding complaints received, including the date the
360.10complaint was received, and the home care provider's investigation and resolution of the
360.11complaint. This complaint record must be kept for each event for at least two years after
360.12the date of entry and must be available to the commissioner for review.
360.13(c) The required complaint system must provide for written notice to each client or
360.14client's representative that includes:
360.15(1) the client's right to complain to the home care provider about the services received;
360.16(2) the name or title of the person or persons with the home care provider to contact
360.17with complaints;
360.18(3) the method of submitting a complaint to the home care provider; and
360.19(4) a statement that the provider is prohibited against retaliation according to
360.20paragraph (d).
360.21(d) A home care provider must not take any action that negatively affects a client
360.22in retaliation for a complaint made or a concern expressed by the client or the client's
360.23representative.
360.24    Subd. 12. Disaster planning and emergency preparedness plan. The home care
360.25provider must have a written plan of action to facilitate the management of the client's care
360.26and services in response to a natural disaster, such as flood and storms, or other emergencies
360.27that may disrupt the home care provider's ability to provide care or services. The licensee
360.28must provide adequate orientation and training of staff on emergency preparedness.
360.29    Subd. 13. Request for discontinuation of life-sustaining treatment. (a) If a
360.30client, family member, or other caregiver of the client requests that an employee or other
360.31agent of the home care provider discontinue a life-sustaining treatment, the employee or
360.32agent receiving the request:
360.33(1) shall take no action to discontinue the treatment; and
360.34(2) shall promptly inform their supervisor or other agent of the home care provider
360.35of the client's request.
361.1(b) Upon being informed of a request for termination of treatment, the home care
361.2provider shall promptly:
361.3(1) inform the client that the request will be made known to the physician who
361.4ordered the client's treatment;
361.5(2) inform the physician of the client's request; and
361.6(3) work with the client and the client's physician to comply with the provisions of
361.7the Health Care Directive Act in chapter 145C.
361.8(c) This section does not require the home care provider to discontinue treatment,
361.9except as may be required by law or court order.
361.10(d) This section does not diminish the rights of clients to control their treatments,
361.11refuse services, or terminate their relationships with the home care provider.
361.12(e) This section shall be construed in a manner consistent with chapter 145B or
361.13145C, whichever applies, and declarations made by clients under those chapters.

361.14    Sec. 18. [144A.4792] MEDICATION MANAGEMENT.
361.15    Subdivision 1. Medication management services; comprehensive home care
361.16license. (a) This subdivision applies only to home care providers with a comprehensive
361.17home care license that provides medication management services to clients. Medication
361.18management services may not be provided by a home care provider that has a basic
361.19home care license.
361.20(b) A comprehensive home care provider who provides medication management
361.21services must develop, implement, and maintain current written medication management
361.22policies and procedures. The policies and procedures must be developed under the
361.23supervision and direction of a registered nurse, licensed health professional, or pharmacist
361.24consistent with current practice standards and guidelines.
361.25(c) The written policies and procedures must address requesting and receiving
361.26prescriptions for medications; preparing and giving medications; verifying that
361.27prescription drugs are administered as prescribed; documenting medication management
361.28activities; controlling and storing medications; monitoring and evaluating medication use;
361.29resolving medication errors; communicating with the prescriber, pharmacist, and client
361.30and client representative, if any; disposing of unused medications; and educating clients
361.31and client representatives about medications. When controlled substances are being
361.32managed, the policies and procedures must also identify how the provider will ensure
361.33security and accountability for the overall management, control, and disposition of those
361.34substances in compliance with state and federal regulations and with subdivision 22.
362.1    Subd. 2. Provision of medication management services. (a) For each client who
362.2requests medication management services, the comprehensive home care provider shall,
362.3prior to providing medication management services, have a registered nurse, licensed
362.4health professional, or authorized prescriber under section 151.37 conduct an assessment
362.5to determine what mediation management services will be provided and how the services
362.6will be provided. This assessment must be conducted face-to-face with the client. The
362.7assessment must include an identification and review of all medications the client is known
362.8to be taking. The review and identification must include indications for medications, side
362.9effects, contraindications, allergic or adverse reactions, and actions to address these issues.
362.10(b) The assessment must identify interventions needed in management of
362.11medications to prevent diversion of medication by the client or others who may have
362.12access to the medications. Diversion of medications means the misuse, theft, or illegal
362.13or improper disposition of medications.
362.14    Subd. 3. Individualized medication monitoring and reassessment. The
362.15comprehensive home care provider must monitor and reassess the client's medication
362.16management services as needed under subdivision 14 when the client presents with
362.17symptoms or other issues that may be medication-related and, at a minimum, annually.
362.18    Subd. 4. Client refusal. The home care provider must document in the client's
362.19record any refusal for an assessment for medication management by the client. The
362.20provider must discuss with the client the possible consequences of the client's refusal and
362.21document the discussion in the client's record.
362.22    Subd. 5. Individualized medication management plan. For each client receiving
362.23medication management services, the comprehensive home care provider must prepare
362.24and include in the service plan a written medication management plan. The written plan
362.25must be updated when changes are made to the plan. The plan must contain at least the
362.26following provisions:
362.27(1) a statement describing the medication management services that will be provided;
362.28(2) a description of storage of medications based on the client's needs and
362.29preferences, risk of diversion, and consistent with the manufacturer's directions;
362.30(3) procedures for documenting medications that clients are taking;
362.31(4) procedures for verifying all prescription drugs are administered as prescribed;
362.32(5) procedures for monitoring medication use to prevent possible complications or
362.33adverse reactions;
362.34(6) identification of persons responsible for monitoring medication supplies and
362.35ensuring that medication refills are ordered on a timely basis;
363.1(7) identification of medication management tasks that may be delegated to
363.2unlicensed personnel; and
363.3(8) procedures for staff notifying a registered nurse or appropriate licensed health
363.4professional when a problem arises with medication management services.
363.5    Subd. 6. Administration of medication. Medications may be administered by a
363.6nurse, physician, or other licensed health practitioner authorized to administer medications
363.7or by unlicensed personnel who have been delegated medication administration tasks by
363.8a registered nurse.
363.9    Subd. 7. Delegation of medication administration. When administration of
363.10medications is delegated to unlicensed personnel, the comprehensive home care provider
363.11must ensure that the registered nurse has:
363.12(1) instructed the unlicensed personnel in the proper methods to administer the
363.13medications with respect to each client, and the unlicensed personnel has demonstrated
363.14ability to competently follow the procedures;
363.15(2) specified, in writing, specific instructions for each client and documented those
363.16instructions in the client's records; and
363.17(3) communicated with the unlicensed personnel about the individual needs of
363.18the client.
363.19    Subd. 8. Documentation of administration of medications. Each medication
363.20administered by comprehensive home care provider staff must be documented in the
363.21client's record. The documentation must include the signature and title of the person
363.22who administered the medication. The documentation must include the medication
363.23name, dosage, date and time administered, and method and route of administration. The
363.24staff must document the reason why medication administration was not completed as
363.25prescribed and document any follow-up procedures that were provided to meet the client's
363.26needs when medication was not administered as prescribed and in compliance with the
363.27client's medication management plan.
363.28    Subd. 9. Documentation of medication set up. Documentation of dates of
363.29medication set up, name of medication, quantity of dose, times to be administered, route
363.30of administration, and name of person completing medication set up must be done at
363.31time of set up.
363.32    Subd. 10. Medications when client is away from home. (a) A home care provider
363.33providing medication management services must develop a policy and procedures for the
363.34issuance of medications to clients for planned and unplanned times the client will be
363.35away from home and need to have their medications with them which complies with
363.36the following:
364.1(1) for planned time away, the medications must be obtained from the pharmacy or
364.2set up by the registered nurse according to appropriate state and federal laws and nurse
364.3standards of practice; and
364.4(2) for unplanned times away from home for temporary periods when an adequate
364.5medication supply cannot be obtained from the pharmacy or set up by the registered nurse in
364.6a timely manner, the provider may allow an unlicensed personnel to set up the medications.
364.7(b) The task of medication set up may be done by an unlicensed personnel who is
364.8trained and has been determined competent according to subdivisions 6 and 7. Prior
364.9to providing the medications to the client, the unlicensed personnel must speak with
364.10the registered nurse to ensure that all appropriate precautions are taken. The unlicensed
364.11personnel may provide the client or the client's representative up to a 72-hour supply of
364.12the client's medications.
364.13(c) When preparing the medications, the medications must be taken from the
364.14original containers prepared by the pharmacist and then placed in a suitable container. The
364.15container must be labeled with the client's name; the medication name, strength, dose, and
364.16route of administration; and the dates and times the medications are to be taken by the
364.17client and any other information that the client should know regarding the medications.
364.18For those medications which cannot be prepared in advance, the client must be given
364.19the original container and complete directions and information for the administration
364.20of that medication.
364.21(d) The client or client's representative must also be provided in writing with the home
364.22care provider's name and contact information for the home care provider's registered nurse.
364.23The unlicensed personnel must document in the client's record the date the medications
364.24were provided to the client; the name of medication; the medication's strength, dose, and
364.25routes and administration times; the amounts of medications that were provided to the
364.26client and to whom the medications were given. The registered nurse must review the
364.27set up of medication and documentation to ensure that the issuance of medications by the
364.28unlicensed personnel was handled appropriately.
364.29    Subd. 11. Prescribed and nonprescribed medication. The comprehensive home
364.30care provider must determine whether it will require a prescription for all medications it
364.31manages. The comprehensive home care provider must inform the client or the client's
364.32representative whether the comprehensive home care provider requires a prescription
364.33for all over-the-counter and dietary supplements before the comprehensive home care
364.34provider will agree to manage those medications.
364.35    Subd. 12. Medications; over-the-counter; dietary supplements not prescribed.
364.36A comprehensive home care provider providing medication management services for
365.1over-the-counter drugs or dietary supplements must retain those items in the original labeled
365.2container with directions for use prior to setting up for immediate or later administration.
365.3The provider must verify that the medications are up-to-date and stored as appropriate.
365.4    Subd. 13. Prescriptions. There must be a current written or electronically recorded
365.5prescription as defined in Minnesota Rules, part 6800.0100, subpart 11a, for all prescribed
365.6medications that the comprehensive home care provider is managing for the client.
365.7    Subd. 14. Renewal of prescriptions. Prescriptions must be renewed at least
365.8every 12 months or more frequently as indicated by the assessment in subdivision 2.
365.9Prescriptions for controlled substances must comply with chapter 152.
365.10    Subd. 15. Verbal prescription orders. Verbal prescription orders from an
365.11authorized prescriber must be received by a nurse or pharmacist. The order must be
365.12handled according to Minnesota Rules, part 6800.6200.
365.13    Subd. 16. Written or electronic prescription. When a written or electronic
365.14prescription is received, it must be communicated to the registered nurse in charge and
365.15recorded or placed in the client's record.
365.16    Subd. 17. Records confidential. A prescription or order received verbally, in
365.17writing, or electronically must be kept confidential according to sections 144.291 to
365.18144.298 and 144A.44.
365.19    Subd. 18. Medications provided by client or family members. When the
365.20comprehensive home care provider is aware of any medications or dietary supplements
365.21that are being used by the client and are not included in the assessment for medication
365.22management services, the staff must advise the registered nurse and document that in
365.23the client's record.
365.24    Subd. 19. Storage of drugs. A comprehensive home care provider providing
365.25storage of medications outside of the client's private living space must store all prescription
365.26drugs in securely locked and substantially constructed compartments according to the
365.27manufacturer's directions and permit only authorized personnel to have access.
365.28    Subd. 20. Prescription drugs. A prescription drug, prior to being set up for
365.29immediate or later administration, must be kept in the original container in which it was
365.30dispensed by the pharmacy bearing the original prescription label with legible information
365.31including the expiration or beyond-use date of a time-dated drug.
365.32    Subd. 21. Prohibitions. No prescription drug supply for one client may be used or
365.33saved for use by anyone other than the client.
365.34    Subd. 22. Disposition of drugs. (a) Any current medications being managed by the
365.35comprehensive home care provider must be given to the client or the client's representative
365.36when the client's service plan ends or medication management services are no longer part
366.1of the service plan. Medications that have been stored in the client's private living space
366.2for a client that is deceased or that have been discontinued or that have expired may be
366.3given to the client or the client's representative for disposal.
366.4(b) The comprehensive home care provider will dispose of any medications
366.5remaining with the comprehensive home care provider that are discontinued or expired or
366.6upon the termination of the service contract or the client's death according to state and
366.7federal regulations for disposition of drugs and controlled substances.
366.8(c) Upon disposition, the comprehensive home care provider must document in the
366.9client's record the disposition of the medications including the medication's name, strength,
366.10prescription number as applicable, quantity, to whom the medications were given, date of
366.11disposition, and names of staff and other individuals involved in the disposition.
366.12    Subd. 23. Loss or spillage. (a) Comprehensive home care providers providing
366.13medication management must develop and implement procedures for loss or spillage of all
366.14controlled substances defined in Minnesota Rules, part 6800.4220. These procedures must
366.15require that when a spillage of a controlled substance occurs, a notation must be made
366.16in the client's record explaining the spillage and the actions taken. The notation must
366.17be signed by the person responsible for the spillage and include verification that any
366.18contaminated substance was disposed of according to state or federal regulations.
366.19(b) The procedures must require the comprehensive home care provider of
366.20medication management to investigate any known loss or unaccounted for prescription
366.21drugs and take appropriate action required under state or federal regulations and document
366.22the investigation in required records.

366.23    Sec. 19. [144A.4793] TREATMENT AND THERAPY MANAGEMENT
366.24SERVICES.
366.25    Subdivision 1. Providers with a comprehensive home care license. This section
366.26applies only to home care providers with a comprehensive home care license that provide
366.27treatment or therapy management services to clients. Treatment or therapy management
366.28services cannot be provided by a home care provider that has a basic home care license.
366.29    Subd. 2. Policies and procedures. (a) A comprehensive home care provider who
366.30provides treatment and therapy management services must develop, implement, and
366.31maintain up-to-date written treatment or therapy management policies and procedures.
366.32The policies and procedures must be developed under the supervision and direction of
366.33a registered nurse or appropriate licensed health professional consistent with current
366.34practice standards and guidelines.
367.1(b) The written policies and procedures must address requesting and receiving
367.2orders or prescriptions for treatments or therapies, providing the treatment or therapy,
367.3documenting of treatment or therapy activities, educating and communicating with clients
367.4about treatments or therapy they are receiving, monitoring and evaluating the treatment
367.5and therapy, and communicating with the prescriber.
367.6    Subd. 3. Individualized treatment or therapy management plan. For each
367.7client receiving management of ordered or prescribed treatments or therapy services, the
367.8comprehensive home care provider must include in the service plan a written management
367.9plan which contains at least the following provisions:
367.10(1) a statement of the type of services that will be provided;
367.11(2) procedures for documenting treatments or therapies the client is receiving;
367.12(3) procedures for monitoring treatments or therapy to prevent possible
367.13complications or adverse reactions;
367.14(4) identification of treatment or therapy tasks that will be delegated to unlicensed
367.15personnel; and
367.16(5) procedures for notifying a registered nurse or appropriate licensed health
367.17professional when a problem arises with treatments or therapy services.
367.18    Subd. 4. Administration of treatments and therapy. Ordered or prescribed
367.19treatments or therapies must be administered by a nurse, physician, or other licensed health
367.20professional authorized to perform the treatment or therapy, or may be delegated or assigned
367.21to unlicensed personnel by the licensed health professional according to the appropriate
367.22practice standards for delegation or assignment. When administration of a treatment or
367.23therapy is delegated or assigned to unlicensed personnel, the home care provider must
367.24ensure that the registered nurse or authorized licensed health professional has:
367.25(1) instructed the unlicensed personnel in the proper methods with respect to each
367.26client and has demonstrated their ability to competently follow the procedures;
367.27(2) specified, in writing, specific instructions for each client and documented those
367.28instructions in the client's record; and
367.29(3) communicated with the unlicensed personnel about the individual needs of
367.30the client.
367.31    Subd. 5. Documentation of administration of treatments and therapies. Each
367.32treatment or therapy administered by a comprehensive home care provider must be
367.33documented in the client's record. The documentation must include the signature and title
367.34of the person who administered the treatment or therapy and must include the date and
367.35time of administration. When treatment or therapies are not administered as ordered or
368.1prescribed, the provider must document the reason why it was not administered and any
368.2follow-up procedures that were provided to meet the client's needs.
368.3    Subd. 6. Orders or prescriptions. There must be an up-to-date written or
368.4electronically recorded order or prescription for all treatments and therapies. The order
368.5must contain the name of the client, description of the treatment or therapy to be provided,
368.6and the frequency and other information needed to administer the treatment or therapy.

368.7    Sec. 20. [144A.4794] CLIENT RECORD REQUIREMENTS.
368.8    Subdivision 1. Client record. (a) The home care provider must maintain records
368.9for each client for whom it is providing services. Entries in the client records must be
368.10current, legible, permanently recorded, dated, and authenticated with the name and title
368.11of the person making the entry.
368.12(b) Client records, whether written or electronic, must be protected against loss,
368.13tampering, or unauthorized disclosure in compliance with chapter 13 and other applicable
368.14relevant federal and state laws. The home care provider shall establish and implement
368.15written procedures to control use, storage, and security of client's records and establish
368.16criteria for release of client information.
368.17(c) The home care provider may not disclose to any other person any personal,
368.18financial, medical, or other information about the client, except:
368.19(1) as may be required by law;
368.20(2) to employees or contractors of the home care provider, another home care
368.21provider, other health care practitioner or provider, or inpatient facility needing
368.22information in order to provide services to the client, but only such information that
368.23is necessary for the provision of services;
368.24(3) to persons authorized in writing by the client or the client's representative to
368.25receive the information, including third-party payers; and
368.26(4) to representatives of the commissioner authorized to survey or investigate home
368.27care providers under this chapter or federal laws.
368.28    Subd. 2. Access to records. The home care provider must ensure that the
368.29appropriate records are readily available to employees or contractors authorized to access
368.30the records. Client records must be maintained in a manner that allows for timely access,
368.31printing, or transmission of the records.
368.32    Subd. 3. Contents of client record. Contents of a client record include the
368.33following for each client:
368.34(1) identifying information, including the client's name, date of birth, address, and
368.35telephone number;
369.1(2) the name, address, and telephone number of an emergency contact, family
369.2members, client's representative, if any, or others as identified;
369.3(3) names, addresses, and telephone numbers of the client's health and medical
369.4service providers and other home care providers, if known;
369.5(4) health information, including medical history, allergies, and when the provider
369.6is managing medications, treatments or therapies that require documentation, and other
369.7relevant health records;
369.8(5) client's advance directives, if any;
369.9(6) the home care provider's current and previous assessments and service plans;
369.10(7) all records of communications pertinent to the client's home care services;
369.11(8) documentation of significant changes in the client's status and actions taken in
369.12response to the needs of the client including reporting to the appropriate supervisor or
369.13health care professional;
369.14(9) documentation of incidents involving the client and actions taken in response
369.15to the needs of the client including reporting to the appropriate supervisor or health
369.16care professional;
369.17(10) documentation that services have been provided as identified in the service plan;
369.18(11) documentation that the client has received and reviewed the home care bill
369.19of rights;
369.20(12) documentation that the client has been provided the statement of disclosure on
369.21limitations of services under section 144A.4791, subdivision 3;
369.22(13) documentation of complaints received and resolution;
369.23(14) discharge summary, including service termination notice and related
369.24documentation, when applicable; and
369.25(15) other documentation required under this chapter and relevant to the client's
369.26services or status.
369.27    Subd. 4. Transfer of client records. If a client transfers to another home care
369.28provider or other health care practitioner or provider, or is admitted to an inpatient facility,
369.29the home care provider, upon request of the client or the client's representative, shall take
369.30steps to ensure a coordinated transfer including sending a copy or summary of the client's
369.31record to the new home care provider, facility, or the client, as appropriate.
369.32    Subd. 5. Record retention. Following the client's discharge or termination of
369.33services, a home care provider must retain a client's record for at least five years, or as
369.34otherwise required by state or federal regulations. Arrangements must be made for secure
369.35storage and retrieval of client records if the home care provider ceases business.

370.1    Sec. 21. [144A.4795] HOME CARE PROVIDER RESPONSIBILITIES; STAFF.
370.2    Subdivision 1. Qualifications, training, and competency. All staff providing
370.3home care services must be trained and competent in the provision of home care services
370.4consistent with current practice standards appropriate to the client's needs.
370.5    Subd. 2. Licensed health professionals and nurses. (a) Licensed health
370.6professionals and nurses providing home care services as an employee of a licensed home
370.7care provider must possess current Minnesota license or registration to practice.
370.8(b) Licensed health professionals and registered nurses must be competent in
370.9assessing client needs, planning appropriate home care services to meet client needs,
370.10implementing services, and supervising staff if assigned.
370.11(c) Nothing in this section limits or expands the rights of nurses or licensed health
370.12professionals to provide services within the scope of their licenses or registrations, as
370.13provided by law.
370.14    Subd. 3. Unlicensed personnel. (a) Unlicensed personnel providing basic home
370.15care services must have:
370.16(1) successfully completed a training and competency evaluation appropriate to
370.17the services provided by the home care provider and the topics listed in subdivision 7,
370.18paragraph (b); or
370.19(2) demonstrated competency by satisfactorily completing a written or oral test on
370.20the tasks the unlicensed personnel will perform and in the topics listed in subdivision
370.217, paragraph (b); and successfully demonstrate competency of topics in subdivision 7,
370.22paragraph (b), clauses (5), (7), and (8), by a practical skills test.
370.23Unlicensed personnel providing home care services for a basic home care provider may
370.24not perform delegated nursing or therapy tasks.
370.25(b) Unlicensed personnel performing delegated nursing tasks for a comprehensive
370.26home care provider must:
370.27(1) have successfully completed training and demonstrated competency by
370.28successfully completing a written or oral test of the topics in subdivision 7, paragraphs (b)
370.29and (c), and a practical skills test on tasks listed in subdivision 7, paragraphs (b), clauses (5)
370.30and (7), and (c), clauses (3), (5), (6), and (7), and all the delegated tasks they will perform;
370.31(2) satisfy the current requirements of Medicare for training or competency of home
370.32health aides or nursing assistants, as provided by Code of Federal Regulations, title 42,
370.33section 483 or section 484.36; or
370.34(3) have, before April 19, 1993, completed a training course for nursing assistants
370.35that was approved by the commissioner.
371.1(c) Unlicensed personnel performing therapy or treatment tasks delegated or
371.2assigned by a licensed health professional must meet the requirements for delegated
371.3tasks in subdivision 4 and any other training or competency requirements within the
371.4licensed health professional scope of practice relating to delegation or assignment of tasks
371.5to unlicensed personnel.
371.6    Subd. 4. Delegation of home care tasks. A registered nurse or licensed health
371.7professional may delegate tasks only to staff that are competent and possess the knowledge
371.8and skills consistent with the complexity of the tasks and according to the appropriate
371.9Minnesota Practice Act. The comprehensive home care provider must establish and
371.10implement a system to communicate up-to-date information to the registered nurse or
371.11licensed health professional regarding the current available staff and their competency so
371.12the registered nurse or licensed health professional has sufficient information to determine
371.13the appropriateness of delegating tasks to meet individual client needs and preferences.
371.14    Subd. 5. Individual contractors. When a home care provider contracts with an
371.15individual contractor excluded from licensure under section 144A.471 to provide home
371.16care services, the contractor must meet the same requirements required by this section for
371.17personnel employed by the home care provider.
371.18    Subd. 6. Temporary staff. When a home care provider contracts with a temporary
371.19staffing agency excluded from licensure under section 144A.471, those individuals must
371.20meet the same requirements required by this section for personnel employed by the home
371.21care provider and shall be treated as if they are staff of the home care provider.
371.22    Subd. 7. Requirements for instructors, training content, and competency
371.23evaluations for unlicensed personnel. (a) Instructors and competency evaluators must
371.24meet the following requirements:
371.25(1) training and competency evaluations of unlicensed personnel providing basic
371.26home care services must be conducted by individuals with work experience and training in
371.27providing home care services listed in section 144A.471, subdivisions 6 and 7; and
371.28(2) training and competency evaluations of unlicensed personnel providing
371.29comprehensive home care services must be conducted by a registered nurse, or another
371.30instructor may provide training in conjunction with the registered nurse. If the home care
371.31provider is providing services by licensed health professionals only, then that specific
371.32training and competency evaluation may be conducted by the licensed health professionals
371.33as appropriate.
371.34(b) Training and competency evaluations for all unlicensed personnel must include
371.35the following:
371.36(1) documentation requirements for all services provided;
372.1(2) reports of changes in the client's condition to the supervisor designated by the
372.2home care provider;
372.3(3) basic infection control, including blood-borne pathogens;
372.4(4) maintenance of a clean and safe environment;
372.5(5) appropriate and safe techniques in personal hygiene and grooming, including:
372.6(i) hair care and bathing;
372.7(ii) care of teeth, gums, and oral prosthetic devices;
372.8(iii) care and use of hearing aids; and
372.9(iv) dressing and assisting with toileting;
372.10(6) training on the prevention of falls for providers working with the elderly or
372.11individuals at risk of falls;
372.12(7) standby assistance techniques and how to perform them;
372.13(8) medication, exercise, and treatment reminders;
372.14(9) basic nutrition, meal preparation, food safety, and assistance with eating;
372.15(10) preparation of modified diets as ordered by a licensed health professional;
372.16(11) communication skills that include preserving the dignity of the client and
372.17showing respect for the client and the client's preferences, cultural background, and family;
372.18(12) awareness of confidentiality and privacy;
372.19(13) understanding appropriate boundaries between staff and clients and the client's
372.20family;
372.21(14) procedures to utilize in handling various emergency situations; and
372.22(15) awareness of commonly used health technology equipment and assistive devices.
372.23(c) In addition to paragraph (b), training and competency evaluation for unlicensed
372.24personnel providing comprehensive home care services must include:
372.25(1) observation, reporting, and documenting of client status;
372.26(2) basic knowledge of body functioning and changes in body functioning, injuries,
372.27or other observed changes that must be reported to appropriate personnel;
372.28(3) reading and recording temperature, pulse, and respirations of the client;
372.29(4) recognizing physical, emotional, cognitive, and developmental needs of the client;
372.30(5) safe transfer techniques and ambulation;
372.31(6) range of motioning and positioning; and
372.32(7) administering medications or treatments as required.
372.33(d) When the registered nurse or licensed health professional delegates tasks, they
372.34must ensure that prior to the delegation the unlicensed personnel is trained in the proper
372.35methods to perform the tasks or procedures for each client and are able to demonstrate
372.36the ability to competently follow the procedures and perform the tasks. If an unlicensed
373.1personnel has not regularly performed the delegated home care task for a period of 24
373.2consecutive months, the unlicensed personnel must demonstrate competency in the task
373.3to the registered nurse or appropriate licensed health professional. The registered nurse
373.4or licensed health professional must document instructions for the delegated tasks in
373.5the client's record.

373.6    Sec. 22. [144A.4796] ORIENTATION AND ANNUAL TRAINING
373.7REQUIREMENTS.
373.8    Subdivision 1. Orientation of staff and supervisors to home care. All staff
373.9providing and supervising direct home care services must complete an orientation to home
373.10care licensing requirements and regulations before providing home care services to clients.
373.11The orientation may be incorporated into the training required under subdivision 6. The
373.12orientation need only be completed once for each staff person and is not transferable
373.13to another home care provider.
373.14    Subd. 2. Content. The orientation must contain the following topics:
373.15    (1) an overview of sections 144A.43 to 144A.4798;
373.16(2) introduction and review of all the provider's policies and procedures related to
373.17the provision of home care services;
373.18(3) handling of emergencies and use of emergency services;
373.19(4) compliance with and reporting the maltreatment of minors or vulnerable adults
373.20under sections 626.556 and 626.557;
373.21(5) home care bill of rights, under section 144A.44;
373.22(6) handling of clients' complaints; reporting of complaints and where to report
373.23complaints including information on the Office of Health Facility Complaints and the
373.24Common Entry Point;
373.25(7) consumer advocacy services of the Office of Ombudsman for Long-Term Care,
373.26Office of Ombudsman for Mental Health and Developmental Disabilities, Managed Care
373.27Ombudsman at the Department of Human Services, county managed care advocates,
373.28or other relevant advocacy services; and
373.29(8) review of the types of home care services the employee will be providing and
373.30the provider's scope of licensure.
373.31    Subd. 3. Verification and documentation of orientation. Each home care provider
373.32shall retain evidence in the employee record of each staff person having completed the
373.33orientation required by this section.
374.1    Subd. 4. Orientation to client. Staff providing home care services must be oriented
374.2specifically to each individual client and the services to be provided. This orientation may
374.3be provided in person, orally, in writing, or electronically.
374.4    Subd. 5. Training required relating to Alzheimer's disease and related
374.5disorders. For home care providers that market, promote, or provide services for persons
374.6with Alzheimer's or related disorders, all direct care staff and their supervisors must
374.7receive training that includes a current explanation of Alzheimer's disease and related
374.8disorders, how to assist clients with activities of daily living, effective approaches to
374.9use to problem solve when working with a client's challenging behaviors, and how to
374.10communicate with clients who have Alzheimer's or related disorders.
374.11    Subd. 6. Required annual training. All staff that perform direct home care
374.12services must complete at least eight hours of annual training for each 12 months of
374.13employment. The training may be obtained from the home care provider or another source
374.14and must include topics relevant to the provision of home care services. The annual
374.15training must include:
374.16(1) training on reporting of maltreatment of minors under section 626.556 and
374.17maltreatment of vulnerable adults under section 626.557, whichever is applicable to the
374.18services provided;
374.19(2) review of the home care bill of rights in section 144A.44;
374.20(3) review of infection control techniques used in the home and implementation of
374.21infection control standards including a review of hand washing techniques; the need for
374.22and use of protective gloves, gowns, and masks; appropriate disposal of contaminated
374.23materials and equipment, such as dressings, needles, syringes, and razor blades;
374.24disinfecting reusable equipment; disinfecting environmental surfaces; and reporting of
374.25communicable diseases; and
374.26(4) review of the provider's policies and procedures relating to the provision of home
374.27care services and how to implement those policies and procedures.
374.28    Subd. 7. Documentation. A home care provider must retain documentation in the
374.29employee records of the staff that have satisfied the orientation and training requirements
374.30of this section.

