Article 1 - Community Supports

Section 1 (144A.351) clarifies that funds appropriated for the long-term care gaps analysis are available in either year of the biennium and deletes obsolete language concerning a completed study.

Section 2 (245D.03, subdivision 1) adds individual community living support, individualized home supports services, employment exploration services, employment development services, and employment support services to the range of services governed by the home and community-based licensing standards under Minnesota Statutes, chapter 245D. The addition of the employment-related services is subject to federal approval.

Section 3 (252.41, subdivision 3) removes supported employment from the definition of day training and habilitation and clarifies that work-related activities included in the definition are only center-based activities and not employment exploration services, employment development services, or employment support services.  This section is subject to federal approval.

Section 4 (256.477) places in statute an existing grant program currently awarded to Achieving Change Together, a statewide self-advocacy network of people with disabilities, and adds additional conditions for the use of grant funds.

Section 5 (256B.0659, subdivision 1) defines a new service to begin July 1, 2018, called complex personal care assistance services.  Complex PCA services are PCA services provided to a person who qualifies for more than ten hours of PCA services per day and that are provided by a PCA with additional training.

Section 6 (256B.0659, subdivision 2) makes a conforming change to a cross-reference.

Section 7 (256B.0559, subdivision 11) specifies that a PCA is qualified to provide complex PCA services only if the PCA meets the home health aide or nursing assistant competency evaluation standards under Medicare, or a similar state standard.

Section 8 (256B.0659, subdivision 17a) specifies that the rate for complex PCA services beginning July 1, 2018, is 110 percent of the rate for PCA services.

Section 9 (256B.0659, subdivision 21) requires PCA provider agencies to maintain documentation that any PCA providing complex PCA services has satisfied all of the requirements for provision of complex PCA services.

Section 10 (256B.0911, subdivision 1a) provides a definition of “person-centered planning” that incorporates a definition of “informed choice.”

Sections 11 to 17 contain changes to MnCHOICES and the reassessment process for home care nursing, personal care assistance services, elderly waiver services, alternative care services, and disability waiver services.

Section 11 (256B.0911, subdivision 3a) modifies existing language concerning assessments and support planning so that the existing requirements apply only to initial assessments and initial support planning and requires assessors to include discussions of independent living and alternatives to corporate foster care.

This section also modifies the risk management standards that must be included in a written community support plan to require that risk management strategies be practical.

Section 12 (256B.0911, subdivision 3f) permits a service plan update or service plan modification to substitute for a reassessment unless a reassessment is required under federal law or the person’s condition or needs have changed significantly.

Section 13 (256B.0911, subdivision 3g) requires annual reassessments whenever required by federal law or when requested by a person receiving services or by the person’s legal representative.

Section 14 (256B.0911, subdivision 4d) modifies the language governing face-to-face assessments of individuals under age 65 who reside in a nursing facility by requiring annual face-to-face reassessments only for individuals whose condition is likely to change.

Section 15 (256B.0915, subdivision 1a) eliminates the requirement for an annual face-to-face visit to elderly waiver recipients by a case manager.

Section 16 (256B.0915, subdivision 5) modifies the requirements for annual reassessments for continued eligibility for elderly waiver services.

Section 17 (256B.49, subdivision 15) eliminates the requirement that people on a maintenance plan under a disability waiver must be reassessed annually.

Section 18 (256B.4913, subdivision 4a) clarifies the historical rate for day service recipients and adds an additional year of banding to the disability waiver rate system implementation.

Currently, banding will continue until January 1, 2019.  The Department of Human Services is awaiting approval of a zero percent band for the 2019 calendar year, which would extend banding until January 1, 2020.  This section adds another one percent banding year, which would extend banding until January 1, 2021, thereby allowing the disability waiver rate system (DWRS) rates to take effect during fiscal year 2021 as individuals renew their individual service plans. The banding provision in this section is subject to federal approval.

Section 19 (256B.4913, subdivision 7) clarifies that new services added to the disability waiver rate system are not subject to banding.

Section 20 (256B.4914, subdivision 2) modifies the definition of “respite care” for the purposes of the disability waiver rate system, thereby allowing respite care services to be reimbursed at a market rate. This section is subject to federal approval.

Section 21 (256B.4914, subdivision 3) adds individualized home supports, independent living skills specialist services, employment exploration services, employment development services, and employment support services to the disability waiver rate system. Portions of this section are subject to federal approval.

Section 22 (256B.1914, subdivision 5) modifies the base wage index, component values and the frequency of inflation adjustments, and requires study and evaluation of various wage and component values.

Paragraph (a) modifies the base wage index by modifying the data to which the commissioner will refer when determining the base wage for staff providing various services and by creating five new base wage calculations for three new employment-related services, for independent living skills specialist services, and for individualized home supports services.  Most of these changes are effective January 1, 2018.

Paragraph (d) modifies various component values effective January 1, 2018, except the absence and utilization factor for day services, which is effective January 1, 2019.

Paragraph (h) eliminates the requirement to apply both the wage inflation factor and the consumer price index factor to the same component values, thereby ensuring that factors that have a wage inflation factor built into them do not also get a CPI adjustment.

Paragraphs (h) and (i) increases the frequency of the automatic inflation adjustments from every five years beginning July 1, 2017, to every two years beginning July 1, 2022.

Paragraph (i) requires the commissioner to make recommendations to the legislature to replace any of the wage codes that become obsolete in the future.

Paragraph (k) requires the commissioner to study the costs of providing services whose rates are determined by the disability waiver rate system, and requires providers to submit business data for the purposes of this study.

Paragraph (l) specifies the timeline for the submission by providers of their business data and specifies penalties the commissioner must impose of providers who fail to meet the timeline.

Paragraph (m) require the commissioner to randomly audit a representative sample of the cost data submitted.

Paragraph (n) permits the commissioner, based on the commissioner’s research, to make recommendations to the legislature concerning changes to the component values and inflationary adjustments.

Paragraph (o) requires the commissioner to provide technical assistance and training to providers so that they are able to comply with the requirement to submit valid business data.

Section 23 (256B.4914, subdivision 6) effective January 1, 2018, reduces the maximum number of foster care and supportive living services that may be authorized from 365 to 350 days, and makes a conforming change.

Sections 24 and 26 make conforming changes, except that section 25 (256B.4914, subdivision 8, clause (13)) modifies the staffing ratio for employment support services.

Section 27 (256B.4914, subdivision 10) modifies the commissioner’s DWRS research duties.

Section 28 (256B.4914, subdivision 16) exempts individualized home support services from the budget neutrality factor the day following enactment.  The budget neutrality factor is repealed in the last section of this article effective July 1, 2017.

Sections 29 to 31 contain changes to MnCHOICES and the reassessment process for community first services and supports.

Sections 32 to 41 modify the Deaf and Hard-of-Hearing Act.

Section 32 (256C.23, subdivision 1a) defines “culturally affirmative.”

Section 33 (256C.23, subdivision 2) modifies the definition of “deaf” by including additional examples of visual and manual means of communication.

Section 34 (256C, subdivision 2c) defines “interpretive services.”

Section 35 (256C.23, subdivision 6) defines “real-time captioning.”

Sections 36 (256C.233, subdivision 1) specifies that the commissioners of education, employment and economic development, and health shall advise the commissioner of human services on the activities of the Deaf and Hard-of-Hearing Division; removes from the jurisdiction of the Division the educational and occupational needs of individuals.

Section 37 (256C.233, subdivision 2) modifies the duties of the Division by supplementing mere promulgation of information with advocacy, training, service provision, including the provision of mental health services, research, and reporting to the legislature on the activities of the Division.

Section 38 (256C.24, subdivision 1) incorporates people first language and requires the Division to establish at least six regional service centers.

Section 39 (256C.24, subdivision 2) modifies the duties of the regional service centers.

Section 40 (256C.24, subdivision 4) permits individuals traveling more than 50 miles round-trip to receive services at a regional service center to be reimbursed at the reimbursement rate established by the Internal Revenue Service.

