Bill Text: MN SF2397 | 2013-2014 | 88th Legislature | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Human services children and family services, health care, chemical and mental services, continuing care and operations obsolete provisions elimination; elderly waiver, alternative care program and mental health services for children provisions modifications

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2014-05-08 - HF substituted on General Orders HF2950 [SF2397 Detail]

Download: Minnesota-2013-SF2397-Engrossed.html

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A bill for an act

relating to human services; removing obsolete provisions from statute and rule
relating to children and family services, health care, chemical and mental health
services, continuing care, and operations; modifying provisions governing the
elderly waiver, the alternative care program, and mental health services for
children;amending Minnesota Statutes 2012, sections 13.46, subdivision 4;
245.4871, subdivisions 3, 6, 27; 245.4873, subdivision 2; 245.4874, subdivision
1; 245.4881, subdivisions 3, 4; 245.4882, subdivision 1; 245A.40, subdivision 8;
245C.04, subdivision 1; 245C.05, subdivision 5; 246.325; 254B.05, subdivision
2; 256.01, subdivision 14b; 256.963, subdivision 2; 256.969, subdivision
9; 256B.0913, subdivisions 5a, 14; 256B.0915, subdivisions 3c, 3d, 3f, 3g;
256B.0943, subdivisions 8, 10, 12; 256B.69, subdivisions 2, 4b, 5, 5a, 5b, 6b, 6d,
17, 26, 29, 30; 256B.692, subdivisions 2, 5; 256D.02, subdivision 11; 256D.04;
256D.045; 256D.07; 256I.04, subdivision 3; 256I.05, subdivision 1c; 256J.425,
subdivision 4; 518A.65; 595.06; 626.556, subdivision 3c; Minnesota Statutes
2013 Supplement, sections 245A.03, subdivision 7; 245A.40, subdivision 5;
245A.50, subdivision 3; 256B.0943, subdivisions 2, 7; 256B.69, subdivisions
5c, 28; 256B.76, subdivision 4; 256D.02, subdivision 12a; 517.04; Laws 2013,
chapter 108, article 3, section 48; repealing Minnesota Statutes 2012, sections
119A.04, subdivision 1; 119B.035; 119B.09, subdivision 2; 119B.23; 119B.231;
119B.232; 245.0311; 245.0312; 245.072; 245.4861; 245.487, subdivisions 4,
5; 245.4871, subdivisions 7, 11, 18, 25; 245.4872; 245.4873, subdivisions 3,
6; 245.4875, subdivisions 3, 6, 7; 245.4883, subdivision 1; 245.490; 245.492,
subdivisions 6, 8, 13, 19; 245.4932, subdivisions 2, 3, 4; 245.4933; 245.494;
245.63; 245.652; 245.69, subdivision 1; 245.714; 245.715; 245.717; 245.718;
245.721; 245.77; 245.821; 245.827; 245.981; 245A.02, subdivision 7b; 245A.09,
subdivision 12; 245A.11, subdivision 5; 245A.655; 246.012; 246.0135;
246.016; 246.023, subdivision 1; 246.16; 246.28; 246.71; 246.711; 246.712;
246.713; 246.714; 246.715; 246.716; 246.717; 246.718; 246.719; 246.72;
246.721; 246.722; 251.045; 252.05; 252.07; 252.09; 254.01; 254.03; 254.04;
254.06; 254.07; 254.09; 254.10; 254.11; 254A.05, subdivision 1; 254A.07,
subdivisions 1, 2; 254A.16, subdivision 1; 254B.01, subdivision 1; 254B.04,
subdivision 3; 256.01, subdivisions 3, 14, 14a; 256.959; 256.964; 256.9691;
256.971; 256.975, subdivision 3; 256.9753, subdivision 4; 256.9792; 256B.04,
subdivision 16; 256B.043; 256B.0656; 256B.0657; 256B.075, subdivision 4;
256B.0757, subdivision 7; 256B.0913, subdivision 9; 256B.0916, subdivisions
6, 6a; 256B.0928; 256B.19, subdivision 3; 256B.431, subdivisions 28, 31, 33,
34, 37, 38, 39, 40, 41, 43; 256B.434, subdivision 19; 256B.440; 256B.441,
subdivisions 46, 46a; 256B.491; 256B.501, subdivisions 3a, 3b, 3h, 3j, 3k, 3l, 5e;
256B.5016; 256B.503; 256B.53; 256B.69, subdivisions 5e, 6c, 24a; 256B.692,
subdivision 10; 256D.02, subdivision 19; 256D.05, subdivision 4; 256D.46;
256I.05, subdivisions 1b, 5; 256I.07; 256J.24, subdivision 10; 256K.35; 259.85,
subdivisions 2, 3, 4, 5; 518A.53, subdivision 7; 518A.74; 626.557, subdivision
16; 626.5593; Minnesota Statutes 2013 Supplement, sections 246.0251; 254.05;
254B.13, subdivision 3; 256B.31; 256B.501, subdivision 5b; 256C.05; 256C.29;
259.85, subdivision 1; Minnesota Rules, parts 9549.0020, subparts 2, 12, 13, 20,
23, 24, 25, 26, 27, 30, 31, 32, 33, 34, 35, 36, 38, 41, 42, 43, 44, 46, 47; 9549.0030;
9549.0035, subparts 4, 5, 6; 9549.0036; 9549.0040; 9549.0041, subparts 1, 2, 3,
4, 5, 7, 8, 9, 10, 11, 12, 13, 14, 15; 9549.0050; 9549.0051, subparts 1, 2, 3, 4, 5, 6,
7, 8, 9, 10, 11, 12, 14; 9549.0053; 9549.0054; 9549.0055, subpart 4; 9549.0056;
9549.0060, subparts 1, 2, 3, 8, 9, 12, 13; 9549.0061; 9549.0070, subparts 1, 4.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