374.31    Sec. 23. [144A.4797] PROVISION OF SERVICES.
374.32    Subdivision 1. Availability of contact person to staff. (a) A home care provider
374.33with a basic home care license must have a person available to staff for consultation on
374.34items relating to the provision of services or about the client.
375.1(b) A home care provider with a comprehensive home care license must have a
375.2registered nurse available for consultation to staff performing delegated nursing tasks
375.3and must have an appropriate licensed health professional available if performing other
375.4delegated services such as therapies.
375.5(c) The appropriate contact person must be readily available either in person, by
375.6telephone, or by other means to the staff at times when the staff is providing services.
375.7    Subd. 2. Supervision of staff; basic home care services. (a) Staff who perform
375.8basic home care services must be supervised periodically where the services are being
375.9provided to verify that the work is being performed competently and to identify problems
375.10and solutions to address issues relating to the staff's ability to provide the services. The
375.11supervision of the unlicensed personnel must be done by staff of the home care provider
375.12having the authority, skills, and ability to provide the supervision of unlicensed personnel
375.13and who can implement changes as needed, and train staff.
375.14(b) Supervision includes direct observation of unlicensed personnel while they
375.15are providing the services and may also include indirect methods of gaining input such
375.16as gathering feedback from the client. Supervisory review of staff must be provided at a
375.17frequency based on the staff person's competency and performance.
375.18(c) For an individual who is licensed as a home care provider, this section does
375.19not apply.
375.20    Subd. 3. Supervision of staff providing delegated nursing or therapy home
375.21care tasks. (a) Staff who perform delegated nursing or therapy home care tasks must be
375.22supervised by an appropriate licensed health professional or a registered nurse periodically
375.23where the services are being provided to verify that the work is being performed
375.24competently and to identify problems and solutions related to the staff person's ability to
375.25perform the tasks. Supervision of staff performing medication or treatment administration
375.26shall be provided by a registered nurse or appropriate licensed health professional and
375.27must include observation of the staff administering the medication or treatment and the
375.28interaction with the client.
375.29(b) The direct supervision of staff performing delegated tasks must be provided
375.30within 30 days after the individual begins working for the home care provider and
375.31thereafter as needed based on performance. This requirement also applies to staff who
375.32have not performed delegated tasks for one year or longer.
375.33    Subd. 4. Documentation. A home care provider must retain documentation of
375.34supervision activities in the personnel records.
375.35    Subd. 5. Exemption. This section does not apply to an individual licensed under
375.36sections 144A.43 to 144A.4799.

376.1    Sec. 24. [144A.4798] EMPLOYEE HEALTH STATUS.
376.2    Subdivision 1. Tuberculosis (TB) prevention and control. A home care provider
376.3must establish and maintain a TB prevention and control program based on the most
376.4current guidelines issued by the Centers for Disease Control and Prevention (CDC).
376.5Components of a TB prevention and control program include screening all staff providing
376.6home care services, both paid and unpaid, at the time of hire for active TB disease and
376.7latent TB infection, and developing and implementing a written TB infection control plan.
376.8The commissioner shall make the most recent CDC standards available to home care
376.9providers on the department's Web site.
376.10    Subd. 2. Communicable diseases. A home care provider must follow
376.11current federal or state guidelines for prevention, control, and reporting of human
376.12immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus, or other
376.13communicable diseases as defined in Minnesota Rules, part 4605.7040.

376.14    Sec. 25. [144A.4799] DEPARTMENT OF HEALTH LICENSED HOME CARE
376.15PROVIDER ADVISORY COUNCIL.
376.16    Subdivision 1. Membership. The commissioner of health shall appoint eight
376.17persons to a home care provider advisory council consisting of the following:
376.18(1) three public members as defined in section 214.02 who shall be either persons
376.19who are currently receiving home care services or have family members receiving home
376.20care services, or persons who have family members who have received home care services
376.21within five years of the application date;
376.22(2) three Minnesota home care licensees representing basic and comprehensive
376.23levels of licensure who may be a managerial official, an administrator, a supervising
376.24registered nurse, or an unlicensed personnel performing home care tasks;
376.25(3) one member representing the Minnesota Board of Nursing; and
376.26(4) one member representing the ombudsman for long-term care.
376.27    Subd. 2. Organizations and meetings. The advisory council shall be organized
376.28and administered under section 15.059 with per diems and costs paid within the limits of
376.29available appropriations. Meetings will be held quarterly and hosted by the department.
376.30Subcommittees may be developed as necessary by the commissioner. Advisory council
376.31meetings are subject to the Open Meeting Law under chapter 13D.
376.32    Subd. 3. Duties. At the commissioner's request, the advisory council shall provide
376.33advice regarding regulations of Department of Health licensed home care providers in
376.34this chapter such as:
377.1(1) advice to the commissioner regarding community standards for home care
377.2practices;
377.3(2) advice to the commissioner on enforcement of licensing standards and whether
377.4certain disciplinary actions are appropriate;
377.5(3) advice to the commissioner about ways of distributing information to licensees
377.6and consumers of home care;
377.7(4) advice to the commissioner about training standards;
377.8(5) identify emerging issues and opportunities in the home care field, including the
377.9use of technology in home and telehealth capabilities; and
377.10(6) perform other duties as directed by the commissioner.

377.11    Sec. 26. [144A.481] HOME CARE LICENSING IMPLEMENTATION FOR
377.12NEW LICENSEES AND TRANSITION PERIOD FOR CURRENT LICENSEES.
377.13    Subdivision 1. Initial home care licenses and changes of ownership. (a)
377.14Beginning October 1, 2013, all initial license applicants must apply for either a temporary
377.15basic or comprehensive home care license.
377.16(b) Initial home care temporary licenses or licenses issued beginning October 1,
377.172013, will be issued according to the provisions in sections 144A.43 to 144A.4799 and
377.18fees in section 144A.472 and will be required to comply with this chapter.
377.19(c) No initial temporary licenses or initial licenses will be accepted or issued
377.20between July 1, 2013, and October 1, 2013.
377.21(d) Beginning July 1, 2013, changes in ownership applications will require payment
377.22of the new fees listed in section 144A.472.
377.23    Subd. 2. Current home care licensees with licenses on July 1, 2013. (a)
377.24Beginning October 1, 2013, department licensed home care providers who are licensed
377.25on July 1, 2013, must apply for either the basic or comprehensive home care license
377.26on their regularly scheduled renewal date.
377.27(b) By September 30, 2014, all home care providers must either have a basic or
377.28comprehensive home care license or temporary license.

377.29    Sec. 27. [144A.4811] APPLICATION OF HOME CARE LICENSURE DURING
377.30TRANSITION PERIOD.
377.31Renewal of home care licenses issued beginning October 1, 2013, will be issued
377.32according to sections 144A.43 to 144A.4799 and, upon license renewal, providers must
377.33comply with sections 144A.43 to 144A.4799. Prior to renewal, providers must comply
377.34with the home care licensure law in effect on June 30, 2013.

378.1    Sec. 28. [144A.482] REGISTRATION OF HOME MANAGEMENT
378.2PROVIDERS.
378.3(a) For purposes of this section, a home management provider is an individual or
378.4organization that provides at least two of the following services: housekeeping, meal
378.5preparation, and shopping, to a person who is unable to perform these activities due to
378.6illness, disability, or physical condition.
378.7(b) A person or organization that provides only home management services may not
378.8operate in the state without a current certificate of registration issued by the commissioner
378.9of health. To obtain a certificate of registration, the person or organization must annually
378.10submit to the commissioner the name, mailing and physical address, e-mail address, and
378.11telephone number of the individual or organization and a signed statement declaring that
378.12the individual or organization is aware that the home care bill of rights applies to their
378.13clients and that the person or organization will comply with the home care bill of rights
378.14provisions contained in section 144A.44. An individual or organization applying for a
378.15certificate must also provide the name, business address, and telephone number of each of
378.16the individuals responsible for the management or direction of the organization.
378.17(c) The commissioner shall charge an annual registration fee of $20 for individuals
378.18and $50 for organizations. The registration fee shall be deposited in the state treasury and
378.19credited to the state government special revenue fund.
378.20(d) A home care provider that provides home management services and other home
378.21care services must be licensed, but licensure requirements other than the home care bill of
378.22rights do not apply to those employees or volunteers who provide only home management
378.23services to clients who do not receive any other home care services from the provider.
378.24A licensed home care provider need not be registered as a home management service
378.25provider, but must provide an orientation on the home care bill of rights to its employees
378.26or volunteers who provide home management services.
378.27(e) An individual who provides home management services under this section must,
378.28within 120 days after beginning to provide services, attend an orientation session approved
378.29by the commissioner that provides training on the home care bill of rights and an orientation
378.30on the aging process and the needs and concerns of elderly and disabled persons.
378.31(f) The commissioner may suspend or revoke a provider's certificate of registration
378.32or assess fines for violation of the home care bill of rights. Any fine assessed for a
378.33violation of the home care bill of rights by a provider registered under this section shall be
378.34in the amount established in the licensure rules for home care providers. As a condition
378.35of registration, a provider must cooperate fully with any investigation conducted by the
378.36commissioner, including providing specific information requested by the commissioner on
379.1clients served and the employees and volunteers who provide services. Fines collected
379.2under this paragraph shall be deposited in the state treasury and credited to the fund
379.3specified in the statute or rule in which the penalty was established.
379.4(g) The commissioner may use any of the powers granted in sections 144A.43 to
379.5144A.4799 to administer the registration system and enforce the home care bill of rights
379.6under this section.

379.7    Sec. 29. INTEGRATED LICENSING SYSTEM FOR HOME CARE AND HOME
379.8AND COMMUNITY-BASED SERVICES.
379.9(a) The Department of Health Compliance Monitoring Division and the Department
379.10of Human Services Licensing Division shall jointly develop an integrated licensing system
379.11for providers of both home care services subject to licensure under Minnesota Statutes,
379.12chapter 144A, and for home and community-based services subject to licensure under
379.13Minnesota Statutes, chapter 245D. The integrated licensing system shall:
379.14(1) require only one license of any provider of services under Minnesota Statutes,
379.15sections 144A.43 to 144A.482, and 245D.03, subdivision 1;
379.16(2) promote quality services that recognize a person's individual needs and protect
379.17the person's health, safety, rights, and well-being;
379.18(3) promote provider accountability through application requirements, compliance
379.19inspections, investigations, and enforcement actions;
379.20(4) reference other applicable requirements in existing state and federal laws,
379.21including the federal Affordable Care Act;
379.22(5) establish internal procedures to facilitate ongoing communications between the
379.23agencies, and with providers and services recipients about the regulatory activities;
379.24(6) create a link between the agency Web sites so that providers and the public can
379.25access the same information regardless of which Web site is accessed initially; and
379.26(7) collect data on identified outcome measures as necessary for the agencies to
379.27report to the Centers for Medicare and Medicaid Services.
379.28(b) The joint recommendations for legislative changes to implement the integrated
379.29licensing system are due to the legislature by February 15, 2014.
379.30(c) Before implementation of the integrated licensing system, providers licensed as
379.31home care providers under Minnesota Statutes, chapter 144A, may also provide home
379.32and community-based services subject to licensure under Minnesota Statutes, chapter
379.33245D, without obtaining a home and community-based services license under Minnesota
379.34Statutes, chapter 245D. During this time, the conditions under clauses (1) to (3) shall
379.35apply to these providers:
380.1(1) the provider must comply with all requirements under Minnesota Statutes, chapter
380.2245D, for services otherwise subject to licensure under Minnesota Statutes, chapter 245D;
380.3(2) a violation of requirements under Minnesota Statutes, chapter 245D, may be
380.4enforced by the Department of Health under the enforcement authority set forth in
380.5Minnesota Statutes, section 144A.475; and
380.6(3) the Department of Health will provide information to the Department of Human
380.7Services about each provider licensed under this section, including the provider's license
380.8application, licensing documents, inspections, information about complaints received, and
380.9investigations conducted for possible violations of Minnesota Statutes, chapter 245D.

380.10    Sec. 30. REPEALER.
380.11(a) Minnesota Statutes 2012, sections 144A.46; and 144A.461, are repealed.
380.12(b) Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
380.134668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035; 4668.0040;
380.144668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075; 4668.0080; 4668.0100;
380.154668.0110; 4668.0120; 4668.0130; 4668.0140; 4668.0150; 4668.0160; 4668.0170;
380.164668.0180; 4668.0190; 4668.0200; 4668.0218; 4668.0220; 4668.0230; 4668.0240;
380.174668.0800; 4668.0805; 4668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830;
380.184668.0835; 4668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
380.194669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; and 4669.0050, are repealed.

380.20    Sec. 31. EFFECTIVE DATE.
380.21Sections 1 to 30 are effective the day following final enactment.


380.24    Section 1. Minnesota Statutes 2012, section 16A.724, subdivision 2, is amended to read:
380.25    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
380.26resources in the health care access fund exceed expenditures in that fund, effective for
380.27the biennium beginning July 1, 2007, the commissioner of management and budget shall
380.28transfer the excess funds from the health care access fund to the general fund on June 30
380.29of each year, provided that the amount transferred in any fiscal biennium shall not exceed
380.30$96,000,000. The purpose of this transfer is to meet the rate increase required under Laws
380.312003, First Special Session chapter 14, article 13C, section 2, subdivision 6.
380.32    (b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and,
380.33if necessary, the commissioner shall reduce these transfers from the health care access
381.1fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
381.2transfer sufficient funds from the general fund to the health care access fund to meet
381.3annual MinnesotaCare expenditures.
381.4(c) Notwithstanding section 295.581, to the extent available resources in the health
381.5care access fund exceed expenditures in that fund, effective for the biennium beginning
381.6July 1, 2013, the commissioner of management and budget shall transfer $1,000,000 each
381.7fiscal year from the health access fund to the medical education and research costs fund
381.8established under section 62J.692, for distribution under section 62J.692, subdivision 4,
381.9paragraph (b).

381.10    Sec. 2. [62D.0425] NET WORTH LIMIT.
381.11(a) Between July 1, 2013, and June 30, 2018, no health maintenance organization
381.12shall have a net worth of more than 25 percent of the sum of all expenses incurred during
381.13the most recent calendar year, except as provided in paragraph (b).
381.14(b) A health maintenance organization may have a net worth of more than 25 percent
381.15of the sum of all expenses incurred during the most recent calendar year if necessary to
381.16maintain capital reserves at the level of the product of 2.0 and its authorized control
381.17level risk-based capital, as required pursuant to sections 60A.50 to 60A.592 and 62D.04.
381.18Paragraphs (c) and (d) do not apply to health maintenance organizations permitted, under
381.19this paragraph, to have a net worth greater than 25 percent of the sum of all expenses
381.20incurred during the most recent calendar year.
381.21(c) By June 15, 2013, and annually thereafter until June 15, 2017, for a health
381.22maintenance organization that has a net worth of more than 25 percent of the sum of all
381.23expenses incurred during the most recent calendar year, the commissioner of health, in
381.24consultation with the commissioners of commerce and human services, shall determine:
381.25(1) capital reserves using the National Association of Insurance Commissioners
381.26definitions of admitted assets, which shall be used in clauses (2) to (5);
381.27(2) the proportion of capital reserves that are reasonably attributable to net
381.28underwriting gains in Minnesota public health care programs based on annual financial
381.29filings for calendar years 2003 through 2012;
381.30(3) the proportion of capital reserves that are reasonably attributable to investment
381.31gains associated with net underwriting gains in Minnesota public health care programs
381.32based on annual financial filings for calendar years 2003 through 2012;
381.33(4) any adjustments needed to clause (1) or (2) based on corporate reorganizations,
381.34since 2003; and
382.1(5) any adjustments needed to account for the impact of annual financial filings for
382.2calendar years 2013 through 2016.
382.3(d) A health maintenance organization that has a net worth of more than 25 percent
382.4of the sum of all expenses incurred during the most recent calendar year shall reduce its
382.5capital reserves as follows:
382.6(1) as determined by paragraph (c), the proportion of capital reserves that are greater
382.7than 25 percent of the sum of all expenses incurred during the most recent calendar
382.8year and that are reasonably attributable to net underwriting gains and investment gains
382.9associated with net underwriting gains in Minnesota public health care programs shall be
382.10spent down. The health maintenance organization shall place excess capital reserves in a
382.11special restricted account under the control of the health maintenance organization. The
382.12special restricted account may only be used to pay for a portion of the health maintenance
382.13organization's current public program enrollee premiums. The health maintenance
382.14organization shall spend no less than 50 percent of this special restricted account in any
382.15state fiscal year beginning on or after July 1, 2013; and
382.16(2) the proportion of capital reserves that are greater than 25 percent of the
382.17sum of all expenses incurred during the most recent calendar year and that are not
382.18reasonably attributable to net underwriting gains and investment gains associated with net
382.19underwriting gains in Minnesota public health care programs shall be spent down. The
382.20health maintenance organization shall place these excess capital reserves in a second
382.21special restricted account under the control of the health maintenance organization. The
382.22health maintenance organization may use this special restricted account to benefit current
382.23enrollees by moderating variation in premium increases, assisting enrollees in accessing
382.24new benefits, reducing health disparities, promoting health, wellness and preventive
382.25services, and improving care coordination. Prior to spending down excess reserves from
382.26this special revenue account, the health maintenance organization's spenddown plan must
382.27be approved by the commissioner of health. The health maintenance organization shall
382.28spend no less than 33 percent of this special restricted account in any state fiscal year
382.29beginning July 1, 2013.
382.30(e) The health maintenance organization must spend down all of the reserves placed
382.31in its special restricted accounts by July 1, 2018. All reserves placed in a special account
382.32must be spent according to paragraph (d), unless the reserves are necessary for the health
382.33maintenance organization to maintain capital reserves at the level of the product of 2.0 and
382.34its authorized control level risk-based capital, as required pursuant to sections 60A.50 to
382.3560A.592 and 62D.04, in which case the health maintenance organization may transfer funds
382.36out of its special restricted accounts in a manner approved by the commissioner of health.
383.1(f) The commissioner of health must approve all health maintenance organization
383.2expenditures for the acquisition of any asset that is not an admitted asset under National
383.3Association of Insurance Commissioners definitions. The commissioner shall disapprove
383.4any acquisition unless the health maintenance organization demonstrates that the
383.5acquisition is: (1) consistent with its long-standing business practices; or (2) more
383.6beneficial to enrollees than benefits to enrollees under paragraph (d).

383.7    Sec. 3. Minnesota Statutes 2012, section 62J.692, subdivision 4, is amended to read:
383.8    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute the
383.9available medical education funds to all qualifying applicants based on a distribution
383.10formula that reflects a summation of two factors:
383.11    (1) a public program volume factor, which is determined by the total volume of
383.12public program revenue received by each training site as a percentage of all public
383.13program revenue received by all training sites in the fund pool; and
383.14    (2) a supplemental public program volume factor, which is determined by providing
383.15a supplemental payment of 20 percent of each training site's grant to training sites whose
383.16public program revenue accounted for at least 0.98 percent of the total public program
383.17revenue received by all eligible training sites. Grants to training sites whose public
383.18program revenue accounted for less than 0.98 percent of the total public program revenue
383.19received by all eligible training sites shall be reduced by an amount equal to the total
383.20value of the supplemental payment.
383.21    Public program revenue for the distribution formula includes revenue from medical
383.22assistance, prepaid medical assistance, general assistance medical care, and prepaid
383.23general assistance medical care. Training sites that receive no public program revenue
383.24are ineligible for funds available under this subdivision. For purposes of determining
383.25training-site level grants to be distributed under paragraph (a), total statewide average
383.26costs per trainee for medical residents is based on audited clinical training costs per trainee
383.27in primary care clinical medical education programs for medical residents. Total statewide
383.28average costs per trainee for dental residents is based on audited clinical training costs
383.29per trainee in clinical medical education programs for dental students. Total statewide
383.30average costs per trainee for pharmacy residents is based on audited clinical training costs
383.31per trainee in clinical medical education programs for pharmacy students. Training sites
383.32whose training site level grant is less than $1,000, based on the formula described in this
383.33paragraph, are ineligible for funds available under this subdivision.
383.34    (b) Of available medical education funds, $1,000,000 shall be distributed each year
383.35for grants to family medicine residency programs located outside of the seven-county
384.1metropolitan area, as defined in section 473.121, subdivision 4, focused on eduction and
384.2training of family medicine physicians to serve communities outside the metropolitan area.
384.3To be eligible for a grant under this paragraph, a family medicine residency program must
384.4demonstrate that over the most recent three calendar years, at least 25 percent of its residents
384.5practice in Minnesota communities outside of the metropolitan area. Grant funds must be
384.6allocated proportionally based on the number of residents per eligible residency program.
384.7    (c) Funds distributed shall not be used to displace current funding appropriations
384.8from federal or state sources.
384.9    (c) (d) Funds shall be distributed to the sponsoring institutions indicating the amount
384.10to be distributed to each of the sponsor's clinical medical education programs based on
384.11the criteria in this subdivision and in accordance with the commissioner's approval letter.
384.12Each clinical medical education program must distribute funds allocated under paragraph
384.13(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
384.14institutions, which are accredited through an organization recognized by the Department
384.15of Education or the Centers for Medicare and Medicaid Services, may contract directly
384.16with training sites to provide clinical training. To ensure the quality of clinical training,
384.17those accredited sponsoring institutions must:
384.18    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
384.19training conducted at sites; and
384.20    (2) take necessary action if the contract requirements are not met. Action may include
384.21the withholding of payments under this section or the removal of students from the site.
384.22    (d) (e) Any funds not distributed in accordance with the commissioner's approval
384.23letter must be returned to the medical education and research fund within 30 days of
384.24receiving notice from the commissioner. The commissioner shall distribute returned funds
384.25to the appropriate training sites in accordance with the commissioner's approval letter.
384.26    (e) (f) A maximum of $150,000 of the funds dedicated to the commissioner
384.27under section 297F.10, subdivision 1, clause (2), may be used by the commissioner for
384.28administrative expenses associated with implementing this section.

384.29    Sec. 4. Minnesota Statutes 2012, section 62Q.19, subdivision 1, is amended to read:
384.30    Subdivision 1. Designation. (a) The commissioner shall designate essential
384.31community providers. The criteria for essential community provider designation shall be
384.32the following:
384.33(1) a demonstrated ability to integrate applicable supportive and stabilizing services
384.34with medical care for uninsured persons and high-risk and special needs populations,
384.35underserved, and other special needs populations; and
385.1(2) a commitment to serve low-income and underserved populations by meeting the
385.2following requirements:
385.3(i) has nonprofit status in accordance with chapter 317A;
385.4(ii) has tax-exempt status in accordance with the Internal Revenue Service Code,
385.5section 501(c)(3);
385.6(iii) charges for services on a sliding fee schedule based on current poverty income
385.7guidelines; and
385.8(iv) does not restrict access or services because of a client's financial limitation;
385.9(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
385.10hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
385.11government, an Indian health service unit, or a community health board as defined in
385.12chapter 145A;
385.13(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
385.14bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
385.15conditions;
385.16(5) a sole community hospital. For these rural hospitals, the essential community
385.17provider designation applies to all health services provided, including both inpatient and
385.18outpatient services. For purposes of this section, "sole community hospital" means a
385.19rural hospital that:
385.20(i) is eligible to be classified as a sole community hospital according to Code
385.21of Federal Regulations, title 42, section 412.92, or is located in a community with a
385.22population of less than 5,000 and located more than 25 miles from a like hospital currently
385.23providing acute short-term services;
385.24(ii) has experienced net operating income losses in two of the previous three
385.25most recent consecutive hospital fiscal years for which audited financial information is
385.26available; and
385.27(iii) consists of 40 or fewer licensed beds; or
385.28(6) a birth center licensed under section 144.615 .; or
385.29(7) a hospital, and its affiliated specialty clinics, whose inpatients are predominantly
385.30under 21 years of age and that meets the following criteria:
385.31(i) provides intensive specialty pediatric services that are routinely provided in
385.32only four or fewer hospitals in the state; and
385.33(ii) serves children from at least one-half of the counties in the state.
385.34(b) Prior to designation, the commissioner shall publish the names of all applicants
385.35in the State Register. The public shall have 30 days from the date of publication to submit
386.1written comments to the commissioner on the application. No designation shall be made
386.2by the commissioner until the 30-day period has expired.
386.3(c) The commissioner may designate an eligible provider as an essential community
386.4provider for all the services offered by that provider or for specific services designated by
386.5the commissioner.
386.6(d) For the purpose of this subdivision, supportive and stabilizing services include at
386.7a minimum, transportation, child care, cultural, and linguistic services where appropriate.

386.8    Sec. 5. Minnesota Statutes 2012, section 103I.005, is amended by adding a subdivision
386.9to read:
386.10    Subd. 1a. Bored geothermal heat exchanger. "Bored geothermal heat exchanger"
386.11means an earth-coupled heating or cooling device consisting of a sealed closed-loop
386.12piping system installed in a boring in the ground to transfer heat to or from the surrounding
386.13earth with no discharge.

386.14    Sec. 6. Minnesota Statutes 2012, section 103I.521, is amended to read:
386.15103I.521 FEES DEPOSITED WITH COMMISSIONER OF MANAGEMENT
386.16AND BUDGET.
386.17Unless otherwise specified, fees collected for licenses or registration by the
386.18commissioner under this chapter shall be deposited in the state treasury and credited to
386.19the state government special revenue fund.

386.20    Sec. 7. Minnesota Statutes 2012, section 144.123, subdivision 1, is amended to read:
386.21    Subdivision 1. Who must pay. Except for the limitation contained in this section,
386.22the commissioner of health shall charge a handling fee may enter into a contractual
386.23agreement to recover costs incurred for analysis for diagnostic purposes for each specimen
386.24submitted to the Department of Health for analysis for diagnostic purposes by any hospital,
386.25private laboratory, private clinic, or physician. No fee shall be charged to any entity which
386.26receives direct or indirect financial assistance from state or federal funds administered by
386.27the Department of Health, including any public health department, nonprofit community
386.28clinic, sexually transmitted disease clinic, or similar entity. No fee will be charged The
386.29commissioner shall not charge for any biological materials submitted to the Department
386.30of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
386.31materials requested by the department to gather information for disease prevention or
386.32control purposes. The commissioner of health may establish other exceptions to the
386.33handling fee as may be necessary to protect the public's health. All fees collected pursuant
387.1to this section shall be deposited in the state treasury and credited to the state government
387.2special revenue fund. Funds generated in a contractual agreement made pursuant to this
387.3section shall be deposited in a special account and are appropriated to the commissioner
387.4for purposes of providing the services specified in the contracts. All such contractual
387.5agreements shall be processed in accordance with the provisions of chapter 16C.
387.6EFFECTIVE DATE.This section is effective July 1, 2014.

387.7    Sec. 8. Minnesota Statutes 2012, section 144.125, subdivision 1, is amended to read:
387.8    Subdivision 1. Duty to perform testing. (a) It is the duty of (1) the administrative
387.9officer or other person in charge of each institution caring for infants 28 days or less
387.10of age, (2) the person required in pursuance of the provisions of section 144.215, to
387.11register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
387.12birth, to arrange to have administered to every infant or child in its care tests for heritable
387.13and congenital disorders according to subdivision 2 and rules prescribed by the state
387.14commissioner of health.
387.15    (b) Testing and the, recording and of test results, reporting of test results, and
387.16follow-up of infants with heritable congenital disorders, including hearing loss detected
387.17through the early hearing detection and intervention program in section 144.966, shall be
387.18performed at the times and in the manner prescribed by the commissioner of health. The
387.19commissioner shall charge a fee so that the total of fees collected will approximate the
387.20costs of conducting the tests and implementing and maintaining a system to follow-up
387.21infants with heritable or congenital disorders, including hearing loss detected through the
387.22early hearing detection and intervention program under section 144.966.
387.23    (c) The fee is $101 per specimen. Effective July 1, 2010, the fee shall be increased
387.24to $106 to support the newborn screening program, including tests administered under
387.25this section and section 144.966, shall be $135 per specimen. The increased fee amount
387.26shall be deposited in the general fund. Costs associated with capital expenditures and
387.27the development of new procedures may be prorated over a three-year period when
387.28calculating the amount of the fees. This fee amount shall be deposited in the state treasury
387.29and credited to the state government special revenue fund.
387.30(d) The fee to offset the cost of the support services provided under section 144.966,
387.31subdivision 3a, shall be $5 per specimen. This fee shall be deposited in the state treasury
387.32and credited to the general fund.

