1.1 	A bill for an act
1.2 	relating to human services; removing obsolete provisions from statute relating to 
1.3 	children and family services, health care, chemical and mental health services, 
1.4 	continuing care, and operations; modifying provisions governing the elderly 
1.5 	waiver, the alternative care program, and mental health services for children;
1.6 	amending Minnesota Statutes 2012, sections 13.46, subdivision 4; 245.4871, 
1.7 	subdivisions 3, 6, 27; 245.4873, subdivision 2; 245.4874, subdivision 1; 
1.8 	245.4881, subdivisions 3, 4; 245.4882, subdivision 1; 245A.40, subdivision 8; 
1.9 	245C.04, subdivision 1; 245C.05, subdivision 5; 246.01; 254B.05, subdivision 
1.10 	2; 256.01, subdivision 14b; 256.963, subdivision 2; 256.969, subdivision 
1.11 	9; 256B.0913, subdivisions 5a, 14; 256B.0915, subdivisions 3c, 3d, 3f, 3g; 
1.12 	256B.0943, subdivisions 8, 10, 12; 256B.69, subdivisions 2, 4b, 5, 5a, 5b, 6b, 
1.13 	6d, 17, 26, 29, 30; 256B.692, subdivisions 2, 5; 256D.02, subdivision 11; 
1.14 	256D.04; 256D.045; 256D.07; 256I.04, subdivision 3; 256I.05, subdivision 1c; 
1.15 	256J.425, subdivision 4; 518A.65; 626.556, subdivision 3c; Minnesota Statutes 
1.16 	2013 Supplement, sections 245A.03, subdivision 7; 245A.40, subdivision 5; 
1.17 	245A.50, subdivision 3; 256B.0943, subdivisions 2, 7; 256B.69, subdivisions 5c, 
1.18 	28; 256B.76, subdivision 4; 256D.02, subdivision 12a; Laws 2013, chapter 108, 
1.19 	article 3, section 48; repealing Minnesota Statutes 2012, sections 4.47; 119A.04, 
1.20 	subdivision 1; 119B.035; 119B.09, subdivision 2; 119B.23; 119B.231; 119B.232; 
1.21 	245.0311; 245.0312; 245.072; 245.4861; 245.487, subdivisions 4, 5; 245.4871, 
1.22 	subdivisions 7, 11, 18, 25; 245.4872; 245.4873, subdivisions 3, 6; 245.4875, 
1.23 	subdivisions 3, 6, 7; 245.4883, subdivision 1; 245.490; 245.492, subdivisions 
1.24 	6, 8, 13, 19; 245.4932, subdivisions 2, 3, 4; 245.4933; 245.494; 245.63; 
1.25 	245.69, subdivision 1; 245.714; 245.715; 245.717; 245.718; 245.721; 245.77; 
1.26 	245.827; 245.981; 245A.02, subdivision 7b; 245A.09, subdivision 12; 245A.11, 
1.27 	subdivision 5; 245A.655; 246.0135; 246.016; 246.023, subdivision 1; 246.16; 
1.28 	246.28; 246.325; 246.70; 246.71; 246.711; 246.712; 246.713; 246.714; 246.715; 
1.29 	246.716; 246.717; 246.718; 246.719; 246.72; 246.721; 246.722; 253B.22; 
1.30 	254.01; 254.03; 254.04; 254.06; 254.07; 254.09; 254.10; 254.11; 254A.05, 
1.31 	subdivision 1; 254A.07, subdivisions 1, 2; 254A.16, subdivision 1; 254B.01, 
1.32 	subdivision 1; 254B.04, subdivision 3; 256.01, subdivisions 3, 14, 14a; 256.959; 
1.33 	256.964; 256.9691; 256.971; 256.975, subdivision 3; 256.9753, subdivision 
1.34 	4; 256.9792; 256B.04, subdivision 16; 256B.043; 256B.0636; 256B.0656; 
1.35 	256B.0657; 256B.075, subdivision 4; 256B.0757, subdivision 7; 256B.0913, 
1.36 	subdivision 9; 256B.0916, subdivisions 6, 6a; 256B.0928; 256B.19, subdivision 
1.37 	3; 256B.431, subdivisions 28, 31, 33, 34, 37, 38, 39, 40, 41, 43; 256B.434, 
1.38 	subdivision 19; 256B.440; 256B.441, subdivisions 46, 46a; 256B.491; 256B.501, 
1.39 	subdivisions 3a, 3b, 3h, 3j, 3k, 3l, 5e; 256B.5016; 256B.503; 256B.53; 256B.69, 
2.1 	subdivisions 5e, 6c, 24a; 256B.692, subdivision 10; 256D.02, subdivision 
2.2 	19; 256D.05, subdivision 4; 256D.46; 256I.05, subdivisions 1b, 5; 256I.07; 
2.3 	256J.24, subdivision 10; 256K.35; 259.85, subdivisions 2, 3, 4, 5; 518A.53, 
2.4 	subdivision 7; 518A.74; 626.557, subdivision 16; 626.5593; Minnesota Statutes 
2.5 	2013 Supplement, sections 246.0141; 246.0251; 254.05; 254B.13, subdivision 3; 
2.6 	256B.501, subdivision 5b; 256C.29; 259.85, subdivision 1; Minnesota Rules, 
2.7 	parts 9549.0020, subparts 2, 12, 13, 20, 23, 24, 25, 26, 27, 30, 31, 32, 33, 34, 35, 
2.8 	36, 38, 41, 42, 43, 44, 46, 47; 9549.0030; 9549.0035, subparts 4, 5, 6; 9549.0036; 
2.9 	9549.0040; 9549.0041, subparts 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15; 
2.10 	9549.0050; 9549.0051, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14; 9549.0053; 
2.11 	9549.0054; 9549.0055, subpart 4; 9549.0056; 9549.0058; 9549.0059; 9549.0060, 
2.12 	subparts 1, 2, 3, 8, 9, 12, 13; 9549.0061; 9549.0070, subparts 1, 4.
2.13 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

2.14 	ARTICLE 1
2.15 	CHILDREN AND FAMILY SERVICES

2.16 	Section 1. Minnesota Statutes 2012, section 256D.02, subdivision 11, is amended to 
2.17 	read:
2.18 		Subd. 11.State aid. "State aid" means state aid to county agencies for general 
2.19 	assistance and general assistance medical care expenditures as provided for in section 
2.20 	256D.03, subdivisions subdivision 2 and 3.

2.21 	Sec. 2. Minnesota Statutes 2013 Supplement, section 256D.02, subdivision 12a, 
2.22 	is amended to read:
2.23 		Subd. 12a.Resident. (a) For purposes of eligibility for general assistance and 
2.24 	general assistance medical care, a person must be a resident of this state.
2.25 	(b) A "resident" is a person living in the state for at least 30 days with the intention of 
2.26 	making the person's home here and not for any temporary purpose. Time spent in a shelter 
2.27 	for battered women shall count toward satisfying the 30-day residency requirement. All 
2.28 	applicants for these programs are required to demonstrate the requisite intent and can do 
2.29 	so in any of the following ways:
2.30 	(1) by showing that the applicant maintains a residence at a verified address, other 
2.31 	than a place of public accommodation. An applicant may verify a residence address by 
2.32 	presenting a valid state driver's license, a state identification card, a voter registration card, 
2.33 	a rent receipt, a statement by the landlord, apartment manager, or homeowner verifying 
2.34 	that the individual is residing at the address, or other form of verification approved by 
2.35 	the commissioner; or
2.36 	(2) by verifying residence according to Minnesota Rules, part 9500.1219, subpart 
2.37 	3, item C.
3.1 	(c) For general assistance, a county shall waive the 30-day residency requirement 
3.2 	where unusual hardship would result from denial of general assistance. For purposes of 
3.3 	this subdivision, "unusual hardship" means the applicant is without shelter or is without 
3.4 	available resources for food.
3.5 	The county agency must report to the commissioner within 30 days on any waiver 
3.6 	granted under this section. The county shall not deny an application solely because the 
3.7 	applicant does not meet at least one of the criteria in this subdivision, but shall continue to 
3.8 	process the application and leave the application pending until the residency requirement 
3.9 	is met or until eligibility or ineligibility is established.
3.10 	(d) For purposes of paragraph (c), the following definitions apply (1) "metropolitan 
3.11 	statistical area" is as defined by the United States Census Bureau; (2) "shelter" includes 
3.12 	any shelter that is located within the metropolitan statistical area containing the county 
3.13 	and for which the applicant is eligible, provided the applicant does not have to travel more 
3.14 	than 20 miles to reach the shelter and has access to transportation to the shelter. Clause (2) 
3.15 	does not apply to counties in the Minneapolis-St. Paul metropolitan statistical area.
3.16 	(e) Migrant workers as defined in section 256J.08and, until March 31, 1998, their 
3.17 	immediate families are exempt from the residency requirements of this section, provided 
3.18 	the migrant worker provides verification that the migrant family worked in this state 
3.19 	within the last 12 months and earned at least $1,000 in gross wages during the time the 
3.20 	migrant worker worked in this state.
3.21 	(f) For purposes of eligibility for emergency general assistance, the 30-day residency 
3.22 	requirement under this section shall not be waived.
3.23 	(g) If any provision of this subdivision is enjoined from implementation or found 
3.24 	unconstitutional by any court of competent jurisdiction, the remaining provisions shall 
3.25 	remain valid and shall be given full effect.

3.26 	Sec. 3. Minnesota Statutes 2012, section 256D.04, is amended to read:
3.27 	256D.04 DUTIES OF THE COMMISSIONER.
3.28 	In addition to any other duties imposed by law, the commissioner shall:
3.29 	(1) supervise according to section 256.01 the administration of general assistance 
3.30 	and general assistance medical care by county agencies as provided in sections 256D.01 to 
3.31 	256D.21;
3.32 	(2) promulgate uniform rules consistent with law for carrying out and enforcing the 
3.33 	provisions of sections 256D.01 to 256D.21, including section 256D.05, subdivision 3, 
3.34 	and section 256.01, subdivision 2, paragraph (16), to the end that general assistance may 
3.35 	be administered as uniformly as possible throughout the state; rules shall be furnished 
4.1 	immediately to all county agencies and other interested persons; in promulgating rules, the 
4.2 	provisions of sections 14.001 to 14.69, shall apply;
4.3 	(3) allocate money appropriated for general assistance and general assistance medical 
4.4 	care to county agencies as provided in section 256D.03, subdivisions subdivision 2 and 3;
4.5 	(4) accept and supervise the disbursement of any funds that may be provided by the 
4.6 	federal government or from other sources for use in this state for general assistance and 
4.7 	general assistance medical care;
4.8 	(5) cooperate with other agencies including any agency of the United States or of 
4.9 	another state in all matters concerning the powers and duties of the commissioner under 
4.10 	sections 256D.01 to 256D.21;
4.11 	(6) cooperate to the fullest extent with other public agencies empowered by law to 
4.12 	provide vocational training, rehabilitation, or similar services;
4.13 	(7) gather and study current information and report at least annually to the governor 
4.14 	on the nature and need for general assistance and general assistance medical care, the 
4.15 	amounts expended under the supervision of each county agency, and the activities of each 
4.16 	county agency and publish such reports for the information of the public;
4.17 	(8) specify requirements for general assistance and general assistance medical care
4.18 	 reports, including fiscal reports, according to section 256.01, subdivision 2, paragraph 
4.19 	(17); and
4.20 	(9) ensure that every notice of eligibility for general assistance includes a notice that 
4.21 	women who are pregnant may be eligible for medical assistance benefits.

4.22 	Sec. 4. Minnesota Statutes 2012, section 256D.045, is amended to read:
4.23 	256D.045 SOCIAL SECURITY NUMBER REQUIRED.
4.24 	To be eligible for general assistance under sections 256D.01 to 256D.21, an individual 
4.25 	must provide the individual's Social Security number to the county agency or submit proof 
4.26 	that an application has been made. An individual who refuses to provide a Social Security 
4.27 	number because of a well-established religious objection as described in Code of Federal 
4.28 	Regulations, title 42, section 435.910, may be eligible for general assistance medical care 
4.29 	under section 256D.03. The provisions of this section do not apply to the determination of 
4.30 	eligibility for emergency general assistance under section 256D.06, subdivision 2. This 
4.31 	provision applies to eligible children under the age of 18 effective July 1, 1997.

4.32 	Sec. 5. Minnesota Statutes 2012, section 256D.07, is amended to read:
4.33 	256D.07 TIME OF PAYMENT OF ASSISTANCE.
5.1 	An applicant for general assistance or general assistance medical care authorized 
5.2 	by section 256D.03, subdivision 3, shall be deemed eligible if the application and the 
5.3 	verification of the statement on that application demonstrate that the applicant is within 
5.4 	the eligibility criteria established by sections 256D.01 to 256D.21 and any applicable rules 
5.5 	of the commissioner. Any person requesting general assistance or general assistance 
5.6 	medical care shall be permitted by the county agency to make an application for assistance 
5.7 	as soon as administratively possible and in no event later than the fourth day following 
5.8 	the date on which assistance is first requested, and no county agency shall require that a 
5.9 	person requesting assistance appear at the offices of the county agency more than once 
5.10 	prior to the date on which the person is permitted to make the application. The application 
5.11 	shall be in writing in the manner and upon the form prescribed by the commissioner 
5.12 	and attested to by the oath of the applicant or in lieu thereof shall contain the following 
5.13 	declaration which shall be signed by the applicant: "I declare that this application has 
5.14 	been examined by me and to the best of my knowledge and belief is a true and correct 
5.15 	statement of every material point." On the date that general assistance is first requested, 
5.16 	the county agency shall inquire and determine whether the person requesting assistance 
5.17 	is in immediate need of food, shelter, clothing, assistance for necessary transportation, 
5.18 	or other emergency assistance pursuant to section 256D.06, subdivision 2. A person in 
5.19 	need of emergency assistance shall be granted emergency assistance immediately, and 
5.20 	necessary emergency assistance shall continue for up to 30 days following the date of 
5.21 	application. A determination of an applicant's eligibility for general assistance shall be 
5.22 	made by the county agency as soon as the required verifications are received by the county 
5.23 	agency and in no event later than 30 days following the date that the application is made. 
5.24 	Any verifications required of the applicant shall be reasonable, and the commissioner 
5.25 	shall by rule establish reasonable verifications. General assistance shall be granted to an 
5.26 	eligible applicant without the necessity of first securing action by the board of the county 
5.27 	agency. The first month's grant must be computed to cover the time period starting with 
5.28 	the date a signed application form is received by the county agency or from the date that 
5.29 	the applicant meets all eligibility factors, whichever occurs later.
5.30 	If upon verification and due investigation it appears that the applicant provided 
5.31 	false information and the false information materially affected the applicant's eligibility 
5.32 	for general assistance or general assistance medical care provided pursuant to section 
5.33 	256D.03, subdivision 3, or the amount of the applicant's general assistance grant, the 
5.34 	county agency may refer the matter to the county attorney. The county attorney may 
5.35 	commence a criminal prosecution or a civil action for the recovery of any general 
5.36 	assistance wrongfully received, or both.

6.1 	Sec. 6. Minnesota Statutes 2012, section 256I.04, subdivision 3, is amended to read:
6.2 		Subd. 3.Moratorium on development of group residential housing beds. (a) 
6.3 	County agencies shall not enter into agreements for new group residential housing beds 
6.4 	with total rates in excess of the MSA equivalent rate except:
6.5 	(1) for group residential housing establishments licensed under Minnesota Rules, 
6.6 	parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction 
6.7 	targets for persons with developmental disabilities at regional treatment centers;
6.8 	(2) to ensure compliance with the federal Omnibus Budget Reconciliation Act 
6.9 	alternative disposition plan requirements for inappropriately placed persons with 
6.10 	developmental disabilities or mental illness;
6.11 	(3)(2) up to 80 beds in a single, specialized facility located in Hennepin County 
6.12 	that will provide housing for chronic inebriates who are repetitive users of detoxification 
6.13 	centers and are refused placement in emergency shelters because of their state of 
6.14 	intoxication, and planning for the specialized facility must have been initiated before July 
6.15 	1, 1991, in anticipation of receiving a grant from the Housing Finance Agency under 
6.16 	section 462A.05, subdivision 20a, paragraph (b);
6.17 	(4) (3) notwithstanding the provisions of subdivision 2a, for up to 190 supportive 
6.18 	housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults with a 
6.19 	mental illness, a history of substance abuse, or human immunodeficiency virus or acquired 
6.20 	immunodeficiency syndrome. For purposes of this section, "homeless adult" means a 
6.21 	person who is living on the street or in a shelter or discharged from a regional treatment 
6.22 	center, community hospital, or residential treatment program and has no appropriate 
6.23 	housing available and lacks the resources and support necessary to access appropriate 
6.24 	housing. At least 70 percent of the supportive housing units must serve homeless adults 
6.25 	with mental illness, substance abuse problems, or human immunodeficiency virus or 
6.26 	acquired immunodeficiency syndrome who are about to be or, within the previous six 
6.27 	months, has been discharged from a regional treatment center, or a state-contracted 
6.28 	psychiatric bed in a community hospital, or a residential mental health or chemical 
6.29 	dependency treatment program. If a person meets the requirements of subdivision 1, 
6.30 	paragraph (a), and receives a federal or state housing subsidy, the group residential housing 
6.31 	rate for that person is limited to the supplementary rate under section 256I.05, subdivision 
6.32 	1a, and is determined by subtracting the amount of the person's countable income that 
6.33 	exceeds the MSA equivalent rate from the group residential housing supplementary rate. 
6.34 	A resident in a demonstration project site who no longer participates in the demonstration 
6.35 	program shall retain eligibility for a group residential housing payment in an amount 
6.36 	determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service 
7.1 	funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching 
7.2 	funds are available and the services can be provided through a managed care entity. If 
7.3 	federal matching funds are not available, then service funding will continue under section 
7.4 	256I.05, subdivision 1a;
7.5 	(5) for group residential housing beds in settings meeting the requirements of 
7.6 	subdivision 2a, clauses (1) and (3), which are used exclusively for recipients receiving 
7.7 	home and community-based waiver services under sections 256B.0915, 256B.092, 
7.8 	subdivision 5, 256B.093, and 256B.49, and who resided in a nursing facility for the six 
7.9 	months immediately prior to the month of entry into the group residential housing setting. 
7.10 	The group residential housing rate for these beds must be set so that the monthly group 
7.11 	residential housing payment for an individual occupying the bed when combined with the 
7.12 	nonfederal share of services delivered under the waiver for that person does not exceed the 
7.13 	nonfederal share of the monthly medical assistance payment made for the person to the 
7.14 	nursing facility in which the person resided prior to entry into the group residential housing 
7.15 	establishment. The rate may not exceed the MSA equivalent rate plus $426.37 for any case;
7.16 	(6) (4) for an additional two beds, resulting in a total of 32 beds, for a facility located 
7.17 	in Hennepin County providing services for recovering and chemically dependent men that 
7.18 	has had a group residential housing contract with the county and has been licensed as a 
7.19 	board and lodge facility with special services since 1980;
7.20 	(7) (5) for a group residential housing provider located in the city of St. Cloud, 
7.21 	or a county contiguous to the city of St. Cloud, that operates a 40-bed facility, 
7.22 	that received financing through the Minnesota Housing Finance Agency Ending 
7.23 	Long-Term Homelessness Initiative and serves chemically dependent clientele, providing 
7.24 	24-hour-a-day supervision;
7.25 	(8) (6) for a new 65-bed facility in Crow Wing County that will serve chemically 
7.26 	dependent persons, operated by a group residential housing provider that currently 
7.27 	operates a 304-bed facility in Minneapolis, and a 44-bed facility in Duluth;
7.28 	(9) (7) for a group residential housing provider that operates two ten-bed facilities, 
7.29 	one located in Hennepin County and one located in Ramsey County, that provide 
7.30 	community support and 24-hour-a-day supervision to serve the mental health needs of 
7.31 	individuals who have chronically lived unsheltered; and
7.32 	(10) (8) for a group residential facility in Hennepin County with a capacity of up to 
7.33 	48 beds that has been licensed since 1978 as a board and lodging facility and that until 
7.34 	August 1, 2007, operated as a licensed chemical dependency treatment program.
7.35 	(b) A county agency may enter into a group residential housing agreement for beds 
7.36 	with rates in excess of the MSA equivalent rate in addition to those currently covered 
8.1 	under a group residential housing agreement if the additional beds are only a replacement 
8.2 	of beds with rates in excess of the MSA equivalent rate which have been made available 
8.3 	due to closure of a setting, a change of licensure or certification which removes the beds 
8.4 	from group residential housing payment, or as a result of the downsizing of a group 
8.5 	residential housing setting. The transfer of available beds from one county to another can 
8.6 	only occur by the agreement of both counties.