CHILDREN AND FAMILY SERVICES

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

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

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

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

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

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

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

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

    Sec. 9. Minnesota Statutes 2012, section 518A.65, is amended to read:
518A.65 DRIVER'S LICENSE SUSPENSION.
(a) Upon motion of an obligee, which has been properly served on the obligor and
upon which there has been an opportunity for hearing, if a court finds that the obligor has
been or may be issued a driver's license by the commissioner of public safety and the
obligor is in arrears in court-ordered child support or maintenance payments, or both,
in an amount equal to or greater than three times the obligor's total monthly support
and maintenance payments and is not in compliance with a written payment agreement
pursuant to section 518A.69 that is approved by the court, a child support magistrate, or
the public authority, the court shall order the commissioner of public safety to suspend the
obligor's driver's license. The court's order must be stayed for 90 days in order to allow the
obligor to execute a written payment agreement pursuant to section 518A.69. The payment
agreement must be approved by either the court or the public authority responsible for
child support enforcement. If the obligor has not executed or is not in compliance with
a written payment agreement pursuant to section 518A.69 after the 90 days expires, the
court's order becomes effective and the commissioner of public safety shall suspend
the obligor's driver's license. The remedy under this section is in addition to any other
enforcement remedy available to the court. An obligee may not bring a motion under this
paragraph within 12 months of a denial of a previous motion under this paragraph.
(b) If a public authority responsible for child support enforcement determines that
the obligor has been or may be issued a driver's license by the commissioner of public
safety and the obligor is in arrears in court-ordered child support or maintenance payments
or both in an amount equal to or greater than three times the obligor's total monthly support
and maintenance payments and not in compliance with a written payment agreement
pursuant to section 518A.69 that is approved by the court, a child support magistrate, or
the public authority, the public authority shall direct the commissioner of public safety to
suspend the obligor's driver's license. The remedy under this section is in addition to any
other enforcement remedy available to the public authority.
(c) At least 90 days prior to notifying the commissioner of public safety according
to paragraph (b), the public authority must mail a written notice to the obligor at the
obligor's last known address, that it intends to seek suspension of the obligor's driver's
license and that the obligor must request a hearing within 30 days in order to contest the
suspension. If the obligor makes a written request for a hearing within 30 days of the date
of the notice, a court hearing must be held. Notwithstanding any law to the contrary, the
obligor must be served with 14 days' notice in writing specifying the time and place of the
hearing and the allegations against the obligor. The notice must include information that
apprises the obligor of the requirement to develop a written payment agreement that is
approved by a court, a child support magistrate, or the public authority responsible for
child support enforcement regarding child support, maintenance, and any arrearages in
order to avoid license suspension. The notice may be served personally or by mail. If
the public authority does not receive a request for a hearing within 30 days of the date
of the notice, and the obligor does not execute a written payment agreement pursuant to
section 518A.69 that is approved by the public authority within 90 days of the date of the
notice, the public authority shall direct the commissioner of public safety to suspend the
obligor's driver's license under paragraph (b).
(d) At a hearing requested by the obligor under paragraph (c), and on finding that
the obligor is in arrears in court-ordered child support or maintenance payments or both
in an amount equal to or greater than three times the obligor's total monthly support
and maintenance payments, the district court or child support magistrate shall order the
commissioner of public safety to suspend the obligor's driver's license or operating
privileges unless the court or child support magistrate determines that the obligor has
executed and is in compliance with a written payment agreement pursuant to section
518A.69 that is approved by the court, a child support magistrate, or the public authority.
(e) An obligor whose driver's license or operating privileges are suspended may:
(1) provide proof to the public authority responsible for child support enforcement
that the obligor is in compliance with all written payment agreements pursuant to section
518A.69 ;
(2) bring a motion for reinstatement of the driver's license. At the hearing, if the
court or child support magistrate orders reinstatement of the driver's license, the court or
child support magistrate must establish a written payment agreement pursuant to section
518A.69 ; or
(3) seek a limited license under section 171.30. A limited license issued to an obligor
under section 171.30 expires 90 days after the date it is issued.
Within 15 days of the receipt of that proof or a court order, the public authority shall
inform the commissioner of public safety that the obligor's driver's license or operating
privileges should no longer be suspended.
(f) On January 15, 1997, and every two years after that, the commissioner of human
services shall submit a report to the legislature that identifies the following information
relevant to the implementation of this section:
(1) the number of child support obligors notified of an intent to suspend a driver's
license;
(2) the amount collected in payments from the child support obligors notified of an
intent to suspend a driver's license;
(3) the number of cases paid in full and payment agreements executed in response
to notification of an intent to suspend a driver's license;
(4) the number of cases in which there has been notification and no payments or
payment agreements;
(5) the number of driver's licenses suspended;
(6) the cost of implementation and operation of the requirements of this section; and
(7) the number of limited licenses issued and number of cases in which payment
agreements are executed and cases are paid in full following issuance of a limited license.
(g) (f) In addition to the criteria established under this section for the suspension of
an obligor's driver's license, a court, a child support magistrate, or the public authority
may direct the commissioner of public safety to suspend the license of a party who has
failed, after receiving notice, to comply with a subpoena relating to a paternity or child
support proceeding. Notice to an obligor of intent to suspend must be served by first class
mail at the obligor's last known address. The notice must inform the obligor of the right to
request a hearing. If the obligor makes a written request within ten days of the date of
the hearing, a hearing must be held. At the hearing, the only issues to be considered are
mistake of fact and whether the obligor received the subpoena.
(h) (g) The license of an obligor who fails to remain in compliance with an
approved written payment agreement may be suspended. Prior to suspending a license for
noncompliance with an approved written payment agreement, the public authority must
mail to the obligor's last known address a written notice that (1) the public authority
intends to seek suspension of the obligor's driver's license under this paragraph, and (2)
the obligor must request a hearing, within 30 days of the date of the notice, to contest the
suspension. If, within 30 days of the date of the notice, the public authority does not
receive a written request for a hearing and the obligor does not comply with an approved
written payment agreement, the public authority must direct the Department of Public
Safety to suspend the obligor's license under paragraph (b). If the obligor makes a written
request for a hearing within 30 days of the date of the notice, a court hearing must be held.
Notwithstanding any law to the contrary, the obligor must be served with 14 days' notice in
writing specifying the time and place of the hearing and the allegations against the obligor.
The notice may be served personally or by mail at the obligor's last known address. If
the obligor appears at the hearing and the court determines that the obligor has failed to
comply with an approved written payment agreement, the court or public authority shall
notify the Department of Public Safety to suspend the obligor's license under paragraph
(b). If the obligor fails to appear at the hearing, the court or public authority must notify
the Department of Public Safety to suspend the obligor's license under paragraph (b).