387.33    Sec. 9. Minnesota Statutes 2012, section 144.212, is amended to read:
388.1144.212 DEFINITIONS.
388.2    Subdivision 1. Scope. As used in sections 144.211 to 144.227, the following terms
388.3have the meanings given.
388.4    Subd. 1a. Amendment. "Amendment" means completion or correction of made
388.5to certification items on a vital record. after a certification has been issued or more
388.6than one year after the event, whichever occurs first, that does not result in a sealed or
388.7replaced record.
388.8    Subd. 1b. Authorized representative. "Authorized representative" means an agent
388.9designated in a written and witnessed statement signed by the subject of the record or
388.10other qualified applicant.
388.11    Subd. 1c. Certification item. "Certification item" means all individual items
388.12appearing on a certificate of birth and the demographic and legal items on a certificate
388.13of death.
388.14    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
388.15    Subd. 2a. Correction. "Correction" means a change made to a noncertification
388.16item, including information collected for medical and statistical purposes. A correction
388.17also means a change to a certification item within one year of the event provided that no
388.18certification, whether paper or electronic, has been issued.
388.19    Subd. 2b. Court of competent jurisdiction. "Court of competent jurisdiction"
388.20means a court within the United States with jurisdiction over the individual and such other
388.21individuals that the court deems necessary.
388.22    Subd. 2a 2c. Delayed registration. "Delayed registration" means registration of a
388.23record of birth or death filed one or more years after the date of birth or death.
388.24    Subd. 2d. Disclosure. "Disclosure" means to make available or make known
388.25personally identifiable information contained in a vital record, by any means of
388.26communication.
388.27    Subd. 3. File. "File" means to present a vital record or report for registration to the
388.28Office of the State Registrar Vital Records and to have the vital record or report accepted
388.29for registration by the Office of the State Registrar Vital Records.
388.30    Subd. 4. Final disposition. "Final disposition" means the burial, interment,
388.31cremation, removal from the state, or other authorized disposition of a dead body or
388.32dead fetus.
388.33    Subd. 4a. Institution. "Institution" means a public or private establishment that:
388.34(1) provides inpatient or outpatient medical, surgical, or diagnostic care or treatment;
388.35or
389.1(2) provides nursing, custodial, or domiciliary care, or to which persons are
389.2committed by law.
389.3    Subd. 4b. Legal representative. "Legal representative" means a licensed attorney
389.4representing an individual.
389.5    Subd. 4c. Local issuance office. "Local issuance office" means a county
389.6governmental office authorized by the state registrar to issue certified birth and death
389.7records.
389.8    Subd. 4d. Record. "Record" means a report of a vital event that has been registered
389.9by the state registrar.
389.10    Subd. 5. Registration. "Registration" means the process by which vital records
389.11are completed, filed, and incorporated into the official records of the Office of the State
389.12Registrar.
389.13    Subd. 6. State registrar. "State registrar" means the commissioner of health or a
389.14designee.
389.15    Subd. 7. System of vital statistics. "System of vital statistics" includes the
389.16registration, collection, preservation, amendment, verification, the maintenance of the
389.17security and integrity of, and certification of vital records, the collection of other reports
389.18required by sections 144.211 to 144.227, and related activities including the tabulation,
389.19analysis, publication, and dissemination of vital statistics.
389.20    Subd. 7a. Verification. "Verification" means a confirmation of the information on a
389.21vital record based on the facts contained in a certification.
389.22    Subd. 8. Vital record. "Vital record" means a record or report of birth, stillbirth,
389.23death, marriage, dissolution and annulment, and data related thereto. The birth record is
389.24not a medical record of the mother or the child.
389.25    Subd. 9. Vital statistics. "Vital statistics" means the data derived from records and
389.26reports of birth, death, fetal death, induced abortion, marriage, dissolution and annulment,
389.27and related reports.
389.28    Subd. 10. Local registrar. "Local registrar" means an individual designated under
389.29section 144.214, subdivision 1, to perform the duties of a local registrar.
389.30    Subd. 11. Consent to disclosure. "Consent to disclosure" means an affidavit filed
389.31with the state registrar which sets forth the following information:
389.32(1) the current name and address of the affiant;
389.33(2) any previous name by which the affiant was known;
389.34(3) the original and adopted names, if known, of the adopted child whose original
389.35birth record is to be disclosed;
389.36(4) the place and date of birth of the adopted child;
390.1(5) the biological relationship of the affiant to the adopted child; and
390.2(6) the affiant's consent to disclosure of information from the original birth record of
390.3the adopted child.

390.4    Sec. 10. Minnesota Statutes 2012, section 144.213, is amended to read:
390.5144.213 OFFICE OF THE STATE REGISTRAR VITAL RECORDS.
390.6    Subdivision 1. Creation; state registrar; Office of Vital Records. The
390.7commissioner shall establish an Office of the State Registrar Vital Records under the
390.8supervision of the state registrar. The commissioner shall furnish to local registrars the
390.9forms necessary for correct reporting of vital statistics, and shall instruct the local registrars
390.10in the collection and compilation of the data. The commissioner shall promulgate rules for
390.11the collection, filing, and registering of vital statistics information by the state and local
390.12registrars registrar, physicians, morticians, and others. Except as otherwise provided in
390.13sections 144.211 to 144.227, rules previously promulgated by the commissioner relating to
390.14the collection, filing and registering of vital statistics shall remain in effect until repealed,
390.15modified or superseded by a rule promulgated by the commissioner.
390.16    Subd. 2. General duties. (a) The state registrar shall coordinate the work of
390.17local registrars to maintain a statewide system of vital statistics. The state registrar is
390.18responsible for the administration and enforcement of sections 144.211 to 144.227, and
390.19shall supervise local registrars in the enforcement of sections 144.211 to 144.227 and the
390.20rules promulgated thereunder. Local issuance offices that fail to comply with the statutes
390.21or rules or to properly train employees may have their issuance privileges and access to
390.22the vital records system revoked.
390.23(b) To preserve vital records the state registrar is authorized to prepare typewritten,
390.24photographic, electronic or other reproductions of original records and files in the Office
390.25of Vital Records. The reproductions when certified by the state registrar shall be accepted
390.26as the original records.
390.27(c) The state registrar shall also:
390.28(1) establish, designate, and eliminate offices in the state to aid in the efficient
390.29issuance of vital records;
390.30(2) direct the activities of all persons engaged in activities pertaining to the operation
390.31of the system of vital statistics;
390.32(3) develop and conduct training programs to promote uniformity of policy and
390.33procedures throughout the state in matters pertaining to the system of vital statistics; and
390.34(4) prescribe, furnish, and distribute all forms required by sections 144.211 to
390.35144.227 and any rules adopted under these sections, and prescribe other means for the
391.1transmission of data, including electronic submission, that will accomplish the purpose of
391.2complete, accurate, and timely reporting and registration.
391.3    Subd. 3. Record keeping. To preserve vital records the state registrar is authorized
391.4to prepare typewritten, photographic, electronic or other reproductions of original records
391.5and files in the Office of the State Registrar. The reproductions when certified by the state
391.6or local registrar shall be accepted as the original records.

391.7    Sec. 11. [144.2131] SECURITY OF VITAL RECORDS SYSTEM.
391.8The state registrar shall:
391.9(1) authenticate all users of the system of vital statistics and document that all users
391.10require access based on their official duties;
391.11(2) authorize authenticated users of the system of vital statistics to access specific
391.12components of the vital statistics systems necessary for their official roles and duties;
391.13(3) establish separation of duties between staff roles that may be susceptible to fraud
391.14or misuse and routinely perform audits of staff work for the purposes of identifying fraud
391.15or misuse within the vital statistics system;
391.16(4) require that authenticated and authorized users of the system of vital
391.17statistics maintain a specified level of training related to security and provide written
391.18acknowledgment of security procedures and penalties;
391.19(5) validate data submitted for registration through site visits or with independent
391.20sources outside the registration system at a frequency specified by the state registrar to
391.21maximize the integrity of the data collected;
391.22(6) protect personally identifiable information and maintain systems pursuant to
391.23applicable state and federal laws;
391.24(7) accept a report of death if the decedent was born in Minnesota or if the decedent
391.25was a resident of Minnesota from the United States Department of Defense or the United
391.26States Department of State when the death of a United States citizen occurs outside the
391.27United States;
391.28(8) match death records registered in Minnesota and death records provided from
391.29other jurisdictions to live birth records in Minnesota;
391.30(9) match death records received from the United States Department of Defense
391.31or the United States Department of State for deaths of United States citizens occurring
391.32outside the United States to live birth records in Minnesota;
391.33(10) work with law enforcement to initiate and provide evidence for active fraud
391.34investigations;
392.1(11) provide secure workplace, storage, and technology environments that have
392.2limited role-based access;
392.3(12) maintain overt, covert, and forensic security measures for certifications,
392.4verifications, and automated systems that are part of the vital statistics system; and
392.5(13) comply with applicable state and federal laws and rules associated with
392.6information technology systems and related information security requirements.

392.7    Sec. 12. Minnesota Statutes 2012, section 144.215, subdivision 3, is amended to read:
392.8    Subd. 3. Father's name; child's name. In any case in which paternity of a child is
392.9determined by a court of competent jurisdiction, a declaration of parentage is executed
392.10under section 257.34, or a recognition of parentage is executed under section 257.75, the
392.11name of the father shall be entered on the birth record. If the order of the court declares
392.12the name of the child, it shall also be entered on the birth record. If the order of the court
392.13does not declare the name of the child, or there is no court order, then upon the request of
392.14both parents in writing, the surname of the child shall be defined by both parents.

392.15    Sec. 13. Minnesota Statutes 2012, section 144.215, subdivision 4, is amended to read:
392.16    Subd. 4. Social Security number registration. (a) Parents of a child born within
392.17this state shall give the parents' Social Security numbers to the Office of the State Registrar
392.18 Vital Records at the time of filing the birth record, but the numbers shall not appear on
392.19the certified record.
392.20(b) The Social Security numbers are classified as private confidential data, as defined
392.21in section 13.02, subdivision 12, on individuals, but the Office of the State Registrar Vital
392.22Records shall provide a Social Security number to the public authority responsible for
392.23child support services upon request by the public authority for use in the establishment of
392.24parentage and the enforcement of child support obligations.

392.25    Sec. 14. Minnesota Statutes 2012, section 144.216, subdivision 1, is amended to read:
392.26    Subdivision 1. Reporting a foundling. Whoever finds a live born infant of unknown
392.27parentage shall report within five days to the Office of the State Registrar Vital Records
392.28 such information as the commissioner may by rule require to identify the foundling.

392.29    Sec. 15. Minnesota Statutes 2012, section 144.217, subdivision 2, is amended to read:
392.30    Subd. 2. Court petition. If a delayed record of birth is rejected under subdivision
392.311, a person may petition the appropriate court in the county in which the birth allegedly
393.1occurred for an order establishing a record of the date and place of the birth and the
393.2parentage of the person whose birth is to be registered. The petition shall state:
393.3(1) that the person for whom a delayed record of birth is sought was born in this state;
393.4(2) that no record of birth can be found in the Office of the State Registrar Vital
393.5Records;
393.6(3) that diligent efforts by the petitioner have failed to obtain the evidence required
393.7in subdivision 1;
393.8(4) that the state registrar has refused to register a delayed record of birth; and
393.9(5) other information as may be required by the court.

393.10    Sec. 16. Minnesota Statutes 2012, section 144.218, subdivision 5, is amended to read:
393.11    Subd. 5. Replacement of vital records. Upon the order of a court of this state, upon
393.12the request of a court of another state, upon the filing of a declaration of parentage under
393.13section 257.34, or upon the filing of a recognition of parentage with a the state registrar, a
393.14replacement birth record must be registered consistent with the findings of the court, the
393.15declaration of parentage, or the recognition of parentage.

393.16    Sec. 17. [144.2181] AMENDMENT AND CORRECTION OF VITAL RECORDS.
393.17(a) A vital record registered under sections 144.212 to 144.227 may be amended
393.18or corrected only according to sections 144.212 to 144.227 and rules adopted by the
393.19commissioner of health to protect the integrity and accuracy of vital records.
393.20(b)(1) A vital record that is amended under this section shall indicate that it has been
393.21amended, except as otherwise provided in this section or by rule.
393.22(2) Electronic documentation shall be maintained by the state registrar that
393.23identifies the evidence upon which the amendment or correction was based, the date
393.24of the amendment or correction, and the identity of the authorized person making the
393.25amendment or correction.
393.26(c) Upon receipt of a certified copy of an order of a court of competent jurisdiction
393.27changing the name of a person whose birth is registered in Minnesota and upon request of
393.28such person if 18 years of age or older or having the status of emancipated minor, the state
393.29registrar shall amend the birth record to show the new name. If the person is a minor or
393.30an incapacitated person then a parent, guardian, or legal representative of the minor or
393.31incapacitated person may make the request.
393.32(d) When an applicant does not submit the minimum documentation required for
393.33amending a vital record or when the state registrar has cause to question the validity
393.34or completeness of the applicant's statements or the documentary evidence, and the
394.1deficiencies are not corrected, the state registrar shall not amend the vital record. The
394.2state registrar shall advise the applicant of the reason for this action and shall further
394.3advise the applicant of the right of appeal to a court with competent jurisdiction over
394.4the Department of Health.

394.5    Sec. 18. Minnesota Statutes 2012, section 144.225, is amended to read:
394.6144.225 DISCLOSURE OF INFORMATION FROM VITAL RECORDS.
394.7    Subdivision 1. Public information; access to vital records. Except as otherwise
394.8provided for in this section and section 144.2252, information contained in vital records
394.9shall be public information. Physical access to vital records shall be subject to the
394.10supervision and regulation of the state and local registrars registrar and their employees
394.11pursuant to rules promulgated by the commissioner in order to protect vital records from
394.12loss, mutilation or destruction and to prevent improper disclosure of vital records which
394.13are confidential or private data on individuals, as defined in section 13.02, subdivisions
394.143 and 12.
394.15    Subd. 2. Data about births. (a) Except as otherwise provided in this subdivision,
394.16data pertaining to the birth of a child to a woman who was not married to the child's father
394.17when the child was conceived nor when the child was born, including the original record
394.18of birth and the certified vital record an individual, are confidential data. At the time of
394.19the birth of a child to a woman who was not married to the child's father when the child
394.20was conceived nor when the child was born, the mother may designate demographic data
394.21pertaining to the birth as public. Notwithstanding the designation of the data as confidential,
394.22it may upon the proper completion of an attestation provided by the commissioner and
394.23payment of the required fee, demographic birth data by certified record shall be disclosed:
394.24(1) to a parent or guardian of the child individual;
394.25(2) to the child individual when the child individual is 16 years of age or older;
394.26(3) under paragraph (b) or (e); or
394.27(4) pursuant to a court order. For purposes of this section, a subpoena does not
394.28constitute a court order.;
394.29(5) to the legal custodian, guardian or conservator, or health care agent of the
394.30individual;
394.31(6) to adoption agencies in order to complete confidential postadoption searches as
394.32required by section 259.83;
394.33(7) to any local, state, or federal governmental agency upon request if the certified
394.34vital record is necessary for the governmental agency to perform its authorized duties; or
394.35(8) to a representative authorized by a person under clauses (1) to (7).
395.1(b) Unless the child individual is adopted, data pertaining to the birth of a child an
395.2individual that are not accessible to the public become public data if 100 125 years have
395.3elapsed since the birth of the child individual who is the subject of the data, or as provided
395.4under section 13.10, whichever occurs first.
395.5(c) If a child is adopted, data pertaining to the child's birth are governed by the
395.6provisions relating to adoption records, including sections 13.10, subdivision 5; 144.218,
395.7subdivision 1 ; 144.2252; and 259.89.
395.8(d) The name and address of a mother under paragraph (a) and the child's date of
395.9birth may be disclosed to the county social services or public health member of a family
395.10services collaborative for purposes of providing services under section 124D.23.
395.11(e) The commissioner of human services shall have access to birth records for:
395.12(1) the purposes of administering medical assistance, general assistance medical
395.13care, and the MinnesotaCare program;
395.14(2) child support enforcement purposes; and
395.15(3) other public health purposes as determined by the commissioner of health.
395.16(f) The fact of birth consisting of the name of the individual, date of birth, county of
395.17birth, and state file number are public data.
395.18    Subd. 2a. Health data associated with birth registration. Information from which
395.19an identification of risk for disease, disability, or developmental delay in a mother or child
395.20can be made, that is collected in conjunction with birth registration or fetal death reporting,
395.21is private confidential data as defined in section 13.02, subdivision 12. The commissioner
395.22may disclose to a local board of health, as defined in section 145A.02, subdivision 2,
395.23health data associated with birth registration which identifies a mother or child at high
395.24risk for serious disease, disability, or developmental delay in order to assure access to
395.25appropriate health, social, or educational services. Notwithstanding the designation of the
395.26private confidential data, the commissioner of human services shall have access to health
395.27data associated with birth registration for:
395.28(1) purposes of administering medical assistance, general assistance medical care,
395.29and the MinnesotaCare program; and
395.30(2) for other public health purposes as determined by the commissioner of health.
395.31    Subd. 2b. Commissioner of health; duties. Notwithstanding the designation of
395.32certain of this data as confidential under subdivision 2 or private under subdivision 2a,
395.33the commissioner shall give the commissioner of human services access to birth record
395.34data and data contained in recognitions of parentage prepared according to section 257.75
395.35necessary to enable the commissioner of human services to identify a child who is subject
395.36to threatened injury, as defined in section 626.556, subdivision 2, paragraph (l), by a
396.1person responsible for the child's care, as defined in section 626.556, subdivision 2,
396.2paragraph (b), clause (1). The commissioner shall be given access to all data included
396.3on official birth records.
396.4    Subd. 3. Laws and rules for preparing vital records. No person shall prepare or
396.5issue any vital record which purports to be an original, certified copy, or copy of a vital
396.6record except as authorized in sections 144.211 to 144.227 or the rules of the commissioner.
396.7    Subd. 4. Access to records for research purposes. The state registrar may permit
396.8persons performing medical research access to the information restricted in subdivision
396.92 or 2a if those persons agree in writing not to disclose private or confidential data on
396.10individuals.
396.11    Subd. 5. Residents of other states. When a resident of another state is born or dies in
396.12this state, the state registrar shall send a report of the birth or death to the state of residence.
396.13    Subd. 6. Group purchaser identity; nonpublic data; disclosure. (a) Except
396.14as otherwise provided in this subdivision, the named identity of a group purchaser as
396.15defined in section 62J.03, subdivision 6, collected in association with birth registration is
396.16nonpublic data as defined in section 13.02.
396.17(b) The commissioner may publish, or by other means release to the public, the
396.18named identity of a group purchaser as part of an analysis of information collected from
396.19the birth registration process. Analysis means the identification of trends in prenatal care
396.20and birth outcomes associated with group purchasers. The commissioner may not reveal
396.21the named identity of the group purchaser until the group purchaser has had 21 days
396.22after receipt of the analysis to review the analysis and comment on it. In releasing data
396.23under this subdivision, the commissioner shall include comments received from the group
396.24purchaser related to the scientific soundness and statistical validity of the methods used in
396.25the analysis. This subdivision does not authorize the commissioner to make public any
396.26individual identifying data except as permitted by law.
396.27(c) A group purchaser may contest whether an analysis made public under paragraph
396.28(b) is based on scientifically sound and statistically valid methods in a contested case
396.29proceeding under sections 14.57 to 14.62, subject to appeal under sections 14.63 to
396.3014.68 . To obtain a contested case hearing, the group purchaser must present a written
396.31request to the commissioner before the end of the time period for review and comment.
396.32Within ten days of the assignment of an administrative law judge, the group purchaser
396.33must demonstrate by clear and convincing evidence the group purchaser's likelihood of
396.34succeeding on the merits. If the judge determines that the group purchaser has made
396.35this demonstration, the data may not be released during the contested case proceeding
396.36and through appeal. If the judge finds that the group purchaser has not made this
397.1demonstration, the commissioner may immediately publish, or otherwise make public, the
397.2nonpublic group purchaser data, with comments received as set forth in paragraph (b).
397.3(d) The contested case proceeding and subsequent appeal is not an exclusive remedy
397.4and any person may seek a remedy pursuant to section 13.08, subdivisions 1 to 4, or
397.5as otherwise authorized by law.
397.6    Subd. 7. Certified birth or death record. (a) The state or local registrar or local
397.7issuance office shall issue a certified birth or death record or a statement of no vital record
397.8found to an individual upon the individual's proper completion of an attestation provided
397.9by the commissioner and payment of the required fee:
397.10(1) to a person who has a tangible interest in the requested vital record. A person
397.11who has a tangible interest is:
397.12(i) the subject of the vital record;
397.13(ii) (i) a child of the subject decedent;
397.14(iii) (ii) the spouse of the subject decedent;
397.15(iv) (iii) a parent of the subject decedent;
397.16(v) (iv) the grandparent or grandchild of the subject decedent;
397.17(vi) if the requested record is a death record, (v) a sibling of the subject decedent;
397.18(vii) (vi) the party responsible for filing the vital record;
397.19(viii) (vii) the legal custodian, guardian or conservator, or health care agent of the
397.20subject decedent;
397.21(ix) (viii) a personal representative, by sworn affidavit of the fact that the certified
397.22copy is required for administration of the estate;
397.23(x) (ix) a successor of the subject decedent, as defined in section 524.1-201, if
397.24the subject is deceased, by sworn affidavit of the fact that the certified copy is required
397.25for administration of the estate;
397.26(xi) if the requested record is a death record, (x) a trustee of a trust by sworn affidavit
397.27of the fact that the certified copy is needed for the proper administration of the trust; or
397.28(xii) (xi) a person or entity who demonstrates that a certified vital record is necessary
397.29for the determination or protection of a personal or property right, pursuant to rules
397.30adopted by the commissioner; or
397.31(xiii) adoption agencies in order to complete confidential postadoption searches as
397.32required by section 259.83;
397.33(2) to any local, state, or federal governmental agency upon request if the certified
397.34vital record is necessary for the governmental agency to perform its authorized duties.
397.35An authorized governmental agency includes the Department of Human Services, the
397.36Department of Revenue, and the United States Citizenship and Immigration Services;
398.1(3) to an attorney upon evidence of the attorney's license;
398.2(4) pursuant to a court order issued by a court of competent jurisdiction. For
398.3purposes of this section, a subpoena does not constitute a court order; or
398.4(5) to a representative authorized by a person under clauses (1) to (4).
398.5(b) The state or local registrar or local issuance office shall also issue a certified
398.6death record to an individual described in paragraph (a), clause (1), items (ii) to (viii), if,
398.7on behalf of the individual, a licensed mortician furnishes the registrar with a properly
398.8completed attestation in the form provided by the commissioner within 180 days of the
398.9time of death of the subject of the death record. This paragraph is not subject to the
398.10requirements specified in Minnesota Rules, part 4601.2600, subpart 5, item B.
398.11    Subd. 8. Standardized format for certified birth and death records. No later than
398.12July 1, 2000, The commissioner shall develop maintain a standardized format for certified
398.13birth records and death records issued by the state and local registrars registrar and local
398.14issuance offices. The format shall incorporate security features in accordance with this
398.15section. The standardized format must be implemented on a statewide basis by July 1, 2001.

398.16    Sec. 19. Minnesota Statutes 2012, section 144.226, is amended to read:
398.17144.226 FEES.
398.18    Subdivision 1. Which services are for fee. The fees for the following services shall
398.19be the following or an amount prescribed by rule of the commissioner:
398.20(a) The fee for the issuance of a certified vital record, a search for a vital record that
398.21cannot be issued, or a certification that the vital record cannot be found is $9. No fee shall be
398.22charged for a certified birth, stillbirth, or death record that is reissued within one year of the
398.23original issue, if an amendment is made to the vital record and if the previously issued vital
398.24record is surrendered. The fee is payable at the time of application and is nonrefundable.
398.25(b) The fee for processing a request for the replacement of a birth record for
398.26all events, except when filing a recognition of parentage pursuant to section 257.73,
398.27subdivision 1 , is $40. The fee is payable at the time of application and is nonrefundable.
398.28(c) The fee for reviewing and processing a request for the filing of a delayed
398.29registration of birth, stillbirth, or death is $40. The fee is payable at the time of application
398.30and is nonrefundable. This fee includes one subsequent review of the request if the request
398.31is not acceptable upon the initial receipt.
398.32(d) The fee for reviewing and processing a request for the amendment of any vital
398.33record when requested more than 45 days after the filing of the vital record is $40. No fee
398.34shall be charged for an amendment requested within 45 days after the filing of the vital
399.1record. The fee is payable at the time of application and is nonrefundable. This fee includes
399.2one subsequent review of the request if the request is not acceptable upon the initial receipt.
399.3(e) The fee for reviewing and processing a request for the verification of information
399.4from vital records is $9 when the applicant furnishes the specific information to locate
399.5the vital record. When the applicant does not furnish specific information, the fee is
399.6$20 per hour for staff time expended. Specific information includes the correct date of
399.7the event and the correct name of the registrant subject of the record. Fees charged shall
399.8approximate the costs incurred in searching and copying the vital records. The fee is
399.9payable at the time of application and is nonrefundable.
399.10(f) The fee for reviewing and processing a request for the issuance of a copy of any
399.11document on file pertaining to a vital record or statement that a related document cannot
399.12be found is $9. The fee is payable at the time of application and is nonrefundable.
399.13    Subd. 2. Fees to state government special revenue fund. Fees collected under
399.14this section by the state registrar shall be deposited in the state treasury and credited to
399.15the state government special revenue fund.
399.16    Subd. 3. Birth record surcharge. (a) In addition to any fee prescribed under
399.17subdivision 1, there shall be a nonrefundable surcharge of $3 for each certified birth or
399.18stillbirth record and for a certification that the vital record cannot be found. The local or
399.19 state registrar or local issuance office shall forward this amount to the commissioner of
399.20management and budget for deposit into the account for the children's trust fund for the
399.21prevention of child abuse established under section 256E.22. This surcharge shall not be
399.22charged under those circumstances in which no fee for a certified birth or stillbirth record
399.23is permitted under subdivision 1, paragraph (a). Upon certification by the commissioner of
399.24management and budget that the assets in that fund exceed $20,000,000, this surcharge
399.25shall be discontinued.
399.26(b) In addition to any fee prescribed under subdivision 1, there shall be a
399.27nonrefundable surcharge of $10 for each certified birth record. The local or state registrar
399.28or local issuance office shall forward this amount to the commissioner of management and
399.29budget for deposit in the general fund. This surcharge shall not be charged under those
399.30circumstances in which no fee for a certified birth record is permitted under subdivision 1,
399.31paragraph (a).
399.32    Subd. 4. Vital records surcharge. (a) In addition to any fee prescribed under
399.33subdivision 1, there is a nonrefundable surcharge of $2 $4 for each certified and
399.34noncertified birth, stillbirth, or death record, and for a certification that the record cannot
399.35be found. The local issuance office or state registrar shall forward this amount to the
399.36commissioner of management and budget to be deposited into the state government special
400.1revenue fund. This surcharge shall not be charged under those circumstances in which no
400.2fee for a birth, stillbirth, or death record is permitted under subdivision 1, paragraph (a).
400.3(b) Effective August 1, 2005, the surcharge in paragraph (a) is $4.
400.4    Subd. 5. Electronic verification. A fee for the electronic verification or electronic
400.5certification of a vital event, when the information being verified or certified is obtained
400.6from a certified birth or death record, shall be established through contractual or
400.7interagency agreements with interested local, state, or federal government agencies.
400.8    Subd. 6. Alternative payment methods. Notwithstanding subdivision 1, alternative
400.9payment methods may be approved and implemented by the state registrar or a local
400.10registrar issuance office.

400.11    Sec. 20. [144.492] DEFINITIONS.
400.12    Subdivision 1. Applicability. For the purposes of sections 144.492 to 144.494, the
400.13terms defined in this section have the meanings given them.
400.14    Subd. 2. Commissioner. "Commissioner" means the commissioner of health.
400.15    Subd. 3. Stroke. "Stroke" means the sudden death of brain cells in a localized
400.16area due to inadequate blood flow.

400.17    Sec. 21. [144.493] CRITERIA.
400.18    Subdivision 1. Comprehensive stroke center. A hospital meets the criteria for a
400.19comprehensive stroke center if the hospital has been certified as a comprehensive stroke
400.20center by the joint commission or another nationally recognized accreditation entity.
400.21    Subd. 2. Primary stroke center. A hospital meets the criteria for a primary stroke
400.22center if the hospital has been certified as a primary stroke center by the joint commission
400.23or another nationally recognized accreditation entity.
400.24    Subd. 3. Acute stroke ready hospital. A hospital meets the criteria for an acute
400.25stroke ready hospital if the hospital has the following elements of an acute stroke ready
400.26hospital:
400.27(1) an acute stroke team available and/or on-call 24 hours a days, seven days a week;
400.28(2) written stroke protocols, including triage, stabilization of vital functions, initial
400.29diagnostic tests, and use of medications;
400.30(3) a written plan and letter of cooperation with emergency medical services regarding
400.31triage and communication that are consistent with regional patient care procedures;
400.32(4) emergency department personnel who are trained in diagnosing and treating
400.33acute stroke;
401.1(5) the capacity to complete basic laboratory tests, electrocardiograms, and chest
401.2x-rays 24 hours a day, seven days a week;
401.3(6) the capacity to perform and interpret brain injury imaging studies 24 hours a
401.4days, seven days a week;
401.5(7) written protocols that detail available emergent therapies and reflect current
401.6treatment guidelines, which include performance measures and are revised at least annually;
401.7(8) a neurosurgery coverage plan, call schedule, and a triage and transportation plan;
401.8(9) transfer protocols and agreements for stroke patients; and
401.9(10) a designated medical director with experience and expertise in acute stroke care.

401.10    Sec. 22. [144.494] DESIGNATING STROKE CENTERS AND STROKE
401.11HOSPITALS.
401.12    Subdivision 1. Naming privileges. Unless it has been designated as a stroke center
401.13or stroke hospital pursuant to section 144.493, no hospital shall use the term "stroke
401.14center" or "stroke hospital" in its name or its advertising or shall otherwise indicate it
401.15has stroke treatment capabilities.
401.16    Subd. 2. Designation. A hospital that voluntarily meets the criteria for a
401.17comprehensive stroke center, primary stroke center, or acute stroke ready hospital may
401.18apply to the commissioner for designation, and upon the commissioner's review and
401.19approval of the application, shall be designated as a comprehensive stroke center, a
401.20primary stroke center, or an acute stroke ready hospital for a three-year period. If a hospital
401.21loses its certification as a comprehensive stroke center or primary stroke center from
401.22the joint commission or other nationally recognized accreditation entity, its Minnesota
401.23designation will be immediately withdrawn. Prior to the expiration of the three-year
401.24designation, a hospital seeking to remain part of the voluntary acute stroke system may
401.25reapply to the commissioner for designation.