Section 41 (256C.261) clarifies the minimum allocation of grant funding for services and supports for children and for adults, and prohibits regional service centers from providing services under the consumer-directed grant program.

Section 42 (CDCS budget Methodology Exception for Persons Leaving Institutions and Crisis Residential Settings) directs the commissioner of human services to establish a consumer-directed community supports budget exception process for individuals who are currently residing in an institutional setting, as defined in paragraph (b), who have been approved for discharge from the institutional setting, but who have not been offered the appropriate services within 60 days of receiving discharge approval, and whose needs cannot be accommodated in a noninstitutional setting within the consumer-directed community supports budget limitations.

Section 43 (Federal Waiver Request) requires the commissioner of human services to make all necessary waiver amendment requests for the elimination of supported employment and the creation of three new employment-related services.

Section 44 (Transportation Study) requires the commissioner of human services to conduct a study to identify opportunities to increase access to transportation for individuals who receive home and community-based services.

Section 45 (Direction to the Commissioner; Telecommunication Equipment program) requires the commissioner and the Commission of Deaf, Deafblind and Hard-of-Hearing Minnesotans to make recommendations to the legislature concerning the modernization of the telecommunication equipment program.

Section 46 (Direction to the Commissioner; Billing for Mental Health Services) requires the commissioner of human services to report to the legislature on the costs and benefits of the Deaf and Hard of Hearing Division providing mental health services.

Section 47 (Direction to the Commissioner of Human Services) requires the commissioner to work with lead agencies to reform to the MnCHOICES assessment tool to reduce the amount of time certified assessors completing the online forms.

Section 48 (Expansion of CDCS Budget Methodology Exception) directs the commissioner of human services to request a waiver amendment to permit a budget increase of up to 30 percent for individuals eligible for consumer-directed community supports who require greater resources than currently allowed in order to increase the amount of time they can work, transition into their own home, or develop a positive support plan.

Section 49 (Repealer) repeals the budget neutrality factor from the disability waiver rate system effective January 1, 2018.  This section also repeals subdivisions within the Deaf and Hard-of-Hearing Services Act, including the definition of "regional service center," the duty of state agencies with respect to the Division, and language concerning interpreter services, which is incorporated elsewhere in the bill.

Article 2 – Housing

Sections 1 and 2 (144D.04, subds. 2 and 2a) amend the housing with services establishment chapter of law by adding contract requirements for residents receiving one or more health-related services from the establishments’ arranged home care provider.

Section 3 (245A.03, subd. 7) adds two exceptions to the DHS licensing moratorium for new foster care licenses or community residential setting licenses; one is for people transitioning from the residential care waivers services to foster care services, as determined to be needed by the commissioner, and the second is for people receiving services under Minnesota Statutes, chapter 245D and residing in an unlicensed setting before May 1, 2017, under certain circumstances.   New paragraph (h) allows the commissioner to adjust capacity to address needs identified in the annual report balancing long-term care services and supports, and new paragraph (i) requires the commissioner to notify the license holder when its beds are reduced.  New paragraph (j) prohibits the commissioner from issuing a license for children’s residential treatment services that the Centers for Medicare and Medicaid Services would consider an institution for mental diseases.

Section 4 (245A.04, subd. 14) requires an adult foster care license holder to receive a copy of the resident termination policy established in section 7.

Section 5 to 7 amend chapter 245A, the DHS licensing act, establishing new subdivisions in the statute related to special conditions for residential programs.

Section 5 (245A.11, subd. 9) requires that a resident receiving services must have the choice of a roommate, and both must consent in writing, and the license holder must provide a lock for each resident’s bedroom door, unless otherwise indicated for health, safety, or well-being of the resident.

Section 6 (245A.11, subd. 10) establishes adult foster care resident rights.

Section 7 (245A.11 subd. 11) specifies the adult foster care service termination provisions for elderly waiver participants.

Sections 8 to 12 amend chapter 245D, the home and community-based waivered services. 

Section 8 (245D.04, subd. 3) expands the rights of a person receiving services by a licensed provider, to include the right to lock the bedroom door and access personal possessions, to name a couple.

Section 9 (245D.071, subd. 3) requires that within 45 days of the service initiation, the provider must determine how to support the person so the person has control of the person’s schedule.

Section 10 (245D.11, subd. 4) modifies license holder admission criteria, by requiring the person or person’s legal representative and the license holder to sign and date the residency agreement when the license holder provides certain services.

Section 11 (245D.24, subd. 3) relates to community residential settings, and requires each person receiving services to have a choice of a roommate. This section also provides that a person must be allowed to lock the person’s bedroom door.

Section 12 (256.045, subd. 3) amends the state agency hearings section of law to allow for a hearing when the person is issued a notice of service termination under 245A.11, subd 11.

Section 13 (256B.051) establishes the housing support services program.  If the program is approved by the federal government, the services will be reimbursed through medical assistance. 

Subdivision 1 states the purpose of the program, which is to provide housing support services to individuals with a disability that limits their ability to obtain or maintain stable housing.

Subdivision 2 defines terms.

Subdivision 3 provides the eligibility criteria for the program.  The individual must (1) be 18 years or older, (2) be enrolled in medical assistance, (3) have a need for the services based on an assessment, (4) reside in or plan to reside in a community-based setting, and (5) have evidence of unstable housing.

Subdivision 4 specifies the methods in which the assessment of functional need must be conducted. 

Subdivision 5 defines the services provided under the program, which include housing transition services and housing and tenancy sustaining services.

Subdivision 6 specifies provider eligibility.

Subdivision 7 provides that supplemental rates for housing with services establishments and group residential housing are reduced if the individual is eligible for housing support services.

Section 14 (256B.0911, subd. 3a) amends long-term care consultation services, by requiring that at the time of reassessment, the certified assessor shall offer the person the option to receive alternative housing and service options, under certain circumstances.

Section 15 to 17 (256B.0915, subd. 1, 256B.092, subd. 4, 256B.49, subd. 11) requires the commissioner to comply with the requirements in the federally approved transition plan for the home and community-based services and elderly waivers.

Section 18 (256B.49, subd. 15) strikes outdated language.

Sections 19 to 21 amend the statute related to adult foster care planned closures.

Section 19 (256B.493, subd. 1) modifies the commissioner’s duties. The commissioner has the authority to manage statewide licensed corporate foster care or community residential settings capacity, including the reduction and realignment of current foster care or community residential settings, to accomplish the consolidation or closure of settings.

Section 20 (256B.493, subd. 2) requires the commissioner to use a resource need determination process, managed at the state level, to align capacity where needed. 

Section 21 (256B.493, subd. 2a) is a new subdivision specifying the closure process.  The commissioner shall work with stakeholders to establish a process for adult foster care or community residential setting closures.  This section lists what the closure plan must include.

Sections 22 and 23 (256D.44, subds. 4 and 5) modify the Minnesota supplemental aid program by increasing the income supplement for individuals who are in need of housing assistance. This section also expands the eligibility for this supplement to individuals who are relocating from group residential housing and individuals who are eligible for personal care assistance services, and strikes paragraph (g), which expired June 30, 2016.

Sections 24, 26, 27, 29, 30, 31, 32, 33, 37, and 40 are technical; “group residential housing” (GRH) is being changed to “housing support services.”  This terminology is changed in several sections.

Section 25 (256I.04, subd. 1) expands the eligibility for GRH to individuals who receive licensed residential crisis stabilization services and medical assistance. The individual may receive concurrent GRH payments when receiving crisis stabilization services.

Section 28 (256I.04, subd. 3) amends an existing group residential housing moratorium exception on the development of group residential housing beds by adding another 36 beds for supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County for homeless adults defined in this section.

Section 34 (256I.05, subd. 1p) adds a supplementary services rate not to exceed $700 per month for a housing support provider (GRH) in St Louis County.

Section 35 (256I.05, subd. 1q) adds a supplementary services rate not to exceed $750 per month for a housing support provider (GRH) in Olmstead County.

Section 36 (256I.05, subd. 1r) adds a supplementary services rate not to exceed the maximum rate in subd 1a for a housing support provider (GRH) in Anoka County.