8.7 	Sec. 7. Minnesota Statutes 2012, section 256I.05, subdivision 1c, is amended to read:
8.8 		Subd. 1c.Rate increases. A county agency may not increase the rates negotiated 
8.9 	for group residential housing above those in effect on June 30, 1993, except as provided in 
8.10 	paragraphs (a) to (g) (f).
8.11 	(a) A county may increase the rates for group residential housing settings to the MSA 
8.12 	equivalent rate for those settings whose current rate is below the MSA equivalent rate.
8.13 	(b) A county agency may increase the rates for residents in adult foster care whose 
8.14 	difficulty of care has increased. The total group residential housing rate for these residents 
8.15 	must not exceed the maximum rate specified in subdivisions 1 and 1a. County agencies 
8.16 	must not include nor increase group residential housing difficulty of care rates for adults in 
8.17 	foster care whose difficulty of care is eligible for funding by home and community-based 
8.18 	waiver programs under title XIX of the Social Security Act.
8.19 	(c) The room and board rates will be increased each year when the MSA equivalent 
8.20 	rate is adjusted for SSI cost-of-living increases by the amount of the annual SSI increase, 
8.21 	less the amount of the increase in the medical assistance personal needs allowance under 
8.22 	section 256B.35.
8.23 	(d) When a group residential housing rate is used to pay for an individual's room 
8.24 	and board, or other costs necessary to provide room and board, the rate payable to 
8.25 	the residence must continue for up to 18 calendar days per incident that the person is 
8.26 	temporarily absent from the residence, not to exceed 60 days in a calendar year, if the 
8.27 	absence or absences have received the prior approval of the county agency's social service 
8.28 	staff. Prior approval is not required for emergency absences due to crisis, illness, or injury.
8.29 	(e) For facilities meeting substantial change criteria within the prior year. Substantial 
8.30 	change criteria exists if the group residential housing establishment experiences a 25 
8.31 	percent increase or decrease in the total number of its beds, if the net cost of capital 
8.32 	additions or improvements is in excess of 15 percent of the current market value of the 
8.33 	residence, or if the residence physically moves, or changes its licensure, and incurs a 
8.34 	resulting increase in operation and property costs.
9.1 	(f) Until June 30, 1994, a county agency may increase by up to five percent the total 
9.2 	rate paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 
9.3 	256D.54 who reside in residences that are licensed by the commissioner of health as 
9.4 	a boarding care home, but are not certified for the purposes of the medical assistance 
9.5 	program. However, an increase under this clause must not exceed an amount equivalent to 
9.6 	65 percent of the 1991 medical assistance reimbursement rate for nursing home resident 
9.7 	class A, in the geographic grouping in which the facility is located, as established under 
9.8 	Minnesota Rules, parts 9549.0050 to 9549.0058.
9.9 	(g) For the rate year beginning July 1, 1996, a county agency may increase the total 
9.10 	rate paid for recipients of assistance under sections 256D.01 to 256D.21 or 256D.33 to 
9.11 	256D.54 who reside in a residence that meets the following criteria:
9.12 	(1) it is licensed by the commissioner of health as a boarding care home;
9.13 	(2) it is not certified for the purposes of the medical assistance program;
9.14 	(3) at least 50 percent of its residents have a primary diagnosis of mental illness;
9.15 	(4) it has at least 17 beds; and
9.16 	(5) it provides medication administration to residents.
9.17 	The rate following an increase under this paragraph must not exceed an amount 
9.18 	equivalent to the average 1995 medical assistance payment for nursing home resident 
9.19 	class A under the age of 65, in the geographic grouping in which the facility is located, as 
9.20 	established under Minnesota Rules, parts 9549.0010 to 9549.0080.

9.21 	Sec. 8. Minnesota Statutes 2012, section 256J.425, subdivision 4, is amended to read:
9.22 		Subd. 4.Employed participants. (a) An assistance unit subject to the time limit 
9.23 	under section 256J.42, subdivision 1, is eligible to receive assistance under a hardship 
9.24 	extension if the participant who reached the time limit belongs to:
9.25 	(1) a one-parent assistance unit in which the participant is participating in work 
9.26 	activities for at least 30 hours per week, of which an average of at least 25 hours per week 
9.27 	every month are spent participating in employment;
9.28 	(2) a two-parent assistance unit in which the participants are participating in work 
9.29 	activities for at least 55 hours per week, of which an average of at least 45 hours per week 
9.30 	every month are spent participating in employment; or
9.31 	(3) an assistance unit in which a participant is participating in employment for fewer 
9.32 	hours than those specified in clause (1), and the participant submits verification from a 
9.33 	qualified professional, in a form acceptable to the commissioner, stating that the number 
9.34 	of hours the participant may work is limited due to illness or disability, as long as the 
9.35 	participant is participating in employment for at least the number of hours specified by the 
10.1 	qualified professional. The participant must be following the treatment recommendations 
10.2 	of the qualified professional providing the verification. The commissioner shall develop a 
10.3 	form to be completed and signed by the qualified professional, documenting the diagnosis 
10.4 	and any additional information necessary to document the functional limitations of the 
10.5 	participant that limit work hours. If the participant is part of a two-parent assistance unit, 
10.6 	the other parent must be treated as a one-parent assistance unit for purposes of meeting the 
10.7 	work requirements under this subdivision.
10.8 	(b) For purposes of this section, employment means:
10.9 	(1) unsubsidized employment under section 256J.49, subdivision 13, clause (1);
10.10 	(2) subsidized employment under section 256J.49, subdivision 13, clause (2);
10.11 	(3) on-the-job training under section 256J.49, subdivision 13, clause (2);
10.12 	(4) an apprenticeship under section 256J.49, subdivision 13, clause (1);
10.13 	(5) supported work under section 256J.49, subdivision 13, clause (2);
10.14 	(6) a combination of clauses (1) to (5); or
10.15 	(7) child care under section 256J.49, subdivision 13, clause (7), if it is in combination 
10.16 	with paid employment.
10.17 	(c) If a participant is complying with a child protection plan under chapter 260C, 
10.18 	the number of hours required under the child protection plan count toward the number 
10.19 	of hours required under this subdivision.
10.20 	(d) The county shall provide the opportunity for subsidized employment to 
10.21 	participants needing that type of employment within available appropriations.
10.22 	(e) To be eligible for a hardship extension for employed participants under this 
10.23 	subdivision, a participant must be in compliance for at least ten out of the 12 months 
10.24 	the participant received MFIP immediately preceding the participant's 61st month on 
10.25 	assistance. If ten or fewer months of eligibility for TANF assistance remain at the time the 
10.26 	participant from another state applies for assistance, the participant must be in compliance 
10.27 	every month.
10.28 	(f) The employment plan developed under section 256J.521, subdivision 2, for 
10.29 	participants under this subdivision must contain at least the minimum number of hours 
10.30 	specified in paragraph (a) for the purpose of meeting the requirements for an extension 
10.31 	under this subdivision. The job counselor and the participant must sign the employment 
10.32 	plan to indicate agreement between the job counselor and the participant on the contents 
10.33 	of the plan.
10.34 	(g) Participants who fail to meet the requirements in paragraph (a), without good 
10.35 	cause under section 256J.57, shall be sanctioned or permanently disqualified under 
10.36 	subdivision 6. Good cause may only be granted for that portion of the month for which 
11.1 	the good cause reason applies. Participants must meet all remaining requirements in the 
11.2 	approved employment plan or be subject to sanction or permanent disqualification.
11.3 	(h) If the noncompliance with an employment plan is due to the involuntary loss of 
11.4 	employment, the participant is exempt from the hourly employment requirement under 
11.5 	this subdivision for one month. Participants must meet all remaining requirements in the 
11.6 	approved employment plan or be subject to sanction or permanent disqualification. This 
11.7 	exemption is available to each participant two times in a 12-month period.

11.8 	Sec. 9. Minnesota Statutes 2012, section 518A.65, is amended to read:
11.9 	518A.65 DRIVER'S LICENSE SUSPENSION.
11.10 	(a) Upon motion of an obligee, which has been properly served on the obligor and 
11.11 	upon which there has been an opportunity for hearing, if a court finds that the obligor has 
11.12 	been or may be issued a driver's license by the commissioner of public safety and the 
11.13 	obligor is in arrears in court-ordered child support or maintenance payments, or both, 
11.14 	in an amount equal to or greater than three times the obligor's total monthly support 
11.15 	and maintenance payments and is not in compliance with a written payment agreement 
11.16 	pursuant to section 518A.69 that is approved by the court, a child support magistrate, or 
11.17 	the public authority, the court shall order the commissioner of public safety to suspend the 
11.18 	obligor's driver's license. The court's order must be stayed for 90 days in order to allow the 
11.19 	obligor to execute a written payment agreement pursuant to section 518A.69. The payment 
11.20 	agreement must be approved by either the court or the public authority responsible for 
11.21 	child support enforcement. If the obligor has not executed or is not in compliance with 
11.22 	a written payment agreement pursuant to section 518A.69 after the 90 days expires, the 
11.23 	court's order becomes effective and the commissioner of public safety shall suspend 
11.24 	the obligor's driver's license. The remedy under this section is in addition to any other 
11.25 	enforcement remedy available to the court. An obligee may not bring a motion under this 
11.26 	paragraph within 12 months of a denial of a previous motion under this paragraph.
11.27 	(b) If a public authority responsible for child support enforcement determines that 
11.28 	the obligor has been or may be issued a driver's license by the commissioner of public 
11.29 	safety and the obligor is in arrears in court-ordered child support or maintenance payments 
11.30 	or both in an amount equal to or greater than three times the obligor's total monthly support 
11.31 	and maintenance payments and not in compliance with a written payment agreement 
11.32 	pursuant to section 518A.69 that is approved by the court, a child support magistrate, or 
11.33 	the public authority, the public authority shall direct the commissioner of public safety to 
11.34 	suspend the obligor's driver's license. The remedy under this section is in addition to any 
11.35 	other enforcement remedy available to the public authority.
12.1 	(c) At least 90 days prior to notifying the commissioner of public safety according 
12.2 	to paragraph (b), the public authority must mail a written notice to the obligor at the 
12.3 	obligor's last known address, that it intends to seek suspension of the obligor's driver's 
12.4 	license and that the obligor must request a hearing within 30 days in order to contest the 
12.5 	suspension. If the obligor makes a written request for a hearing within 30 days of the date 
12.6 	of the notice, a court hearing must be held. Notwithstanding any law to the contrary, the 
12.7 	obligor must be served with 14 days' notice in writing specifying the time and place of the 
12.8 	hearing and the allegations against the obligor. The notice must include information that 
12.9 	apprises the obligor of the requirement to develop a written payment agreement that is 
12.10 	approved by a court, a child support magistrate, or the public authority responsible for 
12.11 	child support enforcement regarding child support, maintenance, and any arrearages in 
12.12 	order to avoid license suspension. The notice may be served personally or by mail. If 
12.13 	the public authority does not receive a request for a hearing within 30 days of the date 
12.14 	of the notice, and the obligor does not execute a written payment agreement pursuant to 
12.15 	section 518A.69 that is approved by the public authority within 90 days of the date of the 
12.16 	notice, the public authority shall direct the commissioner of public safety to suspend the 
12.17 	obligor's driver's license under paragraph (b).
12.18 	(d) At a hearing requested by the obligor under paragraph (c), and on finding that 
12.19 	the obligor is in arrears in court-ordered child support or maintenance payments or both 
12.20 	in an amount equal to or greater than three times the obligor's total monthly support 
12.21 	and maintenance payments, the district court or child support magistrate shall order the 
12.22 	commissioner of public safety to suspend the obligor's driver's license or operating 
12.23 	privileges unless the court or child support magistrate determines that the obligor has 
12.24 	executed and is in compliance with a written payment agreement pursuant to section 
12.25 	518A.69 that is approved by the court, a child support magistrate, or the public authority.
12.26 	(e) An obligor whose driver's license or operating privileges are suspended may:
12.27 	(1) provide proof to the public authority responsible for child support enforcement 
12.28 	that the obligor is in compliance with all written payment agreements pursuant to section 
12.29 	518A.69;
12.30 	(2) bring a motion for reinstatement of the driver's license. At the hearing, if the 
12.31 	court or child support magistrate orders reinstatement of the driver's license, the court or 
12.32 	child support magistrate must establish a written payment agreement pursuant to section 
12.33 	518A.69; or
12.34 	(3) seek a limited license under section 171.30. A limited license issued to an obligor 
12.35 	under section 171.30 expires 90 days after the date it is issued.
13.1 	Within 15 days of the receipt of that proof or a court order, the public authority shall 
13.2 	inform the commissioner of public safety that the obligor's driver's license or operating 
13.3 	privileges should no longer be suspended.
13.4 	(f) On January 15, 1997, and every two years after that, the commissioner of human 
13.5 	services shall submit a report to the legislature that identifies the following information 
13.6 	relevant to the implementation of this section:
13.7 	(1) the number of child support obligors notified of an intent to suspend a driver's 
13.8 	license;
13.9 	(2) the amount collected in payments from the child support obligors notified of an 
13.10 	intent to suspend a driver's license;
13.11 	(3) the number of cases paid in full and payment agreements executed in response 
13.12 	to notification of an intent to suspend a driver's license;
13.13 	(4) the number of cases in which there has been notification and no payments or 
13.14 	payment agreements;
13.15 	(5) the number of driver's licenses suspended;
13.16 	(6) the cost of implementation and operation of the requirements of this section; and
13.17 	(7) the number of limited licenses issued and number of cases in which payment 
13.18 	agreements are executed and cases are paid in full following issuance of a limited license.
13.19 	(g)(f) In addition to the criteria established under this section for the suspension of 
13.20 	an obligor's driver's license, a court, a child support magistrate, or the public authority 
13.21 	may direct the commissioner of public safety to suspend the license of a party who has 
13.22 	failed, after receiving notice, to comply with a subpoena relating to a paternity or child 
13.23 	support proceeding. Notice to an obligor of intent to suspend must be served by first class 
13.24 	mail at the obligor's last known address. The notice must inform the obligor of the right to 
13.25 	request a hearing. If the obligor makes a written request within ten days of the date of 
13.26 	the hearing, a hearing must be held. At the hearing, the only issues to be considered are 
13.27 	mistake of fact and whether the obligor received the subpoena.
13.28 	(h) (g) The license of an obligor who fails to remain in compliance with an 
13.29 	approved written payment agreement may be suspended. Prior to suspending a license for 
13.30 	noncompliance with an approved written payment agreement, the public authority must 
13.31 	mail to the obligor's last known address a written notice that (1) the public authority 
13.32 	intends to seek suspension of the obligor's driver's license under this paragraph, and (2) 
13.33 	the obligor must request a hearing, within 30 days of the date of the notice, to contest the 
13.34 	suspension. If, within 30 days of the date of the notice, the public authority does not 
13.35 	receive a written request for a hearing and the obligor does not comply with an approved 
13.36 	written payment agreement, the public authority must direct the Department of Public 
14.1 	Safety to suspend the obligor's license under paragraph (b). If the obligor makes a written 
14.2 	request for a hearing within 30 days of the date of the notice, a court hearing must be held. 
14.3 	Notwithstanding any law to the contrary, the obligor must be served with 14 days' notice in 
14.4 	writing specifying the time and place of the hearing and the allegations against the obligor. 
14.5 	The notice may be served personally or by mail at the obligor's last known address. If 
14.6 	the obligor appears at the hearing and the court determines that the obligor has failed to 
14.7 	comply with an approved written payment agreement, the court or public authority shall 
14.8 	notify the Department of Public Safety to suspend the obligor's license under paragraph 
14.9 	(b). If the obligor fails to appear at the hearing, the court or public authority must notify 
14.10 	the Department of Public Safety to suspend the obligor's license under paragraph (b).

14.11 	Sec. 10. Laws 2013, chapter 108, article 3, section 48, is amended to read:
14.12 	Sec. 48. REPEALER.
 14.13 	(a) Minnesota Statutes 2012, section 256J.24, subdivision 6, is repealed January 
14.14 	1, 2015.
14.15 	(b) Minnesota Statutes 2012, section 609.093, is repealed effective the day following 
14.16 	final enactment.

14.17 	Sec. 11. TRANSITION; PROVISIONS GOVERNING PERFORMANCE BASE 
14.18 	FUNDS.
 14.19 	(a) Laws 2013, chapter 107, article 4, section 19, is repealed effective January 1, 2016.
14.20 	(b) Laws 2013, chapter 108, article 3, section 31, is effective January 1, 2016.

14.21 	Sec. 12.  REPEALER.
 14.22 	(a) Minnesota Statutes 2012, sections 119A.04, subdivision 1; 119B.035; 119B.09, 
14.23 	subdivision 2; 119B.23; 119B.231; 119B.232; 256.01, subdivisions 3, 14, and 14a; 
14.24 	256.9792; 256D.02, subdivision 19; 256D.05, subdivision 4; 256D.46; 256I.05, 
14.25 	subdivisions 1b and 5; 256I.07; 256K.35; 259.85, subdivisions 2, 3, 4, and 5; 518A.53, 
14.26 	subdivision 7; 518A.74; and 626.5593, are repealed.
14.27 	(b) Minnesota Statutes 2012, section 256J.24, subdivision 10, is repealed effective 
14.28 	October 1, 2014.
14.29 	(c) Minnesota Statutes 2013 Supplement, section 259.85, subdivision 1, is repealed.

14.30 	ARTICLE 2
14.31 	HEALTH CARE

14.32 	Section 1. Minnesota Statutes 2012, section 256.963, subdivision 2, is amended to read:
15.1 		Subd. 2.Evaluation. (a) The grantee must report to the commissioner on a quarterly 
15.2 	basis the following information:
15.3 	(1) the total number of appointments available for scheduling by specialty;
15.4 	(2) the average length of time between scheduling and actual appointment;
15.5 	(3) the total number of patients referred and whether the patient was insured or 
15.6 	uninsured; and
15.7 	(4) the total number of appointments resulting in visits completed and number of 
15.8 	patients continuing services with the referring clinic.
15.9 	(b) The commissioner, in consultation with the Minnesota Hospital Association, 
15.10 	shall conduct an evaluation of the emergency room diversion pilot project and submit the 
15.11 	results to the legislature by January 15, 2009. The evaluation shall compare the number of 
15.12 	nonemergency visits and repeat visits to hospital emergency rooms for the period before 
15.13 	the commencement of the project and one year after the commencement, and an estimate 
15.14 	of the costs saved from any documented reductions.