401.26    Sec. 23. [144.554] HEALTH FACILITIES CONSTRUCTION PLAN
401.27SUBMITTAL AND FEES.
401.28For hospitals, nursing homes, boarding care homes, residential hospices, supervised
401.29living facilities, freestanding outpatient surgical centers, and end-stage renal disease
401.30facilities, the commissioner shall collect a fee for the review and approval of architectural,
401.31mechanical, and electrical plans and specifications submitted before construction begins
401.32for each project relative to construction of new buildings, additions to existing buildings,
401.33or for remodeling or alterations of existing buildings. All fees collected in this section
401.34shall be deposited in the state treasury and credited to the state government special revenue
402.1fund. Fees must be paid at the time of submission of final plans for review and are not
402.2refundable. The fee is calculated as follows:

402.3	Construction project total estimated cost	Fee
402.4	$0 - $10,000	$30
402.5	$10,001 - $50,000	$150
402.6	$50,001 - $100,000	$300
402.7	$100,001 - $150,000	$450
402.8	$150,001 - $200,000	$600
402.9	$200,001 - $250,000	$750
402.10	$250,001 - $300,000	$900
402.11	$300,001 - $350,000	$1,050
402.12	$350,001 - $400,000	$1,200
402.13	$400,001 - $450,000	$1,350
402.14	$450,001 - $500,000	$1,500
402.15	$500,001 - $550,000	$1,650
402.16	$550,001 - $600,000	$1,800
402.17	$600,001 - $650,000	$1,950
402.18	$650,001 - $700,000	$2,100
402.19	$700,001 - $750,000	$2,250
402.20	$750,001 - $800,000	$2,400
402.21	$800,001 - $850,000	$2,550
402.22	$850,001 - $900,000	$2,700
402.23	$900,001 - $950,000	$2,850
402.24	$950,001 - $1,000,000	$3,000
402.25	$1,000,001 - $1,050,000	$3,150
402.26	$1,050,001 - $1,100,000	$3,300
402.27	$1,100,001 - $1,150,000	$3,450
402.28	$1,150,001 - $1,200,000	$3,600
402.29	$1,200,001 - $1,250,000	$3,750
402.30	$1,250,001 - $1,300,000	$3,900
402.31	$1,300,001 - $1,350,000	$4,050
402.32	$1,350,001 - $1,400,000	$4,200
402.33	$1,400,001 - $1,450,000	$4,350
402.34	$1,450,001 - $1,500,000	$4,500
402.35	$1,500,001 and over	$4,800

402.36    Sec. 24. Minnesota Statutes 2012, section 144.966, subdivision 2, is amended to read:
402.37    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
402.38commissioner of health shall establish a Newborn Hearing Screening Advisory Committee
402.39to advise and assist the Department of Health and the Department of Education in:
403.1    (1) developing protocols and timelines for screening, rescreening, and diagnostic
403.2audiological assessment and early medical, audiological, and educational intervention
403.3services for children who are deaf or hard-of-hearing;
403.4    (2) designing protocols for tracking children from birth through age three that may
403.5have passed newborn screening but are at risk for delayed or late onset of permanent
403.6hearing loss;
403.7    (3) designing a technical assistance program to support facilities implementing the
403.8screening program and facilities conducting rescreening and diagnostic audiological
403.9assessment;
403.10    (4) designing implementation and evaluation of a system of follow-up and tracking;
403.11and
403.12    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
403.13culturally appropriate services for children with a confirmed hearing loss and their families.
403.14    (b) The commissioner of health shall appoint at least one member from each of the
403.15following groups with no less than two of the members being deaf or hard-of-hearing:
403.16    (1) a representative from a consumer organization representing culturally deaf
403.17persons;
403.18    (2) a parent with a child with hearing loss representing a parent organization;
403.19    (3) a consumer from an organization representing oral communication options;
403.20    (4) a consumer from an organization representing cued speech communication
403.21options;
403.22    (5) an audiologist who has experience in evaluation and intervention of infants
403.23and young children;
403.24    (6) a speech-language pathologist who has experience in evaluation and intervention
403.25of infants and young children;
403.26    (7) two primary care providers who have experience in the care of infants and young
403.27children, one of which shall be a pediatrician;
403.28    (8) a representative from the early hearing detection intervention teams;
403.29    (9) a representative from the Department of Education resource center for the deaf
403.30and hard-of-hearing or the representative's designee;
403.31    (10) a representative of the Commission of Deaf, DeafBlind and Hard-of-Hearing
403.32Minnesotans;
403.33    (11) a representative from the Department of Human Services Deaf and
403.34Hard-of-Hearing Services Division;
403.35    (12) one or more of the Part C coordinators from the Department of Education, the
403.36Department of Health, or the Department of Human Services or the department's designees;
404.1    (13) the Department of Health early hearing detection and intervention coordinators;
404.2    (14) two birth hospital representatives from one rural and one urban hospital;
404.3    (15) a pediatric geneticist;
404.4    (16) an otolaryngologist;
404.5    (17) a representative from the Newborn Screening Advisory Committee under
404.6this subdivision; and
404.7    (18) a representative of the Department of Education regional low-incidence
404.8facilitators.
404.9The commissioner must complete the appointments required under this subdivision by
404.10September 1, 2007.
404.11    (c) The Department of Health member shall chair the first meeting of the committee.
404.12At the first meeting, the committee shall elect a chair from its membership. The committee
404.13shall meet at the call of the chair, at least four times a year. The committee shall adopt
404.14written bylaws to govern its activities. The Department of Health shall provide technical
404.15and administrative support services as required by the committee. These services shall
404.16include technical support from individuals qualified to administer infant hearing screening,
404.17rescreening, and diagnostic audiological assessments.
404.18    Members of the committee shall receive no compensation for their service, but
404.19shall be reimbursed as provided in section 15.059 for expenses incurred as a result of
404.20their duties as members of the committee.
404.21    (d) This subdivision expires June 30, 2013 2019.

404.22    Sec. 25. Minnesota Statutes 2012, section 144.98, subdivision 3, is amended to read:
404.23    Subd. 3. Annual fees. (a) An application for accreditation under subdivision 6 must
404.24be accompanied by the annual fees specified in this subdivision. The annual fees include:
404.25(1) base accreditation fee, $1,500 $600;
404.26(2) sample preparation techniques fee, $200 per technique;
404.27(3) an administrative fee for laboratories located outside this state, $3,750 $2,000; and
404.28(4) test category fees.
404.29(b) For the programs in subdivision 3a, the commissioner may accredit laboratories
404.30for fields of testing under the categories listed in clauses (1) to (10) upon completion of
404.31the application requirements provided by subdivision 6 and receipt of the fees for each
404.32category under each program that accreditation is requested. The categories offered and
404.33related fees include:
404.34(1) microbiology, $450 $200;
404.35(2) inorganics, $450 $200;
405.1(3) metals, $1,000 $500;
405.2(4) volatile organics, $1,300 $1,000;
405.3(5) other organics, $1,300 $1,000;
405.4(6) radiochemistry, $1,500 $750;
405.5(7) emerging contaminants, $1,500 $1,000;
405.6(8) agricultural contaminants, $1,250 $1,000;
405.7(9) toxicity (bioassay), $1,000 $500; and
405.8(10) physical characterization, $250.
405.9(c) The total annual fee includes the base fee, the sample preparation techniques
405.10fees, the test category fees per program, and, when applicable, an administrative fee for
405.11out-of-state laboratories.
405.12EFFECTIVE DATE.This section is effective the day following final enactment.

405.13    Sec. 26. Minnesota Statutes 2012, section 144.98, subdivision 5, is amended to read:
405.14    Subd. 5. State government special revenue fund. Fees collected by the
405.15commissioner under this section must be deposited in the state treasury and credited to
405.16the state government special revenue fund.
405.17EFFECTIVE DATE.This section is effective the day following final enactment.

405.18    Sec. 27. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
405.19to read:
405.20    Subd. 10. Establishing a selection committee. (a) The commissioner shall
405.21establish a selection committee for the purpose of recommending approval of qualified
405.22laboratory assessors and assessment bodies. Committee members shall demonstrate
405.23competence in assessment practices. The committee shall initially consist of seven
405.24members appointed by the commissioner as follows:
405.25(1) one member from a municipal laboratory accredited by the commissioner;
405.26(2) one member from an industrial treatment laboratory accredited by the
405.27commissioner;
405.28(3) one member from a commercial laboratory located in this state and accredited by
405.29the commissioner;
405.30(4) one member from a commercial laboratory located outside the state and
405.31accredited by the commissioner;
405.32(5) one member from a nongovernmental client of environmental laboratories;
406.1(6) one member from a professional organization with a demonstrated interest in
406.2environmental laboratory data and accreditation; and
406.3(7) one employee of the laboratory accreditation program administered by the
406.4department.
406.5(b) Committee appointments begin on January 1 and end on December 31 of the
406.6same year.
406.7(c) The commissioner shall appoint persons to fill vacant committee positions,
406.8expand the total number of appointed positions, or change the designated positions upon
406.9the advice of the committee.
406.10(d) The commissioner shall rescind the appointment of a selection committee
406.11member for sufficient cause as the commissioner determines, such as:
406.12(1) neglect of duty;
406.13(2) failure to notify the commissioner of a real or perceived conflict of interest;
406.14(3) nonconformance with committee procedures;
406.15(4) failure to demonstrate competence in assessment practices; or
406.16(5) official misconduct.
406.17(e) Members of the selection committee shall be compensated according to the
406.18provisions in section 15.059, subdivision 3.

406.19    Sec. 28. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
406.20to read:
406.21    Subd. 11. Activities of the selection committee. (a) The selection committee
406.22will determine assessor and assessment body application requirements, the frequency
406.23of application submittal, and the application review schedule. The commissioner shall
406.24publish the application requirements and procedures on the accreditation program Web site.
406.25(b) In its selection process, the committee shall ensure its application requirements
406.26and review process:
406.27(1) meet the standards implemented in subdivision 2a;
406.28(2) ensure assessors have demonstrated competence in technical disciplines offered
406.29for accreditation by the commissioner; and
406.30(3) consider any history of repeated nonconformance or complaints regarding
406.31assessors or assessment bodies.
406.32(c) The selection committee shall consider an application received from qualified
406.33applicants and shall supply a list of recommended assessors and assessment bodies to
406.34the commissioner of health no later than 90 days after the commissioner notifies the
406.35committee of the need for review of applications.

407.1    Sec. 29. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
407.2to read:
407.3    Subd. 12. Commissioner approval of assessors and scheduling of assessments.
407.4(a) The commissioner shall approve assessors who:
407.5(1) are employed by the commissioner for the purpose of accrediting laboratories
407.6and demonstrate competence in assessment practices for environmental laboratories; or
407.7(2) are employed by a state or federal agency with established agreements for
407.8mutual assistance or recognition with the commissioner and demonstrate competence in
407.9assessment practices for environmental laboratories.
407.10(b) The commissioner may approve other assessors or assessment bodies who are
407.11recommended by the selection committee according to subdivision 11, paragraph (c). The
407.12commissioner shall publish the list of assessors and assessment bodies approved from the
407.13recommendations.
407.14(c) The commissioner shall rescind approval for an assessor or assessment body for
407.15sufficient cause as the commissioner determines, such as:
407.16(1) failure to meet the minimum qualifications for performing assessments;
407.17(2) lack of availability;
407.18(3) nonconformance with the applicable laws, rules, standards, policies, and
407.19procedures;
407.20(4) misrepresentation of application information regarding qualifications and
407.21training; or
407.22(5) excessive cost to perform the assessment activities.

407.23    Sec. 30. Minnesota Statutes 2012, section 144.98, is amended by adding a subdivision
407.24to read:
407.25    Subd. 13. Laboratory requirements for assessor selection and scheduling
407.26assessments. (a) A laboratory accredited or seeking accreditation that requires an
407.27assessment by the commissioner must select an assessor, group of assessors, or an
407.28assessment body from the published list specified in subdivision 12, paragraph (b). An
407.29accredited laboratory must complete an assessment and make all corrective actions at least
407.30once every 24 months. Unless the commissioner grants interim accreditation, a laboratory
407.31seeking accreditation must complete an assessment and make all corrective actions
407.32prior to, but no earlier than, 18 months prior to the date the application is submitted to
407.33the commissioner.
407.34(b) A laboratory shall not select the same assessor more than twice in succession
407.35for assessments of the same facility unless the laboratory receives written approval
408.1from the commissioner for the selection. The laboratory must supply a written request
408.2to the commissioner for approval and must justify the reason for the request and provide
408.3the alternate options considered.
408.4(c) A laboratory must select assessors appropriate to the size and scope of the
408.5laboratory's application or existing accreditation.
408.6(d) A laboratory must enter into its own contract for direct payment of the assessors
408.7or assessment body. The contract must authorize the assessor, assessment body, or
408.8subcontractors to release all records to the commissioner regarding the assessment activity,
408.9when the assessment is performed in compliance with this statute.
408.10(e) A laboratory must agree to permit other assessors as selected by the commissioner
408.11to participate in the assessment activities.
408.12(f) If the laboratory determines no approved assessor is available to perform
408.13the assessment, the laboratory must notify the commissioner in writing and provide a
408.14justification for the determination. If the commissioner confirms no approved assessor
408.15is available, the commissioner may designate an alternate assessor from those approved
408.16in subdivision 12, paragraph (a), or the commissioner may delay the assessment until
408.17an assessor is available. If an approved alternate assessor performs the assessment, the
408.18commissioner may collect fees equivalent to the cost of performing the assessment
408.19activities.
408.20(g) Fees collected under this section are deposited in a special account and are
408.21annually appropriated to the commissioner for the purpose of performing assessment
408.22activities.
408.23EFFECTIVE DATE.This section is effective the day following final enactment.

408.24    Sec. 31. Minnesota Statutes 2012, section 144.99, subdivision 4, is amended to read:
408.25    Subd. 4. Administrative penalty orders. (a) The commissioner may issue an
408.26order requiring violations to be corrected and administratively assessing monetary
408.27penalties for violations of the statutes, rules, and other actions listed in subdivision 1. The
408.28procedures in section 144.991 must be followed when issuing administrative penalty
408.29orders. Except in the case of repeated or serious violations, the penalty assessed in the
408.30order must be forgiven if the person who is subject to the order demonstrates in writing
408.31to the commissioner before the 31st day after receiving the order that the person has
408.32corrected the violation or has developed a corrective plan acceptable to the commissioner.
408.33The maximum amount of an administrative penalty order is $10,000 for each violator for
408.34all violations by that violator identified in an inspection or review of compliance.
409.1(b) Notwithstanding paragraph (a), the commissioner may issue to a large public
409.2water supply, serving a population of more than 10,000 persons, an administrative penalty
409.3order imposing a penalty of at least $1,000 per day per violation, not to exceed $10,000
409.4for each violation of sections 144.381 to 144.385 and rules adopted thereunder.
409.5(c) Notwithstanding paragraph (a), the commissioner may issue to a certified lead
409.6firm or person performing regulated lead work, an administrative penalty order imposing a
409.7penalty of at least $5,000 per violation per day, not to exceed $10,000 for each violation of
409.8sections 144.9501 to 144.9512 and rules adopted thereunder. All revenue collected from
409.9monetary penalties in this section shall be deposited in the state treasury and credited to
409.10the state government special revenue fund.

409.11    Sec. 32. Minnesota Statutes 2012, section 145.986, is amended to read:
409.12145.986 STATEWIDE HEALTH IMPROVEMENT PROGRAM.
409.13    Subdivision 1. Grants to local communities Purpose. The purpose of the statewide
409.14health improvement program is to:
409.15(1) address the top three leading preventable causes of illness and death: tobacco use
409.16and exposure, poor diet, and lack of regular physical activity;
409.17(2) promote the development, availability, and use of evidence-based, community
409.18level, comprehensive strategies to create healthy communities; and
409.19(3) measure the impact of the evidence-based, community health improvement
409.20practices which over time work to contain health care costs and reduce chronic diseases.
409.21    Subd. 1a. Grants to local communities. (a) Beginning July 1, 2009, the
409.22commissioner of health shall award competitive grants to community health boards
409.23established pursuant to section 145A.09 and tribal governments to convene, coordinate,
409.24and implement evidence-based strategies targeted at reducing the percentage of
409.25Minnesotans who are obese or overweight and to reduce the use of tobacco.
409.26    (b) Grantee activities shall:
409.27    (1) be based on scientific evidence;
409.28    (2) be based on community input;
409.29    (3) address behavior change at the individual, community, and systems levels;
409.30    (4) occur in community, school, worksite, and health care settings; and
409.31    (5) be focused on policy, systems, and environmental changes that support healthy
409.32behaviors.; and
409.33(6) address the health disparities and inequities that exist in the grantee's community.
409.34    (c) To receive a grant under this section, community health boards and tribal
409.35governments must submit proposals to the commissioner. A local match of ten percent
410.1of the total funding allocation is required. This local match may include funds donated
410.2by community partners.
410.3    (d) In order to receive a grant, community health boards and tribal governments
410.4must submit a health improvement plan to the commissioner of health for approval. The
410.5commissioner may require the plan to identify a community leadership team, community
410.6partners, and a community action plan that includes an assessment of area strengths and
410.7needs, proposed action strategies, technical assistance needs, and a staffing plan.
410.8    (e) The grant recipient must implement the health improvement plan, evaluate the
410.9effectiveness of the interventions strategies, and modify or discontinue interventions
410.10 strategies found to be ineffective.
410.11    (f) By January 15, 2011, the commissioner of health shall recommend whether any
410.12funding should be distributed to community health boards and tribal governments based
410.13on health disparities demonstrated in the populations served.
410.14    (g) (f) Grant recipients shall report their activities and their progress toward the
410.15outcomes established under subdivision 2 to the commissioner in a format and at a time
410.16specified by the commissioner.
410.17    (h) (g) All grant recipients shall be held accountable for making progress toward
410.18the measurable outcomes established in subdivision 2. The commissioner shall require a
410.19corrective action plan and may reduce the funding level of grant recipients that do not
410.20make adequate progress toward the measurable outcomes.
410.21(h) Notwithstanding paragraph (a), the commissioner may award funding to
410.22convene, coordinate, and implement evidence-based strategies targeted at reducing other
410.23risk factors, aside from tobacco use and exposure, poor diet, and lack of regular physical
410.24activity, that are associated with chronic disease and may impact public health. The
410.25commissioner shall develop a criteria and procedures to allocate funding under this section.
410.26    Subd. 2. Outcomes. (a) The commissioner shall set measurable outcomes to meet
410.27the goals specified in subdivision 1, and annually review the progress of grant recipients
410.28in meeting the outcomes.
410.29    (b) The commissioner shall measure current public health status, using existing
410.30measures and data collection systems when available, to determine baseline data against
410.31which progress shall be monitored.
410.32    Subd. 3. Technical assistance and oversight. (a) The commissioner shall provide
410.33content expertise, technical expertise, and training to grant recipients and advice on
410.34evidence-based strategies, including those based on populations and types of communities
410.35served. The commissioner shall ensure that the statewide health improvement program
410.36meets the outcomes established under subdivision 2 by conducting a comprehensive
411.1statewide evaluation and assisting grant recipients to modify or discontinue interventions
411.2found to be ineffective.
411.3(b) For the purposes of carrying out the grant program under this section, including
411.4for administrative purposes, the commissioner shall award contracts to appropriate entities
411.5to assist in training and provide technical assistance to grantees.
411.6(c) Contracts awarded under paragraph (b) may be used to provide technical
411.7assistance and training in the areas of:
411.8(1) community engagement and capacity building;
411.9(2) tribal support;
411.10(3) community asset building and risk behavior reduction;
411.11(4) legal;
411.12(5) communications;
411.13(6) community, school, health care, work site, and other site-specific strategies; and
411.14(7) health equity.
411.15    Subd. 4. Evaluation. (a) Using the outcome measures established in subdivision
411.163, the commissioner shall conduct a biennial an evaluation of the statewide health
411.17improvement program funded under this section. Grant recipients shall cooperate with
411.18the commissioner in the evaluation and provide the commissioner with the information
411.19necessary to conduct the evaluation.
411.20(b) Grant recipients will collect, monitor, and submit to the Department of Health
411.21baseline and annual data, and provide information to improve the quality and impact of
411.22community health improvement strategies.
411.23(c) For the purposes of carrying out the grant program under this section, including
411.24for administrative purposes, the commissioner shall award contracts to appropriate entities
411.25to assist in designing and implementing evaluation systems.
411.26(d) Contracts awarded under paragraph (c) may be used to:
411.27(1) develop grantee monitoring and reporting systems to track grantee progress,
411.28including aggregated and disaggregated data;
411.29(2) manage, analyze, and report program evaluation data results; and
411.30(3) utilize innovative support tools to analyze and predict the impact of prevention
411.31strategies on health outcomes and state health care costs over time.
411.32    Subd. 5. Report. The commissioner shall submit a biennial report to the legislature
411.33on the statewide health improvement program funded under this section. These reports
411.34must include information on grant recipients, activities that were conducted using grant
411.35funds, evaluation data, and outcome measures, if available. In addition, the commissioner
411.36shall provide recommendations on future areas of focus for health improvement. These
412.1reports are due by January 15 of every other year, beginning in 2010. In the report due
412.2on January 15, 2010, the commissioner shall include recommendations on a sustainable
412.3funding source for the statewide health improvement program other than the health care
412.4access fund.
412.5    Subd. 6. Supplantation of existing funds. Community health boards and tribal
412.6governments must use funds received under this section to develop new programs, expand
412.7current programs that work to reduce the percentage of Minnesotans who are obese or
412.8overweight or who use tobacco, or replace discontinued state or federal funds previously
412.9used to reduce the percentage of Minnesotans who are obese or overweight or who use
412.10tobacco. Funds must not be used to supplant current state or local funding to community
412.11health boards or tribal governments used to reduce the percentage of Minnesotans who are
412.12obese or overweight or to reduce tobacco use.

412.13    Sec. 33. Minnesota Statutes 2012, section 149A.02, subdivision 1a, is amended to read:
412.14    Subd. 1a. Alkaline hydrolysis. "Alkaline hydrolysis" means the reduction of a dead
412.15human body to essential elements through exposure to a combination of heat and alkaline
412.16hydrolysis and the repositioning or movement of the body during the process to facilitate
412.17reduction, a water-based dissolution process using alkaline chemicals, heat, agitation, and
412.18pressure to accelerate natural decomposition; the processing of the hydrolyzed remains
412.19after removal from the alkaline hydrolysis chamber, vessel; placement of the processed
412.20remains in a hydrolyzed remains container,; and release of the hydrolyzed remains to an
412.21appropriate party. Alkaline hydrolysis is a form of final disposition.

412.22    Sec. 34. Minnesota Statutes 2012, section 149A.02, is amended by adding a
412.23subdivision to read:
412.24    Subd. 1b. Alkaline hydrolysis container. "Alkaline hydrolysis container" means a
412.25hydrolyzable or biodegradable closed container or pouch resistant to leakage of bodily
412.26fluids that encases the body and into which a dead human body is placed prior to insertion
412.27into an alkaline hydrolysis vessel. Alkaline hydrolysis containers may be hydrolyzable or
412.28biodegradable alternative containers or caskets.

412.29    Sec. 35. Minnesota Statutes 2012, section 149A.02, is amended by adding a
412.30subdivision to read:
412.31    Subd. 1c. Alkaline hydrolysis facility. "Alkaline hydrolysis facility" means a
412.32building or structure containing one or more alkaline hydrolysis vessels for the alkaline
412.33hydrolysis of dead human bodies.

413.1    Sec. 36. Minnesota Statutes 2012, section 149A.02, is amended by adding a
413.2subdivision to read:
413.3    Subd. 1d. Alkaline hydrolysis vessel. "Alkaline hydrolysis vessel" means the
413.4container in which the alkaline hydrolysis of a dead human body is performed.

413.5    Sec. 37. Minnesota Statutes 2012, section 149A.02, subdivision 2, is amended to read:
413.6    Subd. 2. Alternative container. "Alternative container" means a nonmetal
413.7receptacle or enclosure, without ornamentation or a fixed interior lining, which is designed
413.8for the encasement of dead human bodies and is made of hydrolyzable or biodegradable
413.9materials, corrugated cardboard, fiberboard, pressed-wood, or other like materials.

413.10    Sec. 38. Minnesota Statutes 2012, section 149A.02, subdivision 3, is amended to read:
413.11    Subd. 3. Arrangements for disposition. "Arrangements for disposition" means
413.12any action normally taken by a funeral provider in anticipation of or preparation for the
413.13entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

413.14    Sec. 39. Minnesota Statutes 2012, section 149A.02, is amended by adding a
413.15subdivision to read:
413.16    Subd. 3c. Branch funeral establishment. "Branch funeral establishment" means
413.17any place or premise used as the office or place of business that provides funeral goods
413.18or services, except on-site preparation of the body, to the public. A branch funeral
413.19establishment is subject to the licensing requirements of sections 149A.50 and 149A.51,
413.20except section 149A.50, subdivision 2, clause (1). A branch funeral establishment must be
413.21associated through a majority ownership of a licensed funeral establishment which meets
413.22the requirements of sections 149A.50 and 149A.92, subdivisions 2 to 10.

413.23    Sec. 40. Minnesota Statutes 2012, section 149A.02, subdivision 4, is amended to read:
413.24    Subd. 4. Cash advance item. "Cash advance item" means any item of service
413.25or merchandise described to a purchaser as a "cash advance," "accommodation," "cash
413.26disbursement," or similar term. A cash advance item is also any item obtained from a
413.27third party and paid for by the funeral provider on the purchaser's behalf. Cash advance
413.28items include, but are not limited to, cemetery, alkaline hydrolysis, or crematory services,
413.29pallbearers, public transportation, clergy honoraria, flowers, musicians or singers, obituary
413.30notices, gratuities, and death records.

413.31    Sec. 41. Minnesota Statutes 2012, section 149A.02, subdivision 5, is amended to read:
414.1    Subd. 5. Casket. "Casket" means a rigid container which is designed for the
414.2encasement of a dead human body and is usually constructed of hydrolyzable or
414.3biodegradable materials, wood, metal, fiberglass, plastic, or like material, and ornamented
414.4and lined with fabric.

414.5    Sec. 42. Minnesota Statutes 2012, section 149A.02, is amended by adding a
414.6subdivision to read:
414.7    Subd. 12a. Crypt. "Crypt" means a space in a mausoleum of sufficient size, used or
414.8intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.

414.9    Sec. 43. Minnesota Statutes 2012, section 149A.02, is amended by adding a
414.10subdivision to read:
414.11    Subd. 12b. Direct alkaline hydrolysis. "Direct alkaline hydrolysis" means a
414.12final disposition of a dead human body by alkaline hydrolysis, without formal viewing,
414.13visitation, or ceremony with the body present.

414.14    Sec. 44. Minnesota Statutes 2012, section 149A.02, subdivision 16, is amended to read:
414.15    Subd. 16. Final disposition. "Final disposition" means the acts leading to and the
414.16entombment, burial in a cemetery, alkaline hydrolysis, or cremation of a dead human body.

414.17    Sec. 45. Minnesota Statutes 2012, section 149A.02, subdivision 23, is amended to read:
414.18    Subd. 23. Funeral services. "Funeral services" means any services which may
414.19be used to: (1) care for and prepare dead human bodies for burial, alkaline hydrolysis,
414.20cremation, or other final disposition; and (2) arrange, supervise, or conduct the funeral
414.21ceremony or the final disposition of dead human bodies.

414.22    Sec. 46. Minnesota Statutes 2012, section 149A.02, is amended by adding a
414.23subdivision to read:
414.24    Subd. 24a. Holding facility. "Holding facility" means a secure enclosed room or
414.25confined area within a funeral establishment, branch funeral establishment, crematory,
414.26or alkaline hydrolysis facility used for temporary storage of human remains awaiting
414.27final disposition.

414.28    Sec. 47. Minnesota Statutes 2012, section 149A.02, is amended by adding a
414.29subdivision to read:
415.1    Subd. 24b. Hydrolyzed remains. "Hydrolyzed remains" means the remains of a
415.2dead human body following the alkaline hydrolysis process. Hydrolyzed remains does not
415.3include pacemakers, prostheses, or similar foreign materials.

415.4    Sec. 48. Minnesota Statutes 2012, section 149A.02, is amended by adding a
415.5subdivision to read:
415.6    Subd. 24c. Hydrolyzed remains container. "Hydrolyzed remains container" means
415.7a receptacle in which hydrolyzed remains are placed. For purposes of this chapter, a
415.8hydrolyzed remains container is interchangeable with "urn" or similar keepsake storage
415.9jewelry.

415.10    Sec. 49. Minnesota Statutes 2012, section 149A.02, is amended by adding a
415.11subdivision to read:
415.12    Subd. 26a. Inurnment. "Inurnment" means placing hydrolyzed or cremated remains
415.13in a hydrolyzed or cremated remains container suitable for placement, burial, or shipment.

415.14    Sec. 50. Minnesota Statutes 2012, section 149A.02, subdivision 27, is amended to read:
415.15    Subd. 27. Licensee. "Licensee" means any person or entity that has been issued
415.16a license to practice mortuary science, to operate a funeral establishment, to operate an
415.17alkaline hydrolysis facility, or to operate a crematory by the Minnesota commissioner
415.18of health.

415.19    Sec. 51. Minnesota Statutes 2012, section 149A.02, is amended by adding a
415.20subdivision to read:
415.21    Subd. 30a. Niche. "Niche" means a space in a columbarium used, or intended to be
415.22used, for the placement of hydrolyzed or cremated remains.

415.23    Sec. 52. Minnesota Statutes 2012, section 149A.02, is amended by adding a
415.24subdivision to read:
415.25    Subd. 32a. Placement. "Placement" means the placing of a container holding
415.26hydrolyzed or cremated remains in a crypt, vault, or niche.