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

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

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

ARTICLE 2

HEALTH CARE

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

    Sec. 2. Minnesota Statutes 2012, section 256.969, subdivision 9, is amended to read:
    Subd. 9. Disproportionate numbers of low-income patients served. (a) For
admissions occurring on or after October 1, 1992, through December 31, 1992, the
medical assistance disproportionate population adjustment shall comply with federal law
and shall be paid to a hospital, excluding regional treatment centers and facilities of the
federal Indian Health Service, with a medical assistance inpatient utilization rate in excess
of the arithmetic mean. The adjustment must be determined as follows:
    (1) for a hospital with a medical assistance inpatient utilization rate above the
arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
federal Indian Health Service but less than or equal to one standard deviation above the
mean, the adjustment must be determined by multiplying the total of the operating and
property payment rates by the difference between the hospital's actual medical assistance
inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
treatment centers and facilities of the federal Indian Health Service; and
    (2) for a hospital with a medical assistance inpatient utilization rate above one
standard deviation above the mean, the adjustment must be determined by multiplying
the adjustment that would be determined under clause (1) for that hospital by 1.1. If
federal matching funds are not available for all adjustments under this subdivision, the
commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for
federal match. The commissioner may establish a separate disproportionate population
operating payment rate adjustment under the general assistance medical care program.
For purposes of this subdivision medical assistance does not include general assistance
medical care. The commissioner shall report annually on the number of hospitals likely to
receive the adjustment authorized by this paragraph. The commissioner shall specifically
report on the adjustments received by public hospitals and public hospital corporations
located in cities of the first class.
    (b) (a) For admissions occurring on or after July 1, 1993, the medical assistance
disproportionate population adjustment shall comply with federal law and shall be paid to
a hospital, excluding regional treatment centers and facilities of the federal Indian Health
Service, with a medical assistance inpatient utilization rate in excess of the arithmetic
mean. The adjustment must be determined as follows:
    (1) for a hospital with a medical assistance inpatient utilization rate above the
arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
federal Indian Health Service but less than or equal to one standard deviation above the
mean, the adjustment must be determined by multiplying the total of the operating and
property payment rates by the difference between the hospital's actual medical assistance
inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
treatment centers and facilities of the federal Indian Health Service;
    (2) for a hospital with a medical assistance inpatient utilization rate above one
standard deviation above the mean, the adjustment must be determined by multiplying
the adjustment that would be determined under clause (1) for that hospital by 1.1. The
commissioner may establish a separate disproportionate population operating payment
rate adjustment under the general assistance medical care program. For purposes of this
subdivision, medical assistance does not include general assistance medical care. The
commissioner shall report annually on the number of hospitals likely to receive the
adjustment authorized by this paragraph. The commissioner shall specifically report on
the adjustments received by public hospitals and public hospital corporations located
in cities of the first class;
    (3) for a hospital that had medical assistance fee-for-service payment volume during
calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service
payment volume, a medical assistance disproportionate population adjustment shall be
paid in addition to any other disproportionate payment due under this subdivision as
follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995.
For a hospital that had medical assistance fee-for-service payment volume during calendar
year 1991 in excess of eight percent of total medical assistance fee-for-service payment
volume and was the primary hospital affiliated with the University of Minnesota, a
medical assistance disproportionate population adjustment shall be paid in addition to any
other disproportionate payment due under this subdivision as follows: $505,000 due on
the 15th of each month after noon, beginning July 15, 1995; and
    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be
reduced to zero.
    (c) (b) The commissioner shall adjust rates paid to a health maintenance organization
under contract with the commissioner to reflect rate increases provided in paragraph (b)
(a), clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust
those rates to reflect payments provided in paragraph (a), clause (3).
    (d) (c) If federal matching funds are not available for all adjustments under paragraph
(b) (a), the commissioner shall reduce payments under paragraph (b) (a), clauses (1) and (2),
on a pro rata basis so that all adjustments under paragraph (b) (a) qualify for federal match.
    (e) (d) For purposes of this subdivision, medical assistance does not include general
assistance medical care.
    (f) (e) For hospital services occurring on or after July 1, 2005, to June 30, 2007:
    (1) general assistance medical care expenditures for fee-for-service inpatient and
outpatient hospital payments made by the department shall be considered Medicaid
disproportionate share hospital payments, except as limited below:
     (i) only the portion of Minnesota's disproportionate share hospital allotment under
section 1923(f) of the Social Security Act that is not spent on the disproportionate
population adjustments in paragraph (b) (a), clauses (1) and (2), may be used for general
assistance medical care expenditures;
     (ii) only those general assistance medical care expenditures made to hospitals that
qualify for disproportionate share payments under section 1923 of the Social Security Act
and the Medicaid state plan may be considered disproportionate share hospital payments;
     (iii) only those general assistance medical care expenditures made to an individual
hospital that would not cause the hospital to exceed its individual hospital limits under
section 1923 of the Social Security Act may be considered; and
     (iv) general assistance medical care expenditures may be considered only to the
extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
All hospitals and prepaid health plans participating in general assistance medical care
must provide any necessary expenditure, cost, and revenue information required by the
commissioner as necessary for purposes of obtaining federal Medicaid matching funds for
general assistance medical care expenditures; and
    (2) certified public expenditures made by Hennepin County Medical Center shall
be considered Medicaid disproportionate share hospital payments. Hennepin County
and Hennepin County Medical Center shall report by June 15, 2007, on payments made
beginning July 1, 2005, or another date specified by the commissioner, that may qualify
for reimbursement under federal law. Based on these reports, the commissioner shall
apply for federal matching funds.
    (g) (f) Upon federal approval of the related state plan amendment, paragraph (f) (e)
is effective retroactively from July 1, 2005, or the earliest effective date approved by the
Centers for Medicare and Medicaid Services.

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

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

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

    Sec. 6. Minnesota Statutes 2012, section 256B.69, subdivision 5a, is amended to read:
    Subd. 5a. Managed care contracts. (a) Managed care contracts under this section
and section 256L.12 shall be entered into or renewed on a calendar year basis beginning
January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to
renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December
31, 1995 at the same terms that were in effect on June 30, 1995. The commissioner may
issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.
    (b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B and 256L is responsible for complying with the terms of its
contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B and 256L established after the effective date of a contract with the
commissioner take effect when the contract is next issued or renewed.
    (c) Effective for services rendered on or after January 1, 2003, The commissioner
shall withhold five percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program pending completion of performance targets. Each performance target
must be quantifiable, objective, measurable, and reasonably attainable, except in the case
of a performance target based on a federal or state law or rule. Criteria for assessment
of each performance target must be outlined in writing prior to the contract effective
date. Clinical or utilization performance targets and their related criteria must consider
evidence-based research and reasonable interventions when available or applicable to the
populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate,
to the commissioner's satisfaction, that the data submitted regarding attainment of
the performance target is accurate. The commissioner shall periodically change the
administrative measures used as performance targets in order to improve plan performance
across a broader range of administrative services. The performance targets must include
measurement of plan efforts to contain spending on health care services and administrative
activities. The commissioner may adopt plan-specific performance targets that take into
account factors affecting only one plan, including characteristics of the plan's enrollee
population. The withheld funds must be returned no sooner than July of the following
year if performance targets in the contract are achieved. The commissioner may exclude
special demonstration projects under subdivision 23.
    (d) Effective for services rendered on or after January 1, 2009, through December
31, 2009, the commissioner shall withhold three percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(e) Effective for services provided on or after January 1, 2010, (d) The commissioner
shall require that managed care plans use the assessment and authorization processes,
forms, timelines, standards, documentation, and data reporting requirements, protocols,
billing processes, and policies consistent with medical assistance fee-for-service or the
Department of Human Services contract requirements consistent with medical assistance
fee-for-service or the Department of Human Services contract requirements for all
personal care assistance services under section 256B.0659.
(f) Effective for services rendered on or after January 1, 2010, through December
31, 2010, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(g) Effective for services rendered on or after January 1, 2011, through December
31, 2011, the commissioner shall include as part of the performance targets described in
paragraph (c) a reduction in the health plan's emergency room utilization rate for state
health care program enrollees by a measurable rate of five percent from the plan's utilization
rate for state health care program enrollees for the previous calendar year. (e) Effective for
services rendered on or after January 1, 2012, the commissioner shall include as part of the
performance targets described in paragraph (c) a reduction in the health plan's emergency
department utilization rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. For 2012, the reduction shall be based on the health plan's
utilization in 2009. To earn the return of the withhold each subsequent year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than ten percent of the plan's emergency department utilization rate for medical assistance
and MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions
23 and 28, compared to the previous measurement year until the final performance target
is reached. When measuring performance, the commissioner must consider the difference
in health risk in a managed care or county-based purchasing plan's membership in the
baseline year compared to the measurement year, and work with the managed care or
county-based purchasing plan to account for differences that they agree are significant.
The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program
enrollees is reduced by 25 percent of the plan's emergency room utilization rate for medical
assistance and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate
with the health plans in meeting this performance target and shall accept payment
withholds that may be returned to the hospitals if the performance target is achieved.
(h) (f) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction
in the plan's hospitalization admission rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than five percent of the plan's hospital admission rate for medical
assistance and MinnesotaCare enrollees, excluding enrollees in programs described in
subdivisions 23 and 28, compared to the previous calendar year until the final performance
target is reached. When measuring performance, the commissioner must consider the
difference in health risk in a managed care or county-based purchasing plan's membership
in the baseline year compared to the measurement year, and work with the managed care
or county-based purchasing plan to account for differences that they agree are significant.
The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that this reduction in the
hospitalization rate was achieved. The commissioner shall structure the withhold so that
the commissioner returns a portion of the withheld funds in amounts commensurate with
achieved reductions in utilization less than the targeted amount.
The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in
calendar year 2011, as determined by the commissioner. The hospital admissions in this
performance target do not include the admissions applicable to the subsequent hospital
admission performance target under paragraph (i) (g). Hospitals shall cooperate with the
plans in meeting this performance target and shall accept payment withholds that may be
returned to the hospitals if the performance target is achieved.
(i) (g) Effective for services rendered on or after January 1, 2012, the commissioner
shall include as part of the performance targets described in paragraph (c) a reduction in
the plan's hospitalization admission rates for subsequent hospitalizations within 30 days of
a previous hospitalization of a patient regardless of the reason, for medical assistance and
MinnesotaCare enrollees, as determined by the commissioner. To earn the return of the
withhold each year, the managed care plan or county-based purchasing plan must achieve
a qualifying reduction of the subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23
and 28, of no less than five percent compared to the previous calendar year until the
final performance target is reached.
The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following calendar year if the managed care plan or county-based purchasing
plan demonstrates to the satisfaction of the commissioner that a qualifying reduction in
the subsequent hospitalization rate was achieved. The commissioner shall structure the
withhold so that the commissioner returns a portion of the withheld funds in amounts
commensurate with achieved reductions in utilization less than the targeted amount.
The withhold described in this paragraph must continue for each consecutive
contract period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23
and 28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar
year 2011. Hospitals shall cooperate with the plans in meeting this performance target and
shall accept payment withholds that must be returned to the hospitals if the performance
target is achieved.
(j) Effective for services rendered on or after January 1, 2011, through December 31,
2011, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.
(k) Effective for services rendered on or after January 1, 2012, through December
31, 2012, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(l) (h) Effective for services rendered on or after January 1, 2013, through December
31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments
under this section and county-based purchasing plan payments under section 256B.692
for the prepaid medical assistance program. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year. The commissioner may
exclude special demonstration projects under subdivision 23.
(m) (i) Effective for services rendered on or after January 1, 2014, the commissioner
shall withhold three percent of managed care plan payments under this section and
county-based purchasing plan payments under section 256B.692 for the prepaid medical
assistance program. The withheld funds must be returned no sooner than July 1 and
no later than July 31 of the following year. The commissioner may exclude special
demonstration projects under subdivision 23.
(n) (j) A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this section that is reasonably expected to be returned.
(o) (k) Contracts between the commissioner and a prepaid health plan are exempt
from the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph
(a), and 7.
(p) (l) The return of the withhold under paragraphs (d), (f), and (j) to (m) (h) and (i)
is not subject to the requirements of paragraph (c).