15.15 	Sec. 2. Minnesota Statutes 2012, section 256.969, subdivision 9, is amended to read:
15.16 		Subd. 9.Disproportionate numbers of low-income patients served. (a) For 
15.17 	admissions occurring on or after October 1, 1992, through December 31, 1992, the 
15.18 	medical assistance disproportionate population adjustment shall comply with federal law 
15.19 	and shall be paid to a hospital, excluding regional treatment centers and facilities of the 
15.20 	federal Indian Health Service, with a medical assistance inpatient utilization rate in excess 
15.21 	of the arithmetic mean. The adjustment must be determined as follows:
15.22 	(1) for a hospital with a medical assistance inpatient utilization rate above the 
15.23 	arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 
15.24 	federal Indian Health Service but less than or equal to one standard deviation above the 
15.25 	mean, the adjustment must be determined by multiplying the total of the operating and 
15.26 	property payment rates by the difference between the hospital's actual medical assistance 
15.27 	inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 
15.28 	treatment centers and facilities of the federal Indian Health Service; and
15.29 	(2) for a hospital with a medical assistance inpatient utilization rate above one 
15.30 	standard deviation above the mean, the adjustment must be determined by multiplying 
15.31 	the adjustment that would be determined under clause (1) for that hospital by 1.1. If 
15.32 	federal matching funds are not available for all adjustments under this subdivision, the 
15.33 	commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for 
15.34 	federal match. The commissioner may establish a separate disproportionate population 
15.35 	operating payment rate adjustment under the general assistance medical care program. 
16.1 	For purposes of this subdivision medical assistance does not include general assistance 
16.2 	medical care. The commissioner shall report annually on the number of hospitals likely to 
16.3 	receive the adjustment authorized by this paragraph. The commissioner shall specifically 
16.4 	report on the adjustments received by public hospitals and public hospital corporations 
16.5 	located in cities of the first class.
16.6 	(b) (a) For admissions occurring on or after July 1, 1993, the medical assistance 
16.7 	disproportionate population adjustment shall comply with federal law and shall be paid to 
16.8 	a hospital, excluding regional treatment centers and facilities of the federal Indian Health 
16.9 	Service, with a medical assistance inpatient utilization rate in excess of the arithmetic 
16.10 	mean. The adjustment must be determined as follows:
16.11 	(1) for a hospital with a medical assistance inpatient utilization rate above the 
16.12 	arithmetic mean for all hospitals excluding regional treatment centers and facilities of the 
16.13 	federal Indian Health Service but less than or equal to one standard deviation above the 
16.14 	mean, the adjustment must be determined by multiplying the total of the operating and 
16.15 	property payment rates by the difference between the hospital's actual medical assistance 
16.16 	inpatient utilization rate and the arithmetic mean for all hospitals excluding regional 
16.17 	treatment centers and facilities of the federal Indian Health Service;
16.18 	(2) for a hospital with a medical assistance inpatient utilization rate above one 
16.19 	standard deviation above the mean, the adjustment must be determined by multiplying 
16.20 	the adjustment that would be determined under clause (1) for that hospital by 1.1. The 
16.21 	commissioner may establish a separate disproportionate population operating payment 
16.22 	rate adjustment under the general assistance medical care program. For purposes of this 
16.23 	subdivision, medical assistance does not include general assistance medical care. The 
16.24 	commissioner shall report annually on the number of hospitals likely to receive the 
16.25 	adjustment authorized by this paragraph. The commissioner shall specifically report on 
16.26 	the adjustments received by public hospitals and public hospital corporations located 
16.27 	in cities of the first class;
16.28 	(3) for a hospital that had medical assistance fee-for-service payment volume during 
16.29 	calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service 
16.30 	payment volume, a medical assistance disproportionate population adjustment shall be 
16.31 	paid in addition to any other disproportionate payment due under this subdivision as 
16.32 	follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995. 
16.33 	For a hospital that had medical assistance fee-for-service payment volume during calendar 
16.34 	year 1991 in excess of eight percent of total medical assistance fee-for-service payment 
16.35 	volume and was the primary hospital affiliated with the University of Minnesota, a 
16.36 	medical assistance disproportionate population adjustment shall be paid in addition to any 
17.1 	other disproportionate payment due under this subdivision as follows: $505,000 due on 
17.2 	the 15th of each month after noon, beginning July 15, 1995; and
17.3 	(4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be 
17.4 	reduced to zero.
17.5 	(c) (b) The commissioner shall adjust rates paid to a health maintenance organization 
17.6 	under contract with the commissioner to reflect rate increases provided in paragraph (b)
17.7 	 (a), clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust 
17.8 	those rates to reflect payments provided in paragraph (a), clause (3).
17.9 	(d) (c) If federal matching funds are not available for all adjustments under paragraph 
17.10 	(b) (a), the commissioner shall reduce payments under paragraph (b) (a), clauses (1) and (2), 
17.11 	on a pro rata basis so that all adjustments under paragraph (b) (a) qualify for federal match.
17.12 	(e) (d) For purposes of this subdivision, medical assistance does not include general 
17.13 	assistance medical care.
17.14 	(f) (e) For hospital services occurring on or after July 1, 2005, to June 30, 2007:
17.15 	(1) general assistance medical care expenditures for fee-for-service inpatient and 
17.16 	outpatient hospital payments made by the department shall be considered Medicaid 
17.17 	disproportionate share hospital payments, except as limited below:
17.18 	 (i) only the portion of Minnesota's disproportionate share hospital allotment under 
17.19 	section 1923(f) of the Social Security Act that is not spent on the disproportionate 
17.20 	population adjustments in paragraph (b) (a), clauses (1) and (2), may be used for general 
17.21 	assistance medical care expenditures;
17.22 	 (ii) only those general assistance medical care expenditures made to hospitals that 
17.23 	qualify for disproportionate share payments under section 1923 of the Social Security Act 
17.24 	and the Medicaid state plan may be considered disproportionate share hospital payments;
17.25 	 (iii) only those general assistance medical care expenditures made to an individual 
17.26 	hospital that would not cause the hospital to exceed its individual hospital limits under 
17.27 	section 1923 of the Social Security Act may be considered; and
17.28 	 (iv) general assistance medical care expenditures may be considered only to the 
17.29 	extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
17.30 	All hospitals and prepaid health plans participating in general assistance medical care 
17.31 	must provide any necessary expenditure, cost, and revenue information required by the 
17.32 	commissioner as necessary for purposes of obtaining federal Medicaid matching funds for 
17.33 	general assistance medical care expenditures; and
17.34 	(2) certified public expenditures made by Hennepin County Medical Center shall 
17.35 	be considered Medicaid disproportionate share hospital payments. Hennepin County 
17.36 	and Hennepin County Medical Center shall report by June 15, 2007, on payments made 
18.1 	beginning July 1, 2005, or another date specified by the commissioner, that may qualify 
18.2 	for reimbursement under federal law. Based on these reports, the commissioner shall 
18.3 	apply for federal matching funds.
18.4 	(g) (f) Upon federal approval of the related state plan amendment, paragraph (f) (e)
18.5 	 is effective retroactively from July 1, 2005, or the earliest effective date approved by the 
18.6 	Centers for Medicare and Medicaid Services.

18.7 	Sec. 3. Minnesota Statutes 2012, section 256B.69, subdivision 2, is amended to read:
18.8 		Subd. 2.Definitions. For the purposes of this section, the following terms have 
18.9 	the meanings given.
18.10 	(a) "Commissioner" means the commissioner of human services. For the 
18.11 	remainder of this section, the commissioner's responsibilities for methods and policies 
18.12 	for implementing the project will be proposed by the project advisory committees and 
18.13 	approved by the commissioner.
18.14 	(b) "Demonstration provider" means a health maintenance organization, community 
18.15 	integrated service network, or accountable provider network authorized and operating 
18.16 	under chapter 62D, 62N, or 62T that participates in the demonstration project according 
18.17 	to criteria, standards, methods, and other requirements established for the project and 
18.18 	approved by the commissioner. For purposes of this section, a county board, or group of 
18.19 	county boards operating under a joint powers agreement, is considered a demonstration 
18.20 	provider if the county or group of county boards meets the requirements of section 
18.21 	256B.692. Notwithstanding the above, Itasca County may continue to participate as a 
18.22 	demonstration provider until July 1, 2004.
18.23 	(c) "Eligible individuals" means those persons eligible for medical assistance 
18.24 	benefits as defined in sections 256B.055, 256B.056, and 256B.06.
18.25 	(d) "Limitation of choice" means suspending freedom of choice while allowing 
18.26 	eligible individuals to choose among the demonstration providers.

18.27 	Sec. 4. Minnesota Statutes 2012, section 256B.69, subdivision 4b, is amended to read:
18.28 		Subd. 4b.Individualized education program and individualized family service 
18.29 	plan services. The commissioner shall amend the federal waiver allowing the state 
18.30 	to separate out individualized education program and individualized family service 
18.31 	plan services for children enrolled in the prepaid medical assistance program and the 
18.32 	MinnesotaCare program. Effective July 1, 1999, or upon federal approval, Medical 
18.33 	assistance coverage of eligible individualized education program and individualized family 
18.34 	service plan services shall not be included in the capitated services for children enrolled 
19.1 	in health plans through the prepaid medical assistance program and the MinnesotaCare 
19.2 	program. Upon federal approval, Local school districts shall bill the commissioner for 
19.3 	these services, and claims shall be paid on a fee-for-service basis.

19.4 	Sec. 5. Minnesota Statutes 2012, section 256B.69, subdivision 5, is amended to read:
19.5 		Subd. 5.Prospective per capita payment. The commissioner shall establish the 
19.6 	method and amount of payments for services. The commissioner shall annually contract 
19.7 	with demonstration providers to provide services consistent with these established 
19.8 	methods and amounts for payment.
19.9 	If allowed by the commissioner, a demonstration provider may contract with an 
19.10 	insurer, health care provider, nonprofit health service plan corporation, or the commissioner, 
19.11 	to provide insurance or similar protection against the cost of care provided by the 
19.12 	demonstration provider or to provide coverage against the risks incurred by demonstration 
19.13 	providers under this section. The recipients enrolled with a demonstration provider are 
19.14 	a permissible group under group insurance laws and chapter 62C, the Nonprofit Health 
19.15 	Service Plan Corporations Act. Under this type of contract, the insurer or corporation may 
19.16 	make benefit payments to a demonstration provider for services rendered or to be rendered 
19.17 	to a recipient. Any insurer or nonprofit health service plan corporation licensed to do 
19.18 	business in this state is authorized to provide this insurance or similar protection.
19.19 	Payments to providers participating in the project are exempt from the requirements 
19.20 	of sections 256.966 and 256B.03, subdivision 2. The commissioner shall complete 
19.21 	development of capitation rates for payments before delivery of services under this 
19.22 	section is begun. For payments made during calendar year 1990 and later years, The 
19.23 	commissioner shall contract with an independent actuary to establish prepayment rates.
19.24 	By January 15, 1996, the commissioner shall report to the legislature on the 
19.25 	methodology used to allocate to participating counties available administrative 
19.26 	reimbursement for advocacy and enrollment costs. The report shall reflect the 
19.27 	commissioner's judgment as to the adequacy of the funds made available and of the 
19.28 	methodology for equitable distribution of the funds. The commissioner must involve 
19.29 	participating counties in the development of the report.
19.30 	Beginning July 1, 2004, the commissioner may include payments for elderly waiver 
19.31 	services and 180 days of nursing home care in capitation payments for the prepaid medical 
19.32 	assistance program for recipients age 65 and older.

19.33 	Sec. 6. Minnesota Statutes 2012, section 256B.69, subdivision 5a, is amended to read:
20.1 		Subd. 5a.Managed care contracts. (a) Managed care contracts under this section 
20.2 	and section 256L.12 shall be entered into or renewed on a calendar year basis beginning 
20.3 	January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to 
20.4 	renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 
20.5 	31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may 
20.6 	issue separate contracts with requirements specific to services to medical assistance 
20.7 	recipients age 65 and older.
20.8 	(b) A prepaid health plan providing covered health services for eligible persons 
20.9 	pursuant to chapters 256B and 256L is responsible for complying with the terms of its 
20.10 	contract with the commissioner. Requirements applicable to managed care programs 
20.11 	under chapters 256B and 256L established after the effective date of a contract with the 
20.12 	commissioner take effect when the contract is next issued or renewed.
20.13 	(c) Effective for services rendered on or after January 1, 2003, The commissioner 
20.14 	shall withhold five percent of managed care plan payments under this section and 
20.15 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
20.16 	assistance program pending completion of performance targets. Each performance target 
20.17 	must be quantifiable, objective, measurable, and reasonably attainable, except in the case 
20.18 	of a performance target based on a federal or state law or rule. Criteria for assessment 
20.19 	of each performance target must be outlined in writing prior to the contract effective 
20.20 	date. Clinical or utilization performance targets and their related criteria must consider 
20.21 	evidence-based research and reasonable interventions when available or applicable to the 
20.22 	populations served, and must be developed with input from external clinical experts 
20.23 	and stakeholders, including managed care plans, county-based purchasing plans, and 
20.24 	providers. The managed care or county-based purchasing plan must demonstrate, 
20.25 	to the commissioner's satisfaction, that the data submitted regarding attainment of 
20.26 	the performance target is accurate. The commissioner shall periodically change the 
20.27 	administrative measures used as performance targets in order to improve plan performance 
20.28 	across a broader range of administrative services. The performance targets must include 
20.29 	measurement of plan efforts to contain spending on health care services and administrative 
20.30 	activities. The commissioner may adopt plan-specific performance targets that take into 
20.31 	account factors affecting only one plan, including characteristics of the plan's enrollee 
20.32 	population. The withheld funds must be returned no sooner than July of the following 
20.33 	year if performance targets in the contract are achieved. The commissioner may exclude 
20.34 	special demonstration projects under subdivision 23.
20.35 	(d) Effective for services rendered on or after January 1, 2009, through December 
20.36 	31, 2009, the commissioner shall withhold three percent of managed care plan payments 
21.1 	under this section and county-based purchasing plan payments under section 256B.692 
21.2 	for the prepaid medical assistance program. The withheld funds must be returned no 
21.3 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
21.4 	exclude special demonstration projects under subdivision 23.
21.5 	(e) Effective for services provided on or after January 1, 2010, (d) The commissioner 
21.6 	shall require that managed care plans use the assessment and authorization processes, 
21.7 	forms, timelines, standards, documentation, and data reporting requirements, protocols, 
21.8 	billing processes, and policies consistent with medical assistance fee-for-service or the 
21.9 	Department of Human Services contract requirements consistent with medical assistance 
21.10 	fee-for-service or the Department of Human Services contract requirements for all 
21.11 	personal care assistance services under section 256B.0659.
21.12 	(f) Effective for services rendered on or after January 1, 2010, through December 
21.13 	31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments 
21.14 	under this section and county-based purchasing plan payments under section 256B.692 
21.15 	for the prepaid medical assistance program. The withheld funds must be returned no 
21.16 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
21.17 	exclude special demonstration projects under subdivision 23.
21.18 	(g) Effective for services rendered on or after January 1, 2011, through December 
21.19 	31, 2011, the commissioner shall include as part of the performance targets described in 
21.20 	paragraph (c) a reduction in the health plan's emergency room utilization rate for state 
21.21 	health care program enrollees by a measurable rate of five percent from the plan's utilization 
21.22 	rate for state health care program enrollees for the previous calendar year. (e) Effective for 
21.23 	services rendered on or after January 1, 2012, the commissioner shall include as part of the 
21.24 	performance targets described in paragraph (c) a reduction in the health plan's emergency 
21.25 	department utilization rate for medical assistance and MinnesotaCare enrollees, as 
21.26 	determined by the commissioner. For 2012, the reduction shall be based on the health plan's 
21.27 	utilization in 2009. To earn the return of the withhold each subsequent year, the managed 
21.28 	care plan or county-based purchasing plan must achieve a qualifying reduction of no less 
21.29 	than ten percent of the plan's emergency department utilization rate for medical assistance 
21.30 	and MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 
21.31 	23 and 28, compared to the previous measurement year until the final performance target 
21.32 	is reached. When measuring performance, the commissioner must consider the difference 
21.33 	in health risk in a managed care or county-based purchasing plan's membership in the 
21.34 	baseline year compared to the measurement year, and work with the managed care or 
21.35 	county-based purchasing plan to account for differences that they agree are significant.
22.1 	The withheld funds must be returned no sooner than July 1 and no later than July 31 
22.2 	of the following calendar year if the managed care plan or county-based purchasing plan 
22.3 	demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate 
22.4 	was achieved. The commissioner shall structure the withhold so that the commissioner 
22.5 	returns a portion of the withheld funds in amounts commensurate with achieved reductions 
22.6 	in utilization less than the targeted amount.
22.7 	The withhold described in this paragraph shall continue for each consecutive contract 
22.8 	period until the plan's emergency room utilization rate for state health care program 
22.9 	enrollees is reduced by 25 percent of the plan's emergency room utilization rate for medical 
22.10 	assistance and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate 
22.11 	with the health plans in meeting this performance target and shall accept payment 
22.12 	withholds that may be returned to the hospitals if the performance target is achieved.
22.13 	(h) (f) Effective for services rendered on or after January 1, 2012, the commissioner 
22.14 	shall include as part of the performance targets described in paragraph (c) a reduction 
22.15 	in the plan's hospitalization admission rate for medical assistance and MinnesotaCare 
22.16 	enrollees, as determined by the commissioner. To earn the return of the withhold each 
22.17 	year, the managed care plan or county-based purchasing plan must achieve a qualifying 
22.18 	reduction of no less than five percent of the plan's hospital admission rate for medical 
22.19 	assistance and MinnesotaCare enrollees, excluding enrollees in programs described in 
22.20 	subdivisions 23 and 28, compared to the previous calendar year until the final performance 
22.21 	target is reached. When measuring performance, the commissioner must consider the 
22.22 	difference in health risk in a managed care or county-based purchasing plan's membership 
22.23 	in the baseline year compared to the measurement year, and work with the managed care 
22.24 	or county-based purchasing plan to account for differences that they agree are significant.
22.25 	The withheld funds must be returned no sooner than July 1 and no later than July 
22.26 	31 of the following calendar year if the managed care plan or county-based purchasing 
22.27 	plan demonstrates to the satisfaction of the commissioner that this reduction in the 
22.28 	hospitalization rate was achieved. The commissioner shall structure the withhold so that 
22.29 	the commissioner returns a portion of the withheld funds in amounts commensurate with 
22.30 	achieved reductions in utilization less than the targeted amount.
22.31 	The withhold described in this paragraph shall continue until there is a 25 percent 
22.32 	reduction in the hospital admission rate compared to the hospital admission rates in 
22.33 	calendar year 2011, as determined by the commissioner. The hospital admissions in this 
22.34 	performance target do not include the admissions applicable to the subsequent hospital 
22.35 	admission performance target under paragraph (i) (g). Hospitals shall cooperate with the 
23.1 	plans in meeting this performance target and shall accept payment withholds that may be 
23.2 	returned to the hospitals if the performance target is achieved.
23.3 	(i) (g) Effective for services rendered on or after January 1, 2012, the commissioner 
23.4 	shall include as part of the performance targets described in paragraph (c) a reduction in 
23.5 	the plan's hospitalization admission rates for subsequent hospitalizations within 30 days of 
23.6 	a previous hospitalization of a patient regardless of the reason, for medical assistance and 
23.7 	MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the 
23.8 	withhold each year, the managed care plan or county-based purchasing plan must achieve 
23.9 	a qualifying reduction of the subsequent hospitalization rate for medical assistance and 
23.10 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 
23.11 	and 28, of no less than five percent compared to the previous calendar year until the 
23.12 	final performance target is reached.
23.13 	The withheld funds must be returned no sooner than July 1 and no later than July 
23.14 	31 of the following calendar year if the managed care plan or county-based purchasing 
23.15 	plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in 
23.16 	the subsequent hospitalization rate was achieved. The commissioner shall structure the 
23.17 	withhold so that the commissioner returns a portion of the withheld funds in amounts 
23.18 	commensurate with achieved reductions in utilization less than the targeted amount.
23.19 	The withhold described in this paragraph must continue for each consecutive 
23.20 	contract period until the plan's subsequent hospitalization rate for medical assistance and 
23.21 	MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 
23.22 	and 28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar 
23.23 	year 2011. Hospitals shall cooperate with the plans in meeting this performance target and 
23.24 	shall accept payment withholds that must be returned to the hospitals if the performance 
23.25 	target is achieved.
23.26 	(j) Effective for services rendered on or after January 1, 2011, through December 31, 
23.27 	2011, the commissioner shall withhold 4.5 percent of managed care plan payments under 
23.28 	this section and county-based purchasing plan payments under section 256B.692 for the 
23.29 	prepaid medical assistance program. The withheld funds must be returned no sooner than 
23.30 	July 1 and no later than July 31 of the following year. The commissioner may exclude 
23.31 	special demonstration projects under subdivision 23.
23.32 	(k) Effective for services rendered on or after January 1, 2012, through December 
23.33 	31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments 
23.34 	under this section and county-based purchasing plan payments under section 256B.692 
23.35 	for the prepaid medical assistance program. The withheld funds must be returned no 
24.1 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
24.2 	exclude special demonstration projects under subdivision 23.
24.3 	(l) (h) Effective for services rendered on or after January 1, 2013, through December 
24.4 	31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments 
24.5 	under this section and county-based purchasing plan payments under section 256B.692 
24.6 	for the prepaid medical assistance program. The withheld funds must be returned no 
24.7 	sooner than July 1 and no later than July 31 of the following year. The commissioner may 
24.8 	exclude special demonstration projects under subdivision 23.
24.9 	(m) (i) Effective for services rendered on or after January 1, 2014, the commissioner 
24.10 	shall withhold three percent of managed care plan payments under this section and 
24.11 	county-based purchasing plan payments under section 256B.692 for the prepaid medical 
24.12 	assistance program. The withheld funds must be returned no sooner than July 1 and 
24.13 	no later than July 31 of the following year. The commissioner may exclude special 
24.14 	demonstration projects under subdivision 23.
24.15 	(n) (j) A managed care plan or a county-based purchasing plan under section 
24.16 	256B.692 may include as admitted assets under section 62D.044 any amount withheld 
24.17 	under this section that is reasonably expected to be returned.
24.18 	(o) (k) Contracts between the commissioner and a prepaid health plan are exempt 
24.19 	from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph 
24.20 	(a), and 7.
24.21 	(p) (l) The return of the withhold under paragraphs (d), (f), and (j) to (m) (h) and (i)
24.22 	 is not subject to the requirements of paragraph (c).