415.27    Sec. 53. Minnesota Statutes 2012, section 149A.02, subdivision 34, is amended to read:
415.28    Subd. 34. Preparation of the body. "Preparation of the body" means placement of
415.29the body into an appropriate cremation or alkaline hydrolysis container, embalming of
416.1the body or such items of care as washing, disinfecting, shaving, positioning of features,
416.2restorative procedures, application of cosmetics, dressing, and casketing.

416.3    Sec. 54. Minnesota Statutes 2012, section 149A.02, subdivision 35, is amended to read:
416.4    Subd. 35. Processing. "Processing" means the removal of foreign objects, drying or
416.5cooling, and the reduction of the hydrolyzed or cremated remains by mechanical means
416.6including, but not limited to, grinding, crushing, or pulverizing, to a granulated appearance
416.7appropriate for final disposition.

416.8    Sec. 55. Minnesota Statutes 2012, section 149A.02, subdivision 37, is amended to read:
416.9    Subd. 37. Public transportation. "Public transportation" means all manner of
416.10transportation via common carrier available to the general public including airlines, buses,
416.11railroads, and ships. For purposes of this chapter, a livery service providing transportation
416.12to private funeral establishments, alkaline hydrolysis facilities, or crematories is not public
416.13transportation.

416.14    Sec. 56. Minnesota Statutes 2012, section 149A.02, is amended by adding a
416.15subdivision to read:
416.16    Subd. 37c. Scattering. "Scattering" means the authorized dispersal of hydrolyzed
416.17or cremated remains in a defined area of a dedicated cemetery or in areas where no local
416.18prohibition exists provided that the hydrolyzed or cremated remains are not distinguishable
416.19to the public, are not in a container, and that the person who has control over disposition
416.20of the hydrolyzed or cremated remains has obtained written permission of the property
416.21owner or governing agency to scatter on the property.

416.22    Sec. 57. Minnesota Statutes 2012, section 149A.02, is amended by adding a
416.23subdivision to read:
416.24    Subd. 41. Vault. "Vault" means a space in a mausoleum of sufficient size, used or
416.25intended to be used, to entomb human remains, cremated remains, or hydrolyzed remains.
416.26Vault may also mean a sealed and lined casket enclosure.

416.27    Sec. 58. Minnesota Statutes 2012, section 149A.03, is amended to read:
416.28149A.03 DUTIES OF COMMISSIONER.
416.29    The commissioner shall:
416.30    (1) enforce all laws and adopt and enforce rules relating to the:
417.1    (i) removal, preparation, transportation, arrangements for disposition, and final
417.2disposition of dead human bodies;
417.3    (ii) licensure and professional conduct of funeral directors, morticians, interns,
417.4practicum students, and clinical students;
417.5    (iii) licensing and operation of a funeral establishment; and
417.6(iv) licensing and operation of an alkaline hydrolysis facility; and
417.7    (iv) (v) licensing and operation of a crematory;
417.8    (2) provide copies of the requirements for licensure and permits to all applicants;
417.9    (3) administer examinations and issue licenses and permits to qualified persons
417.10and other legal entities;
417.11    (4) maintain a record of the name and location of all current licensees and interns;
417.12    (5) perform periodic compliance reviews and premise inspections of licensees;
417.13    (6) accept and investigate complaints relating to conduct governed by this chapter;
417.14    (7) maintain a record of all current preneed arrangement trust accounts;
417.15    (8) maintain a schedule of application, examination, permit, and licensure fees,
417.16initial and renewal, sufficient to cover all necessary operating expenses;
417.17    (9) educate the public about the existence and content of the laws and rules for
417.18mortuary science licensing and the removal, preparation, transportation, arrangements
417.19for disposition, and final disposition of dead human bodies to enable consumers to file
417.20complaints against licensees and others who may have violated those laws or rules;
417.21    (10) evaluate the laws, rules, and procedures regulating the practice of mortuary
417.22science in order to refine the standards for licensing and to improve the regulatory and
417.23enforcement methods used; and
417.24    (11) initiate proceedings to address and remedy deficiencies and inconsistencies in
417.25the laws, rules, or procedures governing the practice of mortuary science and the removal,
417.26preparation, transportation, arrangements for disposition, and final disposition of dead
417.27human bodies.

417.28    Sec. 59. [149A.54] LICENSE TO OPERATE AN ALKALINE HYDROLYSIS
417.29FACILITY.
417.30    Subdivision 1. License requirement. Except as provided in section 149A.01,
417.31subdivision 3, a place or premise shall not be maintained, managed, or operated which
417.32is devoted to or used in the holding and alkaline hydrolysis of a dead human body
417.33without possessing a valid license to operate an alkaline hydrolysis facility issued by the
417.34commissioner of health.
418.1    Subd. 2. Requirements for an alkaline hydrolysis facility. (a) An alkaline
418.2hydrolysis facility licensed under this section must consist of:
418.3(1) a building or structure that complies with applicable local and state building
418.4codes, zoning laws and ordinances, wastewater management and environmental standards,
418.5containing one or more alkaline hydrolysis vessels for the alkaline hydrolysis of dead
418.6human bodies;
418.7(2) a method approved by the commissioner of health to dry the hydrolyzed remains
418.8and which is located within the licensed facility;
418.9(3) a means approved by the commissioner of health for refrigeration of dead human
418.10bodies awaiting alkaline hydrolysis;
418.11(4) an appropriate means of processing hydrolyzed remains to a granulated
418.12appearance appropriate for final disposition; and
418.13(5) an appropriate holding facility for dead human bodies awaiting alkaline
418.14hydrolysis.
418.15(b) An alkaline hydrolysis facility licensed under this section may also contain a
418.16display room for funeral goods.
418.17    Subd. 3. Application procedure; documentation; initial inspection. An
418.18application to license and operate an alkaline hydrolysis facility shall be submitted to the
418.19commissioner of health. A completed application includes:
418.20(1) a completed application form, as provided by the commissioner;
418.21(2) proof of business form and ownership;
418.22(3) proof of liability insurance coverage or other financial documentation, as
418.23determined by the commissioner, that demonstrates the applicant's ability to respond in
418.24damages for liability arising from the ownership, maintenance management, or operation
418.25of an alkaline hydrolysis facility; and
418.26(4) copies of wastewater and other environmental regulatory permits and
418.27environmental regulatory licenses necessary to conduct operations.
418.28Upon receipt of the application and appropriate fee, the commissioner shall review and
418.29verify all information. Upon completion of the verification process and resolution of any
418.30deficiencies in the application information, the commissioner shall conduct an initial
418.31inspection of the premises to be licensed. After the inspection and resolution of any
418.32deficiencies found and any reinspections as may be necessary, the commissioner shall
418.33make a determination, based on all the information available, to grant or deny licensure. If
418.34the commissioner's determination is to grant the license, the applicant shall be notified and
418.35the license shall issue and remain valid for a period prescribed on the license, but not to
418.36exceed one calendar year from the date of issuance of the license. If the commissioner's
419.1determination is to deny the license, the commissioner must notify the applicant in writing
419.2of the denial and provide the specific reason for denial.
419.3    Subd. 4. Nontransferability of license. A license to operate an alkaline hydrolysis
419.4facility is not assignable or transferable and shall not be valid for any entity other than the
419.5one named. Each license issued to operate an alkaline hydrolysis facility is valid only for the
419.6location identified on the license. A 50 percent or more change in ownership or location of
419.7the alkaline hydrolysis facility automatically terminates the license. Separate licenses shall
419.8be required of two or more persons or other legal entities operating from the same location.
419.9    Subd. 5. Display of license. Each license to operate an alkaline hydrolysis
419.10facility must be conspicuously displayed in the alkaline hydrolysis facility at all times.
419.11Conspicuous display means in a location where a member of the general public within the
419.12alkaline hydrolysis facility will be able to observe and read the license.
419.13    Subd. 6. Period of licensure. All licenses to operate an alkaline hydrolysis facility
419.14issued by the commissioner are valid for a period of one calendar year beginning on July 1
419.15and ending on June 30, regardless of the date of issuance.
419.16    Subd. 7. Reporting changes in license information. Any change of license
419.17information must be reported to the commissioner, on forms provided by the
419.18commissioner, no later than 30 calendar days after the change occurs. Failure to report
419.19changes is grounds for disciplinary action.
419.20    Subd. 8. Notification to the commissioner. If the licensee is operating under a
419.21wastewater or an environmental permit or license that is subsequently revoked, denied,
419.22or terminated, the licensee shall notify the commissioner.
419.23    Subd. 9. Application information. All information submitted to the commissioner
419.24for a license to operate an alkaline hydrolysis facility is classified as licensing data under
419.25section 13.41, subdivision 5.

419.26    Sec. 60. [149A.55] RENEWAL OF LICENSE TO OPERATE AN ALKALINE
419.27HYDROLYSIS FACILITY.
419.28    Subdivision 1. Renewal required. All licenses to operate an alkaline hydrolysis
419.29facility issued by the commissioner expire on June 30 following the date of issuance of the
419.30license and must be renewed to remain valid.
419.31    Subd. 2. Renewal procedure and documentation. Licensees who wish to renew
419.32their licenses must submit to the commissioner a completed renewal application no later
419.33than June 30 following the date the license was issued. A completed renewal application
419.34includes:
419.35(1) a completed renewal application form, as provided by the commissioner; and
420.1(2) proof of liability insurance coverage or other financial documentation, as
420.2determined by the commissioner, that demonstrates the applicant's ability to respond in
420.3damages for liability arising from the ownership, maintenance, management, or operation
420.4of an alkaline hydrolysis facility.
420.5Upon receipt of the completed renewal application, the commissioner shall review and
420.6verify the information. Upon completion of the verification process and resolution of
420.7any deficiencies in the renewal application information, the commissioner shall make a
420.8determination, based on all the information available, to reissue or refuse to reissue the
420.9license. If the commissioner's determination is to reissue the license, the applicant shall
420.10be notified and the license shall issue and remain valid for a period prescribed on the
420.11license, but not to exceed one calendar year from the date of issuance of the license. If
420.12the commissioner's determination is to refuse to reissue the license, section 149A.09,
420.13subdivision 2, applies.
420.14    Subd. 3. Penalty for late filing. Renewal applications received after the expiration
420.15date of a license will result in the assessment of a late filing penalty. The late filing penalty
420.16must be paid before the reissuance of the license and received by the commissioner no
420.17later than 31 calendar days after the expiration date of the license.
420.18    Subd. 4. Lapse of license. Licenses to operate alkaline hydrolysis facilities
420.19shall automatically lapse when a completed renewal application is not received by the
420.20commissioner within 31 calendar days after the expiration date of a license, or a late
420.21filing penalty assessed under subdivision 3 is not received by the commissioner within 31
420.22calendar days after the expiration of a license.
420.23    Subd. 5. Effect of lapse of license. Upon the lapse of a license, the person to whom
420.24the license was issued is no longer licensed to operate an alkaline hydrolysis facility in
420.25Minnesota. The commissioner shall issue a cease and desist order to prevent the lapsed
420.26license holder from operating an alkaline hydrolysis facility in Minnesota and may pursue
420.27any additional lawful remedies as justified by the case.
420.28    Subd. 6. Restoration of lapsed license. The commissioner may restore a lapsed
420.29license upon receipt and review of a completed renewal application, receipt of the late
420.30filing penalty, and reinspection of the premises, provided that the receipt is made within
420.31one calendar year from the expiration date of the lapsed license and the cease and desist
420.32order issued by the commissioner has not been violated. If a lapsed license is not restored
420.33within one calendar year from the expiration date of the lapsed license, the holder of the
420.34lapsed license cannot be relicensed until the requirements in section 149A.54 are met.
420.35    Subd. 7. Reporting changes in license information. Any change of license
420.36information must be reported to the commissioner, on forms provided by the
421.1commissioner, no later than 30 calendar days after the change occurs. Failure to report
421.2changes is grounds for disciplinary action.
421.3    Subd. 8. Application information. All information submitted to the commissioner
421.4by an applicant for renewal of licensure to operate an alkaline hydrolysis facility is
421.5classified as licensing data under section 13.41, subdivision 5.

421.6    Sec. 61. Minnesota Statutes 2012, section 149A.65, is amended by adding a
421.7subdivision to read:
421.8    Subd. 6. Alkaline hydrolysis facilities. The initial and renewal fee for an alkaline
421.9hydrolysis facility is $300. The late fee charge for a license renewal is $25.

421.10    Sec. 62. Minnesota Statutes 2012, section 149A.65, is amended by adding a
421.11subdivision to read:
421.12    Subd. 7. State government special revenue fund. Fees collected by the
421.13commissioner under this section must be deposited in the state treasury and credited to
421.14the state government special revenue fund.

421.15    Sec. 63. Minnesota Statutes 2012, section 149A.70, subdivision 1, is amended to read:
421.16    Subdivision 1. Use of titles. Only a person holding a valid license to practice
421.17mortuary science issued by the commissioner may use the title of mortician, funeral
421.18director, or any other title implying that the licensee is engaged in the business or practice
421.19of mortuary science. Only the holder of a valid license to operate an alkaline hydrolysis
421.20facility issued by the commissioner may use the title of alkaline hydrolysis facility, water
421.21cremation, water-reduction, biocremation, green-cremation, resomation, dissolution, or
421.22any other title, word, or term implying that the licensee operates an alkaline hydrolysis
421.23facility. Only the holder of a valid license to operate a funeral establishment issued by the
421.24commissioner may use the title of funeral home, funeral chapel, funeral service, or any
421.25other title, word, or term implying that the licensee is engaged in the business or practice
421.26of mortuary science. Only the holder of a valid license to operate a crematory issued by
421.27the commissioner may use the title of crematory, crematorium, green-cremation, or any
421.28other title, word, or term implying that the licensee operates a crematory or crematorium.

421.29    Sec. 64. Minnesota Statutes 2012, section 149A.70, subdivision 2, is amended to read:
421.30    Subd. 2. Business location. A funeral establishment, alkaline hydrolysis facility, or
421.31crematory shall not do business in a location that is not licensed as a funeral establishment,
422.1alkaline hydrolysis facility, or crematory and shall not advertise a service that is available
422.2from an unlicensed location.

422.3    Sec. 65. Minnesota Statutes 2012, section 149A.70, subdivision 3, is amended to read:
422.4    Subd. 3. Advertising. No licensee, clinical student, practicum student, or intern
422.5shall publish or disseminate false, misleading, or deceptive advertising. False, misleading,
422.6or deceptive advertising includes, but is not limited to:
422.7    (1) identifying, by using the names or pictures of, persons who are not licensed to
422.8practice mortuary science in a way that leads the public to believe that those persons will
422.9provide mortuary science services;
422.10    (2) using any name other than the names under which the funeral establishment,
422.11alkaline hydrolysis facility, or crematory is known to or licensed by the commissioner;
422.12    (3) using a surname not directly, actively, or presently associated with a licensed
422.13funeral establishment, alkaline hydrolysis facility, or crematory, unless the surname had
422.14been previously and continuously used by the licensed funeral establishment, alkaline
422.15hydrolysis facility, or crematory; and
422.16    (4) using a founding or establishing date or total years of service not directly or
422.17continuously related to a name under which the funeral establishment, alkaline hydrolysis
422.18facility, or crematory is currently or was previously licensed.
422.19    Any advertising or other printed material that contains the names or pictures of
422.20persons affiliated with a funeral establishment, alkaline hydrolysis facility, or crematory
422.21shall state the position held by the persons and shall identify each person who is licensed
422.22or unlicensed under this chapter.

422.23    Sec. 66. Minnesota Statutes 2012, section 149A.70, subdivision 5, is amended to read:
422.24    Subd. 5. Reimbursement prohibited. No licensee, clinical student, practicum
422.25student, or intern shall offer, solicit, or accept a commission, fee, bonus, rebate, or other
422.26reimbursement in consideration for recommending or causing a dead human body to
422.27be disposed of by a specific body donation program, funeral establishment, alkaline
422.28hydrolysis facility, crematory, mausoleum, or cemetery.

422.29    Sec. 67. Minnesota Statutes 2012, section 149A.71, subdivision 2, is amended to read:
422.30    Subd. 2. Preventive requirements. (a) To prevent unfair or deceptive acts or
422.31practices, the requirements of this subdivision must be met.
422.32    (b) Funeral providers must tell persons who ask by telephone about the funeral
422.33provider's offerings or prices any accurate information from the price lists described in
423.1paragraphs (c) to (e) and any other readily available information that reasonably answers
423.2the questions asked.
423.3    (c) Funeral providers must make available for viewing to people who inquire in
423.4person about the offerings or prices of funeral goods or burial site goods, separate printed
423.5or typewritten price lists using a ten-point font or larger. Each funeral provider must have a
423.6separate price list for each of the following types of goods that are sold or offered for sale:
423.7    (1) caskets;
423.8    (2) alternative containers;
423.9    (3) outer burial containers;
423.10(4) alkaline hydrolysis containers;
423.11    (4) (5) cremation containers;
423.12(6) hydrolyzed remains containers;
423.13    (5) (7) cremated remains containers;
423.14    (6) (8) markers; and
423.15    (7) (9) headstones.
423.16    (d) Each separate price list must contain the name of the funeral provider's place
423.17of business, address, and telephone number and a caption describing the list as a price
423.18list for one of the types of funeral goods or burial site goods described in paragraph (c),
423.19clauses (1) to (7) (9). The funeral provider must offer the list upon beginning discussion
423.20of, but in any event before showing, the specific funeral goods or burial site goods and
423.21must provide a photocopy of the price list, for retention, if so asked by the consumer. The
423.22list must contain, at least, the retail prices of all the specific funeral goods and burial site
423.23goods offered which do not require special ordering, enough information to identify each,
423.24and the effective date for the price list. However, funeral providers are not required to
423.25make a specific price list available if the funeral providers place the information required
423.26by this paragraph on the general price list described in paragraph (e).
423.27    (e) Funeral providers must give a printed price list, for retention, to persons who
423.28inquire in person about the funeral goods, funeral services, burial site goods, or burial site
423.29services or prices offered by the funeral provider. The funeral provider must give the list
423.30upon beginning discussion of either the prices of or the overall type of funeral service or
423.31disposition or specific funeral goods, funeral services, burial site goods, or burial site
423.32services offered by the provider. This requirement applies whether the discussion takes
423.33place in the funeral establishment or elsewhere. However, when the deceased is removed
423.34for transportation to the funeral establishment, an in-person request for authorization to
423.35embalm does not, by itself, trigger the requirement to offer the general price list. If the
423.36provider, in making an in-person request for authorization to embalm, discloses that
424.1embalming is not required by law except in certain special cases, the provider is not
424.2required to offer the general price list. Any other discussion during that time about prices
424.3or the selection of funeral goods, funeral services, burial site goods, or burial site services
424.4triggers the requirement to give the consumer a general price list. The general price list
424.5must contain the following information:
424.6    (1) the name, address, and telephone number of the funeral provider's place of
424.7business;
424.8    (2) a caption describing the list as a "general price list";
424.9    (3) the effective date for the price list;
424.10    (4) the retail prices, in any order, expressed either as a flat fee or as the prices per
424.11hour, mile, or other unit of computation, and other information described as follows:
424.12    (i) forwarding of remains to another funeral establishment, together with a list of
424.13the services provided for any quoted price;
424.14    (ii) receiving remains from another funeral establishment, together with a list of
424.15the services provided for any quoted price;
424.16    (iii) separate prices for each alkaline hydrolysis or cremation offered by the funeral
424.17provider, with the price including an alternative container or alkaline hydrolysis or
424.18cremation container, any alkaline hydrolysis or crematory charges, and a description of the
424.19services and container included in the price, where applicable, and the price of alkaline
424.20hydrolysis or cremation where the purchaser provides the container;
424.21    (iv) separate prices for each immediate burial offered by the funeral provider,
424.22including a casket or alternative container, and a description of the services and container
424.23included in that price, and the price of immediate burial where the purchaser provides the
424.24casket or alternative container;
424.25    (v) transfer of remains to the funeral establishment or other location;
424.26    (vi) embalming;
424.27    (vii) other preparation of the body;
424.28    (viii) use of facilities, equipment, or staff for viewing;
424.29    (ix) use of facilities, equipment, or staff for funeral ceremony;
424.30    (x) use of facilities, equipment, or staff for memorial service;
424.31    (xi) use of equipment or staff for graveside service;
424.32    (xii) hearse or funeral coach;
424.33    (xiii) limousine; and
424.34    (xiv) separate prices for all cemetery-specific goods and services, including all goods
424.35and services associated with interment and burial site goods and services and excluding
424.36markers and headstones;
425.1    (5) the price range for the caskets offered by the funeral provider, together with the
425.2statement "A complete price list will be provided at the funeral establishment or casket
425.3sale location." or the prices of individual caskets, as disclosed in the manner described
425.4in paragraphs (c) and (d);
425.5    (6) the price range for the alternative containers offered by the funeral provider,
425.6together with the statement "A complete price list will be provided at the funeral
425.7establishment or alternative container sale location." or the prices of individual alternative
425.8containers, as disclosed in the manner described in paragraphs (c) and (d);
425.9    (7) the price range for the outer burial containers offered by the funeral provider,
425.10together with the statement "A complete price list will be provided at the funeral
425.11establishment or outer burial container sale location." or the prices of individual outer
425.12burial containers, as disclosed in the manner described in paragraphs (c) and (d);
425.13(8) the price range for the alkaline hydrolysis container offered by the funeral
425.14provider, together with the statement: "A complete price list will be provided at the funeral
425.15establishment or alkaline hydrolysis container sale location.", or the prices of individual
425.16alkaline hydrolysis containers, as disclosed in the manner described in paragraphs (c)
425.17and (d);
425.18(9) the price range for the hydrolyzed remains container offered by the funeral
425.19provider, together with the statement: "A complete price list will be provided at the
425.20funeral establishment or hydrolyzed remains container sale location.", or the prices
425.21of individual hydrolyzed remains container, as disclosed in the manner described in
425.22paragraphs (c) and (d);
425.23    (8) (10) the price range for the cremation containers offered by the funeral provider,
425.24together with the statement "A complete price list will be provided at the funeral
425.25establishment or cremation container sale location." or the prices of individual cremation
425.26containers and cremated remains containers, as disclosed in the manner described in
425.27paragraphs (c) and (d);
425.28    (9) (11) the price range for the cremated remains containers offered by the funeral
425.29provider, together with the statement, "A complete price list will be provided at the funeral
425.30establishment or cremation cremated remains container sale location," or the prices of
425.31individual cremation containers as disclosed in the manner described in paragraphs (c)
425.32and (d);
425.33    (10) (12) the price for the basic services of funeral provider and staff, together with a
425.34list of the principal basic services provided for any quoted price and, if the charge cannot
425.35be declined by the purchaser, the statement "This fee for our basic services will be added
425.36to the total cost of the funeral arrangements you select. (This fee is already included in
426.1our charges for alkaline hydrolysis, direct cremations, immediate burials, and forwarding
426.2or receiving remains.)" If the charge cannot be declined by the purchaser, the quoted
426.3price shall include all charges for the recovery of unallocated funeral provider overhead,
426.4and funeral providers may include in the required disclosure the phrase "and overhead"
426.5after the word "services." This services fee is the only funeral provider fee for services,
426.6facilities, or unallocated overhead permitted by this subdivision to be nondeclinable,
426.7unless otherwise required by law;
426.8    (11) (13) the price range for the markers and headstones offered by the funeral
426.9provider, together with the statement "A complete price list will be provided at the funeral
426.10establishment or marker or headstone sale location." or the prices of individual markers
426.11and headstones, as disclosed in the manner described in paragraphs (c) and (d); and
426.12    (12) (14) any package priced funerals offered must be listed in addition to and
426.13following the information required in paragraph (e) and must clearly state the funeral
426.14goods and services being offered, the price being charged for those goods and services,
426.15and the discounted savings.
426.16    (f) Funeral providers must give an itemized written statement, for retention, to each
426.17consumer who arranges an at-need funeral or other disposition of human remains at the
426.18conclusion of the discussion of the arrangements. The itemized written statement must be
426.19signed by the consumer selecting the goods and services as required in section 149A.80.
426.20If the statement is provided by a funeral establishment, the statement must be signed by
426.21the licensed funeral director or mortician planning the arrangements. If the statement is
426.22provided by any other funeral provider, the statement must be signed by an authorized
426.23agent of the funeral provider. The statement must list the funeral goods, funeral services,
426.24burial site goods, or burial site services selected by that consumer and the prices to be paid
426.25for each item, specifically itemized cash advance items (these prices must be given to the
426.26extent then known or reasonably ascertainable if the prices are not known or reasonably
426.27ascertainable, a good faith estimate shall be given and a written statement of the actual
426.28charges shall be provided before the final bill is paid), and the total cost of goods and
426.29services selected. At the conclusion of an at-need arrangement, the funeral provider is
426.30required to give the consumer a copy of the signed itemized written contract that must
426.31contain the information required in this paragraph.
426.32    (g) Upon receiving actual notice of the death of an individual with whom a funeral
426.33provider has entered a preneed funeral agreement, the funeral provider must provide
426.34a copy of all preneed funeral agreement documents to the person who controls final
426.35disposition of the human remains or to the designee of the person controlling disposition.
426.36The person controlling final disposition shall be provided with these documents at the time
427.1of the person's first in-person contact with the funeral provider, if the first contact occurs
427.2in person at a funeral establishment, alkaline hydrolysis facility, crematory, or other place
427.3of business of the funeral provider. If the contact occurs by other means or at another
427.4location, the documents must be provided within 24 hours of the first contact.

427.5    Sec. 68. Minnesota Statutes 2012, section 149A.71, subdivision 4, is amended to read:
427.6    Subd. 4. Casket, alternate container, alkaline hydrolysis containers, and
427.7cremation container sales; records; required disclosures. Any funeral provider who
427.8sells or offers to sell a casket, alternate container, alkaline hydrolysis container, hydrolyzed
427.9remains container, or cremation container, or cremated remains container to the public
427.10must maintain a record of each sale that includes the name of the purchaser, the purchaser's
427.11mailing address, the name of the decedent, the date of the decedent's death, and the place
427.12of death. These records shall be open to inspection by the regulatory agency. Any funeral
427.13provider selling a casket, alternate container, or cremation container to the public, and not
427.14having charge of the final disposition of the dead human body, shall provide a copy of the
427.15statutes and rules controlling the removal, preparation, transportation, arrangements for
427.16disposition, and final disposition of a dead human body. This subdivision does not apply to
427.17morticians, funeral directors, funeral establishments, crematories, or wholesale distributors
427.18of caskets, alternate containers, alkaline hydrolysis containers, or cremation containers.

427.19    Sec. 69. Minnesota Statutes 2012, section 149A.72, subdivision 3, is amended to read:
427.20    Subd. 3. Casket for alkaline hydrolysis or cremation provisions; deceptive acts
427.21or practices. In selling or offering to sell funeral goods or funeral services to the public, it
427.22is a deceptive act or practice for a funeral provider to represent that a casket is required for
427.23alkaline hydrolysis or cremations by state or local law or otherwise.

427.24    Sec. 70. Minnesota Statutes 2012, section 149A.72, is amended by adding a
427.25subdivision to read:
427.26    Subd. 3a. Casket for alkaline hydrolysis provision; preventive measures. To
427.27prevent deceptive acts or practices, funeral providers must place the following disclosure
427.28in immediate conjunction with the prices shown for alkaline hydrolysis: "Minnesota
427.29law does not require you to purchase a casket for alkaline hydrolysis. If you want to
427.30arrange for alkaline hydrolysis, you can use an alkaline hydrolysis container. An alkaline
427.31hydrolysis container is a hydrolyzable or biodegradable closed container or pouch resistant
427.32to leakage of bodily fluids that encases the body and into which a dead human body is
427.33placed prior to insertion into an alkaline hydrolysis vessel. The containers we provide
428.1are (specify containers provided)." This disclosure is required only if the funeral provider
428.2arranges alkaline hydrolysis.

428.3    Sec. 71. Minnesota Statutes 2012, section 149A.72, subdivision 9, is amended to read:
428.4    Subd. 9. Deceptive acts or practices. In selling or offering to sell funeral goods,
428.5funeral services, burial site goods, or burial site services to the public, it is a deceptive act
428.6or practice for a funeral provider to represent that federal, state, or local laws, or particular
428.7cemeteries, alkaline hydrolysis facilities, or crematories, require the purchase of any funeral
428.8goods, funeral services, burial site goods, or burial site services when that is not the case.

428.9    Sec. 72. Minnesota Statutes 2012, section 149A.73, subdivision 1, is amended to read:
428.10    Subdivision 1. Casket for alkaline hydrolysis or cremation provisions; deceptive
428.11acts or practices. In selling or offering to sell funeral goods, funeral services, burial site
428.12goods, or burial site services to the public, it is a deceptive act or practice for a funeral
428.13provider to require that a casket be purchased for alkaline hydrolysis or cremation.

428.14    Sec. 73. Minnesota Statutes 2012, section 149A.73, subdivision 2, is amended to read:
428.15    Subd. 2. Casket for alkaline hydrolysis or cremation; preventive requirements.
428.16To prevent unfair or deceptive acts or practices, if funeral providers arrange for alkaline
428.17hydrolysis or cremations, they must make a an alkaline hydrolysis container or cremation
428.18container available for alkaline hydrolysis or cremations.