Section 38 (256I.05, subd. 11) modifies (GRH) by establishing an alternative financing mechanism for existing emergency shelter beds, based on a plan submitted by the county and approved by the commissioner. The Commissioner of Human Services is required to make a cost-neutral transfer of funding from the GRH fund to the county  for emergency shelter beds removed from the GRH census.  The county must submit a biennial plan by August 1, beginning in 2017, which describes outcomes, efficiencies, eligibility, and quality assurance.  The funding may be used for room and board or supplemental services.  

Section 39 (256I.05 , subd. 12) provides that for every provider with a supplementary services rate over $300, the commissioner shall reduce by 5% the difference between the total supplementary rate in effect 7/1/17, and $300, and decrease by 10% the difference between the total supplementary service rate in effect 7/1/19, and $300.  One provider is exempt from this reduction. 

Section 41 (256I.06, subd. 8) adds a new paragraph (c) specifying that the GRH rate for an individual who receives licensed residential crisis stabilization services is calculated so the state pays the full room and board rate.

Section 42 (256I.09) requires the commissioner to award grants to agencies through the annual competitive process for:  (1) outreach to locate and engage people who are homeless or residing in segregated settings to screen for basic needs and assist with a referral to community living resources; (2) build capacity to provide technical assistance on housing and support service resources, and (3) streamline the administration and monitoring of activities related to housing support funds.

Section 43 is a revisor instruction changing “group residential housing” to “housing support services.”

Article 3 – Continuing Care

Section 1 (144.0724, subdivision 4) clarifies existing law by making explicit in state statute the federal requirements with respect to the frequency of change in status assessments for residents of nursing homes.

Section 2 (144.0724, subdivision 6) reduces the threshold at which facilities may apply for a reduction in their penalty for late or nonsubmission of resident assessments, and also reduces the length of time during which the facilities are penalized.

Section 3 (144A.071, subdivision 4d) modifies the date for nursing facility property rate changes related to consolidation projects to the first January or July following both the completion of the upgrades in the remaining facility and the closure of the other facility.

Section 4 (256.975, subdivision 7) modifies the services the Senior Linkage Line must provide to ensure that older adults are properly referred for counseling regarding the new self-directed caregiver grant program.

Section 5 (256.975, subdivision 12) establishes a new self-directed caregiver grant program to provide assistance to family care-givers who help older adults age in place.

Section 6 (256B.0911, subdivision 3a) allows persons being assessed for adult day services to grant permission for their current or proposed service provider to submit to the certified assessor the provider’s nursing assessment and recommendations concerning the person’s care needs.  If a provider submits its nursing assessment and recommendations for a person being assessed for elderly waiver services, then the provider must receive a draft of the assessment, be allowed to submit additional information before the assessment is final, and receive a copy of the final community support plan, case mix level and Residential Services Workbook.

In addition, this section permits an eligibility update 90 days after the last face-to-face assessment under the alternative care program, the elderly waiver, and the disability waivers.

Section 7 (256B.0915, subdivision 3a) specifies that if a legislatively authorized rate increase for home and community-based services is service-specific, then the way this increase will be applied to the monthly cost limits under the elderly waiver is by increasing each monthly cost limit by the percent increase in spending for the program that is affected by the service-specific rate increase.

In addition, this section aligns the date of future increases in the monthly cost limits for elderly waiver services with the date on which nursing facility rate increases are effective.

Section 8 (256B.0915, subdivision 3e) modifies the language governing the payment rates for customized living services under the elderly waiver by adding, effective January 1, 2022, a cognitive and behavioral needs factor. 

This section also aligns the date of future increases in the individualized service rate limits for customized living services with the date on which nursing facility rate increases are effective.

Section 9 (256B.0915, subdivision 3h) aligns the date of future increases in the individualized service rate limits for 24-hour customized living services with the date on which nursing facility rate increases are effective.

Section 10 (256B.0915, subdivision 5) amends the language governing change in status assessments for elderly waiver recipients by specifying the criteria for an assessment, who may request an assessment, and the timing of the assessment.

Sections 11 to 16 establish new rates for services offered under the elderly waiver and for similar services.

Section 11 (256B.0915, subdivision 11) specifies that a new rate methodology under 256B.0915, subdivisions 12 to 16, applies to the following services and programs:

(1) Elderly waiver

(2) Elderly waiver customized living

(3) Alternative care

(4) Essential community supports

(6) CADI waiver customized living

(7) BI waiver customized living

(8) Elderly waiver foster care

(9) Elderly waiver residential care

Section 12 (256B.0915, subdivision 12) provides for a phase-in of the new EW rates beginning January 1, 2019. The phase in is as follows:

(1) a blended rate between January 1, 2019, and December 31, 2020, consisting of 12 percent of the new rate and 88 percent of the old rate; and

(2) a blended rate beginning January 1, 2021, consisting of 20 percent of the new rate and 80 percent of the old rate.

Section 13 (256B.0915, subdivision 13) specifies the data sources that will be used to set the wage and component value rates under the proposed rate methodology and outlines the factors included in the methodology.

Section 14 (256B.0915, subdivision 14) specifies the base wage calculations for all the services affected by this rate methodology.

Section 15 (256B.0915, subdivision 15) specifies how each of the factors are calculated.

Section 16 (256B.0915, subdivision 16) specifies how the total payment rate is calculated for each service.

Section 17 (256B.0915, subdivision 17) requires the commissioner, in consultation with stakeholders, to study the appropriateness and effect of the new rates and to make recommendations to the legislature by January 1, 2019.

Section 18 (256B.0922, subdivision 1) increases from $400 to $600 the monthly limit for essential community supports, and adds respite care and companion services to the list of services available under the essential community supports program.

Section 19 (256B.431, subdivision 10) modifies the date for nursing facility property rate changes related to construction projects to the first January or July following the completion of the construction project and the submission of the provider’s rate adjustment request.

Section 20 (256B.431, subdivision 16) modifies the date for nursing facility property rate changes related to major additions or facility replacements to the first January or July following the completion of the addition or replacement.

Section 21 (256B.431, subdivision 30) modifies the date for nursing facility property rate adjustments resulting from bed layaway or bed delicensure to the first January or July following the layaway or delicensure.

Section 22 (256B.434, subdivision 4) strikes obsolete language, thereby clarifying that inflationary adjustments apply only to the property rate and not to the other nursing facility rate components.

This section also specifies that the next property rate inflation adjustment will be delayed until January 1, 2019.

Section 23 (256B.434, subdivision 4f) modifies the date for nursing facility property rate adjustments resulting from certain construction projects to the first July or January following the completion of the project.

Section 24 (256B.50, subdivision 1b) clarifies that nursing facilities have 60 days from the publication of rates to file an appeal of their rates.

Section 25 (256B.5012, subdivision 3a) modifies the conditions under which an intermediate care facility for persons with developmental disabilities can be reimbursed for therapeutic leave days. 

Section 26 (256R.04, subdivision 4) clarifies which forms of insurance are administrative costs and which are fringe benefit costs.

Section 27 (256R.02, subdivision 18) clarifies that the employer health insurance cost category includes the actual expenses incurred by self-insured plans for reinsurance and clarifies the definition of a full-time employee.

Section 28 (256R.07, subdivision 6) permits electronic signatures on documents submitted to the commissioner for the purposes of setting nursing facility rates.

Section 29 (256R.10, subdivision 7) gives the commissioner the authority, after consulting with stakeholders, to determine the cost category for cost items or services not otherwise categorized.

Section 30 (256R.18) requires the commissioner beginning January 1, 2019 to submit to the legislature a biennial report on the effectiveness of the new value-based reimbursement system.

Section 31 (256R.37) removes the requirement that registered nurses, licensed practical nurses, or nursing assistants who receive scholarships must be recent graduates.

Section 32 (256R.40, subdivision 5) limits to just twice a year the effective date of planned closure rate adjustments.

Section 33 (256R.41) limits to just twice a year the effective date of single-bed room incentive rate adjustments.

Section 34 (256R.47) extends for an additional two years the existing suspension of the rate adjustment for critical access nursing facilities.