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

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

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

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

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

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

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

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

    Sec. 15. Minnesota Statutes 2012, section 256B.69, subdivision 30, is amended to read:
    Subd. 30. Provision of required materials in alternative formats. (a) For the
purposes of this subdivision, "alternative format" means a medium other than paper and
"prepaid health plan" means managed care plans and county-based purchasing plans.
(b) A prepaid health plan may provide in an alternative format a provider directory
and certificate of coverage, or materials otherwise required to be available in writing
under Code of Federal Regulations, title 42, section 438.10, or under the commissioner's
contract with the prepaid health plan, if the following conditions are met:
(1) the prepaid health plan, local agency, or commissioner, as applicable, informs the
enrollee that:
(i) an alternative format is available and the enrollee affirmatively requests of
the prepaid health plan that the provider directory, certificate of coverage, or materials
otherwise required under Code of Federal Regulations, title 42, section 438.10, or under
the commissioner's contract with the prepaid health plan be provided in an alternative
format; and
(ii) a record of the enrollee request is retained by the prepaid health plan in the
form of written direction from the enrollee or a documented telephone call followed by a
confirmation letter to the enrollee from the prepaid health plan that explains that the
enrollee may change the request at any time;
(2) the materials are sent to a secure electronic mailbox and are made available at a
password-protected secure electronic Web site or on a data storage device if the materials
contain enrollee data that is individually identifiable;
(3) the enrollee is provided a customer service number on the enrollee's membership
card that may be called to request a paper version of the materials provided in an
alternative format; and
(4) the materials provided in an alternative format meets all other requirements of
the commissioner regarding content, size of the typeface, and any required time frames
for distribution. "Required time frames for distribution" must permit sufficient time for
prepaid health plans to distribute materials in alternative formats upon receipt of enrollees'
requests for the materials.
(c) A prepaid health plan may provide in an alternative format its primary care
network list to the commissioner and to local agencies within its service area. The
commissioner or local agency, as applicable, shall inform a potential enrollee of the
availability of a prepaid health plan's primary care network list in an alternative format. If
the potential enrollee requests an alternative format of the prepaid health plan's primary
care network list, a record of that request shall be retained by the commissioner or local
agency. The potential enrollee is permitted to withdraw the request at any time.
The prepaid health plan shall submit sufficient paper versions of the primary
care network list to the commissioner and to local agencies within its service area to
accommodate potential enrollee requests for paper versions of the primary care network list.
(d) A prepaid health plan may provide in an alternative format materials otherwise
required to be available in writing under Code of Federal Regulations, title 42, section
438.10 , or under the commissioner's contract with the prepaid health plan, if the conditions
of paragraphs (b), and (c), and (e), are met for persons who are eligible for enrollment in
managed care.
(e) The commissioner shall seek any federal Medicaid waivers within 90 days after
the effective date of this subdivision that are necessary to provide alternative formats of
required material to enrollees of prepaid health plans as authorized under this subdivision.
(f) (e) The commissioner shall consult with managed care plans, county-based
purchasing plans, counties, and other interested parties to determine how materials required
to be made available to enrollees under Code of Federal Regulations, title 42, section
438.10 , or under the commissioner's contract with a prepaid health plan may be provided
in an alternative format on the basis that the enrollee has not opted in to receive the
alternative format. The commissioner shall consult with managed care plans, county-based
purchasing plans, counties, and other interested parties to develop recommendations
relating to the conditions that must be met for an opt-out process to be granted.