428.19    Sec. 74. Minnesota Statutes 2012, section 149A.73, subdivision 4, is amended to read:
428.20    Subd. 4. Required purchases of funeral goods or services; preventive
428.21requirements. To prevent unfair or deceptive acts or practices, funeral providers must
428.22place the following disclosure in the general price list, immediately above the prices
428.23required by section 149A.71, subdivision 2, paragraph (e), clauses (4) to (10): "The goods
428.24and services shown below are those we can provide to our customers. You may choose
428.25only the items you desire. If legal or other requirements mean that you must buy any items
428.26you did not specifically ask for, we will explain the reason in writing on the statement we
428.27provide describing the funeral goods, funeral services, burial site goods, and burial site
428.28services you selected." However, if the charge for "services of funeral director and staff"
428.29cannot be declined by the purchaser, the statement shall include the sentence "However,
428.30any funeral arrangements you select will include a charge for our basic services." between
428.31the second and third sentences of the sentences specified in this subdivision. The statement
428.32may include the phrase "and overhead" after the word "services" if the fee includes a
429.1charge for the recovery of unallocated funeral overhead. If the funeral provider does
429.2not include this disclosure statement, then the following disclosure statement must be
429.3placed in the statement of funeral goods, funeral services, burial site goods, and burial site
429.4services selected, as described in section 149A.71, subdivision 2, paragraph (f): "Charges
429.5are only for those items that you selected or that are required. If we are required by law or
429.6by a cemetery, alkaline hydrolysis facility, or crematory to use any items, we will explain
429.7the reasons in writing below." A funeral provider is not in violation of this subdivision by
429.8failing to comply with a request for a combination of goods or services which would be
429.9impossible, impractical, or excessively burdensome to provide.

429.10    Sec. 75. Minnesota Statutes 2012, section 149A.74, is amended to read:
429.11149A.74 FUNERAL SERVICES PROVIDED WITHOUT PRIOR APPROVAL.
429.12    Subdivision 1. Services provided without prior approval; deceptive acts or
429.13practices. In selling or offering to sell funeral goods or funeral services to the public, it
429.14is a deceptive act or practice for any funeral provider to embalm a dead human body
429.15unless state or local law or regulation requires embalming in the particular circumstances
429.16regardless of any funeral choice which might be made, or prior approval for embalming
429.17has been obtained from an individual legally authorized to make such a decision. In
429.18seeking approval to embalm, the funeral provider must disclose that embalming is not
429.19required by law except in certain circumstances; that a fee will be charged if a funeral
429.20is selected which requires embalming, such as a funeral with viewing; and that no
429.21embalming fee will be charged if the family selects a service which does not require
429.22embalming, such as direct alkaline hydrolysis, direct cremation, or immediate burial.
429.23    Subd. 2. Services provided without prior approval; preventive requirement.
429.24To prevent unfair or deceptive acts or practices, funeral providers must include on
429.25the itemized statement of funeral goods or services, as described in section 149A.71,
429.26subdivision 2 , paragraph (f), the statement "If you selected a funeral that may require
429.27embalming, such as a funeral with viewing, you may have to pay for embalming. You do
429.28not have to pay for embalming you did not approve if you selected arrangements such
429.29as direct alkaline hydrolysis, direct cremation, or immediate burial. If we charged for
429.30embalming, we will explain why below."

429.31    Sec. 76. Minnesota Statutes 2012, section 149A.90, subdivision 8, is amended to read:
429.32    Subd. 8. Proper holding facility required. The funeral establishment to which a
429.33dead human body is taken shall have an appropriate holding facility for storing the body
429.34while awaiting final disposition. The holding facility must be secure from access by
430.1anyone except the authorized personnel of the funeral establishment, preserve the dignity
430.2of the remains, and protect the health and safety of the funeral establishment personnel. A
430.3holding facility may not be used for preparation or embalming of the body.

430.4    Sec. 77. Minnesota Statutes 2012, section 149A.91, subdivision 9, is amended to read:
430.5    Subd. 9. Embalmed Bodies awaiting final disposition. All embalmed bodies
430.6awaiting final disposition shall be kept in an appropriate holding facility or preparation
430.7and embalming room. The holding facility must be secure from access by anyone except
430.8the authorized personnel of the funeral establishment, preserve the dignity and integrity of
430.9the body, and protect the health and safety of the personnel of the funeral establishment.

430.10    Sec. 78. Minnesota Statutes 2012, section 149A.92, subdivision 1, is amended to read:
430.11    Subdivision 1. Exemption Exemptions. (a) All funeral establishments having a
430.12preparation and embalming room that has not been used for the preparation or embalming
430.13of a dead human body in the 12 calendar months prior to July 1, 1997, are exempt from
430.14the minimum requirements in subdivisions 2 to 6, except as provided in this section. At
430.15the time that ownership of a funeral establishment changes, the physical location of the
430.16establishment changes, or the building housing the funeral establishment or business space
430.17of the establishment is remodeled the existing preparation and embalming room must be
430.18brought into compliance with the minimum standards in this section.
430.19(b) Funeral establishments are not required to contain a preparation and embalming
430.20room when it is a branch funeral establishment of a Minnesota licensed funeral
430.21establishment that has a preparation and embalming room meeting the standards set forth
430.22in subdivisions 2 to 10.

430.23    Sec. 79. Minnesota Statutes 2012, section 149A.93, subdivision 3, is amended to read:
430.24    Subd. 3. Disposition permit. A disposition permit is required before a body can
430.25be buried, entombed, alkaline hydrolyzed, or cremated. No disposition permit shall be
430.26issued until a fact of death record has been completed and filed with the local or state
430.27registrar of vital statistics.

430.28    Sec. 80. Minnesota Statutes 2012, section 149A.93, subdivision 6, is amended to read:
430.29    Subd. 6. Conveyances permitted for transportation. A dead human body may be
430.30transported by means of private vehicle or private aircraft, provided that the body must be
430.31encased in an appropriate container, that meets the following standards:
430.32    (1) promotes respect for and preserves the dignity of the dead human body;
431.1    (2) shields the body from being viewed from outside of the conveyance;
431.2    (3) has ample enclosed area to accommodate a cot, stretcher, rigid tray, casket,
431.3alternative container, alkaline hydrolysis container, or cremation container in a horizontal
431.4position;
431.5    (4) is designed to permit loading and unloading of the body without excessive tilting
431.6of the cot, stretcher, rigid tray, casket, alternative container, alkaline hydrolysis container,
431.7 or cremation container; and
431.8    (5) if used for the transportation of more than one dead human body at one time,
431.9the vehicle must be designed so that a body or container does not rest directly on top of
431.10another body or container and that each body or container is secured to prevent the body
431.11or container from excessive movement within the conveyance.
431.12    A vehicle that is a dignified conveyance and was specified for use by the deceased
431.13or by the family of the deceased may be used to transport the body to the place of final
431.14disposition.

431.15    Sec. 81. Minnesota Statutes 2012, section 149A.94, is amended to read:
431.16149A.94 FINAL DISPOSITION.
431.17    Subdivision 1. Generally. Every dead human body lying within the state, except
431.18unclaimed bodies delivered for dissection by the medical examiner, those delivered for
431.19anatomical study pursuant to section 149A.81, subdivision 2, or lawfully carried through
431.20the state for the purpose of disposition elsewhere; and the remains of any dead human
431.21body after dissection or anatomical study, shall be decently buried, or entombed in a
431.22public or private cemetery, alkaline hydrolyzed or cremated, within a reasonable time
431.23after death. Where final disposition of a body will not be accomplished within 72 hours
431.24following death or release of the body by a competent authority with jurisdiction over the
431.25body, the body must be properly embalmed, refrigerated, or packed with dry ice. A body
431.26may not be kept in refrigeration for a period exceeding six calendar days, or packed in dry
431.27ice for a period that exceeds four calendar days, from the time of death or release of the
431.28body from the coroner or medical examiner.
431.29    Subd. 3. Permit required. No dead human body shall be buried, entombed, or
431.30cremated without a disposition permit. The disposition permit must be filed with the person
431.31in charge of the place of final disposition. Where a dead human body will be transported out
431.32of this state for final disposition, the body must be accompanied by a certificate of removal.
431.33    Subd. 4. Alkaline hydrolysis or cremation. Inurnment of alkaline hydrolyzed or
431.34cremated remains and release to an appropriate party is considered final disposition and no
432.1further permits or authorizations are required for transportation, interment, entombment, or
432.2placement of the cremated remains, except as provided in section 149A.95, subdivision 16.

432.3    Sec. 82. [149A.941] ALKALINE HYDROLYSIS FACILITIES AND ALKALINE
432.4HYDROLYSIS.
432.5    Subdivision 1. License required. A dead human body may only be hydrolyzed in
432.6this state at an alkaline hydrolysis facility licensed by the commissioner of health.
432.7    Subd. 2. General requirements. Any building to be used as an alkaline hydrolysis
432.8facility must comply with all applicable local and state building codes, zoning laws and
432.9ordinances, wastewater management regulations, and environmental statutes, rules, and
432.10standards. An alkaline hydrolysis facility must have, on site, a purpose built human
432.11alkaline hydrolysis system approved by the commissioner of health, a system approved by
432.12the commissioner of health for drying the hydrolyzed remains, a motorized mechanical
432.13device approved by the commissioner of health for processing hydrolyzed remains and
432.14must have in the building a holding facility approved by the commissioner of health for
432.15the retention of dead human bodies awaiting alkaline hydrolysis. The holding facility
432.16must be secure from access by anyone except the authorized personnel of the alkaline
432.17hydrolysis facility, preserve the dignity of the remains, and protect the health and safety of
432.18the alkaline hydrolysis facility personnel.
432.19    Subd. 3. Lighting and ventilation. The room where the alkaline hydrolysis vessel
432.20is located and the room where the chemical storage takes place shall be properly lit and
432.21ventilated with an exhaust fan that provides at least 12 air changes per hour.
432.22    Subd. 4. Plumbing connections. All plumbing fixtures, water supply lines,
432.23plumbing vents, and waste drains shall be properly vented and connected pursuant to the
432.24Minnesota Plumbing Code. The alkaline hydrolysis facility shall be equipped with a
432.25functional sink with hot and cold running water.
432.26    Subd. 5. Flooring, walls, ceiling, doors, and windows. The room where the
432.27alkaline hydrolysis vessel is located and the room where the chemical storage takes place
432.28shall have nonporous flooring, so that a sanitary condition is provided. The walls and
432.29ceiling of the room where the alkaline hydrolysis vessel is located and the room where
432.30the chemical storage takes place shall run from floor to ceiling and be covered with tile,
432.31or by plaster or sheetrock painted with washable paint or other appropriate material so
432.32that a sanitary condition is provided. The doors, walls, ceiling, and windows shall be
432.33constructed to prevent odors from entering any other part of the building. All windows
432.34or other openings to the outside must be screened and all windows must be treated in a
432.35manner that prevents viewing into the room where the alkaline hydrolysis vessel is located
433.1and the room where the chemical storage takes place. A viewing window for authorized
433.2family members or their designees is not a violation of this subdivision.
433.3    Subd. 6. Equipment and supplies. The alkaline hydrolysis facility must have a
433.4functional emergency eye wash and quick drench shower.
433.5    Subd. 7. Access and privacy. (a) The room where the alkaline hydrolysis vessel is
433.6located and the room where the chemical storage takes place must be private and have no
433.7general passageway through it. The room shall, at all times, be secure from the entrance of
433.8unauthorized persons. Authorized persons are:
433.9(1) licensed morticians;
433.10(2) registered interns or students as described in section 149A.91, subdivision 6;
433.11(3) public officials or representatives in the discharge of their official duties;
433.12(4) trained alkaline hydrolysis facility operators; and
433.13(5) the person(s) with the right to control the dead human body as defined in section
433.14149A.80, subdivision 2, and their designees.
433.15    (b) Each door allowing ingress or egress shall carry a sign that indicates that the
433.16room is private and access is limited. All authorized persons who are present in or enter
433.17the room where the alkaline hydrolysis vessel is located while a body is being prepared for
433.18final disposition must be attired according to all applicable state and federal regulations
433.19regarding the control of infectious disease and occupational and workplace health and
433.20safety.
433.21    Subd. 8. Sanitary conditions and permitted use. The room where the alkaline
433.22hydrolysis vessel is located and the room where the chemical storage takes place and all
433.23fixtures, equipment, instruments, receptacles, clothing, and other appliances or supplies
433.24stored or used in the room must be maintained in a clean and sanitary condition at all times.
433.25    Subd. 9. Boiler use. When a boiler is required by the manufacturer of the alkaline
433.26hydrolysis vessel for its operation, all state and local regulations for that boiler must be
433.27followed.
433.28    Subd. 10. Occupational and workplace safety. All applicable provisions of state
433.29and federal regulations regarding exposure to workplace hazards and accidents shall be
433.30followed in order to protect the health and safety of all authorized persons at the alkaline
433.31hydrolysis facility.
433.32    Subd. 11. Licensed personnel. A licensed alkaline hydrolysis facility must employ
433.33a licensed mortician to carry out the process of alkaline hydrolysis of a dead human body.
433.34It is the duty of the licensed alkaline hydrolysis facility to provide proper procedures for
433.35all personnel, and the licensed alkaline hydrolysis facility shall be strictly accountable for
434.1compliance with this chapter and other applicable state and federal regulations regarding
434.2occupational and workplace health and safety.
434.3    Subd. 12. Authorization to hydrolyze required. No alkaline hydrolysis facility
434.4shall hydrolyze or cause to be hydrolyzed any dead human body or identifiable body part
434.5without receiving written authorization to do so from the person or persons who have the
434.6legal right to control disposition as described in section 149A.80 or the person's legal
434.7designee. The written authorization must include:
434.8(1) the name of the deceased and the date of death of the deceased;
434.9(2) a statement authorizing the alkaline hydrolysis facility to hydrolyze the body;
434.10(3) the name, address, telephone number, relationship to the deceased, and signature
434.11of the person or persons with legal right to control final disposition or a legal designee;
434.12(4) directions for the disposition of any nonhydrolyzed materials or items recovered
434.13from the alkaline hydrolysis vessel;
434.14(5) acknowledgment that the hydrolyzed remains will be dried and mechanically
434.15reduced to a granulated appearance and placed in an appropriate container and
434.16authorization to place any hydrolyzed remains that a selected urn or container will not
434.17accommodate into a temporary container;
434.18(6) acknowledgment that, even with the exercise of reasonable care, it is not possible
434.19to recover all particles of the hydrolyzed remains and that some particles may inadvertently
434.20become commingled with particles of other hydrolyzed remains that remain in the alkaline
434.21hydrolysis vessel or other mechanical devices used to process the hydrolyzed remains;
434.22(7) directions for the ultimate disposition of the hydrolyzed remains; and
434.23(8) a statement that includes, but is not limited to, the following information:
434.24"During the alkaline hydrolysis process, chemical dissolution using heat, water, and an
434.25alkaline solution is used to chemically break down the human tissue and the hydrolyzable
434.26alkaline hydrolysis container. After the process is complete, the liquid effluent solution
434.27contains the chemical by-products of the alkaline hydrolysis process except for the
434.28deceased's bone fragments. The solution is cooled and released according to local
434.29environmental regulations. A water rinse is applied to the hydrolyzed remains which are
434.30then dried and processed to facilitate inurnment or scattering."
434.31    Subd. 13. Limitation of liability. A licensed alkaline hydrolysis facility acting in
434.32good faith, with reasonable reliance upon an authorization to hydrolyze, pursuant to an
434.33authorization to hydrolyze and in an otherwise lawful manner, shall be held harmless from
434.34civil liability and criminal prosecution for any actions taken by the alkaline hydrolysis
434.35facility.
435.1    Subd. 14. Acceptance of delivery of body. (a) No dead human body shall be
435.2accepted for final disposition by alkaline hydrolysis unless:
435.3(1) encased in an appropriate alkaline hydrolysis container;
435.4(2) accompanied by a disposition permit issued pursuant to section 149A.93,
435.5subdivision 3, including a photocopy of the completed death record or a signed release
435.6authorizing alkaline hydrolysis of the body received from the coroner or medical
435.7examiner; and
435.8(3) accompanied by an alkaline hydrolysis authorization that complies with
435.9subdivision 12.
435.10    (b) An alkaline hydrolysis facility shall refuse to accept delivery of an alkaline
435.11hydrolysis container where there is:
435.12(1) evidence of leakage of fluids from the alkaline hydrolysis container;
435.13(2) a known dispute concerning hydrolysis of the body delivered;
435.14(3) a reasonable basis for questioning any of the representations made on the written
435.15authorization to hydrolyze; or
435.16(4) any other lawful reason.
435.17    Subd. 15. Bodies awaiting hydrolysis. A dead human body must be hydrolyzed
435.18within 24 hours of the alkaline hydrolysis facility accepting legal and physical custody of
435.19the body.
435.20    Subd. 16. Handling of alkaline hydrolysis containers for dead human bodies.
435.21All alkaline hydrolysis facility employees handling alkaline hydrolysis containers for
435.22dead human bodies shall use universal precautions and otherwise exercise all reasonable
435.23precautions to minimize the risk of transmitting any communicable disease from the body.
435.24No dead human body shall be removed from the container in which it is delivered.
435.25    Subd. 17. Identification of body. All licensed alkaline hydrolysis facilities shall
435.26develop, implement, and maintain an identification procedure whereby dead human
435.27bodies can be identified from the time the alkaline hydrolysis facility accepts delivery
435.28of the remains until the hydrolyzed remains are released to an authorized party. After
435.29hydrolyzation, an identifying disk, tab, or other permanent label shall be placed within the
435.30hydrolyzed remains container before the hydrolyzed remains are released from the alkaline
435.31hydrolysis facility. Each identification disk, tab, or label shall have a number that shall
435.32be recorded on all paperwork regarding the decedent. This procedure shall be designed
435.33to reasonably ensure that the proper body is hydrolyzed and that the hydrolyzed remains
435.34are returned to the appropriate party. Loss of all or part of the hydrolyzed remains or the
435.35inability to individually identify the hydrolyzed remains is a violation of this subdivision.
436.1    Subd. 18. Alkaline hydrolysis vessel for human remains. A licensed alkaline
436.2hydrolysis facility shall knowingly hydrolyze only dead human bodies or human remains
436.3in an alkaline hydrolysis vessel, along with the alkaline hydrolysis container used for
436.4infectious disease control.
436.5    Subd. 19. Alkaline hydrolysis procedures; privacy. The final disposition of
436.6dead human bodies by alkaline hydrolysis shall be done in privacy. Unless there is
436.7written authorization from the person with the legal right to control the disposition,
436.8only authorized alkaline hydrolysis facility personnel shall be permitted in the alkaline
436.9hydrolysis area while any dead human body is in the alkaline hydrolysis area awaiting
436.10alkaline hydrolysis, in the alkaline hydrolysis vessel, being removed from the alkaline
436.11hydrolysis vessel, or being processed and placed in a hydrolyzed remains container.
436.12    Subd. 20. Alkaline hydrolysis procedures; commingling of hydrolyzed remains
436.13prohibited. Except with the express written permission of the person with the legal right
436.14to control the disposition, no alkaline hydrolysis facility shall hydrolyze more than one
436.15dead human body at the same time and in the same alkaline hydrolysis vessel, or introduce
436.16a second dead human body into an alkaline hydrolysis vessel until reasonable efforts have
436.17been employed to remove all fragments of the preceding hydrolyzed remains, or hydrolyze
436.18a dead human body and other human remains at the same time and in the same alkaline
436.19hydrolysis vessel. This section does not apply where commingling of human remains
436.20during alkaline hydrolysis is otherwise provided by law. The fact that there is incidental
436.21and unavoidable residue in the alkaline hydrolysis vessel used in a prior hydrolyzation is
436.22not a violation of this subdivision.
436.23    Subd. 21. Alkaline hydrolysis procedures; removal from alkaline hydrolysis
436.24vessel. Upon completion of the alkaline hydrolysis process, reasonable efforts shall be
436.25made to remove from the alkaline hydrolysis vessel all of the recoverable hydrolyzed
436.26remains and nonhydrolyzed materials or items. Further, all reasonable efforts shall be
436.27made to separate and recover the nonhydrolyzed materials or items from the hydrolyzed
436.28human remains and dispose of these materials in a lawful manner, by the alkaline
436.29hydrolysis facility. The hydrolyzed human remains shall be placed in an appropriate
436.30container to be transported to the processing area.
436.31    Subd. 22. Drying device or mechanical processor procedures; commingling of
436.32hydrolyzed remains prohibited. Except with the express written permission of the
436.33person with the legal right to control the final disposition or otherwise provided by
436.34law, no alkaline hydrolysis facility shall dry or mechanically process the hydrolyzed
436.35human remains of more than one body at a time in the same drying device or mechanical
436.36processor, or introduce the hydrolyzed human remains of a second body into a drying
437.1device or mechanical processor until processing of any preceding hydrolyzed human
437.2remains has been terminated and reasonable efforts have been employed to remove all
437.3fragments of the preceding hydrolyzed remains. The fact that there is incidental and
437.4unavoidable residue in the drying device, the mechanical processor, or any container used
437.5in a prior alkaline hydrolysis process, is not a violation of this provision.
437.6    Subd. 23. Alkaline hydrolysis procedures; processing hydrolyzed remains. The
437.7hydrolyzed human remains shall be dried and then reduced by a motorized mechanical
437.8device to a granulated appearance appropriate for final disposition and placed in an
437.9alkaline hydrolysis remains container along with the appropriate identifying disk, tab,
437.10or permanent label. Processing must take place within the licensed alkaline hydrolysis
437.11facility. Dental gold, silver or amalgam, jewelry, or mementos, to the extent that they
437.12can be identified, may be removed prior to processing the hydrolyzed remains, only by
437.13staff licensed or registered by the commissioner of health; however, any dental gold and
437.14silver, jewelry, or mementos that are removed shall be returned to the hydrolyzed remains
437.15container unless otherwise directed by the person or persons having the right to control the
437.16final disposition. Every person who removes or possesses dental gold or silver, jewelry,
437.17or mementos from any hydrolyzed remains without specific written permission of the
437.18person or persons having the right to control those remains is guilty of a misdemeanor.
437.19The fact that residue and any unavoidable dental gold or dental silver, or other precious
437.20metals remain in the alkaline hydrolysis vessel or other equipment or any container used
437.21in a prior hydrolysis is not a violation of this section.
437.22    Subd. 24. Alkaline hydrolysis procedures; container of insufficient capacity.
437.23If a hydrolyzed remains container is of insufficient capacity to accommodate all
437.24hydrolyzed remains of a given dead human body, subject to directives provided in the
437.25written authorization to hydrolyze, the alkaline hydrolysis facility shall place the excess
437.26hydrolyzed remains in a secondary alkaline hydrolysis remains container and attach the
437.27second container, in a manner so as not to be easily detached through incidental contact, to
437.28the primary alkaline hydrolysis remains container. The secondary container shall contain a
437.29duplicate of the identification disk, tab, or permanent label that was placed in the primary
437.30container and all paperwork regarding the given body shall include a notation that the
437.31hydrolyzed remains were placed in two containers. Keepsake jewelry or similar miniature
437.32hydrolyzed remains containers are not subject to the requirements of this subdivision.
437.33    Subd. 25. Disposition procedures; commingling of hydrolyzed remains
437.34prohibited. No hydrolyzed remains shall be disposed of or scattered in a manner or in
437.35a location where the hydrolyzed remains are commingled with those of another person
437.36without the express written permission of the person with the legal right to control
438.1disposition or as otherwise provided by law. This subdivision does not apply to the
438.2scattering or burial of hydrolyzed remains at sea or in a body of water from individual
438.3containers, to the scattering or burial of hydrolyzed remains in a dedicated cemetery, to
438.4the disposal in a dedicated cemetery of accumulated residue removed from an alkaline
438.5hydrolysis vessel or other alkaline hydrolysis equipment, to the inurnment of members
438.6of the same family in a common container designed for the hydrolyzed remains of more
438.7than one body, or to the inurnment in a container or interment in a space that has been
438.8previously designated, at the time of sale or purchase, as being intended for the inurnment
438.9or interment of the hydrolyzed remains of more than one person.
438.10    Subd. 26. Alkaline hydrolysis procedures; disposition of accumulated residue.
438.11Every alkaline hydrolysis facility shall provide for the removal and disposition in a
438.12dedicated cemetery of any accumulated residue from any alkaline hydrolysis vessel,
438.13drying device, mechanical processor, container, or other equipment used in alkaline
438.14hydrolysis. Disposition of accumulated residue shall be according to the regulations of the
438.15dedicated cemetery and any applicable local ordinances.
438.16    Subd. 27. Alkaline hydrolysis procedures; release of hydrolyzed remains.
438.17Following completion of the hydrolyzation, the inurned hydrolyzed remains shall be
438.18released according to the instructions given on the written authorization to hydrolyze. If
438.19the hydrolyzed remains are to be shipped, they must be securely packaged and transported
438.20by a method which has an internal tracing system available and which provides for a
438.21receipt signed by the person accepting delivery. Where there is a dispute over release
438.22or disposition of the hydrolyzed remains, an alkaline hydrolysis facility may deposit
438.23the hydrolyzed remains with a court of competent jurisdiction pending resolution of the
438.24dispute or retain the hydrolyzed remains until the person with the legal right to control
438.25disposition presents satisfactory indication that the dispute is resolved.
438.26    Subd. 28. Unclaimed hydrolyzed remains. If, after 30 calendar days following
438.27the inurnment, the hydrolyzed remains are not claimed or disposed of according to the
438.28written authorization to hydrolyze, the alkaline hydrolysis facility or funeral establishment
438.29may give written notice, by certified mail, to the person with the legal right to control
438.30the final disposition or a legal designee, that the hydrolyzed remains are unclaimed and
438.31requesting further release directions. Should the hydrolyzed remains be unclaimed 120
438.32calendar days following the mailing of the written notification, the alkaline hydrolysis
438.33facility or funeral establishment may dispose of the hydrolyzed remains in any lawful
438.34manner deemed appropriate.
438.35    Subd. 29. Required records. Every alkaline hydrolysis facility shall create and
438.36maintain on its premises or other business location in Minnesota an accurate record of
439.1every hydrolyzation provided. The record shall include all of the following information
439.2for each hydrolyzation:
439.3(1) the name of the person or funeral establishment delivering the body for alkaline
439.4hydrolysis;
439.5(2) the name of the deceased and the identification number assigned to the body;
439.6(3) the date of acceptance of delivery;
439.7(4) the names of the alkaline hydrolysis vessel, drying device, and mechanical
439.8processor operator;
439.9(5) the time and date that the body was placed in and removed from the alkaline
439.10hydrolysis vessel;
439.11(6) the time and date that processing and inurnment of the hydrolyzed remains
439.12was completed;
439.13(7) the time, date, and manner of release of the hydrolyzed remains;
439.14(8) the name and address of the person who signed the authorization to hydrolyze;
439.15(9) all supporting documentation, including any transit or disposition permits, a
439.16photocopy of the death record, and the authorization to hydrolyze; and
439.17(10) the type of alkaline hydrolysis container.
439.18    Subd. 30. Retention of records. Records required under subdivision 29 shall be
439.19maintained for a period of three calendar years after the release of the hydrolyzed remains.
439.20Following this period and subject to any other laws requiring retention of records, the
439.21alkaline hydrolysis facility may then place the records in storage or reduce them to
439.22microfilm, microfiche, laser disc, or any other method that can produce an accurate
439.23reproduction of the original record, for retention for a period of ten calendar years from
439.24the date of release of the hydrolyzed remains. At the end of this period and subject to any
439.25other laws requiring retention of records, the alkaline hydrolysis facility may destroy
439.26the records by shredding, incineration, or any other manner that protects the privacy of
439.27the individuals identified.

439.28    Sec. 83. Minnesota Statutes 2012, section 149A.96, subdivision 9, is amended to read:
439.29    Subd. 9. Hydrolyzed and cremated remains. Subject to section 149A.95,
439.30subdivision 16 , inurnment of the hydrolyzed or cremated remains and release to an
439.31appropriate party is considered final disposition and no further permits or authorizations
439.32are required for disinterment, transportation, or placement of the hydrolyzed or cremated
439.33remains.

439.34    Sec. 84. Minnesota Statutes 2012, section 257.75, subdivision 7, is amended to read:
440.1    Subd. 7. Hospital and Department of Health; recognition form. Hospitals that
440.2provide obstetric services and the state registrar of vital statistics shall distribute the
440.3educational materials and recognition of parentage forms prepared by the commissioner of
440.4human services to new parents, shall assist parents in understanding the recognition of
440.5parentage form, including following the provisions for notice under subdivision 5, shall
440.6provide notary services for parents who complete the recognition of parentage form, and
440.7shall timely file the completed recognition of parentage form with the Office of the State
440.8Registrar of Vital Statistics Records unless otherwise instructed by the Office of the State
440.9Registrar of Vital Statistics Records. On and after January 1, 1994, hospitals may not
440.10distribute the declaration of parentage forms.

440.11    Sec. 85. Minnesota Statutes 2012, section 260C.635, subdivision 1, is amended to read:
440.12    Subdivision 1. Legal effect. (a) Upon adoption, the adopted child becomes the legal
440.13child of the adopting parent and the adopting parent becomes the legal parent of the child
440.14with all the rights and duties between them of a birth parent and child.
440.15(b) The child shall inherit from the adoptive parent and the adoptive parent's
440.16relatives the same as though the child were the birth child of the parent, and in case of the
440.17child's death intestate, the adoptive parent and the adoptive parent's relatives shall inherit
440.18the child's estate as if the child had been the adoptive parent's birth child.
440.19(c) After a decree of adoption is entered, the birth parents or previous legal parents
440.20of the child shall be relieved of all parental responsibilities for the child except child
440.21support that has accrued to the date of the order for guardianship to the commissioner
440.22which continues to be due and owing. The child's birth or previous legal parent shall not
440.23exercise or have any rights over the adopted child or the adopted child's property, person,
440.24privacy, or reputation.
440.25(d) The adopted child shall not owe the birth parents or the birth parent's relatives
440.26any legal duty nor shall the adopted child inherit from the birth parents or kindred unless
440.27otherwise provided for in a will of the birth parent or kindred.
440.28    (e) Upon adoption, the court shall complete a certificate of adoption form and mail
440.29the form to the Office of the State Registrar Vital Records at the Minnesota Department
440.30of Health. Upon receiving the certificate of adoption, the state registrar shall register a
440.31replacement vital record in the new name of the adopted child as required under section
440.32144.218 .