Section 35 (256R.49) establishes a rolling two-year expiration of rate increases for compensation-related costs for minimum wage changes.

Section 36 (Direction to the Commissioner; Adult Day Services Staffing Ratios) requires the commissioner to study existing staffing ratio requirements for adult day services and make recommendations to the legislature by January 1, 2018.

Section 37 (Direction to the Commissioner; Border City Nursing Facility Rate Study) requires the commissioner to study the disparity between nursing facility rates in Moorhead and the rates paid by North Dakota in Fargo and the surrounding communities, as well as the effect of the rate disparities on the Moorhead workforce and access to nursing facility services.

Section 38 (Revisor’s Instruction) requires nonpartisan legislative staff and the Department of Human Services to propose a recodification of the language governing the elderly waiver.

Article 4 - Health Care

Section 1 (3.972 subdivision 2b) requires the legislative auditor to audit each managed care organization that contracts with the Commissioner of Human Services to provide services under sections 256B.69, 56B.692, and 256L.12.

Section 2 (13.69, subdivision 1) permits the Department of Public Safety to share social security numbers, which are otherwise classified as private government data of the Department of Public Safety, with the Department of human services for the purposes recovering medical assistance benefits provided to medical assistance recipients injured in motor vehicle accidents.

Section 3 (62J.815) requires health care providers to maintain a list of services and procedures that correspond with the provider’s 35 most frequent CPT codes and the ten most frequent CPT codes for preventive services used for reimbursement, and the provider’s charges for each of these services that the provider would charge a patient who did not have coverage and make the list available to the public.

Section 4 (62U.02, subdivision 1) requires the Commissioner of Health to establish statewide measures for use by health plan companies that assess the quality of health care services offered by health care providers.  Requires that the statewide measures must (1) for the purposes of assessing the quality of care provided at physician clinics, be selected from the available measures as defined in federal regulations, unless the stakeholders determine that a particular diagnosis, condition, service, or procedure is not reflected in any of the available measures in a way that meets identified needs; (2) be based on medical evidence; and (3) be developed through a process in which providers participate in and consumer and community input and perspectives are obtained.

This subdivision also requires the commissioner to develop a measurement framework by June 30, 2018, that identifies the most important elements for assessing the quality of care, articulates statewide quality improvement goals, ensures clinical relevance, fosters alignment with other measurement efforts, and defines the roles of stakeholders.  By December 15, 2018, the commissioner must use the framework to update the statewide measures used to assess the quality of health care services offered by health care providers, including providers certified as health care homes.  The commissioner shall develop the framework in consultation with the stakeholders and must review the framework at least once every three years and shall report to the legislature by September 30, 2018, summarizing the development of the measurement framework and making recommendations on the type and appropriate maximum number of measures in the statewide measurement set.

Subdivision 3 requires the commissioner to issue periodic public reports on trends in provider quality at the statewide, regional, and clinic levels.  This subdivision also requires physician clinics and hospitals to submit standardized information for the identified statewide measures to the commissioner in the formats specified by the commissioner or the commissioner’s designee which must include alternative formats for clinics or hospitals experiencing technological or economic barriers to submission in standardized electronic form.  The commissioner shall ensure that any quality data reporting requirements for physician clinics are aligned with the specifications and timelines for the selected measures and may develop additional data on race, ethnicity, preferred language, country of origin, or other sociodemographic factors.  None of the statewide measures selected shall require providers to use an external vendor to administer or collect data.

Subdivision 5 makes minor changes by removing obsolete language and referring to a standard set of measures.

Section 5 (62V.05, subdivision 12) removes the requirement that the MNsure Board provide the legislature with copies of certain agreements.

Section 6 [256.01, subdivision 18f] requires the commissioner of human services to implement an Asset Verification System to verify the assets of persons who are blind, persons age 65 and older, and persons with disabilities applying for or renewing benefits under medical assistance.

Section 7 (256.01, subdivision 41) removes the requirement that the Commissioner of Human Services provide the legislature with copies of certain agreements.

Section 8 (256.969, subdivision 2b) delays the next hospital rebasing by 4 years until July 1, 2021.

Section 9 [256.969, subdivision 2e) creates a contingent alternative payment rate for children’s hospitals that is retroactive to rate years beginning on or after January 1, 2015.

Paragraph (a) specifies a trigger for the calculation of an alternative payment rate for children’s hospitals.  The trigger is any requirement that the days, costs, and revenue associated with MA-eligible patients who also have private health insurance be included in a children’s hospital’s disproportionate share hospital (DSH) payment limit.  If these days, costs, and revenue are included, then the commissioner must calculate the alternative payment rate described in paragraph (b), compare the alternative rate to the DSH rate, and reimburse the children’s hospital at the higher rate.

Paragraph (b) specifies the alternative rate, prohibits a children’s hospital from receiving payments under both the alternative rate and the DSH rate, and directs the commissioner to consider the interaction of the alternative rate and inflation adjustments whenever hospital rates are rebased.

Section 10 (256.969, subdivision 4b) requires children’s hospitals to submit annual medical assistance cost reports within six months of the end of the hospital’s fiscal year.

Section 11 (256B.0371, subdivision 1) requires the commissioner to contract with up to two dental administrators to administer dental services for all recipients of medical assistance and MinnesotaCare.

Subdivision 2, paragraph (a), specifies that recipients shall be give a choice of dental provider who agrees to the requirements and payment rate of this section.  Also requires the administrator to comply with network adequacy geographic access, and essential community provider requirements that apply to managed care organizations for nondental services.

Paragraph (b) requires the commissioner to implement this section in consultation with representatives of dental providers who provide dental services to patients enrolled in medical assistance and MinnesotaCare.

Paragraph (c) requires the commissioner to consult with county-based purchasing plans on the development and review of a request for proposals and development of metrics to evaluate the performance of a dental administrator.

Section 12 (256B.04, subdivision 21) updates and clarifies provider enrollment, reenrollment, and revalidation requirements for medical assistance and MinnesotaCare providers.

Section 13 (256B.04, subdivision 22) updates the personal care assistance revalidation process to require revalidation at least every three years.

Section 14 (256B.056, subdivision 5c) increases the medical assistance excess income standard (aka spenddown) for persons with a disability who are blind or who are over 64 years of age, from 80 percent of federal poverty guidelines to 81 percent, effective June 1, 2019.

Section 15 (256B.0621, subdivision 10) allows medical assistance reimbursement for interactive video for relocation case management services, that helps recipients gain access to needed services and supports if they choose to move from an institution to the community.

Section 16 (256B.0625, subdivision 3b) includes in the definition of “licensed health care provider” for telemedicine services covered under medical assistance, services provided by a mental health provider.

Section 17 (256B.0625, subdivision 7) eliminate a cross-reference to the home care nursing interpreter-communicator service which is being repealed.

Section 18 (256B.0625, subdivision 20) modifies the mental health case management section of law to allow medical assistance reimbursement for contact by interactive video, that meet the requirements of section 256B.0625, subdivision 20b.

Section 19 (256B.0625, subdivision 20b) adds a new subdivision creating a new benefit under the medical assistance chapter for mental health targeted case management through interactive video.

Section 20 (256B.0625, subdivision 56a) allows medical assistance to cover post arrest community- based service coordination for an individual who has been identified as having a mental illness or substance abuse; does not require the security of a public detention facility and is not considered an inmate of a public institution; meet eligibly requirements in section 256b.056; and has agreed to participate in postarrest community-based service coordination through a diversion contract in lieu of incarceration.  Specifies that the nonfederal share of cost for postarrest community-based service coordination services shall be provided by the recipient’s count of residence.

Section 21 (256B.0625, subdivision 57) excludes from Medicare part B crossover claims limit to the medical assistance total allowed payments to Indian Health Services.

Section 22 (256B.0625, subdivision 64) authorizes the coverage of stiripentol by the EPSDT program under certain conditions.

Section 23 (256B.0659, subdivision 21) requires personal care assistance provider agencies to maintain bonds and insurances for each practice location and authorizes the commissioner to deny medical assistance payments during times of non-compliance with the bond and insurance requirements or to suspend and terminate providers who display patterns of noncompliance with the bond and insurance requirements.