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

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

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

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

ARTICLE 3

CHEMICAL AND MENTAL HEALTH SERVICES

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

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

    Sec. 3. Minnesota Statutes 2012, section 245.4871, subdivision 27, is amended to read:
    Subd. 27. Mental health professional. "Mental health professional" means a
person providing clinical services in the diagnosis and treatment of children's emotional
disorders mental illnesses or emotional disturbances. A mental health professional must
have training and experience in working with children consistent with the age group to
which the mental health professional is assigned. A mental health professional must be
qualified in at least one of the following ways:
    (1) in psychiatric nursing, the mental health professional must be a registered nurse
who is licensed under sections 148.171 to 148.285 and who is certified as a clinical
specialist in child and adolescent psychiatric or mental health nursing by a national nurse
certification organization or who has a master's degree in nursing or one of the behavioral
sciences or related fields from an accredited college or university or its equivalent, with
at least 4,000 hours of post-master's supervised experience in the delivery of clinical
services in the treatment of mental illness;
    (2) in clinical social work, the mental health professional must be a person licensed
as an independent clinical social worker under chapter 148D, or a person with a master's
degree in social work from an accredited college or university, with at least 4,000 hours of
post-master's supervised experience in the delivery of clinical services in the treatment
of mental disorders;
    (3) in psychology, the mental health professional must be an individual licensed by
the board of psychology under sections 148.88 to 148.98 who has stated to the board of
psychology competencies in the diagnosis and treatment of mental disorders;
    (4) in psychiatry, the mental health professional must be a physician licensed under
chapter 147 and certified by the American board of psychiatry and neurology or eligible
for board certification in psychiatry;
    (5) in marriage and family therapy, the mental health professional must be a
marriage and family therapist licensed under sections 148B.29 to 148B.39 with at least
two years of post-master's supervised experience in the delivery of clinical services in the
treatment of mental disorders or emotional disturbances; or
    (6) in licensed professional clinical counseling, the mental health professional shall
be a licensed professional clinical counselor under section 148B.5301 with at least 4,000
hours of post-master's supervised experience in the delivery of clinical services in the
treatment of mental disorders or emotional disturbances; or.
    (7) in allied fields, the mental health professional must be a person with a master's
degree from an accredited college or university in one of the behavioral sciences or related
fields, with at least 4,000 hours of post-master's supervised experience in the delivery of
clinical services in the treatment of emotional disturbances.

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

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

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

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

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

    Sec. 9. Minnesota Statutes 2012, section 246.325, is amended to read:
246.325 GARDEN OF REMEMBRANCE.
The cemetery located on the grounds of the Cambridge State Hospital shall be
known as the Garden of Remembrance. The commissioner of human services shall
approve the wording and design for a sign at the cemetery indicating its name. The
commissioner may approve a temporary sign before the permanent sign is completed and
installed. All costs related to the sign must be paid with nonstate funds.

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

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

    Sec. 12. Minnesota Statutes 2013 Supplement, section 256B.0943, subdivision 2,
is amended to read:
    Subd. 2. Covered service components of children's therapeutic services and
supports. (a) Subject to federal approval, medical assistance covers medically necessary
children's therapeutic services and supports as defined in this section that an eligible
provider entity certified under subdivision 4 provides to a client eligible under subdivision
3.
(b) The service components of children's therapeutic services and supports are:
(1) individual patient or family member, family, psychotherapy for crisis, and group
psychotherapy;
(2) individual, family, or group skills training provided by a mental health
professional or mental health practitioner;
(3) crisis assistance;
(4) mental health behavioral aide services;
(5) direction of a mental health behavioral aide;
(6) mental health service plan development; and
(7) clinical care consultation under section 256B.0625, subdivision 62; children's
day treatment.
(8) family psychoeducation under section 256B.0625, subdivision 61; and
(9) services provided by a family peer specialist under section 256B.0616.
(c) Service components in paragraph (b) may be combined to constitute therapeutic
programs, including day treatment programs and therapeutic preschool programs.
EFFECTIVE DATE.This section is effective the day following final enactment.

    Sec. 13. Minnesota Statutes 2013 Supplement, section 256B.0943, subdivision 7,
is amended to read:
    Subd. 7. Qualifications of individual and team providers. (a) An individual
or team provider working within the scope of the provider's practice or qualifications
may provide service components of children's therapeutic services and supports that are
identified as medically necessary in a client's individual treatment plan.
(b) An individual provider must be qualified as:
(1) a mental health professional as defined in subdivision 1, paragraph (n); or
(2) a mental health practitioner as defined in section 245.4871, subdivision 26 or
clinical trainee. The mental health practitioner or clinical trainee must work under the
clinical supervision of a mental health professional; or
(3) a mental health behavioral aide working under the clinical supervision of
a mental health professional to implement the rehabilitative mental health services
previously introduced by a mental health professional or practitioner and identified in the
client's individual treatment plan and individual behavior plan.
(A) A level I mental health behavioral aide must:
(i) be at least 18 years old;
(ii) have a high school diploma or general equivalency diploma (GED) or two years
of experience as a primary caregiver to a child with severe emotional disturbance within
the previous ten years; and
(iii) meet preservice and continuing education requirements under subdivision 8.
(B) A level II mental health behavioral aide must:
(i) be at least 18 years old;
(ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering
clinical services in the treatment of mental illness concerning children or adolescents or
complete a certificate program established under subdivision 8a; and
(iii) meet preservice and continuing education requirements in subdivision 8.
(c) A preschool program multidisciplinary team must include at least one mental
health professional and one or more of the following individuals under the clinical
supervision of a mental health professional:
(i) a mental health practitioner; or
(ii) a program person, including a teacher, assistant teacher, or aide, who meets the
qualifications and training standards of a level I mental health behavioral aide.
(d) (c) A day treatment multidisciplinary team must include at least one mental
health professional or clinical trainee and one mental health practitioner.
EFFECTIVE DATE.This section is effective the day following final enactment.

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

    Sec. 15. Minnesota Statutes 2012, section 256B.0943, subdivision 10, is amended to
read:
    Subd. 10. Service authorization. The commissioner shall publish in the State
Register a list of health services that require prior authorization, as well as the criteria
and standards used to select health services on the list. The list and the criteria and
standards used to formulate the list are not subject to the requirements of sections 14.001
to 14.69. The commissioner's decision on whether prior authorization is required for a
health service is not subject to administrative appeal. Children's therapeutic services and
supports are subject to authorization criteria and standards published by the commissioner
according to section 256B.0625, subdivision 25.
EFFECTIVE DATE.This section is effective the day following final enactment.

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

    Sec. 17. REPEALER.
(a) Minnesota Statutes 2012, sections 245.0311; 245.0312; 245.4861; 245.487,
subdivisions 4 and 5; 245.4871, subdivisions 7, 11, 18, and 25; 245.4872; 245.4873,
subdivisions 3 and 6; 245.4875, subdivisions 3, 6, and 7; 245.4883, subdivision 1;
245.490; 245.492, subdivisions 6, 8, 13, and 19; 245.4932, subdivisions 2, 3, and 4;
245.4933; 245.494; 245.63; 245.652; 245.69, subdivision 1; 245.714; 245.715; 245.717;
245.718; 245.721; 245.77; 245.821; 245.827; 245.981; 246.012; 246.0135; 246.016;
246.023, subdivision 1; 246.16; 246.28; 246.71; 246.711; 246.712; 246.713; 246.714;
246.715; 246.716; 246.717; 246.718; 246.719; 246.72; 246.721; 246.722; 251.045;
252.05; 252.07; 252.09; 254.01; 254.03; 254.04; 254.06; 254.07; 254.09; 254.10; 254.11;
254A.05, subdivision 1; 254A.07, subdivisions 1 and 2; 254A.16, subdivision 1; 254B.01,
subdivision 1; and 254B.04, subdivision 3, are repealed.
(b) Minnesota Statutes 2013 Supplement, sections 246.0251; 254.05; and 254B.13,
subdivision 3, are repealed.