440.33    Sec. 86. Minnesota Statutes 2012, section 517.001, is amended to read:
440.34517.001 DEFINITION.
441.1As used in this chapter, "local registrar" has the meaning given in section 144.212,
441.2subdivision 10 means an individual designated by the county board of commissioners to
441.3register marriages.

441.4    Sec. 87. Laws 2011, First Special Session chapter 9, article 2, section 27, is amended to
441.5read:
441.6    Sec. 27. MINNESOTA TASK FORCE ON PREMATURITY.
441.7    Subdivision 1. Establishment. The Minnesota Task Force on Prematurity is
441.8established to evaluate and make recommendations on methods for reducing prematurity
441.9and improving premature infant health care in the state.
441.10    Subd. 2. Membership; meetings; staff. (a) The task force shall be composed of at
441.11least the following members, who serve at the pleasure of their appointing authority:
441.12(1) 15 representatives of the Minnesota Prematurity Coalition including, but not
441.13limited to, health care providers who treat pregnant women or neonates, organizations
441.14focused on preterm births, early childhood education and development professionals, and
441.15families affected by prematurity;
441.16(2) one representative appointed by the commissioner of human services;
441.17(3) two representatives appointed by the commissioner of health;
441.18(4) one representative appointed by the commissioner of education;
441.19(5) two members of the house of representatives, one appointed by the speaker of
441.20the house and one appointed by the minority leader; and
441.21(6) two members of the senate, appointed according to the rules of the senate.
441.22(b) Members of the task force serve without compensation or payment of expenses.
441.23(c) The commissioner of health must convene the first meeting of the Minnesota
441.24Task Force on Prematurity by July 31, 2011. The task force must continue to meet at
441.25least quarterly. Staffing and technical assistance shall be provided by the Minnesota
441.26Perinatal Coalition.
441.27    Subd. 3. Duties. The task force must report the current state of prematurity in
441.28Minnesota and develop recommendations on strategies for reducing prematurity and
441.29improving premature infant health care in the state by considering the following:
441.30(1) promoting adherence to standards of care for premature infants born less than 37
441.31weeks gestational age, including recommendations to improve utilization of appropriate
441.32 hospital discharge and follow-up care procedures;
441.33(2) coordination of information among appropriate professional and advocacy
441.34organizations on measures to improve health care for infants born prematurely;
442.1(3) identification and centralization of available resources to improve access and
442.2awareness for caregivers of premature infants; and
442.3(4) development and dissemination of evidence-based practices through networking
442.4and educational opportunities;
442.5(5) a review of relevant evidence-based research regarding the causes and effects of
442.6premature births in Minnesota;
442.7(6) a review of relevant evidence-based research regarding premature infant health
442.8care, including methods for improving quality of and access to care for premature infants;
442.9(7) (4) a review of the potential improvements in health status related to the use of
442.10health care homes to provide and coordinate pregnancy-related services; and.
442.11(8) identification of gaps in public reporting measures and possible effects of these
442.12measures on prematurity rates.
442.13    Subd. 4. Report; expiration. (a) By November 30, 2011 January 15, 2015, the
442.14task force must submit a final report to the chairs and ranking minority members of
442.15the legislative policy committees on health and human services on the current state of
442.16prematurity in Minnesota to the chairs of the legislative policy committees on health and
442.17human services, including any recommendations to reduce premature births and improve
442.18premature infant health in the state.
442.19(b) By January 15, 2013, the task force must report its final recommendations,
442.20including any draft legislation necessary for implementation, to the chairs of the legislative
442.21policy committees on health and human services.
442.22(c) (b) This task force expires on January 31, 2013 2015, or upon submission of the
442.23final report required in paragraph (b) (a), whichever is earlier.

442.24    Sec. 88. STAFFING PLAN DISCLOSURE ACT.
442.25    Subdivision 1. Definitions. (a) For the purposes of this section, the following terms
442.26have the meanings given.
442.27(b) "Core staffing plan" means the projected number of full-time equivalent
442.28nonmanagerial care staff that will be assigned in a 24-hour period to an inpatient care unit.
442.29(c) "Nonmanagerial care staff" means registered nurses, licensed practical nurses,
442.30and other health care workers, which may include but is not limited to nursing assistants,
442.31nursing aides, patient care technicians, and patient care assistants, who perform
442.32nonmanagerial direct patient care functions for more than 50 percent of their scheduled
442.33hours on a given patient care unit.
442.34(d) "Inpatient care unit" means a designated inpatient area for assigning patients and
442.35staff for which a distinct staffing plan exists and that operates 24 hours per day, seven days
443.1per week in a hospital setting. Inpatient care unit does not include any hospital-based
443.2clinic, long-term care facility, or outpatient hospital department.
443.3(e) "Staffing hours per patient day" means the number of full-time equivalent
443.4nonmanagerial care staff who will ordinarily be assigned to provide direct patient care
443.5divided by the expected average number of patients upon which such assignments are based.
443.6(f) "Patient acuity tool" means a system for measuring an individual patient's need
443.7for nursing care. This includes utilizing a professional registered nursing assessment of
443.8patient condition to assess staffing need.
443.9    Subd. 2. Hospital staffing report. (a) The chief nursing executive or nursing
443.10designee of every reporting hospital in Minnesota under section 144.50 will develop a
443.11core staffing plan for each patient care unit.
443.12(b) Core staffing plans shall specify the full-time equivalent for each patient care
443.13unit for each 24-hour period.
443.14(c) Prior to submitting the core staffing plan, as required in subdivision 3,
443.15hospitals shall consult with representatives of the hospital medical staff, managerial and
443.16nonmanagerial care staff, and other relevant hospital personnel about the core staffing plan
443.17and the expected average number of patients upon which the staffing plan is based.
443.18    Subd. 3. Standard electronic reporting developed. (a) Hospitals must submit
443.19the core staffing plans to the Minnesota Hospital Association by January 1, 2014. The
443.20Minnesota Hospital Association shall include each reporting hospital's core staffing plan on
443.21the Minnesota Hospital Association's Minnesota Hospital Quality Report Web site by April
443.221, 2014. Any substantial changes to the core staffing plan shall be updated within 30 days.
443.23(b) The Minnesota Hospital Association shall include on its Web site for each
443.24reporting hospital on a quarterly basis the actual direct patient care hours per patient and
443.25per unit. Hospitals must submit the direct patient care report to the Minnesota Hospital
443.26Association by July 1, 2014, and quarterly thereafter.

443.27    Sec. 89. STUDY; NURSE STAFFING LEVELS AND PATIENT OUTCOMES.
443.28The Department of Health shall convene a work group to study the correlation
443.29between nurse staffing levels and patient outcomes. This report shall be presented to the
443.30chairs and ranking minority members of the health and human services committees in the
443.31house of representatives and the senate by January 15, 2015.

443.32    Sec. 90. REVISOR'S INSTRUCTION.
444.1The revisor shall substitute the term "vertical heat exchangers" or "vertical
444.2heat exchanger" with "bored geothermal heat exchangers" or "bored geothermal heat
444.3exchanger" wherever it appears in Minnesota Statutes, sections 103I.005, subdivisions
444.42 and 12; 103I.101, subdivisions 2 and 5; 103I.105; 103I.205, subdivision 4; 103I.208,
444.5subdivision 2; 103I.501; 103I.531, subdivision 5; and 103I.641, subdivisions 1, 2, and 3.

444.6    Sec. 91. REPEALER.
444.7(a) Minnesota Statutes 2012, sections 103I.005, subdivision 20; 149A.025; 149A.20,
444.8subdivision 8; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, subdivision 6;
444.9149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a; 149A.53,
444.10subdivision 9; and 485.14, are repealed.
444.11(b) Minnesota Statutes 2012, section 144.123, subdivision 2, is repealed effective
444.12July 1, 2014.

444.15

Section 1. SUMMARY OF APPROPRIATIONS.

444.16The amounts shown in this section summarize direct appropriations, by fund, made
444.17in this article.

444.18			2014		2015		Total
444.19	General	$	5,648,596,000	$	5,914,450,000	$	11,563,046,000
444.20 444.21	State Government Special Revenue		70,996,000		73,066,000		144,062,000
444.22	Health Care Access		597,449,000		424,738,000		1,022,187,000
444.23	Federal TANF		269,628,000		266,526,000		536,154,000
444.24	Lottery Prize Fund		1,665,000		1,665,000		3,330,000
444.25	Total	$	6,588,334,000	$	6,680,445,000	$	13,268,779,000

444.26 444.27

Sec. 2. COMMISSIONER OF HUMAN SERVICES

444.28

Subdivision 1.Total Appropriation

$

(161,031,000)

444.29	Appropriations by Fund
444.30		2013
444.31	General Fund	(158,668,000)
444.32	Health Care Access	(7,179,000)
444.33	TANF	4,816,000

444.34	Subd. 2.Forecasted Programs
444.35	(a) MFIP/DWP Grants

445.1	Appropriations by Fund
445.2	General Fund	(8,211,000)
445.3	TANF	4,399,000

445.4

(b) MFIP Child Care Assistance Grants

10,113,000

445.5

(c) General Assistance Grants

3,230,000

445.6

(d) Minnesota Supplemental Aid Grants

(1,008,000)

445.7

(e) Group Residential Housing Grants

(5,423,000)

445.8

(f) MinnesotaCare Grants

(7,179,000)

445.9This appropriation is from the health care
445.10access fund.

445.11

(g) Medical Assistance Grants

(159,733,000)

445.12

(h) Alternative Care Grants

-0-

445.13

(i) CD Entitlement Grants

2,364,000

445.14

Subd. 3.Technical Activities

417,000

445.15This appropriation is from the TANF fund.

445.16    Sec. 3. EFFECTIVE DATE.
445.17Sections 1 and 2 are effective the day following final enactment.

445.20

Section 1. SUMMARY OF APPROPRIATIONS.

445.21The amounts shown in this section summarize direct appropriations, by fund, made
445.22in this article.

445.23			2014		2015		Total
445.24	General	$	5,626,218,000	$	5,880,932,000	$	11,507,150,000
445.25 445.26	State Government Special Revenue		71,369,000		73,822,000		145,246,000
445.27	Health Care Access		663,756,000		426,355,000		1,090,112,000
445.28	Federal TANF		269,628,000		266,526,000		536,154,000
445.29	Lottery Prize Fund		1,667,000		1,668,000		3,335,000
445.30	Total	$	6,632,637,000	$	6,649,359,000	$	13,281,996,000

445.31

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

446.1The sums shown in the columns marked "Appropriations" are appropriated to the
446.2agencies and for the purposes specified in this article. The appropriations are from the
446.3general fund, or another named fund, and are available for the fiscal years indicated
446.4for each purpose. The figures "2014" and "2015" used in this article mean that the
446.5appropriations listed under them are available for the fiscal year ending June 30, 2014, or
446.6June 30, 2015, respectively. "The first year" is fiscal year 2014. "The second year" is fiscal
446.7year 2015. "The biennium" is fiscal years 2014 and 2015.

446.8				APPROPRIATIONS
446.9				Available for the Year
446.10				Ending June 30
446.11					2014		2015

446.12 446.13

Sec. 3. COMMISSIONER OF HUMAN SERVICES

446.14

Subdivision 1.Total Appropriation

$

6,437,862,000

$

6,460,121,000

446.15	Appropriations by Fund
446.16		2014	2015
446.17	General	5,542,688,000	5,802,575,000
446.18 446.19	State Government Special Revenue	4,117,000	6,371,000
446.20	Health Care Access	631,476,000	394,638,000
446.21	Federal TANF	257,915,000	254,813,000
446.22	Lottery Prize Fund	1,667,000	1,668,000

446.23Receipts for Systems Projects.
446.24Appropriations and federal receipts for
446.25information systems projects for MAXIS,
446.26PRISM, MMIS, and SSIS must be deposited
446.27in the state system account authorized
446.28in Minnesota Statutes, section 256.014.
446.29Money appropriated for computer projects
446.30approved by the commissioner of Minnesota
446.31information technology services, funded
446.32by the legislature, and approved by the
446.33commissioner of management and budget,
446.34may be transferred from one project to
446.35another and from development to operations
446.36as the commissioner of human services
446.37considers necessary. Any unexpended
447.1balance in the appropriation for these
447.2projects does not cancel but is available for
447.3ongoing development and operations.
447.4Nonfederal Share Transfers. The
447.5nonfederal share of activities for which
447.6federal administrative reimbursement is
447.7appropriated to the commissioner may be
447.8transferred to the special revenue fund.
447.9ARRA Supplemental Nutrition Assistance
447.10Benefit Increases. The funds provided for
447.11food support benefit increases under the
447.12Supplemental Nutrition Assistance Program
447.13provisions of the American Recovery and
447.14Reinvestment Act (ARRA) of 2009 must be
447.15used for benefit increases beginning July 1,
447.162009.
447.17Supplemental Nutrition Assistance
447.18Program Employment and Training.
447.19(1) Notwithstanding Minnesota Statutes,
447.20sections 256D.051, subdivisions 1a, 6b,
447.21and 6c, and 256J.626, federal Supplemental
447.22Nutrition Assistance employment and
447.23training funds received as reimbursement of
447.24MFIP consolidated fund grant expenditures
447.25for diversionary work program participants
447.26and child care assistance program
447.27expenditures must be deposited in the general
447.28fund. The amount of funds must be limited to
447.29$4,900,000 per year in fiscal years 2014 and
447.302015, and to $4,400,000 per year in fiscal
447.31years 2016 and 2017, contingent on approval
447.32by the federal Food and Nutrition Service.
447.33(2) Consistent with the receipt of the federal
447.34funds, the commissioner may adjust the
447.35level of working family credit expenditures
448.1claimed as TANF maintenance of effort.
448.2Notwithstanding any contrary provision in
448.3this article, this rider expires June 30, 2017.
448.4TANF Maintenance of Effort. (a) In order
448.5to meet the basic maintenance of effort
448.6(MOE) requirements of the TANF block grant
448.7specified under Code of Federal Regulations,
448.8title 45, section 263.1, the commissioner may
448.9only report nonfederal money expended for
448.10allowable activities listed in the following
448.11clauses as TANF/MOE expenditures:
448.12(1) MFIP cash, diversionary work program,
448.13and food assistance benefits under Minnesota
448.14Statutes, chapter 256J;
448.15(2) the child care assistance programs
448.16under Minnesota Statutes, sections 119B.03
448.17and 119B.05, and county child care
448.18administrative costs under Minnesota
448.19Statutes, section 119B.15;
448.20(3) state and county MFIP administrative
448.21costs under Minnesota Statutes, chapters
448.22256J and 256K;
448.23(4) state, county, and tribal MFIP
448.24employment services under Minnesota
448.25Statutes, chapters 256J and 256K;
448.26(5) expenditures made on behalf of legal
448.27noncitizen MFIP recipients who qualify for
448.28the MinnesotaCare program under Minnesota
448.29Statutes, chapter 256L;
448.30(6) qualifying working family credit
448.31expenditures under Minnesota Statutes,
448.32section 290.0671;
449.1(7) qualifying Minnesota education credit
449.2expenditures under Minnesota Statutes,
449.3section 290.0674; and
449.4(8) qualifying Head Start expenditures under
449.5Minnesota Statutes, section 119A.50.
449.6(b) The commissioner shall ensure that
449.7sufficient qualified nonfederal expenditures
449.8are made each year to meet the state's
449.9TANF/MOE requirements. For the activities
449.10listed in paragraph (a), clauses (2) to
449.11(8), the commissioner may only report
449.12expenditures that are excluded from the
449.13definition of assistance under Code of
449.14Federal Regulations, title 45, section 260.31.
449.15(c) For fiscal years beginning with state fiscal
449.16year 2003, the commissioner shall ensure
449.17that the maintenance of effort used by the
449.18commissioner of management and budget
449.19for the February and November forecasts
449.20required under Minnesota Statutes, section
449.2116A.103, contains expenditures under
449.22paragraph (a), clause (1), equal to at least 16
449.23percent of the total required under Code of
449.24Federal Regulations, title 45, section 263.1.
449.25(d) The requirement in Minnesota Statutes,
449.26section 256.011, subdivision 3, that federal
449.27grants or aids secured or obtained under that
449.28subdivision be used to reduce any direct
449.29appropriations provided by law, do not apply
449.30if the grants or aids are federal TANF funds.
449.31(e) For the federal fiscal years beginning on
449.32or after October 1, 2007, the commissioner
449.33may not claim an amount of TANF/MOE in
449.34excess of the 75 percent standard in Code
450.1of Federal Regulations, title 45, section
450.2263.1(a)(2), except:
450.3(1) to the extent necessary to meet the 80
450.4percent standard under Code of Federal
450.5Regulations, title 45, section 263.1(a)(1),
450.6if it is determined by the commissioner
450.7that the state will not meet the TANF work
450.8participation target rate for the current year;
450.9(2) to provide any additional amounts
450.10under Code of Federal Regulations, title 45,
450.11section 264.5, that relate to replacement of
450.12TANF funds due to the operation of TANF
450.13penalties; and
450.14(3) to provide any additional amounts that
450.15may contribute to avoiding or reducing
450.16TANF work participation penalties through
450.17the operation of the excess MOE provisions
450.18of Code of Federal Regulations, title 45,
450.19section 261.43(a)(2).
450.20For the purposes of clauses (1) to (3),
450.21the commissioner may supplement the
450.22MOE claim with working family credit
450.23expenditures or other qualified expenditures
450.24to the extent such expenditures are otherwise
450.25available after considering the expenditures
450.26allowed in this subdivision and subdivisions
450.272 and 3.
450.28(f) Notwithstanding any contrary provision
450.29in this article, paragraphs (a) to (e) expire
450.30June 30, 2017.
450.31Working Family Credit Expenditures
450.32as TANF/MOE. The commissioner may
450.33claim as TANF maintenance of effort up to
451.1$6,707,000 per year of working family credit
451.2expenditures in each fiscal year.

451.3 451.4

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

451.5The commissioner may count the following
451.6amounts of working family credit
451.7expenditures as TANF/MOE:
451.8(1) fiscal year 2014, $43,576,000; and
451.9(2) fiscal year 2015, $43,548,000.

451.10 451.11

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

451.12(a) The following TANF fund amounts
451.13are appropriated to the commissioner for
451.14purposes of MFIP/transition year child care
451.15assistance under Minnesota Statutes, section
451.16119B.05:
451.17(1) fiscal year 2014; $14,020,000; and
451.18(2) fiscal year 2015, $14,020,000.
451.19(b) The commissioner shall authorize the
451.20transfer of sufficient TANF funds to the
451.21federal child care and development fund to
451.22meet this appropriation and shall ensure that
451.23all transferred funds are expended according
451.24to federal child care and development fund
451.25regulations.

451.26

Subd. 4.Central Office

451.27The amounts that may be spent from this
451.28appropriation for each purpose are as follows:

451.29

(a) Operations

451.30	Appropriations by Fund
451.31	General	94,972,000	91,133,000
451.32 451.33	State Government Special Revenue	3,974,000	6,207,000
452.1	Health Care Access	13,252,000	13,154,000
452.2	Federal TANF	117,000	100,000

452.3DHS Receipt Center Accounting. The
452.4commissioner is authorized to transfer
452.5appropriations to, and account for DHS
452.6receipt center operations in, the special
452.7revenue fund.
452.8Administrative Recovery; Set-Aside. The
452.9commissioner may invoice local entities
452.10through the SWIFT accounting system as an
452.11alternative means to recover the actual cost
452.12of administering the following provisions:
452.13(1) Minnesota Statutes, section 125A.744,
452.14subdivision 3;
452.15(2) Minnesota Statutes, section 245.495,
452.16paragraph (b);
452.17(3) Minnesota Statutes, section 256B.0625,
452.18subdivision 20, paragraph (k);
452.19(4) Minnesota Statutes, section 256B.0924,
452.20subdivision 6, paragraph (g);
452.21(5) Minnesota Statutes, section 256B.0945,
452.22subdivision 4, paragraph (d); and
452.23(6) Minnesota Statutes, section 256F.10,
452.24subdivision 6, paragraph (b).
452.25Systems Modernization. The following
452.26amounts are appropriated for transfer to
452.27the state systems account authorized in
452.28Minnesota Statutes, section 256.014:
452.29(1) $1,825,000 in fiscal year 2014 and
452.30$2,502,000 in fiscal year 2015 is for the
452.31state share of Medicaid-allocated costs of
452.32the health insurance exchange information
452.33technology and operational structure. The
453.1funding base is $3,222,000 in fiscal year 2016
453.2and $3,037,000 in fiscal year 2017 but shall
453.3not be included in the base thereafter; and
453.4(2) $6,662,000 in fiscal year 2014 and
453.5$1,148,000 in fiscal year 2015 are for the
453.6modernization and streamlining of agency
453.7eligibility and child support systems. The
453.8funding base is $5,921,000 in fiscal year
453.92016 and $1,792,000 in fiscal year 2017 but
453.10shall not be included in the base thereafter.
453.11The unexpended balance of the $6,662,000
453.12appropriation in fiscal year 2014 and the
453.13$1,148,000 appropriation in fiscal year 2015
453.14must be transferred from the Department of
453.15Human Services state systems account to
453.16the Office of Enterprise Technology when
453.17the Office of Enterprise Technology has
453.18negotiated a federally approved internal
453.19service fund rates and billing process with
453.20sufficient internal accounting controls to
453.21properly maximize federal reimbursement
453.22to Minnesota for human services system
453.23modernization projects, but not later than
453.24June 30, 2015.
453.25Base Adjustment. The general fund base
453.26is increased by $6,099,000 in fiscal year
453.272016 and $1,185,000 in fiscal year 2017.
453.28The health access fund base is decreased by
453.29$551,000 in fiscal years 2016 and 2017.

453.30

(b) Children and Families

453.31	Appropriations by Fund
453.32	General	7,626,000	7,634,000
453.33	Federal TANF	2,282,000	2,282,000

453.34Financial Institution Data Match and
453.35Payment of Fees. The commissioner is
454.1authorized to allocate up to $310,000 each
454.2year in fiscal years 2014 and 2015 from the
454.3PRISM special revenue account to make
454.4payments to financial institutions in exchange
454.5for performing data matches between account
454.6information held by financial institutions
454.7and the public authority's database of child
454.8support obligors as authorized by Minnesota
454.9Statutes, section 13B.06, subdivision 7.
454.10Base Adjustment. The general fund base is
454.11decreased by $300,000 in fiscal years 2016
454.12and 2017, and the federal TANF fund base is
454.13increased by $300,000 in fiscal years 2016
454.14and 2017.

454.15

(c) Health Care

454.16	Appropriations by Fund
454.17	General	13,920,000	13,794,000
454.18	Health Care Access	26,599,000	30,306,000

454.19Base Adjustment. The health care access
454.20fund base is increased by $8,177,000 in fiscal
454.21year 2016 and by $6,712,000 in fiscal year
454.222017.

454.23

(d) Continuing Care

454.24	Appropriations by Fund
454.25	General	18,899,000	19,410,000
454.26 454.27	State Government Special Revenue	127,000	129,000

454.28Base Adjustment. The general fund base is
454.29increased by $3,324,000 in fiscal year 2016
454.30and by $3,324,000 in fiscal year 2017.

454.31

(e) Chemical and Mental Health

454.32	Appropriations by Fund
454.33	General	4,592,000	4,412,000
454.34	Lottery Prize Fund	159,000	160,000

455.1

Subd. 5.Forecasted Programs

455.2The amounts that may be spent from this
455.3appropriation for each purpose are as follows:

455.4

(a) MFIP/DWP

455.5	Appropriations by Fund
455.6	General	72,583,000	74,634,000
455.7	Federal TANF	83,104,000	80,510,000

455.8

(b) MFIP Child Care Assistance

59,662,000

59,393,000

455.9

(c) General Assistance

54,787,000

56,068,000

455.10General Assistance Standard. The
455.11commissioner shall set the monthly standard
455.12of assistance for general assistance units
455.13consisting of an adult recipient who is
455.14childless and unmarried or living apart
455.15from parents or a legal guardian at $203.
455.16The commissioner may reduce this amount
455.17according to Laws 1997, chapter 85, article
455.183, section 54.
455.19Emergency General Assistance. The
455.20amount appropriated for emergency general
455.21assistance funds is limited to no more
455.22than $6,729,812 in fiscal year 2014 and
455.23$6,729,812 in fiscal year 2015. Funds
455.24to counties shall be allocated by the
455.25commissioner using the allocation method in
455.26Minnesota Statutes, section 256D.06.

455.27

(d) MN Supplemental Assistance

38,646,000

39,821,000

455.28

(e) Group Residential Housing

140,460,000

150,022,000

455.29

(f) MinnesotaCare

455.30

Health Care Access

296,581,000

227,598,000

455.31

(g) Medical Assistance

456.1	Appropriations by Fund
456.2	General	4,345,062,000	4,595,874,000
456.3	Health Care Access	292,067,000	121,417,000

456.4The Departments of Human Services and
456.5Management and Budget shall identify
456.6general fund medical assistance populations
456.7costing $273,184,000 for fiscal year 2016
456.8and $251,405,000 for fiscal year 2017 and
456.9transfer those costs to the HCAF. The base for
456.10these costs shall be counted in the health care
456.11access fund for fiscal years 2016 and 2017.

456.12

(h) Alternative Care

47,197,000

45,084,000

456.13Alternative Care Transfer. Any money
456.14allocated to the alternative care program that
456.15is not spent for the purposes indicated does
456.16not cancel but shall be transferred to the
456.17medical assistance account.

456.18

(i) CD Treatment Fund

81,440,000

74,875,000

456.19Balance Transfer. The commissioner must
456.20transfer $18,188,000 from the consolidated
456.21chemical dependency treatment fund to the
456.22general fund by September 30, 2013.

456.23

Subd. 6.Grant Programs

456.24The amounts that may be spent from this
456.25appropriation for each purpose are as follows:

456.26

(a) Support Services Grants

456.27	Appropriations by Fund
456.28	General	8,715,000	8,715,000
456.29	Federal TANF	91,832,000	90,952,000

456.30Paid Work Experience. $2,168,000 each
456.31year is from the general fund for paid work
456.32experience for long-term MFIP recipients.
456.33Paid work includes full and partial wage
457.1subsidies and other related services such as
457.2job development, marketing, preworksite
457.3training, job coaching, and postplacement
457.4services. These are onetime appropriations.
457.5Unexpended funds for fiscal year 2014 do not
457.6cancel but are available to the commissioner
457.7for this purpose in fiscal year 2015.
457.8Work Study Funding for MFIP
457.9Participants. $250,000 each year is from
457.10the general fund to pilot work study jobs for
457.11MFIP recipients in approved postsecondary
457.12education programs. This is a onetime
457.13appropriation. Unexpended funds for fiscal
457.14year 2014 do not cancel but are available for
457.15this purpose in fiscal year 2015.
457.16Local Strategies to Reduce Disparities.
457.17$2,000,000 each year is from the general
457.18fund, for local projects that focus on services
457.19for subgroups within the MFIP caseload
457.20who are experiencing poor employment
457.21outcomes. These are onetime appropriations.
457.22Unexpended funds for fiscal year 2014 do not
457.23cancel but are available to the commissioner
457.24for this purpose in fiscal year 2015.
457.25Home Visiting Collaborations for MFIP
457.26Teen Parents. $200,000 each year is from
457.27the general fund for technical assistance and
457.28training to support local collaborations that
457.29provide home visiting services for MFIP teen
457.30parents. The TANF fund base is increased by
457.31$200,000 in fiscal years 2016 and 2017.
457.32Base Adjustment. The general fund base is
457.33decreased by $4,618,000 in fiscal years 2016
457.34and 2017. The TANF fund base is increased
457.35by $1,700,000 in fiscal years 2016 and 2017.

458.1 458.2

(b) Basic Sliding Fee Child Care Assistance Grants

38,356,000

38,681,000

458.3Base Adjustment. The general fund base is
458.4increased by $1,278,000 in fiscal year 2016
458.5and by $1,349,000 in fiscal year 2017.

458.6

(c) Child Care Development Grants

1,487,000

1,487,000

458.7

(d) Child Support Enforcement Grants

50,000

50,000

458.8Federal Child Support Demonstration
458.9Grants. Federal administrative
458.10reimbursement resulting from the federal
458.11child support grant expenditures authorized
458.12under United States Code, title 42, section
458.131315, is appropriated to the commissioner
458.14for this activity.

458.15

(e) Children's Services Grants

458.16	Appropriations by Fund
458.17	General	47,438,000	47,801,000
458.18	Federal TANF	140,000	140,000

458.19Adoption Assistance and Relative Custody
458.20Assistance. The commissioner may transfer
458.21unencumbered appropriation balances for
458.22adoption assistance and relative custody
458.23assistance between fiscal years and between
458.24programs.
458.25Privatized Adoption Grants. Federal
458.26reimbursement for privatized adoption grant
458.27and foster care recruitment grant expenditures
458.28is appropriated to the commissioner for
458.29adoption grants and foster care and adoption
458.30administrative purposes.
458.31Adoption Assistance Incentive Grants.
458.32Federal funds available during fiscal years
458.332014 and 2015 for adoption incentive grants
459.1are appropriated to the commissioner for
459.2these purposes.
459.3Base Adjustment. The general fund base is
459.4increased by $5,139,000 in fiscal year 2016
459.5and by $9,155,000 in fiscal year 2017.

459.6

(f) Child and Community Service Grants

53,301,000

53,301,000

459.7Reform 2020 Contingency. The
459.8appropriation from the general fund may be
459.9adjusted as provided in article 2, section 49,
459.10in order to implement Reform 2020.

459.11

(g) Child and Economic Support Grants

16,472,000

16,473,000

459.12Minnesota Food Assistance Program.
459.13Unexpended funds for the Minnesota food
459.14assistance program for fiscal year 2014 do
459.15not cancel but are available for this purpose
459.16in fiscal year 2015.
459.17Family Assets for Independence. $250,000
459.18each year is for the Family Assets for
459.19Independence Minnesota program. This
459.20appropriation is available in either year of the
459.21biennium and may be transferred between
459.22fiscal years. This appropriation is added to
459.23the base.