24.23 	Sec. 7. Minnesota Statutes 2012, section 256B.69, subdivision 5b, is amended to read:
24.24 		Subd. 5b.Prospective reimbursement rates. (a) For prepaid medical assistance 
24.25 	program contract rates set by the commissioner under subdivision 5 and effective on or 
24.26 	after January 1, 2003, capitation rates for nonmetropolitan counties shall on a weighted 
24.27 	average be no less than 87 percent of the capitation rates for metropolitan counties, 
24.28 	excluding Hennepin County. The commissioner shall make a pro rata adjustment in 
24.29 	capitation rates paid to counties other than nonmetropolitan counties in order to make 
24.30 	this provision budget neutral. The commissioner, in consultation with a health care 
24.31 	actuary, shall evaluate the regional rate relationships based on actual health plan costs 
24.32 	for Minnesota health care programs. The commissioner may establish, based on the 
24.33 	actuary's recommendation, new rate regions that recognize metropolitan areas outside of 
24.34 	the seven-county metropolitan area.
25.1 	(b) This subdivision shall not affect the nongeographically based risk adjusted rates 
25.2 	established under section 62Q.03, subdivision 5a.

25.3 	Sec. 8. Minnesota Statutes 2013 Supplement, section 256B.69, subdivision 5c, is 
25.4 	amended to read:
25.5 		Subd. 5c.Medical education and research fund. (a) The commissioner of human 
25.6 	services shall transfer each year to the medical education and research fund established 
25.7 	under section 62J.692, an amount specified in this subdivision. The commissioner shall 
25.8 	calculate the following:
25.9 	(1) an amount equal to the reduction in the prepaid medical assistance payments as 
25.10 	specified in this clause. Until January 1, 2002, the county medical assistance capitation 
25.11 	base rate prior to plan specific adjustments and after the regional rate adjustments under 
25.12 	subdivision 5b is reduced 6.3 percent for Hennepin County, two percent for the remaining 
25.13 	metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and
25.14 	 After January 1, 2002, the county medical assistance capitation base rate prior to plan 
25.15 	specific adjustments is reduced 6.3 percent for Hennepin County, two percent for the 
25.16 	remaining metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. 
25.17 	Nursing facility and elderly waiver payments and demonstration project payments 
25.18 	operating under subdivision 23 are excluded from this reduction. The amount calculated 
25.19 	under this clause shall not be adjusted for periods already paid due to subsequent changes 
25.20 	to the capitation payments;
25.21 	(2) beginning July 1, 2003, $4,314,000 from the capitation rates paid under this 
25.22 	section;
25.23 	(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates 
25.24 	paid under this section; and
25.25 	(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid 
25.26 	under this section.
25.27 	(b) This subdivision shall be effective upon approval of a federal waiver which 
25.28 	allows federal financial participation in the medical education and research fund. The 
25.29 	amount specified under paragraph (a), clauses (1) to (4), shall not exceed the total amount 
25.30 	transferred for fiscal year 2009. Any excess shall first reduce the amounts specified under 
25.31 	paragraph (a), clauses (2) to (4). Any excess following this reduction shall proportionally 
25.32 	reduce the amount specified under paragraph (a), clause (1).
25.33 	(c) Beginning September 1, 2011, of the amount in paragraph (a), the commissioner 
25.34 	shall transfer $21,714,000 each fiscal year to the medical education and research fund.
26.1 	(d) Beginning September 1, 2011, of the amount in paragraph (a), following the 
26.2 	transfer under paragraph (c), the commissioner shall transfer to the medical education 
26.3 	research fund $23,936,000 in fiscal years 2012 and 2013 and $49,552,000 in fiscal year 
26.4 	2014 and thereafter.

26.5 	Sec. 9. Minnesota Statutes 2012, section 256B.69, subdivision 6b, is amended to read:
26.6 		Subd. 6b.Home and community-based waiver services. (a) For individuals 
26.7 	enrolled in the Minnesota senior health options project authorized under subdivision 23, 
26.8 	elderly waiver services shall be covered according to the terms and conditions of the 
26.9 	federal agreement governing that demonstration project.
26.10 	(b) For individuals under age 65 enrolled in demonstrations authorized under 
26.11 	subdivision 23, home and community-based waiver services shall be covered according to 
26.12 	the terms and conditions of the federal agreement governing that demonstration project.
26.13 	(c) The commissioner of human services shall issue requests for proposals for 
26.14 	collaborative service models between counties and managed care organizations to 
26.15 	integrate the home and community-based elderly waiver services and additional nursing 
26.16 	home services into the prepaid medical assistance program.
26.17 	(d) Notwithstanding Minnesota Rules, part 9500.1457, subpart 1, item C, elderly 
26.18 	waiver services shall be covered statewide no sooner than July 1, 2006, under the prepaid 
26.19 	medical assistance program for all individuals who are eligible according to section 
26.20 	256B.0915. The commissioner may develop a schedule to phase in implementation of 
26.21 	these waiver services, including collaborative service models under paragraph (c). The 
26.22 	commissioner shall phase in implementation beginning with those counties participating 
26.23 	under section 256B.692, and those counties where a viable collaborative service model 
26.24 	has been developed. In consultation with counties and all managed care organizations 
26.25 	that have expressed an interest in participating in collaborative service models, the 
26.26 	commissioner shall evaluate the models. The commissioner shall consider the evaluation 
26.27 	in selecting the most appropriate models for statewide implementation.

26.28 	Sec. 10. Minnesota Statutes 2012, section 256B.69, subdivision 6d, is amended to read:
26.29 		Subd. 6d.Prescription drugs. Effective January 1, 2004, The commissioner 
26.30 	may exclude or modify coverage for prescription drugs from the prepaid managed care 
26.31 	contracts entered into under this section in order to increase savings to the state by 
26.32 	collecting additional prescription drug rebates. The contracts must maintain incentives 
26.33 	for the managed care plan to manage drug costs and utilization and may require that the 
26.34 	managed care plans maintain an open drug formulary. In order to manage drug costs and 
27.1 	utilization, the contracts may authorize the managed care plans to use preferred drug lists 
27.2 	and prior authorization. This subdivision is contingent on federal approval of the managed 
27.3 	care contract changes and the collection of additional prescription drug rebates.

27.4 	Sec. 11. Minnesota Statutes 2012, section 256B.69, subdivision 17, is amended to read:
27.5 		Subd. 17.Continuation of prepaid medical assistance. The commissioner may 
27.6 	continue the provisions of this section after June 30, 1990, in any or all of the participating 
27.7 	counties if necessary federal authority is granted. The commissioner may adopt permanent 
27.8 	rules to continue prepaid medical assistance in these areas.

27.9 	Sec. 12. Minnesota Statutes 2012, section 256B.69, subdivision 26, is amended to read:
27.10 		Subd. 26.American Indian recipients. (a) Beginning on or after January 1, 1999,
27.11 	 For American Indian recipients of medical assistance who are required to enroll with a 
27.12 	demonstration provider under subdivision 4 or in a county-based purchasing entity, if 
27.13 	applicable, under section 256B.692, medical assistance shall cover health care services 
27.14 	provided at Indian health services facilities and facilities operated by a tribe or tribal 
27.15 	organization under funding authorized by United States Code, title 25, sections 450f to 
27.16 	450n, or title III of the Indian Self-Determination and Education Assistance Act, Public 
27.17 	Law 93-638, if those services would otherwise be covered under section 256B.0625. 
27.18 	Payments for services provided under this subdivision shall be made on a fee-for-service 
27.19 	basis, and may, at the option of the tribe or tribal organization, be made according to 
27.20 	rates authorized under sections 256.969, subdivision 16, and 256B.0625, subdivision 34. 
27.21 	Implementation of this purchasing model is contingent on federal approval.
27.22 	(b) The commissioner of human services, in consultation with the tribal 
27.23 	governments, shall develop a plan for tribes to assist in the enrollment process for 
27.24 	American Indian recipients enrolled in the prepaid medical assistance program under 
27.25 	this section. This plan also shall address how tribes will be included in ensuring the 
27.26 	coordination of care for American Indian recipients between Indian health service or 
27.27 	tribal providers and other providers.
27.28 	(c) For purposes of this subdivision, "American Indian" has the meaning given 
27.29 	to persons to whom services will be provided for in Code of Federal Regulations, title 
27.30 	42, section 36.12.

27.31 	Sec. 13. Minnesota Statutes 2013 Supplement, section 256B.69, subdivision 28, 
27.32 	is amended to read:
28.1 		Subd. 28.Medicare special needs plans; medical assistance basic health 
28.2 	care. (a) The commissioner may contract with demonstration providers and current or 
28.3 	former sponsors of qualified Medicare-approved special needs plans, to provide medical 
28.4 	assistance basic health care services to persons with disabilities, including those with 
28.5 	developmental disabilities. Basic health care services include:
28.6 	(1) those services covered by the medical assistance state plan except for ICF/DD 
28.7 	services, home and community-based waiver services, case management for persons with 
28.8 	developmental disabilities under section 256B.0625, subdivision 20a, and personal care 
28.9 	and certain home care services defined by the commissioner in consultation with the 
28.10 	stakeholder group established under paragraph (d); and
28.11 	(2) basic health care services may also include risk for up to 100 days of nursing 
28.12 	facility services for persons who reside in a noninstitutional setting and home health 
28.13 	services related to rehabilitation as defined by the commissioner after consultation with 
28.14 	the stakeholder group.
28.15 	The commissioner may exclude other medical assistance services from the basic 
28.16 	health care benefit set. Enrollees in these plans can access any excluded services on the 
28.17 	same basis as other medical assistance recipients who have not enrolled.
28.18 	(b) Beginning January 1, 2007, The commissioner may contract with demonstration 
28.19 	providers and current and former sponsors of qualified Medicare special needs plans, to 
28.20 	provide basic health care services under medical assistance to persons who are dually 
28.21 	eligible for both Medicare and Medicaid and those Social Security beneficiaries eligible 
28.22 	for Medicaid but in the waiting period for Medicare. The commissioner shall consult with 
28.23 	the stakeholder group under paragraph (d) in developing program specifications for these 
28.24 	services. The commissioner shall report to the chairs of the house of representatives and 
28.25 	senate committees with jurisdiction over health and human services policy and finance by 
28.26 	February 1, 2007, on implementation of these programs and the need for increased funding 
28.27 	for the ombudsman for managed care and other consumer assistance and protections 
28.28 	needed due to enrollment in managed care of persons with disabilities. Payment for 
28.29 	Medicaid services provided under this subdivision for the months of May and June will 
28.30 	be made no earlier than July 1 of the same calendar year.
28.31 	(c) Notwithstanding subdivision 4, beginning January 1, 2012, the commissioner 
28.32 	shall enroll persons with disabilities in managed care under this section, unless the 
28.33 	individual chooses to opt out of enrollment. The commissioner shall establish enrollment 
28.34 	and opt out procedures consistent with applicable enrollment procedures under this section.
28.35 	(d) The commissioner shall establish a state-level stakeholder group to provide 
28.36 	advice on managed care programs for persons with disabilities, including both MnDHO 
29.1 	and contracts with special needs plans that provide basic health care services as described 
29.2 	in paragraphs (a) and (b). The stakeholder group shall provide advice on program 
29.3 	expansions under this subdivision and subdivision 23, including:
29.4 	(1) implementation efforts;
29.5 	(2) consumer protections; and
29.6 	(3) program specifications such as quality assurance measures, data collection and 
29.7 	reporting, and evaluation of costs, quality, and results.
29.8 	(e) Each plan under contract to provide medical assistance basic health care services 
29.9 	shall establish a local or regional stakeholder group, including representatives of the 
29.10 	counties covered by the plan, members, consumer advocates, and providers, for advice on 
29.11 	issues that arise in the local or regional area.
29.12 	(f) The commissioner is prohibited from providing the names of potential enrollees 
29.13 	to health plans for marketing purposes. The commissioner shall mail no more than 
29.14 	two sets of marketing materials per contract year to potential enrollees on behalf of 
29.15 	health plans, at the health plan's request. The marketing materials shall be mailed by the 
29.16 	commissioner within 30 days of receipt of these materials from the health plan. The health 
29.17 	plans shall cover any costs incurred by the commissioner for mailing marketing materials.

29.18 	Sec. 14. Minnesota Statutes 2012, section 256B.69, subdivision 29, is amended to read:
29.19 		Subd. 29.Prepaid health plan rates. In negotiating the prepaid health plan 
29.20 	contract rates for services rendered on or after January 1, 2011, the commissioner of 
29.21 	human services shall take into consideration, and the rates shall reflect, the anticipated 
29.22 	savings in the medical assistance program due to extending medical assistance coverage to 
29.23 	services provided in licensed birth centers, the anticipated use of these services within 
29.24 	the medical assistance population, and the reduced medical assistance costs associated 
29.25 	with the use of birth centers for normal, low-risk deliveries.

29.26 	Sec. 15. Minnesota Statutes 2012, section 256B.69, subdivision 30, is amended to read:
29.27 		Subd. 30.Provision of required materials in alternative formats. (a) For the 
29.28 	purposes of this subdivision, "alternative format" means a medium other than paper and 
29.29 	"prepaid health plan" means managed care plans and county-based purchasing plans.
29.30 	(b) A prepaid health plan may provide in an alternative format a provider directory 
29.31 	and certificate of coverage, or materials otherwise required to be available in writing 
29.32 	under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's 
29.33 	contract with the prepaid health plan, if the following conditions are met:
30.1 	(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the 
30.2 	enrollee that:
30.3 	(i) an alternative format is available and the enrollee affirmatively requests of 
30.4 	the prepaid health plan that the provider directory, certificate of coverage, or materials 
30.5 	otherwise required under Code of Federal Regulations, title 42, section 438.10, or under 
30.6 	the commissioner's contract with the prepaid health plan be provided in an alternative 
30.7 	format; and
30.8 	(ii) a record of the enrollee request is retained by the prepaid health plan in the 
30.9 	form of written direction from the enrollee or a documented telephone call followed by a 
30.10 	confirmation letter to the enrollee from the prepaid health plan that explains that the 
30.11 	enrollee may change the request at any time;
30.12 	(2) the materials are sent to a secure electronic mailbox and are made available at a 
30.13 	password-protected secure electronic Web site or on a data storage device if the materials 
30.14 	contain enrollee data that is individually identifiable;
30.15 	(3) the enrollee is provided a customer service number on the enrollee's membership 
30.16 	card that may be called to request a paper version of the materials provided in an 
30.17 	alternative format; and
30.18 	(4) the materials provided in an alternative format meets all other requirements of 
30.19 	the commissioner regarding content, size of the typeface, and any required time frames 
30.20 	for distribution. "Required time frames for distribution" must permit sufficient time for 
30.21 	prepaid health plans to distribute materials in alternative formats upon receipt of enrollees' 
30.22 	requests for the materials.
30.23 	(c) A prepaid health plan may provide in an alternative format its primary care 
30.24 	network list to the commissioner and to local agencies within its service area. The 
30.25 	commissioner or local agency, as applicable, shall inform a potential enrollee of the 
30.26 	availability of a prepaid health plan's primary care network list in an alternative format. If 
30.27 	the potential enrollee requests an alternative format of the prepaid health plan's primary 
30.28 	care network list, a record of that request shall be retained by the commissioner or local 
30.29 	agency. The potential enrollee is permitted to withdraw the request at any time.
30.30 	The prepaid health plan shall submit sufficient paper versions of the primary 
30.31 	care network list to the commissioner and to local agencies within its service area to 
30.32 	accommodate potential enrollee requests for paper versions of the primary care network list.
30.33 	(d) A prepaid health plan may provide in an alternative format materials otherwise 
30.34 	required to be available in writing under Code of Federal Regulations, title 42, section 
30.35 	438.10, or under the commissioner's contract with the prepaid health plan, if the conditions 
31.1 	of paragraphs (b), and (c), and (e), are met for persons who are eligible for enrollment in 
31.2 	managed care.
31.3 	(e) The commissioner shall seek any federal Medicaid waivers within 90 days after 
31.4 	the effective date of this subdivision that are necessary to provide alternative formats of 
31.5 	required material to enrollees of prepaid health plans as authorized under this subdivision.
31.6 	(f) (e) The commissioner shall consult with managed care plans, county-based 
31.7 	purchasing plans, counties, and other interested parties to determine how materials required 
31.8 	to be made available to enrollees under Code of Federal Regulations, title 42, section 
31.9 	438.10, or under the commissioner's contract with a prepaid health plan may be provided 
31.10 	in an alternative format on the basis that the enrollee has not opted in to receive the 
31.11 	alternative format. The commissioner shall consult with managed care plans, county-based 
31.12 	purchasing plans, counties, and other interested parties to develop recommendations 
31.13 	relating to the conditions that must be met for an opt-out process to be granted.

31.14 	Sec. 16. Minnesota Statutes 2012, section 256B.692, subdivision 2, is amended to read:
31.15 		Subd. 2.Duties of commissioner of health. (a) Notwithstanding chapters 62D and 
31.16 	62N, a county that elects to purchase medical assistance in return for a fixed sum without 
31.17 	regard to the frequency or extent of services furnished to any particular enrollee is not 
31.18 	required to obtain a certificate of authority under chapter 62D or 62N. The county board 
31.19 	of commissioners is the governing body of a county-based purchasing program. In a 
31.20 	multicounty arrangement, the governing body is a joint powers board established under 
31.21 	section 471.59.
31.22 	(b) A county that elects to purchase medical assistance services under this section 
31.23 	must satisfy the commissioner of health that the requirements for assurance of consumer 
31.24 	protection, provider protection, and, effective January 1, 2010, fiscal solvency of chapter 
31.25 	62D, applicable to health maintenance organizations will be met according to the 
31.26 	following schedule:
31.27 	(1) for a county-based purchasing plan approved on or before June 30, 2008, the 
31.28 	plan must have in reserve:
31.29 	(i) at least 50 percent of the minimum amount required under chapter 62D as 
31.30 	of January 1, 2010;
31.31 	(ii) at least 75 percent of the minimum amount required under chapter 62D as of 
31.32 	January 1, 2011;
31.33 	(iii) at least 87.5 percent of the minimum amount required under chapter 62D as 
31.34 	of January 1, 2012; and
32.1 	(iv) at least 100 percent of the minimum amount required under chapter 62D as 
32.2 	of January 1, 2013; and
32.3 	(2) for a county-based purchasing plan first approved after June 30, 2008, the plan 
32.4 	must have in reserve:
32.5 	(i) at least 50 percent of the minimum amount required under chapter 62D at the 
32.6 	time the plan begins enrolling enrollees;
32.7 	(ii) at least 75 percent of the minimum amount required under chapter 62D after 
32.8 	the first full calendar year;
32.9 	(iii) at least 87.5 percent of the minimum amount required under chapter 62D after 
32.10 	the second full calendar year; and
32.11 	(iv) at least 100 percent of the minimum amount required under chapter 62D after 
32.12 	the third full calendar year.
32.13 	(c) Until a plan is required to have reserves equaling at least 100 percent of the 
32.14 	minimum amount required under chapter 62D, the plan may demonstrate its ability 
32.15 	to cover any losses by satisfying the requirements of chapter 62N. A county-based 
32.16 	purchasing plan must also assure the commissioner of health that the requirements of 
32.17 	sections 62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all applicable provisions 
32.18 	of chapter 62Q, including sections 62Q.075; 62Q.1055; 62Q.106; 62Q.12; 62Q.135; 
32.19 	62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 
32.20 	62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.
32.21 	(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62M, 
32.22 	62N, and 62Q are hereby granted to the commissioner of health with respect to counties 
32.23 	that purchase medical assistance services under this section.
32.24 	(e) The commissioner, in consultation with county government, shall develop 
32.25 	administrative and financial reporting requirements for county-based purchasing programs 
32.26 	relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31, 
32.27 	and other sections as necessary, that are specific to county administrative, accounting, and 
32.28 	reporting systems and consistent with other statutory requirements of counties.
32.29 	(f) The commissioner shall collect from a county-based purchasing plan under 
32.30 	this section the following fees:
32.31 	(1) fees attributable to the costs of audits and other examinations of plan financial 
32.32 	operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800, 
32.33 	subpart 1, item F; and
32.34 	(2) an annual fee of $21,500, to be paid by June 15 of each calendar year, beginning 
32.35 	in calendar year 2009; and
33.1 	(3) for fiscal year 2009 only, a per-enrollee fee of 14.6 cents, based on the number of 
33.2 	enrollees as of December 31, 2008.
33.3 	All fees collected under this paragraph shall be deposited in the state government special 
33.4 	revenue fund.