ARTICLE 4

CONTINUING CARE

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

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

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

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

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

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

    Sec. 7. Minnesota Statutes 2013 Supplement, section 517.04, is amended to read:
517.04 PERSONS AUTHORIZED TO PERFORM CIVIL MARRIAGES.
Civil marriages may be solemnized throughout the state by an individual who has
attained the age of 21 years and is a judge of a court of record, a retired judge of a court
of record, a court administrator, a retired court administrator with the approval of the
chief judge of the judicial district, a former court commissioner who is employed by the
court system or is acting pursuant to an order of the chief judge of the commissioner's
judicial district, the residential school administrators of the Minnesota State Academy
for the Deaf and the Minnesota State Academy for the Blind, a licensed or ordained
minister of any religious denomination, or by any mode recognized in section 517.18. For
purposes of this section, a court of record includes the Office of Administrative Hearings
under section 14.48.

    Sec. 8. Minnesota Statutes 2012, section 595.06, is amended to read:
595.06 CAPACITY OF WITNESS.
When an infant, or a person apparently of weak intellect, is produced as a witness,
the court may examine the infant or witness person to ascertain capacity, and whether the
person understands the nature and obligations of an oath, and the court may inquire of any
person what peculiar ceremonies the person deems most obligatory in taking an oath.

    Sec. 9. REPEALER.
(a) Minnesota Statutes 2012, sections 245.072; 256.971; 256.975, subdivision 3;
256.9753, subdivision 4; 256B.04, subdivision 16; 256B.0656; 256B.0657; 256B.0913,
subdivision 9; 256B.0916, subdivisions 6 and 6a; 256B.0928; 256B.431, subdivisions 28,
31, 33, 34, 37, 38, 39, 40, 41, and 43; 256B.434, subdivision 19; 256B.440; 256B.441,
subdivisions 46 and 46a; 256B.491; 256B.501, subdivisions 3a, 3b, 3h, 3j, 3k, 3l, and 5e;
256B.5016; 256B.503; and 626.557, subdivision 16, are repealed.
(b) Minnesota Statutes 2013 Supplement, sections 256B.31; 256B.501, subdivision
5b; 256C.05; and 256C.29, are repealed.
(c) Minnesota Rules, parts 9549.0020, subparts 2, 12, 13, 20, 23, 24, 25, 26, 27, 30,
31, 32, 33, 34, 35, 36, 38, 41, 42, 43, 44, 46, and 47; 9549.0030; 9549.0035, subparts 4, 5,
and 6; 9549.0036; 9549.0040; 9549.0041, subparts 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13,
14, and 15; 9549.0050; 9549.0051, subparts 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, and 14;
9549.0053; 9549.0054; 9549.0055, subpart 4; 9549.0056; 9549.0060, subparts 1, 2, 3, 8,
9, 12, and 13; 9549.0061; and 9549.0070, subparts 1 and 4, are repealed.

ARTICLE 5

OPERATIONS

    Section 1. Minnesota Statutes 2012, section 13.46, subdivision 4, is amended to read:
    Subd. 4. Licensing data. (a) As used in this subdivision:
    (1) "licensing data" are all data collected, maintained, used, or disseminated by the
welfare system pertaining to persons licensed or registered or who apply for licensure
or registration or who formerly were licensed or registered under the authority of the
commissioner of human services;
    (2) "client" means a person who is receiving services from a licensee or from an
applicant for licensure; and
    (3) "personal and personal financial data" are Social Security numbers, identity
of and letters of reference, insurance information, reports from the Bureau of Criminal
Apprehension, health examination reports, and social/home studies.
    (b)(1)(i) Except as provided in paragraph (c), the following data on applicants,
license holders, and former licensees are public: name, address, telephone number of
licensees, date of receipt of a completed application, dates of licensure, licensed capacity,
type of client preferred, variances granted, record of training and education in child care
and child development, type of dwelling, name and relationship of other family members,
previous license history, class of license, the existence and status of complaints, and the
number of serious injuries to or deaths of individuals in the licensed program as reported
to the commissioner of human services, the local social services agency, or any other
county welfare agency. For purposes of this clause, a serious injury is one that is treated
by a physician.
(ii) When a correction order, an order to forfeit a fine, an order of license suspension,
an order of temporary immediate suspension, an order of license revocation, an order
of license denial, or an order of conditional license has been issued, or a complaint is
resolved, the following data on current and former licensees and applicants are public: the
substance and investigative findings of the licensing or maltreatment complaint, licensing
violation, or substantiated maltreatment; the record of informal resolution of a licensing
violation; orders of hearing; findings of fact; conclusions of law; specifications of the final
correction order, fine, suspension, temporary immediate suspension, revocation, denial, or
conditional license contained in the record of licensing action; whether a fine has been
paid; and the status of any appeal of these actions.
(iii) When a license denial under section 245A.05 or a sanction under section
245A.07 is based on a determination that the license holder or applicant is responsible for
maltreatment under section 626.556 or 626.557, the identity of the applicant or license
holder as the individual responsible for maltreatment is public data at the time of the
issuance of the license denial or sanction.
(iv) When a license denial under section 245A.05 or a sanction under section
245A.07 is based on a determination that the license holder or applicant is disqualified
under chapter 245C, the identity of the license holder or applicant as the disqualified
individual and the reason for the disqualification are public data at the time of the
issuance of the licensing sanction or denial. If the applicant or license holder requests
reconsideration of the disqualification and the disqualification is affirmed, the reason for
the disqualification and the reason to not set aside the disqualification are public data.
    (2) Notwithstanding sections 626.556, subdivision 11, and 626.557, subdivision 12b,
when any person subject to disqualification under section 245C.14 in connection with a
license to provide family day care for children, child care center services, foster care for
children in the provider's home, or foster care or day care services for adults in the provider's
home is a substantiated perpetrator of maltreatment, and the substantiated maltreatment is
a reason for a licensing action, the identity of the substantiated perpetrator of maltreatment
is public data. For purposes of this clause, a person is a substantiated perpetrator if the
maltreatment determination has been upheld under section 256.045; 626.556, subdivision
10i ; 626.557, subdivision 9d; or chapter 14, or if an individual or facility has not timely
exercised appeal rights under these sections, except as provided under clause (1).
    (3) (2) For applicants who withdraw their application prior to licensure or denial of
a license, the following data are public: the name of the applicant, the city and county
in which the applicant was seeking licensure, the dates of the commissioner's receipt of
the initial application and completed application, the type of license sought, and the date
of withdrawal of the application.
    (4) (3) For applicants who are denied a license, the following data are public: the
name and address of the applicant, the city and county in which the applicant was seeking
licensure, the dates of the commissioner's receipt of the initial application and completed
application, the type of license sought, the date of denial of the application, the nature of
the basis for the denial, the record of informal resolution of a denial, orders of hearings,
findings of fact, conclusions of law, specifications of the final order of denial, and the
status of any appeal of the denial.
    (5) The following data on persons subject to disqualification under section 245C.14 in
connection with a license to provide family day care for children, child care center services,
foster care for children in the provider's home, or foster care or day care services for adults
in the provider's home, are public: the nature of any disqualification set aside under section
245C.22, subdivisions 2 and 4, and the reasons for setting aside the disqualification; the
nature of any disqualification for which a variance was granted under sections 245A.04,
subdivision 9 ; and 245C.30, and the reasons for granting any variance under section
245A.04, subdivision 9; and, if applicable, the disclosure that any person subject to
a background study under section 245C.03, subdivision 1, has successfully passed a
background study. If a licensing sanction under section 245A.07, or a license denial under
section 245A.05, is based on a determination that an individual subject to disqualification
under chapter 245C is disqualified, the disqualification as a basis for the licensing sanction
or denial is public data. As specified in clause (1), item (iv), if the disqualified individual
is the license holder or applicant, the identity of the license holder or applicant and the
reason for the disqualification are public data; and, if the license holder or applicant
requested reconsideration of the disqualification and the disqualification is affirmed, the
reason for the disqualification and the reason to not set aside the disqualification are
public data. If the disqualified individual is an individual other than the license holder or
applicant, the identity of the disqualified individual shall remain private data.
    (6) (4) When maltreatment is substantiated under section 626.556 or 626.557 and
the victim and the substantiated perpetrator are affiliated with a program licensed under
chapter 245A, the commissioner of human services, local social services agency, or
county welfare agency may inform the license holder where the maltreatment occurred of
the identity of the substantiated perpetrator and the victim.
    (7) (5) Notwithstanding clause (1), for child foster care, only the name of the license
holder and the status of the license are public if the county attorney has requested that data
otherwise classified as public data under clause (1) be considered private data based on the
best interests of a child in placement in a licensed program.
    (c) The following are private data on individuals under section 13.02, subdivision
12 , or nonpublic data under section 13.02, subdivision 9: personal and personal financial
data on family day care program and family foster care program applicants and licensees
and their family members who provide services under the license.
    (d) The following are private data on individuals: the identity of persons who have
made reports concerning licensees or applicants that appear in inactive investigative data,
and the records of clients or employees of the licensee or applicant for licensure whose
records are received by the licensing agency for purposes of review or in anticipation of a
contested matter. The names of reporters of complaints or alleged violations of licensing
standards under chapters 245A, 245B, 245C, and applicable rules and alleged maltreatment
under sections 626.556 and 626.557, are confidential data and may be disclosed only as
provided in section 626.556, subdivision 11, or 626.557, subdivision 12b.
    (e) Data classified as private, confidential, nonpublic, or protected nonpublic under
this subdivision become public data if submitted to a court or administrative law judge as
part of a disciplinary proceeding in which there is a public hearing concerning a license
which has been suspended, immediately suspended, revoked, or denied.
    (f) Data generated in the course of licensing investigations that relate to an alleged
violation of law are investigative data under subdivision 3.
    (g) Data that are not public data collected, maintained, used, or disseminated under
this subdivision that relate to or are derived from a report as defined in section 626.556,
subdivision 2 , or 626.5572, subdivision 18, are subject to the destruction provisions of
sections 626.556, subdivision 11c, and 626.557, subdivision 12b.
    (h) Upon request, not public data collected, maintained, used, or disseminated under
this subdivision that relate to or are derived from a report of substantiated maltreatment as
defined in section 626.556 or 626.557 may be exchanged with the Department of Health
for purposes of completing background studies pursuant to section 144.057 and with
the Department of Corrections for purposes of completing background studies pursuant
to section 241.021.
    (i) Data on individuals collected according to licensing activities under chapters
245A and 245C, data on individuals collected by the commissioner of human services
according to investigations under chapters 245A, 245B, and 245C, and sections 626.556
and 626.557 may be shared with the Department of Human Rights, the Department
of Health, the Department of Corrections, the ombudsman for mental health and
developmental disabilities, and the individual's professional regulatory board when there
is reason to believe that laws or standards under the jurisdiction of those agencies may
have been violated or the information may otherwise be relevant to the board's regulatory
jurisdiction. Background study data on an individual who is the subject of a background
study under chapter 245C for a licensed service for which the commissioner of human
services is the license holder may be shared with the commissioner and the commissioner's
delegate by the licensing division. Unless otherwise specified in this chapter, the identity
of a reporter of alleged maltreatment or licensing violations may not be disclosed.
    (j) In addition to the notice of determinations required under section 626.556,
subdivision 10f , if the commissioner or the local social services agency has determined
that an individual is a substantiated perpetrator of maltreatment of a child based on sexual
abuse, as defined in section 626.556, subdivision 2, and the commissioner or local social
services agency knows that the individual is a person responsible for a child's care in
another facility, the commissioner or local social services agency shall notify the head
of that facility of this determination. The notification must include an explanation of the
individual's available appeal rights and the status of any appeal. If a notice is given under
this paragraph, the government entity making the notification shall provide a copy of the
notice to the individual who is the subject of the notice.
    (k) All not public data collected, maintained, used, or disseminated under this
subdivision and subdivision 3 may be exchanged between the Department of Human
Services, Licensing Division, and the Department of Corrections for purposes of
regulating services for which the Department of Human Services and the Department
of Corrections have regulatory authority.