459.24

(h) Health Care Grants

459.25	Appropriations by Fund
459.26	General	90,000	90,000
459.27	Health Care Access	2,228,000	1,413,000

459.28Base Adjustment. The health care access
459.29fund is decreased by $1,223,000 in fiscal
459.30years 2016 and 2017.

459.31

(i) Aging and Adult Services Grants

22,149,000

23,015,000

459.32

(j) Deaf and Hard-of-Hearing Grants

1,767,000

1,767,000

459.33

(k) Disabilities Grants

18,498,000

18,808,000

460.1(a) $800,000 each year from the general fund
460.2is for a grant to the Minnesota Organization
460.3on Fetal Alcohol Syndrome (MOFAS). Of
460.4the grant money dispersed by MOFAS, at
460.5least $360,000 must be used to support
460.6nonprofit Fetal Alcohol Spectrum Disorders
460.7(FASD) outreach prevention programs in
460.8Olmsted County. Other grant recipients must
460.9be selected from communities which are not
460.10currently served by federal substance abuse
460.11prevention and treatment block grant funds.
460.12(b) Grant money must be used to reduce the
460.13incidence of FASD and other prenatal drug
460.14related effects in children in Minnesota by
460.15identifying and serving pregnant women
460.16suspected of or known to use or abuse alcohol
460.17or other drugs. Grant recipients must provide
460.18intensive services to chemically dependent
460.19women in order to increase positive birth
460.20outcomes. The organization may retain eight
460.21percent of the grant money for administrative
460.22costs.
460.23(c) A grant recipient must report to the
460.24commissioner of human services annually
460.25by January 15 on the services and programs
460.26funded by the appropriation. The report must
460.27include measurable outcomes, including
460.28the number of pregnant women served and
460.29toxic-free babies born in the previous year.
460.30Base Adjustment. The general fund base
460.31is increased by $502,000 in fiscal year 2016
460.32and by $676,000 in fiscal year 2017.

460.33

(l) Adult Mental Health Grants

460.34	Appropriations by Fund
460.35	General	71,219,000	69,550,000
461.1	Health Care Access	750,000	750,000
461.2	Lottery Prize	1,508,000	1,508,000

461.3Funding Usage. Up to 75 percent of a fiscal
461.4year's appropriations for adult mental health
461.5grants may be used to fund allocations in that
461.6portion of the fiscal year ending December
461.731.
461.8Base Adjustment. The general fund base is
461.9decreased by $4,461,000 in fiscal years 2016
461.10and 2017.
461.11Mental Health Pilot Project. $230,000
461.12each year is for a grant to the Zumbro
461.13Valley Mental Health Center. The grant
461.14shall be used to implement a pilot project
461.15to test an integrated behavioral health care
461.16coordination model. The grant recipient must
461.17report measurable outcomes and savings
461.18to the commissioner of human services by
461.19January 15, 2016.

461.20

(m) Child Mental Health Grants

17,599,000

19,988,000

461.21Funding Usage. Up to 75 percent of a fiscal
461.22year's appropriation for child mental health
461.23grants may be used to fund allocations in that
461.24portion of the fiscal year ending December
461.2531.

461.26

(n) CD Treatment Support Grants

1,516,000

1,516,000

461.27Base Adjustment. The general fund base is
461.28decreased by $300,000 in fiscal years 2016
461.29and 2017.

461.30

Subd. 7.State-Operated Services

186,844,000

188,283,000

461.31Transfer Authority Related to
461.32State-Operated Services. Money
461.33appropriated for state-operated services
462.1may be transferred between fiscal years
462.2of the biennium with the approval of the
462.3commissioner of management and budget.
462.4The amounts that may be spent from the
462.5appropriation for each purpose are as follows:

462.6

(a) SOS Mental Health

116,698,000

117,567,000

462.7Dedicated Receipts Available. Of the
462.8revenue received under Minnesota Statutes,
462.9section 246.18, subdivision 8, paragraph
462.10(a), $1,000,000 each year is available for
462.11the purposes of paragraph (b), clause (1),
462.12of that subdivision, $1,000,000 each year
462.13is available to transfer to the adult mental
462.14health budget activity for the purposes of
462.15paragraph (b), clause (2), of that subdivision,
462.16and up to $2,713,000 each year is available
462.17for the purposes of paragraph (b), clause (3),
462.18of that subdivision.

462.19

(b) SOS MN Security Hospital

70,146,000

70,715,000

462.20

Subd. 8.Sex Offender Program

77,341,000

80,895,000

462.21Transfer Authority Related to Minnesota
462.22Sex Offender Program. Money
462.23appropriated for the Minnesota sex offender
462.24program may be transferred between fiscal
462.25years of the biennium with the approval of the
462.26commissioner of management and budget.

462.27

Subd. 9.Technical Activities

80,440,000

80,829,000

462.28This appropriation is from the federal TANF
462.29fund.
462.30Base Adjustment. The federal TANF fund
462.31base is decreased by $22,000 in fiscal year
462.322016 and by $49,000 in fiscal year 2017.

462.33

Subd. 10.Transfer.

463.1The commissioner of management and
463.2budget must transfer $65,000,000 in fiscal
463.3year 2014 from the general fund to the health
463.4care access fund. This is a onetime transfer.

463.5

Sec. 4. COMMISSIONER OF HEALTH

463.6

Subdivision 1.Total Appropriation

$

172,560,000

$

166,943,000

463.7	Appropriations by Fund
463.8		2014	2015
463.9	General	78,159,000	72,960,000
463.10 463.11	State Government Special Revenue	50,418,000	50,553,000
463.12	Health Care Access	32,280,000	31,717,000
463.13	Federal TANF	11,713,000	11,713,000

463.14The amounts that may be spent for each
463.15purpose are specified in the following
463.16subdivisions.

463.17

Subd 2.Health Improvement

463.18	Appropriations by Fund
463.19	General	51,483,000	46,219,000
463.20 463.21	State Government Special Revenue	1,043,000	1,054,000
463.22	Health Care Access	21,752,000	21,731,000
463.23	Federal TANF	11,713,000	11,713,000

463.24Statewide Health Improvement Program.
463.25 $20,000,000 in fiscal year 2014 and
463.26$20,000,000 in fiscal year 2015 are
463.27appropriated from the health care access
463.28fund for the statewide health improvement
463.29program under Minnesota Statutes, section
463.30145.986.
463.31Statewide Cancer Surveillance System.
463.32 Of the general fund appropriation, $350,000
463.33in fiscal year 2014 and $350,000 in fiscal
463.34year 2015 are appropriated to develop and
463.35implement a new cancer reporting system
463.36under Minnesota Statutes, sections 144.671
464.1to 144.69. Any information technology
464.2development or support costs necessary
464.3for the cancer surveillance system must
464.4be incorporated into the agency's service
464.5level agreement and paid to the Office of
464.6Enterprise Technology.
464.7TANF Appropriations. (1) $1,156,000 of
464.8the TANF funds is appropriated each year of
464.9the biennium to the commissioner for family
464.10planning grants under Minnesota Statutes,
464.11section 145.925.
464.12(2) $3,579,000 of the TANF funds is
464.13appropriated each year of the biennium to
464.14the commissioner for home visiting and
464.15nutritional services listed under Minnesota
464.16Statutes, section 145.882, subdivision 7,
464.17clauses (6) and (7). Funds must be distributed
464.18to community health boards according to
464.19Minnesota Statutes, section 145A.131,
464.20subdivision 1.
464.21(3) $2,000,000 of the TANF funds is
464.22appropriated each year of the biennium to
464.23the commissioner for decreasing racial and
464.24ethnic disparities in infant mortality rates
464.25under Minnesota Statutes, section 145.928,
464.26subdivision 7.
464.27(4) $4,978,000 of the TANF funds is
464.28appropriated each year of the biennium to the
464.29commissioner for the family home visiting
464.30grant program according to Minnesota
464.31Statutes, section 145A.17. $4,000,000 of the
464.32funding must be distributed to community
464.33health boards according to Minnesota
464.34Statutes, section 145A.131, subdivision 1.
464.35$978,000 of the funding must be distributed
465.1to tribal governments based on Minnesota
465.2Statutes, section 145A.14, subdivision 2a.
465.3(5) The commissioner may use up to 6.23
465.4percent of the funds appropriated each fiscal
465.5year to conduct the ongoing evaluations
465.6required under Minnesota Statutes, section
465.7145A.17, subdivision 7, and training and
465.8technical assistance as required under
465.9Minnesota Statutes, section 145A.17,
465.10subdivisions 4 and 5.
465.11TANF Carryforward. Any unexpended
465.12balance of the TANF appropriation in the
465.13first year of the biennium does not cancel but
465.14is available for the second year.

465.15

Subd. 3.Policy Quality and Compliance

465.16	Appropriations by Fund
465.17	General	9,400,000	9,409,000
465.18 465.19	State Government Special Revenue	16,599,000	16,578,000
465.20	Health Care Access	10,555,000	9,986,000

465.21Base Level Adjustment. The state
465.22government special revenue fund base shall
465.23be reduced by $2,000 in fiscal year 2017. The
465.24health care access base shall be increased by
465.25$600,000 in fiscal year 2015.

465.26

Subd. 4.Health Protection

465.27	Appropriations by Fund
465.28	General	9,503,000	9,558,000
465.29 465.30	State Government Special Revenue	32,776,000	32,921,000

465.31Infectious Disease Laboratory. Of the
465.32general fund appropriation, $200,000 in
465.33fiscal year 2014 and $200,000 in fiscal year
465.342015 are appropriated to the commissioner
466.1to monitor infectious disease trends and
466.2investigate infectious disease outbreaks.
466.3Surveillance for Elevated Blood Lead
466.4Levels. Of the general fund appropriation,
466.5$100,000 in fiscal year 2014 and $100,000
466.6in fiscal year 2015 are appropriated to the
466.7commissioner for the blood lead surveillance
466.8system under Minnesota Statutes, section
466.9144.9502.
466.10Base Level Adjustment. The state
466.11government special revenue base is increased
466.12by $6,000 in fiscal year 2016 and by $27,000
466.13in fiscal year 2017.

466.14

Subd. 5.Administrative Support Services

7,773,000

7,774,000

466.15Regional Support for Local Public Health
466.16Departments. $350,000 in fiscal year
466.172014 and $350,000 in fiscal year 2015
466.18are appropriated to the commissioner for
466.19regional staff who provide specialized
466.20expertise to local public health departments.

466.21

Sec. 5. HEALTH-RELATED BOARDS

466.22

Subdivision 1.Total Appropriation

$

16,834,000

$

16,898,000

466.23This appropriation is from the state
466.24government special revenue fund. The
466.25amounts that may be spent for each purpose
466.26are specified in the following subdivisions.

466.27

Subd. 2.Board of Chiropractic Examiners

473,000

477,000

466.28

Subd. 3.Board of Dentistry

1,835,000

1,850,000

466.29Health Professional Services Program. Of
466.30this appropriation, $704,000 in fiscal year
466.312014 and $704,000 in fiscal year 2015 from
466.32the state government special revenue fund are
466.33for the health professional services program.

467.1 467.2

Subd. 4.Board of Dietetic and Nutrition Practice

112,000

112,000

467.3 467.4

Subd. 5.Board of Marriage and Family Therapy

169,000

170,000

467.5

Subd. 6.Board of Medical Practice

3,883,000

3,900,000

467.6

Subd. 7.Board of Nursing

3,664,000

3,692,000

467.7 467.8

Subd. 8.Board of Nursing Home Administrators

1,240,000

1,196,000

467.9Administrative Services Unit - Operating
467.10Costs. Of this appropriation, $676,000
467.11in fiscal year 2014 and $626,000 in
467.12fiscal year 2015 are for operating costs
467.13of the administrative services unit. The
467.14administrative services unit may receive
467.15and expend reimbursements for services
467.16performed by other agencies.
467.17Administrative Services Unit - Volunteer
467.18Health Care Provider Program. Of this
467.19appropriation, $150,000 in fiscal year 2014
467.20and $150,000 in fiscal year 2015 are to pay
467.21for medical professional liability coverage
467.22required under Minnesota Statutes, section
467.23214.40.
467.24Administrative Services Unit - Contested
467.25Cases and Other Legal Proceedings. Of
467.26this appropriation, $200,000 in fiscal year
467.272014 and $200,000 in fiscal year 2015 are
467.28for costs of contested case hearings and other
467.29unanticipated costs of legal proceedings
467.30involving health-related boards funded
467.31under this section. Upon certification of a
467.32health-related board to the administrative
467.33services unit that the costs will be incurred
467.34and that there is insufficient money available
467.35to pay for the costs out of money currently
468.1available to that board, the administrative
468.2services unit is authorized to transfer money
468.3from this appropriation to the board for
468.4payment of those costs with the approval
468.5of the commissioner of management and
468.6budget. This appropriation does not cancel.
468.7Any unencumbered and unspent balances
468.8remain available for these expenditures in
468.9subsequent fiscal years.
468.10Criminal Background Checks. $390,000
468.11each year from the state government special
468.12revenue fund is for the Administrative
468.13Support Services Unit for the implementation
468.14of a criminal background check program.

468.15

Subd. 9.Board of Optometry

108,000

108,000

468.16

Subd. 10.Board of Pharmacy

2,362,000

2,380,000

468.17Prescription Electronic Reporting. Of
468.18this appropriation, $356,000 in fiscal year
468.192014 and $356,000 in fiscal year 2015 from
468.20the state government special revenue fund
468.21are to the board to operate the prescription
468.22electronic reporting system in Minnesota
468.23Statutes, section 152.126.

468.24

Subd. 11.Board of Physical Therapy

348,000

351,000

468.25

Subd. 12.Board of Podiatry

76,000

77,000

468.26

Subd. 13.Board of Psychology

853,000

861,000

468.27

Subd. 14.Board of Social Work

1,061,000

1,069,000

468.28

Subd. 15.Board of Veterinary Medicine

232,000

234,000

468.29 468.30

Subd. 16.Board of Behavioral Health and Therapy

418,000

421,000

468.31 468.32

Sec. 6. EMERGENCY MEDICAL SERVICES REGULATORY BOARD

$

2,749,000

$

2,756,000

469.1Regional Grants. $585,000 in fiscal year
469.22014 and $585,000 in fiscal year 2015 are
469.3for regional emergency medical services
469.4programs, to be distributed equally to the
469.5eight emergency medical service regions.
469.6Cooper/Sams Volunteer Ambulance
469.7Program. $700,000 in fiscal year 2014 and
469.8$700,000 in fiscal year 2015 are for the
469.9Cooper/Sams volunteer ambulance program
469.10under Minnesota Statutes, section 144E.40.
469.11(a) Of this amount, $611,000 in fiscal year
469.122014 and $611,000 in fiscal year 2015
469.13are for the ambulance service personnel
469.14longevity award and incentive program under
469.15Minnesota Statutes, section 144E.40.
469.16(b) Of this amount, $89,000 in fiscal year
469.172014 and $89,000 in fiscal year 2015 are
469.18for the operations of the ambulance service
469.19personnel longevity award and incentive
469.20program under Minnesota Statutes, section
469.21144E.40.
469.22Ambulance Training Grant. $361,000 in
469.23fiscal year 2014 and $361,000 in fiscal year
469.242015 are for training grants.
469.25EMSRB Board Operations. $1,095,000 in
469.26fiscal year 2014 and $1,095,000 in fiscal year
469.272015 are for operations.

469.28

Sec. 7. COUNCIL ON DISABILITY

$

618,000

$

622,000

469.29 469.30 469.31

Sec. 8. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,668,000

$

1,680,000

469.32

Sec. 9. OMBUDSPERSON FOR FAMILIES

$

336,000

$

339,000

470.1    Sec. 10. Minnesota Statutes 2012, section 256.01, subdivision 34, is amended to read:
470.2    Subd. 34. Federal administrative reimbursement dedicated. Federal
470.3administrative reimbursement resulting from the following activities is appropriated to the
470.4commissioner for the designated purposes:
470.5(1) reimbursement for the Minnesota senior health options project; and
470.6(2) reimbursement related to prior authorization and inpatient admission certification
470.7by a professional review organization. A portion of these funds must be used for activities
470.8to decrease unnecessary pharmaceutical costs in medical assistance.; and
470.9(3) reimbursement resulting from the federal child support grant expenditures
470.10authorized under United States Code, title 42, section 1315.

470.11    Sec. 11. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
470.12to read:
470.13    Subd. 35. Federal reimbursement for privatized adoption grants. Federal
470.14reimbursement for privatized adoption grant and foster care recruitment grant expenditures
470.15is appropriated to the commissioner for adoption grants and foster care and adoption
470.16administrative purposes.

470.17    Sec. 12. Minnesota Statutes 2012, section 256.01, is amended by adding a subdivision
470.18to read:
470.19    Subd. 36. DHS receipt center accounting. The commissioner may transfer
470.20appropriations to, and account for DHS receipt center operations in, the special revenue
470.21fund.

470.22    Sec. 13. TRANSFERS.
470.23    Subdivision 1. Grants. The commissioner of human services, with the approval of
470.24the commissioner of management and budget, may transfer unencumbered appropriation
470.25balances for the biennium ending June 30, 2015, within fiscal years among the MFIP,
470.26general assistance, general assistance medical care under Minnesota Statutes 2009
470.27Supplement, section 256D.03, subdivision 3, medical assistance, MinnesotaCare, MFIP
470.28child care assistance under Minnesota Statutes, section 119B.05, Minnesota supplemental
470.29aid, group residential housing programs, the entitlement portion of the chemical
470.30dependency consolidated treatment fund, and between fiscal years of the biennium. The
470.31commissioner shall inform the chairs and ranking minority members of the senate Health
470.32and Human Services Finance Division and the house of representatives Health and Human
470.33Services Finance Committee quarterly about transfers made under this provision.
471.1    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
471.2money may be transferred within the Departments of Human Services and Health as the
471.3commissioners consider necessary, with the advance approval of the commissioner of
471.4management and budget. The commissioner shall inform the chairs and ranking minority
471.5members of the senate Health and Human Services Finance Division and the house of
471.6representatives Health and Human Services Finance Committee quarterly about transfers
471.7made under this provision.

471.8    Sec. 14. INDIRECT COSTS NOT TO FUND PROGRAMS.
471.9The commissioners of health and human services shall not use indirect cost
471.10allocations to pay for the operational costs of any program for which they are responsible.

471.11    Sec. 15. EXPIRATION OF UNCODIFIED LANGUAGE.
471.12All uncodified language contained in this article expires on June 30, 2015, unless a
471.13different expiration date is explicit.

471.14    Sec. 16. EFFECTIVE DATE.
471.15This article is effective July 1, 2013, unless a different effective date is specified.

471.18

Section 1. HUMAN SERVICES APPROPRIATIONS.

471.19The sums shown in the columns marked "Appropriations" are added to or, if shown
471.20in parentheses, subtracted from the appropriations in article 14 to the agencies and for the
471.21purposes specified in this article. The appropriations are from the general fund or other
471.22named fund and are available for the fiscal years indicated for each purpose. The figures
471.23"2014" and "2015" used in this article mean that the addition to or subtraction from the
471.24appropriation listed under them is available for the fiscal year ending June 30, 2014, or
471.25June 30, 2015, respectively. Supplemental appropriations and reductions to appropriations
471.26for the fiscal year ending June 30, 2014, are effective the day following final enactment
471.27unless a different effective date is explicit.

471.28				APPROPRIATIONS
471.29				Available for the Year
471.30				Ending June 30
471.31					2014		2015

472.1 472.2

Sec. 2. COMMISSIONER OF HUMAN SERVICES

472.3

Subdivision 1.Total Appropriation

$

1,906,000

$

2,047,000

472.4	Appropriations by Fund
472.5		2014	2015
472.6	General	1,906,000	2,047,000

472.7Reform 2020 Contingency. The
472.8appropriation from the general fund may
472.9be adjusted as provided in article 2, section
472.1049, in order to implement Reform 2020 and
472.11systems modernization.

472.12

Subd. 2.Central Office Operations

472.13

(a) Operations

3,384,000

14,506,000

472.14Systems Modernization Transfer. If
472.15contingent funding is fully or partially
472.16disbursed as provided in article 2, section 49,
472.17and transferred to the state systems account,
472.18the unexpended balance of that appropriation
472.19must be transferred to the Office of Enterprise
472.20Technology in accordance with clause (2)
472.21of the systems modernization provision in
472.22article 14. Contingent funding under this
472.23provision must not exceed $16,992,000 for
472.24the biennium.

472.25

(b) Children and Families

109,000

206,000

472.26

(c) Health Care

100,000

100,000

472.27

(d) Continuing Care

5,236,000

5,541,000

472.28

Subd. 3.Forecasted Programs

472.29

(a) Group Residential Housing

(1,166,000)

(8,602,000)

472.30

(b) Medical Assistance

(3,770,000)

(10,086,000)

472.31

(c) Alternative Care

(6,981,000)

(4,394,000)

472.32

Subd. 4.Grant Programs

473.1

(a) Child and Community Services Grants

3,000,000

3,000,000

473.2

(b) Aging and Adult Services Grants

1,430,000

1,237,000

473.3

(c) Disability Grants

564,000

539,000"

473.4Delete the title and insert:
473.6relating to state government; establishing the health and human services budget;
473.7modifying provisions related to health care, continuing care, nursing facility
473.8admission, children and family services, human services licensing, chemical and
473.9mental health, program integrity, managed care organizations, waiver provider
473.10standards, home care, and the Department of Health; redesigning home and
473.11community-based services; establishing community first services and supports;
473.12establishing payment methodologies for home and community-based services;
473.13modifying background study requirements; adjusting nursing and ICF/DD
473.14facility rates; setting and modifying fees; establishing autism early intensive
473.15intervention benefits; making technical changes; requiring studies; requiring
473.16reports; appropriating money; repealing MinnesotaCare;amending Minnesota
473.17Statutes 2012, sections 16A.724, subdivisions 2, 3; 16C.10, subdivision
473.185; 16C.155, subdivision 1; 62J.692, subdivision 4; 62Q.19, subdivision 1;
473.19103I.005, by adding a subdivision; 103I.521; 119B.13, subdivision 7; 144.051,
473.20by adding subdivisions; 144.0724, subdivision 4; 144.123, subdivision 1;
473.21144.125, subdivision 1; 144.212; 144.213; 144.215, subdivisions 3, 4; 144.216,
473.22subdivision 1; 144.217, subdivision 2; 144.218, subdivision 5; 144.225; 144.226;
473.23144.966, subdivision 2; 144.98, subdivisions 3, 5, by adding subdivisions; 144.99,
473.24subdivision 4; 144A.351; 144A.43; 144A.44; 144A.45; 144D.01, subdivision
473.254; 145.986; 145C.01, subdivision 7; 148E.065, subdivision 4a; 149A.02,
473.26subdivisions 1a, 2, 3, 4, 5, 16, 23, 27, 34, 35, 37, by adding subdivisions;
473.27149A.03; 149A.65, by adding subdivisions; 149A.70, subdivisions 1, 2, 3, 5;
473.28149A.71, subdivisions 2, 4; 149A.72, subdivisions 3, 9, by adding a subdivision;
473.29149A.73, subdivisions 1, 2, 4; 149A.74; 149A.90, subdivision 8; 149A.91,
473.30subdivision 9; 149A.92, subdivision 1; 149A.93, subdivisions 3, 6; 149A.94;
473.31149A.96, subdivision 9; 174.30, subdivision 1; 243.166, subdivisions 4b, 7;
473.32245.4661, subdivisions 5, 6; 245.4682, subdivision 2; 245A.02, subdivisions 1,
473.339, 10, 14; 245A.03, subdivisions 7, 8, 9; 245A.04, subdivision 13; 245A.042,
473.34subdivision 3; 245A.07, subdivision 3; 245A.08, subdivision 2a; 245A.10;
473.35245A.11, subdivisions 2a, 7, 7a, 7b, 8; 245A.16, subdivision 1; 245C.04, by
473.36adding a subdivision; 245C.08, subdivision 1; 245D.02; 245D.03; 245D.04;
473.37245D.05; 245D.06; 245D.07; 245D.09; 245D.10; 246.18, subdivision 8, by
473.38adding a subdivision; 246.54; 254B.04, subdivision 1; 256.01, subdivisions 2, 24,
473.3934, by adding subdivisions; 256.9657, subdivisions 2, 3a; 256.9685, subdivision
473.402; 256.969, subdivision 3a; 256.975, subdivision 7, by adding subdivisions;
473.41256.9754, subdivision 5, by adding subdivisions; 256B.02, by adding
473.42subdivisions; 256B.021, by adding subdivisions; 256B.04, subdivisions 18, 21,
473.43by adding a subdivision; 256B.055, subdivisions 3a, 6, 10, 14, 15, by adding a
473.44subdivision; 256B.056, subdivisions 1, 1c, 3, 4, 5c, 10, by adding a subdivision;
473.45256B.057, subdivisions 1, 8, 10, by adding a subdivision; 256B.059, subdivision
473.461; 256B.06, subdivision 4; 256B.0625, subdivisions 9, 13e, 19c, 31, 39, 58, by
473.47adding subdivisions; 256B.0631, subdivision 1; 256B.064, subdivisions 1a, 1b, 2;
473.48256B.0659, subdivision 21; 256B.0755, subdivision 3; 256B.0756; 256B.0911,
473.49subdivisions 1, 1a, 3a, 4d, 6, 7, by adding a subdivision; 256B.0913, subdivision
473.504, by adding a subdivision; 256B.0915, subdivisions 3a, 5, by adding a
473.51subdivision; 256B.0916, by adding a subdivision; 256B.0917, subdivisions 6, 13,
473.52by adding subdivisions; 256B.092, subdivisions 11, 12, by adding subdivisions;
473.53256B.0946; 256B.434, subdivision 4, by adding a subdivision; 256B.437,
473.54subdivision 6; 256B.439, subdivisions 1, 2, 3, 4, by adding a subdivision;
474.1256B.441, subdivisions 13, 53; 256B.49, subdivisions 11a, 12, 14, 15, by
474.2adding subdivisions; 256B.4912, subdivisions 1, 2, 3, 7, by adding subdivisions;
474.3256B.4913; 256B.492; 256B.493, subdivision 2; 256B.5011, subdivision 2;
474.4256B.5012, by adding subdivisions; 256B.69, subdivision 5c; 256B.694;
474.5256B.76, by adding a subdivision; 256B.761; 256B.764; 256I.05, subdivision 1e,
474.6by adding a subdivision; 256L.01, subdivisions 3a, 5, by adding subdivisions;
474.7256L.02, subdivision 2, by adding subdivisions; 256L.03, subdivisions 1, 1a,
474.83, 5, 6, by adding a subdivision; 256L.04, subdivisions 1, 7, 8, 10, by adding
474.9subdivisions; 256L.05, subdivisions 1, 2, 3; 256L.06, subdivision 3; 256L.07,
474.10subdivisions 1, 2, 3; 256L.09, subdivision 2; 256L.11, subdivision 6; 256L.15,
474.11subdivisions 1, 2; 257.75, subdivision 7; 260C.635, subdivision 1; 471.59,
474.12subdivision 1; 517.001; 626.556, subdivisions 2, 3, 10d; 626.557, subdivisions 4,
474.139, 9a, 9e; 626.5572, subdivision 13; Laws 1998, chapter 407, article 6, section
474.14116; Laws 2011, First Special Session chapter 9, article 2, section 27; article 10,
474.15section 3, subdivision 3, as amended; proposing coding for new law in Minnesota
474.16Statutes, chapters 62D; 144; 144A; 149A; 214; 245; 245D; 254B; 256; 256B;
474.17256L; repealing Minnesota Statutes 2012, sections 103I.005, subdivision 20;
474.18144.123, subdivision 2; 144A.46; 144A.461; 149A.025; 149A.20, subdivision
474.198; 149A.30, subdivision 2; 149A.40, subdivision 8; 149A.45, subdivision 6;
474.20149A.50, subdivision 6; 149A.51, subdivision 7; 149A.52, subdivision 5a;
474.21149A.53, subdivision 9; 245A.655; 245B.01; 245B.02; 245B.03; 245B.031;
474.22245B.04; 245B.05, subdivisions 1, 2, 3, 5, 6, 7; 245B.055; 245B.06; 245B.07;
474.23245B.08; 245D.08; 256B.0911, subdivisions 4a, 4b, 4c; 256B.0917, subdivisions
474.241, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 14; 256B.49, subdivision 16a; 256B.5012,
474.25subdivision 13; 256J.24, subdivision 6; 256L.01, subdivision 4a; 256L.031;
474.26256L.04, subdivisions 1b, 9, 10a; 256L.05, subdivision 3b; 256L.07, subdivisions
474.275, 8, 9; 256L.11, subdivision 5; 256L.12; 256L.17, subdivisions 1, 2, 3, 4, 5;
474.28485.14; Laws 2011, First Special Session chapter 9, article 7, section 54, as
474.29amended; Minnesota Rules, parts 4668.0002; 4668.0003; 4668.0005; 4668.0008;
474.304668.0012; 4668.0016; 4668.0017; 4668.0019; 4668.0030; 4668.0035;
474.314668.0040; 4668.0050; 4668.0060; 4668.0065; 4668.0070; 4668.0075;
474.324668.0080; 4668.0100; 4668.0110; 4668.0120; 4668.0130; 4668.0140;
474.334668.0150; 4668.0160; 4668.0170; 4668.0180; 4668.0190; 4668.0200;
474.344668.0218; 4668.0220; 4668.0230; 4668.0240; 4668.0800; 4668.0805;
474.354668.0810; 4668.0815; 4668.0820; 4668.0825; 4668.0830; 4668.0835;
474.364668.0840; 4668.0845; 4668.0855; 4668.0860; 4668.0865; 4668.0870;
474.374669.0001; 4669.0010; 4669.0020; 4669.0030; 4669.0040; 4669.0050."