33.5 	Sec. 17. Minnesota Statutes 2012, section 256B.692, subdivision 5, is amended to read:
33.6 		Subd. 5.County proposals. (a) On or before September 1, 1997, A county board 
33.7 	that wishes to purchase or provide health care under this section must submit a preliminary 
33.8 	proposal that substantially demonstrates the county's ability to meet all the requirements 
33.9 	of this section in response to criteria for proposals issued by the department on or before 
33.10 	July 1, 1997. Counties submitting preliminary proposals must establish a local planning 
33.11 	process that involves input from medical assistance recipients, recipient advocates, 
33.12 	providers and representatives of local school districts, labor, and tribal government to 
33.13 	advise on the development of a final proposal and its implementation.
33.14 	(b) The county board must submit a final proposal on or before July 1, 1998, that 
33.15 	demonstrates the ability to meet all the requirements of this section, including beginning 
33.16 	enrollment on January 1, 1999, unless a delay has been granted under section 256B.69, 
33.17 	subdivision 3a, paragraph (g).
33.18 	(c) After January 1, 1999, For a county in which the prepaid medical assistance 
33.19 	program is in existence, the county board must submit a preliminary proposal at least 15 
33.20 	months prior to termination of health plan contracts in that county and a final proposal 
33.21 	six months prior to the health plan contract termination date in order to begin enrollment 
33.22 	after the termination. Nothing in this section shall impede or delay implementation or 
33.23 	continuation of the prepaid medical assistance program in counties for which the board 
33.24 	does not submit a proposal, or submits a proposal that is not in compliance with this section.
33.25 	(d) The commissioner is not required to terminate contracts for the prepaid medical 
33.26 	assistance program that begin on or after September 1, 1997, in a county for which a 
33.27 	county board has submitted a proposal under this paragraph, until two years have elapsed 
33.28 	from the date of initial enrollment in the prepaid medical assistance program.

33.29 	Sec. 18. Minnesota Statutes 2013 Supplement, section 256B.76, subdivision 4, is 
33.30 	amended to read:
33.31 		Subd. 4.Critical access dental providers. (a) Effective for dental services 
33.32 	rendered on or after January 1, 2002, the commissioner shall increase reimbursements 
33.33 	to dentists and dental clinics deemed by the commissioner to be critical access dental 
33.34 	providers. For dental services rendered on or after July 1, 2007, the commissioner shall 
34.1 	increase reimbursement by 35 percent above the reimbursement rate that would otherwise 
34.2 	be paid to the critical access dental provider. The commissioner shall pay the managed 
34.3 	care plans and county-based purchasing plans in amounts sufficient to reflect increased 
34.4 	reimbursements to critical access dental providers as approved by the commissioner.
34.5 	(b) The commissioner shall designate the following dentists and dental clinics as 
34.6 	critical access dental providers:
34.7 	(1) nonprofit community clinics that:
34.8 	(i) have nonprofit status in accordance with chapter 317A;
34.9 	(ii) have tax exempt status in accordance with the Internal Revenue Code, section 
34.10 	501(c)(3);
34.11 	(iii) are established to provide oral health services to patients who are low income, 
34.12 	uninsured, have special needs, and are underserved;
34.13 	(iv) have professional staff familiar with the cultural background of the clinic's 
34.14 	patients;
34.15 	(v) charge for services on a sliding fee scale designed to provide assistance to 
34.16 	low-income patients based on current poverty income guidelines and family size;
34.17 	(vi) do not restrict access or services because of a patient's financial limitations 
34.18 	or public assistance status; and
34.19 	(vii) have free care available as needed;
34.20 	(2) federally qualified health centers, rural health clinics, and public health clinics;
34.21 	(3) city or county owned and operated hospital-based dental clinics;
34.22 	(4) a dental clinic or dental group owned and operated by a nonprofit corporation in 
34.23 	accordance with chapter 317A with more than 10,000 patient encounters per year with 
34.24 	patients who are uninsured or covered by medical assistance or MinnesotaCare;
34.25 	(5) a dental clinic owned and operated by the University of Minnesota or the 
34.26 	Minnesota State Colleges and Universities system; and
34.27 	(6) private practicing dentists if:
34.28 	(i) the dentist's office is located within a health professional shortage area as defined 
34.29 	under Code of Federal Regulations, title 42, part 5, and United States Code, title 42, 
34.30 	section 254E;
34.31 	(ii) more than 50 percent of the dentist's patient encounters per year are with patients 
34.32 	who are uninsured or covered by medical assistance or MinnesotaCare;
34.33 	(iii) the dentist does not restrict access or services because of a patient's financial 
34.34 	limitations or public assistance status; and
34.35 	(iv) the level of service provided by the dentist is critical to maintaining adequate 
34.36 	levels of patient access within the service area in which the dentist operates.
35.1 	(c) A designated critical access clinic shall receive the reimbursement rate specified 
35.2 	in paragraph (a) for dental services provided off site at a private dental office if the 
35.3 	following requirements are met:
35.4 	(1) the designated critical access dental clinic is located within a health professional 
35.5 	shortage area as defined under Code of Federal Regulations, title 42, part 5, and United 
35.6 	States Code, title 42, section 254E, and is located outside the seven-county metropolitan 
35.7 	area;
35.8 	(2) the designated critical access dental clinic is not able to provide the service 
35.9 	and refers the patient to the off-site dentist;
35.10 	(3) the service, if provided at the critical access dental clinic, would be reimbursed 
35.11 	at the critical access reimbursement rate;
35.12 	(4) the dentist and allied dental professionals providing the services off site are 
35.13 	licensed and in good standing under chapter 150A;
35.14 	(5) the dentist providing the services is enrolled as a medical assistance provider;
35.15 	(6) the critical access dental clinic submits the claim for services provided off site 
35.16 	and receives the payment for the services; and
35.17 	(7) the critical access dental clinic maintains dental records for each claim submitted 
35.18 	under this paragraph, including the name of the dentist, the off-site location, and the 
35.19 	license number of the dentist and allied dental professionals providing the services.

35.20 	Sec. 19.  REPEALER.
 35.21 	Minnesota Statutes 2012, sections 256.959; 256.964; 256.9691; 256B.043; 
35.22 	256B.0636; 256B.075, subdivision 4; 256B.0757, subdivision 7; 256B.19, subdivision 
35.23 	3; 256B.53; 256B.69, subdivisions 5e, 6c, and 24a; and 256B.692, subdivision 10, are 
35.24 	repealed.

35.25 	ARTICLE 3
35.26 	CHEMICAL AND MENTAL HEALTH SERVICES

35.27 	Section 1. Minnesota Statutes 2012, section 245.4871, subdivision 3, is amended to read:
35.28 		Subd. 3.Case management services. "Case management services" means activities 
35.29 	that are coordinated with the family community support services and are designed to 
35.30 	help the child with severe emotional disturbance and the child's family obtain needed 
35.31 	mental health services, social services, educational services, health services, vocational 
35.32 	services, recreational services, and related services in the areas of volunteer services, 
35.33 	advocacy, transportation, and legal services. Case management services include assisting 
35.34 	in obtaining a comprehensive diagnostic assessment, if needed, developing a functional 
36.1 	assessment, developing an individual family community support plan, and assisting the 
36.2 	child and the child's family in obtaining needed services by coordination with other 
36.3 	agencies and assuring continuity of care. Case managers must assess and reassess the 
36.4 	delivery, appropriateness, and effectiveness of services over time.

36.5 	Sec. 2. Minnesota Statutes 2012, section 245.4871, subdivision 6, is amended to read:
36.6 		Subd. 6.Child with severe emotional disturbance. For purposes of eligibility for 
36.7 	case management and family community support services, "child with severe emotional 
36.8 	disturbance" means a child who has an emotional disturbance and who meets one of the 
36.9 	following criteria:
36.10 	(1) the child has been admitted within the last three years or is at risk of being 
36.11 	admitted to inpatient treatment or residential treatment for an emotional disturbance; or
36.12 	(2) the child is a Minnesota resident and is receiving inpatient treatment or 
36.13 	residential treatment for an emotional disturbance through the interstate compact; or
36.14 	(3) the child has one of the following as determined by a mental health professional:
36.15 	(i) psychosis or a clinical depression; or
36.16 	(ii) risk of harming self or others as a result of an emotional disturbance; or
36.17 	(iii) psychopathological symptoms as a result of being a victim of physical or sexual 
36.18 	abuse or of psychic trauma within the past year; or
36.19 	(4) the child, as a result of an emotional disturbance, has significantly impaired home, 
36.20 	school, or community functioning that has lasted at least one year or that, in the written 
36.21 	opinion of a mental health professional, presents substantial risk of lasting at least one year.
36.22 	The term "child with severe emotional disturbance" shall be used only for purposes 
36.23 	of county eligibility determinations. In all other written and oral communications, 
36.24 	case managers, mental health professionals, mental health practitioners, and all other 
36.25 	providers of mental health services shall use the term "child eligible for mental health case 
36.26 	management" in place of "child with severe emotional disturbance."

36.27 	Sec. 3. Minnesota Statutes 2012, section 245.4871, subdivision 27, is amended to read:
36.28 		Subd. 27.Mental health professional. "Mental health professional" means a 
36.29 	person providing clinical services in the diagnosis and treatment of children's emotional 
36.30 	disorders mental illnesses or emotional disturbances. A mental health professional must 
36.31 	have training and experience in working with children consistent with the age group to 
36.32 	which the mental health professional is assigned. A mental health professional must be 
36.33 	qualified in at least one of the following ways:
37.1 	(1) in psychiatric nursing, the mental health professional must be a registered nurse 
37.2 	who is licensed under sections 148.171 to 148.285 and who is certified as a clinical 
37.3 	specialist in child and adolescent psychiatric or mental health nursing by a national nurse 
37.4 	certification organization or who has a master's degree in nursing or one of the behavioral 
37.5 	sciences or related fields from an accredited college or university or its equivalent, with 
37.6 	at least 4,000 hours of post-master's supervised experience in the delivery of clinical 
37.7 	services in the treatment of mental illness;
37.8 	(2) in clinical social work, the mental health professional must be a person licensed 
37.9 	as an independent clinical social worker under chapter 148D, or a person with a master's 
37.10 	degree in social work from an accredited college or university, with at least 4,000 hours of 
37.11 	post-master's supervised experience in the delivery of clinical services in the treatment 
37.12 	of mental disorders;
37.13 	(3) in psychology, the mental health professional must be an individual licensed by 
37.14 	the board of psychology under sections 148.88 to 148.98 who has stated to the board of 
37.15 	psychology competencies in the diagnosis and treatment of mental disorders;
37.16 	(4) in psychiatry, the mental health professional must be a physician licensed under 
37.17 	chapter 147 and certified by the American board of psychiatry and neurology or eligible 
37.18 	for board certification in psychiatry;
37.19 	(5) in marriage and family therapy, the mental health professional must be a 
37.20 	marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least 
37.21 	two years of post-master's supervised experience in the delivery of clinical services in the 
37.22 	treatment of mental disorders or emotional disturbances; or
37.23 	(6) in licensed professional clinical counseling, the mental health professional shall 
37.24 	be a licensed professional clinical counselor under section 148B.5301 with at least 4,000 
37.25 	hours of post-master's supervised experience in the delivery of clinical services in the 
37.26 	treatment of mental disorders or emotional disturbances; or.
37.27 	(7) in allied fields, the mental health professional must be a person with a master's 
37.28 	degree from an accredited college or university in one of the behavioral sciences or related 
37.29 	fields, with at least 4,000 hours of post-master's supervised experience in the delivery of 
37.30 	clinical services in the treatment of emotional disturbances.

37.31 	Sec. 4. Minnesota Statutes 2012, section 245.4873, subdivision 2, is amended to read:
37.32 		Subd. 2.State level; coordination. The Children's Cabinet, under section 4.045, in 
37.33 	consultation with a representative of the Minnesota District Judges Association Juvenile 
37.34 	Committee, shall:
38.1 	(1) educate each agency about the policies, procedures, funding, and services for 
38.2 	children with emotional disturbances of all agencies represented;
38.3 	(2) develop mechanisms for interagency coordination on behalf of children with 
38.4 	emotional disturbances;
38.5 	(3) identify barriers including policies and procedures within all agencies represented 
38.6 	that interfere with delivery of mental health services for children;
38.7 	(4) recommend policy and procedural changes needed to improve development and 
38.8 	delivery of mental health services for children in the agency or agencies they represent; and
38.9 	(5) identify mechanisms for better use of federal and state funding in the delivery of 
38.10 	mental health services for children; and.
38.11 	(6) perform the duties required under sections 245.494 to 245.495.

38.12 	Sec. 5. Minnesota Statutes 2012, section 245.4874, subdivision 1, is amended to read:
38.13 		Subdivision 1.Duties of county board. (a) The county board must:
38.14 	(1) develop a system of affordable and locally available children's mental health 
38.15 	services according to sections 245.487 to 245.4889;
38.16 	(2) establish a mechanism providing for interagency coordination as specified in 
38.17 	section 245.4875, subdivision 6;
38.18 	(3) consider the assessment of unmet needs in the county as reported by the local 
38.19 	children's mental health advisory council under section 245.4875, subdivision 5, paragraph 
38.20 	(b), clause (3). The county shall provide, upon request of the local children's mental health 
38.21 	advisory council, readily available data to assist in the determination of unmet needs;
38.22 	(4) assure that parents and providers in the county receive information about how to 
38.23 	gain access to services provided according to sections 245.487 to 245.4889;
38.24 	(5) coordinate the delivery of children's mental health services with services provided 
38.25 	by social services, education, corrections, health, and vocational agencies to improve the 
38.26 	availability of mental health services to children and the cost-effectiveness of their delivery;
38.27 	(6) assure that mental health services delivered according to sections 245.487 
38.28 	to 245.4889 are delivered expeditiously and are appropriate to the child's diagnostic 
38.29 	assessment and individual treatment plan;
38.30 	(7) provide the community with information about predictors and symptoms of 
38.31 	emotional disturbances and how to access children's mental health services according to 
38.32 	sections 245.4877 and 245.4878;
38.33 	(8) (7) provide for case management services to each child with severe emotional 
38.34 	disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, 
38.35 	subdivisions 1, 3, and 5;
39.1 	(9) (8) provide for screening of each child under section 245.4885 upon admission 
39.2 	to a residential treatment facility, acute care hospital inpatient treatment, or informal 
39.3 	admission to a regional treatment center;
39.4 	(10) (9) prudently administer grants and purchase-of-service contracts that the 
39.5 	county board determines are necessary to fulfill its responsibilities under sections 245.487
39.6 	to 245.4889;
39.7 	(11) (10) assure that mental health professionals, mental health practitioners, and 
39.8 	case managers employed by or under contract to the county to provide mental health 
39.9 	services are qualified under section 245.4871;
39.10 	(12) (11) assure that children's mental health services are coordinated with adult 
39.11 	mental health services specified in sections 245.461 to 245.486 so that a continuum of 
39.12 	mental health services is available to serve persons with mental illness, regardless of 
39.13 	the person's age;
39.14 	(13) (12) assure that culturally competent mental health consultants are used as 
39.15 	necessary to assist the county board in assessing and providing appropriate treatment for 
39.16 	children of cultural or racial minority heritage; and
39.17 	(14) (13) consistent with section 245.486, arrange for or provide a children's mental 
39.18 	health screening for:
39.19 	(i) a child receiving child protective services;
39.20 	(ii) a child in out-of-home placement;
39.21 	(iii) a child for whom parental rights have been terminated;
39.22 	(iv) a child found to be delinquent; or
39.23 	(v) a child found to have committed a juvenile petty offense for the third or 
39.24 	subsequent time.
39.25 	A children's mental health screening is not required when a screening or diagnostic 
39.26 	assessment has been performed within the previous 180 days, or the child is currently 
39.27 	under the care of a mental health professional.
39.28 	(b) When a child is receiving protective services or is in out-of-home placement, 
39.29 	the court or county agency must notify a parent or guardian whose parental rights have 
39.30 	not been terminated of the potential mental health screening and the option to prevent the 
39.31 	screening by notifying the court or county agency in writing.
39.32 	(c) When a child is found to be delinquent or a child is found to have committed a 
39.33 	juvenile petty offense for the third or subsequent time, the court or county agency must 
39.34 	obtain written informed consent from the parent or legal guardian before a screening is 
39.35 	conducted unless the court, notwithstanding the parent's failure to consent, determines that 
39.36 	the screening is in the child's best interest.
40.1 	(d) The screening shall be conducted with a screening instrument approved by 
40.2 	the commissioner of human services according to criteria that are updated and issued 
40.3 	annually to ensure that approved screening instruments are valid and useful for child 
40.4 	welfare and juvenile justice populations. Screenings shall be conducted by a mental health 
40.5 	practitioner as defined in section 245.4871, subdivision 26, or a probation officer or local 
40.6 	social services agency staff person who is trained in the use of the screening instrument. 
40.7 	Training in the use of the instrument shall include:
40.8 	(1) training in the administration of the instrument;
40.9 	(2) the interpretation of its validity given the child's current circumstances;
40.10 	(3) the state and federal data practices laws and confidentiality standards;
40.11 	(4) the parental consent requirement; and
40.12 	(5) providing respect for families and cultural values.
40.13 	If the screen indicates a need for assessment, the child's family, or if the family lacks 
40.14 	mental health insurance, the local social services agency, in consultation with the child's 
40.15 	family, shall have conducted a diagnostic assessment, including a functional assessment, 
40.16 	as defined in section 245.4871. The administration of the screening shall safeguard the 
40.17 	privacy of children receiving the screening and their families and shall comply with the 
40.18 	Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance 
40.19 	Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be 
40.20 	considered private data and the commissioner shall not collect individual screening results.
40.21 	(e) When the county board refers clients to providers of children's therapeutic 
40.22 	services and supports under section 256B.0943, the county board must clearly identify 
40.23 	the desired services components not covered under section 256B.0943 and identify the 
40.24 	reimbursement source for those requested services, the method of payment, and the 
40.25 	payment rate to the provider.

40.26 	Sec. 6. Minnesota Statutes 2012, section 245.4881, subdivision 3, is amended to read:
40.27 		Subd. 3.Duties of case manager. (a) Upon a determination of eligibility for case 
40.28 	management services, the case manager shall complete a written functional assessment 
40.29 	according to section 245.4871, subdivision 18. The case manager shall develop an 
40.30 	individual family community support plan for a child as specified in subdivision 4, review 
40.31 	the child's progress, and monitor the provision of services. If services are to be provided 
40.32 	in a host county that is not the county of financial responsibility, the case manager shall 
40.33 	consult with the host county and obtain a letter demonstrating the concurrence of the host 
40.34 	county regarding the provision of services.
41.1 	(b) The case manager shall note in the child's record the services needed by the 
41.2 	child and the child's family, the services requested by the family, services that are not 
41.3 	available, and the unmet needs of the child and child's family. The case manager shall 
41.4 	note this provision in the child's record.

41.5 	Sec. 7. Minnesota Statutes 2012, section 245.4881, subdivision 4, is amended to read:
41.6 		Subd. 4.Individual family community support plan. (a) For each child, the case 
41.7 	manager must develop an individual family community support plan that incorporates the 
41.8 	child's individual treatment plan. The individual treatment plan may not be a substitute 
41.9 	for the development of an individual family community support plan. The case manager 
41.10 	is responsible for developing the individual family community support plan within 30 
41.11 	days of intake based on a diagnostic assessment and a functional assessment and for 
41.12 	implementing and monitoring the delivery of services according to the individual family 
41.13 	community support plan. The case manager must review the plan at least every 180 
41.14 	calendar days after it is developed, unless the case manager has received a written request 
41.15 	from the child's family or an advocate for the child for a review of the plan every 90 
41.16 	days after it is developed. To the extent appropriate, the child with severe emotional 
41.17 	disturbance, the child's family, advocates, service providers, and significant others must 
41.18 	be involved in all phases of development and implementation of the individual family 
41.19 	community support plan. Notwithstanding the lack of an individual family community 
41.20 	support plan, the case manager shall assist the child and child's family in accessing the 
41.21 	needed services listed in section 245.4884, subdivision 1.
41.22 	(b) The child's individual family community support plan must state:
41.23 	(1) the goals and expected outcomes of each service and criteria for evaluating the 
41.24 	effectiveness and appropriateness of the service;
41.25 	(2) the activities for accomplishing each goal;
41.26 	(3) a schedule for each activity; and
41.27 	(4) the frequency of face-to-face contacts by the case manager, as appropriate to 
41.28 	client need and the implementation of the individual family community support plan.