    Sec. 2. Minnesota Statutes 2013 Supplement, section 245A.03, subdivision 7, is
amended to read:
    Subd. 7. Licensing moratorium. (a) The commissioner shall not issue an initial
license for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340,
or adult foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under
this chapter for a physical location that will not be the primary residence of the license
holder for the entire period of licensure. If a license is issued during this moratorium, and
the license holder changes the license holder's primary residence away from the physical
location of the foster care license, the commissioner shall revoke the license according
to section 245A.07. The commissioner shall not issue an initial license for a community
residential setting licensed under chapter 245D. Exceptions to the moratorium include:
(1) foster care settings that are required to be registered under chapter 144D;
(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph (b);
(3) new foster care licenses or community residential setting licenses determined to
be needed by the commissioner under paragraph (b) for the closure of a nursing facility,
ICF/DD, or regional treatment center; restructuring of state-operated services that limits
the capacity of state-operated facilities; or allowing movement to the community for
people who no longer require the level of care provided in state-operated facilities as
provided under section 256B.092, subdivision 13, or 256B.49, subdivision 24;
(4) new foster care licenses or community residential setting licenses determined
to be needed by the commissioner under paragraph (b) for persons requiring hospital
level care; or
(5) new foster care licenses or community residential setting licenses determined to
be needed by the commissioner for the transition of people from personal care assistance
to the home and community-based services.
(b) The commissioner shall determine the need for newly licensed foster care
homes or community residential settings as defined under this subdivision. As part of the
determination, the commissioner shall consider the availability of foster care capacity in
the area in which the licensee seeks to operate, and the recommendation of the local
county board. The determination by the commissioner must be final. A determination of
need is not required for a change in ownership at the same address.
(c) When an adult resident served by the program moves out of a foster home
that is not the primary residence of the license holder according to section 256B.49,
subdivision 15 , paragraph (f), or the adult community residential setting, the county
shall immediately inform the Department of Human Services Licensing Division. The
department shall decrease the statewide licensed capacity for adult foster care settings
where the physical location is not the primary residence of the license holder, or for adult
community residential settings, if the voluntary changes described in paragraph (e) are
not sufficient to meet the savings required by reductions in licensed bed capacity under
Laws 2011, First Special Session chapter 9, article 7, sections 1 and 40, paragraph (f),
and maintain statewide long-term care residential services capacity within budgetary
limits. Implementation of the statewide licensed capacity reduction shall begin on July
1, 2013. The commissioner shall delicense up to 128 beds by June 30, 2014, using the
needs determination process. Under this paragraph, the commissioner has the authority
to reduce unused licensed capacity of a current foster care program, or the community
residential settings, to accomplish the consolidation or closure of settings. Under this
paragraph, the commissioner has the authority to manage statewide capacity, including
adjusting the capacity available to each county and adjusting statewide available capacity,
to meet the statewide needs identified through the process in paragraph (e). A decreased
licensed capacity according to this paragraph is not subject to appeal under this chapter.
(d) Residential settings that would otherwise be subject to the decreased license
capacity established in paragraph (c) shall be exempt under the following circumstances:
(1) until August 1, 2013, the license holder's beds occupied by residents whose
primary diagnosis is mental illness and the license holder is:
(i) a provider of assertive community treatment (ACT) or adult rehabilitative mental
health services (ARMHS) as defined in section 256B.0623;
(ii) a mental health center certified under Minnesota Rules, parts 9520.0750 to
9520.0870;
(iii) a mental health clinic certified under Minnesota Rules, parts 9520.0750 to
9520.0870; or
(iv) a provider of intensive residential treatment services (IRTS) licensed under
Minnesota Rules, parts 9520.0500 to 9520.0670; or
(2) if the license holder's beds are occupied by residents whose primary diagnosis is
mental illness and the license holder is certified under the requirements in subdivision 6a
or section 245D.33.
(e) A resource need determination process, managed at the state level, using the
available reports required by section 144A.351, and other data and information shall
be used to determine where the reduced capacity required under paragraph (c) will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351 , and employ a variety of methods to improve the state's capacity to meet
long-term care service needs within budgetary limits, including seeking proposals from
service providers or lead agencies to change service type, capacity, or location to improve
services, increase the independence of residents, and better meet needs identified by the
long-term care services reports and statewide data and information. By February 1, 2013,
and August 1, 2014, and each following year, the commissioner shall provide information
and data on the overall capacity of licensed long-term care services, actions taken under
this subdivision to manage statewide long-term care services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over
health and human services budget.
    (f) At the time of application and reapplication for licensure, the applicant and the
license holder that are subject to the moratorium or an exclusion established in paragraph
(a) are required to inform the commissioner whether the physical location where the foster
care will be provided is or will be the primary residence of the license holder for the entire
period of licensure. If the primary residence of the applicant or license holder changes, the
applicant or license holder must notify the commissioner immediately. The commissioner
shall print on the foster care license certificate whether or not the physical location is the
primary residence of the license holder.
    (g) License holders of foster care homes identified under paragraph (f) that are not
the primary residence of the license holder and that also provide services in the foster care
home that are covered by a federally approved home and community-based services
waiver, as authorized under section 256B.0915, 256B.092, or 256B.49, must inform the
human services licensing division that the license holder provides or intends to provide
these waiver-funded services.