Section 24 (256B.072) modifies the measures used for the performance reporting system for inpatient hospitals by requiring that the measures used are consistent with the statewide measures under section 62U.02, subd.1. Requires the commissioner to consider and adjust availability metrics and benchmarks for providers who primarily serve socioeconomically complex patient populations and request to be scored on these additional measures.

Section 25 (256B.0755, subdivision 1) changes terminology from “health care delivery systems” to “integrated health partnerships” or IHPs, and specifies that an IHP may be customized for special needs and barriers of patient populations experiencing health disparities due to social, economic, racial, or ethnic factors.

Section 26 (256B.0755, subdivision 3) specifies that the accountability standards for IHPs must be appropriate to the particular population served.

Section 27 (256B.0755, subdivision 4) specifies that the payment system for IHPs must include a population-based payment that supports care coordination services for enrollees served by the IHP and is risk adjusted to reflect varying levels of care coordination intensiveness.  Specifies that the payment must be a per-member per-month payment paid at least on a quarterly basis and specifies that IHPs that receive this payment must continue to meet cost and quality metrics in order to maintain eligibility for the population-based payment.

Section 28 (256B.0755, subdivision 9) states that the commissioner may authorize an IHP to provide financial incentives for patients to see a primary care provider for an initial health assessment; maintain a continuous relationship with a primary care provider; and participate in ongoing health improvement and coordination of care activities.

Section 29 (256B.0924, subdivision 4a) allows medical assistance reimbursement for interactive video contact for targeted case management for vulnerable adults and adults with developmental disabilities.  This section also sets the parameters for contact by interactive video for targeted case management.  Interactive video is subject to federal approval, and is allowed if the requirements are met.

Section 30 (256B.196, subdivision 2) phases out the “managed care intergovernmental transfer” over seven years by reducing the total value of supplemental payments to Hennepin County Medical Center and Regions Hospital by approximately $1,800,000 per year.

Section 31 (256B.69, subdivision 9e) modifies the current financial audit language for managed care organizations by adding a cross reference to section 3.972, subd.2b.

Section 32 (256B.76, subdivision 1) reduces the payment rates by 2.3 percent for physician and professional services provided on or after July 1, 2017, through June 30, 2019, and by 3.0 percent for services provided on or after July 1, 2019.

Section 33 (256B.76, subdivision 2) increases payment rates for dental services provided on or after July 1, 2017, by 25 percent.

Section 34 (256B.7635) specifies for services provided on or after January 1, 2018, prenatal and postpartum follow-up home visits provide by public health nurses or registered nurses using evidence-based models. The payment shall be a minimum of $140 per visit.

Section 35 (256B.766) reduces the payment rates by 2.3 percent for basic care services provided on or after July 1, 2017, through June 30, 2019, and by 3.0 percent for services provided on or after July 1, 2019.  Specifies that EPSPT services are included in this reduction.  Specifies that the therapy services provided at Gillette Children’s Hospital are not included in this reduction.

Sections 36 to 39 make changes in the MinnesotaCare program to conform to federal requirements and current practices.

Section 36 (256L.03, subdivision 1) clarifies that a child means an individual younger than 19 years of age.

Section 37 (256L.03, subdivision 1a) removes coverage for individualized education program (IEP) services from MinnesotaCare coverage.

Section 38 (256L.03, subdivision 5) updates the cost-sharing by removing references in place prior to 2015, expands the definition to include co-insurance and deductibles, and replaces a reference that exempts American Indians from cost-sharing.

Section 39 (256L.15, subdivision 2) replaces the premium table to reflect the legislative changes enacted in 2015.

Section 40 delays part of the capitation payment to managed care plans and county-based purchasing plans due in April 2019, and all of the payment due in May 2019, and the payment due in April 2019 for special needs basic care until July 1, 2019.  This section also delays the capitation payment due in April 2021 and May 2021 and the payment due in April 2021 for special needs basic care until July 1, 2021.

Section 41 requires the Commissioner of Human Services to seek federal approval to implement case management via interactive video contact.

Section 42 establishes a legislative commission to study and make recommendations on issues relating to the competitive bidding process and procurement process for the medical assistance and MinnesotaCare contracts with managed care plans and county-based purchasing plans for nonelderly, nondisabled adults and children.  The study shall also include recommendations of a process that meets federal regulations that ensures that provider rate increases passed by the legislature are incorporated into capitation rates paid to managed care organizations and how the managed care organizations pay the providers.

Section 43 (Health Care Access Fund Assessment) requires the Commissioner of Human Services to assess any federal health care reform legislation passed at the federal level on its effect on the MinnesotaCare program and the need for the health care access fund as its continued source of funding.

Section 44 (Opiate Use and Acupuncture Study) requires the Human Services Policy Committee to study and compare the use of opiates for the treatment of chronic pain conditions when acupuncture services are also part of the treatment for chronic pain.

Section 45 is a Revisor’s instruction requiring the Revisor to change the term “health care delivery system” to “integrated health partnership” where it appears in section 256B.0755.

Section 46 (Repealer) repeals the annual review for personal care assistance provider agencies, and the home care nursing interpreter-communicator service, and IGT2.

Article 5 Health Insurance

This article makes a number of changes to private health coverage in the individual and small group markets.  This article also requires a nonprofit health care entity before entering into a conversion transaction to notify the attorney general and requires the attorney general to approve of the transaction.  This article also makes several minor clean up changes to SF 1 (premium subsidy program).

Section 1 (62A.04, subd. 1) specifies that certain required standard policy provisions when referenced in other sections do not apply to accident and sickness or accident and health insurance that are health plans.

Section 2 (62A.21, subd. 2a) specifies that continuation of coverage only applies to a former spouse who was covered on the insured’s health plan on the day before entry of a valid divorce decree.

Section 3 (62A.3075) requires a health plan company that provides coverage for cancer chemotherapy treatment to indicate the level of coverage for orally administered anticancer medication in its pharmacy benefit filing with the commissioner.

Section 4 (62D.105, subd. 1) specifies that an health maintenance organization (HMO) only has to provide coverage to an enrollee’s dependent children and former spouse who was covered on the day before the entry of a valid divorce decree.

Section 5 (62D.105, subd. 2) clarifies the definition of dependent children.

Section 6 (62E.04, subd. 11) clarifies that any policy of accident and health insurance subject to the requirements of the ACA, the requirements of this section do not apply.

Section 7 (62E.05, subd. 1) clarifies that any policy of accident and health insurance subject to the requirements of the ACA do not have to certify whether the plan is a #1, #2, or #3 coverage plan.

Section 8 (62E.06, subd. 5) clarifies that the requirements for qualified plans do not apply to any policy of accident and health insurance subject to the requirements of the ACA.

Section 9 (62K.16) requires health carriers issuing individual health plans to permit enrollees to terminate coverage by directly contacting either the health carrier or MNsure if the enrollee purchased coverage through MNsure.  Requires health carriers and MNsure to develop a form for terminating coverage online.

Section 10 (62M.07) Paragraph (d) specifies that any authorization for a prescription drug must remain valid for the duration of an enrollee’s contract term so long as the drug continues to be prescribed to the patient, the drug remains safe, has not been withdrawn from use by the FDA or the manufacturer, and no drug warnings or recommended changes in drug usage has occurred.  Excludes public health care programs from this paragraph.

Section 11 (62Q.575, subd. 1) requires a health plan company to contract with a primary care provider as an in- network provider if the provider is certified as a health care home or is in the process of becoming certified as a health care home.

Subd. 2 prohibits a health plan company from imposing a co-payment or fee or other cost-sharing requirement for selecting or designating a primary care provider of the enrollee’s choosing, unless the health plan company imposes the same cost-sharing requirements or fees upon an enrollee’s selection or designation on any of the health plan company’s primary care providers.

Subd. 3 requires the provider contract to include a care coordination payment in addition to the payment rate for the covered services provided by the primary care provider, and prohibits the health care company from imposing a co-payment, fee, or other cost-sharing requirement on care coordination services.