41.29 	Sec. 8. Minnesota Statutes 2012, section 245.4882, subdivision 1, is amended to read:
41.30 		Subdivision 1.Availability of residential treatment services. County boards must 
41.31 	provide or contract for enough residential treatment services to meet the needs of each 
41.32 	child with severe emotional disturbance residing in the county and needing this level of 
41.33 	care. Length of stay is based on the child's residential treatment need and shall be subject 
41.34 	to the six-month review process established in section 260C.203, and for children in 
42.1 	voluntary placement for treatment, the court review process in section 260D.06. Services 
42.2 	must be appropriate to the child's age and treatment needs and must be made available as 
42.3 	close to the county as possible. Residential treatment must be designed to:
42.4 	(1) prevent placement in settings that are more intensive, costly, or restrictive than 
42.5 	necessary and appropriate to meet the child's needs;
42.6 	(2) (1) help the child improve family living and social interaction skills;
42.7 	(3) (2) help the child gain the necessary skills to return to the community;
42.8 	(4) (3) stabilize crisis admissions; and
42.9 	(5) (4) work with families throughout the placement to improve the ability of the 
42.10 	families to care for children with severe emotional disturbance in the home.

42.11 	Sec. 9. Minnesota Statutes 2012, section 246.01, is amended to read:
42.12 	246.01 POWERS AND DUTIES.
42.13 	The commissioner of human services is hereby specifically constituted the guardian 
42.14 	of all persons with developmental disabilities, the guardianship of whom has heretofore 
42.15 	been vested in the State Board of Control or in the director of social welfare whether by 
42.16 	operation of law or by an order of court without any further act or proceeding, and all the 
42.17 	powers and duties vested in or imposed upon the State Board of Control or the director of 
42.18 	social welfare, with reference to mental testing of persons with developmental disabilities, 
42.19 	and with reference to the institutions of the state of Minnesota except correctional facilities 
42.20 	administered and managed by the commissioner of corrections, are hereby transferred to, 
42.21 	vested in, and imposed upon the commissioner of human services, and in relation thereto is 
42.22 	hereby charged with and shall have the exclusive power of administration and management 
42.23 	of all of the following state institutions: state hospitals for persons with developmental 
42.24 	disabilities, mental illness, or chemical dependency. The commissioner shall have power 
42.25 	and authority to determine all matters relating to the unified and continuous development 
42.26 	of all of the foregoing institutions and of such other institutions, the supervision of which 
42.27 	may, from time to time, be vested in the commissioner. It is intended that there be vested 
42.28 	in the commissioner all of the powers, functions, and authority heretofore vested in the 
42.29 	State Board of Control relative to such state institutions. The commissioner shall have the 
42.30 	power and authority to accept, in behalf of the state, contributions and gifts of money and 
42.31 	personal property for the use and benefit of the residents of the public institutions under 
42.32 	the commissioner's control, and all money and securities so received shall be deposited 
42.33 	in the state treasury subject to the order of the commissioner of human services. If the 
42.34 	gift or contribution is designated by the donor for a certain institution or purpose, the 
42.35 	commissioner of human services shall expend or use the same as nearly as may be in 
43.1 	accordance with the conditions of the gift or contribution, compatible with the best 
43.2 	interests of the inmates and the state. The commissioner of human services is hereby 
43.3 	constituted the "state agency" as defined by the Social Security Act of the United States 
43.4 	and the laws of this state for all purposes relating to mental health and mental hygiene.
43.5 	For the purpose of carrying out these duties, the commissioner of human services 
43.6 	shall accept from wards with developmental disabilities for whom the commissioner is 
43.7 	specifically appointed guardian a signed application for consent to the marriage of said 
43.8 	ward. Upon receipt of such application the commissioner shall promptly conduct such 
43.9 	investigation as the commissioner deems proper and determine if the contemplated 
43.10 	marriage is for the best interest of the ward and the public. A signed copy of the 
43.11 	commissioner's determination shall be mailed to the ward and to the court administrator of 
43.12 	the district court of the county where the application for such marriage license was made.
43.13 	There is hereby appropriated to such persons or institutions as are entitled to such 
43.14 	sums as are provided for in this section, from the fund or account in the state treasury to 
43.15 	which the money was credited, an amount sufficient to make such payment.

43.16 	Sec. 10. Minnesota Statutes 2012, section 254B.05, subdivision 2, is amended to read:
43.17 		Subd. 2.Regulatory methods. (a) Where appropriate and feasible, the 
43.18 	commissioner shall identify and implement alternative methods of regulation and 
43.19 	enforcement to the extent authorized in this subdivision. These methods shall include:
43.20 	(1) expansion of the types and categories of licenses that may be granted;
43.21 	(2) when the standards of an independent accreditation body have been shown to 
43.22 	predict compliance with the rules, the commissioner shall consider compliance with the 
43.23 	accreditation standards to be equivalent to partial compliance with the rules; and
43.24 	(3) use of an abbreviated inspection that employs key standards that have been 
43.25 	shown to predict full compliance with the rules.
43.26 	If the commissioner determines that the methods in clause (2) or (3) can be used in 
43.27 	licensing a program, the commissioner may reduce any fee set under section 254B.03, 
43.28 	subdivision 3, by up to 50 percent.
43.29 	(b) The commissioner shall work with the commissioners of health, public 
43.30 	safety, administration, and education in consolidating duplicative licensing and 
43.31 	certification rules and standards if the commissioner determines that consolidation is 
43.32 	administratively feasible, would significantly reduce the cost of licensing, and would 
43.33 	not reduce the protection given to persons receiving services in licensed programs. 
43.34 	Where administratively feasible and appropriate, the commissioner shall work with the 
44.1 	commissioners of health, public safety, administration, and education in conducting joint 
44.2 	agency inspections of programs.
44.3 	(c) The commissioner shall work with the commissioners of health, public safety, 
44.4 	administration, and education in establishing a single point of application for applicants 
44.5 	who are required to obtain concurrent licensure from more than one of the commissioners 
44.6 	listed in this clause.

44.7 	Sec. 11. Minnesota Statutes 2012, section 256.01, subdivision 14b, is amended to read:
44.8 		Subd. 14b.American Indian child welfare projects. (a) The commissioner of 
44.9 	human services may authorize projects to test tribal delivery of child welfare services to 
44.10 	American Indian children and their parents and custodians living on the reservation. 
44.11 	The commissioner has authority to solicit and determine which tribes may participate 
44.12 	in a project. Grants may be issued to Minnesota Indian tribes to support the projects. 
44.13 	The commissioner may waive existing state rules as needed to accomplish the projects. 
44.14 	Notwithstanding section 626.556, the commissioner may authorize projects to use 
44.15 	alternative methods of investigating and assessing reports of child maltreatment, provided 
44.16 	that the projects comply with the provisions of section 626.556 dealing with the rights 
44.17 	of individuals who are subjects of reports or investigations, including notice and appeal 
44.18 	rights and data practices requirements. The commissioner may seek any federal approvals 
44.19 	necessary to carry out the projects as well as seek and use any funds available to the 
44.20 	commissioner, including use of federal funds, foundation funds, existing grant funds, 
44.21 	and other funds. The commissioner is authorized to advance state funds as necessary to 
44.22 	operate the projects. Federal reimbursement applicable to the projects is appropriated 
44.23 	to the commissioner for the purposes of the projects. The projects must be required to 
44.24 	address responsibility for safety, permanency, and well-being of children.
44.25 	(b) For the purposes of this section, "American Indian child" means a person under 21 
44.26 	years old and who is a tribal member or eligible for membership in one of the tribes chosen 
44.27 	for a project under this subdivision and who is residing on the reservation of that tribe.
44.28 	(c) In order to qualify for an American Indian child welfare project, a tribe must:
44.29 	(1) be one of the existing tribes with reservation land in Minnesota;
44.30 	(2) have a tribal court with jurisdiction over child custody proceedings;
44.31 	(3) have a substantial number of children for whom determinations of maltreatment 
44.32 	have occurred;
44.33 	(4) have capacity to respond to reports of abuse and neglect under section 626.556;
44.34 	(5) provide a wide range of services to families in need of child welfare services; and
44.35 	(6) have a tribal-state title IV-E agreement in effect.
45.1 	(d) Grants awarded under this section may be used for the nonfederal costs of 
45.2 	providing child welfare services to American Indian children on the tribe's reservation, 
45.3 	including costs associated with:
45.4 	(1) assessment and prevention of child abuse and neglect;
45.5 	(2) family preservation;
45.6 	(3) facilitative, supportive, and reunification services;
45.7 	(4) out-of-home placement for children removed from the home for child protective 
45.8 	purposes; and
45.9 	(5) other activities and services approved by the commissioner that further the goals 
45.10 	of providing safety, permanency, and well-being of American Indian children.
45.11 	(e) When a tribe has initiated a project and has been approved by the commissioner 
45.12 	to assume child welfare responsibilities for American Indian children of that tribe under 
45.13 	this section, the affected county social service agency is relieved of responsibility for 
45.14 	responding to reports of abuse and neglect under section 626.556 for those children 
45.15 	during the time within which the tribal project is in effect and funded. The commissioner 
45.16 	shall work with tribes and affected counties to develop procedures for data collection, 
45.17 	evaluation, and clarification of ongoing role and financial responsibilities of the county 
45.18 	and tribe for child welfare services prior to initiation of the project. Children who have not 
45.19 	been identified by the tribe as participating in the project shall remain the responsibility 
45.20 	of the county. Nothing in this section shall alter responsibilities of the county for law 
45.21 	enforcement or court services.
45.22 	(f) Participating tribes may conduct children's mental health screenings under section 
45.23 	245.4874, subdivision 1, paragraph (a), clause (14) (13), for children who are eligible for 
45.24 	the initiative and living on the reservation and who meet one of the following criteria:
45.25 	(1) the child must be receiving child protective services;
45.26 	(2) the child must be in foster care; or
45.27 	(3) the child's parents must have had parental rights suspended or terminated.
45.28 	Tribes may access reimbursement from available state funds for conducting the screenings. 
45.29 	Nothing in this section shall alter responsibilities of the county for providing services 
45.30 	under section 245.487.
45.31 	(g) Participating tribes may establish a local child mortality review panel. In 
45.32 	establishing a local child mortality review panel, the tribe agrees to conduct local child 
45.33 	mortality reviews for child deaths or near-fatalities occurring on the reservation under 
45.34 	subdivision 12. Tribes with established child mortality review panels shall have access 
45.35 	to nonpublic data and shall protect nonpublic data under subdivision 12, paragraphs (c) 
45.36 	to (e). The tribe shall provide written notice to the commissioner and affected counties 
46.1 	when a local child mortality review panel has been established and shall provide data upon 
46.2 	request of the commissioner for purposes of sharing nonpublic data with members of the 
46.3 	state child mortality review panel in connection to an individual case.
46.4 	(h) The commissioner shall collect information on outcomes relating to child safety, 
46.5 	permanency, and well-being of American Indian children who are served in the projects. 
46.6 	Participating tribes must provide information to the state in a format and completeness 
46.7 	deemed acceptable by the state to meet state and federal reporting requirements.
46.8 	(i) In consultation with the White Earth Band, the commissioner shall develop 
46.9 	and submit to the chairs and ranking minority members of the legislative committees 
46.10 	with jurisdiction over health and human services a plan to transfer legal responsibility 
46.11 	for providing child protective services to White Earth Band member children residing in 
46.12 	Hennepin County to the White Earth Band. The plan shall include a financing proposal, 
46.13 	definitions of key terms, statutory amendments required, and other provisions required to 
46.14 	implement the plan. The commissioner shall submit the plan by January 15, 2012.

46.15 	Sec. 12. Minnesota Statutes 2013 Supplement, section 256B.0943, subdivision 2, 
46.16 	is amended to read:
46.17 		Subd. 2.Covered service components of children's therapeutic services and 
46.18 	supports. (a) Subject to federal approval, medical assistance covers medically necessary 
46.19 	children's therapeutic services and supports as defined in this section that an eligible 
46.20 	provider entity certified under subdivision 4 provides to a client eligible under subdivision 
46.21 	3.
46.22 	(b) The service components of children's therapeutic services and supports are:
46.23 	(1) individual patient or family member, family, psychotherapy for crisis, and group 
46.24 	psychotherapy;
46.25 	(2) individual, family, or group skills training provided by a mental health 
46.26 	professional or mental health practitioner;
46.27 	(3) crisis assistance;
46.28 	(4) mental health behavioral aide services;
46.29 	(5) direction of a mental health behavioral aide;
46.30 	(6) mental health service plan development; and
46.31 	(7) clinical care consultation under section 256B.0625, subdivision 62; children's 
46.32 	day treatment.
46.33 	(8) family psychoeducation under section 256B.0625, subdivision 61; and
46.34 	(9) services provided by a family peer specialist under section 256B.0616.
47.1 	(c) Service components in paragraph (b) may be combined to constitute therapeutic 
47.2 	programs, including day treatment programs and therapeutic preschool programs.

47.3 	EFFECTIVE DATE. This section is effective the day following final enactment.

47.4 	Sec. 13. Minnesota Statutes 2013 Supplement, section 256B.0943, subdivision 7, 
47.5 	is amended to read:
47.6 		Subd. 7.Qualifications of individual and team providers. (a) An individual 
47.7 	or team provider working within the scope of the provider's practice or qualifications 
47.8 	may provide service components of children's therapeutic services and supports that are 
47.9 	identified as medically necessary in a client's individual treatment plan.
47.10 	(b) An individual provider must be qualified as:
47.11 	(1) a mental health professional as defined in subdivision 1, paragraph (n); or
47.12 	(2) a mental health practitioner as defined in section 245.4871, subdivision 26 or 
47.13 	clinical trainee. The mental health practitioner or clinical trainee must work under the 
47.14 	clinical supervision of a mental health professional; or
47.15 	(3) a mental health behavioral aide working under the clinical supervision of 
47.16 	a mental health professional to implement the rehabilitative mental health services 
47.17 	previously introduced by a mental health professional or practitioner and identified in the 
47.18 	client's individual treatment plan and individual behavior plan.
47.19 	(A) A level I mental health behavioral aide must:
47.20 	(i) be at least 18 years old;
47.21 	(ii) have a high school diploma or general equivalency diploma (GED) or two years 
47.22 	of experience as a primary caregiver to a child with severe emotional disturbance within 
47.23 	the previous ten years; and
47.24 	(iii) meet preservice and continuing education requirements under subdivision 8.
47.25 	(B) A level II mental health behavioral aide must:
47.26 	(i) be at least 18 years old;
47.27 	(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering 
47.28 	clinical services in the treatment of mental illness concerning children or adolescents or 
47.29 	complete a certificate program established under subdivision 8a; and
47.30 	(iii) meet preservice and continuing education requirements in subdivision 8.
47.31 	(c) A preschool program multidisciplinary team must include at least one mental 
47.32 	health professional and one or more of the following individuals under the clinical 
47.33 	supervision of a mental health professional:
47.34 	(i) a mental health practitioner; or
48.1 	(ii) a program person, including a teacher, assistant teacher, or aide, who meets the 
48.2 	qualifications and training standards of a level I mental health behavioral aide.
48.3 	(d) (c) A day treatment multidisciplinary team must include at least one mental 
48.4 	health professional or clinical trainee and one mental health practitioner.

48.5 	EFFECTIVE DATE. This section is effective the day following final enactment.

48.6 	Sec. 14. Minnesota Statutes 2012, section 256B.0943, subdivision 8, is amended to read:
48.7 		Subd. 8.Required preservice and continuing education. (a) A provider entity 
48.8 	shall establish a plan to provide preservice and continuing education for staff. The plan 
48.9 	must clearly describe the type of training necessary to maintain current skills and obtain 
48.10 	new skills and that relates to the provider entity's goals and objectives for services offered.
48.11 	(b) A provider that employs a mental health behavioral aide under this section must 
48.12 	require the mental health behavioral aide to complete 30 hours of preservice training. The 
48.13 	preservice training must include topics specified in Minnesota Rules, part 9535.4068, 
48.14 	subparts 1 and 2, and parent team training. The preservice training must include 15 hours 
48.15 	of in-person training of a mental health behavioral aide in mental health services delivery 
48.16 	and eight hours of parent team training. Curricula for parent team training must be 
48.17 	approved in advance by the commissioner. Components of parent team training include:
48.18 	(1) partnering with parents;
48.19 	(2) fundamentals of family support;
48.20 	(3) fundamentals of policy and decision making;
48.21 	(4) defining equal partnership;
48.22 	(5) complexities of the parent and service provider partnership in multiple service 
48.23 	delivery systems due to system strengths and weaknesses;
48.24 	(6) sibling impacts;
48.25 	(7) support networks; and
48.26 	(8) community resources.
48.27 	(c) A provider entity that employs a mental health practitioner and a mental health 
48.28 	behavioral aide to provide children's therapeutic services and supports under this section 
48.29 	must require the mental health practitioner and mental health behavioral aide to complete 
48.30 	20 hours of continuing education every two calendar years. The continuing education 
48.31 	must be related to serving the needs of a child with emotional disturbance in the child's 
48.32 	home environment and the child's family. The topics covered in orientation and training 
48.33 	must conform to Minnesota Rules, part 9535.4068.
48.34 	(d) The provider entity must document the mental health practitioner's or mental 
48.35 	health behavioral aide's annual completion of the required continuing education. The 
49.1 	documentation must include the date, subject, and number of hours of the continuing 
49.2 	education, and attendance records, as verified by the staff member's signature, job 
49.3 	title, and the instructor's name. The provider entity must keep documentation for each 
49.4 	employee, including records of attendance at professional workshops and conferences, 
49.5 	at a central location and in the employee's personnel file.

49.6 	EFFECTIVE DATE. This section is effective the day following final enactment.

49.7 	Sec. 15. Minnesota Statutes 2012, section 256B.0943, subdivision 10, is amended to 
49.8 	read:
49.9 		Subd. 10.Service authorization. The commissioner shall publish in the State 
49.10 	Register a list of health services that require prior authorization, as well as the criteria 
49.11 	and standards used to select health services on the list. The list and the criteria and 
49.12 	standards used to formulate the list are not subject to the requirements of sections 14.001
49.13 	 to 14.69. The commissioner's decision on whether prior authorization is required for a 
49.14 	health service is not subject to administrative appeal. Children's therapeutic services and 
49.15 	supports are subject to authorization criteria and standards published by the commissioner 
49.16 	according to section 256B.0625, subdivision 25.

49.17 	EFFECTIVE DATE. This section is effective the day following final enactment.

49.18 	Sec. 16. Minnesota Statutes 2012, section 256B.0943, subdivision 12, is amended to 
49.19 	read:
49.20 		Subd. 12.Excluded services. The following services are not eligible for medical 
49.21 	assistance payment as children's therapeutic services and supports:
49.22 	(1) service components of children's therapeutic services and supports simultaneously 
49.23 	provided by more than one provider entity unless prior authorization is obtained;
49.24 	(2) treatment by multiple providers within the same agency at the same clock time;
49.25 	(3) children's therapeutic services and supports provided in violation of medical 
49.26 	assistance policy in Minnesota Rules, part 9505.0220;
49.27 	(4) mental health behavioral aide services provided by a personal care assistant who 
49.28 	is not qualified as a mental health behavioral aide and employed by a certified children's 
49.29 	therapeutic services and supports provider entity;
49.30 	(5) service components of CTSS that are the responsibility of a residential or 
49.31 	program license holder, including foster care providers under the terms of a service 
49.32 	agreement or administrative rules governing licensure; and
50.1 	(6) adjunctive activities that may be offered by a provider entity but are not 
50.2 	otherwise covered by medical assistance, including:
50.3 	(i) a service that is primarily recreation oriented or that is provided in a setting that 
50.4 	is not medically supervised. This includes sports activities, exercise groups, activities 
50.5 	such as craft hours, leisure time, social hours, meal or snack time, trips to community 
50.6 	activities, and tours;
50.7 	(ii) a social or educational service that does not have or cannot reasonably be 
50.8 	expected to have a therapeutic outcome related to the client's emotional disturbance;
50.9 	(iii) consultation with other providers or service agency staff about the care or 
50.10 	progress of a client;
50.11 	(iv) (iii) prevention or education programs provided to the community; and
50.12 	(v) (iv) treatment for clients with primary diagnoses of alcohol or other drug abuse; 
50.13 	and.
50.14 	(7) activities that are not direct service time.