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

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

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

    Sec. 6. Minnesota Statutes 2012, section 245C.04, subdivision 1, is amended to read:
    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
background study of an individual required to be studied under section 245C.03,
subdivision 1 , at least upon application for initial license for all license types.
    (b) The commissioner shall conduct a background study of an individual required
to be studied under section 245C.03, subdivision 1, at reapplication for a license for
family child care.
    (c) The commissioner is not required to conduct a study of an individual at the time
of reapplication for a license if the individual's background study was completed by the
commissioner of human services for an adult foster care license holder that is also: and
    (1) registered under chapter 144D; or
    (2) licensed to provide home and community-based services to people with
disabilities at the foster care location and the license holder does not reside in the foster
care residence; and
    (3) the following conditions are met:
    (i) (1) a study of the individual was conducted either at the time of initial licensure
or when the individual became affiliated with the license holder;
    (ii) (2) the individual has been continuously affiliated with the license holder since
the last study was conducted; and
    (iii) (3) the last study of the individual was conducted on or after October 1, 1995.
    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services shall
conduct a study of an individual required to be studied under section 245C.03, at the
time of reapplication for a child foster care license. The county or private agency shall
collect and forward to the commissioner the information required under section 245C.05,
subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The background
study conducted by the commissioner of human services under this paragraph must
include a review of the information required under section 245C.08, subdivisions 1,
paragraph (a), clauses (1) to (5), 3, and 4.
    (e) (d) The commissioner of human services shall conduct a background study
of an individual specified under section 245C.03, subdivision 1, paragraph (a), clauses
(2) to (6), who is newly affiliated with a child foster care license holder. The county or
private agency shall collect and forward to the commissioner the information required
under section 245C.05, subdivisions 1 and 5. The background study conducted by the
commissioner of human services under this paragraph must include a review of the
information required under section 245C.08, subdivisions 1, 3, and 4.
    (f) From January 1, 2010, to December 31, 2012, unless otherwise specified in
paragraph (c), the commissioner shall conduct a study of an individual required to
be studied under section 245C.03 at the time of reapplication for an adult foster care
or family adult day services license: (1) the county shall collect and forward to the
commissioner the information required under section 245C.05, subdivision 1, paragraphs
(a) and (b), and subdivision 5, paragraphs (a) and (b), for background studies conducted
by the commissioner for all family adult day services and for adult foster care when
the adult foster care license holder resides in the adult foster care or family adult day
services residence; (2) the license holder shall collect and forward to the commissioner
the information required under section 245C.05, subdivisions 1, paragraphs (a) and (b);
and 5, paragraphs (a) and (b), for background studies conducted by the commissioner for
adult foster care when the license holder does not reside in the adult foster care residence;
and (3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08, subdivision 1,
paragraph (a), clauses (1) to (5), and subdivisions 3 and 4.
(g) (e) The commissioner shall conduct a background study of an individual
specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is
newly affiliated with an adult foster care or family adult day services license holder: (1)
the county shall collect and forward to the commissioner the information required under
section 245C.05, subdivision 1, paragraphs (a) and (b), and subdivision 5, paragraphs (a)
and (b), for background studies conducted by the commissioner for all family adult day
services and for adult foster care when the adult foster care license holder resides in
the adult foster care residence; (2) the license holder shall collect and forward to the
commissioner the information required under section 245C.05, subdivisions 1, paragraphs
(a) and (b); and 5, paragraphs (a) and (b), for background studies conducted by the
commissioner for adult foster care when the license holder does not reside in the adult
foster care residence; and (3) the background study conducted by the commissioner under
this paragraph must include a review of the information required under section 245C.08,
subdivision 1 , paragraph (a), and subdivisions 3 and 4.
(h) (f) Applicants for licensure, license holders, and other entities as provided in
this chapter must submit completed background study forms to the commissioner before
individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
contact in any licensed program.
    (i) (g) A license holder must initiate a new background study through the
commissioner's online background study system when:
    (1) an individual returns to a position requiring a background study following an
absence of 90 or more consecutive days; or
    (2) a program that discontinued providing licensed direct contact services for 90 or
more consecutive days begins to provide direct contact licensed services again.
    The license holder shall maintain a copy of the notification provided to
the commissioner under this paragraph in the program's files. If the individual's
disqualification was previously set aside for the license holder's program and the new
background study results in no new information that indicates the individual may pose a
risk of harm to persons receiving services from the license holder, the previous set-aside
shall remain in effect.
    (j) (h) For purposes of this section, a physician licensed under chapter 147 is
considered to be continuously affiliated upon the license holder's receipt from the
commissioner of health or human services of the physician's background study results.
(k) (i) For purposes of family child care, a substitute caregiver must receive repeat
background studies at the time of each license renewal.

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

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

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

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