Subd. 4 requires the health plan company to provide notice to enrollees of the provisions of this section.

Subd. 5 defines primary care provider.

Subd. 6 specifies that this section only applies to individual health plans and does not apply to the public health care programs.

Subd. 7 specifies that the Commissioner of Health enforces this section.

Section 12 (62Q.678) requires a health plan company that actively markets an individual health plan to offer in each county at least one individual health plan with a provider network that includes in network access to more than a single health care provider system or a health plan that includes more than one primary care location in each county.

Section 13 (62Q.83) creates prescription drug benefit transparency and management requirements.

Subd. 1 defines the following terms:  drug; enrollee contract year; formulary; health plan company; and prescription.

Subd. 2 requires a health plan company that cover prescription drugs and uses a formulary to make its formulary and related benefit information available by electronic means and, upon request, in writing at least 30 days prior to annual renewal dates.

Subd. 3. Paragraph (a), specifies that once a formulary has been established a health plan company, may at any time during an enrollee’s contract year, expand its formulary by adding drugs to the formulary; reduce the copayments or coinsurance; or move a drug to a benefit category that reduces the enrollee’s cost.

Paragraph (b) states that a health plan company may remove a brand name drug from its formulary or place a brand name drug in a benefit category that increases an enrollee’s cost only if a generic or multisource brand name drug rated as therapeutically equivalent or a biological drug rated as interchangeable is added to the formulary at a lower cost to the enrollee and upon 60 notice to prescribers, pharmacists, and affected enrollees.

Paragraph (c) permits a health plan company to change utilization review requirements or move drugs to a benefit category that increases an enrollee’s cost during the enrollee’s contract year upon at least a 60-day notice to prescribers, pharmacists, and affected enrollees, provided that the changes do not apply to enrollees who are currently taking the drugs affected by the changes for the duration of the enrollee's contract year.  

Paragraph (d) permits a health plan company to remove drugs from its formulary that have been deemed unsafe by the FDA, or that have been withdrawn by the FDA or the product manufacturer, or when an independent source has issued drug-specific warnings or recommended changes in drug usage.

Subdivision 4 excludes public health care programs from this section.

Sections 14 to 19 establish the notification and approval requirements for nonprofit health care entities conversion transactions.

Section 14 (317A.811, subd.1) specifies that a health maintenance organization (HMO) and a service plan corporation  are required to notify the attorney general of their intent to dissolve, merge, or consolidate or to transfer all or substantially all of their assets.

Section 15 (317A.811, subd.1a) specifies that a HMO and a service plan corporation are subject to notice and approval requirements for certain transactions under section 317A.814.

Section 16 (317A.814) establishes nonprofit health care entity conversion notification and approval requirements.

Subdivision 1 defines the following terms:  commissioner; conversion benefit entity; conversion transaction; family member; nonprofit health care entity; public benefit assets; and related organization.

Subdivision 2 prohibits a nonprofit entity from entering into a conversion transaction if a person who has been an officer, director or other executive of the nonprofit health care entity, or a related organization or a family member of that person; (1) has or will receive any compensation or other financial benefit in connection with the conversion transaction; (2) has or will hold an ownership stake, stock, securities or other financial interest in or receive any type of financial benefit from any entity in which the nonprofit health care entity transfers public benefit assets in connection with a conversion transaction; or (3) has or will hold an ownership stake or other financial interest in or receive any financial benefit  from any entity that has or will have a business relationship with an entity to which the nonprofit health care entity transfers public benefit assets in connection with a conversion transaction.

Subdivision 3 requires a nonprofit health care entity to notify the Attorney General before entering into a conversion transaction and include as part of the notification, an itemization of the entity’s public benefit assets and the valuation the entity attributes to those assets, a proposed plan for distribution of those assets to a conversion benefit entity, and other information the Attorney General considers necessary for review of the proposed transaction. Requires the Attorney General to approve the transaction.  Requires a copy of the notice and the information required with the notice to be provided to either the Commissioner of Health or commerce.

Subdivision 4 outlines the elements that the Attorney General must consider in making a decision to approve or disapprove a conversion transaction.  Requires the Attorney General to consult with either the Commissioner of Health or commerce in making this decision.

Subdivision 5 specifies the requirements that an entity must meet to be considered a conversion benefit entity for purposes of accepting assets from a nonprofit health care entity as part of a conversion transaction.

Subdivision 6 authorizes the attorney general to solicit public comment regarding the proposed conversion transaction.

Subdivision 7 requires the Attorney General to notify the nonprofit health care entity in writing of its decision to approve or disapprove the transaction within 150 days of receiving notice of the transaction.  Requires the Attorney General to include the reason for a decision not to approve the transaction, and permits the Attorney General to extend the period for an additional 90 days if needed to obtain additional information.

Subdivision 8 requires the nonprofit health care entity to transfer the entirety of the full and fair value of its public benefit assets to one or more conversion benefit entities as part of the transaction if the proposed conversion transaction is approved or conditionally approved.

Subdivision 9 requires the nonprofit health care entity or conversion benefit entity to reimburse the attorney general or a state agency for all reasonable and actual costs incurred by the attorney general or a state agency in reviewing a proposed conversion transaction.

Subdivision 10 requires a conversion benefit entity to submit an annual report to the Attorney General that contains a description of its charitable activities related to the use of the public benefit assets received under an approved transaction.

Subdivision 11 states that a conversion transaction entered into in violation of this section is null and void and the attorney general has the authority to bring an action to unwind a conversion transaction entered into in violation of subdivision 2.

Subdivision 12 states that this section does not affect any power or responsibility of a health maintenance organization, service plan corporation, a conversion benefit entity, the attorney general, or the commissioner under chapter 62C, 62D, 317A, 501B or other law.

Sections 17 to 27 make a number of minor clarifications and clean up to SF1.

Section 17 clarifies the definition of an eligible individual in SF1as a Minnesota resident who is not receiving an advanced premium tax credit in a month in which their overage is effective.

Section 18 clarifies in SF1 that the legislative auditor may maintain not public government data on an enrollee or health carrier required for the audits may be maintained for a longer period of time then stated in order to comply with generally accepted government auditing standards.

Section 19 adds a data sharing subdivision to SF1 that requires the commissioner of human services and the executive director of MNsure to disclose to the commissioner of management and budget data on public program coverage enrollment and data on an enrollee’s receipt of an advanced premium tax credit.  This subdivision also requires the commissioner of management and budget to disclose data to health carriers on enrollees’ enrollment in public program coverage to the extent it is necessary to determine eligibility for the premium subsidy program.   Specifies that the data disclosed may only be used for the purpose of the administration of the premium subsidy program.

Section 20 clarifies in SF1 that the commissioner of management and budget must consult with the commissioners of health and commerce and human services to develop and implement a process to recover from health carriers the amount of premium subsidies received by an enrollee determined to be ineligible for the subsidy.

Section 21 clarifies the sunset date for SF1 article 1.

Section 22 clarifies in SF1 the dates in which the appropriations are available. 

Section 23 clarifies that the unauthorized provider services section passed in SF1 does not apply to the public health care programs.

Section 24 modifies the effective date for the unauthorized provider services section passed in SF1 to January 1, 2019.

Section 25 requires MNsure to seek any federal waiver necessary to implement section 62K.16 permitting an enrollee to terminate individual health coverage by directly contacting the carrier, even when the coverage was purchased through MNsure.

Article 6 - Direct Care and Treatment

Section 1(253B.10, subd. 1) provides that, regardless of when the 48-hour time period expires, a regional treatment center is not required to admit a patient after 12:00 pm on Friday and before 8:00 am on Monday.

Section 2 (253B.22, subd. 1) imposes term limits on the members of the review board under the civil commitment act.

Section 3 requires the commissioner to review alternatives to state-operated group homes housing one person, and report back to the legislative committees having jurisdiction over human services issues by January 15, 2018.

Article 7 – Children and Families

Section 1 (13.32, subd. 12) amends the education data statute to establish a process under which the community services system may request access to education data in order to coordinate services for a student or family. 