50.15 	EFFECTIVE DATE. This section is effective the day following final enactment.

50.16 	Sec. 17.  REPEALER.
 50.17 	(a) Minnesota Statutes 2012, sections 4.47; 245.0311; 245.0312; 245.4861; 245.487, 
50.18 	subdivisions 4 and 5; 245.4871, subdivisions 7, 11, 18, and 25; 245.4872; 245.4873, 
50.19 	subdivisions 3 and 6; 245.4875, subdivisions 3, 6, and 7; 245.4883, subdivision 1; 245.490; 
50.20 	245.492, subdivisions 6, 8, 13, and 19; 245.4932, subdivisions 2, 3, and 4; 245.4933; 
50.21 	245.494; 245.63; 245.69, subdivision 1; 245.714; 245.715; 245.717; 245.718; 245.721; 
50.22 	245.77; 245.827; 245.981; 246.0135; 246.016; 246.023, subdivision 1; 246.16; 246.28; 
50.23 	246.325; 246.70; 246.71; 246.711; 246.712; 246.713; 246.714; 246.715; 246.716; 246.717; 
50.24 	246.718; 246.719; 246.72; 246.721; 246.722; 253B.22; 254.01; 254.03; 254.04; 254.06; 
50.25 	254.07; 254.09; 254.10; 254.11; 254A.05, subdivision 1; 254A.07, subdivisions 1 and 2; 
50.26 	254A.16, subdivision 1; 254B.01, subdivision 1; and 254B.04, subdivision 3, are repealed.
50.27 	(b) Minnesota Statutes 2013 Supplement, sections 246.0141; 246.0251; 254.05; 
50.28 	and 254B.13, subdivision 3, are repealed.

50.29 	ARTICLE 4
50.30 	CONTINUING CARE

50.31 	Section 1. Minnesota Statutes 2012, section 256B.0913, subdivision 5a, is amended to 
50.32 	read:
51.1 		Subd. 5a.Services; service definitions; service standards. (a) Unless specified in 
51.2 	statute, the services, service definitions, and standards for alternative care services shall 
51.3 	be the same as the services, service definitions, and standards specified in the federally 
51.4 	approved elderly waiver plan, except alternative care does not cover transitional support 
51.5 	services, assisted living services, adult foster care services, and residential care and 
51.6 	benefits defined under section 256B.0625 that meet primary and acute health care needs.
51.7 	(b) The lead agency must ensure that the funds are not used to supplant or 
51.8 	supplement services available through other public assistance or services programs, 
51.9 	including supplementation of client co-pays, deductibles, premiums, or other cost-sharing 
51.10 	arrangements for health-related benefits and services or entitlement programs and services 
51.11 	that are available to the person, but in which they have elected not to enroll. The 
51.12 	lead agency must ensure that the benefit department recovery system in the Medicaid 
51.13 	Management Information System (MMIS) has the necessary information on any other 
51.14 	health insurance or third-party insurance policy to which the client may have access. For a 
51.15 	provider of supplies and equipment when the monthly cost of the supplies and equipment 
51.16 	is less than $250, persons or agencies must be employed by or under a contract with the 
51.17 	lead agency or the public health nursing agency of the local board of health in order to 
51.18 	receive funding under the alternative care program. Supplies and equipment may be 
51.19 	purchased from a vendor not certified to participate in the Medicaid program if the cost for 
51.20 	the item is less than that of a Medicaid vendor.
51.21 	(c) Personal care services must meet the service standards defined in the federally 
51.22 	approved elderly waiver plan, except that a lead agency may contract with authorize 
51.23 	services to be provided by a client's relative who meets the relative hardship waiver 
51.24 	requirements or a relative who meets the criteria and is also the responsible party under 
51.25 	an individual service plan that ensures the client's health and safety and supervision of 
51.26 	the personal care services by a qualified professional as defined in section 256B.0625, 
51.27 	subdivision 19c. Relative hardship is established by the lead agency when the client's care 
51.28 	causes a relative caregiver to do any of the following: resign from a paying job, reduce 
51.29 	work hours resulting in lost wages, obtain a leave of absence resulting in lost wages, incur 
51.30 	substantial client-related expenses, provide services to address authorized, unstaffed direct 
51.31 	care time, or meet special needs of the client unmet in the formal service plan.

51.32 	Sec. 2. Minnesota Statutes 2012, section 256B.0913, subdivision 14, is amended to read:
51.33 		Subd. 14.Provider requirements, payment, and rate adjustments. (a) Unless 
51.34 	otherwise specified in statute, providers must be enrolled as Minnesota health care 
52.1 	program providers and abide by the requirements for provider participation according to 
52.2 	Minnesota Rules, part 9505.0195.
52.3 	(b) Payment for provided alternative care services as approved by the client's 
52.4 	case manager shall occur through the invoice processing procedures of the department's 
52.5 	Medicaid Management Information System (MMIS). To receive payment, the lead agency 
52.6 	or vendor must submit invoices within 12 months following the date of service. The lead 
52.7 	agency and its vendors under contract shall not be reimbursed for services which exceed 
52.8 	the county allocation. Service rates are governed by section 256B.0915, subdivision 3g.
52.9 	(c) The lead agency shall negotiate individual rates with vendors and may authorize 
52.10 	service payment for actual costs up to the county's current approved rate. Notwithstanding 
52.11 	any other rule or statutory provision to the contrary, the commissioner shall not be 
52.12 	authorized to increase rates by an annual inflation factor, unless so authorized by the 
52.13 	legislature. To improve access to community services and eliminate payment disparities 
52.14 	between the alternative care program and the elderly waiver program, the commissioner 
52.15 	shall establish statewide maximum service rate limits and eliminate county-specific 
52.16 	service rate limits.
52.17 	(1) Effective July 1, 2001, for service rate limits, except those in subdivision 5, 
52.18 	paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative 
52.19 	care statewide maximum rate or the elderly waiver statewide maximum rate.
52.20 	(2) Lead agencies may negotiate individual service rates with vendors for actual 
52.21 	costs up to the statewide maximum service rate limit.

52.22 	Sec. 3. Minnesota Statutes 2012, section 256B.0915, subdivision 3c, is amended to read:
52.23 		Subd. 3c.Service approval and contracting provisions. (a) Medical assistance 
52.24 	funding for skilled nursing services, private duty nursing, home health aide, and personal 
52.25 	care services for waiver recipients must be approved by the case manager and included in 
52.26 	the coordinated service and support plan.
52.27 	(b) A lead agency is not required to contract with a provider of supplies and 
52.28 	equipment if the monthly cost of the supplies and equipment is less than $250.

52.29 	Sec. 4. Minnesota Statutes 2012, section 256B.0915, subdivision 3d, is amended to read:
52.30 		Subd. 3d.Adult foster care rate. The adult foster care rate shall be considered a 
52.31 	difficulty of care payment and shall not include room and board. The adult foster care 
52.32 	service rate shall be negotiated between the lead agency and the foster care provider. The 
52.33 	elderly waiver payment for the foster care service in combination with the payment for 
53.1 	all other elderly waiver services, including case management, must not exceed the limit 
53.2 	specified in subdivision 3a, paragraph (a).

53.3 	Sec. 5. Minnesota Statutes 2012, section 256B.0915, subdivision 3f, is amended to read:
53.4 		Subd. 3f.Individual service rates Payments for services; expenditure forecasts.
 53.5 	(a) The lead agency shall negotiate individual service rates with vendors and may 
53.6 	authorize payment for actual costs up to the lead agency's current approved rate. Persons 
53.7 	or agencies must be employed by or under a contract with the lead agency or the public 
53.8 	health nursing agency of the local board of health in order to receive funding under the 
53.9 	elderly waiver program, except as a provider of supplies and equipment when the monthly 
53.10 	cost of the supplies and equipment is less than $250. Lead agencies shall authorize 
53.11 	payments for services in accordance with the payment rates and limits published annually 
53.12 	by the commissioner.
53.13 	(b) Reimbursement for the medical assistance recipients under the approved waiver 
53.14 	shall be made from the medical assistance account through the invoice processing 
53.15 	procedures of the department's Medicaid Management Information System (MMIS), 
53.16 	only with the approval of the client's case manager. The budget for the state share of the 
53.17 	Medicaid expenditures shall be forecasted with the medical assistance budget, and shall 
53.18 	be consistent with the approved waiver.

53.19 	Sec. 6. Minnesota Statutes 2012, section 256B.0915, subdivision 3g, is amended to read:
53.20 		Subd. 3g.Service rate limits; state assumption of costs. (a) To improve access 
53.21 	to community services and eliminate payment disparities between the alternative care 
53.22 	program and the elderly waiver, the commissioner shall establish statewide maximum
53.23 	 service rate limits and eliminate lead agency-specific service rate limits.
53.24 	(b) Effective July 1, 2001, for statewide service rate limits, except those described 
53.25 	or defined in subdivisions 3d and, 3e, and 3h, the statewide service rate limit for each 
53.26 	service shall be the greater of the alternative care statewide maximum rate or the elderly 
53.27 	waiver statewide maximum rate.
53.28 	(c) Lead agencies may negotiate individual service rates with vendors for actual 
53.29 	costs up to the statewide maximum service rate limit.

53.30 	Sec. 7.  REPEALER.
 53.31 	(a) Minnesota Statutes 2012, sections 245.072; 256.971; 256.975, subdivision 3; 
53.32 	256.9753, subdivision 4; 256B.04, subdivision 16; 256B.0656; 256B.0657; 256B.0913, 
53.33 	subdivision 9; 256B.0916, subdivisions 6 and 6a; 256B.0928; 256B.431, subdivisions 28, 
54.1 	31, 33, 34, 37, 38, 39, 40, 41, and 43; 256B.434, subdivision 19; 256B.440; 256B.441, 
54.2 	subdivisions 46 and 46a; 256B.491; 256B.501, subdivisions 3a, 3b, 3h, 3j, 3k, 3l, and 5e; 
54.3 	256B.5016; 256B.503; and 626.557, subdivision 16, are repealed.
54.4 	(b) Minnesota Statutes 2013 Supplement, sections 256B.501, subdivision 5b; and 
54.5 	256C.29, are repealed.
54.6 	(c) Minnesota Rules, parts 9549.0020, subparts 2, 12, 13, 20, 23, 24, 25, 26, 27, 30, 
54.7 	31, 32, 33, 34, 35, 36, 38, 41, 42, 43, 44, 46, and 47; 9549.0030; 9549.0035, subparts 4, 
54.8 	5, and 6; 9549.0036; 9549.0040; 9549.0041, subparts 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 
54.9 	13, 14, and 15; 9549.0050; 9549.0051, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, and 
54.10 	14; 9549.0053; 9549.0054; 9549.0055, subpart 4; 9549.0056; 9549.0058; 9549.0059; 
54.11 	9549.0060, subparts 1, 2, 3, 8, 9, 12, and 13; 9549.0061; and 9549.0070, subparts 1 
54.12 	and 4, are repealed.

54.13 	ARTICLE 5
54.14 	OPERATIONS

54.15 	Section 1. Minnesota Statutes 2012, section 13.46, subdivision 4, is amended to read:
54.16 		Subd. 4.Licensing data. (a) As used in this subdivision:
54.17 	(1) "licensing data" are all data collected, maintained, used, or disseminated by the 
54.18 	welfare system pertaining to persons licensed or registered or who apply for licensure 
54.19 	or registration or who formerly were licensed or registered under the authority of the 
54.20 	commissioner of human services;
54.21 	(2) "client" means a person who is receiving services from a licensee or from an 
54.22 	applicant for licensure; and
54.23 	(3) "personal and personal financial data" are Social Security numbers, identity 
54.24 	of and letters of reference, insurance information, reports from the Bureau of Criminal 
54.25 	Apprehension, health examination reports, and social/home studies.
54.26 	(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, 
54.27 	license holders, and former licensees are public: name, address, telephone number of 
54.28 	licensees, date of receipt of a completed application, dates of licensure, licensed capacity, 
54.29 	type of client preferred, variances granted, record of training and education in child care 
54.30 	and child development, type of dwelling, name and relationship of other family members, 
54.31 	previous license history, class of license, the existence and status of complaints, and the 
54.32 	number of serious injuries to or deaths of individuals in the licensed program as reported 
54.33 	to the commissioner of human services, the local social services agency, or any other 
54.34 	county welfare agency. For purposes of this clause, a serious injury is one that is treated 
54.35 	by a physician.
55.1 	(ii) When a correction order, an order to forfeit a fine, an order of license suspension, 
55.2 	an order of temporary immediate suspension, an order of license revocation, an order 
55.3 	of license denial, or an order of conditional license has been issued, or a complaint is 
55.4 	resolved, the following data on current and former licensees and applicants are public: the 
55.5 	substance and investigative findings of the licensing or maltreatment complaint, licensing 
55.6 	violation, or substantiated maltreatment; the record of informal resolution of a licensing 
55.7 	violation; orders of hearing; findings of fact; conclusions of law; specifications of the final 
55.8 	correction order, fine, suspension, temporary immediate suspension, revocation, denial, or 
55.9 	conditional license contained in the record of licensing action; whether a fine has been 
55.10 	paid; and the status of any appeal of these actions.
55.11 	(iii) When a license denial under section 245A.05 or a sanction under section 
55.12 	245A.07 is based on a determination that the license holder or applicant is responsible for 
55.13 	maltreatment under section 626.556 or 626.557, the identity of the applicant or license 
55.14 	holder as the individual responsible for maltreatment is public data at the time of the 
55.15 	issuance of the license denial or sanction.
55.16 	(iv) When a license denial under section 245A.05 or a sanction under section 
55.17 	245A.07 is based on a determination that the license holder or applicant is disqualified 
55.18 	under chapter 245C, the identity of the license holder or applicant as the disqualified 
55.19 	individual and the reason for the disqualification are public data at the time of the 
55.20 	issuance of the licensing sanction or denial. If the applicant or license holder requests 
55.21 	reconsideration of the disqualification and the disqualification is affirmed, the reason for 
55.22 	the disqualification and the reason to not set aside the disqualification are public data.
55.23 	(2) Notwithstanding sections 626.556, subdivision 11, and 626.557, subdivision 12b, 
55.24 	when any person subject to disqualification under section 245C.14 in connection with a 
55.25 	license to provide family day care for children, child care center services, foster care for 
55.26 	children in the provider's home, or foster care or day care services for adults in the provider's 
55.27 	home is a substantiated perpetrator of maltreatment, and the substantiated maltreatment is 
55.28 	a reason for a licensing action, the identity of the substantiated perpetrator of maltreatment 
55.29 	is public data. For purposes of this clause, a person is a substantiated perpetrator if the 
55.30 	maltreatment determination has been upheld under section 256.045; 626.556, subdivision 
55.31 	10i; 626.557, subdivision 9d; or chapter 14, or if an individual or facility has not timely 
55.32 	exercised appeal rights under these sections, except as provided under clause (1).
55.33 	(3)(2) For applicants who withdraw their application prior to licensure or denial of 
55.34 	a license, the following data are public: the name of the applicant, the city and county 
55.35 	in which the applicant was seeking licensure, the dates of the commissioner's receipt of 
56.1 	the initial application and completed application, the type of license sought, and the date 
56.2 	of withdrawal of the application.
56.3 	(4) (3) For applicants who are denied a license, the following data are public: the 
56.4 	name and address of the applicant, the city and county in which the applicant was seeking 
56.5 	licensure, the dates of the commissioner's receipt of the initial application and completed 
56.6 	application, the type of license sought, the date of denial of the application, the nature of 
56.7 	the basis for the denial, the record of informal resolution of a denial, orders of hearings, 
56.8 	findings of fact, conclusions of law, specifications of the final order of denial, and the 
56.9 	status of any appeal of the denial.
56.10 	(5) The following data on persons subject to disqualification under section 245C.14 in 
56.11 	connection with a license to provide family day care for children, child care center services, 
56.12 	foster care for children in the provider's home, or foster care or day care services for adults 
56.13 	in the provider's home, are public: the nature of any disqualification set aside under section 
56.14 	245C.22, subdivisions 2 and 4, and the reasons for setting aside the disqualification; the 
56.15 	nature of any disqualification for which a variance was granted under sections 245A.04, 
56.16 	subdivision 9; and 245C.30, and the reasons for granting any variance under section 
56.17 	245A.04, subdivision 9; and, if applicable, the disclosure that any person subject to 
56.18 	a background study under section 245C.03, subdivision 1, has successfully passed a 
56.19 	background study. If a licensing sanction under section 245A.07, or a license denial under 
56.20 	section 245A.05, is based on a determination that an individual subject to disqualification 
56.21 	under chapter 245C is disqualified, the disqualification as a basis for the licensing sanction 
56.22 	or denial is public data. As specified in clause (1), item (iv), if the disqualified individual 
56.23 	is the license holder or applicant, the identity of the license holder or applicant and the 
56.24 	reason for the disqualification are public data; and, if the license holder or applicant 
56.25 	requested reconsideration of the disqualification and the disqualification is affirmed, the 
56.26 	reason for the disqualification and the reason to not set aside the disqualification are 
56.27 	public data. If the disqualified individual is an individual other than the license holder or 
56.28 	applicant, the identity of the disqualified individual shall remain private data.
56.29 	(6) (4) When maltreatment is substantiated under section 626.556 or 626.557 and 
56.30 	the victim and the substantiated perpetrator are affiliated with a program licensed under 
56.31 	chapter 245A, the commissioner of human services, local social services agency, or 
56.32 	county welfare agency may inform the license holder where the maltreatment occurred of 
56.33 	the identity of the substantiated perpetrator and the victim.
56.34 	(7) (5) Notwithstanding clause (1), for child foster care, only the name of the license 
56.35 	holder and the status of the license are public if the county attorney has requested that data 
57.1 	otherwise classified as public data under clause (1) be considered private data based on the 
57.2 	best interests of a child in placement in a licensed program.
57.3 	(c) The following are private data on individuals under section 13.02, subdivision 
57.4 	12, or nonpublic data under section 13.02, subdivision 9: personal and personal financial 
57.5 	data on family day care program and family foster care program applicants and licensees 
57.6 	and their family members who provide services under the license.
57.7 	(d) The following are private data on individuals: the identity of persons who have 
57.8 	made reports concerning licensees or applicants that appear in inactive investigative data, 
57.9 	and the records of clients or employees of the licensee or applicant for licensure whose 
57.10 	records are received by the licensing agency for purposes of review or in anticipation of a 
57.11 	contested matter. The names of reporters of complaints or alleged violations of licensing 
57.12 	standards under chapters 245A, 245B, 245C, and applicable rules and alleged maltreatment 
57.13 	under sections 626.556 and 626.557, are confidential data and may be disclosed only as 
57.14 	provided in section 626.556, subdivision 11, or 626.557, subdivision 12b.
57.15 	(e) Data classified as private, confidential, nonpublic, or protected nonpublic under 
57.16 	this subdivision become public data if submitted to a court or administrative law judge as 
57.17 	part of a disciplinary proceeding in which there is a public hearing concerning a license 
57.18 	which has been suspended, immediately suspended, revoked, or denied.
57.19 	(f) Data generated in the course of licensing investigations that relate to an alleged 
57.20 	violation of law are investigative data under subdivision 3.
57.21 	(g) Data that are not public data collected, maintained, used, or disseminated under 
57.22 	this subdivision that relate to or are derived from a report as defined in section 626.556, 
57.23 	subdivision 2, or 626.5572, subdivision 18, are subject to the destruction provisions of 
57.24 	sections 626.556, subdivision 11c, and 626.557, subdivision 12b.
57.25 	(h) Upon request, not public data collected, maintained, used, or disseminated under 
57.26 	this subdivision that relate to or are derived from a report of substantiated maltreatment as 
57.27 	defined in section 626.556 or 626.557 may be exchanged with the Department of Health 
57.28 	for purposes of completing background studies pursuant to section 144.057 and with 
57.29 	the Department of Corrections for purposes of completing background studies pursuant 
57.30 	to section 241.021.
57.31 	(i) Data on individuals collected according to licensing activities under chapters 
57.32 	245A and 245C, data on individuals collected by the commissioner of human services 
57.33 	according to investigations under chapters 245A, 245B, and 245C, and sections 626.556
57.34 	and 626.557 may be shared with the Department of Human Rights, the Department 
57.35 	of Health, the Department of Corrections, the ombudsman for mental health and 
57.36 	developmental disabilities, and the individual's professional regulatory board when there 
58.1 	is reason to believe that laws or standards under the jurisdiction of those agencies may 
58.2 	have been violated or the information may otherwise be relevant to the board's regulatory 
58.3 	jurisdiction. Background study data on an individual who is the subject of a background 
58.4 	study under chapter 245C for a licensed service for which the commissioner of human 
58.5 	services is the license holder may be shared with the commissioner and the commissioner's 
58.6 	delegate by the licensing division. Unless otherwise specified in this chapter, the identity 
58.7 	of a reporter of alleged maltreatment or licensing violations may not be disclosed.
58.8 	(j) In addition to the notice of determinations required under section 626.556, 
58.9 	subdivision 10f, if the commissioner or the local social services agency has determined 
58.10 	that an individual is a substantiated perpetrator of maltreatment of a child based on sexual 
58.11 	abuse, as defined in section 626.556, subdivision 2, and the commissioner or local social 
58.12 	services agency knows that the individual is a person responsible for a child's care in 
58.13 	another facility, the commissioner or local social services agency shall notify the head 
58.14 	of that facility of this determination. The notification must include an explanation of the 
58.15 	individual's available appeal rights and the status of any appeal. If a notice is given under 
58.16 	this paragraph, the government entity making the notification shall provide a copy of the 
58.17 	notice to the individual who is the subject of the notice.
58.18 	(k) All not public data collected, maintained, used, or disseminated under this 
58.19 	subdivision and subdivision 3 may be exchanged between the Department of Human 
58.20 	Services, Licensing Division, and the Department of Corrections for purposes of 
58.21 	regulating services for which the Department of Human Services and the Department 
58.22 	of Corrections have regulatory authority.