Sections 2 and 3 (13.46, subds. 1 and 2) amend the welfare data statute.  The definitions of “program” and “welfare system” are expanded to include Native American tribe programs that provide a service component of the community services system.  In addition, public health agencies, veteran services agencies, and housing agencies are included. Section 3 allows data on individuals to be disclosed to the chief administrative officer of a school or a county correctional agency to coordinate services.

Section 4 (13.84, subd. 5) amends the court services data statute to allow the disclosure of data to county personnel within the welfare system.

Sections 5 to 20, 22 to 33, and 35 (119B.011, subds. 15b and 19C, 119B.02, subd. 5, 119B.09, subd. 9a, 119B.097, 119B.125, subds 4 and 6, 119B.13, subd. 1, 119B.13, subd. 6, 119B.16, subds. 1, 1a, 1b, 1c, 3, 4, 119B.161, 245E.01, subd. 6a, 245E.02, subds. 1, 3, 4, 245E.03, subd. 2, 4, 245E.04, 245E.05, subd. 1, 245E.06, subds. 1, 2, and 3, 245E.07, subd. 1, 256.98, subd. 8) implement the Child Care Assistance Program integrity budget item.

Section 21 (245A.50, subd. 5) exempts from the sudden unexpected infant death and abusive head trauma training relatives of the license holder caring for the license holder’s infant or child.

Section 34 (252.27, subd. 2a) reduces the parental contribution for TEFRA services by 13 percent.

Section 36 (256E.30, subd. 2) modifies the funding formula allocating funds to community action agencies.

Section 37 (256J.24, subd. 5) increases the MFIP cash portion by $13 per month.

Sections 38 and 40 (256J.45, subd. 2, 256P.06, subd. 2) amend the definition of exempted individuals for purposes of the Minnesota family investment program and child care assistance, by excluding the income of a new spouse for 12 consecutive months from the date of the marriage certificate, provided the combined income of the family does not exceed the respective program income caps.

Section 39 (256N.261) codifies a program to reduce the need for out-of-home placements or changes in those arrangements, that will provide services, to the extent that federal funds are available, which include: (1) providing information, referrals, peer support for youth, respite care, crisis services, and mental health services; (2) training for adoptive and kinship families, and additional training for foster families on the effects of trauma, and common disabilities of adopted children and children in foster care; and (3) periodic evaluations of the services to ensure program effectiveness.

Section 41 (260C.451, subd. 6) modifies the juvenile safety and placement chapter, specifically the foster care benefits section of law relating to young adults who are 18 to 21 years of age who ask to reenter foster care.  This section requires that the state fund, and the social services agency provide, services to increase the young adults’ ability to live safely and independently, and develop a plan for the young adults.  New language expands these services to young adults who left foster care six months prior to their 18th birthday.

Section 42 (626.556, subd. 10j) amends the Child Maltreatment Reporting Act to require an agency responsible for providing child protective services to provide relevant data to a mandated reporter who made a report (current law is limited to the agency responsible for assessing or investigating the report).

Section 43 establishes the Minnesota Birth to Eight Pilot project, which requires the Commissioner of Human Services to award a grant to Dakota County to develop and implement the pilot from July 1, 2017, to June 30, 2021.   The pilot will track the developmental milestones of children of the program participants.  The program participants must be enrolled in WIC, participating in a home visit plan, qualify as early language learners, and voluntarily agree to participate in the pilot.  The final report is due January 1, 2022.

Section 44 allows the Commissioner of Human Services to develop the Minnesota Pathways to Prosperity pilot project, to test an alternative financing model to reduce the historical separation between the state funds and systems affecting families who are receiving public assistance.  The pilot shall eliminate, where possible, funding restrictions to allow a more comprehensive approach to the needs of families.  Subdivision 3 specifies the program participants, who are individuals 26 years of age or younger with a minimum of one child, voluntarily agree to participate in the pilot, eligible for or receiving  public benefits, and enrolled in an education program that is focused on obtaining a career that will likely result in a livable wage.  Subdivision 4 specifies the pilot outcomes.

Section 45 requires the Commissioner of Human Services to report back to the Legislature by February 1, 2018, on a system for the review of cases reported by counties for aid payments under section 477A.0126 for compliance with the Indian Child Welfare Act and the Minnesota Indian Family Preservation Act.

Section 46 repeals the current statute dealing with data sharing within counties, and repeals the subdivision for MFIP innovation projects.

Article 8 - Chemical and Mental Health Services

Section 1 (245.4662) establishes the Mental Health Innovation Grant Program, subdivision 1 defines terms.

Subdivision 2 requires the commissioner to award grants to eligible applicants to plan, establish, or operated programs to improve accessibility and quality of community-based, outpatient mental health services.

Subdivision 3 requires the applicant to submit an application by October 31, 2017, and by October 31 thereafter. This subdivision specifies what the application must contain.  In determining whether applicants receive grants, the commissioner shall give preference to applications with the four factors listed in paragraph (d).

Subdivision 4 requires the commissioner to notify grantees by December 15, and disperse grants by January 1.

Section 2 (245.4889, subd. 1) allows the children’s mental health grants to be used for start-up funds to establish new childrens’ mental health programs to support providers to meet program requirements and begin operations, and for transportation to school-linked mental health services.

Section 3 to 5 modify provisions related to the Ombudsman for Mental Health and Developmental Disabilities.

Section 3 (245.91, subd. 4) expands the definition of “facility or program” to include any agency, facility or program providing services for mental illness, developmental disabilities, chemical dependency, or emotional disturbances that is licensed, certified, or registered by the Commissioner of Human Services, health, or education.  Existing law limited this definition to programs licensed by the Commissioner of Human Services.

Section 4 (245.91, subd. 6) amends the definition of the term “serious injury.”

Section 5 (245.97, subd. 6) changes the terms, compensation, and removal of the ombudsman committee, which is under the jurisdiction of the state government committee.

Sections 6 and 7 (245A.03, subd. 2, 245A.191) update terminology to refer to substance use disorder and insert cross-references to the new substance abuse in Minnesota Statutes, chapter 245G.

((245A.03, subd. 7) previously in this article, which prohibits the commissioner from issuing a license for children’s residential treatment services that the Centers for Medicare and Medicaid Services would consider an institution for mental diseases, is consolidated in article 2, section 3).

Sections 8 to 29 (245G.01, 245G.02, 245G.03, 245G.04, 245G.05, 245G.06, 245G.07, 245G.08, 245G.09, 245G.10, 245G.11, 245G.12, 245G.13, 245G.14, 245G.15, 245G.16, 245G.17, 245G.18, 245G.19, 245G.20, 245G.21, 245G.22) establish the standards for the substance use disorder services.  A majority of the language in these sections is existing rule, and is being codified in this new chapter.  New language in section 14 includes the expansion of services, which are peer recovery support services and care coordination, subject to federal approval.  Also, the existing provisions related to opioid treatment programs are consolidated in this chapter in section 29.

Sections 30 to 44 amend the treatment for alcohol and drug abuse chapter of law.

Section 30 (254A.01) modifies the public policy statement related drug and alcohol addiction.

Sections 31 to 34, 36, and 37 (254A.02, subds. 2, 3, 5, 6, 8, and 10) update terminology and strike obsolete references.

Section 35 (254A.02, subd. 6a) adds a new subdivision defining the term “substance misuse.”

Section 38 (254A.02, subd. 10a) adds a new subdivision defining the term “substance use disorder.”

Section 39 (254A.03) updates the statute delegating authority to the alcohol and drug abuse section in DHS, by incorporating the new services and updating terminology.  Subdivision 3 of this section also specifies that upon federal approval of a comprehensive assessment as a Medicaid benefit, an eligible vendor may determine and approve the appropriate level of substance use disorder treatment for a recipient of public assistance. The commissioner shall develop and implement a utilization review process for publicly funded treatment placements to monitor and review the clinical appropriateness and timeliness of publicly funded placements in treatment.

Sections 40 to 43 (254A.035, subd. 1, 254A.04, 254A.08, 254A.09) update terminology and incorporate references to rule.