58.23 	Sec. 2. Minnesota Statutes 2013 Supplement, section 245A.03, subdivision 7, is 
58.24 	amended to read:
58.25 		Subd. 7.Licensing moratorium. (a) The commissioner shall not issue an initial 
58.26 	license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, 
58.27 	or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under 
58.28 	this chapter for a physical location that will not be the primary residence of the license 
58.29 	holder for the entire period of licensure. If a license is issued during this moratorium, and 
58.30 	the license holder changes the license holder's primary residence away from the physical 
58.31 	location of the foster care license, the commissioner shall revoke the license according 
58.32 	to section 245A.07. The commissioner shall not issue an initial license for a community 
58.33 	residential setting licensed under chapter 245D. Exceptions to the moratorium include:
58.34 	(1) foster care settings that are required to be registered under chapter 144D;
59.1 	(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or 
59.2 	community residential setting licenses replacing adult foster care licenses in existence on 
59.3 	December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
59.4 	(3) new foster care licenses or community residential setting licenses determined to 
59.5 	be needed by the commissioner under paragraph (b) for the closure of a nursing facility, 
59.6 	ICF/DD, or regional treatment center; restructuring of state-operated services that limits 
59.7 	the capacity of state-operated facilities; or allowing movement to the community for 
59.8 	people who no longer require the level of care provided in state-operated facilities as 
59.9 	provided under section 256B.092, subdivision 13, or 256B.49, subdivision 24;
59.10 	(4) new foster care licenses or community residential setting licenses determined 
59.11 	to be needed by the commissioner under paragraph (b) for persons requiring hospital 
59.12 	level care; or
59.13 	(5) new foster care licenses or community residential setting licenses determined to 
59.14 	be needed by the commissioner for the transition of people from personal care assistance 
59.15 	to the home and community-based services.
59.16 	(b) The commissioner shall determine the need for newly licensed foster care 
59.17 	homes or community residential settings as defined under this subdivision. As part of the 
59.18 	determination, the commissioner shall consider the availability of foster care capacity in 
59.19 	the area in which the licensee seeks to operate, and the recommendation of the local 
59.20 	county board. The determination by the commissioner must be final. A determination of 
59.21 	need is not required for a change in ownership at the same address.
59.22 	(c) When an adult resident served by the program moves out of a foster home 
59.23 	that is not the primary residence of the license holder according to section 256B.49, 
59.24 	subdivision 15, paragraph (f), or the adult community residential setting, the county 
59.25 	shall immediately inform the Department of Human Services Licensing Division. The 
59.26 	department shall decrease the statewide licensed capacity for adult foster care settings 
59.27 	where the physical location is not the primary residence of the license holder, or for adult 
59.28 	community residential settings, if the voluntary changes described in paragraph (e) are 
59.29 	not sufficient to meet the savings required by reductions in licensed bed capacity under 
59.30 	Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f), 
59.31 	and maintain statewide long-term care residential services capacity within budgetary 
59.32 	limits. Implementation of the statewide licensed capacity reduction shall begin on July 
59.33 	1, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the 
59.34 	needs determination process. Under this paragraph, the commissioner has the authority 
59.35 	to reduce unused licensed capacity of a current foster care program, or the community 
59.36 	residential settings, to accomplish the consolidation or closure of settings. Under this 
60.1 	paragraph, the commissioner has the authority to manage statewide capacity, including 
60.2 	adjusting the capacity available to each county and adjusting statewide available capacity, 
60.3 	to meet the statewide needs identified through the process in paragraph (e). A decreased 
60.4 	licensed capacity according to this paragraph is not subject to appeal under this chapter.
60.5 	(d) Residential settings that would otherwise be subject to the decreased license 
60.6 	capacity established in paragraph (c) shall be exempt under the following circumstances:
60.7 	(1) until August 1, 2013, the license holder's beds occupied by residents whose 
60.8 	primary diagnosis is mental illness and the license holder is:
60.9 	(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental 
60.10 	health services (ARMHS) as defined in section 256B.0623;
60.11 	(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to 
60.12 	9520.0870;
60.13 	(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to 
60.14 	9520.0870; or
60.15 	(iv) a provider of intensive residential treatment services (IRTS) licensed under 
60.16 	Minnesota Rules, parts 9520.0500 to 9520.0670; or
60.17 	(2) if the license holder's beds are occupied by residents whose primary diagnosis is 
60.18 	mental illness and the license holder is certified under the requirements in subdivision 6a 
60.19 	or section 245D.33.
60.20 	(e) A resource need determination process, managed at the state level, using the 
60.21 	available reports required by section 144A.351, and other data and information shall 
60.22 	be used to determine where the reduced capacity required under paragraph (c) will be 
60.23 	implemented. The commissioner shall consult with the stakeholders described in section 
60.24 	144A.351, and employ a variety of methods to improve the state's capacity to meet 
60.25 	long-term care service needs within budgetary limits, including seeking proposals from 
60.26 	service providers or lead agencies to change service type, capacity, or location to improve 
60.27 	services, increase the independence of residents, and better meet needs identified by the 
60.28 	long-term care services reports and statewide data and information. By February 1, 2013, 
60.29 	and August 1, 2014, and each following year, the commissioner shall provide information 
60.30 	and data on the overall capacity of licensed long-term care services, actions taken under 
60.31 	this subdivision to manage statewide long-term care services and supports resources, and 
60.32 	any recommendations for change to the legislative committees with jurisdiction over 
60.33 	health and human services budget.
60.34 	(f) At the time of application and reapplication for licensure, the applicant and the 
60.35 	license holder that are subject to the moratorium or an exclusion established in paragraph 
60.36 	(a) are required to inform the commissioner whether the physical location where the foster 
61.1 	care will be provided is or will be the primary residence of the license holder for the entire 
61.2 	period of licensure. If the primary residence of the applicant or license holder changes, the 
61.3 	applicant or license holder must notify the commissioner immediately. The commissioner 
61.4 	shall print on the foster care license certificate whether or not the physical location is the 
61.5 	primary residence of the license holder.
61.6 	(g) License holders of foster care homes identified under paragraph (f) that are not 
61.7 	the primary residence of the license holder and that also provide services in the foster care 
61.8 	home that are covered by a federally approved home and community-based services 
61.9 	waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the 
61.10 	human services licensing division that the license holder provides or intends to provide 
61.11 	these waiver-funded services.

61.12 	Sec. 3. Minnesota Statutes 2013 Supplement, section 245A.40, subdivision 5, is 
61.13 	amended to read:
61.14 		Subd. 5.Sudden unexpected infant death and abusive head trauma training. (a) 
61.15 	License holders must document that before staff persons and volunteers care for infants, 
61.16 	they are instructed on the standards in section 245A.1435 and receive training on reducing 
61.17 	the risk of sudden unexpected infant death. In addition, license holders must document 
61.18 	that before staff persons care for infants or children under school age, they receive training 
61.19 	on the risk of abusive head trauma from shaking infants and young children. The training 
61.20 	in this subdivision may be provided as orientation training under subdivision 1 and 
61.21 	in-service training under subdivision 7.
61.22 	(b) Sudden unexpected infant death reduction training required under this 
61.23 	subdivision must be at least one-half hour in length and must be completed at least once 
61.24 	every year. At a minimum, the training must address the risk factors related to sudden 
61.25 	unexpected infant death, means of reducing the risk of sudden unexpected infant death in 
61.26 	child care, and license holder communication with parents regarding reducing the risk of 
61.27 	sudden unexpected infant death.
61.28 	(c) Abusive head trauma training under this subdivision must be at least one-half 
61.29 	hour in length and must be completed at least once every year. At a minimum, the training 
61.30 	must address the risk factors related to shaking infants and young children, means to 
61.31 	reduce the risk of abusive head trauma in child care, and license holder communication 
61.32 	with parents regarding reducing the risk of abusive head trauma.
61.33 	(d) The commissioner shall make available for viewing a video presentation on the 
61.34 	dangers associated with shaking infants and young children. The video presentation must 
61.35 	be part of the orientation and annual in-service training of licensed child care center 
62.1 	staff persons caring for children under school age. The commissioner shall provide to 
62.2 	child care providers and interested individuals, at cost, copies of a video approved by the 
62.3 	commissioner of health under section 144.574 on the dangers associated with shaking 
62.4 	infants and young children.

62.5 	Sec. 4. Minnesota Statutes 2012, section 245A.40, subdivision 8, is amended to read:
62.6 		Subd. 8.Cultural dynamics and disabilities training for child care providers.
 62.7 	(a) The training required of licensed child care center staff must include training in the 
62.8 	cultural dynamics of early childhood development and child care. The cultural dynamics 
62.9 	and disabilities training and skills development of child care providers must be designed 
62.10 	to achieve outcomes for providers of child care that include, but are not limited to:
62.11 	(1) an understanding and support of the importance of culture and differences in 
62.12 	ability in children's identity development;
62.13 	(2) understanding the importance of awareness of cultural differences and 
62.14 	similarities in working with children and their families;
62.15 	(3) understanding and support of the needs of families and children with differences 
62.16 	in ability;
62.17 	(4) developing skills to help children develop unbiased attitudes about cultural 
62.18 	differences and differences in ability;
62.19 	(5) developing skills in culturally appropriate caregiving; and
62.20 	(6) developing skills in appropriate caregiving for children of different abilities.
62.21 	(b) Curriculum for cultural dynamics and disability training shall be approved by 
62.22 	the commissioner.
62.23 	(c) The commissioner shall amend current rules relating to the training of the 
62.24 	licensed child care center staff to require cultural dynamics training. Timelines established 
62.25 	in the rule amendments for complying with the cultural dynamics training requirements 
62.26 	must be based on the commissioner's determination that curriculum materials and trainers 
62.27 	are available statewide.
62.28 	(d)(b) For programs caring for children with special needs, the license holder shall 
62.29 	ensure that any additional staff training required by the child's individual child care 
62.30 	program plan required under Minnesota Rules, part 9503.0065, subpart 3, is provided.

62.31 	Sec. 5. Minnesota Statutes 2013 Supplement, section 245A.50, subdivision 3, is 
62.32 	amended to read:
62.33 		Subd. 3.First aid. (a) When children are present in a family child care home 
62.34 	governed by Minnesota Rules, parts 9502.0315 to 9502.0445, at least one staff person 
63.1 	must be present in the home who has been trained in first aid. The first aid training must 
63.2 	have been provided by an individual approved to provide first aid instruction. First aid 
63.3 	training may be less than eight hours and persons qualified to provide first aid training 
63.4 	include individuals approved as first aid instructors. First aid training must be repeated 
63.5 	every two years.
63.6 	(b) A family child care provider is exempt from the first aid training requirements 
63.7 	under this subdivision related to any substitute caregiver who provides less than 30 hours 
63.8 	of care during any 12-month period.
63.9 	(c) Video training reviewed and approved by the county licensing agency satisfies 
63.10 	the training requirement of this subdivision.

63.11 	Sec. 6. Minnesota Statutes 2012, section 245C.04, subdivision 1, is amended to read:
63.12 		Subdivision 1.Licensed programs. (a) The commissioner shall conduct a 
63.13 	background study of an individual required to be studied under section 245C.03, 
63.14 	subdivision 1, at least upon application for initial license for all license types.
63.15 	(b) The commissioner shall conduct a background study of an individual required 
63.16 	to be studied under section 245C.03, subdivision 1, at reapplication for a license for 
63.17 	family child care.
63.18 	(c) The commissioner is not required to conduct a study of an individual at the time 
63.19 	of reapplication for a license if the individual's background study was completed by the 
63.20 	commissioner of human services for an adult foster care license holder that is also: and
63.21 	(1) registered under chapter 144D; or
63.22 	(2) licensed to provide home and community-based services to people with 
63.23 	disabilities at the foster care location and the license holder does not reside in the foster 
63.24 	care residence; and
63.25 	(3) the following conditions are met:
63.26 	(i)(1) a study of the individual was conducted either at the time of initial licensure 
63.27 	or when the individual became affiliated with the license holder;
63.28 	(ii)(2) the individual has been continuously affiliated with the license holder since 
63.29 	the last study was conducted; and
63.30 	(iii)(3) the last study of the individual was conducted on or after October 1, 1995.
63.31 	(d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall 
63.32 	conduct a study of an individual required to be studied under section 245C.03, at the 
63.33 	time of reapplication for a child foster care license. The county or private agency shall 
63.34 	collect and forward to the commissioner the information required under section 245C.05, 
63.35 	subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background 
64.1 	study conducted by the commissioner of human services under this paragraph must 
64.2 	include a review of the information required under section 245C.08, subdivisions 1, 
64.3 	paragraph (a), clauses (1) to (5), 3, and 4.
64.4 	(e)(d) The commissioner of human services shall conduct a background study 
64.5 	of an individual specified under section 245C.03, subdivision 1, paragraph (a), clauses 
64.6 	(2) to (6), who is newly affiliated with a child foster care license holder. The county or 
64.7 	private agency shall collect and forward to the commissioner the information required 
64.8 	under section 245C.05, subdivisions 1 and 5. The background study conducted by the 
64.9 	commissioner of human services under this paragraph must include a review of the 
64.10 	information required under section 245C.08, subdivisions 1, 3, and 4.
64.11 	(f) From January 1, 2010, to December 31, 2012, unless otherwise specified in 
64.12 	paragraph (c), the commissioner shall conduct a study of an individual required to 
64.13 	be studied under section 245C.03 at the time of reapplication for an adult foster care 
64.14 	or family adult day services license: (1) the county shall collect and forward to the 
64.15 	commissioner the information required under section 245C.05, subdivision 1, paragraphs 
64.16 	(a) and (b), and subdivision 5, paragraphs (a) and (b), for background studies conducted 
64.17 	by the commissioner for all family adult day services and for adult foster care when 
64.18 	the adult foster care license holder resides in the adult foster care or family adult day 
64.19 	services residence; (2) the license holder shall collect and forward to the commissioner 
64.20 	the information required under section 245C.05, subdivisions 1, paragraphs (a) and (b); 
64.21 	and 5, paragraphs (a) and (b), for background studies conducted by the commissioner for 
64.22 	adult foster care when the license holder does not reside in the adult foster care residence; 
64.23 	and (3) the background study conducted by the commissioner under this paragraph must 
64.24 	include a review of the information required under section 245C.08, subdivision 1, 
64.25 	paragraph (a), clauses (1) to (5), and subdivisions 3 and 4.
64.26 	(g) (e) The commissioner shall conduct a background study of an individual 
64.27 	specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is 
64.28 	newly affiliated with an adult foster care or family adult day services license holder: (1) 
64.29 	the county shall collect and forward to the commissioner the information required under 
64.30 	section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a) 
64.31 	and (b), for background studies conducted by the commissioner for all family adult day 
64.32 	services and for adult foster care when the adult foster care license holder resides in 
64.33 	the adult foster care residence; (2) the license holder shall collect and forward to the 
64.34 	commissioner the information required under section 245C.05, subdivisions 1, paragraphs 
64.35 	(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the 
64.36 	commissioner for adult foster care when the license holder does not reside in the adult 
65.1 	foster care residence; and (3) the background study conducted by the commissioner under 
65.2 	this paragraph must include a review of the information required under section 245C.08, 
65.3 	subdivision 1, paragraph (a), and subdivisions 3 and 4.
65.4 	(h) (f) Applicants for licensure, license holders, and other entities as provided in 
65.5 	this chapter must submit completed background study forms to the commissioner before 
65.6 	individuals specified in section 245C.03, subdivision 1, begin positions allowing direct 
65.7 	contact in any licensed program.
65.8 	(i) (g) A license holder must initiate a new background study through the 
65.9 	commissioner's online background study system when:
65.10 	(1) an individual returns to a position requiring a background study following an 
65.11 	absence of 90 or more consecutive days; or
65.12 	(2) a program that discontinued providing licensed direct contact services for 90 or 
65.13 	more consecutive days begins to provide direct contact licensed services again.
65.14 	The license holder shall maintain a copy of the notification provided to 
65.15 	the commissioner under this paragraph in the program's files. If the individual's 
65.16 	disqualification was previously set aside for the license holder's program and the new 
65.17 	background study results in no new information that indicates the individual may pose a 
65.18 	risk of harm to persons receiving services from the license holder, the previous set-aside 
65.19 	shall remain in effect.
65.20 	(j) (h) For purposes of this section, a physician licensed under chapter 147 is 
65.21 	considered to be continuously affiliated upon the license holder's receipt from the 
65.22 	commissioner of health or human services of the physician's background study results.
65.23 	(k) (i) For purposes of family child care, a substitute caregiver must receive repeat 
65.24 	background studies at the time of each license renewal.

65.25 	Sec. 7. Minnesota Statutes 2012, section 245C.05, subdivision 5, is amended to read:
65.26 		Subd. 5.Fingerprints. (a) Except as provided in paragraph (c), for any background 
65.27 	study completed under this chapter, when the commissioner has reasonable cause to 
65.28 	believe that further pertinent information may exist on the subject of the background 
65.29 	study, the subject shall provide the commissioner with a set of classifiable fingerprints 
65.30 	obtained from an authorized agency.
65.31 	(b) For purposes of requiring fingerprints, the commissioner has reasonable cause 
65.32 	when, but not limited to, the:
65.33 	(1) information from the Bureau of Criminal Apprehension indicates that the subject 
65.34 	is a multistate offender;
66.1 	(2) information from the Bureau of Criminal Apprehension indicates that multistate 
66.2 	offender status is undetermined; or
66.3 	(3) commissioner has received a report from the subject or a third party indicating 
66.4 	that the subject has a criminal history in a jurisdiction other than Minnesota.
66.5 	(c) Except as specified under section 245C.04, subdivision 1, paragraph (d), For 
66.6 	background studies conducted by the commissioner for child foster care or adoptions, 
66.7 	the subject of the background study, who is 18 years of age or older, shall provide the 
66.8 	commissioner with a set of classifiable fingerprints obtained from an authorized agency.

66.9 	Sec. 8. Minnesota Statutes 2012, section 626.556, subdivision 3c, is amended to read:
66.10 		Subd. 3c.Local welfare agency, Department of Human Services or Department 
66.11 	of Health responsible for assessing or investigating reports of maltreatment. (a) 
66.12 	The county local welfare agency is the agency responsible for assessing or investigating 
66.13 	allegations of maltreatment in child foster care, family child care, legally unlicensed 
66.14 	child care, juvenile correctional facilities licensed under section 241.021 located in the 
66.15 	local welfare agency's county, and reports involving children served by an unlicensed 
66.16 	personal care provider organization under section 256B.0659. Copies of findings related 
66.17 	to personal care provider organizations under section 256B.0659 must be forwarded to 
66.18 	the Department of Human Services provider enrollment.
66.19 	(b) The Department of Human Services is the agency responsible for assessing or 
66.20 	investigating allegations of maltreatment in facilities licensed under chapters 245A and 
66.21 	245B, except for child foster care and family child care.
66.22 	(c) The Department of Health is the agency responsible for assessing or investigating 
66.23 	allegations of child maltreatment in facilities licensed under sections 144.50 to 144.58 
66.24 	and 144A.46.
66.25 	(d) The commissioners of human services, public safety, and education must 
66.26 	jointly submit a written report by January 15, 2007, to the education policy and finance 
66.27 	committees of the legislature recommending the most efficient and effective allocation 
66.28 	of agency responsibility for assessing or investigating reports of maltreatment and must 
66.29 	specifically address allegations of maltreatment that currently are not the responsibility 
66.30 	of a designated agency.

66.31 	Sec. 9. REVISOR'S INSTRUCTION.
 66.32 	The revisor of statutes shall make necessary technical cross-reference changes in 
66.33 	Minnesota Statutes and Minnesota Rules to conform with the sections and parts repealed 
66.34 	in articles 1 to 5.

67.1 	Sec. 10. REPEALER.
 67.2 	Minnesota Statutes 2012, sections 245A.02, subdivision 7b; 245A.09, subdivision 
67.3 	12; 245A.11, subdivision 5; and 245A.655, are repealed.