Section 44 (254A.19, subd.  3) clarifies that an eligible vendor may conduct a comprehensive assessment and approve treatment services, but the individual may access any enrolled provider that is licensed to provide the level of services authorized, including the provider who completed the assessment.

Sections 45 to 58 amend chapter 254B, the chemical dependency treatment chapter of law.

Section 45 (254B.01, subd. 3) updates terminology by changing “chemical dependency” to “substance use disorder.”

Section 46 (254B.01, subd. 8) defines the term “recovery community organization.”

Section 47 (254B.03, subd. 2) updates terminology and prohibits a vendor from requiring clients to use their public benefits to offset the cost of services paid under this section.  Clarifies that SNAP benefits belong to the client.

Sections 48 and 49 (254B.04, subds. 1, 2b) modify the chemical dependency fund services by striking obsolete language.

Section 50 (254B.05, subd. 1) provides that on July 1, 2018, or upon federal approval, whichever is later, licensed professionals in private practice and counties are eligible vendors of comprehensive assessment and assessment summary services, under new paragraphs (b) and (c), respectively.  The counties are also eligible providers of care coordination services. New paragraph (d) provides that on July 1, 2018, or upon federal approval, whichever is later, a recovery community organization is an eligible vendor of peer support services.

Section 51 (254B.05, subd. 1a) updates cross-references to new chapter 245G.

Section 52 (254B.05, subd. 5) requires the commissioner to establish rates for the eligible services under this section.  New eligible services include comprehensive assessments, care coordination, peer recovery support services, and withdrawal management services effective July 1, 2018, or upon federal approval, whichever is later. This section also updates references to the new chapter 245G.

Sections 53 to 58 (254B.051, 254B.07, 254B.08, 254B.09, 254B.12, subd. 2, 254B.13, subd. 2a) update terminology and references. Section 55 gives the commissioner the authority to apply for the federal waivers necessary to secure federal financial participation for substance use disorder services.

Section 59 (256B.0625, subd. 45a) adds a cross-reference to the new section of law establishing eligibility for PRTF and strikes obsolete language.

Section 60 (256B.0941) establishes the eligibility for the Psychiatric Residential Treatment Facilities (PRTF) for persons under 21 years of age and specifies the services that must be provided, the statewide per diem rate, and criteria for leave days.

Section 61 (256B.0943, subd. 13) amends the children’s therapeutic services and supports (CTSS) statute by striking a problematic reference to group homes, and adding a reference to PRTF.  This section allows up to 15 hours of CTSS provided within a six-month period in the locations listed in this section of law.

Sections 62 and 63 (256B.0945, subds. 2 and 4) modify provisions related to residential facilities for children with severe emotional disturbance. If the federal Centers for Medicare and Medicaid Services determine that these residential facilities are institutions for mental diseases, resulting in the discontinuation of federal financial participation, state funds must be used to pay for the lost federal financial participation.

Section 64 requires the Commissioner of Human Services to conduct a comprehensive analysis of Minnesota’s continuum of intensive mental health services and develop recommendations for a sustainable and community-driven continuum of care for children with serious mental health needs, including children currently being served in residential treatment. The report is due by November 15, 2018.

Section 65 requires the commissioner to contract with an outside expert to identify recommendations for the development of a substance use disorder residential treatment program model and payment structure that is not subject to the federal institutions for mental diseases exclusion, and is financially sustainable. The report is due no later than December 15, 2018.

Section 66 is a revisor’s instruction to make necessary cross-references changes.

Section 67 repeals obsolete statutes and rules.

Article 9 - Operations

Section 1 (13.46, subd. 4) amends the Data Practice Act, making certain data related to a family day care or group family day care nonpublic data.

Sections 2 and 3 (245A.02, subds. 2b and 2c) define the term “annual” for purposes of family child care training.

Section 4 (245A.055) requires the county employee conducting a licensing inspection or home visit at a family child care or group family child care home to provide written notification of potential licensing violations before departing.  The notification must include the condition that constitutes the violation.

Section 5 (245A.06, subd. 2) modifies the reconsideration process of DHS licensing correction orders for licensed family child care providers.  By January 1, 2018, and each year thereafter, the commissioner is required to report data to the Legislature on the number of licensed family child care providers who appealed correction orders, the number of correction order appeals that DHS granted, and the number denied.

Section 6 (245A.07, subd. 3) amends the DHS licensing act by imposing a fine on a license holder following the determination of maltreatment.

Section 7 (245A.1434) requires the commissioner to inform family child care and child care center license holders on a timely basis, of changes in statute, rule, federal law, regulation, and policy relating to the provision of child care, child care assistance, quality rating and improvement system, and licensing functions.  Communication shall be by electronic means and made available to the public online.

Section 8 (626.556, subd. 3c) requires that investigations of maltreatment occurring in children’s residential facilities licensed by the Commissioner of Corrections be conducted by the Department of Human Services Licensing Division.

Article 10 -Department of Health

Sections 1 to 18 make minor changes to chapter 103I to align the codes for wells and borings and other minor changes.

Section 1 (103I.101, subd. 2) changes registration to license when referring to monitoring well contractors.

Section 2 (103I.101, subd. 5) changes registration to license or certification.

Section 3 (103I.111, subd. 6) adds borings when referring to unsealed wells.

Section 4 (103I.111, subd. 7) removes reference to registration.

Section 5 (103I.111, subd. 8) changes “shaft’ to “boring”.

Section 6 (103I.205) adds borings to the well construction section.  It also changes registration to license.

Section 7 (103I.301) adds borings to the section heading and removes a reference to registered.

Section 8 (103I.501) removes a reference to register.

Section 9 (103I.505) changes registration to certification.

Section 10 (103I.515) changes registration to certification.

Section 11 (103I.535, subd. 3) clarifies that the examination referred to in this section is a certification examination.

Section 12 (103I.535, subd. 3b) requires a representative to file an application and a renewal application to renew the certification by the date stated in the certification.

Section 13 (103I.535, subd. 6) changes shaft to boring.

Section 14 (103I.541) changes registration to certification and removes references to registration.  Clarifies that a representative must file an application and a renewal application to renew the certification and must include information that the certified representative has met continuing education requirements.  Also clarifies that if a person employs a certified representative, submits the required bond and pays the required license fee for a monitoring well contractor license the commissioner shall issue a monitoring well contractor license.

Section 15 (103I.545, subd. 1) removes reference to registration.

Section 16 (103I.545, subd. 2) removes reference to registration.

Section 17 (103I.711, subd. 1) changes shaft to borings.

Section 18 (103I.715, subd. 2) changes shafts to borings.

Section 19 (144.05, subd. 6) removes the requirement that the Commissioner of Health provide the legislature with copies of certain agreements.

Section 20 [144.059 Palliative Care Advisory Council] establishes a Palliative Care Advisory Council.

Subd. 1 [Membership] specifies that a Palliative Care Advisory Council has 18 public members.

Subd. 2 [Public members] requires the commissioner of health to appoint 18 public members and specifies experience or qualities required of those members.

Subd. 3 [Term] sets the membership term at three years and permits reappointment. Members serve until a successor is appointed.

Subd. 4 [Administration] requires the commissioner of health or a designee to provide meeting space and administrative services.

Subd. 5 [Chairs] requires the council to elect a chair and vice chair biennially.

Subd. 6 [Meeting] requires the council to meet at least twice each year.

Subd. 7 [No compensation] specifies that public members serve without compensation.

Subd. 8 [Duties] requires the council to consult with and advise the commissioner of health on palliative care initiatives.  Requires an annual report to the legislature.

Subd. 9 [Open meetings] makes the council subject to the Open Meetings law.

Subd. 10 [Sunset] sunsets the council on January 1, 2025.

Section 21 (144.122) specifies that the fees collected under this section are nonrefundable even if the fee was received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017, or later.

Section 22 (144.1501, subd. 2) expands eligibility  for the current health professional education loan forgiveness program to include nurses who agree to work in a housing with services establishment or for a home health care provider.

Section 23 (144.1505) creates a primary care professions clinical training expansion grant program for advanced practice registered nurses, physician assistants, and mental health professionals.